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  • 1 Department of International Health, Johns Hopkins Bloomberg School of Public Health, & Johns Hopkins University Global Digital Health Initiative, Baltimore, MD, USA
  • | 2 Institute for Health and Sport, Victoria University, Melbourne, Australia
  • | 3 Department of Psychology, National and Kapodistrian University of Athens, Athens, Greece
  • | 4 International Gaming Research Unit, Psychology Department, Nottingham Trent University, Nottingham, UK
Open access

Abstract

In August of 2021, China imposed severe restrictions on children’s online gaming time. We argue that such a policy may seem useful on the surface but does not reflect the current evidence concerning prevention of disordered gaming. Videogame play is normal for children worldwide, and like other leisure activities can lead to benefits for the majority and problems for a minority. Problematic or disordered play results from the interaction of multiple risk factors that are not addressed by draconian policy measures. Identifying these factors through stakeholder-engaged research and current evidence will be much more likely to succeed in preventing disordered gaming and promoting youth wellbeing.

Abstract

In August of 2021, China imposed severe restrictions on children’s online gaming time. We argue that such a policy may seem useful on the surface but does not reflect the current evidence concerning prevention of disordered gaming. Videogame play is normal for children worldwide, and like other leisure activities can lead to benefits for the majority and problems for a minority. Problematic or disordered play results from the interaction of multiple risk factors that are not addressed by draconian policy measures. Identifying these factors through stakeholder-engaged research and current evidence will be much more likely to succeed in preventing disordered gaming and promoting youth wellbeing.

Draconian policy measures are unlikely to prevent disordered gaming

In 2019, the Chinese government imposed significant restrictions on minors’ online videogame play out of concerns regarding gaming addiction (State Council Information Office of the People’s Republic of China, 2019). These new regulations limited underage gamers to 90 minutes of gaming on weekdays and three hours on weekends and holidays, with a complete ban on gaming between 10pm and 8am. Citing continuing concerns by parents that these restrictions were not sufficient to reduce problems related to online gaming (Shin, 2021), the government reduced time even further in August 2021 to a limit of one hour of play only on Friday, Saturday and Sunday, with the frequency and intensity of government inspections of online gaming companies increased to ensure compliance (Goh, 2021). Such policies reflect a perspective that gaming is intrinsically negative without taking into the role of gaming in normal development and how differences between gamers in their unique gaming contexts may account for the diverse impact of gaming experiences over time (Stavropoulos, Gomez, & Griffiths, 2021; Stavropoulos, Kuss, Griffiths, Wilson, & Motti-Stefanidi, 2017). Such policies seem to deny evidence for the many benefits that moderate gaming involvement can bring from educational, health, cognitive, and therapeutic perspectives (Colder Carras, Van Rooij, et al., 2018; Griffiths, 2019; Nuyens, Kuss, Lopez-Fernandez, & Griffiths, 2019) and also fail to address the need to consider disordered gaming as a maladaptive solution to another problem (Brown, Stavropoulos, Christidi, Papastefanou, & Matsa, 2021; Kardefelt Winther, 2014).

Both changes in technology and advances in gaming disorder research point to the need for prevention and policy that take a nuanced approach. Cutting-edge advancements in internet gaming such as increased possibilities for interactions between gamers and game worlds and the use of algorithms that tailor one’s gaming experience to their user profile have led to a boom in internet gaming (Stavropoulos, Motti-Stefanidi, & Griffiths, 2021). This expansion in popularity of internet gaming has precipitated an impassioned dialogue regarding the possible benefits of gaming in relation to its likely deleterious impact (Raith et al., 2021; Richard, Temcheff, & Derevensky, 2020). While older public health approaches mostly segregated gaming as either being inherently “good” and/or “bad” for gamers, newer research findings point to the necessity of determining how differences between gamers, including individual factors, in-game experiences, and out-of-game context, and their interactions over time, may generate diverse outcomes (Stavropoulos, Motti-Stefanidi, & Griffiths, 2021).

