Blog Archives

Working while lurking: A brief look at participant observation in online forums

In offline situations, many social science researchers have employed ethnographic methods as a means of understanding and describing different culture and behaviours. However, ethnographic methods can also be used online for studying various types of excessive behaviour. For instance, I argued in a 2010 paper in the International Journal of Mental Health and Addiction that by being online, gaming researchers have the capacity to become a part of the phenomenon that is being studied. Recently, I along with a number of my research colleagues at Nottingham Trent University, published a paper in Studia Psychologia that online forums are providing a new and innovative methodology for data collection in the social sciences.

cyberpsychology

For those who don’t know, ethnography focuses on accounting for the actions and intentions of the studied social agents, and outlining how such behaviour is rationalized and understood by the wider group. Traditionally derived from anthropology, ethnography aims at studying people and their behaviours and cultures within their socio-cultural contexts. Behaviours and communications are engulfed with meaning by being situated within the field site. What is needed on behalf of the researcher is what Dr. Clifford Geertz described as the production of a “thick description” of what takes place in these field sites to discern the latter’s contextualized meaning.

When it comes to virtual (i.e., online) ethnography, it is important to notice that while in-person ethnography is constrained by the laws of the physical world where the researcher needs to interact with the participants, online ethnography or as Dr. Robert Kozinets calls it in his 2010 book about online ethnography – “netnography” – can be done in a more unobtrusive way without the need to interact with the participants. Lurking is a possibility that Dr. Kozinets describes as opening a “window into naturally occurring behaviour” without the interference of the researcher.

Virtual ethnography takes the idea of participant observation a step further by challenging the notion of a geographically bound and relatively stagnant field site by replacing it with the virtual sphere that has no set boundaries. In this respect, virtual ethnography is what Dr. Christine Hine says “ethnography in, of and through the virtual”. The Internet is used as place, topic and means of research. It is an important qualitative online methodology and has been used in a variety of different research endeavours, including the studies of people’s explorations of multi-layered identities on the Internet, different levels of online experience, and playing Massively Multiplayer Online Role-Playing Games such as Everquest.

There are a number of principles that underlie virtual ethnography. Ethnographers must immerse themselves in the (virtual) field site in order to gain an in depth insight into why and how interactions take place and what they mean within the context of the respective virtual sphere. However, the relationship of the latter’s agents to their real (embodied) lives cannot be disregarded. The online space is a space ‘in between’ that is connected to the world outside of the Internet. Therefore, virtual ethnography is but a partial study and cannot deliver a full account of what it sets out to study. It can never be a holistic approach. Nevertheless, this is aided by the researchers who must be reflexive about what they experience, and about the method they use. The involvement of the researcher and the researcher’s interpretation of the actions and communications that occur within the virtual field site are integral to this type of research. In addition to this, the technology of the Internet itself is essential because it provides the tools for, the objects and the context of analysis.

Given the wide variety of advantages of and important insights virtual ethnography can offer for the researcher, potential disadvantages also need to be taken into consideration. The researchers’ active participation in the field site offers them the possibility of in-depth insights that would not be possible without their involvement. However, at the same time, they might lose their critical distance towards the object of their study. Sacrificing some critical distance therefore is a trade-off for in the collection of invaluable and profound data. As Dr. Christine Hine notes, these data are necessarily biased by the researchers’ experience and perception of online interactions in the respective realm that, due to their immersion, is knowledgeable and familiar.

Dr. Adrian Parke and I applied online ethnography to the study of poker skill development within online poker forums, and published our findings in a 2011 issue of the International Journal of Cyber Behavior, Psychology and Learning. Our study was a virtual ethnographical research design looking at how poker gamblers utilized computer-mediated communication (CMC) to develop their poker skill and profitability, and to examine the factors associated with problem gambling. The study was a six-month participant observational analysis of two independent online poker forums. Dr. Parke participated in poker gambling during the entire study period and used strategies proposed from forum members to develop poker ability. This approach provided an insider’s perspective into how skill development through CMC affects poker gambling behaviour.

We generated forum discussions regarding specific behavioural concepts and cognitive processes based on accumulative analysis of emergent data from the online poker players. Forum interaction was observed, monitored and analyzed through traditional content analytic methods. Membership and participation in such online community forums provided poker players the opportunity to benefit from the consequences of reporting gambling experience and acquiring both poker gambling structural knowledge and skill.

One of the key advantages of data collection via online forums is that it can provide a detailed record of events that can be revisited after the event itself has finished. Furthermore, screen captures can be taken and used as examples or related back to the data collected – something that has been used in the gaming studies field (and outlined in a 2007 paper I published with Dr. Richard Wood in the International Journal of Mental Health and Addiction). Study findings can be posted on bulletin boards and participants have the opportunity to comment on their accuracy or comment on any other observations that they may have. This also helps to empower the participant and can prevent misrepresentation.

Given the increase in the number of hours we now spend online every day, carrying out research online is going to become an ever more popular (and useful).

Dr Mark Griffiths, Professor of Gambling Studies, International Gaming Research Unit, Nottingham Trent University, Nottingham, UK

Further reading

Geertz, C. (1973). The interpretation of cultures: Selected essays. London: Fontana Press. 

Griffiths, M.D. (2010). The use of online methodologies in data collection for gambling and gaming addictions. International Journal of Mental Health and Addiction, 8, 8-20.

Griffiths, M.D., Lewis, A., Ortiz de Gortari, A.B. & Kuss, D.J. (2016). Online forums and blogs: A new and innovative methodology for data collection. Studia Psychologica, in press.

Hine, C. (Ed.). (2005). Virtual methods. Issues in social research on the Internet. Oxford, UK: Berg.

Hine, C. (2000). Virtual ethnography. London: Sage.

Kozinets, R.V. (2010). Netnography. Doing ethnographic Research Online. Sage: London.

Parke, A., & Griffiths, M.D. (2011). Poker gambling virtual communities: The use of Computer-Mediated Communication to develop cognitive poker gambling skills. International Journal of Cyber Behavior, Psychology and Learning, 1(2), 31-44.

Wood, R.T.A. & Griffiths, M.D. (2007). Online data collection from gamblers: Methodological issues. International Journal of Mental Health and Addiction, 5, 151-163.

Wood, R.T.A., Griffiths, M.D. & Eatough, V. (2004). Online data collection from videogame players: Methodological issues. CyberPsychology and Behavior, 7, 511-518.

Game over-view: A brief overview of our recent papers on gaming addiction

Following my recent blogs where I outlined some of the papers that my colleagues and I have published on mindfulness and Internet addiction, here is a round-up of recent papers that my colleagues and I have published on gaming addiction.

Pontes, H. & Griffiths, M.D. (2015). Measuring DSM-5 Internet Gaming Disorder: Development and validation of a short psychometric scale. Computers in Human Behavior, 45, 137-143.

