Video games, harmless toys or lethal weapons?

No one is surprised that today's youth behave differently than we adults did today, years ago, when the digital age had not yet entered our lives. It is logical and expected that evolution pushes us all, to changes in our way of living our day to day.

However, we naturally contemplate and excuse behaviors that harm health and well-being in general, hiding ourselves because it is different now and avoiding facing young people who are used to immediacy, loneliness and in many cases to lack of communication and affectivity. by the elders.

Although there are individual differences, the search for pleasure, and / or intolerance to the unpleasant, allows them to escape, through access to a virtual world that occupies long hours of their lives.

The use of the Internet is already a majority practice in young people between 16 and 24 years old, with a similar percentage in this age group (98.6% in men and 98.2% in women).

On the other hand, with data from the INE for 2014, 63.5% of children between 10 and 15 years old have a mobile phone, incorporating an internet connection. This indicates that they use new technologies at an increasingly early age..

What's behind a look at a screen that may have different sizes, but is a simple, flat screen?

With data not yet updated for 2008, in Spain, there are 6.2% of young students with frequent problems and 26.6% with occasional problems related to the use of the Internet. The consultations of teenagers addicted to video games "online”They multiply exponentially and adolescents between 12 and 18 years old present Internet addiction. There are already associations and centers that are beginning to treat young people who are "hooked" to video games, observing that it is a vulnerable group.

In the Diagnostic and Statistical Manual of Mental Disorders (DSM-V), in its section III reserved to the conditions that require further study, the Internet Gaming Disorder (Internet Gaming Disorder). Gambling and other social or sexual addictions are not included here. If you play for money on the Internet it is Pathological gambling (Internet Gambling disorder) found in the Substance-Related Disorders and Addictive Disorders section.

When do we refer to a behavioral addiction?

When we refer to addictions, we usually associate them with drugs, but the essential element of all addictive disorders is the lack of control about a certain behavior, which little by little dominates the life of the person who suffers it.

In short, when we are faced with a repetitive habit, difficult to control, that compromises the physical and psychological health, as well as the social life of the person, we are talking about behavioral addictions. They can be linked to new technologies or other behaviors such as compulsive shopping, uncontrolled sex, excessive exercise, etc..

The main symptoms of a behavioral addiction are:

• Intense desire, craving or unstoppable need to do the pleasurable activity.

• Progressive loss of control over it, until reaching the uncontrolled.

• Neglect of previous usual activities, both family, academic, work or free time.

• Denial of the problem. These negative consequences are usually noticed by close people who communicate it to them and despite this, they do not stop the activity, becoming defensive.

• Progressive targeting of relationships, activities and interests around addiction, neglecting interests and relationships.

• • Irritability and discomfort at the impossibility of specifying the pattern or addictive sequence (abstinence) and the impossibility of stopping doing it, after a short period.

A non-addicted person can connect to the network for pleasure, unlike an addicted person who does it to alleviate their emotional discomfort (boredom, loneliness, anger, or excitement) and harmless, adaptive and functional behaviors can become an addiction according to the frequency, intensity or time and money invested.

I will refer only to addictions to online videogames and not to other technological addictions that have been less investigated, such as games that do not need an internet connection, social networks, mobile phones and social use of the internet.

The Massively Multiplayer Online Role-Playing Games (MMORPG) are video games in which thousands of players can connect simultaneously in a virtual world.

Each one creates an avatar or several, with physical and mental characteristics that he chooses and has the possibility of overcoming levels of gradual difficulty with the missions to be carried out. Among these games the best known is the world of warcraft, others also popular are Everquest, Final Fantasy, League of Legends, PES or FIFA and Lineage.

Why can we get hooked?

We have accessible objects, relatively cheap, with a continuous connection that are rewarding and act to reinforce us instantly, allowing us to escape, excitement and mainly virtual social relationships. Thus, due to characteristics of the:

• own video game:

One feature to consider is its availability and accessibility (24 hours seven days a week); a impunity absolute after engaging in destructive behaviors that have no penalizing consequences or are ridiculous compared to reality; the player can risk without suffering any physical harm; and instead actions are rewarded by giving a feedback almost immediate by actions performed, which does not always happen in the real world.

• youth environment:

His easy availability, the fashions about the games, the pressure of the group to participate in it; an overprotective and permissive educational style that does not establish limits, or on the contrary a rigid style, poor communication and lacking alternative leisure; To all this, stressful events such as conflictive environments, loneliness of the young person even when accompanied, can be added..

• personality:

Special attention should be paid to young people who have difficulty coping with problems, low self-esteem, impulsivity, not putting up with the unpleasant, such as pain, sadness, or another unpleasant mood. Also young people who seek strong sensations, have a greater predisposition and vulnerability.

The presence of dual pathology. Addiction does not usually appear independently, but coexists with another mental disorder such as autism spectrum disorders (ASD), Attention deficit (ADHD), oppositional defiant (ODD), obsessive-compulsive (OCD), social phobia and / or school, depression, anxiety ... .

When do you cross the border between a playful, social, apparently harmless behavior such as playing a video game? online and an addiction?

The DSM-5 contemplates up to nine symptoms, of which five are necessary, for a continuous period of 12 months (in children and adolescents 3 months). These are:

1. 1. Worry for video games over the Internet.
2. Symptoms of abstinence when internet access is prevented to play.
3. Tolerance (need to play more and more).
4. Unsuccessful attempts to control Internet use for gaming.
5. Loss of interest in other activities such as academic, work, social or recreational activities.
6. Continue playing on excess, despite knowing the psychosocial problems caused by gambling over the Internet.
7. Cheat to family, friends or others regarding the amount of time connected to the internet to play.
8. Use video games over the Internet to escape discomfort emotional (boredom, anger, nervousness, loneliness, etc.) or to improve mood.
9. Lose or endanger a meaningful relationship, a job, an educational or professional opportunity, as a result of online gambling.

What are the warning signs?

• Too much technological leisure time (approximate max. 1-2 hours / day)
• Absorbed by the screen
• Excessive spending of money
• "I'm good, they won't be able to play without me"
• Absenteeism and / or decrease in school / work performance
• Conflicts with relatives due to the use of computers, mobile phones, tablets ...
• Breach of schedules and housework
• Irritability or aggressiveness in the face of parental attempts to control
• Concealment, denial (lies), justification of overuse
• More interest in gambling than other activities (going out with friends, girlfriend, hobbies)
• Nonspecific physical complaints, usually mild, sleepy, tired, etc..
• Take refuge in the game in the face of problems or difficulties

How to prevent?

Adolescents are not aware of the negative consequences of engaging in video games and yet they cannot be denied that they play, because it is part of our daily lives. However, it is necessary that, in a transversal way, in addition to parents and relatives, other adults who are in their daily lives join forces to prevent.

Although not all the criteria required to speak of addiction are met, intervention in an initial phase is adequate to prevent escalation towards progression. As in aviation terms, there is a point of no return in which in the case of addictions, the brain already has activated the reward circuit (limbic system in the temporal lobe) that triggers dopamine and is pleasant.

An empathic attitude that fosters awareness will facilitate the adolescent the possibility of wanting to change their attitude, and depending on age and risk factors (such as, as is, life events), and protective factors (values , close supportive people, non-conflictive environment ...) this will be the prognosis.

What can parents do?

• Choose age-appropriate games that promote values
• Teach responsible use by setting an example. Use gambling as a privilege, not a right
• Put the video game device in a common area
• Respect family meal and sleep schedules
• Promote alternative leisure activities (sports, outdoor outings, cinema ...)
• Help you develop personal protective factors (improvement of self-esteem, social skills, coping with stress, problem solving, emotional self-regulation, etc.)
• Show an understanding attitude in relation to the need to play, but setting limits
• Asking for help (prevention) at signs of alarm

It is highly recommended to help them to be aware of the problem, interacting as behavioral models and according to age, we will dialogue with understanding, but firmness, training them in effort and tolerance of frustration.

Since the brain is mature, playing facilitates the learning of certain skills, helps to make decisions more quickly at the motor level, improves coordination and enhances creativity. Let's not forget that there are areas of the brain that are not fully developed in adolescence, such as executive functions (prefrontal lobe) that do not develop until the age of 20-30..

New technologies are synonymous with progress and help to the human being, however rapid evolution and little or no training in their use as well as the risks they entail, can enhance addictive behaviors in vulnerable individuals.

Link of interest of the portal of health and well-being for the families of the Hospital Sant Joan de Déu (HEADLIGHTS):

The new technologiesdays in niBoys and teenagers Guway to educate healthily in a digital society http://bit.ly/2hu2Z5q

"Nothing is poison, everything is poison: the difference is in the dose", Paracelsus 

Bibliographic references:

APA (2013) Diagnostic and Statistical Manual of Mental Disorders (DSM-V) (Fifth Edition). Washington, D.C: American Psychiatric Association.

Carbonell, X. (2014) Video game addiction in DSM-5. Addictions, vol.26 no.2, pp. 91-95

Company A. (2013). Non-substance addictions (DSM-5, APA, 2013): a first step towards the inclusion of Behavioral Addictions in the current categorical classifications. Rev. Neuropsiquiatr 76 (4), 213.