UCLA Study to Tackle Online Gambling, Gaming

The Daily Bruin reports on an ambitious survey slated for the following school year that will examine UCLA students’ online gambling and video playing habits. Timothy Fong, codirector of the UCLA Gambling Studies Program is quoted:

“The genesis of this study came about after we started to see more students and younger patients with Internet gambling and video game addictions … It led us to wonder how big of a problem this was.”

Other questions in the survey will seek to identify popular games and pinpoint the differences in game players and online gamblers.

Most people who are gambling online or playing video games have no problems at all and lead normal and balanced lives, but for some, it can cause problems when done in excess.

“Many lose the ability to distinguish reality from fantasy and even begin to prefer fantasy,” said Dr. Richard Rosenthal, codirector of the program. “They just cannot stop playing.”

Daily Bruin author Seda Terzyan then proceeds to interview students who have habitually gambled online. Although Congress passed an anti-online gambling bill last year that prohibits banks and credit card companies from processing payments to online gambling companies, loopholes abound and UCLA students report ongoing activity.

With no current regulation on these sites or by the school, there is no way of knowing the fairness of the games, no way to protect compulsive gamblers and no way to determine who is playing, Fong said.

Then the article turns controversial, and Terzyan reports on potential bias in the study.

Though compulsive gaming was recently rejected as a mental illness or addiction by the American Medical Association, the diagnosis for it is essentially identical to the criteria used to diagnose pathological gambling, Rosenthal said.

There is a progressive failure to control the impulse to gamble, followed by disturbances in personal and family life – it works the same way for gaming, he added, stating that an addiction is essentially the loss of control.

In many ways, he added, compulsive video gaming can be viewed as the purest form of addiction, since it does not require a substance as seen in chemical dependency, nor does it require the rewards of monetary loss and gain present in gambling addiction.

Terzyan offers additional anecdotal evidence of video game addiction, interviewing World of Warcraft players who have spent several hours at a time on the game.

On a personal note, I know I am engaged in an uphill battle against the concept of labeling video games as addictive. Nonetheless, here is my stance: the term “addiction” should be reserved for chemical dependencies. Behavioral attributes that affect ones’ life should be termed “overuse.” When the Council on Science and Public Health (CSPH) presented its report to the AMA on research in violence and video games, the term video game “overuse” was used. At the very least, some sort of differentiation needs to be made clear, such as indicating chemical addictions versus behavioral addictions.

OK, enough soapboxing. I’ll look forward to reading the results from Rosenthal and Fong’s study.

References

Terzyan, S. (2007, July 9). Addictions for the Internet generation. Daily Bruin. [Online]. Available: http://www.dailybruin.com/news/2007/jul/09/addictions_internet
_generation/

Journal of Adolescent Health Study

Another medical journal study on video games making headlines this month was published in the Journal of Adolescent Health. Rather than focus on an experimental effort, the study is survey research of children and their video gaming habits. Cheryl K. Olsen, over at the Harvard Medical School Center for Mental Health and Media in the Massachusetts General Hospital Department of Psychiatry was the lead author. The other authors were Lawrence A. Kutner, Dorothy E. Warner, Jason B. Almerigi, Lee Baer, Armand M. Nicholi II, and Eugene V. Beresin.

The survey was administered to seventh and eighth graders in fall, 2004. The students attended two separate schools in Pennsylvania and South Carolina. A total of 1254 students submitted surveys.

In an interview with reporter Shari Rudavsky over at the Indianapolis Star, Dr. Olsen indicated that most children surveyed played video games, with only 80 stating they had not played in the previous six months. The researchers were surprised by the number of girls playing games rated as violent. Games in the Grand Theft Auto series came in second for girls, behind those in The Sims series. Rudavsky offered this quote from Dr. Olsen to reassure parents concerned about their children playing violent video games:

“First, don’t freak out if you find your child has played an M-rated game, because it’s normal,” she said. “It doesn’t make sense to think that video games are turning kids into killers.”

Rudavsky’s article concludes that while violent video games can contribute to other risk factors for violence that are pre-existing, the games by themselves are not an issue for concern in healthy families.

References

Olson, C. K., Kutner, L. A., Warner, D. E., Almerigi, J. B., Baer, L., Nicholi II, A. M., & Beresin, E. V. (2007, July). Factors correlated with violent video game use by adolescent boys and girls. Journal of Adolescent Health, 41(1). 77-83.

Rudavsky, S. (2007, July 10). Violent video games appeal to girls and boys alike. Indianapolis Star. [Online]. Retrieved July 10, 2007 from http://www.indystar.com/apps/pbcs.dll/article?AID=/
20070710/LIVING01/707100314/-1/LOCAL17

AMA Backs Away from Video Game Addiction

The AMA, in perhaps a nod to critics, decided not to recommend that so-called “video game addiction” be listed as a diagnostic disorder in upcoming revisions of the DSM. Lindsey Tanner over at the AP wrote the primary article that was picked up by several news outlets last week. AMA delegates voted to research the issue further.

I was very encouraged at the wording in the AMA press release on the matter. The opening paragraph is as follows:

Given that approximately 70 to 90 percent of U.S. youths play video games, the American Medical Association (AMA) today called for more research on the long-term beneficial and detrimental effects of video game and Internet use, as well as a review of the current video game ratings system.

The key phrase here is “long-term beneficial and detrimental effects of video game and Internet use.” This is a clear acknowledgement that there are benefits to video game use, and the inclusion of beneficial effects alongside detrimental ones shows at least some realization that not all video gaming is harmful. Too often, the bias is against video games, especially in the media where issues are often simplified and broadly categorized. Someone over at the AMA realizes there needs to be unbiased research of video games, and that benefits are on an equal standing as possibilities for research findings.

All told, a very nice outcome. I’m all for more research of video games.

References

AMA (2007, June 27). AMA takes action on video games. [Online]. Available:

http://www.ama-assn.org/ama/pub/category/17770.html

Tanner, L. (2007, June 28). AMA won’t call video gaming an addiction. [Online]. Retrieved July 2, 2007 from

http://www.usatoday.com/tech/products/2007-06-28-2398179556_x.htm

The APA and Video Game “Addiction”

The newswires were abuzz today regarding the upcoming AMA vote on whether video games “addiction” (what I prefer to call overuse) should be classified as a psychiatric disorder. Recall that the AMA set up a subcommittee to study the research on video game overuse last year, and the results were presented this year. Official psychiatric disorders are listed in the DSM, which is administered by the APA. Typically, the APA takes the AMA’s recommendations to heart, so it was disheartening to me as well as other educational video game advocates that the APA is poised to officially recommend a new disorder called Internet/video game addiction.

The first article is from the Sun-Sentinal newspaper in Florida. Linda Shrieves begins with a catchy opening:

So you think your teenager is addicted to his Xbox?

You may be right — and if the American Medical Association has its way, video game addiction could become a legitimate medical condition.

Shrieves gives both sides, and quotes Steve Jones, a communications prof over at Illinois and a researcher with Pew. He claims to be a video game “addiction” skeptic (though I’ve never met Dr. Jones, right off the bat I can say he has excellent judgment). His key statement:

“Just because any activity might interfere with other activities is not enough to call it an addiction.”

The second big article to hit the newswires is by Lindsey Tanner from the AP, and was picked up by USA Today. Here is the (rather breathless) opening:

The telltale signs are ominous: teens holing up in their rooms, ignoring friends, family, even food and a shower, while grades plummet and belligerence soars.

The culprit isn’t alcohol or drugs. It’s video games, which for certain kids can be as powerfully addictive as heroin, some doctors contend.

Heroin? With all due respect to Tanner, equating a game with one of the most powerful narcotics in the world is, frankly, irresponsible. Tanner points out Online Gamers Anonymous, which offers a traditional 12 Step program.

Tanner does report both sides, though, ending with comments by two psychiatrists who maintain that separate diagnoses for obsessive gamers are unnecessary. The article ends with a quote from Michael Brody over at the American Academy of Child and Adolescent Psychiatry:

“You could make lots of behavioral things into addictions. Why stop at video gaming?” Brody asked. Why not Blackberries, cellphones, or other irritating habits, he said.

The reader comments for this online article are pretty good, and well worth wading through (up to 4 pages at this writing), with plenty of fodder for both sides of the debate.

