We make games so that people can enjoy them, and I've noticed that throwing around a dirty word like “addiction” is a lot like throwing rocks at people. Heavy rocks. I try to be very careful with how I use that word in relation to games, because it's a very, very complicated subject. Yes, South Korean and American gamers have died from exhaustion. Yes, this makes bored journalists and unpopular politicians very happy. China has already thrown a fair bit of legislation at video games, whether or not games are the problem. On the other hand, such legislation might fail to address the real problem. In this article I explain addiction simply. Then, I talk about research that attempts to connect addiction to gaming, and some clear problems in that research. One caveat: this article is not going to make anyone into a trained clinician.

Part 1: Psychology lite, with neuroscience sprinkles.

If gaming can be considered an addiction, it would most likely fit the mold of a behavioral addiction. First, we're going to talk about the common-sense psychology side of addiction: behavioral addiction. Then we'll talk about the neuroscience side of addiction: brain chemistry and dopamine. What you should get from the following section is a very basic sense of what addiction is. After this section we'll explore how addiction might or might not relate to games.

Theoretical Behavioral Addiction

Dr. Mark Griffiths is one of a growing body of psychologists forwarding the concept that “excessive behaviors of all types,” for instance addictions to shopping, gambling, or sex, are addictive in very similar ways. These addictions don't have to involve drugs, yet even drug addiction shares features with these other addictions. The actual features cited by Griffiths hearken back to the theoretical models of Iain Brown, and may even represent a psychology-based foundation for all addiction.

Everyone is vulnerable to becoming addicted, according to Brown, but to different extents. Some people have had an excessively rough life, and still others have had too easy a life, or are just bored. Specifically culture, economics, social circumstances, personality, and low tolerances for stress are some of the factors that might make one person more susceptible to addiction. You might call particularly vulnerable people “addictive personalities,” simply because they are more at risk.

While these certain personalities are susceptible, behavioral addiction requires a behavior. A normal personality usually has a number of activities that they regularly use to feel excited, relaxed, or what have you. Yet people are drawn to some things over others. A huge gambling win is more attractive than cleaning a toilet. For most people. When the soon-to-be addict finds that special activity, they can have what Brown calls an “aha” moment. As this especially alluring behavior becomes more prominent in a person's life, other things disappear completely from that person's repertoire of activities. At its most extreme, such a behavioral addiction dominates a person's life. They need the activity, and they'll sacrifice nearly anything – long term plans, the company of people, even work in order to have it.

Dopamine and Brain Chemistry

Back in the forbidden caverns of hard science, addiction is usually attributed to genetic factors and dopamine. The National Institute of Health states that genetic factors are significant in addiction. Some brains are just more susceptible to the neurotransmitter dopamine, a type of chemical in the brain. The research of neuroscientists Depue and Collins reflects this in stating that individual differences in dopamine processing can predetermine individuals as more or less likely to develop addictions. They also assert that motivation is based on two major factors, “the availability of reward, and the effort required to obtain it…”

Enter such a nefarious behavior. So much dopamine is released while engaging in some behaviors that neurons, our basic brain cells, get accustomed to having that dopamine around. These neurons stimulate the nucleus accumbens, part of the brain. As the brain gets used to this stimulation, it requires more and more dopamine for the same effect. When the dopamine producing behavior is finally stopped, the brain isn't used to the lowered dopamine levels. At this point, craving and addiction enter the picture.

Regardless of the perspective you like best – psychology, neuroscience, or any of the many humanities-based theories out there, there seems to be good backing for the idea that addiction has a lot to do with your personality. If a person has an addictive personality, then the actual activity isn't the problem. These people are going to get addicted to whatever they try, be it games, running, eating peanuts, or even work. If a person thinks that they have a problem, then they need to take responsibility, seek treatment, and modify their behavior. Following is research that has actually suggested that some gamers may be addicted.

Research

German researchers Sabine Grüsser and Ralf Thalemann have suggested that some gamers exhibit signs traditionally associated with addiction: susceptibility to triggers and diminished startle reflex. Grüsser additionally reflects our earlier conversation on addiction by saying that as one activity comes to be used exclusively in order to deal with adversity, it becomes the only behavior that can activate the brain's dopamine system, and that such chemical monopolization is common to all addictions.

Is this great news for journalists, unpopular politicians, or groups such as Online Gamers Anonymous and EverQuest Widows? First off, keep in mind that much of the research in this field is above all preliminary in nature. Moreover, so far research has simply suggested that at most, people are becoming addicted to games, not that games themselves are actually responsible for addicting people. The difference is subtle, yet significant. It also helps to keep in mind that certain works in psychology and the humanities are not entirely definitive.

This is not to discount addicted gamers. Some people do play to a point where gaming negatively affects their lives, and we need to be sensitive to that. The most populous country in the world, China, wouldn't have passed a law regulating massively multiplayer online (MMO) gameplay without at least some reason. Who knows? Dazzling new research might, hypothetically, prove that games addict in ways that television and gambling may never hope to rival. But for now we don't know exactly what's happening. Research into games is new.

