Psychosocial causes and consequences of pathological gaming (Lemmens et al., 2011)

I’ve heard from that Jeroen Lemmens (University of Amsterdam) has recently defended his doctoral dissertation and as it turns out one of his article has just been published in the 27th volume of Computers in Human Behavior. So, in celebration of his level up and subsequent class change, I review a part of his dissertation work.


Pathological use of computer and video games has been associated with indicators of psychosocial well-being, such as loneliness, low self-esteem, low social competence, and low life satisfaction. However, few studies have decisively demonstrated whether these indicators of psychosocial well-being are causes or consequences of pathological gaming. To address this gap in the literature, we conducted a two-wave panel study among 851 Dutch adolescents (543 gamers). Causal relations were analyzed using autoregressive structural equation models. These analyses indicated that social competence, self-esteem, and loneliness were significant predictors of pathological gaming six months later. Thus, lower psychosocial well-being can be considered an antecedent of pathological gaming among adolescent gamers. Our analyses further indicated that loneliness was also a consequence of pathological gaming. This suggests that displacement of real-world social interaction resulting from pathological use of video games may deteriorate existing relationships, which could explain the increase in adolescent gamers’ feelings of loneliness.

I wonder how long I’ll be in grad school…

Lemmens and colleagues spotted three problems on videogame addiction research (yes, I know they call it pathological gaming, but renaming it for a more technically precise term is just not worth it, since the general population will just mess with it). The first problem is that it is unknown whether videogame addiction is a cause for decreasing well-being or second whether well-being causes videogame addiction. These problems hark back to correlational studies that can only show links, but not causes. Third problem is that videogame addiction and well-being are not reciprocally related.

Okay what is well-being according to Lemmens and company? Specifically psychosocial well-being is defined by four interrelated concepts. First, life satisfaction refers to “a general cognitive assessment of a person’s subjective well-being or “how’s your life going?” Second, loneliness defined as “an unpleasant experience that derives from important deficiencies in a person’s network of social relationships.” So, it applies those who can’t find companionship and not those who want some alone time, like I am doing when writing this post. Third, social competence defined as “the relative tendency or disposition to be sociable or associate with one’s peer.” I am not sure if shyness is conceptually related. Finally the fourth one is self-esteem defined as “one’s self-concept, heavily dependent on reflected appraisals, social comparisons and self-attributions.” Hence, their definition of well-being is not about the physical sense, but more psychological and introspective.

Lemmens cites some studies suggesting that low psychosocial well-being may be a factor leading towards videogame addiction. Generally, individuals with low self-esteem or unhappy with relationships would use MMOs to escape reality and use it as a substitute since I gathered that it’s easier, less painful to form relationships and faster to achieve some sort of meaningful relationship. The same hold true for those can’t hold conversations well with others (i.e. social competence), it’s probably easier to interact through the screen than face-to-face. However, Lemmens and company pose the question of reciprocity whether those with low psychosocial well-being would play MMOs which can further exacerbate their well-being and spirals downwards towards addiction. Well, this is what they’re looking at.

There’s the gender matter and whether it plays a moderating role in videogame addiction. Statistically speaking, videogame culture is predominantly male. So the few girl gamers you’d find typically spent less time on videogames than boys, are less likely to show signs of videogame addiction and differ in their psychosocial well-being. For example, girls are more socially competent than boys. So, gender is entered consideration in their analyses.



Dutch adolescents were their subjects, age range 11 to 17 (M = 13.9, SD = 1.4). Near equal gender ratio (51% are boys). Their study is a two-wave longitudinal study. So at Wave 1, they started out with a sample of 1024 adolescents from four Dutch high schools. Six months later (Wave 2), they managed to get 851 adolescents. The rest couldn’t be used because of all of lot circumstances. Out of those 851, 543 were selected into their analyses because they played videogames throughout the longitudinal study. From that sample, 70% are boys. Six months sounds neat, but a longer and multi-wave study would be better (and expensive).


Pathological gaming: a seven-item scale answered on a 5-point Likert frequency scale (e.g. 1 never, 5 very often) that they previously developed. Each item measures a criterion of videogame addiction: salience, tolerance, mood modification, relapse, withdrawal, conflict and problems.

Time spent on videogames: Three sets of questions about their time on different platforms, PC, consoles and portables. First, they asked how many days per week, they spent playing. Then, how many hours they play on an average day.

Loneliness: the UCLA loneliness scale, a 20-item scale on a 5-point Likert agreement scale.

Life satisfaction: the Satisfaction With Life Scale, a 5-item scale on a 5-point Likert agreement scale.

Social competence: this one was constructed from others scales which measured social skills and interpersonal competence among adolescents. It’s a 4-item scale on a 5-point Likert difficulty scale (1 very hard, 5 very easy).

Self-esteem: the self-esteem scale, a 6-item scale on a 5-point Likert agreement scale.


Nothing peculiar.


