research paper about online gaming

Playing games: advancing research on online and mobile gaming consumption

Internet Research

ISSN : 1066-2243

Article publication date: 9 April 2019

Issue publication date: 9 April 2019

Seo, Y. , Dolan, R. and Buchanan-Oliver, M. (2019), "Playing games: advancing research on online and mobile gaming consumption", Internet Research , Vol. 29 No. 2, pp. 289-292. https://doi.org/10.1108/INTR-04-2019-542

Emerald Publishing Limited

Copyright © 2019, Emerald Publishing Limited

Introduction

Computer games consistently generate more revenue than the movie and music industries and have become one of the most ubiquitous symbols of popular culture ( Takahashi, 2018 ). Recent technological developments are changing the ways in which consumers are able to engage with computer games as individuals – adult gamers, parents and children ( Christy and Kuncheva, 2018 ) – and as collectives, such as communities, networks and subcultures ( Hamari and Sjöblom, 2017 ; Seo, 2016 ). In particular, with the proliferation of online and mobile technologies, we have witnessed the emergence of newer forms of both computer games themselves (e.g. advertising games (advergames), virtual and augmented reality games and social media games) ( Rauschnabel et al. , 2017 ) and of gaming practices (e.g. serious gaming, hardcore gaming and eSports) ( Seo, 2016 ).

It is, therefore, not surprising that the issues concerning the ways computer games consumption is changing in light of these technological developments have received much attention across diverse disciplines of social sciences, such as marketing (e.g. Seo et al. , 2015 ), information systems (e.g. Liu et al. , 2013 ), media studies (e.g. Giddings, 2016 ) and internet research (e.g. Hamari and Sjöblom, 2017 ). The purpose of this introductory paper to the special issue “Online and mobile gaming” is to chart future research directions that are relevant to a rapidly changing postmodern digital gaming landscape. In this endeavor, this paper first provides an integrative summary of the six articles that comprise this special issue, and then draws the threads together in order to elicit the agenda for future research.

An integrative summary of the special issue

The six articles that were selected for this special issue advance research into online and mobile gaming in several ways. The opening article by Pappas, Mikalef, Giannakos and Kourouthanassis draws attention to the complex ecosystem of mobile applications in which multiple factors influence consumer behavior in mobile games. Pappas and his colleagues shed light on how price value, game content quality, positive and negative emotions, gender, and gameplay time interact with one another to predict the intention to download mobile games. This study offers useful insights by demonstrating how fuzzy set qualitative comparative analysis methodology can be applied to advance research into computer games consumption.

The study by Bae, Kim, Kim and Koo addresses the digital virtual consumption that occurs within computer games. This second paper explores the relationship between in-game items and mood management to determine the affective value of purchasing in-game items. The findings reveal that game users manage their levels of arousal and mood valence through the use of in-game purchases, suggesting that stressed users are more likely to purchase decorative items, whereas bored users tend to purchase functional items. This study offers an informative perspective of how mood management and selective exposure theories can be applied to understand the in-game purchases. Continuing this theme, the third study by Bae, Park and Koo investigates the effect of perceived corporate social responsibility (CSR) initiatives. Park and colleagues extend previous research by identifying important motivational mechanisms, such as self-esteem and compassion, which link CSR initiative perceptions with the intentions to purchase in-game items.

The fourth and fifth studies of this special issue draw our attention to the use of avatars and game characters. Liao, Cheng and Teng use social identity and flow theories to construct a novel model that explains how avatar attractiveness and customization impact loyalty among online game consumers. In the fifth study, Choi explores the importance of game character characteristics being congruent with product types in order to make advergames more persuasive.

The final study by Lee and Ko reviews the predictors of game addiction based on loneliness, motivation and inter-personal competence. The findings of these authors suggest that regulatory focus mediates the effect of loneliness on online game addiction, and that inter-personal competence significantly buffers the indirect effect of loneliness on online game addiction. This study advances our knowledge about online game addiction through an investigation of the important role played by loneliness.

Future directions for research

Taken together, our introductory commentary and the six empirical studies that make up this special issue deepen and broaden the current understanding of how online and mobile technologies augment the consumption of computer games. In this final section of our paper, we outline potential directions for future research.

First, this special issue highlights that computer games consumption is a diverse interdisciplinary phenomenon, where important issues range from establishing the factors that determine the adoption of particular computer games to what consumers do within these games; from whether computer games enhance consumer well-being (e.g. Howes et al. , 2017 ), to whether they engender addiction (e.g. Frölich et al. , 2016 ); and from establishing how computer gaming experiences are influenced by internal psychological mechanisms to querying the effects of broader social aspects of consumer lives on computer games consumption ( Kowert et al. , 2015 ). Informed by these findings, we assert that as computer games consumption becomes more complex and interactive, incorporating more technology brought about by the proliferation of online and mobile gaming, it is important that our theorizing follows by tracking the mutual imbrication of consumers, play, technology, culture, well-being and other salient issues.

Computer games consumption is a phenomenon of global significance, which is reflected by the international interest that we have received for this special issue. This prompts us to consider similarities and differences in the ways that computer games are consumed across cultures ( Elmezeny and Wimmer, 2018 ). Many computer games themselves now foster intercultural, multicultural and transcultural experiences ( Cruz et al. , 2018 ) by enabling consumers from different countries and regions to connect and build relationships within the shared virtual space. How do such experiences shape the consumption of computer games? This gap in the literature has been previously noted ( Seo et al. , 2015 ), but it has not been either sufficiently detailed or theorised. Future studies should explore the role of various transcultural experiences and practices within online and mobile games consumption.

Finally, one increasingly promising area for future research is the rise of virtual reality (VR) applications. Although the earliest references to VR date back to the 1990s (e.g. Gigante, 1993 ), it has been only recently that technological developments have allowed VR to evolve from a niche technology into an everyday phenomenon that is readily available to consumers ( Lamkin, 2017 ; Oleksy and Wnuk, 2017 ). Given that VR is an experientially distinct medium, how will it augment computer games consumption experiences and practices? Will it foster more diverse applications of computer games across various aspects of consumer lives (e.g. Tussyadiah et al. , 2018 ), or will it increase computer games addiction (e.g. Chou and Ting, 2003 )? What are the current and future intersections between VR technology, online and mobile games, and how are they likely to develop and affect consumers? We envision that these and many other questions related to the application and proliferation of VR technology in computer games consumption will be an exceptionally fruitful area for future research.

In summary, we hope that this paper and the special issue, with its emphasis on online and mobile gaming, will offer new insights for researchers and practitioners who are interested in the advancement of research on computer games consumption.

Chou , T.J. and Ting , C.C. ( 2003 ), “ The role of flow experience in cyber-game addiction ”, CyberPsychology and Behavior , Vol. 6 No. 6 , pp. 663 - 675 .

Christy , T. and Kuncheva , L.I. ( 2018 ), “ Technological advancements in affective gaming: a historical survey ”, GSTF Journal on Computing , Vol. 3 No. 4 , pp. 32 - 41 .

Cruz , A.G.B. , Seo , Y. and Buchanan-Oliver , M. ( 2018 ), “ Religion as a field of transcultural practices in multicultural marketplaces ”, Journal of Business Research , Vol. 91 , pp. 317 - 325 .

Elmezeny , A. and Wimmer , J. ( 2018 ), “ Games without frontiers: a framework for analyzing digital game cultures comparatively ”, Media and Communication , Vol. 6 No. 2 , pp. 80 - 89 .

Frölich , J. , Lehmkuhl , G. , Orawa , H. , Bromba , M. , Wolf , K. and Görtz-Dorten , A. ( 2016 ), “ Computer game misuse and addiction of adolescents in a clinically referred study sample ”, Computers in Human Behavior , Vol. 55 , pp. 9 - 15 .

Giddings , S. ( 2016 ), “ Pokémon Go as distributed imagination ”, Mobile Media and Communication , Vol. 5 No. 1 , pp. 59 - 62 .

Gigante , M.A. ( 1993 ), “ Virtual reality: definitions, history and applications ”, in Earnshaw , R.A. (Ed.), Virtual Reality Systems , Academic Press , New York, NY , pp. 3 - 14 .

Hamari , J. and Sjöblom , M. ( 2017 ), “ What is eSports and why do people watch it ”, Internet Research , Vol. 27 No. 2 , pp. 211 - 232 .

Howes , S.C. , Charles , D.K. , Marley , J. , Pedlow , K. and McDonough , S.M. ( 2017 ), “ Gaming for health: systematic review and meta-analysis of the physical and cognitive effects of active computer gaming in older adults ”, Physical Therapy , Vol. 97 No. 12 , pp. 1122 - 1137 .

Kowert , R. , Vogelgesang , J. , Festl , R. and Quandt , T. ( 2015 ), “ Psychosocial causes and consequences of online video game play ”, Computers in Human Behavior , Vol. 45 , pp. 51 - 58 .

Lamkin , P. ( 2017 ), “ Virtual reality headset sales hit 1 million ”, available at: www.forbes.com/sites/paullamkin/2017/11/30/virtual-reality-headset-sales-hit-1-million/#241697c42b61/ (accessed October 4, 2018 ).

Liu , D. , Li , X. and Santhanam , R. ( 2013 ), “ Digital games and beyond: what happens when players compete ”, MIS Quarterly , Vol. 37 No. 1 , pp. 111 - 124 .

Oleksy , T. and Wnuk , A. ( 2017 ), “ Catch them all and increase your place attachment! The role of location-based augmented reality games in changing people–place relations ”, Computers in Human Behavior , Vol. 76 , pp. 3 - 8 .

Rauschnabel , P.A. , Rossmann , A. and tom Dieck , M.C. ( 2017 ), “ An adoption framework for mobile augmented reality games: the case of Pokémon Go ”, Computers in Human Behavior , Vol. 76 , pp. 276 - 286 .

Seo , Y. ( 2016 ), “ Professionalized consumption and identity transformations in the field of eSports ”, Journal of Business Research , Vol. 69 No. 1 , pp. 264 - 272 .

Seo , Y. , Buchanan‐Oliver , M. and Fam , K.S. ( 2015 ), “ Advancing research on computer game consumption: a future research agenda ”, Journal of Consumer Behaviour , Vol. 14 No. 6 , pp. 353 - 356 .

Takahashi , D. ( 2018 ), “ Newzoo: games market expected to hit $180.1 billion in revenues in 2021 ”, available at: https://venturebeat.com/2018/04/30/newzoo-global-games-expected-to-hit-180-1-billion-in-revenues-2021/ (accessed October 4, 2018 ).

Tussyadiah , I.P. , Wang , D. , Jung , T.H. and tom Dieck , M.C. ( 2018 ), “ Virtual reality, presence and attitude change: empirical evidence from tourism ”, Tourism Management , Vol. 66 , pp. 140 - 154 .

Acknowledgements

The guest editors would like to offer special thanks to the Editor of Internet Research , Christy Cheung, for supporting the publication of this special issue. The guest editors would also like to thank all of the authors who contributed to this research for the “Online and mobile gaming” special issue. Finally, the guest editors gratefully acknowledge the contribution of reviewers, who generously spent their time in helping to review submissions: Luke Butcher, Curtin University, Australia; Hsiu-Hua Chang, Feng Chia University, Taiwan; I-Cheng Chang, National Dong Hwa University, Taiwan; Chi-Wen Chen, California State University, USA; Zifei Fay Chen, University of San Francisco, USA; Sujeong Choi, Chonnam National University, Korea; Diego Costa Pinto, New University of Lisbon, Portugal; Angela Cruz, Monash University, Australia; Robert Davis, Massey University, New Zealand; Julia Fehrer, University of Auckland, New Zealand; Tony Garry, University of Otago, New Zealand; Tracy Harwood, De Montfort University, UK; Mu Hu, Beihang University, China; Tseng-Lung Huang, Yuan Ze University, Taiwan; Kun-Huang Huang, Feng Chia University, Taiwan; Chelsea Hughes, Virginia Commonwealth University, USA; Euejung Hwang, Otago University, New Zealand; Sang-Uk Jung, Hankuk University of Foreign Studies, Korea; Kacy Kim, Bryant University, USA; Dong-Mo Koo, Kyungpook National University, Korea; Jun Bum Kwon, University of New South Wales, Australia; Chun-Chia Lee, National Chiao Tung University, Taiwan; Jacob Chaeho Lee, Ulsan National Institute of Science and Technology, Korea; Loic Li, University of Auckland, New Zealand; Marcel Martončik, University of Presov, Slovakia; Mike Molesworth, University of Reading, UK; Gavin Northey, University of Auckland, New Zealand; James Richard, Victoria University of Wellington, New Zealand; Ryan Rogers, University of Pennsylvania, USA; Felix Septianto, University of Auckland, New Zealand; Zhen Shao, Harbin Institute of Technology, China; Kai-Shuan Shen, Fo Guang University, Taiwan; Jungmin Son, Chungnam National University; Korea; Yang Sun, Zhejiang Sci-Tech University, China; Eva van Reijmersdal, University of Amsterdam, Netherlands; Ekant Veer, University of Canterbury, New Zealand; John Velez, Indiana University, USA; Wei-Tsong Wang, National Cheng Kung University, Taiwan; Ya-Ling Wu, Tamkang University, Taiwan; Sheau-Fen Yap, Auckland University of Technology, New Zealand; and Sukki Yoon, Bryant University, USA.

Corresponding author

About the authors.

Yuri Seo is Senior Lecturer at the University of Auckland of Business School, New Zealand. His research interests include digital technology and consumption, cultural branding and multicultural marketplaces.

Rebecca Dolan is Lecturer at the University of Adelaide School of Business, Australia. Her research focuses on understanding, facilitating and optimizing customer relationships, engagement, and online communication strategies. She has a specific interest in the role that digital and social media play in the modern marketing communications environment.

Margo Buchanan-Oliver is Professor in the Department of Marketing and the Co-Director of the Centre of Digital Enterprise (CODE) at the University of Auckland Business School. Her research concerns interdisciplinary consumption discourse and practice, particularly that occurring at the intersection of the digital and physical worlds.

