Video Game Addiction vs. Brain Activity & Response Inhibition: A Cued Go/NoGo Task Study

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Video game addiction (VGA) is associated with significant deficits in response inhibition and preparatory processes, reflected by more commission errors and reduced N2 amplitudes in the cued Go/NoGo task.

Highlights:

  • Increased Commission Errors: Individuals with VGA made significantly more commission errors in NoGo trials compared to healthy controls, indicating impaired response inhibition.
  • Faster Reaction Times: The VGA group had faster reaction times in Go trials than the control group, suggesting a speed-accuracy trade-off favoring speed over accuracy.
  • Reduced N2 Amplitude: VGA subjects showed significantly reduced N2 amplitudes in both cue and NoGo trials, highlighting deficits in early-stage cognitive control and conflict monitoring.

Source: Addiction Biology (2024)

Major Findings: Video Game Addiction (VGA) vs. Response Inhibition Processes (2024)

Fathi et al. evaluated behavioral responses and brain activity related to response inhibition in individuals addicted to video games (action video games) using the cued Go/NoGo task – below are the major findings.

1. Increased Commission Errors

Explanation: Individuals addicted to video games made significantly more mistakes by pressing the button when they shouldn’t have (in the NoGo trials) compared to healthy individuals.

This higher rate of commission errors indicates that people with video game addiction (VGA) struggle with stopping themselves from performing actions that are inappropriate or unnecessary in a given situation.

This suggests that VGA affects the brain’s ability to control impulses effectively.

2. Faster Reaction Times

Explanation: The group with VGA responded faster in the Go trials than the control group.

Although faster reaction times might seem like a positive trait, in this context, it suggests a lack of careful consideration before acting.

People with VGA may prioritize speed over accuracy, which can lead to more mistakes, especially in tasks that require inhibition or restraint.

This reflects a potential trade-off where quick responses compromise precision and control.

3. Reduced N2 Amplitude

Explanation: Individuals with VGA showed significantly lower N2 amplitudes during both the cue and NoGo trials compared to the control group.

The N2 component of the event-related potential (ERP) is associated with cognitive control and conflict monitoring.

Reduced N2 amplitudes in VGA subjects suggest they have a harder time preparing for and monitoring conflicts.

This deficit points to difficulties in the early stages of inhibitory control, meaning that VGA impairs the brain’s ability to get ready to inhibit an action effectively.

4. Lack of N2 Amplitude Difference Between Go & NoGo Trials

Explanation: Unlike healthy individuals, those with VGA did not show a significant difference in N2 amplitudes between Go and NoGo trials.

In a healthy brain, N2 amplitude is typically larger in NoGo trials because it requires more cognitive effort to inhibit a response.

The absence of this difference in VGA subjects indicates a malfunction in how their brains handle the challenge of stopping an action.

This uniformity in response suggests an impaired ability to distinguish between situations that require action and those that require inhibition.

5. No Significant Differences in P3 Amplitudes

Explanation: There were no significant differences in P3 amplitudes between VGA and control groups in both Go and NoGo trials.

The P3 component is linked to the evaluation of the inhibitory process and the outcome of inhibition.

The lack of significant differences in P3 amplitudes suggests that while VGA affects early inhibitory processes (as shown by the N2 results), it does not significantly impact the later stages of evaluating these processes.

This might mean that VGA affects the initial stages of response control but not the final stages of processing the results of those responses.

What is Video Game Addiction (VGA)?

Video game addiction, also known as gaming disorder, is characterized by a pattern of persistent or recurrent gaming behavior that is so extensive it negatively impacts various aspects of an individual’s life.

Impaired Control over Gaming

  • Difficulty in controlling the onset, frequency, intensity, duration, termination, and context of gaming sessions.
  • Inability to stop playing despite a desire to reduce or cease gaming.

Increased Priority Given to Gaming

  • Gaming takes precedence over other life interests and daily activities.
  • Neglect of personal, social, educational, or occupational responsibilities in favor of gaming.

Continuation or Escalation of Gaming Despite Negative Consequences

  • Persistent gaming behavior despite awareness of the negative impact it has on relationships, work, education, or other important areas of functioning.
  • Continued gaming despite experiencing physical or psychological problems related to gaming.

Significant Dysfunction in Various Life Domains

  • Gaming behavior leads to significant impairment in personal, family, social, educational, or occupational functioning.

How is video game addiction diagnosed?

According to the World Health Organization (WHO) and the American Psychiatric Association (APA), the diagnosis of gaming disorder or video game addiction requires that these behaviors are evident for at least 12 months.

However, the diagnosis may be made sooner if all diagnostic requirements are met and symptoms are severe.

World Health Organization (WHO) Definition

In the International Classification of Diseases (ICD-11), the WHO defines gaming disorder as:

A pattern of gaming behavior characterized by impaired control over gaming, increasing priority given to gaming over other activities, and continuation or escalation of gaming despite negative consequences.

American Psychiatric Association (APA) Definition

The APA’s Diagnostic and Statistical Manual of Mental Disorders (DSM-5) includes Internet Gaming Disorder as a condition for further study, with the following criteria:

  • Preoccupation with gaming.
  • Withdrawal symptoms when gaming is taken away or not possible.
  • The need to spend increasing amounts of time gaming.
  • Unsuccessful attempts to control gaming.
  • Loss of interest in previous hobbies and entertainment as a result of, and with the exception of, gaming.
  • Continued excessive use of games despite knowledge of psychosocial problems.
  • Deceiving family members, therapists, or others regarding the amount of gaming.
  • Use of games to escape or relieve a negative mood.
  • Jeopardizing or losing a significant relationship, job, or education or career opportunity because of gaming.

