The sharp increase in the Pathological Gambling and Behavioral Addictions Unit could be one of the lockdown’s consequences on mental health in the medium and long term. In the last decade, there had already been a growth of this type of consultations, but the figures since 2021 have skyrocketed.
It can take months before patients and families recognise that a disorder exists and reach out to healthcare providers.
Warning signs include relevance to the person's life, loss of self-control and withdrawal from other social, leisure and work/school activities.
Video games are entertaining, motivating, stimulating and fun. However, abusive use can become a major disorder. Video game addiction is a clinical reality. In fact, the latest scientific evidence indicates that approximately 3% of the population is subject to suffer from this type of behavioural addiction, with serious consequences in the personal, family, social, work and/or academic spheres. "The problematic risk of video game use exists in both genders. Although it has traditionally been associated with the male gender, we receive more and more consultations from girls," explained clinical psychologist Susana Jiménez, head of the Unit of Pathological Gambling and Behavioural Addictions of the Bellvitge University Hospital (HUB) and IDIBELL researcher.
"These data are evidence of the medium and long-term mental health consequences of the abusive use of video games during periods of lockdown", as the clinical psychologist points out. "Until patients and families don’t recognise that the passion for video games is in fact an addiction, they do not go for consultations to care facilities and self-help associations. This can take months," she adds. Most studies suggest that massively multiplayer online, role-playing and multiplayer video games - known as MMORPGs - are the ones that generate the most problems of excessive use. What are the signs to look out for? According to the team at the Pathological Gambling and Behavioural Addictions Unit (non-substance) at Bellvitge Hospital, the warning signs are the following:
- Relevance in the person's life;
- Loss of self-control over this activity;
- Excessive time spent playing video games on a daily basis (e.g. 4-5 hours);
- Increased irritability, anxiety and sadness when not playing the game;
- Neglect of other social, school/work and leisure activities, as well as negative consequences in other aspects of life;
- Persistence in the use of video games, despite all their negative consequences.
The support of other professionals, such as teachers and primary care teams, is essential for the early detection of other warning signs.
"In the right context and with a healthy pattern of use, video games can be educational, increase certain skills and abilities, improve self-esteem and social relations and even practice languages. But, at the same time, we must recognise and prevent the negative impact they can have as a result of abusive use, and as a society we must take shared responsibility for promoting the healthy use of new technologies," insists Susana Jiménez.
Loot boxes, the fine line between pathological gambling and video games
Some video games allow the purchase of 'loot boxes', which are virtual items that produce random rewards when 'bought', either with hours of play or by paying a real amount of money. From a psychological point of view, "there are similarities between gambling addiction and this type of video game, as they encourage spending money on items that are not actually purchased, but are the product of a computer algorithm", according to the expert in pathological gambling at Bellvitge Hospital.
The uncertainty and excitement of buying these loot boxes facilitates repeating the habit of seeking the desired reward. As in gambling, the positive reinforcement of the reward has an intermittent and variable pattern (with an unknown outcome), and more and more money is spent in an attempt to make up for the investment. Some authors argue that loot boxes may represent the transition from healthy to problematic video game use, or even the transition to gambling.