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• Published: 10 December 2020

Effect of internet use and electronic game-play on academic performance of Australian children

• Md Irteja Islam 1 , 2 ,
• Raaj Kishore Biswas 3 &
• Rasheda Khanam 1  

Scientific Reports volume  10 , Article number:  21727 ( 2020 ) Cite this article

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This study examined the association of internet use, and electronic game-play with academic performance respectively on weekdays and weekends in Australian children. It also assessed whether addiction tendency to internet and game-play is associated with academic performance. Overall, 1704 children of 11–17-year-olds from young minds matter (YMM), a cross-sectional nationwide survey, were analysed. The generalized linear regression models adjusted for survey weights were applied to investigate the association between internet use, and electronic-gaming with academic performance (measured by NAPLAN–National standard score). About 70% of the sample spent > 2 h/day using the internet and nearly 30% played electronic-games for > 2 h/day. Internet users during weekdays (> 4 h/day) were less likely to get higher scores in reading and numeracy, and internet use on weekends (> 2–4 h/day) was positively associated with academic performance. In contrast, 16% of electronic gamers were more likely to get better reading scores on weekdays compared to those who did not. Addiction tendency to internet and electronic-gaming is found to be adversely associated with academic achievement. Further, results indicated the need for parental monitoring and/or self-regulation to limit the timing and duration of internet use/electronic-gaming to overcome the detrimental effects of internet use and electronic game-play on academic achievement.

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Introduction

Over the past two decades, with the proliferation of high-tech devices (e.g. Smartphone, tablets and computers), both the internet and electronic games have become increasingly popular with people of all ages, but particularly with children and adolescents 1 , 2 , 3 . Recent estimates have shown that one in three under-18-year-olds across the world uses the Internet, and 75% of adolescents play electronic games daily in developed countries 4 , 5 , 6 . Studies in the United States reported that adolescents are occupied with over 11 h a day with modern electronic media such as computer/Internet and electronic games, which is more than they spend in school or with friends 7 , 8 . In Australia, it is reported that about 98% of children aged 15–17 years are among Internet users and 98% of adolescents play electronic games, which is significantly higher than the USA and Europe 9 , 10 , 11 , 12 .

In recent times, the Internet and electronic games have been regarded as important, not just for better results at school, but also for self-expression, sociability, creativity and entertainment for children and adolescents 13 , 14 . For instance, 88% of 12–17 year-olds in the USA considered the Internet as a useful mechanism for making progress in school 15 , and similarly, electronic gaming in children and adolescents may assist in developing skills such as decision-making, smart-thinking and coordination 3 , 15 .

On the other hand, evidence points to the fact that the use of the Internet and electronic games is found to have detrimental effects such as reduced sleeping time, behavioural problems (e.g. low self-esteem, anxiety, depression), attention problems and poor academic performance in adolescents 1 , 5 , 12 , 16 . In addition, excessive Internet usage and increased electronic gaming are found to be addictive and may cause serious functional impairment in the daily life of children and adolescents 1 , 12 , 13 , 16 . For example, the AU Kids Online survey 17 reported that 50% of Australian children were more likely to experience behavioural problems associated with Internet use compared to children from 25 European countries (29%) surveyed in the EU Kids Online study 18 , which is alarming 12 . These mixed results require an urgent need of understanding the effect of the Internet use and electronic gaming on the development of children and adolescents, particularly on their academic performance.

Despite many international studies and a smaller number in Australia 12 , several systematic limitations remain in the existing literature, particularly regarding the association of academic performance with the use of Internet and electronic games in children and adolescents 13 , 16 , 19 . First, the majority of the earlier studies have either relied on school grades or children’s self assessments—which contain an innate subjectivity by the assessor; and have not considered the standardized tests of academic performance 16 , 20 , 21 , 22 . Second, most previous studies have tested the hypothesis in the school-based settings instead of canvassing the whole community, and cannot therefore adjust for sociodemographic confounders 9 , 16 . Third, most studies have been typically limited to smaller sample sizes, which might have reduced the reliability of the results 9 , 16 , 23 .

By considering these issues, this study aimed to investigate the association of internet usage and electronic gaming on a standardized test of academic performance—NAPLAN (The National Assessment Program—Literacy and Numeracy) among Australian adolescents aged 11–17 years using nationally representative data from the Second Australian Child and Adolescent Survey of Mental Health and Wellbeing—Young Minds Matter (YMM). It is hypothesized that the findings of this study will provide a population-wide, contextual view of excessive Internet use and electronic games played separately on weekdays and weekends by Australian adolescents, which may be beneficial for evidence-based policies.

Subject demographics

Respondents who attended gave NAPLAN in 2008 (N = 4) and 2009 (N = 29) were removed from the sample due to smaller sample size, as later years (2010–2015) had over 100 samples yearly. The NAPLAN scores from 2008 might not align with a survey conducted in 2013. Further missing cases were deleted with the assumption that data were missing at random for unbiased estimates, which is common for large-scale surveys 24 . From the initial survey of 2967 samples, 1704 adolescents were sampled for this study.

The sample characteristics were displayed in Table 1 . For example, distribution of daily average internet use was checked, showing that over 50% of the sampled adolescents spent 2–4 h on internet (Table 1 ). Although all respondents in the survey used internet, nearly 21% of them did not play any electronic games in a day and almost one in every three (33%) adolescents played electronic games beyond the recommended time of 2 h per day. Girls had more addictive tendency to internet/game-play in compare to boys.

The mean scores for the three NAPLAN tests scores (reading, writing and numeracy) ranged from 520 to 600. A gradual decline in average NAPLAN tests scores (reading, writing and numeracy) scores were observed for internet use over 4 h during weekdays, and over 3 h during weekends (Table 2 ). Table 2 also shows that adolescents who played no electronic games at all have better scores in writing compared to those who play electronic games. Moreover, Table 2 shows no particular pattern between time spent on gaming and NAPLAN reading and numeracy scores. Among the survey samples, 308 adolescents were below the national standard average.

Internet use and academic performance

Our results show that internet (non-academic use) use during weekdays, especially more than 4 h, is negatively associated with academic performance (Table 3 ). For internet use during weekdays, all three models showed a significant negative association between time spent on internet and NAPLAN reading and numeracy scores. For example, in Model 1, adolescents who spent over 4 h on internet during weekdays are 15% and 17% less likely to get higher reading and numeracy scores respectively compared to those who spend less than 2 h. Similar results were found in Model 2 and 3 (Table 3 ), when we adjusted other confounders. The variable addiction tendency to internet was found to be negatively associated with NAPLAN results. The adolescents who had internet addiction were 17% less and 14% less likely to score higher in reading and numeracy respectively than those without such problematic behaviour.

Internet use during weekends showed a positive association with academic performance (Table 4 ). For example, Model 1 in Table 4 shows that internet use during weekends was significant for reading, writing and national standard scores. Youths who spend around 2–4 h and over 4 h on the internet during weekends were 21% and 15% more likely to get a higher reading scores respectively compared to those who spend less than 2 h (Model 1, Table 4 ). Similarly, in model 3, where the internet addiction of adolescents was adjusted, adolescents who spent 2–4 h on internet were 1.59 times more likely to score above the national standard. All three models of Table 4 confirmed that adolescents who spent 2–4 h on the internet during weekends are more likely to achieve better reading and writing scores and be at or above national standard compared to those who used the internet for less than 2 h. Numeracy scores were unlikely to be affected by internet use. The results obtained from Model 3 should be treated as robust, as this is the most comprehensive model that accounts for unobserved characteristics. The addiction tendency to internet/game-play variable showed a negative association with academic performance, but this is only significant for numeracy scores.

Electronic gaming and academic performance

Time spent on electronic gaming during weekdays had no effect on the academic performance of writing and language but had significant association with reading scores (Model 2, Table 5 ). Model 2 of Table 5 shows that adolescents who spent 1–2 h on gaming during weekdays were 13% more likely to get higher reading scores compared to those who did not play at all. It was an interesting result that while electronic gaming during weekdays tended to show a positive effect on reading scores, internet use during weekdays showed a negative effect. Addiction tendency to internet/game-play had a negative effect; the adolescents who were addicted to the internet were 14% less likely to score more highly in reading than those without any such behaviour.

All three models from Table 6 confirm that time spent on electronic gaming over 2 h during weekends had a positive effect on readings scores. For example, the results of Model 3 (Table 6 ) showed that adolescents who spent more than 2 h on electronic gaming during weekdays were 16% more likely to have better reading scores compared to adolescents who did not play games at all. Playing electronic games during weekends was not found to be statistically significant for writing and numeracy scores and national standard scores, although the odds ratios were positive. The results from all tables confirm that addiction tendency to internet/gaming is negatively associated with academic performance, although the variable is not always statistically significant.

Building on past research on the effect of the internet use and electronic gaming in adolescents, this study examined whether Internet use and playing electronic games were associated with academic performance (i.e. reading, writing and numeracy) using a standardized test of academic performance (i.e. NAPLAN) in a nationally representative dataset in Australia. The findings of this study question the conventional belief 9 , 25 that academic performance is negatively associated with internet use and electronic games, particularly when the internet is used for non-academic purpose.

In the current hi-tech world, many developed countries (e.g. the USA, Canada and Australia) have recommended that 5–17 year-olds limit electronic media (e.g. internet, electronic games) to 2 h per day for entertainment purposes, with concerns about the possible negative consequences of excessive use of electronic media 14 , 26 . However, previous research has often reported that children and adolescents spent more than the recommended time 26 . The present study also found similar results, that is, that about 70% of the sampled adolescents aged 11–17 spent more than 2 h per day on the Internet and nearly 30% spent more than 2-h on electronic gaming in a day. This could be attributed to the increased availability of computers/smart-phones and the internet among under-18s 12 . For instance, 97% of Australian households with children aged less than 15 years accessed internet at home in 2016–2017 10 ; as a result, policymakers recommended that parents restrict access to screens (e.g. Internet and electronic games) in children’s bedrooms, monitor children using screens, share screen hours with their children, and to act as role models by reducing their own screen time 14 .

This research has drawn attention to the fact that the average time spent using the internet, which is often more than 4 h during weekdays tends to be negatively associated with academic performance, especially a lower reading and numeracy score, while internet use of more than 2 h during weekends is positively associated with academic performance, particularly having a better reading and writing score and above national standard score. By dividing internet use and gaming by weekdays and weekends, this study find an answer to the mixed evidence found in previous literature 9 . The results of this study clearly show that the non-academic use of internet during weekdays, particularly, spending more than 4 h on internet is harmful for academic performance, whereas, internet use on the weekends is likely to incur a positive effect on academic performance. This result is consistent with a USA study that reported that internet use is positively associated with improved reading skills and higher scores on standardized tests 13 , 27 . It is also reported in the literature that academic performance is better among moderate users of the internet compared to non-users or high level users 13 , 27 , which was in line with the findings of this study. This may be due to the fact that the internet is predominantly a text-based format in which the internet users need to type and read to access most websites effectively 13 . The results of this study indicated that internet use is not harmful to academic performance if it is used moderately, especially, if ensuring very limited use on weekdays. The results of this study further confirmed that timing (weekdays or weekends) of internet use is a factor that needs to be considered.

Regarding electronic gaming, interestingly, the study found that the average time of gaming either in weekdays or weekends is positively associated with academic performance especially for reading scores. These results contradicted previous literatures 1 , 13 , 19 , 27 that have reported negative correlation between electronic games and educational performance in high-school children. The results of this study were consistent with studies conducted in the USA, Europe and other countries that claimed a positive correlation between gaming and academic performance, especially in numeracy and reading skills 28 , 29 . This is may be due to the fact that the instructions for playing most of the electronic games are text-heavy and many electronic games require gamers to solve puzzles 9 , 30 . The literature also found that playing electronic games develops cognitive skills (e.g. mental rotation abilities, dexterity), which can be attributable to better academic achievement 31 , 32 .

Consistent with previous research findings 33 , 34 , 35 , 36 , the study also found that adolescents who had addiction tendency to internet usage and/or electronic gaming were less likely to achieve higher scores in reading and numeracy compared to those who had not problematic behaviour. Addiction tendency to Internet/gaming among adolescents was found to be negatively associated with overall academic performance compared to those who were not having addiction tendency, although the variables were not always statistically significant. This is mainly because adolescents’ skipped school and missed classes and tuitions, and provide less effort to do homework due to addictive internet usage and electronic gaming 19 , 35 . The results of this study indicated that parental monitoring and/ or self-regulation (by the users) regarding the timing and intensity of internet use/gaming are essential to outweigh any negative effect of internet use and gaming on academic performance.

Although the present study uses a large nationally representative sample and advances prior research on the academic performance among adolescents who reported using the internet and playing electronic games, the findings of this study also have some limitations that need to be addressed. Firstly, adolescents who reported on the internet use and electronic games relied on self-reported child data without any screening tests or any external validation and thus, results may be overestimated or underestimated. Second, the study primarily addresses the internet use and electronic games as distinct behaviours, as the YMM survey gathered information only on the amount of time spent on internet use and electronic gaming, and included only a few questions related to addiction due to resources and time constraints and did not provide enough information to medically diagnose internet/gaming addiction. Finally, the cross-sectional research design of the data outlawed evaluation of causality and temporality of the observed association of internet use and electronic gaming with the academic performance in adolescents.

This study found that the average time spent on the internet on weekends and electronic gaming (both in weekdays and weekends) is positively associated with academic performance (measured by NAPLAN) of Australian adolescents. However, it confirmed a negative association between addiction tendency (internet use or electronic gaming) and academic performance; nonetheless, most of the adolescents used the internet and played electronic games more than the recommended 2-h limit per day. The study also revealed that further research is required on the development and implementation of interventions aimed at improving parental monitoring and fostering users’ self-regulation to restrict the daily usage of the internet and/or electronic games.

Data description

Young minds matter (YMM) was an Australian nationwide cross-sectional survey, on children aged 4–17 years conducted in 2013–2014 37 . Out of the initial 76,606 households approached, a total of 6,310 parents/caregivers (eligible household response rate 55%) of 4–17 year-old children completed a structured questionnaire via face to face interview and 2967 children aged 11–17 years (eligible children response rate 89%) completed a computer-based self-reported questionnaire privately at home 37 .

Area based sampling was used for the survey. A total of 225 Statistical Area 1 (defined by Australian Bureau of Statistics) areas were selected based on the 2011 Census of Population and Housing. They were stratified by state/territory and by metropolitan versus non-metropolitan (rural/regional) to ensure proportional representation of geographic areas across Australia 38 . However, a small number of samples were excluded, based on most remote areas, homeless children, institutional care and children living in households where interviews could not be conducted in English. The details of the survey and methodology used in the survey can be found in Lawrence et al. 37 .

Following informed consent (both written and verbal) from the primary carers (parents/caregivers), information on the National Assessment Program—Literacy and Numeracy (NAPLAN) of the children and adolescents were also added to the YMM dataset. The YMM survey is ethically approved by the Human Research Ethics Committee of the University of Western Australia and by the Australian Government Department of Health. In addition, the authors of this study obtained a written approval from Australian Data Archive (ADA) Dataverse to access the YMM dataset. All the researches were done in accordance with relevant ADA Dataverse guidelines and policy/regulations in using YMM datasets.

