Skip to main content

Policy and Prevention Approaches for Disordered and Hazardous Gaming and Internet Use: an International Perspective

Prevention Science volume 19, pages 233–249 (2018)Cite this article

Abstract

Problems related to high levels of gaming and Internet usage are increasingly recognized as a potential public health burden across the developed world. The aim of this review was to present an international perspective on prevention strategies for Internet gaming disorder and related health conditions (e.g., Internet addiction), as well as hazardous gaming and Internet use. A systematic review of quantitative research evidence was conducted, followed by a search of governmental reports, policy and position statements, and health guidelines in the last decade. The regional scope included the USA, UK, Australia, China, Germany, Japan, and South Korea. Prevention studies have mainly involved school-based programs to train healthier Internet use habits in adolescents. The efficacy of selective prevention is promising but warrants further empirical attention. On an international scale, the formal recognition of gaming or Internet use as a disorder or as having quantifiable harms at certain levels of usage has been foundational to developing structured prevention responses. The South Korean model, in particular, is an exemplar of a coordinated response to a public health threat, with extensive government initiatives and long-term strategic plans at all three levels of prevention (i.e., universal, selective, and indicated). Western regions, by comparison, are dominated by prevention approaches led by non-profit organizations and private enterprise. The future of prevention of gaming and Internet problems ultimately relies upon all stakeholders working collaboratively in the public interest, confronting the reality of the evidence base and developing practical, ethical, and sustainable countermeasures.

This is a preview of subscription content, access via your institution.

Access options

Buy single article

Instant access to the full article PDF.

USD 39.95

Price includes VAT (USA)
Tax calculation will be finalised during checkout.

References

  • Act on Development of an Environment that Provides Safe and Secure Internet Use for Young People (Act No. 79 of 2008). Government of Japan. Available from: http://www8.cao.go.jp/youth/youth-harm/law/pdf/english.pdf.

  • Ahn, H., Park, G., & Lee, H. (2013). Design and implementation of usage monitoring and regulation application for understanding and treatment of smart phone addiction for teenagers. Korean Society for Computer Game, 26, 99–106.

    Google Scholar 

  • American Academy of Pediatrics. (2011). Policy statement: Media use by children younger than 2 years. Pediatrics, 128, 1040–1045.

    Article  Google Scholar 

  • Blaszczynski, A., Ladouceur, R., & Shaffer, H. J. (2004). A science-based framework for responsible gambling: The Reno model. Journal of Gambling Studies, 20, 301–317.

    Article  PubMed  Google Scholar 

  • Busiol, D., & Lee, T. Y. (2015). Prevention of Internet addiction: The PATHS program. In In Student well-being in Chinese adolescents in Hong Kong (pp. 185–193). Singapore: Springer.

    Chapter  Google Scholar 

  • Ceyhan, A. A., & Ceyhan, E. (2008). Loneliness, depression, and computer self-efficacy as predictors of problematic internet use. Cyber Psychology & Behavior, 11, 699–701.

    Article  Google Scholar 

  • Dau, W., Hoffman, J. D. G., & Banger, M. (2015). Therapeutic interventions in the treatment of problematic Internet use: Experiences from Germany. In C. Montag & M. Reuter (Eds.), Internet addiction: Neuroscientific approaches and therapeutical interventions (pp. 183–217). New York: Springer International Publishing.

    Google Scholar 

  • Davies, B., & Blake, E. (2016). Evaluating existing strategies to limit video game playing time. IEEE Computer Graphics and Applications, 36, 47–57.

    Article  PubMed  Google Scholar 

  • Deng, L., Fang, X., Chaoying, L., Jing, L., Jintao, Z., & Qinxue, L. (2013). The pilot exploration of psycho-education on adolescent internet addiction prevention. Psychological Research, 6, 75–81.

    Google Scholar 

  • Department of Health. (2014). Report of Advisory Group on health effects of use of internet and electronic screen products. Department of Health: The Government of the Hong Kong SAR. Retrieved: studenthealth.gov.hk/english/internet/report/files/e_report.pdf.