Most gamers benefit through online gaming. It may promote their socialization, cognitive skills, and the development of dexterity (Colder Carras, Van Rooij, et al., 2018; Raith et al., 2021). In contrast, a relative few may lose control over their gaming, which may have detrimental consequences for their mental health and functioning (Richard et al., 2020; Stavropoulos, Motti-Stefanidi, & Griffiths, 2021). For these individuals, excessive gaming may be a way to cope with existing problems such as low social competence, depression, anxiety, and dysfunctional family relationships or to stave off severe symptoms such as suicidal thoughts or substance cravings (Colder Carras, Kalbarczyk, et al., 2018; Hygen, Belsky, et al., 2020; Hygen, Skalická, et al., 2020; Li, Garland, & Howard, 2014).

Although guidelines exist that address screen time in general and focus on balancing screen and other activities (e.g., Chassiakos et al., 2016), there is no consensus on the acceptable amount of videogame play for children and adolescents. One study of European adolescents suggested that those who played for two or more hours a day had twice the odds of having dysfunctional internet behavior, but the same levels of social networking use were associated with three times the odds (Tsitsika et al., 2014). A large representative sample of children in the United Kingdom found that those who played videogames between one and three hours a day had similar levels of wellbeing as those who did not play games at all (Przybylski, 2014). Although those seeking treatment for internet addiction played for six to seven hours a day in one sample (Müller, Beutel, & Wölfling, 2014), a case series demonstrates that even gaming for fourteen hours a day is not necessarily indicative of addiction, e.g., if temporary and the gamer is able to cut back when competing demands arise (Griffiths, 2010). These considerations point to the vital need to adopt a multifaceted and individualized view when designing and implementing prevention and intervention policies. Such policies must not focus only on gaming time, but also address risk factors of disordered gaming and capitalize on the range of benefits for all types of gamers (Király, Tóth, Urbán, Demetrovics, & Maraz, 2017).

Thus, draconian policy measures to reduce time spent gaming may seem useful on the surface, but don’t reflect current theory and knowledge about prevention of problematic or disordered digital media use (Stavropoulos, Motti-Stefanidi, & Griffiths, 2021) and often fail to work at all (Koh, 2015). According to one systematic review, the idea that simply reducing time spent playing games will reduce problematic gaming is "deeply misleading" (Király et al., 2018). Such strict regulations that limit personal freedoms will be difficult to enforce, and recent news articles indicate that even measures such as facial recognition systems are already being fooled (Borak, 2020; Lee, Kim, & Lee, 2019; Shen, 2021). A similar approach in preventing youth gambling is age restrictions, which have little empirical support for their effectiveness and have been shown to be difficult to enforce (Shi, Colder Carras, Potenza, & Turner, 2021). Policies that address only the time spent playing also fail to consider the role of online gaming in the normative development of children and may provoke reactance and excessive gaming in adulthood (Hygen, Skalická, et al., 2020). Most importantly, policies such as these may fail to address the other contributing factors that may lead individuals to use gaming as a coping mechanism, which runs the risk of driving youth to other maladaptive coping methods such as substance use (Hsu & Marlatt, 2012).

Concerns about the extent to which cultural differences drive gaming-related research and policy have been expressed in the gaming disorder literature (Király et al., 2018; Stavropoulos et al., 2020). For instance, in South East Asia, parents tend to pathologize any online leisure activities that take time away from family and/or educational activities (Griffiths, Kuss, Billieux, & Pontes, 2016). In China specifically, internet addiction has been associated with family-level risk factors such as psychological and physical abuse, which suggests that Chinese adolescents may use the internet to cope with difficult and uncontrollable life situations (Li et al., 2014).

As Solon in 594 BCE had to revise the Draconian constitution to allow ancient Athens to flourish socially, politically and financially (Lape, 2002), draconian gaming measures implemented in China may need to be revised to enhance the wellbeing of children and adolescents. Indeed, Draco’s laws in ancient Athens, as the currently introduced Chinese policies, tended to rigidly and horizontally impose the same severe punishment (in Draco’s case the death penalty) across a series of minor and major offences whilst ignoring their substantial differences and providing no right of appeal. Acknowledging the lack of a differential and case-by-case approach, Solon varied the sentences imposed and provided the right to appeal for those who felt that their circumstances deserved alternative treatment (Rhodes, 2006).

