attention deficit hyperactivity disorder and video games

7/27/2019 Attention Deficit Hyperactivity Disorder and Video Games

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Original article

Attention deficit/hyperactivity disorder and video games: A comparativestudy of hyperactive and control children

Stephanie Bioulac*, Lisa Arfi, Manuel P. Bouvard

Centre Hospitalier Charles Perrens, Service universitaire de psychiatrie de lenfant et de ladolescent, 121, ru e de la Bechade,

33076 Bordeaux cedex, France

Received 30 January 2007; received in revised form 4 October 2007; accepted 4 November 2007

Abstract

Introduction. e This study describes and compares the behavior of hyperactive and control children playing video games.

Subjects and methods. e The sample consisted of 29 ADHD children and 21 controls aged between 6 and 16 years playing video games. We

used the Child Behavior Checklist and the Problem Videogame Playing scale (PVP scale). This instrument gives objective measures of problem

use, which can be considered as an indication of addictive videogame playing. We designed a questionnaire for the parents, eliciting qualitative

information about their childs videogame playing. There were no significant differences concerning frequency or duration of play between

ADHD children and controls but differences were observed on the PVP scale. None of the controls scored above four whereas 10 hyperactive

children answered affirmatively to five or more questions. These children presented a greater intensity of the disorder than the other ADHD

children.

Conclusion. e While no differences concerning video game use were found, ADHD children exhibited more problems associated with vid-

eogame playing. It seems that a subgroup of ADHD children could be vulnerable to developing dependence upon video games.

2007 Elsevier Masson SAS. All rights reserved.

Keywords: Attention deficit hyperactivity disorder; Video game; Children; Addiction

1. Introduction

During recent decades, videogame playing has become one

of the main leisure activities in children and adolescents. Grif-

fiths [31] found that 10% of children between 10 and 18 years

played 1 h or more per day. In 1996, Buchman reported that

90% of children played 1 h or more per day at 9 years and

the figure was 75% at 13 years (900 children aged 9e

13)[11]. While other studies have confirmed the period of 1 h

per day [17,23,24,54], the effect of video games on children

and adolescents is not well understood. The initial studies fo-

cused on the negative effects of this activity [4,5,19]. Excessive

videogame playing may be associated with various problems

similar to those described in addiction such as preoccupation,

tolerance, loss of control, withdrawal, family or school disrup-

tion, lies, disregard for physical or psychological conse-

quences, and illegal acts [26]. It has been compared with

pathological gambling and considered as a non-financial form

of gambling [31]. Griffiths [34] used the term technological

addictions, such addictions including addictions to the Inter-

net and slot machines. They have been operationally defined

as non-chemical (behavioral) addictions that involve excessivehumanemachine interaction. Technological addictions can be

viewed as a subset of behavioral addictions [37,41]. Griffiths

has operationally defined addictive behavior as any behavior

that features all the core components of addiction. For this au-

thor any behavior (e.g. videogame playing) that fulfils these six

criteria (salience, tolerance, mood modification, withdrawal

symptoms, conflicts and relapse) is therefore operationally de-

fined as an addiction.

Some authors suggest the existence of videogame addic-

tion, but to date this area has received little attention. Griffiths* Corresponding author. Tel.: 33 0556 561728; fax: 33 0556 561732.

E-mail address: [email protected] (S. Bioulac).

0924-9338/$ - see front matter 2007 Elsevier Masson SAS. All rights reserved.

doi:10.1016/j.eurpsy.2007.11.002

Available online at www.sciencedirect.com

European Psychiatry 23 (2008) 134e141http://france.elsevier.com/direct/EURPSY/
mailto:[email protected]://france.elsevier.com/direct/EURPSY/http://france.elsevier.com/direct/EURPSY/mailto:[email protected]


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[31] adapted a set of criteria from the DSM-III-R [2] to

discriminate pathological gambling. Using this instrument,

Griffiths and Hunt [34] reported that 8% of their test subjects

were addicted to computer games. In another study, Griffiths

[35] reported that one in five adolescents was currently depen-

dent at the time of the study (387 adolescents aged between 12

and 16 years). Fisher [20,21] adapted the criteria for patholog-ical gambling in the DSM-IV [3] to create the DSM-IV-JV (J:

Juvenile, V: arcade video game). In that study, 6% of the 460

subjects (aged 11e16 years) were found to be addicted. Other

studies have reported similarities between computer video-

game addiction and pathological gambling or substance de-

pendence [12,27,35,48].

If it is accepted that videogame playing can be addictive,

then it is appropriate to look for the neural foundation of

this behavior. Dopaminergic neurotransmission (ventral stria-

tum or nucleus accumbens) may be involved in the neural sub-

strate of reinforcement [38]. Koepp et al. [40] have

demonstrated an increase in the release of dopamine within

the nucleus accumbens as a function of videogame playing.The same area is involved in drug addiction like cocaine

[50]. Their results are in favor of a link between playing video

game and dopamine release.

It is now well known that attention deficit/hyperactivity

disorder (ADHD) is a risk factor for later substance use disor-

der (SUD) [16,52]. Additional psychiatric comorbidity, such

as conduct disorder, increases this risk [6,8]. Higher rates of

ADHD have been reported in adolescents with SUD relative

to controls [13]. In a prospective study, Biederman et al.

[7,8] found a similar rate of substance abuse in adolescents

both with and without ADHD. However, between adolescence

and adulthood, the rate of substance abuse increases substan-tially for individuals with ADHD. Adults with ADHD begin

to abuse substances at an earlier age and abuse substances

more often than their peers without ADHD [53].

Since ADHD is a risk factor for later SUD, could hyperac-

tive children be more vulnerable to videogame addiction, if

such a pathology exists? To our knowledge, this issue has re-

ceived little attention. A recent study [14] reported that adoles-

cents who play for more than 1 h on a console or Internet

video game may have more intense symptoms of ADHD or in-

attention than those who do not. A significant relationship be-

tween Internet use and ADHD has also been shown in

elementary school children [56].

Most reported effects of video games centered on the al-

leged negative consequences. However, there are more and

more references to the positive benefits of video games in

the literature [32,33]. Few studies have examined whether

video games might be able to help in the treatment of children

with impulsive and attentional difficulties. For example,

Kappes and Thompson [39] tried to reduce impulsivity in

incarcerated adolescents by providing either biofeedback or

experience with a video game. With the aid of a computer dis-

play, attention deficit patients can learn to modulate brain

waves associated with focusing [55]. Another study found

that an action video game modified visual selective attention

[30], which is impaired in ADHD.

In our work, we studied only videogame addiction and not

Internet addiction. (Internet addiction is a broad term that covers

a wide variety of behaviors and impulse control problems such

as cybersex addiction, cyber-relationship addiction, net compul-

sions, information overload and computer game addiction [57].)

The current study started from our clinical observation about

ADHD children and adolescent behaviors. In fact, in our dailypractice, many parents of hyperactive children have reported

that their children spend considerable time playing video

games while they are reluctant to engage in tasks that require

sustained mental efforts. These children present attention diffi-

culties and often change their activities. They seem to be able to

sustain their attention longer in front of video games than

classical games. Such behaviors might be explained by

examining cognitive regulation in ADHD children. Cognitive

and motivational dysfunction in ADHD children causes

changes in quality/quantity task engagement, and preference

for immediate rewards and events over delayed ones [46].

Moreover, a tendency of stimulation-seeking in ADHD chil-

dren has been reported. Videogame playing provides ever-changing, multimodal stimuli and an immediate reward with

a minimal delay. Videogame use may fit the cognitive style

of ADHD very well. These notions could explain why

ADHD children spend considerable time playing video games.

