Breaking Down the Effects of Gaming Disorder

Gaming disorder, also known as video game addiction or internet gaming disorder, is a condition characterized by excessive and compulsive video gaming, which causes significant impairment in personal, social, educational, or occupational functioning. Gaming disorder, which was recognized as a mental health condition by the World Health Organization (WHO) in 2019, is similar to other behavioral addictions, such as gambling addiction, in terms of the compulsive nature of the behavior and the impact it has on an individual’s life.

Understanding Gaming Disorder

Gaming disorder is more than just an excessive interest in video games; it is a serious mental health condition that can have long-term consequences for an individual’s well-being. Individuals with gaming disorder frequently find themselves unable to control the amount of time they spend gaming, despite being aware of the negative effects it has on their health, relationships, and responsibilities.

The disorder is defined by three main criteria:

1. Limited gaming control (for example, inability to limit playtime or stop playing when desired).
2. Gaming is becoming increasingly important in comparison to other life interests and activities.
3. Continuation or escalation of gaming in the face of negative consequences.

These criteria must be present for at least 12 months before a diagnosis can be made, though the duration can be reduced if the symptoms are severe.

Neurological Basis of Gaming Disorder

The neurological mechanisms that underpin gaming disorder are similar to those found in substance use disorders. When a person plays video games, particularly those that are intended to be highly engaging, such as massively multiplayer online role-playing games (MMORPGs) or first-person shooters, the brain’s reward system is activated. This system, which involves dopamine release, is critical for pleasure perception and behavioral reinforcement.

Dopamine is a neurotransmitter that influences reward-motivated behavior. In the context of gaming, each achievement or success can cause a dopamine release, resulting in a sense of pleasure and reinforcing the behavior. Over time, the brain begins to associate gaming with these rewarding feelings, potentially leading to the development of an addictive pattern of behavior.

Functional magnetic resonance imaging (fMRI) research has shown that individuals with gaming disorder have changes in the brain’s reward pathways, particularly in the ventral striatum and prefrontal cortex. The ventral striatum processes rewards, whereas the prefrontal cortex is responsible for decision-making, impulse control, and behavioral regulation. Individuals with gaming disorder may experience decreased activity in the prefrontal cortex, making it more difficult for them to control their gaming habits and resist the urge to play, even when it interferes with other important aspects of their life.

Psychological Factors Contributing to Gaming Disorder

Several psychological factors influence the development and maintenance of gaming disorder. These factors frequently interact with one another, resulting in a complex web of influences that makes it difficult for people to break free from their gaming habits.

• Escapism: Many people with gaming disorder use video games to avoid real-life problems or to cope with negative emotions like stress, anxiety, or depression. The immersive nature of video games allows players to lose themselves in a virtual world where they can forget about their problems, at least for a while. This escapism can be especially appealing to people who are dealing with difficult life circumstances, such as relationship issues, academic pressures, or social isolation.
• Achievement and Reward Systems: Video games frequently incorporate intricate reward systems to keep players engaged by providing a sense of accomplishment. Whether it is leveling up, earning new items, or unlocking new features, these rewards provide a steady stream of positive reinforcement, making it difficult for players to stop playing. For some people, pursuing these in-game achievements takes precedence over real-world responsibilities and goals.
• Social Interaction: Online multiplayer games, in particular, allow for social interaction and the creation of virtual communities. Individuals who struggle with social interactions in the real world may find that virtual connections play an important role in their social lives. Being a part of an online gaming community provides a strong sense of belonging and camaraderie, but it can also contribute to the development of gaming disorder as players prioritize their online relationships over real-world interactions.
• Impaired Time Management: One of the defining characteristics of gaming disorder is an inability to manage time effectively. Individuals with this condition may spend hours or even days playing video games, frequently at the expense of sleep, work, or school. This lack of time management can result in a vicious cycle in which the individual becomes increasingly isolated and disconnected from other aspects of life, reinforcing their reliance on gaming.

Environmental and Social Influences

The individual’s living environment, as well as broader societal factors, can have a significant impact on the development of gaming disorder. These factors can influence people’s attitudes toward gaming, the availability of games, and how much gaming is integrated into daily life.

