Addicted to Video Games?

Addicted to Video Games? Internet Gaming Disorder or “Video Game Addiction”

Today’s blog is about Internet Gaming Disorder, to shed some light on this issue from a professional perspective. If you recognize yourself in it, or if you think that a loved one might suffer from video game addiction, I recommend seeking a psychologist or mental health professional who is familiar with this topic!

As a researcher and psychologist in my own practice in Tennessee, I am very familiar with “internet addiction”, video game addiction or Internet gaming disorder for over ten years now. Several studies confirm that a high amount of time spent online playing games is connected with depression, loneliness, anxiety disorders or aggression. On the other hand, gamers have more fun with playing video games, and most of them report a greater number of friends they found online. Therefore, occasional gaming can definitely increase the quality of life!

I do not believe that everyone who plays video games is “addicted”; my own research suggests that we have to distinguish between a healthy and an unhealthy use of video games. In therapy, my stated goal is the achievement of a controlled use of video games because it can be part of a healthy lifestyle if it is used in moderation.

However, the question remains: What is a “healthy” use of video games, and when is it “addiction”?

Internet Gaming Disorder: Criteria

Millions of people play video games online without no serious effects at all. They have fun engaging with other players, collect items online, go on quests, and explore virtual worlds.

However, a small minority of them seems to have problems with an overuse of video games. These problems seem to be comparable to behavioral addiction; this is why the American Psychiatric Association introduced “Internet Gaming Disorder” (IGD) in their recent edition of the Diagnostic and Statistical Manual of Mental Disorders—5th Edition (DSM-5) as a condition that needs further research.

The DSM-5 proposes nine criteria for the assessment of IGD:

  • preoccupation,
  • withdrawal,
  • tolerance,
  • unsuccessful attempts to control the use of video games
  • loss of interests in other activities,
  • continued excessive use despite psychosocial problems (e.g., problems at work)
  • deceiving (lying about the use of video games)
  • escape, and
  • functional impairment.

An excessive use of the Internet (for either video games or for other purposes, such as sexual desires) seems to be linked to a variety of comorbid psychopathological and personality differences.

Studies suggest that users suffering from depression tend to spend significantly more time online compared to non-depressed users (mood disorders seem to be connected with a higher use of the Internet). It is interesting to note that users from massively multiplayer online roleplaying games (MMORPGs) suffer significantly more often from depression, compared to other game genres. Also, anxiety disorders (such as social anxiety disorder) seem to be another significant predictor of excessive or problematic Internet use.

However, it is important to note that correlation does not equal causation. Just because users from MMORPGs suffer more often from depression, that does not mean that MMORPGs lead to depression. It might be quite the opposite, that playing games can lead to a “self-medication” – this means that depressed people with a lack of external gratification might look into video games to seek gratification online. This is not necessarily a bad thing, and studies are needed to look into long-term effects of the use of online-games for purposes like this one.

Differences between engagement and addiction

As a practicing psychologist and as a researcher, I truly believe that we have to distinguish between a healthy use of video games and an unhealthy over-use of games. My research points two factors explaining an an over-use of video games:

A) Engagement is connected to variables like cognitive salience, tolerance, and euphoria (meaning, engaged players have fun playing the games, they report feelings of euphoria, and they need to play more to experience the same feeling of euphoria they had in the beginning of playing games)

B) Addiction is connected with conflicts, withdrawal symptoms, relapse and reinstatements, and behavioral symptoms. Just because someone spends a lot of time playing video games online, he or she cannot be labeled as addicted right away.

Warning signs of addiction

My research suggests that addicted players seem to spend more time online playing video games, compared to engaged players (for example, one study found that addicted players spent 32 hours on average per week online playing World of Warcraft, while engaged players only pay 21 hours per week, on average).

However, it is very important to note, that even in a large sample of high-level players, I was only able to classify 3% of them as addicted. 97% of high-level players are NOT addicted; therefore, I am against labeling any gamers as “addicted” just because they play a lot of games online or because they spend a lot of time per week online playing games.

While engagement might be just experiencing fun playing games, addiction is a more serious issue. Some of the warning signs of behavioral addiction to video games include:

  • Playing more and more, investing more and more time and money into video games
  • Escapism: using video games as a vehicle to avoid real life issues
  • Skipping meals, showers or important meetings because of video games
  • Deceive other people, lying to other people about the amount of time spent with video games
  • Problems at work or in school, the performance decreases

Assessment and treatment possibilities

If you think that you or a loved one might suffer from IGD or “video game addiction”, I recommend seeking a psychologist or mental health professional who is familiar with this topic.

In my own practice in Tennessee, I usually use several questionnaires to assess IGD and surrounding factors like mood disorders, anxiety disorders, and negative effects on one’s life. I also have a look into who else is affected by an over-use of games; for example, in many cases it’s marital problems because one partner spends too much time playing video games online. I also always have to rule out underlying problems like mood disorders or anxiety disorders before I make any IGD treatment recommendations.

I am trained in cognitive-behavioral therapy (CBT), and CBT seems to be the gold-standard for treating IGD. My therapy recommendations usually include the following steps:

  • Detect, explore and examine thoughts that lead to IGD
  • Explore behavioral triggers that lead to a use of video games
  • Replace irrational thoughts with healthier ones
  • Modify behavioral triggers
  • Modify thoughts, feelings and ultimately the behavior that lead to IGD

Each individual suffering from IGD might have different triggers; therefore, it is important to adjust any therapy individually.

My stated goal is the achievement of a controlled use of video games because it can be part of a healthy lifestyle if it is used in moderation!

Conclusion

While millions of people play video games online without no serious effects at all, a small minority of them seems to have problems with an overuse of video games. Some of the warning signs of behavioral addiction to video games include investing more and more time and money into video games despite negative consequences on one’s life (such as work or school problems), using video games to avoid real life issues, skipping meals, showers or important meetings because of video games, and lying to other people about the real amount of time spent with video games.

Cognitive-behavioral therapy seems to be the gold-standard for treating video game addiction. Therapy usually includes exploring and modifying behavioral triggers, thoughts and emotions. My stated goal of therapy is not to ban the use of the Internet or video games, but to achieve a controlled use of video games; after all, it can be part of a healthy lifestyle!

Please note: Parts of this blog come from my peer-reviewed publication: Lehenbauer-Baum, M. et al., (2015). Addiction and Engagement: An Explorative Study Toward Classification Criteria for Internet Gaming Disorder. Cyberpsychology, Behavior, and Social Networking, 18(6), 343–349. http://doi.org/10.1089/cyber.2015.0063

 

About the writer: Dr. Mario Lehenbauer-Baum is a Licensed Psychologist, and the founder and director of Thrive in Life Counseling and Therapy LLC, his private practice in Franklin/Nashville, Tennessee. He is a researcher as well as the author of several peer-reviewed papers and book-chapters about internet gaming disorder, internet addiction and anxiety disorders. He offers services in English and German. Dr. Mario Lehenbauer-Baum diagnoses and treats individuals, couples and groups with a wide range of challenges in their lives, such as internet addiction, video game addiction, ADHD, shyness, social anxiety disorder and other anxiety disorders, phobias, diversity, relationship issues, mens issues, career and life challenges, marital and couple issues and other challenges. His research work focuses on “new” technologies, such as online-based social skills trainings as well as the “side effects” of using new technologies, such as addiction.