Video Games' Addictive Nature Unclear: AMA

By E.J. Mundell
HealthDay Reporter

WEDNESDAY, June 27 (HealthDay News) -- There's not yet enough evidence to label excessive use of video games an addiction, according to Wednesday's vote on the issue by top U.S. doctors.

The American Medical Association, meeting in Chicago, backed away from the stronger language included in a recommendation from the group's Council on Science and Public Health.

That report had called for the AMA to add video game addiction to a list of "formal disorders," where it would join other problem behaviors such as pathological gambling.

But the new recommendations don't go that far. Instead, the AMA is calling for more research into the issue, as well as a review of the video game ratings system, which was first put in place in 1994.

"While more study is needed on the addictive potential of video games, the AMA remains concerned about the behavioral, health and societal effects of video game and Internet overuse," AMA president Dr. Ronald Davis said in a statement.

The physicians' group noted that there was accumulated data linking children's exposure to media violence with increases in aggression. The review of the current ratings system is an attempt to minimize that exposure, the group added.

"We would like to see a ratings system that better alerts parents to the content of the video game and recommended age of the player, so they can decide whether or not their child should be playing it," Davis said.

Dr. Martin Wasserman, executive director of MedChi, the Maryland State Medical Society, helped spearhead the new proposal, which resulted in a 10-page report submitted to the AMA by the group's Council on Science and Public Health. The recommendations released Wednesday sprang from the AMA's consideration of that report

"The concern came up because one of our psychiatrists here in Maryland was seeing older people who were losing their social contacts," specifically because of their overuse of video games, Wasserman said before the vote. "It was ruining their family life. So, it was not unlike gambling addictions or alcohol, where it was having a profound impact on the lives of individuals."

According to the council's report, one soon-to-be-released British study polled 7,000 "gamers" and found that 12 percent of them met World Health Organization criteria for addictive behaviors.

Statistics released in 2005 by the Entertainment Software Association (ESA), an industry group, estimated that 70 percent to 90 percent of American children play video games. The typical gamer is a 30-year-old male who spends about seven or eight hours a week gaming.

According to the authors of the AMA council report, video game overuse is most prevalent among users who play against others online in "massive multi-player online role-playing games."

The council's report defined "heavy game use" as at least two hours a day. But Wasserman, who is a pediatrician, said addictions are best defined by their impact on an individual's life and psyche.

"Basically, you're using a disproportionate amount of time on the video game, and it's what you are thinking about even when you're not on the video game," he said. "And even though it's having negative consequences for you in school or your family situation, or it's taking a disproportionate amount of your money, you still continue to do it. You spend less time with your friends or in other social things."

One theory why certain individuals spend so much time on online games is that they prefer the experience to real-world interaction.

According to the report's authors, the "current theory is that these individuals achieve more control of their social relationships and more success in social relationships in the virtual reality realm than in real relationships."

But that sense of control may come at a price, Wasserman said, especially for children and adults obsessed with games loaded with violent imagery.

"The violent aspects of this, in particular, have got to be a threat to the normal growth and development that we'd like to see in young people," he said. "People have observed more aggressive behaviors [linked to gaming], and if you do subjective testing, there are studies which have shown aggressive behaviors in young people and less supportive behaviors."

Wasserman also questioned the sedentary aspects of hours of video game use. "I can't tell you if this is associated with our current epidemic of child obesity," he said, "but too much time in front of a video tube -- and much of that time spent watching violent interactions -- can't be good for our kids."

That's a sentiment shared by a majority of the American public, according to a survey of more than 1,000 parents of children aged 2 to 17 that was released last week by the nonprofit Kaiser Family Foundation. According to the Associated Press, two-thirds of parents responding to the survey said they were "very concerned" about the amount of sex and violence their children are exposed to in various media.

The report's authors had also urged that the AMA pressure the American Psychiatric Association (APA) to include "Internet/video game addiction" in the next edition of the Diagnostic and Statistical Manual of Mental Disorders, the standard diagnostic text used by psychiatrists worldwide.

That won't happen, based on Wednesday's vote, although the APA's new recommendations will be passed on to the psychiatric group.

Dr. James Scully, medical director at the APA, had said before the vote that any decision on the matter is a long way offr.

Right now, "we don't agree or disagree" with the notion that video game overuse might be an addiction, he said. "As a diagnostic issue, it is going to be several years before we make a determination of that. It's clearly something that we want to consider."

In the meantime, he said, it's up to parents to limit their child's exposure to video games, especially the more violent ones.

Both the AMA and the APA support current recommendations from the American Academy of Pediatrics that limit children's exposure to all "screen time" -- TV, computers and video games -- to a total of two hours a day.

Wasserman believes this simple rule can minimize media's potentially harmful effects. Media, in itself, isn't always bad, he said, but "everything needs to be done in moderation."


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"That's what we taught our kids -- if they didn't do it in moderation in our home, we moderated it for them," he said. "It didn't hurt them."

And the AMA's Davis believes a fresh look at the video game ratings system might also help.

"Parents need to more closely monitor and restrict the types of video games their children are playing and buying, and a clear rating system would help them do that," he said.

SOURCES: June 27, 2007, statement, Ronald Davis, M.D., president, American Medical Association; Martin Wasserman, M.D., pediatrician and executive director, MedChi, Maryland State Medical Society, Baltimore; James Scully, M.D., medical director, American Psychiatric Association, Arlington, Va.; American Medical Association, Report of the Council on Science and Public Health

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