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Justin Trifari

Professor Malcolm Campbell

UWRT 1104

April 4, 2019

Fact or Fiction: Is Video Game Addiction Linked to Mental Health Disorders? Deleted: g
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The gaming industry is seeing rapid growth due to the continued innovations in Deleted: l
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technological advancements. Since technology is easily accessible, younger generations are
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being introduced to technology at far higher rates than any generation previously. This continued Deleted: d

technological advancement leads to better game mechanics, graphics, audio, and overall

playability of the game. With the increase in the playability of a game combined with

generations becoming exposed at younger ages the audience grows and becomes more heavily

involved with what they are playing. With that being said, are video games addictive and can Deleted: ng

excessive gaming lead to depression or other major mental health disorders?

To start, according to Medical News Todays, in 2018 the World Health Organization Formatted: Font: Italic

(WHO) classified excessive gaming as a disorder within the International Statistical

Classification of Diseases and Related Health Problems (ICD) which is a list of diseases and

conditions that are used by health professionals to make a diagnosis and treatment plan for their

patient. The World Health Organization states, “Gaming disorder is characterized by a pattern of

persistent or recurrent gaming behavior (‘digital gaming’ or ‘video-gaming’), which may be

online (i.e., over the internet) or offline, manifested by: 1) impaired control over gaming (e.g.,

onset, frequency, intensity, duration, termination, context); 2) increasing priority given to gaming

to the extent that gaming takes precedence over other life interests and daily activities; and 3)

continuation or escalation of gaming despite the occurrence of negative consequences.”

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Signs of excessive gaming disorder include prioritizing gaming over other activities and

interests, lack of sleep, isolation, and lying to create more time to play video games. This is

reinforced with Sophia Achab and her colleagues in their study that compared characteristics of

addict vs non-addict online gamers and how the addicted gamers reported three times more daily

sleepiness, sleep deprivation, and emotional changes. The study was designed to target a French

population of MMORPG gamers aged over eighteen and utilized online discussion forums

visited by gamers. Through the forums they sent a questionnaire that took forty-five minutes and

consisted of a sixty-three item self-administrated list of questions assessing social and

demographical data, the relationship between gaming and health, gaming and socio-professional

consequences, and clinical criteria screening for IA and online gaming addiction. Deleted:

Furthermore, gaming disorder is also described within the American Psychiatric

Association’s Diagnostic and Statistical Manuel of Mental Disorders (DSM-5). The DSM-5

focuses more on what they consider “Significant impairment or distress”. A diagnosis would Deleted:

require experiencing five or more symptoms within a year. These symptoms include anxiety,

sadness, and irritability when not playing video games, inability to reduce playing, deceiving

family members or others on the amount your gaming, jeopardizing your job or relationship, and

preoccupation with gaming. Mark Griffiths is a distinguished professor of behavioral addiction at

Nottingham Trent University. Griffiths is well known internationally for his work into gambling

and gaming addiction. In one of Griffiths studies he states that 80% of online gamers sacrificed

some aspect of their lives such as education, sleeping, working, socializing with friends, family,
Deleted: Mark Griffiths study states that 80% of online
and partners. gamers sacrificed some aspect of their lives such as
education, sleeping, working, socializing with friends,
family, and partners. A diagnosis would require
Another study by the University of New Mexico states that 6 to 15 percent of all gamers experiencing 5 or more symptoms within a year. These
symptoms can include anxiety, sadness, and irritability when
exhibit symptoms of gaming addiction. For perspective, if there were 5000 gamers not playing video games, inability to reduce playing,
deceiving family members or others on the amount your
gaming, jeopardizing your job or relationship, and
preoccupation with gaming.
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approximately 300 to 750 of them would show symptoms of gaming addiction. On a smaller

scale, this seems pretty minimal but if you take the world population of approximately 7.5 billion

people and multiply that number by 15% that would be equivalent to 1,125,000,000 people who

show symptoms of gaming addiction. Of the 7.5 billion, approximately 211 million people play

video games. With this in mind after multiplying the 211 million people by 15% we could

approximate that 31,650,000 people have showed signs of gaming addiction.

