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Online gaming addiction is a topic of increasing research interest. Since the early 2000s, there has been a significant increase in the number of empirical studies examining various aspects of problematic online gaming and online gaming addiction. This entry examines the contemporary research literature by analyzing :

 (1) the prevalence of problematic online gaming use and online gaming addiction;

 (2) the negative consequences of excessive online gaming;

 (3) the factors associated with problematic online gaming and online gaming addiction;

 (4) the treatment of problematic online gaming and online gaming addiction. The entry concludes by looking at the trends in the field and a consideration of what the future of online gaming addiction might be.

Since the early 2000s there has been a significant increase in the number of empirical studies examining various aspects of problematic online gaming and online gaming addiction. There is a lack of consensus as to whether video game addiction exists and/or whether the term “addiction” is the most appropriate to use. Some researchers use terminology such as “excessive” or “problematic” to denote the harmful use of video games. Terminology for what appears to be the same disorder and/or its consequences includes problem video game playing, problematic online game use, video game addiction, online gaming addiction, internet gaming addiction, and compulsive internet use. This entry uses the term “gaming addiction” to describe the phenomenon of excessive problematic gaming since there is demonstrable empirical evidence that such behavior can include all the core components of addiction including salience, mood modification, tolerance, withdrawal, conflict, and relapse (Griffiths, 2010).


The Rise of the Internet

The 2000s saw a substantial growth in the number of studies on gaming addiction particularly as gaming expanded into the online medium where games could be played as part of a gaming community, that is, massively multiplayer online role playing games (MMORPGs) such as World of Warcraft and Everquest. Approximately 60 studies were published on online gaming addiction between 2000 and 2010 and a vast majority of these examined MMORPG addiction and were not limited to the study of adolescent males (Griffiths, Kuss, & King, 2012). Furthermore, many of these studies were based on data collected online and a significant minority of studies examined various other aspects of gaming addiction using non‐self‐report methodologies. These include studies using polysomnographic measures and visual and verbal memory tests; medical examinations including the patient’s history and physical, radiological, intraoperative, and pathological findings; functional magnetic resonance imaging; electroencephalography; and genotyping

Griffiths et al. (2012) reviewed the prevalence studies examining problematic gaming and gaming addiction from 1994 to 2012. The studies they selected were based on samples of at least 300 participants and used some kind of screening instrument to assess problematic gaming (rather than self‐diagnosis). They reported that prevalence rates of problematic gaming ranged from 1.7% to over 10% among general samples. Prevalence rates among gamers were, in some cases, much higher (some as high as 17% to 34%). These studies indicated that, in general, males are significantly more likely than females to report problems relating to their gaming. The differences in methods of assessing gaming problems may partly account for differences in prevalence rates (King, Delfabbro, & Griffiths, 2012; King et al., 2013). Furthermore, many studies fail to assess prior problems (i.e., lifetime prevalence). King and colleagues (2012) also noted that some studies did not consider subclinical cases (i.e., meeting some but not all criteria for problematic use), and the presence of comorbid psychopathology was not routinely assessed.


Negative Consequences of Excessive Online Gaming

Irrespective of whether problematic video gameplay can be classed as an addiction, there is now a relatively large number of studies all indicating that excessive online gaming can lead to a wide variety of negative psychosocial consequences for a minority of affected individuals. In extreme cases, these can include sacrificing work, education, hobbies, socializing, time with partner/family, and sleep; increased stress; an absence of real‐life relationships; lower psychosocial well‐being and loneliness; poorer social skills; decreased academic achievement; increased inattention; aggressive/oppositional behavior and hostility; maladaptive coping; decreases in verbal memory performance; maladaptive cognitions; and suicidal ideation (Griffiths et al., 2012). In addition to the reported negative psychosocial consequences, Griffiths et al. also reported many health and medical consequences that may result from excessive gaming (both online and offline). These included epileptic seizures, auditory hallucinations, obesity, wrist pain, neck pain, blisters, calluses, sore tendons, and numbness of fingers, sleep abnormalities, and repetitive strain injuries. Taken together, this relatively long list of potential psychosocial and negative medical consequences indicates that excessive online gaming is an issue irrespective of whether it is an addiction. It also suggests that more extensive recognition by the medical community is needed of the wide range of potential negative and life limiting consequences of excessive gaming.


Factors Associated with Problematic Gaming and Gaming Addiction

A number of studies have examined the role of personality factors, comorbidity factors, and biological factors, and their association with online gaming addiction. In relation to personality traits, gaming addiction has been shown to be associated with neuroticism, aggression and hostility, avoidant and schizoid interpersonal tendencies, loneliness and introversion, social inhibition, boredom inclination, sensation seeking, diminished agreeableness, diminished self‐control and narcissistic personality traits, low self‐esteem, state and trait anxiety, and low emotional intelligence (Griffiths et al., 2012). Considering the relatively high frequency of co‐occurring personality, comorbidity, and biological factors, it is hard to assess the etiological significance of these associations with online gaming addiction as they may not be unique to the disorder and further research is needed. Research has also shown online gaming addiction to be associated with a variety of comorbid disorders. These include attention deficit hyperactivity disorder, symptoms of generalized anxiety disorder, panic disorder, depression, social phobia, school phobia, and various psychosomatic symptoms (Griffiths et al., 2012).

Through use of functional magnetic resonance imaging (fMRI), biological research has found that gaming addicts show similar neural processes and increased activity in brain areas associated with substance related addictions and other behavioral addictions, such as pathological gambling (significant activation in the left occipital lobe, parahippocampal gyrus, dorsolateral prefrontal cortex, nucleus accumbens, right orbitofrontal cortex, bilateral anterior cingulate, medial frontal cortex, and the caudate nucleus (Kuss & Griffiths, 2012). It has also been reported that gaming addicts (like substance addicts) have a higher prevalence of two specific polymorphisms of the dopaminergic system (i.e., Taq1A1 allele of the dopamine D2 receptor and the Val158Met in the catecholamine‐O‐methyltransferase), which suggests that, among some players, there might be some genetic predisposition to develop video game addiction (Kuss & Griffiths, 2012).

Therapies for Video Game Addicts

Research on treatment for video game addiction is ongoing, but few clinical trials have been conducted in relation to the problem. Experts agree that the same treatments used for sufferers of other addictions appear to work for video game addicts. As a result, they generally recommend counseling and psychotherapy, cognitive behavioral therapy, 12-step programs and medication, either individually or in combination with other treatment methods.

One-on-one counseling and family counseling are both effective in treating a gaming addict. Psychotherapists attempt to help the addict understand how gaming is related to their school or job, emotions and moods, and sense of life goals and rewards.

Where 12-step programs are concerned, the primary resource available is Online Gamers Anonymous, a non-profit organization founded in 2002.






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