I have written before about how gamers identify themselves. Not being a gamer myself (I am too old and get nauseous playing first-person shooters), I interviewed many of my patients about their gaming habits. I also talked extensively with many of our LearningWorks for Kids interns, upper-level undergraduates at the University of Rhode Island who identify themselves as gamers. The gamer identity goes far beyond describing oneself as a sports fan, a vegetarian, or a liberal/conservative and reflects an immersion in the lifestyle and culture of video games. I can state with great conviction that all of these self-identified gamers love playing video games (sometimes to the point of it getting in the way of other activities), can be preoccupied with games (thinking about them frequently), look forward to hanging out with fellow gamers, use gaming to reduce stress, and do not demonstrate signs of a video game addiction. These gamer interns uniformly describe having learned problem-solving and academic skills as a result of their video-game play and how important their gameplay has been in developing real-world friendships. Many of the self-described gamers have nurtured technology skills such as video editing, coding, online marketing, and website design through their interest in video gaming. From my perspective, these gamers are far better described as passionate, engaged, and normal gamers but not as addicted.
The introduction of the Internet Gaming Disorder diagnosis into the DSM-V as a condition for further study has prompted some excellent research into how an addiction to video games and Internet gaming might best be described. In my clinical observations, I have noticed that many of my preteen and teenage patients who demonstrate a few symptoms of video game addiction are diagnosed with ADHD, autism, Learning Disabilities, executive-functioning problems, anxiety, or depression and that psychiatric issues may exacerbate our use of the term “addiction.” As I have immersed myself in the research, one thing has become clear: a variety of terms have been proposed to describe individuals who play a lot of video games but may not demonstrate the clinical signs of an addiction. Some of these non-addicted but heavy gamers would benefit from reducing their gaming behavior and from psychological interventions, but many others do not display any impairment or distress from their propensity for gaming.
The new studies exploring these issues have generated a variety of labels to describe heavy gamers. Gamers who acknowledged modest difficulty with the core symptoms of addiction described as relapse, withdrawal, conflicts, and problems due to gameplay were classified as problem gamers. Problem gamers were described as constituting about 7% of the total population of gamers. Engaged gamers reported less of these symptoms and constituted about 4% of the total population of gamers. For problem and engaged gamers, there was no relationship with unemployment, but problem gamers did display signs of increased difficulty with physical health.
Other studies have used terms such as passionate gamers or obsessed gamers, describing highly involved gamers who love gaming and spend much of their time thinking about their gameplay. For the most part, other studies have not found that these gamers are demonstrating signs of addiction and that their interest in video-game play is better described as reflecting one end of the continuum of video-game play, perhaps excessive at times, but not impairing. For many of these obsessive, highly engaged, and passionate gamers, their video-game play is ego-syntonic, meaning that it is consistent with their personality and not causing a sense of discomfort for them.
Having a passion or focused interest or being highly engaged and attentive to any task is often a core ingredient for developing expertise. We often celebrate individuals (such as musicians, scientists, and athletes) who display these behaviors, pursuing excellence with 10,000 hours of practice and a devotion to their craft. But if the devotion is to Minecraft, we are less likely to view it in such a positive light. There is fairly compelling evidence that too much devotion and time to any one activity, video games included, produces the obvious result: individuals who would benefit from a bit more balance in their lives.
So the next time we look at kids and teens who are spending a lot of their time playing video games and attached to their screens, let’s not immediately label them as addicted. Better would be to describe their intense interests in a more positive light as engaged, passionate, or even obsessed gamers. So while we won’t slap a diagnosis on them, we can certainly provide them with advice, structure, and direction to get a better balance of activities (a healthy “Play Diet”) and assist them in using their love of games to pursue a career, find friends, and develop a lifelong hobby.