Overview of gaming

Gaming includes playing video games on the internet and offline. While moderate gaming can foster social connections and promote cognitive skills and coordination, excessive gaming is potentially harmfulLoton, 2016. Potential harms of gaming include marked distress or significant impairment in personal, family, social, educational, occupational, or other important areas of functioningWorld Health Organization (WHO). Physical health can be affected by lack of sleep or exercise, poor diet, dehydration and gaming-associated behaviours such as substance useZajac, 2017.

Gaming harms tend to arise in online social games with an endless reward structure. Massively multiple online role player games (MMORPG) and first-person shooting games (where the player sees combat through the eyes of their character) are associated with gaming disorderRehbein, 2021. Some games have elements of gambling, which may contribute to compulsive behaviourBrowne, 2020; examples include ‘micro-transactions’ (such as gambling to win the opportunity to buy loot boxes) and e-sports (multiplayer video games played competitively for spectators who can gamble on the outcomes).

Individual risk factors for gaming harm are also important. As with gambling, the prevalence of other psychiatric comorbidities (eg social anxiety, depression, attention deficit hyperactivity disorder, autism spectrum disorderSaunders, 2018) is high among people with gaming disorderLoton, 2016. Evidence on the prevalence of disorders of substance use is limited but suggests an associationBurleigh, 2019. Males are at least twice as likely as females to be at risk of gaming disorder; people of any age can be affectedLoton, 2016Stevens, 2021 but those from mid-teens to late twenties are overrepresentedSaunders, 2018. Impulsive character traits, low self-esteem, limited interests, difficult family dynamics and gaming peers are other risk factorsKing, 2018.