Many of us parents with teenage children often worry about how much time is ok for our kids to be on video games. The Chinese government recently issued a diktat “restricting the under-18s to an hour of gaming a day, on only three nights a week”. But even if we were to take a liberal view, the WHO’s announcement earlier this month should raise concerns: “On January 1st the latest edition of its International Classification of Diseases (ICD), a manual widely used by doctors and health-insurance firms, comes into force. For the first time it recognises an affliction it calls “gaming disorder”.”
This puts gaming as the only behavioral addiction other than gambling (all others are substance addictions) in the manual. As the article highlights many might argue exercise, sex and work have known to have addictive tendencies as well but WHO relies on compulsive use and negative consequences.
“That a few players develop unhealthy relationships with their pastimes seems hard to argue with. Psychologists describe gamers who forgo sleep, offline relationships and work. Rows with families are common. Many call themselves addicts, and struggle to kick their habits. Hilarie Cash, the clinical director of re start, a game-addiction clinic near Seattle, says many of her patients arrive having been expelled from school or university, after gaming swamped their schoolwork.
…But the concept is still fuzzy. And even researchers who agree that games can be addictive in a medical sense disagree over how common such addiction is. Dr Cash reckons 10% of Americans may meet some of the diagnostic criteria. Dr Griffiths says that even a rate of 1% is surely far too high. “If that were right, there would be a clinic in every city,” he says.
One possibility is that obsessive gaming is a symptom, or coping mechanism, rather than a disorder in its own right. “At least half those with gaming problems have a depressive disorder. Another third have anxiety,” says Andrew Przybylski of the Oxford Internet Institute. “There have always been people who are a bit socially awkward, and interested in systems rather than other people,”
But gaming today as an industry is $170bn, bigger than cinema and music and hence not restricted to a few people with social issues. The article turns to how game developers use psychological insight to build reward mechanisms within games to keep gamers hooked:
“One well-known result, first shown in rats in the 1950s, is that semi-random rewards (where completing a task may sometimes provide nothing, sometimes a small payout and occasionally a big one), are more compelling than predictable ones. That insight is used in almost all game design. “Candy Crush Saga”, a popular pattern-matching game, gives players extra rewards for finding unusual combinations on the board, providing an unpredictable but enjoyable reward when the tiles fall in the right place.
A more overt tactic is to punish players who do not log in regularly. “Adopt Me”, a subgame in “Roblox”, in which players care for virtual pets, provides in-game benefits to players who log in at least every 15 hours. In “Farmville”, players who neglect their virtual crops will see them wither—though they can be revived for a price.
Other tricks are designed to persuade players to convert playtime into purchases. Virtual items are bought with in-game currencies, such as gold, crystals or the v-Bucks used in “Fortnite”. Studies of people using foreign currencies suggest that unfamiliarity helps them spend more freely. (This is one reason, says Dr Mentzoni, why casinos use chips.) Players who run out of lives in “Candy Crush” can wait half an hour before playing again, or pay money to dive straight back in. In 2018 King, the developer of “Candy Crush”, told Britain’s Parliament that one player had spent $2,600 on lives and other in-game perks in a single day (though, to be fair, the digital goodies did last him seven months).
…Moreover, all these features can be tweaked using analytics data, harvested from a game’s players. Developers can run experiments with everything from difficulty curves to the price of different in-game items and see the effects on user-retention or revenue. King extols the use of data to help “make our titles irresistible”.

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