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In excess: How can we best assess gaming addiction?
by Mark Griffiths on 04/25/14 02:22:00 am   Expert Blogs   Featured Blogs

The following blog post, unless otherwise noted, was written by a member of Gamasutra’s community.
The thoughts and opinions expressed are those of the writer and not Gamasutra or its parent company.


To date, there has been a lack of agreement among researchers as to the precise name and definition of video game addiction (both online and offline). However, there is a general consensus that excessive gaming can lead to a wide range of physical and psychological problems, and therefore necessary to explore the nature and the scale of the phenomenon. In doing so, it is important to use psychometrically validated measurement tools. Unfortunately, there is lack of these in the literature so far. Along with some colleagues (led by Dr. Daniel King), we published a paper examining all the instruments that have been used to assess problematic video gaming in the journal Clinical Psychology Review.

Our paper noted that pathological video-gaming, or its proposed classification by the American Psychiatric Association of “Internet Gaming Disorder” (in the latest 2013 [fifth] edition of the Diagnostic and Statistical Manual of Mental Disorders [DSM-5]), is of increasing interest to scholars and practitioners in allied health disciplines. Our systematic review was designed to evaluate the standards in pathological video-gaming instrumentation and guidelines for sound psychometric assessment. We assessed a total of 63 quantitative studies, including eighteen instruments (representing 58,415 participants). Our findings indicated that the instruments were generally characterized as inconsistent. The strengths of available measures included: (i) short length and ease of scoring, (ii) excellent internal consistency and convergent validity, and (iii) potentially adequate data for development of standardized norms for adolescent populations. However, the key limitations included: (a) inconsistent coverage of core addiction indicators, (b) varying cut-off scores to indicate clinical status, (c) a lack of a temporal dimension, (d) untested or inconsistent dimensionality, and (e) inadequate data on predictive validity and inter-rater reliability. An emerging consensus suggested that pathological video-gaming is commonly defined by (1) withdrawal, (2) loss of control, and (3) conflict.

Most of the tools in current use have been modified from other questionnaires without their reliability and validity being tested. This includes those based on internet addiction (e.g., Kimberley Young’s Internet Addiction Test), pathological gambling (using the DSM criteria), or behavioural addictions. An additional problem is that many of the measures focus exclusively on Massively Multiplayer Online Role Playing Game (MMORPG) users. In order to cover the whole range of online gamers, I recently helped co-develop an empirically based questionnaire consisting of 18 items called the Problematic Online Gaming Questionnaire (POGQ) that we published in the journal PLoS ONE.

In a 2011 study, some of my Hungarian research colleagues (led by Dr. Koronczai) claimed in the journal Cyberpsychology, Behavior and Social Networking that a suitable measure should fit the following six requirements. It should have: (i) comprehensiveness (i.e., examining more, possibly all, aspects of problematic online gaming); (ii) brevity (in order to assess the more impulsive population as well and to facilitate incorporation into time-limited surveys); (iii) reliability and validity for different methods of data collection (e.g., online, paper-and-pencil self-rating, face-to-face); (iv) reliability and validity for different age groups (e.g., adolescents and adults); (v) cross-cultural reliability and validity; (vi) been validated on clinical samples. The measure should also serve as a basis for defining cutoff scores for dependence.

The POGQ is a short comprehensive measure and therefore fits to the first two requirements. It was also found to be a psychometrically adequate measure in a large convenience sample of adult online gamers. However, there is great need for a measure that is also suitable for survey type research in an offline data collection setting, and is reliable and valid for adolescents. Therefore, we modified the original POGQ to a 12-item version and applied it to an offline adolescent sample using pen-and-pencil data collection method (and published the findings in the journal Cyberpsychology, Behavior and Social Networking. This way both the third and the fourth points of the six criteria above were fulfilled.

The aim of our more recent study was twofold. The first goal was to explore the psychometric properties of the POGQ on a nationally representative adolescent sample as until recently it had only been used on adult gamer samples. The second goal was to assess the prevalence of problematic online gaming in a nationwide adolescent sample, as there have been only two nationally representative studies carried out on adolescents in the US and Germany.

The results of our study showed that the 12-item POGQ-SF had appropriate psychometric properties according to the statistical analysis performed on a nationally representative sample of adolescents. The analysis showed that 8.2% of gamers (4.6% of the whole sample) belonged to the at-risk group. We also found an additional 13.3% of adolescents (23.9% of gamers) showed symptoms of problematic online gaming above the average. Gamers belonging to the at-risk class were more likely to be male, more likely to play for five or more hours a day, have lower grade point average, have lower self-esteem, and higher depression score than gamers belonging to the other two classes. All these results are in line with findings of other studies confirming the validity of the measurement tool.

