Here is the Survey on Video Game Addiction template.

Survey on Video Game Addiction

Hello,
We are a group of students from the National University of Singapore. This is a
survey questionnaire for a research that we are conducting regarding online
game addiction for our social science module. It will take approximately 7
minutes of your time. Your response and your identity will be kept confidential
and we will not share the information we obtained with anybody else. It will be
used for academic purpose only. Your response to this survey is very valuable
and will be appreciated. Thank you very much for your participation. Should you
have any questions regarding this survey or improvements to suggest, please
contact us at weimin_c38@hotmail.com any time.

Section 1: For questions 1 and 4, non-violent online games refer to those games
that do not have any killings or physical harm to the other objects (living and
non living) inside the gameworld. Examples of non-violent online games
includes puzzle games, eg Tetris, checkers, etc

1. Please state the types of online games that you play (you may choose more
than one) *
MMORPG(Massively Multiplayer Online Role-Playing Game)
MMORPG (FPS - First Person Shooter)
MUDs(Multi-User Dungeon)
RTS(Real Time Strategy)
FPS( First Person Shooter)
Non-violent Online Games (please state names)

2. Please provide the name/s of the online game you play. *

3. Do you usually play over a LAN outside home (i.e. Cyber Caf, game shop) or
at home over the internet/LAN. *
Outside home
At home

4. Please State the Game You Play The Most Often

(Please select only one option) *
MMORPG(Massively Multiplayer Online Role-Playing Game)
MMORPG (FPS - First Person Shooter)
MUDs(Multi-User Dungeon)
RTS(Real Time Strategy)
FPS( First Person Shooter)
Non-violent Online Games (please state names)

5. Do you consider yourself to be addicted to your most frequently played online

game? *
Yes
No

Others

6. Please provide the name/s of your most favourite/preferred online game.

(Only one name required) *

7. How frequently do you spend playing online games? *

Once a week
3-6 times a week
Everyday
Others

8. How much time do you spend normally per game session playing the game
without taking any breaks? *
Less than 1 hour
Less than 3 hours
Less than 6 hours
More than 10 hours
Others

9. How many of those hours are usually spent playing your favourite online
game? *

10. Do you prefer playing games to going out? *

Usually

Seldom

Others

11. Do you prefer playing games to spending time with friends? *

Usually

Seldom

Others

12. Do you prefer playing games to spending time with your family? *
Usually

Seldom

Others

13. Do you skip sleep just to finish your game? *

Yes

No

14. Do you hold off going to the toilet just to complete a non-competition
game? *
Yes

No

15. Do you skip your meals just to finish your game? *

Yes

No

Section 2:
Please tell me how much you agree or disagree with each of the following
statements (1=strongly disagree: 5=strongly agree)

Strongly
Agree

Agree

Neutral

Disagree

Strongly
Disagree

Neutral

Disagree

Strongly
Disagree

16. I had tried quitting the online game

after I became addicted to it but found
that I was unsuccessful. *

Strongly
Agree
17. I feel frustrated if I am unable to
play the online game. *

Agree

Strongly
Agree

Agree

Neutral

Disagree

Strongly
Disagree

18. I have a sense of higher self esteem

when playing the online game. *

Strongly
Agree

Agree

Neutral

Disagree

Strongly
Disagree

Strongly
Agree

Agree

Neutral

Disagree

Strongly
Disagree

Neutral

Disagree

Strongly
Disagree

19. I continue to play the online game

even after my character is deleted in the
game and I want to get back my
characters previous experience level by
starting over again. *

20. Playing the online game causes me

to have real life (academic, health,
financial, or relationship) problems. *

Strongly
Agree
21. I feel that I am scheduling my life to
meet my gaming needs. *

Agree

Strongly
Agree

Agree

Neutral

22. It would be easy for me to become

addicted to online games after playing
them. *

23. It would be easy for others to become

addicted to online games after playing
them. *

24. Gamers in general are at risk of

being addicted to online gaming. *

25.I have friends that I regard to be

addicted to gaming. *

26. If I have a lot of friends playing a

particular online game, I will have a
greater tendency to play that game. *

27. The advertisers' sales pitches

(sellers presentation of the game) attract
me to play the game in the first place. *

28. What attracted you to the game in the first place? *

Game Sites
Friends
Curiosity
Affordable Game Price
Others

Disagree

Strongly
Disagree

Strongly
Agree

Agree

Neutral

Disagree

Strongly
Disagree

29. I keep playing online games just to

wait for an expansion (add-on to the
original game). *

30. Why do you like to play online games? *

I am able to interact with my friends when gaming.
I feel a sense of control when gaming.
Online gaming is more immersive and challenging than games played by myself.
Online games can help me to destress.
Others

Strongly
Agree
31. If I am addicted to my online game,
the amount of addiction that I experience
is similar to other addicted gamers. *

Please tell us more about yourself

Agree

Neutral

Disagree

Strongly
Disagree

Age *

Gender *

Occupation *

Marital Status *

Nationality *

Highest Formal Education Attained: *

Juni
or High
School

Hig
h
nic
School

Polytech

Colle
ge

Gradua
te School

Others