Elsevier

Journal of Affective Disorders

Volume 225, 1 January 2018, Pages 265-272
Journal of Affective Disorders

Research paper
Video game addiction in emerging adulthood: Cross-sectional evidence of pathology in video game addicts as compared to matched healthy controls

https://doi.org/10.1016/j.jad.2017.08.045Get rights and content

Highlights

  • Measures of socio-emotional, mental, and physical health were given.

  • Addicts displayed poorer overall health.

  • Addicts were more likely to report internet pornography problematic use.

Abstract

Background

The Internet Gaming Disorder Scale (IGDS) is a widely used measure of video game addiction, a pathology affecting a small percentage of all people who play video games. Emerging adult males are significantly more likely to be video game addicts. Few researchers have examined how people who qualify as video game addicts based on the IGDS compared to matched controls based on age, gender, race, and marital status.

Method

The current study compared IGDS video game addicts to matched non-addicts in terms of their mental, physical, social-emotional health using self-report, survey methods.

Results

Addicts had poorer mental health and cognitive functioning including poorer impulse control and ADHD symptoms compared to controls. Additionally, addicts displayed increased emotional difficulties including increased depression and anxiety, felt more socially isolated, and were more likely to display internet pornography pathological use symptoms. Female video game addicts were at unique risk for negative outcomes.

Limitations

The sample for this study was undergraduate college students and self-report measures were used.

Conclusions

Participants who met the IGDS criteria for video game addiction displayed poorer emotional, physical, mental, and social health, adding to the growing evidence that video game addictions are a valid phenomenon.

Introduction

Video games have become a normative part of Western culture. For most video game players, video games are a harmless way to relive stress, socialize with peers, and spend time. Parents of adolescents and young adults frequently joke that their kids are "addicted" to video games, but this is hyperbole for most youth. However, there is evidence that for some individuals, video game play can interfere with social functioning and well-being. There is no universal definition of addiction, but Orford (2001) defined addiction as "a combination of operant reward, usually in the form of some powerful emotional change, plus wide cue elicitation of conditioned responses that assists consumption in one way or the other, operating within diverse social contexts, between them constitute a powerful set of processes responsible for the amplification of a small and unremarkable liking into a strong and potentially troublesome attachment (p.22)." Hellman et al. (2013) further elaborate that a reward in this context can be anything that is pleasurable, and does not limit only to substances, but can include rewards like gambling and video games. Therefore, addiction need not be limited only to substances, but can include any external stimuli that creates a "strong and potentially troublesome attachment." Video game use becomes pathological when this strong attachment damages multiple levels of functioning such as family life, social functioning, school or work performance, or psychological functioning (Gentile et al., 2011).

A nationally representative sample of 8–18-year-old youth in the United States found that approximately 8% of video game players displayed pathological patterns of play (Gentile, 2009). In a nationally representative sample of 15–40-year-old participants in Norway approximately 4.6% of video game players displayed pathological patterns of play and .6% met the criteria for true video game addiction (Mentzoni et al., 2011), suggesting that video game addiction is a rare, but valid phenomenon affecting a small percentage of video game players. In fact, formal features of video games may increase the likelihood of developing addictive behaviors, similar to the formal features of slot machines increasing the likelihood of gambling addiction. Previous researchers have argued that video games are exceptional teachers because they increase in difficulty as players’ master game content and technique, present multiple ways of solving or mastering a problem, require repeated practice over multiple days, provide rewards for achievement, increase popularity by achieving success, and provide an adrenaline rush which excite learners (Gentile and Gentile, 2005). These exceptional “teachers” have narrative and identity features such as being able to create an avatar playing in the game that looks like the player or how the player wishes they looked and constant reward and punishment features such as experience points, loss of life, gaining health, repairing items, difficult "bosses" at the end of a level, instant rewards, and the ability to instant replay a level, which all lead to increased difficulty disengaging from video games (King et al., 2010). These formal features which make video games excellent teachers and difficult to disengage from also increase the likelihood of developing addictive behaviors and tendencies.

