Significant variability in the classification and assessment of internet gaming disorder (IGD) has resulted in inconsistent evidence relating to its phenomenology, prevalence, cross-cultural application, course, biomarkers and treatment. Petry and colleagues have made an important contribution to research and practice by standardizing the diagnostic criteria for this disorder, which is included as a condition for further study in the DSM-5.Internet gaming is one of the most popular online leisure activities. These activities, particularly massively multi player online role-playing games, deliver pleasure, a sense of achievement, social interaction, and an immersive experience to online gamers. However, excessive online gaming may have negative consequences by limiting real-life experiences. Because of its prominent negative consequences and similarity to other addictive disorders, the loss of control over online gaming was termed ‘internet gaming disorder’ (IGD) and included in section III of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) Video games are now one of the most popular media for connecting people throughout the world. However, loss of control over video games played online has revealed a series of negative consequences. Because of its major mental health impact, the loss of control over online gaming was termed ‘internet gaming disorder’ (IGD) and included in section III of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM5). Extensive studies have provided new perspectives of IGD. Among Internet-based games, massively multiplayer online role-playing games (MMORPGs) are the most complex and require the most intensive social interaction. Currently, MMORPGs are a very popular and enjoyable leisure activity. However, MMORPG players reveal a high (27.5 %) rate of IGD, and playing MMORPGs is the most frequently cited activity in studies of Internet addiction. Studies indicate that optimal experiences motivate people to continue playing online games. Examples of optimal experiences include effective interaction with the system and pleasant social interactions with other gamers. New Internet technologies that enable real-time interaction and a smooth visual field have resulted in gaming experiences comparable to those in the real world and have led to the development of effective delivery systems that provide high user satisfaction. Further, because most popular MMORPGs have extensive and well designed virtual worlds, players can express themselves in ways that would cause them discomfort in real life because of their appearance, gender, sexuality, and/or age. Of all online activities, online gaming has the strongest association with compulsive Internet use. Excessive computer game playing without monetary rewards is considered problematic. People who play MMORPGs experience more gaming-related problems compared with people who engage in other online activities. Further, addiction to online games, particularly MMORPGs, might be associated with sleep related problems, such as insomnia and poor sleep quality. Moreover, a stronger belief in the realism of the games and more time spent playing MMORPGs increase online support but decrease offline social support.
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