  • Despite the large growth on gaming behaviour research, little has been done to overcome the problem stemming from the heterogeneity of gaming addiction nomenclature and the use of non-standardised measurement tools. Following the recent inclusion of Internet Gaming Disorder [IGD] as a condition worthy of future studies in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders [DSM-5], researchers have now an opportunity to reach consensus and unification in the field. The aim of this study was to develop a new nine-item short-form scale to assess Internet Gaming Disorder (IGDS-SF9) and to further explore its psychometric properties. A sample of 1060 gamers (85.1% males, mean age 27 years) recruited via online gaming forums participated. Exploratory factor analysis [EFA], confirmatory factor analysis [CFA], analyses of the criterion-related and concurrent validity, reliability, standard error of measurement [SEM], population cross-validity, and floor and ceiling effects were performed to assess the instrument’s psychometric properties. The results from the EFA revealed a single-factor structure for IGD that was also confirmed by the CFA. The nine items of the IGDS-SF9 are valid, reliable, and proved to be highly suitable for measuring IGD. It is envisaged that the IGDS-SF9 will help facilitate unified research in the field.

Benrazavi, S.R., Teimouri, M. & Griffiths, M.D. (2015). Utility of parental mediation model on youth’s problematic online gaming. International Journal of Mental Health and Addiction, 13, 712-727.

  • The Parental Mediation Model (PMM) was initially designed to regulate children’s attitudes towards the traditional media. In the present era, because of prevalent online media there is a need for similar regulative measures. Spending long hours on social media and playing online games increase the risks of exposure to the negative outcomes of online gaming. This paper initially applied the PMM developed by European Kids Online to (i) test the reliability and validity of this model and (ii) identify the effectiveness of this model in controlling problematic online gaming (POG). The data were collected from 592 participants comprising 296 parents and 296 students of four foreign universities, aged 16 to 22 years in Kuala Lumpur (Malaysia). The study found that the modified model of the five-factor PMM (Technical mediation, Monitoring mediation, Restrictive mediation, Active Mediation of Internet Safety, and Active mediation of Internet Use) functions as a predictor for mitigating POG. The findings suggest the existence of a positive relation between ‘monitoring’ and ‘restrictive’ mediation strategies and exposure to POG while Active Mediation of Internet Safety and Active mediation of Internet use were insignificant predictors. Results showed a higher utility of ‘technical’ strategies by the parents led to less POG. The findings of this study do not support the literature suggesting active mediation is more effective for reducing youth’s risky behaviour. Instead, parents need to apply more technical mediations with their children and adolescents’ Internet use to minimize the negative effects of online gaming.

Hussain, Z., Williams, G. & Griffiths, M.D. (2015). An exploratory study of the association between online gaming addiction and enjoyment motivations for playing massively multiplayer online role-playing games. Computers in Human Behavior, 50, 221–230.

  • Massively multiplayer online role-playing games (MMORPGs) are a popular form of entertainment used by millions of gamers worldwide. Potential problems relating to MMORPG play have emerged, particularly in relation to being addicted to playing in such virtual environments. In the present study, factors relating to online gaming addiction and motivations for playing in MMORPGs were examined to establish whether they were associated with addiction. A sample comprised 1167 gamers who were surveyed about their gaming motivations. Latent Class Analysis revealed seven classes of motivations for playing MMORPGs, which comprised: (1) novelty; (2) highly social and discovery-orientated; (3) aggressive, anti-social and non-curious; (4) highly social, competitive; (5) low intensity enjoyment; (6) discovery-orientated; and (7) social classes. Five classes of gaming addiction-related experiences were extracted including: (1) high risk of addiction, (2) time-affected, (3) intermediate risk of addiction, (4) emotional control, and (5) low risk of addiction classes. Gender was a significant predictor of intermediate risk of addiction and emotional control class membership. Membership of the high risk of addiction class was significantly predicted by belonging to a highly social and competitive class, a novelty class, or an aggressive, anti-social, and non-curious class. Implications of these findings for assessment and treatment of MMORPG addiction are discussed.

Király, O., Griffiths, M.D. & Demetrovics Z. (2015). Internet gaming disorder and the DSM-5: Conceptualization, debates, and controversiesCurrent Addiction Reports, 2, 254–262.

  • Scientific interest in behavioral addictions (such as Internet gaming disorder [IGD]) has risen considerably over the last two decades. Moreover, the inclusion of IGD in Section 3 of DSM-5 will most likely stimulate such research even more. Although the inclusion of IGD appears to have been well received by most of the researchers and clinicians in the field, there are several controversies and concerns surrounding its inclusion. The present paper aims to discuss the most important of these issues: (i) the possible effects of accepting IGD as an addiction; (ii) the most important critiques regarding certain IGD criteria (i.e., preoccupation, tolerance, withdrawal, deception, and escape); and (iii) the controversies surrounding the name and content of IGD. In addition to these controversies, the paper also provides a brief overview of the recent findings in the assessment and prevalence of IGD, the etiology of the disorder, and the most important treatment methods.

Király, O., Urbán, R., Griffiths, M.D., Ágoston, C., Nagygyörgy, K., Kökönyei, G. & Demetrovics, Z. (2015). Psychiatric symptoms and problematic online gaming: The mediating effect of gaming motivation. Journal of Medical Internet Research, 17(4) :e88.

  • Background: The rapid expansion of online video gaming as a leisure time activity has led to the appearance of problematic online gaming (POG). According to the literature, POG is associated with different psychiatric symptoms (eg, depression, anxiety) and with specific gaming motives (ie, escape, achievement). Based on studies of alcohol use that suggest a mediator role of drinking motives between distal influences (e.g., trauma symptoms) and drinking problems, this study examined the assumption that there is an indirect link between psychiatric distress and POG via the mediation of gaming motives. Furthermore, it was also assumed that there was a moderator effect of gender and game type preference based on the important role gender plays in POG and the structural differences between different game types. Objective: This study had two aims. The first aim was to test the mediating role of online gaming motives between psychiatric symptoms and problematic use of online games. The second aim was to test the moderator effect of gender and game type preference in this mediation model. Methods: An online survey was conducted on a sample of online gamers (N=3186; age: mean 21.1, SD 5.9 years; male: 2859/3186, 89.74%). The Brief Symptom Inventory (BSI), the Motives for Online Gaming Questionnaire (MOGQ), and the Problematic Online Gaming Questionnaire (POGQ) were administered to assess general psychiatric distress, online gaming motives, and problematic online game use, respectively. Structural regression analyses within structural equation modeling were used to test the proposed mediation models and multigroup analyses were used to test gender and game type differences to determine possible moderating effects. Results: The mediation models fitted the data adequately. The Global Severity Index (GSI) of the BSI indicated that the level of psychiatric distress had a significant positive direct effect (standardized effect=.35, P<.001) and a significant indirect (mediating) effect on POG (standardized effect=.194, P<.001) via 2 gaming motives: escape (standardized effect=.139, P<.001) and competition (standardized effect=.046, P<.001). The comparison of the 2 main gamer types showed no significant differences in the model. However, when comparing male and female players it was found that women had (1) slightly higher escape scores (on a 5-point Likert scale: mean 2.28, SD 1.14) than men (mean 1.87, SD 0.97) and (2) a stronger association between the escape motive and problematic online gaming (standardized effect size=.64, P<.001) than men (standardized effect size=.20, P=.001). Conclusions: The results suggest that psychiatric distress is both directly and indirectly (via escape and competition motives) negatively associated with POG. Therefore, the exploration of psychiatric symptoms and gaming motives of POG can be helpful in the preparation of prevention and treatment programs.

