Video game addiction: A parent’s evidence-based guide

Some kids spend long hours playing video games. Do they suffer from video game addiction? Not necessarily.

Kids might play video games with disturbingly violent themes. They might spend too much time on the couch, becoming more sedentary and socially reclusive. Kids might sometimes neglect their chores or homework, and they might fail to develop the ability to entertain themselves. But such problems don’t mean that a child suffers from an addiction.

What’s an addiction?

Originally, the term referred to a physiological dependence on a drug. Nowadays, people use “addiction” to describe all sorts of excessive behavior, like eating too much chocolate.

But while researchers avoid this usage, they recognize that some pastimes, like gambling, can become pathological and resemble true addiction.

And some kids who play video games meet the clinical criteria for an “addiction” in this sense.

Video games dominate their lives. Playing gives them a sense of euphoria, or at least a sense of relief from unpleasant feelings. Kids experience “withdrawal” if they are denied access to games. And gaming interferes with everyday life, including school and social relationships (Gentile 2009).

So pathological gaming is about more than how much time your child spends playing game. It’s about video games taking over his or her life.

How many kids are in this fix? To get an idea, let’s consider this screening tool developed by Douglas Gentile.

The Video Game Addiction Questionnaire

Gentile surveyed a random sample of 1178 American youth (aged 8 to 18), asking kids to answer each of the questions below with either a “Yes,” “No,” or “Sometimes.”

Kids were considered to be pathological gamers if they responded with a “Yes” or “Sometimes” to at least 6 of these 11 questions:

1. Over time, have you been spending much more time thinking about playing video games, learning about video-game playing, or planning the next opportunity to play?

2. Do you need to spend more and more time and/or money on video games in order to feel the same amount of excitement?

3. Have you tried to play video games less often or for shorter periods of time, but are unsuccessful?

4. Do you become restless or irritable when attempting to cut down or stop playing video games?

5. Have you played video games as a way of escaping from problems or bad feelings?

6. Have you ever lied to family or friends about how much time you play video games?

7. Have you ever stolen a video game from a store or a friend, or have you ever stolen money to buy a video game?

8. Do you sometimes skip household chores in order to spend more time playing video games?

9. Do you sometimes skip doing homework in order to spend more time playing video games?

10. Have you ever done poorly on a school assignment or test because you spent too much time playing video games?

11. Have you ever needed friends or family to give you extra money because you spent too much money on video game equipment, software, or game/Internet fees?

Gentile scored responses in multiple ways. When he lumped together “Yes” and “Sometimes” responses, about 20% of his sample met the criteria for a video game addiction.

When Gentile counted only “Yes” responses, about 8% of the kids qualified as pathological gamers (Gentile 2006).

Either way, that’s a lot of addiction, and the problem seemed to affect kids across a wide range of background. In Gentile’s study, pathological video game use was unrelated to cultural variables, like race or the type of school attended.

Moreover, Gentile notes that pathological gaming has been reported all  around the world.

In Spain, for instance, the rate of game addiction has been estimated at around 10% (Tejeiro Salguero and Bersabe Moran 2002). Video game addiction is also a major concern for some researchers in East Asia (e.g., Sun et al 2008). And in Singapore, the prevalence of pathological gaming may be around 9%(Gentile et al 2011).

But despite their varied backgrounds, game addicts have certain things in common. In Gentile’s study, pathological gamers spent about twice as much time playing games (24 hours per week). They were more likely to have game systems in their bedrooms. And they also reported

• more trouble paying attention in school

• poorer grades, and

• more health problems

In a Singapore study, researchers found that kids who met clinical criteria for a video game addiction performed worse at school (Skoric et al 2009). Interestingly, this study found no correlation between time spent playing games and school performance.

It was the symptoms of addiction that predicted poor school work, not playing per se.

What does it all mean?

As noted above, you don’t have to suffer from a video game addiction to have a problem. So what’s important about identifying pathological game habits?

I haven’t found any scientific research on the subject, but clinicians advise that pathological gaming should be taken more seriously. It isn’t “just a phase” that will get better on its own.