Additionally, both the DSM-5 and the ICD agree there are two different types of

symptoms. These symptoms are classified as physical and emotional. Physical symptoms include

migraines due to excessive gaming, fatigue due to lack of sleep, and carpal tunnel due to high

usage of a mouse and keyboard. Emotional symptoms include irritability due to lack of sleep, Deleted: too long

isolation because of gaming too much, and lying to create more time to play video games.

The main question that arises following much research is, what makes video games so

addicting. According to Dr. Brent Conrad, a clinical psychologist in Halifax, Nova Scotia, there

are many factors to consider such as no pre-defined ends, in-game rewards are based on leveling

up, social connections, collaboration among other players, harmless online activity, and rewards

being set on variable schedules. A common trend among these factors is related to in-game

rewards. In-game rewards promote a sense of self-accomplishment but, to earn the rewards one

must first complete the leveling system in place. As a player increases his level the tasks become

increasingly harder and the skill gap becomes wider thus making the game consume more of the

players time. Additionally, setting rewards on variable schedules makes players log on and play

more hours to ensure they don’t miss a chance at earning a specific reward.

I’ve experienced this while playing the well-known game World of Warcraft. In this Formatted: Font: Italic

game, you are able to collect mounts and other items to increase your item level and engage in
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Player vs player (PvP) and Player vs enemies (PvE) gameplay. Player vs player is combat

between two or more online players in events or places such as duels, battlegrounds, and arenas.

Whereas, player vs enemies are combat between in game artificial intelligence in places such as

dungeons, and raids where you complete quests and fight mobs. Item level indicates the

usefulness of an item and mounts are used to traverse around the open world more efficiently. I

spent hours on end trying to acquire the headless horseman mount. The headless horseman Deleted: reason for this is that the

mount was only available during the hallows end holiday in World of Warcraft which lasts for Formatted: Font: Italic

only 13 days. Additionally, it was set on a fixed drop rate of .05%. A fixed drop rate is classified

as a set percentage at which an item or reward could be acquired. Overall, to obtain the mount

one has to complete the dungeon which on average takes 45 minutes, not including queue time.

Then pray your .05% chance of obtaining the item happens. For perspective out of the 12 million Deleted: So

World of Warcraft players only 600,000 people are likely to obtain the mount based on the fixed

drop rate which doesn’t include time. And finally, this can only be obtained during the Hallows

End holiday which lasts a maximum of 13 days.

Additionally, with no pre-defined ends, the game can expand forever thus allowing the Deleted: , to get this mount you must complete a dungeon
which takes around 45 minutes, not including the queue
time. Then if you complete the dungeon you have a .05%
gaming companies to earn more money and the players to enjoy new experiences. Gaming chance of obtaining the item. Since this mount is only
available during the hallows end holiday it is extremely time-
companies utilize what they call DLC. Ben Stenger, a deputy editor for MakeUseOf reinforces consuming to obtain the mount. Finally, with
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this notion when he states, “From expansion packs to microtransactions, DLC has been around Formatted: Font: Not Italic
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for over a decade and allows developers to introduce more content into their games. As a color: Text 1

consequence, this makes it hard to properly finish a game since new content could show up at

any time.” An abundance of games utilizes DLC these include Call of Duty, World of Warcraft, Formatted: Font: Italic
Formatted: Font: Italic
and Destiny. They introduce new content such as maps, guns, camos, reticles, and supply drops. Formatted: Font: Italic

Kate Cox, a writer for the Consumerist states, “According to the Wall Street Journal, video game Formatted: Font: Italic
Formatted: Font: Italic
Formatted: Default Paragraph Font, Font color: Text 1
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makers are bringing in billions of dollars a year in these post-purchase add-ons, with at least one

major distributor raking in more than $1 billion annually on its own.” Gaming companies

utilizing no pre-defined ends showcases the disregard they have on people who experience

videogame addiction.

