Today’s video game addict has many places to go. Websites like Online Gamers Anonymous, Quit Wow Now, and Video Game Addiction all exist to offer him relief. There are even clinics specifically aimed at helping video game addicts. On top of that, research has found that video game playing can release as much dopamine in your brain as a shot of intravenous amphetamines. This dopamine is, among other things, the “damn-I’m-so-good” neurotransmitter involved in learning and achievements.
So are video games the drug of our generation, or might something else be going on?
Definition of Addiction
To know if video game addiction exists at all, we have to know what an “addiction” truly is. In common day speech an addiction is a “persistent compulsive use of a substance known by the user to be harmful”. For every day use, this definition is great. You can say you are addicted to cashew nuts, because 3 bags a day is really too many. You can say that you are addicted to taking the car to work, because walking/biking would be so much healthier but you cannot bring yourself to do it. In the same way, you can say you are addicted to playing video games, because you play more than you think is good for you. However, this Merriam Webster definition is not enough to define clinical addiction. That is the type of addiction that you get treatment for, because it is considered a mental illness.
The definition of a clinical addiction is a lot more elaborate. You can find it in the Diagnostic and Statistical Manual (DSM), the bible of mental illnesses. This bookwork contains all the criteria for all recognized mental disorders. It is put together by the American Psychological Association (APA), the largest group of psychologists in the world that ever sat down together to write a book. If a disorder is not in the DSM, then it is traditionally not considered a mental problem (in the Western World). They are not infallible, of course. Homosexuality was recognized as a disorder in the DSM from 1952 through to 1973. They publish a new version of the book every few years, updating the criteria and recognized conditions based on recent research. Currently they are considering video game addiction as a candidate.
Not under that name though. “Addiction” is not a term that they use in the DSM. Right now they recognize substance-related disorders and impulse-control disorders. Video games cannot fall in the first category as they do not come in pills, syringes, or any other form that would make it pleasant to insert them into your body. The category of impulse-control disorders is more hopeful. One of its members is “pathological gambling”. You can find the criteria here. Some criteria might apply to video games too, while others really cannot. Most notably, the life-destroying-criteria do not apply: Gamers do not need to play more and more to get the same effect (2). Gamers do not involve themselves in criminal activity to support their addiction (8). Gamers do not generally need to financially rely on others because they lost money gaming (10). If they did lose money gaming then it was probably a gambling game. Also, a gamer cannot “chase his loses” because there are none (6). So four out of ten criteria for a gaming addiction similar to that of gambling already fall away. Now, the criteria for pathological gambling have one big footnote. This diagnosis only applies if the symptoms cannot be better explained by another disorder (in this case Manic Episode). Now, the question is, could “pathological gaming” be added to the DSM in a similar form to its gambling cousin?
The American Medical Association (AMA) sure thinks so. They urged the APA to do so in a report they brought out in 2007. This report reviews the effect of video games on our health. They conclude the research so far is inconclusive but that they still encourage “internet/video game addiction” to be included in the DSM. Based on the report, we can only conclude that they reason that it is better to include this diagnosis “in case video game addiction exists”. This lack of research evidence will hardly convince the APA to add such an addiction in the next version of the DSM.
Research
There are two major issues plaguing all research into video gaming addiction. The first is the most important: a causal link. They need to find healthy, balanced people whose lives gaming ruined. This is a lot harder than it sounds. Part of what makes gaming so alluring is that it so good at making us forget about our daily concerns. Escapism is a powerful way of dealing with negative emotions. There is nothing wrong with this. If you dread a visit to the dentist, then it is better to distract yourself with a game than to indulge in agonizing mouth surgery fantasies. In the same way, gaming is often a symptom of other problems in people’s lives. Anything from depression, to grieving for a loved one, to anxiety, can make a powerful fantasy world very appealing. So if gaming can be a symptom of other problems, then it becomes much harder to find cases in which the games are the sole cause of the problems. I have not been able to find any research showing a significant causal link between gaming and the symptoms of an addiction/compulsion.
The second major problem is definition. There is a lot of research into the prevalence of video gaming addiction. Many researchers assume that there is a problem, pick a set of criteria and see who fits into that slot. There is even research that uses the Merriam Webster definition. That was the definition we declared irrelevant a few paragraphs up. Fortunately, the more common criteria are adjustments of the substance-related disorder and the pathological gambling diagnosis. As mentioned before, the first definition is meaningless until the day that gaming molecules can pass through the blood-brain barrier. A definition based on pathological gambling might be a more hopeful road. However, we should all agree what that should be. Some papers simply mention they adapted criteria from pathological gaming, without saying what adjustments they made. Others try to find reliable criteria, but admit there is still a way to go.
One interesting area of research into video game addiction is brain research. Avid gamers do activate the same brain pathways that substance abusers do. Dopamine was mentioned before, but the general brain activity of video game enjoyment is also very similar to getting high on drugs. In itself, there is nothing wrong with these pathways being activated. It is probably a big part of why games are so much fun in the first place. It will be interesting to see where such research will lead.