  • Dooley, J. J., Cross, D., Hearn, L., & Treyvaud, R. (2009). Review of existing Australian and international cyber-safety research. Child Health Promotion Research Centre. Perth: Edith Cowan University.

    Google Scholar 

  • Dreier, M., Wölfling, K., Beutel, M. E., & Müller, K. W. (2015). Prävention der Internetsucht. Workshop für Kinder und Jugendliche mit digitalen Methodenkoffern [Internet addiction prevention. Workshop for children and adolescents using digital methods]. Pädiatrie und Pädologie, 50, 200–205.

    Article  Google Scholar 

  • Drug Commissioner of the Federal Ministry of Health. (2012). National strategy on drug and addiction policy. Berlin: Federal Ministry of Health.

    Google Scholar 

  • Evers-Wölk, M., Opielka, M., & Sonk, M. (2016). Neue elektronische Medien und Suchtverhalten. Endbericht zum TA Projekt [New electronic media and behavioural addiction. Final report for the TA project] (Vol. TAB Arbeitsbericht Nr. 166). Berlin: Büro für Technologieabschätzung beim Deutschen Bundestag.

  • Fang, X., Liu, L., Deng, L., Liu, Q., Su, W., & Lan, J. (2015). The prevention and intervention of adolescent internet addiction. Psychological Development and Education, 31, 100–107.

    Google Scholar 

  • Ferguson, C. J., Coulson, M., & Barnett, J. (2011). A meta-analysis of pathological gaming prevalence and comorbidity with mental health, academic and social problems. Journal of Psychiatric Research, 45, 1573–1578.

    Article  PubMed  Google Scholar 

  • Fontalba-Navas, A., Marin-Olalla, M., Gil-Aguilar, V., Rodriguez-Hurtado, J., Ríos-García, G., & Pena-Andreu, J. M. (2015). Mental health promotion: Prevention of problematic Internet use among adolescents. African Journal of Psychiatry, 18, 218–220.

    Google Scholar 

  • Gentile, D. (2009). Pathological video-game use among youth ages 8 to 18. A national study. Psychological Science, 20, 594–602.

    Article  PubMed  Google Scholar 

  • Griffiths, M. D. (2009). Online computer gaming: Advice for parents and teachers. Education and Health, 27, 3–6.

    Google Scholar 

  • Griffiths, M. D., van Rooij, A., Kardefelt-Winther, D., Starcevic, V., Király, O., Pallesen, S., Müller, K., Dreier, et al. (2016). Working towards an international consensus on criteria for assessing Internet gaming disorder: A critical commentary on Petry et al. (2014). Addiction, 111, 167–178.

    Article  PubMed  PubMed Central  Google Scholar 

  • Joint Select Committee on Cyber-Safety (2011). High-wire act: Cyber-safety and the young. Commonwealth of Australia.

  • Joo, A., & Park, I. (2010). Effects of an empowerment education program in the prevention of Internet games addiction in middle school students. Journal of Korean Academy of Nursing, 40, 255–263.

    Article  PubMed  Google Scholar 

  • Kelley, K. J., & Gruber, E. M. (2012). Problematic Internet use and physical health. Journal of Behavioral Addictions, 2, 108–112.

    Article  Google Scholar 

  • King, D. L., & Delfabbro, P. H. (2014). Internet gaming disorder treatment: A review of definitions of diagnosis and treatment outcome. Journal of Clinical Psychology, 70, 942–955.

    Article  PubMed  Google Scholar 

  • King, D. L., Delfabbro, P. H., Griffiths, M. D., & Gradisar, M. (2011). Assessing clinical trials of Internet addiction treatment: A systematic review and CONSORT evaluation. Clinical Psychology Review, 31, 1110–1116.

    Article  PubMed  Google Scholar 

  • King, D. L., Delfabbro, P. H., & Griffiths, M. D. (2012a). Clinical interventions for technology-based problems: Excessive Internet and video game use. Journal of Cognitive Psychotherapy: An International Quarterly, 26, 43–56.

