Evidence-Based Reviews

Video games: When does play become pathology?

Current Psychiatry. 2007 December;6(12):27-38

References

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Recommended approach

Explore whether a child’s behavior could be characterized as normative or excessive, in terms of how much time he or she spends playing video games. This can help put parents’ concerns in context. Regardless of how much time the patient spends playing video games, pay attention to whether his or her thoughts, emotions, and behaviors seem pathologic.

Try to determine if the child is experiencing distress or functional impairment because of video game play or if excessive time spent playing video games is exacerbating symptoms of a comorbid mood, anxiety, or disruptive behavior disorder. Assess overall functioning, participation in activities, engagement in relationships, and how the child perceives his or her play. Investigate the family environment, peer relationships, and history of trauma.

Clinical Point

Work with parents to monitor video game exposure; keep computers in the home’s community area instead of the child’s bedroom

Address underlying issues, monitor and regulate video game play, and focus on how video game play changes as other problems are resolved. Work with parents to control children’s video game exposure (Table 5). Consider cognitive-behavioral methods to help the child recognize the negative consequences of excessive video game play.

If these interventions fail to address excessive or pathologic video game play, or if comorbid disorders and functional impairment are severe, medication or residential treatment may be needed to effectively control video game exposure.

Table 5

Advice to parents for monitoring children’s video game use

Keep computer and game consoles in a community area in the home
Check age-based ratings and content descriptors of games before renting or buying
Talk to your kids’ friends’ parents about the video games they play in their households
Talk with your kids about Internet safety, particularly if they play MMOs
Play games with your kids—have them teach you how to play and show you what they like about particular games
Engage in frequent casual conversations with your kids about the games they play and what the experience is like for them
Consult a mental health professional if you’re concerned about changes in your child’s mood, school performance, social relationships, or eating or sleeping habits
MMOs: massively-multiplayer online games

Related Resources

Entertainment Software Rating Board. Search for video game titles or publishers by rating, platform, and content descriptor. www.esrb.org.
Jones G. Killing monsters: why children need fantasy, super heroes, and make-believe violence. New York: Basic Books; 2003.

Disclosure

The author reports no financial relationship with any company whose products are mentioned in this article or with manufacturers of competing products.