thesis statement gaming addiction

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An Investigation into Video Game Addiction in Pre-Adolescents and Adolescents: A Cross-Sectional Study

Maria rosaria esposito.

1 Istituto Nazionale Tumori “Fondazione G. Pascale”, via M. Semmola, 80131 Naples, Italy; [email protected]

Nicola Serra

2 Department of Molecular Medicine and Medical Biotechnology, University Federico II of Naples, via S. Pansini, 80131 Naples, Italy

Assunta Guillari

3 Department of Public Health, University Federico II of Naples, via S. Pansini, 80131 Naples, Italy; moc.liamg@07iralliuga (A.G.); [email protected] (T.R.)

Silvio Simeone

4 Department of Biomedicine and Prevention, University of Rome “Tor Vergata,” Montpellier 1, 00133 Rome, Italy; ti.orebil@ailicecoivlis

Franca Sarracino

5 Department of Pediatrics, Betania Evangelical Hospital, via Argine, 80147 Naples, Italy; ti.ilacsit@onicarrasacnarf

Grazia Isabella Continisio

6 Continuing Medical Education Unit, University Federico II of Naples, via S. Pansini, 80131 Naples, Italy; ti.aninu@sinitnoc

Background and Objectives : Game addiction is an emerging problem in public health. A gaming disorder is characterized by a pattern of persistent or recurrent gaming behavior. The behavioral pattern is severe enough to implicate a significant involvement of family, social, educational, professional, or other relationships. Therefore, greater attention needs to be paid to potential addictive behaviors in terms of video games in order to identify both pre-adolescents and adolescents at risk and to provide them with adequate assistance. Materials and Methods : A random sample of 622 students including pre-adolescents and adolescents were enrolled from September 1st to October 31th 2016, and the Game Addiction Scale (GAS) interview was used to identify pathological students with both Monothetic and Polythetic analysis. Results : This study shows the presence of pathological students is equal to 1.93%, with 37.46% and 4.50% obtained with Monothetic and Polythetic analysis (global and partial), respectively. In our sample, the most frequent were students with a gaming time of 1 or 2 h, and students with a day gaming frequency of 1, 2, or 3 times a day. The items with more pathological students were Item 2 (i.e., Tolerance) and 4 (i.e., Withdrawal). Every item was positively correlated with Daily gaming time (hours) and Daily game frequency, excluding Item 4 (i.e., Withdrawal). Finally, the Monothetic GAS score was positively correlated with Daily gaming time while the Polythetic Global GAS was positively correlated with Daily game frequency and negatively with Education level; instead, the Polythetic Partial GAS score was positively correlated with only Daily gaming time. Conclusion : Males are pathological gamblers more so than females and spend more time playing video games. An increase in Daily game frequency or Daily gaming time implicates an increase in video game addictions, while an increase in Education level, which generally corresponds to a greater age, implicates a decrease in game addiction. Finally, we observed that the correlations obtained between the Polythetic Partial GAS score with the independent variables such as Age, Gender, Education level, Daily gaming time (hours), and Daily game frequency were analogous to the significant correlations obtained with the Monothetic GAS score, while these correlations were different for the Polythetic Global GAS and the independent variables. These results suggest that the use of the original Polythetic scale should not be neglected.

1. Introduction

Most of the free time dedicated to recreational activities is represented by “video games,” which respond to a “playful need,” captivating people of all ages, sexes, and social classes [ 1 ]. The video game industry is prevalent worldwide, with products running on mobile phones, computers, and video game devices, showing positive effects on basic mental processes such as perception, attention, memory, and decision-making [ 2 ]. However, abuse of such a play activity can become an addiction, i.e., a video game addiction [ 3 ].

The World Health Organization (WHO) included gaming disorder, both online (Internet computerized games) and offline (non-Internet computerized games), for the first time in the draft of 11th revision of the International Classification of Diseases (ICD-11). This problem has also been confirmed in the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), which includes diagnostic criteria for Internet gaming disorders [ 4 ].

Many studies have examined Internet use problems, including online gaming, while other authors have focused their attention only on problems connected to online gaming, such as interpersonal relations and school/social functions [ 5 , 6 ], impulsivity and neuroticism [ 7 ], aggression and violence [ 8 ], attention deficit [ 9 ], depression [ 10 , 11 ], anxiety [ 10 , 12 ], sleep problems (including subjective insomnia and poor sleep quality [ 13 ]), and spending money on gaming [ 6 ].

A systematic review [ 1 ] on Internet gambling disorder (IGD) reported a higher prevalence in males than in females and among young people compared to the elderly [ 6 ]. Variations were also observed based on the geographical position [ 6 , 7 , 9 , 11 , 14 , 15 , 16 , 17 ]; For example, in Italy [ 18 ], the prevalence among adolescents is about 9%, which is comparable to that of the main European nations.

Gaming disorders were initially identified as having the characteristics, normally evident over a period of at least 12 months, of a pattern of persistent or recurrent gaming behavior (i.e., inability to control excessive gaming) [ 19 ], which may be in relation to online (i.e., over the internet) or offline games [ 20 , 21 ], and which severely impacts on the family, social, educational, professional, or other relationships of the player.

In addition, there is a need for studies with greater heterogeneity to understand potentially addictive behavior, including that related to video games [ 22 ]. In fact, there is a disagreement between some authors on the inclusion of the term disturbance of the game, stemmed from the fact that gambling may not be the most appropriate starting point for considering behavioral addiction [ 23 ]. However, there is still an open debate to identify addiction syndrome in comparison to behavioral dependence in a more specific way in order not to pathologize common behaviors [ 24 ]. Furthermore, it is not yet clear how behaviors considered pathological can be related to the duration of the game, or how to understand the seriousness of dependent behaviors [ 25 ]. This association is due to the fact that a gaming disorder shares many features with addictions related to psychoactive substances and with gambling disorder [ 26 ]. The American Psychiatric Association applies to this behavior the same diagnostic criteria used for substance addictions, to new forms of behavioral addiction [ 4 ]. Behavioral addictions—and therefore, those including video games—according to some experts, should be placed among “Impulse Behavior Disorders,” as is already the case for gambling [ 27 ].

A variety of terms have been employed to describe this condition including: Excessive Internet addiction (encompassing gaming, social networking sites, and video viewing) or video game addiction; problematic computer game use [ 28 ], problematic video gaming [ 29 ], video game dependency, or pathological video gaming [ 7 , 30 ]; or excessive gaming, pathological gaming, video game addiction, digital game addiction, or online gaming addiction [ 26 , 27 ].

These behaviors are measured in various subjects (e.g., children, adolescents, gamers) and geographical areas [ 31 ]. In this study, video game addiction is used as the preferred term to refer to the problematic or pathological use of video games. Lemmens et al. defined video game addiction as an “excessive and compulsive use of computer or video games that results in social and/or emotional problems; despite these problems, the gamer is unable to control this excessive use” [ 3 ]. Moreover, the time spent playing video games, and specifically a higher frequency and gaming time, are strongly correlated with symptoms of pathological gaming [ 19 , 32 , 33 , 34 ].

These signs of addiction are adapted to adolescent video game playing as follows: [ 35 ] Increased time spent playing or thinking about video games, scheduling the next game or remembering previous games, bad mood or irritability when it is not possible to play, increased time spent playing during difficult times, failed attempts to control game playing time, concealing the time spent playing from parents or friends, failing to do homework, lying about it in order to play video games, losing hours of sleep, missing meals, and spending less time with family or friends in order to play more. There is greater agreement that gaming problems are connected to other negative factors. Some studies claim that Internet or video games addictions are associated with psychiatric co-morbidities [ 36 ], such as depression [ 30 ], substance abuse (e.g., alcohol [ 37 ]), attention deficit disorder [ 38 ], decreased academic achievement [ 39 ], and problematic conduct [ 32 ]. In particular Brunborg et al., 2014, found that youths who had problematic conduct or were addicted gamers had a greater risk of feeling low, irritable, or nervous, of being in a bad mood, tired, or exhausted, and of feeling afraid when compared to non-problem gamers [ 32 ].

Unfortunately, proving a prevalence rate for video games addiction is not easy because a variety of assessment tools have been used in related studies, as well as different population types and classifications or cutoffs for problematic, addicted, or pathologic gamers.

For this study, we used the scale developed by Lemmens et al. to assess gaming among adolescents [ 3 ]; this tool has already been used by other authors [ 15 , 35 , 40 , 41 ], and is conceptually based on the criteria for pathological gambling, described by the fourth edition of the DSM.

In our study, we focused on pre-adolescents and adolescents because they generally play computer and video games more frequently than adults [ 42 ] and are considered more vulnerable to gambling addiction than adults [ 40 ].

The objective of this study was to investigate video game addiction and the associated risk factors using a sample of pre-adolescent and adolescent students in Southern Italy.

2. Materials and Methods

2.1. study design and population.

A cross-sectional study was conducted from September 1st to October 31th 2016 using a sample of 622 pre-adolescent and adolescent students recruited from two primary ( n = 217) and two secondary ( n = 405) schools.

Informed consent was signed by all parents of the students included in this study. For all students anonymity was guaranteed. No economic incentives were offered or provided for participation in this study. This study was approved by “Circolo Didattico Giancarlo Siani, Mugnano (Naples), prot. 2366 (May 19, 2015),” “Circolo Didattico Giovanni Falcone, Melito (Naples), prot. 1113/B32 (May 20, 2015),” “Scuola Secondaria Statale di I Grado, Marino Guarano, Melito (Naples), prot. 1279/C23 (May 25, 2015),” and “Scuola Secondaria Statale di I Grado, Illuminato-Cirino, Mugnano (Naples), prot. 3240/C12 (September 30, 2015).”

All teachers involved in this study were informed about the purpose and method of investigation and were trained by the research team. All information and data were archived according to Legislative Decree 196/2003. The study was performed in accordance with the ethical considerations of the Helsinki Declaration.

The questionnaire, based on the Game Addiction Scale (GAS), was administered to students after a brief explanation. Some teachers were present in the classroom during the completion of the questionnaire, to help the students with its completion. All students aged under 10 years were excluded from the study.

2.2. Instrument

The questionnaire was structured in two parts; the first part was designed to collect information about variables including Age , Gender , Education level , Daily gaming time , and Daily game frequency .

The second part was based on the Game Addiction Scale (GAS) [ 3 ], i.e., a tool developed to measure computer and video game addiction among adolescents using the clinical criteria for pathological gambling in the DSM-5 [ 43 ].

