Computers in Human Behavior 49 (2015) 517–525

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Computers in Human Behavior

journal homepage: www.elsevier.com/locate/comphumbeh

Relationships and associations between video game and Internet

addictions: Is tolerance a symptom seen in all conditions
Selim Gunuc ⇑
Yuzuncu Yil University, Faculty of Education, Department of Computer Education and Instructional Technologies, 65000 Van, Turkey

a r t i c l e i n f o a b s t r a c t

Article history: There are several similarities and relationships between behavioral addictions. These relationships
between behavioral addictions could be said to result especially from Internet use. It is seen that problem-
atic or excessive use of the Internet not only results in Internet addiction but also leads to and contributes
Keywords: to such other behavioral addictions as video game addiction. The present study examined the associations
Video game addiction in related literature with the relationships between video game and Internet addictions and aimed at
Internet addiction determining the correlations between video game and Internet addictions. Also, the study further focused
Behavioral addictions
on whether the symptom of tolerance occurred in all conditions or not. In the study, correlational research
Tolerance
Symptom
was used. The study was carried out with 200 students from a high school located in the Eastern part of
Turkey. Video Game Addiction Questionnaire and Internet Addiction Scale were used to collect the
research data. For the analysis of the data, descriptive statistics, TwoStep Cluster Analysis, correlation
analysis and Independent Samples t-Test were applied. Consequently, it was found that there was a strong
correlation between video game addiction and Internet addiction. Also, not in all conditions can tolerance
be said to be among the symptoms of video game addiction or Internet addiction.
Ó 2015 Elsevier Ltd. All rights reserved.

1. Introduction excessive and harmful for individuals/society in psychological,

Video game and Internet addictions are considered to be a type
of behavioral addictions (non-chemical or non-substance) different
from substance addiction. In substance addiction, addiction
develops depending on the substance used, while in behavioral
addictions, addiction develops based on the activity carried out
or on the behavior. However, regarding video game and Internet
addictions, it is an issue of discussion whether individuals are
addicted to the platform or to the content provided by the
Internet or whether one is more influential on individuals than
the other (Griffiths, 1999a). Some researchers claim that addiction
develops in relation to such contents of the Internet as games,
chatting, shopping and gambling rather than the Internet platform
itself (Davis, 2001), while others assert that software and software
design are influential on addiction (Alrobai, Phalp, & Ali, 2014). In
any case, the Internet provides different types of content: useful–
harmful, good-bad or safe-dangerous. One important difference
between behavioral addictions and substance addiction is that it
is not possible or reasonable to avoid behaviors completely. The
reason is that most behaviors provide benefits for individuals. On
the other hand, the main problem is that such behaviors are
physiological and sociological aspects. For example, in today’s digi-
tal age, online shopping is a necessity in some cases, while exces-
sive shopping or lack of self-control is likely to result in addiction.
Another example could be the fact that the purpose of playing
online games is socialization, spending nice time and learning via
entertainment (Cole & Griffiths, 2007; De Freitas & Griffiths,
2007, 2008; Griffiths, 2002). However, excessive or uncontrolled
online gaming could lead to addiction accompanied by loss of con-
siderable time, depression, failure in school and sleeping problems
(Eidenbenz, 2011; Stojakovic, 2011). It is not easy to diagnose
behavioral addiction or to observe its symptoms easily as it is in
substance addiction. Therefore, not only because it is difficult to
diagnose behavioral addiction but also because it is impossible to
remove such behaviors completely from our lives, it is not easy
to reach a consensus on the definition, diagnosis, prevention and
treatment of behavioral addiction. It is seen that with the develop-
ing technology, video game and Internet addictions are among the
most striking behavioral addictions especially for children and
adolescents.
2. Behavioral addictions: video game and internet addictions

⇑ Cell: +90 505 750 6254. Among behavioral addictions are such addictions or disorders
E-mail address: selimgunuc@hotmail.com as video game addiction (online or offline) (Porter, Starcevic,

http://dx.doi.org/10.1016/j.chb.2015.03.063
0747-5632/Ó 2015 Elsevier Ltd. All rights reserved.
518 S. Gunuc / Computers in Human Behavior 49 (2015) 517–525
Berle, & Fenech, 2010), Internet addiction (Ko, Yen, Chen, Yeh, &
Yen, 2009; Ko, Yen, Chen, Yang, et al., 2009), sexual addiction
(Goodman, 1992), pathological gambling (Blanco, Moreyra,
Nunes, Sáiz-Ruiz, & Ibáñez, 2001; Griffiths, 2008a) and shopping
addiction or compulsive buying (Black, 1996) (Diagnostic and
Statistical Manual of Mental Disorders [DSM-V], 2013). Internet
and computer addictions are considered within the scope of
technological addictions based on human–machine interaction
(Griffiths, 1999a). Technological addictions can be regarded as a
subset of behavioral addictions.
It is seen that behavioral addictions such as the Internet, video
game and gambling addictions have some common points regard-
ing symptoms as well as prevention and treatment (Griffiths,
2008a, 2008b, 2010; Keepers, 1990; Kuczmierczyk, Walley, &
Calhoun, 1987). Before DSM-V, the fact that video game and
Internet addictions have been defined using the diagnosis criteria
for pathological gambling shows the relationships between these
addictions (Fisher, 1994; Griffiths, 2005b; Johansson & Götestam,
2004; Thurlow, Lengel, & Tomic, 2004). Internet addiction, though
not currently found fully in the scope of DSM-V, is considered to be
similar to ‘‘Online Gaming Disorder’’ found in DSM-V. These
symptoms include mood modification, salience, conflict, relapse,
preoccupation with gaming/Internet, lying or hiding gaming/
Internet use, loss of Interest in other activities, defensiveness and
anger, social and psychological withdrawal, tolerance, using
gaming/Internet as an escape, excessive use and negative conse-
quences (DSM-V, 2013). Withdrawal symptoms are defined by
DSM-V (2013) as symptoms that occur when Internet gaming is
taken away. These symptoms are typically described as irritability,
anxiety, or sadness, but there are no physical signs of pharmaco-
logical withdrawal. Tolerance is defined by DSM-V (2013) as the
need to spend increasing amounts of time engaged in Internet or
Internet games. The negative consequences of Internet addiction
and video game addiction are likely to cause problems in a wide
range of areas in physiological, psychological and sociological
aspects and to have negative influence on the welfare of individu-
als and on the order in the society (Chou, Condron, & Belland, 2005;
Flisher, 2010; Gunuc & Dogan, 2013; Ko, Yen, Chen, Yeh, et al.,
2009; Kraut et al., 1998; Lam, Peng, Mai, & Jing, 2009; Murali &
George, 2007; Ni, Yan, Chen, & Liu, 2009; Park, Kim, & Cho, 2008;
Scherer, 1997; Young, 1998; Young & Rogers, 1998). Aspects of
tolerance and withdrawal are seen with concomitant physical
discomfort (Greenfield, 2011), and these symptoms are used as
the primary and common symptoms for the diagnosis of
behavioral addictions in a number of studies (Beard & Wolf,
2001; Blaszczynski, Walker, Sharpe, & Nower, 2008; Block, 2008;
Caplan, 2002; DSM-V, 2013; Griffiths, 1993; Ko, Chen, Chen, &
Yen, 2005; Kuss & Griffiths, 2012b; Kwon, 2011; Paik, Oh, & Kim,
2014). In addition, tolerance and withdrawal symptoms are also
found among the diagnosis criteria put forward by Goldberg
(1996), Goodman (1990), Griffiths (1996) and Young (1998).
Although all these symptoms have been used by researchers, there
is still no consensus on the number of symptoms necessary for the
diagnosis of addiction or on whether all symptoms have equal
importance (Blinka & Smahel, 2011).
Gunuc and Kayri (2010), in their Internet Addiction Scale,
determined the sub-dimensions of Internet addiction as
Withdrawal, Controlling Difficulty, Disorder in Functionality and
Social Isolation. Within the scope of these sub-dimensions, though
the tolerance-related indicator was found as an item in the scale,
tolerance did not occur as a separate dimension. However, in
DSM-V, tolerance is regarded as one of the important symptoms
of video game and Internet addictions. In this respect, it is impor-
tant to find answers to the questions of ‘‘Is tolerance a symptom of
video game/Internet addiction that occurs in all conditions?’’, ‘‘Do
Internet-addicted adolescents get rid of their addiction when they
do not have the opportunity to increase the amount of their gam-
ing/Internet-use time?’’, ‘‘If Game/Internet-addicted adolescents’
gaming/Internet-use time were restricted, would this be enough
for treatment alone? and ‘‘Is analysis of only the symptoms enough
for the diagnosis of addiction?’’
Though not valid for every behavioral addiction, beneficial use
of the Internet and video game differs from substance addiction
and certain behavioral addictions such as gambling. Therefore, it
is not possible and reasonable to fully avoid not only the
Internet, which is an indispensable tool today, and but also the
video games, which constitute an indispensable source of enter-
tainment especially for children and young people. It is seen that
individuals start playing video games to have fun and generally
to experiment the exciting and satisfying process (Blinka &
Smahel, 2011; Paik et al., 2014). As individuals enjoy this process,
they want to continue the process and to increase their delight in
time. In addition, video games are not played just for entertain-
ment purposes; there are also other types of video games, though
few in number, used for such educational purposes as personal
development, memory development and learning (De Freitas &
Griffiths, 2007, 2008; Griffiths, 2002; Procci, Bowers, Wong, &
Andrews, 2013), therapy (Blinka & Smahel, 2011; Griffiths,
2005a) and social interaction (Cole & Griffiths, 2007). However, it
could be stated that addiction develops mostly due to entertaining
video games (Beranuy, Carbonell, & Griffiths, 2013; Wan & Chiou,
2006b) not due to educational video games. Use of video games
and of the Internet is likely to bring about positive and negative
results. Therefore, purpose and duration of use of video games
are important for balanced use of these games (Gunuc, 2013).
Establishment of balance regarding the purpose and duration of
use of video games could prevent problematic and excessive use
of video games (Griffiths & Meredith, 2009). Failure to establish
such a balance either in time or with the involvement of other
internal and external factors in the process is likely to ruin the
balance. In order to maintain this balance, a number of internal
and external factors such as individual, family-related, social and
financial factors should be kept under control. Especially for
children and adolescents, this balance could be said to be fairly
fragile due to factors specific to several developmental periods.
Besides these factors, some other factors resulting from the use
of the Internet or video game mechanisms also play a role in
addiction. Among these factors, probably the most important one
is easy access to the Internet and video games (DSM-V, 2013). In
other words, accessing video games via the Internet and mobile
devices is likely to lead to negative results regarding addiction. In
this respect, video games can be divided into online and offline
video games. Therefore, video game addiction could be regarded
as online video game addiction and offline video game addiction.
