Daniel L. King* and Paul H. Delfabbro
Version of Record online: 14 JUN 2016
© 2016 Society for the Study of Addiction
Addiction
Keywords:
- Addiction;
- behavioural addiction;
- DSM-5;
- internet gaming disorder;
- MMO;
- multiplayer games;
- tolerance
The inclusion of internet gaming disorder (IGD) in the appendix of the DSM-5 is a preliminary endorsement of gaming as an addictive behaviour [1]. Further research is now required to validate the proposed criteria [2]. However, applying the concept of tolerance to a complex activity such as gaming may be more difficult than is currently acknowledged in the DSM-5 formulation. There has been some preliminary scholarly debate that has examined the topic of gaming tolerance [3], relative to wider discussion of other IGD features such as preoccupation [4-6], withdrawal [7, 8] and harm [9, 10]. However, an important question that remains unresolved is: what specific gaming stimuli do individuals with IGD develop a tolerance for? The DSM-5 conceptualization refers to ‘the need to spend an increasing amount of time engaged in Internet games’ ([1], p. 795). Although, at first glance, this may be an appealing definition due to its simplicity and objectivity, it may not necessarily be valid to equate time with dosage, in that this variable alone may fail to capture many other factors that motivate and maintain excessive behaviour [11].
A useful case in point is the popular internet gaming activity called Massively Multiplayer Online (MMO) gaming. MMO games feature large, persistent on-line worlds that support social cooperative play and intricate reward systems wherein players aim to accomplish various goals. As they progress, MMO players reach ‘end-game’ activities, the parts of the game where basic level advancement reaches a predetermined fixed-interval cap and it is no longer possible to achieve new levels. End-game activities typically involve ‘grinding’ (i.e. repeatable actions) to achieve a kind of horizontal progression, such as refinement or customization of game items already acquired by the player. The MMO end-game employs time-consuming variable-ratio reinforcement schedules, featuring very low likelihoods of obtaining desired rewards. Items with low ‘drop-rates’ become highly prized by players, who employ optimizing strategies and join groups (e.g. clans, guilds) to maximize their chances of obtaining them. Players may spend more time playing to adhere to an increasingly demanding, rigid or complex and/or socially dependent schedule of play in pursuit of a specific reward payout. Longer durations of play may, therefore, only be a reflection of other underlying factors and not the principal reason for gaming.
Based on this reasoning, problematic MMO players do not appear to merely seek increasing time in the game, as specified in the DSM-5, but instead appear more driven by a need for better, rarer, more valuable, more novel and/or difficult-to-obtain rewards. A reduction or cessation of play is accompanied by a rising ‘fear of missing out’ on such rewards [12]. Accordingly, a possible revised formulation of gaming tolerance could refer to the player’s changing standards for game progress or completion, the pursuit of more unique or narrowly defined goals and/or a diminishing sense of satisfaction with the familiar and already acquired rewards of the game. As stated by Kaptsis et al. [7], a problematic gamer may experience withdrawal-like states even while playing a game if certain requirements of the activity are not met. While gambling disorder denotes the act of ‘chasing losses’ in recognition of the importance of wins and losses, IGD lacks comparable acknowledgement of actual game play activities. Further research on players’ perceptions of and dynamic responses to gaming stimuli, including their manifestation in clinical cases, will advance our understanding of this proposed disorder and suggest new possibilities for treatment.
Declaration of interests
None.
Acknowledgements
This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors.
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