“The internet is used as not just a tool anymore but as part of our daily makeup. Almost like oxygen. Discipline goes a long way in protecting our sanity.”
― Torron-Lee Dewar
A study published in the Journal of Psychiatry and Neuroscience has put forth novel evidence in support of a non-invasive brain stimulation technique as a potential treatment option for those addicted to internet gaming.
This study was completed by Lu-lu Wu, MS; Marc N. Potenza, PhD, MD; Nan Zhou, PhD; Hedy Kober, PhD; Xin-hui Shi, MS; Sarah W. Yip, PhD; Jia-hua Xu, MS; Lei Zhu, MS; Rui Wang, MS; Guan-qun Liu, BS; and Jin-tao Zhang, PhD, at the State Key Laboratory of Cognitive Neuroscience and Learning, and the Institute for Brain Research in the Haidian District of China.
Many people struggle with addictions -- uncontrollable and debilitating propensities to indulge in certain substances or behaviors. One of the most recognizable symptoms of addiction are cravings. These pernicious urges to use the problem substance or to engage in the problem behavior have been associated with the development, maintenance, and relapse of addiction.
There are two distinct types of cravings. While background cravings can be described as more constant sensations that occur when no situational triggers are present, cue-induced cravings arise as intense sensations that occur as a result of perceiving an associated addiction trigger.
Along with these behavioral symptoms, addiction has been associated with brain changes characterized by underactivation of a specific region (dorsolateral) in the right prefrontal cortex which can lead to a deficit in one’s ability to stop a physical action. This brain function abnormality has been linked to many forms of substance dependence and excessive behaviours.
There are many reasons people enjoy playing online videogames. They provide players with a reliable source of competition, excitement, and social connections. However, when taken to the extreme, the gratifying sensations games create can fuel addictions. The constant availability of the internet has led to an increased risk of Internet Gaming Disorder (IGD).
IGD is a behavioral addiction characterized by poor control over internet gaming and has been linked to abnormal brain activity in the right prefrontal cortex, which, in other addictions, has been found to be related to a reduced ability to control one’s actions.
One emerging treatment for addiction is the application of transcranial direct current stimulation (tDCS) through which a low electrical current is emitted to the brain targeting outer (cortical) layers that are believed to be involved with controlling one’s own actions. The current is administered via electrodes placed over the scalp which cause an increase in cortical activation. This technique has been found to reduce cravings for food, cigarettes and cocaine when applied over the prefrontal cortex area in individuals diagnosed with addiction.
The purpose of the current study was to investigate if tDCS can lead to a significant activation of the right prefrontal cortex in order to elicit enhanced control over one’s addictive internet gaming behaviors.
To participate in the study, participants had to have spent at least 20 hours per week gaming for the past year, had to have spent half of their total amount of time on the internet gaming, and had to score 50 or above on a revised version of the Internet Addiction Test which assesses the existence and intensity of internet addiction with items such as “Do you lose sleep due to late-night logins?” and “Do you try to hide how long you’ve been online?”. Finally, participants had to meet 5 or more of the criteria for IGD proposed in the 5th edition of the Diagnostic and Statistical Manual of Mental Health. Of the 364 gamers initially recruited, after the screening process and unrelated dropouts, 33 participants went through to the experimental trials.
All remaining participants went through an experimental and a control session. The experimental session consisted of the administration of a direct current with a 30-second ramp-up period, 20-minute active stimulation, followed by a 30-second ramp-down period. The control session also included ramp-up, stimulation, and ramp-down periods to simulate the experimental session, however, there was no active current delivery in the 20-minute stimulation window.
Sessions were carried out one week apart. Before each session participants rated their background craving for internet gaming on a nine-point scale ranging from “not craving at all” to “craving very much”. Twenty minutes after the administration of tDCS or control, participants were again asked to rate their background craving using the same methods as described previously.
Participants then performed a task to assess their control over stopping gaming addictive behaviors. This task presented participants with either a neutral, gaming-related, or abstract picture. Located above and below the picture were three target letters, each surrounded by five o’s. Participants were asked to ignore the picture and judge what the target letter was. Researchers recorded the amount of time it took to decide which target letter was presented.
The results indicated that when participants received tDCS they had a reduction of background cravings compared to before tDCS. It was also found that when tDCS was administered, participants exhibited reduced response times when a gaming-related picture was shown in the inhibitory control task.
Trying to contain an addiction can be extremely difficult. To do so, people have to exhibit self-control when faced with cravings in order to maintain healthy behaviors. This research provides initial evidence of an effective treatment option for individuals with gaming addictions. Administering brain stimulation via tDCS was found to reduce videogame cravings and increase one’s control over their actions, and may therefore have the potential to reduce these addictive behaviors.