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 Table of Contents  
ORIGINAL ARTICLE
Year : 2020  |  Volume : 4  |  Issue : 2  |  Page : 164-169

Gaming addiction: Study of gaming characteristics and personality traits among the health professional undergraduates


1 Department of Psychiatry, M. P. Shah. Government Medical College, Jamnagar, Gujarat, India
2 Dr. M K Shah Medical College and Research Center, Ahmedabad, Gujarat, India

Date of Submission15-Apr-2020
Date of Acceptance10-Aug-2020
Date of Web Publication25-Nov-2020

Correspondence Address:
Dr. Vishal Kanaiyalal Patel
Department of Psychiatry, Dr. M K Shah Medical College and Research Center, Ahmedabad, Gujarat
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/aip.aip_21_20

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  Abstract 


Background: Gaming addiction (GA) is a recent diagnosis in problematic or pathological video game users. This study is aimed to examine the correlation of gaming characteristics and personality traits in GA. Subjects and Methods: This was a cross-sectional, observational study of 225 intern doctors posted to the Department of Psychiatry over a period of 12 months. GA Scale-short version was used to screen for GA. Clinical interview using the Diagnostic and Statistical Manual of Mental Disorder-5 research diagnostic criteria for Internet Gaming Disorder was used to diagnose GA. Neuroticism and extraversion of the Eysenck Personality Questionnaire, Arnett Inventory of Sensation Seeking, Buss Perry Aggression Questionnaire, and State Self-Esteem scale were used for assessment of personality factors. Descriptive statistics, independent t-test, Chi-square test, multiple logistic regression, and multiple linear regressions were used for the analysis of data. Results: Around three-fourth or more interns played online games, spent money on gaming, and playing for 5 years or more had GA. Nearly 70% of addicted interns were using multiple gadgets and 91.42% were playing games in other than leisure time also. Statistically, a significant association was found between GA and gaming variables. Neuroticism, aggression, and sensation-seeking had positive and significant associations while self-esteem and extraversion had negative and significant associations with GA. Conclusions: GA is prevalent among intern doctors with certain gaming characteristics. It is associated with a high level of neuroticism, aggression, and sensation seeking and low level of extraversion, and self-esteem

Keywords: Characteristics, gaming addiction, personality traits, undergraduates


How to cite this article:
Raja HH, Patel VK, Tiwari DS, Bhavin Kadavala NC, Patel N. Gaming addiction: Study of gaming characteristics and personality traits among the health professional undergraduates. Ann Indian Psychiatry 2020;4:164-9

How to cite this URL:
Raja HH, Patel VK, Tiwari DS, Bhavin Kadavala NC, Patel N. Gaming addiction: Study of gaming characteristics and personality traits among the health professional undergraduates. Ann Indian Psychiatry [serial online] 2020 [cited 2021 Jan 22];4:164-9. Available from: https://www.anip.co.in/text.asp?2020/4/2/164/301428




  Introduction Top


Twenty- first century is the era of mobile, gadgets, and Internet use. Now a days gaming use increased (either offline/online) as part of leisure activities due to easy availability and accessibility of gadgets and Internet in adolescents and adults. Although, most of the times, playing video games is harmless and even may be associated with cognitive, social, or physical benefits excessive use of playing games can lead to various health problems in some individuals, with reports of game-induced seizures and even deaths.[1]

Studies on gaming use estimate that 2%–16% of adolescents having signs of gaming addiction (GA). GA could be a significant health hazard with a harmful impact on physical, social, and mental well-being. It is associated with sleep deprivation, eating irregularities, physical strain and fatigue, obesity, social incompetence, mood disorders, and isolation from friends and family.[2]

Excessive use of video games reflects disproportionate but not necessarily problematic behavior, whereas pathological gaming is defined as the persistent inability to control excessive gaming habits despite associated social or emotional problems.[3] GA (either online or offline) is not yet an established diagnosis. Internet Gaming Disorder (IGD) has been included in the latest edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) as a condition for further research.[4] Gaming disorder is recently included in the latest International classification of disease-11 as an independent diagnosis.[5] Gaming characteristics, like game genre, time and money spent, duration of gaming, devices used for gaming, are in positive relation with GA.[6],[7],[8],[9]

Globally, some studies have mentioned the significant relationship between personality traits and GA.[10],[11] In India, few published studies found the correlation between GA, personality traits among the medical students.[12] Hence, this study was planned to add the research findings of gaming characteristics, personality traits, and GA among the health professional undergraduates.


  Subjects and Methods Top


Study design

This was 12 months; cross-sectional, observational study was conducted from January to December 2017. Intern doctors posted during the compulsory rotatory internship in the psychiatry were explained the study objectives and those who gave written informed voluntary consent were included.

Subjects

A total of 225 intern doctors posted to the Department of Psychiatry for a compulsory rotational internship for 12 months. The intern doctors playing the video game for the period of the last 12 months or more were included in the study, and five who refused consent to participate in the study were excluded. The study was approved by the Institutional Ethical Committee.

Tools

GA was detected using the shorter version of the Game Addiction Scale (GAS), consisting of seven questions relating to salience, tolerance, mood modification, relapse, withdrawal, conflict, and problems. Each statement is scored on a 5-point Likert scale (1, never, to 5, very often). The mid-point of Likert scale was taken as cutoff, and if, four or more questions met this cutoff, then it was considered as GA. The construct validity of the GAS is found to be significantly high.[13] Clinical assessment and interview using the DSM-5 research diagnostic criteria for IGD to confirm GA.[4],[14]

Aggression was measured by the Buss-Perry Aggression Questionnaire (BPAQ). It consists of total 29 questions. Participants rate themselves based on five-point Likert scale, (e.g., One, extremely uncharacteristic of me, to 5, extremely characteristic of me), and higher the total score, the higher the level of aggression. The BPAQ has test–retest reliability coefficients ranging from 0.72 to 0.80.[15]

The Arnett Inventory of Sensation Seeking (AISS) was used to measure sensation seeking. It contains 20 descriptive statements to which participants respond on a 4-point Likert scale (4, describes me very well; 1, does not describe me at all). Test–retest reliabilities of the AISS is 0.80 and above, and internal reliability is 0.70.[16] Extraversion and neuroticism were measured with the Eysenck Personality Questionnaire-revised (EPQ-R). The EPQ-R comprises 100 items (traits of neuroticism, extraversion, psychoticism, and the lie scale). Higher the score suggests higher the intensity of traits. Eysenck et al. reported reliabilities for males and females, respectively, of 0.84 and 0.80 for neuroticism and 0.88 and 0.84 for extraversion.[17] Self-esteem of the participants was measured with the State Self-Esteem Scale (SSES). It is a 20-item scale, and it has three components: performance, social, and appearance self-esteem. It has satisfactory psychometric properties. All the items are answered using a 5-point Likert scale (1 = not at all, to 5 = extremely). The sum score from all the items was used as a continuous measure of state self-esteem.[18]

Assessment

One of the junior resident doctors interviewed the participants regarding gaming use and requested them to fill up a semi-structured performa which included information about demographic and gaming characteristics of the participants such as gender, type of gaming, gaming hours, time and money spent on gaming, gadgets used for gaming, mode of gaming, the total duration of gaming, GAS, and scale for the personality assessment. No participants refused to give consent for the study participation. Participants required around 45 min to complete the semi-structured performa, including scales. Participants were screened for GA using GAS, and then those having higher scores were clinically interviewed using the proposed research diagnostic criterion of IGD to diagnose GA. Experienced and trained consultant psychiatrists of the department assessed the participants for GA in clinical interview and educated participants with GA about Gaming disorder and various treatment options. Participants were assessed for personality traits using the questionnaires of AISS, BPAQ, EPQ-R, and SSES.

Statistical analysis

Data collected were subjected to appropriate descriptive statistics using frequencies, percentages, mean and standard deviation of different variables. Independent t-test and Chi-square tests were used for the analysis of data. The value of P < 0.05 was considered statistically significant. Binary logistic regression analysis was used to calculate the odds ratio, and multiple linear regression analysis was used to assess the strength of association. The IBM Statistical Package for the Social Sciences (SPSS) version 15 was applied to analyze the data was applied to analyze the data.


  Results Top


Out of the total 225, 176 intern doctors (78.22%) were playing video games for a period of 12 months or more. Among the interns playing video games, 38.63% were female and 55.68% were male. The mean age of the participants was 22.9 years. The prevalence of GA was 19.88% and 15.55% among game users and total intern doctors, respectively. Participants were playing Candy Crush Saga, Subway Surfer, temple run 2, teen Patti, ludo king, clash of clans, racing in the car, call of duty, and God of Rom frequently in mobile, laptop/PC, and gaming device.

Gaming determinants

Nearly three-fourth or more of addicted interns played online, spent money on gaming, and were playing for >5 years. Nearly 70% of interns with GA were using multiple gadgets for gaming and 91.42% of addicted interns were playing in leisure time and other time. There was a statistically significant association between GA and gaming variables (mode of gaming, money spent, gadgets use, leisure/other time activity, and duration of gaming) except type of game and time spent on gaming [Table 1]. Independent variables showing statistically significant association with Chi-square test were selected for further analysis using binary logistic regression analysis. Mode of gaming, gadgets used for gaming, total duration of gaming, and gaming as leisure and/or other time activity emerged as statistically significant predictors of the GA [Table 2].
Table 1: Distribution of video game playing and other gaming variables

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Table 2: Binary logistic regression analysis of gaming variables in gaming addiction

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Personality factors

Mean score GAS was higher for sensation seeking, aggression and neuroticism and lower for extroversion and self-esteem in interns with GA compared to without addiction. There was a statistically significant association found between GA and personality factors (sensation seeking, self-esteem, aggression, neuroticism, extraversion) using independent t-test [Table 3].
Table 3: Distribution of personality factors and gaming addiction

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Multiple linear regression analysis found sensation seeking, aggression, and neuroticism were found to be positively correlated and significantly associated while extraversion and self-esteem was negatively correlated and significantly associated with GA [Table 4]. Neuroticism, extraversion, aggression, sensation seeking, and self-esteem were predictors of the GA.
Table 4: Multiple linear regression analysis of personality factors and game users

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  Discussion Top


In the present study, the prevalence of GA was 19.88% and 15.55% among game users and total intern doctors, respectively. Some studies have reported 8%–9% prevalence of GA in young adults and adolescents.[19],[20],[21] While a few studies have reported a lower prevalence (1%–3%) among adolescents and young adults.[6],[22] The variations of prevalence rate may be due to the differences in sociocultural background, available resources, defining and measuring GA, and other methodological differences.



In the present study, significant number of participants with GA spent money on gaming as compared to non-addicts. This finding was corroborating with the studies conducted among the game users of Hong Kong, Korea, and French population, respectively.[7],[8],[9] This may due to expense on additional features of games, graphics, and gaming instruments. In this study, interns with GA significantly played online games. Kuss and Griffiths suggests that playing an online game may increase the chances of potential addiction compared to an offline game.[23] This could be due to the content, its rapidly changing derivatives, and the reinforcing nature of interactional experience being considered to be the addictive stimuli in online role playing games.[24]

In this study, significant number of interns with GA used mobile and other gadgets for playing games. This corroborates with Paik et al., who found that combined users, especially those playing computer and Smartphone games evenly, had a higher prevalence of IGD.[25] In this study, significant number of participants with GA spent time apart from their leisure time activity on gaming and were playing for 5 years or more compared to the nonaddict. Lemmens et al. found a strong positive correlation between disordered gamers and time spent on games.[3],[26] Hellman et al. found that spending an increasing amount of time in online gaming carries the risk of developing a GA.[27] This may suggest a development of tolerance and also playing games early in adolescent age has higher risk of GA.[28]

In this study, participants with high sensation seeking reported high GA. Zuckerman and Hu et al. found that video game addiction was positively correlated with sensation seeking.[29],[30] Fest et al. reported that gamers admitted having a strong desire for seeking excitement and sensation from playing violent and aggressive games.[31] Perhaps, because sensation seeking provides a coping mechanism for individuals to overcome their boredom, and/or video games provide stimulation and rewards for sensation seekers.[10]

The present study shows a significant number of participants with GA having low self-esteem. Many studies from different regions have found that low self-esteem was positively and significantly related to Internet addiction and IGD among adolescents and college students.[32],[33],[34],[35] Participants may involve excessively in playing games, and hence, they can escape from their negative self-evaluation.

In the present study, high level of aggression was seen in participants with GA. Festl et al. found that high score of GAS is associated with aggression among the German population.[30] In adolescents committing violence (both traditional and cyber) against peers predicts the problematic gaming significantly.[36] Lemmens et al. found that higher the level of trait aggressiveness in boys, the more likely they were to choose a violent game to play.[37] This may suggest that the aggression during games is rewarding and it facilitate the development of GA.

In the present study, higher neuroticism and lower extraversion were significantly associated with GA. Mehroof and Griffiths found that neuroticism had significant associations with online video game addiction. Neurotic gamers may be playing as a way of counteracting their negative emotions.[10] Chen et al. found that neuroticism has significant negative influence on life satisfaction and neurotic individuals are inclined toward games that reduce pressure and soothe their emotions.[38] A large scale study of gamers found that video game addiction was positively associated with neuroticism and negatively associated with conscientiousness.[39] Müller et al. reported that IGD was associated with higher neuroticism, decreased conscientiousness and low extraversion compared to healthy controls.[40] Another study reported although, extroverts may explore the self in both online and traditional interactions, introverts use the Internet primarily for self-exploration. This suggests that introverts may be highly attracted to features of the internet gaming that improve their social capabilities, where they struggle offline.[41]

Future implications

Replication and extension of findings presented here requires further large scale, prospective study of GA in young adults to understand relations of gaming characteristics and personality factors.

Strength of study

Separate clinical interview was used to diagnose GA. This study explores the role of personality factors in GA using different standard questionnaires in India.

Limitations

Our research only considers a sample of the medical college intern doctors. Hence, it will be difficult to generalize the results of this study. Study was conducted on the intern doctors during their posting in the same department. As the interns are the junior most in the departmental hierarchy during their posting, they are clearly vulnerable and dependent for issue of posting completion certificate. This creates a conflict of interest between investigators and study participants. Lie Scale of EPQ-R was not used to determine the validity of responses, future research studies must include it for the robustness of the study.


  Conclusions Top


GA has 15.55% prevalence among intern doctors. It is more commonly seen in those interns having common gaming characteristics like playing online games, using more gadgets, spent more money, gaming in leisure and other time and playing for >5 years. GA is seen more with high level of neuroticism, aggression, and sensation seeking while it is associated more with low self-esteem and low extraversion. This suggests that personality factors may have a role in development and maintenance of GA and it would be prudent to include them for the treatment of GA.

Ethical statement

This study was approved by Institutional Ethics Committee with reference number IEC/Certi/54/2017 obtained on May 12, 2017.

Declaration of participant consent

Consent statement was taken from each participant as per institutional ethics committee approval along with consent taken for participation in the study and publication of the scientific results/clinical information/image without revealing their identity, name or initials. The participants were aware that though confidentiality would be maintained anonymity cannot be guaranteed.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
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    Tables

  [Table 1], [Table 2], [Table 3], [Table 4]



 

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