Gizem ?ahin

University of Bucharest, Psychology and Educational


Over the last years internet included our lives more
and more and change its purpose from helping communication and organize data to
these two features and entertainment, encourage and enterprise. While internet
was becoming midpoint of people’s lives the side effects of internet has
emerged. One of these side effects is internet gaming disorder. Researchers
made studies about damages of Internet Gaming or non-internet gaming on several
conditions and also benefits of Internet Gaming or non-internet gaming on them.
Internet gaming disorder most often involves specific internet games, but it
could involve non-internet computerized games as well (American
Psychiatric Association, 2012-2013).

Damages of internet games or non-internet games generally
gather under those titles: physical damages, academically deficiency,
encouraging violence, economical issues, lack of attention, social damages and
psychological damages. Laura Lockner has studied about gamers’ repetitious
motions may annoy hand tendons eventually and cause Carpel Tunnel Syndrome (Reuters & Syndicate, 1999) which this disease
is common (Tingle, Graham, & Hammert,
In fact, a recent study showed that video games improve balance youth with
autism. The researchers reviewed 29 participants with autism spectrum disorder,
aged between 7 and 17 years to study the effects of 6-week balance training. The
results showed that the study participants made significant improvements in not
only them in-game poses but also their balance and posture outside of the game
environment (Travers, et al, 2017). Loneliness,
lack of communication skills, social anxiety, lower leves of well-being, lack
of sense of belonging, les fulfilling real life relationships, lack of
environmental awareness, traumatic experiences because of sexual harrasment,
anger control issues can exampfily as psychogical and social damages of internet
or non-internet gaming addiction (Young, 2009; Kowert, Vogelgesang, Festl,
& Quandt, 2015; Block, 2008)

Clinical presentations of excessive Internet gaming
behavior are increasingly recognized as an issue of psychiatric relevance due
to the negative effect of Internet gaming on multiple domains of functioning (Daniel L.
King, 2014).
Internet Gaming Disorder formally presented by Kimberly Young (1996), mentioned
in DSM-IV but there wasn’t enogh data, for the first time diagnosed in
Diagnostics and Statistical Manual of Mental Disorders Fifth Edition.

Young likens Internet Addiction to other addictions, it
can cause a loss of control, social isolation, problems in marital and family
relationships, and educational or employment problems (Freeman,
After that diagnose confirmation the topic increased its research speed.
Internet gaming disorder is defined in DSM-V as “Persistent and recurrent use
of the Internet to engage in games, often with other players, leading to
clinically significant impairment or distress” and the symptoms are in 5 or
more of the following in a 12-month period:

1. Preoccupation with Internet games. (The individual
thinks about previous gaming activity or anticipates playing the next game;
Internet gaming becomes the dominant activity in daily life). Note that this
disorder is distinct from Internet gambling, which is included under gambling

2. Withdrawal symptoms when Internet gaming is taken
away. (These symptoms are typically described as irritability, anxiety, or
sadness, but there are no physical signs of pharmacological withdrawal.)

3. Tolerance—the need to spend increasing amounts of time
engaged in Internet games.

4. Unsuccessful attempts to control the participation
in Internet games.

5. Loss of interests in previous hobbies and
entertainment as a result of, and with the exception of, Internet games.

6. Continued excessive use of Internet games despite
knowledge of psychosocial problems.

7. Has deceived family members, therapists, or others
regarding the amount of Internet gaming.

8. Use of Internet games to escape or relieve a
negative mood (e.g., feelings of helplessness, guilt, anxiety).

9. Has jeopardized or lost a significant relationship,
job, or educational or career opportunity because of participation in Internet
games. (American Psychiatric Association, 2012-2013)




Treatment services for Internet gaming disorder are
becoming increasingly prevalent worldwide, particularly in East Asia (Daniel L. Kinga, et al, 2017). Internet
gaming addiction has been found to be more common in some Asian countries than
U.S. (Zhang, Amos, & McDowell, 2008). South Korea has
trained 1,043 counselors and enlisted over 190 hospitals and treatment centers
of June 2007 (Block, 2008)
and use the Shutdown Law to ban under 16 years olds to access online games 12
a.m. to 6 a.m. (Shutdown Law, 2017). Recently in China a teenager has died
after entering internet addiction boot camp was thought due to harsh addiction
treatment and corporal punishment (Hersey, 2017).

Investigating the study literature, most of the studies
employed cognitive-behavioral therapy (CBT), motivational interviewing (MI), reality
training, or a combination of psychological and/or counseling therapies within
a broader treatment program (Daniel L. King,
2014; Daniel L. Kinga, et al, 2017). According to Daniel L, et al(2017)’s
review psychological therapy and counseling regulations ranged from a single
therapy session to programs that involved participation for up to 19 months.
Nevertheless, the most common interventions were based on 6- session cure and
pharmalogical interventions were mainly antidepressants. However, out of 30
studies only 14 studies reported changes in gaming behavior.  In terms of adverse outcomes, the 4
pharmacological intervention studies and the electro-acupuncture documented
nausea, fainting, headaches, insomnia, fatigue, libido changes, and abdominal
pain or discomfort. None of the studies reported null effect but some of the
has weaker efficiency than expected e.g. “still playing daily” (Daniel L. Kinga, et al, 2017) The reasons of these
weaker effection could be using limited measurement methods and lacked blinding

Joseph M. Graham Jr. Found out that
Narrative Therapy can be used for internet gaming addiction. Narrative therapy
is developed by White and Epston (1990) as a framework to provide individuals the
opportunity to view their experiences within larger contexts, such as cultural,
political, and social.

The four central tenets of narrative
therapy are: a) externalizing the problem, b) developing the “team,” c)
creating the preferred story, and d) thickening the thread (Poole, Gardner, Flower, & Cooper,
Derived from Carr (1998), Gardner and Poole (2009) developed a three-stage
model of narrative therapy. The first step is to deconstruct the problem-saturated
stories, which includes the first two tenets of narrative therapy. Next, the
second stage reauthors new stories that encompass the other two tenets of
narrative therapy. Finally, the third stage is making the new story real and
salient. (Graham, 2014)

In Joseph M. Graham’s case study 17
years old WoW(World of Warcraft, online game) addicted Sammy discovered that he
had a lack of control ability and has learned how to internalize his strengths
and translate his skills between the online and offline worlds. (Graham,
And researcher advised to counselors be more aware of bias for online gaming
and should think of how to transfer skills from game to real life.

Specific video games designed also to use in mental
health care. Comparing to other media forms, video games are useful delivering
manual based interventions such as in Cognitive-Behavioral Therapy (Cerano?lu, 2010; USAB, Holzinger, &
Gesselschaft, 2007) Also video games can use for maintain client resistence and
therapies with children (Cerano?lu, 2010). Using the main
stimulating power of games can used individual and especially online games in
group therapies is recommended for future researches. Also online games can be used
to collect data.



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