Outcome variables

The NAPLAN, conducted annually since 2008, is a nationwide standardized test of academic performance for all Australian students in Years 3, 5, 7 and 9 to assess their skills in reading, writing numeracy, grammar and spelling 39 , 40 . NAPLAN scores from 2010 to 2015, reported by YMM, were used as outcome variables in the models; while NAPLAN data of 2008 (N = 4) and 2009 (N = 29) were excluded for this study in order to reduce the time lag between YMM survey and the NAPLAN test. The NAPLAN gives point-in-time standardized scores, which provide the scope to compare children’s academic performance over time 40 , 41 . The NAPLAN tests are one component of the evaluation and grading phase of each school, and do not substitute for the comprehensive, consistent evaluations provided by teachers on the performance of each student 39 , 41 . All four domains—reading, writing, numeracy and language conventions (grammar and spelling) are in continuous scales in the dataset. The scores are given based on a series of tests; details can be found in 42 . The current study uses only reading, writing and numeracy scores to measure academic performance.

In this study, the National standard score is a combination of three variables: whether the student meets the national standard in reading, writing and numeracy. Based on national average score, a binary outcome variable is also generated. One category is ‘below standard’ if a child scores at least one standard deviation (one below scores) from the national standard in reading, writing and numeracy, and the rest is ‘at/above standard’.

Independent variables

Internet use and electronic gaming.

In the YMM survey, owing to the scope of the survey itself, an extensive set of questions about internet usage and electronic gaming could not be included. Internet usage omitted the time spent in academic purposes and/or related activities. Playing electronic games included playing games on a gaming console (e.g. PlayStation, Xbox, or similar console ) online or using a computer, or mobile phone, or a handled device 12 . The primary independent covariates were average internet use per day and average electronic game-play in hours per day. A combination of hours on weekdays and weekends was separately used in the models. These variables were based on a self-assessed questionnaire where the youths were asked questions regarding daily time spent on the Internet and electronic game-play, specifically on either weekends or weekdays. Since, internet use/game-play for a maximum of 2 h/day is recommended for children and adolescents aged between 5 and 17 years in many developed countries including Australia 14 , 26 ; therefore, to be consistent with the recommended time we preferred to categorize both the time variables of internet use and gaming into three groups with an interval of 2 h each. Internet use was categorized into three groups: (a) ≤ 2 h), (b) 2–4 h, and (c) > 4 h. Similar questions were asked for game-play h. The sample distribution for electronic game-play was skewed; therefore, this variable was categorized into three groups: (a) no game-play (0 h), (b) 1–2 h, and (c) > 2 h.

Other covariates

Family structure and several sociodemographic variables were used in the models to adjust for the differences in individual characteristics, parental inputs and tastes, household characteristics and place of residence. Individual characteristics included age (continuous) and sex of the child (boys, girls) and addiction tendency to internet use and/or game-play of the adolescent. Addiction tendency to internet/game-play was a binary independent variable. It was a combination of five behavioural questions relating to: whether the respondent avoided eating/sleeping due to internet use or game-play; feels bothered when s/he cannot access internet or play electronic games; keeps using internet or playing electronic games even when s/he is not really interested; spends less time with family/friends or on school works due to internet use or game-play; and unsuccessfully tries to spend less time on the internet or playing electronic games. There were four options for each question: never/almost never; not very often; fairly often; and very often. A binary covariate was simulated, where if any four out of five behaviours were reported as for example, fairly often or very often, then it was considered that the respondent had addictive tendency.

Household characteristics included household income (low, medium, high), family type (original, step, blended, sole parent/primary carer, other) 43 and remoteness (major cities, inner regional, outer regional, remote/very remote). Parental inputs and taste included education of primary carer (bachelor, diploma, year 10/11), primary carer’s likelihood of serious mental illness (K6 score -likely; not likely); primary carer’s smoking status (no, yes); and risk of alcoholic related harm by the primary carer (risky, none).

Statistical analysis

Descriptive statistics of the sample and distributions of the outcome variables were initially assessed. Based on these distributions, the categorization of outcome variables was conducted, as mentioned above. For formal analysis, generalized linear regression models (GLMs) 44 were used, adjusting for the survey weights, which allowed for generalization of the findings. As NAPLAN scores of three areas—reading, writing and numeracy—were continuous variables, linear models were fitted to daily average internet time and electronic game play time. The scores were standardized (mean = 0, SD = 1) for model fitness. The binary logistic model was fitted for the dichotomized national standard outcome variable. Separate models were estimated for internet and electronic gaming on weekends and weekdays.

We estimated three different models, where models varied based on covariates used to adjust the GLMs. Model 1 was adjusted for common sociodemographic factors including age and sex of the child, household income, education of primary carer’s and family type 43 . However, the results of this model did not account for some unobserved household characteristics (e.g. taste, preferences) that are unobserved to the researcher and are arguably correlated with potential outcomes. The effects of unobserved characteristics were reduced by using a comprehensive set of observable characteristics 45 , 46 that were available in YMM data. The issue of unobserved characteristics was addressed by estimating two additional models that include variables by including household characteristics such as parental taste, preference and inputs, and child characteristics in the model. In addition to the variables in Model 1, Model 2 included remoteness, primary carer’s mental health status, smoking status and risk of alcoholic related harm by the primary carer. Model 3 further included internet/game addiction of the adolescent in addition to all the covariates in Model 2. Model 3 was expected to account for a child’s level of unobserved characteristics as the children who were addicted to internet/games were different from others. The model will further show how academic performance is affected by internet/game addiction. The correlation among the variables ‘internet/game addiction’ and ‘internet use’ and ‘gaming’ (during weekdays and weekends) were also assessed, and they were less than 0.5. Multicollinearity was assessed using the variance inflation factor (VIF), which was under 5 for all models, suggesting no multicollinearity 47 .

p value below the threshold of 0.05 was considered the threshold of significance. All analysis was conducted in R (version 3.6.1). R-package survey (version 3.37) was used for modelling which is suited for complex survey samples 48 .

Data availability

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Acknowledgements

The authors would like to thank the University of Western Australia, Roy Morgan Research, the Australian Government Department of Health for conducting the survey, and the Australian Data Archive for giving access to the YMM survey dataset. The authors also would like to thank Dr Barbara Harmes for proofreading the manuscript.

This research did not receive any specific Grant from funding agencies in the public, commercial, or not-for-profit sectors.

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Islam, M.I., Biswas, R.K. & Khanam, R. Effect of internet use and electronic game-play on academic performance of Australian children. Sci Rep 10 , 21727 (2020). https://doi.org/10.1038/s41598-020-78916-9

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ORIGINAL RESEARCH article

The association between video gaming and psychological functioning.

• 1 Department of Psychology, Johannes Gutenberg University Mainz, Mainz, Germany
• 2 Department of Psychosomatic Medicine, University Medical Center, Mainz, Germany

Video gaming is an extremely popular leisure-time activity with more than two billion users worldwide ( Newzoo, 2017 ). However, the media as well as professionals have underscored the potential dangers of excessive video gaming. With the present research, we aimed to shed light on the relation between video gaming and gamers’ psychological functioning. Questionnaires on personality and psychological health as well as video gaming habits were administered to 2,734 individuals (2,377 male, 357 female, M age = 23.06, SD age = 5.91). Results revealed a medium-sized negative correlation between problematic video gaming and psychological functioning with regard to psychological symptoms, affectivity, coping, and self-esteem. Moreover, gamers’ reasons for playing and their preferred game genres were differentially related to psychological functioning with the most notable findings for distraction-motivated players as well as action game players. Future studies are needed to examine whether these psychological health risks reflect the causes or consequences of video gaming.

Introduction

Video gaming is a very popular leisure activity among adults ( Pew Research Center, 2018 ). The amount of time spent playing video games has increased steadily, from 5.1 h/week in 2011 to 6.5 h/week in 2017 ( The Nielsen Company, 2017 ). Video gaming is known to have some benefits such as improving focus, multitasking, and working memory, but it may also come with costs when it is used heavily. By spending a predominant part of the day gaming, excessive video gamers are at risk of showing lower educational and career attainment, problems with peers, and lower social skills ( Mihara and Higuchi, 2017 ). On the one hand, video game use is widespread, and it may come with certain precursors as well as consequences. On the other hand, little is known about the relations between various video gaming habits and psychological functioning. This study aims to shed light on these important relations using a large sample.

A video game is defined as “a game which we play thanks to an audiovisual apparatus and which can be based on a story” ( Esposito, 2005 ). In the last few years, the amount of scientific research devoted to video game playing has increased (e.g., Ferguson, 2015 ; Calvert et al., 2017 ; Hamari and Keronen, 2017 ). Most scientific studies in this area of research have focused on the extent of video game play and its diverse correlates. While some researchers have emphasized the benefits of game playing and even suggested a therapeutic use of video games ( Primack et al., 2012 ; Granic et al., 2014 ; Colder Carras et al., 2018 ), others have been intrigued by its potential dangers ( Anderson et al., 2010 ; Müller and Wölfling, 2017 ).

Parents and professionals may be worried about their excessively playing children being “addicted.” However, problematic and potentially addictive video game use goes beyond the extent of playing (in hours per week; Skoric et al., 2009 ). It also includes such issues as craving, loss of control, and negative consequences of excessive gaming. While it is still a matter of debate whether problematic video game play should be considered a behavioral addiction , its status as a mental disorder has been clarified since the release of the DSM-5 in 2013. In the DSM-5, the American Psychiatric Association (2013) defined Internet Gaming Disorder with diagnostic criteria closely related to Gambling Disorder. Generally, this decision has been supported by many researchers (e.g., Petry et al., 2014 ) but has also caused controversies. Researchers have criticized the selection of diagnostic criteria and the vague definition of the Internet Gaming Disorder construct, which excludes offline games from being related to addictive use (e.g., Griffiths et al., 2016 ; Bean et al., 2017 ).

Several studies, literature reviews, and meta-analyses have focused on the correlates of problematic video gaming, usually assessed as a continuum with addiction marking the upper end of the scale (e.g., Ferguson et al., 2011 ; Kuss and Griffiths, 2012 ). The degree of addictive video game use has been found to be related to personality traits such as low self-esteem ( Ko et al., 2005 ) and low self-efficacy ( Jeong and Kim, 2011 ), anxiety, and aggression ( Mehroof and Griffiths, 2010 ), and even to clinical symptoms of depression and anxiety disorders ( Wang et al., 2018 ). Potential consequences of video game use have been identified as well, such as a lack of real-life friends ( Kowert et al., 2014a ), stress and maladaptive coping ( Milani et al., 2018 ), lower psychosocial well-being and loneliness ( Lemmens et al., 2011 ), psychosomatic problems ( Müller et al., 2015 ; Milani et al., 2018 ), and decreased academic achievement ( Chiu et al., 2004 ; Gentile, 2009 ). Effect sizes have varied widely across studies ( Ferguson et al., 2011 ). There seem to be sex and age differences with regard to video gaming behavior: potentially problematic video gaming was found to be more likely among males than females (e.g., Greenberg et al., 2010 ; Estévez et al., 2017 ), and among younger gamers ( Rehbein et al., 2016 ).

In addition to looking at problematic video game use and its relation to psychological functioning, it is relevant to also focus on why individuals play video games. Players use video games for very different reasons ( Ryan et al., 2006 ; Yee, 2006 ) such as to distract themselves from daily hassles or because they enjoy the social relationships they have developed in the virtual world. Potentially problematic video gaming has been found to be related to various reasons for playing such as coping and escape ( Hussain and Griffiths, 2009 ; Schneider et al., 2018 ), socialization ( Laconi et al., 2017 ), and personal satisfaction ( Ng and Wiemer-Hastings, 2005 ). Coping ( Laconi et al., 2017 ), social interaction, and competition were among the main reasons for gaming among males but not among females ( Lucas and Sherry, 2004 ). Mixed results emerged concerning age differences ( Greenberg et al., 2010 ), but especially younger gamers seemed to be motivated for video gaming by social interactions ( Hilgard et al., 2013 ). However, so far it remains unclear to what extent people’s various reasons for playing video games are differentially related to their psychological functioning.

Besides investigating the links between potentially problematic video game use and psychological functioning as well as between reasons for playing video games and psychological functioning, it is relevant to also look at which game genres individuals prefer. Correlates of preferences for certain game genres (e.g., simulation, strategy, action, role-playing) are cognitive enhancement ( Dobrowolski et al., 2015 ; Bediou et al., 2018 ), but also the amount of time spent playing ( Lemmens and Hendriks, 2016 ; Rehbein et al., 2016 ) and psychopathological symptoms ( Laconi et al., 2017 ). Males were shown to prefer action and strategy games, whereas females showed a preference for games of skill ( Scharkow et al., 2015 ; Rehbein et al., 2016 ). Younger gamers seemed to prefer action games, older players more so games of skill ( Scharkow et al., 2015 ). However, it is not yet understood to what extent preferences for certain video game genres are differentially related to psychological functioning.

Typically, research has focused merely on violent video games (e.g., Anderson and Bushman, 2001 ; Elson and Ferguson, 2014 ) or one specific game within one specific game genre (frequently World of Warcraft; Graham and Gosling, 2013 ; Visser et al., 2013 ; Herodotou et al., 2014 ), thereby neglecting the variety of possible gaming habits across various game genres.

In the present study, our objective was to examine the relation between video gaming and psychological functioning in a fine-grained manner. For this purpose, we examined psychological functioning by employing various variables such as psychological symptoms, coping strategies, and social support. Likewise, we assessed video gaming in a similarly detailed way, ranging from (a) problematic video game use, (b) the reasons for playing, to (c) the preferred game genres. This strategy prevented us from making potentially invalid generalizations about video gaming in general and allowed us to examine the spectrum of gaming habits and the respective relations between such habits and a diverse set of variables representing psychological functioning.