The short version of the GAS includes seven Items: S alience (Item 1): Playing a game becomes the most important activity in a person’s life and dominates his thinking (preoccupation), feelings (cravings), and behavior; Tolerance (Item 2): The process where a person begins playing games more often, gradually building up the amount of time spent on games; Mood modification (Item 3): The subjective experiences that people report as a result of engagement in games; Withdrawal (Item 4): Unpleasant emotions and/or physical effects that occur when game play is suddenly reduced or discontinued, i.e., it consists mostly of moodiness and irritability, but may also include physiological symptoms, such as shaking; Relapse (Item 5): The tendency to repeatedly revert to earlier patterns of game play—excessive playing patterns are quickly restored after periods of abstinence or control; Conflict (Item 6): This refers to all interpersonal conflicts resulting from excessive gaming—conflicts exist between the player and those around him, and may include arguments and neglect, but also lies and deception; Problems (Item 7): This refers to problems caused by excessive gaming time—it mainly concerns displacement problems as the object of addiction takes preference over activities, such as school, work, and socializing.

Each item of the GAS is preceded by the statement “During the last six months, how often…” and is scored with a 5-point Likert scale (1 = never, 2 = rarely, 3 = sometimes, 4 = often, and 5 = very often). Lemmens et al. suggested two forms for evaluation of the presence of game addiction: One Monothetic form and two possible polythetic forms [ 3 ]. Monothetic form refers to when the pathologic subject is identified only by all items having a score ≥ 3; Polythetic form 1 ( Polythetic Global GAS ) refers to when the pathologic subject is identified only by at least half of the items having a score ≥ 3; and Polythetic form 2 (Polythetic partial GAS ) refers to when the pathologic subject is identified only by Items 4, 5, 6, and 7 simultaneously having a score ≥ 3.

2.3. Cultural Validation of the Gas and Preliminary Testing

The translation and cultural adaptation of the GAS tool has followed the phases of the model proposed by the World Health Organization [ 44 ]. With the authors’ help, as well as that of bilingual and non-bilingual translators, and of the support of experts, the Italian version of the GAS tool was defined. The aim of the translation and validation process was to produce a new language version of the GAS tool that was conceptually equivalent to the original version. The correct validation process of this model led to an equivalent tool that can be used in a new cultural reality, and it represents a correct conceptual translation rather than a simple literary translation. In order to test the scale, a pilot study was carried out on a random sample of 15 students (9 pre-adolescents and 6 adolescents with 10 males and 5 females) to make sure the respondents were interpreting the questions as intended, prior to carrying out the study on a larger scale. The questions were determined to be clear and understandable, as the children had no difficulty in answering them.

2.4. Statistical Analysis

Statistical analysis was performed using the Matrix Laboratory (MATLAB) Statistical toolbox version 2008 (MathWorks, Natick, MA, USA). Data are presented as numbers and percentages for categorical variables, and continuous data expressed as the mean ± standard deviation (SD) unless otherwise specified. A binomial test was performed to compare two mutually exclusive proportions. A multiple comparison chi-square test was used to define significant differences among percentages. In this case, if the chi-square test was significant ( p < 0.05), a post hoc Z-test was performed. In the case of paired data, a multiple comparison Cochran’s Q test was used to compare the differences among percentages under the consideration of the null hypothesis that there were no differences between the variables. When the Cochran’s Q test was positive ( p < 0.05), then a minimum required difference for a significant difference between two proportions was calculated using the Minimum Required Differences method with Bonferroni p -value corrected for multiple comparisons according to Sheskin [ 45 ]. Finally, to perform both linear and logistic regression, we considered the following variables: Item n ( n = 1, ..., 7): pathologic = 1 (score ≥ 3); non-pathologic = 0 (score < 3); Monothetic GAS score : pathologic = 1 (all items with a score ≥ 3); non-pathologic = 0; Polythetic Global GAS score : pathologic = 1 (subjects with a minimum of 4 out of 7 Items with a score ≥ 3); non-pathologic = 0; Polythetic Partial GAS score : pathologic = 1 (subjects with Items 4, 5, 6 and 7 simultaneously having a score ≥ 3); non-pathologic = 0; Gender : Male = 0 and female = 1; Education level : elementary school degree = 1, middle school degree = 2; Daily gaming time : 1 h = 1, 2 h = 2, 3 h = 3, 4 h = 4, greater or equal to 5 h = 5; Daily game frequency : one = 1, two = 2, three = 3, greater or equal to four = 4.

Univariate and multivariate linear correlation analyses were also performed. In this case the test on Pearson’s linear correlation coefficient R was performed with Student’s t -test, under the null hypothesis of Pearson’s linear correlation coefficient R = 0. For this we considered the dependent variable as every Item (Item:1= Salience , 2= Tolerance , 3= Mood modification , 4= Withdrawal ; 5= Relapse , 6= Conflict , 7= Problem ), using a 5-point Likert scale, and the independent variables as: Age , Gender , Education level , Daily gaming time , and Daily game frequency . Instead, logistic regression was performed to analyze the relationship between the Monothetic GAS score, Polythetic Global GAS score, and Polythetic Partial GAS score with independent variables: Age , Gender , Education level , Daily gaming time , and Daily game frequency . All tests with p < 0.05 were considered significant.

The student sample was composed of 52.89% males and 47.11% females, all of Italian ethnicity, with an age range 10–15 years old (a mean of 11.5 years old and a standard deviation equal to 1.28 years old), as shown in Table 1 . In particular Table 1 shows the characteristics of the sample in our study, with interviews and statistical analysis performed among the modalities for every variable.

Characteristics of the 622 participants in our study.

* = significant test; ** = most frequent; *** = less frequent; C = Multiple comparison χ 2 test; Z = Z-test;B = Binomial test; Q = Cochran’s Q test; MRD= Minimum Required Differences method with Bonferroni p-value corrected for multiple comparisons; SD = standard deviation; + = pathological students, considering every Item; ++ = using Game Addiction Scale(GAS) scale of both Monothetic and Polythetic structure to define pathological students; Monothetic Global GAS score = we considered simultaneously all Items with a score ≥ 3; Polythetic Global GAS score = polythetic structure, including all Items and considering subjects with a minimum of 4 out of 7 Items with a score ≥ 3 as pathological; Partial GAS score = we considered simultaneously Items 4,5,6 and 7 with a score ≥ 3.

The results show a significant presence of students who attended lower secondary school in comparison to elementary school (65.11% > 34.89%, p < 0.0001).

Regarding Day gaming time , the significantly most frequent answers were two (32.15%) and three hours (34.24%), while one (12.38%), four (12.54%), and greater or equal to five hours (1.29%) were the significantly less frequent answers. In regard to Day gaming frequency , the most frequent answers were one (32.15%), two(34.24%), and three (32.48%), while greater or equal to four was given significantly less frequent(0.96%). In addition, many students were pathological in terms of Item 2 (64.15%, p < 0.0001) and Item 4 (60.13%, p < 0.0001), while few students were pathological in terms of Item 3 (20.26%, p < 0.0001) and Item 7 (23.47%, p < 0.0001). Finally, according to GAS classification [ 3 ], we observed a low presence of pathological students, i.e., 1.93% (12/622), by Monothetic GAS score . A similar case was also seen for Polythetic Partial GAS score —4.50% (22/622)—while for Polythetic Global GAS score, more students were at risk, i.e., 37.46% (233/622).

In Table 2 , the percentages of the students’answers for every item and every score defined by a Likert scale of 1–5 are shown.

Percentages of students’ answers for every items and every score considering a Likert scale of 1–5.

+ = using a Likert scale of 1–5: 1 = never, 2 = rarely, 3 = sometimes, 4 = often, and 5 = very often.

Table 3 shows the univariate and multivariate linear correlation analyses, considering the independent variables as Age , Gender , Education level , Daily gaming time, and Daily game frequency , and the dependent variable as every item considered singularly.

Univariate and multivariate linear correlation analyses between every item and independent variables: Age , Gender, Education level, Daily gaming time (hours) ,and Daily gaming frequency.

* = significant test; R = Pearson’s linear correlation coefficient; R_partial = the partial correlation coefficient is the coefficient of correlation of the variable with the dependent variable, adjusted for the effect of the other variables in the mode.

As can be seen, more significant correlations were individuated. Particularly for Item 1 (i.e., Salience ), the univariate analysis showed a low but significant negative correlation with Age , Gender , and Education level ; in other words, an increase (decrease) in Age, in the presence of females, and in students with a greater Education level implicate a decrease(increase) in the Item 1 score. In contrast, Daily gaming time and Daily game frequency were positively correlated with Item 1, i.e., an increase (decrease) in Daily gaming time and Daily game frequency implicate an increase (decrease) in the Item 1 score. In the multivariate analysis, Daily gaming time and Daily game frequency were positive predictors in comparison to the others for Item 1, while Education level and Gender , were negative predictors, confirming the results of the univariate analysis.

For Item 2, in the univariate analysis, analogous results for Item 1 were observed, apart from Education level , which was not correlated with Item 2. In the multivariate analysis, the positive and negative predictors were Daily gaming time and Gender respectively, in comparison to the other variables, i.e., an increase (decrease) in Daily gaming time and in the presence of males were predictors of an increase (decrease) of Item 2 score (i.e., Tolerance ).

In the univariate analysis, Item 3 (i.e., Mood modification ) was positively correlated with Daily gaming time and Daily game frequency , i.e., mood swings increase (decrease) with an increase (decrease) in Daily gaming time and/or Daily game frequency . In the multivariate analysis, only Daily gaming time represented a significant positive predictor for mood swings in comparison to the other variables, i.e., the presence of greater Daily gaming time implicates greater mood swings.

For Item 4 (i.e., Withdrawal ), no significant correlations in either the univariate or the multivariate analysis were observed. In other words, among Age , Gender , Education level , Daily gaming time , and Daily gaming frequency , none had a significant impact on students, in terms of unpleasant emotions and/or physical effects, when the game was suddenly reduced or suspended.

For Item 5 (i.e., Relapse ) in the univariate analysis, the results were analogous to those for Item 1. In other words, only Daily gaming time , Daily game frequency, and the presence of males induced the tendency to return several times to previous models of video game use, while conversely, an increase in Age or Education level implicates a reduction of this tendency. In the multivariate analysis, Daily gaming time and Daily game frequency represented two significant positive predictors for Relapse in comparison to the others.

