Video Game Addiction: Summaries

Summaries of the latest research papers on video gaming addiction. I created a sperate summary list for “Internet Addiction studies“. As with food and gambling addiction, brain studies reveal the same major changes as seen in drugs (hypofrontality, desensitization, sensitization).

Altered regional cerebral glucose metabolism in internet game overusers: a 18F-fluorodeoxyglucose positron emission tomography study.

CNS Spectr. 2010 Mar;15(3):159-66. (South Korea)

Internet game overuse is an emerging disorder and features diminished impulse control and poor reward-processing. Twenty right-handed male participants (9 normal users: 24.7+/-2.4 years of age, 11 overusers: 23.5+/-2.9 years of age) participated. A trait measure of impulsivity was also completed after scanning.

Results: Internet game overusers showed greater impulsiveness than the normal users and there was a positive correlation between the severity of Internet game overuse and impulsiveness.

Conclusion: Internet game overuse may be associated with abnormal neurobiological mechanisms in the orbitofrontal cortex, striatum, and sensory regions, which are implicated in impulse control, reward processing, and somatic representation of previous experiences. Our results support the idea that Internet game overuse shares psychological and neural mechanisms with other types of impulse control disorders and substance/non-substance-related addiction.

COMMENTS: Brain study on video gamers. As with all other studies it showed differences between control group and those who “overuse” video games. Brain metabolism patterns mimic those with substance addiction.

Bupropion sustained release treatment decreases craving for video games and cue-induced brain activity in patients with Internet video game addiction.

Exp Clin Psychopharmacol. 2010 Aug;18(4):297-304. doi: 10.1037/a0020023.

Bupropion has been used in the treatment of patients with substance dependence based on its weak inhibition of dopamine and norepinephrine reuptake.

We hypothesized that 6 weeks of bupropion sustained release (SR) treatment would decrease craving for Internet game play as well as video game cue-induced brain activity in patients with Internet video game addiction (IAG).

After a 6 week period of bupropion SR, craving for Internet video game play, total game play time, and cue-induced brain activity in dorsolateral prefrontal cortex were decreased in the IAG. We suggest that bupropion SR may change craving and brain activity in ways that are similar to those observed in individuals with substance abuse or dependence.

Comments: The signs and symptoms of vidoe game addiction were reduced by a drug that is used to do the same for drug addicts.

Brain correlates of craving for online gaming under cue exposure in subjects with Internet gaming addiction and in remitted subjects. (2011)

Addict Biol. 2011 Oct 26. doi: 10.1111/j.1369-1600.2011.00405.x.

Their region-of-interest was also positively correlated with subjective gaming urge under cue exposure. These activated brain areas represent the brain circuit corresponding to the mechanism of substance use disorder. Thus, it would suggest that the mechanism of IGA is similar to substance use disorder.

Comments: Unlike most studies this one included both controls and former Internet addicts. This study found that those with Internet addiction had different activation patterns from controls and from former Internet addicts. Addicts brain differ, and recovery leads to normalization.

Brain activities associated with gaming urge of online gaming addiction. (2009)

J Psychiatr Res. 2009 Apr;43(7):739-47. Taiwan.

The aim of this study was to identify the neural substrates of online gaming addiction through evaluation of the brain areas associated with the cue-induced gaming urge.

The activation of the region-of-interest (ROI) defined by the above brain areas was positively correlated with self-reported gaming urge and recalling of gaming experience provoked by the WOW pictures. The results demonstrate that the neural substrate of cue-induced gaming urge/craving in online gaming addiction is similar to that of the cue-induced craving in substance dependence. The above-mentioned brain regions have been reported to contribute to the craving in substance dependence, and here we show that the same areas were involved in online gaming urge/craving. Thus, the results suggest that the gaming urge/craving in online gaming addiction and craving in substance dependence might share the same neurobiological mechanism.

Comments: There’s not much research on the brains of video game players. This study found that WOW players had the same parts of the brain activated by cues as do addicts. The players were shown pictures of WOW, and their brains lit up the same as would a crack addict seeing a crack pipe. 

