Game on

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With big business behind it, the hobby of computer gaming can turn into an unhealthy obsession. The addiction field is well placed to offer support, says Peter Smith 

The video and online gaming industry is big business. The recently launched video game Call of Duty: Black Ops II recorded sales of £324m in the first 24 hours after going on sale and another, Halo 4, took more than £150m in the same period. People ordered well in advance and queued to be among the first to obtain their copy and start playing. 

Such was the intensity and excitement that people in homes across the UK – most of them young men – were up all night and into the next day playing virtually non-stop, depriving themselves of sleep, food and attendance at school or work. Parents, partners and siblings were left bemused, dismayed, dejected and angry – though for some it has become an all-too-familiar and often-repeated pattern of behaviour.

We are in an age dominated by ‘screen’ technology; one that many younger people have embraced and benefited from. Referred to by some as ‘screenagers’, this group has grown up with the advances in information technology. They recognise it as a core school subject, can apply for college and university courses in one of its innumerable variants and ultimately seek jobs where computer skills are a core requirement. But for a few young people the use of this technology, specifically related to game playing, is a growing cause for serious concern. 

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Game playing is not unlike the use of alcohol, where most people use within healthy and responsible limits and benefit from its social and pleasurable aspects. Many millions worldwide play video and online computer games and gain a considerable amount of pleasure from doing so. However research studies indicate that as many as 4.6 per cent of adolescents engaging in regular internet use do so to the point of excess and will likely experience negative consequences as a result. 

While discussion continues around accurate and suitable wording – including such terms as excessive, dependant, addictive and pathological – terminology is purely academic for those individuals and families where the problem is present. In this situation, parents are often struggling to find the best way of dealing with their teenage son as his repertoire becomes progressively more limited to computer game playing. The gamer becomes more alienated from the rest of the family, limits his relationships to other online players, and is reluctant to consider any other activity that might restrict his game playing, leaving those around him increasingly anxious, frustrated and resentful. 

Such a situation creates upset, arguments and tensions within the family.  Any attempt to control, reason, negotiate or compromise can end in anger, a breakdown in communications and an increasing sense of helplessness and hopelessness. While examples have been documented of more extreme outcomes resulting from excessive game playing, including fatalities, the help most frequently sought by family members is associated with the insidious wearing away at established family relationships and norms, and fears for the future if nothing changes. 

The impact on the family is of very real concern, but the consequences of excessive game playing for the individual can be at least as serious. In a recently reported case at a Plymouth primary school, the head teacher was surprised to find that pupils as young as seven and eight were arriving at school tired and ‘not ready to learn’, and discovered that some were playing games until late at night. In a survey of a Weston-super-Mare Secondary School, teachers were able to identify pupils in each year group where educational attainment had suffered as a result of computer game playing. 

Among the calls from people seeking advice recently received at Broadway Lodge, a significant number were from parents looking for help as a result of their sons’ exclusion from university. In such instances, failing to maintain course requirements was related to the removal of the parental controls that were in place while at home, allowing unrestricted game playing to escalate to the detriment of academic achievement.

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The games that probably give rise to greatest concern are referred to as massively multiplayer online role playing games (MMORPG). These MMORPGs invite players to immerse themselves in complex virtual worlds. Players can live out fantasies through a ‘virtual personality’ of their own creation and play with millions of other players around the world at any time of night or day. These games do not have an ending, so can be played continuously, and such is the immersion in them that players consistently report becoming so preoccupied that they easily lose track of time and the need to eat, and get frustrated at being interrupted by the need to go to the toilet.

While older people sometimes get into difficulties with playing games to excess – a recent caller sought advice about her husband who spent all evenings and weekends playing online games – the issue still has a generational dimension to it. Many people playing and experiencing problems are younger and many of the people with the greatest concerns about it are older. This may be due to the adult generation having limited understanding of the technology and its capabilities. 

In discussion with a 17-year-old male gamer recently, parents were surprised to learn from their son how much he felt he gained from playing games, including the skills, strategic thinking, information processing and decision-making involved; the connections he made with others worldwide; and the socialising aspects of ‘lan’ (local area network) parties – where friends brought their own computers to plug into a network to play the same multi-player game. 

However, while it was helpful for them to learn this, the parents were still concerned that balance seemed to have been lost as game playing became ever more consuming, and raised questions about its physiological and neurological impact. Sitting for hours without any physical activity might contribute to circulation and digestion problems and while gaming may be training the brain to process large inputs of information speedily and make decisions quickly, excessive game playing may be to the detriment of less adrenalin-inducing cognitive processes, such as reading or revising for exams.

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There is currently very limited help available, so where does someone experiencing problems of this nature go? Health, education and social care services have little knowledge, training or understanding of these issues and there is currently no statutory funding for third sector services. The UK Interactive Entertainment (UKIE) games industry representatives are unwilling to help in this area or to accept that they might have at least some level of social responsibility, and central government has not yet fully acquainted itself with the implications for public health. 

In fact at present, the games industry is lobbying parliament for tax concessions to maintain the UK’s leading role in game production and has suggested that computer games should be introduced to primary schools. We can only hope that any concessions of this type are conditional upon a financial commitment from the industry to support the development of specific counselling and advisory services for those who get into difficulties. I would suggest that UKIE follow the good example set by the gambling industry in making financial contributions to the voluntary sector, distributed through the Responsible Gambling Trust (RGT), to support people experiencing problems resulting from gambling.

As for the future, we might predict that the problems resulting from this issue are likely to increase in coming years and that data gathering and research studies will be essential. At present we are managing one generation, but as this generation grows up (with some continuing to play into their adult life), the next generation of game-competent youngsters will emerge and add to the numbers of problem users, with increasing demands on services. Eventually, cross-generational status will be reached. 

At the same time, current research investigating the impact of game playing will begin to report on findings with results from longitudinal research studies, which we hope will provide us with detailed and accurate information regarding the precise nature of the issues and the specific help required. Who knows, while not in DSM V (the fifth edition of the American Psychiatric Association’s Diagnostic and statistical manual of mental disorders), with research evidence to support it we may find its inclusion in DSM VI.   

I believe that the alcohol, drug and gambling treatment fields could be well placed to help in this area, delivering the advice, support and treatment necessary to manage the consequences of excessive game playing. While there are differences, there are also sufficient similarities with chemical and other ‘process’ addictions and the skills and knowledge of practitioners in this field can be harnessed to respond to the presenting problems of this new client group. It would be timely for organisations to gather information, seek appropriate training for staff, and talk with gaming enthusiasts themselves to learn about their experiences. DDN

Peter Smith is development director at Broadway Lodge. 

Suggested reading: Young, K.S. and de Abreu, C.N. eds (2011). Internet Addiction, Wiley Aboujaoude, E. and Koran, L.M. eds (2010). Impulse Control Disorders, Cambridge University Press