In 2007, video game addiction was denied entry into the Diagnostic and Statistical Manual for Mental Disorders. The American Psychological Association concluded that there was insufficient evidence to prove that video game overuse can be classified as an addiction. The overriding factor in the rejection was that gaming compulsively acted as an outlet for a patient's pre-existing mental disorder. Video games – and specifically online games – posses many characteristics of substance dependence, though, and should be recognized as an official addiction. To say that the popularity of online video games has risen over the last decade would be the understatement of the millennium. Millions of gamers spend hundreds of hours every week playing online video games. Massively Multiplayer Online games are the most popular type of online games, specifically the Role Playing Games (better known as an MMORPG's). This genre includes titles such as Warcraft, Everquest, and GuildWars. These games generally function the same, so they have similar affects on gamers.
While the American Psychiatric Association has rejected the inclusion of video game addiction from the DSM, gaming should absolutely be recognized as an official addiction. According to the DSM, for substance dependence to occur one or more of these symptoms must be present:
1.Substance abuse
2.Continuation of use despite related problems
3.Increase in tolerance
4.Withdrawal symptoms
All four of these factors are relevant when it comes to online gaming. Many gamers can attest to the increase in tolerance and withdrawal symptoms, especially those who play MMORPG's. Substance abuse is also applicable to this issue.
According to the DSM, substance abuse occurs when one or more of these factors take place: (1) recurrent use interferes with school/work/home obligations; (2) recurrent use in physically hazardous situations; (3) legal problems resulting from use; or (4) continued use despite social or interpersonal problems which were originally caused by the addiction.
Two of these factors are definitely in play for gaming. There are many gamers who skirt off work, school, or relationships to play video games instead. Stories can be found all over the Web about how video game playing has intruded on people's lives – and not just kids either. Many of these examples stem from the playing of World of Warcraft, currently the most popular MMORPG. These testimonies expose the potentially harmful nature of online gaming and how it can interfere with real world obligations and relationships. (See 'external link' below.)
Another aspect which was evident in the testimonies from the link was the difficulty of quitting. Two of the gamers said that they had tried to quit playing, but eventually came back and got hooked on the game again. Withdrawal symptoms were also clearly present. One of the gamers claimed that playing the game was “all [he] thought about.”
The most dangerous aspect of these games, though, may be how easily and quickly a gamer's tolerance can rise. MMORPG's, for example, become more time consuming as the player progresses. They are also open-ended, meaning a player can never beat the game. The appeal of these games is to watch your character grow. As a gamer fights through the game, his/her character builds experience; and as it gains experience, the character grows to higher levels. As the gamer progresses to the higher experience levels, new items and abilities are unlocked. An increase in tolerance stems from the fact that the higher level a character is, the more experience, and time, it takes to achieve the next growth level. So, in MMORPG's, an increase in tolerance is actually necessary to continue playing the game.
Clearly MMORPG's possess all of the attributes of substance dependence. Substance abuse, continuation of use despite related problems, increase in tolerance, and withdrawal symptoms are all present. But even with all of this evidence, gaming was denied its place in the DSM. It has been deied entrance for two reasons: (1) it is a fairly new concept and requires more research to completely understand the disease; (2) and more disturbing, is the fact that this addiction receives very little public attention.
In-game content is normally the focus of video games in the media. There has been an outcry from parents in recent years over the severe violence, language, and sexual content of video games. Gaming addiction has always remained in the shadow of this issue. While monitoring the content of games is important, studies have shown that there is little correlation between the behavior in children and the video games that they play. Gaming addiction has more scientific data to support it, with more substantial studies on the way. Also, if we can find ways to treat an addicted gamer it would help in stopping kids from spending too much time playing these violent games.
There is no question that gamers experience symptoms of substance dependence. Also, like many recognized addictions, there is a major problem in diagnosing the condition. Like pathological gambling, for instance, gaming addiction does not take a noticeable physical toll. The affect of the disorder is completely behavioral which makes it much harder to diagnose the addict from a more intense gamer who has the ability to quit.
Dr. Allison Conner, a cognitive behavioral therapist, recognizes Internet addiction – including gaming – as a serious psychological issue. She believes this addiction could result in a patient's “retreat from real-life face-to-face relationships.” The more a gamer shies away from real human relationships, the more likely they are to become increasingly dependent on their virtual ones, thereby compounding the problem. Dr. Conner added: “video game addiction may eventually be recognized as a specific classification among other mental disorders.”
Although the physical dangers of gaming are minuscule, there are a myriad of examples of social and behavioral damage directly caused by video game overuse. Addiction clinics all over the world have begun to open their doors to gamers. I think that it is time that the rest of the psychiatric community do the same.
Resources
Brad Wright, “Sounding the Alarm on Video Game Ratings,” CNN.com, 18 Feb. 2004 (Oct. 20, 2008), http://archives.cnn.com/2002/TECH/fun.games/12/19/games.ratings.
“Drug and Substance Abuse, Addiction Treatment,” 2008, (Oct. 20, 2008), http://www.cognitive-therapy-associates.com/drug-substance-abuse.php.
“Psychiatric Disorders: Substance Abuse,” May 15, 2004 (Oct. 20, 2008), http://allpsych.com/disorders/substance/substanceabuse.html.
Sherry Rauh, “Detox for Video Gamer Addiction,” CBSNews.com, 3 July 2006 (Oct. 2, 2008), http://www.cbsnews.com/stories/2006/07/03/health/webmd/main1773956.shtml.
Wikipedia.org, “Video Game Controversy,” October 20, 2008 (Oct. 20, 2008), http://en.wikipedia.org/wiki/Video_game_controversy#Crime_and_violence.
If you are located in the New York City area and would like to contact Dr. Conner call (212)258-2577.
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Contributor's Note
Joe is the Director of Communications for Cognitive Therapy Associates in New York City.
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This intel first appeared on: http://addiction-dirkh.blogspot.com/2008/10/guest-post-video-games-...
