Pathological Video Gaming and Its Relationship to Substance Use Disorders

Abstract

Video games are becoming an increasingly popular form of entertainment, yet many individuals have difficulty controlling their level of video game play, entering into a territory of clinical concern termed pathological gaming. Pathological gaming is associated with higher rates of mental illness and bears a strong resemblance to substance use disorders (SUDs). Diagnostic criteria proposed for “Internet gaming disorder” in the appendix of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) share similar criteria to many SUDs. This review highlights research on the epidemiological, psychiatric, neurobiological, and psychological characteristics of pathological gaming, and how these overlap with SUDs. Research suggests that early substance use or pathological gaming may increase the odds of developing either. Neurobiological research indicates that pathological gaming shares numerous characteristics with SUDs, though distinct features are evident. Impulsivity is reviewed here as a psychological mechanism involved in the predisposition to pathological gaming. Finally, there are several potential treatments for pathological gaming, though thorough clinical testing is still needed. Given the comorbidity and neurobiological similarities of pathological gaming and SUDs, existing therapies for SUDs hold promise for the treatment of pathological gaming.