Video games: When does play become pathology?
Most kids have fun and don’t get ‘hooked,’ but some boys may be at particular risk.
Recommended approach
Explore whether a child’s behavior could be characterized as normative or excessive, in terms of how much time he or she spends playing video games. This can help put parents’ concerns in context. Regardless of how much time the patient spends playing video games, pay attention to whether his or her thoughts, emotions, and behaviors seem pathologic.
Try to determine if the child is experiencing distress or functional impairment because of video game play or if excessive time spent playing video games is exacerbating symptoms of a comorbid mood, anxiety, or disruptive behavior disorder. Assess overall functioning, participation in activities, engagement in relationships, and how the child perceives his or her play. Investigate the family environment, peer relationships, and history of trauma.
If these interventions fail to address excessive or pathologic video game play, or if comorbid disorders and functional impairment are severe, medication or residential treatment may be needed to effectively control video game exposure.
Table 5
Advice to parents for monitoring children’s video game use
| Keep computer and game consoles in a community area in the home |
| Check age-based ratings and content descriptors of games before renting or buying |
| Talk to your kids’ friends’ parents about the video games they play in their households |
| Talk with your kids about Internet safety, particularly if they play MMOs |
| Play games with your kids—have them teach you how to play and show you what they like about particular games |
| Engage in frequent casual conversations with your kids about the games they play and what the experience is like for them |
| Consult a mental health professional if you’re concerned about changes in your child’s mood, school performance, social relationships, or eating or sleeping habits |
| MMOs: massively-multiplayer online games |
- Entertainment Software Rating Board. Search for video game titles or publishers by rating, platform, and content descriptor. www.esrb.org.
- Jones G. Killing monsters: why children need fantasy, super heroes, and make-believe violence. New York: Basic Books; 2003.
The author reports no financial relationship with any company whose products are mentioned in this article or with manufacturers of competing products.
