Psychiatrists are investigating internet gaming disorder and say it has traits in common with more recognisable addict-related conditions, writes Justin Thomas
The lying, the deceit, the rage: is video gaming as addictive and destructive as alcoholism or drug-taking?
In 1981 I became the proud owner of my first tabletop video game, Astro Wars. The object of the game was simple: shoot aliens. I spent endless hours each day, face buried in the screen, determined to kill all comers. At some point during 1982, I finally completed every level the game threw at me. I had succeeded in repelling the alien invasion. For a few days after my victory, I was a neighbourhood boss, with other kids seeking me out for consultation on how to overcome various obstacles in the game. A week later I was a noob (novice) again, this time grappling with Pacman.
Today, Astro Wars is consigned to the pages of gaming history, vintage electronica and 80s memorabilia. The latest incarnation of this particular form of onscreen entertainment, however, is far more potent, engaging and accessible. The current game of the hour is called Fortnite Battle Royale and it is described as “too addictive”, “worryingly addictive” and “the most addicting game in history”.
The game is a cross between Minecraft (where you build protective barriers) and The Hunger Games (children killing other children). Unlike Astro Wars, Fortnite has no definitive end and rather than being a solitary affair, you can choose to interact (kill or co-operate) with other people playing the game. The game’s boundlessness and social element are particularly potent ingredients and undoubtedly part of the secret sauce that has helped spread the Fortnite pandemic. How long will this craze last? Maybe a little longer than the game’s name but not too much longer I imagine. But there will be other games, perhaps even more addictive.
Nothing becomes extremely popular without mental health experts and commentators trying to wrap it up in psychiatric, jargonistic terminology: Biebermania, shopaholism, tanorexia (the latter relating sunbed addiction). Video games don’t escape our tendency to psycho-pathologise popular things either. Video game addiction has been a familiar term used by concerned parents and clinicians alike since the time of Astro Wars.
It is easy to see how gaming, especially online gaming, could be conceived of as “addictive”. In addition to rewarding gamers with a sense of achievement and the adrenaline rush from a high score, games can also provide a social dimension and a shortlived sense of purpose and belonging.
However, anything that is delicious, dulls a pain or fills a void, runs the risk of being engaged in excessively. Gaming, like many other behaviours, can cross this line. People overly involved with video games can fail exams, lose jobs and put a strain on their relationships or marriages. At the sensational end of the spectrum, there are occasional reports of gaming-related suicides and homicides.
When it is excessive, gaming fits the classic three Ds model of psychological disorder - it’s deviant, distressing and dysfunctional. Deviance is reflected in the inordinate amount of time it can demand. Distress might be experienced by family members concerned or angry about the excessive gaming. Game play could also be considered dysfunctional at the point when real world social or occupational obligations get neglected.
Despite the apparent problems associated with excessive gaming, there is still no official psychiatric diagnosis for such behaviour. The latest version of the American Psychiatric Association's diagnostic manual lists internet gaming disorder (IGD) as a “condition for further study”. Not being listed has implications in that many medical insurers won’t cover the cost of treatment for unrecognised problems.
As a condition for further study, IGD has already attracted lots of research attention. The findings suggest that the behaviour shares many similarities with traditional addictions such as alcohol and opiate-related disorders. For example, like other addictions, there is a near-obsessive preoccupation with the desired activity. There is also a kind of withdrawal, characterised by agitation and irritation, when prevented from playing. Finally, there is the interpersonal conflict, denial and deception – for example, lying about how long you spend on the game and refusing to concede that the time spent might have been better devoted to studying or some more beneficial pursuit.
The questions we need to answer now are: how long is too long? And how can we best help people who cross the line into excessive, self-destructive game play?
Dr Justin Thomas is an associate professor at Zayed University
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