A conclusion?

When I started blogging on the subject of excessive computer gaming, my assumption was that while some people seem to spend a great deal of time on gaming, often to the detriment of social life, education and work, this wouldn’t really apply as an addiction per se. Some of the initial evidence which I examined seemed to support my hypothesis, many of the case studies presented seemed to have social issues unrelated to gaming and were using gaming as an escapist retreat. Now that I’ve looked at the brain states generated by gaming such as flow state and the dopamine response, my ideas have had to be modified. I am now convinced that, while video game addiction has not been in the DSM manual for mental health conditions, if it looks, acts and smells like an addiction then it should be treated in that way. I must admit I was surprised by my findings but we have to follow the evidence!

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Dopamine with your Supermario?

Dopamine is the neuro-transmitter chemical released by the pleasure/reward mechanism of brain function. It is responsible for feelings of pleasure and enjoyment and reinforcement motivating a person to perform certain activities such as eating, sex, drug taking and the neural stimuli that become linked to these activities.

Koepp and colleagues in 1998 showed a massive increase in the amount of dopamine released in the brain was indeed observed during video game play, in particular in areas thought to control reward and learning. The level of increase was remarkable, being comparable to that observed when amphetamines are injected intravenously.

 The following instructive quote is from the 2007 Harvard Mental Heath Letter.

“Studies have shown that addictive drugs stimulate a reward circuit in the brain. The circuit provides incentives for action by registering the value of important experiences. Rewarding experiences trigger the release of the brain chemical dopamine, telling the brain “do it again.” What makes permanent recovery difficult is drug-induced change that creates lasting memories linking the drug to a pleasurable reward.”

So we can see that given the dopamine dump delivered to the brain from gaming, and the fact that this neurotransmitter feeds into mental processes of addiction, we can draw the conclusion that gaming can have a physiological hook.

 As the only study I could find which actually measured dopamine output after gaming was carried out in 1998, I wonder if the fact that recent games are more absorbing and compelling will have an impact on the amount of dopamine produced?

Refs:

Arias-Carrión O, Pöppel E (2007). “Dopamine, learning and reward-seeking behavior”. Act Neurobiol Exp 67 (4): 481–488. Accessed online at http://www.ane.pl/pdfdownload.php?art=6738 (13th Nov. 2011)

 Koepp, M. Et al. (1998)‘Evidence for striatal dopamine release during a video game’ Nature, 393

Achtman, R. L.; Green, C. S.; Bavelier, D.(2008) ‘Video games as a tool to train visual skills.’ Restorative Neurology & Neuroscience, Vol. 26 Issue 4/5, p435-446

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Go with The Flow

Given my reading so far about problem gaming, it’s clear that a small but significant number of players exhibit problem behaviour. What we need to be clear about are the reasons for this. In my post about the panorama article, it was clear that some, or all, of the case studies had emotional or mental issues which may have contributed to them using gaming as a form of escapism. While this explains the problems with some users, it’s by no means comprehensive. Anecdotally (personal and from friends) well adjusted players can also succumb to this excessive behaviour to the point that their social and professional lives suffer for it.

In an entirely un-related activity came across the concept of Flow State. This is, essentially, the mental state achieved when a person can be said to be ‘lost in their work’. The psychologist Mihaly Csikszentmihalyi has been studying this mental state since the 1960’s, interested by how some artists and writers become so immersed in their work they eschew food, drink and sleep in a state of high engagement in their task.

