Video game addiction gets in the way of normal life. As such, symptoms of video game addiction include signs of changes in everyday life habits. Recognising these signs is important so that people may seek expert help either for themselves or others to treat the addiction.
Introduction
It is estimated that video gaming addiction affects about 3.1% of the population.1 Also known as gaming disorder, it is considered an addiction, and its main trait is not having control over gaming in a way that it becomes a priority over other tasks, eventually impacting personal and social aspects of life.2,3
The consequences of game addiction can be severe. Addicted gamers neglect taking care of themselves, be it their hygiene or biological needs like eating and sleeping. Furthermore, video game addiction often leads to social isolation.
Video game addiction does not only affect the addicted person but may also have an impact on their family. In the worst cases of video game addiction, it has led to parents fatally or near-fatally neglecting their children due to this addiction.3 As such, it is necessary to be able to recognise video game addiction symptoms to seek proper treatment.
Risk factors
According to demographic data, males are more likely to exhibit video game addiction behaviour than females. This behaviour might be associated with personal interests that favour addiction to games. In regards to age, video game addiction is highest in those between 10-19 years of age.4
Personal traits, such as low self-esteem and shyness, are considered to be risk factors for developing video game addiction. Stress and social-environmental factors may also play a role in video game addiction.5
Symptoms
Time spent in gaming
An evident symptom of gaming addiction is time spent engaged in gaming.3 The time spent gaming to be considered an addiction can vary but is defined as being excessive. However, excessive would be different in each case, depending on the amount of free time each person has. That said, time spent in gaming by itself might be an indication of addiction, but it is no absolute proof.
Neglect of important tasks
Excessive time spent playing video games usually comes with the addicted person making gaming a priority in their everyday life. Prioritisation of gaming above other important tasks often results in neglect of these tasks. For example, neglecting the need for eating or frequent bathing due to spending more time gaming.6
Everything else seems boring
It is not only mundane tasks that might be set aside in favour of gaming. Video game addiction can take over enjoyable activities as well. Real-life activities, such as other hobbies that the addicted person used to enjoy, may not be as interesting to them anymore.6
Withdrawal from friends and family
Prioritisation of gaming and giving up on other enjoyable activities, oftentimes group activities, is a step towards social isolation. Game addicts might also prefer playing games rather than meeting friends or spending time with their family.3 This may gradually lead to impaired relationships and, in time, social isolation. Moreover, there is a possible link between video game addiction and the ability to recognise facial expressions of emotion, a characteristic that also affects social interactions.7
Lying
Those with a video game addiction will try to hide how much time they spend playing games. They will usually take measures, including lying, to make sure their circle of family and friends do not become aware of how much they are preoccupied with gaming.3
Escapism
Either from the start or at some later point, playing games serves as an outlet from the real world.3,6 The world of games may feel like a refuge from real-life problems, and so the need to hide from them fuels the addictive behaviour.
Disturbed sleep
Studies have linked poor sleep quality with video gaming addiction.8,9 Interestingly, sleep disturbances may be caused not only by video gaming but by a more general addiction to the Internet.8,10
Skin conditions
Video gaming addiction has been linked to several health conditions. These conditions may concern the eyes (e.g. as an aftereffect of the abovementioned sleep disturbances), may be caused by a direct effect on the skin (e.g. burns caused by the heat emanating from devices, allergies or screen dermatitis), or may be associated with specific actions and movements while gaming. An example of the latter is called “PlayStation Lip” and is caused by actions such as biting on the lower lip while playing games.11 There are also the added effects of poor hygiene, as a result of video game addiction, that also can affect the skin.
Aggression
When confronted with evidence, those with video game addiction may become aggressive. When faced with evidence of their preference for playing games over performing other activities, those addicted may even become aggressive to defend their case and continue their current addictive behaviour.3
Continued gaming despite hardships caused by it
Even when all of the symptoms above are severe, and real-life consequences have taken hold, such as losing friends, dropping out of school, or losing their jobs, they might continue to play games without cutting down on the time spent on it.3
Diagnosis
For a person to be diagnosed with a gaming disorder, there needs to be an evident impairment in their functions on everyday life tasks, as mentioned in the symptoms. In addition, proper diagnosis requires symptoms to be clear for at least a year.2
Brain imaging studies also aim to shed light on brain changes that might take place in cases of video game addiction. It appears that the changes in the brain as a result of video game addiction might be similar to those associated with drug addiction. Dopamine release, which is associated with reward mechanisms, is also linked to video game addiction similar to that in drug addiction.13REF Hopefully, further research towards the understanding of the brain and how it is affected by video game addiction will aid the development of proper diagnostic tools and effective treatment methods.
Treatment
Three lines of therapies may be approached according to each case: Cognitive Behavior Therapy (CBT), Programa Individualizado Psicoterapéutico para la Adicción a las Tecnologías de la Información y la Comunicación (PIPATIC) and treatment using medication.3
CBT
CBT refers to a method of psychotherapy that is widely used to treat various mental conditions. CBT is the result of two psychotherapy approaches: Behavioral Therapy (BT) and Cognition Therapy (CT).12 CBT involves the assessment of three aspects: thoughts, emotions, and behaviour. The person under therapy would have to work on the answers to three questions: what do you think, how do you feel, and what were the consequences of previous behaviours on the matter? This approach does not involve medication or any other invasive methods.12,13
CBT approach is usually followed in cases of video game addiction. A meta-analysis of previous findings supports the short-term efficacy of CBT on internet game addiction treatment.18REF However, the overall long-term impact of CBT on game addiction remains to be fully understood. The effect of CBT on anxiety and depression of people with video game addiction may, in turn, help with specific symptoms, such as social withdrawal. All in all, CBT seems to be an effective method to treat at least part of the symptoms associated with video gaming addiction.
