To wrap up summer vacation, the two leading countries combating internet and gaming addiction—China and South Korea—took a step in diverging directions. This raises the issue of which country serves as a better model for the U.S. government and American gaming companies. With both countries entering the year enforcing similar policies of reducing the amount of play time available to minors, it came as a surprise when China’s increase in limitations was met alongside South Korea’s plan to abolish the harsh restraints. Ultimately, South Korea recognized the flaws in their previous law and is modifying their game plan to include less restrictions and encourage more self-regulation. After reviewing scholarship and research studies which analyzed the previous laws enacted by China and South Korea, the latter’s new, more flexible approach appears to be most promising for the U.S. to take into consideration.
Douglas Gentile, developmental psychologist and the Director of Research for the National Institute on Media and the Family, estimated that over 8.5 percent of children and teenagers—roughly 3 million Americans—exhibit multiple signs of gaming addiction . Currently in the Western world, video game-related regulations are limited to rating systems which evaluate content and maturity-levels rather than the overuse of gaming . As video game addiction becomes increasingly prevalent, understanding, and ultimately comparing, the different prevention approaches is vital in protecting the health and development of younger generations.
What is Gaming Addiction?
Video gaming has beneficial and adverse effects on the cultural attitudes, psychological development, and lifestyle choices of young gamers . For instance, a 2009 study in the Annual Review of Cybertherapy and Telemedicine found gaming can alleviate stress and depression; Dr. Daphen Maurer of the Visual Development Lab discovered gaming can improve eyesight and increase dopamine levels; and cognitive neuroscientists at the University of Rochester found video games can enhance decision-making skills . Especially during the recent pandemic, where isolation and a lack of social interaction was prominent, the ability to engage with others via gaming provided much needed “social connection, escapism and relief for millions of kids and teens” .
Although the evolution of technology and the internet has brought numerous benefits, many negative ramifications have been uncovered as well. One of the most significant impacts of problematic internet-use gaining momentum is the onslaught of video gaming addiction. As a subset of internet addiction, video gaming addiction is often when gaming is taken to the extreme—ultimately impairing an individual’s ability to function either socially, academically, or financially . In 2014, a study by Zhejiang Normal University discovered that gaming addiction can lead to “lower volumes of gray and white brain matter,” which can cause impairment in decision-making, regulating emotions, and impulse control . Likewise, the comorbidity rate of the gaming disorder with depression, anxiety, and ADHD is significantly high, as many young gamers use gaming as a coping mechanism .
While the classification of video gaming addiction as a mental illness is somewhat controversial, organizations have recently spoken up about the issue. In 2013, the American Psychiatric Association (APA) included an Internet Gaming Disorder in the DSM-5, and, in 2018, the World Health Organization (WHO) stated Gaming Disorder (GD) will be listed in the 11th addition of the International Classification of Diseases . With nearly three billion people playing video games worldwide, 3-4 percent of them—more than 60 million gamers—are likely to be suffering from gaming disorder .
In China, problematic video gaming has been recognized as a public health crisis . In 2007, around 14 percent of Chinese adolescent internet users—about 10 million teenagers—met the diagnostic criteria for internet addiction . According to the China Internet Network Information Center, this number increased 16 percent by 2018, with over 30 percent of minors suffering from gaming disorder . With the issue growing in severity, China placed video gaming addiction on par with substance-abuse and drug addictions, labeling the activity as “spiritual opium” .
Similarly, South Korea considers internet addiction as one of the country’s most critical health issues . By 2015, internet usage in South Korean households rose to 85.1 percent across all ages . Comparable to the duration of a part-time job, the average South Korean teen spends over 23 hours per week playing video games . In Seoul, the capital of South Korea, a common leisure activity for youths is to stop by a ‘PC bang’—an internet gaming room or cafe, typically open 24 hours, where players have access to comfortable seating and fast computers for a dollar an hour .
Following trend lines for the addiction in South Korea, in 2012, an estimated 2.55 million people were addicted to their smartphones and the internet . For adolescents in particular, around 12.5 percent of teenagers were at risk for internet addiction disorder in 2014 . And in 2019, the latest government-issued survey revealed over 20 percent of South Korea’s population—nearly 10 million citizens—were now at risk for the addiction . Due to the isolating nature of the COVID-19 pandemic, many countries have reported an uptake in the amount of time minors spent gaming, suggesting a probable increase in problematic gaming for South Korean adolescents .
Initial Prevention Response Plans
International response and prevention plans vary, with some countries authorizing harsher, more hands-on restrictions than others. But how effective are these various responses in curbing behavioral addictions? China and South Korea provide case studies of possible responses and their likely consequences.
From 2000 until 2015, China banned the production and sale of popular gaming consoles—including Xbox and PlayStation—in an attempt to reduce the likelihood of children developing addictions . However, many players worked around this obstacle by illegally purchasing consoles, or simply turning towards PC and mobile games instead. Shortly after the ban was lifted, their government placed restrictions and censors on the “harmful attributes” in video games, including the addictive qualities of in-game rewards and achievements, as well as the portrayal of violence . Specifically, China introduced an Online Game Addiction Prevention System (Fatigue System) in 2007, which targeted the addictive qualities of games . In this system, as the time a person spent gaming increased, the number of rewards they could obtain decreased and pop-up warnings of unhealthy playtime appeared in an effort to limit the gamer’s desire to keep playing. However, as mentioned in sections below, this system proved largely ineffective and was ultimately discarded .
As for treatment measures, China established centers aimed at rehabilitation to address problematic gaming, such as at the General Hospital of Beijing Military Region’s Internet Addiction Treatment Center . Likewise, to further reduce the negative impact of the internet on minors, China passed the Minors Internet Protection Ordinance in 2016, which limited nighttime gaming, provided education to guide players, and required gaming companies to adhere to anti-addiction parameters . Yet, with more minors continuing down a path towards addiction, a revision for the law was required . In 2019, China went a step further and created tighter time restraints on how long minors were allowed to play video games—limiting players to 1.5 hours on weekdays, 3 hours on weekends and holidays, and only during daytime hours .
With over 720 million gamers by 2021, gaming culture prospered in China, leading the country towards becoming the largest market in the video gaming industry . By having such a substantial portion of the population active in gaming, and with many of the previous restrictions easily circumvented, the need for an effective method in China to stop addiction became even more crucial.
In response to the rise in internet-related addictions, South Korea established the Internet Addiction Prevention & Resolution Comprehensive Plan in 2010 . Led by the National Safety Administration-affiliated agency of the MSIP, the primary goal was to establish intervention systems for problematic game and internet use before addiction manifested . Although, while posing many benefits for minors at risk, these approaches were also criticized for the lack of “inter-agencies collaboration and clinical conceptualization” .
To assist those already effected, many treatment centers were founded to support the recovery of youths suffering from gaming addiction . One of these programs is the Jump Up Internet Rescue School, where internet or online gaming addicted children are sent to a camp designed for rehabilitation—guiding minors in their journey through adapting healthier hobbies and learning new coping mechanisms .
In 2011, South Korea passed the Youth Protection Act, also known as the Shutdown Law or “Cinderella Law,” restricting the hours minors could play video games . Under this law, those under the age of 16 were unable to access online games between midnight and 6am in an effort to promote healthy sleeping habits, increase productivity and attentiveness in the classroom, and prevent the likelihood of addictions to develop .
2021 Modifications in Gaming Prevention
Although both countries enforced strict video gaming strictions in the past, their policies deviated in 2021: China pushing for even stricter regimens on gaming, while South Korea is tearing down their shutdown law in favor of more flexible moderating and a stronger emphasis on health services. For China, authorities claim that rolling out firmer measures to limit minors’ gaming exposure come from a desire to safeguard their physical and mental health—as well as to satisfy a concern from parents that the old policy was insufficient . On the other hand, South Korea is moving in the opposite direction in hopes of “respecting the rights of the youth and encourage[ing] healthy home education,” and to break away from the shutdown law’s ineffectiveness .
