Is "Gaming Disorder" Real and What Causes It?

Christian Cashman 3 hours 53 minutes ago. 0 comments
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(TL;DR version: Games don’t addict people, terrible game designers do.)

Having played a multitude of games into the wee hours of the night (and sometimes into the morning), I can attest to video games being highly addictive. The World Health Organization (WHO) believes they are so addictive that they have decided to include “gaming disorder” in their upcoming version of International Classification of Diseases (ICD). Is it fair to add games to this list, or is this an overreaction on the part of well-meaning medical professionals?

In its listing, the WHO will define gaming disorder as having the following characteristics:

  • impaired control over gaming (e.g., onset, frequency, intensity, duration, termination, context);
  • increasing priority given to gaming to the extent that gaming takes precedence over other life interests and daily activities; and
  • continuation or escalation of gaming despite the occurrence of negative consequences.

Does this condition mean that all video games, or even just the industry, have an element of addiction equivalent to drugs, gambling, and other dangerous activities? Games in and of themselves won’t cause people to be instantly addicted to Call of Duty like they will to heroin and other opiates, which can take hold of someone in a matter of days. Video games can even be therapeutic for those experiencing PTSD, social anxiety, and are just in general introverted and need a social outlet. If a person does get addicted to a game, it is due to how they prioritize their needs and wants, which is a behavioral issue. That being said, it is entirely possible to be unhealthily attached to any activity, whether it is gambling, extreme ironing, or gaming.

These negative behaviors that lead to the disorder are real, and we should be considering how the game industry actively encourages them. The symptoms of the disorder are rather similar to those found in gambling addiction, as those who suffer from this issue also prioritize their time, attention, and resources to gambling more and more. There are even elements of gambling that are sometimes added into the design of many games that encourage players to keep playing endlessly. There are random cosmetic elements that either drop after a certain amount of playing or are purchased for actual money, not in-game currency. When a developer releases an update or expansion to their product, people who completed every aspect of the game prior now have a reason to delve back into it. While others joyfully welcome the chance to play the new content, some people reluctantly do so because they have an overriding completionist urge, and they won’t stop until that achievement list finally says “100%”.

One of the more recent elements of certain video games that have drawn the ire of players for having an addictive quality is the concept of loot boxes . These items contain entertaining, mostly decorative features that designers put into the game to encourage players to both play more and spend real money on the game (if it has an in-game microtransaction system). Some of the items that people can get from loot boxes are unique skins for their characters, rare weapons, special vehicles, etc. Since there are usually so many of these features programmed into the game, it gives players a lot to work for, and therefore a reason to keep coming back to play. The problem with loot boxes, however, is they essentially enable gambling in their games. The rewards found in the loot boxes are randomly selected, and each time you buy a pack of boxes, you are practically playing a game of roulette for items that have no monetary value outside of the world of the game. Most people can do a small, one-time purchase for a loot box and leave it at that, but for those who are completionists and gamblers, they can either delve deeper into the game, playing for hours on end to farm as many boxes as possible, or they can make a multitude of purchases to get what they want. Either way, it can have a massive detrimental impact on one’s real life if a player goes down that road. If a developer is actively setting up their game to unfairly push people to that path, then they are committing a grievous moral offense.

There are few game companies that indulge in this unscrupulous practice. A recent offender is Bungie. In Destiny 2, a game in which players fight against the threat of a proper main story by relentlessly grinding the same side mission over and over, there is discord in the community about how Bungie handles its microtransaction system, the Eververse store. As you progress in Destiny 2, the experience points (XP) you gain work towards earning Bright Engrams, the loot boxes of the game. During one weekend event, the amount of XP was supposed to be greatly increased when playing with friends. It was later found out that if you played for a significant amount of time, the XP bonus would precipitously drop, effectively rigging the game against players from earning Bright Engrams. When a game is intentionally designed to keep moving goal posts for players to get rewards, it is actively and subtly encouraging people to spend more time in-game and less time in the real world, or even push people to buy the damn boxes to speed up the process. These tactics can force people to play more and more and increase how much they are willing to spend on in-game purchases, and this can have dire consequences.

There are numerous stories of people shutting themselves away from friends, family, and the real world in order to keep playing. People have shirked responsibilities, and even died from dehydration and starvation as they were too focused on their game. One couple in South Korea became the subject for a documentary, Love Child, when they raised a virtual child while fatally neglecting their real infant. Having games that are specifically designed to lure players into playing non-stop can lead to the detriment of their and others’ lives, but are video games, as an industry, guilty of fueling addicting behavior?

What matters here is how an industry sets itself up to make a profit. Gambling, like gaming, can be harmless fun. You can wager with your friend about who can run the fastest, play a low-stakes card game, and make other bets that don’t do any real harm. Where it becomes dicey is when there is an industry that is set up specifically to not only make you play more, but also actively rigs the games in its favor. Up until the introduction of Massively Multiplayer Online games (MMO) and microtransactions, the game industry had been largely devoid of this deleterious behavior. When it became possible, however, for players to download new features at reasonable speeds, buyable downloadable content (DLC), companies with less scruples than most could consistently send out and hype up new content to ensure that people were playing. Games that don’t have a firm ending point, like World of Warcraft, encourage people to stay playing through the constant flow of expansions, DLCs, and rare items to collect. This alone isn’t a huge problem, but once game designers tweak their products to do something akin to what happened in Destiny 2, they are effectively making an addictive product.

In the end, it’s not that video games are inherently addictive, but it’s how they are made by companies. If they want to make extra cash from a game by selling expansions and updates that increase replayability, that’s ok, so as long as they are not forcing players to tirelessly stay in the game or to set things up to make us completely empty our wallets. Gaming Disorder may be a new condition, but it is a real one, and game designers need to find a proper balance between making a profit and making people into addicts.

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