18 April 2019
Many youngsters spend so much time playing mobile games like Pokémon GO. Photo: HKEJ
Many youngsters spend so much time playing mobile games like Pokémon GO. Photo: HKEJ

When playing internet games becomes harmful

A worried mom brought her 17-year-old son who was wearing a crumpled school uniform to my clinic today.

The boy had cuts and bruises on his arms and legs. On top of that, the mother also begged me to conduct a drug test on him as she noticed that he always looked tired and performed extremely poorly in all his subjects in school.

Feeling untrusted, disappointed and annoyed, the boy talked back and denied having engaged in anything illegal.

As their family doctor, I tried to mediate between the mother and the son, saying that I would like to first treat the boy’s cuts and bruises.

While the mom waited outside the consultation room, the boy confided to me.

As the only child of working parents, he said he felt so alone at home after school.

In his last birth anniversary, he received a gift from his parents, the latest model of a popular smartphone. Since then, it has practically become his only companion.

Like many Hong Kong teenagers, the boy loves playing all kinds of mobile games. Puzzle & Dragons, Candy Crush Saga and LINE Rangers are his favorites.

The games all are beautifully designed and involved challenging yet manageable tasks.

Players gradually indulge in a reward system built into mobile games from which they could derive immediate pleasure or a quick sense of achievement.

However, since the stimuli are rather short-lived, players have to continue playing the games.

The game developers are very good at luring the users into completing one level after another till they reach the end of the game, which unfortunately rarely exists because the games are regularly updated.

Unsurprisingly, the boy has become so addicted with the games that after classes, he isolates himself from his friends and classmates and has shunned other after-school activities in order to indulge himself in his favorite games.

He often stays awake way past midnight so he could play on his mobile phone for longer hours.

Lacking sleep, he naturally performs poorly in school.

As for his cuts and bruises, the boy, though embarrassed, told me that he tripped over a drain cover and fell while playing Pokémon GO on his mobile phone.

But he refused to explain the injuries to his parents, who are now getting increasingly suspicious about what he has been doing.

Technological advances work like a double-edged sword – they can improve our daily life but they can also wreak havoc if used inappropriately.

In the May 2013 (fifth) edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) published by the American Psychiatric Association, Internet Gaming Disorder has been listed as one of the conditions for further study.

Though it is still largely debatable if it should be considered a formal mental disorder, readers should nevertheless seek professional help if they have five or more of the following diagnostic criteria in the past 12 months:

1. Preoccupation with internet games.

2. Withdrawal symptoms (irritability, sadness, anxiety) when the internet is not available or taken away.

3. Tolerance indicated by the need to spend increasing amounts of time playing internet games.

4. Unsuccessful attempts to control participation.

5. Loss of interest in other meaningful activities or recreation, except for internet games.

6. Continued use despite knowledge that excessive use of the internet is causing problems.

7. Lying or other forms of deceit regarding the amount of internet gaming.

8. Using internet gaming as a means to escape or relieve negative feelings.

9. Jeopardized important relationships, job, or limited occupational or educational opportunities due to internet gaming.

(References: Király, O., Griffiths, M.D. & Demetrovics Z. (2015). Internet gaming disorder and the DSM-5: Conceptualization, debates, and controversies, Current Addiction Reports, 2, 254-262.)

This article appeared in the Hong Kong Economic Journal on July 28.

Translation by Darlie Yiu

[Chinese version 中文版]

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Fellow of the Hong Kong Academy of Medicine (Family Medicine)

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