The relationship between ADHD and video games is un-

known. Videogame playing has become one of the main lei-

sure activities in children and adolescents and ADHD places

a significant burden on medical, financial and educational re-

sources. For these reasons, we decided to examine the relation-

ship between ADHD and videogame use. The current

exploratory study sought to describe and compare the behavior

of hyperactive children playing video games vs. controls.Moreover, we hypothesized that hyperactive children would

present a higher score on the Problem Videogame Playing

scale than the controls.

2. Subjects and methods

2.1. Subjects

The sample consisted of 50 children aged between 6 and 16

years playing a video game. The ADHD children were

recruited among outpatients referred for a psychiatric exami-

nation to the Child and Adolescent Psychiatry Department,

Bordeaux University Hospital. The controls were recruited

among outpatients consulting a dental facility in the Bordeaux

area. Controls were excluded if they had a pathological T-

score (>60) for attention problems on the Child Behavior

Checklist [1,22]. Numerous studies of children in the general

population or in clinical samples using behavior ratings such

as the CBCL have confirmed the existence of a dimension

of hyperactive behavior [10].

2.2. Methods: assessment procedure

Clinical diagnosis of ADHD was made by a psychiatrist

using DSM-IV criteria after several interviews with the child

135S. Bioulac et al. / European Psychiatry 23 (2008) 134e141


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and with his parents. Psychiatric comorbidity was also

specified and divided in two categories: behavioral disorder

(oppositional and defiant disorder and conduct disorder) and

emotional disorder (mood and anxiety disorders). The parents

of hyperactive children completed the Conners parents rating

scale [18]. The Conners parent rating scale (CPRS) is a popular

clinical tool for obtaining parental reports of childhood behav-ior problems. This questionnaire-based instrument presents

a standardized measurement of childrens behavior with a par-

ticular emphasis on hyperactivity.

For both groups of children, we noted age and gender and

collected behavioral data with the Child Behavior Checklist

(CBCL) completed by the parents. The children filled in the

Problem Videogame Playing (PVP) questionnaire to obtain

the PVP score. The PVP scale is a nine-item self-administered

questionnaire exploring preoccupation, tolerance, loss of con-

trol, withdrawal, escape, lies and deception, disregard for

physical or psychological consequences and family/school

disruption with dichotomous yes/no answers [47,48]. These

dimensions are derived from the DSM-IV criteria for sub-stance dependence and pathological gambling. The PVP gives

objective measures of problem use, which can be considered

as an indication of addictive videogame playing. In their study

on 223 adolescents, Tejeiro et al. found a relationship between

high PVP scores, as calculated by the number of affirmative

answers, and the frequency and duration of play. They also

found a positive correlation with high scores on the Severity

of Dependence Scale, a self-administered scale designed to

measure dependence on different types of drugs. We translated

the PVP scale into French with the authorization of its authors.

This questionnaire was developed for adolescents aged be-

tween 13 and 18 years. For the children we asked the parentsto read the questionnaire with the children. None of the parents

reported difficulties for their children to answer questions. To

further investigate videogame playing, we designed a question-

naire for the parents (Appendix 1), eliciting qualitative infor-

mation about their childs videogame playing: frequency and

duration of play, childs behavior (during play, when stopping

playing, lies in order to play, missing meals because of play-

ing, impact on schooling), and parents attitude (parental

control).

Written informed consent was obtained from the parents

and children, respectively.

2.3. Statistical analysis

We performed statistical analysis between ADHD children

and controls. We used the Chi-square test for qualitative analysis

(sex and parental questionnaire) (or the Fischer probability test

when the size of the group was too small).

The differencesin demographic variables,CBCLdimensions

and PVP scores between the ADHD children and controls were

analyzed by using the Students ttest or ManneWhitney Utest.

Statistical significance was set at p< 0.05. Statistical analysis

was performed with Statview 5.0.

