Adolescents As The Most Vulnerable Of All Age Brackets

Over the years, internet users have grown exponentially with more than three billion users now. Notably, 830 million online are young people or 80% of the youth population in 104 countries according to the global data released by the International Telecommunication Union (ITU), the United Nation’s specialized agency on Information and Communication Technologies (ICT). The 2017 ICT data shows up to 35% of individuals using the internet are aged 15-24, which are mostly adolescents; and in China and India alone, up to 320 million young people use the internet (ITU, 2017). India is among the top 5 countries driving 50% of the world’s online gaming sessions with 13% share next to the US which comes first with 20% followed by China (7%), Brazil (5%) and Russia (5%) (Venkatraman, 2017).

In 2016, India has an online gamers’ base of 120 million and with the increasing penetration of smartphone and digital payment options becoming available in the country, the figure may increase to more than double at 310 million by 2021 (Google and KPMG, May 2017). The prevalent use of internet among the vast majority of the adolescents, ages 10-19, has become a significant social context affecting their personality and development (Govindappa, Kasi, & Henry, 2014); and has become an integral (APA, 2013) almost indispensable part of their day (Soh et al, 2018; Castellaci & Tveito, 2018) used for personal recreation to social engagements. However, compulsive internet gaming has emerged as a growing social issue and a significant public health concern affecting an increasing number of countries (WHO, 2015).

While Young, in 1998, first empirically analyzed problematic behaviors pertaining to internet use (Young, 1998) and, in 1996, if can cause addiction, the most recent and significant undertaking by the World Health Organization (WHO) on the growing phenomenon of internet gaming addiction is to recognize it as a mental health condition under ‘gaming disorder’ as its official nomenclature. In the 11th International Classification of Diseases (ICD-11) released mid-2018, “gaming disorder is characterized as a pattern of persistent or recurrent gaming behavior (‘digital-gaming’ or ‘video-gaming’), which maybe online (i.e., over the internet) or offline, manifested by:

1. impaired control over gaming (e.g., onset, frequency, intensity, duration, termination, context);
2. increasing priority given to gaming to the extent that gaming takes precedence over other life interests and daily activities;
3. continuation or escalation of gaming despite the occurrence of negative consequences.”

The dysfunction experienced by an individual in various life areas should be occurring for at least 12 months which can be continuous, episodic or recurrent to be significant for diagnosis. The length of time it continues to exist may be shorter provided all diagnostic criteria are present and symptoms are severe (WHO, 2018a). The American Psychiatric Association (APA), for its part, uses the term Internet Gaming Disorder (IGD) and describes it as a pattern of excessive online gaming which results in a cluster of cognitive and behavioral symptoms accompanying progressive loss of control over gaming, tolerance and withdrawal symptoms similar to those of substance use disorders. Broadly depicted, it is a form of persistent and recurrent involvement with video games which in many cases lead to the decline of daily work and/or education activities. Persistent and recurring engagement in computer gaming, especially group games for long hours is the central feature of IGD (APA, 2013).

Existing empirical literature shows that internet gaming addiction develops when gaming time or frequency increases significantly. The symptoms of IGD begin to appear as gamers experience loss of control, narrow behavioral focus and serious life conflicts occur (Kuss & Griffiths, 2012a). Given the variety of existing and potential negative consequences of IGD which allow the behavior to be classified as pathological based on established clinical standard as per APA (2000), IGD may require professional treatment (Kuss & Griffiths, 2012b). Individuals assessed with IGD have impaired daily functioning such as unhealthy lifestyle displayed by willingness to forgo food, sleep or real life human interaction and abandoning normal obligations such as in school, work or family life (Kuss & Griffiths, 2012a).

Research evidences on lack of adequate sleep consistently suggests negative implications on cognitive performance (Sarchiapone et al, 2012). They may also endure related health problems such as eye strain, carpel tunnel syndrome, back strain and repetitive stress injury. They, then, develop a need or impulsive craving for more of internet gaming as the disorder develops and when stopped from gaming manifest withdrawal symptoms causing them to become agitated, violent and anxious and suffer from signs of depression, anxiety, restlessness, trembling hands, irritability and obsessive thoughts about the internet game (King & Delfabbro, 2014).

Alarmingly, a number of empirical studies have linked compulsive internet gaming or IGD with poor psychological well-being among adolescents. The manifestation of behavioral addiction among the young people to internet gaming has paved the way for many researchers to investigate the causes, symptoms and effects of this behavior. Where there is higher penetration of internet access and availability and where gaming is socially accepted, the higher the prevalence of gaming problems (King, Delfabbro & Griffiths, 2012), which partially explains why much of the literature stems from evidence of studies undertaken by mostly Asian countries on young males (APA, 2013). For instance, internet gaming addiction is found significantly associated with negative consequences, self-harming behaviors and impact to psychological well-being (Kuss & Griffiths, 2012b; Gentile et al., 2010) identical to internet addiction (Young & Rodgers, 1998).

According to studies undertaken by many researchers, psychological problems arising from gaming addiction involve sacrificing real-life relationships, other pastime activities, sleep, work, education, socializing and relationships; obsession with gaming; lack of real-life relationships; and dysfunctional coping (Kuss, 2013). More recently, due to reported incidents of suicide in India related to online gaming, the government took action on the deadly game, Blue Whale challenge, a game with curator who instructs its players what to do; and recently directed internet majors- Google, Facebook, Whatsapp, Instagram, Microsoft and Yahoo- to erase its links (“Blue Whale challenge”, 2017).

Some infamous crime cases committed by adolescents inspired by video game playing have also been reported (Cahill, 2017). In one study, theft (73.7%) and fraud (20.2%) are of the highest number of cases where offenders surrounding these circumstances are of young ages 15 to 20 years old – 3.3%, and under 15 years old – 8.3% (Chen et al, 2005 as cited in Wan & Chiou, 2007). The most frequently cited and believed relevant cognitive-behavioral conceptualization of IGD is that of Davis (2001) who explained the Cognitive–Behavioral Model such that an individual’s problematic thought patterns can be a source of pathological behavior. The model suggests that pathologic internet use results from “problematic cognitions coupled with behaviors that either intensify or maintain the maladaptive response” (p.191).

It proposes that maladaptive cognitions are proximal sufficient causes of symptoms of IGD. The two main subtypes of maladaptive cognitions are thoughts about oneself and thoughts about the world. The thoughts or focused attention about one’s self have ruminative cognitive style which makes a person remember more reinforced memories about the internet that in turn maintains the vicious cycle of IGD. Self-doubt, negative self-appraisals and low self-efficacy are some samples of cognitive distortions about the self. Some distorted thoughts about self are, “I am worthless offline but online I am someone” and “I am a failure when I am offline” (Davis, 2001, p. 191).

In general terms, a person has a negative view of one self and uses the internet to gain positive social interactions and feedback from others. Generalizing specific event to global trends is a cognitive distortion about the world. An individual with cognitive distortions about the world thinks, “The internet is the only place I am respected”, “Nobody loves me offline”, “People treat me badly offline” and “The internet is my only friend” (Davis, 2001, p.198). This type of maladaptive cognitive distortion intensifies the dependence of an individual to internet gaming. Hence, whenever exposed to stimulus associated with internet game, these cognitive distortions are activated which lead to IGD. Given the foregoing empirical evidences, this study is designed to establish the relationship of internet gaming and psychological well-being by examining 456 adolescents who are actively playing internet games from India where no same kind of research has been conducted and reported based on existing literature on IGD.