This topic has been the subject of many controversial but fruitful debates among neurophysiologists, neurobiologists, psychiatrists, other medical experts, the layperson and video gamers of course. A recent review in Nature Reviews: Neuroscience published on-line for the issue of December of this year gathered the opinion of six experts in the field of video game addiction and its consequences on brain physiology and behavior. The review highlights the positive and negative consequences of video game playing and provides an in-depth perspective on the future of video gaming and how the positive effects of video games can be used to exploit video gaming for use in rehabilitation, educational settings and for enhancing certain cognitive skills while suppressing the negative effects of video gaming. For example, certain video games can improve memory such as those that involve trivia or using mnemonics (Where in the World is Carmen San Diego, Jeopardy, and the Oregon Trail)
The panel of six experts was asked four questions for which they needed to elaborate. Only those comments and opinions for which there is common ground will be shown in this article while the most relevant differences among the experts will also be highlighted.
1. Does playing video games have beneficial effects on brain behavior?
There is a need to redefine the meaning of "video game". Just as cancer is a multitude of diseases categorized as such, there are hundreds of different types of video games of many genres. It is interesting to know that the media has categorized video games with a broad brush and there is usually a negative association when one thinks about video games, especially violent video games such as Grand Theft Auto. In terms on the beneficial effects of video game playing, there is some evidence that shows that "certain" type of video games, especially the ones that involve fast pace first-person shooters, improve peripheral vision, enhances attention, task switching, object tracking, decision making, eye-hand coordination, reaction time, enhancements in low-level vision, visual spatial capacity, among others. There is also some evidence of improvement in certain cognitive skills seen in video gamers compared to non-video gamers showing interesting enhanced basal cognitive effects. One particular expert noted that time spent playing is an important factor that should be involved in this equation. He specifically pointed out that brief periods of playing time is usually associated with a positive trend in enhanced cognitive and motor abilities for certain types of games while a negative association is seen when players spend more than four hours a day. In other words, time spent playing excessively will impair social and academic abilities in teenagers and young adults.
Another expert mentioned that many of the beneficial effects depends on the genre of the video game. Specifically, pro-social and role-playing video games that contain "chatting" or other social networking functions (ie., Tribes or Halo) that promote collaboration and multiple players tend to enhance social and leadership skills.
Does playing video games have negative effects on brain behavior?
This is a very controversial question that has not been clearly answered to date. Clearly, all the panel of experts agreed that excessive video game playing is co-morbid with other psychiatric disorders such as chronic depression, ADHD, autism-like behaviors, bipolar disorders, Internet addiction and anxiety spectrum disorders. Violent video games that involve the shooting and destruction of other human beings, animals and objects tend to produce anxiety behavior, and is associated with promoting confrontational and disruptive behaviors in affected individuals and increases “hostile attribution bias”. However, some experts cautioned to take the evidence with a grain of salt. They specifically commented that playing violent video games does not generate a "mass murderer" or directly promote violent and aggressive behavior but increases the likelihood and risk for developing such aggressive behavior. For instance, there have been reported incidents in which a thirteen year old killed his mother after repeatedly being told that he is “spending too much time playing video games”. Another incident involved a young adult father who killed his child who insisted for food while playing video games. Video games that tend to be more addictive are those that do not involve accomplishing a specific series of levels or goals but are simply role-playing tournament games.
How strong is the evidence that video games are addictive?
All the experts in the panel strongly agreed that there is no definitive answer but there are some neuroimaging studies that strongly suggest that the neuronal circuits and pathways involved with drug addiction are also involved with pathological video game addiction. Namely, the areas of the brain that light up according to these fMRI studies involve the basal ganglia, parahippocampus, thalamus, prefrontal cortex and nucleus accumbens. Another expert pointed to a study that showed that video game addiction parallels the brain areas affected in alcoholics, namely the orbitofrontal and anterior cyngulate cortex and mentioned that 1 out of 5 children are considered to be classified as addicted to video games. There is some evidence that brain neurochemistry may be altered in addicted video gamers which suggests that excessive video game playing can lead to alterations in brain circuitry. For instance, one study suggested that anti-depressants such as Prozac or Cymbalta can certainly help to reduce the dependence and the addiction to video games in certain individuals.
Is there a place for video games in rehab and education?
This question drawed the most interesting and insightful comments from the experts. Although the academic gains are modest, the experts agreed that video games have been shown to positively influenced academic performance in pre-school and elementary education but that there has been many educational video games with poor software design that leads to poor sales. In the medical field, one interesting study published in PLOS Biology this year showed that playing first person shooter video games (Medal of Honor) can alleviate the symptoms of amblyopia by enhancing peripheral vision, visual acuity and reaction time in certain individuals. Some medical residents that play video games have shown dramatic improvement in performing complicated micro-surgeries using the DaVinci robo-surgical system. In rehab, it has been well documented that video games have been used to help soldiers recover and alleviate from postraumatic stress disorders following a combat operation. Other video games have been used to help alleviate certain phobias and anxiety stress spectrum disorders as well.
What are the future and challenges of neuroscience research in this field?
There was a high variation in the responses for each expert for this question. However, they all agree that the future of neuroscience research needs to focus more on trying to better document the brain pathology associated with video game addiction in order to determine whether this is an actual brain disorder or addiction and whether it can be effectively treated in those individuals who exhibit pathological video game addiction. Another group of experts agreed that more research should be directed to specifically identify the elements or components of video games that can increase the positive effects in humans while trying to exclude specific video game features that promote negative behavior (aggression, isolation, anxiety). This type of research will be critical for enhancing educational video games and video games of high therapeutic value. The last group of experts mentioned that research should focus more on trying to determine the impact of video games on brain cognition and behavior based on its dimension, mechanics, structure and context. Eluding to the first question, it is important to know that there are hundreds of different types of video games (on-line, cell phone, collaborative, puzzles, first-person, role-playing) and more research needs to be done to know which mechanics, dimensions and structure of video games do not produce addictive behaviors while improving cognitive function.
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