Young adult males have been shown to be at the greatest risk for video game addiction possibly due to the flexible work/study hours associated with the higher education typical during this age range, living outside of the home for the first time, and increased autonomy (King et al., 2012, Young, 1998). Time spent playing video games, poor social competence (Gentile et al., 2011), poor impulse control, increased sensation seeking, increased narcissistic personality traits (Griffiths et al., 2012), high state and trait anxiety (Mehroof and Griffiths, 2010) and previous truancy and few leisure activities (Rehbein et al., 2010) are all risk factors to developing video game addictions and in fact are risk factors to most addictive behaviors. In adolescents, being from a single parent home is a risk factor for developing a video game addiction (Rehbein and Baier, 2013), likely due to lack of monitoring and increased time spent playing video games. A series of studies by Dong et al., 2010, Dong et al., 2013 found executive functioning problems in response to a color word stroop task in video game addicts, further reflecting the importance of poor impulse control and behavioral inhibition in video game addiction.

Video game addiction has been associated with a variety of negative psychological and social outcomes including decreased life satisfaction, loneliness, social competence (Lemmens et al., 2009), poorer academic achievement, increased impulsivity (Gentile, 2009), increased aggression (Griffiths et al., 2012), and increased depression and anxiety (Mentzoni et al., 2011). It is important to note that time spent playing video games alone was not associated with these negative social, emotional, and psychological outcomes and that these negative outcomes are specifically related to video game addiction (Brunborg et al., 2014). Some research suggests that some of the negative consequences of pathological gaming can be negated if gamers are able to disconnect from the gaming world. For example, Gentile et al. (2011) found that depression, anxiety, and social phobias all improve when adolescents stop being a pathological gamer. Similarly, Cognitive Behavioral Therapy (CBT), a therapeutic approach that teaches people to recognize emotions and thought processes associated with addictions and learn coping skills to correct these cognitions, has been relatively effective at treating and preventing relapse of video game addictions (Griffiths and Meredith, 2009).

Though much research has examined the risks and outcomes of video game addiction, all of the previously mentioned studies failed to compare video game addicts to age and gender matched healthy controls and instead compare addicts to the general population. Comparing video game addicts to the general population fails to take into account subtle differences in mental, social, physical, and emotional health outcomes that vary by gender, ethnicity, age, and marital status. For example, racial-ethnic minority populations display significantly higher rates of obesity (Carroll et al., 2008, Paeratakul et al., 2002) and married people display lower rates of depression (Inaba et al., 2005). Thus, comparing a racial-ethnic minority or married video game addict to the general population may compound outcomes and falsely attribute differences in health outcomes to video game addiction. Similarly, the previous studies did not use measures of social and psychological functioning recommended by leading health organizations. This study seeks to further lend support to the potential validity of the IGDS as a measure of video game addiction by assessing the relationship between participants whose IGDS scores would qualify them as video game addicts and how this classification is associated with poorer emotional, social, mental, and physical health. Therefore, the goal of the present study is to compare video game addicts to healthy controls that are matched on age, race, gender, and marital status on measures of physical, social, mental, and emotional health recommended by the National Institute of Mental Health, the U.S. Department of Health and Human Services, and the World Health Organization. This study will also assess comorbidity between IGD video game addiction, substance use, and other online addictions. Previous researchers have shown high comorbidity between substance addiction and addictions to other substances (Dani and Harris, 2005), gambling addiction and tobacco use (McGrath and Barrett, 2009), and gambling addiction and substance use and abuse (Lorains et al., 2011), and the comorbidity between addiction and psychiatric disorders (Kessler et al., 2008; Stein et al., 2001). However, few researchers have examined video game addiction and potential comorbidity with substance use, gambling, and internet pornography use.

We hypothesize that IGD video game addicts will display poorer social, emotional, physical, and mental health than matched non-addicts. We also hypothesize that IGD video game addicts will display increased comorbidity between video game addiction and other addictive behaviors as compared to matched non-addicts.

Section snippets

Participants

1205 young adults (mean age = 20.32, SD age = 4.17; 48.85% male, 50.15% female, all participants reported their gender) who reported playing video games were recruited from two large universities in the United States, one in a large urban setting in the Midwest and one in the Mountain West. Of the 1205 young adults screened, 87 met the criteria for video game addiction (approximately 7%). The 87 video game addicts (mean age = 20.80, SD age = 2.18; 68% male, 15% female; 78.3% Non-Hispanic White,

Results

In order to compare IGD video game addicts to matched healthy controls in terms of physical, emotional, social, mental health, and comorbidity of substance use and internet addictions, and take into account potential gender differences and interactions, a series of 2 × 2MANOVAs were conducted in SPSS version 22. The means and standard deviations and the video game addiction main effects for the MANOVAs for each major variable are reported in Table 1 and Fig. 1. Gender interactions are only

Discussion

In line with previous research, approximately 7% of the young adults who played video games met the IGD criteria for video game addiction (Gentile, 2009), with males being more likely to be video game addicts than females (King et al., 2012, King et al., 2012, Young, 1998). In general, video game addicts reported poorer mental, physical, and emotional heath and being a female video game addict placed individuals at particular risk for certain negative outcomes. Video game addiction was also

Limitations

The current study employs self-report, cross-sectional data with undergraduate college students.

