Two year longitudinal study of videogame addiction among Singaporean youths (Gentile et al., 2011)

News erupted when the ESA [1][2][3][4][5] sent out a warning about Douglas Gentile (Iowa State University) and colleagues’ latest Pediatrics article, now available if you google around, on their videogame addiction longitudinal study in Singapore. As of this writing, I can’t find that press release that everyone has been talking about. Statements were posted on various blogs and their criticisms were just odd, their attacks on Gentile et al.’s methodologies, such as saying “that the definition of ‘pathological gaming’ is neither scientifically nor medically accepted and the type of measure used has been criticized by other scholars.” What a strong statement in framing the video game addiction research. However, I find their criticisms lacking in substance.


Objectives: We aimed to measure the prevalence and length of the problem of pathological video gaming or Internet use, to identify risk and protective factors, to determine whether pathological gaming is a primary or secondary problem, and to identify outcomes for individuals who become or stop being pathological gamers.

Methods: A 2-year, longitudinal, panel study was performed with a general elementary and secondary school population in Singapore, including 3034 children in grades 3 (N = 743), 4 (N = 711), 7 (N = 916), and 8 (N = 664). Several hypothesized risk and protective factors for developing or overcoming pathological gaming were measured, including weekly amount of game play, impulsivity, social competence, depression, social phobia, anxiety, and school performance.

Results: The prevalence of pathological gaming was similar to that in other countries (9%). Greater amounts of gaming, lower social competence, and greater impulsivity seemed to act as risk factors for becoming pathological gamers, whereas depression, anxiety, social phobias, and lower school performance seemed to act as outcomes of pathological gaming.

Conclusion: This study adds important information to the discussion about whether video game “addiction” is similar to other addictive behaviors, demonstrating that it can last for years and is not solely a symptom of comorbid disorders.

Mercifully, the article is a short 8 page read and I’ll forgo my usual summarization since this post is a rush job. Disclaimer: I’m a graduate student who has a lot of breadth, but lacks significant depth on any particular line of videogame research. The opinions expressed do not carry any weight, but the arguments do.

Overall, I don’t see any major flaws that would vindicate the ESA’s criticisms. Let’s go in detail:

“Other outcomes are also measured using dubious instruments when well-validated tools are readily available”: All the outcome measures were referenced from studies published in peer-review journals. For example, Parent-family connectedeness questionnaire was referenced to Resnick et al., 1997 in JAMA. Impulsiveness was measured by the Barratt Impulsiveness Scale also peer-reviewed. So what do you consider dubious or well-validated tools for a Singaporean population?

If it’s about validity of the pathological video game use questionnaire (which is about “definition of ‘pathological gaming’ is neither scientifically nor medically accepted”), I could understand since the definition (both conceptually and operationally) is a work in progress. Mark Griffiths (Trent Nottingham University) voiced his criticism in a Reuters’ interview, saying that it might be measuring preoccupation instead of addiction. I have some prior and (others too) reservations about the 10-item measure, I can’t really express well these reservations, but all I could say is that the questionnaire might be missing something important, just don’t know what because an ultimate conceptual definition of videogame addiction isn’t easy to write, we’re still debating forever about what we define intelligence. Nevertheless, knowing what Gentile and company operationalize (in this case through the lens of the DSM-IV) what they measure as videogame addiction gives readers what angle the authors are looking through, thus  just because they’re looking at angle that you disagree doesn’t mean it’s invalid (until you come up with a better or best angle). How one study conceptualize videogame addiction can affect your results, for example one study operationalize videogame addiction through three questions and got lower percentages, this gives building tips in constructing a good theory.

“because the effect sizes of the outcomes are mainly trivial”. At first, it sounded like a cut-and-paste, but I’ll take a look into the table… Nope, I can’t interpret it.

“The error – which he acknowledged to ABC News in a blog posting after publication – arises from the fact that the sample group for the study was not randomly chosen. Instead, it was a ‘convenience’ sample of individuals who agreed to participate in the survey, a significant factor that greatly compromises that study’s purported findings.” ( Random sampling can never be achieved because we’re dealing with humans with something called self-interest. Ever try working as a telemarketer? How would you convince every randomly selected person to participate without resorting to exorbitant resources of a government census? No one has the answer and quite frankly all samples in social science research can be classified as convenience sampling if you would just look around in google scholar. So, we have to go with the best methods.

The statistical procedure is beyond my comprehension, but results revealed some consistencies with other studies that I read earlier. First, the percentages (around 10%) of students who are deemed addicted (those who endorse 5 out of the 10 items) were similar to other studies[1][2]. Second, lower social competence was also reported as a significant factor by Lemmens et al. (2011). Third, the play time differences (over 30 hours vs. around 20 hours weekly) were also reported by other studies[1]. Additionally, the authors argued that the amount of time is not a sufficient criterion to define videogame addiction, of which is echoed in two other studies[1][2]. Fourth, correlations between videogame addiction and aggression were also reported by Lemmens et al. (2011). In brief, looks like Gentile et al.’s study share some consistent results with other recently published studies.

To conclude, I don’t see any significant weaknesses in this study besides my inability to read effect size and their operational definition of ‘pathological video game use’, which at this point partially grasp its conceptual definition. Like a broken radio, all studies should taken with a grain of salt, it’s one study towards building a good theory of videogame addiction and criticisms should come from its peers.

update: I forgot to mention that Douglas Gentile did addressed some of the criticisms at Gamasutra and Gamespot.

Gentile, D. A., Choo, H., Liau, A., Sim, T., Li, D., Fung, D., & Khoo, A. (2011). Pathological Video Game Use Among Youths: A Two-Year Longitudinal Study. Pediatrics , (pp. 2010+). doi: 10.1542/peds.2010-1353.


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