Let’s hope that over at the APA cooler heads prevail, and video game “addiction” is not added as a disorder to the DSM. Heck, let’s hope the AMA doesn’t vote to recommend this in the first place. Goodness knows, if a person spends way too much time playing games, something else is wrong with them.

References

Shrieves, L. (2007, June 21). AMA to vote on “internet/video-game addiction” as medical condition. [Online]. Available:

http://www.sun-sentinel.com/news/local/southflorida/sfl-flasands0621nbjun21,0,771832.story?coll=sfla-news-sfla

Tanner, L. (2007, June 21). Video games: A psychiatric disorder? [Online]. Available:

http://www.usatoday.com/tech/gaming/2007-06-21-video-game-addiction_N.htm?csp=34

The AMA, DSM-IV, and Video Games

Kudos to John Timmer over at Ars Technica for keeping up with legislative and activist efforts surrounding video games. Many bills seeking to restrict video game sales to minors have either failed at the federal level or have been overturned at the state level. The legislative efforts have usually centered on alleged links between violent behavior and violent video games, with little concern for any actual research backing up the link.

Perhaps the low concern for research is related to the fact the research is not clear-cut in displaying a link. There does appear to be a link between violent video games (if defined correctly) with “violent cognition,” though there is no strong data supporting a permanent link. For instance, children playing violent video games may feel more aggressive shortly after playing, but not carry aggressive attitudes toward others on a permanent basis due to their video game exposure. Similar thrills may occur shortly after watching stimulating action movies or TV shows.

I strongly suspect many attitudes toward research carried by journalists, legislators, parents, and other people are based on misunderstandings of how research is conducted as well as a lack of understanding as to what can actually be “proven” with research. (I have to laugh and admit I have no way to prove my suspicion, making me guilty of carrying an assumed tenet … just as I suspect others of carrying.)

Now, Timmer brings us news of a report from the American Medical Association’s (AMA) Council on Science and Public Health (CSPH). According to Timmer, the CSPH was charged with reviewing the published research on violence and video games in the 2006 AMA annual meeting, and reporting back at the 2007 meeting. This report has been released, and it will be of high interest to video game academics and others interested in the research.

The report provides a good review of the medical and psychological literature going as far back as 1985. The medical journals, especially, are often overlooked by gaming academics. I recognized some of the references, particularly Anderson and Bushman’s (2001) meta-analysis of studies on the effects of violent video games on behavior. Plenty of other references in the document should prove to be of high interest to those in the field of video game research.

The report addresses the topic of video game addiction. I discussed video game addiction in a prior post, which actually received a comment or two. Dr. Lemoyne Dunn over at the Texas Center for Educational Technology suggested a broader definition of addiction than I felt was justified when discussing video games. The CSPH report, presented by Mohamed K. Kahn who holds a Ph.D. as well as an MD, calls for a definition of addiction that includes not only video games but the Internet as well. The justification for this expanded definition is that the majority of those addicted to video games appear to be playing MMORPGs, and MMORPGs elicit higher opportunities for overuse.

The report further states the term “Internet addiction” was coined in the 1990s, and is not currently a DSM-IV classification. The authors initially shied away from calling video games addictive in nature, preferring the term overuse. Here is the pertinent paragraph (I’ve eliminated footnotes):

Although video game overuse can be associated with any type of video game, it is most commonly seen among MMORPG players, who represent approximately 9% of gamers. This is consistent with prior research on Internet addiction that suggests Internet use involving interactive, real-time applications has the most potential for overuse. MMORPGs are simultaneously competitive and highly social, and provide interactive real-time services. Researchers have attempted to examine the type of individual most likely to be susceptible to such games, and current data suggest these individuals are somewhat marginalized socially, perhaps experiencing high levels of emotional loneliness and/or difficulty with real life social interactions. Current theory is that these individuals achieve more control of their social relationships and more success in social relationships in the virtual reality realm than in real relationships.

Overall, the report states a lot more research is needed (a phrase oft repeated by researchers). One reason: no one really knows how many children may be affected negatively by overusing video games in general and MMORPGs in particular. The report states that “dependence-like behavior” may be evident in children, and may be related to over-using games rated high in violent characteristics. But here the logic fell down in linking video games with Internet addiction through MMORPGs, since most MMORPGs are rated T for Teen rather than the more violent M for Mature (with allowances that circumstances involving other players may change during gameplay (i.e., someone drops the f-bomb or makes some other comment inappropriate for children)). The authors call for the AMA to participate in revamping the ESRB game ratings at some point in the future. Anyway, the key summative sentence suggesting against video game addiction is as follows:

However, as with findings on long-term aggression, there is currently insufficient research to definitively conclude that video game overuse is an addiction.