    Article  Google Scholar 

  • King, D. L., Delfabbro, P. H., Griffiths, M. D., & Gradisar, M. (2012b). Cognitive-behavioral approaches to outpatient treatment of Internet addiction in children and adolescents. Journal of Clinical Psychology, 68, 1185–1195.

    Article  PubMed  Google Scholar 

  • King, D. L., Delfabbro, P. H., Zwaans, T., & Kaptsis, D. (2013). Clinical features and axis I comorbidity of Australian adolescent pathological Internet and video-game users. Australian and New Zealand Journal of Psychiatry, 47, 1058–1067.

    Article  PubMed  Google Scholar 

  • King, D. L., Delfabbro, P. H., Wu, A. M. S., Doh, Y. Y., Kuss, D. J., Mentzoni, R., Pallesen, S., Carragher, N., & Sakuma, H. (2017). Treatment of Internet gaming disorder: An international systematic review and CONSORT evaluation. Clinical Psychology Review, 54, 123–133.

    Article  PubMed  Google Scholar 

  • Koh, Y.-S. (2015). The Korean national policy for Internet addiction. In C. Montag & M. Reuter (Eds.), Internet addiction: Neuroscientific approaches and therapeutical interventions (pp. 219–233). Cham: Springer International Publishing.

    Google Scholar 

  • Koo, H. Y. (2013). Effects of a prevention program for media addiction on television addiction, internet addiction, cellular addiction, and impulsiveness in elementary school students. Child Health Nursing Research, 19, 270–281.

    Article  Google Scholar 

  • Koo, C., Wati, Y., Lee, C. C., & Oh, H. Y. (2011). Internet-addicted kids and South Korea government efforts: Boot-camp case. Cyberpsychology, Behavior, & Social Networking, 14, 391–394.

    Article  Google Scholar 

  • Kuss, D. J., & Lopez-Fernandez, O. (2016). Internet addiction and problematic Internet use: A systematic review of clinical research. World Journal of Psychiatry, 6, 143.

    Article  PubMed  PubMed Central  Google Scholar 

  • Kwon, J-H. (2011). Toward the prevention of adolescent Internet addiction. In K. Young & Nabuco de Abreu (Eds). Internet addiction: A handbook and guide to evaluation and treatment. pp. 223–243.

  • Lawrence, D., Johnson, S., Hafekost, J., Boterhoven De Haan, K., Sawyer, M., Ainley, J., & Zubrick, S. R. (2015). The mental health of children and adolescents. Report on the second Australian Child and Adolescent Survey of Mental Health and Wellbeing. Canberra: Department of Health.

    Google Scholar 

  • Lee, S. J. (2012). Parental restrictive mediation of children’s internet use: Effective for what and for whom? New Media & Society. doi:10.1177/1461444812452412.

  • Lee, H., Ahn, H., Choi, S., & Choi, W. (2014). The SAMS: Smartphone addiction management system and verification. Journal of Medical Systems, 38, 1–10.

    Article  PubMed  Google Scholar 

  • Li, L. (2013). Prevention of adolescents’ Internet addiction: Based on the evidence from research. Advances in Psychological Science, 20, 791–797.

    Article  Google Scholar 

  • Li, Y., Zhang, X., Lu, F., Zhang, Q., & Wang, Y. (2014). Internet addiction among elementary and middle school students in China: A nationally representative sample study. Cyberpsychology, Behavior, and Social Networking, 17, 111–116.

    Article  Google Scholar 

  • Lim, S. S. (2012). Regulatory initiatives for managing online risks and opportunities for youths—The East Asian experience. In M. Walrave (Ed.), e-Youth: Balancing between opportunities and risks? (pp. 271–290). Brussels: Peter Lang.

    Google Scholar 

  • Mak, K. K., Lai, C. M., Watanabe, H., Kim, D. I., Bahar, N., Ramos, M., et al. (2014). Epidemiology of internet behaviors and addiction among adolescents in six Asian countries. Cyberpsychology, Behavior, and Social Networking, 17, 720–728.

