Department of Psychiatry
Penn Behavioral Health

PAH Outpatient Behavioral Health Clinic

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Newsletter: January 2012

Pathological Gaming

Scott Swan, MA


Although the term was first coined in 1997, Massive Multiplayer Online Roleplaying Games (MMORPG’s) have only recently received more mainstream attention among academic and clinical psychologists. Everquest and World of Warcraft are two of the most popular examples. These games offer virtual environments including complex factors such as the customization of characters, cooperative groups typically called guilds, long running plot lines involving political rivalries and alliances, and even full economies encouraging the buying, selling, and trading of commodities. Customization of the character’s appearance, or avatar, can be quite complex, including vast options such as race, gender, skin tone, hair color and style, build, height, and even facial features. Consciously or not, simply the choice of gender for one’s avatar can hold considerable meaning. Also, the “class” of a character can often be revealing (for example warrior, wizard, priest, or thief) and vocations are often available (such as blacksmith, herbalist, or jeweler).

Nick Yee, author of the Daedalus Project, has collected data from MMORPG players since 1999. His results have debunked several popular misconceptions about this subculture. For example, the average age of a MMORPG player is 26, while 50% of players have full-time employment, 36% are married, and 22% have children. Players spend on average 22 hours a week in the game environment, while 80% report playing simultaneously with someone they know in real life. Different needs are met according to the individual’s reasons for playing. The Bartle Test of Gamer Psychology originally rated players on four dimensions: Achievers, Explorers, Socializers, and Killers. For example, Killers thrive on the competitive aspect of a game, often succeeding in active leadership positions within guilds, and dominating the market share of in-game economies. On the other hand, Socializers thrive on immersing themselves in systems of groups and affiliations, fostering complex relationships and social obligations.

For the very reasons that many people are drawn to MMORPG environments (such as feelings of power and efficacy, the relative safety of social interaction, and opportunities to experiment with one’s identity), some players’ personal lives maladaptively begin to suffer due to excessive play. Roughly half of Yee’s respondents considered themselves addicted to these games, yet there is no professionally agreed-upon cutoff or classification system for applying the term addiction to this form of behavior. Factors that could typically be helpful in determining the extent to which gaming has become pathological include the relative salience of gaming in one’s life, mood modification associated with play, the development of tolerance, withdrawal, or relapse symptoms, the strength of the compulsion, and one’s overall well-being and functioning.

A recent study in Norway found that while 56% of their sample played video games, only 4% met criteria for excessive or compulsive gaming. A higher risk of problematic gaming was found in younger male respondents reporting higher anxiety or depression, and lower satisfaction with life. Interestingly, another study in the UK found that problematic MMORPG play was correlated negatively with agreeableness and impulse regulation, but not with emotional intelligence, openness, or extraversion as expected.

Exploration of the form and function of MMORPG’s in an individual’s life can be particularly helpful for understanding many factors, including personal identity, social anxiety, and unmet needs. Some gamers use their online identities to envision and experiment with an ideal self, while others unwittingly play out aspects of the self that would normally be unacceptable or disavowed. Content from an MMORPG can fuel a vital exploration of discrepancies between the real, ideal, or even shadow selves. Also, for many players, social roles develop within guilds and other groups, and these are often meaningful ways of experiencing efficacy. Compensating for problems with anxiety or bullying, these experiences can be compelling to the exclusion of relationships in real life. Bridging these rewarding roles to similar ones outside the game can provide opportunities for personal development, such that a gaming environment can become a transitional and experimental space, rather than simply a maladaptive coping strategy.

If you are working with patients who suffer from the problematic use of online games, or if you are concerned about a possible problem in yourself or a loved one, remember that such behavior always serves some important purpose, even at a price. It can be helpful to keep in mind that, especially to the extent that gaming actually represents play beyond compulsion, meaningful things can be learned if one fosters curiosity about the unique meaning and function it serves for the individual. Although the MMORPG culture can initially be difficult for an outsider to understand or appreciate, a little effort can go a long way towards understanding and growth.

For comparison, the A. C. Nielsen Co. reports that the average American watches 28 hours of television per week.