Partly because of this lack of consensus, and because this degree of gaming is still relatively new, research into the question of whether video game addiction is real is scarce. The fundamental questions of how to come up with an agreeable definition for video game addiction are unanswered, so the debate continues on how to prevent and treat compulsive gaming behaviors.
In 2017, Psychiatry and Clinical Neurosciences published a review of the research that existed up to that point and reported on evidence that “pathological gaming symptoms” and game addiction, but not gaming itself, were connected with poor health and social outcomes, including depression and reduced academic achievement. The review further pointed out the “obvious insufficiency” of current research into the detection and prevention of gaming problems, and that studies on how gaming addiction develops are “limited,” highlighting that this is still an emerging field of addiction research.
Even those who criticized the World Health Organization for adding gaming disorder to its International Statistical Classification of Diseases and Related Health Problems (on the basis of the research being scant and there being too many challenges and controversies to fully accept) agreed that “excessive gaming” is a serious problem. But the question remains: Is there enough evidence to determine that excessive gaming is a legitimate mental health disorder?
A public health researcher at Radboud University in the Netherlands argued that there isn’t, pointing to the accepted criteria for drug and gambling addiction. For those conditions, there is a wealth of evidence that must be cited for a person to receive a diagnosis that leads to appropriate treatment
But when it comes to video gaming, there are stark contrasts. For example, saying that video games being used to boost mood is a sign of addiction (in the same way that drugs and gambling are used to boost mood) does not hold up because “just about every hobby is […] about improving a person’s mood.”
When it comes to the science on the treatment of gaming addiction, the research is similarly sparse. To date, there have not been any large-scale randomized trials to examine the different ways to treat excessive gaming. For all the evidence regarding the negative consequences, there is still a dearth of evidence-based treatment. Nonetheless, more people are actively looking for gaming addiction treatment, either for themselves or a loved one.
The Crosscut story about the ADHD patient who became addicted to gaming notes some anecdotal coverage that suggests that “young men are particularly susceptible to gaming addiction,” possibly because video games “provide a full spectrum of what young men are looking for” — specifically, competition, accomplishment, mastery of skills, fun, independence, intellectual stimulation, and varied social interaction. Other experts have argued that girls and women are no less likely to fall prey to video game addiction, but gaming companies understand their male demographic much better and have simply not caught up to what their female consumers are looking for.
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In March 2019, the Journal of Abnormal Psychology published a report that found that the rate of depression among children and young adults (between the ages of 14 and 17) increased by 60 percent between 2005 and 2017. This led a Seattle-based therapist who specializes in gaming disorders to direct his treatment to ask “what circumstances were present in the kid’s life,” that made it such that excessive video gaming appeared to be the only way out.
In the same way that treating a more established form of substance abuse or a compulsive behavioral problem can be complicated, treating a video game addiction can be similarly challenging, especially when the addiction covers other forms of technology, such as mobile device use. In the case of drugs or alcohol, the standard approach is total abstinence. Technology, on the other hand, is much more difficult to avoid, and it may be an unrealistic goal.
For that reason, some therapists in this field recommend simply reducing the number of hours spent online or gaming, incentivizing this change and providing positive support and reinforcement when the change is made.
However, abstinence treatment for those with severe gaming addiction does exist, although this form of therapy is still in its infancy. Individuals are completely disconnected from the digital world, “in order to figure out what to do with their boredom,” in the words of the founder of one such program. This is done through the use of teaching (or re-teaching) fundamental life and social skills that may have atrophied during the gaming problem.
Clients learn how to take care of themselves (basic cooking classes), but more importantly, how to improve their communication skills to build what organizers call “social confidence” to balance their lives in a healthy way.
Much of the treatment modality is borrowed from traditional substance abuse treatment, with the understanding that in the outside world, people will be subjected to many of the same temptations to go back to gaming, the way that people in alcohol recovery will see relapse triggers.
These programs seek to equip clients with coping skills and mechanisms to help them monitor their thoughts and regulate their emotions, so they can function as well-balanced adults who don’t need to use video games as a pathological escape from the real world.
In 2019, many parents are rightfully concerned about how to bring up a child in the smartphone age while setting realistic boundaries for gaming and computer use. Talking to Crosscut, one expert recommends that parents look at not only how much time their children spend playing games, but also how digital entertainment affects their behavior:
In and of themselves, these are not necessarily signs that a child will develop a video game addiction. However, they do strongly suggest a susceptibility to problematic behavior based on gaming. These signs might call for the intervention of a child therapist and necessary lifestyle changes.
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