Who’s the Addict?
Though video game addiction is not a clinical diagnosis, there are still people who adopt or receive the label. According to the information we have now, those people fall into one of four categories (based on work by Richard T.A. Wood):
1. People who are labeled video game addicts by others even though they do not experience any problems with their gaming behavior themselves.
2. People who have labeled themselves as addicts as a result of “being convinced” by the media or others of their problems.
3. People who are not good at managing their game time and communicating about it with their friends and family.
4. People who use video games as an escape from deeper problems.
If you feel you might have a problem with your gaming behavior, then try to find out in which category you fall. Categories 1 and 2 are harmless. If you are a healthy and balanced person, then do not worry about your gaming habits. If there is more going on, try to see if it is simply a matter of time management and communication. If none of this applies to you and you still feel there is a problem, then you might want to look more closely at your life. Gaming is offering you a relief, but a relief from what?
If you are interested in reading in more detail about this topic, I highly recommend reading this literature review. It is an overview of the solid facts without any media distortion.
“But what about gaming clinics and people who play themselves to death?”. Clinics like the one in Amsterdam obviously have an audience. If people feel these programs help them, then I am the last one to try to convince them otherwise. However, might these clinics not simply be teaching people those time management skills we talked about? Or maybe they treat the underlying issues that cause gamers to go overboard on the play hours? As for the extreme cases of gamers playing to exhaustion or death, there is most likely more going on with these individuals than meets the eye. The extreme cases will always get a lot of media attention, and “uninteresting” details might be left out in favor of hyping a good story. Check out the literature review for some case studies and explanations.
For now, we have seen that the concept of a video game addiction is more likely to be a media hype or symptom of an underlying problem than a true addiction. Of course, in daily speech most of us are probably video game addicts. Just like most of the Western population is a TV addict or a car addict. However, clinically speaking, there is no such thing. All the research so far that says otherwise is based on shoddy premises. One day new facts might come to light that change the whole situation. For now, just focus on leading a healthy and balanced life. And game on!
If you want to, of course 
An interesting topic for sure. There’s a great Eve Sedgwick essay, Epidemics of the Will, which deals with the way our culture’s learnt to see everything as potentially addictive…
I found the essay here, about two thirds down. I read the first three pages and it struck me as rather philosophical, linguistic and sociological. It seemed to emphasize the confusion more than point to what would be the correct taxonomy of addiction. I prefer the clarity of science
But I can see it’s a valuable contribution. Thanks!
Here’s a brief review of some other evidence on video game/internet addiction.
Thanks for the link. What I was missing in the article was a summary of facts.
“My personal opinion is that problematic use of the internet should be regarded as a pathological behaviour, and that it is best thought of as an impulse-control disorder.”
Does is matter what personal opinions are? Psychopathology should follow the facts, right?
“However I think it has to be acknowledged that games, and especially MMORPGS, have features which may promote problematic use in vulnerable people.”
No sources?
I can’t agree with this article, I’m missing a lot of grounding in science (facts) and explanations of his assumptions. I think it might put a lot of people off on the wrong foot.
Either way, thanks for the contribution!
I agree that you shouldn’t just accept opinions as fact, but I am an experienced psychiatrist with an interest in this field. Anyway, there are several links in the SLS article to academic papers that provide evidence that internet/game addiction is a real phenomenon. In particular Block’s article in the American Journal of Psychiatry is well referenced and, I think, fairly convincing.
I’m going to look into this. Some of the sources Block mentions seem interesting. Especially the literature review on Impulse-Control Disorder. I found the full article here. I need to take the time to sit down for this one
My problem with the previous link was the emphasis on personal opinion and few facts being quoted in the text. However, this new article you link to is really great. I have no idea if I will agree once I’ve read the source material, but it’s well-written en well-cited.
Well, my piece was a blog post, not an academic essay, hence the informal style, but if you click on the links in it you will find evidence to back up the opinions.
I agree with your general point that the threat of game addiction is hyped up by politicians and the media, but I think that saying it doesn’t exist at all is going too far.
I was not aware the first article was yours. I did not mean to offend. Since I started this website I’ve tried only to focus on academic material, and leaving opinions be. So when I saw references to personal opinion, and no directly quoted facts in your article, my academic filter went into effect. It might lend your writing more weight if you indicate within your text what type of sources you are linking to. First impressions are worth gold, and I admit I did not check the sources because the article seemed to center on a subjective view. I’m in the same process of learning how to hit the right tone with my articles, so I fully understand it can be difficult, and you’re always welcome to suggest some tips for me as well
I’m glad you mostly agree with my article. You might be correct that video game addiction does exist. My article was simply a literature review in an informal style, so I’m just reporting on the status quo as far as I’ve been able to discover it. The Block article is still on my to-do list, and I’m keeping the option open to add a 5th category of people that might have a particular flavor of Impulse-control disorder. I think the case in favor of video game addiction is being weakened by a lot of flimsy arguments and media hype. They will always cloud over any possible solid reasoning/research. As I said, I’d have to take my time with the Block article to be able to say anything substantive. Till that time, I’ll stick with the view I propose in the article.
