Internet Gaming Disorder

Theory, Assessment, Treatment, and Prevention

Daniel King, Paul Delfabbro

• Publisher: Academic Press
• Year: 2018
• ISBN:
  9780128129258
• Topic: Psychology
• Subtopic: Addiction in Psychology
• Index: Psychology

Internet Gaming Disorder: Theory, Assessment, Treatment, and Prevention is an informative and practical introduction to the topics of Internet gaming disorder and problematic gaming. This book provides mental health clinicians with hands-on assessment, prevention, and treatment techniques for clients with problematic gaming behaviors and Internet gaming disorder. It provides an overview of the existing research on epidemiology, risk and protective factors, and discusses the distinct cognitive features that distinguish gaming from gambling and other related activities and disorders. Clinicians will find interest in discussion of the latest developments in cognitive-behavioral approaches to gaming disorder as well as the best structure for clinical interviews. Included in clinical sections are details of the key indicators of harm and impairment associated with problem gaming and how these might present in clinical cases. Internet Gaming Disorder is strongly evidence-based, draws extensively upon the latest international research literature, and provides insights into the likely future developments in this emerging field both in terms of technological development and new research approaches.

• Discusses the conceptual basis of Internet gaming disorder as a behavioral addiction
• Provides screening approaches for measuring excessive gaming
• Details a structured clinical interview approach for assessing gaming disorder
• Provides evidence-based clinical strategies for prevention and treatment
• Covers cognitive behavioral therapy and harm reduction strategies

1

An introduction to gaming and IGD

Abstract

This chapter introduces the topic of video games as well as what has been termed Internet gaming disorder (IGD). Gaming is a rapidly growing and socially significant digital leisure activity, with many millions of regular players worldwide. This chapter will describe some of the important types and characteristics of video games, including discussion of recent innovations in gaming products and technologies that have transformed gaming into a time-consuming and potentially addictive activity. We will then highlight some of the research approaches to the study of IGD as well as current knowledge of the prevalence of gaming-related problems. This information provides a foundation for subsequent, more detailed discussions of IGD in relation to our current theoretical understanding of the phenomenon; how it is assessed; the most suitable service interventions; and examples of how clinical cases might present in practice contexts.

Keywords

Internet gaming disorder; Digital media; Gaming; Online; Technology; Prevalence; Monetization

Chapter Outline

• Introduction and overview
• What are video games?
• What are mmos and mobas?
• Other popular game types
• Recent gaming innovations
  • Games as a “service”
  • Monetization schemes
  • eSports and streaming
  • Virtual reality
  • Augmented reality
  • Social media and smartphone integration
  • Portability
• Research methodologies for IGD
• Prevalence of problem gaming and IGD
• Why does IGD matter?
• Addressing the skill gap in IGD care
• Aim and coverage of this book
• Summary: the procession of simulacra
• References

Introduction and overview

Games can influence people’s lives. Throughout recorded history, the playing of games has been considered an essential and normal activity across the life-span. Through games, children learn to explore, to rehearse cognitive capacities, to release tension, and to bond with parents or affiliate with peers. Games can provide conditions that allow people to practice skills or act out roles of who they might want to be in real life. Moreover, the specific types of games that people choose to play can influence their personal development. For example, memory games can develop cognitive skills, social games can develop cooperation and communication skills, and adventure games can help people to confront their fears. People play what they like and get better at what they like by playing. Indeed, such is the psychological, social, and cultural importance of play that the lack of an ability to engage in play has often been seen as an early indicator of developmental disorders or delays or impairments later in life.

Although games in general are seen to be beneficial activities, the massive popularity of digital gaming over the last few decades, particularly online social games, has given rise to a new kind of concern: people who play too much. Researchers and clinicians are increasingly recognizing that some people play video games to such an extent that it interferes with their family life, work, education, sleep, hobbies, and social relationships. For these individuals, gaming is no longer a beneficial activity, but one that causes harm. Such players do not play freely or for enjoyment. They are unable to stop or control their gaming behavior.

Studies of problematic gaming behavior have led to our current understanding of some gaming-related problems as a new type of addiction—more specifically, a “behavioral addiction.” For some, an addiction to an activity rather than a type of substance may sound unconventional, if not questionable. However, as we will indicate in the chapters that follow, the available evidence shows that some vulnerable individuals are susceptible—due to factors including psychological predisposition, stress, risky environments, and the availability of gaming opportunities—to developing a habitual and self-destructive pattern of gaming. This behavior is characterized by many of the same features as disorders including gambling disorder and substance use disorder.