Fuster, H., Carbonell, X., Pontes, H.M. & Griffiths, M.D. (2016). Spanish validation of the Internet Gaming Disorder-20 (IGD-20) Test. Computers in Human Behavior, 56, 215-224.

  • In recent years, problematic and addictive gaming has been a phenomenon of growing concern worldwide. In light of the increasing awareness about this issue, the latest (fifth) edition of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-5) included Internet Gaming Disorder (IGD) as an area in need of more empirical research. The Internet Gaming Disorder Test (IGD-20 Test) was developed as a valid and reliable tool to assess IGD. The aim of the present study was to validate the Spanish version of the IGD-20 Test, and analyze the different profiles found among a sample of 1074 Spanish-speaking gamers. A confirmatory factor analysis showed the validity of the Spanish version of the IGD-20 Test and its six factor structure (i.e., salience, mood modification, tolerance, withdrawal, conflict and relapse). The latent profile analysis (LPA) showed five different gamer classes. The ‘disordered gamers’ class comprised 2.6% of the participants. Based on this class, sensitivity and specificity analyses showed an adequate empirical cut-off point of 75 (out of 100). It is concluded that the Spanish version of the IGD-20 Test is valid and reliable and can be used in research into IGD among Spanish speaking populations.

Griffiths, M.D., Van Rooij, A., Kardefelt-Winther, D., Starcevic, V., Király, O…Demetrovics, Z. (2016). Working towards an international consensus on criteria for assessing Internet Gaming Disorder: A critical commentary on Petry et al (2014). Addiction, 111, 167-175.

  • This commentary paper critically discusses the recent debate paper by Petry et al. (2014) that argued there was now an international consensus for assessing Internet Gaming Disorder (IGD). Our collective opinions vary considerably regarding many different aspects of online gaming. However, we contend that the paper by Petry and colleagues does not provide a true and representative international community of researchers in this area. This paper critically discusses and provides commentary on (i) the representativeness of the international group that wrote the ‘consensus’ paper, and (ii) each of the IGD criteria. The paper also includes a brief discussion on initiatives that could be taken to move the field towards consensus. It is hoped that this paper will foster debate in the IGD field and lead to improved theory, better methodologically designed studies, and more robust empirical evidence as regards problematic gaming and its psychosocial consequences and impact.

Kim, N.R., Hwang, S.S-H., Choi, J-S., Kim, D-J., Demetrovics, Z., Király, O., Nagygyörgy, K., Griffiths, M.D., Hyun, S.Y., Youn, H.C. & Sam-Wook Choi, S-W. (2016). Characteristics and psychiatric symptoms of Internet Gaming Disorder among adults using self-reported DSM-5 criteria. Psychiatry Investigation, 13(1), 58-66.

  • Objective: The Section III of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) proposed nine diagnostic criteria and five cut-point criteria for Internet Gaming Disorder (IGD). We aimed to examine the efficacy of such criteria. Methods: Adults (n=3041, men: 1824, women: 1217) who engaged in internet gaming within last 6 months completed a self-report online survey using the suggested wordings of the criteria in DSM-5. Major characteristics, gaming behavior, and psychiatric symptoms of IGD were analyzed using ANOVA, chi-square, and correlation analyses. Results: The sociodemographic variables were not statistically significant between the healthy controls and the risk group. Among the participants, 419 (13.8%) were identified and labeled as the IGD risk group. The IGD risk group scored significantly higher on all motivation subscales (p<0.001). The IGD risk group showed significantly higher scores than healthy controls in all nine psychiatric symptom dimensions, i.e., somatization, obsession-compulsion, interpersonal sensitivity, depression, anxiety, hostility, phobic anxiety, paranoid ideation, and psychoticism (p<0.001). Conclusion: The IGD risk group showed differential psychopathological manifestations according to DSM-5 IGD diagnostic criteria. Further studies are needed to evaluate the reliability and validity of the specific criteria, especially for developing screening instruments.

Dr. Mark Griffiths, Professor of Behavioural Addiction, International Gaming Research Unit, Nottingham Trent University, Nottingham, UK

Further reading

Beranuy, M., Carbonell, X., & Griffiths, M.D. (2013). A qualitative analysis of online gaming addicts in treatment. International Journal of Mental Health and Addiction, 11, 149-161.

Billieux, J., Deleuze, J., Griffiths, M.D., & Kuss, D.J. (2015). Internet addiction: The case of massively multiplayer online role playing games. In N. El-Guebaly, M. Galanter, & G. Carra (Eds.), The Textbook of Addiction Treatment: International Perspectives (pp.1516-1525). New York: Springer.

Griffiths, M.D., King, D.L. & Demetrovics, Z. (2014). DSM-5 Internet Gaming Disorder needs a unified approach to assessment. Neuropsychiatry, 4(1), 1-4.

Griffiths, M.D. & Pontes, H.M. (2014). Internet addiction disorder and internet gaming disorder are not the same. Journal of Addiction Research and Therapy, 5: e124. doi:10.4172/2155-6105.1000e124.

King, D.L., Delfabbro, P.H., Griffiths, M.D. (2013). Trajectories of problem video gaming among adult regular gamers: An 18-month longitudinal study. Cyberpsychology, Behavior and Social Networking, 16, 72-76.

King, D.L., Haagsma, M.C., Delfabbro, P.H., Gradisar, M.S., Griffiths, M.D. (2013). Toward a consensus definition of pathological video-gaming: A systematic review of psychometric assessment tools. Clinical Psychology Review, 33, 331-342.

Király, O., Griffiths, M.D., Urbán, R., Farkas, J., Kökönyei, G. Elekes, Z., Domokos Tamás, D. & Demetrovics, Z. (2014). Problematic internet use and problematic online gaming are not the same: Findings from a large nationally representative adolescent sample. Cyberpsychology, Behavior and Social Networking, 17, 749-754.

Lopez-Fernandez, O., Honrubia-Serrano, M.L., Baguley, T. & Griffiths, M.D. (2014). Pathological video game playing in Spanish and British adolescents: Towards the Internet Gaming Disorder symptomatology. Computers in Human Behavior, 41, 304–312.