Part 2: Trouble in paradise.

There are problems with some of the most influential articles studying both games, and their relation to addiction. The most notable problems have to do with conceptual confusion, reliance on self tests, sampling techniques, and differences between games. Problems with all of these slow the advancement of gaming knowledge.

Conceptual Confusion

Conceptual confusion is when an author takes two or more important keywords, and then mixes them up. Usually this just happens when one researcher talks about another researcher's work a little bit carelessly. In Internet addiction research, which originally served as a foundation for computer-related and gaming-related addiction research, major works have been accused of conceptual confusion. This is important, because this research continues to be used by new studies, even studies involving games. This means that new researchers entering the field must critically analyze any addiction criteria they plan on using. Additionally, these foundational authors could gain a great deal of credibility by revisiting and defending their methods.

Self Assessments

Size matters. While Dr. Kimberly Young's criteria for Internet addiction has recently grown in size, her criteria for 'obsessive online gaming' still consists of eight questions. According to Young the test taker “may be addicted to online gaming” if they answer yes to just one of the eight questions. Psychologist John Charlton has asserted that attempting to diagnose addicts using checklists is likely to drastically overestimate the amount of people who are actually addicted.

Sampling

Many studies, especially the more humanities-based studies of gaming in general, suffer from major problems when it comes to something called sampling. A researcher can have the greatest survey of all time, but it won't matter if the right people don't fill it out. The goal here is to make sure that the 50 people who take that survey perfectly represent the 5000 people that you want to talk about. Gaming research so far has distributed most surveys through online forums, college classrooms, and websites. The problem is that the people who visit online forums, or go to college, or visit gaming websites, probably don't represent the whole gamer population. Some people get their games at Blockbuster. Some MMO players aren't very likely to take boring academic surveys when “rolling on epic drops” is also an option for their evening. Very little of the gaming research out there represents all gamers.

Differences Between Games

One last distinction that is sometimes overlooked by psychologists and other practitioners: the differences between games. We have to be careful not to interchangeably use some studies of single player, online, or especially MMO games. There are differences between these games. For example, if one study examines single player and online FPS game players, and finds that they enjoy greater visual acuity, then we should not assume that MMORPG players will necessarily also enjoy such benefits. It's possible, even probable that players in different types of games will reap these ocular benefits, but it is not guaranteed.

Part 3: Are games addictive?

To revisit part one: so far research has simply suggested that at most, people are becoming addicted to games, not that games themselves are actually responsible for addicting people. Some people do seem to be addicted, yet games may not be the real culprit. Nevertheless, research that directly examines whether certain games are addictive should not be shunned, it should be welcomed. There are two reasons for this, neither of which is completely obvious. First, it is entirely possible that games are in no way addictive. If research can prove this, then it would inspire a huge amount of confidence in parents, legislators, and gamers. The second, less obvious, advantage to studying links between addiction and games is understanding. If games can be linked to addiction, then knowing how and why could possibly show us what a “healthier” game would look like.

To keep this article in perspective, we're talking about games. Recreation. Stuff that people do for fun. Even if it were possible to remove the proverbial nicotine, or addictive ingredient, would we want to? If it takes the fun out of games, then the answer is probably no. We still have responsible players who count on us for quality entertainment. But who knows? Perhaps laborious, calculated efforts to create that “healthier” game will help one developer to produce the most exciting game ever. In any case, there are people who do seem to have serious problems with gaming, but there are also people who watch too much TV, or spend too much time reading. Do these other media forms face criticism, or a looming threat of legislation? Not really.

Addiction is complicated. To revisit the introduction's caveat: this article isn't intended to transform you into a trained clinician. Instead, it's meant to shed some light on the very basics of addiction. It also shows why some of the research deserves to be viewed with a critical eye. Some people do have problems with games; that's getting harder to discount. What we can do, as game creators, is understand that a problem exists, and try to understand research advances as they occur.

Resource List

Brown, I., A Theoretical Model of Behavioral Addictions – Applied to Offending. In Hodge, J. E., McMurran, M. & Hollin, C. R. Eds. (1997). Addicted to Crime? John Wiley & Sons Ltd., New York , NY . (p. 13).

Charlton, J.P. (2002). A factor-analytic investigation of computer ‘addiction' and engagement. British Journal of Psychology, 93, 329-344.

Depue, R. & Collins, P. (1999). Neurobiology of the structure of personality: Dopamine, facilitation of incentive motivation, and extraversion. Behavioral and Brain Sciences, vol. 22, p. 491-569.

Griffiths, M. (2005). A ‘components' model of addiction within a biopsychosocial framework. Journal of Substance Use, vol. 10, p. 191-197

Kimberly Young's website. Links to her surveys come from her website:

National Institute of Health website

Press release discussing Sabine Grüsser and Ralf Thalemann's research, presented at the 2005 Annual meeting of the Society for Neuroscience.

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