3. Results

3.1. Socio-demographic and clinical data

Our total sample comprised 50 children, 29 ADHD subjects

and 21 controls. The mean age and the sex ratio did not differ

between the two groups (ADHD group: 25 boys/3 girls, meanage 10.8 years; control group: 18 boys/3 girls, mean age 12.1

years) (Table 1). There were significant differences between

the two groups regarding CBCL scores. The children with

ADHD had higher T-scores on the following syndromes: anx-

ious/depressed, social problems, thought problems, attention

problems, aggressive behavior, internalizing and externalizing

problems. They also had lower scores on the total competence

(Table 1). Among the hyperactive children, seven (24%) had

a behavioral disorder and six (21%) an associated emotional

disorder, and 23 (79%) were receiving pharmacological treat-

ment for ADHD. The mean hyperactivity index on the Con-

ners parents rating scale was 68.9 (for ADHD children).

3.2. Commitment to video game

The survey did not show any significant differences con-

cerning the frequency or duration of play between the two

samples. Thirty eight percent of the control children played

less than once a week whereas one third of the ADHD children

played between one and three times a week (Fig. 1). Time per

session was between 1 and 2 h for the majority of the sample

(65% for ADHD and 50% for controls). The two groups did

not differ with regard to the type of video game since they

played both with action and reflection games (adventure

games, role playing games, logic games).

Regarding videogame use according to the parents, hyper-

active children were less likely than controls to stop playing of

their own accord (59% ADHD vs. 90% controls; p 0.02). All

Table 1

Socio-demographic and Child Behavior Checklist (CBCL) data of the

population

Controls

(N 21)

ADHD

children

(N 29)

p

(ManneWhitney

U test)

Girls 3 3

Boys 18 26

Mean age (DS) 12.1 (2.6) 10.8(2.5)

CBCL

Withdrawal 53 55.16 > 0.05

Somatic plaints 56.7 56.4 > 0.05

Anxious/depression 54.9 63.48 0.02

Social problems 53.05 64.32 0.002

Thought problems 52.85 57.88 0.03

Attention problems 55.45 68.64 < 0.0001

Delinquent behavior 54.4 59.76 0.05

Aggressive behavior 52.35 65.04 0.0003

Internalizing problems 52.15 60.2 0.01

Externalizing problems 47.9 62.56 0.0002

Total score 50.2 64.92 < 0.0001

Total competence 45.15 34.91 0.004

136 S. Bioulac et al. / European Psychiatry 23 (2008) 134e141


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control children stopped playing when their parents asked

them to, whereas 66% of the ADHD children stopped playing

(p 0.01). Hyperactive children reacted more often than con-

trols with reactions of refusal, tears, anger or violence when

they had to stop playing (59% ADHD vs. 19% controls;

p 0.008). In neither group did almost any parent report

any negative impact on schooling, lies or missing of meals be-

cause of video games.

3.3. Problem Videogame Playing (PVP) scores

PVP scores (Fig. 2) indicated significant differences be-

tween the ADHD children and controls. None of the controls

scored above four whereas 10 hyperactive children (34% of

the ADHD children) answered affirmatively to five or morequestions (p 0. 002) (Fig. 3).

We focused on this subgroup of ADHD children with high

PVP scores and found significant differences between them

and the other hyperactive children. The subgroup had a higher

hyperactivity index on the Conners parents rating scale (mean

index 79 for ADHD with PVP score 5 vs. mean index 64.26

for ADHD with PVP score< 5; p 0.02). They also had

higher scores on the following CBCL dimensions: delinquent

behavior (p 0.003), aggressive behavior (p 0.02) and

externalizing problems (p 0.01) (Table 2). There were no

significant differences for the other CBCL dimensions.

4. Discussion

The use of video games in children and adolescents with

psychiatric disorders has received little attention. In our work,

we did not find any significant differences concerning the

frequency or the duration of play between ADHD children

and controls, even if ADHD children seemed to play a little

more often than the latter. This result is a little surprising. In

fact, in most cases addiction is accompanied by greater

frequency or duration of the addiction (as with gambling or

alcohol). Some explanations might account for this. First, our

cohort is rather small, so these findings remain to be confirmed.

