Dissociation in Problematic Gaming: a Systematic Review
- 170 Downloads
Purpose of Review
The present article consists of a systematic review of recent (2007–2018) empirical studies addressing the relationship between problematic gaming and dissociation. Nineteen peer-reviewed empirical studies that examined the relationship between problematic gaming and dissociation were identified.
The findings suggest that excessive video game use is linked to a variety of dissociative phenomena (e.g. depersonalisation experiences, escapism, psychotic-like experiences, game transfer phenomena).
Dissociative experiences are associated with problematic gaming. The findings support the hypothesis that problematic video game use can represent a maladaptive coping strategy on which people can rely to escape from disturbing mental states, adverse emotions or real-life problems. In these circumstances, dissociative symptoms might represent the side effects of an alteration in consciousness that is generated by excessive video game use. However, further research (especially experimental and longitudinal) is required in order to establish a potential causal link between problematic gaming patterns and dissociation.
KeywordsProblematic gaming Gaming disorder Dissociation Depersonalisation Escapism Psychotic-like experiences Game transfer phenomena
Compliance with Ethical Standards
Conflict of Interest
The authors declare that they have no conflict of interest. This article has been edited by Editor-in-Chief Marc Potenza instead of Joël Billieux and Adriano Schimmenti, as Joël Billieux and Adriano Schimmenti are the Section Editors of the “Dissociation and Addictive Behaviors” topical collection.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
- 1.Greenfield D. The addictive properties of Internet usage. In: Young KS, de Abreu CN, editors. Internet addiction: a handbook and guide to evaluation and treatment. Hoboken, NJ: John Wiley & Sons, Inc.; 2011. p. 135–53.Google Scholar
- 2.Mérelle SYM, Kleiboer A, Schotanus M, et al. Which health-related problems are associated with problematic video-gaming or social media use in adolescents? Clin Neuropsychiatry. 2017;14(1):11–9.Google Scholar
- 15.Billieux J, Philippot P, Schmid C, Maurage P, De Mol J, Van der Linden M. Is dysfunctional use of the mobile phone a behavioural addiction? Confronting symptom-based versus process-based approaches. Clin Psychol Psychother. 2015;22(5):460–8. https://doi.org/10.1002/cpp.1910.CrossRefPubMedGoogle Scholar
- 19.Wéry A, Schimmenti A, Karila L, Billieux J. Where the mind cannot dare: a case of addictive use of online pornography and its relationship with childhood trauma. J Sex Marital Ther. 2018. https://doi.org/10.1080/0092623X.2018.1488324.
- 20.World Health Organization [WHO]. Mental, behavioural or neurodevelopmental disorders. In: ICD-11 beta draft—mortality and morbidity statistics;. 2018. https://icd.who.int/dev11/l-m/en#/http%3a%2f%2fid.who.int%2ficd%2fentity%2f334423054. Accessed 31 Oct 2018.
- 21.Billieux J, King DL, Higuchi S, et al. Functional impairment matters in the screening and diagnosis of gaming disorder. Commentary on: scholars’ open debate paper on the World Health Organization ICD-11 gaming disorder proposal (Aarseth et al.). J Behav Addict. 2017;6(3):285–9. https://doi.org/10.1556/2006.6.2017.036.CrossRefPubMedPubMedCentralGoogle Scholar
- 24.Männikkö N, Ruotsalainen H, Miettunen J, Pontes HM, Kääriäinen M. Problematic gaming behaviour and health-related outcomes: a systematic review and meta-analysis. J Health Psychol. 2017. https://doi.org/10.1177/1359105317740414.
