Earlier this month, a 32-year old male
gamer was found dead at a Taiwanese Internet
cafe following a non-stop three-day gaming
session. This followed the death of another
male gamer who died in Taipei at the start of
the year following a five-day gaming binge.
While these cases are extremely rare, it does
beg the question of why gaming can lead to
such excessive behavior. I have spent nearly
three decades studying videogame addiction
and there are many studies published in both
the medical and psychological literature
showing that very excessive gaming can lead to
a variety of health problems that range from
repetitive strain injuries and obesity, through to
auditory and visual hallucinations and addiction.
I have to stress that there is lots of scientific
research showing the many educational and
therapeutic benefits of playing but there is
definitely a small minority of gamers that
develop problems as a result of gaming overuse.
But what is it that makes gaming so compulsive
and addictive for the small minority?
For me, addiction boils down to constant
reinforcement, or put more simply, being
constantly rewarded while playing the game.
Gaming rewards can be physiological (such as
feeling "high" or getting a "buzz" while playing
or beating your personal high score),
psychological (such as feeling you have
complete control in a specific situation or
knowing that your strategic play helped you
win), social (such as being congratulated by
fellow gamers when doing something well in the
game) and, in some cases, financial (such as
winning a gaming tournament).
Most of these rewards are -- at least to some
extent -- unpredictable. Not knowing when the
next reward will come keeps some players in
the game. In short, they carry on gaming even
though they may not have received an
immediate reward. They simply hope that
another reward is "just around the corner" and
keep on playing.
Added to this is the shift over the last decade
from standalone console gaming to massively
multiplayer online games where games never
end and gamers have to compete and/or
collaborate with other gamers in real time
(instead of being able to pause the game and
come back and play from the point at which the
player left it). Many excessive gamers report
that they hate logging off and leaving such
games. They don't like it as they don't know
what is going on in the game when they are not
online.
The last five years has seen large increase in
the number of scientific studies on problematic
gaming. In May 2013, the American Psychiatric
Association published the fifth edition of the
"Diagnostic and Statistical Manual of Mental
Disorders"(DSM-5) . For the first time, the DSM-5
included "internet gaming disorder" (IGD) as a
psychological condition that warrants future
research.
Throughout my research career I have argued
that although all addictions have particular and
idiosyncratic characteristics, they share more
commonalities than differences such as total
preoccupation, mood modification, cravings,
tolerance, withdrawal symptoms, conflict with
work, education and other people, and loss of
control. These similarities likely reflect a
common etiology of addictive behavior.
So when does a healthy enthusiasm turn into an
addiction? At the simplest level, healthy
enthusiasms add to life and addictions take
away from it. But how much is too much? This
is difficult to answer as I know many gamers
who play many hours every day without any
detrimental effects.
The DSM-5 lists nine criteria for IGD. If any
gamer endorses five or more of the following
criteria they would likely be diagnosed as having
IGD: (1) preoccupation with internet games; (2)
withdrawal symptoms when internet gaming is
taken away; (3) the need to spend increasing
amounts of time engaged in internet gaming, (4)
unsuccessful attempts to control participation in
internet gaming; (5) loss of interest in hobbies
and entertainment as a result of, and with the
exception of, internet gaming; (6) continued
excessive use of internet games despite
knowledge of psychosocial problems; (7)
deception of family members, therapists, or
others regarding the amount of internet gaming;
( use of the internet gaming to escape or
relieve a negative mood; and (9) loss of a
significant relationship, job, or educational or
career opportunity because of participation in
internet games.
The good news is that only a small minority of
gamers suffer form IGD. Most online games are
fun and exciting to play. But like any activity
that is taken to excess, in a minority of cases
the activity can become addictive.
Any activity if done for days on end could lead
to severe health problems and even death -- and
gaming is no exception. Instead of demonizing
games, we need to educate gamers about the
potential dangers of very excessive use.