Online and offline video game addictions differ from one another
with respect to the digital platform they are played in. The
differences between these concepts can be seen not only in the
symptoms of video game addiction but also in psychological
outcomes. It is seen that from time to time, gamers play games
using the two platforms. In this respect, the question of whether
online video game addiction also has a relationship with Internet
use or Internet addiction comes into the mind. Although online
and offline video game addictions are similar in many respects,
online video game addiction is different since there is a need for
Internet connection to play the game.
3. Internet addiction and its relationships with video game
addiction and other behavioral addictions
Interaction of Internet or video game addiction with other
behavioral addictions is important not only for the identification
of causes of Internet or video game addictions but also for its
 S. Gunuc / Computers in Human Behavior 49 (2015) 517–525
prevention and treatment. In this respect, for the purpose of
examining the factors triggering Internet/video game addiction or
its development, it is necessary to determine the relationships
between Internet or video game addictions and other behavioral
addictions.
There are several similarities and relationships between behav-
ioral addictions. These relationships between behavioral addic-
tions could be said to result especially from Internet use. Among
the most common Internet use purposes for children and adoles-
cents is playing video games. Playing individual or group (network)
video games via the Internet has increased the tendency toward
Internet-based games especially in recent years. One important
reason for this is that it is quite easy and rapid to access the
Internet and thus games via smart phones and tablet computers
(DSM-V, 2013). Especially with the increase in the capacity, speed
and quality of mobile devices as well as with their larger screens, it
is now so easy to access and play video games in any place at
any time that individuals can play video games with these
devices on the bus, during the lesson breaks and at any moment.
Individuals’ access to online video games in any place at any time
makes it easy for them to play video games even when they have
the opportunity for social interaction. This makes it difficult
especially for children and adolescents to end their relationships
with video games.
Internet addiction could be said to be the one that has the
closest relationship with video game addiction. This concept
mentioned for the first time as ‘‘Internet addiction’’ in related
literature was later named by different researchers and clinicians
using different concepts. These concepts were Internet dependency
(Tvedt, 2007), pathological Internet use (Davis, 2001; Young,
2004), problematic Internet use (Caplan, 2002), excessive
Internet use (Yang, Choe, Baity, Lee, & Cho, 2005), Internet abuse
(Young & Case, 2004), Internet addiction disorder (Gonzalez,
2002; Kiralla, 2005) and so on. Basically, all these concepts were
similar to one another, yet all covered problematic or excessive
use of the Internet (Beard & Wolf, 2001; Weinstein & Lejoyeux,
2010). It is seen that problematic or excessive use of the Internet
not only results in Internet addiction but also leads and contributes
to such other behavioral addictions as sex addiction, offline video
game addiction, pathological gambling and shopping addiction
which exist in real life (not Internet-based addictions). In other
words, the Internet facilitates the transformation of offline
behavioral addictions into Internet-based addictions (e.g. online
gambling addiction) (Griffiths, 1999a, 1999b, 2011; Rehbein &
Mößle, 2013). In real life (offline), such addictions as video game
addiction, sexual addiction, pathological gambling and shopping
addiction that individuals already have before they start using
the Internet are likely to develop more easily and rapidly due to
easy access to contents (e.g. gambling) via the Internet (Griffiths,
2011; Griffiths & Barnes, 2008). In this respect, the Internet
facilitates and accelerates the development of these addictions
because it is possible to hide user identity; there is no age-related
restrictions; it is more difficult to identify cybercrimes; there are
difficulties in the implementation of laws; and because it is
possible to access the Internet in any place at any time. In addition,
such addictions as online pathological gambling, online shopping
addiction, online sexual addiction and online video game addiction
which the individual has developed after using the Internet are
likely to occur in time with problematic Internet use. This situation
may not be valid for all individuals yet is likely to constitute a
serious risk factor.
One of the most popular purposes of use of the Internet for chil-
dren and adolescents is playing online games. Although gambling
is illegal especially for children and adolescents in many countries
(Calado, Alexandre, & Griffiths, 2014), it is seen that gambling is
also popular among adolescents and that pathological gambling
519
is quite wide-spread (Rahman et al., 2012; Wilber & Potenza,
2006). Adolescents regard gambling as an activity for adults
(Calado et al., 2014) and as an activity to win money (Wood &
Grifftiths, 2004). Adolescents have a more positive perception
and attitudes toward gambling when compared to adults (Calado
et al., 2014). Not just for this reason but also because adolescents
are less competent in making judgment and evaluation than
adults, adolescents tend to be at more risk of pathological gam-
bling (Calado et al., 2014). Legislation related to gambling could
prevent from gambling, yet increased accessibility and availability
of the Internet are likely to facilitate pathological gambling (Calado
et al., 2014; Froberg, 2006; Griffiths, 1999b; Messerlian, Byrnes, &
Derevensky, 2004). On the other hand, because especially adults
are legally allowed to gamble online (Calado et al., 2014), they tend
to have a higher rate of gambling and pathological gambling when
compared to adolescents (Welte, Barnes, Tidwell, & Hoffman,
2008). In addition, gambling is also regarded by adults as gaming
(Calado et al., 2014). For whatever reason, both for adolescents
and for adults, there are some similarities, associations and
relationships between online gaming (a non-financial form of
gambling (Griffiths, 1991a)) and online gambling (Delfabbro,
King, Lambos, & Puglies, 2009; Griffiths, 2005b; Gupta &
Derevensky, 1996; Johansson & Götestam, 2004; King, Ejova, &
Delfabbro, 2012). In addition, as one important difference, the
negative outcomes and effects of gambling can be easily reflected
in family life as well as in social life since gambling generally
requires money. The relationships between the Internet and other
behavioral addictions can be obviously seen in related studies
conducted. Many studies examined the relationships between
Internet addiction and Internet use purposes. In these studies, it
was revealed that use of the Internet for such purposes as playing
video game, chatting, gambling, social networks and pornography
leads to Internet addiction and that Internet-addicted individuals
mostly used the Internet for these purposes (Chang & Man Law,
2008; Chen, Chen, & Paul, 2001; Everhard, 2000; Gunuc, 2013;
Jang, Hwang, & Choi, 2008; Meerkerk, van den Eijnden, &
Garretsen, 2006; Müller, Glaesmer, Brähler, Woelfling, & Beutel,
2014; Young, 1998). In other words, it is seen that these Internet
use purposes are now in relationship with other behavioral
addictions due to the Internet. Besides, this could be said to
include the most prominent relationships and associations
between behavioral addictions.