• Video Game Availability: With video games available on a variety of platforms such as consoles, PCs, and mobile devices, gaming has become an integral part of modern life. The availability of free-to-play games, which frequently include in-game purchases and other monetization strategies, has also contributed to a rise in gaming across all age groups. Individuals who have constant access to games may struggle to moderate their gaming habits.
• Cultural Attitudes Toward Gaming: Many cultures regard gaming as a normal and even desirable activity, particularly among younger generations. The rise of esports and professional gaming has further glamorized the gaming lifestyle, with some people aspiring to be professional players or streamers. While gaming can be a healthy and enjoyable pastime, the cultural emphasis on gaming as a legitimate career path or social activity has the potential to normalize excessive gaming behavior.
• Marketing and Monetization Strategies: Video game developers frequently employ sophisticated marketing and monetization strategies to keep players interested and spending money. These strategies may include loot boxes, microtransactions, and other in-game purchases that allow players to enhance their gaming experience. The constant availability of these purchases, combined with the pressure to keep up with other players, can result in compulsive spending and long gaming sessions, both of which can contribute to the development of gaming disorder.
• Social Media and Streaming Platforms: The rise of social media and streaming platforms such as Twitch and YouTube has made gaming more integrated into everyday life. Gamers can now share their gameplay experiences with a global audience, get feedback from viewers, and interact with other players in real time. While these platforms can foster a sense of community, they can also put pressure on users to perform and maintain a certain level of engagement with their audience, resulting in increased gaming time and the risk of addiction.

Demographics and Prevalence of Gaming Disorders

Gaming disorder affects people of all ages and backgrounds, but certain demographic groups may be more prone to developing the condition. Understanding the prevalence of gaming disorder and the characteristics of those who are most at risk can aid in identifying and addressing the issue.

• Global Prevalence: A 2022 study published in the journal Addictive Behaviors estimates that gaming disorder affects approximately 2-3% of the global population. However, the prevalence varies significantly depending on region, age group, and diagnostic criteria. According to studies, the prevalence of gaming disorder may be higher in East Asia, particularly in countries such as South Korea and China, where gaming is a popular and culturally significant activity.
• Age-Related Factors: Gaming disorder is most common in adolescents and young adults, especially men. This demographic is more likely to use gaming as their primary form of entertainment and may be more vulnerable to the addictive aspects of video games. The transition from adolescence to adulthood, which frequently includes significant life changes and challenges, can also be a risk factor for the development of gaming disorder. However, it is important to note that gaming disorder can affect people of any age, including older adults.
• Gender Differences: Studies show that males are more likely than females to develop gaming disorder, with some indicating that the condition is up to three times more common in men. This gender difference could be attributed to a variety of factors, including the types of games that males prefer, the social aspects of gaming, and societal norms that encourage males to engage in competitive and aggressive behavior. However, the prevalence of gaming disorder among females is increasing, owing to the rise of mobile and casual gaming.
• Socioeconomic Status: While gaming disorder can affect people of all socioeconomic backgrounds, there may be some risk factors associated with lower socioeconomic status. Individuals from lower-income households, for example, may have fewer opportunities for leisure activities other than gaming, so they spend more time playing video games. Furthermore, the stress of financial difficulties may cause some people to use gaming as a form of escapism, increasing the risk of developing an addiction.

Health Effects of Gaming Disorder

The health consequences of gaming disorder are significant, affecting both physical and mental well-being. Individuals with gaming disorder may experience a variety of health problems that impair their quality of life and overall functioning.

• Physical Health Issues: Prolonged gaming sessions, especially those that involve sitting for extended periods of time, can cause a variety of physical health issues. Musculoskeletal problems, such as back pain and carpal tunnel syndrome, can also cause eye strain and headaches. Excessive gaming, in extreme cases, can contribute to the development of obesity, cardiovascular disease, and other chronic health conditions due to a lack of physical activity and poor eating habits.
• Sleep Disturbances: People with gaming disorder frequently experience sleep problems because they stay up late or even all night playing video games. This can result in chronic sleep deprivation, which can have negative consequences for overall health and well-being. Sleep deprivation can impair cognitive function, reduce attention span, and have a negative impact on mood, resulting in increased stress, anxiety and depression. Chronic sleep deprivation can lead to more serious mental and physical health problems, such as weakened immune function, weight gain, and an increased risk of heart disease.
• Mental Health Issues: Gaming disorder is linked to a variety of mental health problems, including anxiety, depression, and social isolation. The intense focus on gaming can lead to withdrawal from real-life activities and relationships, causing people to feel increasingly isolated. This isolation can exacerbate feelings of loneliness and depression, creating a difficult cycle to break. Furthermore, the stress and frustration associated with in-game failures or the pressure to succeed can lead to anxiety and irritability, compromising mental health.
• Cognitive Impairments: While some research suggests that playing video games can help with problem-solving and hand-eye coordination, excessive gaming can have the opposite effect. Individuals with gaming disorder may have executive function impairments, such as difficulty planning, organizing, and controlling their impulses. These cognitive impairments can have a negative impact on academic or occupational performance, leading to increased stress and frustration.
• Impact on Academic and Occupational Functioning: One of the most serious consequences of gaming disorder is a reduction in an individual’s ability to function effectively in academic or vocational settings. Students with gaming disorder may struggle to keep up with their studies, resulting in poor grades, missed deadlines, and even dropping out of school. Similarly, working adults may struggle to balance their job responsibilities and gaming habits, resulting in lower productivity, absenteeism, and job loss. Financial insecurity caused by these issues can exacerbate the stress and anxiety felt by people with gaming disorders, reinforcing the addictive behavior.

