Internet Gaming Disorder: Disorder or Natural Progression

Since the early 1970s, when Pong first released on home systems, children and adults alike have been infatuated with video games. From the rise of arcades to desktop and now mobile gaming, video games have profoundly affected modern life as we know it. The current video gaming industry makes more money yearly than the Film/TV and Music industries combined, totaling billions of dollars. Fortnite, one of the most popular games, generated $5.8 billion in 2021. Epic Games, the publishers of Fortnite, smashed their previous record the year before, a paltry $5.1 billion.

Epic Games, the developers of Fortnite, found the secret to this money-printing system: Create a free-to-play game, market it to children, and have every cosmetic item in the game purchasable for a small sum of money, a couple of dollars at most. Then, sit back and watch the money roll in. Ever since Fortnite’s runaway success, every other developer has copied their methods and had similar, though far less profitable, success. But why are people paying real money for digital skins and emotes for their characters? These microtransactions allow people to pay real money for in-game currency, which they use to buy character outfits or emotes.

While this seems extortionist, it is a fairer system than previously seen in the industry. Loot box gambling is a lottery system in many games. Overseas, this is called “gacha” games. Gacha games are a form of gaming where the core principle is acquiring in-game materials or characters through a lottery system. In-game money buys a pull on the banner, and a player may get lucky. It is a prevalent and acceptable form of gaming in places such as South Korea and Japan. In the West, however, not so much.

Western titles that have loot box gambling prioritize targeting children as a leading source of income. One of the most well-known examples is the FIFA video game series, where some playable characters are so rare and expensive that people spend thousands on an account and then sell the account with the card if they get it. Star Wars Battlefront II, which launched in 2017, met with immediate uproar after its hyper-predatory loot box system was unveiled.

Many excuse loot box gambling in free-to-play games as a source of revenue, but when it’s in AAA games at $60 price tags and up, few come to the developers’ defense. Battlefront II had a pay-to-win model, where real money for these loot boxes got in-game cards that made a character better than other players. EA quickly retracted the system, but the game never recovered after the initial gut punch.

Most recently, however, the worst example of predatory microtransactions in games is the mobile game Diablo Immortal, a free-to-play game. Getting a maxed-out character with all the best gear and upgrades in the game would cost your average person around $500,000.

Predatory micro-transactions in games such as these prey on weak-willed people and those with little to no self-control, which is why many countries have spoken out against these practices, with Belgium having banned loot box gambling in 2018 altogether.

Everyone knows there are addictive effects in video games. Many more argue that there is a disorder, like gambling and smoking. The answer to this, unsurprisingly, is a complicated one.

Internet Gaming Disorder, or IGD for short, was proposed in 2013 to the Diagnostic and Statistical Manual of Mental Disorders, fifth edition, or DSM-5 for short. In the publication, there was not enough clear evidence to label it as its own disorder or if it is more akin to gambling and smoking addiction. IGD was lumped in with the latter, but a criteria list for IGD was put into the manual to help identify subjects with IGD. To be diagnosed with IGD, one must meet at least five of the criteria in the DSM-5 list:

Preoccupation with gaming.
Withdrawal symptoms when gaming is taken away or not possible (sadness, anxiety, irritability).
Tolerance, the need to spend more time gaming to satisfy the urge.
Inability to reduce playing, unsuccessful attempts to quit gaming.
Giving up other activities, loss of interest in previously enjoyed activities due to gaming.
Continuing to game despite problems.
Deceiving family members or others about the amount of time spent on gaming.
The use of gaming to relieve negative moods, such as guilt or hopelessness.
Risk, having jeopardized or lost a job or relationship due to gaming.

When I looked at this list, my heart sank. I identified multiple criteria in this list that would diagnose me with IGD. I became curious about this subject and started to do research into IGD and the effects it has on people. One researcher by the name of Peter K.H. Chew of James Cook University, Singapore, had some answers.

The study by Mr. Chew, titled “A meta-analytic review of Internet gaming disorder and the Big Five personality factors,” gave a fascinating insight into the correlation between the two.

The Big Five personality factors of psychology, or the Big Five, are conscientiousness, extraversion, agreeableness, openness, and neuroticism. Most personalities are built on these five and used as groundwork for many psychological studies.

Two likely candidates could answer these questions: Mr. Chew and Dr. Christine Murphy, Professor of Psychology at Grand Canyon University. While I was waiting for Mr. Chews’ responses to my questions, I got in contact with Dr. Murphy.

When I contacted Dr. Murphy, she was thrilled to be interviewed on the subject and took an interest in it immediately. When I asked her about her thoughts on microtransactions and loot box gambling, she said,

“These companies want children to spend more and more time playing their video games; they want children to become addicted to them. So, they create the games to create the psychological effects where it becomes habit and addiction.”