Playing video games excessively should be appealing to individuals with poor psychological functioning because games allow people to avoid their everyday problems and instead immerse themselves in another environment ( Taquet et al., 2017 ). Moreover, video games offer people a chance to connect with other people socially despite any more or less evident psychological problems they may have ( Kowert et al., 2014b ; Mazurek et al., 2015 ). On the other hand, potentially problematic video game use may also lead to psychological problems because it reduces the amount of time and the number of opportunities gamers have to practice real-life behavior ( Gentile, 2009 ). Thus, we expected to find a negative correlation between problematic video gaming and variables representing psychological functioning such that we expected more potentially problematic video game use to be related to dysfunctional coping strategies ( Wood and Griffith, 2007 ), negative affectivity ( Mathiak et al., 2011 ), and poor school performance ( Mihara and Higuchi, 2017 ). Moreover, we expected to find differential correlates of people’s reasons for playing video games and their psychological functioning: Playing for escape-oriented reasons such as distraction should go along with diverse indices of poor psychological functioning ( Király et al., 2015 ), whereas playing for gain-oriented reasons such as the storyline or the social connections in the game should be related to adequate psychological functioning ( Longman et al., 2009 ). Also, we expected to find people’s preferred game genres (e.g., strategy, action) to be differentially related to their psychological functioning ( Park et al., 2016 ). Finally, we aimed to shed light on the unique contribution of each measure of psychological functioning to the prediction of problematic video game use.

Materials and Methods

Participants 1.

A total of N = 2,891 individuals (2,421 male, 470 female) with a mean age of 23.17 years ( SD = 5.99, Range: 13–65) participated in our study. Of these participants, N = 2,734 (95%) confirmed their use of video games and were thus included in further analyses (2,377 male, 357 female, with a mean age of 23.06 years; SD = 5.91, Range: 13–65). The distribution of participants with regard to sex and age mirrors the findings of past research with males and younger individuals being more likely to play video games (e.g., Griffiths et al., 2004 ). Participants’ place of residence was Germany.

Procedure and Instruments 2

We posted links to our online questionnaire on various online forums as well as on popular online game sites. To achieve heterogeneity of the sample, no exclusion criteria other than having access to the Internet and understanding German were specified. As an incentive to participate in the study, four vouchers of 50€ were raffled.

Video Gaming

Potentially problematic video game use.

The AICA-S, the Scale for the Assessment of Internet and Computer game Addiction ( Wölfling et al., 2016 ), was used to assess participants’ gaming behavior with regard to potential problematic use. Based on the DSM criteria for Internet Gaming Disorder (tolerance, craving, loss of control, emotion regulation, withdrawal, and unsuccessful attempts to cut back), this standardized self-report scale consists of 15 items usually with a five-point scale ranging from 1 ( never ) to 5 ( very often ). The final score (Min = 0, Max = 27 points) is computed using weighted scoring (items with an item-total correlation > 0.55 in the norm sample are weighted double; Wölfling et al., 2011 ). The AICA-S score can be used to differentiate between regular (0–6.5 points) and problematic use of video games (7–13 points: abuse; 13.5–27 points: addiction). In our sample, N = 2,265 (83%) were identified as regular gamers, and N = 469 (17%) as problematic gamers. We used the AICA-S as a continuous variable for all further analyses ( M = 3.98, SD = 3.22, Range: 0–24). The instrument has been validated for different age groups in the general population and in clinical samples ( Müller et al., 2014a , 2019 , but note small sample size; Müller et al., 2014b ). Cronbach’s alpha was α = 0.70. As expected, the AICA-S score was correlated with male sex ( r = 0.17 ∗∗∗ ) and age ( r = –0.15 ∗∗∗ ). On average, participants played video games for M = 4.09 hours per weekday ( SD = 4.44, Range: 0–24), and M = 4.21 h per day at the weekend ( SD = 2.99, Range: 0–24).

Reasons for playing

Gamers indicated how often they played video games for certain reasons. They rated each of 10 reasons separately on Likert scales ranging from 1 ( never ) to 4 ( very often ). The most prevalent reasons were relaxation ( M = 2.96, SD = 0.91), amusement ( M = 2.94, SD = 0.85), and because of the storyline ( M = 2.67, SD = 1.10).

Game genres

Gamers were asked how often they usually played various video game subgenres such as first-person shooter, round-based strategy, massively multiplayer online role-playing games (MMORPGs), life simulations, and others. Ratings were made on Likert scales ranging from 1 ( never ) to 4 ( very often ). Using Apperley’s (2006) classification of game genres, we categorized the subgenres into the main genres action ( M = 2.54, SD = 0.84), strategy ( M = 2.13, SD = 0.80), role-playing ( M = 2.01, SD = 0.73), and simulation ( M = 1.58, SD = 0.44). A cluster for unclassified subgenres ( M = 1.54, SD = 0.39) was added to additionally account for such subgenres as jump’n’runs and games of skill. Descriptive statistics and intercorrelations for all measures (including sex and age) are presented in Supplementary Tables S1–S4 .

Psychological Functioning

Participants provided ratings of their psychological functioning on the following constructs:

General psychopathology

The SCL-K-9 ( Klaghofer and Brähler, 2001 ), a short version of the SCL-90-R ( Derogatis, 1975 ), was administered to assess participants’ subjective impairment regarding psychological symptoms (somatization, obsessive-compulsive, interpersonal sensitivity, depression, anxiety, hostility, phobic anxiety, paranoid ideation, and psychoticism). The SCL-K-9 score is strongly correlated with the original score of the SCL-90-R ( r = 0.93). The 9 items were answered on 5-point Likert-type scales ranging from 1 ( do not agree at all ) to 5 ( agree completely ). Cronbach’s alpha was satisfactory (α = 0.77).

We assessed 10 coping strategies with the Brief COPE ( Carver, 1997 ; German version by Knoll et al., 2005 ), which is the shorter version of the COPE ( Carver et al., 1989 ): self-distraction, denial, substance use, venting, self-blame, behavioral disengagement, acceptance, active coping, planning, and positive reframing. The two items per subscale were administered on 5-point Likert-type scales ranging from 1 ( never ) to 5 ( very often ). Intercorrelations of the two items per subscale ranged from r = 0.32, p < 0.001 for positive reframing to r = 0.78, p < 0.001 for substance use (with one exception: r = -0.05, p = 0.01 for self-distraction).

We measured general affect as a trait and affect during video gaming as a state using the German version ( Krohne et al., 1996 ) of the Positive and Negative Affect Schedule (PANAS; Watson et al., 1988 ). On a 5-point Likert-type scale ranging from 1 ( not at all ) to 5 ( completely ), participants rated the intensity of 20 adjectives. Cronbach’s alpha was α = 0.78 for general positive affect, α = 0.83 for general negative affect, α = 0.85 for positive affect while playing, and α = 0.83 for negative affect while playing.

The measure for the assessment of shyness in adults ( Asendorpf, 1997 ) consists of 5 items that were answered on a 5-point Likert-type scale ranging from 1 ( not at all ) to 5 ( completely ). Cronbach’s alpha was excellent (α = 0.86).

We administered the German version ( Elbing, 1991 ) of the NYU Loneliness Scale ( Rubenstein and Shaver, 1982 ). The 4 items were answered on 5- to 6-point Likert-type scales. Cronbach’s alpha was satisfactory (α = 0.79).

Preference for solitude

A 10-item measure of preference for solitude ( Nestler et al., 2011 ) was answered on a 6-point Likert-type scale ranging from 1 ( not at all ) to 6 ( completely ). Cronbach’s alpha was excellent (α = 0.86).

Life satisfaction

Participants answered a one-item life satisfaction measure on a 4-point Likert-type scale ranging from 1 ( not at all ) to 4 ( completely ).

Self-esteem

We administered the German version ( von Collani and Herzberg, 2003 ) of the Rosenberg Self-Esteem Scale (RSES; Rosenberg, 1979 ). The 10 items were answered on a 4-point Likert-type scale ranging from 1 ( not at all ) to 4 ( completely ). Cronbach’s alpha was excellent (α = 0.88).

Self-efficacy

We administered a 10-item generalized self-efficacy scale ( Schwarzer and Jerusalem, 1995 ), which was answered on a 4-point Likert-type scale ranging from 1 ( not at all ) to 4 ( completely ). Cronbach’s alpha was excellent (α = 0.86).

Social support and friends

We administered the perceived available social support subscale from the Berlin Social Support Scales (BSSS; Schwarzer and Schulz, 2003 ). The 8 items were answered on a 5-point Likert-type scale ranging from 1 ( not at all ) to 5 ( completely ). Cronbach’s alpha was excellent (α = 0.94). Participants indicated how many offline friends and offline acquaintances they had ( r = 0.44, p < 0.001) as well as how many online friends and online acquaintances they had ( r = 0.33, p < 0.001). Due to left-skewed distributions, we logarithmized the data before aggregation.

Participants reported their grade point average. German grades are assessed on a scale that ranges from 1 ( excellent ) to 6 ( insufficient ). Thus, higher scores indicate worse grades.

Participants further reported their sex and age. Both were used as control variables in further analyses.

In a first step, we computed zero-order correlations between the video gaming variables and the measures of psychological functioning. In a second step, we computed partial correlations in which we controlled for sex and age because past research has repeatedly shown that sex and age are correlated with both video gaming ( Homer et al., 2012 ; Mihara and Higuchi, 2017 ) and psychological functioning ( Kessler et al., 2007 ; Nolen-Hoeksema, 2012 ). Finally, we explored the unique contribution of each measure of psychological functioning to the prediction of potentially problematic video gaming. Therefore, we computed regressions with potentially problematic video gaming as the dependent variable and sex, age, and the measures of psychological functioning as predictors (entered simultaneously into the regression equation). By employing this procedure, we were able to determine the effect that each variable had over and above the other ones. For instance, we could identify whether general psychopathology was predictive of potentially problematic video game use when the influence of all other variables (e.g., shyness, loneliness, and others) was held constant.

Additionally, we included analyses regarding sex and age differences in the link between video gaming and psychological functioning. Since we collected a self-selected sample where different sexes and age groups were not represented equally, our findings are only preliminary, but may stimulate future research.

Potentially Problematic Video Game Use and Psychological Functioning

First, we examined whether potentially problematic video game use was related to various psychological functioning variables. As can be seen in Table 1 , the results for the zero-order correlations were similar to those for the partial correlations in which we controlled for sex and age. A medium-sized positive relation to the potentially problematic use of video games emerged for the presence of psychological symptoms including depression, anxiety, and hostility. Furthermore, several coping strategies were differentially associated with the potentially problematic use of video games: Self-blame and behavioral disengagement showed the strongest positive relations to potentially problematic video game use, followed by denial, acceptance, substance use, self-distraction, and venting. Planning, active coping, and, to a lesser extent, positive reframing were negatively associated with the potentially problematic use of video games. Moreover, the association with potentially problematic video game use was negative for general positive affect and positive and larger in size for general negative affect. However, potentially problematic video game use was clearly positively associated with the experience of both positive and negative affect while playing. Further, a preference for solitude, shyness, and loneliness were positively correlated with the potentially problematic use of video games. Lower self-esteem, lower life satisfaction, and, to a lesser extent, poorer perceived social support and lower self-efficacy went along with potentially problematic video game use. There was an association between fewer offline friends and acquaintances but more online connections with potentially problematic video gaming. Finally, poorer performance in school (i.e., higher grades) was related to the potentially problematic use of video games. These results suggest that potentially problematic video gaming goes along with poor psychological functioning and vice versa.

Table 1. Associations between potentially problematic video gaming and psychological functioning.

Reasons for Playing Video Games and Psychological Functioning

Second, we investigated whether players’ reasons for playing video games were differentially related to the psychological functioning variables. Table 2 presents the partial correlations, controlling for sex and age. Using video games to distract oneself from stress was clearly connected to a high level of psychological symptoms. Distraction-motivated gamers preferred coping strategies such as self-blame, behavioral disengagement, self-distraction, denial, substance use, venting, and acceptance, but they neglected active coping and planning. They showed less general positive affect and more negative affect both in general and while playing as well as more positive affect while playing. These gamers further reported low self-esteem and low life satisfaction, loneliness, a preference for solitude, shyness, a lack of self-efficacy and social support, and poor achievement in school. A similar but somewhat less extreme picture was revealed for gamers who played video games in order to have something to talk about . However, these gamers reported more online connections. Gamers who played video games to improve their real-life abilities also reported more online connections. In addition, these gamers showed higher levels of general positive affect. The strongest association with online friends and acquaintances emerged, as expected, for gamers who played because of the social relations in the virtual world. Although all reasons for playing video games were related to positive affect while playing, the strongest associations emerged for gamers who played because of the social relations , to stimulate their imagination , and for curiosity . It is interesting that, for gamers who played video games because of the storyline and for relaxation , there was a relation only to positive but not to negative affect while playing. Reasons for playing were only weakly related to sex and age (see Supplementary Table S2 ). In sum, several reasons for playing video games were differentially associated with psychological functioning.

Table 2. Associations between reasons for playing video games and psychological functioning.

Video Game Genre and Psychological Functioning

Third, we examined whether players’ preferences for different video game genres were differentially associated with the measures of psychological functioning. Table 3 shows the partial correlations in which we controlled for sex and age. There was a weak connection between general psychological symptoms and all of the video game genres we investigated except strategy. A preference for action games had the strongest association with affect while playing. Thus, action games seem to be both rewarding and a source of frustration. A preference for action games went along with poorer school performance. Gamers who preferred role-playing games scored higher on shyness and a preference for solitude and lower on self-esteem; they also reported fewer offline connections. By contrast, preferences for games of the unclassified category on average went along with a larger number of offline friends and more positive affect, both while playing and in general. Two game genres (i.e., role-playing and unclassified games) were related to the coping strategy of self-distraction. Because preferred game genre was related to participants’ sex (see Supplementary Table S3 ), we had a more detailed look at the correlations between preferred game genre and psychological functioning separately for both sexes: For males ( n = 2,377), the strongest correlation between general psychopathology and game genre emerged for action ( r = 0.08, p < 0.001), followed by role playing ( r = 0.07, p < 0.01), and unclassified ( r = 0.07, p < 0.01). For females ( n = 357), the strongest relation between general psychopathology and game genre emerged for simulation ( r = 0.17, p < 0.01). Differences were also found regarding the strength of the relation between number of friends online and the genre action: r = 0.06, p < 0.01 for males, and r = 0.27, p < 0.001 for females. Similarly, preferred game genre was related to participants’ age (see Supplementary Table S3 ). However, there were merely differences with regard to the relation of psychological functioning and game genre, when analyzed separately for different age groups (<19 years, n = 557; 19–30 years, n = 1916; >31 years, n = 261). In sum, our results speak to the idea that individuals with different levels of psychological functioning differ in their choices of game genres and vice versa.

Table 3. Associations between preferred video game genre and psychological functioning.

Predicting Potentially Problematic Video Game Use by Psychological Functioning Variables

In a final step, we entered all of the investigated psychological functioning variables as well as sex and age as predictors of the potentially problematic use of video games. By employing this procedure, we were able to determine the unique contribution of each psychological functioning variable when the influence of all other variables was held constant. As Table 4 shows, the number of online friends and acquaintances as well as positive affect while playing were most predictive of potentially problematic video game use over and above all other variables. General psychopathology, a lack of offline connections, and poor school performance were weaker but still relevant predictors of potentially problematic video game use.

