Video games, computers, and the Internet are regular parts of our daily lives. For
most people, computer and video game use is integrated into their lives in a balanced
and healthy manner. For others, time spent on the computer or video game is out of
balance, and causes disruptions to work, school, friends, and family.
But is this really an addiction?
Computer and Video Game “Addiction”
I began studying this issue in 1999 because I was highly skeptical of people using
the term "addiction" to talk about computer or game use. I felt that parents only
meant "My kid plays a lot, and I don't understand why." Spending a lot of time doing
something is not a proper way to diagnose an addiction. For example, many people
drink alcohol a lot but are not addicted to it.
To be an addiction means that addicts do something in such a way that it damages
their ability to function in life. It also means that they must damage their functioning
in multiple areas of their lives, not just one or two. They need to be damaging
their social functioning, their occupational functioning, their family functioning,
their school functioning, and/or their psychological or emotional functioning. Sadly,
even when we take this conservative approach to defining it, it turns out that 8.5%
of American youth gamers would classify as pathological or "addicted" (Gentile, 2009).
Interestingly, this percentage seems to be about the same in the US as in many other
countries where it has been studied, including 10.3% in China (Peng & Li, 2009),
8.0% in Australia (Porter, Starcevic, Berle, & Fenech, 2010), 11.9% in Germany (Grüsser,
Thalemann, & Griffiths, 2007), 8.7% in Singapore (Choo, Gentile, Sim, Li, Khoo, &
Liau, 2010), and 7.5% in Taiwan (Ko, Yen, Yen, Lin, & Yang, 2007).
Of those who were pathological gamers at the start of the study, 84% of them still
were pathological gamers 2 years later. This means that it isn’t just a phase children
go through and get out of easily.
When looking for risk factors predicting who would become a pathological gamer, we
found that children who were more impulsive, had lower social competence, and spent
more than the average amount of timing predicted who became pathological (or “addicted”
if you prefer).
When looking at outcomes, we were surprised to see that other psychiatric disorders
such as depression, social phobias, and anxiety seemed to act as if they followed
the gaming problems, rather than the other way around. That is, when children became
pathological gamers, their depression, social phobias, anxiety, and grades got worse.
When children stopped being pathological gamers, their depression, social phobias,
and anxiety improved. Now we don’t know exactly what the causal processes are, but
that probably isn’t the important issue. The important issue we can take away from
this pattern is that gaming doesn’t seem to be simply a symptom of other problems,
and therefore should not be ignored as if it is epiphenomenal. It is likely that
pathological gaming is comorbid with other problems, where they can each reinforce
each other in a downward spiral.
What are the warning signs?
There is (as of yet) no agreed-upon set of symptoms or risk factors, because the
research has not yet identified them clearly. I therefore offer these symptoms as
a general guide.
Symptoms of computer or video game addiction:
Most of non-school hours are spent on the computer or playing video games.
Not keeping up with assignments.
Lying about computer or video game use.
Choosing to use the computer or play video games, rather than to see friends.
Changing friends to only those who also game.
Dropping out of other social groups (clubs or sports).
Irritable when not playing a video game or on the computer.
Falling asleep in school.
Aggressive responding when you try to stop their play.
Computer or video game use is characterized by intense feelings of pleasure and guilt.
Obsessing and pre-occupied about being on the computer, even when not connected.
Hours playing video games or on the computer increasing, seriously disrupting family,
social or even work life.
Lying about computer or video game use.
Experience feelings of withdrawal, anger, or depression when not on the computer
or involved with their video game.
May incur large phone or credit bills for on-line services.
Can't control computer or video game use.
Fantasy life on-line replaces emotional life with partner.
There are even physical symptoms that may point to addiction:
Back, neck aches
Failure to eat regularly or neglect personal hygiene
For the computer or video game addicted person, a fantasy world on-line or in a game
has partially replaced his or her real world. The virtual reality of the computer
or game is more inviting than the every day world of family, school or work. With
the increased access to pornography on the Internet and in games, this fantasy world
may be highly sexual.
What is the theory?
