The Natural History of Problematic Internet Use and Gaming: Recent Findings, Challenges, and Future Directions

Internet use and gaming technologies may, under certain conditions, be associated with clinically significant harm across multiple domains of functioning. However, relatively little is known about the natural history of these problems, including their etiology, symptom trajectory, and risk factors. The aim of this chapter is to summarize and discuss some of the literature on the natural course of Internet-related disorders, with a focus on gaming disorder, and to highlight potentially useful areas for further investigation. The chapter is organized into two main sections which provide summaries of qualitative and quantitative research. It is shown that qualitative evidence is relatively limited in scope. Case reports suggest that problematic Internet and gaming behaviors can have a rapid onset that often arises in the context of busy and unfulfilled lives, particularly among individuals with preexisting psychological issues (e.g., depression, anxiety). The quantitative evidence is more developed and growing. Most studies have focused on adolescence. Studies suggest that social factors such as family life and parent-child relationships play a strong role in the development of persistent behaviors (e.g., gaming to escape from parental conflict). Preexisting poorer social skills, attention issues, and neurotic personality type are risk factors. Overall, the evidence suggests that many individuals, representing a diverse range of social background and psychological vulnerabilities, report long-term problems with Internet and gaming activities. Future research is needed to gain better understanding of these problems to assist affected individuals and their families.