Understanding that video games are addicting is important to understand how it causes Deleted: ¶

depression and other mental health disorders. Caitlin Gibson a writer for the Washington Post

stated that in 1998, a study showed that video games raised the level of dopamine in the brain by

approximately 100%. Dopamine commonly referred to as the “Feel-Good” hormone is a

neurotransmitter that helps regulate movement, learning, and show emotional responses such as

motivation, euphoria, and concentration. This amount of dopamine released repeatedly creates

withdrawal and cravings due to changes in the amount of dopamine being released to the

dopamine receptors while not gaming. Charles Hymas a writer for The Telegraph stated,” Formatted: Font: Italic

Fortnite and other addictive video games can have a similar effect on children’s brains as drug Formatted: Font: Italic

abuse or alcoholism, MRI scans reveal.” This is important because people who experience

depression struggle to feel happiness and pleasure among leisurely activities. One cause of this is

video game addiction as it allows for an unhealthy amount of dopamine to be expended into the

dopamine receptors. Another problem is that human brains aren’t fully developed until the age of

25. With that in mind, people as young as 13 who experience video game addiction develop a Deleted: w
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reward or impulse system much faster than others. This would lead to an uneven distribution

between the developed reward system and its necessary counterpart the self-control system. This

would lead the individual to exhibit more impulsive and risky behavior.

Video game addiction is often viewed as a disorder that only affects teenagers. However,

this is simply not true. According to the BBC in 2010 South Korean prosecutors charged a couple
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with negligent homicide for allowing their child to starve to death while playing the well-known

MMORPG, Prius Online. Another tragic case involved a 28-year-old South Korean man dying of

heart failure due to exhaustion after playing a 50-hour StarCraft session in 2005. Although these

events are uncommon it would be ignorant to ignore them. Both cases showcase how video

games create a false reality that leads to neglect of personal health and well-being of individuals

and others around them.

Moreover, there are ongoing debates over if violent video games are linked to mass

shootings and other violent acts such as school shootings. ABC News reported that Texas Lt.

Gov. Dan Patrick argued that violent video games have created people who are “Desensitized to

violence.” His argument was defended by the American Psychological Association (APA) which

passed a resolution in 2015 declaring that “Scientific research has demonstrated an association

between violent video game use and both increases in aggressive behavior, aggressive cognitions

and decreases in prosocial behavior, empathy, and moral engagement,” among other findings.

Many people worry about the rates at which children are playing video games. According to the

APA in the United States alone, 90% of children play video games. The APA also states that

85% of videogames within the market contain some form of violence. Understanding that violent

video games could be associated with things such as mass shootings show the effects that video

games have on the brain and how it impacts youth and adults around the world.

However, not all scientist and doctors believe that video game addiction should be

classified as a disorder within the ICD and DSM-5. Some doctors state that there isn’t enough

evidence to establish that gaming disorder is a disease. The World Health Organization also

stated that the disorder only affects 3 percent of gamers. It’s also important to note that the

symptoms provided by both the ICD and DSM-5 are extremely vague and could lead to
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misdiagnosis of a person. Romeo Vitelli a writer for Psychology Today states, “In China, for Formatted: Font: Italic

example, military-style "boot camps" for the treatment of video game addicts have become

extremely popular with parents sending their children to be "cured," often after weeks or months

of grueling treatment.” These “boot camps” utilize running, push-ups, antidepressants, and

sedatives to help fight against gaming addiction. Sedatives are drugs taken to induce a calming

feeling or sleep-inducing effect and antidepressants are drugs that are used to relieve symptoms

of depression, and other anxiety disorders. Additionally, the cost of sending kids to this camp is

extremely expensive with one family spending around 170,000 yuan which is equal to

$25,328.52 U.S. dollars. Although this is an extreme example you can’t deny that boot camps Deleted:

similar to the ones in China will continue to grow and spread worldwide becoming more Deleted: it could happen and
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problematic then they are now. Overall, the lack of reliable evidence and a small percentage of Deleted: e
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those affected lead the doctors to debate the validity of video game addiction being classified as

a disorder.

