Daniel L. King

Video game structural characteristics: a new psychological taxonomy

Excessive video game playing behaviour may be influenced by a variety of factors including the structural characteristics of video games. Structural characteristics refer to those features inherent within the video game itself that may facilitate initiation, development and maintenance of video game playing over time. Numerous structural characteristics that influence gambling frequency and expenditure have been identified in the gambling literature, and some researchers have drawn comparisons between the rewarding elements in video gaming and those in slot machine gambling. However, there have been few rigorous attempts to classify and organise the psycho-structural elements of video games in a similar way to gambling. In order to aid current psychological understanding of problem video game playing and guide further research questions in this area, a new taxonomy of video game features is proposed, which includes: (a) social features, (b) manipulation and control features, (c) narrative and identity features, (d) reward and punishment features, and (e) presentation features. Each category is supported with relevant theory and research, where available, and the implications of these features for excessive video game playing are discussed.

The convergence of gambling and digital media: Implications for gambling in young people

Adolescents’ use of the Internet and other digital media for the purpose of gambling represents a serious concern in modern society. This paper overviews some of the available monetary and non-monetary forms of gambling within new digital and online media and monetary forms of games with gambling-like experiences. With reference to current psychological knowledge on the risk factors that promote adolescent gambling, it is suggested that new gambling technologies may: (a) make gambling more accessible and attractive to young people, (b) may promote factually incorrect information about gambling, (c) provide an easy escape from real world problems such as depression and social isolation, (d) create a gambling environment that easily facilitates peer pressures to gamble, (e) ease parental transmission of gambling attitudes and beliefs, and (f) make gambling more ubiquitous and socially acceptable. The unique risks of Internet gambling for young people are critically discussed, as well as the lack of restricted classification for video games and other media that feature interactive, non-monetary forms of gambling.

Video Game Addiction: Past, Present and Future

Gaming addiction has become a topic of increasing research interest. The last decade has witnessed a significant increase in the number of empirical studies examining various aspects of problematic video game play and video game addiction. This paper begins with a brief past history of how research into video game addiction has changed over the last three decades (i.e., the 1980s, 1990s and 2000s). It then examines more thoroughly the contemporary research literature by analyzing the (i) prevalence of problematic video game use and video game addiction, (ii) negative consequences of excessive video game use, (iii) factors associated with problematic video game use and video game addiction, and (iv) the treatment of problematic video game use and video game addiction. The paper concludes by looking at the trends in the field and a somewhat theoretical examination of what the future of video game addiction might be.

Clinical features and axis I comorbidity of Australian adolescent pathological Internet and video game users

Objectives: Although there is growing international recognition of pathological technology use (PTU) in adolescence, there has been a paucity of empirical research conducted in Australia. This study was designed to assess the clinical features of pathological video gaming (PVG) and pathological Internet use (PIU) in a normative Australian adolescent population. A secondary objective was to investigate the axis I comorbidities associated with PIU and video gaming. Method: A total of 1287 South Australian secondary school students aged 12–18 years were recruited. Participants were assessed using the PTU checklist, Revised Children’s Anxiety and Depression Scale, Social Anxiety Scale for Adolescents, revised UCLA Loneliness Scale, and Teenage Inventory of Social Skills. Adolescents who met the criteria for PVG or PIU or both were compared to normal adolescents in terms of axis I comorbidity. Results: The prevalence rates of PIU and PVG were 6.4% and 1.8%, respectively. A subgroup with co-occurring PIU and PVG was identified (3.3%). The most distinguishing clinical features of PTU were withdrawal, tolerance, lies and secrecy, and conflict. Symptoms of preoccupation, inability to self-limit, and using technology as an escape were commonly reported by adolescents without PTU, and therefore may be less useful as clinical indicators. Depression, panic disorder, and separation anxiety were most prevalent among adolescents with PIU. Conclusions: PTU among Australian adolescents remains an issue warranting clinical concern. These results suggest an emerging trend towards the greater uptake and use of the Internet among female adolescents, with associated PIU. Although there exists an overlap of PTU disorders, adolescents with PIU appear to be at greater risk of axis I comorbidity than adolescents with PVG alone. Further research with an emphasis on validation techniques, such as verified identification of harm, may enable an informed consensus on the definition and diagnosis of PTU.

