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The difficulties of researching gaming disorder and addiction

Dr Pete Etchells says there is an endemic problem with psychological research, as confirmation bias shapes the literature

The games industry could and should play a larger role in understanding gaming addiction, according to psychologist and author Dr Pete Etchells.

Speaking with GamesIndustry.biz at EGX Rezzed, the Bath Spa University reader said the games industry should "definitely" be involved with academic research into problematic behaviour around gaming, and could even provide funding.

While academics have called previously for greater collaboration from the games industry -- particularly around granting access to valuable objective data -- it has also been argued that research needs to be "absolutely free of the gaming industry" when it comes to funding.

Any industry-funded research which found that loot boxes were harmless, for example, would quite rightly be called into question. However, Etchells suggested that while there is certainly a "perception issue," there are ways to "immunise you to a certain extent" against these problems.

"There is unconscious bias about how we're brought up to do science and do data analysis that is having a real impact on what the state of literature looks like"

"One thing that psychologists are starting to do more and more of is something known as pre-registration where you say: 'I'm going to do this study, and this is how I'm going to analyse my data' before you actually collect the data. You make that publicly available, so people know when you collect your data that's what you were always going to do with it, rather than doing the analysis behind closed doors and do it five million ways to find the answer that you or your investors want.

"It's not a perfect solution, it's not going to completely inoculate you against conflicts of interest, but there are these things that you can do to make research more open and transparent that I think would be a really important first step."

Here Etchells taps into one of the key problems impacting psychological research at present. Speaking earlier on-stage with Rock Paper Shotgun deputy editor Alice Bell, he outlined the endemic issue of confirmation bias where psychology researchers analyse data multiple ways looking for the answer they were expecting. It's a cultural issue, said Etchells, where psychologists presume if the answer is different to the one expected, they say, "Well I analysed the data wrong, but if I do it this way, maybe that works."

Dr Pete Etchells on stage at Rezzed with Rock Paper Shotgun deputy editor, Alice Bell

Dr Pete Etchells on stage at Rezzed with Rock Paper Shotgun deputy editor, Alice Bell

"If you do that enough times, you might throw up a false positive where you show an effect when none exists," said Etchells. "But that's the point where you stop and say: 'There's the effect. I knew it was there,' and that's the one you report... I don't think for the most part anybody is doing it deliberately [except in a few extreme cases]... In general people are trying to do the right thing, and do the research as best they can, but there is an unconscious bias about how we're brought up to do science and do data analysis that is having a real impact on what the state of literature looks like."

It's a problem exacerbated by the industry's position to not share data with researchers about player behaviours. Etchells highlighted a longitudinal study he conducted a few years ago on the question of violent video games. It found there was a small association between aggressive behaviour and playing violent games at ages eight and nine, and some conduct problems at age 15.

The link was "really quite small" however and the "absolute risk was tiny." Importantly, the study -- like many others done in the field -- was unable to account for external factors such as family and home environment.

"Microsoft and Sony all have that data, and game developers have that data, and it would be nice to even just get a snapshot of what people are doing"

"Because the research is quite ambiguous and there is this flexibility in it, there's no concrete definitive answer either way," said Etchells. "So there's always going to be people either side of the debate saying 'yes, they do cause problems' and 'no, they don't'. It just means that it can't quite resolve itself in the public eye."

Even further still, researchers don't even really know what sort of games people are playing, or how much time they are really spending in those games. Ask any medical doctor how much people drink or smoke, and they'll tell you about the flaws of self-reported data.

"We really don't have a clear idea as research scientists what games people are actually playing on a day-to-day basis... Microsoft and Sony all have that data, and game developers have that data, and it would be nice to even just get a snapshot of what people are doing," said Echells.

The debate around gaming addiction was given real life last year when the World Health Organisation (WHO) announced it would be including 'gaming disorder' in its latest draft of the International Compendium of Diseases.

Currently the draft is under review and by no means finalised. However, critics have said it is premature to consider a clinical diagnosis of 'gaming disorder' and that there isn't conclusive enough evidence.

Speaking last year with GamesIndustry.biz, Dr Vladimir Poznyak -- coordinator for the WHO Department of Mental Health and Substance Abuse -- said formalising 'gaming disorder' as a condition would provide cohesion and coherence to treatment of problematic gaming behaviour.

In response to this argument, Etchells said that while he was sympathetic to how a clinical definition could open the doors to formal treatment and facilitate financial support for people suffering, it also creates problems of misdiagnosis.

"I don't think anybody is saying there aren't some people for which this is a demonstrable problem," he told us. "I think the issue is if this is done haphazardly -- and we don't have a clear idea on what this thing specifically looks at the minute -- then we risk doing things like over-diagnosing, sticking people in treatment centres who maybe show some problems but when it's not actually a clinical diagnosis, and I think that's where things like stigmatisation of gaming comes in... It's just that it's too premature. We've not got a clear enough angle on what it is yet in order to direct treatment research in an appropriate way."

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Latest comments (1)

Neil Young Programmer, Rebellion Developments2 months ago
All seems very sensible. Pre-registration is good for avoiding publication bias and other concerns over conclusions regardless of funding, and the misdiagnosis issue came up when the WHO inclusion was announced. The argument I saw then that "excessive" gaming is known to be a symptom, or coping strategy for, other conditions, and a diagnosis of "gaming disorder" may actual end up doing harm.
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