Changes in Cue Induced Prefrontal Cortex Activity with Video Game Play. (2010)

Cyberpsychol Behav Soc Netw. 2010 Dec;13(6):655-61. Epub 2010 May 11. South Korea

Brain responses, particularly within the orbitofrontal and cingulate cortices, to Internet video-game cues in college students are similar to those observed in patients with substance dependence in response to the substance-related cues. During a standardized 6-week video-game play period, brain activity in the anterior cingulate and orbitofrontal cortex of the excessive Internet game-playing group (EIGP) increased in response to Internet video-game cues. In contrast, activity observed in the general player group (GP) was not changed or decreased. These changes in frontal-lobe activity with extended video-game play may be similar to those observed during the early stages of addiction.

COMMENTS:  In this study college students played Internet video games for 6 straight weeks. Before and after measures were done. The ones with the highest cravings also had the most changes in their brains that indicate early addictions process. The control group, which played a less stimulating game, had no such brain changes.

 Cue induced positive motivational implicit response in young adults with internet gaming addiction (2011)

Psychiatry Res. 2011 Aug 3. Taiwan.

It suggests that the IGA group had a positive motivational implicit response to screenshots of online games. Implicit cognition is an important mechanism of dyscontrolled substance use, such as alcohol dependence. This result suggests that implicit cognition might also associate with dyscontrolled online gaming.

COMMENTS Another study measuring the characteristics of addiction that Internet addiction and substance abuse share. Every study that examines a characteristic finds that Internet addiction parallels chemical addictions.

Excessive Internet gaming and decision making: Do excessive World of Warcraft players have problems in decision making under risky conditions? (2011)

Psychiatry Res. 2011 Jun 16. University of Duisburg-Essen, Germany.

The results indicate that the reduced decision-making ability of EIG is comparable with patients with other forms of behavioral addiction (e.g. pathological gambling), impulse control disorders or substance abusers. Thus, these results suggest that excessive Internet gaming may be based on a myopia for the future, meaning that EIG prefer to play World of Warcraft despite the negative long-term consequences in social or work domains of life.

Comments: Use despite negative consequences is a hallmark of addiction.

Excessive computer game playing evidence for addiction and aggression? (2007)

 Cyberpsychol Behav. 2007 Apr;10(2):290-2. Berlin, Germany

A sample comprising of 7069 gamers answered two questionnaires online. Data revealed that 11.9% of participants (840 gamers) fulfilled diagnostic criteria of addiction concerning their gaming behavior.

Comments: 12% of video gamers can be classified as addicted

Functional magnetic resonance imaging of brain of college students with internet addiction (2011)

Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2011 Aug;36(8):744-9. [Article in Chinese]

Conclusions: Abnormal brain function and lateral activation of the right brain may exist in Internet Addiction.

 The neural basis of video gaming (2011).

Translational Psychiatry (2011)1, e53; doi:10.1038/tp.2011.53. Germany.

The key finding of higher volume in left ventral striatum associated with frequent video game playing is in conceptual accordance with findings of enhanced dopamine release during video game playing and excessive gambling in Parkinson’s patients due to dopaminergic medication.

Comments: Increased volume in the striatum (reward circuit) is associated with addiction.

The effect of family therapy on the changes in the severity of on-line game play and brain activity in adolescents with on-line game addiction.

Psychiatry Res. 2012 May 31;202(2):126-31. doi: 10.1016/j.pscychresns.2012.02.011.

We evaluated whether a brief 3-week family therapy intervention would change patterns of brain activation in response to affection and gaming cues in adolescents from dysfunctional families who met criteria for on-line game addiction.

Over 3 weeks, families were asked to carry out homework assignments focused on increasing family cohesion for more than 1 hour/day and 4 days/week. Before therapy, adolescents with on-line game addiction demonstrated decreased activity as measured by functional magnetic resonance imaging (fMRI) within the caudate, middle temporal gyrus, and occipital lobe in response to images depicting parental affection and increased activity of the middle frontal and inferior parietal in response scenes from on-line games, relative to healthy comparison subjects.

Improvement in perceived family cohesion following 3 weeks of treatment was associated with an increase in the activity of the caudate nucleus in response to affection stimuli and was inversely correlated with changes in on-line game playing time. With evidence of brain activation changes in response to on-line game playing cues and images depicting parental love, the present findings suggest that family cohesion may be an important factor in the treatment of problematic on-line game playing.

Comments: Bonding with loved ones altered the brain, and lessened addictive activities.

Pathological video game use among youths a two year longitudinal study. Pediatrics. 2011

Feb;127(2):e319-29. Epub 2011 Jan 17.

