In recent decades, video gaming has become one of the most popular forms of entertainment worldwide, with adolescents and young adults forming the most substantial group of consumers, spending an average of nine hours per day interacting with some form of entertainment media.
The growth of the Internet and access to high-speed connectivity has led to a shift from ‘traditional’ video gaming (one player versus machine) to sophisticated interactive multi-player video gaming, substantially increasing the proportion of time spent playing video games.
A young video gamer. Image Credit: Anton27 / Shutterstock
As the development of video gaming and its use has increased, apprehension regarding dysfunctional or problematic video gaming has grown in tandem.
One recently described phenomenon known as video gaming addiction (a term often used interchangeably with Internet addiction) has parallels with other forms of addictive behaviour.
Individuals with problematic preoccupations with gaming show similar patterns of behaviour to those with recognised addiction disorders, including compulsive use, decline in functioning and withdrawal symptoms.
Although the term is controversial, the growing body of evidence surrounding problematic gaming has led to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM–5; American Psychiatric Association, 2013) deeming ‘Internet Gaming Disorder’ (IGD) as warranting further study regarding whether it should be included as a unique mental disorder.
Population studies in Europe and the United States estimate the prevalence of problematic gaming at between 1.5% and 8.2%. Clearly, most gamers do not develop a dysfunctional relationship with video gaming.
WHO: Gaming disorder: questions and answers (Q&A)
The effect of gaming on non-problematic gamers
Media reports on the impact of gaming have been mixed, making positive and negative health claims about the effects of engaging in video game play, although these are rarely evidence based. Nonetheless, there is a growing body of scientific literature exploring the possible benefits and disadvantages of video gaming.
A recent systematic review analysed the results of over one hundred studies to determine if, and to what extent, playing video games can influence brain activity and behaviour, and grouped results into the following categories.
The most researched area with regards the impact of playing video games, several studies have shown that video game playing can lead to improvements in several attentional processes, including selective, sustained and divided attention.
More rigorous research is required about processes underpinning these advantages, but there is emerging evidence that regions of the brain implicated in attention are more proficient in gamers.
Resource allocation (the amount of resource within the brain recruited to complete a task) appears more efficient. Using brain imaging techniques, found that compared to non-gamers, gamers completing processing tasks during MRI scanning were able to allocate attention resources more effectively, possibly filtering out irrelevant information automatically.
Visuospatial skills refer to the neural processes that allow us to perceive visual information and understand spatial relationships between objects.
Skills include navigation of the environment and judging distance, and visuospatial processing is predominantly controlled by the hippocampal region of the brain. Given that video games predominantly include interactive visual tasks, research has investigated differences in the neural correlates of visuospatial processing between gamers and non-gamers.
A series of MRI studies found positive correlations between the lifetime amount of video gaming and hippocampus volume.
Furthermore, comparisons of controls with people who completed thirty minutes of video game playing for two months showed a significant increase in hippocampal matter following training.
Cognitive control encompasses skills such as reactive inhibition (learning to avoid certain actions), proactive inhibition (where learning is inhibited by previous memories), rapidly switching between tasks and working memory. Such processes which are controlled by the prefrontal cortex, are key skills in video game playing.
During game playing, increased activation has been observed in these areas, with the level of activation positively correlated with the difficulty level of the game. Moreover, studies which include cognitive training via video gaming have shown volumetric increases in this brain region.
Interestingly, different categories of video games appear to affect different cognitive processes. For example, a study examining the benefit of ‘brain training’ using video games with older adults showed a strategy game improved verbal memory span but had no effect on working memory or problem-solving skills. When training involved an action game, improvements were seen in problem-solving and reasoning.
A regularly cited concern is the impact of gaming on aggression. Derived from theories of social learning, proponents of a link between the two have theorised that repeated exposure to violent material increases violent thoughts, emotions and behaviour.
Attempts to demonstrate a link empirically have been mixed, and reviews of the evidence base point to methodological shortcomings and publication bias.
Adopting a stringent methodology, these authors sampled over one thousand adolescents and their carers in the UK and found no association between time spent playing violent video games and likelihood of antisocial behaviour or aggression.
Mayo Clinic Minute: 3 tips on what to do if your child is addicted to gaming
Adolescents and adults who spend large amounts of time playing video games or otherwise engaging in screen time need to be cognizant of their physical activity levels.
Most video game playing time is sedentary and even the use of active video games has not been shown to improve overall physical activity levels. Daily moderate to vigorous physical activity should be prioritized over screen time for both children and adults.
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