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Craighead, Britney; Huskey, Richard; Weber, René : What Can We Learn From a Media Perspective? Revista Argentina de Ciencias del Comportamiento, vol. 7, núm. 3, diciembre, 2015, pp. 119-131 Universidad Nacional de Córdoba Córdoba, Argentina

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Craighead, Britney*'", Huskey, Richard" y Weber, René" Sección Especial: Videojuegos y Cognición

Abstraet Resumen Table of Contents In recen! years, video game addiction hJs Adicción a 105 Videojuegos: ¿Qué podemos aprender Introduction 119 received considerable ernpirical attentiorl. desde la perspectiva de la neurociencia de la Definingaoo 121 Unfortunately, this research is stymied by comunicación? En los últimos años, la adicción a 105 DiJgnosing Video inconsistencies In both con(eplU~1 ~nd videojuegos ha recibido una atención empínca Game Addiction operJtional definitions 01 video game addiction. considerable. Desafortunadamente, la investigación en este DiJgnosing Video 121 Moreover, the us.e of severJI video gilme campo se encuentra ob,Taculizada por inconsistencias en Game Addiction addiclion sea les makes it difficult to e5timate the definiciones conceptuales y operacionales de la adicción a Predictors and 122 prev~len(e and polenLi~1 erfe<.:LS or video game los videojuegos. Por OLro lado, el uso de varias escalas de Consequences of addiction. While galTl€ genre is alten treated ~s a ~dicción ~ 105 videojuegos diflCult~ la estim~ción de I~ Video G~me Addiction pre(lictor of video garYl€ addiction, existing prevalencia y los efectos potenciales de la adi

Key Words Key Words Video Game Addiction, Behavioral Addiction, Adicción a los Videojuegos; Neurociencia de la Neuroscience Communici1:ion Comunicoción, Adicción Conductual Recibido el 01 de Enero de 2015; Recibida la revisión el21 de Abril de 2015; Aceptado el13 de Octubre de 2015

1. Introduction Video game addiction is a topic of increasing Statistical Manual (DSM-V; American Psychological interest for both researchers and the general public. Association, 2013) as an issue warranting further Perhaps one of the best indicators of this increased study. While IGD is not included in the main DSM focus is the recent inclusion of Internet Gaming book as a formal disorder, this choice demonstrates a Disorder (IGDl to Section 111 of the Diagnostic and specific and somewhat narrowly focused interest in

., University of California. Santa Barbara. USA. 'Send Correspondence to:Craighead, B. E-mail: [email protected]

Cite this article as: Craighead, B.; Huskey" R. & Weber, R. (2015). Video Game Addiction: What Can We Learn From ~ Media Neuroscience Perspective? Revista Argentina de Ciencias del Comportamiento, 7 (1), 119-131 119 Craighead, B., Huskey, R. & Weber, R. / RACC, 2015, Vol. 7, W3, 119-131 the effects of online games. However, we adopt a disorders appear to fa 11 on a spectrum where more general view and propose that content features individuals may shift from normative behaviors in video games, both online and offline, are a crucial towards pathological behaviors when influenced by and largely overlooked aspect that may contribute to environmental factors & 2012). video game addiction. Over the past three decades, Unfortunately, as this paper will discuss, video research on the topic of video game addiction has game addiction research suffers from both theoretical increased steadily with the early 20005 marking an and operational ambiguities. For instance, a variety of important turning point both for the video games terms including video game addiction, excessive industry as well as research on video games and game use, problematic game use, and Internet addiction. This last decade was characterized by gaming disorder (among others) are used within the growth in the number of video game players as well Iiterature, yet they appear to be different terminology as the expansion of video games into online for similar phenomenon and outcomes el environments. Research followed suit by investigating 2012). For the sake of clarity and consistency, we will how these new avenues for play impacted game use the term video game addiction to describe this addiction & 2012). Today, 59% of phenomenon throughout the papero Americans play video games Software Researchers have used a variety of scales to 2014). Western Europe and Singapore measure video game addiction, most of which are show similar rates of play & adapted from criteria for gambling disorders. While Van 2014). For millions of people, playing video parallels have been drawn between gambling games is part of everyday Iife. Therefore, it is crucial disorders and video game addiction & that we understand the cause and prevalence of 2000), there are important differences between video video game addiction. games and casino games. Reward structures in video Broadly speaking, there are two types of games and casino games share many similarities, addiction: chemical and behavioral. The mesolimbic however one key difference between gambling and is a network of brain structures that gaming is that video games do not typically feature developed to reinforce survival-relevant behaviors (Dí monetary rewards.2 Moreover, one of the latest trends Chíara. 