Linköpings universitet | Institutionen för kultur och samhälle (IKOS) Examensarbete på grundläggande nivå | Socionomprogrammet Vårterminen 2020
Problematiska spelvanor, upplevt stigma
och hjälpsökande beteende hos
datorspelare
Lisa Derman
Brigitta Andrea Kato
Problematic Gaming Habits, Perceived
Stigma and Help-Seeking Behaviour Among
Gamers
Lisa Derman
Brigitta Andrea Kato
Abstract
Exaggerated gaming is a rising issue both in Sweden and internationally that has a negative effect on many lives. It can be a cause of isolation which leads to various social consequences. It can cause economic problems due to large amounts of money being spent on games or in-game purchases or because of prioritizing gaming before going to work or studying. Excessive gaming has been categorized as a disorder/addiction since mid-2018 by the World Health Organisation based on reviews done on the available evidence and consensus among experts from different disciplines. However, there are not a lot of studies regarding the kind of help that is available as well as how likely those that have gaming disorder seek help nor are there many studies about stigma around the phenomenon.
The aim of our study was to investigate if perceived stigma has any effect on whether or not and to what extent people who have problematic gaming habits decide to seek help as well as where they turn, should they have gaming disorder. We also want to see if problematic gaming habits increase the level of perceived stigma. Our hypotheses were therefore the following:
H1: the more someone’s gaming habits are close to those of someone with a gaming disorder, the higher the perceived stigma becomes around the phenomenon.
H2: the greater the perceived stigma is, the less likely a person is to seek help for their problem H3: the greater the perceived stigma, the less likely a person is to turn to professionals for help. We constructed a survey and distributed it on forums that discuss gaming related issues hoping to reach as many gamers as possible and we got a total of 177 responses.
After having done the analysis in SPSS, our result showed that there was a weak positive correlation between problematic gaming habits and perceived stigma. We also found that the level of perceived stigma did not influence whether they would seek help or not. When it came to seeking help from professionals, we found statistically significant data relating to stigma and seeking professional help in that the higher the perceived stigma was, the more likely the individual was to seek professional help.
Sammanfattning
Överdrivet dataspelande är ett socialt problem som är allt större i Sverige och internationellt och har negativa konsekvenser för mångas liv. Det kan bidra till isolering vilket kan leda till olika sociala konsekvenser. Det kan bidra till ekonomiska svårigheter på grund av att man spenderar mycket pengar på spel eller på grund av att man prioriterar dataspelandet istället för arbete eller studier. Baserad på undersökningar gjorda på befintliga studier och konsensus bland experter från olika discipliner kring fenomenet, överdriven dataspelande har blivit kategoriserad som ett
störning/missbruk av World Health Organisation i mitten av 2018. Däremot finns det få studier kring vilken sorts hjälp det finns tillgänglig, hur sannolikt det är att personer som har ett
dataspelmissbruk kommer att söka hjälpen samt hur stigmatiserad dataspelmissbruk är. Syftet med denna studie var att undersöka om upplevt stigma påverkar personers hjälpsökande samt i vilken grad och vart de skulle söka hjälp. Vi ville också undersöka om problematiska spelvanor ökar det upplevda stigmatiseringen. Vi valde därför att utgå ifrån följande hypoteser: H1: Ju mer en persons dataspelvanor liknar definitionen av dataspelmissbruk desto större blir det upplevda stigmat kring fenomenet.
H2: Ju högre är det upplevda stigmat desto mindre sannolikt att personer söker hjälp för sin problematik.
H3: Ju högre är det upplevda stigmat desto mindre sannolikt att personer söker professionellt hjälp.
Vi konstruerade en webbenkät och delade den på olika forums som fokuserar på att diskutera dataspelmissbruk eller problematisk dataspelande för att kunna nå så många som möjligt och fick sammanlagt 177 respondenter.
Efter att ha gjort dataanalysen i SPSS visade vårt resultat att det fanns ett svag positiv korrelation mellan problematiska dataspelvanor och upplevt stigma. Vi också fann att nivån av upplevt stigma inte påverkade om respondenter skulle söka hjälp eller inte. När det gäller professionellt hjälp, vi fann statistiskt signifikant data som relaterar stigma och sökandet av professionell hjälp vilket innebär att de som visade sig att uppleva stigma i högre grad var mer sannolikt att söka professionell hjälp.
Nyckelord: dataspelstörning, dataspelmissbruk, dataspelvanor, dataspelande, stigma, hjälpsökande
Preface
This is a thesis conducted by two social work students at Linköpings university in Sweden. The subjects of this thesis stems from an interest and curiosity about the culture of gaming that has come along with the technological revolution. As the world moves further into the digital age more people are affected by gaming in various ways. This is still a comparatively new issue and we believe that there will be a greater need for knowledge about the subject and the problems that are associated with it in the future.
There has been a lot of work constructing this thesis and we would like to thank our mentor professor Dimitris Michailakis for his help and guidance through this process. Furthermore, we would like to thank our lecturer Susanne Kelfve for guiding us in the process of analysing quantitative data. Lastly this research would not have been possible without the communities of gamers who let us use their platforms to spread our survey and collect respondents, thank you.
Linköping May 2020
Index
Abstract 5 Sammanfattning 6 Preface 7 Index 8 1. Introduction 10 1.1 Background 10 1.2 Aim 11 1.3 Research Questions 11 1.4 Hypothesis 11 2. Previous Research 122.1 Definition of Gaming Disorder 12
2.2 Consequences of Gaming Disorder 13
2.3 Stigma Around Gaming Disorder 14
2.4 Help for Gaming Disorder 16
2.5 Summary of previous research 17
3. Theoretical Framework 19
3.1 Stigma 19
3.2 Help-Seeking Behaviour 19
4. Method 21
4.1 Choosing our method 21
4.2 Selection 21
4.2.1 Population 21
4.2.2 Sampling 21
4.2.3 Criteria 22
4.3 Survey Construction 22
4.3.1 Gaming habits – Operationalizing and creating the variable 22 4.3.2 Perceived Stigma – operationalizing and creating the variable 23 4.3.3 Help-seeking behaviour – operationalizing and creating the variable 23
4.3.4 Pilot Test 24
4.3.5 Data Collection 24
4.4 Analysis 25
4.4.1 Correlation between gaming and perceived stigmatization 25 4.4.2 Correlation between help seeking-behaviour and perceived stigmatization 26
4.4.3 Does stigma affect whether a person would seek professional help? 26 4.5 Ethical Deliberation 26 5. Result 28 5.1 Response Rate 28 5.2 Descriptive Analysis 28 5.2.1 Stigma 28 5.2.2 Gaming Habits 29
5.2.3 Time spent gaming 29
5.2.4 Help-Seeking Behaviour 30
5.3 Correlation Between Problematic Gaming Habits and Stigma 31
5.4 Correlation Between Help-Seeking Behaviour and Stigma 32
5.4.1 Would Seek Help 32
5.4.2 Did Seek Help 33
5.4.3 Tendency to Seek Professional Help 33
5.5 Summary 34
6. Discussion 35
6.0.1 Do gaming habits associated with gaming disorder correlate with perceived
stigmatization? 35
6.0.2 Does help seeking-behaviour differ with level of perceived stigmatization? 35 6.0.3 Does stigma affect whether or not a person would seek professional help? 35
6.1 Results in Relation to Background, Previous Research, and Theory 35
6.2 Further Research 37
7. Critical Reflections 39
7.1 Validity and Reliability 39
7.2 Critical Reflection Regarding Selection 40
7.3 Critical Reflection Regarding Survey Construction 40
7.4 Critical Reflections regarding analysis 41
7.5 Potential Improvements 41
References 43
Official Publications 43
1. Introduction
1.1 Background
Exaggerated gaming is a rising issue both in Sweden and internationally that has a negative effect on many lives. It can be a cause of isolation which leads to various social consequences. It can cause economic problems due to large amounts of money being spent on games or in-game purchases or because of prioritizing gaming before going to work or studying. Furthermore, gaming addiction or disorder can cause physical problems such as health complications or sleeping disorders due to unhealthy living habits. Though playing games in itself is not harmful and some people use it as their main form of income, it becomes an issue when it takes over one's life and a person starts to prioritize gaming over maintaining social relations, hygiene, healthy eating- and sleeping habits and has an overall negative effect on their lives as a whole (Mihara & Higuchi 2017).