In the univariate analysis, Item 6 (i.e., Conflict ) was positively correlated with Daily gaming time and Daily game frequency , i.e., the interpersonal conflicts resulting from excessive game play increased(decreased) with an increase (decrease) in Daily gaming time and/or Daily game frequency . In the multivariate analysis only Daily gaming time represented a significant positive predictor for interpersonal conflicts in comparison to the others.

Finally, in the univariate analysis, we observed for Item 7 (i.e., Problems ), analogous results to those for Item 1. Specifically an increase in Daily gaming time, Daily game frequency , and the presence of males was connected to problems caused by excessive video game use such as reduction of school-related activities, work, and socialization. In comparison, Age and Education level implicate a reduction of these problems. In the multivariate analysis, we observed that only Age, Daily gaming time , and Daily game frequency were significant positive predictors for Item 7, i.e., students with a greater Age , and an increase in Daily gaming time and Daily gaming frequency were more exposed to problems caused by excessive video game use.

In Table 4 , we reported the results of the logistic regression between the Monothetic GAS , Polythetic Global GAS , and Polythetic Partial GAS scores and the independent variables (i.e., Age , Gender , Education level , Daily gaming time , and Daily game frequency ).

Logistic regression between Monothetic GAS score, Polythetic Global GAS score, Polythetic Partial GAS score, and the independent variables (i.e., Age, Gender, Education level, Daily gaming time (hours), and Daily gaming frequency).

* = significant test; OR = odds ratios; CI = odds ratios confidence interval at 95%; null model= −2ln(L 0 ), where L 0 is the likelihood of obtaining the observations if the independent variables do not affect the outcome, the full model: −2ln(L 0 ), where L 0 is the likelihood of obtaining the observations with all independent variables incorporated in the model; C = chi-square test.

For this scope, two models were considered. The null model: −2ln(L 0 ), where L 0 was the likelihood of obtaining the observations if the independent variables did not affect the outcome, and the full model: −2ln(L 0 ), where L 0 was the likelihood of obtaining the observations with all independent variables incorporated in the model. The difference between these two yields was estimated with the chi-square test, to define how well the independent variables affect the outcome or dependent variable; if chi-square test was positive ( p < 0.05), than there was evidence that at least one of the independent variables contributes to the prediction of the outcome.

By using logistic regression, it was shown that Daily gaming time was positively correlated with Monothetic GAS score (Odds Ratio (OR) = 3.70 and p = 0.0057); in other words, an increase (decrease) in Daily gaming time contributes to an increase (decrease) in the Monothetic GAS score , i.e., to pathologic (non-pathologic) comportment in students in comparison to the other variables.

Regarding the Polythetic Global GAS score , the variables Daily gaming time and Daily game frequency were significantly positively correlated with it (OR = 2.64 and p < 0.0001, OR = 1.40 and p = 0.0063, respectively); in other words, an increase (decrease) in Daily gaming time or Daily game frequency contributes to an increase (decrease) in the Polythetic Global GAS score , i.e., individualized pathologic (non-pathologic) comportment in students in comparison to the other variables. Finally, the variable Daily gaming time was positively correlated with Polythetic Partial GAS score (OR = 2.16 and p = 0.0059); in other words, an increase (decrease) in Daily gaming time contributes to an increase (decrease) in the Polythetic Partial GAS score , i.e., individualized pathologic (non-pathologic) comportment in students.

4. Discussion

In this study we investigated the dependence on video games in adolescent and pre-adolescent students in Naples province, considering every item of the Game Addiction Scale (GAS) and factors such as Age , Gender , Education level, Daily gaming time , and Daily gaming frequency .

For this scope, we considered both Monothetic and Polythetic GAS structure. By Monothetic structure, i.e., considering students with all item scores greater or equal to 3 as pathologic, it was shown that only 1.93% of students were classified as problem gamblers, which is less than in other studies on pathological players, such as in that by Khazaal, Chatton et al. 2016, where it was reported that 2.3% of respondents were classified as problem gamblers, using Monothetic scale [ 15 ]. However, this is a percentage that underestimates pathological players according to other authors [ 46 , 47 ]; meanwhile, when using the Polythetic structure, we observed in our study that 37.46% of the students were classified as problem gamblers. Analogous results were obtained in France with 156 and 306 adolescents, where the authors declared that the Monothetic structure could underestimate pathological gamblers; in fact, only 0.6% and 1% of the adolescents, respectively, were classified as problematic video game players, while 28% were identified as excessive pathological players when using the Polythetic structure [ 35 ]. Instead, Wang et al., using a sample of 503 students in middle secondary school in Hong Kong, reported a prevalence of 15.6% of players who could be considered problematic [ 6 ]. However, our results show different outcomes and this could be due to various reasons. First of all, the GAS score was viewed as the Polythetic score by the authors, because in the DSM-5 the symptoms of internet gaming disorder should have been present for at least three months, while Lemmens et al. suggested that all seven items must occur at least sometimes in the last six months in order to indicate video game addiction [ 3 ]. However, this approach could underestimate the results of pathological gaming reported in the study of Wang et al. [ 6 ].

Secondly, in our study, both online and offline games were considered, which contributes to a greater inclusion of video games available for children with consoles and CD ROMs or DVD games [ 22 ].

Thirdly, unlike the study carried out in Hong Kong by Wang et al. [ 6 ] where they considered only secondary school students (age > 11 years), we considered students aged 10 years and above. In a longitudinal study carried out in the primary and secondary schools of Singapore, using a population of 3034 children aged 8 years and above, although in the youngest age group, only 1% of children became a pathological player it seems that the pathological game is not simply a “phase” that passes in most children [ 30 ].

Our study showed different GAS scores, in comparison to studies performed in Norway [ 31 , 32 ], where the authors considered an additional subdivision of the players, dividing them into dependent, problematic, and very committed by those who are not dependent.

Generally, in the literature, all items of the GAS are used to identify both pathological and non-pathological players, but some authors had affirmed that some items of the GAS could be considered as marginal criteria, such as Salience , Tolerance , and Mood modification , while items such as Withdrawal , Relapse , Conflict , and Problems can be considered fundamental in comparison to others [ 46 ].

In this study, we considered, in addition, the classification of the items of the GAS suggested by Fergusson Coulson et al. [ 46 ]; therefore, we identified 4.5% as problematic students ( Polythetic Partial GAS score). This result is higher than the 1.2% and 0.89% of the two Norwegian studies, performed using samples of 10,081 subjects with an age range of 16–74 years old and of 3389 subjects an age range also of 16–74 years old, respectively [ 31 , 41 ], while our Monothetic GAS score results were similar to their 0.7% [ 41 ] and 1.41%, respectively [ 31 ].

It is likely that our sample is comparable to the stratified sample in the study of Wittek et al, where the authors observed that immigrants in Norway such as African, Asian, and both South and Middle American populations were positively associated with addicted and problem gamers, in contrast to those born in Norway [ 31 ]. In fact Wittek et al. affirmed that these immigrants are more susceptible to developing video game addiction, similarly to our Italian population, due to their rooted interest in gaming.

The regression analysis identified more significant correlations. In particular considering every item, we observed that age was negatively correlated with Salience and Relapse only in the univariate analysis, and positively correlated with Problems both in the univariate and the multivariate analyses. Instead, for the variable Gender , a negative correlation was observed with Salience, Tolerance , and Relapse , both in the univariate and the multivariate analyses; meanwhile a negative correlation only in the univariate analysis with Problems and a positive correlation only in the multivariate analysis with Mood modification were observed. In other words, male gender and students with a low age were correlated with the presence of dependent and problematic players. In fact, students with a greater age, had more self control, while young students in comparison had a tendency to perceive more unpleasant emotions that occur when the game is suddenly interrupted or suspended, and thus, consequently, were more likely to experience irritability and mood swings [ 10 ].

The results of this study are in agreement with those of previous studies, where it is described that males are pathological players more so than females, and those of a younger age are more involved [ 6 , 7 , 10 , 35 , 46 ].

In addition, the variables Daily gaming time and Daily game frequency were positively correlated with all items of the GAS, except Item 4 (i.e., Withdrawal ). In other words, the time dedicated to video games and the frequency of gaming represents predictors of probable dependence.

Finally, the Education level variable was negatively correlated with Salience , both in the univariate and the multivariate analyses, and negatively correlated only in the univariate analysis with Relapse , i.e., the Education level was only negatively correlated with some items.

By using logistic regression, a positive correlation between the Monothetic GAS score and Polythetic Partial GAS score with Daily gaming time was evidenced, in agreement with other studies [ 25 , 34 , 47 ]. This correlation was not present with the Polythetic Global GAS score ; in this case, it was shown that Daily game frequency and Education level were a positive and negative predictor of Polythetic Global GAS score , respectively. We observed that when considering all items (including Items 1, 2, and 3), additional information was obtained, i.e., different predictors were individuated. In fact, Daily game frequency represents a clear symptom of game addiction [ 40 ] and is linked to gaming time [ 47 , 48 ], while a higher education level implicates a greater capacity of self-control and therefore less of a game addiction. This result is according tothe correlations between age and some items; in fact, generally, students with a high education level are of a greater age in comparison to students with a low education level according to Khazaal Y et al. (2016) [ 15 ]. Our results regarding time spent gaming and game addiction are in accordance with those of Griffiths M., et al., and Triberti S, et al. [ 40 , 48 ]; in fact, Daily gaming time is synonymous with dependence, as described by Brunborg G.S., et al. [ 32 ], but some authors argue that there is a need for more information to evaluate the impact considering additional activities or commitments of the subjects [ 40 , 49 ]. These results suggest that the dependence on video games linked to Daily gaming time is described by the Polythetic Global GAS score . In fact, a student who plays for five minutes but twenty times a day—i.e., for a total of 1 h and 40 min, shows behavior that indicates symptoms of dependence, expressed by the subject’s difficulty to break away from the video game. This information was individuated considering the Polythetic Global GAS score , while the Polythetic Partial GAS score did not individualize this correlation. Therefore, we observed that the use of the Polythetic Partial GAS score i.e., not considering Items 1, 2, and 3, implicates a loss of information and, in addition, the Partial GAS score furnishes results similarly to the Monothetic GAS score .

5. Conclusions

This study showed that, according to previous studies, males are pathological gamblers more so than females and spend more time playing video games. In particular, a high daily game frequency or daily gaming time is a symptom of video game addiction, while a higher education level, which generally corresponds to a greater age, is associated with a reduction in game addiction. Finally, the results obtained by using the Polythetic ( Global and Partial GAS ) and Monothetic structures suggest that analysis of the original GAS (Polythetic Global GAS score) should not be neglected.