Scientists and doctors also state that playing video games can improve cognitive skills. Formatted: Indent: First line: 0.5"

Cognitive skills are core skills your brain uses to think, learn, reason, remember, and pay

attention. These skills learned while playing video games include, coordination, enhanced

memory, improved problem-solving skills, improved brain speed, improved multitasking skills,

and improved social skills. Peter Gray an author for Psychology Today states, “Green & Bavelier

(2012) found that action video gaming improved performance on the ability to locate, quickly, a

target stimulus in a field of distractors—a test that has been found to be a good predictor of

driving abilities.” Moreover, studies showed that video games improved job performance,

especially for jobs that require good hand-eye coordination, attention, working memory, and

quick decision making. A study by Dr. James Rosser, Jr. and his colleagues concluded that video
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game skill correlates with laparoscopic surgical skills. Laparoscopy is a surgical procedure in

which a fiber-optic instrument is inserted through the abdominal wall to view the organs in the

abdomen or to permit a surgical procedure. Knowing that playing video games can improve the

cognitive skills necessary to perform an important task such as a laparoscopy reinforce the fact

that video games are important to an individual’s growth. Deleted: ¶

After intensive research I concluded that gaming addiction is real and is directly related

to other mental health disorders. My research shows clear correlation between video game

addiction and mental health disorders such as depression, and anxiety. With scientific evidence

and a multitude of cases there is sufficient information to prove that video game addiction is a

growing problem. While researching I also noticed that gaming addiction isn’t strictly related to

younger audiences. This is important as most people refer to video game addiction as a problem

for the youth. This is simply not true and there are several cases in my research that showcase its

effects on adults.

Furthermore, I want to clarify I don’t agree with everything the ICD and DSM-5 state

about video game addiction. I agree with the opposing sides views that the symptoms classified

within both of these documents are extremely vague. Vague symptoms lead to widespread

misdiagnoses of people. Through my research I understand the magnitude of problems related to

a misdiagnosis of videogame addiction. Additionally, I support doctors’ concerns with the

validity of video game addiction since it affects a minuscule amount of people worldwide.

As research furthers and new studies form, more information will be readily available to shape Formatted: Left, Indent: First line: 0"

the minds of non-believers. I believe there will be a clearer understanding of video game

addiction and what symptoms should be used to help make a diagnosis on a patient. With the
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ongoing cases and increase in technological advancements I believe video game addiction should

be taken more seriously. Deleted: ¶

Formatted: Left, Indent: First line: 0"

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Work Cited Deleted: Citations

Achab, Sophia, et al. “Massively Multiplayer Online Role-Playing Games: Comparing

Characteristics of Addict vs Non-Addict Online Recruited Gamers in a French Adult

Population.” BMC Psychiatry, BioMed Central, 26 Aug. 2011, Accessed 16 Mar. 2019.

Conrad, Brent. “15 Reasons & Theories on Why Video Games Are Addictive.” TechAddiction, Accessed 12 Mar. 2019. Deleted:

dictive.html. Accessed 12 Mar. 2019

Dodds, Charles Hymas, et al. “Addictive Video Games May Change Children's Brains in the Deleted: ; Laurence

Same Way as Drugs and Alcohol, Study Reveals.” The Telegraph, Telegraph Media

Group, 12 Jun. 2018,

change-childrens-brains-way-drugs/. Accessed 15 Mar. 2019.