Pontes, H. & Griffiths, M.D. (2014). The assessment of internet gaming disorder in clinical research. Clinical Research and Regulatory Affairs, 31(2-4), 35-48.

Pontes, H., Király, O. Demetrovics, Z. & Griffiths, M.D. (2014). The conceptualisation and measurement of DSM-5 Internet Gaming Disorder: The development of the IGD-20 Test. PLoS ONE, 9(10): e110137. doi:10.1371/journal.pone.0110137.

Spekman, M.L.C., Konijn, E.A, Roelofsma, P.H.M.P. & Griffiths, M.D. (2013). Gaming addiction, definition, and measurement: A large-scale empirical study, Computers in Human Behavior, 29, 2150-2155.

Playing the field: Another look at Internet Gaming Disorder

Research into online addictions has grown considerably over the last two decades and much of it has concentrated on problematic gaming, particularly MMORPGs (Massively Multiplayer Online Role-Playing Games). In the latest (fifth) edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5; American Psychiatric Association, 2013), Internet Gaming Disorder (IGD) (also commonly referred in the literature as problematic gaming and gaming addiction) was included in Section 3 (‘Emerging Measures and Models’) as a promising area that needed future research before being included in the main section of future editions of the DSM.

The DSM-5 proposed nine criteria for IGD (of which five or more need to be endorsed over the period of 12 months and result in clinically significant impairment to be diagnosed as experiencing IGD). More specifically the criteria include (1) preoccupation with games; (2) withdrawal symptoms when gaming is taken away; (3) the need to spend increasing amounts of time engaged in gaming, (4) unsuccessful attempts to control participation in gaming; (5) loss of interest in hobbies and entertainment as a result of, and with the exception of, gaming; (6) continued excessive use of games despite knowledge of psychosocial problems; (7) deception of family members, therapists, or others regarding the amount of gaming; (8) use of gaming to escape or relieve a negative mood;  and (9) loss of a significant relationship, job, or educational or career opportunity because of participation in games.

There is no agreement on the prevalence of IGD as the vast majority of studies have surveyed non-representative self-selected samples using over 20 different screening instruments. A review of problematic gaming prevalence studies that I published with Orsi Király, Halley Pontes, and Zsolt Demetrovics (in the 2015 book Mental Health in the Digital Age: Grave Dangers, Great Promise) reported a large variation in the prevalence rates (from 0.2% up to 34%). However, we noted that there were many factors that could have accounted for the wide variation in prevalence rates including the type of gaming examined (i.e., some studies just examined online gaming, whereas others examined console gaming or a mixture of both), sample size, participants’ age range, participant type (i.e., some surveyed the general population while others assessed gamers only), and instruments used to assess gaming.

There have been a handful of studies that have reported the prevalence of IGD using nationally representative samples. The prevalence rates reported were 8.5% of American youth aged 8–18 years, 1.2% of German adolescents aged 13-18 years, 5.5% among Dutch adolescents aged 13-20, and 5.4% among Dutch adults, 4.3% of Hungarian adolescents aged 15-16 years, 1.4% of Norwegian gamers, and 1.6% of European youth from seven countries aged 14-17 years.

There are now over 20 different screening instruments including a number of new ones specifically incorporating the IGD criteria (including a number that I have co-developed with Halley Pontes). The multiplicity of problematic gaming screens remains a key challenge in the field and partially reflects the lack of consensus in terms of the assessment of the phenomenon. A comprehensive 2013 review that I published with Daniel King and others in Clinical Psychology Review examined the criteria of 18 problematic gaming screens. The 18 screens had been utilized in 63 quantitative studies (N=58,415 participants). The main weaknesses identified were (i) inconsistency of core addiction indicators across studies, (ii) a general lack of any temporal dimension, (iii) inconsistent cutoff scores relating to clinical status, (iv) poor and/or inadequate inter-rater reliability and predictive validity, and (v) inconsistent and/or untested dimensionality. We also questioned the appropriateness of certain screens for certain settings, because those used in clinical practice may require a different emphasis than those used in epidemiological, experimental, or neurobiological research settings.

Research into IGD is needed from clinical, epidemiological, and neurobiological aspects of IGD. There has been an increasing number of neurobiological studies on IGD and a 2014 meta-analysis by Dr. Y. Meng and colleagues in Addiction Biology of 10 neuroimaging studies investigating the functional brain response to cognitive tasks from IGD using quantitative effect size signed differential mapping meta-analytic methods. found reliable clusters of abnormal activation in IGD within the regions comprising the bilateral medial frontal gyrus/cingulate gyrus, the left middle temporal gyrus and fusiform gyrus when compared to healthy controls. The same review also found that greater amounts of time spent per week playing was associated with hyper-activity in the left medial frontal gyrus and the right cingulate gyrus. Despite the useful findings reported, one of the major limitations of this meta-analysis was that 90% of the studies reviewed were conducted in Asian countries or regions, which might be problematic since prevalence rates of IGD in these populations are usually inflated compared to prevalence rates reported in Western countries. Furthermore, a systematic review of neuroimaging studies examining Internet addiction (IA) and IGD by Daria Kuss and myself in the journal Brain Sciences concluded that:

“These studies provide compelling evidence for the similarities between different types of addictions, notably substance-related addictions and Internet and gaming addiction, on a variety of levels. On the molecular level, Internet addiction is characterized by an overall reward deficiency that entails decreased dopaminergic activity. On the level of neural circuitry, Internet and gaming addiction lead to neuroadaptation and structural changes that occur as a consequence of prolonged increased activity in brain areas associated with addiction. On a behavioral level, Internet and gaming addicts appear to be constricted with regards to their cognitive functioning in various domains”

Over the last decade, a number of studies have investigated the association between IGD (and its derivatives) and various personality and comorbidity factors. Our recent review in the book Mental Health in the Digital Age: Grave Dangers, Great Promise summarized the research examining the relationship between personality traits and IGD. Empirical studies have shown IGD to be associated with (i) neuroticism, (ii) aggression and hostility, (iii) avoidant and schizoid tendencies, loneliness and introversion, (iv) social inhibition, (v) boredom inclination, (vi) sensation-seeking, (vii) diminished agreeableness, (viii) diminished self-control and narcissistic personality traits, (ix) low self-esteem, (x) state and trait anxiety, and (xi) low emotional intelligence. However, we noted that it was difficult to assess the aetiological significance of such associations because these personality factors are not unique to problematic gaming. Our review also reported that IGD had been associated with various comorbid disorders, including (i) attention deficit hyperactivity disorder, (ii) symptoms of generalized anxiety disorder, panic disorder, depression, and social phobia, and (iii) various psychosomatic symptoms.