Acknowledgement

We would like to that the Loyola University Office of the Provost for funding this research.

References (56)

  • D. Cella et al.

    Neuro-QOL: brief measures of health related quality of life for clinical research in neurology

    Neurology

    (2012)
  • J.A. Dani et al.

    Nicotine addiction and comorbidity with alcohol abuse and mental illness

    Nat. Neurosci.

    (2005)
  • P.M. Diamond et al.

    The short-form Buss-Perry Aggression Questionnaire (BPAQ-SF): a validation study

    Assessment

    (2006)
  • K.E. Dill et al.

    Video game characters and the socialization of gender roles: young people's perceptions mirror sexist media depictions

    Sex Roles

    (2007)
  • G. Dong et al.

    Impaired error-monitoring function in people with internet addiction disorder: an event-related fMRI study

    Addict. Res.

    (2013)
  • M.S. Eastin

    Video game violence and the female game player: self-and opponent gender effects on presence and aggressive thoughts

    Hum. Commun. Res.

    (2006)
  • D. Gentile

    Pathological video-game use among youth ages 8 to 18: a national study

    Psychol. Sci.

    (2009)
  • D.A. Gentile et al.

    Pathological video game use among youths: a two-year longitudinal study

    Pediatrics

    (2011)
  • Gentile, D.A., Gentile, J.R., 2005. Violent Video Games And Exemplary...
  • M.D. Griffiths et al.

    Video game addiction: past, present, and future

    Curr. Psychiatry Rev.

    (2012)
  • M.D. Griffiths et al.

    Videogame addiction and its treatment

    J. Contemp. Psychother.

    (2009)
  • J.B. Grubbs et al.

    The cyber-pornography use inventory: the development of a new assessment instrument

    Sex. Addict. Compuls.

    (2010)
  • R.D. Hayes et al.

    Development of physical and mental health summary scores for the patient-report outcome measurement information system (PROMIS) global items

    Quality Life Res.

    (2009)
  • M. Hellman et al.

    Is there such a thing as online video game addiction? A cross-disciplinary review

    Addicti. Res. Theory

    (2013)
  • R.C. Kessler et al.

    The World Health Organization adult ADHD self-report scale (ASRS): a short screening scale for use in the general population

    Psychol. Med.

    (2004)
  • R.C. Kessler et al.

    Validity of the World Health Organization adult ADHD self-report scale (ASRS) screener in a representative sample of health plan members

    Int. J. Methods Psychiatr. Res.

    (2007)
  • R.C. Kessler et al.

    The prevalence and correlates of DSM-IV pathological gambling in the National Comorbidity Survey Replication

    Psychol. Med.

    (2008)
  • B.A. King et al.

    Current tobacco use among adults in the United States: findings from the National Adult Tobacco Survey

    Am. J. Public Health

    (2012)
  • Cited by (114)

    • The Role of Depression, Anxiety, and Stress in Problematic Smartphone Use among a Large Sample of Iranian Population

      2022, Journal of Affective Disorders Reports
      Citation Excerpt :

      Stress was most strongly related to PSU on bivariate and multivariate manners, consistent with the previous evidence suggesting that stress severity was associated with PSU, with small to medium effects (Elhai et al., 2017a; Vahedi and Saiphoo, 2018). It is well-established in the literature that stress increases vulnerability to technology overuse (Xu et al., 2019; Sinha, 2008) (e.g., online-game addiction (Snodgrass et al., 2014a), internet addiction (Dong et al., 2020)). Stressed individuals experience physiological and psychological distress, which may cause maladaptive coping strategies to alleviate tension and negative emotions (Sinha, 2008).

    View all citing articles on Scopus

    This research was funded by a LUROP fellowship awarded by the Loyola University Chicago Office of the Provost.

    View full text