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VIDEOGAME ADDICTION

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Vika M

on 26 October 2014

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Transcript of VIDEOGAME ADDICTION

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BACKGROUND
DSM does not officially recognize any disorder that is characterized by an addiction to video games
However they have described “internet gaming disorder” as a condition that needs to be further explored and studied
Should gaming addiction be recognized by the DSM-5 as a behavioral addiction disorder?
GAMING?
What comes to mind when we think of
There's...
...gamers...
Retrieved from http://callofgamers.moonfruit.com/communities/6/004/009/645/556/images/4556575022.jpg
There's...
...games like this...
There's...
...even games like this...
Retrieved from https://lh5.ggpht.com/OcXIK6XHiGhsymYSf3W0Em8wsYSRk-YYy7v-i1JkuRxeYSxXY9T3x_LpHeS7A_uSVQ=h900
Retrieved from http://www.versusbattle.com/wp-content/uploads/2013/03/Final_Fantasy_7.jpg
There's...
...definitely games like this...
Retrieved from http://img4.wikia.nocookie.net/__cb20100105162447/wowwiki/images/d/d6/Magazine1CoverArtwork.jpg
Retrieved from http://beta.images.theglobeandmail.com/static/templates/interactives/gameSlider/gamer-profile2.jpg
In Canada...
SO, why gaming Addiction?
A Case study...
DIagnosing gaming addiction
Five or more of the proposed symptoms for at least a 12-month period:

Preoccupation with Internet games

Obsessive thinking about previous gaming
Anticipation of playing next game
Dominant activity in daily life
loss of time and neglect of basic drives
Withdrawal symptoms when games are taken away
Irritability
Anxiety
Sadness
Tolerance
The need to spend increasing amounts of time gaming
Trying to get better computer hardware, better software, better in-game equipment
5 hours per day, 25 hours per week
Unsuccessful attempts to control gaming behavior
Inability to stop or cut down gaming behavior
Loss of interests in previous hobbies and entertainment
Entertainment not including gaming
Not necessarily true in the context were gaming is part of the culture
Deception of family members and others about gaming activity

Again, not necessarily true in cultures like that of South Korea
Feelings of helpless­ness
Guilt
Anxiety
Continued excessive use of Internet games despite knowledge of psychosocial problems

Use of Internet games to escape or relieve a negative mood
Has jeopardized or lost a significant relationship, job, or educational or career opportunity because of participation in Internet games

1. Preoccupation with Internet games
2. Tolerance
3. Loss of interests in previous hobbies
4. Use of Internet games to escape or relieve a dysphoria
5. Has jeopardized or lost a significant relationship
6. Withdrawal symptoms
7. Unsuccessful attempts to control gaming behavior
8. Continued excessive use despite knowledge of psychosocial problems
9. Deception of family members and others about gaming activity
Back to the case study...
Understanding mechanisms
Neural correlates
Videogames, just like stimulant substances, can increase DA pathway activation
Nucleus accumbens (NAcc)
Orbitofrontal Cortex (OFC)
Anterior Cingulate Cortex (ACC)
Ventral Tegmental Area (VTA)

Experience of flow
Characteristics
Altered perception of time
A feeling of control
Loss of self-consciousness
Helpful conditions to enter flow
Intrinsic motivation
Immediate feedback
Match between complexity of challenges and skills
Why is flow important?
“The flow experience itself is so enjoyable that people will do it even at great cost, for the sheer sake of doing it”
cognitive mechanism...
cognitive mechanism...
Chou & Ting (2003)
Effects of behavioral repetition and flow upon addiction?
Repetition alone not sufficient to cause an addiction!
Addictive behavior formed when repetitive behavior triggers flow

Wu, Scott, & Yang (2013)
Relationship b/w experience of flow and addiction tendencies?
Flow positively correlated with degree of specialization
Addiction tendencies positively correlated with degree of specialization
cue reactivity
Treating gaming addiction...
How do we treat Yoo-Chul and Mi-Sun?
Videogame addiction is thought to be a sign of some underlying problem
Treatment has two components:
Treating the addiction itself
Diagnose and treat the underlying problem.
Impediments to treatment
Taking away the escape – demigods in video games gives a sense of control
Lose their social network – on line gaming
Important elements in treatment:
Finding another activity that will provide escape
Allowing the gamer to accomplish goals
Filling the free time that abstinence creates

Approaching treatment...
Yoo-CHUL and MI-SUN are undergoing wilderness therapy where they are detoxifying. They attend group and individual therapy weekly.
DETOXIFICATION:

may need to be in rehab
DETox
Remove CONtact
Examine underlying psychological issues
develop treatment plan
Medication?
Cognitive-behavioral therapy (CBT)
Learn and practice new skills e.g. coping, self-esteem, socializing
Group therapy
Identifying faulty thoughts
Thoughts and feeling that affect behavior