There are many different approaches to defining addictions. Nonetheless, they tend
to share many characteristics. Brown (1991) summarized six core facets for the presence
of addiction, and these are often similar across different approaches. Brown's facets
are salience (the activity dominates the person’s life, either cognitively or behaviorally),
euphoria/relief (the activity provides a ‘high’), tolerance (greater activity is
needed to achieve the same ‘high’), withdrawal symptoms (the experience of unpleasant
physical effects or negative emotions when unable to engage in the activity), conflict
(the activity leads to conflict with others, work, or the self), and relapse and
reinstatement (the activity is continued despite attempts to abstain from it).
Many researchers (myself included) have tended to define it based on the criteria
that medical professionals use to diagnose gambling addiction (more properly called
pathological gambling). There is no agreed-upon standard approach for measuring
it yet. The scale that I currently use (although I am continuing to modify it based
on new research) is:
1.During the past year, have you become more preoccupied with playing video games,
studying video game playing, or planning the next opportunity to play? (suggested
response scale: Yes, No, Sometimes)
2.In the past year, do you need to spend more and more time and/or money on video
games in order to achieve the desired excitement? (Y/N/S)
3.In the past year, have you sometimes tried to limit your own playing? (Y/N) If
yes, are you successful in limiting yourself? (Y/N/S)
4.In the past year, have you become restless or irritable when attempting to cut
down or stop playing video games? (Y/N/S)
5.In the past year, have you played video games as a way of escaping from problems
or bad feelings? (Y/N/S)
6.In the past year, have you ever lied to family or friends about how much you play
video games? (Y/N/S)
7.In the past year, have you ever committed illegal/unsocial acts such as theft from
family, friends, or elsewhere in order to get video games? (Y/N/S)
8.In the past year, have you ever neglected household chores to spend more time playing
9.(For students) In the past year, have you ever done poorly on a school assignment
or test because you spent too much time playing video games? (For non-students)
In the past year, has your work ever suffered (e.g., postponing things, not meeting
deadlines, being too tired to function well, etc.) because you spent too much time
playing video games? (Y/N/S)
10.In the past year, have you ever needed friends or family to help you financially
because you spent too much money on video game equipment, software, or game/Internet
To score it, count a 'yes' as a 1, a 'no' as 0, and a 'sometimes' as .5 (with the
exception of item 3, where you get a 1 only if you try to limit, but are not successful).
Someone would be considered a pathological (addicted) gamer if they score at least
a 5 (see Gentile, 2009 for more details, and please cite this article if you wish
to use the scale above). This approach is based on the DSM-IV clinical approach
to diagnosing mental health problems, and requiring that someone have at least five
symptoms means that they are damaging multiple areas of their lives because of how
they are gaming. I am currently conducting some studies to see how this scale may
What kind of a disorder is this?
My opinion is that it is an impulse-control disorder. That is, the gamer knows he
should do his homework, but he can't stop the impulse to keep playing.... This means
that it's not something about the games that is "addictive," but instead that the
person has allowed his/her computer or game habit to get out of balance with the
rest of life.
Why are games and the Internet so fascinating that they could be a problem?
One way to think about it is to understand what leads to intrinsic motivations. One
theory about human motivation is Self-Determination Theory, which argues that three
basic needs lead to human motivation. These needs are the need for autonomy (we
want to feel like we are in charge of what we are doing), the need for relatedness
(we want to feel connected to other people), and the need for competence (we want
to feel like we are good at things). The Internet and video games are excellent
at satisfying these needs, and are therefore highly motivating. Compare that with
how people often feel about their school or work, and you can immediately see why
people might let things get out of balance.
What can be done?
Because pathological gaming or Internet use are not yet recognized by the American
Psychiatric Association as a medical disorder, very few therapists know about it
or how to treat it. I am not a clinical psychologist and cannot recommend a treatment
plan. I do believe, however, that it is possible to treat. If you or a loved one
is having problems keeping the computer or games in balance with the rest of daily
life, I would recommend seeking a local counselor who has experience treating impulse
control disorders, or perhaps one who has experience with chemical dependency disorders.
I would also recommend taking a copy of my paper along to the first meeting, as
a way of helping the therapist to understand what the issue is that concerns you
(I often hear from people saying that they have been told by a therapist that there
it isn't a "real" issue, so you may need to help educate them about why they should
take it seriously.)
You should recognize that trying to help your child may mean large changes to your
family patterns. The adults have probably gotten very used to having lots of free
time because the kids entertain themselves with the games. If you limit the games,
you will need to replace them with something. This means being actively involved
with your child in a way you may not have had to in a long time.