He identifies 10 factors accompanying flow state

  1. The task must be challenging and the subject must have a high skill level
  2. High level of concentration and focusing narrowly on the task
  3. A loss of self-conciousness and lack of awareness of self
  4. An altered sense of time, as if hours can pass but it feels only as if minutes have
  5. Immediate feedback so performance can be adjusted and improved
  6. Balance between subject’s skill level and difficulty of the challenge
  7. Sense of control
  8. Activity being carried out is rewarding to the subject
  9. Lack of awareness of bodily needs
  10.  Can become absorbed in the activity losing focus on the external world

 

You can watch Mihaly Csikszentmihalyi’s TED Talk here, it’s well worth the 20 minutes.

http://www.ted.com/talks/mihaly_csikszentmihalyi_on_flow.html

Holt’s 2000 Thesis study showed 22 novice games getting their flow on. They spent an hour and a half playing Crash Bandicoots 2 on the Playstation and almost all participants achieved more or less flow state during their experiences. I found this somewhat surprising as I think the Crash series of games have all been stinkers but hey-ho! 😉

In their 2004 study into why almost 2000 MMO players continued to play online games, their flow experience was considered to be a (or THE) major factor.

Csikszentmihalyi himself describes flow as able to “produce intense feelings of enjoyment and its improvement of performance results in satisfying achievement” so that any flow activity is intrinsically compelling in-and-of-itself. Therefore, it can be easily seen how such activity could easily come to take up a large amount of time for anyone participating in this mental state, often they will not be entirely aware of the passage of time whilst so engaged.

I think I might be getting close to answering some of my questions about compulsive gaming.

Next posting is hopefully going to look at how the dopamine response relates with gaming.

 Refs.

Holt, R. Examining Video Game Immersion as a Flow State. B.A. Thesis,Department of Psychology, Brock University, St. Catharines, Ontario, Canada, 2000. Accessed online at www.holtschool.com/headshrinker/R_Holt%20Game_Thesis.pdf (12th Nov 2011)

Why People Continue to Play Online Games: In Search of Critical Design Factors to Increase Customer Loyalty to Online Contents.Full Text Available By: Choi, Dongseong; Kim, Jinwoo. CyberPsychology & Behavior, Feb2004, Vol. 7 Issue 1, p11-24, 14p

Csikszentmihalyi, M. (1988), “The flow experience and its significance for human psychology”, in Csikszentmihalyi, M., Optimal experience: psychological studies of flow in consciousness, Cambridge, UK: Cambridge University Press, pp. 15–35

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Made me think!

As part of Questions in psychology, we have been asked to look at a classmate’s blog which has changed our thinking on a subject. This post http://cstfuturetech.wordpress.com/2011/11/04/how-young-is-too-young/ by Caledonian Superluminal Transport gave me pause for thought. I’ve always been pretty careful about the type of games and tv my kids are exposed to. I’m pretty strict with the ratings system as I don’t want them to be exposed to unsavory and violent imagary at a young age. I had not given any consideration to the possibilities of unsupervised interactions with unknown adults. While my kids don’t currently play any on-line games, the oldest one is 9 and will no doubt be getting to that point soon enough. I am now going to have to consider the answer to the “How old do I have to be to play Lego Universe?” question!

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Some people really should know better…

As Professor of synaptic pharmacology at Oxford University, Baroness Susan Greenfield is likely to know a thing or two about

  1. Brain function
  2. Basic Scientific Method

In a number of press articles over the last 2 months, she has been touting the line that says basically “video games and social media are re-wiring our brains to unknown outcome”. Recent reporting of her speech during the opening of a new wing of a girls’ school led to a slew of articles of variable quality.

The Telegraph is properly questioning and correct in attributing research where available.

http://www.telegraph.co.uk/health/children_shealth/8825655/Video-games-can-alter-childrens-brains.html

The Daily Mail – almost can’t help but go overboard with the headlines!

Computer games leave children with ‘dementia’ warns top neurologist.

http://www.dailymail.co.uk/health/article-2049040/Computer-games-leave-children-dementia-warns-neurologist.html?ITO=1490

Leading to the Hindustan Times

Facebook can trigger dementia

http://www.hindustantimes.com/Facebook-can-trigger-dementia/Article1-757139.aspx

The New Scientist asks a number of specific (and to my mind, pretty leading) questions in this profile, which she answers to poor effect.

http://www.newscientist.com/article/mg21128236.400-susan-greenfield-living-online-is-changing-our-brains.html

 

In fact looking at the huge variation between different publications on the reporting of this event is going to be my next post on this blog as I think it will be instructive to look at the differences in details.