Study Details: Video Game Addiction vs. Brain Activity for Response Inhibition (2024)

Sample

  • Participants: 50 male individuals aged 17-35 years
  • Groups: 25 individuals with video game addiction (VGA), recruited from local game clubs & 25 matched healthy controls
  • Criteria for VGA Group: Playing action video games for 30+ hours per week for at least 12 months. Scoring 2.5 or higher on the Video Game Addiction Test (VAT).
  • Criteria for Control Group: Scoring less than 1.5 on the VAT
  • Exclusions: Substance abuse (except smoking), traumatic brain injury, psychological and neurological disorders, use of psychotropic medications, severe memory problems
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Methods

  • Task: Cued Go/NoGo task with 400 pairs of images (animals, humans, plants) in four combinations (Go, NoGo, irrelevant trials)
  • Procedure: Each trial consisted of two stimuli (S1 and S2) with specific instructions to respond (Go) or inhibit response (NoGo). EEG recordings measured brain activity, focusing on N2 and P3 components.
  • Measures: Behavioral: Commission and omission errors, reaction times, Electrophysiological: Amplitudes and latencies of N2 and P3 components
  • Questionnaires: VAT (Video Game Addiction Test), Barratt Impulsiveness Scale (BIS-11), Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), Edinburgh Handedness Inventory

Limitations

  1. Sample Size: The study had a relatively small sample size, which may limit the generalizability of the findings.
  2. Sex: Only male participants were included, which may not reflect the effects of VGA across different genders.
  3. Game Type: The study focused exclusively on action video games, potentially limiting the applicability of the results to other game genres.
  4. Self-Reported Data: Reliance on self-reported questionnaires may introduce bias or inaccuracies in assessing video game addiction and associated behaviors.
  5. Speed-Accuracy Trade-Off: The study observed faster reaction times in VGA subjects but did not delve into the speed-accuracy trade-off in detail, which could be explored in future research.
  6. Correlations: The correlation analysis showed near-marginal significance, suggesting that a larger sample size might be necessary to fully understand these relationships.

Potential Treatments for Video Game Addiction (VGA) Based on the Study Findings

1. Cognitive Behavioral Therapy (CBT)

Rationale: Given the study’s findings on deficits in inhibitory control and cognitive preparation in VGA subjects, CBT can help individuals develop better impulse control and coping strategies.

  • Impulse Control Training: Techniques to delay gratification and manage impulsive behaviors.
  • Cognitive Restructuring: Addressing and modifying maladaptive thought patterns related to gaming.
  • Behavioral Interventions: Setting goals and limits for gaming time and reinforcing alternative activities.

2. Mindfulness & Meditation

Rationale: The study indicates problems in early cognitive control processes. Mindfulness practices can enhance attention regulation and cognitive control.

  • Mindfulness-Based Stress Reduction (MBSR): Teaching awareness and acceptance of thoughts and urges without acting on them.
  • Meditation Practices: Regular sessions to improve focus and reduce compulsive gaming urges.

3. Neurofeedback Training

Rationale: Reduced N2 amplitudes suggest deficits in neural processes related to conflict monitoring and inhibition. Neurofeedback can train individuals to regulate their brain activity.

  • EEG Biofeedback: Monitoring real-time brain activity and providing feedback to promote healthier brain patterns.
  • Targeted Interventions: Specifically focusing on enhancing activity in brain regions associated with impulse control and decision-making.

4. Behavioral Interventions

Rationale: The study found increased commission errors and faster reaction times, indicating impulsivity and poor decision-making.

  • Structured Schedules: Creating a balanced daily routine that includes limited gaming time.
  • Reward Systems: Positive reinforcement for adhering to gaming limits and engaging in other activities.
  • Parental/Peer Involvement: Encouraging support systems to help monitor and guide gaming behavior.

5. Pharmacological Interventions

Rationale: In cases where VGA is comorbid with anxiety, depression, or other psychiatric conditions, medication might be beneficial.

Approach:

  • SSRIs (Selective Serotonin Reuptake Inhibitors): To manage underlying anxiety and depression that may exacerbate VGA.
  • ADHD Medications: For individuals with comorbid ADHD, medications like stimulants can improve attention and impulse control.

6. Psychoeducation & Support Groups

Rationale: Educating individuals and their families about VGA and its impacts can facilitate understanding and cooperation in treatment.

  • Workshops and Seminars: Providing information on the risks of excessive gaming and strategies to mitigate them.
  • Support Groups: Creating communities where individuals can share experiences and coping strategies.

7. Technological Interventions

Rationale: Utilizing technology to monitor and limit gaming can directly address excessive gaming behavior.

  • Parental Control Software: Tools to limit gaming time and block access during certain hours.
  • Gamification of Healthy Habits: Using game-like elements to promote positive behaviors and reduce gaming.

Conclusion: Video Game Addiction & Inhibitory Control Deficits

The study demonstrates that individuals with video game addiction (VGA) exhibit significant deficits in inhibitory control and cognitive preparation, as evidenced by more commission errors in NoGo trials and faster reaction times in Go trials.

These behavioral findings are supported by electrophysiological data showing reduced N2 amplitudes in VGA subjects, indicating impairments in early cognitive control and conflict monitoring.

The lack of significant differences in P3 amplitudes between VGA and control groups suggests that while early stages of response inhibition are affected, later stages of evaluating inhibitory processes remain intact.

Overall, the findings highlight the need for targeted interventions that address these specific cognitive deficits to effectively manage and treat VGA.

References