In relation to the open question about the use of the GAS tool in the evaluation of video game addiction, these results should be further confirmed. Particularly, in a recent study on GAS validation, Khazaal Y et al., (2018) [ 50 ], suggested that the analysis of single items should also be considered. In addition, Lin, C. Y. et al. [ 51 ] tested the psychometric properties of the Persian GAS through both classical and modern test theories, showing that the Persian GAS is a reliable and valid instrument for healthcare providers to assess the level of gaming addiction among Persian-speaking adolescents.

In light of these recent studies, our results could contribute to increasing the knowledge on the use of the GAS, to offer a comparison with the results of other studies using this scale, and to enrich the ongoing debate regarding the evaluation of video game addiction.

Limitations

In this study we did not distinguish between different types of video games, such as online and offline video games. We also did not evaluate other correlations such as the time spent studying or the reduction in primary or secondary school performance, as described by Brunborg, Mentzoni et al. [ 32 ]. In fact, it is possible that some games are likely correlated more to dependence, while other game types can stimulate study, i.e., the characteristics of a game can be of importance in the development of video game addiction [ 52 ]. Finally, to reduce the statistical bias connected to sample selection, the authors suggest a multicenter study. Regardless, these limitations do not diminish the statistical significance of the results.

Acknowledgments

The authors M.R.E. and N.S. contributed equally to this paper. The authors thank the school managers and teachers who supported this study, as well as Debora Fiordelisi and Gaetano Manna for their collaboration.

Author Contributions

M.R.E. and A.G. conceived and designed the experiments and wrote the manuscript; S.S., G.I.C., and T.R. defined the database and wrote the manuscript; S.S. reviewed the final draft; M.R.E. and T.R. designed the experiments andreviewed the manuscript; N.S. conducted the statistical analysis, interpretation of the data, wrote the manuscript, and reviewed the final draft; M.R.E., S.S., G.I.C., F.S. and A.G. supported the interviews. All authors have read and agreed to the published version of the manuscript.

This research received no external funding.

Conflicts of Interest

The authors declare no conflict of interest.

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Online Gaming Addiction and Basic Psychological Needs Among Adolescents: The Mediating Roles of Meaning in Life and Responsibility

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• Published: 10 January 2023

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• Alican Kaya   ORCID: orcid.org/0000-0003-2933-0161 1 ,
• Nuri Türk   ORCID: orcid.org/0000-0002-7059-9528 2 ,
• Hasan Batmaz   ORCID: orcid.org/0000-0002-5979-1586 3 &
• Mark D. Griffiths   ORCID: orcid.org/0000-0001-8880-6524 4  

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Individuals whose basic needs are naturally satisfied are much less dependent on their environment and more autonomous. Basic psychological needs (i.e., the general motivators of human actions) are significant predictors of online gaming addiction. Moreover, it has been posited that meaning and responsibility in life are at the center of life from an existential point of view. Therefore, a hypothetical model was tested to examine the relationships between basic psychological needs (autonomy, competence, relatedness), online gaming addiction, responsibility, and meaning in life. Data were collected from a sample of 546 participants. Mediation analysis was conducted, and the results indicated that basic psychological needs, online gaming addiction, responsibility, and meaning in life had significant negative and positive relationships. The findings indicated that responsibility and meaning in life had a serial mediating effect in the relationship between basic psychological needs and online gaming addiction. The findings also showed that the inverse relationship between online gaming addiction and basic psychological needs was at least partially explained by meaning in life and responsibility. The results of the present study are of great importance and suggest that interventions to satisfy the basic psychological needs of adolescents may help prevent online gaming addiction.

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Introduction

Technological addictions have become an area of increasing research interest and are conceptualized as non-chemical (i.e., behavioral) addictions (Kuss & Billieux, 2017 ). Moreover, they can be engaged in actively or passively (Widyanto & Griffiths, 2006 ). For example, television addiction is a passive technological addiction, whereas smartphone addiction and Internet addiction are active technological addictions (Griffiths, 2017 ). Online addictions have increased rapidly due to the increased use of smartphones, tablets, and laptops. Furthermore, overuse of the Internet has been conceptualized in a number of different ways, including problematic Internet use (Aboujaoude et al., 2006 ; Young, 2009 ), excessive Internet use (Choi et al., 2009 ; Lee et al., 2008 ), and Internet addiction (Griffiths, 2017 ) with some considering it to be an impulsive disorder (Young & Rodgers, 2009 ). In addition, online gaming addiction, which is another addiction associated with the Internet, is defined by the American Psychiatric Association (APA, 2013 ) as the consistent and prolonged use of the Internet to play videogames, frequently with other gamers, that causes disruption and clinically impairs several aspects of a person’s life (e.g., personal relationships, occupation and/or education). Key characteristics of online gaming addiction are individuals obsessively playing online videogames to the point of neglecting everything else in their lives, which leads to social and/or psychological disorders in such individuals (Ates et al., 2018 ; Batmaz & Çelik, 2021 ).

Previous studies have indicated various variables that predict and/or are associated with gaming addiction, including attention-deficit/hyperactivity disorder (ADHD), obsessive-compulsive disorder (OCD), anxiety and depression (Andreassen et al., 2016 ), social anxiety (Karaca et al., 2020 ), low self-esteem (Kim et al., 2022 ), inter-personal competence (Lee et al., 2019 ), relationship problems and relationship problems, and hostile family environment (Sela et al., 2020 ). In addition, social skill deficits (Mun & Lee, 2022 ), social and psychological isolation (Young, 2009 ), perceived stress (Rajab et al., 2020 ), suicidality (Erevik et al., 2022 ), and aggressive behaviors (McInroy & Mishna, 2017 ) have been reported among individuals who develop gaming addiction.

Although online gaming meets the various needs of individuals, when the behavior turns into an addiction, it leads to adverse effects on individuals, especially adolescents, where it can impair their mental health (Batmaz et al., 2020 ; Purwaningsih & Nurmala, 2021 ). Among adolescents, online gaming addiction has been reported to disrupt mental health, increase depression, anxiety, and psychoticism, disrupt family relationships (De Pasquale et al., 2020 ), lower quality of life (Beranuy et al., 2020 ), increase social phobia (Wei et al., 2012 ), lower school performance, and improve sleep deprivation (Chamarro et al., 2020 ; Király et al., 2015 ). In short, online gaming addiction negatively affects adolescents’ lives in different areas (Griffiths, 2022 ; Haberlin & Atkin, 2022 ). Therefore, research is needed to delineate the causes of online gaming addiction, eliminate its adverse effects, and implement necessary treatment.

Although many studies have been conducted examining online game addiction among adolescents (see Rosendo-Rios et al., 2022 ) for a recent review of studies), there are few studies examining the relationship between basic psychological needs and online game addiction (Bekir & Celik, 2019 ). In the present study, it is posited that basic psychological needs could be predictors due to the relationship with gaming disorders and problematic gaming (Allen & Anderson, 2018 ; Liu et al., 2021 ; Yu et al., 2015 ). When basic psychological needs are not met, it pushes individuals to exhibit maladaptive behavioral reactions (i.e., online gaming addiction) (Bekir & Çelik, 2019 ). In addition, few studies have addressed the relationship between responsibility and meaning in life and online game addiction (Arslan, 2021 ; Kaya, 2021 ). Moreover, no study has ever examined the mediating role of responsibility and meaning in life in the relationship between basic psychological needs and online game addiction. For these reasons, the present study examined the mediating roles of responsibility and meaning in life in explaining the relationship between basic psychological needs and online game addiction.

Online Gaming Addiction and Basic Psychological Needs

Self-determination theory is a well-established motivational theory comprising six mini-theories (Ryan & Deci, 2017 ). One of these mini-theories is the Basic Psychological Needs Theory (BPNT), which claims that the satisfaction of basic psychological needs is associated with better health and greater psychological well-being (Ryan & Deci, 2000 ). Basic psychological needs are requirements for psychological development, integrity, and well-being (Deci & Ryan, 2000 ). In contrast to the often-frustrating real world, videogames are designed to satisfy all three psychological needs (i.e., autonomy, competence, and relatedness) (Rigby & Ryan, 2011 ). Satisfaction of the needs for competence, autonomy, and relatedness can explain large amounts of the variance in game enjoyment (Rigby & Ryan, 2011 ; Tamborini et al., 2011 ). Online gaming can fulfill the (i) need for relatedness by directing players to social relationships with real or fictional characters, (ii) need for autonomy by giving them management and control within the game, and (iii) need for competence by making them feel successful in playing challenging videogames (Allen & Anderson, 2018 ).

Individuals addicted to videogames need novelty seeking, socialization, competition, and/or entertainment (Hussain et al., 2012 ; Larrieu et al., 2022 ). Studies have shown that gaming addiction is related to basic needs (Billieux et al., 2015 ) and psychological needs such as success, independence, fun, and respect (Herodotou et al., 2012 ). The increasing demand for playing videogames shows that adolescents try to satisfy some of their psychological needs via the Internet (Shen et al., 2013 ; Turan, 2021 ). One longitudinal study found that problematic online gaming and satisfaction of basic psychological needs were positively associated (Yu et al., 2015 ). It has also been reported that adolescents whose basic psychological needs were not met and whose perceived social support was low had high levels of gaming addiction (Yıldırım & Zeren, 2021 ). In this context, some studies claim that online games are tools for satisfying basic psychological needs (Oliver et al., 2016 ). However, studies have shown that the low level of basic psychological need satisfaction in real life can be met with high need satisfaction in online gaming, which leads to addiction for a small minority (Kardefelt-Winther, 2014 ; Rigby & Ryan, 2017 ; Wu et al., 2013 ). Based on the aforementioned literature, it was expected that there would be a significant negative relationship between basic psychological needs derived from real-life and online gaming addiction.

Online Gaming Addiction and Meaning in Life

The debate about the meaning in life has been ongoing for years (Yalom, 2020 ). Because there are many definitions of meaning in life, making a standard definition of meaning in life has been difficult (King & Hicks, 2021 ; Park, 2010 ). Meaning in life is a multifaceted construct conceptualized in various ways that address the value and purpose of life, meaningful life goals, and sometimes spirituality (Jim et al., 2006 ). According to Ryff ( 1989 ), meaning in life is a sign of a sense of direction, goals, and well-being. Frankl ( 2009 ) states that meaning in life differs from individual to individual, day to day, and hour to hour. Many studies have been conducted regarding meaning in life and concepts in the literature. For instance, some of these studies assert that meaning in life increases happiness (Debats et al., 1993 ) and life satisfaction (Yıkılmaz & Demir Güdül, 2015 ) and that the presence of meaning in life positively affects psychological health (Bailey & Phillips, 2016 ) and has a high level of meaning that can lower the incidence of depression (Mascaro & Rosen, 2005 ).