In Sweden there is no legal obligation for the municipality or the department of social work to prevent gaming disorder beyond that is written about preventing gambling in 3 chapter 7 § the Law of Social Services (Socialtjänstlagen 2001:453). At the same time gaming disorder is now a diagnosis according to the World Health Organization (2018) which indicates that this is an issue to be taken seriously. The support for this kind of addiction seems to be sparse and the help that is offered is not adapted for this type of addiction. The Swedish national guidelines for counsel and support regarding addiction focuses primarily on alcohol and drug addictions while video game addiction is not been mentioned at all (Socialstyrelsen 2019). This leads us to conclude that the document does not include any specific guidelines in providing adequate support and aid to people with gaming disorder. In other words, we argue that Swedish social services aren’t
properly equipped to deal with this specific phenomenon. This argument is also supported by the lack of studies based around gaming disorder and the support available in a Swedish context. This study attempts to show if perceived stigma and tendency to seek help covariate and it contributes to social work because firstly, in Sweden, it is the social sector that deals with social issues related to addiction in general as it is stated in the 3 chapter 7 § of the Law on Social Services (Socialtjänstlagen 2001:453). Secondly, the study aims to illustrate to what degree individuals with problematic gaming habits seek help, hopefully providing some insight about how many people would need help but never seek it. In this case it should inspire social services and perhaps even the government to think about possible solutions to reach out to these
individuals and provide them with adequate help.
In addition, The Law of Social Services 1. chapter 1§ states that social services must support individuals economic and social security, equal living standards and active participation in society. This paragraph includes social services’ duty to work pre-emptively to prevent social issues (Lundgren, Sunesson & Thunved 2018, pp. 21). Addiction is a social issue, hence The Law of Social Services chapter. 7§ specifically states that social services must strive to prevent it. As
shown later in this thesis gaming disorder has significant health and social consequences and thus should be included by the law, or at the very least the guidelines of dealing with addictions. Gaming disorder is a recognized social problem in Sweden and internationally. A constantly growing group is developing gambling addiction and are suffering from its negative
consequences on both health and social life. Therefore, the practice of social work must develop methods of providing help and support. To be effective in this endeavour, the phenomenon must be studied further, which our research contributes to. We hope that through our study we can shed more light to the significance of addressing the issue regarding gaming disorder as well as be used as an inspiration to do further research within the subject that will hopefully serve to better equip our system to deal with this kind of problem in the future.
1.2 Aim
The aim of the study is to investigate if perceived stigma has any effect on whether or not, and if so to what extent, people who have problematic gaming habits decide to seek help as well as where they would prefer to seek help, should they have gaming disorder. We also want to see if problematic gaming habits increase with the level of perceived stigma.
1.3 Research Questions
● Do gaming habits associated with gaming disorder correlate with perceived stigmatization?
● Does help seeking-behaviour differ with level of perceived stigmatization? ● Does stigma affect whether or not a person would seek professional help?
1.4 Hypothesis
H1: the more someone’s gaming habits are close to those of someone with a gaming disorder, the higher the perceived stigma becomes around the phenomenon.
H2: the greater the perceived stigma is, the less likely a person is to seek help for their problem H3: the greater the perceived stigma, the less likely a person is to turn to professionals for help.
2. Previous Research
2.1 Definition of Gaming Disorder
In order to be able to understand and operationalize the term “gaming addiction” or “gaming disorder” we must first take a look at existing studies related to the phenomenon in order to have a basic understanding of it and define it correctly. Today more and more elements are shown to be able to cause addiction without necessarily having to be a substance that is ingested. Such elements of addiction can sex, gambling, exercise, videogames and internet (Griffiths 2005). There is growing evidence which indicates that excessive behaviours of all types seem to have many commonalities, and that addictions seem to have a number of distinct components, such as salience, mood modification, tolerance, withdrawal, conflict and relapse (ibid.). When it comes to gaming addiction, several studies have been conducted using neuroimaging techniques in order to see neuro correlations between internet and gaming addiction and results have shown that internet gaming addiction is associated with functional and structural changes in the brain. In other words, this addiction increases brain activity in regions commonly associated with substance-related addictions. In addition to that the brain itself seemed to change as a result of excessive internet use and gaming (Kuss & Griffiths 2012).
Excessive gaming has been categorized as a disorder/addiction since mid-2018 by the World Health Organisation based on reviews done on the available evidence and consensus among experts from different disciplines. As described by the World Health Organization, according the 11th Revision of the International Classification of Diseases video/digital gaming disorder is characterized by the lack of control over gaming where the afflicted prioritizes gaming over other interests and activities as well as a continuation or escalation of gaming despite the occurrence of negative consequences (World Health Organization 2018). For gaming to be diagnosed as a disorder it is required that it is evident for at least 12 months and results in significant impairment in personal, social, family, occupational, educational or other important areas of functioning (ibid.).
Regarding the cultural aspects of gaming and how gaming disorder is viewed it might be worth looking at how gamers1 view video game addiction. There seems to be a consistent consensus shown in several studies that some symptoms related to problematic gaming can be associated with a set of core criteria. Generally gamers seem to agree with some of these gaming disorder criteria proposed in the DSM-5 (Diagnostic and Statistical Manual of Mental Disorder), namely that when games interfere with everyday life to such an extent that people prioritize it over other aspects which leads to neglecting needs and responsibilities as well as loss of interest in other activities are a sign of gaming disorder. In addition, continuing to play games, due to being unable to stop, even after recognizing that it is a problem is also a sign of addiction (Carras et al. 2018).
