Game addiction' is a term used to describe the compulsive playing of any type of video games to the extent that it disrupts other aspects of a person’s life . This condition currently impacts less than 3 percent of all gamers in the United States, but is growing rapidly . The term is used to diagnose people meeting this condition. Game addiction is characterized by intense feelings of pleasure when playing video games, obsessions about gaming, prioritizing gaming over other aspects of life, interference with social, family and/or work life, signs of withdrawal when prevented from playing the game, and an uncontrollable feeling that one needs to play the game. 
Originally, gaming addiction was not recognized as a formal mental pathology in the DSM. In 2007, the American Psychiatric Association reviewed whether or not they should include "game addiction" as part of the DSM 2012, but rejected the idea, saying that there was not enough conclusive evidence to support the idea that game addiction is truly a mental disorder . However, it was officially recognized as a disorder by the World Health Organization in 2018 . There has been an increasing amount of concern in the public sphere about the negative effects of excessive gaming.
Online game addiction can be experienced by anyone, including children, adolescents, and adults.  In fact, playing games can be a fun way to deal with stress. However, if done to excess, this habit can be bad for sufferers. Not a few people make online games a hobby to fill their spare time. If it is still carried out within reasonable limits and does not interfere with activities or health conditions, this habit is actually not a problem. Online game addiction can be defined as a mental disorder characterized by the urge to play games for hours and even forget or ignore other activities, such as work or school assignments.  This type of addiction can even cause the sufferer to experience various other psychological problems, such as anxiety disorders and depression. People who are addicted to online games can experience physical symptoms, such as fatigue, headaches or migraines, back pain, and lightheadedness. In severe cases, online game addicts can even experience hand nerve disorders due to playing games too often for a long time. 
Some online game addicts do not feel a problem with the behavioral disorders they experience. Therefore, it takes a psychiatric examination from a psychologist or psychiatrist to determine whether a person is indeed addicted to online games or not.  One way that can be done to prevent and overcome the problem of online game addiction is to limit playing time. If you often spend too long playing games, try to schedule a game play and set a time limit for playing, for example, only 1 hour per day. Having a regular schedule can help you divide your time between playing games and completing other tasks. If necessary, you can also make a note of reminders or alarms on your cellphone so you don't play the game too long.
- 1 Media Coverage
- 2 Causes
- 3 Diagnosis and treatment of game addiction
- 4 Notable game addiction incidents
- 5 Ethical Concerns
- 6 See Also
- 7 References
- 2011: the National Geographic Channel aired an episode of Taboo on the topic of addiction.
The show specifically focused on children in Korea, who are put into a government-funded rehabilitation center (The Internet Rescue School) for a 12-day program. The first 2-3 days are typically spent in denial, where the children insist that they are not addicted to the Internet or online gaming. However over the program, the children engage in physical activities that will re-teach them how to interact with others face-to-face and talk with counselors to see how they can divert their attention away from online gaming to other activities. The parents also teach the parents of the children on how they can help their children end their addiction. Experts believe that the typical Korean household structure contributes to the growing "gaming epidemic." Many families in Korea only have one child, breeding the loneliness of the child. The child is able to take his mind of off the loneliness by playing and interacting with other online, in the safe confines of the home. 
Children are increasingly vulnerable to game addiction, due to the salience of computer use in public and at home.
In the case of Korea, the typical one-child structure of modern families isolates the child from other activities and playing with siblings and parents who work. To fill in the feeling of isolation, many children turn to the Internet to chat or to play Massively Multi-player Online Role Playing Games (MMORPGs). Many young children become addicted to popular video games such as League of Legends and Starcraft in order to occupy time and have fun. Parents believe that it is a cheap form of entertainment and do not express concern or limit play at much of the early stage of addiction. This consequently creates a cycle of addictive gameplay for young children in Korea who grow up with the habit. The Korean culture also celebrates high-level video game players and offers career opportunities for the best of these players as e-sports has grown more and more popular.
The structure of the games themselves also encourage addiction, as players are able to gain levels and win more loot by increased playing time or involvement in virtual guilds. The feeling of satisfaction as they gain levels is also a notable source of reinforcement. There is a snowball effect as these factors enhance each other, eventually leading to full-fledged addiction.  The more invested in the game, the more addicted the player becomes to the game and wants to continue to get better at it.