The success of policy measures can be increased through collaborative approaches that are both culturally aware and sensitive (Hudson, Hunter, & Peckham, 2019; O’Farrell, Baynes, Pontes, Griffiths, & Stavropoulos, 2020). More specifically, stakeholder-engaged and community-based research may improve the outcomes of applied empirical findings and promote their successful adoption in public health interventions and population health (Freudenberg & Tsui, 2014; Katapally, 2019). Previous research with gamer stakeholders demonstrates their willingness to discuss problems such as gaming disorder and to provide their own recommendations for interventions. For example, small studies with gamer stakeholders (i.e., gamers who attended gaming fan conventions) identified a specific game feature that promoted excessive play (i.e., appointment mechanics, a game feature that requires players to log in at a specific time to receive some award or be able to take a specific action, Kim, 2015) as well as a novel target for a preventive intervention (peer support for recognizing and preventing prolonged play periods; Colder Carras, Carras, & Labrique, 2020; Colder Carras, Porter, et al., 2018). This suggests that involvement of voices from the ground up can help inform interventions that would be acceptable and effective in the population for which they are designed.

As we have shown here, evidence consistently suggests that identifying all contextual factors in an appropriate cultural context, rather than focusing exclusively on reducing access to the “pull factors” of digital and gaming media itself, stands a much better chance of reducing disordered gaming risk (Stavropoulos, Motti-Stefanidi, & Griffiths, 2021). Many empirical evaluations of policy and programmatic interventions to prevent problematic gaming exist (King et al., 2018; Király et al., 2018, 2020; Throuvala, Griffiths, Rennoldson, & Kuss, 2019), and these evidence-based reviews, when combined with appropriate stakeholder and community-engaged research, are most likely to promote the development and implementation of successful prevention interventions and policy.

Funding sources

VS: Australian Research Council, Discovery Early Career Researcher Aw, Grant/Award Number: DE210101107. No other financial support was received for this article.

Authors’ contributions

MCC wrote the first draft of the paper and worked with the other co-authors on subsequent drafts. All authors contributed to the editorial process and have approved the final submitted version of the manuscript.

Conflict of interest

MCC consults with various companies around videogames and wellbeing and is the CEO and founder of Gaming and Wellness Association, Inc., a nonprofit organization dedicated to research and education about healthy videogame play. MDG’s university currently receives funding from Norsk Tipping (the gambling operator owned by the Norwegian Government) for research evaluating responsible gambling tools in Norway. MDG has received funding for a number of research projects in the area of gambling education for young people, social responsibility in gambling and gambling treatment from Gamble Aware (formerly the Responsibility in Gambling Trust), a charitable body which funds its research program based on donations from the gambling industry. MDG also undertakes consultancy for various gaming companies in the area of social responsibility in gambling. AL, FMS, and VS declare no conflict of interest.

Ethics

This commentary article does not involve human participants.

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The author instruction is available in PDF.
Please, download the file from HERE

Dr. Zsolt Demetrovics
Institute of Psychology, ELTE Eötvös Loránd University
Address: Izabella u. 46. H-1064 Budapest, Hungary
Phone: +36-1-461-2681
E-mail: jba@ppk.elte.hu

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2021  
Web of Science  
Total Cites
WoS
5223
Journal Impact Factor 7,772
Rank by Impact Factor Psychiatry SCIE 26/155
Psychiatry SSCI 19/142
Impact Factor
without
Journal Self Cites
7,130
5 Year
Impact Factor
9,026
Journal Citation Indicator 1,39
Rank by Journal Citation Indicator

Psychiatry 34/257

Scimago  
Scimago
H-index
56
Scimago
Journal Rank
1,951
Scimago Quartile Score Clinical Psychology (Q1)
Medicine (miscellaneous) (Q1)
Psychiatry and Mental Health (Q1)
Scopus  
Scopus
Cite Score
11,5
Scopus
CIte Score Rank
Clinical Psychology 5/292 (D1)
Psychiatry and Mental Health 20/529 (D1)
Medicine (miscellaneous) 17/276 (D1)
Scopus
SNIP
2,184