As named earlier withdrawal is a common component related to addictive behaviour (Griffith 2005) and gaming disorder is no exception. To be diagnosed with gaming disorder one needs to exhibit withdrawal symptoms, however, there seems to be inconsistencies as to how these symptoms manifest themselves (Carras et al. 2018). Two main symptoms that appear in relation to withdrawal are anger/irritability and stress when not gaming or when having to stop gaming (ibid.). Gamers themselves seem to associate stress reactions as the main symptom of withdrawal while anger and irritability do not seem to be associated with withdrawal (Carras et al. 2018). When it comes to interpersonal relations, gaming disorder is associated with problems with peers, with bullying or being bullied and having friends who are addicted to video games (Mihara & Higuchi 2017). Gamers seemed to show a high level of consensus regarding the criteria of
avoiding socializing, cancelling in person plans, isolation, social phobia, social anxiety (Carras et al. 2018) which we think shows that despite having online interactions and relations interpersonal relations are damaged as a result of gaming disorder.
A systematic review of longitudinal studies that shows both the causes and effects of gaming disorder states that many studies have shown that adolescent males are at a higher risk when it comes to IGN (Mihara & Higuchi 2017). They also suggest that more time spent playing games was an additional risk factor as it predicted a higher tendency of pathological gaming (ibid.). Some studies also indicate that people with gaming disorder had a genre preference when it came to videogames, namely that they preferred massive-multiplayer online role-playing games, first person shooters, fighting games and real time strategy games (Mihara & Higuchi 2017). A study that examined the online gaming practices of preteens between the ages 7 and 11 in the United States has concluded that preteens are not spending extensive time playing video games or are they playing with friends or strangers because of the domestic environment these children are a part of, meaning that they tend to occupy specific positions in the household undergoing regulations and surveillance (Willett 2016). Therefore, we can conclude that preteens who are supervised and regulated by their parents tend to have a lower risk of developing a gaming disorder. However, more research is needed regarding children’s gaming practices to be able to generalize (ibid.).
2.2 Consequences of Gaming Disorder
Plenty of previous research has explored the connection between gaming addiction and a person’s mental and physical health. Results from many studies show a significant correlation to several variables. A quantitative study that conducted surveys on adolescents in Hong-Kong, China found that there is a correlation between internet addiction and psychological wellbeing (Cheung, Chan, Lui, Tsui, & Chan 2018). The results indicate that internet addiction has a negative
correlation with self-esteem where loneliness and depression are positively correlated with internet addiction. This means that loneliness and depression increase with internet addiction, where self-esteem decreases. It also shows that depression has a stronger correlation than the other factors. However, this is a cross-sectional study that cannot establish causality i.e. if internet addiction is the cause of loneliness and depression or if it is the other way around (Cheung et al. 2018). A study conducted on college-aged males in America examined the relationship between videogames and psychosocial functioning (Wack & Tanleff-Dunn 2009).
This study showed a positive correlation between frequency of play and self-reported frequency of playing when feeling lonely, stressed and/or bored. It indicates that gaming can be a coping mechanism to deal with negative emotions and that gaming may provide healthy socialization and relaxation (ibid.). Participants in a South Korean study also reported that internet games helped to reduce stress and boredom (Seok, Lee, Park & Park 2018). This South Korean study explored people's motivations for gaming as well as their own perceptions about the concept and was conducted on 10 adolescents with serious symptoms of gaming addiction (Seok et al. 2018). Through interviews, focus groups and photovoice they expressed how they perceive video games, their emotions about video games, how it has affected their lives, what they have gained and lost from it as well as how they themselves made sense of gaming addiction. The study concluded that gaming had a negative effect on psychosocial health in that it had a correlation with feeling a disconnection in peer-relationships. Results showed that the participants were aware that
excessive gaming had a negative effect on their relationships, daily life, and academic
performance. However, the participants also perceived games as peer bonding, stress relief and entertainment (ibid.).
Furthermore, a qualitative study conducted on vocational school students in Finland examined the connection between problematic gaming and health through an online survey. The results showed significant and positive correlation between problematic gaming scores and the variables having no friends, daily game use, monthly drug use, self-perceived underweight and male gender (Männikkö, Ruotsalainen, Tolvanen & Kääriäinen 2019). Cheung et al. (2018) also states that male gender is more likely to be correlated to heavy game use. When it comes to body mass, the results vary. Wack & Tanleff-Dunn (2009) showed in their study that there was no significant correlation between body mass index and frequency of play. However, Ko, Lin, Lin, & Yen (2019) states in their study of young adults in Taiwan that having gaming disorder correlates with obesity, further showing that gaming disorder can negatively impact physical health. While Männikkö et al. (2019) present a correlation between problematic gaming and having no friends, Eklund and Roman (2019) found in their study that high use did not lead to social isolation, but also rarely led to new friendships. They argued that it was rather a person's ability to manage time rather than the amount of time spent gaming that affected well-being.
2.3 Stigma Around Gaming Disorder
During the 1980’s and 1990’s teenagers who played video games were stapled as “nerds”, were marginalized, and often had the characteristics of intelligent white boys with an interest in programming and computers. Nowadays this negative stereotype has more or less disappeared as computers, internet and gaming became a part of everyday life (Aarsand 2012). To understand a bit about how gaming became part of the everyday life and how the group formerly known as nerds are no longer marginalised, we looked at a mixed method study conducted on n=115+10 Swedish young people between the ages of 17 and 19 looked at young people’s abilities to maintain friendships as well as their time managing skills (Eklund & Roman 2019). The study pinpoints that gaming in itself did not cause social isolation while it still argued that video gaming rarely leads to friendships. However, they still pointed out that gaming mattered for social life in school as it was part of the social and cultural discussions and other out-of-class
activities (Eklund & Roman 2019). Furthermore, most of the young people in this study did not show any issues when it came to managing their gaming time and other activities. Playing games, even among those that spent a lot of time playing video games, was referred to as a waste of time for the most part and most teenagers that moved closer to adulthood seemed to express a desire to distance themselves from gaming and the social stigma associated with it (ibid.). To us this is very interesting because gaming is portrayed as a cultural and social element of everyday social life that didn’t hinder or help with making friends, and yet they still found the need to distance themselves from gaming due to the “social stigma associated with it” (Eklund & Roman 2019). Taking a look at a study that used discourse analysis to investigate stereotypes, norms and
attitudes towards gaming, we see that when it comes to gamer stereotypes there are two kinds that are distinctive: the hardcore player and the casual player. Generally the hardcore player is
generally associated with obesity, aggression, sexualisation and addiction and are known to spend a lot of time and money on many different video games, especially games that are difficult, first-person shooters and massive multiplayer online role playing games (MMORPG). In other words, the hardcore player tends to be seen as a problematic group within the media. The second group, the casual players, are often seen as non-problematic as they do not spend excessive time and money on games, dislikes difficult and long-duration games and is neutral when it comes to playing games (Aarsand 2012).
