Skip to main content Accessibility help

Online gaming and gaming disorder: more than just a trivial pursuit

  • David Columb (a1), Mark D. Griffiths (a2) and Colin O’Gara (a1) (a3)


Gaming disorder is set to be included in the International Statistical Classification of Diseases and Related Health Problems alongside other behavioural addictions (gambling disorder) and substance-related addictions. Given the popularity of online gaming, this is set to become an increasingly common presentation to general mental health professionals, addiction specialists, and general practitioners. This article briefly examines online gaming and describes the characteristics of gaming disorder. Some features of online gaming that have addictive potential and similarities to other addictive behaviours such as gambling disorder are discussed. Finally, the article examines treatment options available for gaming disorder and treatment going forward from an Irish perspective.

  • View HTML
    • Send article to Kindle

      To send this article to your Kindle, first ensure is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

      Note you can select to send to either the or variations. ‘’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      Online gaming and gaming disorder: more than just a trivial pursuit
      Available formats

      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

      Online gaming and gaming disorder: more than just a trivial pursuit
      Available formats

      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

      Online gaming and gaming disorder: more than just a trivial pursuit
      Available formats


Corresponding author

*Address for correspondence: David Columb, Addiction Department, St John of God Hospital, Stillorgan, Co., Dublin, Ireland. (Email:


Hide All
Agarwal, P (2017). Economics of Microtransactions in Video Games. Retrieved from
American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders (DSM-5®). American Psychiatric Association Publishing: Arlington, VA.
Ballabio, M, Griffiths, MD, Urbán, R, Quartiroli, A, Demetrovics, Z, Király, O (2017) Do gaming motives mediate between psychiatric symptoms and problematic gaming? An empirical survey study. Addiction Research & Theory, 25, 397408.
Bányai, F, Griffiths, MD, Király, O, Demetrovics, Z (2019) The psychology of esports: a systematic literature review. Journal of Gambling Studies, 35, 351365.
Batchelor, J (2018). Games industry generated $108.4bn in revenues in 2017. Retrieved from
Chalk, A (2018). Fortnite passes PUBG with 3.4 million concurrent players. Retrieved from
Chen, C, Leung, L (2016). Are you addicted to Candy Crush Saga? An exploratory study linking psychological factors to mobile social game addiction. Telematics and Informatics 33, 11551166.
Clark, L, Lawrence, AJ, Astley-Jones, F, Gray, N (2009). Gambling near-misses enhance motivation to gamble and recruit win-related brain circuitry. Neuron 61, 481490.
Cocking, S (2018). Will 2018 be the year that Ireland finally embraces eSports? Retrieved from
Columb, D, O’Gara, C (2018). A national survey of online gambling behaviours. Irish Journal of Psychological Medicine 35, 311319.
Duverge, G (2016). Insert More Coins: The Psychology Behind Microtransactions. Retrieved from
Engl, S, Nacke, LE (2013). Contextual influences on mobile player experience–A game user experience model. Entertainment Computing 4, 8391.
Evans, E (2016). The economics of free: Freemium games, branding and the impatience economy. Convergence 22, 563580.
Ewoldsen, DR, Eno, CA, Okdie, BM, Velez, JA, Guadagno, RE, DeCoster, J (2012). Effect of playing violent video games cooperatively or competitively on subsequent cooperative behavior. Cyberpsychology, Behavior, and Social Networking, 15(5), 277280.
Feng, W, Ramo, D, Chan, S, Bourgeois, J (2017). Internet gaming disorder: trends in prevalence 1998–2016. Addictive behaviors 75, 17.
Fuller, S (2018). eSports market – Statistics & Facts. Retrieved from
Gambling Commission (2017). Loot boxes within video games. Retrieved from
GamesIndustry International (2004). Blizzard Entertainment Announces World Of Warcraft “Street Date”. Retrieved from
Gentile, D (2009). Pathological video-game use among youth ages 8 to 18: a national study. Psychological Science 20, 594602.
Gentile, DA, Choo, H, Liau, A, Sim, T, Li, D, Fung, D, Khoo, A (2011). Pathological video game use among youths: a two-year longitudinal study. Pediatrics 127, e319e329.
González-Bueso, V, Santamaría, J, Fernández, D, Merino, L, Montero, E, Ribas, J (2018). Association between internet gaming disorder or pathological video-game use and comorbid psychopathology: a comprehensive review. International Journal of Environmental Research And Public Health 15, 668.
Granic, I, Lobel, A, Engels, RC (2014). The benefits of playing video games. American Psychologist 69, 66.
Grant, JE, Potenza, MN, Weinstein, A, Gorelick, DA (2010). Introduction to behavioral addictions. The American Journal of Drug and Alcohol Abuse 36, 233241. doi:10.3109/00952990.2010.491884
Griffiths, M (1991). Psychobiology of the near-miss in fruit machine gambling. The Journal of Psychology 125, 347357.
Griffiths, MD (2002). The educational benefits of videogames. Education and Health 20, 4751.
Griffiths, M (2009). Online computer gaming: advice for parents and teachers. Education and Health 27, 36.
Griffiths, MD (2010). The role of context in online gaming excess and addiction: some case study evidence. International Journal of Mental Health and Addiction 8, 119125.
Griffiths, M (2017). The psychosocial impact of professional gambling, professional video gaming & eSports. Casino & Gaming International 28, 5963.
Griffiths, MD (2018). Is the buying of loot boxes in video games a form of gambling or gaming? Gaming Law Review 22, 5254.
Griffiths, MD, Nuyens, F (2017). An overview of structural characteristics in problematic video game playing. Current Addiction Reports 4, 272283.
Hamari, J, Sjöblom, M (2017). What is eSports and why do people watch it? Internet research 27, 211232.
Hamari, J, Alha, K, Järvelä, S, Kivikangas, JM, Koivisto, J, Paavilainen, J (2017). Why do players buy in-game content? An empirical study on concrete purchase motivations. Computers in Human Behavior 68 538546.
Han, DH, Hwang, JW, Renshaw, PF (2010). Bupropion sustained release treatment decreases craving for video games and cue-induced brain activity in patients with Internet video game addiction. Experimental and Clinical Psychopharmacology 18, 297304.
Irish Legal (2018). Government shies away from crackdown on ‘loot box’ games. Retrieved from
Kato, PM, Cole, SW, Bradlyn, AS, Pollock, BH (2008). A video game improves behavioral outcomes in adolescents and young adults with cancer: a randomized trial. Pediatrics 122, e305e317.
Kelleher, L (2019, February 17). Irish psychiatrists treating children for ‘gaming disorder. Irish Independent. Retrieved from
King, D, Delfabbro, P, Griffiths, M (2010). Video game structural characteristics: a new psychological taxonomy. International Journal of Mental Health and Addiction 8, 90106.
King, DL, Delfabbro, PH, Wu, AM, Doh, YY, Kuss, DJ, Pallesen, S, … Sakuma, H (2017). Treatment of internet gaming disorder: an international systematic review and CONSORT evaluation. Clinical Psychology Review 54, 123133.
King, DL, Gainsbury, SM, Delfabbro, PH, Hing, N, Abarbanel, B (2015). Distinguishing between gaming and gambling activities in addiction research. Journal of Behavioral Addictions 4, 215220.
Kuss, DJ, Griffiths, MD (2012). Internet gaming addiction: a systematic review of empirical research. International Journal of Mental Health and Addiction 10, 278296.