Second, it is also rather young, so the subjects are perhaps at thebeginningof the disorder. Third, videogameaddiction is perhaps

a vulnerability factor for other addictions and does not meet all

the criteria of classical addictions. Moreover, parents could

protect their children by limiting the duration of playing (at

least at the beginning).

On the contrary, there were differences in the behavior of the

two populations when playing video games. According to the

parents, hyperactive children were less likely than controls to

stop playing of their own accord. ADHD children are known

0

5

10

15

20

25

30

35

40

3/week Everyday

Frequency (per week)

Sub

jects(

)

ADHD

Controls

Fig. 1. Frequency of play in ADHD children and controls.

0

10

20

30

40

50

6070

Preoccupation

Tolerance

Lossofcontrol

Relapse

Withdrawal

Escape

Lies

Illegalacts

Family

/schooling

disruption

Dimensions of PVP questionnaire

Subjects(

) ADHD

Controls

PVP: Problem videogame playing

Fig. 2. Affirmative responses on the PVP questionnaire in the two populations.

0

5

10

15

20

25

30

0 1 2 3 4 5 6 7 8 9Number of affirmative responses

Subjects(

)

ADHD

Controls

PVP: Problem videogame playing

Fig. 3. Number of affirmative responses on the PVP scale.

Table 2Clinical data of subgroups of ADHD children

ADHD

children

with PVP5

(n 10)

ADHD

children

with PVP

score< 5

(n 19)

p

(ManneWhitney

U test)

CPRS 79 64.26 0.02

Delinquent

behavior (CBCL)

67.25 56.5 0.003

Aggressive

behavior (CBCL)

72.5 61.38 0.02

Externalizing

problems (CBCL)

70.62 58.83 0.01

CPRS: Conners parents rating scale; CBCL: Child Behavior Checklist.



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to have difficulties in organizing themselves and being compli-

ant, although this is likely rather due to a clinical effect of their

disorder. Moreover, PVP scores underlined significant differ-

ences between the ADHD and control children, hence raising

the question whether ADHD children have a greater tendency

to be addicted to video games. On Griffiths scale [31], a score

of four or more criteria is considered as a sign of videogamedependence. In the DSM-IV-JV [20,21], if a person answered

yes to four (or more) of the nine items,the person wasdeemed

to be a videogame addict. Moreover, in the DSM-IV, the

diagnosis of pathological gambling needs five (or more) criteria

to be met. In our study, none of the controls scored above four on

the PVP scale whereas 10 hyperactive children answered

affirmatively to five or more questions. Yoo [56] suggested

that ADHD symptoms are potentially important risk factors

for Internet addiction and found that ADHD symptoms had

significant positive correlations with the degree of Internet

addiction. In that study, the authors found that the ADHD group

had higher Internet addiction scores compared with the non-

ADHD group, while no cut-off point was proposed for thePVP scale by Tejeiro [47,48]. If dependence is considered as

a score of five, all our dependent players were ADHD children.

Along the same lines, we suggest that the severity of ADHD is

significantly positively correlated with the degree of videogame

addiction. The 10 ADHD children represented 20% of the

gamers. Thesame percentage wasfound in the study by Griffiths

[34] where onein fiveadolescents wascurrentlydependent upon

computer games. In the future, videogame addiction might

come to be regarded as being on a continuum with other kinds

of addictions.

The reward deficiency theory is another theoretical assump-

tion about the association between game addiction and ADHD[9]. It proposes that individuals who are less satisfied with

natural rewards (pleasure drive for eating, love and

reproduction) tend to adopt substances as a way to seek an en-

hanced stimulation of the reward pathway. Natural rewards

involve the release of dopamine in the nucleus accumbens and

frontal lobes. However, the same release of dopamine and pro-

duction of pleasurable sensations can be produced by unnat-

ural rewards such as alcohol, cocaine, amphetamine and

other drugs, and by compulsive activities such as gambling,

eating, sex, and risk-taking behaviors. Videogame addiction

could serve as another relatively new kind of unnatural

reward.