When it comes to teenagers in particular they seem to like to present themselves as “ordinary'' teenage players, thus attempting to create a third stereotype within which being a “knowledgeable player” seems to be desired (Aarsand 2012). These teenagers seemed to possess cultural
knowledge regarding what gaming habits are considered to be acceptable and what are
considered to be problematic. As such, when talking about their gaming habits, tension seemed to arise in their speech patterns when teenagers talked about time spent playing games, what kind of games they were playing and the desire to be seen as a knowledgeable player as opposed to the hardcore player, seeing as the two concepts were very close to each other (ibid.).
In regards to the types of games being played, MMORPG’s were seen as problematic not only because they were associated with the hardcore player but also because these types of games have been a target of criticism in the media due to being a source of computer game addiction. This is interesting to keep in mind as teenagers seemed eager to present themselves as ordinary players through distancing themselves from MMORPG’s. Several of them pointed out that they used to play such games but no longer do it and they are also trying to indicate clearly that they stopped playing the “problematic” games on their own initiative, giving the impression that they were very much in control of their gaming habits. While the concept of playing games for fun in a mature manner while also being in control of how much one plays are a way for ordinary teenage players to distance themselves from the hardcore player, the study pinpoints that the way these teenagers talk about their control over their gaming is similar to how drug users talk about control over drug use (Aarsand 2012).
What we observed and concluded after having read these studies is that while video games have become more accepted within the sociocultural sphere, there is still some stigma around gaming
not only in society in general, but also within the gaming community itself, for instance the stigma around hardcore players as described above. Young people seem to be aware of what consists as socially (un)acceptable and are actively trying to distance themselves from these concepts.
2.4 Help for Gaming Disorder
Seeing as internet gaming disorder has gained a lot of attention and is now classified as a
behavioural addiction, one must wonder what kind of aid and help there is available to help deal with the phenomenon. Many governments seem to have taken steps by establishing treatment facilities to deal with the issue, specifically in China and South Korea (Zastrow 2017). There are not a lot of studies regarding the kind of help that is available in a European setting. In Russia an experimental attempt to establish contact and perform social work with teenagers in a gaming setting was made and the results showed that this approach was very impractical not only because getting in touch with teenagers was hard but maintaining the contact and relationship was
extremely time-consuming (Khlomov et al. 2018).
Some studies have suggested that due to the home environment and parental supervision kids were less likely to develop problematic gaming habits (Eklund & Roman 2019) which should lead to the conclusion that in order to prevent and or help with this specific addiction parents and loved ones were an important component, one study from South Korea went as far as to suggest that intervention involving family and friends is “crucial” (Seok et al. 2018). Part of that is because it was important for the adolescents addicted to internet gaming to form healthy online relationships as well as to build a social network even outside of an online setting (ibid.). Another study suggests that parents’ roles in preventing children from playing too much game by stopping them did not change how often a child played games and that parent-child closeness was more effective on boys than girls (Choo, Sim, Liau, Gentile, Khoo 2015). This leads us to conclude that some of the interventions that have been shown to somewhat work cannot be applied to everyone, namely that prevention methods would be less effective on a female demographic which in turn means that the system is not well equipped to help everyone that has a gaming addiction (Choo, et al. 2015).
For those addicted to gaming in South Korea there are a variety of different interventions available to help with gaming addiction such as educational, counselling, and treatment programs, however these are described as problematic due to the fact that they don’t focus on preventing gaming disorder (Seok et al. 2018). As such we think that it is important to emphasize that further research is needed on the effectiveness of preventive and helping interventions in relation to gender, ethnic and cultural differences. What we see currently is that there is little research regarding what kind of intervention is most effective for different groups of people and that governments should focus more on providing effective care for people with gaming
2.5 Summary of previous research
After having gone through previous research based on the different aspects of gaming disorder, we can see that gaming disorder is an issue that has been proven to show similar symptoms to other addictions such as sex, gambling and exercise (Griffiths 2005) and this has also been shown through neuroimaging that has shown neuro correlations between internet gaming disorder and functional as well as structural changes in the brain, showing increased brain activity in regions commonly associated with substance-related addictions (Kuss & Griffiths 2012). Symptoms of withdrawal were also noticeable in the form of anger/irritability and stress when not gaming or when having to stop gaming (Carras et al. 2018).
The main characteristics associated with gaming disorder, as described by the World Health Organisation (2018), are the lack of control over gaming where the afflicted prioritizes gaming over other interests and activities as well as a continuation or escalation of gaming despite the occurrence of negative consequences. For gaming to be diagnosed as a disorder it is required that it is evident for at least 12 months and results in significant impairment in personal, social, family, occupational, educational or other important areas of functioning (World Health Organisation 2018).
Gaming is not as stigmatized as much nowadays as it used to be in the 1980’s and 1990’s due to computers, internet and gaming becoming more available to people and as such, become a part of everyday life (Aarsand 2012). In some cases, gaming has been shown to be one of the main ways for students to socialize outside of class activities (Eklund & Roman 2019). However, despite the increase in acceptance, some gaming habits are still considered problematic or unacceptable among young people (ibid.). Such habits are aggression, sexualisation and excessive gaming. These habits tend to be associated with the so-called hardcore gamer (Aarsand 2012). This stereotype is usually the one teenagers and young people try to distance themselves from the most. Young people also had the tendency to distance themselves from certain gaming genres such as first-person shooters and massive-multiplayer online roleplaying games as these genres were also associated with the hardcore gamer stereotype (ibid.). What was interesting for us was that although gaming was portrayed as a part of the social and cultural elements of everyday life, it was still associated with immaturity, meaning that most young people had a tendency to distance themselves from video games as they moved closer to adulthood (Eklund & Roman 2019). What this shows us is that while gaming in itself is not necessarily a subject of stigmatization, certain gaming habits are.
When we look at help available for gaming disorder, we see that although several governments seem to have taken steps by establishing treatment facilities to deal with the issue (Zastrow 2017) we see that most of the help provided is reactive rather than pre-emptive. Seok et al. (2018) implies that pre-emptive intervention was preferred when wanting to deal with gaming disorder. Some studies have attempted to look at ways to prevent problematic gaming habits and what they found was that family, loved ones and friends were crucial if an early intervention was to be considered (Eklund & Roman 2019) (Seok et al. 2018). However, it was shown that in order for parental prevention to work there needed to be a certain degree of closeness between parents and
their children, which showed to be less effective in girls than in boys (Choo et al. 2015). In conclusion what we see is that although there is a variety of help in some Asian countries in the form of education, counselling, and treatment programs (Seok et al. 2018), there is still need for further research on the effectiveness of preventive and helping interventions in relation to gender, ethnic and cultural differences. In other words, we still don’t know how some countries deal with the issue, the availability of help, as well as what would work best to help prevent and/or treat gaming disorder.
3. Theoretical Framework
3.1 Stigma
Stigma can be described as “when a person possesses or is believed to possess some attribute or characteristic that conveys a social identity that is devalued in a particular context” (Baumberg 2016).Humans tend to categorize and that is true in a social and cultural setting as well. Social and cultural categorisations are made through social norms, behaviour and speech patterns that are considered acceptable, normal, and natural. The person that ends up being stigmatized are given characteristics or are viewed as less than human and are often subjected to discrimination (Goffman 2014,p. 9).
