ADHD & Video Games: An Update

Earlier this year, a team of researchers published findings from a study examining the connection between problematic video game use and ADHD in the American Journal of Drug and Alcohol Abuse. The results add to a small but growing body of evidence suggesting that kids and adults with ADHD are at increased risk for problematic video game use. This particular study found that among adults who play video games, higher levels of ADHD symptoms are associated with more severe symptoms of video game addiction (the average age of the adults in the study was 22, and over 90% of the participants were men). The study also explored whether specific characteristics of the games being played had an impact on video game addiction symptoms. Surprisingly, factors like how much someone feels the video game encourages them to continue playing, or how reinforcing they find a video game to be, did not have any impact on the connection between video game addiction and ADHD symptoms. While more research is needed in this area, the study authors suggest that individuals with ADHD who play video games should be informed about the signs of video game addiction and the elevated risk that may be associated ADHD.   

So, what are the signs of video game addiction?
There are currently no formal diagnostic criteria available for video game addiction; however, the most recent edition of the DSM (the diagnostic tool used the US for categorizing mental health disorders and addictions) does include Internet Gaming Disorder in the appendix as a tentative diagnostic category.

The DSM-5¹ suggests that Internet Gaming Disorder (which can include playing video games off-line as well as on-line), may be identified when an individual has displayed at least 5 of the following 9 symptoms in the past 12 months:

1. Preoccupation with games: The individual thinks about previous gaming activity or anticipates playing the next game; gaming becomes the dominant activity in daily life
2. Withdrawal symptoms when gaming is taken away: These symptoms are typically described as irritability, anxiety, or sadness
3. Tolerance: The need to spend increasing amounts of time engaged in games
4. Unsuccessful attempts to control or reduce participation in games
5. Loss of interest in real-life relationships, previous hobbies, and other entertainment as a result of, and with the exception of, games
6. Continued excessive use of games despite knowledge of psychosocial problems;
7. Has deceived family members, therapists, or others regarding the amount of gaming;
8. Use of games to escape or relieve a negative mood (like feelings of helplessness, guilt, or anxiety); and
9. Has jeopardized or lost a significant relationship, job, or educational or career opportunity because of participation in games.

Why might kids and adults with ADHD be at higher risk?
Researchers are not entirely sure why individuals with ADHD are at higher risk for video game addiction, but they have some theories that are being studied. Some factors being considered include:

• Impulsivity and difficulty stopping an activity that is highly reinforcing or engaging
• Difficulty with time management and other executive functions
• Avoiding stressful social interactions or academic/work-related activities
• Self-medicating untreated symptoms of anxiety or depression (which occur at higher rates in individuals with ADHD)
• A biological predisposition to addiction: Many activities (including video gaming), foods, and drugs can become addictive because they trigger the release of dopamine in the brain. Kids and adults with ADHD naturally have lower levels of dopamine in the brain, and as a result they are more likely to have an additive response to anything that triggers a dopamine rush.  

Knowing that kids and teens with ADHD may be at higher risk for problematic video game use is important, but when it comes to helping a child change his or her behavior it can be hard for parents to know where to start. In my next post I’ll talk about 5 steps parents can take to help their kids and teens develop healthy video game habits.

¹Diagnostic and Statistical Manual of Mental Disorders – 5^th edition (DSM-5) https://www.psychiatry.org/psychiatrists/practice/dsm

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ABOUT DR. MARY ROONEY

Mary Rooney, Ph.D., is a licensed clinical psychologist in the Department of Psychiatry at the University of California San Francisco. Dr Rooney is a researcher and clinician specializing in the evaluation and treatment of ADHD and co-occurring behavioral, anxiety, and mood disorders. A strong advocate for those with attention and behavior problems, Dr. Rooney is committed to developing and providing comprehensive, cutting edge treatments tailored to meet the unique needs of each child and adolescent. Dr. Rooney's clinical interventions and research avenues emphasize working closely with parents and teachers to create supportive, structured home and school environments that enable children and adolescents to reach their full potential. In addition, Dr. Rooney serves as a consultant and ADHD expert to Huntington Learning Centers.

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This website does not provide medical advice, diagnosis, or treatment. The material on this site is provided for educational purposes only.

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