They analyzed using structural equation modeling, something I’ll be learning in the near future and hopefully I can understand it so I can explain in plain English.

They rated videogame addiction on a continuum scale, so they did not establish a cut-off score where they would designate someone exceeding that cut-off as addicted. What they found was that a large group scored an average under 1.3 (wave 1: 25%, wave 2: 38%) which the authors reasoned they did not suffer signs of addictions whereas a very small group scored an average score of 3 or higher (wave 1: 6%, wave 2: 4%) which makes sense they’re showing signs of addiction.

Let’s see… there’s a reciprocal relationship between loneliness and videogame (VG) addiction. Loneliness at wave 1 predicted VG addiction for wave 2. So does VG addiction at wave 1 predicted for loneliness at wave 2. Life satisfaction and VG addiction have no significant relationships. Social competence at wave 1 predicted VG addiction at wave 2 only. Self-esteem at wave 1 predicted VG addiction at wave 2 only. They further tested through bootstrapping, and found that self-esteem fell out of significance.

The analysis on gender as a moderator found that on a preliminary analysis is that girls (M = 5.5 hours) played less than boys (M = 13.6 hours), lower addiction scores on average (girls M = 1.52 vs. boys M = 1.85), reported more loneliness and lower self-esteem. After the statistical jargon, the end result was that gender did not have any significant moderating effect in the relationship between psychosocial well-being and VG addiction.

What about the relationship with time spent playing videogames and psychosocial well-being? Nothing.


Shinji Ikari (Neon Genesis Evangelion) alone in his shell

Borrowing a concept from a professor whose office is right across mine, there’s a downward spiral of loneliness and videogame addiction going on. Of course, these two alone are not going to spiral by themselves; you’d have to consider low self-esteem and low social competence to have a role in this. Gender in this study has nothing to do with it (in this study at least), despite boys scoring much higher than girls, probably the cultural norm of videogames being a male-dominant activity. But, what matters is that the process is the same for both boys and girls.

This study would question the argument that the online gaming would compensate individuals’ lack of social competence and alleviate low self-esteem. The authors argue that these are temporary, it would do little to develop real-life relationships, addiction would displace it and worsen existing relationships. They argued that this is how loneliness and videogame addiction spirals. Some might argue that perhaps they are using the MMOs to create relationships online and then develop it into the offline world. Perhaps, but then you’d still have the existing problem of low social competence. Do you think they are likely to develop the confidence in stepping out of the door and meet people? Would the people in their virtual world pick up the cues that they are lonely offline? That’s kind of tough. On the other hand, I vaguely recall a study that measured virtual loneliness. It might be relevant for videogame addiction, but I can’t quite put my finger on it.

In regards to self-esteem losing its significance in the relationship with VG addiction by statistical boostrapping, the authors argued that it’s probably that their measure of self-esteem isn’t robust enough. So the question of self-esteem’s role should be treated with caution and be given more attention for future studies. Well, the self-esteem measure consisted of 6 questions.

Anyways, their advice is to take preventive measures in dealing with adolescents with low self-esteem, low social competence and high loneliness. And it should be implemented during adolescence and not after. They do warn that lower psychosocial well-being does not necessarily leads to playing online videogames; there are plenty of scary places they might go, like drugs or locking yourself in your room for years. Nor does playing videogames would decrease well-being, well someone else beg to differ about your grades. But they reiterated that online videogames are more attractive to those vulnerable adolescents.

There are some limitations to consider. First, Lemmens and others noted that the sample consisted of Dutch adolescents and asked for more research if their findings apply in different societies, Japan and Korea I’m looking at you. Future research directions they recommend is looking at family circumstances in videogame addiction and how it would progress into young adulthood. I’d like to see this replicated with college students since most are away from their parents for the first time and given the anecdotes I heard, very tempted to play MMOs. And they are convenient sample to recruit. Another study published in the same issue investigated different gaming contexts, such multiplayer FPS games, and found MMO players reported more problematic symptoms.

Lemmens, J. S., Valkenburg, P. M., & Peter, J. (2011). Psychosocial causes and consequences of pathological gaming. Computers in Human Behavior , 27 (1), 144-152. doi: 10.1016/j.chb.2010.07.015


4 thoughts on “Psychosocial causes and consequences of pathological gaming (Lemmens et al., 2011)

  1. Limitation: (Morahan-Martin, 2007; Young, 1999) – Gaming hours do not always denote addiction.

    Morahan-Martin, J. (2007). Internet use and abuse and psychological problems. In J. Joinson, K. McKenna, T. Postmes, & u-D Reips, Oxford Handbook of Internet Psychology, 331-345. Oxford UK: Oxford University Press.

    Young, K. (1999). Internet addiction: symptoms, evaluation, and treatment. In: Vande Creek, L. & Jackson, T. (Eds.), Innovations in clinical practice: a source book.

  2. Pingback: Two year longitudinal study of videogame addiction among Singaporean youths (Gentile et al., 2011) « VG Researcher

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