title: Neurobiological correlates of physical self-concept and self-identification with avatars in addicted players of Massively Multiplayer Online Role-Playing Games (MMORPGs).
abstract: OBJECTIVE
  MMORPG addiction has been associated with self-concept impairments and increased identification with the own avatar. Yet, the underlying neurobiological mechanisms of self-identification with avatars, especially reflected in the left angular gyrus (AG), have only been assessed in regular gamers. Therefore, the study aims to examine neurobiological processes in addicted MMORPG players while evaluating their own and their personal avatar's body image (physical self-concept).
  
  
  METHODS
  Sixteen addicted and seventeen non-addicted gamers underwent functional Magnetic Resonance Imaging (fMRI) while viewing images of themselves, their own avatar and unfamiliar persons. The Body Image Questionnaire (FKB-20) and Visual Analog Scales (VAS) assessing the degree of attractiveness, sympathy and gender identity of the self, of the avatar as well as of the unfamiliar persons were applied.
  
  
  RESULTS
  Addicts showed a significantly extended negative body image and lower gender identity levels as well as decreased bilateral brain activations in the AG and the middle occipital gyrus during self-perception. They further exhibited higher activations in the left AG during avatar-perception. Regression analyses in the overall group and in addicted gamers indicated a significant positive correlation between gender identity and brain activation in the left AG during self-perception.
  
  
  CONCLUSIONS
  Our results confirm addicted MMORPG players to have physical self-concept deficits which may be related to hypoactivations in the AG. The findings further indicate addicted gamers to have a tendency to identify themselves easier with their own avatar than with their real self. Lower gender identity levels might be associated with physical self-concept deficits in MMORPG addiction.
authors.affiliation: Department of Addictive Behaviour and Addiction Medicine, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, J5, D-68159 Mannheim, Germany. Electronic address: Tagrid.Lemenager@zi-mannheim.de.
authors.forename: Tagrid
authors.initials: T
authors.lastname: Leménager
authors.affiliation: Department of Addictive Behaviour and Addiction Medicine, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, J5, D-68159 Mannheim, Germany. Electronic address: Julia.Dieter@zi-mannheim.de.
authors.forename: Julia
authors.initials: J
authors.lastname: Dieter
authors.affiliation: Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Hertzstraße 16, D-76187 Karlsruhe, Germany. Electronic address: Holger.Hill@kit.edu.
authors.forename: Holger
authors.initials: H
authors.lastname: Hill
authors.affiliation: Department of Addictive Behaviour and Addiction Medicine, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, J5, D-68159 Mannheim, Germany. Electronic address: Anne.Koopmann@zi-mannheim.de.
authors.forename: Anne
authors.initials: A
authors.lastname: Koopmann
authors.affiliation: Department of Addictive Behaviour and Addiction Medicine, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, J5, D-68159 Mannheim, Germany. Electronic address: Iris.Reinhard@zi-mannheim.de.
authors.forename: Iris
authors.initials: I
authors.lastname: Reinhard
authors.affiliation: Department of Addictive Behaviour and Addiction Medicine, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, J5, D-68159 Mannheim, Germany. Electronic address: Madlen.Sell@zi-mannheim.de.
authors.forename: Madlen
authors.initials: M
authors.lastname: Sell
authors.affiliation: Department of Addictive Behaviour and Addiction Medicine, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, J5, D-68159 Mannheim, Germany. Electronic address: Falk.Kiefer@zi-mannheim.de.
authors.forename: Falk
authors.initials: F
authors.lastname: Kiefer
authors.affiliation: Department of Addictive Behaviour and Addiction Medicine, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, J5, D-68159 Mannheim, Germany. Electronic address: Sabine.Vollstaedt-Klein@zi-mannheim.de.
authors.forename: Sabine
authors.initials: S
authors.lastname: Vollstädt-Klein
authors.affiliation: Department of Addictive Behaviour and Addiction Medicine, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, J5, D-68159 Mannheim, Germany. Electronic address: Karl.Mann@zi-mannheim.de.
authors.forename: Karl
authors.initials: K
authors.lastname: Mann
mesh_terms: D000328:Adult; D016739:Behavior, Addictive / Q000523:psychology*; D001828:Body Image / Q000523:psychology; D001921:Brain / Q000503:physiopathology*; D001931:Brain Mapping / Q000379:methods; D005260:Female; D006801:Humans; D007062:Identification, Psychological; D020407:Internet; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D011594:Psychometrics; D012381:Role Playing; D012649:Self Concept; D011795:Surveys and Questionnaires; D018910:Video Games / Q000523:psychology* / Q000706:statistics & numerical data; D055815:Young Adult
keywords: Avatar identification; Body image; MMORPG players; Self-concept