Furthermore, impulsivity could be defined as a predisposi-

tion toward rapid, unplanned reactions to internal or external

stimuli. Studies using rewardechoice paradigms have found

that individuals with a history of substance abuse are more

likely to choose an immediate reward. Similarly, studies mea-

suring impulsivity in substance-dependent individuals have

also supported a link between impulsivity and substance

abuse. Impulsivity is one of the core symptoms of ADHD.

This notion could explain why ADHD children are attracted

to video games.

A recent study showed that Internet-addicted subjects

(screened with the Youngs Internet Addiction Scale) had vari-

ous comorbid psychiatric disorders [36]. Twelve children and

12 adolescents were randomly selected for evaluation of the cur-

rent psychiatric diagnoses. Seven children, but none of the ado-

lescents, were diagnosed with ADHD. Consequently, they

concluded that comorbidities differ with age. The authors did

not conclude that Internet addiction is a cause or consequence

of these disorders, but they suggested the possibility of age-spe-

cific comorbid psychiatric disorders in cases of Internet addic-tion. In our work, we did not study the age factor. However,

future investigations could examine to what extent the results

of PVP scores and other scales differ with age. Importantly,

we studied videogame addiction and not Internet addiction.

There may be differences between these two behaviors, and

the age factor would need to be taken into account [44,45].

We then examined the subgroup of ADHD children with

high PVP scores (group A) and found significant differences

between them and the other hyperactive children (group B).

The intensity of disorder in group A was more severe, as

shown by the hyperactivity index of the Conners parents rating

scale. Group A exhibited behavioral characteristics different

from those in group B. These results suggest an associationbetween the level of ADHD symptoms and the severity of vid-

eogame addiction in children. Recent data suggest that the

presence of ADHD symptoms, both in the inattention and hy-

peractivity-impulsivity domains, may be one of the important

risk factors for Internet addiction [14,56]. Group A probably

included ADHD children with a risk of developing videogame

problems. Indeed, this subgroup might be vulnerable to devel-

oping dependence upon video games.

4.1. Limitations

The present study has certain limitations. First our cohortwas rather small; so it is difficult to compare the various sub-

groups. For this reason, the subgroup of ADHD children with

high PVP scores and the other hyperactive children were not

compared. Moreover, all subjects were recruited in an

ADHD outpatient clinic, a setting where patients are likely

to be more severely ill. Moreover, the study was descriptive

and prospective, i.e. we sought to identify which behaviors

or symptoms are a risk factor for videogame addiction or other

addictive behaviors. For an exploratory study, we decided to

keep the girls in the two groups. These results must be inter-

preted with caution because many children (45%) have an-

other psychiatric diagnosis, so the differences found could

be due to ADHD or to comorbid psychiatric problems.

Finally, the focus is on videogame addiction, yet there are

still no well-validated diagnostic criteria for this form of ad-

diction. Further research into the area of videogame addiction

is therefore required.

5. Conclusion

Research into videogame addiction has received little atten-

tion. We did not find any significant differences between the

ADHD children and controls concerning the use of video games

(frequency and duration of play). However, ADHD children ex-

hibited more problems associated with videogame playing. It



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seems that a subgroup of ADHD children (with a high PVP

score) could be vulnerable to developing dependence upon

video games. Since videogame playing will doubtlessly grow

among the general population in the foreseeable future, well-

validated diagnostic criteria are required for videogame addic-

tion. Larger samples need to be investigated. Patient outcome

should be explored as well as investigating whether suchpatients risk developing other addictive behaviors.

Appendix 1. Parents videogame questionnaire

(Who is answering the questionnaire: father/mother/both

parents)

Date: / /200 .

1. Has your child played video games

during the last 12 months?