There are different ways to look at and measure stigma. Stigma can be divided into “personal stigma” and “stigmatization”. Personal stigma is a person’s own feelings of being less worthy because of their different characteristics, while stigmatization is when a person thinks that others will devalue them because of it (Baumberg 2016). When Curcio and Corboy (2019) conducted a systematic review of literature on stigma and anxiety disorder, three types of stigma were
identified: public stigma, personal stigma and self-stigma. Public stigma is when members of a community have stigmatizing attitudes towards an individual's attributes. Personal stigma references an individual's own attitudes and beliefs about stigmatized individuals in the group, while self-stigma involves internalizing stigmatizing attitudes and labelling oneself (Curcio & Corboy 2019). This thesis will include all forms of stigma since we feel these are all important parts of the concept. However, the study will not focus on asking general and hypothetical questions that convey a perception about the phenomenon “stigma” in the cultural context. To operationalize stigma, we use Goffman's (2014) theory of social stigma as well as previous research that measure the concept. We used a study that developed a standardized instrument on measuring stigma of mental illness (King et al. 2007) as well as a quantitative study on the stigma of claiming benefits (Baumberg 2016). Previous research and theory indicate that important variables of stigma are shame/embarrassment, thinking less of oneself or others, avoiding people with the “different” characteristics as well as wanting the characteristic to remain a secret (King et al. 2007). Goffman (2014, p. 82) states that a person at risk to be stigmatized can choose to hide their flaws or differences (if they are not obvious) and try to pass as an “ordinary” person in order to avoid attracting attention. This can be problematic for those who need help but chose not to seek it due to the fear of being stigmatized.
3.2 Help-Seeking Behaviour
The action of seeking help is a complex decision-making process, which normally begins with recognizing a problem that challenges one’s personal abilities and then taking intentional action to try and solve it with the help of others (Sato, Drennan & Lings 2017). Seeing as the process of help-seeking is complex and the literature on it is considered to be lacking conceptual clarity, defined scope and valid consistent measures (ibid.) we decided to exclude the process itself and focus only on whether or not participants want to seek help or not. Therefore, to define the term
help-seeking behaviour itself, rather than the process, we take inspiration from an international review of literature published by the World Health Organization where help-seeking behaviour in adolescents is defined as “any action or activity carried out by an adolescent who perceives herself/himself as needing personal, psychological, affective assistance or health or social services, with the purpose of meeting this need in a positive way” (World Health Organization 2007). Help-seeking behaviour can be categorized as formal and informal, where formal counts as help from professional sources while informal is help received from friends, family and/or other kinship groups and communities (ibid.).
In our study, the primary form of sought help we want to focus on, and map is social support. Social support, as defined by WHO, is a range of interpersonal relationships or connections which often have an impact on the individual’s functioning and are the kind of support that is generally provided by individuals, such as friends, family and community, and by social institutions which includes instrumental, informational, affiliative and/or emotional support (World Health Organization 2007). Extra attention will be given to the formal forms of support, meaning we will examine the help sought from professionals in more detail.
4. Method
4.1 Choosing our method
In the thesis we will collect numerical data which we will transform into statistics. This is a quantitative method of conducting research. We choose to conduct a quantitative study since our research aims to quantify attitudes about perceived stigma and behaviours regarding problematic gaming habits and then seek for correlation between them. The quantitative method is best for uncovering patterns or finding an explanation to what is affecting a larger group of people. Quantitative research can also say something about the frequency or magnitude of a phenomenon within a population. Quantitative research also typically uses more structured methods of
collecting data, compared to qualitative research (Eliasson 2018, p. 29-32).
4.2 Selection
Since our research questions ask for personal experiences and perception, the population consists of people who have encountered the phenomenon; namely people who play videogames, also known as gamers. We tried to exclude functional gamers2 and instead tried to reach a group of people who may exhibit problematic gaming habits or encountered people who have or have had problematic gaming habits.
4.2.1 Population
To say something specifically about gaming addicts we would have to be certain that all
respondents have a gaming disorder. We did not see that as a liable option since we had no way to confirm the respondents’ identity and as such prove that all the participants did have a gaming disorder. Therefore, we chose to focus our study on problematic gaming habits rather than only focusing on people who have been diagnosed with a gaming disorder. By doing so, we broadened our selection to all gamers who frequent forums discussing problematic gaming habits. The reason we specify the theme of the forum discussions is in order to still try and control our population as much as possible and get reliable results, seeing as our population is so wide and varied.
4.2.2 Sampling
A probability sampling is a selection method where the sampling is randomly picked from a known number of individuals within a population. This is a good selection method for quantitative research since it allows you to calculate the probability of any given individual within the population being selected to be part of the study. This can allow you to generalise your results outside of your sampling (Djurfeldt, Larsson & Stjärnhagen 2010, p. 101-103, Eliasson 2018, p. 44-53). However, making a probability selection would require having access to and knowledge about the entire population, which we do not have since there is no public list or documents of all people who have come in contact with gaming disorder. Furthermore, some of 2 “Functional gamers” - in this study we use the term to describe gamers who spend the majority of their time playing games, are successful at using gaming as a source of income and socialize primarily through games, thus gaming is a positive aspect in their lives rather than something that hinders them.
the forums we intend to put our survey up on do not need people to register in order to access threads, meaning that while the forum displays the number of registered members, it does not display the number of visitors. Therefore, we cannot make a probability sample and must make a non-probability selection. We will post a link to our survey on online forums where people who want to respond to the survey can do so, making our selection a voluntary selection (Eliasson 2018, p. 49-50).
4.2.3 Criteria
We tried to reach as many forums as possible to get as many responses to our survey as we could in the short amount of time that we had for data collection. One of the criteria we had for these forums was that the primary language needed to be English to avoid having to lose any meaning in translation. The second criterion was that we needed to get permission from the administrators to post our survey. The latter was mainly set for ethical reasons. The forums also had to primarily focus on discussing problematic gaming habits and/or gaming addiction. Furthermore, we also chose to exclude participants under the age of 18 due to the ethical guidelines of our university.
4.3 Survey Construction
Since our aim is to collect empirical data from a larger group of people, we think a survey is the best option for this purpose. A survey was created on Google Forms with separate sections for each concept: gaming habits, stigma, and help-seeking behaviour. We took inspiration from surveys created in earlier research and constructed our own set of questions that we felt would help us answer our research questions.
To be able to measure the research questions “Do gaming habits associated with gaming disorder correlate with perceived stigmatization?”, “Does help seeking-behaviour differ with level of perceived stigmatization?” and “Does stigma affect whether or not a person would seek
professional help?”, we needed to break down and operationalize the concept of gaming habits, stigma, and help-seeking behaviour and then create variables out of them.
4.3.1 Gaming habits – Operationalizing and creating the variable
We used previous research and theory about gaming disorder to study what kind of
characteristics or symptoms gaming disorder is associated with and based on that we created ten questions about problematic gaming habits that can be associated with gaming disorder. Our first course of action was to select specific descriptions or characteristics related to gaming addiction and write them into questions.
As mentioned in the previous research section of our study, the World Health Organization (2018) describes gaming disorder as being characterized by lack of control over gaming where the afflicted prioritizes gaming over other interests and activities as well as a continuation or escalation of gaming despite the occurrence of negative consequences. Further studies break this down a bit more and specify that the negative consequences consist of gaming interfering with everyday life in a way that the afflicted prioritizes gaming also contributes to the negligence of one's needs, such as sleep (Carras et al. 2018).
Based on this information we chose to focus on the following aspects of problematic gaming: excessive time spent gaming, prioritizing gaming over non-gaming related hobbies or social activities, preoccupation with gaming even in situations that are not related to gaming, how gaming affects sleeping habits, using gaming as a coping mechanism to various negative emotions, withdrawal related symptoms when not gaming, the need to enhance the gaming
experience through expensive equipment in order to be able to get the same amount of excitement they used to and inability to quit gaming. After having picked out these specific characteristics we formulated questions touching on each of them (see Appendix 1).
We created the gaming habit variable through nine questions which were formulated based on the aspects of problematic gaming habits. These questions were measured in a nominal scale with the answer options yes or no. Each question answered affirmatively gave one point and at the end we added up all the points creating a total gaming habit score which got converted into a discrete ratio scale variable because it has an absolute zero point and it has no decimals.
4.3.2 Perceived Stigma – operationalizing and creating the variable
When operationalizing perceived stigma, we looked to previous research once more to understand the different layers of stigma and decided to look at personal stigma, self-stigma, and public stigma (Curcio & Corboy 2019). To touch on each of these forms of stigma we constructed questions asking about participants' view on gaming disorder in general, their view of themselves should they have gaming disorder and their views on others who have gaming disorder while focusing on their perception of stigma as opposed to their personal experience.
Regarding self-stigmatization, the respondents were asked if they would like it to remain a secret or if they would feel ashamed or embarrassed if they had gaming disorder. We also asked participants about their view on others that may be stigmatized in order to touch on personal stigma. Lastly, we asked how they think others around them would react towards them should they have a gaming disorder with the intention to map perceptions to public stigma.
The stigma variable consisted of a total of seven questions and the respondents were asked to rate the extent to which they agree with each statement, with the ordinal scale answers ranging from strongly disagree, disagree, neutral, agree and strongly agree. Each question gave a score from 1 to 5 with strongly disagree being considered as 1 and strongly agree as 5. Then we calculated the mean stigma score of each participant, converting the variable into a continuous ratio scale variable because this variable also has an absolute zero point with the difference being that this variable has decimals.
4.3.3 Help-seeking behaviour – operationalizing and creating the variable
To try and operationalize help-seeking behaviour we formulated three questions about seeking help. Firstly we asked if participants would seek help or advice if they had gaming disorder, then we asked if they have sought help for gaming disorder in the past, and lastly, we asked where
people would turn to for help. This way we can see clearly if people have experience with getting help, if they would turn to help in the future and who they trust most to get the help they need. On the question regarding who they would seek help from, participants could pick multiple answers. However, extra focus will be put on analysing professional help seeking because that is the most relevant variable within help seeking behaviour, seeing as this is a thesis is within social work and our task in the future will be to help individuals in a professional setting.
Help-seeking behaviour was divided into three separate variables, the first being the nominal variable called “did seek help” where the response alternatives were yes and no. The second variable under the category help-seeking behaviour was the nominal variable called “would seek help” which in addition to the yes and no response alternatives also had “I don’t know” as a third option. And lastly, because the question regarding where participants would turn to help had multiple response alternatives (friends, family members, someone on the internet, professionals, other or no one), each response was converted into a nominal variable in itself where each ticked alternative indicated a “yes” response whereas each unticked alternative indicated a “no”
response. 4.3.4 Pilot Test
Once the first version of the survey was complete, we conducted a pilot test to test the survey. We sent it to friends and family as well as chat groups on a chat platform called Discord where we asked for feedback. A total of 20 people answered and about 15 of them gave us feedback on the survey. Based on the feedback we added an additional question asking about weekly time spent gaming, changed the order of some of the questions as well as rephrased some of them for more clarity. Once the final version of our survey was complete, we published it on the forums and started collecting data.
4.3.5 Data Collection
A total of 12 forums were selected and requests were sent to the administrator or moderator of each forum. A total of 5 forums replied and gave us permission to post a link to the survey. From the forums that were selected, three of them were dedicated to discussing gaming addiction in particular. These forums were StopGaming on the website reddit
(https://www.reddit.com/r/StopGaming/), the website gamequitter’s forum (https://forum.gamequitters.com/) and on-line gamers anonymous forum
(https://www.olganon.org/forum). Furthermore, it was posted on two forums that are dedicated to discussing gaming in general. Many of the forums about gaming in general have rules against posing surveys but we got permission from Eurogamers forum
(https://community.eurogamer.net/) and the reddit forum AskGames (https://www.reddit.com/r/AskGames/).
The reddit forum StopGaming was the biggest most active forum about problematic gaming habits, and since many new posts were made every day our post with the survey got pushed further down in the feed. This led to fewer people seeing it and soon no new respondents came in.
To counteract this a new post was made a few times to get as many people as possible to see it. Furthermore, when noticing not many people were answering we discussed alternative places to post the survey and found a discord chat called “stopgaming”. Discord is a platform designed for video gaming communities that specializes in sharing text, images, video and audio between users and is similar to a forum in that way. The link to our survey was posted in the “stopgaming” chat on three occasions. When posting the survey multiple times on the same forum or chat we had to be careful not to come across as spamming3 since that may cause disturbance and annoy people in the community. The survey was available for 25 days.
4.4 Analysis
Our research questions produced non-numeric qualitative variables that are nominal and ordinal scaled. Our yes/no questions on gaming habits are dichotomous nominal and the questions on perceived stigma with answers strongly agree, agree, neutral, disagree and strongly agree are ordinal. To be able to analyse correlation between stigma and gaming habits, we will convert these variables into quantitative ratio scale variables. A ratio scale variable is quantitative, that is to say it is measured on a numeric scale.
For the stigma variable we will make it into a ratio scale variable by giving every answer
alternative a number: strongly disagree=1, disagree=2, neutral=3, agree=4, strongly agree=5. To obtain the mean, the value of each respondents’ answer is summed up and divided by the number of questions. The stigma variable will be continuous which means it can assume decimal values. To obtain a mean for gaming habits we assigned the answer yes=1 and no=0, then gave every individual a “point” for every yes answer they had in the section, giving everyone a number between 0-9 since we had 9 questions about gaming habits. This variable cannot adopt decimal values.
Furthermore, before analysing the results we need to set a significance level. A common level is 0.05, which means that if we get a p value of 0.05, we can say with 95% certainty that our results are not explained by chance but actually reflect reality. For this thesis we set the significance level to 0.05.
4.4.1 Correlation between gaming and perceived stigmatization
Our hypothesis was that the higher the score on problematic gaming habits, the higher the score on stigma i.e. there is a positive correlation between the two variables. The null- and counter null hypothesis is H0: r=0, H1: r≠0. To find out if there is any correlation between gaming habits and stigma, as well as the strength and direction of the correlation, we make a scatter diagram and a regression analysis. We also calculate the correlation coefficient r with Pearson's correlations analysis. Pearson's is used when measuring correlation between two ratio scale variables and is therefore the best test for us to use, since both stigma and gaming habits have been made into ratio scale variables (Djurfeldt, Larsson & Stjärnhagen 2010, p. 154-155, 259-267).
4.4.2 Correlation between help seeking-behaviour and perceived stigmatization
When examining the relationship between stigma and help-seeking behaviour we have one ratio scale variable for stigma and a few different nominal variables for help-seeking behaviour: have you sought help? Should you seek help? Who would you turn to? To be able to analyse
correlation between a ratio scale variable and a nominal, the best test to use is an independent samples t-test. A t-test compares the mean score between two groups and can be used when the scale ratio variable has a relatively normal distribution, or your sample is big enough (Djurfeldt, Larsson & Stjärnhagen 2010, p. 229-251). Our hypothesis was that the “yes” and “no” groups have statistically significantly different mean stigma scores i.e. the null hypothesis is H0: My
=
Mn and the counter null hypothesis is H1: My≠Mn. Furthermore, when conducting an independent samples t-test, the assumption of homogeneity of variances it tested in Levene’s test. If the p-value in this test is bigger than 0.05 we can assume that the variances in the groups are equal and can read from the top row of the table.4.4.3 Does stigma affect whether a person would seek professional help?
When analysing help-seeking behaviours, we will put extra focus on analysing “professional help” since that will be the most relevant variable for our thesis. The question “who would you turn to?” have several nominal answer alternatives and since it is a multiple-choice question and several groups contain the same respondent, we cannot compare two groups to each other. So, to analyse this we make the answer alternative professional into a nominal dichotomous variable where we have two groups: would turn to professional vs. would not turn to professional. We can then compare the difference in mean between the two groups through a t-test. We will also use crosstabs to clearly see and present differences in the groups.
4.5 Ethical Deliberation
There are a few ethical dilemmas with our methodology. First, we do not want to collect information from children. Studies conducted on children need extra careful considerations of ethical dilemmas before implemented (UNICEF 2013). Since we are only students and this study is a thesis, we do not have the experience or position to take on that task. Furthermore to collect data from children their parents need to give consent according to 18 § in the law on ethical review regarding research conducted on people (Lag 2003: 460 om etikprövning av forskning som avser människor) which would be highly impractical or even impossible with the
methodology we've chosen. We don’t intend to collect any personal data about the participants, however to counteract that children answer the survey and become a part of our sampling we will ask about age, to be able to remove them from our data.
Furthermore, we have to weigh the knowledge interest versus potential harm it could cause the participants (Larsson 2005) The knowledge interest will be difficult to assess since it is a thesis and the knowledge it produces is not considered official scientific knowledge. This thesis is a form of examination and scientists in the future will generally not be able to refer to our study as previous research. However, the knowledge this study produces will still shed some light on a perspective that has not yet been explored in much detail. It will contribute to the field in form of enlightenment on the subject and inspiration to further studies as well as inspiration for future
development of help and support systems. On the other hand, our selected population are the people who have problematic gaming habits and potentially even a gaming disorder, which makes them a vulnerable group. Some of the questions in the survey could potentially cause participants to feel uncomfortable or have negative emotional reactions, such as it may make the participant feel judged and maybe even attacked based on their gaming habits. This is something that must be considered when formulating the survey and while we can’t completely guarantee that people won't have any negative experiences, we will still try to mitigate this effect to some extent. In order to do so, we chose to specify in the information form that we do not seek to judge, diagnose or categorize anyone based on their gaming habits and clarify that the purpose of this study is to map gaming habits, the stigma associated with them and help-seeking behaviour. As an attempt to give participants an advanced notice, we will also make it clear that the subject of stigma is a major part in our study and that stigma is generally associated with negative experiences. This will hopefully give participants the opportunity to prepare themselves ahead of time or, should they prefer to not be exposed to said negative emotions and experiences, to refer from taking the survey altogether.
Furthermore, the consequences of the results of the study must be taken into consideration. Could the result be damaging or harmful to gaming addicts or could the result be used in a way that would cause harm? The results may be used with bad intentions, however we will do what we can to mitigate that effect by being transparent and clear about the purpose of this study and what it should be used for, which is to increase the understanding of gaming addiction and help people dealing with it. We have also made it clear that the results cannot be generalized outside of this study. Furthermore, the study does not target gaming addicts but gamers in general. The aim of the study is not to diagnose or label but to try to improve the situation of those who might feel stigmatized and are avoiding seeking help due to it.
We can see how participants reading the study could be affected negatively. However, it could also trigger positive behavioural changes such as seeking help or start reflecting on gaming behaviour as well as helping people realise that there is nothing to be ashamed of. It’s a difficult consideration to make and to make sure we are not breaking any laws or conducting unethical research we contacted the Ethical Review Authority of Sweden (Etikprövningsmyndigheten) who said that we as students writing our thesis are not covered by the law of ethical review of research § 2 (Lag 2003: 460 om etikprövning av forskning som avser människor). Furthermore, the fact that the administrator of the forum must approve the survey before posting it online will be an extra layer of consent from the community.
5. Result
5.1 Response Rate
There was a total of 224 respondents to the survey and data from 177 were used in our results. Since we did not make a random selection and had no predetermined number of individuals to send the survey to, we cannot calculate the response rate. However, 21 % (47 respondents) fell outside of our selection group since they were under 18 years of age and their data was therefore not collected and used in the research, leaving 177 respondents. Furthermore, all survey questions had 100% response rate, except the last one asking if they wanted to add anything. This question had 47 responses and these responses were used in our discussion below.
5.2 Descriptive Analysis
5.2.1 Stigma
Each question about stigma had five response alternatives; strongly disagree, disagree, neutral, agree, strongly agree (see Appendix 2.). The results from the questions about stigma showed that approximately 54% agreed or strongly agreed that they would feel ashamed or embarrassed if they had a gaming addiction, while 32% answered disagree or strongly disagreed and 14% were neutral. When asked if the respondent would want to keep it a secret if they had gaming disorder, 45% answered agree/strongly agree, 32% disagree/strongly disagree and 23% were neutral. Of the 177 respondents, 52% said they agree/strongly agree that they would think less of themselves if they had gaming addiction while 35% disagree/strongly disagreed and 13% were neutral. When then asked if they thought others would think less of them 64% said they agreed/strongly agreed, 20% disagreed/strongly disagreed and 16% were neutral. However only 20% agreed/strongly agreed that they thought others would avoid them if they had gaming disorder, while 55% disagreed/strongly disagreed and 25% were neutral.
