Alice in Warcraftland

5. December 2011
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As part of the focus campaign "Adolescent Medicine" emerging from the 49th Annual Meeting of the ÖGKJ (Austrian Society of Therapeutics for Children and Youth), paediatricians and doctors specialised in dealing with adolescents have warned of the negative influence of computer games on children's health. They make demands for more stringent protective measures.

“According to a German study published in 2009 (Rehbein study), more than 4% of girls and nearly 16% of boys show (excessive) computer game behaviour involving more than 4.5 hours of daily computer game use”, states Conference President of the ÖGKJ Univ.-Prof. Dr. Robert Birnbacher. 3% of boys and 0.3% of girls were diagnosed as computer-dependent and another group of nearly 5% of boys and 0.5% of girls as being at risk. These figures are stated as also being applicable to populations of children and young people from other western nations.

How does computer-game addiction originate?

The elements making up formation conditions which lead to computer game addiction are numerous. The formation itself must be seen as an interplay of personality traits of the child / youth and integral characteristics of the computer games themselves. “I would however warn that even games categorised by producers as fully safe for children’s use are believed to an increasing extent to be able during childhood or with adolescent users to lead to psychological problems,” says Birnbacher, Head of the Department of Child and Adolescent Medicine in Villach Regional Hospital. The addiction problem in relation to computer games has a similar basis to that of other addictions, a multifactorial causal mechanism. On the part of the personality of the user, aside from motivational aspects there are also traumatic experiences, stress factors and personality characteristics which play a role. The choice of computer and video games is also nonetheless influential, since they differ in game format, reward mechanisms, penalty for misuse; they also vary in ways in which other players can be involved/ it is combined with pause or non-play periods and in their potential attachment to a game’s character, and thus have a behaviour-reinforcing effect independent of the identity of the player.

The computer game “World of Warcraft” in particular clearly reveals the greatest potential for addiction. The daily game-time for boys amounts to nearly four hours, while 36% play more than 4.5 hours per day. “20% of them are either already at risk or already dependent”, warns Birnbacher.
Another danger emanates from so-called cyber bullying. Here the victims are exposed and humiliated by intimate photos, untruths, insults or individually-targeted messages published online. According to a U.S. study, already half of American young people between 14-24 years have been victims of cyberbullying.

Computer-game addictions are expressed as such

The existing, verifiable correlations between computer game dependency and psychosocial-stress indicators provide evidence of the nature of the disorder involved in this addiction and show parallels to other addictions. “Boys develop more often a habit of spending excessive amounts of time, as well as a psychological addiction to computer games, than do girls”, warns Birnbacher. This may be, according to studies, due to the fact that boys exhibit higher impulsivity and an elevated level of acceptance of violence. Young people who have a computer dependency frequently show dips in performance at school, increased absenteeism, truancy, school phobia, have deficits in the experience of self-efficacy and choose erratic leisure-time activities, which are also characterised by lack of exercise. For many young people – in line with other addictive disorders – there is in the past a traumatising experience of aetiologic significance. Furthermore, the compensatory use of computer games as a tool against real problems and failures in life and its presence in a social context is something to which attention should be paid, because in these phases the misuse of computer games is intensified.
Widespread advisory and treatment services for computer games dependencies do not exist right now. Moreover, there is the risk that alternative diagnoses such as “adjustment disorder”, “depression” or “personality disorder” are attributed responsibilty in order to have the patient transferred to treatment, which leads to the stigmatisation of those affected and to the loss of focus on the problem of dependency potential of computer games. The American Medical Association has already made a worldwide call with the aim of studying computer games and Internet dependency more thorougly, so that it can be determined whether the disease might be included in the next revision of the DSM (Diagnostic and Statistical Manual of Mental Disorders) in 2012.

Demands for references to dependency-potential

“We should demand that, in relation to media protection of youth, attention be paid to the dependence potential of the various games as part of the test process and that the games in question should be accessible only from the age of eighteen“, says Dirnbacher. In particular, signs of legitimation of violence and rewards for violence have to be consistently included in the consideration of the age classification, which is currently not the case. The aim must be to sensitise manufacturers, players and parents to addiction problems with respect to the types of games and to investigate aspects of games which increase the risk of particularly long gameplay periods and the risk of developing computer games dependencies.

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