Table 4. Prediction of potentially problematic video game use by psychological functioning variables.

With this study, we aimed to shed light on the association of diverse video gaming habits with gamers’ psychological functioning. Drawing on a large sample, our results revealed a medium-sized relation between potentially problematic video game use and poor psychological functioning with regard to general psychological symptoms, maladaptive coping strategies, negative affectivity, low self-esteem, and a preference for solitude as well as poor school performance. These findings are in line with those of prior work (e.g., Kuss and Griffiths, 2012 ; Milani et al., 2018 ). Also, reasons for playing video games were differentially related to psychological functioning with the most pronounced findings for escape-oriented in contrast to gain-oriented motives. Specifically, distraction-motivated gaming went along with higher symptom ratings, lower self-esteem, and more negative affectivity, whereas playing to establish social relationships in the virtual world was related to a larger number of online connections and more positive affect while playing. Furthermore, there were only weak relations between the preferred game genres and psychological functioning. The action games genre was associated with the strongest ratings of affect while playing. These results on reasons and genres may help to explain conflicting findings of former studies, because in our work we examined various reasons for playing, several game genres, and various aspects of psychological functioning simultaneously. Finally, positive affect while playing and a larger number of online friends were the strongest unique predictors of potentially problematic video game use, followed by psychological symptoms, a lack of offline connections, and poor school performance. These findings suggest that, on the one hand, independent of one’s psychological conditions, enjoying oneself during gaming (i.e., experiencing positive affect, connecting with online friends) may go along with potentially problematic use of video games. On the other hand, poor psychological functioning seems to be a unique risk factor for potentially problematic video gaming.

The presented results are generally in line with previous work that has identified a connection between video gaming and psychological health, academic problems, and social problems ( Ferguson et al., 2011 ; Müller et al., 2015 ). However, our study moved beyond prior research by providing in-depth analyses of both video gaming habits (including potentially problematic use, reasons for playing, and preferred game genre) and psychological functioning (including psychological symptoms, coping styles, affectivity, as well as variables that are related to individuals and their social environments). In addition, we identified unique predictors of potentially problematic video game use.

How can the findings on differential relations between video gaming and various indices of psychological functioning – ranging from beneficial results ( Latham et al., 2013 ) to unfavorable results ( Barlett et al., 2009 ; Möller and Krahé, 2009 ; Anderson et al., 2010 ) – be integrated? According to Kanfer and Phillips (1970) , problematic behavior (e.g., excessive video gaming) can be understood as a function of the situation (e.g., being rejected by a peer); the organism (e.g., low self-esteem); the person’s thoughts, physical reactions, and feelings (e.g., sadness, anger); and finally, the short- as well as long-term consequences of the behavior (termed SORKC model). In the short run, according to our results, playing video games may be a way to distract oneself from everyday hassles and may lead to positive affect while playing and a feeling of being connected to like-minded people, all of which are factors that have an immediate reinforcing value. In the long run, however, spending many hours per day in front of a computer screen may prevent a person from (a) developing and practicing functional coping strategies, (b) finding friends and support in the social environment, and (c) showing proper school achievement, factors that are potentially harmful to the person. Thus, differentiating between short- and long-term perspectives may help us understanding the differential correlates of intensive video gaming.

When is it appropriate to speak of video game addiction? More and more researchers have suggested a continuum between engagement ( Charlton and Danforth, 2007 ; Skoric et al., 2009 ) and pathological gaming/addiction, instead of a categorical perspective. In part, this recommendation has also been followed in the DSM-5 ( American Psychiatric Association, 2013 ) where Internet Gaming Disorder is classified with different degrees of severity, ranging from mild to moderate to severe, according to the functional impairment associated with it. The AICA-S also allows for a differential perspective on gaming behavior by providing ways to assess both the time spent playing video games and the main DSM criteria that indicate Internet Gaming Disorder. However, in our study we did not aim at making a diagnosis, but at having a closer look at potentially problematic gaming behavior and its correlates in a non-clinical sample.

In sum, it seems relevant to assess not only the extent of video game use but also the reasons behind this behavior (e.g., distraction) and the concrete rewards that come from playing (e.g., the experience of strong affect while playing action games) to fully understand the relation between video gaming and psychological functioning.

Limitations and Future Directions

With the present study, we aimed to uncover the association between video gaming and psychological functioning. Our approach was cross-sectional and warrants interpretative caution because correlations cannot determine the direction of causation. It remains unclear whether potentially problematic gaming is a factor that contributes to the development of psychological dysfunction or whether psychological dysfunction contributes to potentially problematic gaming. Also, a third factor (e.g., preexisting mental difficulties) may produce both psychological dysfunction and potentially problematic gaming. Thus, longitudinal studies that are designed to identify the causal pathway may provide a promising avenue for future research. Future studies may also answer the question whether the link between video gaming and psychological functioning is moderated by sex, age, the reasons for playing, or the preferred game genre. In addition, it is important not to forget that the present results are based on a self-selected sample in which potentially problematic video gamers were overrepresented (e.g., Festl et al., 2013 , for a representative sample). Thus, future research should replicate our findings in a representative sample. Further, we relied on self-reported data, which is a plausible method for assessing inner affairs such as people’s reasons for their behaviors, but it would be helpful to back up our findings with evidence derived from sources such as peers, caregivers, and health specialists. Our work reflects only a first approach to the topic, and future work may additionally collect in-game behavioral data from the players ( McCreery et al., 2012 ; Billieux et al., 2013 ) to objectively and more specifically investigate diverse patterns of use. Furthermore, one must not forget that the used taxonomy to classify video game genres is only one of various possible options and one should “think of each individual game as belonging to several genres at once” ( Apperley, 2006 , p. 19). Finally, some of the effects reported in our paper were rather modest in size. This is not surprising considering the complexity and multiple determinants of human behavior. In our analyses, we thoroughly controlled for the influence of sex and age and still found evidence that video gaming was differentially related to measures of psychological functioning.

The current study adds to the knowledge on gaming by uncovering the specific relations between video gaming and distinct measures of psychological functioning. Potentially problematic video gaming was found to be associated with positive affect and social relationships while playing but also with psychological symptoms, maladaptive coping strategies, negative affectivity, low self-esteem, a preference for solitude, and poor school performance. Including gamers’ reasons for playing video games and their preferred game genres helped deepen the understanding of the specific and differential associations between video gaming and psychological health. This knowledge might help developing adequate interventions that are applied prior to the occurrence of psychological impairments that may go along with potentially problematic video gaming.

Ethics Statement

In our online survey, participants were given information on voluntary participation, risks, confidentiality/anonymity, and right to withdraw. Whilst participants were not signing a separate consent form, consent was obtained by virtue of completion. We implemented agreed procedures to maintain the confidentiality of participant data.

Author Contributions

BB, BE, JH, and KM conceived and designed the study. BB, JH, and KM collected and prepared the data. JH analyzed the data. BE and JH wrote the manuscript.

Conflict of Interest Statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Supplementary Material

The Supplementary Material for this article can be found online at: https://www.frontiersin.org/articles/10.3389/fpsyg.2019.01731/full#supplementary-material

• ^ The data were gathered as part of a larger project ( Stopfer et al., 2015 ; Braun et al., 2016 ). However, the analyses in the present article do not overlap with analyses from previous work.
• ^ Other measures were administered, but they were not relevant to the present research questions and are thus not mentioned in this paper. The data set and analysis script supporting the conclusions of this manuscript can be retrieved from https://osf.io/emrpw/?view_only=856491775efe4f99b407e258c2f2fa8d .

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Keywords : computer games, video gaming behavior, game genres, coping, psychological health

Citation: von der Heiden JM, Braun B, Müller KW and Egloff B (2019) The Association Between Video Gaming and Psychological Functioning. Front. Psychol. 10:1731. doi: 10.3389/fpsyg.2019.01731

Received: 14 September 2018; Accepted: 11 July 2019; Published: 26 July 2019.

Reviewed by:

Copyright © 2019 von der Heiden, Braun, Müller and Egloff. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

*Correspondence: Juliane M. von der Heiden, [email protected]

Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

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Title: deep pattern network for click-through rate prediction.

Abstract: Click-through rate (CTR) prediction tasks play a pivotal role in real-world applications, particularly in recommendation systems and online advertising. A significant research branch in this domain focuses on user behavior modeling. Current research predominantly centers on modeling co-occurrence relationships between the target item and items previously interacted with by users in their historical data. However, this focus neglects the intricate modeling of user behavior patterns. In reality, the abundance of user interaction records encompasses diverse behavior patterns, indicative of a spectrum of habitual paradigms. These patterns harbor substantial potential to significantly enhance CTR prediction performance. To harness the informational potential within user behavior patterns, we extend Target Attention (TA) to Target Pattern Attention (TPA) to model pattern-level dependencies. Furthermore, three critical challenges demand attention: the inclusion of unrelated items within behavior patterns, data sparsity in behavior patterns, and computational complexity arising from numerous patterns. To address these challenges, we introduce the Deep Pattern Network (DPN), designed to comprehensively leverage information from user behavior patterns. DPN efficiently retrieves target-related user behavior patterns using a target-aware attention mechanism. Additionally, it contributes to refining user behavior patterns through a pre-training paradigm based on self-supervised learning while promoting dependency learning within sparse patterns. Our comprehensive experiments, conducted across three public datasets, substantiate the superior performance and broad compatibility of DPN.

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‘An epidemic of loneliness’: How the pandemic changed life for aging adults

Stock image of a sign at a park in 2020, calling for social distancing. Four years later, a new study shows many are still keeping to themselves more than they did pre-pandemic.  

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Years after the U.S. began to slowly emerge from mandatory COVID-19 lockdowns, more than half of older adults still spend more time at home and less time socializing in public spaces than they did pre-pandemic, according to new CU Boulder research. 

Participants cited fear of infection and “more uncomfortable and hostile” social dynamics as key reasons for their retreat from civic life.

“The pandemic is not over for a lot of folks,” said Jessica Finlay, an assistant professor of geography whose findings are revealed in a series of new papers . “Some people feel left behind.”

The study comes amid what the U.S. Surgeon General recently called an “ epidemic of loneliness ” in which older adults—especially those who are immune compromised or have disabilities—are particularly vulnerable.

“We found that the pandemic fundamentally altered neighborhoods, communities and everyday routines among aging Americans, and these changes have long-term consequences for their physical, mental, social and cognitive health,” said Finlay.

‘I just can’t go back’

As a health geographer and environmental gerontologist, Finlay studies how social and built environments impact health as we age.

In March 2020 as restaurants, gyms, grocery stores and other gathering places shuttered amid shelter-in-place orders, she immediately wondered what the lasting impacts would be. Shortly thereafter, she launched the COVID-19 Coping Study with University of Michigan epidemiologist Lindsay Kobayashi. They began their research with a baseline and monthly survey. Since then, nearly 7,000 people over age 55 from all 50 states have participated.

The researchers check in annually, asking open-ended questions about how neighborhoods and relationships have changed, how people spend their time, opinions and experiences of the COVID-19 pandemic, and their physical and mental health.

By the numbers

How aging adults spend their time

• 59% spend more time at home than before pandemic
• 41% go to the grocery less often
• 75% eat out less often 
• 57% exercise indoors less often
• 62% visit an arts or cultural site less often
• 53% attend religious services less often
• 10% exercise outdoors more often

Source: Data from COVID-19 Coping Study survey results from May 2022. A more recent survey found that more than half still had not returned to pre-pandemic social routines.

“We’ve been in the field for some incredibly pivotal moments,” said Finlay, noting that surveys went out shortly after George Floyd was murdered in May 2020 and again after the attack on the U.S. Capitol on Jan. 6, 2021.

Collectively, the results paint a troubling picture in which a substantial portion of the older population remains isolated even after others have moved on. 

In one paper published in February in the journal Wellbeing, Space and Society , 60% of respondents said they spend more time in their home while 75% said they dine out less. Some 62% said they visit cultural and arts venues less, and more than half said they attend church or the gym less than before the pandemic.

The most recent survey, taken in spring 2023, showed similar trends, with more than half of respondents still reporting that their socialization and entertainment routines were different than they were pre-pandemic. 

In another paper titled “ I just can’t go back ,” 80% of respondents reported there are some places they are reluctant to visit in person anymore.

“The thought of going inside a gym with lots of people breathing heavily and sweating is not something I can see myself ever doing again,” said one 72-year-old male.

Those who said they still go to public places like grocery stores reported that they ducked in and out quickly and skipped casual chitchat. 

“It’s been tough,” said one 68-year-old female. “You don’t stop and talk to people anymore.”

Many respondents reported they were afraid of getting infected with a virus or infecting young or immune-compromised loved ones, and said they felt “irresponsible” for being around a lot of people.

Some reported getting dirty looks or rude comments when wearing masks or asking others to keep their distance—interpersonal exchanges that reinforced their inclination to stay home.

Revitalizing human connection

Jessica Finlay, a health geographer and environmental gerontologist, studies how built environments impact aging.

The news is not all bad, stresses Finlay.

At least 10% of older adults report exercising outdoors more frequently since the pandemic. And a small but vocal minority said that their worlds had actually opened up, as more meetings, concerts and classes became available online.

Still, Finlay worries that the loss of spontaneous interactions in what sociologists call “third places” could have serious health consequences.

Previous research shows that a lack of social connection can increase risk of premature death as much as smoking 15 cigarettes a day and exacerbate mental illness and dementia.

“For some older adults who live alone, that brief, unplanned exchange with the butcher or the cashier may be the only friendly smile they see in the day, and they have lost that,” Finlay said.

Societal health is also at risk.

“It is increasingly rare for Americans with differing sociopolitical perspectives to collectively hang out and respectfully converse,” she writes. 

Finlay hopes that her work can encourage policymakers to create spaces more amenable to people of all ages who are now more cautious about getting sick—things like outdoor dining spaces, ventilated concert halls or masked or hybrid events.

She also hopes that people will give those still wearing masks or keeping distance some grace.

“It is a privilege to be able to ‘just get over’ the pandemic and many people, for a multitude of reasons, just don’t have that privilege. The world looks different to them now,” she said. “How can we make it easier for them to re-engage?”

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Partisan divides over K-12 education in 8 charts

K-12 education is shaping up to be a key issue in the 2024 election cycle. Several prominent Republican leaders, including GOP presidential candidates, have sought to limit discussion of gender identity and race in schools , while the Biden administration has called for expanded protections for transgender students . The coronavirus pandemic also brought out partisan divides on many issues related to K-12 schools .