1 Traditionally, chemical are in video game development is the inclusion of social characterized by a dependence on a substance that features as an integral aspect of gameplay. Gambling pharmacologically hijacks the reward circuitry in the sometimes involves multiple participants or includes brain & 2012). By comparison, social features, yet, in video game play, the social behavior is motivated by an interaction between the features themselves are often highly rewarding. environment and evolved systems that motivate Furthermore, gambling does not involve narratives individuals to engage in rewarding activities while and stories as many video games do and it is well avoiding negative experiences (Lang, Crucially, known that humans are inherently attracted to stories even in the absence of drug taking, behaviors can as a form of survival relevant information exchange induce chemical changes in the brain's reward & networks that are similar to those seen in substance Video game addiction has emerged as a topic of addiction et 1 transforming naturally multidisciplinary research. Our goal in this review is to occurring rewards into repetitive craving or seeking synthesize current research on the topic of video behaviors (Karim & 2012). Dopaminergic game addiction and to illuminate areas where a dysregulation, which may reduce the ability of the deeper understanding is needed in order to promote prefrontal cortex to regulate behavior, is a common progress on this topie. Therefore, we: (1) provide a factor in both chemical and behavioral addictions and review of research on video game addiction, (2) suggests that both chemical and behavioral discuss the unique characteristics of video games that addictions share common neuroadaptations. Video are crucial for any conceptualization of video game game addiction has been conceptualized as a addiction, (3) integrate this research within the behavioral addiction (Kuss & 2012; broader context of behavioral addictions and their & 2012; & neurological foundation, and (4) suggest avenues for Apart from video games, the term behavioral addiction has been applied to a variety of behaviors including gambling, media use, eating disorders, 2 There is a wide array of video game genres and some video games or physical , and pathological working (Alavi et game genres may feature reward schedules that resemble gambling more closely than others. While this makes heuristic sense, the truth of this is an 2012). Importantly, addiction and addiction related untested empirical question. 120 Craighead, B., Huskey, R. & Weber, R. / RACC, 2015, Vol. 7, W3, 119-131 media neuroscientists to increase the understanding Connecticut (United States of America) found that and prediction of video game addiction by exploring 5.9% of boys and 3% of girls were classified as how game content features interact with reward problematic & systems in the brain. This includes suggestions for 2010). A meta-analysis of the prevalence of sound neuroscientific investigations of video game video game addiction found that the most precise addiction, even as scholars work to develop a measures indicate that 3.1% of gamers are formalized and widely agreed upon definition of problematic gamers & video game addiction. 2011). These results suggest that there is a problem: inconsistent definitions of addiction and , 1.1. Defining and Diagnosing Video Game coupled with different sampling strategies, make it Addiction difficult to grasp the true extent of video game Video game addiction has been the subject of addiction around the world. cross-disciplinary research, capturing the attention of scholars in communication, , , 1.2. Diagnosing Video Game Addiction and neuroscience. This is unsurprising since gaming is A potential explanation for differing results is the a prevalent form of entertainment around the world. use of multiple measurement scales. The problem However, inconsistencies in the definition of video video game playing (PVP) short scale game addiction make it problematic to compare the & Bersabé was adapted from DSM prevalence of this phenomenon across studies. criteria for substance dependency and focuses on Indeed, researchers have yet to establish a clear seven dimensions of problematic game use definition of what it means to be a gamer making it (preoccupation, 1055 of control, withdrawal, escape, difficult to measure and compare the prevalence of lies and deception, disregard for physical and gameplay, let alone pathological gameplay, between psychological consequences, and family and school studies and across countries. This point is well related disruptions). The game addiction scale (GAS; demonstrated in a recent investigation of the & 2009) is modified from prevalence of video game play in Germany, Belgium the DSM criteria for gambling disorders and it focuses (Flanders), Finland, and Singapore el on seven somewhat different dimensions of 2014). This study compared existing studies of problematic use (salience, tolerance, mood gameplay prevalence in these four countries. Since modification, withdrawal, relapse, conflict, and there is no established definition of what it means to problems). Genlile utilized an 11-item be a gamer, each study used different criteria to pathological gaming scale based on the DSM-IV c1assify individuals as gamers. el al. 4) criteria for pathological gambling and included found that in Finland, Flanders, and Singapore, 40­ somewhat similar dimensions (salience, or 50% of the population are gamers while in Germany, relief, withdrawal, relapse and reinstatement). 