Similar to the aforementioned studies, adolescents’ having meaning in life can protect them from problematic behaviors such as substance abuse and eating disorders (Brassai et al., 2011 ; Shek et al., 2019 ). Adolescence is a period of seeking identity (Erikson, 1968 ) and decision-making (Marcia, 1980 ). Steger et al., ( 2006 ) pointed out that adolescents’ experience of seeking meaning in life or having a meaning in life may be determinative for successful identity development. However, considering that questioning the meaning in life results from the search for identity, it could be speculated that adolescents who constantly play online videogames will be far from such a search. Although studies have shown that adolescents search for identity in while online gaming (Monacis et al., 2017 ; Subrahmanyam & Šmahel, 2011 ; Tanhan & Özlem, 2015 ), it has been reported that excessive online gaming can also make this exploration more maladaptive, and this may lead to online gaming addiction (King & Delfabbro, 2014 ; Kokkini et al., 2022 ). One study reported that as gaming addiction decreases among adolescents, the level of meaning in life increases (Kaya, 2021 ). In general, it is expected in the present study that the existence of meaning in life in among adolescents will reduce online gaming addiction.

Online Gaming Addiction and Responsibility

One of the characteristic features of online gaming addiction is that individuals spend their time playing online games by procrastinating and/or not doing their daily work (Thatcheret al., 2008 ). According to the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) criteria, one criterion for Internet gaming disorder is that individuals continue to play online games despite being aware of psychosocial problems (American Psychiatric Association, 2013 ). Here, individuals fail to engage in important day-to-day responsibilities and play online games instead. Similarly, it has been shown that online gaming addicts jeopardize or lose their job, education, and/or career opportunities to play online games (Kardefelt-Winther, 2014 ). Time spent playing games instead of engaging in life’s more important tasks can be viewed as a lack of responsibility by individuals themselves, their families, and/or friends (Wartberg et al., 2017 ; Zhang et al., 2019 ).

Responsibility consists of three elements: accountability, liability, and imputability (Robinson, 2009 ). Imputability refers to individuals being responsible for their actions and decisions, accountability refers to fulfilling contractual expectations, and liability refers to assuming a moral responsibility without a contract (Holdorf & Greenwald, 2018 ). The concept of responsibility therapy is defined as the ability of individuals to meet their own needs while allowing others around them to meet their needs (Corey, 2015 ). Being conscious of responsibility means that individuals are aware of themselves and their feelings, thoughts, and pain (Yalom, 2020 ). Dökmen ( 2019 ) defines it as a responsibility to accept the consequences on others of what an individual does or does not do based on his thoughts.

In addition, it is discussed in the literature under two dimensions: emotion (Berkowitz & Daniels, 1963 ; Özen, 2013 ) and behavior (Glasser, 2005 ; Taylı, 2006 ). Individuals with a sense of responsibility have characteristics such as acting with awareness of their own and others’ rights, respecting others, and attempting to fulfill their responsibilities (Özen, 2011 ; Yough et al., 2022 ). On the other hand, individuals who do not have a sense of responsibility make themselves and others feel worthless while living without a plan or program (Cüceloğlu, 2015 ). Studies have shown that a low sense of responsibility can lead to aggression, lying, and avoidance of responsibility, while a high level of responsibility can trigger perfectionism, leading to anxiety, depression, and obsessive-compulsive disorders (Taylı, 2013 ; Wang et al., 2022 ).

The behavior of responsibility, the second sub-dimension of responsibility (Yalom, 2020 ), means that individuals can take responsibility by bearing the consequences of their behavior without attributing it to someone else (Douglass, 2001 ; Shahzadi et al., 2022 ). It has a function that improves positive activities and prevents harmful activities (Kesici, 2018 ). For example, individuals who act responsibly are respected by society and avoid punishment (Douglass, 2001 ). On the other hand, during adolescence, when serious responsibilities begin to be undertaken, a minority of individuals may move away from social life due to gaming addiction. Because of this situation, other people in the individual’s social life (e.g., family and friends) become unimportant to adolescents with low awareness of responsibility. Recent studies have observed that adolescents who excessively play videogames have difficulty fulfilling their responsibilities (Dinçer & Kolan, 2020 ; Doğan & Pamuk, 2022 ). In the present study, it was expected that adolescents with higher levels of responsibility would be less addicted to online gaming (i.e., an inverse relationship).

Basic Psychological Needs, Meaning in Life, Responsibility, and Online Game Addiction

Basic Psychological Needs Theory (BPNT) focuses on the satisfaction and frustration of psychological needs and argues that these needs significantly impact individuals’ psychological health and well-being (Ryan & Deci, 2000 ). Lack of fulfillment of basic psychological needs leads to negative consequences (e.g., depression, stress, and addiction) (Cantarero et al., 2021 ; Levine et al., 2022 ; Orkibi & Ronen, 2017 ; Xiao & Zheng, 2022 ). However, satisfying these needs is associated with positive outcomes such as general self-efficacy (İhsan et al., 2011 ), mental resilience (Kilinç & Gürer, 2019 ), subjective well-being (Akbağ & Ümmet, 2018 ), and obtaining meaning in life (Çelik & Gazioğlu, 2017 ). Furthermore, Weinstein et al. ( 2012 ) suggested that the search for meaning increased significantly when these needs were satisfied. Individuals whose needs are fulfilled are more prone to seek meaning in their life and, therefore, to experience meaning in their life, whereas individuals whose needs are not fulfilled experience a sense of meaninglessness (Eakman, 2013 ). According to Steger ( 2006 ), although individuals continue to search for meaning in one area of their lives, they may have meaning in a different area of their life. Meaning in life is defined as the purpose and importance of the life that individuals derive from their experiences (Baumeister & Vohs, 2002 ; Steger et al., 2006 ). Frankl ( 1969 ) posited that to achieve the meaning of life, an individual must take responsibility for realizing their potential, even at a young age. Therefore, a meaningful life requires individuals taking responsibility for themselves and others.

Responsibility refers to the individual’s sense of duty toward family, friends, and society (Geçtan, 2006 ), and can be examined in personal and social dimensions (Arslan & Wong, 2022 ). Personal responsibility means that an individual is accountable to themselves and to the needs or well-being of others (Ruyter, 2002 ). It also emphasizes self-responsibility by representing the individual’s behaviors and choices that can affect themselves and others (Mergler & Shield, 2016 ). Social responsibility relates to values that support individuals’ moral and prosocial behavior (Wray-Lake & Syvertsen, 2011 ). It includes decisions and actions that benefit others and society (Martins et al., 2015 ). Moreover, it is an important source of support in strengthening individuals’ mental health and improving their life skills (Martins et al., 2017 ) as well as coping with addictions (Amini et al., 2020 ). Therefore, individuals’ personal and social responsibility can protect them against negative situations such as developing addictions (e.g., online gaming addiction) (Chiou & Wan, 2007 ).

Online games allow individuals to meet other players, have fun, achieve status, and obtain financial benefits (Ballabio et al., 2017 ; Columb et al., 2022 ). In addition, escaping from the problems of real life, even temporarily, and achieving relaxation are among the benefits that individuals gain through gaming (Yee, 2006 ). Consequently, online gaming can lead individuals to play online games frequently and for long periods of time, which in turn can lead to the risk of addiction (Luciana, 2010 ; Sachdeva & Verma, 2015 ). The 11th revision of the International Classification of Diseases (ICD-11) characterized gaming disorder as a repetitive or persistent pattern of gaming behavior (World Health Organization, 2019 ). Individuals that are affected by online gaming addiction have also been reported to experience problems with interpersonal relationships (Wongpakaran et al., 2021 ), occupation (Lelonek-Kuleta et al., 2021 ), and health (Chan et al., 2022 ). As such, online gaming addiction can lead to situations that threaten the lives and functionality of individuals through the process and its consequences.

The Present Study

The present study was framed according to self-determination and existentialist positive psychology theories. Self-determination theory (SDT) suggests that the non-satisfaction or inhibition of basic psychological needs can lead to negative consequences (i.e., online gaming addiction). In addition, it emphasizes that behaviors emerge from the individual’s beliefs, meaning, and value judgments rather than external factors (i.e., social norms and group pressure). According to the SDT, need (autonomy, competence, and relatedness) predicts meaning in life (Eakman, 2013 ). Moreover, in a longitudinal study based on SDT, individuals whose basic psychological needs were fulfilled had increased meaning in life (Zhang et al., 2022 ). In addition, the existentialist theory of positive psychology suggests that the meaning in life, which individuals create themselves, can be sustained through responsibility. Individuals having responsibility can also enable them to lead a meaningful life (Arslan & Yıldırım, 2021 ; Wong, 2019 ). According to Wong ( 2010 ), meaning consists of the components of purpose, understanding, responsibility, and enjoyment (PURE). In addition to responsibility being one of the basic concepts that constitute meaning, the search for meaning in life continues intensely during adolescence (Steger, 2012 ). This is especially the case for adolescents who begin to question people and the world deeply, having a meaningful life can protect them from behavioral addictions (Qiu et al., 2022 ; Zhao et al., 2020 ). Considering the role of responsibility and meaning in the life of adolescents, it is important to examine online game addiction, which may be affected by basic psychological needs. Therefore, a serial mediation model was determined based on the assumptions of self-determination and existential positive psychotherapy theory.

In addition to the aforementioned theoretical framework, studies have shown that unfulfilled basic psychological needs are predictors of online gaming addiction (Allen & Anderson, 2018 ; Liang et al., 2021 ; Mills & Allen, 2020 ; Yu et al., 2015 ). However, studies conducted with adolescents have found a relationship between online gaming addiction and responsibility and meaning in life (Doğan & Pamuk, 2022 ; Kaya, 2021 ). In the present study, which also considers the different dynamics in online gaming addiction, a new model is proposed to examine the relationship between basic psychological needs and online gaming addiction through responsibility and meaning in life. In this context, the present study assessed whether basic psychological needs (i.e., autonomy, relatedness, competence) affect the relationship between online gaming addiction, meaning in life, and responsibility among adolescents. Four research questions were investigated: Do basic psychological needs predict online gaming addiction? (RQ1); Does the level of responsibility have a mediating effect on the relationship between basic psychological needs and online game addiction? (RQ2); Does meaning in life have a mediating effect on the relationship between basic psychological needs and online game addiction? (RQ3); Do responsibility and meaning in life have a serial mediating effect on the relationship between basic psychological needs and online game addiction? (RQ4).