Today, the public is sharply divided along partisan lines on topics ranging from what should be taught in schools to how much influence parents should have over the curriculum. Here are eight charts that highlight partisan differences over K-12 education, based on recent surveys by Pew Research Center and external data.

Pew Research Center conducted this analysis to provide a snapshot of partisan divides in K-12 education in the run-up to the 2024 election. The analysis is based on data from various Center surveys and analyses conducted from 2021 to 2023, as well as survey data from Education Next, a research journal about education policy. Links to the methodology and questions for each survey or analysis can be found in the text of this analysis.

Most Democrats say K-12 schools are having a positive effect on the country , but a majority of Republicans say schools are having a negative effect, according to a Pew Research Center survey from October 2022. About seven-in-ten Democrats and Democratic-leaning independents (72%) said K-12 public schools were having a positive effect on the way things were going in the United States. About six-in-ten Republicans and GOP leaners (61%) said K-12 schools were having a negative effect.

About six-in-ten Democrats (62%) have a favorable opinion of the U.S. Department of Education , while a similar share of Republicans (65%) see it negatively, according to a March 2023 survey by the Center. Democrats and Republicans were more divided over the Department of Education than most of the other 15 federal departments and agencies the Center asked about.

In May 2023, after the survey was conducted, Republican lawmakers scrutinized the Department of Education’s priorities during a House Committee on Education and the Workforce hearing. The lawmakers pressed U.S. Secretary of Education Miguel Cardona on topics including transgender students’ participation in sports and how race-related concepts are taught in schools, while Democratic lawmakers focused on school shootings.

Partisan opinions of K-12 principals have become more divided. In a December 2021 Center survey, about three-quarters of Democrats (76%) expressed a great deal or fair amount of confidence in K-12 principals to act in the best interests of the public. A much smaller share of Republicans (52%) said the same. And nearly half of Republicans (47%) had not too much or no confidence at all in principals, compared with about a quarter of Democrats (24%).

This divide grew between April 2020 and December 2021. While confidence in K-12 principals declined significantly among people in both parties during that span, it fell by 27 percentage points among Republicans, compared with an 11-point decline among Democrats.

Democrats are much more likely than Republicans to say teachers’ unions are having a positive effect on schools. In a May 2022 survey by Education Next , 60% of Democrats said this, compared with 22% of Republicans. Meanwhile, 53% of Republicans and 17% of Democrats said that teachers’ unions were having a negative effect on schools. (In this survey, too, Democrats and Republicans include independents who lean toward each party.)

The 38-point difference between Democrats and Republicans on this question was the widest since Education Next first asked it in 2013. However, the gap has exceeded 30 points in four of the last five years for which data is available.

Republican and Democratic parents differ over how much influence they think governments, school boards and others should have on what K-12 schools teach. About half of Republican parents of K-12 students (52%) said in a fall 2022 Center survey that the federal government has too much influence on what their local public schools are teaching, compared with two-in-ten Democratic parents. Republican K-12 parents were also significantly more likely than their Democratic counterparts to say their state government (41% vs. 28%) and their local school board (30% vs. 17%) have too much influence.

On the other hand, more than four-in-ten Republican parents (44%) said parents themselves don’t have enough influence on what their local K-12 schools teach, compared with roughly a quarter of Democratic parents (23%). A larger share of Democratic parents – about a third (35%) – said teachers don’t have enough influence on what their local schools teach, compared with a quarter of Republican parents who held this view.

Republican and Democratic parents don’t agree on what their children should learn in school about certain topics. Take slavery, for example: While about nine-in-ten parents of K-12 students overall agreed in the fall 2022 survey that their children should learn about it in school, they differed by party over the specifics. About two-thirds of Republican K-12 parents said they would prefer that their children learn that slavery is part of American history but does not affect the position of Black people in American society today. On the other hand, 70% of Democratic parents said they would prefer for their children to learn that the legacy of slavery still affects the position of Black people in American society today.

Parents are also divided along partisan lines on the topics of gender identity, sex education and America’s position relative to other countries. Notably, 46% of Republican K-12 parents said their children should not learn about gender identity at all in school, compared with 28% of Democratic parents. Those shares were much larger than the shares of Republican and Democratic parents who said that their children should not learn about the other two topics in school.

Many Republican parents see a place for religion in public schools , whereas a majority of Democratic parents do not. About six-in-ten Republican parents of K-12 students (59%) said in the same survey that public school teachers should be allowed to lead students in Christian prayers, including 29% who said this should be the case even if prayers from other religions are not offered. In contrast, 63% of Democratic parents said that public school teachers should not be allowed to lead students in any type of prayers.

In June 2022, before the Center conducted the survey, the Supreme Court ruled in favor of a football coach at a public high school who had prayed with players at midfield after games. More recently, Texas lawmakers introduced several bills in the 2023 legislative session that would expand the role of religion in K-12 public schools in the state. Those proposals included a bill that would require the Ten Commandments to be displayed in every classroom, a bill that would allow schools to replace guidance counselors with chaplains, and a bill that would allow districts to mandate time during the school day for staff and students to pray and study religious materials.

Mentions of diversity, social-emotional learning and related topics in school mission statements are more common in Democratic areas than in Republican areas. K-12 mission statements from public schools in areas where the majority of residents voted Democratic in the 2020 general election are at least twice as likely as those in Republican-voting areas to include the words “diversity,” “equity” or “inclusion,” according to an April 2023 Pew Research Center analysis .

Also, about a third of mission statements in Democratic-voting areas (34%) use the word “social,” compared with a quarter of those in Republican-voting areas, and a similar gap exists for the word “emotional.” Like diversity, equity and inclusion, social-emotional learning is a contentious issue between Democrats and Republicans, even though most K-12 parents think it’s important for their children’s schools to teach these skills . Supporters argue that social-emotional learning helps address mental health needs and student well-being, but some critics consider it emotional manipulation and want it banned.

In contrast, there are broad similarities in school mission statements outside of these hot-button topics. Similar shares of mission statements in Democratic and Republican areas mention students’ future readiness, parent and community involvement, and providing a safe and healthy educational environment for students.

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About 1 in 4 U.S. teachers say their school went into a gun-related lockdown in the last school year

About half of americans say public k-12 education is going in the wrong direction, what public k-12 teachers want americans to know about teaching, what’s it like to be a teacher in america today, race and lgbtq issues in k-12 schools, most popular.

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Internet gaming addiction: current perspectives

Daria j kuss.

Psychology Research and Behavior Management, Birmingham City University, Birmingham, UK

In the 2000s, online games became popular, while studies of Internet gaming addiction emerged, outlining the negative consequences of excessive gaming, its prevalence, and associated risk factors. The establishment of specialized treatment centers in South-East Asia, the US, and Europe reflects the growing need for professional help. It is argued that only by understanding the appeal of Internet gaming, its context, and neurobiologic correlates can the phenomenon of Internet gaming addiction be understood comprehensively. The aim of this review is to provide an insight into current perspectives on Internet gaming addiction using a holistic approach, taking into consideration the mass appeal of online games, the context of Internet gaming addiction, and associated neuroimaging findings, as well as the current diagnostic framework adopted by the American Psychiatric Association. The cited research indicates that the individual’s context is a significant factor that marks the dividing line between excessive gaming and gaming addiction, and the game context can gain particular importance for players, depending on their life situation and gaming preferences. Moreover, the cultural context is significant because it embeds the gamer in a community with shared beliefs and practices, endowing their gaming with particular meaning. The cited neuroimaging studies indicate that Internet gaming addiction shares similarities with other addictions, including substance dependence, at the molecular, neurocircuitry, and behavioral levels. The findings provide support for the current perspective of understanding Internet gaming addiction from a disease framework. The benefits of an Internet gaming addiction diagnosis include reliability across research, destigmatization of individuals, development of efficacious treatments, and the creation of an incentive for public health care and insurance providers. The holistic approach adopted here not only highlights empirical research that evidences neurobiologic correlates of Internet gaming addiction and the establishment of a preliminary diagnosis, but also emphasizes the necessity of an indepth understanding of the meaning, context, and practices associated with gaming.

Introduction: the mass appeal of Internet gaming

Internet gaming is a booming market. In 2012, more than one billion individuals played computer games, which fuelled the 8% growth of the computer gaming industry in the same year. 1 A recent report by the market research company Niko Partners has estimated the People’s Republic of China’s online gaming market at $12 billion in 2013. 2 Massively Multiplayer Online games (MMOs) offer the possibility to play together with many other players and can be differentiated based on game content and player experience. A latent profile analysis of survey data from 4,374 Hungarian online gamers (91% male, mean age 21±6 years) indicated that the most prominent MMOs were role-playing games, first-person shooters, real-time strategy, and other games. 3 First-person MMO shooter games are based on skill because they require good reaction time and attention, and competition is a key aspect of these games. In real-time MMO strategy games, players organize teams, develop their skills, and play for status in the game. 4

Massively Multiplayer Online Role-Playing Games (MMORPGs), on the other hand, appear of particular interest to players because they offer a variety of incentives for play relative to other game genres. Of all online gamers, 46% play MMORPGs, 3 confirming their position as the most popular online games. MMORPGs are game universes inhabited by thousands of players at the same time (massively multiplayer) with no spatial or temporal boundaries because they are played online, and they allow players to adopt various virtual personas vis-à-vis their avatars (role playing). 5 Today’s most popular MMORPG is “World of Warcraft”, the latest game in Blizzard’s Warcraft series, situated in the fantasy world of Azeroth that is populated by members of the opposing factions of the Alliance and the Horde. 6 According to a recent report published by the Entertainment Software Association, 7 World of Warcraft’s extension “Cataclysm” was among the top five selling computer games in 2011. In 2013, eight million players immersed themselves in the world of Azeroth, 8 clearly demonstrating the game’s mass appeal. The game tailors to most age groups, both sexes, and various player interests and preferences, 6 making it an MMORPG success story par excellence.

Online games such as World of Warcraft satisfy various gaming motivations. The analysis by Yee 9 of 3,000 MMORPG players’ gaming motivations revealed that MMORPGs allow players to achieve game goals, be social, and immerse in the game. Each of these factors is composed of a number of subcomponents as particularized by the gamers. First, achievement includes advancing in the game, namely progressing via leveling up, acquiring status and power in the game, the game’s mechanics, including the possibilities for optimizing game play, and competition, including challenging and dominating others. 9 Reputation and admiration from the gaming community for gaming achievements are further key factors motivating players to keep playing. 6 The game mechanics or structural characteristics have been claimed to reinforce the potentially addictive qualities of games because they contribute to initiation, development, and maintenance of gaming. 10

Second, the social factor is composed of socializing, including chatting and making new friends in the game, forming new relationships, and working in a team. 9 Research 11 suggests that the social element in MMORPGs is particularly important for gamers because it is an integral component of the enjoyment of playing. Moreover, it denotes a complex interaction between real and virtual social networks, further blurring the boundaries between these networks, making MMORPGs inherently social spaces. 12

Third, immersion in the game is denoted by discovery, ie, exploring the game and “hidden” game content, role-playing via one’s avatar, customization of one’s online character (such as sex, race, profession, appearance), and escapism, ie, playing in order to avoid real life. 9 Escapism is an aspect of mood modification whereby individuals suffering from addictions induce a subjective shift in their mood by way of engaging in an addictive behavior, making the latter a coping strategy to deal with everyday problems. 13

The variety of gaming motivations satisfied by MMOR-PGs indicates that these types of games are particularly versatile because they can be tailored to individual players with different game preferences. Consequently, one could assume that there are many ways that might lead some individuals to get hooked on MMORPGs. In a sample of 696 MMORPG players (93% male, mean age 26±7.4 years), achievement, socializing, and escapism motivations were found to be predictive of addictive play, together with sex accounting for 19% of variance in the MMORPG addiction score. 14 Similarly, in a sample of 175 primarily Dutch MMORPG players (87% male, mean age 21±6.5 years), escapism and game mechanics predicted excessive gaming over and above the contribution of the time spent gaming, together explaining 46% of the variance in problematic gaming. 5 In a nutshell, the mass appeal of MMORPGs rests on their versatility because they are tailored to gamers young and old, male and female, who have different game preferences. MMORPGs are particularly good at meeting various players’ different needs. This mass appeal may have contributed to findings from research which indicate that online games, and specifically MMORPGs, are more addictive than any other types of both offline and online games 15 because they reward players on partial reinforcement schedules, leading to maintenance of play. 16

Internet gaming addiction

In recent years, research about Internet gaming addiction has increased both in quantity as well as in quality. Research on gaming addiction dates back to 1983, when the first report emerged suggesting that video gaming addiction is a problem for students. 17 Shortly thereafter, the first empirical study on gaming addiction was published by Shotton, 18 based on self-reports of young male players who claimed they were “hooked” on their games. The early studies suffered from a lack of standardized psychometric instruments used for assessing gaming addiction. 19 However, research 20 indicates that self-reports correlate with standardized measures. Following on from that, further studies were carried out in the 1990s, initially assessing gaming addiction based on the criteria for pathologic gambling as stipulated in the third and fourth editions of the Diagnostic and Statistical Manual for Mental Disorders (DSM). 21 Although similar, pathological gambling and excessive gaming do not present with the same clinical picture, and some have argued that using the diagnostic criteria for pathological gambling in order to diagnose pathological gaming only taps into obsessive use and preoccupation rather than actual psychopathology. 22 In the 2000s, online games became popular, while studies of Internet gaming addiction emerged. 23 , 24

The studies on Internet gaming addiction in the new millennium reported prevalence estimates which vary significantly and range from 0.2% in Germany 25 , 26 to 50% of Korean teenagers. 27 This discrepancy in estimates is due to various conceptualizations, diverse measurement instruments, as well as the different cutoff points used. Further, dissimilar constructs (“Internet gaming addiction”, “dependence”, “problematic”, and “excessive play”) are measured in various samples (children, adolescents, gamers) and cultures. In most studies, self-reports have been used, which puts the reliability and validity of the potential diagnosis in question. 28 However, research 20 indicates that self-diagnosis correlates with standardized measures of addiction, suggesting that the individual’s perception of problems can be relatively accurate.

