Is gambling an addiction?

Between fun and addictionWhen computer games become a disease

Jakob started playing as a child.

"I think I played computers for the first time when I was six or seven years old. At the time, my father still had a nice old computer with the wonderful game 'The Settlers 3'. And that's when my fascination for it awoke. And then I did got my own computer pretty soon, immersed myself in the gaming world and it fascinated me very much. "

That has consequences. In elementary school, and later also in high school, he is not really present. He thinks of computer games, his classmates ignore him. It's different in the virtual world. There he is a commander, a strategist, can play in a protected environment, he can realize himself.

"'The Settlers' is such a development game, strategy game. You build castles, land and try to defeat your opponent. I sat down one Sunday and started a huge game, that is, one that lasted eight hours takes, and then I played it through in one day. Then my father came into the room and was pretty ... was not exactly very gallant in the manners then - you have to go out now, you have no friends and so on you don't even care about school anymore. How can you only play eight hours. I thought to myself: Yes, that's still true, but I didn't want to admit it. "

Day and night in front of the PC

In fact, as a teenager, Jakob spends whole days in front of the pc. At some point he switches to online games that encourage him to play longer and longer. He also sits at the computer at night. In the morning he goes to school tired.

"It wasn't that healthy anymore. And then there was the strong stress with my parents."

They worry. While Jacob's mother shakes her head at her son, his father disciplines him with ever new prohibitions - in vain, because Jacob can no longer be stolen from his beloved world.

"Father or mother block the Internet. I steal the Internet again, that is, I go to my father's PC and go into the Fritz-Box and release the child lock, or I buy myself cables to connect my PC directly to the router. Of course that kept escalating. There was never any physical violence, but verbally it was already at a very high level. "

Because Jakob is addicted to computer games.

Computer game addiction is - compared to other addictions - a relatively young addiction. In 2013 it was officially included as a research diagnosis for the first time, in the fifth revision of the Diagnostic and Statistical Manual, DSM for short - the addiction catalog of the American Psychiatric Society.

Just as addicting as gambling

In 2018, Europe stepped up, following the decision of the World Health Organization (WHO) to classify computer game addiction as a disease. This addiction is therefore the second behavioral addiction after gambling addiction and can now also be made as a diagnosis.

Not everyone who spends hours in front of the PC or smartphone has to be addicted (picture alliance / dpa / Christophe Gateau)
"There are, you have to say, if you look at the entire literature, clear connections between the results that have been observed in computer game addiction research, which were previously also found in research into substance-related addictions such as alcoholism and nicotine dependence, Was able to observe cocaine addiction.

That should not sound so flat that it would all be the same, but rather I am talking very specifically about the psychological addiction mechanisms, which in my opinion, according to the literature, show clear overlaps with other forms of addiction that have long been recognized. "

Says Professor Christian Monday. He heads the Department of Molecular Psychology at Ulm University and has been researching video game addiction since 2009. For him, the disease is an exciting phenomenon, especially because addiction mechanisms can be examined there without bias.

"Of course you always have the problem when you investigate addiction in alcoholics that the addiction mechanism is always superimposed by a toxic substance. This toxic substance can of course also distort these addiction mechanisms. That means that we actually have a purer addiction model here because of the The patient or the patient groups actually do not consume any substance here. This is very helpful for scientists in order to better understand addictions in general. "

Men in particular are affected by computer game addiction (dpa / Marius Becker)
One of Monday's interests lies in the unequal distribution between male and female addicts and the connection with genetic factors. Montag examined the prenatal testosterone levels of dependent and non-dependent players. These values ​​can be derived from the ratio of the ring finger to the index finger. A longer ring finger means: People have developed more testosterone as unborn babies, a shorter one indicates less.

"And what we were able to show in our work is actually that a more feminine hand goes hand in hand with a lower tendency towards computer game addiction. So this shows to some extent that a lower prenatal testosterone level can at least provide a small explanation for why there are differences in the sexes come here. "

A development that Jakob Florack from the Vivantes Clinic in Berlin-Friedrichshain is also familiar with. The child psychiatrist looks after cases of computer game and media addiction and has had a single female patient in recent years. In order to build the closest possible bond with his patients - among other things, Florack also looked after the computer game addict Jakob - the psychiatrist tries to find his way around the world of young people as best he can.

Treatment at Florack begins with a media history, a survey of how high the media consumption is. In the next step, he wants to find out whether their consumption is harmful to the young people.

