Interactive Gaming 2009

Long, but fascinating! Thanks again to Digital Spy for this insight into game addiction.

The debate over the addictive nature of games has raged since the days of Pong, but it has risen to a new level of prevalence since the advent of the massively multiplayer online role-playing game (MMORPG). There are several schools of thought on the matter. While there are those who scoff at the concept of game dependency as a legitimate medical condition, others perceive it as a growing problem for the industry in the age of online gaming.

Theorists on video game overuse can be divided into two separate camps - those who believe it to be a social problem, and those who propose it is a psychological disorder.

The American Psychological Association certainly takes the issue seriously. Last year the organisation considered the idea that gaming addiction may be comparable with other psychological disorders such as compulsive gambling. It was even discussed whether the proposed condition warranted inclusion in the Diagnostic and Statistic Manual of Disorders, but a lack of evidence and research meant the notion was dismissed.

Doctor Maressa Orzack of the McLean Hospital in Massachusetts sparked controversy in 2005 when she suggested that 40% of the ten million World Of Warcraft subscribers might be clinically addicted. Orzack - herself a former computer Solitaire addict - has been treating compulsive computer users for over a decade. She firmly believes that gaming addiction is a psychological condition that should be treated in the same way as compulsive gambling or eating disorders.

"Computer misuse is so complex and its ever-increasing prevalence so challenging that a comparison with eating disorders is necessary," said Orzack via her website. "The basic approach in treatment is to teach people how to normalise their behaviour. Normalising eating behaviour is a key goal in treatment of eating disorders.

"Normalising computer uses is more and more a requirement in our modern society. The challenges that face the therapist are manifold. The lines between work and home, work and play, are unclear and vague. Therapists must help individuals conflicted by the many demands of society to learn effective coping skills that will allow them to normalise their behaviour."Orzack's treatment programme involves a combination of behavioural therapy, anti-depressants and Zyban, a drug given to smokers to help them off nicotine.

Evidence backing Orzack’s claim comes from numerous sources. In July 2007 a case came to light involving a 15-year-old boy from Perth, Australia. The boy abandoned all other activities to play the MMORPG RuneScape, leading his father to liken the obsession to heroin addiction.From a more empirical standpoint, Dr. Karen Pierce, a Seattle-based child psychiatrist, treats at least two compulsive gamers per week, and approaches each case "like any other addiction".

Dr. Michael Brody, head of the media committee at the American Academy of Child and Adolescent Psychiatry, believes that gaming addiction is often an indication of deeper psychological problems such as depression and antisocial personality disorder.

In June 2006, The Smith and Jones Centre in Amsterdam became the first clinic in Europe to offer treatment to young people with obsessive gaming tendencies. Its founder, Keith Bakker, believes that compulsive gaming is a social problem rather than a psychological one.

"The more we work with these kids the less I believe we can call this addiction," Bakker told the BBC. "What many of these kids need is their parents and their school teachers - this is a social problem."

In response to this, the clinic has altered its treatment programme to focus on the development of communication and social skills to help patients to rejoin society.Bakker believes that referring to compulsive gaming as an addiction is counterproductive. "If I continue to call gaming an addiction it takes away the element of choice these people have," he explained. "It's a complete shift in my thinking and also a shift in the thinking of my clinic and the way it treats these people."

Naturally, the juxtaposition of games with narcotics has been met with fierce opposition within the industry. Many designers, developers and programmers object to games being labelled as addictive, claiming that the term's negative connotations have brought unjust criticism to the industry and handed ammunition to its opponents.

Developer Ernest Adams claims that seeing games as addictive is a misconception. In an article written for Gamasutra in 2002, Adams pointed out that addiction is comprised of two intertwined mechanisms: physical dependence and psychological addiction. "Physical dependence is a state in which it becomes necessary to have the desired stimulus in order to feel normal. It's also characterised by withdrawal symptoms in the absence of the stimulus," he wrote. "Nobody stops feeling human if they stop playing Tetris. Nobody becomes physically unwell if they don't play Solitaire for a while. Clearly games don't involve physical addiction to a substance."

Adams did acknowledge that games could have a psychologically addictive aspect, but only in the same way any other kind of behaviour that offers rewards and reinforcements does. He argued that in most cases, the compulsive behaviour involved in excessive gaming is relatively harmless compared to the likes of gambling addiction.Central to the industry's defence is a lack of reliable evidence and research on gaming and addiction. Writer and researcher Neils Clark has written about the subject at great length. He believes that researchers often lack a fundamental understanding of the nature of games, which renders their studies unreliable.

"The researchers themselves too often seem distanced from any real understanding of gaming, creating data that serves to label gamers, misrepresent games and further mislead the public," he wrote in a Gamasutra article. "Worst of all, some gamers clearly have problems. Until we explore this topic cogently, we're not in a position to help them.

"Without doubt there are health issues in gaming, as with any activity, many of which often go unaddressed. Earlier this year, however, the Game Development Corporation sponsored two roundtable events to discuss the matter. Neils Clark reported on the events.

"The most interesting voice in the roundtable was a programmer from Blizzard Entertainment, who discussed some of the company's design discussions prior to theBurning Crusade expansion for World Of Warcraft," he wrote.

"He said that they wanted to distinguish between gameplay elements that might encourage all players to go overboard, versus those that caused problems for a select few. The idea was to keep the pieces that make the game enjoyable for everybody, but make sure that everyone's enjoyment wasn't punctuated by a design that required too much maintenance."

Design is certainly something that can influence healthy play and it wouldn't hurt the industry if other developers took a page from Blizzard's book and addressed this.Terming excessive gaming as an addiction can be detrimental to the industry and those prone to the compulsion. As Keith Bakker has found from his work at the Smith and Jones Centre, labelling gamers as addicts is unlikely to aid their recovery, if such a thing is necessary. Furthermore, the term's negative connotations have brought the industry much undeserved bad press. It is important to acknowledge the health issues in gaming and keep an open mind where each case is concerned, but until more reliable research on the subject exists, let's keep the narcotics comparisons to a minimum.