In the fifth edition of the Diagnostic and Statistical

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1 CYBERPSYCHOLOGY, BEHAVIOR, AND SOCIAL NETWORKING Volume 19, Number 4, 2016 ª Mary Ann Liebert, Inc. DOI: /cyber Addictive Online Games: Examining the Relationship Between Game Genres and Internet Gaming Disorder Jeroen S. Lemmens, PhD, and Stefan J.F. Hendriks, BSc Abstract Internet gaming disorder (IGD) is the most recent term used to describe problematic or pathological involvement with computer or video games. This study examined whether this disorder is more likely to involve pathological involvement with online (i.e., Internet) games as opposed to offline games. We also explored the addictive potential of nine video game genres by examining the relationship between IGD and 2,720 games played by a sample of 13- to 40-year olds (N = 2,442). Although time spent playing both online and offline games was related to IGD, online games showed much stronger correlations. This tendency is also reflected within various genres. Disordered gamers spent more than four times as much time playing online role-playing games than nondisordered gamers and more than thrice as much time playing online shooters, whereas no significant differences for offline games from these genres were found. Results are discussed within the frame of social interaction and competition provided by online games. Introduction In the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders, the American Psychiatric Association included Internet gaming disorder (IGD) as a tentative disorder. 1 According to the DSM-5, gaming disorder can be diagnosed when a player meets five or more of the proposed nine criteria (i.e., preoccupation, tolerance, withdrawal, persistence, escape, problems, deception, displacement, and conflict) during a period of 12 months. 1,2 The DSM-5 definition for IGD further states that only the use of video games, and not gambling or any other kind of Internet use, must cause significant impairment to constitute a diagnosis. 1 Although this pathological involvement with games is labeled IGD, the DSM-5 specifically states that. it could involve non-internet computerized games as well, although these have been less researched (p. 796). Indeed, many studies on pathological gaming have focused specifically on online games, 3 7 whereas others have simply labeled the behavior Internet addiction, thereby excluding pathological use of offline games, but including all sorts of online behavior (e.g., porn, gambling). 8,9 Although many researchers suggest that pathological gaming is more prevalent among players of online games than among players of offline games, 5,10 13 pathological gaming is certainly not limited to online games. Many types and genres of computer and video games have been linked to game addiction, including offline games Nevertheless, the precise relationship between online or offline gaming and IGD remains unclear. One of the most evident antecedents of pathological gaming is a lower psychosocial well-being. 18,19 Specifically, players who report more loneliness, lower self-esteem, and lower social competence are more likely to develop signs of game addiction. 9 Although all sorts of video games could fulfill some of the needs that are otherwise met through friendships and interpersonal contact, 20 the social interaction provided by online multiplayer games is particularly appealing to people who are socially unskilled, have an unmet need for sociability in their offline lives, or feel anxious over establishing real-life interpersonal relationships. 21,22 Virtual online worlds can provide players with a community where lonely gamers with low self-esteem and diminished social skills may avoid their real-life deficiencies through virtual social contacts and achievements. 18,23 Therefore, psychosocially vulnerable gamers seem more susceptible to pathological involvement with online games in general and certain online game genres in particular. Several studies have suggested that massively multiplayer online role-playing games (MMORPGs) are particularly popular among players who show problematic or pathological involvement with games. 3,5,22,24 28 Because of the many achievements that require extensive cooperative play, this Amsterdam School of Communication Research (ASCoR), University of Amsterdam, Amsterdam, The Netherlands. 270

2 ADDICTIVE VIDEO GAMES 271 genre may have more addictive potential than others. 29 MMORPGs are not the only games associated with pathological use, other popular video game genres, such as First- Person Shooters (FPS), and real-time strategy games have also been associated with higher levels of pathological gaming. 28,30 However, it is unclear whether pathological gamers played these genres online, offline, or both. Because of the uncertainties regarding the relationship between IGD and online or offline game genres, the current study first aims to examine whether players are indeed more likely to show pathological involvement with online games as opposed to offline games. The second aim is to examine the relationship between IGD and nine validated game genres, thereby specifically differentiating between online and offline play, player-gender, and age, to explore the addictive potential of specific video game genres. Materials and Methods Sample and procedure In June 2013, an international market research company distributed two online versions of an IGD survey among a representative sample of 2,442 adults and adolescents aged 13 through 40 from the Netherlands. Half of them received the IGD survey with dichotomous response categories (i.e., yes or no, N = 1,251, Mage = 24.8, SD = 8.1), 50.4 percent female (n = 630). This type of measurement is labeled the dichotomous IGD scale. The other half received the survey with six polytomous response categories to the IGD items, ranging from never through almost daily (N = 1,191, Mage = 24.4, SD = 7.6), 51.6 percent female (n = 615). This type of measurement is labeled the polytomous IGD scale. Four respondents (three dichotomous and one polytomous) reported playing for more than 140 hours each week (more than 20 hours per day). Because it seems very unlikely that anyone could sustain playing 20 hours per day over an extended period and these four respondents standard z-scores on this variable were all >6, they were deemed unreliable and were removed from further analysis. Measures Time spent playing video games Respondents weekly time spent playing computer or video games was measured by multiplying the days per week by the number of minutes per day respondents reported playing games. If they indicated that they had played a game in the previous month, but generally played less than 1 day per week, their weekly days spent on games was set at 0.5. If they did not play games, their time was set at 0 (n = 565, 23 percent). The weekly time spent playing games ranged from 0 through 105 hours per week, with an average of 7.03 hours per week (SD = 11.22) across samples (N = 2,438). Internet gaming disorder Previous research has constructed two short scales for IGD (polytomous and dichotomous) based on the nine criteria proposed in the DSM-5. 1,2 In the two scales, each of the nine underlying criteria (Preoccupation, Tolerance, Withdrawal, Persistence, Escape, Problems, Deception, Displacement, and Conflict) was measured with one item each. The term internet gaming or internet games as used in the description of the DSM-5 criteria was replaced with gaming or games to avoid exclusion of offline games. If respondents reported not playing any games, their response to all IGD items was set at 0. The polytomous and dichotomous scale consisted of the same nine items, differing only in their response options. If respondents had received the dichotomous scale, they rated all items with either no (0) or yes (1). All individual yesanswers (range 0 9) were summed (M = 1.17, SD = 1.91). The dichotomous IGD scale proved reliable with a Cronbach s alpha of Respondents who had received the polytomous IGD scale rated all nine items on a six-point ordinal frequency scale: (0) never, (1) one to five times in the last year, (2) 5 11 times in the last year, (3) about once to thrice a month, (4) once or more a week, and (5) every day or almost every day. Individual mean scores were calculated (M = 0.17, SD = 1.03). The nine-item polytomous IGD scale was also reliable with a Cronbach s alpha of Data Analysis Video games and genres Respondents could report up to two game titles that they had played the most in the last 6 months. To assign the games to specific genres, a literature study was conducted to identify all relevant genres. First, 14 scientific articles on game genres were examined. Second, six relevant Websites on video game genres (e.g., review sites, age rating sites) were examined. Table 1 shows an overview of the most common genres mentioned across studies and Websites. Only the genres that were present in more than 50 percent of the literature and Websites were used in the genre classification. This lead to nine possible genre classifications. These are, in order of prominence across literature and Websites: (a) Action/adventure, (b) Sports, (c) Role-Playing Games, (d) Strategy, (e) Simulation, (f) Puzzle, (g) Shooter, (h) Racing, and (i) Fighting. Respondents were asked Which games have you played the most during the last 6 months? Respondents could report up to two titles. More than 78 percent of the respondents mentioned at least one game title, 46 percent mentioned two game titles. The aggregated 425 unique titles were assigned to one of the nine genres based on the most frequent genre categorization across the six prominent game Websites (Table 1). If a game could not be assigned to one of the nine genres, it was assigned to the category (10) other. Offline or online gameplay For each game, respondents were asked to indicate how frequent it was played online on a five-point scale: (0) never online to, (1) almost never online, (2) sometimes online, (3) often online, and (4) always online. The mean score for playing online was assessed by averaging the frequencies of online play of the first game and, if applicable, the second game. The combined mean score of online gameplay (range 0 4) was 1.83 (SD = 1.47). This score was divided by four and then multiplied with the weekly time spent playing games, to assess the weekly time spent playing online games (M = 3.53, SD = 7.96). The underlying assumption was that (1) almost never online was equal to 25 percent of the time spent online,

3 Table 1. Overview of Video Game Genres Within Literature and Game Websites Action/ adventure Sports RPG Strategy Simulation Puzzle Shooter Racing Fighting MMO Platform Music dance Total genres Article authors Elliot et al. 27 O O O O O O O O O O 16 Elliot et al. 31 O O O O O O O O O O 16 Floros and Siomos 32 O O O O O O O O O 15 Lee et al. 33 O O O O 8 Wolf 34 O O O O O O O O O O O 42 Lucas and Sherry 35 O O O O O O O O O 13 Sherry 36 O O O O O 7 Hanninger and Thompson 37 O O O O O O O O 11 Van Mierlo and Van den Bulck 38 O O O O O O 8 Hamlen 39 O O O O O O O O O O 14 Homer et al. 40 O O O O O O O O 13 Bonanno and Kommers 41 O O O O O O O O O 10 Myers 42 O O O O 6 Donati et al. 43 O O O O O O O O O 14 Websites GameFaqs O O O O O O O 10 IGN O O O O O O O O O O 27 Gamespot O O O O O O O O O O 13 Gamefront O O O O O O O O O O O O 33 Giantbomb O O O O O O O O O O O O 50 PEGI O O O O O O O O 12 Total representation in sources MMO, massively multiplayer online; RPG, role-playing game. 272

4 ADDICTIVE VIDEO GAMES 273 FIG. 1. Prevalence, time spent, and Internet gaming disorder (IGD) score for the three most popular games. (2) sometimes online equaled 50 percent of the time online, and (3) often online was equal to 75 percent of the time online. Never online and always online represented 0 percent and 100 percent time spent online, respectively. Weekly time spent playing offline games was subsequently assessed by subtracting the time spent playing online games from the weekly time spent playing games (M = 3.62, SD = 11.04). For all players, time spent online and offline was calculated for each genre. To create a weighted score of the time spent playing specific genres online and offline, we first assessed the relative frequency of playing specific genres by multiplying the relative frequency of genres mentioned (0 percent, 50 percent, 100 percent) with the time spent on games. Next, we examined the frequency of online play for each of the genres mentioned (0 4), again dividing the outcome by four, and multiplying that with the time spent playing a genre. By deducting this online genre-weighted score from the time spent playing a genre, we calculated the weighted score for offline time spent playing each genre. Results Descriptive results Out of 2,438 respondents included in the analyses, 1,921 respondents reported at least one game title (78.7 percent). In total, 3,272 video games were reported, of which 2,720 (83.2 percent) could be assigned to a specific video game genre. These 2,720 reported games could be aggregated into *425 unique video game titles/franchises. These 425 titles were distributed over the genres. Shooters were mentioned most (18.6 percent, n = 507), followed by Action/adventure (16.6 percent, n = 452), and Puzzle (15.8 percent, n = 429). Roleplaying games (RPGs) were mentioned 236 times (8.7 percent). Players spent the most time on Shooters (2.2 hours per week), Action/adventure games were played for more than 1.8 hours per week, and RPGs for 1.3 hours per week, whereas Puzzle games were only played for 45 minutes per week. There were four games that emerged as more popular (i.e., significantly more mentions) than the rest. The four most popular games among the 1,921 gamers were Call of Duty (e.g., Black Ops: II, and Modern Warfare 3, n = 234, 8.8 percent of all games), FIFA (e.g., FIFA 2012 and FIFA 2013, n = 184, 7.4 percent of all games), Candy Crush Saga (n = 157, 6.3 percent of all games), and The Sims (e.g., The Sims Medieval and The Sims 3, n = 115, 4.6 percent of all games). Figure 1 shows an overview of the relevant scores for each of these titles. We found that gender strongly influenced playing video games. In general, male respondents spent more time on games (M = 9.94, SD = 13.21) than female respondents (M = 4.43, SD = 8.13), t (1,974.74) = 12.35, p < 0.001, 95% CI [4.63, 6.39], d = 60. Similar significant gender differences were found for weekly time spent playing online (Mdiff = 3.23) and offline (Mdiff = 2.28). When comparing genres across gender, male gamers spent significantly ( ps < 0.001) more time per week playing Shooters (Mdiff = 2.52), Action/adventure (Mdiff = 1.31), RPG (Mdiff = 0.89), Strategy (Mdiff = 0.53), and Racing games (Mdiff = 0.21). Conversely, female gamers spent significantly ( ps < 0.001) more time per week playing Simulation games (Mdiff = 0.53) and Puzzle games (Mdiff = 0.60). Regarding age (range 13 40), we found that it was negatively correlated with weekly time spent on games (r =-0.14, p < 0.001), both online (r =-0.11, p < 0.001) and offline (r = -0.12, p < 0.001). Similarly, many genres correlated negatively with respondents age. Older respondents spent less time playing Shooters (r =-0.10, p < 0.001), Action/adventures (r =-0.11, p < 0.001), RPGs (r =-0.07, p = 0.001), Sports (r =-0.07, p = 0.001), and Simulation games (r = -0.05, p = 0.03). Interestingly, time spent on Strategy games was slightly higher among older respondents (r = 0.04, p = 0.03). Because of the influence of gender and age on both IGD and gameplay variables, we controlled for these factors when examining the impact of online and offline genres on IGD. Gameplay, genres, and IGD The mean time spent playing online games (M = 3.53, SD = 7.96) did not differ significantly from the mean time spent playing offline games (M = 3.62, SD = 11.04), t (1,895) = -0.51, p = 0.61, 95% CI [-0.60, 0.35]. Time spent playing games showed significant positive correlations with the polytomous IGD scale (r = 0.33, p < 0.001), both online (r = 0.26, p < 0.001) and offline (r = 0.25, p < 0.001). The dichotomous IGD scale also showed positive correlations with time spent on games (r = 0.22, p < 0.001) and time spent on online games (r = 0.22, p < 0.001) and a weaker correlation with time spent on offline games (r = 0.11, p < 0.001). We performed multiple linear regressions with age, gender, and time spent playing a genre as predictors of IGD. As Table 2 shows, time spent on four out of nine genres (RPG, Shooter, Action, and Simulation) showed positive effects on both IGD scales. The genres Sports and Puzzle showed small significant effects on the polytomous IGD scale, but not on the dichotomous scale. To further differentiate the relationships between IGD and genres, separate regressions were performed for online and offline gameplay, again controlling for age and gender. Time spent playing RPGs and Shooters,

5 274 LEMMENS AND HENDRIKS Table 2. Multiple Regressions of Gender, Age, and Time Spent Playing Online/Offline Game Genres on IGD Polytomous IGD scale Dichotomous IGD scale B SE B b R 2 F B SE B b R 2 F Time on games *** *** Online games *** *** Offline games *** *** RPG *** *** Online RPG *** *** Offline RPG ** ** Shooter *** *** Online shooter *** *** Offline shooter ** ** Action *** ** Online action * * Offline action ** Sports * Online sports ** ** Offline sports Simulation * * Online sim * Offline sim Puzzle * Strategy Racing Fighting *p < 0.05; **p < 0.01; ***p < All F-scores were significant p < IGD, Internet gaming disorder. both online and offline, had a positive effect on both IGD scales. Although online and offline action/adventure games showed a positive effect on polytomous IGD scores, only online action games had a significant effect on the dichotomous IGD scores. Time spent playing online sport games, but not offline sport games, was correlated with both IGD scales. Online simulations showed a positive effect on polytomous IGD scores. Although the time spent playing the remaining five genres (Strategy, Puzzle, Racing, and Fighting) were also tested for online and offline play, none showed a Table 3. T Test Differences Between Disordered Gamers and Nondisordered Gamers Disordered gamers mean (SD) Nondisordered mean (SD) t df CI Lower CI Upper p Cohen s d Time on Games (13.95) 6.92 (11.05) < Online 8.30 (12.12) 3.44 (8.08) < games Offline 5.27 (5.39) 3.41 (5.78) , games RPG 3.48 (10.39) 0.79 (3.91) Online RPG 2.61 (8.58) 0.54 (3.43) Offline RPG 0.87 (3.41) 0.25 (1.40) Shooter 4.20 (8.87) 1.44 (5.62) Online 3.16 (7.38) 1.01 (4.70) shooter Offline 1.00 (2.64) 0.42 (2.24) shooter Action 1.48 (5.67) 1.33 (4.54) , Sports 1.21 (3.86) 0.73 (3.90) , Simulation 0.71 (2.35) 0.43 (2.05) Puzzle 0.40 (1.77) 0.56 (2.19) , Strategy 0.10 (0.82) 0.30 (2.91) , Racing 0.08 (0.70) 0.30 (1.82) , Fighting 0.10 (0.82) 0.11 (1.06) ,

6 ADDICTIVE VIDEO GAMES 275 significant effect on any of the two IGD scales, and were therefore omitted from Table 2. Disordered gamers preferences According to the DSM-5, gamers who respond positively to at least five of the nine criteria for IGD can be considered disordered gamers. In the dichotomous sample, 5.8 percent responded yes to five or more of the nine items on the scale. These players (n = 73, 35 percent female) are therefore considered disordered gamers. As the results of several t tests show (Table 3), disordered gamers spent almost twice as much time on games compared to nondisordered gamers. Similarly, disordered gamers spent more than twice as much time playing online games than nondisordered gamers. Disordered gamers also spent slightly more time playing offline games than nondisordered gamers. Across genres, we found two significant differences: Disordered gamers spent much more time playing shooters and RPGs than nondisordered gamers. Specifically, time spent playing online Shooters and online RPGs was significantly higher among disordered gamers, compared to nondisordered gamers. Time spent on offline Shooters and offline RPGs did not differ significantly, and no other significant differences between disordered and nondisordered gamers were found. Discussion The main aims of this study were to examine the validity of the label Internet in the latest DSM-5 terminology for game addiction and explore the relationship between IGD and game genres. In general, time spent playing online games showed stronger correlations with IGD than time spent playing offline games. This tendency was also reflected within genres. Time spent playing both online and offline RPGs and Shooters positively correlated with both IGD scales, but for both genres, the correlation with online play was stronger. Furthermore, disordered gamers spent more than four times as much time playing online RPGs than nondisordered gamers, whereas the difference between these groups in time spent on offline RPGs was not significant. Disordered gamers spent more time playing both online and offline Shooters than nondisordered gamers. Although these findings clearly suggest that online games have more addictive potential than offline games, there seems to be no reason to exclude computer or video games solely based on their disconnection from the Internet. Furthermore, Internet games, as used in the descriptions of the DSM-5 criteria for IGD, is generally reserved only for browser games. 2 Thus, removing the word Internet or at least replacing it with online seems fitting when discussing gaming disorder. Regarding game genres, the results suggest that popularity and addiction are not necessarily related. For instance, Puzzle and Action are both popular genres, but only weakly related to IGD, whereas RPGs are not very popular, but strongly related to IGD. The relationship between Action games and IGD may be partially explained by the fact that two popular games Minecraft (2012) and GTA V (2013) were categorized as Action games. Minecraft allows for broad customization options that are characteristic of RPGs, 39 and GTA V contains many elements of the Shooter genre. Across many genres, the social component provided by online play seemed to contribute to pathological involvement. Online RPGs and Shooters showed the strongest relationship with IGD, which supports previous claims that MMORPGs and online FPS are potentially addictive game genres. 3,5,22,24,25,30 Future research may determine whether pathological gaming is mostly encouraged by the social competition 44 or the sense of community 45 provided by these online games. General factors that contribute to pathological use of games, such as reward systems and immersion techniques, 25,46 could also be more effective within the social confines of online games. A valuable contribution of this study is the application of a valid systematic game genre classification based on the most common genres from previous research and prominent game Websites. Although all relevant genres were present in our survey data, the genre definitions and classifications themselves were not tested on validity, and since there is no consensus about the exact definitions and boundaries of each genre, future research should further test the genre classification on its validity and causal relationships with gaming disorder. Author Disclosure Statement No competing financial interests exist. References 1. American Psychiatric Association. (2013) Diagnostic and statistical manual of mental disorders. 5th ed. Washington, DC: Author. 2. Lemmens JS, Valkenburg PM, Gentile DA. 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