- 30.King DL, Delfabbro P. Understanding and assisting excessive players of video games: a community psychology perspective. Aust Comm Psychol. 2009;21(1):62–74.Google Scholar
- 34.Bartle RA. Designing virtual worlds. New Riders Publishing: United States of America; 2004.Google Scholar
- 36.American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 4th ed. Washington, DC: American Psychiatric Association; 1994.Google Scholar
- 43.Turkle S. Life on the screen: identity in the age of the internet. New York, NY: Simon & Schuster; 1995.Google Scholar
- 45.Schimmenti A, Caretti V. Video-terminal dissociative trance: toward a psychodynamic understanding of problematic internet use. Clin Neuropsychiatry. 2017;14(1):64–72.Google Scholar
- 51.• Schimmenti A, Guglielmucci F, Barbasio C, Granieri A. Attachment disorganization and dissociation in virtual worlds: a study on problematic Internet use among players of online role playing games. Clin Neuropsychiatry. 2012;9(5):195–202 The authors reported that dissociative experiences mediated the relationship between unresolved states of mind regarding attachment and scores on problematic Internet use in a sample of excessive gamers. Google Scholar
- 54.Floros G, Siomos K, Stogiannidou A, Giouzepas I, Garyfallos G. Comorbidity of psychiatric disorders with Internet addiction in a clinical sample: the effect of personality, defense style and psychopathology. Addict Behav. 2014;39(12):1839–45. https://doi.org/10.1016/j.addbeh.2014.07.031.CrossRefPubMedGoogle Scholar
- 58.Männikkö N, Billieux J, Nordström T, Koivisto K, Kääriäinen M. Problematic gaming behaviour in Finnish adolescents and young adults: relation to game genres, gaming motives and self-awareness of problematic use. Int J Ment Heal Addict. 2017;15(2):324–38. https://doi.org/10.1007/s11469-016-9726-7.CrossRefGoogle Scholar
- 60.• Billieux J, Thorens G, Khazaal Y, Zullino D, Achab S, Van der Linden M. Problematic involvement in online games: a cluster analytic approach. Comput Hum Behav. 2015;43:242–50. https://doi.org/10.1016/j.chb.2014.10.055 The authors showed that individuals using video games as a mean to escape from reality spent more time online and reported more negative affects than other gamers. CrossRefGoogle Scholar
- 62.Billieux J, Van der Linden M, Achab S, et al. Why do you play World of Warcraft? An in-depth exploration of self-reported motivations to play online and in-game behaviours in the virtual world of Azeroth. Comput Hum Behav. 2013;29(1):103–9. https://doi.org/10.1016/j.chb.2012.07.021.CrossRefGoogle Scholar
- 63.•• Király O, Urbán R, Griffiths MD, et al. The mediating effect of gaming motivation between psychiatric symptoms and problematic online gaming: an online survey. J Med Internet Res. 2015;17(4):e88. https://doi.org/10.2196/jmir.3515 In a large sample of 3,186 online gamers, the authors found that avoiding real-life problems (i.e., escapism) was significantly related to psychiatric symptoms and problematic gaming. CrossRefPubMedPubMedCentralGoogle Scholar
- 68.• Vadlin S, Åslund C, Hellström C, Nilsson KW. Associations between problematic gaming and psychiatric symptoms among adolescents in two samples. Addict Behav. 2016;61:8–15. https://doi.org/10.1016/j.addbeh.2016.05.001 The authors found that more than 10% of adolescent problematic gamers showed psychotic-like experiences in both clinical and community samples. CrossRefPubMedGoogle Scholar
- 69.Guglielmucci F, Saroldi M, Zullo G, Munno D, Granieri A. Personality profiles and problematic Internet use: a study with a sample of Italian adolescents. Clin Neuropsychiatry. 2017;14(1):94–103.Google Scholar
- 72.Ortiz de Gortari AB. Targeting the real life impact of virtual interactions: the game transfer phenomenon: 42 video games players’ experiences (Master dissertation). Retrieved from Digitala Vetenskapliga Arkivet database. 2010;425850.Google Scholar
- 74.• Ortiz de Gortari AB, Griffiths MD. Prevalence and characteristics of Game Transfer Phenomena: a descriptive survey study. Int J Hum Comput Interact. 2016;32(6):470–80. https://doi.org/10.1080/10447318.2016.1164430 This large online survey on a sample of 2362 online gamers showed a high prevalence of bodily alterations related with Game Transfer Phenomena. CrossRefGoogle Scholar
- 77.Renard SB, Huntjens RJ, Lysaker PH, Moskowitz A, Aleman A, Pijnenborg GH. Unique and overlapping symptoms in schizophrenia spectrum and dissociative disorders in relation to models of psychopathology: a systematic review. Schizophr Bull. 2017;43(1):108–21. https://doi.org/10.1093/schbul/sbw063.CrossRefPubMedGoogle Scholar
- 78.Lemma A. An order of pure decision: growing up in a virtual world and the adolescent’s experience of the body. In: Psychoanalysis in the technoculture era: Routledge; 2013. p. 97–118. https://doi.org/10.1177/0003065110385576.
- 80.Turkle S. Alone together: why we expect more from technology and less from each other. New York: Basic Books; 2011.Google Scholar