Internet addiction can be regarded as a more general type of
addiction. Addictions caused by such Internet use purposes as
online video games and Facebook can not only be referred to as
online video game addiction or Facebook addiction but also be
evaluated under the concept of Internet addiction. Therefore, some
researchers have examined video game addiction (especially
online) within the scope of Internet addiction (as a sub-addiction)
(Block, 2008; Peltoniemi, 2002; Rehbein & Mößle, 2013; Young,
Pistner, O’mara & Buchanan, 2000). In addition, a strong correlation
was found between video game addiction and use of social net-
works such as Facebook (van Rooij, Schoenmakers, van de
Eijnden, & van de Mheen, 2010). One possible reason for this find-
ing is that video game-addicted individuals use Facebook to play
game. This situation also draws attention to the relationship
between (online) video game addiction and Internet addiction.
The symptoms of online video game addiction and Internet addic-
tion are quite similar to each other, and this similarity points to the
relationship between the two addictions from a different perspec-
tive. In both addictions, there are such observed symptoms as pre-
occupation with gaming, lying or hiding gaming, disobedience at
time limits, loss of Interest in other activities, social withdrawal
from family and friends, psychological withdrawal from the game,
use of gaming as an escape and continuing to play game despite
its possible negative consequences (Young, 2009). van Rooij,
520 S. Gunuc / Computers in Human Behavior 49 (2015) 517–525

Schoenmakers, van den Eijnden, Vermulst, and van de Mheen addictions even if these are widely-accepted symptoms and that
(2012), found a high level of correlation between Internet addic- considering only the symptoms could be misleading in some cases.
tion and video game addiction. Moreover, playing online video
games leads to a higher risk of video game and Internet addictions
5. Method
when compared to playing offline or video games (Griffiths, 2009;
Ko, Yen, Yen, Lin, & Yang, 2007; Rehbein & Mößle, 2013; van Rooij
5.1. Sample
et al., 2012). Probably for this reason, in DSM-V, video game addic-
tion was regarded as ‘‘Internet Gaming Disorder’’, and the attention
In the study, the correlational research method was used. The
was drawn onto online video game addiction as well as onto the
correlation statistical test is used to describe and measure the
association between video game and Internet addictions.
degree of association (or relationship) between two or more vari-
Online video games can be played either by a single player or by
ables or sets of scores (Creswell, 2012). The study started with
multiplayers. Internet and network systems that allow playing
200 students from a high school located in the Eastern part of
multiplayer games aim at helping users get more pleased with
Turkey in 2014. While determining the research sample, the pur-
the game due to competition with other users as well as due to
posive sampling method was used. The reason for using this
the desire to win the game (DSM-V, 2013). Entertainment, experi-
method was that a high school from a region with family-related,
menting, leisure, the need for power, emotional coping, the need
social and financial problems was selected to examine the vari-
for excitement, escaping from reality, reward, achievement and
ables – related to Internet use and video game playing – in line
social and immersion components increase players’ motivation to
with the research purpose. The interview held with the school
play online video games (Blinka & Smahel, 2011; Kuss & Griffiths,
administration revealed that the adolescents at school had a high
2012a, 2012b; Wan & Chiou, 2006b; Yee, 2006). Online video
number of sisters/brothers (5–6 on average); that their families
games such as World of Warcraft and Massively Multiplayer
had low levels of financial status; that most of them had problems
Online Role-Playing Games (MMORPGs) could be said to result in
with their families and with their environments (especially includ-
more addiction, or they are as a facilitator of Internet addiction
ing violence); that they had a lower rate of access to technology
(Kuss, Louws, & Wiers, 2012; Ng & Wiemer-Hastings, 2005;
when compared to other regions; and that they had low levels of
Parsons, 2005). The reason is that online video games deliver more
academic achievements. In this respect, it was predicted that the
rewards, points, credits, prizes, money, pleasure and satisfaction
problems experienced by the adolescents would also influence
and help establish interaction with other users (Ang & Zaphiris,
their technology use. In other words, the adolescents who had
2010; Beranuy et al., 2013; Kuss & Griffiths, 2012a; Ng &
sociological and financial problems were thought to provide
Wiemer-Hastings, 2005; Parks & Floyd, 1996; Peters & Malesky,
opportunities for examining the symptom of ‘‘tolerance’’ and video
2008). When individuals win something via online games (like
game/Internet addiction and to help obtain related findings. In
credits, prizes and money), they may develop online gambling or
order to examine the relationships and associations between these
pathological gambling in future (Griffiths, 1991b; Gupta &
variables, a research sample was taken from this school.