Yes No

2. How often does your child play video games?

Less than once a week Yes NoOnce to three times a week Yes No

More than three times a week Yes No

Every day Yes No

3. What are the names of the three most used video games?

d

d

d

4. What does your child play video games on? (several answers are possible)

Playstation on the TV Yes No

Portable playstation (e.g. Game

Boy.)

Yes No

Video games on computer Yes No

Video games online Yes No

Arcade video games Yes No

5. How long does your child play video games?Less than 1 h Yes No

1e2 h Yes No

2e3 h Yes No

More than 3 h Yes No

6. At home, does your child have free

access to video games?

Yes No

7. Have you decided on the

conditions of use of the video

games? If affirmative, please

specify which conditions? (several

answers are possible)

Yes No

Time in week Yes No

Time in day Yes No

Maximal playing time Yes No

Type of game Yes NoConditions before playing (specify):

............................. ..

............................. ..

............................. ..

8. Does your child respect the conditions of playing video games?

Never Yes No

Rarely Yes No

Often Yes No

Always Yes No

9. Does your child stop playing video games of his/her own accord?

Never Yes No

Rarely Yes No

Often Yes No

Always Yes No

10. Does your child stop playing video games when you ask him/her to?

Never Yes No

Rarely Yes No

Often Yes No

Always Yes No

11. Do you need to get angry to make him/her stop playing video games?

Never Yes No

Rarely Yes NoOften Yes No

Always Yes No

12. How does he/she react when you make him/her stop playing video games?

(several answers are possible)

Indifference Yes No

Agreement Yes No

Refusal Yes No

Anger Yes No

Tears Yes No

Violence Yes No

Others:...........................

..............................

13. What is your childs behavior during videogame playing? (several answers

are possible)

Stays calm Yes NoRestless Yes No

Quiet Yes No

Comments, screams Yes No

Happy Yes No

Worried, sad Yes No

Others:..........................

............................. ..

14. How does he/she react when losing on video games? ( several answers are

possible)

Calm Yes No

Restless Yes No

Angry Yes No

Sad, cries Yes No

Breaks the videogame equipment Yes No

Hurts himself or others around Yes NoOthers:..........................

............................. ..

15. Has your child missed meals because of playing video games?

Never Yes No

Rarely Yes No

Often Yes No

Always Yes No

16. Has your child already lied in order to play video games?

Never Yes No

Rarely Yes No

Often Yes No

Always Yes No

Comments: ........................

............................. .

17. When not playing video games, does your child read/talk about video

games?

Never Yes No

Rarely Yes No

Often Yes No

Always Yes No

18. Is his/her behavior different when

he/she does not play video games

for several days? If affirmative,

please specify (several answers

are possible)

Yes No

Calm Yes No

Restless Yes No

Angry Yes No

Sad Yes No



7/8

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Appendix 1 (continued)

Happy Yes No

Other comments: ......................

.............................

19. Do you think your childs

behavior significantly disturbs

family relationships because of

playing video games (e.g. conflictwith parents, with brother/sister,

withdrawal.)?

Yes No

Specify:.........................

.............................

..............................

20. Do you think your childs

behavior significantly disturbs his/

her schooling because of playing

video games?

Yes No

Specify:.........................

.............................

.............................

21. After playing video games, has

your child complained about

somatic problems (e.g. headache,eyestrain, abdominal pain, back

pain)?

Yes No

Specify:.........................

.............................

.............................

22. Do you think your child has

a problem with videogame

playing?

Yes No

23. Do you think your child plays

video games too much?

Yes No

24. If you think your child plays

video games too much, are you

worried about it?

Yes No

25. Do other members of the family

play video games?

Yes No

Please specify (several answers are possible)

Brother/sister Yes No

Mother Yes No

Father Yes No

Comments: ........................

.............................

.............................

26. If your child is taking medication

for ADHD, do you think his/her

behavior regarding video games

has been modified by the

treatment?

Yes No

Specify the name of medication and the changes you have noticed:

.............................

.............................

.............................



8/8

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