Cognitive‐Behavioral Approaches to Outpatient Treatment of Internet Addiction in Children and Adolescents

Excessive and potentially addictive use of the Internet among children and adolescents has emerged as a major concern in recent times. Internet addiction is often conceptualized as an impulse control disorder, with features similar to pathological gambling. However, there remains considerable debate about the core components, etiological processes, course, and maintaining factors of the disorder. This article presents a case study of a 16-year-old male with generalized pathological Internet use. Critical issues relevant to case conceptualization, assessment, and choice of therapy are examined. Although the evidence base is limited in this emerging area of clinical psychology, we provide a summary of empirically supported cognitive-behavioral techniques for Internet addiction.

Internet gaming disorder treatment: a review of definitions of diagnosis and treatment outcome.

OBJECTIVE Internet gaming disorder (IGD) is a new disorder currently positioned in the appendix of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Few clinical studies report that psychological and pharmacological interventions can significantly reduce the severity of IGD symptomatology. The aim of this review was to assess current knowledge of the short- and long-term benefits of IGD interventions. This review presents a systematic evaluation of definitions of diagnosis and treatment outcomes employed in IGD treatment studies, including an assessment of goodness of fit with the DSM-5 classification. METHOD A computer database search of Academic Search Premier, PubMed, PsychINFO, ScienceDirect, Web of Science, and Google Scholar was conducted to identify all available research evidence on Internet gaming disorder treatment (N = 8 studies). Diagnostic and treatment outcome parameters were systematically evaluated. RESULTS Several weaknesses of IGD treatment literature were identified. Only 2 treatment studies have employed an equivalent method of diagnosis for IGD. Studies have not assessed formative change in diagnostic status at posttreatment or follow-up. Duration of follow-up has been inadequate to assess relapse and remission. Posttreatment assessment has been predominantly limited to IGD symptomatology, comorbidity, and frequency of gaming behavior. CONCLUSION Currently, there is insufficient evidence to warrant suggestion that trialled IGD interventions confer a long-term therapeutic benefit. Several improvements to study design and reporting are proposed to guide future studies of IGD.

Adolescent simulated gambling via digital and social media: An emerging problem

Recently, there has been significant expansion in the range of gambling activities supported by digital technology. The convergence of gambling and digital media is of particular concern with respect to the immense potential for earlier age of gambling involvement, and development of positive attitudes and/or behavioral intentions toward gambling. This study examined the prevalence of adolescent involvement in a range of digital and social media gambling activities, and the association between exposure to, and involvement in, simulated gambling and monetary gambling and indicators of pathological gambling risk. A total of 1287 adolescents aged 12-17years were recruited from seven secondary schools in Adelaide, South Australia. The results indicated that a significant proportion of young people engage in a range of simulated gambling activities via internet gambling sites, social media, smartphone applications, and video-games. A logistic regression analysis showed that adolescents with a history of engagement in simulated gambling activities appear to be at greater risk of endorsing indicators of pathological gambling. These findings highlight the need for further research on the potential risks of early exposure to simulated gambling activities, as well as greater consideration of the need for regulation and monitoring of gambling activity via digital technologies.

Clinical interventions for technology-based problems: excessive Internet and video game use

Psychological problems arising from excessive use of digital technologies, particularly in relation to the Internet and video games, are of growing clinical concern. Although there is no consensus whether technology-based problems constitute primary psychopathologies that should be recognized as clinical disorders, a significant number of problem users have used clinical treatment services. There is therefore a growing need for the mental health community to be aware of available clinical treatments for technology-based problem behaviors and the efficacy of these treatments. This article presents an overview of the prevalence of technology-based problems in Eastern and Western countries and the known cognitive-behavioral dimensions of problematic technology use. We also consider issues related to the assessment of technology-based problems, and critically review clinical treatments for technology-based problems.