According to a 2013 editorial in the journal Addiction, Nancy Petry and Charles O’Brien (2013), IGD will not be included as a separate mental disorder in future editions of the DSM until the (i) defining features of IGD have been identified, (ii) reliability and validity of specific IGD criteria have been obtained cross-culturally, (iii) prevalence rates have been determined in representative epidemiological samples across the world, and (iv) aetiology and associated biological features have been evaluated.

Dr. Mark Griffiths, Professor of Behavioural Addiction, International Gaming Research Unit, Nottingham Trent University, Nottingham, UK

Please note: Additional input from Daria Kuss and Halley Pontes

Further reading

Gentile, D. (2009). Pathological video-game use among youth ages 8–18: A national study. Psychological Science, 20(5), 594-602. doi: 10.1111/j.1467-9280.2009.02340.x

Griffiths, M.D., Van Rooij, A., Kardefelt-Winther, D., Starcevic, V., Király, O…Demetrovics, Z. (2016). Working towards an international consensus on criteria for assessing Internet Gaming Disorder: A critical commentary on Petry et al (2014). Addiction, 111, 167-175.

Griffiths, M. D., King, D. L., & Demetrovics, Z. (2014). DSM-5 Internet Gaming Disorder needs a unified approach to assessment. Neuropsychiatry, 4(1), 1-4. doi: 10.2217/npy.13.82

Griffiths, M. D., Király, O., Pontes, H. M., & Demetrovics, Z. (2015). An overview of problematic gaming. In E. Aboujaoude & V. Starcevic (Eds.), Mental Health in the Digital Age: Grave Dangers, Great Promise (pp. 27-45). Oxford: Oxford University Press. doi: 10.1093/med/9780199380183.003.0002

Griffiths, M. D., & Pontes, H. M. (2014). Internet Addiction Disorder and Internet Gaming Disorder are not the same. Journal of Addiction Research & Therapy, 5(4), e124. doi: 10.4172/2155-6105.1000e124

Griffiths, M. D., & Szabo, A. (2014). Is excessive online usage a function of medium or activity? An empirical pilot study. Journal of Behavioral Addictions, 3(1), 74-77. doi: 10.1556/JBA.2.2013.016

King, D. L., Haagsma, M. C., Delfabbro, P. H., Gradisar, M. S. & Griffiths, M. D. (2013). Toward a consensus definition of pathological video-gaming: A systematic review of psychometric assessment tools. Clinical Psychology Review, 33(3), 331-342. doi: 10.1016/j.cpr.2013.01.002

Király, O., Griffiths, M. D., & Demetrovics, Z. (2015). Internet Gaming Disorder and the DSM-5: Conceptualization, debates, and controversies. Current Addiction Reports, 2(3), 254-262. doi: 10.1007/s40429-015-0066-7

Király, O., Griffiths, M. D., Urbán, R., Farkas, J., Kökönyei, G., Elekes, Z., Tamás, D., & Demetrovics, Z. (2014). Problematic internet use and problematic online gaming are not the same: Findings from a large nationally representative adolescent sample. Cyberpsychology, Behavior, and Social Networking, 17(12), 749-754. doi: 10.1089/cyber.2014.0475

Király, O., Sleczka, P., Pontes, H. M., Urbán, R., Griffiths, M. D., & Demetrovics, Z. (2016). Validation of the ten-item Internet Gaming Disorder Test (IGDT-10) and evaluation of the nine DSM-5 Internet Gaming Disorder criteria. Addictive Behaviors. doi: 10.1016/j.addbeh.2015.11.005

Kuss, D. J., & Griffiths, M. D. (2015). Internet addiction in psychotherapy. London: Palgrave.

Kuss, D. J., & Griffiths, M. D. (2012). Internet and gaming addiction: A systematic literature review of neuroimaging studies. Brain Sciences, 2(3), 347-374. doi: 10.3390/brainsci2030347

Kuss, D. J., Griffiths, M. D., Karila, L., & Billieux, J. (2014). Internet addiction: A systematic review of epidemiological research for the last decade. Current Pharmaceutical Design, 20(25), 4026-4052. doi: 10.2174/13816128113199990617

Lemmens, J. S., Valkenburg, P. M., & Gentile, D.A. (2015). The Internet Gaming Disorder Scale. Psychological Assessment, 27(2), 567-582. doi: 10.1037/pas0000062

Meng, Y., Deng, W., Wang, H., Guo, W., & Li, T. (2014). The prefrontal dysfunction in individuals with Internet Gaming Disorder: A meta-analysis of functional magnetic resonance imaging studies. Addiction Biology, 20(4), 799-808. doi: 10.1111/adb.12154

Müller, K. W., Janikian, M., Dreier, M., Wölfling, K., Beutel, M. E., Tzavara, C., Richardson, C., & Tsitsika, A. (2015). Regular gaming behavior and internet gaming disorder in European adolescents: results from a cross-national representative survey of prevalence, predictors, and psychopathological correlates. European Child and Adolescent Psychiatry, 24(5), 565-574. doi: 10.1007/s00787-014-0611-2

Petry, N. M., & O’Brien, C. P. (2013). Internet gaming disorder and the DSM-5. Addiction 108(7), 1186–1187. doi: 10.1111/add.12162

Pontes, H. M., & Griffiths, M. D. (2015). New concepts, old known issues: The DSM-5 and Internet Gaming Disorder and its assessment. In J. Bishop (Ed.), Psychological and Social Implications Surrounding Internet and Gaming Addiction (pp. 16-30). Hershey, PA: Information Science Reference. doi: 10.4018/978-1-4666-8595-6.ch002

Pontes, H. & Griffiths, M.D. (2015). Measuring DSM-5 Internet Gaming Disorder: Development and validation of a short psychometric scale. Computers in Human Behavior, 45, 137-143. doi: 10.1016/j.chb.2014.12.006

Pontes, H. M., Szabo, A., & Griffiths, M. D. (2015). The impact of Internet-based specific activities on the perceptions of Internet Addiction, Quality of Life, and excessive usage: A cross-sectional study. Addictive Behaviors Reports, 1, 19-25. doi: 10.1016/j.abrep.2015.03.002

Pontes, H., Király, O. Demetrovics, Z., & Griffiths, M. D. (2014). The conceptualisation and measurement of DSM-5 Internet Gaming Disorder: The development of the IGD-20 Test. PLoS ONE, 9(10): e110137. doi:10.1371/journal.pone.0110137.

