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Recent Review Article Summarizes Research on Internet Gaming

The male-dominated addiction needs male-focused clinical care.

Janelle Weaver, Contributor
Fri, 06/29/2018


Internet gaming is increasingly gaining attention as a mental health problem -- one that disproportionately affects men. On June 18, the World Health Organization released the latest version of the International Classification of Diseases, which categorizes gaming disorder as a type of addictive behavior. A review article published in the American Journal of Men’s Health synthesized the existing literature on internet gaming disorder to raise awareness of this emergent psychological issue among males.

“Gaming addiction is a serious matter in the sense that it has harmed many in various magnitudes,” said author Kevin Chen, a nurse practitioner at Vancouver General Hospital in British Columbia, Canada. “It has led to loss of employment, damaged relationships and marriages, and even caused death on several occasions in documented reports. The detrimental effects of gaming addictions are well-documented, but it has not attracted enough attention from the medical community to investigate and intervene.”

The review summarized 13 research articles on internet gaming published between 2008 and 2017 -- a timeframe corresponding to an explosive growth in massive multiplayer online role-playing games.

According to the authors, one striking finding was the conspicuous absence of studies investigating the problem from the perspective of male users. In general, males across all age ranges devote more time and effort gaming on computers than females. To partially explain this phenomenon, the authors pointed out that most games on the market are designed by males for males, and gaming companies target male customers to boost sales.

Overall, evidence suggests that being male may be used as a predictor for internet gaming disorder. In particular, one survey of 3,000 gamers revealed that males are more likely to be driven by a sense of achievement than their female counterparts are. Compared to females, adolescent and adult males demonstrate far more addictive internet gaming use in terms of screen hours, craving and negative impacts on health. Neuroimaging studies have shown that internet gaming can trigger changes in brain regions involved in reward, motivation and substance-related addiction. Over time, restructuring in the gamer brain can even diminish the pleasure produced by natural rewards such as food and sex.

Internet gaming disorder has not been formally included in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) released by the American Psychiatric Association (APA), but the manual does recommend further clinical research on the behavioral addiction and offers preliminary diagnostic criteria.

The review article summarizes these proposed symptoms, which include preoccupation, withdrawal, tolerance, unsuccessful attempts to quit, deceit, escapism and functional impairment. According to the authors, masculine ideals including autonomy, stoicism, strength and competitiveness can predispose men to escape into gaming worlds and fuel their reticence for professional help. “The risk of a male developing gaming addiction lies in the social construct of masculinity and in the male health-seeking behavior,” Chen said.

Past research has neglected the important role that masculinity plays in the development and perpetuation of internet gaming disorder, said Danielle Ramo, director of the Research on Addiction and Digital Interventions Lab at the University of California, San Francisco. She also noted that literature reviews will be essential as the APA decides whether to include this condition in the DSM as a formal mental illness. 

Marc Palaus Gallego, a graduate student in the Cognitive NeuroLab at the Universitat Oberta de Catalunya in Barcelona, thinks the review article raises awareness of video game addiction as a gendered issue. “Its main strength is its comprehensiveness and the novelty of treating the disorder as mainly a male issue,” he said. “On the other side, it only superficially deals with how this issue has to be addressed by primary care providers and psychologists.”

For their own part, the authors recommended that primary care providers acknowledge the negative feelings that men may associate with needing professional help for a problem they cannot independently solve. They also advised that future research focus on using standardized addiction scales, validating the current diagnostic criteria and taking into account cross-cultural factors, as well as more research on potential prevention and treatment options beyond cognitive behavioral therapy.

“If being male was truly a risk factor for developing gaming disorder, then I hope more research could go into understanding this. This could potentially help health professionals in early detection of one developing gaming disorder and in timely provision of intervention as necessary,” Chen said.

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