So Greenfield makes a number of claims without any evidence to back them up.

The PlosOne study which is the only quoted source accepts that Internet Addiction Disorder is a valid psychiatric disorder (Chinese Government policy, despite not being included in the DSM-IV manual) and is carried out on 18 students. This is not really large enough scale to draw inferences to the population as a whole. Also we are not able to tell if heavy gaming/internet use caused the abnormalities apparently discovered or if their effects led the participants into a pattern of inappropriate computer usage.

http://www.plosone.org/article/info:doi/10.1371/journal.pone.0020708

The New Scientist asks a number of specific (and to my mind, pretty leading) questions in this profile, which she answers to poor effect.

http://www.newscientist.com/article/mg21128236.400-susan-greenfield-living-online-is-changing-our-brains.html

Lets look at the Shlock/Horror figure quoted of 2000 hours of screen time between a child’s 10th and 11th birthdays and break it down a little.

Firstly we need to take out the time kids of that age traditionally spend glued to the TV for the last 30 years (from my personal experiences both as a parent and having watch the same amount of TV as my peer group, more or less).

Weekdays – 1.5 hours of kids TV daily (whether morning or afternoon) and the same again of family viewing (X factor, Dr Who, Britain’s Got Stupid etc.). 3×5 = 15

Weekend – 1 DVD – 1.5 hours. Sport/cartoons – 1.5 hours. 2×3 = 6

Total 21 hours a week, multiply by 52 equals 1092. That’s just in TV time at home, before we factor in the time spent on games consoles or hand held devices on car journeys, cinema time, class-room PC use, emailing distant relatives and friends etc.

When we consider how much more screen time we’re exposed to as adults given the amount of time most jobs put us in front of a PC for, then a headline figure of 2000 hours doesn’t seem so extraordinary for most people.

So the rest of the claims

  • Addiction to technology could disable connections in the brain, literally ‘blowing the mind’.
  • Children’s brains could be left damaged and they could suffer temporary ‘dementia’ by playing computer games.

are left without evidence to back them up. As she received her CBE for her contribution to the public understanding of science she really ought to know better. I’ve heard the hypothesis…now where’s the evidence?

To End.

What concerns me with these articles is that there is an important issue being missed. There are some people who will use online gaming and the internet to excess and rather than blame the media, we need to figure out what drives these particular people to this behaviour. I’m hoping to look at this later in the semester.

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Panorama – Addicted to Games

So, as part of the Body Language material we were asked to look at a Panorama Episode from last year about computer gaming. The piece we were looking at was a small snippet about a boy who apparently loses his blink reflex during gaming and cries constantly while he plays. This was presented anecdotally by a photo-artist and would be considered poor evidence. What did strike me, however, was that I had watched the show when it was first aired but had been so incensed by what I thought was painfully poor journalism (I expect better from Panorama!) that I couldn’t finish watching it! For the purposes of my blog, I will conduct a close reading and criticism of the episode and see what we can make of it. Also it’s a bit like picking at a scab, I know it isn’t good but I just can’t leave it alone, perhaps this will get it out of my system!

00.00-01.30 Intro – Is it harmless fun or dangerous health hazard? 24 million people play in UK voice over imagery from games which are all violent.

01.30 The Reporter opens at a new game premier with the phrase “I just can’t believe how many people are here just to buy a game” this is value laden – the inference is that he thinks their time would be better spent in other ways.