PIPATIC
Another therapeutic approach includes the Programa Individualizado Psicoterapéutico para la Adicción a las Tecnologías de la Información y la Comunicación (PIPATIC), which translates to “Individualized psychotherapy program for addiction to information and communication technologies”. This program was designed to treat addictive behaviour related to technology, including online video games, in adolescents aged 12 to 18 years old. PIPATIC comprises six modules and includes 22 weekly sessions of 45 minutes over the space of six months. These modules work first to understand any causes that led to video game addiction before helping overcome addictive behaviours. The following modules help improve personal traits such as self motivation and ability to avoid distractions as well as working on relationships and communication between friends and family.5
Medication
Those with video game addiction may be treated with medication if they are found to have other conditions that can affect their addiction, such as a mental health diagnosis. Medications used to treat depression or ADHD have been found to have a positive effect on internet game addiction treatment.3
Summary
Video game addiction symptoms greatly impact everyday life. People with video game addiction may neglect their own biological needs, their family members and their needs, other life tasks, either enjoyable or not, as well as their social interactions with friends. At some point, symptoms usually become evident to people close to the addicted person. For someone to be diagnosed with video game addiction, symptoms would need to be evident for at least one year. Treatment with CBT or PIPATIC methods usually follows. In the case of video game addiction being found with another disorder, such as depression or ADHD, medication may also be given to help with addiction treatment as well.
References
- Ferguson CJ, Coulson M, Barnett J. A meta-analysis of pathological gaming prevalence and comorbidity with mental health, academic and social problems. Journal of Psychiatric Research [Internet]. 2011 Dec [cited 2024 Feb 4];45(12):1573–8. Available from: https://www.researchgate.net/publication/51650110_A_meta-analysis_of_pathological_gaming_prevalence_and_comorbidity_with_mental_health_academic_and_social_problems
- Addictive behaviours: Gaming disorder [Internet]. [cited 2024 Feb 4]. Available from: https://www.who.int/news-room/questions-and-answers/item/addictive-behaviours-gaming-disorder
- Mohammad S, Jan RA, Alsaedi SL. Symptoms, mechanisms, and treatments of video game addiction. Cureus [Internet]. [cited 2024 Feb 4];15(3):e36957. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10065366/
- Király O, Koncz P, Griffiths MD, Demetrovics Z. Gaming disorder: A summary of its characteristics and aetiology. Comprehensive Psychiatry [Internet]. 2023 Apr 1 [cited 2024 Feb 4];122:152376. Available from: https://www.sciencedirect.com/science/article/pii/S0010440X23000135
- Torres-Rodríguez A, Griffiths MD, Carbonell X. The treatment of internet gaming disorder: a brief overview of the pipatic program. Int J Ment Health Addict [Internet]. 2018 [cited 2024 Feb 4];16(4):1000–15. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6096606/
- Deleuze J, Maurage P, Schimmenti A, Nuyens F, Melzer A, Billieux J. Escaping reality through videogames is linked to an implicit preference for virtual over real-life stimuli. J Affect Disord [Internet]. 2019 Feb 15;245:1024–31. Available from: https://dial.uclouvain.be/pr/boreal/object/boreal%3A221803/datastream/PDF_01/view
- Hurel E, Grall-Bronnec M, Bouillard O, Chirio-Espitalier M, Barrangou-Poueys-Darlas M, Challet-Bouju G. Systematic review of gaming and neuropsychological assessment of social cognition. Neuropsychol Rev [Internet]. 2023 Sep 5 [cited 2024 Feb 4]; Available from: https://doi.org/10.1007/s11065-023-09599-y
- Wong HY, Mo HY, Potenza MN, Chan MNM, Lau WM, Chui TK, et al. Relationships between severity of internet gaming disorder, severity of problematic social media use, sleep quality and psychological distress. Int J Environ Res Public Health [Internet]. 2020 Mar [cited 2024 Feb 4];17(6):1879. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7143464/
- Zaman M, Babar MS, Babar M, Sabir F, Ashraf F, Tahir MJ, et al. Prevalence of gaming addiction and its impact on sleep quality: A cross-sectional study from Pakistan. Ann Med Surg (Lond) [Internet]. 2022 Apr 20 [cited 2024 Feb 4];78:103641. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9206897/
- Lam LT. Internet gaming addiction, problematic use of the internet, and sleep problems: a systematic review. Curr Psychiatry Rep [Internet]. 2014 Apr;16(4):444. Available from: https://opus.lib.uts.edu.au/bitstream/10453/116252/4/Internet%20Gaming%20Addiction%20and%20sleep%20problems-accepted%20manuscript.pdf
- Kyriakou G, Glentis A. Skin in the game: Video-game–related cutaneous pathologies in adolescents. Int J Pediatr Adolesc Med [Internet]. 2021 Jun [cited 2024 Feb 4];8(2):68–75. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8144863/
- Cognitive behavioral therapy. In: InformedHealth.org [Internet] [Internet]. Institute for Quality and Efficiency in Health Care (IQWiG); 2016 [cited 2024 Feb 4]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK279297/
- KART A, ÖZDEL K, TÜRKÇAPAR MH. Cognitive behavioral therapy in treatment of schizophrenia. Noro Psikiyatr Ars [Internet]. 2021 Sep 20 [cited 2024 Feb 4];58(Suppl 1):S61–5. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8498814/