Each answer in the stigma section of the questionnaire gave a score from 1 to 5 and at the end we calculated each respondents' mean stigma score based on their answers. The histogram in figure 1. illustrates all stigma scores that occurred and the amount of people that had that specific score. The idea was that the closer the score was to five, the higher the person’s perceived stigma would be. We can see that the distribution of the stigma score is approximately normal with the score 3.14 being the highest occurring figure. The total mean of the stigma score of all the participants' stigma is 2,83 and the median is 2,86.
5.2.2 Gaming Habits
Figure 2. Bar count of gaming habits score distribution
Gaming score was given to each participant based on their answers on a series of questions considering gaming habits. The mean gaming habits score for our respondents is 4.21 out of 10 with a unimodal positively skewed distribution.
Participants were asked about the average amount of time they spend playing games each week in order to try and map game time seeing as it is part of the criteria to be diagnosed with gaming disorder and as such, excessive time spent gaming consists as a problematic gaming habit. What we found in our research was that 52% of the participants play more than 20 hours a week, out of which 21.5% play more than 30 hours a week.
5.2.4 Help-Seeking Behaviour
We divided the term “help-seeking behaviour” in three parts: Did they seek any kind of help in the past, would they seek help if they had symptoms corresponding to gaming disorder and who would they turn to for help. The results showed that 13 % (N=23) of the respondents have sought help in the past (Figure 3.). 36.7% (N=65) of the respondents said that they would seek help should they have gaming disorder, 33.9% (N=60) expressed uncertainty whether or not they would seek help and 29.4%(N=52) said they wouldn’t (see Figure 4.).
Figure 3. Responses to survey question “Have you sought help for gaming disorder in the past?”
Figure 4. Responses to survey question “If you had gaming disorder would you seek help or advice?”
The participants could check multiple boxes when answering to whom they would rather turn for help if they had to. In Figure 5. we can see that the majority of the respondents said they would seek help from professionals (59%) as well as from someone on the internet (52%) and from friends (49%).
Figure 5. Responses to survey question “If you felt like you had to seek help or advice for gaming disorder who would you rather turn to?”
5.3 Correlation Between Problematic Gaming Habits and Stigma
When comparing the variables gaming habit score and mean stigma score in a scatter diagram, results show a weak positive correlation between problematic gaming habits and level of perceived stigma (r=0.209).
Figure 6. Scatter diagram graph with showing correlation between gaming habit score and mean stigma score
Since we set the significance level to 95% the p value shown in the “sig. (2-tailed)” column must be ≤0.05 for our results to be statistically significant. Our results show 0.005 which means they are statistically significant and there is only a 0.5% risk that we have obtained these results without there being a real effect.
Table 1. Pearson correlation coefficient between gaming habit score and mean stigma score
5.4 Correlation Between Help-Seeking Behaviour and Stigma
5.4.1 Would Seek Help
In the first question about help seeking, participants were asked if they would seek help if they had gaming disorder. Here they could answer “yes”, “no” and “don’t know”. The participants who answered that they would seek help, the “yes” group (N=65) have a mean stigma score of My=2.71 (SD=0.69). The group who answered they would not seek help, the ”no” group (N=52) have a mean stigma score of Mn=2.75 (SD=0.84) while the “don’t know” group have Mdk=3.01 (SD=0.74).
Table 2. Group statistics of mean stigma score in “would seek help” groups
Figure 7. Independent samples t-test comparing mean stigma in “no” and “yes” group
The independent samples t-test have the conditions t(115)=0.29, p= 0.78 which shows that there is no statistically significant difference in scores between the yes and no group. Furthermore, we tested the “don’t know” group against the “yes” and the “no” group to see if there is any
statistically significant difference between the mean stigma in these groups. The results show a significant difference between the “yes” and the “don’t know” group with the conditions; t(123)=-2.38, p=0.02.
Figure 8. Independent samples t-test comparing mean stigma in “yes” and “don’t know” group
5.4.2 Did Seek Help
The number of participants who have sought help for gaming addiction in the past is N=23. The mean gaming habits score for the respondents who have sought help in the past is 6.26, while mean gaming habits score for those who have not sought help is 3.90 (Table 3). The difference in mean stigma score between the two groups was explored (Table 4) but results show no
statistically significant difference between the means stigma score of the no group Mn=2.83 and the yes group My=2.80 with the conditions t(175)=0.20, P=0.84.
Table 3. Group statistics of mean gaming habit score between the group who have sought help in the past and the group who have not sought help in the past.
Table 4. Group statistics of mean stigma score between the group who have sought help in the past and the group who have not sought help in the past.
5.4.3 Tendency to Seek Professional Help
The cross-table (Table 5.) compares the difference between those who answered “yes” and those who answered “no” on whether or not they would seek professional help if they had a gaming disorder. It shows that 59% of the participants (N=104) said they would turn to professionals if they had to seek help.
Table 5. Crosstabulation of variables “would seek help” and “would turn to professionals for help or advice”.
We compared mean stigma score for the group who would (N=104) and the group who would not (N=73) turn to professionals for help if they had gaming disorder. The results show a statistically significant difference in the scores for the “no” group (Mn=2.68, SD=0.83) and the “yes” group (My=2.92, SD=0.7) conditions; t(137)=-2.01, P= 0.05. These results, however, are on the verge of being statistically significant (P=0.047). The results show that the group who would not seek professional help have a lower mean stigma score than the group who said they would turn to professionals.
Table 6. Group statistics of mean stigma score in “would turn to professionals for help or advice” groups
Figure 9. Independent samples t-test comparing mean stigma in the group who would turn to professionals for help if they had gaming disorder, and the group who would not
5.5 Summary
The analysed data from 177 participants show a mean stigma score of 2.83 out of 5 and a mean gaming habits score of 4.21 out of 9, where 0 was the lowest score and 9 was the highest. The results show a statistically significant, weak positive correlation between gaming habits score and stigma score. This means that the more excessive a person's gaming habits, the higher that person would score on perceived stigma, proving our hypothesis right.
The results on stigma and help-seeking do not show a statistically significant difference in mean stigma score between the group that would seek help and the group that would not seek help, proving our hypothesis wrong. There is however a significant difference between the mean stigma score of those who would seek help and those who don’t know if they would seek help or not, where the “don’t know” group had a higher stigma score. Furthermore, the group who said that they have sought help for their gaming addiction in the past had a higher gaming habit score than those who had not sought help. There was however no statistically significant difference in mean perceived stigma score between the two groups.
A majority of the participants (59%) said they would turn to professionals for help if they had gaming addiction. Furthermore, the results showed a statistically significant difference between mean stigma scores in those who would turn to professionals for help and those who would not. These results show that the greater the perceived stigma the higher the tendency to turn to professionals for help, contrary to our hypothesis that predicted a lower tendency to seek professional help with a higher score of perceived stigma.