Derevensky, 1996). In addition, it is seen that the concepts of
The ages of the adolescents participating in the study ranged
‘‘Presence’’ and ‘‘Flow’’ have a relationship with online video game
between 15 and 18. The measurement tools were given to the ado-
addiction (Chou & Ting, 2003; Liu, Chou, & Lin, 2001; Wan & Chiou,
lescents who were determined randomly, yet 10 adolescents (5%)
2006a). Online game players want to have not only the feeling of
reported that they never used the Internet. In addition, of all the
presence, defined as sense of being there, but also the experiences
participating adolescents, 59 of them (29.5%) said they used the
of flow and continuous scoring, promotion, immediate feedback
Internet but never played video games. In the present study, there
and achievement of self-satisfaction (Park & Hwang, 2009).
was a need for adolescents who both used the Internet and played
video games based on the research purpose. Therefore, these 69
4. The problem adolescents, who did not serve the purpose of the present study,
were not included in the data analysis process. As a result, the
Although the relationships between video game and Internet
analyses were conducted with the remaining 131 adolescents.
addictions were identified in some studies (Ng & Wiemer-
Hastings, 2005; van Rooij et al., 2010), there is a need for more
studies to be conducted to confirm this relationship empirically. 5.2. Data collection tools
In addition, when the related literature is reviewed, it is seen that
there is a need for research to be conducted not only to examine In the study, ‘‘Demographic Variables Form’’, ‘‘Video Game
the relationships between technology-based addictions such as Addiction Questionnaire (VGAQ)’’ and ‘‘Internet Addiction Scale
video game and Internet addictions but also to discuss the related (IAS)’’ were used. The data were collected with the paper-and-pen-
reasons. In order to fill this gap, the present study examined the cil method in their classes. The interview held with the school
associations in related literature (non-empirical) with the relation- administrators described demographic data regarding such vari-
ships between video game and Internet addictions and aimed at ables as number of the students’ sisters/brothers, their families’
determining the (empirical) correlations between video game financial status, relationships between family members, rate of
and Internet addictions. In this respect, studies examining and access to technology and level of academic achievements. In addi-
discussing the relationships and comparisons are important to tion, research data were also collected from the students regarding
understand the causes of video game and Internet addictions and to their age, Internet use and video game use (e.g. duration, platform,
take the necessary prevention and treatment regarding the process. who they play with).
Also, the study further focused on whether the symptom of tol- Video Game Addiction Questionnaire (VGAQ). The Video Game
erance occurred in all conditions or not (e.g. social, financial). In the Addiction Questionnaire was developed by the researcher. In the
present study, the symptom of tolerance was discussed. For this process of developing the items, nine indicators in relation to
reason, depending on the findings obtained and considering the Internet Gaming Disorder found in DSM-V (2013) were taken as
social structure, several conclusions were drawn. In the study, reference. In this study, no discrimination was made between com-
within the scope of the interaction of different cultural structures puter games, online games and video games, and the items regard-
with technology, it was claimed that symptoms of behavioral ing the games played in the digital platform were developed for the
addictions are not efficient for the process of diagnosis of questionnaire. One item was prepared for each indicator. Five field
 S. Gunuc / Computers in Human Behavior 49 (2015) 517–525 521

experts were asked for their views about a total of nine items, and
the content validity and face validity were achieved. For the
scoring of VGAQ, a five-point Likert-type scale was used with
scores and answers ranging from ‘(1) Strongly Disagree’ to
‘(5) Strongly Agree’. Certain evidence was necessary to use VGAQ
as a continuous variable and as a reliable tool. For this purpose,
item analysis was conducted. The correlation values between each
item and VGAQ total score and between each item pair were found
significant at p < .05. The reliability of VGAQ was calculated as .71.
The data set regarding VGAQ demonstrated a normal distribution.
The findings obtained regarding the item analysis revealed that
VGAQ could be used for the intended measurement.
Internet Addiction Scale (IAS). IAS was developed in Turkish
by Gunuc and Kayri (2010) via a study carried out with 754
adolescents. The average participant age was 15.8. The scale was
made up of 35 items. In their study, the Cronbach’s Alpha internal
consistency coefficient of the five-point Likert-type scale rated as
(1) strongly disagree and (5) strongly agree was calculated by the
researchers as .94. As for the Cronbach’s Alpha (a) reliability
coefficients regarding the four sub-factors of IAS, they were
calculated as a = .877 for the sub-factor of Withdrawal, as
a = .855 for the sub-factor of Controlling Difficulty, as a = .827 for
the sub-factor of Disorder in Functionality and as a = .791 for the
sub-factor of Social Isolation. Higher scores received from the scale
indicate Internet addiction.
5.3. Data analysis
Before the analyses, the data set was made appropriate to
analysis. As a result, the reliability analysis and descriptive
statistics regarding the measurement tools were conducted. After
evidence indicating that the measurement tools could be used
was obtained, TwoStep Cluster Analysis was conducted to examine
whether the adolescents were video game and Internet addicts.