One way to think about it is to consider what needs of theirs are being met by games?
Is it their sense of independence and autonomy? Their social and belongingness
needs? Their sense of competence? (It may be all three!) If you take away the
games, what will you give them to help them meet those needs elsewhere?
There are some places that claim to specialize in treatment for computer and game
addiction. I do not know any details about these places and am only providing links
here for your information - I am not specifically recommending them as I do not know
how effective their programs are.
Black, D.W., Belsare, G., & Schlosser, S. (1990). Clinical features, psychiatric
comorbidity, and health-related quality of life in persons reporting complusive computer
use behavior. Journal of Clinical Psychiatry, 60(12), 839-844.
Brenner, Viktor. (1997, June). Parameters of Internet use, abuse, and addiction:
The first 90 days of the Internet usage survey. Psychological Reports, 80, 879-882.
Brody, Jane E. (2000, May 16). First step is recognizing the signs of Internet abuse.
The New York Times, pD7(N), pF7(L).
Brown, R.I.F. (1991). Gaming, gambling and other addictive play. In J.H. Kerr & M.J.
Apter (Eds.), Adult place: A reversal theory approach (pp. 101-118). Amsterdam: Swets
Charlton, J.P. (2002). A factor-analytic investigation of computer ‘addiction’ and
engagement. British Journal of Psychology, 93(Part 3), 329-344.
Choo, H., Gentile, D.A., Sim, T., Li, D., Khoo, A., & Liau, A.K. (2010). Pathological
video-gaming among Singaporean youth. Annals of the Academy of Medicine Singapore,
Doten, Patti (1999, October 18). When the Net becomes a trap: On-line addicts may
be mired in a virtual world, leaving behind families, friends and real lives. Boston
Dvorak, John C. (1997, June). Net addiction. PC/Computing, 10, 85.
Fisher, S. (1994). Identifying video game addiction in children and adolescents.
Addictive Behaviors, 19(5), 545-553.
Griffiths, M. (2000) Does internet and computer “addiction” exist? Some case study
evidence. CyberPsychology & Behavior, 3(2), 211-218.
Harvard Mental Health Letter (1999, January). Computer addiction: Is it real or virtual?
Hauge, M. R., Gentile, D. A., (2003, April). Video game addiction among adolescents:
Associations with academic performance and aggression. Paper presented at a Society
for Research in Child Development Conference, Tampa Florida.
Johansson, A., & Götestam, K.G. (2004a). Internet addiction: Characteristics of a
questionnaire and prevalence in Norwegian youth. Scandinavian Journal of Psychology,
Johansson, A. & Götestam, K.G. (2004b). Problems with computer games with monetary
reward: Similarity to pathological gambling. Psychological Reports, 95(2), 641-650.
Orzack, Dr. Maressa. Licensed clinical psychologist, on the Harvard Medical School
faculty, Coordinator of Computer Addiction Services at McLean Hospital. at http://www.computeraddiction.com/
(last visited 3/15/05).
Parents Network Advice about Teenagers - Computer Game Addiction. http://parents.berkeley.edu/advice/teens/gameaddiction.html
(last accessed 2/25/05).
Salguero, R. A., Moran, T., Bersabe, R. M. (2002, December). Measuring problem video
game playing in adolescents. Addiction, 97,12, 1601.
Shaffer, H. J., Hall, M. N., Vander Bilt, J. (2000, April). Computer addiction: A
critical consideration. American Journal of Orthopsychiatry,70, 162-168.
Video Games and Public Health (2004, February). Journal of Adolescence, 27, 1.
Widyanto, L., & McMurran, M. (2004). The psychometic properties of the internet addiction
test. CyberPsychology & Behavior, 7(4), 443-450.
Yang, Dori J. (2000, January 17). Craving your next web fix: Internet addiction is
no laughing matter. U.S. News and World Report, 128, 41.
Yee, N. (2002). Ariadne: Understanding MMORPG Addiction. Retreived November 28, 2005,
from Nick Yee’s Homepage: http://www.nickyee.com/hub/addiction/home.html
Young, K.S. (1997). Internet addiction: The emergence of a new clinical disorder.
CyberPsychology & Behavior, 1, 237-244.