Internet Gaming Disorder’s Case Study
Internet Gaming Experience among Adolescents in Metro Manila: A Case Study
This study explored the experience of internet gaming disorder (IGD) among adolescents in a high school in Metro Manila. It aimed to understand the antecedents, symptoms and consequences of IGD. The respondents of the study consisted of 8 adolescents with IGD and 8 highly engaged adolescent gamers. This paper used multiple case study research design. Responses from the participants revealed four major themes namely:
a) experience of internet gaming
b) risk factors in developing IGD
c) warning signs of IGD
d) ramifications of IGD
IGD experience includes cognitive, affective, physiological and behavioral reactions. Risk factors in developing IGD involve excessive gaming, escapism and coping, entertainment and peer recognition. Pre-‐occupation with gaming, inability to control the urge to play and lie/deception about gaming are warning signs of IGD while having relational conflicts caused by gaming and declining of grades are ramifications of IGD. Parental control over gaming serves as protective factors for the highly engaged gamers. Implications for counseling practice are discussed.
Keywords: internet gaming disorder, internet gaming, counseling, Filipino adolescents
The internet has become part of daily living for several people across the world in this digital age; they rely on it for social interaction, doing business, entertainment, keeping abreast of the news and for a host of other activities. However, many recent scientific reports have begun focusing on the preoccupation of some people on certain aspects of the internet, especially the internet games (American Psychiatric Association [APA], 2013). Some internet gamers play compulsively and persistently to the extent of neglecting other important activities such as academic and occupational responsibilities, resulting in clinically significant psychosocial impairment, and over time, they develop a need for more of internet gaming and manifest withdrawal symptoms when their internet gaming is stopped (Young, 2009). The American Psychological Association expressed that internet gaming disorder (IGD) is a condition that needs further qualitative study. IGD is the term used by APA (2013), to refer to excessive, compulsive, prolonged and problematic use of internet games. APA (2013) defined IGD as “A pattern of excessive and prolonged internet gaming that results in a cluster of cognitive and behavioral symptoms, including progressive loss of control over gaming, tolerance and withdrawal symptoms analogous to the symptoms of substance use disorders.”
Yen, Yen, Chen, Chen, and Ko (2007) found that ineffective parenting and poor family relationship are the first steps towards developing IGD among adolescents. Besides familial factors, social context is another contributing factor for development of IGD (Davis, 2001). Peer pressure and environmental stressors highly influence adolescents in getting involved with internet gaming (Young, 2009).
Gamers who play a lot appear to have more problems than casual gamers (Oggins & Sammis, 2012). Beranuy, Carbonell and Griffiths (2013) conducted a qualitative face-‐to-‐face interview with nine gamers with IGD undergoing treatment and found that the initial gaming motives of those gamers were entertainment, escapism and virtual friendship. However, once duration of the gaming significantly increased, these gamers lost control over the game and developed narrow behavioral focus and the symptoms of IGD began to appear.
Numerous negative consequences of excessive and prolonged internet gaming have been reported both by the media as well as by empirical studies. A Korean federal government release on internet gaming states, “at least 2.2 million young gamers are addicted and that the affliction is pandemic” (Clark & Scott, 2009, p.4). Gamers with IGD become so preoccupied with internet gaming and are unable to control their gaming that they willingly forgo food, sleep or real life human interaction simply to experience spending time in the world of virtual reality (Young, 2009). As a result, they jeopardize important relationships, academic work and/or employment; they may also suffer from many health problems like eye strain, carpel tunnel syndrome, back strain and repetitive stress injury (Young, 2009). Yet, no known study has examined the consequences of Filipino adolescent IGD. To date, no known study has identified
factors that distinguish an adolescent gamer with IGD from a highly engaged adolescent gamer in the Philippines.
This study specifically focused on the adolescents because (a) the prevalence appears to be highest among adolescent males (APA, 2013), (b) adolescents play internet games for longer hours than adults (Griffiths, Davies & Chappell, 2004) and (c) adolescents are considered more at risk of developing IGD than adults are (Griffiths & Wood, 2000). Thus, the purpose of this study was to explore the experience of the phenomenon of IGD among Filipino adolescent internet gamers in Metro Manila. A qualitative research design with multiple-‐case study as strategy of enquiry was employed.
The purpose of this qualitative multiple-‐case study was to explore the experience of IGD among Filipino adolescents in Metro Manila and understand the antecedents, symptoms and consequences of IGD. To achieve this goal, this investigation sought to answer the following questions:
1. How do Filipino adolescents who are
(a) with IGD, and
(b) highly engaged internet gamers describe their internet gaming experience?