There are several theories as to the cause of addiction, not limited to game addiction: 
- Moral choice/Free will: people who have low willpower and moral standards become addicted
- Genetic basis: "addiction gene" and "addictive personality" causes addiction
- Learned behavior/Social learning: children observe and mimic the behavior of those around them
- Disease model: dopamine release, similar to drug and substance addicts, reinforces the addiction behavior
Diagnosis and treatment of game addiction
- Back and neck aches
- Carpal tunnel syndrome
- Dry eyes
- Failure to eat or take care of personal hygiene
- Sleep disturbances
Dr. Kimberley Young, recognized as the "world's foremost cyber-psychologist," developed a questionnaire to diagnose whether a person has game addiction. The questionnaire is as follows, and anyone can do it on their own to gauge their gaming activities:
- Do you need to play (online) games with increasing amounts of time in order to achieve the desired excitement?
- Are you preoccupied with gaming (thinking about it offline, anticipating your next online session)?
- Have you lied to friends and family members to conceal extent of your (online) gaming?
- Do you feel restless or irritable when attempting to cut down or stop (online) gaming?
- Have you made repeated unsuccessful efforts to control, cut back, or stop (online) gaming?
- Do you use gaming as a way of escaping from problems or relieve feelings of helpfulness, guilt, anxiety, or depression?
- Have you jeopardized or lost a significant relationship, or even risked your marriage because of your (online) gaming habits?
- Have you jeopardized a job, educational, or career opportunity because of your gaming habits?
Answering yes to any of the above indicates that a person may be addicted to games. 
Mark D. Griffiths, a prominent psychologist in the field of gambling and addiction, has established five criteria for Internet addiction. Although not constrained to gaming activities, it covers most of the symptoms exhibited by game addicts, and is a useful measure. 
- Salience: Using the Internet dominates the person’s life, feelings and behavior.
- Mood modification: The person experiences changes in mood (e.g. a ‘buzz’) when using the Internet.
- Tolerance: Increasing amounts of Internet use are needed to achieve the same effects on mood.
- Withdrawal symptoms: If the person stops using the Internet, they experience unpleasant feelings or physical effects.
- Relapse: The addict tends to relapse into earlier patterns of behavior, even after years of abstinence or control.
Proposed IGD (Internet Gaming Disorder)
The APA or American Psychiatric Association has put Internet Gaming Disorder in Section III as a condition that requires more clinical research, and experience before it can be put in the Diagnostic and Statistical Manual of Mental Disorders, also known as(DSM-5).
There are two phases to game addiction treatment:
- Reduce the rewards from playing games
- Increase the rewards from doing other activities
Thus, the primary method is not withdrawal, but gradually weaning the addict off playing the games.
An example of first-phase treatment occurs in China, where the amount of experience points a player can gain after 3 hours is limited. All registered players under 18 years old gain half as many experience points after 3 hours of play, and no points at all after 5 points of play. Although such a serious measure directly changing the game infrastructure is rare, it is successful in reducing the rewards from the game. However, new problems arise as players find ways to deceive the system, using identities of parents and others to fake their ages. This raises other ethical concerns because players feel compelled to try deceptive tactics in order to feed their video game addiction.
An example of second-phase treatment is to promote participation in other activities, especially for children and young adults. Interaction with others promotes positive feelings and less dependence on game activities for pleasure. The more time a person spends doing other activities unrelated to playing a video game, the more invested they become in other activities, which can help curb the desire and addictive feeling to play the game constantly. Possible methods of cutting back on playing video games includes quitting cold turkey and uninstalling the video game, or slowly dialing back through controlled processes that help the player become less and less addicted to the game.
The World Health Organization’s recognition of gaming addiction as a disorder has jump started the need for treatment centers for those impacted by this disorder. restart, one of the first video game treatment centers, has noticed an increase in demand for their services since the recognition Cite error: Invalid
refs with no content must have a name. While medical protocols do not all applying to gaming addiction as they do towards substance addition, a more cognitive behavior therapy is implemented within the treatment centers in order to help gamers identify underlying reasons for their addiction. Depression, substance abuse or past trauma tend to be the main impacts of gaming disorders .
