What’s in a Game: The Draw to Video Games in ADHD
Why are video games a magnet for people with ADHD?
Posted Mar 07, 2016
Video games get plenty of bad press. Apprehension about their negative influence on kids. Concerns about the violence. Social isolation. Mind-numbing procrastination. Potential for addiction. The games are sometimes viewed as the ultimate time waster. Right up there with reality TV marathons.
And they remain as popular as ever. A 2014 Time article reported that gamers spent an average of 6.3 hours a week on video games in 2013: http://time.com/120476/nielsen-video-games/.
Others see at least some benefits from video games. For instance, research suggests video games can help with hand-eye coordination. One recent study even proposed that video games might benefit thinking skills. The study from Florida State University showed that subjects who played games on the Portal 2 system made more cognitive gains on average than those who were trained on Lumosity®! (For full details on the study, see: http://www.sciencedirect.com/science/article/pii/S0360131514001869).
As you know, Lumosity had been just about everywhere on the web, radio, and TV, making claims about the effectiveness of their product. Like a computerized version of the product Prevagen® that’s now all over the airwaves. But Portal 2 still came out ahead of Lumosity. And to add insult to injury, Lumosity recently got a (fairly mild) slap down from the FTC about making unproven claims about their product. (Prevagen has incidentally had its own tangles with the FDA in the past few years).
Video game use is quite common in individuals with ADHD. And in today’s blog we look not so much at the goods and evils of video games, but at the attraction to video games that many kids and adults with ADHD have. What keeps them coming back? And why can people with ADHD focus so intensely on video games for so long but not focus on other things in their lives?
In fact, the attraction to video games is easy to understand. Think of what video games offer. Fun. Anticipation. A plot that keeps you engaged. A sense of accomplishment. Bright colors. Music. Many things that ignite the ADHD mind. And on top of that video games easily activate two common companions of ADHD: procrastination and hyperfocus.
Video games are a great tool for procrastination. They are instantly engaging and rewarding. The games are designed to draw us in and keep us there. They’re enjoyable. The chance to escape is powerful. I mean, who really wants to read a school book or plan a work budget rather than playing these games?
I once had a therapy client who hadn’t worked in over a year, was well past getting unemployment checks, months behind on his rent and other bills, in a strained marriage, and still spent 3-4 hours every day breaking records on the latest version of his favorite video game.
And yet it makes sense. The video games are a means to escape. A chance to numb out and not harshly judge himself. A way to avoid the extreme anxiety he always felt when trying to look for a job and address his marital issues.
Video games as a stall tactic are reasonably effective. They’re entertaining and give a sense of personal accomplishment. They’re designed so that you keep playing them. They’re also effective at temporarily blocking out anxiety, depression, and low self-esteem.
All of those conditions are frequent travelers with ADHD. And all cause discomfort. Now the ADHD brain is usually attracted to bright and shiny objects so to speak, and it also tends to have difficulty managing impulses. So video games are a natural fit. But there’s a second part to it as well, beyond just the ADHD.
Think about the client’s anxiety mentioned in the paragraph above. When we are really nervous about something or not sure how to begin it, it’s quite easy to find something else to do. TV. Movies. Even cleaning house! Now add that element of avoidance to something that actually draws your attention and there is a problem. The procrastination serves multiple functions. Additionally, for kids or adults who are shy, uncomfortable making small talk, or not particularly good at group activities like sports, video games can be a welcome relief.
An interesting if counterintuitive characteristic of ADHD is the capacity to focus intensely on a narrow topic of interest for long periods of time. This is referred to as “hyperfocus.” Sometimes it can be used effectively. For more on hyperfocus, check out my blog on the topic at: https://www.psychologytoday.com/blog/the-distracted-couple/201411/adhd-h....
Hyperfocus in ADHD is intense. It can be so concentrated that other things going on around the person are essentially ignored. Kids and adults with ADHD tend to hyperfocus on topics of particular appeal or significance to them. Video games can be one of these things.
Now parents, spouses, and others might interpret hyperfocus as a sign that the person really doesn’t have ADHD, can focus when s/he wants to, and so on. But it’s not really the case. Hyperfocus in ADHD is as unconscious a process as are distractibility and impulsivity. And while the DSM-5 criteria for ADHD do not explicitly mention hyperfocus as a symptom, it has long been recognized as part of the ADHD experience by clinicians and researchers who work with condition. In a way hyperfocus and inattention are like two sides of the same coin: either too much or too little attention, but in either case not well regulated.
So when we look at the specific attributes of video games and the cognitive and behavioral patterns in ADHD and other frequently co-occurring disorders, it’s easy to see why video games are appealing but their use might become problematic. It unlikely for a child or adult with ADHD to abstain from video games altogether, unless they’re just not interested in them. Rather, environmental structure to limit the overuse of these games is often needed.
Limiting the time and location (e.g., not in the bedroom) allowed on games and only playing them after school, work, and other essential tasks are done are often helpful rules. Parents need to be willing to set up and apply rules with children for this to work effectively. For adults, verbally sharing the parameters you set around video game usage with a partner, therapist, or close friend is an important method of personal commitment to behavioral change and to accountability in one’s own behaviors.