Psychiatric Quarterly

, Volume 86, Issue 3, pp 381–384 | Cite as

Psychiatrists’ Perceptions of Role-Playing Games

  • Eric Lis
  • Carl Chiniara
  • Robert Biskin
  • Richard Montoro
Original Paper


The literature has seen a surge in research on the mental health impacts of technologies such as Facebook, video games, and massively-multiplayer online role-playing games such as World of Warcraft, but little is known regarding the mental health impact of non-video role-playing games, such as Dungeons & Dragons. The present study examines how psychiatrists’ perceive role-playing games and whether they play them. Psychiatrists at a tertiary care centre in Canada completed a questionnaire assessing history of playing role-playing games and whether they associate them with psychopathology. Forty-eight psychiatrists responded. Twenty-three percent have played a role-playing game over their lifetimes. Twenty-two percent believed there was an association between psychopathology and role-playing games. A majority of psychiatrists who responded do not associate role-playing games with psychopathology. Implications for clinical practice and future research are discussed.


Role-playing games Dungeons & Dragons Stereotypes Psychiatrists 


Table-top role-playing games (RPGs) such as Dungeons & Dragons constitute an important element of Western culture. Recent years have seen a surge in research on the health impacts of massively-multiplayer online role-playing games (MMORPGs) [1, 2, 3] but little research on non-video games. RPGs have intrinsic social elements, requiring multiple players to cooperate to elaborate a narrative. Studies have not demonstrated any differences between RPG-players and “healthy controls” [4, 5, 6, 7, 8]. However, movies and television demonstrate that RPG-players are stereotyped as socially inept and often suffering from psychiatric disorders. Millions worldwide regularly play RPGs [9], but no data exist regarding whether mental health professionals play RPGs or consider RPGs harmful.

This pilot study was conducted as part of a larger project to gather exploratory data in the uncanvassed areas of psychiatrists’ perception of RPGs, MMORPGs, and technologies such as Facebook. We had two hypotheses:
  1. (1)

    RPGs will be perceived by a majority of participants as being associated with at least one DSM–IV-TR diagnosis.

  2. (2)

    Age will predict psychiatrists’ perceptions of psychopathology associated with RPGs.


Materials and Methods

Psychiatrists were recruited from six hospitals within the McGill University hospital network. All were currently-employed English-speaking psychiatrists over the age of 18. Email contact information was obtained from the faculty listserv.

A recruitment letter was distributed via email which linked to an electronic questionnaire hosted on the LimeSurvey website ( The questionnaire was accessible for a period of 2 months.

The online questionnaire was created by consensus between the authors and consisted of sixty-three questions, eight of which specifically pertained to RPGs. No demographic information was collected except for the participants’ ages. Questions assessed recent use (“In the last 6 months, have you used a social networking site such as Facebook or Google Plus?”), knowledge (“How knowledgeable do you feel about blog or status update sites such as Twitter or Livejournal?”), perceived associations with specific psychiatric disorders [“Do you feel that there is a link or association (causative or not) between use of table-top RPGs and mental health problems (such as depression, social anxiety, etc.)?”; “How strongly associated are the following DSM IV diagnoses with table-top games?”]. All questions were either yes/no or rated on a five point Likert scale. The questionnaire was not validated prior to administration.

All statistical analyses were conducted with SPSS version 19 (IBM Corp. Released 2010. IBM SPSS Statistics for Windows, Version 19.0. Armonk, NY: IBM Corp.). Our specific hypotheses were tested in the following manner:

Hypothesis 1

Mean scores were calculated for the association between psychopathology and RPGs. Results of these were provided as descriptives.

Hypothesis 2

Participants were stratified into different age groups (30–45, 45–60, 60+). A mean score of the association between psychopathology and RPGs was calculated. The mean scores were compared using a one-way ANOVA.

Ethics approval was obtained from the McGill University Institutional Review Board. Each participant electronically signed a consent form prior to completing the questionnaire.


Out of a total population of 160, 48 (30 %) completed the questionnaire. Ages ranged from 32–77 (mean = 53.8, SD = 10.8). Among our participants, 23 % have played an RPG, compared to 8 % who have played MMORPGs and 69 % who have played video games.

With respect to perceived associations between mental illness and RPGs, 22 % believed there was a link. This was lower than the percentage who endorsed an association with social networking sites (37 %), blogs or Twitter (33 %), or MMORPGs (37 %).

There were no significant differences by age group for perceived psychopathology (F = .11, df = 2, p > .05).


Our data did not support our hypotheses. None the less, interesting findings emerge.

Only 22 % of this sample perceived an association between RPGs and psychopathology. This has never previously been demonstrated and is important because RPGs are often presented in popular culture as associated with social withdrawal and personality disorder. Among our sample, these stereotypes are not widespread.

Twenty-three percent reported having played RPGs in their lives, 6 % in the past six months. Psychiatrists may be more likely to have played RPGs than members of the general public, based on limited marketing data from RPG companies.

Our study has a number of important limitations. Our participants are a convenience sample from hospitals at a single university centre; our results may not be generalizable to psychiatrists in the community or other centers. Forty eight out of one-hundred and sixty eligible psychiatrists completed questionnaires, and there was probably response bias. Our online questionnaire was distributed by email, so more computer-literate psychiatrists were more able to participate. We know that a number of individuals in our population do not use computers and were therefore functionally excluded; our results may not generalize to less computer-literate psychiatrists. However, 16 % of respondents were at least age 65 and our mean age was 54.3 years, suggesting that we did not entirely exclude older staff.

Our 30 % response rate, though low, is typical of questionnaires distributed to physicians [10, 11, 12].

Our study was powered to detect moderate effect sizes. We could have been underpowered to detect smaller effects.

We did not collect extensive demographic information due to concerns about length and to minimize questions which could identify participants. Our sample included both adult and child and adolescent psychiatrists, but our questionnaire did not ask what age group(s) participants work with. We cannot comment on whether general psychiatrists and child psychiatrists have a different perception of RPGs.

These findings suggest directions for future research. It would be valuable to distribute this questionnaire to psychiatrists at other sites in culturally diverse settings. Similarly, different results might be obtained from non-psychiatrist mental health workers or other physicians. Future studies should also consider whether respondents work primarily with general or pediatric populations.


This study represents the first data collected on psychiatrists’ perceptions of RPGs, a significant cultural phenomenon associated with stereotypes related to mental health. Our results suggest that psychiatrists do not assume that RPG-players are at higher risk of psychopathology. This is a potentially understudied area and future research could potentially add significantly to our understanding.



The authors acknowledge the members of the McGill University Psychiatry Perceptions of Emerging Technologies Labs for their support.

Conflict of interest

All authors declare that they have no conflict of interest.

Ethical Standards

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000 (5). Informed consent was obtained from all patients for being included in the study.


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Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  • Eric Lis
    • 1
  • Carl Chiniara
    • 1
  • Robert Biskin
    • 1
  • Richard Montoro
    • 1
  1. 1.McGill University Psychiatry Perceptions of Emerging Technologies LabsMontrealCanada

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