The Argument for Video Game Addiction

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.

In 1982, three psychiatrists warned of a new concern, which they named Space Invaders Obsession. They had observed three men in their 20’s and 30’s whose time spent playing the popular arcade game was undermining their personal relationships. Mental health professionals worldwide noted similar patterns in their clients for the next several decades.

As a result of these reports and accompanying research, the World Health Organization added “Gaming Disorder” to the list of recognized health conditions in 2019. Although this inclusion was controversial, it reflected a growing understanding of the harm which video games can cause.

Consumer psychology

Many popular video games are intentionally designed to be habit-forming. Psychologists at major game studios frequently replicate strategies from the gambling and retail industries to ensure that players keep coming back.

For example, people are easily fooled into believing that they were very close to winning a game of chance. When McDonald’s releases Monopoly pieces, customers must complete a set of three tokens to win a prize. Random tokens accompany many of the food items. Anyone who acquires all three could win a car, one million dollars, or other sizable prizes. For the biggest prizes, McDonald’s prints a flood of the first two tokens and only a few of the third.

This means that, in practice, the prize would go to whomever found the third, rare token. However, consumers who had gathered the first two tokens in the set assumed that they were close to winning and therefore were motivated to continue buying McDonald’s food. They were not close to winning, but they felt they were.

Slot machines also use this strategy; the first two of the spinning wheels usually contain many iterations of the winning icons, but the third has very few. This results in many “near misses,” which excite us and make us more likely to keep playing. If all three wheels were distributed evenly, the game would not be as thrilling.

Video games use similar mechanics. For example, on-screen roulette wheels often do not actually represent the game’s programming. When players spin a virtual wheel, the animation is likely to show the needle almost lining up with a winning segment. In reality, the game simply selects a random number, decides that the player has lost, then plays an exciting animation to convince them that they were very close to winning. This keeps players coming back.

The “near miss” is just one of many strategies developers use to keep players engaged. Others include:

• Chasing: “You just lost some money; you should keep playing to get it back.”
• Entrapment: “You might be about to win. If you leave, you could miss a huge reward.”
• Fear of missing out: “This special helmet is only available for the next three days,” or, “This deal only lasts for two more hours.”
• Exclusivity: “We only produced 10,000 of this cool, golden sword; you will miss it if you don’t buy it now.”

Although most consumers are aware of these tricks, they influence our decisions without our conscious knowledge or consent. This is especially true for children and adolescents.

Neurological Differences

Our brains do not finish developing until around age 25. Because of this, young people’s more pliable brains are particularly susceptible to the gaming industry’s tricks. In fact, studies suggest that playing fast-paced video games can actually change our brains’ structure. Several studies have found that people who play internet games have less gray matter in regions of the brain responsible for impulse control, attention, emotional regulation, among others.

Critics of these studies note that they are correlative, not causal. They argue that the studies have not demonstrated that the video games caused these changes, only that these changes are observed in people who play games. People with less self-control, ability to focus attention, regulate emotions, etc. might simply be more drawn to video games than those with more of each.

Addiction Essential Reads

The Polysubstance Use Epidemic Has Arrived

Are There Racial Differences in Opioid Misuse Among Seniors?

However, recent studies have found more compelling evidence for a causal link. Half of the participants in one study were instructed to spend ten hours playing violent video games over a period of one week, then refrain from playing for a second week. After the first week, those who had played violent video games showed less activity in areas of the brain responsible for controlling emotion and aggression. After a week of abstaining from gaming, these observed changes reduced significantly. Although the study included only 22 subjects, the research provides some evidence that video games do contribute to changes in brain functioning.

Financial Difficulty

These strategies sometimes cost players more money than they can afford. More than 95 percent of players never spend money on optional purchases. However, the players who do spend money on otherwise free games spend so much that they subsidize the game for everyone else. Developers compete for these “whales”—an industry term for gamers who spend the most money on free-to-play games.

Some whales are wealthy enough that they can easily afford to spend a few thousand dollars on a hobby. However, the allure of in-game purchases is so strong that some choose to buy items in a video game instead of paying rent or buying food.

Whales often use similar language to those with a gambling addiction to explain their purchases: "I had this unbeatable rush of adulation and excitement. For someone who didn't get out much, I was on cloud nine. And at that point things changed—I started chasing that high.” “There were nights where I'd be up until 3am, drinking beer and playing Team Fortress and chasing those silly hats with purple text, ignoring the gambler's fallacy and swearing that if I dropped another $50 I'd be sure to win this time.” “I'm in a position where I'm living paycheck to paycheck for the moment as the result of that spending—beyond incurring overdraft for my rent.”

Other Harm

In my therapy practice, I frequently counsel people who were failing classes or have dropped out of school as a result of their gaming. They report that they were unable to balance video games, homework, and class attendance. They felt so compelled to continue playing that they also regularly skipped meals and in-person social events. When describing why they are seeking treatment, some have told me that they had done nothing in the preceding weeks except sit in front of a computer and play their favorite game.

Some report that they have tried and failed to quit numerous times. One man told the New York Times that he disassembled his computer and hid the pieces in different boxes in a desperate attempt to get work done. He reassembled it a month later when he found it too difficult to stay away from the game. Others worry about “missing out” so much that they play mobile games while driving.

Many researchers note that some also experience difficulty sleeping, dehydration, malnutrition, irritability, depression, and even seizures as a result of playing for long periods of time.

International Response

As a result of these reports, video game overuse or addiction has become a major concern for many organizations and countries. In 2006, South Korea declared internet addiction to be the most significant health problem for young people. The country enacted a controversial “shutdown” law in 2011, which prohibited children from playing between midnight and 6am. The law was repealed in 2021 and replaced by a "choice permit" system, which empowers parents to decide when to limit their children's game time.

Some governments have proposed or made sweeping changes to protect children from games. China’s government banned all minors from playing video games on weekdays and restricted play to one hour per day Fridays, Saturdays, and Sundays from 8 to 9pm. American Senators Josh Hawley and Chris Lee have both proposed legislation banning children from accessing randomized rewards for purchases within games. Although this legislation was not enacted, it reflects growing concern within the United States government. Several countries have already enacted laws regulating randomized rewards, to varying degrees.

Video Games Can Be Addictive

The vast majority of gamers do not meet the criteria for a diagnosis of “gaming disorder.” For most, video games are a source of social connection, relaxation, and fun.

However, a very small percent of gamers do experience significant harm due to the games they love. Even though they face significant social, financial, and health-related problems, they report that they cannot stop playing without help.

People are considered “addicted” to a substance or behavior like gambling when it causes significant harm to them and they cannot quit without help. This is what self-professed gaming addicts report: they are unable to stop despite harm to their relationships, financial and job security, and other aspects of their life.

The Diagnostic and Statistical Manual (DSM-5) is the book mental health professionals use to diagnose clients. The DSM-5 categorizes gaming disorder only as a “condition for further study.” It may be formalized as an official diagnosis in the future.

This has led a number of clinics and rehabilitation facilities to specialize in treating video game addiction. Each reports great success helping people regain control over their lives and break free from technology’s grip. Although many of these reports have not been independently validated, they align with anecdotal reports of mental health professionals helping patients reduce their use of video games.

In short, video games have a unique allure. Psychologists and game developers use proven strategies from consumer psychology research to augment their intrinsic appeal, which makes them difficult to turn off. Some gamers report that they cannot put the controller down, even when the games cause them significant harm. Should it not, therefore, be considered an addiction?