In a recently published study in the journal Nature Human Behavior, researchers investigated the impact of video games on mental health in Japan during the COVID-19 pandemic.
Study: Causal effects of video games on mental health in Japan 2020-2022. Image credit: Gorodenkoff / Shutterstock.com
Public health concerns about gaming
As video game use increases, there are growing concerns about its potential negative impacts on mental health. Public skepticism and controversial health policy choices, such as the World Health Organization's debate about gaming disorder, have reinforced negative attitudes towards gaming.
The inclusion of gaming disorder in the 11th edition of the International Classification of Diseases (ICD-11) also contributes to stigma among young people and their treatment providers.Policymakers, academics, and public stakeholders are concerned about gaming addiction and its negative impact on mental health.
Although correlational findings largely support that video games have a detrimental effect on mental health, further research is needed to identify the mechanisms involved in this association. Furthermore, many of the published experimental studies are limited by methodological issues, such as a lack of causal data and external validity checks.
About the Research
In this study, we used credible causal assumptions to assess the relationship between video games and mental health in a real-world setting. To this end, a gaming console lottery was used as a natural experiment.
Causal inference was applied to observational data collected from 97,602 Japanese adults aged 10 to 69 years from December 2020 to March 2022. Survey participants were provided with a questionnaire to assess lottery involvement, video game ownership, gaming preferences, life satisfaction, mental health, and sociodemographic characteristics. Of the 97,602 survey respondents, 8,192 participated in the lottery.
The primary exposure was video game involvement, with respondents mentioning ownership of a Nintendo Switch or PlayStation 5 (PS5) and the amount of time they had spent playing these games in the past 30 days.
Primary study outcomes included mental health and satisfaction: the Japanese version of the Kessler Screening Scale (K6) measured psychological distress, and the Satisfaction with Life Scale (SWLS) assessed life satisfaction.
Statistical analyses included multivariate regression, propensity score matching (PSM), and instrumental variables (IV). The primary intention-to-treat (ITT) analysis used multivariate regression and PSM to estimate the causal effect of winning the console lottery.
Machine learning (ML)-based causal forest or generalized random forest (GRF) algorithms were used to examine the moderating effect of socio-demographic variables on the association between video game playing and health outcomes. Covariates in the study included age, sex, occupation, employment, marital status, number of children, place of residence, and video game preferences.
Instrumental variables (IVs) were used to assess local average treatment effects (LATE) for PS5 or Switch ownership, play in the survey month, and gaming duration. An IV forest algorithm calculated estimates of conditional local average treatment effects (CLATE) for video game ownership. Validity of the natural experiment was based on standard difference and pseudo-outcome tests assessing baseline characteristics and pre-lottery happiness.
Research findings
Of the lottery participants, 39% were between 45 and 69 years old, 21% were students, 39% were employed full time, 11% were unemployed, 35% were avid gamers, and 20% were core gamers.
Despite the psychological benefits associated with playing Nintendo Switch and PS5, these benefits were less evident among younger PS5 users than adult Nintendo Switch users. PS5 ownership had a greater impact on men, while Nintendo Switch ownership had similar benefits for both men and women. The impact of PS5 usage was more pronounced for those living in households without children and those who worked full-time, while Nintendo Switch usage had a greater impact on non-gamers.
Use of the Nintendo Switch was associated with a 0.8 standard deviation (SD) improvement in psychological symptoms, whereas use of a PS5 was associated with only a 0.2 SD improvement. Winning a PS5 was associated with increased time spent playing video games but not smartphone games.
Assessment of baseline characteristics and pseudo-outcome tests verified the absence of confounding factors in the lottery outcomes. Support and balance checks confirmed the validity of the PSM estimates.
Conclusion
Video games appear to improve mental health. However, playing games for more than three hours reduces the psychological benefits. Socio-demographic characteristics such as gender, age, occupation, and family status also influence the effects of gaming.
All of our estimates showed a positive correlation between video games and life satisfaction, which is counterintuitive given public perceptions about gaming, but is consistent with recent research findings.”
The effect changes for Nintendo Switch were significantly different from those for PS5, highlighting the need for additional research to elucidate the mechanisms of video game impacts on mental health. The current study was conducted during the COVID-19 pandemic, a time when levels of psychological distress were high and opportunities for physical activity were limited. Thus, the positive effects on mental health associated with gaming may be context dependent, necessitating additional research in post-pandemic contexts.
Journal References:
Egami H, Rahman MS, Yamamoto T et al. (2024). Causal effects of video games on mental health in Japan, 2020-2022. Nature Human Behavior. doi:10.1038/s41562-024-01948-y
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