Researchers in Germany have published a new study they claim shows promise for treating video game addiction. Researchers claim that patients experienced a 70 percent remission rate, and the treatment doesn’t use psychiatric drugs. Rather than wean them off gaming entirely, the methods described in the study seek to re-configure the patient’s relationship with gaming as a whole.
Experts still disagree on the exact nature of video game addiction—or if it even exists. Last September, the World Health Organization added “gaming disorder” to its list of recognized diseases. America’s Diagnostic and Statistical Manual of Mental Disorders (DSM-5) recognizes that something’s going on, but calls for closer study. Recognizing gaming addiction as a legitimate psychological disorder could help thousands of gamers with addiction get help, but cures may be worse than the disease.
Other people have studied video game addiction and proposed treatment, but used a small sample size, or performed the study without a control group.
“In some studies there was no supervising institution that took care of the data collected and provided an independent statistical analysis of them,” Kai W. Müller, one of the authors of the study, published in JAMA Psychiatry, said in an email. “In our study we were particularly ambitious in avoiding all these smaller and bigger problems by having as sound methodological approach.”
Müller and his co-authors conducted the research from 2012 to 2017 in four outpatient clinics in Germany and Austria. They conducted the research on 143 men who they randomly divided into two groups—72 who’d receive treatment and 71 who would act as the control. The researchers then used a modified form of cognitive behavior therapy (CBT) that consisted of 15 weekly group sessions and up to eight two-week one-on-one sessions.
“It is important to emphasize that it does not automatically mean you are addicted if you are keen on playing computer games,” Müller said. “It is important to keep in mind that only a minority is developing an addictive behavior towards gaming and other internet activities. On the same hand, it is equally important to take these patients seriously and to accept that they are suffering and in need of help. Anything else would be mere ignorance.”
The goal wasn’t abstinence, but a readjustment of the patients’ relationship with computers, the internet, and video games.
“Our major aim is not to have the patients away from any screen but rather to enable them [to control] their behavior,” Müller said, though people in the study started with a six week “partial abstinence” from computer games and the internet.
To help control the study, the researchers excluded subjects who were using psychiatric drugs, and didn’t use such drugs as part of the treatment. Müller said that, in his experience, people with a misuse disorder that isn't substance related don’t respond well to pharmacological treatment. Instead, the researchers used CBT—a form of talk therapy that tasks patients with analyzing and adjusting their own thoughts.
“It usually starts with a thorough inventory of the patient’s characteristics that are contributing to the development and maintenance of the gaming disorder,” Müller said. The researchers started by educating the patients on the mechanism and effects of video game addiction. Patients kept a personal diary of the triggers that caused them to play games, often focusing on how they felt just before a marathon session, then learned how to take that energy and redirect it.
“In a third step, modification of the relevant characteristics is the crucial aim of the intervention,” Müller said. “This can for instance be enhancing the patient’s resilience towards stressful events, or his or her social skills, understanding of his or her emotional responses and simultaneously developing alternative explanations and reactions.”
The study is promising but imperfect. For one, it focused exclusively on men. Müller said this reflected the clinic’s typical clientele. “While recent epidemiological surveys have shown almost no sex differences regarding the prevalence of [internet addiction,] female patients with [internet addiction] are seldom represented in the help system. Therefore, further clinical trials are needed to evaluate the effectiveness of [the treatment] in females.”
Müller knows about the blindspot and said women do get help for gaming and other misuse disorders, but noted that they often don’t seek treatment at rehab clinics.
“Women suffering from internet-related disorders indeed do not find their way into the specific, addiction-related, health care system but rather seem to seek other therapeutic help because of other comorbid disorders that are perceived as the main problem,” he said. “We are currently investigating this phenomenon in a different research project.”