While playing video games for four hours a day can be worrisome
behavior, not everyone who does so is at risk of developing symptoms of
addiction or depression, new Johns Hopkins Bloomberg School of Public Health-led research
The findings, scheduled for publication in the March 2017 issue of the journal Computers in Human Behavior
suggest that while heavy gaming, particularly in boys, can be viewed as
a warning signal for parents, not everyone who plays many hours a day
is at risk for developing problems related to gaming.
‘Teenagers who play video games for more than four hours a day suffer from symptoms of depression, but frequent use of social media and instant messaging may mitigate symptoms of game addiction in these teens.’
Some of the
downsides of gaming, the researchers say, may be balanced out in those
who are socially engaged either online or in real life with friends. In
fact, the researchers say, boys with high-quality friendships appear
immune from the depression associated with heavy use of video games.
Researchers say the findings could inform organizations such as the
World Health Organization and the American Psychiatric Association that
have proposed making Internet Gaming Disorder a condition that would be
on par with disorders relating to substance abuse and pathological
"Teenagers who play video games for more than four hours a day suffer
from symptoms of depression, but frequent use of social media and
instant messaging may mitigate symptoms of game addiction in these
teens," says study leader Michelle Colder Carras, a post-doctoral researcher in the Department of Mental Health at the
Bloomberg School. "If these adolescents are sitting around playing games
together with their friends or chatting regularly with their friends
online as they play, this could be part of a perfectly normal
developmental pattern. We shouldn't assume all of them have a problem."
Colder Carras and her colleagues analyzed 2009-2012 data from the
annual Monitor Internet and Youth study, a school-based survey of nearly
10,000 teenagers across the Netherlands. Researchers asked the teens
about how often they play video games, use social media and instant
messaging, and about their friendships. The survey also had the teens
answer questions about addictive behaviors, including whether they feel
like they can stop gaming if they want to and whether they get irritable
if they're not playing. While only Dutch teens participated in the
survey, Colder Carras and her colleagues believe that the responses
would likely be similar in teens in other developed nations such as the
In doing their statistical analysis, the researchers focused on many
subsets of respondents, notably heavy gamers who also reported frequent
online social interactions and those who did not. They found that
symptoms of video game addiction depend not only on video game play but
also on concurrent levels of online communication and that those who
were socially active online reported fewer symptoms of game addiction.
All of the subsets of heavy gamers had more depressive symptoms, but
boys who were not very social online showed more loneliness and anxiety,
regardless of the quality of their friendships. Girls who gamed
extensively but were also very active in online social settings had less
loneliness and social anxiety but also lower self-esteem.
Internet Gaming Disorder was proposed for further study in the most
recent edition of the Diagnostic and Statistical Manual of Mental
Disorders (DSM-5), known as the bible of the American Psychiatric
Association. Questions remain about how to best distinguish engaged
gamers - who have fewer symptoms of addiction and depression problems -
from problematic gamers, or those who have a loss of control over gaming
associated with problems that lead to significant harm or distress.
To be sure, Colder Carras says, most of the adolescents who reported
playing video games for four or more hours a day did report depressive
symptoms, possibly reflecting problems that need treatment. But it
shouldn't be assumed that all those adolescents have a gaming-related
disorder that needs treating. Parents and clinicians need to look at the
underlying reasons for why the teens play so many video games.
"Our findings open up the idea that maybe playing a lot of video
games can be part of having an active social life. Instead of being
concerned about the game playing, we should focus on those who also lack
a social life or have other problems," she says. "Rather than seeing a
lot of video game playing and worrying that this reflects gaming-related
problems, parents and clinicians should figure out whether these teens
also have high-quality friendships. It could just be that they have good
friends who they like to hang out and play video games with. That is
probably not a worrisome equation."
A key, she says, is looking for the reasons why the teen spends so
many hours behind a console or computer. Is it because the teen is too
depressed to cope with the real world and uses gaming as an attempt to
stave off loneliness? Or are games a way to socialize and bond with
others, either in person or through interactive online games?
Colder Carras says that while older teens can usually recognize when
their use of the internet is problematic, younger ones may need help to
put everything into perspective and be given tools on how to handle
potential gaming-related issues that may arise.