A teenager plays online game. Game addiction has become one of the most pressing issues for medical experts, social workers and educators. / Korea Times file

By Noh Hyun-gi

Game addiction has bred frightening crimes in the last few years including a 22-year-old man who killed his mother for attempting to stop him from playing and a woman giving birth during an online game in the bathroom of an internet café.

It is not a problem only in Korea; 2.5 percent of Koreans are identified as internet addicts along with 19.8 percent of Taiwanese adolescents, 12 percent of Britons and 2.4 percent of Chinese online gamers.

Yet, the diagnostic classifications and guidelines are being debated among experts, and preventive measures remain scarce. Psychiatrists from across the globe and Korea’s leading game producer, NHN, gathered at the Grand International Hotel, Seoul to speak on the definitions and review the clinical research on the growing addiction Friday

Internet addiction is similar to gambling and substance addiction, stressed Lee Yong-sik of Chungang University department of psychiatry. Key components of Internet and online game addictions include preoccupation, unsuccessful attempts at reducing use, a decrease in cognitive function, and rising anxiety, depression or impulsive disorders.

Who is at risk?

An alarming risk factor is the exposure age to games can increase the probably of addiction significantly. “With smartphones, even infants are being exposed to games. The first-contact age with games through a smartphone is 18 months,” said Kim Boong-nyun, professor of psychiatry at Seoul National University Hospital.

Children with attention deficit hyperactivity disorder (ADHD) and depressive adolescents are susceptible.

“Ample research found that ADHD is not a result but a key cause of game and Internet addiction,” Kim said. “Our policy makers need to accept this and understand the need for early intervention.”

Depressive teenagers may turn to the Internet and playing games to avoid difficulties in their lives; a compensatory action for comfort. “As psychiatrists, for an affective intervention, we must think about ADHD kids and depressed youngsters.”

In addition, genetic, social, personal and behavioral components can make someone prone to gaming or Internet addiction. A family history of addiction and gambling is a risk factor. Males are more susceptible than females.

People from poorer backgrounds are more likely to become addicted, especially in Korea. “The income threshold for access to high-speed internet is very low in Korea compared to countries in, for example, Europe. High quality connection is as prevalent as TV,” Kim said. This leaves poor and neglected children prone to playing games for entertainment and as socialization.

Characteristics such as low self-esteem, high extroversion and risk-taking propensity are correlated with Internet use and game addiction.

The key to preventing online game and Internet dependency is to foster an individual’s resilience. There are protective factors that educators, parents, and doctors can endorse; group activities in school and exercises that promote high achievement.

The awareness raising material targeting children should be entertaining. Kim suggested using animations. “The most powerful venue to prevent addiction is school,” he said.

Medical definition

Though the number of cases is on the rise, there is no set diagnostic category for Internet and online game addiction.

Currently, two international diagnostic codes are undergoing revision with attempts to include the two types of addiction. Currently, the Diagnostic and Statistical Manual for Mental Disorder (DSM) includes internet addiction in its appendix. Its fifth version, set for release in 2014, does not have a single appropriate category for this type of disorder. It has substance use and addictive disorders, and behavioral addictions (to include addiction to gambling). The situation is similar for the International Classification of Diseases (ICD) version 11 which will also be released in 2014.

Though many professionals believe that the two types of dependency fall under behavioral addiction, others employ different perspectives. Some see adolescent game addiction as a type of obsessive compulsive disorder (OCD); the continuous behavior can be seen not as a pleasurable activity but a ritual to overcome certain obsessions.

A survey of 71 psychiatrists in Korea shows that nearly 50 percent of them treat about five internet related conditions a month; eight percent of them saw more than 30 cases. More than 90 percent of them claim that the Internet is as addictive as drugs and gambling, and consider more than six months of heavy use as adequate for a diagnosis.