In South-East Asian countries, the negative impacts of Internet gaming addiction have led governments and health care providers to take the problem seriously and to develop a series of initiatives to curb and alleviate the problem. In South Korea, Internet gaming addiction is viewed as a significant concern for public health, 29 and up to 24% of children who have been diagnosed with Internet addiction are hospitalized. 30 In Japan, the government has recognized the problem following a study by the Ministry of Education, which has led to the development of “fasting camps” where individuals suffering from Internet and gaming addiction are helped by being cut off from technology completely. 31 It has been stated that the higher the Internet penetration and social acceptance of gaming, the higher the prevalence of gaming problems, 32 partially explaining the higher prevalence rates reported in South-East Asian countries. In addition to this, there is good reason to think that the lower acceptance of excessive gaming in a culture, the more distress (not less) gamers experience in engaging in the activity, potentially fuelling problem perception. Therefore, a lack of acceptance of excessive gaming and thus stigmatization of the behavior might contribute to higher rates of addiction and problematic play in some way. Following growing concern, specialized treatment centers and programs have been established in Europe (including the outpatient clinic for behavioral addictions in Mainz, Germany, and the Capio Nightingale Hospital in London, UK) and the US (including the inpatient centers RESTART Internet Addiction Recovery Program in Seattle and the recently opened digital detoxification and recovery center in Pennsylvania), reflecting the growing need for professional help.

The concerns appear to be grounded as a growing number of studies indicate that Internet gaming addiction is associated with various negative consequences. 15 The psychological consequences include the following: sacrificing real-life relationships, other pastime activities, sleep, work, education, socializing, and relationships, 33 – 40 obsession with gaming and a lack of real-life relationships, 41 lack of attention, 33 , 42 aggression and hostility, 42 , 43 stress, 33 dysfunctional coping, 33 , 44 , 45 worse academic achievement, 38 , 46 problems with verbal memory, 47 and low well-being and high loneliness. 48 Moreover, psychosomatic consequences have been found in a number of studies. These included problems with sleeping, 41 , 47 seizures, 49 and psychosomatic challenges. 33 This long list indicates that Internet gaming problems must be taken seriously as they can affect the individual negatively in a variety of ways.

Internet gaming addiction is a behavioral problem that has been classified and explained in numerous ways. According to Griffiths, 13 biopsychosocial processes lead to the development of addictions, such as Internet gaming addiction, which include the following components. First, the behavior is salient (the individual is preoccupied with gaming). Second, the individual uses the behavior in order to modify their mood (ie, gaming is used to escape reality or create the feeling of euphoria). Third, tolerance develops (the individual needs increasingly more time to feel the same effect). Fourth, withdrawal symptoms occur upon discontinuation of the behavior (the individual feels anxious, depressed, and irritable if they are prevented from playing). Fifth, interpersonal and intra-personal conflict develops as a consequence of the behavior (the individual has problems with their relationship, job, and hobbies, and lack of success in abstinence). Finally, upon discontinuation of the behavior, the individual experiences relapse (they reinitiate gaming). 13

Although the core criteria appear to be established, the etiology of Internet gaming addiction has yet to be studied in detail. Research 15 indicates that a number of risk factors are associated with Internet gaming addiction. These risk factors include certain personality traits, gaming motivations, and structural game characteristics. The personality traits most commonly associated with Internet addiction include neuroticism, 37 , 50 aggression and hostility, 43 , 50 – 52 and sensation-seeking. 43 , 50 Factors that appear to protect frequent online gamers from developing problems with their gaming were found to be conscientiousness and extraversion, 53 suggesting that for different individuals the same behavior can have different psychological repercussions.

In addition to this, the following gaming motivations were found to be most commonly associated with gaming addiction: coping with daily stressors and escapism, 5 , 16 , 44 , 54 – 57 online relationships, 16 , 51 , 57 – 59 and mastery, control, recognition, completion, excitement, and challenge. 34 , 56 , 60 This indicates that the reasons for game play may be an important indicator of potential risk for Internet gaming addiction. Specifically, in comparison with non-MMORPG players, MMORPG players preferred their online friends over their real-life friends. 16 Similarly, significantly more dependent gamers were found to prefer spending time with their online friends than their offline friends relative to nondependent gamers and felt their social needs were met better online than offline. 44 Moreover, while online games provide nonaddicted players with satisfaction, addicted players play to avoid dissatisfaction, 55 which can be an indication of withdrawal symptoms they want to overcome by engaging in gaming compulsively. The motivational differences to play games between dependent and nondependent as well as MMORPG and other gamers appear to be useful clinical information because these motivations can be specifically targeted in treatment sessions. For instance, elements of exposure therapy may be used for the socially fearful in order to decrease discomfort and reintroduce clients to real-life social environments. Also, alternative pastime activities that are perceived as satisfying can be encouraged specifically in group therapy sessions. Encouraging engagement in group sports might satisfy both the need to engage in competitive and satisfying activities and the need to interact with peers in real life.

Moreover, a number of structural game characteristics have been found to increase the risk for developing Internet gaming addiction, namely online relative to offline gaming, 61 positive reinforcement, 62 the enjoyment of particular game features, such as adult content, finding rare in-game items, and watching game cut scenes, 63 and viewing one’s virtual persona as better than oneself. 64 These characteristics indicate that particular games can be more addictive than others, 15 which appears important for game developers and public prevention campaigns that focus on decreasing risk and raising awareness of potential problems. Prevention campaigns could target school-aged children, teachers, and parents in education settings. They could be based on the principles of providing information and a discussion platform concerning Internet and gaming use and possible negative consequences via psychoeducation, with the ultimate goal of encouraging healthy media use. Success could be determined over the long term using triangulation of data and reports obtained from the targeted populations.

Most reviews to date have primarily focused on specific aspects of Internet gaming addiction, including methods used to assess gaming addiction, 65 , 66 structural characteristics, 60 and treatment. 67 – 69 In light of this, the aim of this review is to provide an insight into current perspectives on Internet gaming addiction using a holistic approach, taking into consideration the mass appeal of online gaming, the context of Internet gaming addiction, and associated neuroimaging findings, as well as the current diagnostic framework adopted by the American Psychiatric Association. 70 It is argued that only by understanding the appeal of Internet gaming, its context, and neurobiologic correlates can the phenomenon of Internet gaming addiction be understood comprehensively. An evaluation of the findings will be presented in the overall discussion.

Gaming addiction: context

Research on gaming addiction has paid little attention to the context of online gaming. However, a few studies have now shed some light on the embedding of Internet gaming addiction in the context of the individual, 71 the game and gaming environment, 6 , 72 and the broader framework of culture. 73 Each of these will be addressed in turn.

Griffiths 71 provided case study evidence of two young men who spent an average of 14 hours a day playing MMORPGs in order to emphasize that the context of the individual’s life is an important factor demarcating gaming excess from gaming addiction. Aged 21 years, unemployed and single, “Dave” reported that gaming had a positive influence on his life because his social life revolved almost exclusively around the game, and playing boosted his self-esteem and gave structure to his everyday life. Dave did not perceive that his excessive gaming impacted upon his life negatively at all. For Dave, his extensive gaming did not lead to significant distress or have a negative impact in his daily life, and therefore his behavior cannot be classified as a condition that would fulfill the requirements of a mental disorder classification as outlined in the DSM-5. 74 Upon starting a new job and entering into a relationship with a woman he met in-game, his excessive gaming decreased significantly.

The second case reported was that of “Jeremy”, a 38-year old financial accountant who was married with two children and experienced detrimental consequences due to his “severe gaming addiction”, namely a relationship breakdown, lack of time for family activities, and loss of his job. Moreover, his playing time, craving for the game, and feelings of low mood and anxiety had increased dramatically. He used gaming to escape from his real-life problems and tried to quit on several occasions, but was unsuccessful in staying abstinent. This led to a number of relapse episodes. 71 The examples of Dave and Jeremy make a compelling case for how the same behavior (namely regular online gaming for excessive periods of time) can have almost diametrically opposed consequences due to different individual contexts, with one experiencing gaming as pleasurable and ultimately beneficial, whereas the other’s entire life was negatively affected by his excessive gaming.

In addition to the individual context, the context of the game appears important in determining the extent to which excessive gaming can truly be an addiction. 6 , 72 Karlsen 72 conducted 12 interviews with online gamers (75% male, mean age 23±2.4 years) who play World of Warcraft and used virtual ethnography 75 in order to assess the consequences of their excessive gaming. The results indicated that some of the players experienced behavioral addiction symptoms as specified by Griffiths, 13 namely salience, mood modification, tolerance, withdrawal, conflict, and relapse, with the latter two demarcating excessive from potentially addictive play. However, rather than advocating current diagnostic frameworks for “pathologizing” gaming, Karlsen 72 advocates to view gaming excess from the vantage point of game structure and gaming context, including the social practice and cultural meaning of games as well as the individual’s connection to the game from the perspective of game and media studies. This understanding entails a move away from the overly simplistic approach of focusing on the psychological rewards that reinforce gaming to include an indepth exploration of gaming motivations, gaming structure and mechanics, as well as the meaning of gaming for the individual. 72

Kuss 6 analyzed online gaming and potential gaming excess by interviewing eleven World of Warcraft players (72% male, mean age 27±7.3 years) and used virtual ethnography 75 as well as ludology principles 76 to understand how playing this particular game mirrors participation in popular media culture. In this context, media culture is understood as a flexible and evolving area of engagement that requires active participation. Potential gaming addiction was found to be associated with escapist motivations and in this context gaming was understood as fulfilling a “narcotic” function. The game context gained particular significance in one participant’s life because of two features of the game. First, he was able to enact heroic tales through his avatar and faction membership. As a member of the Horde, he fought the opposing faction, the Alliance, and was involved in killing their king, an episode “he would not forget until the end of his life”. Second, he was enabled to return to a familiar cultural context by means of his guild which consisted of fellow countrymen, after he had physically migrated to a foreign country. In this way, the provisions of the game (namely participation in the game’s narrative, 77 community, and belonging) 78 were utilized to a problematic extent, leaving the participant feeling “addicted to wow [World of Warcraft]”. Eventually, the analysis revealed that the meaning that is attached to the game can lead to excessive play which may cause a retreat from real life. 6

Snodgrass et al 73 surveyed 252 respondents (78% male, mean age 27±9.0 years) using Yee’s 9 motivational factors achievement, social and immersion to assess problematic MMORPG play in World of Warcraft from the perspective of culture under the supposition that gaming allows for formation of communities and cultures. 12 , 79 , 80 The cultural context situates the individual and his potentially addictive game play (assessed using Young’s Internet Addiction Test) 81 within the framework of commonly shared beliefs and practices. 82 Snodgrass et al 73 used an anthropological approach focusing on meaning, practice, and experience, mirrored in their understanding of gaming motivations and problematic play. They found that achievement motivation may lead to problematic play if players are less successful in real life (ie, less “culturally consonant”) and use game success to compensate, 73 causing stress and negative health outcomes. 83 In terms of social motivation, the extent to which online relationships gain significance over offline relationships was analyzed 73 because research indicates that lack of cultural consonance regarding social networks impacts negatively upon health. 84 Regarding immersion, the amalgamation of online and offline life and identities was assessed, 73 because association of the self with the game and the avatar could lead to dissociation. 85 , 86 The results indicated that game play in World of Warcraft mirrors cultural models of success regarding objectives and responsibilities, indicating that the game world can in some ways substitute the real world. Moreover, the culturally sensitive motivations achievement, social and immersion significantly predicted problematic MMORPG play if they were incongruent with real life, that is, if the game was used to compensate for lack of success and relationships in real life, and to dissociate from real life. 73

Taken together, the individual, game, and cultural contexts appear to have a significant impact upon the extent to which problems occur as a consequence of excessive gaming in terms of how Internet gaming addiction is conceptualized. In this way, the cultural context can be seen as a lens through which individuals and others around them perceive and give meanings to behaviors and their consequences. It is critical to understand gaming problems not only by means of the observable symptoms, but to situate them within the broader context of the game, the individual, and culture.

Gaming addiction: neuroscience

In the last decade, psychiatry has increasingly made use of neuroscientific evidence to understand and conceptualize mental disorders. 87 The major funding body for mental health research, the National Institute of Mental Health, has recently introduced research domain criteria to reclassify mental disorders as based on neuroscience and shared underlying pathophysiology rather than the more subjective approach of phenomenology and clinical presentation that has been utilized previously. 88 The ultimate aim is to improve the reliability and validity of clinical diagnosis and accordingly to deliver optimal treatment. 89 In accordance with this approach, research on Internet gaming addiction is now increasingly making use of neuroimaging techniques to allow for analysis of neurobiological changes due to excessive gaming and neurochemical correlates of addiction. 90

Some studies have shown that changes in brain activity and structure related to addiction are relevant for brain regions involved in reward, motivation, and memory, as well as cognitive control. 91 It has been hypothesized that initially the prefrontal cortex and ventral striatum are involved in the decision to initiate the addictive behavior. Over time, the individual habituates to the behavior and develops a compulsion to engage in it, which is accompanied by alterations of activity in the dorsal striatum as it becomes activated through dopaminergic innervation. There is some evidence for the idea that dopamine is released. 92 The longer the engagement continues, the more permanent the changes in the dopaminergic pathways become. It has been suggested that activity in the anterior cingulate, orbitofrontal cortex, and nucleus accumbens is modified in such a way that natural rewards are experienced as less pleasurable, further reducing control over the behavior. 93 , 94 Research suggests that over time, synaptic activity is reduced, leading to long-term depression and neuroadaptation, 95 as well as behavioral sensitization. The synapses in the ventral tegmental area become stronger, glutamate in the nucleus accumbens is reduced, and activity in the amygdala and hippocampus (related to memory) is increased, which can in turn result in craving 91 , 96 and increased response to the availability and particular context of the addictive behavior. 93 , 97 Some studies have shown that the addictive behavior becomes associated with these cues through activity in the nucleus accumbens, which reinforces the effects of the behavior. 98 With time, tolerance to the addictive behavior develops and natural rewards are depreciated, resulting in a reward system deficiency and activation of the antireward system. 99 The consequent lack of dopamine in mesocortical brain regions can lead to withdrawal symptoms, and in order to overcome these, renewed engagement in the addictive behavior ensues, and may ultimately impact upon the functions of the orbitofrontal cortex and cingulate gyrus. 91 , 100 , 101

Over the last decade, a number of neuroimaging techniques have been applied to Internet gaming research, allowing for an analysis of addiction correlates regarding both brain function as well as brain structure. Electroencephalograms measure brain activity via changes in voltage in the cerebral cortex via electrodes, 102 and were used in six studies of Internet and gaming addiction. 103 – 108 Positron emission tomography measures neuronal metabolism through photons from positron emissions via positively charged electrons. 109 Two studies 110 , 111 made use of positron emission tomography to measure Internet and gaming addiction. Like positron emission tomography, single photon emission computed tomography measures metabolic activity in the brain at the level of individual photons, 112 and was applied in one study of Internet addiction. 113 Eight studies 114 – 121 used functional magnetic resonance imaging to measure changes in blood oxygen levels in order to indicate brain activity in individuals with Internet and gaming addiction. 122 Finally, structural magnetic resonance imaging uses methods such as voxel-based morphometry 123 and diffusion-tensor imaging 124 to image brain morphometry, 125 and was used in two studies 126 , 127 in order to assess Internet addiction.

