Video game addiction: pathological gaming

The pathological addiction to video games was included in the latest version of the DSM-5 in “Section 3”, dedicated to the conditions that need further studies and insights.

Specifically, we find it under the label “Internet Gaming Disorder” which includes addiction to video games both online and offline . It must be said that Internet Gaming Disorder is the only other behavioral addiction included, along with pathological gambling , in section 3 of the DSM-5 (American Psychiatric Association, 2013).

L ‘ excessive use of video games is a very common phenomenon, especially in adolescents. However, spending time playing is not a sufficient condition for detecting a clinical malaise or psychiatric condition. Only a fraction of the excessive gamblers also show symptoms that open up the possibility of diagnosing an addiction.

Differential Diagnosis of Video Game Addiction

It is important to diversify this disorder from “Internet Addiction” and “Gambling Disorder”.

The first, or internet addiction , refers to the negative consequences deriving from any activity that can be carried out online (Young et al., 1999). So not only the excessive and problematic use of online or offline games as in the case of video game addiction.

The second refers to excessive and problematic involvement with games involving money bets. This does not concern video games , although some of these provide the possibility of “unlocking” functions by paying. However, the prerogative of the game remains another.

Video Game Addiction Symptoms

The working group that has devoted itself to the study of this phenomenon states that there is not yet sufficient evidence to support a specific diagnosis. It is, however, proposed a number of possible diagnostic criteria of dependence on videogame to detect a risk situation:

  1. Strong concern about gambling (cognitive salience);
  2. Behavior of isolation when play is not possible;
  3. Tolerance (need to increase playing time to experience satisfaction);
  4. Unsuccessful attempts to control / reduce use;
  5. Loss of interest in other hobbies or activities (behavioral salience);
  6. Excessive use despite the knowledge that there is a problem;
  7. Lies about time spent playing;
  8. Use of the game to sedate / regulate / reduce an unpleasant emotional experience;
  9. Loss or impairment of relevant interpersonal relationships; impaired academic or work performance due to gambling.

The DSM-5 considers the presence of 5 of the 9 aforementioned criteria as a threshold for identifying clinically relevant situations. It also explicitly states that the “video game addiction” diagnostic label includes online (played on the Internet) and offline games. This is even if the word “Internet” is included in the diagnosis of “Internet Gaming Disorder”.

The authors explain this apparent ambiguity with the need to distinguish the dependence on video games from that of gambling (respectively “gaming disorder” and “gambling disorder”).

Diagnostic specifications

The authors of the DSM-5 also carry out a series of reflections and theoretical expansions on the various diagnostic criteria presented.

The concern for the game must be present at the moment when the player is not engaged in the game. It must occur several times a day during the same day.

The increase in time spent playing must be explained by an increase in the desire to play . There should be a perception of not being satisfied with shorter gaming sessions. The increase in time spent playing does not depend solely on an increase in free time (eg the end of school).

Other disorders coexisting with video game addiction

People with Internet Gaming Disorder usually exhibit higher levels of psychological distress (Starcevic et al., 2011). Compared to pathological non-gamers, they have greater problems in sleep (Achab et al., 2011) and in falling asleep (Rehbein et al., 2013).

The depression is a condition that mostly has been observed in relation to video game addiction (Desai et al., 2010; Gentile et al., 2011). It is important to say that approximately 43% of females and 13% of males with this addiction report suicidal ideation (Rehbein et al., 2013).

At least three studies have witnessed the association between Attention Deficit / Hyperactivity Disorder (ADD / I) and Internet Gaming Disorder, in children, adolescents and young adults (Bioulac et al., 2008; Gentile, 2009; Walther et al. , 2012).

Other authors have shown the association between video game addiction and anxiety symptoms (Gentile et al., 2011; Mentzoni et al., 2011).

Relatively few studies have investigated the relationship between Internet Gaming Disorder and other behavioral addictions . Rehbein and his collaborators (2013) report that 26% of teens in their sample of video game addicts also had Internet addiction (excluding online games).

Finally, the studies that have tried to highlight the long-term inferences of video game addiction have spoken of depression and anxiety as two of the main symptomatological consequences of this addiction (Gentile et al., 2011).

Cure of video game addiction

There is still no data that confirms the effectiveness of particular treatments for people suffering from this type of addiction. Due to the diagnostic and clinical overlap with other forms of behavioral addiction , it is reasonable to assume that they benefit from cognitive behavioral psychotherapeutic treatments . These can be complemented by motivational interview techniques and relapse prevention strategies useful for addictions in general.


by Abdullah Sam
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