The Trouble with "Addiction"
Getting Past "Either-Or" (Part One)
Another complication with MMOs is that they can be therapeutic and destructive at the same time. While the media likes to describe the issue is terms of polarized pro-game and anti-game opinions, it's not clear why online games can't be both enabling and disabling at the same time. For example, some people have access to social opportunities in virtual worlds that they do not have in the real world. And no, I don't mean resurrecting the dead. Teenagers who are sufficiently mature can become guild leaders and take on a leadership and management role in a group of a dozen or more adults. It bears emphasizing that this kind of social opportunity does not exist in the real world for teenagers because of how our society is structured. In the real world, teenagers aren't allowed to lead a large group of adults, set their play schedules, draft rules and guidelines, and resolve their personality conflicts. It's not hard to see why these opportunities can be seductive for all the right and wrong reasons.
A more complicated example comes from a recent article from the American Journal of Psychiatry (Allison, Wahlde, Shockley, & Gabbard, 2006). In this case study, an 18-year old patient (referred to as Mr. A) with online gaming problems received diagnoses and recommended treatment from a panel of four clinical practitioners. The case presentation was clear in describing the contextual factors of Mr. A's life history that may have played a role in the development of the problem. For example, one therapist noted that:
Mr. A had a lifelong history of school refusal and anxiety about new social situations, in part related to the fact that his family had relocated 14 times in his 18 years of life; the last move was in 2000 just before his eighth-grade year. His anxiety led to home schooling off and on throughout his school years.
The authors also struggled with whether "online gaming addiction" was a meaningful diagnostic category.
Whether or not these behaviors represent true addictions is controversial. A modest body of literature has developed on this subject. Part of the controversy centers on how the authors define an addiction. Physiological signs, such as withdrawal-related symptoms and increasing tolerance, are problematic as defining features because Internet use, like other so-called behavioral addictions, are without these elements …
On the other hand, some investigators have emphasized the positive aspects of role-playing Internet games. One survey of MMORPG users found that they do not fit the profile of addicts. The investigators concluded that these game-players simply have a different perspective on social life. They seek social experiences that may not otherwise be available to them for a variety of reasons.
It is probably an oversimplification to approach the addiction issue as an either-or choice. In the case of Mr. A, a both-and conceptual model was more useful.
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