Video game addiction in teens: A problem or a myth?

By Nestor Lopez-Duran PhD

During the last decade there has been much debate about the dangers of excessive video game playing. Some have argued that excessive video game playing can become an addiction and can lead to many negative consequences. Yet, much of the research linking video game playing to negative factors had methodological limitations that prevented the researchers from determining what causes what. For example, it is difficult to determine whether video game leads to negative outcomes (e.g., excessive video game playing leads to depression) or instead whether negative factors lead to more video game playing (depression leads to more video game playing).

The study reported in Pediatrics provides data from over 3,000 children and adolescents attending 3rd, 7th, and 8th grade in Singapore and who were surveyed annually between 2007 and 2009.

The authors were interested in answering a number of questions, including:

1. What are the rates of pathological gaming? (see below for a definition)

2. What factors predict becoming a pathological gamer?

3. What are the negative consequences of pathological gaming?

To answer these questions the authors asked the participants to complete a series of surveys that measured the kids social skills, impulsivity, social phobia, depression, anxiety, parent-child relationship quality, and school performance. The surveys also included an assessment of gaming patterns and experiences in order to determine whether the child met the criteria for pathological gaming

What is pathological gaming?

The authors based their definition of pathological gaming on the criteria used by psychiatrists to diagnose pathological gambling.  Specifically, the authors classified a child as engaging in pathological gaming if the child endorsed 5 out of 10 specific symptoms. Although the authors did not explicatively define these symptoms in the article, here are the 10 symptoms of pathological gambling as adapted for pathological gaming:

Persistent or recurrent maladaptive gaming behavior as indicated by 5 or more of the following:

  1. is preoccupied with gaming
  2. needs to play more and more in order to achieve the desired excitement
  3. has repeated unsuccessful efforts to control, cut back, or stop gaming
  4. is restless or irritable when attempting to cut down or stop gaming
  5. plays games as a way to avoid problems or relieving sad mood
  6. after losing at gaming, often returns to get even
  7. lies to family or others to conceal the extend of involvement in gaming
  8. has committed illegal acts to pay for gaming
  9. has jeopardized or lost a significant relationship, job, or education/career opportunity because of gaming
  10. relies on others to provide money because he/she spends all her money on gaming.

So what did they find?

As you can see below, most of the kids (90%) did not engage in pathological gaming during the 3-year study. About 1% had high levels of pathological gaming symptoms during year 1 but then stopped completely by year 3. About 6% were chronic pathological gamers. And about another 1% were not pathological gamers during year one but became pathological gamers by year 3.

Some additional results:

Impulsivity, poor emotion regulation skills, and poor social competence predicted increases in pathological gaming symptoms over time.

Not surprisingly, more gaming at time 1 predicted becoming a pathological gamer at time 3. For example, those who became pathological gamers at time 3 played an average of 31 hours per week (almost a full time job!) at time 1. In contrast, those who did not become pathological gamers played an average of 19 hours per week at time 1 (still surprisingly high).


Children with high levels of pathological gaming at time 1 had higher symptoms of depression, anxiety, social phobia, and academic difficulties at time 3. However, I could not determine from the article if the authors controlled for the levels of depression, anxiety, etc. at time 1.

In sum, about 7% of the kids in this study had symptoms related to their video game playing habits that are similar to those observed in adults with pathological gambling problems. It seems that impulsivity and poor social skills are one of the best predictors of developing these problems. These kids also had significantly more mental health symptoms and problems in the schools.

The Reference: Gentile, D., Choo, H., Liau, A., Sim, T., Li, D., Fung, D., & Khoo, A. (2011). Pathological Video Game Use Among Youths: A Two-Year Longitudinal Study PEDIATRICS, 127 (2) DOI: 10.1542/peds.2010-1353