Video Game Addiction and Engagement in Adult Gamers

283 Pages·2014·1.8 MB·English

by  Valued Gateway Customer

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Video Game Addiction and Engagement in Adult Gamers:
Differentiation Based on Relationships with Health and
Functioning

Daniel John Loton, BPsych (Hons)

Institute for Sports, Exercise and Active Living
College of Sports and Exercise Science
Victoria University, Melbourne, Australia

Submitted in fulfilment of the requirements of the degree of Doctor of Philosophy

March, 2014
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Authors

PhD Student:
Daniel John Loton

Primary Supervisor:
Professor Remco Polman
ISEAL, VU

Co-Supervisors:
Doctor Erika Borkoles
College of Sport and Exercise Science, VU

And

Professor Dan Lubman
Director, Turning Point Drug and Alcohol Centre and Professor of Addiction Studies,
Monash University.
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Acknowledgments

This thesis is for A.S. For certain, it would not have happened without her.

Sincere thanks also go to:

My principal supervisor, Prof. Remco Polman, for your guidance, calmness,
pragmatism as well as amazingly quick and continued feedback on all aspects of this
thesis. Wishing you many holes-in-one.

Dr. Erika Borkoles, co-supervisor, for our debates, your extensive editing and
unceasing positive support.

To Prof. Dan Lubman, my second co-supervisor. Dan’s door was always open despite
being extremely busy and accepting no payment for supervision. With his expertise in
substance-related disorders, Dan’s input in the initial planning and final stages of this
thesis were invaluable.

Dr. Tom Curran, for your statistical guidance, input and discussions. Especially, many
thanks for your assistance in the longitudinal analysis of this thesis.

To Shaun, Pete, Brod, Dave, Josh and all of my closest friends - for your company,
support and endless interest in this thesis, including providing a sharp and logical
sounding board for the arguments presented here.

To my mum and auntie, and all of my family, for always supporting me throughout my
education.

Thanks also to Victoria University and the Australian Government for making available
springboards into research in the form of the Australian Postgraduate Award
scholarships, which I was lucky enough to receive. Undertaking such an extensive
piece of work would have been more daunting, and would have taken far longer,
without this support.

Thanks must also go to colleagues in various research centres and institutes who
found me useful enough to employ in Research Officer roles throughout the PhD. I
have learned a great deal from these experiences.

Finally, thanks go to all participants, for their extensive time and willingness to
contribute to this study. I am particularly grateful as the content focussed heavily on
health and functioning, which, for some people, may not have been easy to reflect on
so regularly. This thesis could not have been completed without your help.
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Declaration

I, Daniel John Loton, declare that the PhD thesis entitled ‘Video Game Addiction and
Engagement in Adult Gamers: Differentiation Based on Relationships with Health and
Functioning’ is no more than 100,000 words in length including quotes and exclusive of
tables, figures, appendices, bibliography, references and footnotes. This thesis
contains no material that has been submitted previously, in whole or in part, for the
award of any other academic degree or diploma. Except where otherwise indicated,
this thesis is my own work.

Signature:

Date: 05/03/2014
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Abstract

Video game addiction now has a tentative diagnosis in the DSM-5, with its validity
hinging on differentiation from close constructs and demonstrable negative
consequences. Investigations of candidate consequences have produced mixed
results. Deleterious correlates vary across studies, and the few which have
investigated confounding factors or temporal precedence draw opposing conclusions.
Resultantly expert opinions range from an example of dangerous superficial mental
illness proliferation to a genuinely new, pathogenic condition.

This PhD measured video game addiction, engagement and the possible negative
consequences of diminished health (mental, social and physical) and functioning (at
work, study, parenting and in romantic relationships), in adult avid gamers. Possible
confounds included measures of satisfaction, stressful events, mental illness history,
treatment seeking and coping styles. 506 geographically dispersed participants (84.7%
male, mostly mid-twenties in age) were surveyed, with 111 returning to complete the
measures six consecutive times. Life circumstances were diverse at baseline, with
62.8% working, 55.3% studying, 14.9% seeking work, 48.9% in a romantic relationship
and 9.5% acting in a parenting role.

Confirmatory factor analysis of the addiction-engagement scale provided mixed results:
a ‘close fit’ by some standards with mostly sensibly correlated error terms. Discriminant
validity was confirmed. Individual scale item analysis indicated some less frequently
endorsed ‘symptoms’ of addiction are more strongly associated with poorer health and
may require diagnostic weightings. Some engagement items showed relationships with
increased health and functioning. Total score analyses showed health and functioning
were more highly related to addiction than engagement; health moreso than
functioning, especially mental, social and sleep health. Three diagnostic cut-off points
used in past studies were compared on ability to predict poorer health and functioning,
all showing equal validity.

Yet further models suggested confounding factors, particularly coping styles, are
important. Addiction contributed no variance beyond satisfaction to functioning at work
or study, but did explain a marginal amount of relationship conflict and a large amount
of parental performance. Job-seeking activities were unrelated. Multiple mediation
analysis indicated engagement had no direct connection with poorer mental health,
unless paired with maladaptive coping styles, while addiction retained a direct
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connection. Finally, the longitudinal analysis using six time points indicated worsening
mental health is an antecedent to addiction, consistent with the strong cross-sectional
mediating effect of coping styles.

Overall results suggest the need for further empirical testing of the proposed negative
consequences for this potential new disorder, particularly establishing temporal
precedence and relative importance amongst other contributors to health. Limitations
included a targeted sample which was gender biased and geographically diverse, a
lack of data triangulation with a reliance on self-response and recollection, and the use
of some composites and indicators with limited validity.
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Structure

The formatting of this thesis follows the publication manual of the American
Psychological Association 6th edition (APA 6th) with some minor departures to conform
to the Victoria University PhD style guide. All effort was made to fit tables on a single
page, including changing line spacing if necessary. Where tables were not able to fit on
a single page, the heading column has been reproduced on following pages for ease of
the reader. The use of asterisks in tables is standard throughout, with *p<.05, **p<.01
and ***p<.001, and the table notes only specify the significance levels actually present
in the table.

• Chapter 1 presents a literature review of video game addiction.
• Chapter 2 is the method, detailing procedures, measures, and the sample,
including some analyses situating the sample relative to available norms.
• Chapter 3 presents a psychometric analysis of the addiction-engagement scale
factorial structure.
• Chapter 4 details an item-level analysis of the addiction-engagement scale,
exploring relationships with indicators of health and functioning.
• Chapter 5 reports analyses of relationships between total scores for addiction
and engagement, and indicators of health and functioning.
• Chapter 6 introduces confounding factors to the models exploring relationships
between addiction and health.
• Chapter 7 introduces confounding factors to the models exploring relationships
between addiction and functioning.
• Chapter 8 delves further into the mediating effect of coping styles in the
relationships between addiction, engagement and mental health, utilising a
multiple mediation analysis.
• Chapter 9 compares three previously used diagnostic cut-off points on their
ability to distinguish participants experiencing declined health and functioning.
• Chapter 10 details a longitudinal analysis of mental health and video game
addiction, including six waves over a roughly seven month period.
• Chapter 11, the epilogue, summarises the results of the thesis and limitations of
the study, and considers the implications of the findings.
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Table of Contents

Title Page ............................................................................................................................................ i
Authors ........................................................................................................................................... ii
Acknowledgments ........................................................................................................................iii
Declaration..................................................................................................................................... iv
Abstract .......................................................................................................................................... v
Structure........................................................................................................................................ vii
List of Figures .............................................................................................................................. xiv
List of Tables ................................................................................................................................ xv
Prologue ............................................................................................................................................. 1
This PhD ........................................................................................................................................ 3
Terminology ................................................................................................................................... 4
Addiction. ................................................................................................................................... 4
Confounds. ................................................................................................................................ 5
Features or Symptoms? .......................................................................................................... 6
Negative consequences. ......................................................................................................... 6
Engagement. ............................................................................................................................. 7
Chapter 1: Literature Review .......................................................................................................... 8
What Are Video Games ............................................................................................................... 8
Contemporary trends. .............................................................................................................. 9
Increasing government regulation. ........................................................................................ 9
Video Game Playing in the General Population: Who Plays and How Much? ................. 10
Time commitment. .................................................................................................................. 11
Gender bias. ............................................................................................................................ 13
Why do people play?.............................................................................................................. 13
Conclusions for general video game playing. .................................................................... 15
Addiction: From Ancient History to Video Game Addiction .................................................. 15
Variety of theories................................................................................................................... 17
The most common aspects of addiction. ............................................................................ 17
General Theories: The Components and Syndrome Models. ............................................. 20
Criticisms of the general models of addiction. ................................................................... 23
Support for the components model. .................................................................................... 28
What is Video Game Addiction ................................................................................................. 29
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Measuring video game addiction. ........................................................................................ 29
Scale Factorial Structures ..................................................................................................... 37
Prevalence: Defining an Addicted Group ............................................................................ 41
Summary of prevalence......................................................................................................... 45
The Search for Negative Consequences ................................................................................ 46
Structural characteristics and motivations for play. ........................................................... 47
Social Health and Video Game Addiction ........................................................................... 50
Mental Health and Video Game Addiction .......................................................................... 58
Physical Health and Video Game Addiction ....................................................................... 64
Academic and Work Functioning ......................................................................................... 66
Brain Studies ........................................................................................................................... 68
Possible Confounds between Video Game Addiction and Well-Being .......................... 70
Positive Effects of Video Game Play ....................................................................................... 76
Therapy. ................................................................................................................................... 77
Social benefits. ........................................................................................................................ 78
Skill development: education, intelligence and cognition. ................................................ 78
Exercise. .................................................................................................................................. 79
Longitudinal results indicating positive outcomes of general video gaming. ................. 79
Societal improvement. ........................................................................................................... 80
Summary of positive outcomes: absence of universal effects......................................... 80
Overview .......................................................................................................................................... 81
This Thesis .................................................................................................................................. 84
Engagement and addiction. .................................................................................................. 84
Possible negative consequences: diminished health and functioning. .......................... 85
Functioning in life domains: work, school, parenting and romantic relationships. ........ 86
Aims .................................................................................................................................................. 87
Chapter 2: Method .......................................................................................................................... 88
Procedure .................................................................................................................................... 88
Communications and recruitment strategy. ........................................................................ 88
Data preparation. .................................................................................................................... 89
Sample ......................................................................................................................................... 91
Wave 1 / cross-sectional. ...................................................................................................... 91
Longitudinal. ............................................................................................................................ 92
Measures ..................................................................................................................................... 94
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Video game playing behaviour. ............................................................................................ 95
Addiction-Engagement. ......................................................................................................... 96
Mental Health ........................................................................................................................ 101
Social Health ......................................................................................................................... 105
Functioning in Life Domains ................................................................................................ 109
Physical Health ..................................................................................................................... 114
Possible Confounds / Mediators or Moderators ............................................................... 116
Satisfaction with life domains. ............................................................................................ 120
Summary of the Sample Characteristics .............................................................................. 123
Chapter 3: Factor Structure of the Addiction-Engagement Scale ......................................... 125
Unifactorial or second-order factor structure scales. ...................................................... 125
Two-factor addiction and engagement scale. .................................................................. 126
Focus of this Chapter ............................................................................................................... 127
Aims and Hypotheses .............................................................................................................. 127
Method ....................................................................................................................................... 128
Model fit. ................................................................................................................................. 128
Discriminant validity. ............................................................................................................ 129
Results ....................................................................................................................................... 131
Model fit. ................................................................................................................................. 131
Discriminant validity. ............................................................................................................ 131
Discussion ................................................................................................................................. 134
Model fit. ................................................................................................................................. 134
Discriminant validity. ............................................................................................................ 137
Chapter 4: Item-Level Analysis of the Addiction-Engagement Scale; Prevalence and
Relationships with Health and Functioning. ............................................................................. 138
Measuring video game addiction and the importance of individual addiction
components. .......................................................................................................................... 139
Differentiation between engagement and addiction. ....................................................... 141
Focus of this Chapter ............................................................................................................... 141
Aims and Hypotheses .............................................................................................................. 142
Method ....................................................................................................................................... 142
Prevalence. ............................................................................................................................ 143
Relationships with health and functioning. ....................................................................... 143
Modelling items as predictors of health and functioning. ............................................... 143
Results ....................................................................................................................................... 145