Despite the robustness of the study, an important limitation was that it was only carried out among Hungarian adolescents. For generalizability it must be applied and psychometrically tested on cross-cultural samples as well (see the aforementioned criterion 5). It is also a future goal to confirm the POGQ on clinical samples (criterion 6). This would allow all the six criteria requirements presented in the introduction to be met. The current POGQ is both short (criterion 2) and comprehensive (criterion 1), and assesses problematic online gaming in different age groups (criterion 4) with different data collection methods (criteria 3). We hope that the POGQ will facilitate future research and will serve as an adequate tool for assessing problematic online gaming.

Dr Mark Griffiths, Professor of Gambling Studies, International Gaming Research Unit, Nottingham Trent University, Nottingham, UK

Further reading

Demetrovics, Z., Urbán, R., Nagygyörgy, K., Farkas, J., Griffiths, M.D., Pápay, O. & Oláh, A. (2012). The development of the Problematic Online Gaming Questionnaire (POGQ). PLoS ONE, 7(5): e36417. doi:10.1371/journal.pone.0036417.

Gentile, D. (2009). Pathological video-game use among youth ages 8 to 18: A national study. Psychological Science, 20, 594-602.

Gentile, D.A., Choo, H., Liau, A., et al. (2011). Pathological video game use among youths: A two-year longitudinal study. Pediatrics, 127, E319-E329.

Griffiths, M.D., King, D.L. & Demetrovics, Z. (2014). DSM-5 Internet Gaming Disorder needs a unified approach to assessment. Neuropsychiatry, 4(1), 1-4.

King, D.L., Haagsma, M.C., Delfabbro, P.H., Gradisar, M.S., Griffiths, M.D. (2013). Toward a consensus definition of pathological video-gaming: A systematic review of psychometric assessment tools. Clinical Psychology Review, in press.

Koronczai, B., Urban, R., Kokonyei, G., et al. (2011). Confirmation of the three-factor model of problematic internet use on off-line adolescent and adult samples. Cyberpsychology, Behavior and Social Networking, 14, 657–664.

Kuss, D.J. & Griffiths, M.D. (2012). Online gaming addiction in children and adolescents: A review of empirical reearch. Journal of Behavioral Addictions, 1, 3-22.

Pápay, O., Urbán, R., Griffiths, M.D., Nagygyörgy, K., Farkas, J. Kökönyei, G., Felvinczi, K., Oláh, A., Elekes, Z., Demetrovics, Z. (2013). Psychometric properties of the Problematic Online Gaming Questionnaire Short-Form (POGQ-SF) and prevalence of problematic online gaming in a national sample of adolescents. Cyberpsychology, Behavior, and Social Networking, in press.

Rehbein, F., Kleimann, M, & Mossle, T. (2010). Prevalence and risk factors of video game dependency in adolescence: results of a German nationwide survey. CyberPsychology, Behavior and Social Networking, 13, 269–277.

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Mitchell Nelson
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I am a maker of MMO and traditional multiplayer games. The products made by our studio are known for dedicated, long-term players with many hours invested. I follow and cautiously apply behavioral game design methods that are intended to trigger neurochemical events.

Learning by playing is a natural behavior in animals and people. We are wired for it. These activities can induce a state of flow, resulting in temporal distortion, and changes in dopamine, serotonin and norepinephrine levels and so, create in players a sense of challenge and reward stronger than other forms of entertainment. In fact, since ludic entertainment is necessarily educational, it is less harmful, in my view, than passive viewing of sports, films, television or web sites, where imprinting chemical rewards are produced by idleness.

Despite the many targeted studies over the last 20 years trying to find the evil in video games, no real dark cloud has been discovered. Work by people, like cognitive researcher Daphne Bavelier, show the real improvements in brain functions created by playing even the most aggressive, violent games. Those improvements are available to people that previously played no video games, for a mere 100 minute investment and the changes last for months.

When I see a post like this, I wonder why concerned professionals are not investigating instead, the known problem with F2P games that manipulate users for money, much like gambling. A requirement of games is to exist in a non-real space where the player is protected from real world harm. Thus gambling and some F2P games commit a ludic fallacy when they continuously cajole real money from players. We can understand how those games can trigger, then withhold chemical rewards to manipulate decision making, compulsion, attention span and desire. Why not start there, where measurable harm is evident.

Wojtek Kawczynski
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Mitchell and Mark, could you guys take a look at this:
ame_Addiction_Issue.php and see if you could offer some advice please?

Ara Shirinian
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Hello Mitchell and Mark,

Many examples of F2P mechanics appear to have a rather insidious relationship with the power of learning by playing which you described so succinctly.

There is a lot of subtlety in the dynamics here, for example one aspect that I do not hear a lot of precise discussion about is how such games first engage players via the learning by playing aspect, then they surreptitiously, gradually, artifically diminish what more can be accomplished by the player via learning, while offering a temporary relief of that anxiety via a $$$ sales proposition.