Individuals who engage in extremely problematic gaming behaviors, specifically those with an inability to self-regulate their gaming, are thought to have Internet gaming disorder (IGD). This classification is still new and not yet fully accepted in all nomenclatures. The Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5), recognizes IGD as a disorder that may be included sometime in the future as a legitimate disorder, but one that for now still requires “further study.” As a related development, the upcoming International Classification of Diseases, 11th revision (ICD-11), is expected to include “Gaming Disorder”—this will mark the first time that gaming disorder is recognized as a diagnostic classification.

This chapter will begin with an introduction to video gaming products and technologies and will highlight the scope and global popularity of gaming. Recent innovations in gaming activities will then be discussed with reference to the potential implications for problem gaming and IGD. We will then highlight some of the common research approaches to the study of IGD and current understanding of the prevalence of gaming-related problems. This information is intended to “set the scene” for later chapters that will delve into the theoretical and practical issues associated with the empirical study and health response to IGD and related issues.

What are video games?

Many millions of people regularly play video games. For those unfamiliar with gaming, it may be helpful to know some of the basics about games, including the diversity of types and the types of experiences they can offer. Being acquainted with specific types of online games (e.g., massively multiplayer online [MMO] games) may be particularly useful for work with clients with IGD, because it may help, for example, in guiding screening questions and in making sense of client’s behaviors. However, one does not need to be a game “expert,” because it is the client’s understanding and experience that really matters in formulating relevant issues.

The term “video game” refers broadly to an interactive form of digital entertainment (Esposito, 2005). A game is designed by its developer to be played by a player. Typically, the player must use the game’s control scheme (e.g., keyboard, controller, or motion sensors) to manipulate images on a visual display (e.g., computer monitor, television, or smartphone) to reach an outcome usually defined as success or failure (Bartle, 2004; Salen & Zimmerman, 2004). Broadly, the player may win or advance, or lose.

This technical definition does not, however, really capture the psychological experience of gaming, particularly in the case of modern gaming. Many modern games offer unlimited experiences of winning and losing, as well as complex narratives and characters, large open worlds to explore, and opportunities to socialize with other players (King, Delfabbro, & Griffiths, 2010). Games enable players to alter their state of mind, experience different emotions, satisfy psychological needs, or simply pass time and escape reality (Ryan, Rigby, & Przybylski, 2006). Games may provide an alternative place to socialize outside of work and play (Steinkuehler & Williams, 2006) or offer some people an alternative existence to the real world (Castronova, 2008).

Games and gaming experiences are highly varied. They can differ according to genre (e.g., shooting, role-playing, and strategy), platforms (e.g., personal computer, smartphone), modes (e.g., single-player, competing against other players), online connectivity (i.e., playing online or offline), and objectives (e.g., defeating an opponent using violence, persuasion, or stealth tactics). Players will often develop a preference for certain types of experiences, just as gamblers have preferences for a specific gambling activity. The term “gamer” should, therefore, be considered only as a loose term to connote a person with a stable interest in gaming. Gamers are a large heterogeneous population, and therefore, problematic gamers vary greatly too.

Gaming may be considered a “leisure” activity. However, some games appear to share much in common with a job or may blur the boundaries between work and play. Individuals dedicated to a game may play on a daily “9 to 5” basis and refer to their gaming activities as a kind of tedious obligation (Yee, 2006a). They may say they are working on a game rather than playing. We have interviewed individuals who have referred to gaming as like a second job, albeit one without any financial return to the player (King & Delfabbro, 2009).

Another important dimension to gaming is the player’s attachment to virtual items, actions, and identities (King & Delfabbro, 2014). The virtual becomes “real enough.” Many people care about and remember what they did in games (Molesworth & Watkins, 2016). In this way, gaming is part of a broader societal trend toward valuing virtual goods and services. Just as people value “likes,” “clicks,” and “swipes” on social media, some gamers value and keep records of their progression and status in games. Gaming is not always simply disposable; it can matter greatly to some people as a supplementary record of their life.

The above characteristics of games form part of the explanation of why they can become problematic—even addictive—for some people. Their interactivity grants the user a sense of mastery and achievement. Their rewards provide a sense of excitement or emotional release. Their immersion helps the user to forget about problems and escape from distressing situations. Their endlessness enables any amount of time to be consumed by games. Their work-like structure gives the user a sens...