25% of the population are gamers. Unfortunately, it is Critically, these scales employ different cut-off points difficult to assess if these values reflect actual for quantifying normal, problematic, and addictive differences in prevalence or if they are the result of gameplay, which may lead to different estimations of differing definitions of"gamer" across all four studies. the prevalence of video game addiction and Unfortunately, this all too common issue may be problematic game use. For example, Gentile partially to blame for the wide variation in estimates c1assified gamers as addicted if they selected 6 of 11 of video game addiction. Studies from various items on the scale. The GAS short scale el Western countries indicate that addiction affects c1assifies individuals as addicted users ifthey between 1.5% and 11.6% of gamers (Kuss, van demonstrate strong agreement with each of the 7 (,rittílh, & van de 2013). A more scale items. And and Bersabé Morán recent representative study in Germany indicated that indicated that further research should be 0.2% of individuals across all age groups are addicted conducted to determine the appropriate cut-off point and 3.7% are problematic users & for their scale. 2013), whereas a study in the Netherlands Video game addiction scales such as the GAS focusing on game usage in adolescents between the comprise two distinct factors: high engagement and ages of 13 and 16 found that 3% of adolescent online problems related to video game play gamers are addicted & 2015). Scales that van den & van de diagnose gamers as addicted if they demonstrate representative sample of high school agreement with only a portion of the scale items (e.g.,

121 Craighead, B., Huskey, R. & Weber, R. / RACC, 2015, Vol. 7, W3, 119-131 may be c1assifying highly engaged addiction. Scharkow et al. 4) used the GAS short gamers as problematic gamers. et al. 5) scale, et al. 3) asked participants to self­ demonstrated that the GAS is a two-dimensional scale identify as problematic users in addition to using the with four core criteria that relate to video game problematic video game playing test, van et al. addiction (withdrawal, relapse, conflict, and (2011) used a compulsive Internet use scale and problems) and three peripheral criteria (salience, measured video game playing time, and Gentile et al. tolerance, and mood modification) that relate to high 1) utilized a scale based on the DSM criteria for engagement. So me researchers have considered problematic gambling. Perhaps the variation in results using only the four core criteria to diagnose video found in these four studies is an indication that some game addiction. Importantly, when using only the scales are more sensitive to problematic behaviors four core criteria (rather than the full seven-item than other, or that some problematic behaviors are scale), more individuals are c1assified as addicted more likely to persist over time. et 2015). It is unclear if individuals A related issue is that these scales do not c1assified as addicted using only the four core features necessarily measure an important component of should be c1assified as addicted or if high video game addiction; that is, the negative engagement is a necessary component of video game consequences and conflict experienced by individuals addiction. as a result of video game addiction. Griffiths These findings highlight the importance of argues that, while some gamers do experience creating an agreed upon definition and measure of negative outcomes as a result of excessive game use, video game addiction. Utilizing scales that categorize other excessive gamers may be using gameplay to highly engaged players as addicted, or scales that add structure to their lives or to socialize when their ignore high engagement may lead to an social groups are disrupted (e.g., after graduating overestimation of the prevalence of video game from college or moving to a new location). For this addiction. Video game research, including research on second group of excessive gamers, new activities the topic of pathological gaming, is susceptible to (such as starting a full-time job or entering a new & 2010; et relationship) begin to displace gameplay to the point 2011). et al. 1) suggest that, "moral where playtime is reduced and is no longer assessed panics result in crises being manufacture by well­ as problematic. Unlike substance addictions, video meaning but ideologically biased scholars and game addiction may be a temporary condition used advocates, regardless