2020  
Total Cites 4024
WoS
Journal
Impact Factor
6,756
Rank by Psychiatry (SSCI) 12/143 (Q1)
Impact Factor Psychiatry 19/156 (Q1)
Impact Factor 6,052
without
Journal Self Cites
5 Year 8,735
Impact Factor
Journal  1,48
Citation Indicator  
Rank by Journal  Psychiatry 24/250 (Q1)
Citation Indicator   
Citable 86
Items
Total 74
Articles
Total 12
Reviews
Scimago 47
H-index
Scimago 2,265
Journal Rank
Scimago Clinical Psychology Q1
Quartile Score Psychiatry and Mental Health Q1
  Medicine (miscellaneous) Q1
Scopus 3593/367=9,8
Scite Score  
Scopus Clinical Psychology 7/283 (Q1)
Scite Score Rank Psychiatry and Mental Health 22/502 (Q1)
Scopus 2,026
SNIP  
Days from  38
submission  
to 1st decision  
Days from  37
acceptance  
to publication  
Acceptance 31%
Rate  

2019  
Total Cites
WoS
2 184
Impact Factor 5,143
Impact Factor
without
Journal Self Cites
4,346
5 Year
Impact Factor
5,758
Immediacy
Index
0,587
Citable
Items
75
Total
Articles
67
Total
Reviews
8
Cited
Half-Life
3,3
Citing
Half-Life
6,8
Eigenfactor
Score
0,00597
Article Influence
Score
1,447
% Articles
in
Citable Items
89,33
Normalized
Eigenfactor
0,7294
Average
IF
Percentile
87,923
Scimago
H-index
37
Scimago
Journal Rank
1,767
Scopus
Scite Score
2540/376=6,8
Scopus
Scite Score Rank
Cllinical Psychology 16/275 (Q1)
Medicine (miscellenous) 31/219 (Q1)
Psychiatry and Mental Health 47/506 (Q1)
Scopus
SNIP
1,441
Acceptance
Rate
32%

 

Journal of Behavioral Addictions
Publication Model Gold Open Access
Submission Fee none
Article Processing Charge 850 EUR/article
Printed Color Illustrations 40 EUR (or 10 000 HUF) + VAT / piece
Regional discounts on country of the funding agency World Bank Lower-middle-income economies: 50%
World Bank Low-income economies: 100%
Further Discounts Editorial Board / Advisory Board members: 50%
Corresponding authors, affiliated to an EISZ member institution subscribing to the journal package of Akadémiai Kiadó: 100%
Subscription Information Gold Open Access

Journal of Behavioral Addictions
Language English
Size A4
Year of
Foundation
2011
Volumes
per Year
1
Issues
per Year
4
Founder Eötvös Loránd Tudományegyetem
Founder's
Address
H-1053 Budapest, Hungary Egyetem tér 1-3.
Publisher Akadémiai Kiadó
Publisher's
Address
H-1117 Budapest, Hungary 1516 Budapest, PO Box 245.
Responsible
Publisher
Chief Executive Officer, Akadémiai Kiadó
ISSN 2062-5871 (Print)
ISSN 2063-5303 (Online)

Senior editors

Editor(s)-in-Chief: Zsolt DEMETROVICS

Assistant Editor(s): Csilla ÁGOSTON

Associate Editors

  • Joel BILLIEUX (University of Lausanne, Switzerland)
  • Beáta BŐTHE (University of Montreal, Canada)
  • Matthias BRAND (University of Duisburg-Essen, Germany)
  • Luke CLARK (University of British Columbia, Canada)
  • Daniel KING (Flinders University, Australia)
  • Ludwig KRAUS (IFT Institute for Therapy Research, Germany)
  • H. N. Alexander LOGEMANN (ELTE Eötvös Loránd University, Hungary)
  • Astrid MÜLLER (Hannover Medical School, Germany)
  • Marc N. POTENZA (Yale University, USA)
  • Hans-Jurgen RUMPF (University of Lübeck, Germany)
  • Attila SZABÓ (ELTE Eötvös Loránd University, Hungary)
  • Róbert URBÁN (ELTE Eötvös Loránd University, Hungary)
  • Aviv M. WEINSTEIN (Ariel University, Israel)