Released by the National Press and Publication Association (NPPA), China tightened the 2019 restrictions of online gaming for minors to one hour per day—8 PM to 9 PM—on Friday, weekends, and public holidays . In addition to strict time restrictions, identification systems were installed to ensure the rules are followed, essentially forcing minors to enter identification—such as real names, government-issued ID documents, or identification numbers—before playing . However, since many gamers under 18 attempt to bypass this limitation by acquiring fake ID numbers or using VPNs, the policy also requires gamers to register their ID number for fact-checking in the national citizen database . Following suit, gaming companies have launched new methods to increase the likelihood of player cooperation. Tencent, one of China’s major gaming companies, recently introduced “facial recognition technology and an algorithm that identifies underage players” .
Issues with China’s 2021 Modification
China is asserting a strong association of high playing time with addiction—where more hours spent gaming equals addiction. However, China’s emphasis on time as the determining factor leading to addiction is misguided . In 2018, a study published in the Journal of Behavioral Addictions by Kiraly et al., analyzed the effectiveness of policy responses on problematic video game use. The study argued that the strict policy and regulation approaches limiting playtime “were not sufficiently effective” and henceforth called for more “integrative approaches” for improvement . Additionally, another data set found that gaming time is “weakly associated with negative psychological factors” often found in problematic use .
According to WHO, the diagnostic criteria for the “gaming disorder” does not include a specific amount of playtime . Rather, that gaming must cause distress, impairment in the gamer’s life and ability to function, and typically last for at least one year . Like with many behaviors, there is a substantial difference between those who are simply enthusiastic about the activity and want to dedicate time towards it with those who are addicted to it. Ultimately, all behaviors exist on a continuum, and the point where an individual falls isn’t fully decided according to the amount of time allotted to the behavior.
Instead, the threshold differentiating regular gaming (unproblematic behavior) from a gaming disorder (problematic behavior) resides with the effect the activity has on the gamer—as well as the gamer’s response to those outcomes . In other words, the amount of time a person spends breaking blocks in Minecraft, farming crops in Stardew Valley, or leading revolutions in Homefront doesn’t guarantee the development of an addictive behavioral disorder. Alternatively, if a person is so absorbed in their gaming that they repeatedly forget to pick up their kids from daycare, sneak in round after round of solitaire in the office instead of finishing a report, or demonstrate their gaming is negatively impacting their life on another significant level—and continue to game regardless—then that behavior can enter the realm of addiction. By itself, the amount of time spent gaming isn’t a reliable predictor of problematic use; therefore, for China to implement harsher time restraints as the primary driver of their response plan to video gaming addiction demonstrates their shortcomings in addressing the heart of this issue.
Another failure with China’s law is that it only effects the gameplay of minors. However, recent data has proven that the median age of gamers is 24, and a growing demographic in gaming addiction is people in their 20s and 30s . According to a specialist in gaming addiction, adults often turn to video gaming for the same reason teens do: to escape the harshness of reality—unemployment, isolation, and relationship issues . Hence, to properly address all vulnerable groups susceptible to gaming addiction, an approach geared towards more than just minors is needed.
Similar Issues with South Korea’s 2011 Law
Regarding South Korea’s shutdown law, Jiyun Choi et al. in the Journal of Adolescent Health analyzed data collected from the Korea Youth Risk Behavior Web-based survey from 2011 to 2015, concluding the “shutdown policy had practically insignificant effects in reducing Internet use for target adolescents” . Among middle school students, the effects of the initiative were null on internet abuse, and only increased sleep duration by a mere 2 minutes . In fact, the shutdown law’s strategy was indicated to have an overall damaging effect—both on the average player’s experience and leaving “the players wanting more,”—consequently raising the potential for addiction .
Mainly, as explained with China’s new law, the shortcomings may be linked to the fact that the policies outlined “only address or influence specific aspects of the problem” and fail to recognize the individual differences between gamers . For instance, the forementioned 2018 study by Kiraly et al. revealed that the policies by China and South Korea tended to focus on only one of the following: (i) reducing time spent gaming, (ii) changing the addictive potential, (iii) trying to help gamers by looking at psychological and motivation factors behind their desire to game . Tackling video gaming addiction through only one of the forementioned approaches isn’t sufficient to properly address the issue, rather the most efficient mode of attack requires a cohesive regulation approach that targets multiple aspects. Additionally, according to the study, another method to solve this issue is through a targeted prevention approach: where warnings can be customized to target problem behaviors without encroaching on the “non-problematic gamers’ enjoyment of a largely healthy pastime activity” .