of evidence to the contrary" (p. to fill time or to add structure to an individual's life in 1577). A number of individuals undoubtedly suffer the absence of other activities. Taken together, from video game addiction, but until the criteria for inconsistent and incomplete measurement may assessing video game addiction are firmly established, explain the variation in addiction retention rates it is difficult to justify appropriate levels of concern. observed in longitudinal studies. While pinpointing Encouragingly, longitudinal studies suggest that exact retention rates is still problematic, it is clear that for many gamers, video game addiction is not a long- for many individuals, video game addiction is not a term problem & 2014; long-term problem. & 2013; van et 2011). 1.3. Predictors and Consequences of Video Garne Scharkow et al. 4) found that among addicted Addiction gamers, 75% cea sed to exhibit symptoms of addiction Several researchers have focused on finding two years later. et al. 3) found that for both personality, biological, and environmental factors that normal gamers and problematic gamers, scores on predict or are associated with video game addiction. the problematic video game playing test decreased While many studies have indicated that male gender over an 18-month periodo By comparison, van et predicts or is associated with video game addiction al. 1) found that after 1 year, half of the addicted (Rp·hhpin & 2013; Zanetta Dauriat et 2011; gamers in their sample still showed signs of game & 2005), Festl et al. 3) addiction. Gentile et al. 1) suggest that found that 4.1% of males and 3.2% of females are pathological gaming is not a passing phase of problematic gamers. This finding suggests that the adolescence and found a higher retention rate of absolute differences in rates of addiction between addictive gameplay behavior indicating that 84% of males and females are rather small. While several pathological gamers continued to show signs of studies have indicated that video game addiction is pathological gaming 2 years later. Unfortunately, each more prevalent in adolescent and young-adult males, study utilized a different measurement scale to access 122 Craighead, B., Huskey, R. & Weber, R. / RACC, 2015, Vol. 7, W3, 119-131 sampling bias may playa role in these findings since playing time and gaming addiction many of these studies rely on self-selected samples & 2014; & and males are over-represented in these samples et 2011; & et 2012). Other potential predictors of MMORPG design encourages social interaction and video game addiction for adolescents include: living interdependence between players since each player in single-parent households, gaming time, and the has access to only a Iimited number of in-game skills. use of violent games & 2013). Children Thus, in order to progress and achieve game goals, who demonstrate impulsive behavior, who have players must collaborate & 2014). lower social competence and empathy, or who have Other game genres associated with addiction include poor emotion regulation are also more Iikely to first-person shooter, action-adventure, and gambling develop a game addiction et 2011). games & 2012). While In addition to looking for predictors, game genre may be an important component of researchers have examined negative consequences video game addiction, communication scholars can and outcomes related to video game addiction. lend their knowledge of game content features to the Spending excessive amounts of time gaming can lead study of video game addiction in order to gain a to a variety of negative consequences such as deeper understanding of which specific mechanisms forfeiting time for family, friends, work, education, within games lead to different behavioral outcomes. and sleep, and it can increase and lower In the area of problematic gambling, researchers psychological well being et 2012). have recognized that the structural characteristics of Pathological gaming in children is associated with slot machine programs contribute to continued use of lower grades and poorer parent-child relationships slot machines & 2000). Various ((;entii,,,, et 2011). Video game addiction is also structural characteristics of gambling machines, associated with negative physiological consequences including the probability of winning, light and sound such as epileptic seizures, , wrist and neck effects, and event frequency, have the potential to pain, sore tendons, numbness of extremities, and promote excessive gambling and can produce sleep abnormalities et 2012). psychologically rewarding experiences, even while While previous research suggests that video players are losing 1993). Drawing on this game addiction is a problem-at least for some body of research, video game addiction researchers individuals-there is disagreement about how to have begun to explore the relationship between define and measure this phenomenon. The variety of specific video game features and excessive use of measurement instruments used to classify video video games. As a starting point, early work in this game addiction may explain the wide range of area identified content features that are important to estimates for game addiction. This is a serious issue players. and Davíes for addiction research since indecision about the cut­ surveyed a self-selected sample of gamers and off points in these measures may lead to an identified 12 content features that are important to all inaccurate diagnosis of video game addiction. These players including: sound, graphics, background and issues are further confounded as game addiction setting, duration of game, rate of play, advancement scales frequently use outcomes (e.g., playing time) to rate, use of humor, control options, game dynamics, define addiction, are modified from scales created to winning and losing features, character development, diagnose other addiction phenomenon, and ignore brand assurance, and multiplayer features. the very characteristics of video games that may and Gríffiths identified psycho- cause addiction in the first place. As the next section structural elements that may be related to will demonstrate, video games contain unique problematic game play. They proposed a taxonomy of content features and mechanisms that, for some features that contribute to video game enjoyment individuals, may contribute to video game addiction. including social, manipulation and control, narrative and identity, reward and punishment, and 1.4. The Characteristics of Video Games that presentation. These features and their relevant Contribute to Addiction theoretical foundations provide a catalyst for research Game genre has been implicated as a predictor of in the area of video game addiction. An empirical addiction and some genres of games are more follow-up study & 2010b) strongly associated with addiction than others. For demonstrated that reward and punishment features instance, massively multiplayer online role playing (Le., earning points, finding rare items) were rated as games (MMORPGs) are associated with increased the most important and enjoyable aspects of 123 Craighead, B., Huskey, R. & Weber, R. / RACC, 2015, Vol. 7, W3, 119-131 gameplay. However, determining which features of predictable rewards et 2010a). Behavioral gameplay are important to players does not research often used highly controlled environments, necessarily explain why players engage in specific such as the 5kinner Boxes that used just one stimulus behaviors, or what game features contribute to to test and reward sensitivity. addiction. Video games provide players with multiple short and While much ofthe research on game content and long term goals, allow players to choose which goals enjoyment has been descriptive, nascent to peruse, and allow players to simultaneously work experimental research is beginning to test towards multiple goals. Reward schedules in games associations between game features and individual are likely to fall along a continuum with some video differences in playing behavior. and games resembling a partial schedule Griffiths examined the effects of reward and and others resembling a continuous reinforcement reinforcement features (along with the level of trait schedule. 5ince video games employ a variety of , gender, and player experience) on self­ rewards, it is likely that games feature a complex mix reported affective response and willingness to of both reward schedules where perhaps larger continue gameplay. They found that trait impulsivity rewards (e.g., completing quests, acquiring rare in­ was not a significant predictor of propensity to play. game items) follow a sporadic partial reinforcement However, an increase in the ratio of positive schedule and smaller rewards (e.g., in-game money or reinforcement to negative reinforcement features points) are awarded to players continuously. increased self-reported propensity to continue As the next section will demonstrate, combining playing and to return to gameplay in the future. This knowledge of specific content features with a provides evidence that manipulating content neurophysiological understanding of human behavior features, such as reward structures, in games may lead can help to determine how game mechanisms lead to to an increase in playing time that works excessive playing time or addiction for some players. independently of self-regulation mechanisms. Conceptualizing video game addiction as a behavioral Reward and punishment features in games are addiction driven by variable reward payout structures informed by theories of reward schedules in is a first step toward overcoming existing conceptual behavioral psychology. Operant conditioning theory and operational ambiguities. Current indicates that the reward schedule (e.g., the conceptualizations and measures of addiction have distribution of rewards) is more important than the been derived from other problematic and addictive rewards themselves for determining behavior (Ferst<'r behaviors. Incorporating the content features that are & 1 Variable reinforcement, versus unique to video games into the definition of video continuous reinforcement, sustains behavior & game addiction may help to resolve conceptual 1 and it has been widely demonstrated ambiguities. One avenue for accomplishing this that partial reinforcement is more effective at objective considers how reward structures in games maintaining behavior than continuous reinforcement contribute to addiction. This also provides a 1 1 It is common for video foundation for integrating research on video game games to provide players with rewards, such as addiction within a broader body of neuroscientific points, in-game items, or character experience, for research attempting to identify the neural substrates little effort early on in gameplay. As players progress of addiction. In the next sections, we will review the through a game, the reward structure often becomes neuroscientific literature on behavioral addiction and less predictable and rewards more difficult to achieve. discuss what can be gained from the integration of While an increase in positive reinforcement neuroscience and more traditional behavioral characteristics (in relation to negative reinforcement investigations into video game addiction. characteristics) increases the likelihood that players 1.5. The Neuroscience ofBehavioral Addiction will continue to playa game and return to gameplay Whereas chemical addiction research focuses on in the future & 2006), game the pharmacological effects of exogenous drugs on designers may also adopt a sporadic reward structure reward networks in the brain & by programing payouts that only occur a small 2012), behavioral addiction research investigates how number of times for a given action. These findings are behavior modulates brain chemistry in these same consistent with operant conditioning theory. When neural networks. The current section has two main playing games with intermittent rewards (e.g., partial goals: (1) to broadly explore neuroscientific research reinforcement effects), players are less likely to quit on behavioral addictions including Internet addiction gameplay in comparison to games featuring 124 Craighead, B., Huskey, R. & Weber, R. / RACC, 2015, Vol. 7, W3, 119-131 and video game addiction and (2) to explore how compared to the non-IAD group & game content features might stimulate the reward 2012). system in the brain. Self-regulation is an important aspect of is a neurotransmitter involved in behavioral control and has important implications for processes such as learning, behavior reinforcement, behavioral addiction research, including video game attention, and sensorimotor integration addiction. Differences in self-regulation and impulse & 1 Robbins & 1 control may help predict susceptibility to video game In animal studies, dopaminergic neurotransmission addiction. Neuroimaging research investigating the has been associated with sensorimotor function neural correlates of self-regulation suggest that self­ related to rewarding, aversive, and stressful stimuli regulation of behavior is dependent on a balance & 1 Dopamine is also thought to between activation in the prefrontal cortex and be a crucial link between reward and addiction. subcortical regions in the brain & Indeed, dopamine is one of the most commonly W'lorler. 2011) where the self-regulation of behavior investigated neurotransmitters studied in requires top-down control from the prefrontal cortex. neuroscientific investigations of gameplay behavior The prefrontal cortex exerts control over the and video game addiction. For instance, el al. subcortical regions of the brain involved in the (1 used positron emission tomography (PET) to regulation of reward and emotion. So me stimuli may demonstrate that dopamine is released in the human evoke a strong impulse, which then tips the balance striatum during video game play. Importantly, this in favor of bottom-up control from the subcortical showed for the first time the behavioral conditions regions. This increases the Iikelihood that an under which dopamine is relea sed in humans and individual will fail to self-regulate behavior demonstrated that a behavior, in this case playing a (HF'~tf"'r1IC\n & 2011). In previous studies, trait video game, can lead to changes in brain chemistry impulsivity has not been implicated as a predictor of that are similar to pharmacologically induced video game addiction & changes. Since then, an abundance of evidence has This may suggest that momentary changes in self­ implicated the dopaminergic system in the regulation regulation are a crucial component of behavioral of rewarding behaviors as well as behavioral control. As we will discuss, video game content addictions & 2012). features may play a role in altering this balance Investigations of the dopaminergic system have between the prefrontal cortex and subcortical shed light on the neurobiological mechanisms of regions. Internet gaming disorder (IGD). Tian el al. 4) used Indeed, behavioral research suggests that the PET to assess dopamine and serotonin receptors in reward schedule in a video game (actual versus the brain and found that dopamine is associated with predicted rewards) plays an important role in glucose metabolism in individuals with IGD. This motivating gameplay behavior. Malhiak el al. 1) suggests that dopamine receptors may play an used fMRI to investigate the role of the reward system important role in the mechanism for 1055 of control in the affective evaluation of playing a violent first­ and associated with IGD. person shooter video game. Specifically, they looked Compared to the control group, participants with IGD at negative reward prediction error (the decrease in demonstrated dysregulation of dopamine receptors neural activity that is observed when outcomes are in the orbitofrontal cortex, suggesting a 1055 of more negative than expected). Deactivations in the control over compulsive behavior. Related research caudate nucleus, a subcortical structure involved in has used electroencephalography (EEG) to examine learning processes when comparing actual versus the cognitive effects of Internet addiction disorder predicted rewards, occurred when players did not (IAD). Participants with IAD demonstrate lower receive an expected reward. Violent events were not impulse control and less efficiency in information found to be directly rewarding for the players-rather processing & 2010) and male gamers played to avoid failure. More recent results participants with IAD demonstrate impaired executive further expand on these findings by demonstrating control & 2011). A study utilizing that the neural structures associated with positive and an event related fMRI Stroop test demonstrated that negative affect correspond to distinct neural patterns participants in the IAD group exhibited less efficiency & of response inhibition processes and demonstrated 2013). Taken together, these studies demonstrate that greater neural activity in the anterior cingulate cortex game outcomes (and not necessarily content) are (a structure which is integral to cognitive control) Iinked with reward network activation, and that the 125 Craighead, B., Huskey, R. & Weber, R. / RACC, 2015, Vol. 7, W3, 119-131 reward network is differentially engaged depending the psychological conflict associated with addiction on the valence of in-game events. may have a dampening effect on the flow experience. Flow, a positively valenced affective experience Relatedly, psychological conflict in addicted players resulting from a balance between task challenge and may result in weaker functional connectivity (a individual skill 1990), is commonly measure of neural synchronization) between offered as an explanation for why video games are attentional and reward networks during video game enjoyable to play. lndeed, players often report that play that balances challenge and skill. Under such the play experience c10sely matches the subjective circumstances, we should expect these players to experience of flow; that is, the sensation of losing report dampened flow experiences. Finally, balance track of time, a disappearance of self-consciousness, theories (e.g., Heatherton & 2011) suggest intense concentration, and a pleasant experience that that addiction occurs when reward networks exert a is not perceived as taxing While these bottom-up dominance over prefrontal executive characteristics are central to the flow experience, they control networks. Conversely, flow is thought to occur may also playa role in an individuals' inability to self­ when these two networks operate simultaneously regulate gameplay behavior (Wood & and in synchronization et The rewarding nature of flow might Admittedly, the synchronization theory of flow also be implicated in video game addiction. While explicitly discusses alerting and orienting attentional there still is not much empirical work in this area, a networks; however, more top-down executive study of Taiwanese gamers found that players who attention networks are also thought to be relevant. have experienced flow in the past are more likely to While these theories specify different neural be addicted to video games & mechanisms and suggest that flow and addiction Indeed, neural activity associated with free play in a represent two distinct higher-order processes, to our video game environment has been shown to result in knowledge, no study has directly tested these activation in reward networks (Klilsell. \PJeller. K¡n:hc·r. predictions. & 2011). However, there are several Finally, time spent playing video games is key distinctions between flow and addiction that are often treated as either a predictor of or consequence important to tease apart. First, flow is characterized by of video game addiction. However, mounting a positive experience whereas addiction is associated evidence points to the inadequacy of simplified with negative outcomes such as social and conceptualizations of time as an antecedent or psychological conflicto 5econdly, having experienced outcome of video game addiction. For instance, a flow in the past and being addicted to video games in recent study investigated anatomical differences the present is not necessarily the same thing as flow between individuals with IGD, professional gamers, causing addiction. In the case of the Chou and and a normal control group & R"'l

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