What Dr. Murphy said reminded me of my experiences with these types of games. Some of them I had spent quite a bit of money on. It never seems like a lot at first, but when you look back at the receipts, they sucked you dry like a vampire.

Dr. Murphy’s answers led me to ask about the feeling of immediate gratification in a video game, taking away the drive to perform real-world tasks, such as going to a job or attending school.

“If children are always rewarded so immediately in these games, then it doesn’t teach them to have to wait or earn over the long term. That can be detrimental to real life. It doesn’t help them problem solve, it doesn’t help them have grit, it doesn’t help them to stick with something to get a reward.”

As I listened to her talk and explain, I realized I knew what she was talking about. Video games are fun but ultimately drive you away from your hobbies and IRL (in real life) social life.

The following is a detailed breakdown of what Mr. Chew found during his study on how each Big Five personality trait correlates to IGD.

Conscientiousness is positively related to the quality of relationships, job performance, and academic achievements. During Chew’s tests, he found that conscientiousness was negatively correlated with IGD, as a person who cares about the quality of their relationships, jobs, and academic integrity would not let video games interfere with those pursuits.

Fig. 3. Forest Plot of the Relationships between IGD and Conscientiousness.

Along with the stated correlations to conscientiousness, this study was done where age moderated conscientiousness. This study showed that older people are much less likely to be targeted for IGD than younger people, as it is not a protective factor for them.

Extraversion was negatively correlated in this study to IGD. Internet gaming is nothing if not sociable. However, many multiplayer games are only optionally multiplayer, as many functions of multiplayer games can be done by playing alone. MMORPGs are famous for their social atmospheres and communities; however, many extroverts may find these lacking in the amount of stimulation compared to real-world encounters.

Fig. 4. Forest Plot of the Relationships between IGD and Extraversion.

Openness was not positively or negatively correlated to IGD in this study. Openness to experience in relation to games is rough to estimate. Many games, such as role-playing games (RPG), offer multiple races, classes, and jobs, giving novelty and replayability. Openness in this study was also moderated by age. However, its relationship to IGD increased with age instead of decreasing.

Fig. 2. Forest Plot of the Relationships between IGD and Openness to Experience.

Agreeableness correlates negatively to IGD. Agreeable people, by nature, avoid conflict where possible. Video games are known for causing anger, rage, or conflict between strangers and family units alike. With the high intensity many gamers rise to when playing these games, you will not find agreeable people here.

Fig. 5. Forest Plot of the Relationships between IGD and Agreeableness.

Neuroticism positively correlates with IGD. Internet gaming is riddled with negative comments, toxicity, verbal abuse, and high amounts of stress. Individuals seeking to flee from these in the real world only have them tempered and solidified here, either becoming part of the problem or developing depression or other harmful thoughts.

Fig. 6.

Forest Plot of the Relationships between IGD and Neuroticism.

The study’s findings show that neuroticism correlated positively with IGD, and all but openness correlated negatively. Mr. Chew may not have done the most lengthy study (in terms of paper length), but the application purposes of his study toward identifying people with IGD are invaluable.

At the end of Dr. Murphy’s interview, when asked about the future of these tests, she said, “These future studies need to include neuroimaging. We need to compare neuroimages of people who have played these games over years with images of people who were regulated.”

In an exciting turn, Mr. Chew is on the fence about using neuroimaging as a measurement.

“One study found that the reward pathways are activated, which further supports the argument that IGD is an addiction,” Chew stated. “However, some studies cast doubt on the validity of neuroimaging research, especially if the sample size is small.”

While Chew provides strong arguments, he also notes that the sample size needs to be large so that the validity cannot be questioned as to the study's results.

Murphy and Chew agree that there needs to be more information about this subject to get a sure answer that IGD is an actual disorder. After our interview, Chew said, “More work needs to be done to show that it is unique and causes a range of negative outcomes for the person. Otherwise, we might end up pathologizing normal behavior, resulting in outcomes like stigmatization and waste of resources. Some countries are allocating money to treat gaming disorders already.”

As a final question during our interview, I asked Dr. Murphy if she thinks video games will become a regulated substance like cigarettes if IGD becomes a serious disorder. She responded in the affirmative that it could happen. Murphy expressed that she “would love to see that happen.”

The proverbial jury still out on whether IGD is an actual disorder or just the natural progression of life evolving around the current social order is yet to be determined. Internet Gaming Disorder can potentially be a perilous mental illness, rivaling PTSD’s social impact. If countries do not start taking the matter with more seriousness and allocating resources to the study of IGD, it could be a ticking time bomb of incalculable volatility.