We all know a gamer: The son who boots up his Xbox to play Fortnite after school, or the cousin who spends winter break in her room playing the new Overwatch. Since the 1970s, video games have become a fixture of American culture. And we’re still grappling with what that means. Video games are often designed to keep us hooked. But that doesn’t mean it’s all bad news. Here’s The Breakdown:
How big is gaming?
The gaming industry is booming, projected to surpass $257 billion in revenue in 2023 — up from $91 billion in 2019. That growth is driven by the rise of mobile apps, from Candy Crush to Call of Duty, which in 2021 accounted for more than half of all revenue. More than 214 million Americans play video games, but only about a quarter are children; roughly half are between 18 and 44 years old. About 1 in 10 report playing for 20 or more hours a week, with an average of 13 hours.
Nintendo thumb and more
When gamers play for too long, many experience pain or swelling in the thumb, hand or wrist, depending on the controller they use. This is popularly known as nintendonitis, or Nintendo thumb. Excessive gaming has also been linked to attention problems, low self-esteem and poor academic performance, as well as depression — though it’s not clear which comes first.

What’s an addiction?
There is currently no scientific consensus about video game addiction. But the American Psychiatric Association has classified internet gaming disorder as an unverified potential diagnosis, while the World Health Organization lists “gaming disorder” on its roster of diseases. It’s clear some gamers became obsessed, which is problematic enough. “An obsession is a behavior we become attached to for psychological reasons,” said California psychiatrist David Reiss, an expert in character and personality dynamics. “So attached, that we begin automatically seeking and taking part in the behavior without considering the consequences.”
The lever
In the 1930s, a psychologist named Burrhus Frederic Skinner developed a research tool known as a Skinner Box. Lab rats were placed in a confined space with a lever that dispensed food. He found that if rats were rewarded with a fixed amount of food each time they pressed the lever, they’d soon get bored and quit. But if rewards were dispensed randomly — sometimes none, sometimes a jackpot — the rats couldn’t stop pressing the lever. Slot machines use this psychological tool to keep people playing and so do video games.

Casinos for kids?
Loot boxes — virtual “containers” holding randomized rewards like new outfits or powers for a player’s on-screen character — have become a staple in many games. These features, which keep players coming back, can often be purchased using real money. Some contend that this makes some games a form of gambling being marketed to minors. “They are specifically designed to exploit and manipulate the addictive nature of human psychology,” argues Hawaii state Sen. Chris Lee, a Democrat.
Underwater
Immersiveness, a major selling point in the industry, references how absorbed a player can become within the game. Advertisements often boast of immersive gameplay or game worlds. This is especially true of massively multiplayer online role-playing games (MMORPGs) like World of Warcraft, one of the most popular titles of all time. These games provide a platform where millions of players create their own characters, build friendships with others and create an alternate life within the fantasy world — some would argue at the cost of their own.

Changing our minds
Playing video games can physically change the brain and how it performs. Studies indicate that gaming can increase IQ in children, boost learning capabilities and even improve teamwork in the workplace. Gaming can make those parts of the brain involved in attention function more efficiently, and can increase the size of regions related to visuospatial skills. On the downside, researchers have also found that excessive gaming can cause structural changes to the neural reward system, analogous to those seen in patients with other addictive disorders.
A surprising endorsement
“There are plenty of skills I’ve learned from playing video games. It’s more interactive than watching TV, because there are problems to solve as you’re using your brain.” — Shaun White, three-time Olympic gold medalist in snowboarding.
Rock on
“Video games are bad for you? That’s what they said about rock ’n’ roll.” — Shigeru Miyamoto, game director at Nintendo.
This story appears in the January/February issue of Deseret Magazine. Learn more about how to subscribe.