Cluster analysis is a multivariate statistical technique to categorize
individuals or objects in sub-classes or clusters depending on their
similarities. The purpose is to gather individuals with similar char-
acteristics in the same group considering a certain characteristic.
For this purpose, the similarities or distances between units are
used as a criterion (Everitt, 1980; Kaufman & Rousseeuw, 1990).
In this study, the total scores obtained via the measurement tools
of VGAQ and IAS were used as the criterion for grouping. In this
respect, TwoStep Cluster Analysis was conducted; the addicted
and non-addicted adolescents were divided in groups; and the
profile of the research sample was defined. Correlation analyses
were conducted between video game addiction and Internet addic-
tion and between game addiction and the sub-factors of Internet
addiction. As it was seen that the measurement tools were con-
tinuous variables and that the distributions were normal, Pearson
product-moment correlation analysis was carried out. Lastly, in
order to compare playing online and offline video games,
Independent Samples t-Test was used since the data had a normal
distribution. For the analyses, the significance level was taken as .05.
5.4. Findings
alone, and the other half said they played video games with
friends.
5.5. Preparing the data for analyses and examining the assumptions
Before the analyses, the missing data, outliers and normality
were examined (Hutcheson & Sofroniou, 1999; Kline, 2009;
Tabachnick & Fidell, 2007). The values of skewness (.440; ±1) and
kurtosis ( .210; ±1) for VGAQ and those of skewness (.592; ±1)
and kurtosis (.176; ±1) for IAS were found to be in acceptable
range. The fact that these values were in the ±1 range referred to
a normal distribution (Huck, 2012). The normality of the data set
was examined with Smirnov’s test. The Kolmogorov Smirnov
p-value was calculated as .200 (p > .05) for VGAQ and IAS.
Insignificant P-value refers to a normal distribution (Huck, 2012).
In addition, when the histogram, P-P and Q-Q graphics for VGAQ
data and the histogram, P-P and Q-Q graphics for IAS data were
examined (Huck, 2012; Kline, 2009; Pallant, 2007), it was seen that
the distributions were normal.
The findings obtained via the reliability analyses conducted for
the measurement tools revealed that the reliability coefficient was
calculated as .71 for VGAQ. Undoubtedly, it could be stated that
reliability increases in line with the increasing number of items
and with that of participants. However, the value of .71 is enough
to use the measurement tool (Fraenkel, Wallen, & Hyun, 2012). The
reliability values were calculated as .914 for the total IAS, as
a = .793 (mean = 26.96) for the sub-factor of Withdrawal, as
a = .816 (mean = 19.15) for the sub-factor of Controlling
Difficulty, as a = .834 (mean = 13.03) for the sub-factor of
Disorder in Functionality and as a = .810 (mean = 13.01) for the
sub-factor of Social Isolation.
5.6. Findings regarding the relationships between video game
addiction and internet addiction
Before examining the relationships between video game and
Internet addictions, the participants were grouped with TwoStep
Cluster Analysis depending on their addiction (Table 1).
When Table 1 is examined, it is seen that that the number of
probable video game addicts was 21 (16%) and that the number
of probable Internet addicts was 14 (10.7%). Though the number
of addicts in each group was close to each other, the percentage
of video game-addicted adolescents was higher than that of
Internet-addicted adolescents. In addition, the first group repre-
sented the non-addicted participants with both video game and
Internet addictions, and the second group represented the partici-
pants with the risk of addiction. Regarding this grouping, it could
be stated that the first group did not have any symptoms of addic-
tion at all; that the second group with the risk of addiction showed
some of the symptoms of addiction, and that the third group, the
addicted group, showed most of the symptoms of addiction.
Table 1
Grouping of the VGAQ and IAS total scores with TwoStep Cluster Analysis.
Group N % Mean sd

The participants’ video game playing and Internet use profiles VGAQ
1 (non-addicted group) 41 31.3 14.390 2.235
were determined. Accordingly, of all the participants, 73% of them 2 (addiction risk group) 69 52.7 22.319 2.604
used the Internet and played video game for one or two hours at 3 (addicted group) 21 16.0 32.286 2.866
most a day, and only 3% of them used the Internet for more than Total 131 100.0 21.435 6.437
five hours. In addition, among the participants, 7% of them
reported that they used the Internet mostly for playing video IAS
games. Also, 40% of them stated that they mostly played online 1 (non-addicted group) 54 41.2 52.593 8.551
2 (addiction risk group) 63 48.1 79.651 8.146
video games, and 60% of them said they mostly played in offline
3 (addicted group) 14 10.7 114.500 10.632
platforms (playstation, smart phone, tablet and so on). Lastly,
Total 131 100.0 72.221 21.262
almost half of the participants reported that they played games
522 S. Gunuc / Computers in Human Behavior 49 (2015) 517–525
Table 2
Pearson correlation coefficients (r) between VGAQ and IAS.
IAS Withdrawal
* *
VGAQ .66 .63
Online video game .68*
Offline video game .64*
*
p < .001.
Table 3
Comparison of online and offline video game playing in terms of IAS scores.
F Sig. t df
Online V.G./IAS .598 .441 2.027 129
Offline V.G./IAS
The relationships between video game and Internet addictions
and between video game addiction and the sub-factors of
Internet addiction were examined with Pearson product-moment
correlation analysis. Table 2 presents the findings obtained.