A 2-year, longitudinal, panel study was performed with a general elementary and secondary school population in Singapore, including 3034 children in grades 3, 4, 7, and 8. The prevalence of pathological gaming was similar to that in other countries (∼9%).

This study adds important information to the discussion about whether video game “addiction” is similar to other addictive behaviors, demonstrating that it can last for years and is not solely a symptom of comorbid disorders.

Comments: Study was about half 3rd and 4th graders, and half female, yet 9% were considered addicted to video games. What might the percentage be if the sample were all 7th and 8th grade males? Also found that children can have this addiction without existing co morbidities.

Pathological video-game use among youth ages 8 to 18: a national study (2009)

Psychol Sci. 2009 May;20(5):594-602. U.S.

Using a national sample, this study gathered information about video-gaming habits and parental involvement in gaming, to determine the percentage of youth who meet clinical-style criteria for pathological gaming. A Harris poll surveyed a randomly selected sample of 1,178 American youth ages 8 to 18. About 8% of video-game players in this sample exhibited pathological patterns of play.

Comments: US study finding 8% of American youth ages 8 to 18 meet the clinical criteria for pathological gaming.

Pathological videogaming among Singaporean youth.

Ann Acad Med Singapore. 2010 Nov;39(11):822-9.

Increase in internet use and video-gaming contributes to public concern on pathological or obsessive play of video games among children and adolescents worldwide. Nevertheless, little is known about the prevalence of pathological symptoms in video-gaming among Singaporean youth and the psychometric properties of instruments measuring pathological symptoms in video-gaming.

RESULTS: Of all the study participants, 8.7% were classified as pathological players with more boys reporting more pathological symptoms than girls.

CONCLUSION: The prevalence rate of pathological video-gaming among Singaporean youth is comparable with that from other countries studied thus far, and gender differences are also consistent with the findings of prior research.

COMMENT: Study found that 8.7% of young people can be classified as being video game addicts.

Specific cue reactivity on computer game related cues in excessive gamers (2007)

Neurosci. 2007 Jun;121(3):614-8.  Berlin Institute for Medical Psychology.

It has been posited that excessive computer game playing behavior, referred to as computer game addiction, meets criteria that have been internationally established to define drug addiction

Significant between-group differences in event-related potentials evoked by computer game related-cues were found at parietal regions and point to an increased emotional processing of these cues in excessive pathological players compared with casual players. These results are in concordance with the suggestion that addiction is characterized and maintained through sensitization of the mesolimbic dopaminergic system along with incentive salience of specific addiction-associated cues

Comments: Study compared computer gamers to non-gamers. Researchers found the gamers had reactions to pictures (cues) that mimicked drug addict’s responses to cues of drug use.

 The effect of methylphenidate on Internet video game play in children with attention-deficit/hyperactivity disorder (2009)

Compr Psychiatry. 2009 May-Jun;50(3):251-6.

A number of studies about attention-deficit/hyperactivity disorder (ADHD) and Internet video game play have examined the prefrontal cortex and dopaminergic system. Stimulants such as methylphenidate (MPH), given to treat ADHD, and video game play have been found to increase synaptic dopamine. We hypothesized that MPH treatment would reduce Internet use in subjects with co-occurring ADHD and Internet video game addictions.

After 8 weeks of treatment, the YIAS-K scores and Internet usage times were significantly reduced.

We suggest that Internet video game playing might be a means of self-medication for children with ADHD. In addition, we cautiously suggest that MPH might be evaluated as a potential treatment of Internet addiction.

COMMENTS: Methylphenidate is Ritalin. Which are they treating – addiction or ADHD? Addiction involves low dopamine, and ritalin elevates dopamine.

Diffusion tensor imaging reveals thalamus and posterior cingulate cortex abnormalities in internet gaming addicts.

J Psychiatr Res. 2012 Jun 22.

Internet gaming addiction (IGA) is increasingly recognized as a widespread disorder with serious psychological and health consequences. Diminished white matter integrity has been demonstrated in a wide range of other addictive disorders which share clinical characteristics with IGA. Abnormal white matter integrity in addictive populations has been associated with addiction severity, treatment response and cognitive impairments. Higher FA in the thalamus was associated with greater severity of internet addiction. Increased regional FA in individuals with internet gaming addiction may be a pre-existing vulnerability factor for IGA, or may arise secondary to IGA, perhaps as a direct result of excessive internet game playing.