All the signs are there - your girlfriend comes over, but plays real-life simulator games on your computer the whole time. You couldn't figure out why your boyfriend was reluctant to have you move in with him until you found out he doesn't really sleep in his bed, he passes out on the couch while playing massively multiplayer online role-playing games (MMORPG's). Your middle schooler is incredibly popular with the other kids and no wonder, because they all come over to play multiplayer motion-control party games in your basement. Your roommate didn't go home over the holidays because there was a first-person shooter online clan action planned and the internet connection is better on campus.
You're concerned that your friend or loved one might be addicted to video games. You're concerned that this person might be "addicted" to video games, and you've heard a lot of worrying things in the media about people who are addicted to video games. What do you do?
Psychological and social issues have to be considered in context; the "medical model" of diagnosing and treating a condition like diabetes isn't appropriate. Think through questions like: Is there something this person is trying to "escape" from? Is this person socially isolated "IRL" (in real life) and using online contacts to make up for it? Is this person part of a video gaming clique or culture where this really is normal? Does this person also use substances, especially while playing? Is this person just sensation-seeking by nature? Does this person just have little else to do all day? The real problem might be something else entirely, or there might not be a problem at all.
Addiction is not synonymous with merely spending a lot of time playing video games. We reserve the term "addiction" for when a behavior gets in the way of real-world responsibilities, if they use it as an escape or self-medication, if they keep doing it even after it stops being fun, if they can't stop even when they try, if they keep going in spite of negative consequences, if they lie or manipulate people in order to get an opportunity to play, etc. If someone really is "addicted," it's important to remember that addiction is progressive. If there's no intervention and nothing else happens to stop an addictive pattern, it'll get worse on its own, not better.
Consult the currently available pediatric clinical guidelines and do what makes sense for your children and your family. Too much entertainment "screen time" is bad for everyone, especially children and adolescents. Entertainment video gaming competes for time with physical activity (along with all the benefits that come from physical activity) and can exacerbate existing problems with attention and focus. Adolescents should be included in the discussion about what limits they should follow and how they will be enforced.
An important consideration in whether someone has a problem with video gaming is whether it is supporting their life and social circle to expand or contract. Video gaming can be highly social, both "IRL" (in real life) and online. Even single-player games like RPG's (role-playing games) are social, as players talk about their games with each other and watch each other play. Multiplayer games, some of which are both popular and family-friendly, are common at parties. Video games have cult followings, international conferences, and cultures of their own. Video gaming can be someone's "life" like any other hobby - or, it can help someone become even more isolated, replace IRL social interactions with less-satisfying online relationships, provide an "out" from the normal push-and-pull of society where the real work of being a person happens, and stunt psychosocial development.
Unfortunately, there are plenty of questionable and ineffective behavioral health options out there offered alongside of theoretically sound and evidence-supported interventions, and people seeking help for friends and loved ones often have to do their own research to find out which is which. Under the principles of evidence-based practice, consumers have a right to know what the research says about whether the intervention or medication they are being offered will be effective for the presenting problem and safe for the person who has the problem. Generally, reputable problem video gaming specialists use non-pharmacological interventions that have been proven effective with addictions and impulse control disorders - a "detox" period, cognitive-behavioral work to train clients to get impulses under control, and addressing other issues in the clients' lives and environment that may have given rise to the presenting problem.
Be particularly careful about unproven, "off-label" use of psychiatric medication with children, and be automatically suspicious of claims that any medication will correct a "chemical imbalance," as research has never actually positively identified any process in the brain connected with a mental illness that could be accurately described as a "chemical imbalance." There is some research that suggests medications indicated for attention-deficit hyperactivity disorder (ADHD) help reduce problem video game play. Psychoactive medication in general, however, is only of limited benefit on its own. It should be part of a comprehensive program of care including non-pharmacological interventions.
If you want someone to change their behavior, there is a big difference between supporting them to do it and merely pressuring them to do it. The common-sense route to causing behavior change is to complain about it or generally make life difficult for someone until they change their behavior. People engaged in undesirable behaviors, however, are usually getting enough of this "negative reinforcement" from society. If people who are engaged in behaviors that they themselves don't like could just quit, they would.
There is always a lot of "moral panic" thinking about video games and it never helps anyone, especially when it comes up in arguments with friends and loved ones about their behavior. All video games are is a medium for communication and artistic expression - no less, no more - and every recent generation has complained that the next generation's new communications technology will destroy human interaction as we know it. Only between 4.9% and 9% (depending on how it is measured) of video game players have an issue with problem video game play. Because concerns about video game violence often come up in the same conversation, it is important to note that, media reporting of school shooting incidents aside, there is no "monkey see, monkey do" connection between violent media and violence.
Most people want to believe their vice of choice is completely benign. Video gaming is not completely benign for the people who seek out treatment for video gaming addiction each year, and there are other claims that do not square with the evidence. Motion-control "exergames," for example, are no magic bullet against obesity in children, as a study in which children were given a motion-control console and game requiring physical activity simply reduced their other physical activity to compensate. Also, there is a connection between violent media and violence that is significant and cannot be explained away by other factors, even if the mechanism underlying this connection isn't through simple behavioral modeling.
Video games are diverse in several respects, including their addictiveness. However, if you run into a lot of confusing and conflicting information about various types of video games, it's because research has generally not done a good job of accounting for video game diversity. There are some studies about video games in general. This approach implicitly assumes that either video games aren't meaningfully different or that only features all games have in common are important. It produces such conclusions as that "winning" is the main self-reinforcing aspect of video games when, in reality, there are plenty of things people engage with in video games that have nothing to do with "winning." Other studies focus on only one kind of game. This approach produces conclusions like that MMORPG's are especially addictive. They are, but so are several other genres, whose common feature is that players identify with fictional characters.
Coping with a friend or love one's behavioral addiction is like having a bad cat - it's a problem that people can think is kind of silly if they haven't been through it themselves, and your internet search may turn up more humor than resources. Media addiction is a niche issue in mental health, it's not an official psychiatric disorder, our culture doesn't take it all that seriously, and not everyone in the mental health community agrees that it exists. Service providers are honor-bound to take you seriously no matter what your presenting issue is, though, and if you find someone who won't, you're entitled to move along until you find someone who will. The question of "does my friend/loved one really have a problem?" and the experience of coping with a friend/loved one's addictive behavior are issues that people have been dealing with throughout the history of the human race. There is professional and peer support out there, and anyone should be able to, at least, empathize.
Video games can be both rewarding and potentially addictive. If you have a friend, loved one, or family member you think might be addicted to video games, it is important that you research all about both the benefits and downfalls, addictive behaviour, and treatment options. Keep this advice in mind.
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