A systematic review of all Internet and gaming addiction studies using neuroimaging methods until 2012 90 revealed that Internet gaming addiction appears similar to other addictions, including substance-related addictions, at the molecular, neurocircuitry, and behavioral levels. From a molecular perspective, gaming results in the release of striatal dopamine. 111 On the other hand, it has been suggested that, in small samples, Internet and gaming addiction is associated with a reward deficiency whereby dopaminergic transporters in the brain are reduced. 110 , 113 In order to reinstate a biochemical equilibrium, 99 individuals whose reward system is deficient seek substances and activities which result in the release of dopamine. Under normal circumstances, pleasure drives (including eating and reproduction) are natural rewards that are craved, whereas unnatural rewards include psychoactive substances and addictive behaviors. 128 Over time, the individual habituates to the hedonic feelings produced by Internet gaming and develops abstinence symptoms, tolerance, and withdrawal. 129 Internet gaming addiction is initiated and maintained. 90 The decreased dopaminergic transporters in Internet gaming addiction may explain its frequent co-occurrence with depression, 130 bipolar disorder, 131 and borderline personality disorder and dissociative symptoms. 132

With regards to neural circuitry, when gaming, brain areas associated with addictions are frequently utilized and therefore the activity in regions such as the orbitofrontal cortex and cingulate gyrus is high, which over time can lead to significant alterations in neuronal connectivity 114 , 116 , 118 , 119 and brain structure. 115 , 126 , 127 Internet gaming becomes increasingly salient and individuals lose control over their gaming. 90 The individual is immanently motivated to play online games as they have learned the behavior, eventuating in continuous engagement. 133

In terms of behavior, excessive Internet gaming can result in problems with impulse control, behavioral inhibition, executive functioning, attention, and general cognitive functioning. 103 , 104 , 107 , 115 , 126 , 127 However, there are plus sides as well, in that the frequent gamer develops and improves a number of other capabilities, namely the integration of perceptual information into the brain and hand-eye coordination. 118 , 120

Taken together, research on Internet gaming addiction has made use of various neuroimaging techniques in order to shed light upon the neurochemical and neuroanatomic correlates of addiction. Although in most studies the direction of the relationship has not been investigated (ie, it is unclear whether Internet gaming addiction causes changes in brain structure and activity or vice versa), the current evidence suggests a relationship between brain alterations and Internet gaming addiction. Neuroimaging studies of Internet gaming addiction contribute to the current understanding of addiction as based on a disease framework. 128 , 134 This indicates that, similar to cardiovascular diseases, lifestyle (ie, excessive gaming) can result in changes to underlying neurobiology. Moreover, the utilization of sophisticated imaging methods in Internet gaming addiction research is in line with research domain criteria, 88 which makes a significant contribution to our understanding of Internet gaming addiction as a chronic neurobiological disease requiring professional care and adequate treatment. 135

Gaming addiction: clinical diagnosis

Following nearly two decades of research, the American Psychiatric Association has now officially recognized Internet Gaming Disorder as a condition that requires consideration by clinicians and researchers. In June 2013, Internet gaming disorder appeared in the appendix of the updated version of the Diagnostic and Statistical Manual for Mental Disorders (DSM-5) for the first time. 70 It stands alongside the only other behavioral addiction, ie, pathological gambling, situating it clearly within the diagnostic category of Substance-Related and Addictive Disorders. Internet gaming disorder has pulled ahead of other behaviors that can become addictive, such as exercise, 136 , 137 work, 138 and shopping. 139

Up until now, researchers have understood Internet addiction or Internet gaming addiction as similar to either impulse control disorders in general or pathological gambling specifically, 140 – 142 substance dependence, 33 , 38 or a combination of the two. 143 , 144 This has led to the development of multiple psychometric instruments, each measuring different aspects associated with Internet gaming problems and addiction. 144 – 153 The multiplicity of conceptualizations used for Internet gaming addiction have led to a diagnostic conundrum leading some researchers to question its existence, 29 and have called for commonly agreed upon criteria which increase reliability across studies and advocate adequate and efficacious treatment. 15

Under the new DSM-5 framework, Internet gaming disorder refers to the “persistent and recurrent use of the Internet to engage in games, often with other players, leading to clinically significant impairment or distress as indicated by five (or more) [criteria] in a 12-month period”. 70 The diagnostic criteria are a preoccupation with gaming, withdrawal symptoms, tolerance (ie, spending more time gaming), lack of control, loss of other interests, use despite negative consequences, deception, mood modification, and losing a relationship, job, and similarly important aspects of life. 70 From a public health perspective, an official diagnosis of Internet gaming addiction is necessary for a number of reasons. First, it will encourage individuals who suffer from associated symptoms to ask for professional help, decreasing morbidity rates, hospitalizations, and potential legal and medical problems. 30 Second, the diagnosis may decrease barriers to care and stigmata with regards to public perception of problematic Internet and gaming use. Third, the diagnosis will support research efforts. 134 Fourth, a diagnostic category will provide the necessary incentive for health care and insurance providers to develop, test, and finance adequate treatment. Ultimately, individuals who require professional care because of substantial distress, suffering, and individual impairment must be helped in an appropriate way. 74 Accordingly, an official diagnosis of Internet gaming addiction is critical for a number of reasons, further emphasizing the need to fully acknowledge and utilize it.

The aim of this review was to provide an insight into current perspectives on Internet gaming addiction using a holistic approach encompassing gaming appeal, context, neuroimaging research, and the diagnostic framework adopted for Internet gaming addiction. It has been shown that Internet gaming has gained increasing popularity since the new millennium, and has led to a substantial growth of the gaming industry and the player fan base. MMORPGs have further been highlighted as offering a wide variety of incentives for players to initiate and maintain playing because they satisfy a variety of needs and tailor to various gaming motives relative to alternative online game genres. Some of these motives, especially escapism, the game’s mechanics, achievement and socializing have been found to be indicative of gaming addiction, 5 suggesting that MMORPGs are more addictive than other offline and online games. 15

This review further shows that until now few studies have investigated the gaming context. Therefore, the context of the individual, the game and gaming environment, and the broader framework of culture are specifically addressed. It has been shown that the individual’s context is a significant factor that marks the dividing line between excessive gaming and gaming addiction. 71 Moreover, it has been emphasized that gaming cannot simply be medicalized if done in excess, but it must be understood from within the context of gaming and the meanings the individual attaches to it. 72 The game context can gain particular importance for players, depending on their life situation and gaming preferences, including the enactment of heroic tales as well as the re-embedding in a (virtual) cultural context that differs from the players’ real-life context. Ultimately, this may lead to a retreat from real life for some individuals. 6 In addition to this, the cultural context is significant because it embeds the gamer in a community with shared beliefs and practices, endowing their gaming with particular meaning. If gaming is used to compensate for lack of success and relationships in real life and to dissociate from real life, Internet gaming addiction can be the consequence. 73 In this context, the “disease” model of addiction can be viewed from the perspective of diseases other than those based on Mendelian genetic mutations or other simple biologically determined pathways. Cardiovascular diseases or adult onset diabetes appear as better models/prototypes for Internet gaming addiction, because these are medical conditions where lifestyles and experiences systematically reshape the body and thus “get under the skin”. That is, the cultural context can become the disease (here addiction) through repeated experiences. Alternatively, cultural norms related to how acceptable game-play is might structure the appeal of the game, which in turn promotes addictive play patterns, which would not be the case in places without such norms.

The cited neuroimaging studies of Internet gaming addiction and associated changes in brain structure and function furthermore correspond with the research domain criteria developed by the National Institute of Mental Health 88 because they emphasize a move away from phenomenology to focus on pathophysiology for clinical diagnosis. Internet gaming addiction was found to share similarities with other addictions, including substance dependence, at the molecular, neurocircuitry, and behavioral levels. These similarities include altered dopaminergic and neuronal activity and brain morphometry, as well as deficient impulse control, behavioral inhibition, and general cognitive functioning. However, there are no known biomarkers of Internet addiction at this point in time. Indeed, there are no known biomarkers of any mental disorder. Ever since Kraepelin, 154 and thus for a century, psychiatrists have been searching to understand mental disorders as underlying physiological diseases, providing an additional incentive to continue research on the neurobiological underpinnings of mental health problems, including Internet gaming addiction.

The findings provide support for the current perspective of understanding Internet gaming addiction from a disease framework. 128 , 134 The dependence classification adopted in previous classification systems 74 , 155 is stigmatizing to patients who require medication because dependence refers to a normal physiological response to the use of a substance (including medication) which, when discontinued, can lead to withdrawal symptoms. 74 The term addiction, on the other hand, denotes a chronic neurobiological disease, 135 which is less stigmatizing because it does not suggest that patients who require medication become “addicted” to their required psychopharmacological treatment. 156 Addiction, unlike dependence, leads to compulsively pursuing rewarding behaviors irrespective of associated biological, psychological, and social problems. 135 Ultimately, the current research base on Internet gaming addiction has led the American Psychiatric Association 70 to include Internet gaming disorder in the appendix of the DSM-5 as the second behavioral addiction alongside pathological gambling, suggesting that the problem is taken seriously. The benefits of such a diagnosis include comparability across research, destigmatization of individuals, development of efficacious treatment, and creation of an incentive for public health care and insurance providers. Once the behavioral problem has an official code, it is worthy of being taken seriously and treated adequately.

However, research concerning the natural course of Internet gaming addiction, the most appropriate interventions, and large-scale epidemiology is scarce, 157 suggesting that more work needs to be done to understand this behavioral problem more fully. King and Delfabbro 158 further question the blurring of the boundaries between Internet addiction and video gaming addiction, as this may “promote further confusion”. Instead, they advocate a conceptualization of Internet addiction which incorporates various subtypes of online behavior, and establishing a diagnostic category of “video gaming disorder” which applies to both online and offline gaming addiction. Ultimately, however, King and Delfabbro 158 concede that the research diagnosis has sparked discussion regarding the nature of behavioral addictions, which testifies to a move away from acknowledging substances only as potentially addictive, and to broaden our understanding of addiction in general.

Moreover, there appear to be problems with regards to the criteria for Internet gaming disorder adopted by the DSM-5 taskforce. Starcevic 29 points out that there exists a debate of whether tolerance is a valid criterion as researchers have validated scales on problematic video game use 159 and compulsive Internet use 160 that do not contain tolerance as a symptom, and some question whether tolerance is a factor involved in gaming. 44 This exemplifies the intricacy of measuring Internet gaming addiction, particularly in light of the reliability of studies as well as the equivalence of findings across studies. Based on these issues, Starcevic 29 recommends the following research approaches: understand when online gaming can be considered a mental disorder; study risk factors and comorbidities, and its position as primary or secondary condition; test a continuum of video gaming problems and video gaming disorder; and revisit its classification as “addiction” rather than an impulse control disorder. 161 Moreover, Pies 134 specifies further that only if the following criteria are satisfied, the condition would qualify to be understood as disease: identify a pattern of genetic transmission; understand its etiology, pathophysiology and/or pathological anatomy; and its course, prognosis, stability, and response to treatment. The current review indicates that research on Internet gaming addiction is on its way to fulfilling these requirements. In terms of understanding the context of Internet gaming addiction, more research is necessary.

Limitations, implications, and suggestions for future research

This review has shown that research on Internet gaming addiction has increased in quality and quantity, particularly over the last decade. Future research is required to overcome the limitations of current research, including closer scrutiny of gaming context (including the individual, game, and culture) and the direction of the relationship between Internet gaming addiction, as well as neuroanatomical and neurochemical changes. Specifically, the following research question requires further exploration: How do individual, game-related, and cultural factors contribute to the etiology, phenomenological experience, and treatment approaches of Internet gaming addiction? Furthermore, the causality of the relationship between neurobiological alterations and neurostructural abnormalities and Internet gaming addiction symptoms should be explored. The further exploration of these issues will enhance our understanding of this potential mental health concern. Moreover, a solid and unequivocal research base will enable the American Psychiatric Association and the World Health Organization to include Internet gaming addiction as an actual diagnosis in their diagnostic systems, which will in turn facilitate future research endeavors as well as clinical parlance.

The context appears crucial to the meaning of the game for the player, and is influenced by individual characteristics, the gaming culture, and the broader society that gamers are situated in. Ultimately, this will allow for developing treatment approaches which can be tailored to different individuals and meet idiosyncratic needs most effectively. The reviewed literature can inform procedures for improving the current treatment of Internet gaming addiction because it puts an emphasis on exploring the life and cultural context of the individual. In terms of neuroimaging studies, the reviewed empirical research has revealed associations between excessive online gaming and alterations in brain structure and function associated with substance addictions. However, understanding the direction of this relationship is crucial because it will provide invaluable insights into the etiology of Internet gaming addiction as well as its status as a primary or secondary disorder. In terms of treatment, establishing the treatment seeker’s most pressing present problem will allow an efficient and efficacious treatment plan to be developed and structuring of treatment sessions. Overall, this literature review suggests that targeting pathogenic neurobiological mechanisms and associated neurological and neurochemical alterations only does not suffice when the clinician’s goal is to alleviate the individual’s idiosyncratic problems. It indicates that Internet gaming addiction must be viewed from a holistic perspective, integrating the neurobiological, individual, game-related, and cultural factors contributing to pathogenesis and symptom experience.

The present review of current perspectives on Internet gaming addiction has shown that research has progressed significantly over the last decade, leading to a larger evidence base which includes important findings from neuroimaging research. Further, it indicates that contextual factors play an important part in our understanding of Internet gaming addiction as a holistic phenomenon. It is suggested that an official diagnosis of Internet gaming addiction must regard embedding of the problematic behavior within the context of the individual, the game, and gaming practices, as well as the broader sociocultural environment as the meaning of the gaming behavior derives from its context. The holistic approach adopted here not only highlights empirical research that confirms neurobiological correlates of Internet gaming addiction and establishment of a preliminary diagnosis, but also emphasizes the need for an indepth understanding of meaning, context, and practices associated with gaming. Ultimately, a holistic understanding will benefit individuals who seek professional help for problematic online gaming as treatment approaches become more targeted and consequently more efficacious.

The author reports no conflicts of interest in this work.