That sentence will likely find its way into papers arguing against video game addiction, and literary efforts battling game censors. However, the report is careful to note broad characterizations of media, not just subsets of larger media. All such related media can be lumped together as “screen time,” and screen time should be limited for children, they opine. Since Internet addiction can encompass a variety of online activities that carried to an extreme can be detrimental to individuals, the authors end their report by recommending the AMA cooperate with other stakeholders to better define current game ratings, educate parents on potential harmful consequences of their children over-indulging in media, and, most intriguingly:

That our AMA strongly encourage the consideration and inclusion of “Internet/video game addiction” as a formal diagnostic disorder in the upcoming revision of the Diagnostic and Statistical Manual of Mental Disorders-IV.

It is interesting that after stating there is not enough research to say that video game overuse is an addiction, the council nonetheless seeks to lump video games with Internet addiction in general, and recommend it be added as a diagnostic disorder in a future revision of the DSM.

I should point out that just because something is added to the DSM, that does not necessarily make it a mental illness. It’s just what a group of doctors currently believe is a disorder. At one time, recall, homosexuality was listed as a disorder in the DSM. As times change, what is considered a mental disorder changes. So, it begs the question, Why should overuse of the Internet and computer games be listed in the DSM as a diagnostic disorder? If a person has an addictive tendency, they will find some way to express it, whether through electronic means or otherwise. To question further, Why not just say Internet overuse, rather than adding video games, is a diagnostic disorder if the only connection between the two is MMORPGs? Why besmirch video games, too?

This lumping of video game addiction with Internet addiction, under the justification that a small percentage of MMORPG players show signs of overuse, is based on flimsy reasoning. The slash between Internet and video game addiction should be eliminated, or at least replaced by “Internet/MMORPG addiction.” But in my (non-medical) opinion, I have to ask, Why should the Internet and MMORPGs receive special consideration anyway? What is it about a computer screen and an Internet connection that makes a disorder any more noteworthy than pre-electronic disorders? What about the person who frequents social spots, or bars, or night clubs and shows addictive social tendencies in real life? Electronic social interactions are not much different than face to face interactions, they are just performed using different communication tools. If a person has an addictive nature, that nature will find release in some way, even if the Internet were to stop working.

The authors state that the Internet has allowed socially retarded people opportunities to control their online lives to an extent not possible in real life, and this in turn causes some to overuse the new tool. But, I don’t buy it. If a person has a problem, the problem exists with or without the opportunity. I would say what AA says about alcoholism: once an alcoholic, always an alcoholic, even 20+ years since the last drink. But then, here we get into the argument of chemical addictions versus social addictions again.

On a more positive note, the council mentioned benefits of video games, particularly within the medical field. Statements like this in the conclusion displayed their medical bias:

As with most other forms of media, video games do have a potentially positive role, especially in the health care and health education sectors.

I would argue that the statement would have been more accurate if the education sector in general were included, rather than limiting it to the health education sector. Obviously, health education is a subset of education in general. To assert instructional video games are limited to being of service to only health education displays a bias toward the report’s audience. This is perhaps understandable, considering the source.

All told, a very interesting report, and well worth reading. I do like what the authors had to say delineating video game overuse as a more correct term than video game addiction, but I would indeed hate to see video game addiction, even couched within a broader context such as Internet addiction, added as a diagnostic disorder to the DSM.

References

Anderson C.A., & Bushman, B.J. (2001). Effects of violent video games on aggressive behavior, aggressive cognition, aggressive affect, physiological arousal, and prosocial behavior: A meta-analytic review of the scientific literature. Psychological Science 12(5). 353-359.

Council on Science and Public Health (2007). CSAPH Report 12-A-07: Emotional and behavioral effects, including addictive potential, of video games. American Medical Association, Chicago. [Online]. Available:

http://ama-assn.org/ama1/pub/upload/mm/467/csaph12a07.doc