Gaming Disorder and Co-occurring Disorders

Gaming disorder is frequently associated with other mental health conditions, complicating diagnosis and treatment. Understanding the link between gaming disorder and co-occurring disorders is critical for developing effective interventions.

• Depression: Depression is one of the most common co-occurring disorders in people with gaming disorder. The relationship between gaming disorder and depression is bidirectional, which means that each condition can influence the development and progression of the other. Individuals who are depressed may turn to gaming to escape their negative emotions; however, excessive gaming can lead to further isolation and neglect of real-life responsibilities, exacerbating depressive symptoms.
• Anxiety Disorders: Generalized anxiety disorder (GAD) and social anxiety disorder are both frequently associated with gaming disorder. The immersive nature of video games can provide a temporary escape from anxiety-inducing situations, but this avoidance behavior can lead to increased reliance on gaming and worsening anxiety symptoms over time. Furthermore, the pressure to succeed in gaming, especially in competitive online environments, can lead to performance anxiety and stress.
• Attention-Deficit/Hyperactivity Disorder (ADHD): There is a strong link between gaming disorder and ADHD, with people with ADHD being more likely to develop problematic gaming behaviors. The fast-paced, stimulating nature of video games may appeal to people with ADHD, who may experience boredom and difficulty focusing on less stimulating tasks. Excessive gaming, on the other hand, can disrupt the management of ADHD symptoms, resulting in difficulties with academic, occupational, and social functioning.
• Substance Use Disorders: In some cases, gaming disorder may coexist with substance use disorders, especially among people who use substances to improve their gaming experience or to cope with the negative emotions associated with gaming. The combination of gaming and substance use can create a dangerous cycle of addiction, with each behavior reinforcing the others. For example, people may use stimulants to stay awake and play longer, or they may use alcohol or other substances to deal with the stress and frustration of gaming.

The Effects of Gaming Disorder on Relationships

Gaming disorder can have a significant impact on a person’s relationships, both within the family and in the larger social context. Excessive time and energy spent on gaming can lead to neglect of important relationships, causing significant stress and conflict.

• Family Relationships: Gaming disorder can cause conflicts in the family over time management, finances, and neglect of household responsibilities. Parents may struggle to establish boundaries for their children’s gaming, resulting in power struggles and tension within the household. In some cases, the disorder can cause estrangement or even the breakdown of family relationships, especially if the person with gaming disorder is unable or unwilling to recognize the impact of their behavior on others.
• Romantic Relationships: Gaming disorder can have a negative impact on romantic relationships, causing one partner to feel neglected or frustrated by the other’s excessive gaming. The lack of communication and emotional intimacy that is common with gaming disorder can lead to feelings of loneliness and resentment, potentially deteriorating the relationship. In extreme cases, gaming disorder can lead to the dissolution of marriages or long-term relationships.
• Social Relationships: Outside of the home, gaming disorder can cause social isolation and the loss of friendships. Individuals with gaming disorder may avoid social activities and engagements, preferring to spend their time gaming rather than interacting with others. This isolation can result in a lack of social support, making it even more difficult for people to overcome their gaming habits. Furthermore, while online gaming communities allow for some social interaction, they may not provide the same level of emotional support and connection as real-life relationships.

Gaming Disorder in Children and Adolescents

Gaming disorder can affect people of all ages, but children and adolescents are especially vulnerable to developing it. The combination of developmental factors, environmental influences, and the availability of video games can make young people particularly vulnerable to gaming addiction.

• Developmental Factors: Children and adolescents are still developing cognitive and emotional regulation skills, which makes them more prone to impulsive behavior and addiction. Their brain’s reward systems are especially sensitive to the dopamine release associated with gaming, which can lead to the development of addictive behaviors. Furthermore, young people may lack the maturity to recognize the long-term consequences of their gaming habits, making it more difficult for them to control their behavior.
• Peer Influence: Peer pressure and a desire for social acceptance can contribute significantly to the development of gaming disorder in children and adolescents. Many young people use gaming to connect with their peers and form social groups. However, the pressure to keep up with friends or succeed in competitive games can lead to overgaming and the development of addictive behaviors. The normalization of gaming among peers can also make it difficult for young people to recognize when their gaming habits have gotten out of control.
• Impact on Academic Performance: Children and adolescents who suffer from gaming disorder may struggle academically. Excessive gaming can make it difficult to focus on schoolwork, complete assignments, and attend class. The resulting decline in academic performance can lead to increased stress and anxiety, reinforcing the cycle of gaming as a coping mechanism. Students may drop out of school or fail to meet educational milestones as a result of their gaming habits.
• Parental Challenges: Parents of children and adolescents with gaming disorder may struggle to establish appropriate boundaries and enforce gaming time limits. The problem is exacerbated by the fact that many parents may not fully comprehend the appeal of video games or the risk of addiction. Furthermore, the widespread availability of gaming devices and the incorporation of gaming into daily life can make it difficult for parents to effectively monitor and regulate their children’s gaming behaviors.

