Is Video Game Addiction Possible?

Videogame addiction?

The other day our 9 year-old asked if he could play on the Wii ®video game console in our home. He had played in the past and got pretty good at the Mario game he was requesting. After playing intensely with his “screen time allotment” for the day several days in a row he abruptly quit. Becoming interested in plants he was tending to his bulb garden for a couple of weeks. Later his interest turned to sculpture, then back to Mario.

My wife and I have had numerous discussions regarding the pitfalls of excessive video game play. She is (appropriately) worried about the implications for addiction as well as the opportunity cost imposed on alternate activities. I suggested that he might miss out on the rich dynamic environment that video games can offer as well as eye-hand coordination benefits and stress reduction. Since it is something he does with his sister there is a shared play element as well.

In my house you had better be able to back up your statements with data. It is in that vein that this brief review article looks at some of the available literature on video game play and its potential pitfalls.

Obsessive game play is a centuries old issue. Before the Spanish colonization of California the local Chumash native people here in what would become Los Angeles played several games that tested skill but others that could be considered games of chance. In 1920s Japan the Pachinko pinball machine was born. It is modeled on American pinball games but the goal is to collect as many steel balls as possible in a trap. Collecting balls leads to points that can be exchanged for prizes. There is a small amount of skill but mostly chance is at work.

This is a $250 billion business as of 2008 and approximately 20% of Japanese adults play the game. If all games of chance are included the number of habitual players swells to 50 million people or about half of all adults in Japan. [i]

In the U.S. people are more likely to play on their home consoles and increasingly on their smart phones. According to the Entertainment Software Association [ii]70% of people play some kind of computer game and 4 in 10 gamers is a woman. The videogame industry is several times larger than the Hollywood film industry.

NEUROSCIENCE

Back in 2003 Daphnie Bavellier and colleagues showed that action video game playing can change the way the visual cortex of the brain picks up on brief stimuli. Players’ visual attention skills were enhanced the more they played. The brain adapts to behavior and in this case to playing the game. [iii]

In a widely cited study of surgical trainees at an academic medical center (Harvard) Rosser and colleagues found that surgeons who reported a history of playing video games were better at laparoscopic surgery[iv] (small incision, skinny instruments, watch movements on a camera to a video screen) than non-game players. The best surgeons also reported playing the most video games. I think the evidence is in that any repetitive activity will change the neural connections in the brain. The question is does this qualify as an addiction?

ADDICTION?

Han[v] and partners at the University College of Medicine in Seoul reported last year a study of 21 volunteers who underwent a six-week research protocol of video game play followed by brain scans. The fMRI scan looks at area specific activity and can reveal the location of greatest activity. In the case of addiction, the portions of the brain called the anterior cingulate and orbito-frontal cortices (AC and OFC). The AC area is implicated in the reward pathway and the OFC has been described as the Judgment Center. The gaming volunteers reported increased craving for playing their games and were irritable when they didn’t get to play.

The same areas of the volunteer’s brains were active in the volunteers shown images from their favorite game as addicts shown drug or alcohol cues: The AC and the OFC.

In a brilliant paper this year by Douglas Gentile[vi] and colleagues that looked at over 3,000 children from Singapore in grades 3 through 8 the idea of addiction to video games was not only confirmed but several other details were illuminated. First, it was a two-year study that tracked the development of game pathology. Researchers there looked at weekly amount of play, depression, social phobia,  anxiety and school performance.

About 8-10% of kids show clear signs of negative social and behavioral consequences that correlate with greater game play. More, the kids in the early grades continued to demonstrate the poorer behavioral measures as the study progressed. Interestingly, most kids did not show a problem but those that did have trouble didn’t “grow out of it.”

WHAT TO DO?

Like anything that a human being can derive pleasure from video games do have the potential for addiction. Interestingly most kids and adults do not develop a self-destructive pattern. With limitation on the total amount of screen time the games get and nurturing of healthy non-game interests and activities video games seem safe.

The evidence on violence in games being adopted by the players is inconclusive at best. I think the guidelines here should match what you will allow your kids to watch. If they don’t watch MPAA ‘R’ rated films then they should not play ESRB ‘M’ games.

So it turned out both my wife and I were each right. She is appropriately concerned that the game play not get out of hand and at the same time she need not be alarmed that playing videogames is intrinsically bad. The kids were happy they got to play for a half-hour then they went outside to play. Wearing sunscreen of course.


[i] Brooks, Graham , Ellis, Tom and Lewis, Chris ‘Pachinko: A Japanese Addiction?’, International Gambling Studies, 8:2, 193 – 205

[ii] http://www.theesa.com/facts/

[iii] Green CS, Bavelier D, Nature. 2003 May 29;423(6939):534-7. Action video game modifies visual selective attention.

[iv] Rosser JC Jr, Arch Surg. 2007 Feb;142(2):181-6; discussion 186.

The impact of video games on training surgeons in the 21st century.

[v] Han DH, Cyberpsychol Behav Soc. Netw. 2010 Dec;13(6):655-61. Epub. 2010 May 11.

Changes in cue-induced, prefrontal cortex activity with video-game play.

[vi] D.A. Gentile, PhD. Pathological Video Game Use Among Youths: A Two-Year Longitudinal Study PEDIATRICS Vol. 127 No. 2 February 2011, pp. e319-e329 (doi:10.1542/peds.2010-1353)

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Category: Current Events

About the Author: Dr. Jason Giles is certified by the American Board of Addiction Medicine and the American Board of Anesthesiology. He is a physician specializing in the treatment of drug, alcohol, and behavioral addictions. He is the founder of Haywire.


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