02.47 Parental concerns – “think of the children” – questions “Is it too much for some people to handle?”.

0300 – 0440 In which we meet Joe Staley who has played since he was a small child. He plays GTA4 and COD4 (shooty games) and could play 12+ hours daily. Joe reports loss of social urges and says he would go 2 or 3 days without sleep to play. Apparently Joe has been kicked out of college and is in thousands of pounds of debt – PARTLY from playing games. No proof that it was gaming which caused either issues. Was joe getting good grades before he got so heavily into the X-Box?. Seems like an awful lot of games to buy to get into “thousands of pounds” of debt. Uncritical analysis from the reporter.

0440 So now we meet “Leo” – he’s happy to be filmed but wants to use a pseudonym(!?!).  WOW player for 3 years – played 12 hours a day for 2 years “you substitute the real world for this world”. Social problems for Leo are caused by his WOW habit such as poor uni grades, lack of socialisation and family issues. “This game is just a disease!” he said while playing WOW. Now he intends going “cold turkey”.

06.20 Playing Pong in National Media Museum in Bradford – we can trace development of games here. But we don’t, instead, we meet Robbie Cooper,  a Video Artist. He says there are huge differences in facial expression between TV watching and video gaming. “Computer games suck you in faster” he says. Can this not be explained by the difference between passive and interactive consumption of media? Assertion that one subject is so engrossed that he loses his blink reflex – no actual evidence presented of this.

07.51 First mention that game addiction is not recognized as medical condition despite many previous references to addiction.

08.00 Ian Livingstone CEO of gaming company Eidos, who says any worries are overblown like rock music and other “corrupters of the young” – disputes description of “addiction” and claims the same can be said of TV and other activities. He addresses issues of “addictive personalities” – i.e. problem gaming being a symptom of a problem, not the cause.

Reporter says there are growing calls from within “scientific community” to recognize this as a problem – but provides no examples or quotes.

A WHO report referenced – “A snapshot of the health of young people in Europe 2009”- Finally! Sources!! So I went and looked up the report at www.euro.who.int/__data/assets/pdf_file/0013/70114/E93036.pdf

 Online games addiction

 Online games abuse or addiction presents a serious threat to the mental health of young people in Europe. “Massive multiplayer online games” (MMOG) are computer games that can be played by thousand of players at the same time. The arising concept of online games addiction is associated with the fact that the young people who are involved in playing the games withdraw from real life and its challenges and duties, such as attending school, sleeping and eating properly and engaging with family life and friends; this can occur when they become increasingly intense and frequent users of MMOG.

In the HBSC survey, the number of adolescents referring to spending several hours a day using a computer, specifically on weekends and in countries that more recently were integrated into the EU, increased dramatically between 2002 and 2006. In some countries, withdrawal from family and school life was associated with computer use (10).

 This was a single paragraph in a huge report and as with the Panorama episode it asserts gaming as a “serious threat to the mental health of young people in Europe” without presenting evidence for this.

 09.00-09.30 Industry body UKIE rep highlights positive aspects of gaming. Michael Rawlins offers benefits of interactive over passive entertainment.  A whole 30 seconds on the positive side – nice balance Panorama!

 09.30 Opens with sinister music – We meet Chris Dando, who started truanting and playing WOW “all night”. Cites escapism as reason for playing – was playing for up to 20 hours a day – how is it possible this was missed by parents before it got to the 20 hour stage? Chris became violent when access was restricted. How can we be sure that this is uncommon behaviour for a teenage boy and caused by computer games?

 11.10 We meet the first health professional – psychiatrist Dr Richard Graham who says that “this is something that needs national recognition” also cites no evidence for his position. Also works for a Mental Health org – looking for another treatment revenue stream?

 12.00 Professor Mark Griffiths of Nottingham Trent Uni. Admits most experiences of VG’s are positive. Small minority experience problems with “things LIKE games” – implies games are not the only factor involved. Not enough research to define seriousness of problem. He asserts that the field is not considered “important enough” for research despite ongoing studies such as http://www.projectmassive.com/about.html

 (also search The Psychologist for computer and video games for other examples).

