1. Heather Titus

2.  Over the last decade, the concept of internet addiction has grown in terms of its acceptance as a legitimate clinical disorder needing treatment  Excess video gaming is identified as a subtype of internet addiction  Video game addiction, or more broadly video game overuse, is excessive or compulsive use of computer and video that interferes with daily life. Users play compulsively, isolating themselves from, or from other forms of, social contact and focusing almost entirely on in-game achievements rather than broader life events

3.  Computer games  Online games  Video games (single player or multiple in- person player games) on gaming consoles and handheld devices, including cell phones  Massive Multi-user Online Role-Playing Games (MMORPGs)(ex. World of Warcraft)

4.  More than half of American adults play video games  The average elementary school child plays video games between 9 and 11 hours a week; teen boys play an average of 13 hours per week  According to the AMA, as many as 15% of children and adolescents may be addicted to video games (Tanner, 2007).

5.  The addiction stems from the creation of virtual worlds  MMORPGs allow the gamer to completely immerse themselves into a living, self-contained society  MMORPGs worlds continue to exist whether playing or not  Players can decide every intricate detail of their character, experiment with their personality & try new identities

6.  Addicts are typically grade school to adolescent males, although some addicts are college-aged or beyond  Hardcore players tend to be younger players who may suffer from emotional problems or low self worth or esteem (Yee, 2006).

7.  1. Preoccupation with gaming  2. Lying or hiding gaming use  3. Loss of Interest in Other Activities  4. Social Withdrawal  5. Defensiveness and Anger  6. Psychological Withdrawal  7. Using Gaming as an Escape  8. Continued Use Despite Consequences

8.  Gamers neglect sleep, proper diet, exercise, hobbies, and real human contact just to spend more time in the virtual world  Adolescents who cannot play the game experience a loss  Addicts will become irritable, anxious, or depressed when forced to go without it (Leung, 2004).

9.  “I stopped bathing. I didn’t eat unless it was a quick snack I could eat in front of my computer. I lost weight. My skin was pasty and pale. I didn’t shave or comb my hair. I did nothing. I looked so bad my mother told me I looked more like a heroin addict.”

10.  Exposure to movie and TV violence increases aggressive behavior in children (Harvard, 2009).  Brain scan research shows that aggressive thoughts and violent scenes in shooter games activate similar parts of the brain  VGA addicts may suffer health problems from back strain, eye strain, carpel tunnel syndrome, and repetitive stress injury  Loss of sleep and lower quality sleep  Often the worst damage done is to marriages and real-life relationships

11.  Children of substance abusing parents are shown to have an increase risk of using gaming as a coping mechanism  It is harder for a teen to recover from gaming addiction, especially because using the computer is a necessary component of their home and school environments  When pressed, most adolescents say they aren’t gaming any more than peers

12.  “My son loved baseball and played Varsity on his high school team until he discovered X-Box Live. His grades plummeted after he discovered the game, but it wasn’t until he quit the baseball team that I knew something was seriously wrong. He loved baseball too much. He won a baseball scholarship for college and dreamed about playing professionally. Now, nothing else matters to him except the game.”

13.  For most adolescents, treatment is involuntary and usually mandated by parents, teachers, or the judicial system  Successful treatment must address both the gaming behavior and help an adolescent navigate the normal developmental tasks of identity formation  Treatment should focus on effective problem solving and social skills necessary to build self esteem

14.  Family therapy can be effective, bringing in an older sibling or friend  Teach adolescents about body language, facial expressions, and role playing conversations

15.  Joining – forming a therapeutic alliance with all family members  Diagnosis – identifying interactional patterns that allow or encourage problematic youth behavior  Restructuring – the process of changing the family interactions related to problem

16.  Often parents fall into an enabling role with a gaming-addicted adolescent  Parents should take the issue seriously and agree on common goals  Parents should: 1. Set limits on play time 2. Use the rating system /online controls 3. Keep consoles out of the bedroom 4. Rest tired eyes and muscles 5. Push for non-online computer games 6. Change the power source 7. Check how their child is doing in school 8. Become more involve in their child’s life

17.  Symptoms of VGA withdrawal include anxiety, depression, irritability, trembling hands, restlessness, and obsessive thinking or fantasizing about the Internet or video games  If the game provides a more appealing, exciting, and supportive environment than does the family, the adolescent will continue to gravitate to the game to meet unmet needs

21.  Game on. Harvard Health Letter, October 2009, p.4-5.  Leung, L. (2004). Net-generation attributes and seductive properties of the internet as predictors of online activities and internet addiction. CyberPsychology & Behavior, 7(3), 333-348.  Tanner, L. (2007). AMA considers video game overuse an addiction. The Associated Press. Retrieved on November 10, 2010 from http://www.washingtonpost.com/wpdyn/content/article/2007/06/ 27/AR2007062700995.html http://www.washingtonpost.com/wpdyn/content/article/2007/06/ 27/AR2007062700995.html  Yee, N. (2006). Motivations of play in online games. CyberPsychology & Behavior, 9, 772-775.  Young, K. (2009). Online gaming: Symptoms, risk factors, and treatment. In A. Browne-Miller (Ed.), The Praeger International Collection on Addictions, Vol. 4 (p. 1-16).  Young, K. (2009). Understanding Online Gaming Addiction and Treatment Issues for Adolescents. The American Journal of Family Therapy, 37: 355-372.