Pontes, H. M., Kuss, D. J., & Griffiths, M. D. (2015). Clinical psychology of Internet addiction: a review of its conceptualization, prevalence, neuronal processes, and implications for treatment. Neuroscience and Neuroeconomics, 4, 11-23. doi: 10.2147/NAN.S60982

Rehbein, F., Kliem, S., Baier, D., Mößle, T., & Petry, N. M. (2015). Prevalence of Internet Gaming Disorder in German adolescents: Diagnostic contribution of the nine DSM-5 criteria in a state-wide representative sample. Addiction, 110(5), 842–851. doi: 10.1111/add.12849

Thomas, N., & Martin, F. (2010). Video-arcade game, computer game and Internet activities of Australian students: Participation habits and prevalence of addiction. Australian Journal of Psychology. 62(2), 59-66. doi: 10.1080/00049530902748283

van Rooij, A. J., Schoenmakers, T. M., & van de Mheen, D. (2015). Clinical validation of the C-VAT 2.0 assessment tool for gaming disorder: A sensitivity analysis of the proposed DSM-5 criteria and the clinical characteristics of young patients with ‘video game addiction’. Addictive Behaviors. doi: 10.1016/j.addbeh.2015.10.018

Wittek, C. T., Finserås, T. R., Pallesen, S., Mentzoni, R. A., Hanss, D., Griffiths, M. D., & Molde, H. (2015). Prevalence and predictors of video game addiction: A study based on a national representative sample of gamers. International Journal of Mental Health and Addiction, 1-15. doi: 10.1007/s11469-015-9592-8

Young, K.S. (1999). Internet addiction: Symptoms, evaluation and treatment. Innovations in clinical practice: A source book, (Vol. 17; pp. 19-31). Sarasota, FL: Professional Resource Press.

Term warfare: Internet Gaming Disorder and Internet Addiction Disorder are not the same

Over the last 15 years, research into various online addictions has greatly increased. Alongside this, there have been scholarly debates about whether internet addiction really exists. Some may argue that because internet use does not involve the ingestion of a psychoactive substance, then it should not be considered a genuine addictive behaviour. However, the latest (fifth) edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) re-classified ‘Gambling Disorder’ as a behavioural addiction rather than as a disorder of impulse control. The implications of this reclassification are potentially far-reaching. The most significant implication is that if an activity that does not involve the consumption of drugs (i.e., gambling) can be a genuine addiction accepted by the psychiatric and medical community, there is no theoretical reason why other problematic and habitual behaviours (e.g., shopping, work, exercise, sex, video gaming, etc.) cannot be classed as a bone fide addiction.

There have also been debates among scholars that consider excessive problematic internet use to be a genuine addiction as to whether the those in the field should study generalized internet addiction (the totality of all online activities) and/or specific addictions on the internet such as internet gambling, internet gaming and internet sex. Since the late 1990s, I have constantly argued that there is a fundamental difference between addictions on the internet, and addictions to the internet. I argued that the overwhelming majority of individuals that were allegedly addicted to the internet were not internet addicts but were individuals that used the medium of the internet as a vehicle for other addictions. More specifically, I argued that internet gambling addicts and internet gaming addicts were not internet addicts but were gambling and gaming addicts using the convenience and ubiquity of the internet to gamble or play video games.

Prior to the publication of the latest DSM-5, there had also been debates as to whether ‘internet addiction’ should be introduced into the text as a separate disorder. Following these debates, the Substance Use Disorder Work Group (SUDWG) recommended that the DSM-5 include a sub-type of problematic internet use (i.e., internet gaming disorder [IGD]) in Section 3 (‘Emerging Measures and Models’) as an area that needed future research before being included in future editions of the DSM. However, far from clarifying the debates surrounding generalized versus specific internet use disorders, the section of the DSM-5 discussing IGD noted that:

“There are no well-researched subtypes for Internet gaming disorder to date. Internet gaming disorder most often involves specific Internet games, but it could involve non-Internet computerized games as well, although these have been less researched. It is likely that preferred games will vary over time as new games are developed and popularized, and it is unclear if behaviors and consequence associated with Internet gaming disorder vary by game type…Internet gaming disorder has significant public health importance, and additional research may eventually lead to evidence that Internet gaming disorder (also commonly referred to as Internet use disorder, Internet addiction, or gaming addiction) has merit as an independent disorder” (p.796).

In light of what has been already highlighted in previous research, two immediate problematic issues arise from these assertions. Firstly, IGD is clearly seen as synonymous with internet addiction as the text claims that internet addiction and internet use disorder are simply other names for IGD. Secondly – and somewhat confusingly – it is asserted that IGD (which is by definition internet-based) can also include offline gaming disorders.

With regards to the first assertion, internet addiction and online gaming addiction are not the same. A number of recent studies (including ones I’ve co-authored) clearly shows that to be the case. The second assertion that IGD can include offline video gaming is both baffling and confusing. Some researchers consider video games as the starting point for examining the characteristics of gaming disorder, while others consider the internet as the main platform that unites different addictive internet activities, including online games. For instance, I have argued that although all addictions have particular and idiosyncratic characteristics, they share more commonalities than differences (i.e., salience, mood modification, tolerance, withdrawal symptoms, conflict, and relapse), and likely reflects a common etiology of addictive behaviour. For me, IGD is clearly a sub-type of video game addiction. For people like Dr. Kimberley Young, ‘cyber-relationship addictions’, ‘cyber-sexual addictions’, ‘net compulsions’ (gambling, day trading) and ‘information overload’ are all internet addictions. However, many would argue that these – if they are addictions – are addictions on the internet, not to it. The internet is a medium and it is a situational characteristic. The fact that the medium might enhance addictiveness or problematic behaviour does not necessarily make it a sub-type of internet addiction.

However, recent studies have made an effort to integrate both approaches. For instance, some researchers claim that neither the first nor the second approach adequately captures the unique features of Massively Multiplayer Online Role-Playing Games (MMORPGs), and argue an integrated approach is a necessity. A common observation is that “Internet users are no more addicted to the Internet than alcoholics are addicted to bottles”. The internet is just a channel through which individuals may access whatever content they want (e.g., gambling, shopping, chatting, sex). On the other hand, online games differ from traditional standalone games, such as offline video games, in important aspects such as the social dimension or the role-playing dimension that allow interaction with other real players. Consequently, it could be argued that IGD can either be viewed as a specific type of video game addiction, or as a variant of internet addiction, or as an independent diagnosis. However, the idea that IGD can include offline gaming disorders does little for clarity or conceptualization.

Finally, it is also worth mentioning that there are some problematic online behaviours that could be called internet addictions as they can only take place online. The most obvious activity that fulfills this criterion is social networking as it is a ‘pure’ online activity and does not and cannot take place offline. Other activities such as gambling, gaming, and shopping can still be engaged in offline (as gamblers can go to a gambling venue, gamers can play a standalone console game, shoppers can go to a retail outlet). However, those engaged in social networking would not (if unable to access the internet) walk into a big room of people and start chatting to them all. However, even if social networking addiction is a genuine internet addiction, social networking itself is still a specific online application and could still be considered an addiction on the internet, rather than to it.

