A Bit of Background
Gaming is becoming an increasingly prevalent and recognised part of modern culture. In fact, games made more than movies and music combined in terms of sales revenue last year. It is a $21 billion industry. A recent study showed that 97% of teenagers in the US had played a video game in the last 24 hours, and new data suggests that middle-aged women are actually a bigger gaming group than teenage boys.
Historically there has been a lot of research done (in response to media attention and public concern) into the behavioural response to gaming, and this has evolved to study the prosocial and beneficial effects. Most recently, clinical efforts have gone into investigating the complex interactions between game players and behaviour, including what draws individuals to game play in the first place. And most excitingly, there are emerging real valid efforts to discover whether video games could be used for therapeutic benefits. These include physical and psychological therapies.
Below you will find a summary of the broad and thrilling selection of clinical research that is being undertaken across the globe to find out whether video games can offer a therapeutic benefit to those individuals struggling with mental health concerns.
Game Players Have Higher Rates of Mental Health Issues
"The online gamers with longer weekly gaming hours tended to have a longer history of online gaming, and more severe depressive, social phobic, and internet addiction symptoms. Female online gamers had fewer weekly online gaming hours and a shorter previous online gaming history, but tended to have more severe somatic, pain, and social phobic symptoms. The predictors for depression were higher social phobic symptom, higher internet addiction symptoms, longer online gaming hours, and female gender."
BMC Psychiatry 2012
"An interesting profile has emerged from the results of this study, suggesting that certain psychological characteristics such as aggression, self-control, and narcissistic personality traits may predispose some individuals to become addicted to online games. This result will deepen our understanding of the "at-risk" population for online game addiction and provide basic information that can contribute to developing a prevention program for people who are addicted to online games."
Eur Psychiatry. 2008
Some Games May Affect the Way People Behave
Last year a team looked at a large sample of other research and put all the results together to see what is what. This is called a meta-analysis and it is one of the strongest forms of evidence. They looked at 98 studies which included nearly 37k people.
But what did they find?
“For both violent video games and prosocial video games, there was a significant association with social outcomes.”
Whereas violent video games increase aggression and aggression-related variables and decrease prosocial outcomes, prosocial video games have the opposite effects. These effects were reliable across experimental, correlational, and longitudinal studies, indicating that video game exposure causally affects social outcomes and that there are both short- and long-term effects.
It does look at though the sample they chose, however, was reasonably indiscriminate and includes studies with poor value. So it's difficult to know how true their results are.
So what next?
We need more studies which use reliable measures of aggressive and prosocial behaviour.
Pers Soc Psychol Bull 2014, Communication Research 2014
Prescription Pixel is an initiative to provide a space for people who enjoy gaming to learn and talk about mental health.
We believe that video games can be therapeutic for mental wellness, and we support clinical research into this area. On the site you can find gaming and non-gaming based resources for all sorts of emotional and psychological experiences.
In addition, we acknowledge that online gaming addiction can be a serious condition. If you think you may be addicted to online gaming, you will find helpful resources here.
You can't simulate actual emotional and psychological responses in a lab. It's just not a true environment. So far they've used things like the "Taylor Competitive Reaction Time Test" - this means blowing an airhorn in someone's face and measuring how long for.
Other methods include dropping pencils on the floor to see who helps.
There's also the issue of the chicken or the egg: what kind of states of mind predispose somebody to play games, and how much of it is the game affecting your state of mind?
How can you tell which is which?
Games Could be an Adjunct
These scientists looked at the impact that introducing video games to a therapy setting, in the context of both psychological and physical treatments, could have. This meant using video games to train the therapist, as part of the therapy itself or by some other measure. Their results were very promising for the therapy of gaming: Video games improved 69% of psychological therapy outcomes. Also, they improved 59% of physical therapy outcomes, 50% of physical activity outcomes, 46% of clinician skills outcomes, 42% of health education outcomes, 42% of pain distraction outcomes, and 37% of disease self-management outcomes. They did, however, comment that these were quite poor studies.
Role of video games in improving health- related outcomes: a systematic review Primack, Carroll, McNamara, Klem, et al Am J Prev Med. 2012 Jun;42(6):630-8.
The Good, the Bad, or the Ugly?
This study looked at the clinical view of video games as something that was either black or white, all or nothing, good or bad. They analysed the existing papers and hypothesised that there are lots more factors that go into a game's impact than just a dichotomous one.
They suggest that for greater understanding of the true impact that Video Games have on our psychology, one would have to analyse all sorts of different levels, topics and areas of interactivity, that "important variables exist at the levels of the individual, game content, and societal time or space".
They then go ahead to make suggestions on how this could happen. Very exciting for the future of video game research!
A Multilevel Perspective on Electronic Game Effects Brian G. Southwell American Behavioral Scientist December 2004 vol. 48 no. 4 391-401
It is well documented that "play" assists with learning and has psychological benefits. From a physiological point of view this is because of dopamine; also involved are the motivation, repetition, and reward pathways.
Achievement tropes in gaming provide incentive based objectives, triggering these pathways.
Games also promote adaptive regulation strategies - helping players with the concepts of acceptance, problem solving and re-appraisal.
“Games continuously provide novel challenges, demanding players to shift already established appraisals to new ones in order to most efficiently reach goals.”
Players must fluidly adjust to unique social and emotional goals, assisting in real life interactions. The reappaisal involved with these emotional experiences teachs players the benefits of dealing with frustration and anxiety in adaptive ways.
Some Awesome Condition-Specific Projects
A computer drawing game for projective use, to stimulate catharsis and affective expression (Aymard, 2002)
The video game was created and developed within the European research project PlayMancer.
It aims to prove potential capacity to change underlying attitudinal, behavioural and emotional processes of patients with impulse-related disorders. New interaction modes were provided by newly developed components, such as emotion recognition from speech, face and physiological reactions, while specific impulsive reactions were elicited.
The Exciting Future for Oculus Rift and PTSD
Albert “Skip” Rizzo of the University of Southern California began studying virtual reality (VR) as psychological treatment in 1993. Since then, dozens of studies, his included, have shown the immersion technique to be effective for everything from post-traumatic stress disorder (PTSD) and anxiety to phobias and addiction.
As the Oculus Rift technology continues to develop, emerging is the obvious role of this immersive hardware in the treatment of complex anxiety disorders.
This works via the concept of "flooding" or immersion therapy. This technique means that the user experiences an artificial environment which will cause them to feel anxious, afraid, or suffer flashbacks - in increasing doses until it does not bother them anymore.
For example, for someone who has a debilitating fear of flying, the Oculus Rift headset could be used to simualte the environment to the user of being on a plane. This enables them to develop regulation strategies and coping mechanisms in a safe and controlled environment.