Video game addiction is a global phenomenon and appears to lead to poorer grades in school and serious psychological problems, including depression, anxiety, and social phobia, said an international team of researchers who followed over 3,000 third through eighth grade students in Singapore and found the percentage of pathological youth gamers there to be similar to other countries.

You can read how Dr Douglas Gentile, an associate professor of psychology at Iowa State University, and five researchers from Singapore and Hong Kong, came to their findings in a study they published online in the 17 January issue of Pediatrics, the journal of the American Academy of Pediatrics.

Gentile and colleagues also found that more hours spent gaming and lower social competence and impulsivity were risk factors for becoming pathological gamers.

For their two-year longitudinal study, they recruited 3,034 elementary and secondary school children in Singapore (743 in grade 3, 711 in grade 4, 916 in grade 7, and 664 in grade 8). The children were attending 12 schools, including five boys' schools.

Using standards similar to those established by the American Psychiatric Association for diagnosing gambling addiction, they trained the classroom teachers to survey video game play and behavior between 2007 and 2009. The measures taken included weekly amount of game play, impulsivity, social competence, depression, social phobia, anxiety and school performance.

Using the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders to define what constitutes pathological behavior, Gentile and colleagues found that between 7.9 and 9.9 of the participants could be defined as pathological gamers over the two years, with 84 per cent of those falling into that category at the start of the period still in that category at the end of it.

But in the same period, only 1 per cent of the participants became new pathological gamers.

The researchers wrote that the prevalence of pathological gaming in Singapore appears to be similar to that of other countries (around 9 per cent), and that:

"Greater amounts of gaming, lower social competence, and greater impulsivity seemed to act as risk factors for becoming pathological gamers, whereas depression, anxiety, social phobias, and lower school performance seemed to act as outcomes of pathological gaming."

They concluded that the study adds weight to the idea that video gaming is similar to other addictive behaviors, it can last for years and is not just a co-symptom of other psychological conditions like depression or anxiety.

In fact, Gentile told the press that "those problems seem to increase as children become more addicted."

"In addition, when children stopped being addicted, depression, anxiety and social phobias decreased as well," he said.

Gentile also explained that:

"We're starting to see a number of studies from different cultures -- in Europe, the US and Asia -- and they're all showing that somewhere around 7 to 11 per cent of gamers seem to be having real problems to the point that they're considered pathological gamers."

To be considered a pathological gamer, the person has to be experiencing damage to several areas of their life, including areas like school, social, family, occupational, and psychological functioning.

Senior investigator Dr Angeline Khoo, associate professor of psychological studies at the National Institute of Education in Singapore, said the study was important because "we didn't know until this research whether some types of children are at greater risk, how long the problem lasts, or whether pathological gaming was a separate problem or simply a symptom of some other problem -- such as depression".

In this study, pathological gamers started with an average of 31 hours game playing per week, compared with 19 hours a week for those who never became pathological gamers.

Gentile said he believes the thresholds are different in different cultures, and for instance we know that in general, children in Singapore spend more time playing video games than children in the US.

In an earlier study he did in the US, they didn't follow the children over time, so they didn't establish a threshold or if there is a certain amount that is too much.

"We do know, however, that playing a lot is not the same as being a pathological gamer -- the gaming must be causing problems for it to be considered pathological," he stressed.

Funds from Singapore's Ministry of Education and media Development Authority helped pay for the research.

"Pathological Video Game Use Among Youths: A Two-Year Longitudinal Study."
Douglas A. Gentile, Hyekyung Choo, Albert Liau, Timothy Sim, Dongdong Li, Daniel Fung, and Angeline Khoo.
Pediatrics, published online 17 January 17, 2011
DOI:10.1542/peds.2010-1353

Additional source: Iowa State University (press release, 16 Jan 2010).

Written by: Catharine Paddock, PhD