As can be seen in Table 2, a significantly positive correlation
was calculated between video game and Internet addictions as
well as between video game addiction and such sub-factors of
Internet addiction as Withdrawal, Controlling Difficulty, Disorder
in Functionality and Social Isolation (p < .001). For the coefficients
of Pearson’s r, an informal guide is suggested: r = ±.80 ‘‘strong
correlation’’, r = ±.50 ‘‘moderate correlation’’ and r = ±.20 ‘‘weak
correlation’’ (Huck, 2012). In this respect, when Table 2 is
examined, it is seen that there was a strong correlation between
video game and Internet addiction as well as between video game
addiction and such sub-factors of Internet addiction as Withdrawal
and Disorder in Functionality. In addition, there was a moderate
correlation between video game addiction and the sub-factors of
Controlling Difficulty and Social Isolation. Also, as can be seen in
Table 2, playing online video game had a slightly higher correlation
with Internet addiction when compared to offline video game
playing.
When Table 3 is examined, it is seen that although a significant
difference was found between the participants playing online and
offline video game (p = .045; p < .05), there was a fairly little
difference. However, it was seen that the adolescents playing
online video game had higher mean scores of Internet addiction.
6. Conclusions and discussion
Consequently, there are relationships between online behav-
ioral addictions due to the bridge established via the Internet or
due to problematic Internet use. The relationship between video
game and Internet addictions was empirically examined as well.
According to the results obtained, there was a strong correlation
between video game and Internet addictions. In addition, it could
be stated that video game playing leads to a higher risk of
addiction for adolescents when compared to Internet use. One
reason for this could be the fact that video game playing is
regarded especially by children and adolescents as a way of enter-
tainment. Another reason is that among the Internet use purposes
are those with no risk of addiction such as research, information,
news, videos and music. Therefore, it could be stated that the risk
of becoming video game addicted and Internet addicted is higher
for all adolescents playing video games.
Since Internet addiction involves such addictions as online
video game addiction and Facebook addiction, it could be stated
that Internet addiction is a higher order concept. In some studies,
the negative effects and symptoms of Internet addiction and video
Controlling difficulty Disorder in functionality Social isolation
* *
.49 .59 .42*
p Mean diff. N Mean sd
.045 7.605 52 76.808 23.266
79 69.203 19.397
game addiction were reported to be parallel to each other (Kim,
Jeong, & Zhong, 2010). Therefore, Internet-based relationships
between behavioral addictions should be taken into consideration
to take the necessary steps for the prevention and treatment of
online video game addiction. Thus, the prevention and treatment
regarding only video game playing are not sufficient. In addition,
prevention and treatment regarding Internet use should be
executed by the shareholders accordingly.
In the study, the relationships of online and offline video game
playing with Internet addiction were examined, and it was found
out via the correlation and t-test results that there was no con-
siderable difference in-between. However, though there was as a
slight difference, it was revealed that online video game playing
was more likely to cause Internet addiction when compared to
offline video game playing. In related literature, there are studies
supporting this finding (Kuss et al., 2012; Ng & Wiemer-Hastings,
2005; Parsons, 2005). One reason for this could be the fact that
video gamers find the opportunity to compete with each other in
online platforms; that this competition increases their feelings of
ambition, satisfaction and joy; and that they aim at making money
(Ang & Zaphiris, 2010; Beranuy et al., 2013; Kuss & Griffiths,
2012a; Ng & Wiemer-Hastings, 2005; Paik et al., 2014; Peters &
Malesky, 2008). However, these results are fairly surprising
because a strong correlation between offline video game playing
and Internet addiction is not an expected result while a strong
correlation between online video game playing and Internet
addiction is expected. In addition, in this study, the number of
those preferring to use the Internet to play video games was fairly
low. For this reason, it was surprisingly found out via the t-test that
there was not much difference between online and offline video
game playing in terms of Internet addiction and that offline video
game playing had a strong correlation with Internet addiction.
As a result of the rapid development and spread of technology,
individuals’ contact with the Internet will undoubtedly develop
and gain strength. For the prevention and treatment of video game
addiction and other behavioral addictions likely to be developed
and facilitated by the Internet, it is certainly wrong to interfere
with individuals’ relationships with the Internet and to help them
move away from this technology despite all the risks posed by the
Internet. Especially online video games (e.g. MMORPG) could be
said to contribute to socialization via the Internet and to the devel-
opment of interaction or communication between individuals (Ang
& Zaphiris, 2010; Cole & Griffiths, 2007). However, this is not valid
for all kinds of games or for offline video games. In addition, it is
thought that there are various benefits of video games (De
Freitas & Griffiths, 2007, 2008; Griffiths, 2002; Procci et al.,
2013), while it is hard to cite positive effects of every behavior like
gambling.
 S. Gunuc / Computers in Human Behavior 49 (2015) 517–525
Another finding was that a great majority of the participants did
not use the Internet for more than two-three hours a day.