Learning mindfulness and acceptance
available treatments?
So, why gaming addiction?
...because it has become a real problem...
Retrieved from http://www.telegraph.co.uk/news/worldnews/asia/southkorea/7376178/Korean-couple-let-baby-starve-to-death-while-caring-for-virtual-child.html
This is Yoo-chul and his pregnant wife, Mi-sun.
Both are successful software developers with a Respected south korean company.
One day, both of them were laid off.
they had always enjoyed playing online games together, so They played for hours to make themselves feel betTer.
One day, the baby came, but they did not stop gaming.
When the baby came, she was so demanding. THey escaped by gaming with friends at internet cafes. malnourished, the baby died.
So, what went wrong with Yoo-Chul and Mi-Sun?
Overview
1. Diagnosing Gaming Addiction
2. Sociocultural Influences
3. Risk Factors and Comorbidities
4. Cognitive Mechanisms & Neural Correlates
5. Sociocultural Influences
6. Treatment Options
Norway:
860 people, 15-40
56.3% are gamers
4.1% problematic gaming
.6% addicted to gaming
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Ontario:
2832 people, 12 - 19
18.3% play daily
9.4% problematic gaming
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South Korea:
1332 students, ages 12-18
25% problematic gaming
2.5% addicted
Germany
44,610, 14 year-olds
3% males addicted
.3% females addicted
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(Mentzoni et al., 2011)
(Nigel et al., 2010)
(Rehbein, Kleinmann & Moessle, 2010)
(Seok & Dacosta, 2012)
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SOCIOCULTURAL INFLUENCES
Variation in prevalence across cultures
Escaping reality to join virtual community
At any point in time, playing with 8.12 other players
Eastern cultures: presence of internet cafes
Gaming is part of the culture (e.g., South Korea)
Some proposed DSM criteria is not problematic
Western cultures: more solitary gaming at home
MMORPGs are more popular than other types of solitary games
Games or extension reality into the virtual realm?
What were the underlying neural mechanisms causing Yoo-Chul and Mi-Sun to become addicted to gaming?
Current Policies and Future Directions
RISK FACTORS AND COMORBIDITIES
Risk factors:
Personality? No consistent personality types have been associated
Narcissistic personality traits, low self-control and aggression
Depressive disorders
Attention-deficit/hyperactivity disorder (ADHD)
Obsessive-compulsive disorder (OCD)
Comorbidities
Since health may be neglected, there may be medical problems (e.g., obesity or malnutrition)

What about pharmacotherapy?
REFERENCES
Gaming Addiction
by Victoria Marshe, Alex Yun, Gayatri Singhania, Pamela Kwizera, IIlyana Boykov Chelsea Chen
1. Mentzoni, R. A., Brunborg, G. S., Molde, H., Myrseth, H., Skouverøe, K. J. M., Hetland, J., & Pallesen, S. (2011). Problematic video
game use: Estimated prevalence and associations with mental and physical health.
Cyberpsychology, Behavior, and Social Networking
, 14(10), 591-596.
2. Turner, N. E., Paglia-Boak, A., Ballon, B., Cheung, J. T. W., Adlaf, E. M., Henderson, J., . . . Mann, R. E. (2012). Prevalence of
problematic video gaming among ontario adolescents.
International Journal of Mental Health and Addiction
, 10(6), 877-889.
3. Rehbein, F., Psych, G., Kleimann, M., Mediasci, G., & Mößle, T. (2010). Prevalence and risk factors of video game dependency in
adolescence: Results of a german nationwide survey.
Cyberpsychology, Behavior, and Social Networking
, 13(3), 269-277.
4. Seok, S., & Dacosta, B. (2012). The world's most intense online gaming culture: Addiction and high-engagement prevalence rates
among south korean adolescents and young adults. Computers in Human Behavior, 28(6), 2143-2151.
5. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American
Psychiatric Publishing.
6. Block, J. J. (2008). Issues for DSM-V: Internet addiction.
American Journal of Psychiatry
, 165(3), 306-307.
7. Chappell, D., Eatough, V., Davies, M. N. O., & Griffiths, M. (2006). EverQuest - it's just a computer game right? an interpretative
phenomenological analysis of online gaming addiction.
International Journal of Mental Health and Addiction
, 4(3), 205-216.
8. Kim, E. J., Namkoong, K., Ku, T., & Kim, S. J. (2008). The relationship between online game addiction and aggression, self-control
and narcissistic personality traits.
European Psychiatry
, 23(3), 212-218.
9. Csikszentmihalyi, M. (1975).
Beyond boredom and anxiety
. San Francisco, CA: Jossey-Bass
10. Csikszentmihalyi, M. (1990).
Flow: The psychology of optimal experience
. New York, NY: Harper Collins.
11. Chou, T. J., & Ting, C. C. (2003). The role of flow experience in cyber-game addiction.
CyberPsycholoy & Behavior
, 6(6), 663-675.
12. Wu, T. C., Scott, D., & Yang, C. C. (2013). Advanced or addicted? Exploring the relationship of recreation specialization to flow
experiences and online game addiction.
Leisure Sciences
, 35(3), 203-217.
13. Chase, H.; Eickhoff, S.B.; Laird, A.R.; Hogarth,L. (2011). The neural basis of drug stimulus processing and craving: an activation
likelihood estimation meta-analysis.
Biological Psychiatry
, 70: 785-793
14. Kuss, D.J. & Griffiths,M.D. (2012). Internet and gaming addiction: a systematic literature review of neuroimaging studies. Brain
Sciences,
2: 347-374.
15. Lorenz, R.C. Et al. (2012). Cue reactivity and its inhibition in pathological computer game players.
Addiction Biology
,18:
134-146.
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Internet Gaming Addiction
Stimulant Drugs
These regions are activated when viewing images of drugs or internet gaming
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After a 6-week treatment:
Those on bupropion showed less craving for internet video games, less total game time and less cue-induced brain activity in DLPFC

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