2. How do the respondents explain the antecedents that contribute to the onset, development and maintenance of
symptoms of IGD?
3. How do the respondents describe the symptoms of IGD?
4. What are the consequences of IGD experienced by Filipino adolescents who are: (a) with IGD, and (b) highly engaged internet gamers?
Method
Research Design
This study employed a qualitative research design using multiple-‐case study as the strategy of enquiry. An in-‐depth exploration of the experience of IGD was done by gathering multiple forms of qualitative data such as interview and documents.
Participants
Sixteen adolescent internet gamers age 13 to 17 participated in the case study interview. Of these, 8 were with IGD (met 5 or more DSM-‐5 [APA, 2013] criteria) while the remaining 8 were highly engaged internet gamers (met 2-‐4 DSM-‐5 [APA, 2013a] criteria). Four other adolescent gamers (2 from disorder group, 2 from highly engaged gamers group) participated in the pilot case study.
Instruments
The instruments used in this study were Internet Gaming Disorder Scale (IGDS), Demographic Information Form (DIF) and Semi-‐structured In-‐depth Interview Guide (IG).
Internet Gaming Disorder Scale (IGDS). The IGDS is a modified version of the short version of Game Addiction Scale (GAS) developed by Lemmens et al., (2009) to measure computer and video games addiction specifically for adolescents based on the criteria for pathological gambling described in the DSM-‐IV (APA, 1994, 2000). Lemmens et al. (2009) found both the 21 items scale as well as the 7 items scale reliable (Cronbach alpha of 0.94 and 0.86 respectively). Several researchers (eg., Lemmens et al., 2011; Collins & Freeman, 2013) have recently used the short version of GAS in their studies. The IGDS was first translated to Tagalog and back to English by language experts and the scale administered to the participants had both English and Tagalog versions. In addition, the IGDS was further pilot tested with 65 Filipino adolescents for its internal consistency reliability and obtained Cronbach alpha of 0.86. Cronbach alpha for both the surveys together (n=391) was also 0.86. Thus the IGDS was found to be very reliable instrument to be used with the Filipino adolescents.
Demographic Information Form (DIF). Along with IGDS, Demographic Information Form with items such as gender, age, number of hours of internet gaming per week, length of gaming per session, frequently played game title & genre, years of experience in internet gaming and family relations etc. was also administered to facilitate purposive sampling.
Semi-‐structured in-‐depth Interview Guide (IG). This research used semi-‐structured, open-‐ended questions as interview guide to capture the unique experience of IGD among the participants and to answer the research questions.
Selection of participants. The study used purposive sampling to select participants using the following procedure. First, the Internet Gaming Disorder Scale (IGDS) and Demographic Information Form (DAF) were administered to 391 third and fourth year high school students. All those who scored 15 or more in the IGDS were invited to volunteer for the case study interview. Fifty one participants volunteered for the case study. Third, intake interview was conducted for 32 of them based on their scores in IGDS as well as DIF. Of these, 7 were dropped as they did not meet all the selection criteria. Fourth, from the remaining 25 volunteer gamers, 15 gamers who met DSM-‐5 criteria for IGD were chosen for interview. Fifth, the remaining 10 participants who were highly engaged gamers were selected for interview using the set inclusion criteria.
Pilot case study. The researcher pilot tested the case study with four adolescents (2 with IGD, 2 highly engaged gamers).
Face-‐to-‐face interview. Following the guideline of Yin (2009) that “The interview will be guided conversation rather than structured queries”(p.106), qualitative data collection was done through in depth, face-‐ to-‐ face, one-‐on-‐one interview ranging from 50 minutes to 80 minutes with the 16 participants, using the interview guide. A second follow up interview lasting for about 10 minutes was also done with all participants to gather any missing data and to clarify data from the first interview. This interview was also tape-‐recorded.
Documents. Apart from the face-‐to-‐face interview with the participants, school records such as term report, attendances etc. were also obtained from the school.
Data analysis
At the outset, the researcher transcribed all the tape recorded interviews verbatim and checked the transcript back against the original tape records for accuracy. The data were then analyzed using thematic analysis outlined by Braun and Clarke (2006) in six phases. “Thematic analysis is a method of identifying, analyzing and reporting patterns (themes) within data” (Braun & Clarke, 2006, p.81). A theme records something significant about the data in relation to research question, and it portrays some degree of patterned response or meaning within the data set; researcher’s judgment is essential to determine what a theme is (Braun & Clarke, 2006).