Notable game addiction incidents
Devin Moore was an Alabama native who played hundred of hours, and was substantially addicted to, Grand Theft Auto: Vice City. Grand Theft Auto is a game which promotes lots of criminal misconduct and violoence, allowing players to steal cars and murder, with little to no consequences. Moore had no criminal background and had enlisted in the Airforce, however, in June of 2003 stole a car in Fayette, Alabama. Moore was then apprehended by the police for his stealing of the cars, and once taken to the police station proceeded to shoot and kill 3 different members of the Fayette police. After killing the three individuals, he was recaptured and said "Life is a video game. Everbody's gotta die sometime.". He was then sentenced to death in the proceeding hearings. This case was massive in sparking debates for both video game addiction and violence in video games .
The earliest incident over video games in the United States happened in 1997 when Noah Wilson, a teenager, was allegedly stabbed to death by his friend while reenacting battles from Mortal Kombat. Noah Wilson's friend was later charged with second-degree murder. Andrea Wilson, Noah Wilson's mother sued the developers of Mortal Kombat, attributing the death of his son having been caused by the violent nature of the video game. This also raised ethical concerns for the violence in video games and how violent video games affect the psychological minds of the younger generation.
In one of the earliest examples of death attributed to gaming addiction, 21-year old Wisconsin resident Shawn Woolley committed suicide on Thanksgiving day in 2008 after being supposedly dumped by a fellow player in the popular MMORPG Everquest.  Woolley's mother Liz went on to become the founder of Online Gamers Anonymous, a non-profit organization dedicated to using a 12-step program to help addicted gamers recover. OLGA was among the earliest and remains one of most popular programs dedicated to treating video game addiction today, with chapters around the United States and Canada and an active online community.  Video game addiction ultimately raises the ethical issue of replacing reality with a virtual reality, causing players to become engrossed in their virtual world even to a point where they prefer and/or prioritize the virtual world over real life.
World of Warcraft Freakout
In 2009, a YouTube video titled “Greatest freak out ever” became a viral video with over 67 million views today. In the video, YouTube user “Wafflepwn” secretly films his brother’s reaction when he finds out his World of Warcraft account has been cancelled.  The angry tantrums and eccentric outbursts his brother displays in the video depict an extreme example of withdrawal symptoms of game addiction. Many people viewed the reaction as hilarious, while others saw it as a real problem. This viral video sparked awareness of game addiction and provided an argument for people who believe game addiction is a real disorder. However, in 2010, Comedy Central’s Daniel Tosh interrogated the boy about the authenticity of the video and revealed that it was actually fake.  The video was deemed as an act of trolling, but it still represents the public’s popular view of game addiction withdrawal.
On October 20, 2007, Daniel Petric, an Ohio teenager, age 16, shot and killed his mother Susan and severeley wounded his father Mark over the fact that they took away Halo 3 from him for a month. According to Mark before the shooting, Daniel said "Would you close your eyes? I have a surprise for you". He then proceeded to shoot both his parents in the head. The judge sentenced him to 23 years in prison and stated "I firmly believe that Daniel Petric had no idea at the time he hatched this plot that if he killed his parents that they would be dead forever". 
Diablo III Death
Shortly after the release of Diablo III, an 18 year-old boy, Chuang, was reported as dying after a 40-hour gaming session involving the game. Chuang booked a room in one of Taiwan's internet cafes and ate nothing while he played. After being spotted by one of the cafe workers, Chuang appeared, "only tired" but collapsed after attempting to walk. He was rushed to the hospital where he died, presumably from cardiovascular difficulties that authorities attribute to sitting in one place for a long period of time.  Blizzard would later make a statement claiming that it encourages players to exercise in moderation when playing their games. Video game designers and companies ultimately do not have to take responsibility for how addicting their video games can be, but they do generally encourage users to play in moderation and live a healthy, well-balanced lifestyle.