Since publishing the article I’ve started thinking how meaningful a diagnosis of video game addiction would be. You say it’s too bold to say it does not exist at all, but even if it does exist and effects a very small minority of the gamer population, would this diagnosis help them at all? Would it not help them more to simply be treated as some one with “deeper problems” (category 4). One of these deeper problems might be impulse-control issues. What can be gained from a separate diagnosis even if it might be justified on some criteria? I cannot think of any therapeutic benefit. I’d love to hear your thoughts on the matter.
Diagnostic categories are useful in psychiatry insofar as they identify discrete groups who differ in terms of aetiology, prognosis, response to treatment etc. They allow clinicians to make a more rational choice about what treatment to choose in any given case.
There are of course a lot of disputes about the validity of particular diagnoses, and, as you say, in this area the main question is whether game/internet addiction is a separate thing, or just a manifestation of a “deeper problem” like a mood or anxiety disorder. There is fairly good evidence now that impulse-control disorders are a separate entity though, and that they respond better to specific treatment approaches.
This is a good book on the subject if you’re interested.
Usually, media would label the addicts especially if something big happened like someone got killed by someone who plays video games(with no relationship between the incident and the game played). A lot of the big news in the internet has been happening lately. I’m sad that gamers have been given a bad name.
But there’s a thin line in casual gaming and over playing. Overplaying will lead you to not taking care of responsibilities. Without the responsibilities in your life, you won’t progress.
If someone finds a balance between gaming and his life, this may be good. This is also like gambling because of the lack of control to get away.
Is this clinically an addiction? maybe no. But if it becomes as alarming as a war, maybe so.
I think computer addiction is a fact. It is indeed something I have experienced myself and seen many other experience. However, the issue should not be sought in the games themselves. It is in my opinion rooted in the way a person is raised, as all addictions are. Here is a video on the topic, which explains everything perfectly:
http://www.youtube.com/watch?v=oZ-FAX4Pz8I
Thank you for the link. I thought it was interesting, though I can’t agree with all the points, but it would be an essay in itself to respond completely on that.
The definition of addiction that they use in this video, and that we use in daily speech, indeed applies to video games. I’m glad you agree that the games themselves should not be the scape goat of this problem, and I agree “gaming addiction” is a real issue for some. However, as far as the literature I’ve read, behavioral addictions like these, are not chemically the same as substance addictions, even though there are similarities. And as such, should not be stigmatized or treated like substance addiction. As far as the arguments and facts I’ve seen, the two problems are distinct, and it’s a shame they both ended up with the same label. I think it breeds more misunderstandings and prejudice for both groups involved.
To Shos. You couldn’t be more wrong. All addictions, both behavioral and susbstance invove the same neural pathways and same brain mechanisms, This is common knowledge among addiction researchers.
Here are studies showing the three critical, physical changes in the brains of Internet addicts.
1) Reduced Striatal Dopamine D2 Deceptors in People With Internet Addiction (2011)
QUOTE: “An increasing amount of research has suggested that Internet addiction is associated with abnormalities in the dopaminergic brain system… [In this study] individuals with Internet addiction showed reduced levels of dopamine D2 receptor availability.”
A reduction of striatal D2 dopamine receptors is the main marker for desensitization of the reward circuitry, a hallmark of all addictions. In this study PET scans of men with and without Internet addiction were compared.
2) Changes in Cue Induced Prefrontal Cortex Activity with Video Game Play. (2010) http://www.liebertonline.com/doi/abs/10.1089/cyber.2009.0327
QUOTE: “These changes in frontal-lobe activity with extended video-game play may be similar to those observed during the early stages of addiction.”
In this study, college students played Internet video games for 6 weeks. Measures were done before and after. Those subjects with the highest cravings also had the most changes in their brains that indicate early addiction process. The control group, which played a less stimulating game, had no such brain changes.
3) Microstructure Abnormalities in Adolescents with Internet Addiction Disorder. (2011) http://www.plosone.org/article/info:doi%2F10.1371%2Fjournal.pone.0020708
In this study, researchers found a 10-20% reduction in frontal cortex gray matter in adolescents with Internet addiction. Research on other addictions has already established that decreases in frontal-lobe gray matter and functioning reduce both impulse control and the ability to foresee consequences
im doing a project and this website did really need what i wanted so thank you!
in the past 10% of teens in the world were addicted to games but now kids are more addicted than teens aboutalmost the same percentage and that really suprised me!
and the part when they say whos addict, that really helped me because my freind acted weird almost everytime and they wouldnt tell me why and now i know it was about a video game!