South Korea’s 2021 Plan
Ten years after the controversial shutdown law, South Korea is removing government-controlled time restraints in gaming to stay up to date on digital trends, respect young people’s rights, and allow households to enforce limitations themselves . By the end of the year, following the modification of the Youth Protection Act, South Korea will be relying on the “choice permit system,” where parents and underage gamers can request a permit to designate their own playing hours . The Korea Association of Game Industry is in favor of the decision, expecting the new plan to release the hold the previous law held over their gaming industry and children’s rights, as well as reducing the likelihood for addiction to significantly manifest .
Notably, one of China’s concerns and motivators behind their aforementioned time restrictions revolve around the misdirection of priorities. It is true that children repeatedly opting to game over completing their algebra homework, or game late into the night instead of getting a full eight hours of sleep, can hinder their ability to learn and satisfy academic responsibilities—as studies in China have shown that problematic video gaming interferes with “sleep, mood, and social learning in children and adolescents” .
However, forcibly removing gamers from the gaming environment ‘cold turkey’ can cause considerable distress and negate the benefits that games have demonstrated . It’s important to acknowledge that gaming can generate positive impacts as well. In a study exploring the benefits of gaming, published by the National Center for Biotechnology Information, it was discovered that children who regularly play video games in healthy doses develop an improvement in cognitive abilities—such as deductive reasoning, processing speeds, mathematical intelligence, and skills pertaining analogy—over those who do not game .
The notion of time constraints isn’t completely invalid, but should be executed on a moderate level according to each case—and in combination with education and treatment programs—to keep individuals focused on their priorities while demonstrating safe ways to game. To achieve this goal, South Korea’s abolishment of the restriction is paired with a shift in attention: one that focuses on “strengthening the monitoring of harmful game content,” supporting “media and game-use education,” and increasing the implementation of prevention and recovery methods—such as counseling and rehabilitation camps . Moreover, with an aim to raise awareness of problematic gaming habits, outreach programs pertaining the nature of gaming culture, media literacy, and the risks for addiction are included in this renewed focus on education .
Hwang Hee, Minister of Culture, Sports and Tourism in South Korea, expressed that gaming is an important avenue for youths to release stress and connect with others; therefore, the new measures strive to encourage these benefits by “establish[ing] a healthy culture of gaming and leisure for teenagers in a flexible manner” . This revised system is more permissive than China’s reinforced gaming restrictions, subsequently leaving “China as the only nation to restrict gaming hours by law” .
Technology will only continue to evolve and integrate into our daily routines. There’s no going back to an age where smart phones and online platforms aren’t essential to everything we do, whether that be flaunting vacation pictures on social media, calculating a tip at the end of a meal, buying the latest Barbie on Amazon for Christmas, or paying taxes at the touch of a button. We have the world at our fingertips; however, as with every device or tool at our disposal, there is a potential for abuse.
And with the gaming industry booming, there’s no denying video gaming addiction is becoming an increasingly significant threat—especially amidst the youngest generation. By identifying the best ways to approach the issue, backed by relevant strategies that don’t take away from the benefits and experience of gaming, the ramifications can be better contained and predicted in the United States. Particularly in the wake of the recent pandemic, where gaming, streaming, and other forms of content consumption on the internet have risen exponentially to fill the void of stimulus in people’s lives.
With South Korea’s newfound direction in their efforts against video gaming addiction, and WHO adding the problematic behavior on the list of addictions, the international awareness regarding the consequences of overusing technology can receive the attention it deserves. Additionally, by analyzing these two contrasting policies, the United States can determine which aspects are most effective and gear similar techniques towards their own prevention plans. While political and cultural differences may limit the capacity for the U.S. government to fully implement all of the policies previously mentioned, gaming companies have more control on a self-regulatory basis. This could include providing built-in parental controls, warning messages for high levels of playtime, and rating systems to evaluate the addictive potential of games.
Above all, there’s a collective responsibility for parents, educators, clinicians, game developers, and the U.S. government to recognize the issue for what it is and work towards protecting all vulnerable demographics. For policymakers and community members to pay attention, take this addiction seriously, identify addict-risk teens, introduce the necessary information, and provide effective treatment programs for those in recovery.
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