Ciaran O'Connor

Ciaran O'Connor

Digital Health

Recognising Addicted and Problematic Gaming

A look at the signs indicating when someone's gaming habit has become unhealthy

Posted Nov 03, 2014

Video gaming is something that we are gradually coming to broadly accept as a common pass-time in our society (IAB 2014). At the same time, we are all too aware of the potential risks that surround gaming, most notably the risk of addiction. While the conception of addiction and video game addiction are hotly debated it is common sense to recognise that at some point someone’s gaming habit can become excessive to the detriment of their wellbeing. But how do we know, for ourselves or for others, when that line is crossed?

The groundwork for making this decision has perhaps best been covered by Mark Griffiths of Nottingham Trent University. He suggested a series of six criteria that help identify an addiction to any behaviour (Griffiths 2011). Griffiths developed these from measures orignially used to identify problem gambling. For the most part, they are an accurate fit, but they can be adapted to better capture the particular nature and quality of video gaming. From my time spent time working as both a video game designer and a therapist working with plenty of young gamers I have come to reconsider the six criteria as the following six signs:

  1. Constantly pre-occupied by gaming. Even when away from the game the gamer is either immersing themselves in game-related media or is simply daydreaming about them.

  2. Not being satisfied with games and gaming but still playing extensively. This might involve playing one game excessively despite finding it boring or repetitive or frequently switching between many games, never satisfied with any of them.

  3. Reacting emotionally when games are withdrawn. This is often when somebody else intervenes and turns it off or when another factor prevents them from gaming.

  4. Frequent arguments and conflicts around how much the gamer plays. This results in the use of manipulative behaviour in attempts to keep gaming including aggression, deceit, flattery and appeals to pity.

  5. A noticeable emotional or physical distress when the gamer is not playing that disappears when the gaming restarts. It seems as if they require gaming in order to control their feelings.

  6. Repeatedly falling back into bad gaming habits. The gamer may have made a number of attempts to control their gaming but has each time ended up once again playing to levels that disturb either them or those living with them.

To make best use of these signs It is worth thinking of gaming in 3 tiers. The first is that of engaged video gaming. This is when someone is genuinely enjoying a game in a healthy way. They are showing none of the signs above and are most likely simply really enjoying their hobby of gaming. Note how none of these signs consider how much time a gamer plays for. This is important; while the duration of gaming sessions and addiction are linked, they are not linked directly. Someone who spends several days on the trot excitedly completing a game is most likely to be simply very engaged. As long as none of the signs emerge and they are not doing so to the exclusion of functioning (they still keep appointments, go to work, eat etc) this can be considered unproblematic. Excessive yes, but not concerning.

The second tier would be those who engage in problematic video gaming. This is where one or more of the above signs are shown, but not all of them. While there is research regarding the frequency of video game addiction (Ferguson 2011) it is, even in studies such as these, self-confessedly difficult to measure. I have come to think that the vast majority of instances where people are playing unhealthily are instances of problematic play rather than addiction. This is when people have a somewhat awkward relationship with gaming but not to the point where it is becoming truly damaging to their lives. A frequent mistake is to label someone with problematic gaming as being an addicted gamer, and it is important that we maintain the distinction (Griffiths 2014).

The final tier is that of addicted video gaming. In this situation, every one of the signs is present. It is in cases such as these that the brain has become so chemically used to the dopamine release of gaming that it is constantly ringing alarm bells when gaming is not present and simultaneously depreciating the benefit of gaming when the person is playing (Berridge 2011). In effect, wanting to play video games has overtaken liking playing video games. This tier of gaming is the polar opposite of engaged play - -where gamers thoroughly enjoy their gaming sessions, but are particularly fussed if they don’t get to play. Those who play to addicted levels run the risk of excluding themselves from both their own bodies and others; they will become reliant upon their internal world. This can lead to either poor social development, social inexperience and an emotional stunting that can leave them with a difficulty in recognising and meeting the needs of their own feelings. The aforementioned article in this paragraph gives some research findings on these outcomes, although I speak more from the experience of having worked therapeutically with excessive gamers as a psychotherapist.

This article is an abridged version of the explanation I offer in my book Control the Controller: Understanding and Resolving Video Game Addiction. This goes into a little more depth about the psyche of the gamer for each of the signs, as well as giving a clearer picture of how members of the same household are likely to be affected. Armed with these aids to recognizing healthy gaming we are in a better position to make a well timed intervention when someone’s gaming is becoming unhealthy. Equally we are better placed to simply let someone be when they are doing no more than enjoying their hobby.


Ferguson, C. Coulson, M. Barnett, J., (2011) A meta-analysis of Pathological Gaming Prevalence and Comorbidity with Mental Health, Academic and Social Problems, Journal of Psychiatric Research 45

Berridge, K.C., Aldridge, J.W., Smith, K.S., (2011) Disentangling Pleasure from Incentive Salience and Learning in Brain Reward Circuitry, University of Michigan