A major concern for people suffering from game addiction is that they are prone to cheating and the behavioral effects it may have. People cheat in online video games for two reasons: to fast forward through levels or events and to gain an advantage over other players. Either way, "players distinguish between interesting and uninteresting parts of a game, and have decided that they would rather skip the uninteresting parts, via various methods". After playing endless hours of a game, tasks may become boring and cause game addicts to turn to cheating for a new source of fun. Both types of online cheating have serious real-world psychological implications based on the findings of an APA Task Force on Violent Media study. They concluded that playing violent video games leads to short and long-term aggressive thoughts, behaviors and emotions. Based on this study, it is safe to assume that other simulations in video games have a noticeable effect on behavior in the real world. Thus, the use of cheats to gain an advantage over others by either shortening the time needed to earn achievements or giving a player an upper hand in a competitive interaction could result in players exhibiting similar behavior in the real world. While most online cheaters won't get offline and rob a bank, they may be prone to taking shortcuts in their educational, professional, and personal lives.
A relatively new issue in the gaming industry is the addition of loot boxes to online games. These are especially troubling because a player doesn't need to be addicted to a game to spend a fortune on loot boxes. Nonetheless, those prone to game addiction can easily fall into a gambling addiction as a result of loot boxes. The loot inside often follows some type of economy system, resulting in different probabilities of certain items dropping. Thus, these systems produce items that can readily be resold for real money and are often compared to gambling or, more specifically, scratch off-cards. One gamer recalls his experience: “I got a big prize with my first $20 and thought, ‘Hey, maybe I’ll get something good again,’ and spent another $5 next week, and then $5 more. It’s a disturbingly easy trap to fall into”. In fact, there is evidence that some games give players worse loot if the system expects them to spend a lot of money on loot crates based on their user data.
Some Reddit users have spoken out about their abusive behavior surrounding video games and loot boxes.
- User Kensgold stated, “I started spending on in-app purchases, moved to real video games, started on CS:GO skins, then into the gambling scene there. At my worst I was working two jobs and considering dropping out of high school. Please consider how unregulated micro transactions can affect the youth of the world.”
- Another writes, “I am currently $15,800 in debt. My wife no longer trusts me. My kids, who ask me why I am playing Final Fantasy all the time, will never understand how I selfishly spent money I should have been using for their activities.”
These quotes show players who were addicted to both games and gambling within those games, and the destruction it caused to their personal and financial well being. In response, lawmakers around the world are beginning to increase restrictions on loot boxes. Minnesota adopted a law in 2018 that rendered sale of games with loot boxes to children under 18 illegal and includes the following warning: “This game contains a gambling-like mechanism that may promote the development of a gaming disorder that increases the risk of harmful mental or physical health effects, and may expose the user to significant financial risk”. Belgium did the same in 2018 after an investigation amid concern that games were encouraging children to gamble . Other governments will likely follow suit in the near future, as the Gaming Commission of Britain claims that 25,000 children aged 11-16 are already problem gamblers in the UK, with another 36,000 at risk..
- Anonymous Behavior in Virtual Environments
- Ethics in Computer & Video Games
- Virtual Reality in Online Role Playing Games
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- Sarkis, Stephanie.Internet Gaming Disorder in the DSM-5 detailsRetrieved on 23 Apr 2018.
- Addicted: Suicide Over Everquest? 
- Online Gamers Anonymous 
- YouTube: WoW Freakout Video http://www.youtube.com/watch?v=YersIyzsOpc
- Tosh.0 Web Investigation. http://tosh.comedycentral.com/video-clips/web-investigation---wow-freakout
- June 16, 2009. John Caniglia. Wellington teen Daniel Petric gets 23 years to life in prison for killing his mother http://www.cleveland.com/crime/index.ssf/2009/06/lorain_county_teen_who_killed.html
- July 18, 2012. The Huffington Post. Diablo III player dies from 40 hour gaming marathon Diablo III player dies in Taiwan
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- Busby, M. (2018, May 29). 'Easy trap to fall into': Why video-game loot boxes need regulation. Retrieved from https://www.theguardian.com/games/2018/may/29/gamers-politicians-regulation-video-game-loot-boxes
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- 25,000 children in Britain are problem gamblers, report finds. Retrieved from https://www.theguardian.com/society/2017/dec/12/children-britain-problem-gamblers-report
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