Editorial Board

  • Max W. ABBOTT (Auckland University of Technology, New Zealand)
  • Elias N. ABOUJAOUDE (Stanford University School of Medicine, USA)
  • Hojjat ADELI (Ohio State University, USA)
  • Alex BALDACCHINO (University of Dundee, United Kingdom)
  • Alex BLASZCZYNSKI (University of Sidney, Australia)
  • Judit BALÁZS (ELTE Eötvös Loránd University, Hungary)
  • Kenneth BLUM (University of Florida, USA)
  • Henrietta BOWDEN-JONES (Imperial College, United Kingdom)
  • Wim VAN DEN BRINK (University of Amsterdam, The Netherlands)
  • Gerhard BÜHRINGER (Technische Universität Dresden, Germany)
  • Sam-Wook CHOI (Eulji University, Republic of Korea)
  • Damiaan DENYS (University of Amsterdam, The Netherlands)
  • Jeffrey L. DEREVENSKY (McGill University, Canada)
  • Naomi FINEBERG (University of Hertfordshire, United Kingdom)
  • Marie GRALL-BRONNEC (University Hospital of Nantes, France)
  • Jon E. GRANT (University of Minnesota, USA)
  • Mark GRIFFITHS (Nottingham Trent University, United Kingdom)
  • Anneke GOUDRIAAN (University of Amsterdam, The Netherlands)
  • Heather HAUSENBLAS (Jacksonville University, USA)
  • Tobias HAYER (University of Bremen, Germany)
  • Susumu HIGUCHI (National Hospital Organization Kurihama Medical and Addiction Center, Japan)
  • David HODGINS (University of Calgary, Canada)
  • Eric HOLLANDER (Albert Einstein College of Medicine, USA)
  • Jaeseung JEONG (Korea Advanced Institute of Science and Technology, Republic of Korea)
  • Yasser KHAZAAL (Geneva University Hospital, Switzerland)
  • Orsolya KIRÁLY (Eötvös Loránd University, Hungary)
  • Emmanuel KUNTSCHE (La Trobe University, Australia)
  • Hae Kook LEE (The Catholic University of Korea, Republic of Korea)
  • Michel LEJOXEUX (Paris University, France)
  • Anikó MARÁZ (Humboldt-Universität zu Berlin, Germany)
  • Giovanni MARTINOTTI (‘Gabriele d’Annunzio’ University of Chieti-Pescara, Italy)
  • Frederick GERARD MOELLER (University of Texas, USA)
  • Daniel Thor OLASON (University of Iceland, Iceland)
  • Nancy PETRY (University of Connecticut, USA)
  • Bettina PIKÓ (University of Szeged, Hungary)
  • Afarin RAHIMI-MOVAGHAR (Teheran University of Medical Sciences, Iran)
  • József RÁCZ (Hungarian Academy of Sciences, Hungary)
  • Rory C. REID (University of California Los Angeles, USA)
  • Marcantanio M. SPADA (London South Bank University, United Kingdom)
  • Daniel SPRITZER (Study Group on Technological Addictions, Brazil)
  • Dan J. STEIN (University of Cape Town, South Africa)
  • Sherry H. STEWART (Dalhousie University, Canada)
  • Attila SZABÓ (Eötvös Loránd University, Hungary)
  • Ferenc TÚRY (Semmelweis University, Hungary)
  • Alfred UHL (Austrian Federal Health Institute, Austria)
  • Johan VANDERLINDEN (University Psychiatric Center K.U.Leuven, Belgium)
  • Alexander E. VOISKOUNSKY (Moscow State University, Russia)
  • Kimberly YOUNG (Center for Internet Addiction, USA)

 

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