Game Addiction and Compulsion: Why Can’t We Just Turn It Off

The concept of being addicted to video games or the Internet is relatively new, but with recent research and abundant clinical evidence there is now little question as to whether their use can be addictive (Greenfield, 1999a, Aboujaoude, E., Koran, L.M., Gamel N, Large, M.D., Serpe R.T.,2006; Chih-Hung, K, et al., 2009; Chou, C., Condron L., & Belland, J.C., 2005; Young, 1998; Shaw, M.Y., Black, D.W., 2008). Young (1997) found that excessive use of the Internet for non-academic and non-professional reasons was associated with detrimental effects to academic and professional performance. Greenfield (1999c) found that approximately 6 percent of those who use the Internet seem to do so compulsively, often to a point of serious negative consequences. Other studies have found compulsive and addictive video game behaviors varying between 2 percent and 12 percent throughout the world.   In my original research published in 1999, we found that there were several key factors that seem to contribute to becoming addicted to these technologies. They are: accessibility, affordability, time-distortion, interactivity, anonymity and pleasurable stimulation. This is in addition to the potent presence of a highly compelling variable ratio reinforcement schedule that also seems to elevate dopamine throughout the reward centers of the mesolimbic system of the brain.

Some of the relevant factors leading to excessive video game play and video game addiction are: the degree of pleasure experienced and mediated by the novelty, unpredictability and power (stimulation intensity) of that reinforcement. The variability and unpredictability, in form or frequency, is what produces the strong resistance to extinction (stopping play)—which ultimately becomes the habit or addiction. This is why people spend hours and hours on the game searching for that ‘hit’, even when they may rationally know that they are wasting their time. What many non-gamers don’t understand is that this potential intellectual awareness is NOT sufficient to discontinue use (just as in other behavioral and substance-based addictions). The gamer, in fact, dissociates and experiences a loss of time and space and an altered mood and consciousness while gaming. They are typically NOT aware of the passage of time or the negative impact excessive gaming may be having on their academics, family, work, health, finances or possible legal issues. All these pleasurable hits lead to the acceleration of dopamine elevation, which is ultimately followed by a dopaminergic down-regulation, desensitization and depletion after long-term abuse. We know this from functional MRI and PET scan research on video game use, looking at glucose metabolism in the pleasure centers of the brain linked to perceived pleasure from the Internet and video games. In several studies, long-term and excessive ‘gamer’s brain’ can loom a lot like cocaine addicts and other addict’s with marked depletion of dopamine receptors in the pre-frontal cortex. Gamers don’t realize that the video game is shaping their behavior, and that they are not really controlling the game—rather it is controlling them in a subtle and powerful way.

In video and computer gaming the rewards come in the form of scores, levels within the game, local and world-wide rankings, the number of other player’s in your group/clan/guild, and the elevation of social stature within the specific game community or amongst your peers. Players have increased dopaminergic elevation, in part due to increased self-efficacy from the fact that they feel accomplished at the game. The game becomes something that they do well which further exacerbates their desire to be on it and play.

The fact that the repetitive video game abuse exists despite potential negative consequences is well established. What we find, particularly with video and computer games (including Smartphone and social media-based games), is that it seems to mimic the same neurobiological processes that occur in compulsive gambling as well as other substance use disorders. This is NOT to say that video game addiction or compulsion is exactly akin to drug use or abuse, but on a neurobiological level there are many similar properties. In essence, compulsive behavioral and substance disorders all follow similar neurobiological and psychological patterns.