Video Game Addiction 101

Internet gaming disorder (IGD) can be hard to identify because playing video games is so commonplace today. In fact, the Entertainment Software Association reports that American consumers spent over $21 billion on games, hardware (like consoles) and accessories in 2013. Internet video games aren’t all bad either, of course; in a Harris poll, 69% of Americans said they thought playing video games is a good thing for children. And while Internet-based games can help kids learn everything from math and geography to music and foreign languages, their link to education can make it that much harder to see the potential risks that come from too much time at the console, and when an affinity for gaming crosses the line into addiction. That’s why it’s important to understand the basic facts about this disorder, including common causes, symptoms and risk factors that may be involved. You should know that:

  • There are similarities between video gaming disorder and substance use disorder; both are marked by an inability to cut back or stop “using,” withdrawal symptoms and tolerance that increases over time, with a need to spend more and more time gaming.
  • According to the Journal of Behavioral Addictions, adolescent boys are more likely than girls to have an online gaming problem. And boys with a gaming problem were also likelier to drink alcohol, smoke cigarettes or use marijuana. Problem gamers of both genders did worse in school and had higher rates of depression, anxiety, loneliness and have negative self-esteem. Depressionmay be associated with a video game addiction, too.
  • Multiplayer games may be particularly risky for gamers when it comes to addiction, some studies have found. Why? These games can’t be paused, so players tend to continue playing for much longer. Offline and casual smartphone games are not as well-studied.
  • Extreme gamers may forgo food and sleep for long periods to play against others across time zones.

If you or a loved one is screened for Internet gaming disorder, a health care practitioner or counselor will look at various criteria to determine if video gaming has become a chronic and detrimental issue.  (See the “Symptoms” section below.)


Given how relatively recent gaming is, it’s probably little surprise to hear that Internet gaming disorder isn’t as well-studied as some other types of addiction; much, but not all, of the research so far has been in studying young men and teenagers in Asian countries. As with any addiction, there’s no clear or single cause to video game addiction, but experts suspect that the following factors play a role in compulsive use of video games:

  • Physiological factors: Gaming triggers the brain’s reward system -the same area of the brain affected by substance use – releasing dopamine, the body’s pleasure hormone, during play; this is primarily what keeps a gamer coming back again and again. Male brains show more activation during video game play than do female brains, typically.
  • Personality: People with video gaming issues tend to struggle with impulsivity, according to researchers at the University of Cambridge in the U.K., and poor impulse control is also an issue with many who have a substance use disorder. Studies show that problem video gamers prefer a small immediate reward over a larger but delayed reward. Those who have a tough time fitting in socially may turn to gaming as a way to bolster their self-esteem and to make social connections.

Symptoms of Video Game Addiction

Doctors, therapists and counselors look at a variety of factors when deciding whether someone has a video gaming problem. According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), there are nine criteria for identifying Internet gaming disorder; having five or more of the indicators below in the last year may point to a problem with video gaming that’s mild, moderate or severe: The more symptoms, the more disruptive gaming is to one’s life. Recognizing a gaming problem is the all-important first step to getting help.

Are you or a loved one…

  1. Preoccupied with buying and playing video games – perhaps with other players – and spending a lot of time thinking about previous gaming experiences and looking forward to playing again?
  2. Feeling anxious, irritable or sad when gaming is stopped or reduced?
  3. Needing to spend more and more time playing video games in order to get a rush?
  4. Losing interest in everything else, including hobbies that are being edged out by time spent on gaming?
  5. Unable to stop playing video games even though it’s causing problems psychologically or socially?
  6. Lying to family or counselors about the amount time spent on Internet games?
  7. Playing Internet games to undo bad moods – feeling guilty or anxious, for example?
  8. Risking relationships, job or education because of the overriding need to game?

Risk Factors

The more you know about video game addiction, the better your chances of preventing a problem before it starts or stopping it from getting worse. Here are several red flags that raise risk:

  • Easy Access: It may seem obvious, but it’s a lot harder to game online without a computer with cutting-edge graphic capabilities and a super-fast Internet connection. The ongoing nature of Web-based games; the social aspect of playing on teams (called guilds) and paying for memberships can all make it much harder for someone to put down the controller. Like other addictions, a problem doesn’t start immediately; repeated use over time is what primes the brain for the dopamine high the addicted gamer feels.
  • Gender: According to the DSM-5, adolescent boys are particularly at risk for a video game addiction. (Owing to the prevalence of this disorder in Asian countries, researchers are examining whether genetic or cultural influences are at play as well.)
  • Genre: The kind of games played can also affect whether someone plays a game much longer than he or she might have intended. Those most likely to lull someone into problem play are MMORPG (massively multiplayer online role-playing games); FPS (first-person shooter); action-adventure and gambling games, according to one study.
  • Autism & ADHD: Kids and teens with these disorders are at risk for developing a problem with video game use, according to Pediatrics, in part because children with autism or ADHD tend to spend more time playing video games compared to other children.

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