Regarding the socio-economic conditions, family structures and
demographic backgrounds of the participants, it was seen that
almost half of them had to restrict their Internet use or increase
the amount of their Internet use due to financial and family-related
factors though they wanted to use the Internet or play video games
longer. Does the symptom of tolerance exist in all addicted individ-
uals? If individuals are prevented from increasing the time they
spend on the Internet/game or if they do not have the opportunity
to increase the amount of their Internet use, do they develop addic-
tion, though? To what extent is the symptom of tolerance impor-
tant for the diagnosis of addiction, and does it influence other
symptoms? The findings obtained in the study revealed that the
duration of Internet use of the Internet-addiction risk group and
the addicted group was mostly one or two hours and that their
Internet-addiction scores were over the medium level. Although
Griffiths and Meredith (2009) stated that excessive activity and
addictive activity are two very different things, excessive use is
an important indicator of addiction. In cases of excessive use of
the Internet or video game, it is likely for addiction to develop
(Griffiths, 2000, 2008b). The results of previous studies, it was seen
that there was a strong correlation between Internet/video game
addiction and the duration of daily Internet use or; that the
Internet-addicted individuals used the Internet for four or five
hours or longer a day; and that the tolerance symptom occurred
as well (Cao & Su, 2007; Gunuc, 2013; Gunuc & Kayri, 2010;
Hardie & Tee, 2007; Lin & Tsai, 2002; Nalwa & Anand, 2003;
Simkova & Cincera, 2004; Young, 2004). An important reason for
the fact that there is a strong correlation between addiction and
the amount of time spent on Internet/game is tolerance because
individuals tend to increase their amount of use in the addiction
process. In this respect, this result found in the present study is
quite important not only in terms of its contribution to the related
literature but also because Internet addiction symptoms could
occur in different forms. This situation means that ‘‘tolerance’’ will
not always be a symptom of Internet addiction. Also, lack of the
symptom of ‘‘tolerance’’ does not mean that the individual is not
an addict. Although tolerance is one of the important symptoms
of video game or Internet addiction (DSM-V, 2013; Kuss &
Griffiths, 2012b), it may not occur due to financial (e.g. Internet
access at home, limited Internet use in an Internet café) and fam-
ily-related causes (e.g. number of children, adolescent-parent
relationships). On the other hand, most of these adolescents could
be said to experience such symptoms more severely as withdrawal,
disorder in Functionality and social isolation. Thus, the IAS mean
score regarding the sub-factor of withdrawal was found a lot
higher than the other sub-factors. The symptoms of withdrawal
and tolerance are two important phenomena used to determine
behavioral addictions (Blaszczynski et al., 2008; Block, 2008;
Greenfield, 2011). In related literature, it is seen that the symptoms
of withdrawal are experienced mostly by Internet-addicted
adolescents (Paik et al., 2014). However, when Internet-addicted
adolescents’ Internet use is restricted, more psychological and
physiological problems are likely to be experienced more severely
since tolerance may not develop. In addition, even though the
individual occurs psychological tolerance, he or she may not
develop physical/behavioral tolerance. In other words, the individ-
ual wants to increase the time he or she spends on the Internet, but
this is prevented for any reason. The school administrators
described their own students as adolescents prone to violence,
nervous, ill-tempered and conflicting with teachers, friends and
family members. This description provides evidence demonstrat-
ing that the severity of symptoms like withdrawal is likely to
increase when tolerance does not occur (Beard, 2011; Greenfield,
2011). In other words, not only when the Internet/game is taken
523
away but also when the individual is prevented from increasing
the time he or she spends on the Internet/game or when he or
she does not have the opportunity to increase that time, tolerance
may not occur. However, in this case, more severe symptoms of
withdrawal can be observed. In this respect, restricting the amount
of time spent on the Internet or preventing from increasing the
time spent on the Internet/game is not enough for treatment alone.
For the diagnosis of behavioral addictions, it is believed that it is
necessary to consider the symptoms together with technology use
conditions and the cultural structure where the technology is used
(family income level, relationships with family members, parents’
attitudes toward technology and with other related demographic
variables). Thus, future studies can focus on the fact that symptoms
of addiction may differ considerably in certain conditions and that
symptoms are not efficient alone for the diagnosis of addiction.
Consequently, tolerance was used in a number of studies with
withdrawal as the symptoms of behavioral addictions (Beard &
Wolf, 2001; Greenfield, 2011), and it was not used in some other
studies as the main symptom (Gunuc & Dogan, 2013; van Rooij
et al., 2010; Wilson, Fornasier, & White, 2010). In this respect,
while examining tolerance, other variables (e.g. amounts of time,
purpose of Internet use, other symptoms) should be taken into
consideration to determine Internet addiction.
7. Limitations and future research
In this study, the number of participants and the problems
experienced during the data collection process constituted the lim-
itations to the study. Although the participants in the present study
were selected from a region considering the financial and
family-related factors, this situation caused certain difficulties in
collecting data from the students. It was observed that some of
the students were bored of filling out questionnaires as they had
dealt with other questionnaires too many times before and that
some of them did not believe in the importance of surveys.
Therefore, the participants responded to the measurement tools
on voluntary basis, and they were motivated to fill out the
measurement tools for a healthy data collection process.
As online video game addicts use the Internet, they may also
develop Internet addiction in time. Although the present study
presented some (empirical and non-empirical) evidence regarding
the relationships and associations especially between Internet and
other online addictions, future studies could still examine certain
problems in detail. In addition, future experimental studies could
also seek answers to such questions: Do the symptoms of
withdrawal and their severity that occur when Internet or internet
gaming is taken away resemble to the symptoms and their severity
that occur when the individual is prevented from increasing the
time he or she spends on the Internet? What are the strong correla-
tions between Internet addiction and offline video game playing,
and what are the causes of these strong correlations? Do types of
addiction trigger one another? (In other words, does one type of
addiction leads to the development of other addictions and weaken
the individual’s resistance to addiction?) What other things,
besides using the Internet to play video games, have influence on
the relationships and associations between Internet addiction
and video game addiction?
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