Whether you’re hitting the online slot machines in Las Vegas, racing in an old-school video games like “Mario Kart,” or having an augmented experience on your cellphone via “Pokemon Go,” internet gaming is just about everywhere these days.
At least one person plays video games in two-thirds of American households, according to the Entertainment Software Association, and according to the American Psychiatric Association, about 160 million U.S. adults play internet-based games, one recent study estimates.
It’s easy to see that internet games and video gambling can be quite entertaining, and it may be just as easy to get caught up in the thrill of the competition. But can playing these types of games truly be addictive?
A study published in September in the Journal of Addictions & Offender Counseling examined the relationships among personality, motivation and internet gaming disorder. According to the APA, the disorder is the “persistent and recurrent use of the internet to engage in games, often with other players, leading to clinically significant impairment or distress.”
Lead author Kristy L. Carlisle, an assistant professor of counseling and human services at Old Dominion University in Norfolk, Virginia, and her three co-authors noted that gamers’ social tendencies, as determined by personality traits, may play a role in developing problematic gaming habits and addiction.
Addiction is by definition continually engaging in a behavior despite harmful consequences,” says Dr. Hallie Zwibel, director of sports medicine at the New York Institute of Technology in New York City. “In the instance of gaming, prolonged uncontrollable game play results in depression and social isolation in addicted individuals.”
When counselors understand the potential social context of clients’ situations, according to the study, they have more information to develop prevention and treatment strategies that treat the whole person and not just a diagnosis. But more research is needed to understand the full interplay among personality, motivation and IGD, along with demographic risk factors.
The study, which included 1,881 adults from various countries, found that predictors of IGD included being male, being neurotic, introverted personality traits, and having motivation related to achievement.
The prevalence of IGD varies based on the source of the information, but a few things are clear, Zwibel says.
Males are more likely to be diagnosed as having gaming disorders compared to females,” he says, adding that some studies have shown men being four to 10 times more likely to demonstrate gaming addiction, and a few characteristics can often be good predictors of IGD, Zwibel says.
Individuals with mental health disorders such as substance abuse, depression and anxiety are risk factors,” he says. “Friends and family members who have gambling addictions can increase one’s risk. Also, individuals with less emotional support or who are more socially isolated or more likely to be predisposed to gaming addiction.”
Gender vs. gender
It’s important to note that, according to the APA, gaming addiction was described in its Diagnostic and Statistical Manual of Mental Disorders to determine whether the condition was a unique mental disorder or the best criteria to classify it at the time that the DSM-5 was published in 2013.
Dr. Donnie Sansom, associate medical director at Sierra Tucson, an addiction and behavioral health care center in Tucson, Arizona, says IDG “is only under study at this point … The APA does feel at this point, however, that there is a growing body of literature to suggest that internet gaming disorder be further studied and has thus included a ‘potential diagnosis.”
Online video games have been shown to elicit more craving-related activations in the brains of male subjects in studies as compared to female subjects, and this may be why so many video games are designed for males, he says.
Men have generally, starting in childhood, had games that involve risk and competition,” Sansom says. “This tends to be true in virtually every culture. Think about this: for men of a certain age, we remember running off into a field or through the neighborhood playing ‘cops and robbers’ or ‘army’ or the like. Now, youngsters are supervised and have play dates from the time they are young with far less autonomous play away from the watchful eyes of parents. So boys now go and seek that competition and risk online or at a video game station that connects to other players online.”
“Women are generally less prone to such competition, so they may engage in betting against the house or the dealer more than sports betting or playing in person, and so online gambling becomes a more attractive option, according to the gambling marketing site GamblingSites.com,” Sansom adds.
Some data also suggests that women advance from “regular” gamblers to IGD faster than men do, a concept that’s referred to as telescoping, says psychologist Erica Fortune, an associate professor of psychology at Arcadia University in Glenside, Pennsylvania.
For gambling, research indicates that women tend to be drawn to gambling machines, which would include video poker, while men tend to prefer card games, casino games and sports betting, she says. “This could be a result of their personal motivations for gambling — some gamble to avoid negative mood, some gamble for excitement, some gamble for socializing purposes, etc.”
The finish line to success
Zwibel says there are multiple negative impacts on health from playing too much internet video games and participating in online poker or gambling.
“Gamers at the college level are having increased levels of body fat and decreased levels of muscle mass compared to their peers,” he says. “Gamers often use LED monitors, which suppress the sleep hormone melatonin which can lead to insomnia. Sitting for prolonged periods of time can result in neck and back pain, while the repetitive movements on the keyboard mouse or controller and results in elbow pain and carpal tunnel syndrome.”
Fortune says those who gamble tend to be in poorer health overall.
“The correlation between gambling and poor health is quite clear. Higher BMI, higher incidence of cardiovascular issues, as well as a high prevalence of comorbid mental health disorders — like anxiety and depression — as well as comorbid addictions — alcohol, tobacco and drugs,” she says.
“I could imagine that you might see some of the same health issues in those who game: poorer physical health due to a rather sedentary lifestyle and poorer mental health due to lack of social interactions/withdrawing from society,” she adds.
When it comes to addressing IGD, specifically internet gaming in men and video poker and gambling in women, Fortune says it’s wise to keep open the lines of communication.
“The best thing people can do is simply talk about it,” she says. Disorders like these “often fall to the wayside. Parents know they need to talk to their kids about things like drugs, drinking and sex, but they often forget about things like gambling and gaming, which look very innocuous at first blush.”
Sansom adds that in both cases, it is often difficult for men and women to recognize or address the problem themselves.
“Some of these issues can be treated as an outpatient with cognitive behavioral therapy, support groups such as Gamblers Anonymous and individual therapy,” he says. “Seek the help of a mental health professional or your primary care physician and start the dialogue. More studies will need to be done, but now that is on the APA radar, that will likely help.”