Your child might benefit from the same treatment therapies that work for pathological gamblers or substance abusers–therapies like cognitive behavioral counseling, peer support groups, and “12 step” programs (which seem helpful insofar as they motivate kids to stay on track—e.g., Kelly et al 2000).

Some thoughts about “flow”

It also seems wise to be vigilant about gaming experiences that might overwhelm a child’s sense of self-control. People can become completely immersed in video games, losing awareness of the passage of time, of their real lives outside the game (e.g., Rao et al 2006).

Psychologists call this experience flow, and it’s not a unique characteristic of video games. Plenty of other activities—including highly productive ones, like sculpting or composing music—can also create a sense of flow.

But some video games seem to have a peculiarly powerful effect, and I wonder how realistic it is to expect kids to keep their gaming habits in check.

Do the studies cited here overestimate rates of video game addiction? Let’s assume they do. We’re still left with evidence that some kids—by their own admission—are letting video games displace other aspects of their lives.

In addition to monitoring our children’s habits—and setting limits—we might also think seriously about ways to cope with the allure of video game flow.

Some studies suggest that the most “addictive” video games are the fantasy role-playing games, especially for kids who are shy or unpopular (Lee et al 2007). So perhaps concerned parents should try to steer susceptible kids away from such games, and towards less overwhelming options, like electronic board games, puzzles, sports games, or simulation games.

And maybe parents can offer kids other, more productive or developmentally stimulating ways to enjoy a sense of flow. Kids can lose themselves in the exploration of local wildlife or the construction of a model bridge. But do they?

It’s interesting to consider that while video games have become more popular, other opportunities for unstructured play have been shrinking. I’m not suggesting that video games are responsible. But perhaps the availability of video games has facilitated a major change in our lifestyles.

I remember when kids used to spend most of their free time outdoors, playing without the direct supervision of adults. Today, this is considered too dangerous, and for kids who live in high-crime neighborhoods, the danger may be real. In a study of American fourth graders, researchers found that gaming addiction rates were higher among kids who perceived their environments as less safe (Pentz et al 2011).

Are video games taking up the slack? Perhaps electronic games would exert less power over our kids if kids had more to do.

More information

For more information, I highly recommend Douglas Gentile’s public web page about video game addiction, violence in the media, and related topics.

In addition, see this collection of evidence-based articles about the effects of video games — good and bad.

References: Video game addiction

Gentile D. 2009. Pathological video-game use among youth ages 8 to 18: a national study. Psychol Sci. 20(5):594-602.

Gentile DA, Choo H, Liau A, Sim T, Li D, Fung D, and Khoo A. 2011. Pathological video game use among youths: a two-year longitudinal study. Pediatrics. 127(2):e319-29.

Kelly JF, Myers MG, and Brown SA. 2000. A multivariate process model of adolescent 12-step attendance and substance use outcome following inpatient treatment. Psychology of Addictive Behaviors. 14(4):376-389.

Lee MS, Ko YH, Song HS, Kwon KH, Lee HS, Nam M, and Jung IK. 2007. Characteristics of Internet use in relation to game genre in Korean adolescents. Cyberpsychol Behav. (2):278-85.

Pentz MA, Spruijt-Metz D, Chou CP, and Riggs NR. 2011. High calorie, low nutrient food/beverage intake and video gaming in children as potential signals for addictive behavior. Int J Environ Res Public Health. 8(12):4406-24.

Rau PL, Peng SY, and Yang CC. 2006. Time distortion for expert and novice online game players. Cyberpsychol Behav. 9(4):396-403.

Skoric MM, Teo LL, and Neo RL. 2009. Children and video games: addiction, engagement, and scholastic achievement. Cyberpsychol Behav. 12(5):567-72.

Sun DL, Ma N, Bao M, Chen XC, and Zhang DR. 2008.Computer games: a double-edged sword? Cyberpsychol Behav. 11(5):545-8.

Tejeiro Salguero RA and Bersabe Morán RM. 2002. Measuring problem video game playing in adolescents. Addiction 97(12): 1601-1606.

Content of “Video game addiction” last modified 3/13

image of boy gamer ©iStockphoto.com/Darren Hendley