"There can be techniques of questioning, there are also people who have dealt intensively with them. This is called motivational interviewing, where I question whether the perceived reality of the young person actually corresponds to reality. Then I can, for example Do something like use extreme formulations: Oh, so is everything really okay with your media consumption? There are no problems at all. And then you sometimes bring the young people into a role where they don't say: Yes, that's right, there are none at all Problems, but then formulates your own concerns. Something like that can be a starting point. "

Criteria for computer game addiction

The questions also provide clarity about who is the victim of computer gaming in the first place. It also happens that Florack is faced with parents who accuse their child of being addicted to computer games just because the grades have dropped a few decimal places. Florack is then amazed - especially when the parents don't even know which games their children are actually playing on the computer. After the anamnesis, Florack compares the behavior of the adolescent with the WHO criteria for computer game addiction.

First: Impaired control of the intensity, frequency and duration of play.
Secondly: an increasing prioritization of the game up to the replacement of other activities.
Third: to continue playing despite negative consequences.

If these criteria apply, behavior can be referred to as pathological. In extreme cases, this can lead to impairments in the family, in social life, in education, employment and in other areas of life.

By promising the player rewards if they pass the level, the user is manipulated in order to keep them in the game for as long as possible (picture alliance / dpa / Henning Kaiser)

However, this definition has not come about without controversial discussions among researchers. In particular, the inclusion in the WHO addiction catalog, first in the USA, then in Europe, was described by some as "hasty". The number of studies in 2013 was not sufficient. The fear of covering up underlying problems with the diagnosis "addicted to computer games" and pathologizing an everyday action was discussed. At least current studies show that over 99 percent of all players in Germany - in 2016 that was a good 30 million people, almost half of them women - have healthy gaming behavior. Psychologist Christian Montag knows these objections.

"The main reason is that - we all have this in mind - that we do not want large groups of people to be wrongly labeled as addiction, especially when it comes to everyday actions. And of course you can say: Yes “Computer games are fun, and at first there is nothing pathological about liking and playing computer games. It's similar when we talk about someone who likes to go shopping in the city somehow.

But these are not the problems we are talking about. We are talking about a rather small but certainly stable group of people who have a problem with computer games and who just need professional help. "

A highly professional industry

If you look at the computer and video game industry, it quickly becomes clear that you are dealing with a highly professionalized and diversified industry that had a turnover of 3.3 billion euros in Germany in 2017 alone. It will be back in Hamburg at the end of the week. Thousands of young people then meet to watch professional players at a tournament. These events often involve prize money of several hundred thousand euros.

E-sports are very important to young people. But that's not why they are immediately addicted. (dpa)
In addition to competitive games, which are particularly suitable for game leagues and tournaments, the smartphone games market has grown rapidly due to the spread of powerful mobile phones. A market that is increasingly focusing on women as a target group. So-called free-to-play marketing is particularly popular in this area

"The free-to-play concept, you might have to say again briefly, is just a free game that you download without paying anything."

Says game designer Arnold Rauers, who himself worked in a company that makes free-to-play games. In addition to the free download, there is ...

"But in-app purchases. That means that from a certain time in the game you can spend money in the game, so to speak used, in order to get as many users as possible to play and then a certain percentage of these users, which is usually a lot is little to actually pull money out of your pocket. "

It's about the money

Rauers, who now designs games with his own company, confirms that game companies are increasingly collecting data from their users in order to calculate exactly the probability of which action will take place.

Games on smartphones and iPads can be expensive and dangerous not only for children. (dpa / Jens Kalaene)
"So there are basically things as simple as: How many users per day, how many users per month. Those are the core figures that such a game spits out, so to speak. But then some of it goes into the level design area, where can really be calculated exactly to a percentage point: How many of the users have made the level? How many of the users have got stuck at which point? And then it is checked how many of the users who get stuck there are buying something. And then, in turn, conclusions are drawn: Why something is bought there or, even better, why not and where it would have to be made more difficult that the 0.01% chance that someone would buy something there increases. "

These findings flow directly into the game design. With minimal changes, players should not give up in tricky places, but instead spend a few euros on in-game purchases in order to overcome the obstacle. This principle is called progress manipulation - not the only trick the designers use to play with the psyche of the players.

The phenomenon that people like to lock things up, but the game prevents its users from doing so through commercial breaks or tight gaming lives, is a technology that is often used. The only way out: the players pay.

"Well, if you ask me personally, these mechanisms play a major role, but are largely unexplored. We can see that very nicely with all of these freemium mobile phone games. There are a lot of mechanisms that induce the user to do more Spending time on the game than he really wants to.