    Article  Google Scholar 

  • McLean, S. (2013). Advice sheets: Problematic Internet use. Department of Education and Training. Retrieved: education.vic.gov.au/Documents/about/programs/bullystoppers/smproblematic.pdf.

  • Microsoft (2016). Windows 10 health gaming guide. Retrieved online: https://support.xbox.com/en-AU/xbox-on-windows/family-safety-and-security/healthy-gaming-guide.

  • Ministry of Science, ICT and Future Planning (2016). National master plan for implementing healthy use of smartphone and Internet (2016–2018).

  • Montag, C., Kannen, C., Lachmann, B., Sariyska, R., Duke, É., Reuter, M., & Markowetz, A. (2015). The importance of analogue zeitgebers to reduce digital addictive tendencies in the 21st century. Addictive Behaviors Reports, 2, 23–27.

    Article  Google Scholar 

  • Mun, S. Y., & Lee, B. S. (2015). Effects of an integrated Internet addiction prevention program on elementary students’ self-regulation and Internet addiction. Journal of Korean Academy of Nursing, 45, 251–261.

    Article  PubMed  Google Scholar 

  • Nakayama, H., & Higuchi, S. (2015). Internet addiction. Japanese Journal of Clinical Medicine, 73, 1559–1566.

    PubMed  Google Scholar 

  • Petry, N. M., Rehbein, F., Gentile, D. A., Lemmens, J. S., Rumpf, H. J., Mößle, T., & Auriacombe, M. (2014). An international consensus for assessing internet gaming disorder using the new DSM‐5 approach. Addiction, 109, 1399–1406.

  • Protection of Minors Act (2006). Law of the People’s Republic of China. Retrieved online: http://www.npc.gov.cn/englishnpc/Law/2007-12/12/content_1383869.htm.

  • RANZCP (2011). The impact of media on vulnerable children and adolescents [Position Statement 72]. Faculty of Child and Adolescent Psychiatry. Retrieved online: https://www.ranzcp.org/Files/Resources/College_Statements/Position_Statements/ps72-pdf.aspx.

  • Romano, J. L., & Hage, S. M. (2000). Prevention and counseling psychology: Revitalizing commitments for the 21st century. The Counseling Psychologist, 28, 733–763.

    Article  Google Scholar 

  • Shek, D. T., & Sun, R. C. (2010). Effectiveness of the tier 1 program of project PATHS: Findings based on three years of program implementation. The Scientific World Journal, 10, 1509–1519.

    Article  PubMed  Google Scholar 

  • Shek, D. T., & Yu, L. (2012). Prevention of adolescent problem behavior: Longitudinal impact of the Project P.A.T.H.S in Hong Kong. The Scientific World Journal, 11, 546–567.

    Article  Google Scholar 

  • Shek, D. T. L., & Yu, L. (2013). Internet addiction phenomenon in early adolescents in Hong Kong. International Journal of Child Health and Human Development, 6, 145–156.

    Google Scholar 

  • Sutter, J. D. (2012). “StarCraft” and “Warcraft” maker’s take on gaming addiction. CNN news article. Retrieved online: http://edition.cnn.com/2012/08/05/tech/gaming-gadgets/blizzard-gaming-addiction-statement/.

  • Turel, O., Mouttapa, M., & Donato, E. (2015). Preventing problematic Internet use through video-based interventions: A theoretical model and empirical test. Behaviour & Information Technology, 34, 349–362.

    Article  Google Scholar 

  • United Kingdom Council for Child Internet Safety: Children’s online activities: Risks and safety (2010). A review of the available evidence.

  • Van Rooij, A. J., Meerkerk, G. J., Schoenmakers, T. M., Griffiths, M., & Van De Mheen, D. (2010). Video game addiction and social responsibility. Addiction Research & Theory, 18, 489–493.

    Article  Google Scholar 

  • Walther, B., Hanewinkel, R., & Morgenstern, M. (2014). Effects of a brief school-based media literacy intervention on digital media use in adolescents: Cluster randomized controlled trial. Cyberpsychology, Behavior, and Social Networking, 17, 616–623.

