Since the 1980’s there has been a movement towards a different conceptualization of addiction, from one that required ingesting a substance, to an alternative perspective that includes a focus on behavior. Through this new behavioral model of addiction, there has been an increased amount of attention considering the diversity of behaviors that could be considered addictive, for example, sex, shopping, gambling, and most recently, addictions associated with the internet. Most recently, the DSM-5 identified Internet Gaming Disorder as a condition warranting more attention from clinicians.
In the late 1980’s, the introduction of the Nintendo home gaming system generated continued interest in video games, and industry sales figures went from $100 million in 1985 to $4 billion in 1990. Over the last decade, as interactive games have migrated computer use over the internet, much of the online game research has examined the impacts of Massively Multiplayer Online Role-Playing Games (MMORPGs). These MMORPGs are virtual three dimensional worlds that allow game players to immerse themselves in different environments and interact with others via the internet and each of them is a self-contained society where game players have characters that can grow and evolve. In the United States, more than 45% of gamers play for over 20 hours a week and over 80% of those who play MMORPGs had indicated that they had gaming sessions that lasted for over eight consecutive hours. Today, popularity of online gaming is widespread, involving nearly one out of every two internet users, totaling 87 million users in the United States alone.
Some of the impacts of internet gaming that have been identified by researchers include: negative effects on social relationships, less social competence, performance decreases in work or school, decreased satisfaction with life, lower self-esteem, and a variety of physical problems.
One important note is that internet gaming addiction has all the common characteristics of other addictions (tolerance, withdrawal, using for longer, unsuccessful attempts to limit use, decrease in other activities, continued use despite negative impacts) but also uniquely gives the ‘user’ the feeling of being connected to a community. This factor is one that is important for clinicians to take note of when treating internet gaming addiction
Other important factors to examine when treating internet gaming addiction are the motivating factors that are keeping the gamer ‘hooked’. Some of these factors are the feeling of community that the gamer gets from playing, the sense of achievement that comes from gaming that the gamer finds lacking in other areas of life, the sense of escape from their real life (RL), being able to create an avatar that has characteristics that the gamer wishes they had, the feelings of control, or an outlet for aggression. Treatment of internet gaming addiction must examine these factors to individualize the treatment for each client’s specific motivational factors.