Based on recent empirical evidence, IGD (or any of the alternate names used to describe problematic gaming) is not the same as Internet Addiction Disorder. The gaming studies field needs conceptual clarity but as demonstrated, the DSM-5 itself is both misleading and misguided when it comes to the issue of IGD.

Dr Mark Griffiths, Professor of Gambling Studies, International Gaming Research Unit, Nottingham Trent University, Nottingham, UK

Further reading

Demetrovics, Z., Urbán, R., Nagygyörgy, K., Farkas, J., Griffiths, M. D., Pápay, O., . . . Oláh, A. (2012). The development of the Problematic Online Gaming Questionnaire (POGQ). PLoS ONE, 7(5), e36417.

Griffiths, M.D. (2000). Internet addiction – Time to be taken seriously? Addiction Research, 8, 413-418.

Griffiths, M. D. (2005). A ‘components’ model of addiction within a biopsychosocial framework. Journal of Substance Use, 10(4), 191-197.

Griffiths, M.D., King, D.L. & Demetrovics, Z. (2014). DSM-5 Internet Gaming Disorder needs a unified approach to assessment. Neuropsychiatry, under review.

Griffiths, M.D., Kuss, D.J. & King, D.L. (2012). Video game addiction: Past, present and future. Current Psychiatry Reviews, 8, 308-318.

Griffiths, M.D. & Pontes, H.M. (2014). Internet addiction disorder and internet gaming disorder are not the same. Journal of Addiction Research and Therapy, 5: e124. doi:10.4172/2155-6105.1000e124.

Kim, M. G., & Kim, J. (2010). Cross-validation of reliability, convergent and discriminant validity for the problematic online game use scale. Computers in Human Behavior, 26(3), 389-398.

King, D. L., Delfabbro, P. H., Griffiths, M. D., & Gradisar, M. (2011). Assessing clinical trials of Internet addiction treatment: A systematic review and CONSORT evaluation. Clinical Psychology Review, 31, 1110-1116.

King, D. L., Delfabbro, P. H., & Griffiths, M. D. (2012). Cognitive-behavioral approaches to outpatient treatment of Internet addiction in children and adolescents. Journal of Clinical Psychology, 68, 1185-1195.

King, D.L., Haagsma, M.C., Delfabbro, P.H., Gradisar, M.S., Griffiths, M.D. (2013). Toward a consensus definition of pathological video-gaming: A systematic review of psychometric assessment tools. Clinical Psychology Review, 33, 331-342.

Koronczai, B., Urban, R., Kokonyei, G., Paksi, B., Papp, K., Kun, B., . . . Demetrovics, Z. (2011). Confirmation of the three-factor model of problematic internet use on off-line adolescent and adult samples. Cyberpsychology, Behavior and Social Networking, 14, 657–664.

Kuss, D.J. & Griffiths, M.D. (2012). Internet and gaming addiction: A systematic literature review of neuroimaging studies. Brain Sciences, 2, 347-374.

Kuss, D.J., Griffiths, M.D., Karila, L. & Billieux, J. (2014).  Internet addiction: A systematic review of epidemiological research for the last decade. Current Pharmaceutical Design, 20, 4026-4052.

Pápay, O., Nagygyörgy, K., Griffiths, M.D. & Demetrovics, Z. (2014). Problematic online gaming. In K. Rosenberg & L. Feder (Eds.), Behavioral Addictions: Criteria, Evidence and Treatment. New York: Elsevier.

Petry, N.M., & O’Brien, C.P. (2013). Internet gaming disorder and the DSM-5. Addiction, 108, 1186–1187.

Pontes, H. & Griffiths, M.D. (2014). The assessment of internet gaming disorder in clinical research. Clinical Research and Regulatory Affairs, 31(2-4), 35-48.

Pontes, H. & Griffiths, M.D. (2015). Measuring DSM-5 Internet Gaming Disorder: Development and validation of a short psychometric scale. Computers in Human Behavior, 45, 137-143.

Pontes, H., Király, O. Demetrovics, Z. & Griffiths, M.D. (2014). The conceptualisation and measurement of DSM-5 Internet Gaming Disorder: The development of the IGD-20 Test. PLoS ONE, 9(10): e110137. doi:10.1371/journal.pone.0110137.

Pontes, H., Kuss, D. & Griffiths, M.D. (2015). The clinical psychology of Internet addiction: A review of its conceptualization, prevalence, neuronal processes, and implications for treatment. Neuroscience and Neuroeconomics, 4, 11-23.

Porter, G., Starcevic, V., Berle, D., & Fenech, P. (2010). Recognizing problem video game use. The Australian and New Zealand Journal of Psychiatry, 44, 120-128.

Young, K. S. (1998). Internet addiction: The emergence of a new clinical disorder. Cyberpsychology and Behavior, 1, 237-244.

Net losses: Another look at problematic online gaming

I have examined problematic and/or addictive video gaming in a number of my previous blogs. Despite the increasing amount of empirical research into problematic online gaming, the phenomenon still sadly lacks a consensual definition. Some researchers (including myself, and others such as John Charlton and Ian Danforth) consider video games as the starting point for examining the characteristics of this specific pathology, while other researchers consider the internet as the main platform that unites different addictive internet activities including online games (such as my friends and colleagues Tony Van Rooij and Kimberley Young). There are also recent studies that have made an effort to integrate both approaches (such as some work I carried out with Zsolt Demetrovics and his team of Hungarian researchers in the journal PLoS ONE).

I have noted in a number of my papers on addiction (particularly in a paper I had published in a 2005 issue of the Journal of Substance Use) that although each addiction has several particular and idiosyncratic characteristics, they have more commonalities than differences that may reflect a common etiology of addictive behaviour. Using the ‘components’ model of addiction, within a biopsychosocial framework, I consider online game addiction a specific type of video game addiction that can be categorized as a nonfinancial type of pathological gambling. I developed the components of video game addiction theory by modifying Iain Brown’s earlier addiction criteria. These are:

(1) Salience: This is when video gaming becomes the most important activity in the person’s life and dominates his/her thinking (i.e., preoccupations and cognitive distortions), feelings (i.e., cravings) and behaviour (i.e., deterioration of socialized behaviour);

(2) Mood modification: This is the subjective experience that people report as a consequence of engaging in video game play (i.e. they experience an arousing ‘buzz’ or a ‘high’ or, paradoxically, a tranquillizing and/or distressing feel of ‘escape’ or ‘numbing’).

(3) Tolerance: This is the process whereby increasing amounts of video game play are required to achieve the former effects, meaning that for persons engaged in video game playing, they gradually build up the amount of the time they spend online engaged in the behaviour.

(4) Withdrawal symptoms: These are the unpleasant feeling states or physical effects that occur when video gaming is discontinued or suddenly reduced, for example, the shakes, moodiness, irritability, etc.

