Addiction to video games and screens has become a topic of intense interest over the past year. Whether the result of kids obsessed with playing Fortnite or the proliferation of mobile screens with younger children, increasing numbers of parents believe that their child is be addicted to video games or technology. These concerns have coincided with the introduction of Internet Gaming Disorder into the newest version of the Diagnostic and Statistical Manual (DSM-V), the American Psychiatric Association code-book for clinical diagnosis. Internet Gaming Disorder is a “Condition for Further Study,” meaning that it is not an “official” disorder in the DSM-V, but included to promote further attention and research. I found 6,000 links in Google Scholar on this topic since it was introduced in 2014. Clearly there is a lot of research on the part of scientists and concerns about screen addiction from the public. But this attention has also resulted in unintended consequences such as pathologizing common gaming behaviors and a tendency to label intense interests as addiction. Many parents who now observe their children’s fascination with screen play are asking if their children are addicted to video games.
The simple answer for 95% of parents is NO! An interesting article by Patrick Markey and Christopher Ferguson notes that estimates of Internet Gaming Disorder range from 0 – 45% of the population, but that the consensus is that it occurs in about 3% of adults. We are not certain of the incidence in children. True addictions have very serious consequences, often biological in nature, and are not characterized only by the obsessions, preoccupation, irritability, frustration, and loss of interest that are seen in many children with problematic video-game behavior. Many of the kids who demonstrate video game based addictive behaviors may be displaying signs of ADHD, Autism, Learning Disabilities, Executive Functioning problems, Anxiety, or Depression. The major concern for most kids is that rather than problematic video-game and screenplay being an addiction, it takes away from other, more productive, growth-oriented activities and causes conflicts at home. There are unquestionably many kids who spend far too much time with screens, but labeling these children with a psychiatric disorder seems extreme and, more importantly, calls for a different form and degree of intervention. Kids who are better described as “problem,” “obsessed, “passionate,” or “overly engaged” gamers do not need to be placed into a video game rehab facility but often require intensive intervention that includes individual and family therapy, enforceable and consistent limit setting, highly structured access to technology, and ongoing expectations for balancing their “Play Diet.” I will write more about the specifics in future articles.
The major criteria (read this for more detail) for Internet Gaming Disorder include:
Preoccupation with games
Tolerance – needing more time
Unsuccessful attempts to control
Loss of interest in previous activities
Continued use despite problems
Deceiving family and friends about gaming
Escape negative mood
When these symptoms are considered for adults, they must cause significant impairment or distress in many parts of an individual’s life. Five or more must be present for a diagnosis. Many highly engaged teenage gamers will demonstrate some of these symptoms, yet at the same time display no impairment of functioning and experience limited stress, except for conflicts with their parents. Obviously, the degree to which these symptoms are problematic is important. For example, consider how an avid sports fan whose team is in the playoffs might be distracted at work and obsessed with individual players or how one might rush through one’s homework in order to play video games online. This is very different from losing one’s job because of a video-game addiction. I am not arguing that these screen-based behaviors are healthy, only that they do not necessarily constitute an addiction.
Can we use the symptoms for Internet Gaming Disorder to determine if your child is addicted to video games? The listed symptoms do not fit children as well as they do adults and teens. Preoccupation about an area of interest is common for many children – think of dinosaurs, Legos, Barbie dolls, Thomas the Train, and Teenage Mutant Ninja Turtles. Consider how the symptom of tolerance – or wanting more and more time – to play basketball, listen to music, or hang out with friends is considered normal. Or how healthy it is when children’s interests change from playing with dolls to wanting to wear earrings and makeup. While problematic, Internet Gaming Disorder is not defined by the game-associated behaviors that frequently upset parents such as oppositionalism, irritability, difficulty with transitioning, and unwillingness to engage in activities promptly. The symptoms of Internet Gaming Disorder are not a great fit for kids.
In part, this is because some of the symptoms rely upon self-report more than the observations of parents and other adults. In addition, our expectation is that teens and adults have more autonomy in their choice of how they spend their time. The distress and impairments they experience with an addiction are with themselves, their relationships, and in their jobs or educational performance. For kids, more of the conflict is with parental expectations and revolves around how they spend their time.
While the vast majority of children are not addicted to video games and do not exhibit the symptoms of Internet Gaming Disorder, parental concern about excessive gaming in children is well founded. Too much gaming takes away time from other activities, face-to-face relationships, and opportunities to expand interests beyond screens. It is not a mistake that well meaning parents expose their kids to a variety of sports, music, religious, and social activities and our schools attempt to provide a well-rounded education that exposes kids to a diversity of subjects. No matter how often I hear a math-hating middle school student tell me that they will never need math in their future, I continue to see the value in a liberal arts education and in a balanced and healthy “Play Diet” where physical, social, creative, and unstructured play are accompanied but not dominated by digital play. As one gets older those balances can be more self-determined, but it is the responsibility of parents and educators to provide this balance for younger children.
One powerful reason for insisting on balance in play and educational activities is brain development. Children’s brains are strongly influenced by their environment and activities. While video game and screen-play have been demonstrated to have some cognitive benefits, they are often localized in particular brain regions as opposed to in many different areas of the brain such as we might observe if a child is learning a new language, playing guitar, exercising, or doing other activities. So, if your child is a “problem,” “obsessed,” “passionate,” or “overly engaged” gamer, I strongly encourage you to be less concerned about addiction and more focused on creating a healthy “Play Diet” that balances digital play with other activities.
Curious about the other levels of gaming engagement? Check out this article from earlier this year: