Can online gaming be positive social behavior?

Can online gaming build social values and behavior?

The game, Urgent Evoke, is funded by the World Bank to the tune of $500,000 and launched today. It will continue for 10 weeks and features weekly challenges. A reporter had asked me what I felt about the utility of using online gaming to promote social behaviors. I thought this was an interesting question. I think games are a great way to promote social benefits. It certain is a better way that some others and it helps gamers learn about social values. It seems like a great partnership. We live in a society that has declined in the volume of community service it provides, so games would be one way to help teach young people service values. It should not be contained to Africa but other geographic areas would benefit as well. Already, 400 people out of 3,500 is a great start, and the game just launched so only time will tell how many more sign up and how effective long range service mindedness can be encouraged through gaming. Online gaming is a great way to reach people that otherwise brick-and-mortar avenues may not. In my clinical practice, gaming behavior transfers to real life, this is part of treatment. A 16-year old might be a great leader of a popular guild online but in real life suffers from low self esteem. Treatment encourages the transfer of these skills to benefit others by using this young person's leadership skills. So, yes, skill sets learned through gaming can transfer to real life, and online learning can also transfer to real life behavior. This all comes at a time when online gaming has become increasingly popular - yes, addictive to some, but a popular way to reach out to people. It seems for both young adults and adults. It would be interesting to hear from online gamers on your thoughts on the effectiveness of this?

Some interesting statistics on Internet addiction

While the Internet has opened the world to many in ways never imagined, new studies continue to replicate prevsiou studies that I have conducted from the 90s and reinforce that Internet overuse can become harmful.

Examples of Internet addiction include online gambling, gaming and shopping, obsession with pornography, blogs, social media and chat rooms.

The hardest part is determining how much time is too much. When you’re looking at someone who spends a great deal of time on the Internet, you’re trying to determine if they’re spending an exorbitant amount of time doing that as opposed to everyday living. If it’s causing you a problem in your life, then it’s a problem.

Internet addiction is similar to substance addictions in that many of the same symptoms are present.

If you’re more interested in spending time with the thing you’re addicted to than you are with your family and friends, then that’s a symptom. If you’re preoccupied with the thing you’re addicted to, then that’s a symptom. Those things are the same for any addiction.

Internet addiction can lead to more serious symptoms, including health problems from a lack of sun or exercise, increased senses of loneliness and depression and the loss of social skills. If left untreated, Internet addictions can increase the likelihood that the individual will get divorced or fired, or have financial, academic or sexual problems.

Internet addictions can be very serious.

Whereas treatment for substance addictions focuses on abstinence, Internet addiction treatment focuses on abstaining from the specific problem, not necessarily from the Internet itself. The reason for that is that it’s not realistic in today’s job market for an individual to never use the Internet.

A person who is an alcoholic should never drink again. The goal (of Internet addiction treatment) is to never engage in the problematic aspect of the Internet. If your addiction is centered around social networking, then our goal for you would be to stop using Facebook or the other social networking options available.

Certain groups of people are more at risk.

Teens are more at risk because, let’s face it, they have been raised in technology their entire life.

Other at-risk groups include people who are immobile or homebound, people who lack social support, people who suffer from depression or anxiety disorders, and people who have addictive personalities.

One of the later large-scale studies conducted on Internet addictions was completed in 2006 by Stanford University’s School of Medicine, which interviewed 2,513 adults in a nationwide telephone survey.

Researchers said 68.9 percent of respondents were regular Internet users, and one in eight displayed at least one possible sign of problematic Internet use.

The team, moreover, said:

That 13.7 percent found it hard to stay away from the Internet for several days at a time.

That 12.3 percent had seen a need to cut back on Internet use at some point.

That 8.7 percent attempted to conceal nonessential Internet use from family, friends and employers.

That 5.9 percent thought their relationships suffered as a result of excessive Internet use.

Elias Aboujaoude, the study’s lead author, said he was particularly concerned by the number of people who hid their nonessential Internet use.

“Obviously something is wrong when people go out of their way to hide their Internet activity,” he said in a news release. “We often focus on how wonderful the Internet is — how simple and efficient it can make things. But we need to consider the fact that it creates real problems for a subset of people.”

Internet usage in general has clearly increased over the past decade, with 68.7 percent of homes boasting Internet access in 2009, compared with 41.5 percent in 2000, according to the U.S. Census Bureau.

What are the signs of Internet addiction?

Even though I have been studying Internet addiction since the 90s, I keep getting the same question among reporters and clients alike, what are the signs of Internet addiction? Is it a matter of time? Yes, to some extent. If someone spends excessive time online for recreational purposes and it cuts into other needed tasks or duties for work, school, or within relationships, the use of the Internet could be considered compulsive. To fully define signs of Internet addiction, a set of diagnostic criteria were developed (in 1998 published in my first article on Internet addiction, this is also referred to as the Internet Addiction Diagnostic Questionnaire, an eighth-item screening instrument) to help see if you match the profile.

Ask yourself the following questions:

1. Do you feel preoccupied with the Internet (think about previous online activity or anticipate next online session)?
2. Do you feel the need to use the Internet with increasing amounts of time in order to achieve satisfaction?
3. Have you repeatedly made unsuccessful efforts to control, cut back, or stop Internet use?
4. Do you feel restless, moody, depressed, or irritable when attempting to cut down or stop Internet use?
5. Do you stay online longer than originally intended?
6. Have you jeopardized or risked the loss of significant relationship, job, educational or career opportunity because of the Internet?
7. Have you lied to family members, therapist, or others to conceal the extent of involvement with the Internet?
8. Do you use the Internet as a way of escaping from problems or of relieving a dysphoric mood (e.g., feelings of helplessness, guilt, anxiety, depression)?

If you answer 5 or more, you most likely fit the DSM-criteria for Internet addiction.

Internet addiction treatment

Centers have existed since 1995 that specialize in treating Internet addiction. Proctor Hospital offered one of the first inpatient settings and several have sprung up across the US. It is something that is slowly evolving and being addressed as a serious condition, requiring inpatient residential care. More will be discussed related to inpatient care in the years to come. For now, the biggest treatment strategy that works is cognitive-behavioral talk therapy, used on an outpatient basis. Treatment studies can be read online at http://www.netaddiction.com/ under ARTICLES but we have long-term data suggesting recovery upon 12 weekly sessions and upon six-month follow-up. This is a good start to a larger dialogue where we need more data on treatment options and treatment efficacy for each. Right now, it seems treatment centers are opening without using standardized techniques or assessment procedures. We need more collaboration on what will work and development of clear standards of practice.

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China Web Addiction Clinics

A story out of China explores the aggressive treatment approach used in Internet addiction recovery. A 14-year-old boy allegedly beaten at a boot camp in China for young Internet addicts was in critical condition - less than three weeks after a youth at a different camp died, Chinese state media reported.

Internet use has skyrocketed in China, especially among teens. And Chinese parents have turned to hundreds of training camps that offer to wean their children -- mostly teenagers -- from excessive Internet use.

There are at least 400 private rehabilitation clinics or camps in the country, according to a recent survey by the China Youth Internet Association, adding that China has 10 million teenage Web addicts.

The injured youth's mother told Chinese media that her son "got addicted to online games and frequented Internet cafes ... at the end of last semester, my son said he didn't want to go to school."

The mother, Li Shubing, saw an ad for the training camp and hoped her son could be helped, she told China Daily. The parents signed a contract with the center and paid 5,000 yuan (about $730), she said.

In a separate incident, 15-year-old Deng Senshan died after his parents sent him to a summer training camp for his Internet addiction, according to Chinese news agency Xinhua. That camp was in south China's Guangxi Zhuang Autonomous Region.

Authorities detained several counselors and were investigating the incident. Injuries found on the body indicated the teen had been beaten, Xinhua reported.

China is in the process of classifying Internet addiction as a mental illness, according to China Tech News. Medical experts have called for laws and regulations to govern treatment.

Last month the government banned electro-shock therapy as treatment for Internet addiction after abuses were reported. Internet users claiming to have received the treatment wrote in blogs and forums about being tied down and subjected to shocks for 30 minutes at a time.

These seem harsher treatment methods than the cognitive-behavioral talk therapy used in the US. We need treatment outcome data to support use of various treatment methods, unfortunately, to date, there is only one study showing the efficacy of cognitive-behavioral therapy. Studies need to be conducted that examine what treatments work the best with what patients suffering from Internet addiction.

Facebook Addiction and Jealousy

A new peer-reviewed study suggests the time spent on Facebook by college students is directly related to feelings of jealousy toward their romantic partner. The view is self-perpetuating as jealousy leads to more time on Facebook searching for additional information –- a behavior that exacerbates their jealousy. In fact, the escalating cycle may become addictive, according to a study reported in CyberPsychology & Behavior. The article is available free online at www.liebertpub.com/cpb.

Amy Muise, MSc, Emily Christofides, MSc, and Serge Desmarais, PhD, from the University of Guelph (Ontario, Canada), surveyed young adults involved in romantic relationships.
They discovered time on social networking sites such as Facebook can lead to new knowledge about their partners that can make them jealous. The jealousy, in turn, leads them to spend more time involved in online surveillance in an effort to uncover even more jealousy-provoking information.

Can Facebook bring out a vicious cycle? Does using Facebook have a negative impact on relationships and bring out feelings of jealousy? It seems that the activity itself can create a problem in relationships if done to excess. That is, using Facebook can hurt a relationship if a partner is spending all their time talking with online friends instead of going to the movies or to dinner with a spouse.

In the new world of social networking, jealousy can parallel the ways that relationships behave offline. A harmless comment can trigger trouble. Something that hurt a once stable relationship.

Facebook Addiction

I am one of the content experts for Addicted.com, a great resource for addiction recovery. I received a recent question regarding Facebook addiction. I am receiving more email on this issue lately so I thought I would repost my answer.

Facebook has become an indispensable way to find old friends, schedule events, play games and even send virtual gifts. But if you’re doing more living online than off, it might be time to reassess. Many students (and adults) are now seeing Facebook more as an addiction than a networking tool, and psychologists are starting to agree.

Ask yourself some of the following questions: Are personal relationships taking a backseat to Facebook? Do you think about Facebook even when you’re offline? Do you use Facebook to escape problems or homework? Do you stay on Facebook longer than intended? Have you ever concealed Facebook use?

If you answered yes to any, you might be a borderline addict. Frequent Facebook visits actually cause something psychologists refer to as intermittent reinforcement. Notifications, messages and invites reward you with an unpredictable high, much like gambling. That anticipation can get dangerously addictive. It is an entire world where one can easily be seduced and sucked in. I have many friends who consider it a time-waster yet they are on it everyday. A few tips for cutting down your Facebook habit is first, keep a log to track your Facebook usage. If you’re shocked by what you see, try the following:

List your Facebook goals. Why did you originally sign up? Is your goal to network? Is your goal to have 5,000 friends? Are these people that you really need to keep in touch with?

Record what you actually do on Facebook. How many times to check status updates of friends? How many notifications do you receive? How much time do you search for new friends on People Search or Classmate search? Facebook can be a time-consuming activity if you let it. Once you see how much you do certain activities you will be able to use that as a baseline to control and moderate your usage.

Make a Facebook schedule. Limit time to maintaining your original goals. Update your e-mail addresses to avoid relying on Facebook messages.Only check it once a day. These are ways to unhook yourself from the behavior without having to completely remove Facebook from your life

Money and Internet Addiction by Neal Frankle, CFP ® - Guest Blogger

The fuel that runs addiction is shame. Even if you are blessed and no longer acting out on the internet, the shame can linger on for years. One of the components of that shame is often financial. We have shame about the hours we wasted indulging our addictions, rather than being productive. We have shame about the money we spent to momentarily quiet our addiction. We have shame about the money we could have earned and spent to benefit our family – and didn’t.

That lingering shame can hurt us and lead us to act out in other ways. You might not be acting out on the computer but are you acting out with money?

To find out, look at your relationship with money and ask yourself a few questions. Consider the way you spend, invest, borrow, save and plan Are you powerless over some aspect of your financial life? Does some part of your financial behavior make your life unmanageable? If you feel you need to work a recovery program around money you are not alone. You can work a program and get the same benefits of recovery. Many resources are available and you deserve the blessings of a life full of joy and peace.

I know. The first step is the most difficult but also the most rewarding. Take an honest look at your financial life. You don’t have to suffer anymore. If you need help, just ask. It’s all around you.

Women prefer Internet over Sex

Nearly half of the women questioned by Harris Interactive said they'd be willing to forgo sex for two weeks, rather than give up their Internet access, according to a study released Monday by Intel, which commissioned the survey.

While 46 percent of the women surveyed were willing to engage in abstinence versus losing their Internet, only 30 percent of the men surveyed were willing to do likewise.

The U.S. survey, which queried 2,119 adults last month, found that the gap grew even wider for both men and woman who were 18 to 34 years old. For woman, the percentage of those willing to skip the sheets in favor of the Web rose to 49 percent, while it climbed to 39 percent for men.

This says so much about our dependency upon the Internet. Beyond addiction, we are focused on creating a connected world. Asking people to give up email, Facebook, or MySpace would mean giving up social relationships. The Internet is a large part of how we relate.

Being online also is more than information searching. We NEED the Internet to do research, book hotels, make airline reservations, or trade stocks. It is a tool that goes beyond anything we first imagined. Forget addiction - giving up the Internet for average people would be difficult for anyone! It is our reality, which makes diagnosis of addiction tricky when we have come to rely upon online use in our daily lives.

Porn in Libraries

The debate of unrestricted access to porn in public libraries is back in the news. Some say that librarians should not be censors to public content available online. On the same side of this argument are those who say the library's so-called, "shoulder tap" policy that allows patrons to object to what others may be watching is also too restrictive. "Is there a problem here or do we have people who want to engage in censorship?" said American Civil Liberties Union.

Early in my career, I spoke at the American Library Association regarding this issue, hearing from many librarians who had to deal with men coming to the library to view porn offending other patrons. They also complained of not feeling comfortable in the role of censor. Feeling that this was not part of their job description.

The debate will surely continue. Not one ounce of doubt about that. The Internet is publicly accessible at a library, and should libraries be censoring any objectionable materials. It isn't just porn but hate sites or access to violent games, for example, may not be something that parents want their children to view. Given these issues, do you believe libraries should censor porn at public computers?

Pathological Computer Use

Pathological Computer Use (PCU) is a proprosed diagnosis for the upcoming fifth edition of the Diagnostic Statistical Manual of Mental Disorders (DSM-V). PCU consists of excessive computer use, withdrawal, tolerance, and serious negative repercussions due to excessive computer use. The debate, to some extent, is in the term. Research has used Internet addiction, Problem Internet use, Pathological Internet use, heavy Internet use to describe the same behavior. As another opinion question, what term do you think best describes the problem?

Should Internet Addiction be in DSM?

In the American Journal of Psychiatry for March, an editorial offers the opinion that Internet addiction is a 'compulsive-impulsive' disorder, and should be added to the official DSM guidebook of disorders. The editorial characterizes net addiction as including 'excessive gaming, online sexual pre-occupations and e-mail/text messaging'. From the article: 'Like other addicts, users experience cravings, urges, withdrawal and tolerance, requiring more and better equipment and software, or more and more hours online, according to Dr. Jerald Block, a psychiatrist at the Oregon Health and Science University in Portland. Dr. Block says people can lose all track of time or neglect "basic drives," like eating or sleeping. Relapse rates are high, he writes, and some people may need psychoactive medications or hospitalization."

Going back to 1994, when I started to study Internet addiction, many did question its validity. Today, documented cases in Italy, Germany, China, Taiwan, and Korea as well as the US, support that Internet addiction is a serious condition.

Last summer, doctors from the Internet Addiction Recovery Center in Beijing had visited with me to personally discuss my work on Internet addiction. They had repeatedly asked me why in America we didn't have more treatment centers for Internet addiction. In China, the government had funded their clinic and were considering opening several more. They were surprised that Internet addiction was being debated as a disorder. To a large extent, in the US, accurate estimates of the prevalence of the disorder are lacking. Unlike in Asia, where Internet cafés are frequently used, in the US, computers are mainly accessed from home. Further, attempts to measure the phenomenon are clouded by shame, denial, and minimization.

Internet addicts often suffer from other psychological problems such as depression or anxiety, masking signs of Internet problems, especially if therapists do not routinely screen for it.

As the psychiatry field gains a deeper understanding, Internet addiction may very well appear in the next DSM. The movement towards its inclusion grows as more professionals are urging a closer examination of the problem. As an opinion question, do you think Internet addiction be included in the next DSM?

Impact on marriage

I received an emaiil today made me want to share this. Repeatedly, studies find that Internet use has a negative impact on marriages. In my first study on Internet addiction, over 50% of respondents said that they suffered marital problems because of their Internet use. It is how I first got involved with this study, as a friend of mine's husband became addicted to chat rooms, which led to their divorce.

In the email, Maggie has been married for 3 years and they do not have children. She writes, "We are both 28 and I thought we had a strong, open and honest relationship; other than the normal marital issues. He started playing World of Warcraft and finds playing this game takes his mind off his concerns, but it has become a problem, he plays all the time. Everything we had together seems to be slipping away."

"I mentioned to my husband that I didn't want to be replaced by a cybergame, and I think that is finally penetrating. After I mentioned that I felt intimacy between us was difficult (to put it mildly) with a computer in the way, he seemed to realize that I was seriously feeling pushed aside. For the past few weeks he hasn't been spending as much time on it. Now I hope this continues, but it is early to tell! I don't want his GRUDGING attention, so I guess I will have to be patient and persistent. I know our relationship IS first for him, so I think he will fight this "addiction." I will suggest we play together - in real time, not online! I do have a backgammon board somewhere (now why didn't I think of that myself...)"

Even if online relationships aren't sexual or involve cybersex, they can still lead to marital problems. Just the basic neglect of the marriage can impede intimacy and trust for a couple. Maggie feels confused yet hopeful that she can regain his attention in a meaningful way.

One Mother's Story

Looking at my last post, asking for your opinions on Internet addiction, I heard from one mother today. She worked in Public Health and had gone to three different psychologists to get her son help for his addiction to World of Warcraft. Known to players as WoW, she compared his addiction to heroin and described her son's state when he came home from college in vivid detail. “He came home from his first year of college. He was thin, emaciated, like a stick, like he hadn’t eaten in months. His skin was pasty and white. He was hairy, hadn’t had a hair cut in forever. His eyes were blood shot from lack of sleep. Our son was a good-looking, muscular guy who used to like being active. Now he is this zombie doing nothing else by staring at the computer. Now he wants to quit school. His father and I just don’t know what to do.”

Parents are looking for help for online gaming addiction. The Online Gamers Anonymous site was started by a mother whose son became addicted to EverQuest, subsequently committing suicide in front of the computer.

Managing online gaming for a son or daughter is difficult. Parents need to watch for signs. Much of my posting focuses on the person dealing with the addiction but we see that not only do the addicts suffer but so do family members.

Is Internet addiction real? Your Opinion

I enclosed an article published in 2000 entitled, "Is Internet Addiction Real?" Some of the point is that it shows where we as a mental health field were at that point in time. We were asking the question as this concept was so new and still evolving. Today, we do have more research, more findings, and more clinical treatment settings devoted to Internet addiction recovery. I thought it would be interesting to ask the same question today to see what online users thought.

One of the true signs of addiction is that a person experiences negative consequences as a result of something, whatever it may be - alcohol, drugs, or sex. With alcohol and drugs, a few common consequences are DUIs, jail time, and the loss of a job and/or relationship. A natural consequence for sex addicts is catching STDs. What are the consequences of Internet addiction?

In August 2005, a 28-year-old South Korean man died – not by committing suicide, but after playing the game Starcraft at an Internet café for 50 hours straight. By all reports, the man had not slept properly and had eaten very little in that time. While no autopsy was performed, he was believed to have died from heart failure stemming from exhaustion. A 13-year-old Chinese boy died falling from a building. His parents are suing Blizzard Entertainment, makers of World of Warcraft. The boy was allegedly re-enacting a scene from the game. In the Nevada, a couple ignored their two toddlers to the point of neglect due to their gaming addiction.

The children of Michael and Iana Straw, a boy age 22 months and a girl age 11 months, were severely malnourished and near death last month when doctors saw them after social workers took them to a hospital, authorities said. Both children are doing well and gaining weight in foster care.

Police said hospital staff had to shave the head of the girl because her hair was matted with cat urine. The 10-pound girl also had a mouth infection, dry skin and severe dehydration. Her brother had to be treated for starvation and a genital infection. His lack of muscle development caused him difficulty in walking, investigators said. The prosecutor said, “They had food; they just chose not to give it to their kids because they were too busy playing video games.”

Attorneys said the Reno couple was too distracted by online video games, mainly the fantasy role-playing “Dungeons & Dragons” series, to give their children proper care.

Studies from China, Germany, Italy, Iran, Pakistan, and India have also documented cases of Internet addiction. Given the dramatic effects reported and studies on the consequences of compulsive use of the Internet, the question is "Do you think Internet addiction should be given the same status as other addictions?"

Internet addiction an epidemic in Korea

Compulsive Internet use has been identified as a mental health issue in other countries, including the United States. However, it has reached epidemic levels in South Korea because of the country’s nearly universal Internet access.

According to an article that appeared in the New York Times, itt has become a national issue in recent years, as users started dropping dead from exhaustion after playing online games for days on end. A growing number of students have skipped school to stay online, shockingly self-destructive behavior in this intensely competitive society.

Up to 30 percent of South Koreans under 18, or about 2.4 million people, are at risk of Internet addiction, said Ahn Dong-hyun, a child psychiatrist at Hanyang University in Seoul who just completed a three-year government-financed survey of the problem.

They spend at least two hours a day online, usually playing games or chatting. Of those, up to a quarter million probably show signs of actual addiction, like an inability to stop themselves from using computers, rising levels of tolerance that drive them to seek ever longer sessions online, and withdrawal symptoms like anger and craving when prevented from logging on.

To address the problem, the government has built a network of 140 Internet-addiction counseling centers, in addition to treatment programs at almost 100 hospitals and, most recently, the Internet Rescue camp, which started this summer. Researchers have developed a checklist for diagnosing the addiction and determining its severity, the K-Scale. (The K is for Korea.)

In the US, the prevalence of Internet addiction appears less than Korea with estimates of 5 to 10 percent of the population who suffer from the problem. The issue of Internet addiction continues to raise significant concern as more therapists see clients who suffer from Internet-related problems, including online gaming, online affairs, Internet pornography and Internet gambling addictions.

Treating Internet Addiction

The October issue of the CyberPsychology & Behavior Journal published the first study to examine treatment outcomes with Internet addicts. The study conducted by the Center for Internt Addiction Recovery examined 114 patients over 12-weekly sessions and upon six-month follow-up after termination. Results showed that clients gained symptom management by the 3rd session and were able to maintain complete recovery after 12 sessions and at six months after treatment ended. The main and most successful treatment with Internet addicts is cognitive-behavioral therapy and the study supports that CBT is the primary therapy to use in treating Internet addiction. This is the first study to examine specific treatment variables with Internet-addicted patients and shows long-term potential in treatment recovery.

To learn more please read the full article published by Mary Anne Liebert entitled, "Cognitive-Behavioral Therapy with Internet Addicts: Treatment Outcomes and Implications" is published by CyberPsychology & Behavior, Vol. 10, No. 5, pages 671-679 (October 2007).

AMA considering Video Game Addiction a disorder

In today's headlines, the American Medical Association is considering video game overuse an addiction. While they say a final diagnostic classification for the behavior is a ways off, studies have been conducted and clinical evidence is mounting to support the validity of this new syndrome.

Dr. Martin Wasserman, executive director of MedChi, the Maryland State Medical Society, helped spearhead the new proposal, which has resulted in a 10-page report submitted to the AMA by the group's Council on Science and Public Health.

"The concern came up because one of our psychiatrists here in Maryland was seeing older people who were losing their social contacts," specifically because of their overuse of video games, Wasserman said. "It was ruining their family life. So, it was not unlike gambling addictions or alcohol, where it was having a profound impact on the lives of individuals."

According to the AMA report, one soon-to-be-released British study polled 7,000 "gamers" and found that 12 percent of them met World Health Organization criteria for addictive behaviors.

Statistics released in 2005 by the Entertainment Software Association (ESA), an industry group, estimated that 70 percent to 90 percent of American children play video games. The typical gamer is a 30-year-old male who spends about seven or eight hours a week gaming.

The ESA survey also found that video game overuse was most prevalent among the approximately 9 percent of video game users who play against others online in Internet-based "massive multiplayer online role playing games."

The new AMA report defines "heavy game use" as two or more hours a day, but Wasserman, a pediatrician, said addictions are best defined by their impact on an individual's life and psyche.

We have already discussed in prior blog posts that online gaming has become problematic for many. These new studies bring to light the issues and continue to add to the growing dialogue of how new technologies can clinically impact individuals and families.

Are you an obsessive online gamer?

As a follow-up to my discussion on online gaming addiction, I received this email from a recovered gaming addict that I wanted to share. I wanted to hear from other gamers to see if physical numbing or problems also result from intensive playing.

"Hello: I play World of Warcraft which I'm sure must be responsible for a great deal of online addiction. I have gone through periods of playing somewhat intensively which I may do for up to 4 hours 4 evenings in a week but then I am suddenly so bored with it that I don't touch it for a month or two then repeat the cycle. So maybe a binge addiction! Anyway, the purpose of this message is to comment on your online survey: Are you an obsessive online gamer? I am a nurse and one thing I have noticed is that frequently people are playing to a point of physical harm. I am in a guild that actually meets every once in a while in San Francisco (so real face time with fellow guildies which I think is unusual) and often they have what seem to me to be tendonitis and other repetitive stress/overuse injuries such as Carpal Tunnel (although as a nurse naturally I would leave diagnosis up to the physicians!). Also I often hear (on Ventrillo which many gamers use for audio) or see (in online comments) remarks that people have tingling or numbness in the nerves of their hands, wrists, forearms, shoulders, or necks, any of which could be the onset of more serious conditions. People seem to accept all this as part of gaming, especially heavy gamers who go on "raids" (something I'd never do) which take hours and hours maybe three times a week to complete. Therefore I think you need to add a question to your online gaming questionnaire: HAVE YOU EVER PLAYED/CONTINUED TO PLAY AN ONLINE GAME AFTER YOUR HANDS OR AMRS BEGIN TO HURT? In this case I am not even addressing lower back pain and possible damage to spine/cartilage, or damage to vision, both of which I suspect as a result of computer use. I think it would be good to see something on your questionnaire about this."