Participants

Power analysis was performed via the G* Power 3.1.9.7 program to determine the sample size required for the present study. For this purpose, at the conventional significance level of 0.05 and power at 0.80, a small effect size is determined as r = 0.20 (Cohen, 2013 ). As a result of the analysis, it was determined that the required sample size was 395. The sample in the present study comprised 546 individuals (393 females and 153 males). The participants ranged from 15 to 18 years old, with a mean age of 16.25 years (SD ± 0.82). Just below half the sample of the participants were in the 9th grade ( n =252; 46.2%), 156 were in the 10th grade (28.6%), 74 were in the 11th grade (13.6%), and 64 were in the 12th grade (11.7%). Over one-third of the sample self-reported their socioeconomic status (SES) as being low ( n =210; 38.5%), 224 reported it as being medium (41.0%), and 112 reported it as being high (20.5%). Participants stated that they played videogames 3.56 h daily on average (SD ± 3.12). The number of devices they used to play online videogames was 2.09 (SD ± 0.96).

Basic Psychological Needs Scale (BPNS)

The 21-item BPNS (Deci & Ryan, 2000 ; Turkish version: Kesici et al., 2003 ) was used to assess basic psychological needs. The scale consists of three subscales: (i) autonomy (AU), (ii) competence (CMP), and (iii) relatedness (RLT). The scale has 21 items that tap into the satisfaction of autonomy (e.g., “I feel free to decide how to live my life”), relatedness (e.g., “There aren’t many people in my life that I feel close to”), and competence (e.g., “The people I know say that I am successful in what I do”) which are rated on five-point Likert scale from 1 ( strongly disagree ) to 5 ( strongly agree ). The higher the score, the greater fulfillment of autonomy, competence, and relatedness. In the present study, the scale’s internal reliabilities for the need for autonomy were α=.76, McDonald’s ω= 76; the need for competence were α =.67, McDonald’s ω= 68; and the need for relatedness were α =.82, McDonald’s ω= 83.

Meaning in Life Questionnaire Scale (MILQS)

The 10-item MILQS (Steger et al., 2006 ; Turkish version: Demirbaş-Çelik and İşmen-Gazioğlu, 2015 ) was used to assess meaning in life. Items (e.g., “I’m always looking for my life’s purpose”) are rated on seven-point Likert scale from 1 ( definitely disagree ) to 7 ( definitely agree ). The total score ranges between 10 and 70. The higher the score, the higher the individual’s level of search for meaning in life. In the present study, the internal reliability for the existence of meaning in life was α=.85 and for seeking meaning in life was α=.82. For the overall scale, Cronbach’s α was .67, and McDonald’s ω was .72.

Sense of Responsibility and Behavior Scale (SRBS)

The 18-item SRBS (Özen, 2013 ) was used to assess responsibility. Items (e.g., “I feel responsible for being a member of charitable organizations”) are rated on four-point scale ranging from 1 ( never ) to 4 ( always ). The total score ranges between 18 and 72. The higher the score, the greater the level of responsibility. The SRBS consists of two subscales and each can be used separately. The sense of responsibility sub-dimension was used in the present study. For this sub-dimension, Cronbach’s α was .86, and McDonald’s ω was .87.

Online Game Addiction Scale (OGAS)

The 21-item OGAS (Başol & Kaya, 2018 ) was used to assess online gaming addiction. Items (e.g., “My friendships were damaged/broken due to online games”) are rated on a five-point Likert scale ranging from 1 ( absolutely disagree ) to 5 ( absolutely agree ). The total score ranges between 21 and 105 points. The higher the score, the greater the risk of online gaming addiction. In the present study, Cronbach’s α was .88, and McDonald’s ω was .89.

Procedure and Ethics

Participants were selected from three different high schools in Turkey in the cities of Ağrı, Karabük, and Siirt. The schools were informed about the purpose and duration of the study. The researchers visited the schools, and informed consent forms were distributed. Written informed consent forms were obtained from the legal guardians or parents of the adolescents who volunteered to participate in the study. The purpose of the study was explained to the participants. The eligibility criteria for participation in the study were being an adolescent and being an individual who played (or used to play) one or more online videogames. An online link to the survey was sent to the participants, and each participant was allowed to complete the survey only once. All data were collected using Google Forms in the classroom. Participants were reminded that they might stop answering at any stage of the survey process if they wanted to. Participants were asked not to provide personal information to ensure anonymity and confidentiality. Ethics committee approval of this research was obtained from Ağrı İbrahim Çeçen University (reference number: 110), and every research stage was carried out in accordance with the Declaration of Helsinki.

Data Analysis

All analyses were carried out using SPSS version 26, Hayes’ ( 2018 ) PROCESS Macro (version 3), and G* Power 3.1.9.7 programs. Before starting the analysis, the necessary assumptions to perform the analysis were tested. The kurtosis and skewness values were examined to understand whether the assumptions required for the prerequisites of parametric tests were met. The skewness and kurtosis values for a normal distribution have acceptable threshold values if they are ±2 (George, 2010 ). There were no assumption violations in the research data. In addition, it was found that the correlation between the study variables was not high. The correlations ranged between .17 and .63 ( p <.001). The research variables were also examined to ensure there were no multicollinearity issues. When the tolerance, variance inflation factor (VIF), and confidence interval (CI) values were examined, these values were all within acceptable limits. It was determined that VIF was between 1.12 and 1.48, the tolerance value was between .67 and .89, and CI was between 7.21 and 17.88. The limit values required to avoid multicollinearity problems are more than 0.20 for the tolerance value, less than 10 for the VIF value, and less than 30 for the CI value (Albayrak, 2005 ; Büyüköztürk, 2016 ; Şata, 2020 ). Consequently, no multicollinearity problems were detected. Mahalanobis distance values were examined to determine whether there were outliers in the sample. A total of 21 outliers were identified in the dataset. These outliers were excluded from the analysis, meaning the final sample size was 546. SPSS PROCESS macro was utilized to conduct mediation analyses (Hayes, 2018 ). The bootstrapping method was employed with 5000 resampling and 95% confidence intervals (CIs) to test the significance of the mediating pathways. An effect is deemed significant if the confidence interval does not contain zero (Preacher & Hayes, 2008 ).

Table 1 shows the correlations between all the main variables in the study (basic psychological needs (autonomy, competence, relatedness), online gaming addiction, responsibility, and meaning in life). Pearson correlations indicated that all variables were significantly (albeit moderately and weakly) related.

Serial Multiple Mediational Analyses—Modeling Data

Table 2 , Table 3 , and Table 4 show the results of the serial mediation analysis. First, there was a direct effect of autonomy on online gaming addiction ( β =−.67, p <.001). Moreover, the relationship between competence and online gaming addiction was examined. There was a direct effect of competence on online gaming addiction ( β =−.63, p < . 001). When the relationship between relatedness, the last of the basic psychological needs, and online gaming addiction was examined, there was a direct effect of relatedness on online gaming addiction ( β =−.48, p < . 001). There was also a significant indirect effect of autonomy on online gaming addiction via responsibility (indirect effect=−.12, SE=.02, 95% CI= [−.20, −.06]). Also, the indirect effect of competence on online gaming addiction via responsibility was significant (indirect effect=−.19, SE=.02, 95% CI= [−.31, −.10]). Lastly, the indirect effect of relatedness on online gaming addiction via responsibility was significant (indirect effect=−.17, SE=.01, 95% CI= [−.26, −.10]).

When indirect effects were examined, there was a significant indirect effect of autonomy on online gaming addiction via meaning in life (indirect effect=−.07, SE=.02, 95% CI= [−.14, −.00]). Also, the indirect effect of competence on online gaming addiction via meaning in life was significant (indirect effect=−.11, SE=.02, 95% CI= [−.22, −.00]). Lastly, the indirect effect of relatedness on online gaming addiction via meaning in life was significant (indirect effect=−.05, SE=.01, 95% CI= [−.10, −.01]).

Moreover, the indirect effects of autonomy on online gaming addiction via meaning in life and responsibility were tested. The effect was significant (testing serial multiple mediation; effect=−.04 SE=.01, 95% CI= [−.07, −.01]). Also, the indirect effects of competence on online gaming addiction via meaning in life and responsibility were tested. The effect was significant (testing serial multiple mediation; effect=−.02 SE=.01, 95% CI= [−.04, −.00]). Moreover, the indirect effects of relatedness on online gaming addiction via meaning in life and responsibility were tested. The effect was significant (testing serial multiple mediation; effect=−.02 SE=.01, 95% CI= [−.06, −.01]). In the relationship between basic psychological needs (autonomy, competence, relatedness) and online gaming addiction, meaning in life and responsibility had serial mediating effects.

The results indicated that autonomy predicted online gaming addiction. When autonomy was entered as the predictor, it significantly predicted online gaming addiction ( β  = −0.67, t = −5.58,  p  < .001), and accounted for 5.4% of the variance in the model. Figure 1  shows the regression coefficients of the mediation model. The indirect path mediated by responsibility ( β =−.12, 95% CI= [−.20, −.06]) produced a higher change in variance than the indirect path mediated by meaning in life ( β =−.07, 95% CI= [−.14, −.00]) in the relationship between relatedness and online gaming addiction (see Table 2 ). Therefore, responsibility appeared to have a higher effect than meaning in life. Autonomy predicted a higher level of meaning in life. It also predicted a higher level of responsibility. Higher meaning in life was associated with a higher level of responsibility. Higher level of responsibility was associated with lower online gaming addiction. Consequently, the results indicated that the relationship between autonomy and online gaming addiction was partially mediated by meaning in life and responsibility (see Fig. 1 ).

The results of the serial multiple mediational models

It was also found that competence predicted online gaming addiction. There was also an indirect relationship between competence and online gaming addiction ( β = −0.64, t = −4.13, p < .001), accounting for 4.7% of the variance in the model. Competence predicted meaning and responsibility in life. The indirect path mediated by responsibility ( β =−.19, 95% CI= [−.31, −.10]) produced a higher change in variance than the indirect path mediated by meaning in life ( β =−.11, 95% CI= [−.22, −.00]) in the relationship between competence and online gaming addiction Furthermore, the relationship between competence and online gaming addiction was mediated by meaning in life and responsibility separately (see Table 3 ). The results also showed that meaning in life and responsibility had serial mediation effects in the relationship between competence and online gaming addiction (see Fig. 2 ).