Eugenio, Sheila. “Public Access - 8 Cognitive Benefits of Playing Video Games for

Kids.” Engadget, 9 Feb. 2017,

playing-video-games-for-kids/. Accessed 28 Mar. 2019.

Fulkerson, Calleah. “Major Depression, Internet and Gaming Addiction: Healing Through Dual-

Diagnosis Treatment.” BrightQuest Treatment Centers, BrightQuest Treatment Centers, 8

Jan. 2019,

diagnosis-treatment/. Accessed 11 Mar. 2019.

“Gaming Disorder.” World Health Organization, World Health Organization, 14 Sept. 2018, Accessed 10 Apr. 2019.

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Gibson, Caitlin. “Video Games Are More Addictive than Ever. This Is What Happens When

Kids Can't Turn Them off.” The Washington Post, WP Company, 2016,

this-is-what-happens-when-kids-cant-turn-them-off/?utm_term=.b72c392e8788. Accessed

21 Mar. 2019.

Gray, Peter. “Cognitive Benefits of Playing Video Games.” Psychology Today, Sussex

Publishers, 2015,

benefits-playing-video-games. Accessed 20 Mar. 2019.

Gray, Peter. “Video Game Addiction: Does It Occur? If So, Why?” Psychology Today, Sussex

Publishers, 2012,

addiction-does-it-occur-if-so-why. Accessed 30 Mar. 2019.

Griffiths, Mark, et al. “Online Computer Gaming: a Comparison of Adolescent and Adult

Gamers.” Journal of Adolescence, Academic Press, 30 Dec. 2003, Accessed 31 Mar. 2019.

Han-Ting Wei, et al. “The Association between Online Gaming, Social Phobia, and Depression:

an Internet Survey.” BMC Psychiatry, BioMed Central, 28 Jul. 2012, Accessed 6 Mar.


Hill, Cami. “Video Game Addiction a Growing Health Problem for

Men.”, 27 Oct. 2017,

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growing-health-problem-for-men/. Accessed 29 Mar. 2019. Deleted: ¶

Kaneaiakala, Benjamin. “Adults Not Immune to Issues with Video Gaming.” Adults Not Immune

to Issues with Video Gaming | Addiction Professional, 2018,

Accessed 26 Mar. 2019.

Keneally, Meghan. “Breaking down the Debate over Violent Video Games and School

Shootings.” ABC News, ABC News Network, 2018,

debate-violent-video-games-school-shootings/story?id=55324231. Accessed 28 Mar.


Leonard, Jayne. “What Is Gaming Disorder and What Does It Mean for Gamers?” Medical News

Today, MediLexicon International, 2018, Accessed 5 Mar. 2019.

Parekh, Ranna. “Internet Gaming.” Internet Gaming, 2018,

families/internet-gaming. Accessed 10 Mar. 2019.

Rohman, Melissa. “Video Game Brain: MRI Shows Similar Results for Gaming, Drug

Addicts.” Health Imaging, 23 Jan. 2019,

results-gaming-drug-addicts. Accessed 22 Mar. 2019.

Scutti, Susan. “Do Video Games Lead to Violence?” CNN, Cable News Network, 2018, www-

violence/index.html? Accessed 25 Mar. 2019.

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“Signs and Symptoms of Video Game Addiction - Causes and Effects.”, 2019,

Accessed 3 Mar. 2019.

Taylor, David G. “Worst Cases of Video Game Addiction.”, Grunge, 14 July 2017, Accessed 16 Mar. 2019.

Tsukayama, Hayley. “Video Game Addiction Is a Real Condition, WHO Says. Here's What That

Means.” The Washington Post, WP Company, 18 Jun. 2018,


means/?noredirect=on&utm_term=.933334453baf. Accessed 3 Mar. 2019.

Vitelli, Romeo. “Does Video Game Addiction Really Exist?” Psychology Today, Sussex

Publishers, 2017,

game-addiction-really-exist. Accessed 29 Mar. 2019.

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