(5) Conflict: This refers to the conflicts between the video game player and those around them (i.e., interpersonal conflict), conflicts with other activities (e.g., job, schoolwork, social life, hobbies and interests) or from within the individual themselves (i.e., intrapsychic conflict and/or subjective feelings of loss of control) which are concerned with spending too much time engaged in video game play.

(6) Relapse: This is the tendency for repeated reversions to earlier patterns of video game play to recur and for even the most extreme patterns typical at the height of excessive video game play to be quickly restored after periods of abstinence or control.

John Charlton and Ian Danforth analyzed these six criteria and found that tolerance, mood modification and cognitive salience were indicators of high engagement, while the other components – withdrawal symptoms, conflict, relapse and behavioural salience – played a central role in the development of addiction.

Researchers such as Guy Porter and Vladan Starcevic don’t differentiate between problematic video game use and problematic online game use. They conceptualized problematic video game use as excessive use of one or more video games resulting in a preoccupation with and a loss of control over playing video games, and various negative psychosocial and/or physical consequences. Their criteria for problematic video game use didn’t include other features usually associated with dependence or addiction, such as tolerance and physical symptoms of withdrawal, because in their opinion there is no clear evidence that problem video game use is associated with these phenomena.

Arguably the most well known representative of the internet-based approach is Kimberley Young who developed her theoretical framework for problematic online gaming based on her internet addiction criteria which were based on the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders – (Fourth Edition, DSM-IV) criteria for pathological gambling. Her theory states that online game addicts gradually lose control over their game play, that is, they are unable to decrease the amount of time spent playing while immersing themselves increasingly in this particular recreational activity, and eventually develop problems in their real life. The idea that internet/online video game addiction can be assessed by the combination of an internet addiction score and the amount of time spent gaming are also reflective of the internet-based approach.

Integrative approaches try to take into consideration both aforementioned approaches. For instance, a 2010 paper by M.G. Kim and J. Kim in Computers in Human Behavior claimed that neither the first nor the second approach can adequately capture the unique features of online games such as Massively Multiplayer Online Role-Playing Games (MMORPGs), therefore it’s absolutely necessary to create an integrated approach. They argued that “internet users are no more addicted to the internet than alcoholics are addicted to bottles” which means that the internet is just one channel through which people may access whatever content they want (e.g., gambling, shopping, chatting, sex, etc.) and therefore users of the internet may be addicted to the particular content or services that the Internet provides, rather than the channel itself. On the other hand, online games differ from traditional stand-alone games, such as offline video games, in important aspects such as the social dimension or the role-playing dimension that allow interaction with other real players.

Their multidimensional Problematic Online Game Use (POGU) model reflects this integrated approach fairly well. It was theoretically developed on the basis of several studies and theories (such as those by Iain Brown, John Charlton, Ian Danforth, Kimberley Young and myself), and resulted in five underlying dimensions: euphoria, health problems, conflict, failure of self-control, and preference of virtual relationship. A 2012 study I carried out with Zsolt Demetrovics and his team also support the integrative approach and stresses the need to include all types of online games in addiction models in order to make comparisons between genres and gamer populations possible (such as those who play online Real-Time Strategy (RTS) games and online First Person Shooter (FPS) games in addition to the widely researched MMORPG players). According to this model, six dimensions cover the phenomenon of problematic online gaming – preoccupation, overuse, immersion, social isolation, interpersonal conflicts, and withdrawal. Personally, I believe that online game addiction can be defined as one type of behavioural addiction. In fact ‘internet gaming disorder’ has just been included in the appendices of the new DSM-5 in order to encourage research to determine whether this particular condition should be added to the manual as a disorder in the future.

Dr Mark Griffiths, Professor of Gambling Studies, International Gaming Research Unit, Nottingham Trent University, Nottingham, UK

Additional input: Orsolya Pápay, Katalin Nagygyörgy and Zsolt Demetrovics

Further reading

Charlton, J. P., & Danforth, I.D.W. (2007). Distinguishing addiction and high engagement in the context of online game playing. Computers in Human Behavior, 23(3), 1531-1548.

Demetrovics, Z., Urbán, R., Nagygyörgy, K., Farkas, J., Griffiths, M.D., Pápay, O. & Oláh, A. (2012). The development of the Problematic Online Gaming Questionnaire (POGQ). PLoS ONE, 7(5): e36417. doi:10.1371/journal.pone.0036417.

Griffiths, M.D. (2005). A ‘components’ model of addiction within a biopsychosocial framework. Journal of Substance Use, 10, 191-197.

Han, D. H., Hwang, J. W., & Renshaw, P. F. (2010). Bupropion sustained release treatment decreases craving for video games and cue-induced brain activity in patients with Internet video game addiction. Experimental and Clinical Psychopharmacology, 18, 297-304.

Kim, M.G., & Kim, J. (2010). Cross-validation of reliability, convergent and discriminant validity for the problematic online game use scale. Computers in Human Behavior, 26(3), 389-398.

King, D.L., Haagsma, M.C., Delfabbro, P.H., Gradisar, M.S., Griffiths, M.D. (2013). Toward a consensus definition of pathological video-gaming: A systematic review of psychometric assessment tools. Clinical Psychology Review, 33, 331-342.

Peters, C. S., & Malesky, L. A. (2008). Problematic usage among highly-engaged players of massively multiplayer online role playing games. Cyberpsychology & Behavior, 11(4), 480-483.

Pontes, H. & Griffiths, M.D. (2014). The assessment of internet gaming disorder in clinical research. Clinical Research and Regulatory Affairs, 31(2-4), 35-48.

Pontes, H., Király, O. Demetrovics, Z. & Griffiths, M.D. (2014). The conceptualisation and measurement of DSM-5 Internet Gaming Disorder: The development of the IGD-20 Test. PLoS ONE, 9(10): e110137. doi:10.1371/journal.pone.0110137.

Pontes, H. & Griffiths, M.D. (2015). Measuring DSM-5 Internet Gaming Disorder: Development and validation of a short psychometric scale. Computers in Human Behavior, 45, 137-143.

Porter, G., Starcevic, V., Berle, D., & Fenech, P. (2010). Recognizing problem video game use. The Australian and New Zealand Journal of Psychiatry, 44, 120-128.

Van Rooij, A. J., Schoenmakers, T. M., Vermulst, A. A., Van den Eijnden, R. J., & Van de Mheen, D. (2011). Online video game addiction: identification of addicted adolescent gamers. Addiction, 106(1), 205-212.

Young, K. S. (1998a). Caught in the Net: How to recognize the signs of Internet addiction and a winning strategy for recovery. New York: Wiley.

Young, K. S. (1999). Internet addiction: Symptoms, evaluation, and treatment. In L. Vande Creek & T. Jackson (Eds.), Innovations in clinical practice: A source book (pp. 17, 19–31). Sarasota, FL: Professional Resource Press.