Lastly, the results indicated that relatedness predicted online gaming addiction ( β = −0.48, t = −4.63, p < .001). When relatedness was included in the model, it was found that it accounted for 3.8% of the variance. Moreover, there was also an indirect relationship between relatedness and online gaming addiction. When the indirect effects are examined, the indirect path mediated by responsibility ( β =−.17, 95% CI= [−.26, −.10]) produced a higher change in variance than the indirect path mediated by meaning in life ( β =−.05, 95% CI= [−.10, −.01]) in the relationship between relatedness and online gaming addiction (see Table 4 ). The results suggested that the relationship between relatedness and online gaming addiction was partially mediated by meaning in life and responsibility (see Fig. 3 ).

In self-determination theory (SDT), basic psychological needs comprise autonomy, competence, and relatedness. In SDT (Deci & Ryan, 2000 ), basic psychological needs are expressed as essential psychological nutrients for psychological development, integrity, and well-being. Negative psychological consequences occur when requirements are not met, neglected, or prevented (Deci & Ryan, 2000 ). If individuals cannot satisfy a basic need, they engage in activities that give pleasure to individuals momentarily, even if they do not satisfy them (Antunes et al., 2020 ; Deci & Ryan, 2011 ). One of these activities is online gaming, which has an incredibly interactive structure. At the same time, online videogames are appreciated because they create an environment where both the need for relatedness and autonomy are met in the virtual world. Individuals naturally seek new challenges to experience a sense of efficacy even when no external rewards (e.g., money) are earned (Dindar, 2018 ; Matsumoto, 2009 ). The fact that online games have a reward mechanism is suitable for activating feelings of competence among individuals. It is thought that adolescents tend to meet their basic psychological needs (need for autonomy, competence, and relatedness) that they cannot fully meet from their parents or close friends through online gaming.

The present study examined the mediating role of meaning in life and the level of responsibility in the relationship between online gaming addiction and basic psychological needs (i.e., autonomy, competence, and relatedness) among adolescents. Findings showed that autonomy predicted online game addiction. In other words, autonomy had significant negative effect on online game addiction. Considering that addiction is related to reduced autonomy (Amatem, 2008 ), it can be said that the finding is compatible with the literature. However, there is a study in which there was a negative relationship between the need for autonomy and digital game addiction among adolescents (Dursun and Çapan, 2018 ), which supports the research finding. On the contrary, there is a study in which autonomy and online game addiction had significant positive relationships (Bekir and Çelik, 2019 ). Similarly, it is known that the need for autonomy has a positive relationship with social media addiction (Young-Ju et al., 2018 ) and a negative relationship with Internet addiction (Piri et al., 2018 ; Zeren & Can, 2019 ). These studies, which have obtained different results, make the relationship between the need for autonomy and digital addictions open to discussion but also show that further research is needed.

According to the present study’s findings, it was found that relatedness and competence, as well as autonomy, predicted online gaming addiction. Studies have shown that competence and relatedness have significant relationships with online gaming addiction (Bekir and Çelik, 2019 ; Dursun and Çapan, 2018 ). In addition, research has shown that relatedness has a negative relationship with short-form video addiction (Yang et al., 2022 ), and relatedness dissatisfaction positively correlates with Internet gaming disorder (Hui et al., 2019 ). Moreover, significant negative relationships have been found between competence and smartphone addiction (Gao et al., 2022 ; Sun et al., 2020 ) and Internet addiction (Zeren & Can, 2019 ; Canoğulları, 2014 ). Based on these results concerning technological addictions, it can be said that the literature findings and the results of the present study are compatible.

The tendency of individuals to play online videogames may be to meet their autonomy, competence, and relatedness needs (Ryan et al., 2006 ). In addition, when basic psychological needs are prevented, technological addictions (gaming addiction, smartphone addiction, social network addiction, and Internet addiction) increase (Gugliandolo et al., 2020 ). This may be the compensation for unmet basic psychological needs through addiction (Kuss et al., 2017 ; Mills et al., 2018 ). Therefore, fulfilling basic psychological needs in real life and eliminating the problems that prevent this satisfaction can be a protective factor against online gaming addiction.

Another finding of the present study was that the level of responsibility hads a mediating effect on the relationship between basic psychological needs and online gaming addiction. However, there was a positive and significant relationship between basic psychological needs and responsibility. In contrast, a significant negative relationship was found between responsibility and online gaming addiction. Considering that the components of responsibility (accountability, liability, and imputability) in Robinson’s ( 2009 ) definition appear less important in online environments, it is assumed that adolescents who are addicted to online gaming experience less sense of responsibility. A recent study found that a higher level of responsibility significantly predicted online gaming addiction, whereas a lower level of responsibility negatively affected online gaming addiction (Kesici, 2020 ).

Research conducted by Arslan ( 2021 ) found that secondary school students’ sense of responsibility and behavior had a crucial predictive role in online gaming addiction. Another study reported a significant negative relationship between the students’ videogame addiction and their personal and social responsibility behavior (Dinçer & Kolan, 2020 ). Based on previous studies and the results of the present study, it is thought that increasing the level of responsibility of secondary and high school students would reduce gaming addiction. Adolescents whose level of responsibility increases are also more likely to engage in responsible behavior. This is supported by studies in the literature that physical education and sports play an essential role in helping adolescents acquire responsible behavior (Bayraktar et al., 2016 ; Bugdayci, 2019 ; Tazegül, 2014 ). These studies’ results are considered necessary regarding online gaming addiction because such behavior leads to a sedentary lifestyle (Cómez-Mármol et al., 2017 ).

Findings indicated that meaning in life had a mediating effect on the relationship between basic psychological needs and online gaming addiction. However, there was a positive and significant relationship between basic psychological needs and meaning in life. In contrast, a significant negative relationship between meaning in life and online gaming addiction was found. These findings demonstrate the importance of meaning in life in preventing online gaming addiction among adolescents. A study by Kaya ( 2021 ) on adolescent online gaming addiction found that as the level of online gaming addiction decreased, the level of meaning in life increased. These results suggest that meaning in life affects online gaming addiction as a cause and consequence. Considering that having a meaningful life increases resilience (Batmaz et al., 2021 ; Doğrusever et al., 2022 ), low resilience increases gaming addiction (Canale et al., 2019 ), and gaming addiction reduces happiness (Kaya, 2021 ; Turan, 2021 ), meaning in life seems to be an essential variable that can affect gaming addiction.

What makes the present study unique to the online gaming addiction literature is that responsibility and meaning in life had a serial mediating effect on the relationship between basic psychological needs and online gaming addiction. In other words, the results indicated that the relationship between relatedness, competence, and autonomy with online gaming addiction was partially mediated by meaning in life and responsibility. This finding suggests that the need for autonomy, competence, and relatedness increases the level of meaning in life, which in turn reduces online game addiction. Similarly, online game addiction can decrease as the need for autonomy, competence, and relatedness increases the level of responsibility. In addition, based on the serial mediation effect, it suggests that meeting the need for autonomy, competence, and relatedness can reduce adolescents’ online game addiction by increasing their meaning in life and their level of responsibility.

To the best of the authors’ knowledge, the present study is the first to examine the mediating role of responsibility and meaning in life between basic psychological needs and online gaming addiction. The associations between these variables provide greater understanding and knowledge concerning online gaming addiction and provide additional insight into the significant causes that underlie playing games online (which may be potential factors in the acquisition, development, and maintenance of online gaming addiction among adolescents). Moreover, fulfilling basic psychological needs appears to increase responsibility and meaning in life and reduce susceptibility to online gaming addiction. The findings enrich the literature because it suggests new protective factors that might prevent adolescents from developing online gaming addiction.

The findings offer relevant practical implications for adolescents, educators, families, private and public health institutions, and mental health professionals to assist them in designing addiction prevention strategies and policies. Results also suggest that basic psychological need satisfaction fulfilment in real life plays an important role in the development and maintenance of online gaming addiction among adolescents. Educators, parents, and adolescents could utilize awareness of the factors contributing to online gaming addiction to help them take preventive measures against it. In addition, if adolescents have high levels of responsibility and meaning in life, it may help reduce online game addiction. Considering the findings, it is recommended that mental health professionals provide training and services that increase the level of responsibility among adolescents and enable them to have meaning in their lives to prevent the onset of online gaming addiction. In addition, private and public health institutions should implement training programs to improve the skills of parents, such as digital parenting, to cope with online gaming addiction. This training should also ensure that parents behave with awareness of the basic psychological needs of adolescents in the family and that they gain thoughts and approaches that can add responsibility and meaning in life.

Limitations

As in all studies, the present study also has some limitations. The first is that the study was cross-sectional. Conducting a cross-sectional study means that causality between the study variables cannot be determined. Second, completing the survey online may have influenced respondents’ responses (with those without home Internet access unable to participate). The online data were also collected during the COVID-19 pandemic. Therefore, adolescents living in isolated environments may have increased their gaming during this period. This unusual situation may have resulted in a lower sense of responsibility and a less meaningful life. This is consistent with the present study’s findings. Another limitation is that the participants were high school students studying in different schools in Turkish provinces, so the findings are not necessarily generalizable to all Turkish schoolchildren. The sample was also limited because it did not include other education levels, such as primary and secondary schools and children from different geographical and cultural regions in Turkey and/or other countries. Future studies are needed with different age groups, such as primary school, secondary school, university students, adults, and various geographical regions in the sample groups (both in and outside Turkey). Such studies are needed to confirm the findings reported here and should include other research designs (e.g., longitudinal studies to determine causality between variables) and other types of data (e.g., qualitative interview data to attain richer data). Another limitation of the present study was that the participant’s responses were self-report and therefore subject to well-established method biases (e.g., social desirability, memory recall).

The study’s findings indicated that adolescents whose basic psychological needs were met exhibited lower levels of online gaming addiction than adolescents whose basic psychological needs were not met. Consequently, the adverse effects of online gaming addiction may be reduced by interventions that meet adolescents’ basic psychological needs. Similarly, a significant negative relationship was found between responsibility and online gaming addiction. Consequently, it appears that adolescents who fulfill the requirements of individual and social responsibilities (studying, spending time with family, going out with friends, etc.) have greater protection from the more negative effects of online gaming. However, when meaning in life and responsibility are included in the relationship between basic psychological needs and online gaming addiction, the effect of basic psychological needs on online game addiction decreases. This suggests that meaning in life and responsibility have a serial mediating role between basic psychological needs and online gaming addiction.

