title: Massively multiplayer online role-playing games: comparing characteristics of addict vs non-addict online recruited gamers in a French adult population.
abstract: BACKGROUND
  Massively Multiplayer Online Role-Playing Games (MMORPGs) are a very popular and enjoyable leisure activity, and there is a lack of international validated instruments to assess excessive gaming. With the growing number of gamers worldwide, adverse effects (isolation, hospitalizations, excessive use, etc.) are observed in a minority of gamers, which is a concern for society and for the scientific community. In the present study, we focused on screening gamers at potential risk of MMORPG addiction.
  
  
  METHODS
  In this exploratory study, we focused on characteristics, online habits and problematic overuse in adult MMORPG gamers. In addition to socio-demographical data and gamer behavioral patterns, 3 different instruments for screening addiction were used in French MMORPG gamers recruited online over 10 consecutive months: the substance dependence criteria for the Diagnostic and Statistical Manual of Mental Disorder, fourth revised edition (DSM-IV-TR) that has been adapted for MMORPG (DAS), the qualitative Goldberg Internet Addiction Disorder scale (GIAD) and the quantitative Orman Internet Stress Scale (ISS). For all scales, a score above a specific threshold defined positivity.
  
  
  RESULTS
  The 448 participating adult gamers were mainly young adult university graduates living alone in urban areas. Participants showed high rates of both Internet addiction (44.2% for GIAD, 32.6% for ISS) and DAS positivity (27.5%). Compared to the DAS negative group, DAS positive gamers reported significantly higher rates of tolerance phenomenon (increased amount of time in online gaming to obtain the desired effect) and declared significantly more social, financial (OR: 4.85), marital (OR: 4.61), family (OR: 4.69) and/or professional difficulties (OR: 4.42) since they started online gaming. Furthermore, these gamers self-reported significantly higher rates (3 times more) of irritability, daytime sleepiness, sleep deprivation due to play, low mood and emotional changes since online gaming onset.
  
  
  CONCLUSIONS
  The DAS appeared to be a good first-line instrument to screen MMORPG addiction in online gamers. This study found high MMORPG addiction rates, and self-reported adverse symptoms in important aspects of life, including mood and sleep. This confirms the need to set up relevant prevention programs against online game overuse.
authors.affiliation: Clinical Psychiatry Department, Besançon University Hospital, 25030 Besançon Cedex, France.
authors.forename: Sophia
authors.initials: S
authors.lastname: Achab
authors.forename: Magali
authors.initials: M
authors.lastname: Nicolier
authors.forename: Frédéric
authors.initials: F
authors.lastname: Mauny
authors.forename: Julie
authors.initials: J
authors.lastname: Monnin
authors.forename: Benoit
authors.initials: B
authors.lastname: Trojak
authors.forename: Pierre
authors.initials: P
authors.lastname: Vandel
authors.forename: Daniel
authors.initials: D
authors.lastname: Sechter
authors.forename: Philip
authors.initials: P
authors.lastname: Gorwood
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Haffen
mesh_terms: D000293:Adolescent; D000328:Adult; D016739:Behavior, Addictive / Q000523:psychology*; D005260:Female; D005602:France; D006801:Humans; D020407:Internet; D007398:Interpersonal Relations; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D012381:Role Playing; D057566:Self Report; D018910:Video Games / Q000009:adverse effects* / Q000523:psychology*