    Article  Google Scholar 

  • Wang, Y., Wu, A. M. S., & Lau, J. T. (2016). The health belief model and number of peers with internet addiction as inter-related factors of Internet addiction among secondary school students in Hong Kong. BMC Public Health, 16, 272.

    Article  PubMed  PubMed Central  Google Scholar 

  • World Health Organization. (2011). Global recommendations on physical activity for health: 5–17 years old.

  • World Health Organization. (2015). Public health implications of excessive use of the internet, computers, smartphones and similar electronic devices: Meeting report, Main Meeting Hall, Foundation for Promotion of Cancer Research, National Cancer Research Centre, Tokyo, Japan, 27–29 August 2014. World Health Organization.

  • Xu, Z., Turel, O., & Yuan, Y. (2012). Online game addiction among adolescents: Motivation and prevention factors. European Journal of Information Systems, 21, 321–340.

    Article  Google Scholar 

  • Yang, M. K., & Oh, W. O. (2007). Effects of the internet game addiction prevention educational program on self-control and time spent on internet games by elementary school students. Journal of Korean Academy of Child Health Nursing, 13, 282–290.

    Google Scholar 

  • Yee, N. (2006). The demographics, motivations, and derived experiences of users of massively multi-user online graphical environments. Presence: Teleoperators and virtual environments, 15, 309–329.

    Article  Google Scholar 

  • Young, K. (2010). Policies and procedures to manage employee Internet abuse. Computers in Human Behavior, 26, 1467–1471.

    Article  Google Scholar 

  • Zhan, J. D. & Chan, H. C. (2012). Government regulation of online game addiction. Communications of the Association for Information Systems, 30, Article 13. Retrieved from: http://aisel.aisnet.org/cais/vol30/iss1/13.

Download references

Author information

Authors and Affiliations

  1. School of Psychology, The University of Adelaide, Level 5, Hughes Building, Adelaide, SA, 5005, Australia

    Daniel L. King & Paul H. Delfabbro

  2. Graduate School of Culture Technology, Korea Advanced Institute of Science and Technology, Daejeon, Republic of Korea

    Young Yim Doh

  3. Department of Psychology, University of Macau, Zhuhai, China

    Anise M. S. Wu

  4. International Gaming Research Unit, Nottingham Trent University, Nottingham, UK

    Daria J. Kuss

  5. Department of Psychosocial Science, University of Bergen, Bergen, Norway

    Ståle Pallesen & Rune Mentzoni

  6. Office of Medical Education, University of New South Wales, Sydney, Australia

    Natacha Carragher

  7. National Hospital Organization, Kurihama Medical and Addiction Center, Yokosuka, Japan

    Hiroshi Sakuma

Authors
  1. Daniel L. King
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Paul H. Delfabbro
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Young Yim Doh
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Anise M. S. Wu
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Daria J. Kuss
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Ståle Pallesen
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Rune Mentzoni
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Natacha Carragher
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Hiroshi Sakuma
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Daniel L. King.

Ethics declarations

Funding

This work was commissioned by the World Health Organization (WHO) in preparation for the WHO meeting on “Policy and programme responses to mental and behavioural disorders associated with excessive use of the internet and other communication and gaming platforms” in Hong Kong SAR, China, September 6–8, 2016. This work also received financial support from a Discovery Early Career Researcher Award (DECRA) DE170101198 funded by the Australian Research Council.

Conflict of Interest

The authors declare that they have no conflict of interest.

Ethical Approval and Informed Consent

Not required for this work.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

King, D.L., Delfabbro, P.H., Doh, Y.Y. et al. Policy and Prevention Approaches for Disordered and Hazardous Gaming and Internet Use: an International Perspective. Prev Sci 19, 233–249 (2018). https://doi.org/10.1007/s11121-017-0813-1

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11121-017-0813-1

Keywords

  • Internet gaming disorder
  • Internet addiction
  • Prevention
  • Public health
  • Policy
  • DSM-5