Lapuz, J, Griffiths, MD (2010). The role of chips in poker gambling: an empirical pilot study. Gambling Research: Journal of the National Association for Gambling Studies (Australia) 22, 34.
Larche, CJ, Musielak, N, Dixon, MJ (2017). The Candy Crush Sweet Tooth: how ‘near-misses’ in Candy Crush increase frustration, and the urge to continue gameplay. Journal of Gambling Studies 33, 599615.
Lopez-Fernandez, O, Männikkö, N, Kääriäinen, M, Griffiths, MD, Kuss, DJ (2018). Mobile gaming does not predict smartphone dependence: A cross-cultural study between Belgium and Finland. Journal of Behavioral Addictions 7, 8899.
MacDonald, K (2018). Belgium is right to class video game loot boxes as child gambling. Retrieved from
Makuch, E (2018). Activision Blizzard made $4 billion on microtransactions last year. Retrieved from
Mihara, S, Higuchi, S (2017). Cross‐sectional and longitudinal epidemiological studies of Internet gaming disorder: a systematic review of the literature. Psychiatry and Clinical Neurosciences 71, 425444.
Mobile Marketing Association (2015). Myth busting: mobile gaming demographics. Retrieved from
Naskar, S, Victor, R, Nath, K, Sengupta, C (2016). “One level more:” a narrative review on internet gaming disorder. Industrial psychiatry journal 25, 145.
Park, JH, Lee, YS, Sohn, JH, Han, DH (2016). Effectiveness of atomoxetine and methylphenidate for problematic online gaming in adolescents with attention deficit hyperactivity disorder. Human Psychopharmacology: Clinical and Experimental 31, 427432.
Peng, W, Liu, M (2010). Online gaming dependency: a preliminary study in China. Cyberpsychology, Behavior, and Social Networking 13, 329333.
Prensky, MR (2012). From Digital Natives to Digital Wisdom: Hopeful Essays for 21st Century Learning. Thousand Oaks: Corwin Press.
Reid, R (1986). The psychology of the near miss. Journal of Gambling Behavior 2, 3239.
Rho, M, Lee, H, Lee, T-H, Cho, H, Jung, D, Kim, D-J, Choi, I (2017). Risk factors for internet gaming disorder: psychological factors and internet gaming characteristics. International Journal of Environmental Research and Public Health 15, 40.
Rouse, M (2018). Loot box. Retrieved from
Runnemark, E, Hedman, J, Xiao, X (2015). Do consumers pay more using debit cards than cash? Electronic Commerce Research and Applications 14, 285291.
Russoniello, CV, Parks, JM (2009). EEG, HRV and Psychological Correlates while Playing Bejeweled II: a randomized controlled study. Studies in Health Technology And Informatics, 144, 189192
Saunders, JB, Hao, W, Long, J, King, DL, Mann, K, Fauth-Bühler, M, … Chung, T (2017). Gaming disorder: its delineation as an important condition for diagnosis, management, and prevention. Journal of Behavioral Addictions 6, 271279.
Shi, J, Renwick, R, Turner, NE, Kirsh, B (2019). Understanding the lives of problem gamers: the meaning, purpose, and influences of video gaming. Computers in Human Behavior 97 291303.
Song, J, Park, JH, Han, DH, Roh, S, Son, JH, Choi, TY, … Lee, YS (2016). Comparative study of the effects of bupropion and escitalopram on Internet gaming disorder. Psychiatry and Clinical Neurosciences 70, 527535.
Stephenson, B (2018). Twitch: everything you need to know. Retrieved from
Stevens, MW, King, DL, Dorstyn, D, Delfabbro, PH (2018). Cognitive–behavioral therapy for Internet gaming disorder: a systematic review and meta‐analysis. Clinical Psychology & Psychotherapy 26, 191203.
Torres-Rodríguez, A, Griffiths, MD, Carbonell, X (2018a). The treatment of internet gaming disorder: a brief overview of the PIPATIC program. International Journal of Mental Health and Addiction 16, 10001015.
Torres-Rodríguez, A, Griffiths, MD, Carbonell, X, Oberst, U (2018b). Psychological characteristics of an adolescent clinical sample with Internet Gaming Disorder. Journal of Behavioral Addictions 7, 707718.
Torres-Rodríguez, A, Griffiths, MD, Carbonell, X, Oberst, U (2018c). Treatment effectiveness of a specialized psychotherapy program for Internet Gaming Disorder. Journal of Behavioral Addictions 7, 939952.
Torres-Rodríguez, A, Griffiths, MD, Carbonell, X, Farriols-Hernando, N, Torres-Jimenez, E (2019). Internet gaming disorder treatment: A case study evaluation of four adolescent problematic gamers. International Journal of Mental Health and Addiction 17, 112.
Uttal, DH, Meadow, NG, Tipton, E, Hand, LL, Alden, AR, Warren, C, Newcombe, NS (2013). The malleability of spatial skills: a meta-analysis of training studies. Psychological Bulletin 139, 352.
Van Rooij, AJ, Kuss, DJ, Griffiths, MD, Shorter, GW, Schoenmakers, TM, Van De Mheen, D (2014). The (co-) occurrence of problematic video gaming, substance use, and psychosocial problems in adolescents. Journal of Behavioral Addictions 3, 157165.
WePC (2019). 2019 Video Game Industry Statistics, Trends & Data. Retrieved from
Wijman, T (2018). Mobile revenues account for more than 50% of the Global Games Market as it reaches $137.9 billion in 2018. Retrieved from
World Health Organization (2018). International statistical classification of diseases and related health problems (11th Revision) – 6C51 Gaming Disorder. Retrieved from
Yee, N (2006). Motivations for play in online games. CyberPsychology & Behavior 9, 772775.
Yen, J-Y, Liu, T-L, Wang, P-W, Chen, C-S, Yen, C-F, Ko, C-H (2017). Association between Internet gaming disorder and adult attention deficit and hyperactivity disorder and their correlates: Impulsivity and hostility. Addictive Behaviors 64, 308313.
Zagal, JP, Björk, S, Lewis, C (2013). Dark patterns in the design of games. In Foundations of Digital Games. Retrieved April 12, 2019, from
Zajac, K, Ginley, MK, Chang, R, Petry, NM (2017). Treatments for Internet gaming disorder and Internet addiction: a systematic review. Psychology of Addictive Behaviors, 31, 979.
Zendle, D, Cairns, P (2018). Video game loot boxes are linked to problem gambling: Results of a large-scale survey. PLoS One, 13, e0206767.



Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed