TOKYO -- Do you "feel isolated from others?" Have you "continued gaming despite the occurrence of negative consequences?" Do you "systematically fail when trying to control or cease your gaming activity?"
These questions were developed by a multinational team of psychologists, led by Halley Pontes at the University of Tasmania, in order to help identify the signs of "gaming disorder," a damaging addiction to video games. Their test, which is available online, was trialed on a group of 560 gamers in the U.K. and China. More than 6% of them met the World Health Organization's criteria for gaming disorder.
In May, gaming disorder was officially classified as a medical disease by the WHO, which defined it as "a pattern of gaming behavior ... characterized by impaired control over gaming [and] increasing priority given to gaming over other activities to the extent that gaming takes precedence over other interests and daily activities."
The condition is on the rise, as games become more accessible to young consumers through mobile phones, and as their designs become more adept at triggering obsessive behavior in order to drive users to spend more money on in-game purchases.
Mobile games derive the majority of their revenue by selling additional content to players, who have often accessed the base game for free; this means it is in their interests to nudge players toward compulsive actions. Tactics such as "loot boxes" can be particularly compelling, according to Hideki Yasuda, senior analyst at Ace Research Institute. These are virtual treasure chests embedded in games; players have to pay a certain amount in order to unlock the treasure without knowing the kind of reward that lies inside.
"Loot boxes can be never-ending," said Yasuda. "Gamers, unable to control themselves, could inject an astounding amount."
The financial cost is only one of the negative consequences of addiction, which has also been linked to aggressive behavior, depression and anxiety. The problem is particularly acute in Asia, where smartphone penetration is high and online gaming has taken off both for leisure and as a spectator sport, and governments are scrambling to tighten regulations and to build prevention programs.
In South Korea, one of the largest game markets in the region and a global hub for professional esports, the health ministry has signaled that they will reflect the WHO's stance on gaming disorder and will try to address problematic behavior, such as compulsive spending on in-game purchases. But a report led by Lee Deok-joo, an engineering professor at Seoul National University, estimates that classifying game addiction as a disorder could cost South Korea up to 11 trillion won ($9.3 billion) in lost revenue.
The Chinese government has taken a hard line since last year, limiting access to try to curb playing time and at one point restricting the number of games that could be launched into the market. In March, one of the country's largest operators, Tencent Holdings, started requiring parents' permission for minors to play online games for the first time; in July, the company extended that to restrict minors' gaming access during certain times of the day.
Japan's Ministry of Health, Labor and Welfare estimates that around 930,000 junior and senior high school students suffer from internet addiction, mainly in the form of online gaming. This figure has doubled in the last five years.
Yuya Kimura of Oneness Group, a private organization in Japan that helps game addicts, says phone calls asking for advice and help have surged in the last two years. "Many of them are minors. 'Fortnite' and 'Knives Out' seem to be the two most popular games right now among those suffering," he said, referring to two online multiplayer mobile titles which, combined, have over 350 million registered users.