Support for problem gaming interventions

Problematic gaming is a significant health issue worldwide, with Flinders University researcher Dr. Daniel King saying the global prevalence is estimated to be about 2% and much higher among male adolescents.

Dr. King, an associate professor and clinical psychologist in Flinders University's College of Education, Psychology, & Social Work, studies digital technology-based addictions, including gaming disorder, and has been working to identify practical interventions for individuals and families who experience gaming-related problems.

Problem gaming in its most extreme form is recognized as "Gaming disorder' in the International Classification of Diseases (ICD-11) and has much in common with problem gambling. However, specific analysis of the disorder has so far been limited in Australia as compared to the US, Europe and Asia, prompting Dr. King's specialized focus in this area.

With his team, including University of Adelaide researchers Matthew Stevens, Paul Delfabbro and Diana Dorstyn, they reviewed the global epidemiological evidence base—53 studies involving more than 226,000 participants across 17 different countries—and found that the prevalence of gaming disorder was 1.96%, which was comparable to figures reported for some substance use disorders (2.6%) and anxiety disorders (up to 3.5% of population).

Dr. King found that significantly more males fit into this category—with gaming disorder rates being about 2.5-to-1 in favor of males compared to females.

In addition to this systematic review examining the extent of gaming disorder—"Global prevalence of gaming disorder: A systematic review and meta-analysis," published in the Australian and New Zealand Journal of Psychiatry (doi.org/10.1177/0004867420962851) – Dr. King has also supervised a large study of frequent gamers, published in the Journal of Primary Prevention (doi.org/10.1007/s10935-021-00629-0), that aims to identify practical strategies and interventions that may address the range of problematic game behaviors.

This research surveyed 992 online gamers and found that most (61%) participants expressed support for broad prevention strategies including educational guidelines, game time self-monitoring tools, and game content information. About half of the respondents supported school-based education (50%) and age restrictions on playing online games (47%).

Also, 48% of participants were supportive of outpatient treatment options for gaming disorder, such as psychological therapy or counseling, whereas 34% had neutral views and 19% were against these options.

There was relatively strong disapproval for prevention measures that would affect the structure of games themselves, such as in-game timers and shutdown features which have been used in East Asia to reduce adolescent gaming.

However, participants believed that some gaming activities were inherently riskier than others, particularly games with 'predatory' in-game spending features (microtransactions), and they commented that the gaming industry should be more proactive to support problem gaming research, including funding research schemes and sharing its player data for the purpose of independent health-focused research.

Dr. King says there is a need for improved assessment, prevention and other intervention options for problem gaming, including educational resources and prevention strategies to address unhealthy gaming habits in young people.

He says further research and policy attention is needed on the types of games and features, particularly unregulated in-game spending (loot boxes), that contribute to excessive time and money spent on gaming to the detriment of health and wellbeing.