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Getting played: gaming disorder

The WHO has now recognised the damage that addiction to computer games does as a disease — and thanks to ‘loot boxes’ the problem can also be financial, writes TOMASZ PIERSCIONEK

ADDICTIONS have existed in their myriad forms for as long as humans have had cravings. As science develops and new technologies become embedded into our culture and lifestyles, so too will new virtues and vices emerge.

A new addiction is known as gaming disorder, a condition predominantly affecting children and young adults who grew up surrounded by the internet, computers and gaming consoles in all their various forms.

Some countries have introduced limits on the length of time under-18s are allowed to play video games. China limits children gaming to a maximum of three hours a week and no more than one hour at a time, in an attempt to curb what it refers to as the “spiritual opium” of gaming.

Perhaps video games are indeed the 21st-century “opium of the masses,” especially those playable through virtual reality headsets, providing, as they do, an escape from the increasing turmoil and uncertainty of 21st-century living.

The lifelike graphics and exciting storylines seen in modern-day computer games can be very enticing. For example, in Assassins Creed, your characters explore Victorian London and can meet with famous people of the day, while taking part in a millennia-long war between two secret societies.

Other games in the Assassins Creed series are set around the time of pivotal moments in history such as the French Revolution or the US war of independence. Far Cry 4 is set in a fictional Himalayan nation, based on the countries of Tibet and Nepal, where you find yourself fighting alongside revolutionary forces seeking to overthrow a dictator.

The World Health Organisation (WHO) has included gaming disorder in the 11th edition of the International Classification of Diseases published in 2019. It describes the condition as a behaviour pattern of at least 12 months’ duration that is severe enough to cause “significant impairment to a person’s functioning in personal, family, social, educational, occupational or other important areas.”

In other words, much like other addictions, it takes over the person’s life to the exclusion of other activities. However, trying to ascertain the prevalence of gaming disorder is a challenge due to various studies looking at the disorder using different diagnostic criteria.

The National Centre for Gaming Disorders, the only such clinic in the NHS, opened in 2019 and records the average age of its clients as 17. The centre reports that the number of individuals it treats increased by over half between 2021-22 when more people started gaming during the coronavirus pandemic as lockdown and social distancing rules came into force.

The gaming industry was valued at $197 billion in 2021 and is expected to increase to $470bn by 2030, driven by the growth of virtual reality games and the metaverse.

In 2021 an estimated 3.2 billion people around the world, almost half of whom live in Asia, were believed to have played video games to some degree. However, the WHO estimates that only 3 per cent of these suffer from gaming disorder.

Perhaps such a low figure is unsurprising as many people can enjoy healthy relationships with alcohol, food, exercise, spending, and gambling without succumbing to addiction.

However, as with the latter list, teenagers and young adults are more susceptible to developing an addiction than older age groups and perhaps this also holds true with regards to gaming.

Conversely, research has found that gaming can even have a positive effect on mental health. A study by researchers from the University of Oxford, published in 2022, examined data from nearly 40,000 individuals playing seven different games and found that gaming did not adversely affect a player’s mental health and wellbeing.

The study found that gaming motivated by healthy intentions, such as playing to have fun or enjoy time with friends, was associated with positive wellbeing, while those who felt a compulsion to play did not feel satisfied.

Professor Andrew K Przybylski summarised the findings thus: “It wasn’t the quantity of gaming, but the quality that counted... If they felt they had to play, they felt worse.  If they played because they loved it, then the data did not suggest it affected their mental health.”

However, Przybylski acknowledges more research is required into the positive and negative effects of gaming: “Looking at just seven games is like looking at seven foodstuffs — when you know Tesco and the other supermarkets sell thousands of different foods and shoppers fill diverse trollies.”

A concerning feature seen in some games is that of “loot packs,” where the player is enticed to spend real money to improve their chances of winning.

For example, in Fifa Ultimate, team players can purchase mystery boxes costing between 79p and £79.99 to improve their in-game football team. The Fifa games are rated as appropriate for anyone aged three and upwards — there are reports that children have used their parents’ money without permission to buy loot packs.

Although this could be seen as promoting in-game gambling and not too dissimilar to the idea of buying scratch cards in the real world (which by law cannot be sold to under-18s in Britain) EA Sports, which produces the Fifa series, maintains the stance that loot packs do not constitute gambling as players cannot cash out their winnings.

Belgium and the Netherlands banned loot boxes and consequently, EA Sports stopped selling its games in these countries.

Other games contain phenomena akin to loot boxes where a player can purchase better armour, weapons, clothing or other equipment to improve their character’s chances in the game or competitions against other players.

Whereas sometimes such items can be found within the game, questing for them may take a lot of time, skill or effort and thus the option of purchasing them without putting in the time and effort can be tempting for some, especially if you can quickly gain an edge over other players.

Apart from encouraging gambling to children and other potentially vulnerable individuals, this is a case of art imitating life — a class system is created within gaming whereby those with money have better chances and prestige than their poorer counterparts, while the latter risk falling into debt as they try to compete and keep up appearances in the virtual world.

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