 13.00 Most games in UK are console but REAL problems are found in MMO games. Reporter suggests this is as we do not have universal superfast internet but implies that once it’s rolled out across the UK then we’ll be in the same boat, gaming wise, as South Korea.

 13.51 Korea’s broadband has “come at a price” – again with the value judgements!

 Journalist gets paid holiday to confirm prejudices from BBC, I meant to say vital research for show required travel to South Korea (value judgement of my own seeing as we’re bandying them around so freely).

 00.10 We meet the Boot Camp for addicted gamers. Sang Uk Kim – Example offered again of poor grades and lack of socialisation.  SK gov’t thinks 2% of children are addicted to games – again un-sourced assertion.

01.15 Reporter at SK gaming café – full of young people. Contrasts to western youth out drinking and clubbing – inference that this is a healthier activity than gaming. Highlights that SK has v popular gaming leagues, top gamers considered celebs etc. This gaming culture has been prevalent in SK for more than a decade. No mention how different from UK gaming culture that this is – all parallels made to SK invalid.  Apparently 12 gaming related deaths since 2005. Blood clotting/DVT issues – can we get figures for the same issues relating to TV watching or book reading for balance?

02.15 Refers to tragic case of baby starving to death while parents played VGs. Parents had previous mental health issues – “mentally not that stable to begin with”. “Problem gamers often have underlying emotional issues” say “experts”. Turns out Sang’s mother used to “hit him a lot”. His mother regrets not having talked and communicated with him in the past. Any surprise he retreated into a computer game?

06.00 Back to the UK and“Leo” and his WOW problems. Cold turkey hasn’t worked. He cites reasons for failure as boredom and missing his in-game friends.  Reporter seems incredulous.

08.20 Game designer Adrian Hon explains methods by which gamers get “hooked”.  Variable Rate of Reinforcement – random rewards keep users involved.  Back to Prof Mark Griffiths – says this only really impacts people with compulsive personalities.  See http://psychology.about.com/od/vindex/g/def_variablerat.htm

10.00 Reporter says he “took his findings” to industry body UKIE to discuss. Findings? A couple of anecdotes and a few experts who all say more research is needed don’t amount to findings!  Rawlins again – rebuts with the “you have no evidence” argument. Reporter asks why industry does not fund research into this. If you ask me, that’s like asking Diageo to fund research into alcoholism. Would we trust the results of industry funded research?

 To end we go back to Joe who recommends that instead of playing games, young people should “ring a friend and go out and get smashed”. Way to find a healthy solution to a problem there Joe! Back to Chris who says not to blame the game companies but suggests underlying problems with small number of players who let a game take over their life. WOW creators Blizzard responded with “Our games are meant to be fun…but like all forms of entertainment…day to day life should always take precedent”. Seems like sensible advice!

The End.

What have we learned?

We have learned that the reporter thinks that gaming is bad, seems to have set out with that in mind and developed an argument to that end based on assertion.

We have learned from “experts” that more study is needed before any conclusions can be drawn on then causality of problem gaming.

We have learned that some gamers have compulsion and impulse control issues that lead them to spend excessive amount of time gaming to the detriment of education/work/social lives.

That a small number of people will develop unhealthy behaviours around problem gaming.

 What have we NOT learned.

That video games, online or otherwise, are addictive in the same sense as alcohol or heroin.

That gaming was the most important contributing factor in the situations shown in what we can charitable call “case studies”.

In all, this was a poorly researched and written piece for what is meant to pass for the BBC’s flagship current affairs. Rafael Rowe, the journalist, set out with the conviction that games were addictive and potentially harmful. He found anecdotal evidence for his position and left the casual viewer with no gaming experience that faster DSL and video games were “a growing menace” to the healthy development of their children.

The really important issues that were missed here were firstly parental responsibility and secondly the real reasons for excessive gaming on the part of the subjects. These two issues may be linked but I will leave the reader to draw their own inference.

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XKCD

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