Let me say 'Candy Crush' is a good example where you have a certain number of lives and when they are gone you have to wait a relatively long time until the game energy has recharged. And psychologically, that is relatively difficult for us to endure. There is something called the Zeigarnik / Ovisiankina effect. This is an old psychological construct that says: If I am interrupted in an action, i.e. in computer games, it means: I did not finish this level in the game. Then it sticks like paste in the brain and we can only release this energy that is pent up when we have successfully completed the level, "says Christian Montag from the University of Ulm.

Mechanisms from the gambling industry

Equally popular: playing with the fear of loss. At the beginning, the player is given a good starting position and many advances, which are then taken from him as the game progresses.

One of the most important reasons for computer game addiction is the sophisticated competition with other players. Game designer Arnold Rauers:

"Competition is deeply anchored especially in male players, simply also in a human-technical way: The strongest survive. It's the same concept all the time and I've played 'League of Legends' for a while, it's even stronger on this 'me' can also dominate others concept 'built up. It is then about this power phantasy, that is: I am stronger than my opponent. The competition is definitely a very strong element .. "

Today, games are not yet analyzed for their addiction factors, although that would be necessary, says Christian Montag. The game designs could turn players into addicts.

Mechanisms that are otherwise only known from the gaming industry are also used, such as the random distribution of valuable objects in role-playing games after a successful phase of the game, or the sale of so-called loot boxes. Virtual boxes with random content, which are intended to enhance the games graphically and to activate the player's desire to collect.

The gaming industry is challenged

In order to limit the addiction factor, psychology professor Christian Montag sees the manufacturers responsible above all. Because here is:

"The gaming industry also sometimes asked to say: What are we doing in this area? In all other areas of addiction, let's say alcoholism, nicotine addiction, there have of course been much longer efforts. Let's just think of nicotine addiction. A good example of how that has been contained in the last few years, that in my opinion it has been the case so far that the gaming industry has slimmed down on the subject, and now that it has been officially recognized by the WHO gives, they now say: Oah, none of that works now, and then comes up with arguments that computer games are generally not bad at all, and looks at literature one-sidedly and then goes on to mix up certain things. "

Criticism of WHO decision

In fact, Felix Falk, the managing director of the industry association GAME, thinks that the WHO decision was not the right one.

"I believe that the decision was made too hastily because it has not yet been scientifically proven, or it is very controversial, whether computer game addiction should be classified as a disease."

He resists the portrayal that computer and video games are addicting goods that will seduce gamers.

"The fact that there are business models, such as free-to-play, where I don't pay 70 euros for a game, which after ten minutes may no longer fit and I don't like at all, but the 70 euros are gone, but I first play a game and only when I like it and use it for a long time do I buy additional content. This is actually a very fair business model, and the success with users shows that it is very well received.

But of course, I can never speak for the individual case where a user is annoyed and says: crap, now I've spent too much money, but I really didn't want that, but I had so much fun.

That happens elsewhere too. You'd have to take the cliffhanger on a series that instructs me to watch the next episode straight away, although I only wanted to watch one, you could also say: It's a mechanism to keep people going. Of course, that also applies to games. "

"That has to do with the fact that not all basic needs can be met by series."

Social pressure can lead to addiction to computer games

Child psychiatrist Jakob Florack contradicts the industry representative. Because:

"Much more than in the series, for example, many games live from the fact that they offer a pronounced social context, I move in guild structures or clan structures, depending on the game that means different, and within these structures I get recognition from others People. I won't get that in a series. And I have something that I think is even more crucial, that is called self-efficacy. That means, for example, I play 'World of Warcraft' and try hard for three hours, in a so-called one Raid and at the end of this experience I will get an item as a reward. "

It is clear that games have a special effect on their users. The conviction that you can successfully cope with difficult situations on your own, the group feeling and the virtual profits are essential factors that drive around one percent of players in Germany into addiction. Industry representative Felix Falk also has the dangers of the group feeling in mind. But he also sees other actors responsible:

"If someone plays with others in a socially networked way and five in the group say: Hey, let's keep playing, and the sixth says: No, I actually didn't want to play anymore, then of course there is social pressure. But that has less with games to do directly, specifically with the content, rather than with the fact that games are now such that you play together, that you play in a social network, that you play with other people and that are then social factors that may also lead to excessive use be able to lead with individuals, and where, I believe, answers from society as a whole are needed. "

For Jakob, too, "belonging to a group" played a major role in computer game addiction. Today the now healed 18-year-old has found connections elsewhere: with friends - online and offline.