Gaming Disorder and the COVID-19 Pandemic

The COVID-19 pandemic has had a significant impact on global gaming habits, with many people turning to video games to cope with the stress, boredom, and social isolation caused by lockdowns and social distancing measures. While gaming can be a valuable source of entertainment and social connection during difficult times, the increased gaming time during the pandemic has raised concerns about the development or worsening of gaming disorder.

• Increased Screen Time: The shift to remote work and online learning during the pandemic has resulted in more screen time for people of all ages. Many people now rely on video games for entertainment and social interaction, which leads to longer gaming sessions and an increased risk of developing gaming disorder. The blurring of the lines between work, school, and leisure time has made it more difficult for people to effectively manage their gaming habits.
• Mental Health Impact: The stress and uncertainty caused by the pandemic have led to an increase in mental health issues such as anxiety and depression. For some people, gaming has become a coping mechanism for negative emotions, increasing the risk of developing gaming disorder. The lack of access to traditional social activities and support systems has exacerbated the problem, as people may rely more on gaming for social interaction and emotional support.
• Challenges in Treatment and Support: The pandemic has also posed difficulties for people seeking treatment and support for gaming disorder. Social distancing measures and the closure of in-person treatment facilities have made it more difficult for people to get the help they require. While online therapy and support groups have grown in popularity, some people may find them less effective than in-person interventions. Furthermore, the increased reliance on digital platforms for treatment may present challenges for people who are already struggling with excessive screen time and gaming.

Additional Resources

Books

• “Reset: Reclaiming the Internet for Civil Society” by Ronald J. Deibert: This book explores the impact of digital technologies, including video games, on society and individual behavior. It provides insights into the broader context of gaming disorder and offers strategies for reclaiming control over digital habits.
• “Game Addiction: The Untold Stories of Video Game Addiction” by Neils Clark and P. Shavaun Gallagher: This book offers an in-depth look at the experiences of individuals who have struggled with video game addiction. It provides personal stories, insights from experts, and practical advice for understanding and addressing gaming disorder.
• “Reality Is Broken: Why Games Make Us Better and How They Can Change the World” by Jane McGonigal: While this book discusses the positive aspects of gaming, it also delves into the potential for gaming to become addictive. McGonigal explores how games can be designed to improve lives while also acknowledging the risks of excessive gaming.
• “Internet Addiction: A Handbook and Guide to Evaluation and Treatment” by Kimberly S. Young and Cristiano Nabuco de Abreu: This comprehensive handbook covers various forms of internet addiction, including gaming disorder. It offers evidence-based approaches to evaluation and treatment, making it a valuable resource for professionals and individuals alike.
• “The Gaming Mind: A New Psychology of Videogames and the Power of Play” by Alexander Kriss: Kriss, a psychologist, examines the psychological impact of video games, including the potential for addiction. The book provides a balanced perspective on gaming, discussing both its benefits and its risks.

Organizations

• International Society for Mental Health Online (ISMHO): ISMHO offers resources and support for individuals dealing with internet-related disorders, including gaming disorder. The organization provides information on the latest research and treatment approaches, as well as online support communities.
• Video Game Addiction Help (VGAH): VGAH is dedicated to providing information, resources, and support for individuals struggling with video game addiction. The organization offers online forums, educational materials, and links to treatment providers specializing in gaming disorder.
• On-Line Gamers Anonymous (OLGA): OLGA is a self-help fellowship that provides support for individuals who are recovering from gaming addiction. The organization offers online meetings, forums, and resources to help individuals regain control of their lives and reduce their gaming time.
• National Institute on Media and the Family (NIMF): NIMF focuses on the impact of media, including video games, on children and families. The organization offers resources for parents and educators to help manage gaming habits and prevent the development of gaming disorder in young people.
• Center for Internet Addiction: Founded by Dr. Kimberly Young, a pioneer in the field of internet addiction, this center provides resources, assessment tools, and treatment options for individuals struggling with gaming disorder and other internet-related addictions.