Data Availability

The data that support the findings of this study are available from the first author upon reasonable request.

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Department of Guidance and Psychological Counselling, Sakarya University PhD Student, Sakarya, Turkey

Hasan Batmaz

International Gaming Research Unit, Psychology Department, Nottingham Trent University, 50 Shakespeare Street, Nottingham, NG1 4FQ, UK

Mark D. Griffiths

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Study conception/design: AK, HB, NT, and MDG. Data collection: AK, HB, and NT. analysis: AK and HB. Drafting of manuscript: AK, HB, NT, and MDG. Editing: MDG. Statistical expertise: AK and HB. Administrative/technical/material support: HB and HYK.

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Correspondence to Mark D. Griffiths .

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All procedures performed in this study involving human participants were in accordance with the ethical standards of University’s Research Ethics Board and with the 1975 Helsinki Declaration.

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Informed consent was obtained from all participants.

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The authors declare no competing interests except for MDG. MDG’s university has received research funding from Norsk Tipping (the gambling operator owned by the Norwegian Government). MDG has also received funding for a number of research projects in the area of gambling education for young people, social responsibility in gambling and gambling treatment from Gamble Aware (formerly the Responsible Gambling Trust) , a charitable body which funds its research program based on donations from the gambling industry. MDG regularly undertakes consultancy for various gambling companies in the area of player protection and social responsibility in gambling.

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Kaya, A., Türk, N., Batmaz, H. et al. Online Gaming Addiction and Basic Psychological Needs Among Adolescents: The Mediating Roles of Meaning in Life and Responsibility. Int J Ment Health Addiction (2023). https://doi.org/10.1007/s11469-022-00994-9

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THE CAUSES OF ONLINE GAMES ADDICTION

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Home — Essay Samples — Nursing & Health — Nursing — Video Games Thesis Statement

Video Games Thesis Statement

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Video Game Addiction

The argument against video game addiction, many researchers are skeptical that video games are truly "addictive.".

Updated July 3, 2023 | Reviewed by Devon Frye

• What Is Video Game Addiction?
• Find a therapist near me
• Video games have many benefits for gamers.
• Research on gaming disorder—aka video game addiction—is flawed and not sufficiently conclusive.
• Because video games are less socially acceptable, they may be unfairly targeted.
• There are other explanations for many reports of video game addiction, including autism, ADHD, and depression.

This is half of a pair of articles that highlight the evidence for and against the existence of video game addiction . Read the counter-argument here .

For decades, psychologists, parents, and gamers have asserted that video games can be addictive. Although video games seem to influence enthusiasts differently from those of other hobbies, there is insufficient empirical evidence to designate them as an actual addiction . Further, video games are a fun and socially beneficial activity for many, so labeling them as addictive would prevent many from accessing these benefits.

For example, video games connect lonely or introverted people with one another , relieve stress , and even help people explore their own identities . Some therefore argue that, because of video games’ benefits and popularity, gaming addiction should not be considered an official diagnosis until overwhelming evidence supports this assertion.

Flawed Research

Several studies have concluded that gaming disorder qualifies as an addiction. Because addictions share several characteristics, researchers created theoretical criteria that a gamer must meet to have the diagnosis. For example, people with addictions suffer consequences in various aspects of their life and struggle to quit without help. This is true regardless of the substance.

Based on the assumption that people with video game addiction must be affected similarly, researchers have surveyed gamers on similar criteria to determine what percent have an addiction. These include questions such as, “How often do you find it difficult to stop gaming?” and “Have you deceived a family member, significant other, employer, or therapist regarding the amount of time spent engaging in gaming activities?”

Although questions like these may reasonably assess someone’s behavior, researchers use too many different questionnaires to be compared cleanly. Even when researchers use the same survey, they sometimes interpret the results differently.

In other words, someone would need to answer “Yes” to six of the eleven Gaming Addiction Screening questions to be considered addicted. They would need to respond “Sometimes” or “Often” to five or more of the ten questions in the Ten Item Internet Gaming Disorder Test to qualify. If the same person took both surveys, one survey might conclude that they had an addiction and the other might not. Further, some studies only measure how many hours per week a person spends gaming instead of targeting the effect games have on their functioning.

This has resulted in wildly different estimates of gaming addiction’s prevalence. It is difficult to draw meaningful conclusions from these data until researchers use standardized measures.

It is also very difficult to estimate one’s actual screen time each week. One meta-analysis of the research found that in 95 percent of studies, participants did not accurately report how much time they spend on screens . This calls into question all studies which rely on participants’ subjective estimates of how they use their time because they have based their conclusions on a statistic that is likely inaccurate.

Why Not Other Hobbies?

Other critics of the diagnosis point out that gaming has been unfairly targeted and pathologized. A person who plays golf instead of spending time with family is inconsiderate. A person who plays video games instead of spending time with family is addicted.

This demonstrates a clear bias . Society considers video games a waste of time, so an enthusiastic gamer is criticized more harshly than someone with a more acceptable hobby.

What Else Might Account for Excessive Gaming

Many of my clients report that they feel addicted to technology. When I continue the assessment process, many report that they were previously diagnosed with autism or ADHD . This complicates the diagnostic process because many people with these disorders already struggle to stop scrolling through social media or playing video games.

Most of us have looked up from our phones and realized that half an hour or more had suddenly passed. The hypnotic “flow” which we experienced blinded us to the passage of time. Autistic people* and those with ADHD are especially susceptible to this phenomenon. So if, for example, a person with ADHD finds it particularly difficult to turn off a game, does that person have an addiction or is it simply how this kind of stimulus affects those with ADHD?

Some research has found that heavy gamers have reduced gray matter in areas of the brain associated with attention , impulse control. However, these studies do not sufficiently demonstrate that gaming caused the differences, only that they are associated. Correlation is not causation. Some studies even show that brain scans for people with ADHD look remarkably similar to scans of those with gaming disorder , even after treatment.

One researcher pointed out this conundrum by relating it to depression . “We would not diagnose depressed individuals with hypersomnia with a comorbid ‘bed addiction.’” In other words, someone with depression might stay in bed for days, but this does not mean that they are addicted to the bed. In the same way, an autistic person or someone with depression or ADHD might appear to be addicted to video games even when they are not. In short, many diagnosed with gaming disorder may simply be autistic or have ADHD.

It is possible that video games are addictive. However, the current body of research is too flawed to state decisively that the negative consequences outweigh the benefits the games afford players. It is premature to consider gaming disorder to be an official addiction.

*Although many refer to autistic people as “people with autism” or “people with autism spectrum disorders,” almost 90 percent of autistic adults prefer “autistic person.” This language is used here to respect that preference.

Bean, A. M., Nielsen, R. K. L., van Rooij, A. J., & Ferguson, C. J. (2017). Video game addiction: The push to pathologize video games. Professional Psychology: Research and Practice, 48 (5). Retrieved from http://psycnet.apa.org/record/2017-29288-001

Diament, M. (2022, December 2). 'Autistic' or 'person with autism'? It depends. Disability Scoop. https://www.disabilityscoop.com/2022/12/02/autistic-or-person-with-auti…

Fishman, A. (2019, January 22). Video games are social spaces. Psychology Today. https://www.psychologytoday.com/us/blog/video-game-health/201901/video-…

Fishman, A. (2022, November 7). Why it's so hard to walk away from a video game. Psychology Today. https://www.psychologytoday.com/us/blog/video-game-health/202211/why-it…

Fishman, A. (2023, February 20). How gamers use video games to explore their gender identity. Psychology Today. https://www.psychologytoday.com/intl/blog/video-game-health/202302/how-…

Gentile, D. (n.d.) Gaming Addiction Screening. University of California, Santa Cruz. https://caps.ucsc.edu/pdf/gaming-addiction-screening.pdf

Han, D.H., Bae, S., Hong, J., Kim, S.M., Son, Y.D., & Renshaw, P. (2019). Resting-state fMRI study of ADHD and Internet Gaming Disorder. Journal of Attention Disorders, 25 (8). Retrieved from https://journals.sagepub.com/doi/10.1177/1087054719883022

Király, O., Bőthe, B., Ramos-Díaz, J., Rahimi-Movaghar, A., Lukavska, K., Hrabec, O., Miovsky, M., Billieux, J., Deleuze, J., Nuyens, F., Karila, L.M., Griffiths, M.D., Nagygyörgy, K., Urbán, R., Potenza, M., King, D.L., Rumpf, H., Carragher, N., Lilly, E., & Demetrovics, Z. (2019). Ten-Item Internet Gaming Disorder Test (IGDT-10): Measurement invariance and cross-cultural validation across seven language-based samples. Psychology of Addictive Behaviors, 33 (1). Retrieved from https://www.researchgate.net/publication/328615597_Ten-Item_Internet_Ga…

Parry, D.A., Davidson, B.I., Sewall, C.J.R., Fisher, J.T., Mieczkowski, H., & Quintana, D.S. (2021). Nature Human Behavior, 5 . Retrieved from https://www.nature.com/articles/s41562-021-01117-5

van Rooij, A.J., Ferguson, C., Carras, M.C. Kardefelt-Winther, D., Shi, J., Aarseth, E., Bean, A., Bergmark, K.H., Brus, A., Coulson, M., Deleuze, J., Dullur, P., Dunkels, E., Edman, J., Elson, M., Etchells, P.J., Fiskaali, A., Granic, I., Jansz, J...& Przybylski, A.K. (2018). A weak scientific basis for gaming disorder: Let us err on the side of caution. Journal of Behavioral Addictions, 7 (1) Retrieved from https://www.researchgate.net/publication/323542721_A_weak_scientific_ba…

van Rooij, A.J., Schoenmakers, T., van den Eijnden, R.J.J.M., Vermulst, A.A., & van de Mheen, D. (2012). Video Game Addiction Test: Validity and psychometric characteristics. Cyberpsychology, Behavior, and Social Networking, 15 (9). Retrieved from https://www.researchgate.net/publication/230696095_Video_Game_Addiction…

Andrew Fishman is a licensed social worker in Chicago, Illinois. He is also a lifelong gamer who works with clients to understand the impact video games have had on their mental health.

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