A taxonomy of gambling and casino games via social media and online technologies

The increased popularity of casino games on social media platforms has prompted international jurisdictions to consider the extent to which these games may be similar to Internet gambling activities and therefore subject to regulatory action. Gambling themes are popular in video and computer games, and simulated-gambling activities are commonly offered by gambling operators as a way of enticing users to gamble online with money. However, little research has evaluated the impact of the digital convergence of gambling and gaming. The lack of a clear definition of online gambling-themed activities to guide such research undertakings represents a significant hurdle to the fields of gambling and gaming. Based on a review of the extant literature, this article proposes a taxonomy to distinguish between many types of online activities with gambling-themed content. This taxonomy suggests that the principal features that differentiate online gambling games include the requirement for payment, the role of skill, the type of platform and the centrality of the gambling theme. The proposed hierarchical framework aims to promote clear and consistent discussion to guide ongoing investigation of new and emerging Internet gambling and gaming technologies.

Issues for DSM-5: video-gaming disorder?

Australian & New Zealand Journal of Psychiatry, 47(1) Internet addiction is a contentious disorder (Pies, 2009). To date, addiction researchers have questioned its construct validity (Shaffer et al., 2000); the precision of definitional criteria (Blaszczynski, 2008; Czincz and Hechanova, 2009); clinical formulation and overlap with other addictive disorders (Sim et al., 2012); aetiology and risk factors (Kuss and Griffiths, 2012); and, the quality of intervention studies (King et al., 2011, 2012). Vladan Starcevic’s insightful commentary (Starcevic, 2012) continues this line of critical analysis. Starcevic highlights in particular that there is no clear consensus as to whether internet addiction ‘exists’, given the variability in terminology, methodology and psychometric measurement used across studies. Recent developments in regard to the DSM-5 have significant bearing on this debate. On 1 May 2012, the DSM-5 Task Force and Work Groups proposed that internet use disorder, which refers primarily to maladaptive video-gaming (or ‘internet gaming’) behaviour, should be included in Section III of the DSM-5 as the subject of further empirical inquiry. The proposed DSM-5 category of internet use disorder was intended to provide greater clarity to the clinical formulation of internet-related disorders. However, we argue that, in practice, this diagnostic category may promote further confusion with its conflation of video-gaming and internet use for other purposes. The lack of a standard definition for internet-related disorders has led to conflicting accounts of the underlying pathology and its symptoms, and how it should be diagnosed or measured (Griffiths, 2008; Weinstein and Lejoyeux, 2010; Wood, 2008). Thus, while many researchers in the field have called for consensus on the criteria for internet-related disorders, they have meanwhile created their own distinct model of the disorder, often with an accompanying assessment tool. By our count, over a dozen assessment tools for problematic video-gaming have been used in research studies since the year 2000. Starcevic provides an example of this divergence in assessment in citing research by his colleagues on ‘problem video game use’ (PVGU) (Porter et al., 2010). He notes that PVGU criteria differ from prevailing models of ‘excessive’ and ‘pathological’ videogaming. Specifically, the PVGU concept does not refer to tolerance (i.e., the process whereby increasing amounts of video-game play are required to achieve the former moodmodifying effects). Starcevic argues that it is not clear whether tolerance is associated with video-gaming behaviour, and states that the research evidence is ‘equivocal’. To our knowledge, at least three widely used instruments of pathological video-gaming assess tolerance (i.e., Problem Videogame Playing Scale (Salguero and Moran, 2002), Game Addiction Scale (Lemmens et al., 2009), Online Game Addiction Scale for Adolescents (Wan and Chiou, 2006)). Therefore, divergent evidence on tolerance in video-gaming may be a reflection of the fact that differing assessment tools have been used across studies, some of which measure tolerance and some of which do not, rather than representing a true division in empirical findings. This again highlights the difficulty in comparing research findings when different definitions are employed, and thus the need for a standardised approach to classification of internet-related disorders. Another important theoretical issue raised by Starcevic is that internet addiction is a misnomer because it refers to an addiction to a ‘delivery mechanism’. In particular, he states: