Credit: W.carter, CC BY-SA 4.0 <https://creativecommons.org/licenses/by-sa/4.0>, via Wikimedia Commons.

Research around gaming usually comes to a positive or negative on a specific area. Depending on the report you read, you can come away with a sense that games can be very beneficial or really harmful. For Nick Ballou of the Oxford Internet Institute, that kind of reporting is not necessarily helpful. Instead he conducted his own research to make gaming reporting more nuanced…

ScienceVega: Why did you decide to undertake this research?

NB: We were very frustrated as scientists reading the literature on this topic and seeing a lot of people talking disconnectedly about the potential effects of games. As we know, there’s a big range: ‘people might become addicted to games’, ‘people might be exposed to toxicity in games’, or ‘people might improve their cognitive abilities by playing games, which is a positive effect’.

But we had not seen that put in one place. We hadn’t seen a menu of things that might be occurring, of labels that we could coalesce around so that the different fields could work together to get to the bottom of whether these effects are happening and, if so, when and for whom? Without these ‘umbrellas’ and priorities, scientists risk duplicating effort by talking about the same ideas with different language.

Credit: Oxford Internet Institute

In particular, we were very frustrated with the lack of causal language around the topic. We see a lot of papers talk about the relationship and the correlation between playing games and, for example, your social health, sleep, physical activity, or stress. But we very rarely saw researchers being explicit about the causal version of this; when is gaming an outcome of other factors (say, your available leisure time) and when is gaming the driving force behind a change in mental health?

So we are looking at two issues: the fact that we didn’t have an holistic overview of what the field thinks are the important problems or benefits that can result from playing games; and we didn’t have them drilled down in enough detail to identify when games are having a clear effect on people’s mental health, as opposed to simply two things that happen to exist at the same time.

ScienceVega: Do you feel there is an overarching negative agenda around this kind of research?

NB: I would say it forks. Any individual paper tends to take either a positive or a negative view. I think the researchers who do it may believe that gaming can be either positive or negative, but their papers typically focus on a single negative effect or a single positive effect without recognising that these things might happen at the same time.

For example, there might be short-term positive effects; ‘I come home, I’m feeling stressed and to help me let go of that, I play a game and I escape into that world and I feel better’. But perhaps I did that instead of doing homework or instead of maintaining a relationship that’s important to me. There is a short-term positive effect and a longer term potentially undermining effect. I have seen very little work that acknowledges the nuance there that we can have positive and negatives at the same time.

ScienceVega: You had three stated aims: first, to map out a wide spectrum of potential mental health impacts; second, to explore how these depend on not just the game itself, but on the individual and context; and third, to reframe these effects in explicitly causal terms. Did the results align with your expectations?

NB: More or less. We definitely found evidence that all of these effects happen sometimes, for some people. Firstly, that means that these effects are something to look out for in your own life when you’re playing, and secondly, it gives us a sphere for us researchers to focus on and identify when they’re most likely to occur. However, at the moment, we still struggle to accurately predict which players will experience for example, nostalgia during gaming, which can be a positive, or gaming displacing other important activities, which can be a negative.

Instead, we were able to put some causal language behind this – to be provocative in proposing specific elements of the game, the player, and the context they’re playing in that might lead to someone experiencing a certain type of effect. For example, perhaps the effect of gaming on social wellbeing is primarily a result of playing with real-life friends versus with online friends versus with strangers.

That may not be exactly true, but by putting it out there as a hypothesis helps the field stop treating games as this monolithic thing, and start identifying the key factors in this big universe.

Gaming can also be a force for good. Credit: San José Public Library, CC BY-SA 2.0 <https://creativecommons.org/licenses/by-sa/2.0>, via Wikimedia Commons.

ScienceVega: There are positives and negative benefits to gaming, but is it more one than the other?

NB: I’d say it’s a scale. People who have negative relationships with games often have really negative relationship. There are people who are suffering tremendously, playing games to the exclusion of almost everything else that’s going on in their life, and that can really trap you in a feedback loop: the more you play games to the to the exclusion of other things, the fewer resources you have to pull yourself out of that spiral.

When played to excess, games can deplete your resources to deal with problems in other ways, so you keep turning back to games to solve those problems – for example, playing to excess may lead your real-world friends to stop inviting you to things, exacerbating your loneliness and making you seek those connections in games even more. That is really serious. The people who are stuck in that cycle, are experiencing a really clear harm. But that’s a small number of people: depending on how you count them, in the order of 1% to 3% of people who play games who experience something like that.

The majority of people are experiencing some kind of benefit. People play these games because they’re fun and because they enjoy them. They do it voluntarily. They wouldn’t do it if they weren’t experiencing some benefits.

I take the view that the majority of people who benefit from games, benefit in some minor day-to-day way. That’s not to say it’s not important; it’s a good way to connect with friends, but it’s only one of several ways to connect with friends. It’s a good way to relieve stress, but it’s only one of several ways to relieve stress, so I think the average person benefits a little bit. We have a lot of people that are benefiting a little bit and a very small number of people who are being harmed a lot. It is tough to weigh those two things against each other.

ScienceVega: Is it as simple as saying some people have an addiction to games?

NB: We are careful with the term ‘addiction’ because this does behave very differently to substance addiction. We often use the term ‘dysregulated’, so that means people who have difficulty regulating their own behaviour in response to how the thing is affecting them, and conceptually that is aligned with addiction, but we are careful that it is not a chemical addiction.

To be clear, there are absolutely people who have addiction-like relationships with games. Researchers and clinicians often think about this ‘problem gaming’ similarly to ‘problem gambling’ – historically the very basis for the idea of an internet gaming disorder. The exact same criteria for what makes someone a problem gambler was used for gaming: feelings of withdrawal, a desire to play or spend more and more, jeopardising important relationships or opportunities, and so on.

But in my view, the average person is more likely to be harmed by gambling than they are to be harmed by gaming – it’s hard to identify exactly where we draw that line, but I do clearly distinguish between the two. The question is just about what definition – addiction, problem gaming, gaming disorder, and so on – is most useful for identifying the people who are playing so much that they need help, without stigmatising them.

Credit: Doctorxgc, CC BY-SA 4.0 <https://creativecommons.org/licenses/by-sa/4.0>, via Wikimedia Commons.

The study outlined 13 mechanisms through which gaming might impact mental wellbeing:  

• Stress relief – Games can help manage emotions when they align with a player’s current needs. But when relied on as the only source of relief, they may contribute to emotional dysregulation and reduced longer-term resilience;  
• Autonomy, belonging, and mastery – Gaming can satisfy players’ needs for autonomy, belonging, and mastery, but can also trigger feelings of coercion, failure and loneliness. People with a stronger sense of coherence (those who view life as comprehensible, manageable and meaningful) are more likely to benefit and less likely to be harmed;
• Social health – Multiplayer gaming with friends can strengthen bonds, but playing online with strangers can expose players to toxic environments, suppress social ties and lead to feelings of loneliness;
• Passion vs Obsession – A healthy, harmonious passion for gaming is likely to positively impact the player’s wellbeing, whereas an obsessive passion, driven by unmet needs elsewhere in life, is likely to have a negative impact;  
• Nostalgia – Emotional investment in storylines and characters can generate a sense of meaning, appreciation, and vitality – in many cases, this connects to nostalgia for one’s youth;   
• Exercise games – Video games with movement controls and involving some physical activity can produce a short-term positive effect on mood and energy;   
• Identity development – Gaming can offer time and space to experiment with different identities. Exploring the self in a safe and social space can create greater coherence and reduce distress from conflicting identities;  
• Cognitive functioning – Fast-paced games with action mechanics are likely to improve executive function, working memory, and attention control;  
• Therapeutic games – Games supporting treatments such as cognitive behavioural therapy can increase motivation to engage with the treatment, making it easier to persist;   
• Displacement – Excessive gaming can crowd out vital activities like sleep, work, exercise or relationships. Spending less time on these activities can lead to feelings of guilt, loneliness and greater fatigue, leading to lower life satisfaction;  
• Financial harms – Features such as in-game purchases and loot boxes are linked to overspending and gambling-like behaviours, potentially increasing financial stress and dysregulation;   
• Gaming disorder – When gaming becomes compulsive and interferes with daily life, it can elevate anxiety and lead to poorer functioning in other aspects of life such as work and school; and  
• Sexualisation – Exposure to sexualised game content may lead to lower body satisfaction for women and increase misogynistic attitudes, especially among men, negatively impacting women’s self-esteem.

ScienceVega: Did you find any evidence of manipulative behaviour by gaming companies to try to ‘lock people in’?

NB: It was not something we particularly looked at in this piece of research, but certainly that is something that’s happening all the time. Games companies are very motivated to keep people playing and spending in their ecosystems, potentially more than they intend to.

We see it a lot in the monetisation strategies. There can be sneaky design elements where, for example, you have to exchange multiple currencies. You pay in real-world money for gold, and then you exchange the gold for rubies and then exchange the rubies for diamonds. By the time you get to the diamonds, you don’t really know what the value of the thing you’re buying is, which makes it very easy to overspend.

For young people especially, these items can have social currency. Having a cool item makes you stand out amongst your peers, which can be a really desirable thing they are willing to spend on even when that’s potentially not in their best interest.

They also do things like daily login rewards in a lot of free-to-play games. A big change in the economics of gaming in the last ten years has been the rise of free-to-play games that you don’t pay for when you download them, but you do pay over the course of playing them. These are now very common. They push it so you have to play every day, or you’re missing out on free things, and that can very quickly help develop a habit that isn’t good for someone.

Another example is ‘battle passes’, which are essentially subscriptions that unlock additional rewards, but only when you play over the course of the next month or whatever. Because you have paid in advance, you might feel an obligation to keep playing and ‘complete’ the pass to make sure you get your money’s worth – even if you’re not enjoying the game. In those instances playing can go against your best interests.

ScienceVega: Conversely are there examples of more responsible and beneficial behaviours from game creators?

NB: Absolutely. I would point to almost the entire world of indie games, where smaller independent developers are doing really creative things with sensitive and responsive subjects. I can point to a game like Spiritfarer, which is a management simulation game that handles the topic of death really sensitively and compassionately. You act as a kind of shepherd to other souls in crisis in a way that can be really soothing for people and can help them understand their own lives, or the grief that someone else might be going through.

There are lots of games in the indie space that are very thoughtfully designed to invite people to reflect on their own lives and invite people to reflect on their relationships or relationships to other people that they might be playing with. There are other games that explore history or politics that can be educational in some capacity, like Papers Please. The world of games is littered with examples like that. They are more likely to be found from indie developers, but not exclusively. There are also larger developers creating fantastic wellbeing supportive games, so I’m not casting aspersions on the entire game development world in terms of predatory practises!

ScienceVega: Do you see much in terms of unhealthy gamer-gamer interactions, such as bullying in games?

NB: Yes, it happens all the time. Trolling is common. Bullying is common. Harassment is common. I won’t go so far as to say they’re the norm – there are all kinds of positive spontaneous interactions that people are having with strangers in game. And game designers can do things to try to foster those positive experiences and punish the negative ones. Some games will have things like a social credit rating behind the scenes, and people who are habitual offenders will end up in lobbies with other habitual offenders. In effect they have quarantined bad actors.

Nearly all multiplayer games have reporting systems where you can report a player for negative behaviour and have them suspended or in some cases banned if it’s egregious enough. Some games companies are even collaborating to track a bad actor across platforms; if they are a habitual bad actor in one game, we can then identify them as a bad actor in another game and potentially monitor them more closely.

Games are digital playgrounds in the same way that we have bullying and harassment in real-world playgrounds and it is something that people are constantly on the lookout for in the game design space.

Concerns remain that age-inappropriate interactions can take place in the gaming world. Credit: Cecilia de la Paz, CC BY-SA 3.0 <https://creativecommons.org/licenses/by-sa/3.0>, via Wikimedia Commons.

ScienceVega: Are games companies policing this well?

NB: We can never win the war, but there’s always room to fight harder. This is especially important for companies where the risk of harm is really quite great, for example those catering to younger audiences. Grooming and child online sexual abuse are unfortunately constant risks in online games for younger players, and this can begin on one platform and then sometimes transition to another platform. The game can give a predator an environment to meet a younger, vulnerable player and then take them elsewhere where their interactions are harder to monitor. There is no amount of work that would constitute ‘enough’ for preventing that. AI tools are now helping to detect these kinds of interactions automatically.

There are some industry-wide standards in place: common sense things such as content labels and age ratings on the back of every game highlighting what kinds of multiplayer options exist, whether the game includes violence, or references to gambling or randomised monetisation. But often the onus falls on players and parents, who have crowdsourced information on sites like Common Sense Media with expanded descriptions and reviews of the gameplay, social environments, and ultimately safety.

Personally, and this is a more controversial take, but I would be open to more real-world ID verification in games. If I had an eight-year-old child, under no circumstances would I want them interacting with a 30-year-old in a game. I don’t think there is any in-gaming situation where they can’t get all the benefits of the games without that occurring. In that instance it would make sense to have identity verification and to segregate by age so that I could be more confident that my child is only interacting with other children of approximately the same age. That isn’t happening yet because of very valid privacy concerns, but it may in the future.

ScienceVega: As a gamer yourself, what are the positives to come from this research?

NB: To me, this paper reaffirms my belief that games are fundamentally good, but that we can make them even better by minimising risks and harms – through advice for players and parents, better policy, and better design standards.

My favourite version of this is the effect we discuss concerning ‘basic psychological needs’, which was the focus of my PhD. Humans have an inherent and universal need for three things: to feel a sense of autonomy that we are in control of our own lives; to feel a sense of confidence that we are mastering things and effective in our actions; and to feel a sense of relatedness that we care for others and they care for us in return.

Games are really good at providing exactly those three things. They allow us to be creative in how we express our character or avatar, and the actions we take. Do we want to be a more supportive player – a healer, for example, or do we want to be someone who protects others as a more brusque and powerful character? We might experiment with something that we’re not actually like in real life and instead get to try on that hat in the game world where we get to feel a sense of growth and improvement.

In terms of relatedness, there are games that, years or decades later, people remember so vividly their connection to some character that they either interacted with or were playing as – I’ll never forget the paternal instincts I felt towards Ellie in The Last of Us, for example. In these ways and others, games can be powerful contributors to wellbeing.

Those growing up in the 1980s are increasingly returning to the games of their youth as they are now approaching retirement. Credit: Samantha Marx, CC BY 2.0 <https://creativecommons.org/licenses/by/2.0>, via Wikimedia Commons.

ScienceVega: Where will your research take you next?

NB: One of the more fun developments we are studying in another paper is about retro gaming and nostalgia. The people who grew up in the 1980s and were the first generation to have consoles in the home, that group of people is slowly approaching an older age where children have left the house or they’re retiring, and they’re looking for activities. They are continuing to play games as they did as a child. We are seeing a tremendous uptick in people playing retro games, playing the games of their youth and reporting that to be a really powerful way to reconnect with their past and sometimes to share their past with the younger generation.

There are very few ways of you being able to take a child or a grandchild and show them this was what life was like for them when they were young, but a video game is exactly that. You can create the exact same environment that you had as a child and share that with somebody else and feel those same needs of autonomy, competence, relatedness with that other person. We will continue to see more and more of that as people who grew up with games get to older age.

Nick Ballou

Postdoctoral Researcher

Oxford Internet Institute

University of Oxford

The link to the original paper can be found here.