I think it is important for us to understand how these things are really working, beyond just knowing that player anxiety is being exploited, because there is a lot more to it than just that.

You may be interested in watching a talk I recently gave where I go into great depth about just how these mechanical devices actually work upon the player psychologically, in both the short and long term:

Stephen Corwin
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It's funny to me how everyone loves to criticize video games and play the addiction card. In my experience, video games are far better than other past time addictions such as watching TV, which I imagine is as common of an addiction. Video games are great! They are mentally stimulating and keep kids more or less out of trouble. I would much rather see my kid interacting with others on a video game, than see him on the couch for several hours like a zombie vegetable to the TV.

On a side note: most of my common history knowledge was actually reinforced because of I grew up playing Age of Empires/Call of Duty/Civilization/Oregon Trail. Not that I would replace the books entirely with video games, but it definitely helps reinforce names, places, and events.

Vos Normandy
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I disagree Stephen, to a point. Yes, it's better than being strung out on drugs but we're raising a generation of kids whose primary interactions are online and via text. They don't have the skills to carry on a face-to-face conversation let alone even look you in the eye when speaking.

Christopher Landry
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Which version of the POGQ did you use? The one I found at
e.0036417 in Appendix S1 has 18 questions, not 12. I have to assume this is at least the baseline document used, since some of the authors are the same.

Here's the issue, though. Looking over it myself, I can easily cut out half or more of those questions as repetititious, useless, or misleading.

One example:
3. How often do you feel depressed or irritable when not gaming only for these feelings to disappear when you start playing?
9. How often do you get irritable, restless or anxious when you cannot play games as much as you want?
14. How often do you get restless or irritable if you are unable to play games for a few days?
18. How often do you get irritable or upset when you cannot play?

Q.3 can be considered somewhat different only because of the last half asking if the feelings disappear when playing a game. The other three questions are completely unnecessary revisions of the same theme, without adding anything new between them. I'd ditch Q.9, Q.14, and Q.18 entirely if I was actually using this questionnaire for a study.

The worst offenders, though, are the ones that seem to gradually shift from asking about whether Flow is achieved when you are gaming (almost universally agreed to be a mark of a good game and a good time playing said game), to poor time management skills, then to family and friends issues. All subtly related, but do we really need this whole spectrum covered in such detail? And why are there questions about Flow in there at all if poor time management and poor interpersonal communications should be the real concerns?

In the list below I've changed the order around to illustrate what I mean by a subtle shift from one concept to the next. I can almost feel the accusing parent shaking their finger at me as I go through this list, as if it’s a slippery slope and no amount of contentiousness (like setting an alarm for that important date with your SO) would ever solve the issue; you’re doomed from the start!

13. How often do you feel time stops while gaming?
8. How often do you lose track of time when gaming?
2. How often do you play longer than originally planned?
15. How often do you feel that gaming causes problems for you in your life?
12. How often do you neglect other activities because you would rather game?
17. How often are you so immersed in gaming that you forget to eat?
4. How often do you feel that you should reduce the amount of time you spend gaming?
10. How often do you unsuccessfully try to reduce the time you spend on gaming?
6. How often do you fail to meet up with a friend because you were gaming?
16. How often do you choose gaming over going out with someone?
5. How often do the people around you complain that you are gaming too much?
11. How often do you argue with your parents and/or your partner because of gaming?

Cut out the first three of those questions altogether (Q.13, Q.8, and Q.2), they’re just referring to the phenomenon of Flow, which is not a bad thing to experience while doing ANYTHING you enjoy, be it riding a bicycle, painting, reading, working out at the gym, or playing a game.

Q.15 is so generic it could be true for nearly every participant in the questionnaire and it would be completely meaningless as a data point. As with the Flow questions, any activity that a person enjoys doing can “cause problems for [them] in [their] life” simply by being an enjoyable past time that occupies a significant portion of their attention and time.

The next four (Q.12, Q.17, Q.4, and Q10) are just different ways to express the idea that the person has bad time management issues. One question would suffice here, perhaps Q.12. Or even two of them, since Q.4 is a slightly different take on the issue.

We start to see the interpersonal issues interspersed with poor time management in the following two questions (Q.6 and Q.16). Couldn’t Q.6 suffice, on its own, to cover the concepts in both of those questions? If necessary, change “friend” to “someone” and it’s fine.

Finally, only interpersonal issues discussed in Q.5 and Q.11. Here's your parent waggling the accusing finger at you, reader! Again, couldn’t Q.5 suffice alone here?

Honestly, with a questionnaire even close to the one I found here, I don’t see how any of your data could be relied upon as substantially relevant regarding the topic being researched.