1. Introduction
Video Gaming is a ubiquitous technology that has become a part of everyday life. In the UK alone, consumers spent roughly £4.75bn on video games in 2022 with the video game consumer market worth £7.05 billion (UKIE, 2023). This has followed a rapid growth of interest in gaming following the Covid-19 pandemic (Pallavicini et al., 2022), in which video games played a crucial role in mitigating experiences of stress and other prominent psychological health concerns during a time of intense social isolation (Giardina et al., 2021; Kriz, 2020; Oe, 2020; Paschke et al., 2021).
However, the growth of video game consumption has piqued the interest of academia: the debate surrounding video games and their social consequences gravitates around two central ideals. On one side, some articles suggest that video games can be utilised for positive psychosocial outcomes such as increasing social connectivity, improving psychological well-being, and encouraging cooperation between players (Halbrook et al., 2019; Jenny & Thompson, 2016; Johannes et al., 2020). On the other side, some articles suggest that video games have the potential to increase aggressive cognitions (Anderson & Bushman, 2001; Hasan et al., 2013) or may be used in problematic ways that can evolve into a behavioural addiction if used in a way that severely disrupts facets of everyday life (Kuss & Griffiths, 2012; Loton et al., 2016; Wolfers & Schneider, 2021).
Video gaming also has a versatile range of applications in healthcare settings: e.g. using video games as a ‘distractor activity’ allowed children undergoing chemotherapy to regain a sense of resilience to the harsh side-effects of the therapy (Govender et al., 2015). Engagement in video gaming also helped to increase coping skills, internal locus of control, and self-management of symptoms by playing minigames as a superhero, including metaphors for beating cancer and ultimately empowering the patient to fight through depressive symptoms (Govender et al., 2015). It has also been used in a traditional therapeutic context in order to bridge the gap between therapist and client, a solution that is particularly effective with younger clients (Fernández-Aranda et al., 2012; Gardner, 1991; Hull, 2009).
Outside of clinical contexts, having an online presence within a video game can help to promote the cultivation of strong relationships with other players through shared experiences (Cole & Griffiths, 2007). Indeed, many choose to keep playing these types of games on the hope that they themselves will partake in such rich social interactions with other players (Tyack et al., 2016). In-game social interactions can provide an unorthodox therapeutic outlet otherwise unavailable to players, and many players find that in-game experiences are not available to them offline (Frostling-Henningson, 2009). It is the availability of diverse emotional experiences that have the potential to elicit complex psychosocial outcomes, such as improved mood and psychological regulation of stress (Bowman & Tamborini, 2012; Porter & Goolkasian, 2019; Russoniello et al., 2009a).
However, extreme exposure to stress offline may drive some to coping mechanisms through widely accessible means, such as technology (Cheikh-Ammar, 2020; Maroney et al., 2019; Reinecke, 2009). It has been widely discussed that escapism-driven uses of video games especially can lead to maladaptive use behaviours if the player becomes dependent on the psychological benefits of these activities to alleviate stress (Hussain et al., 2021; Kardefelt-Winther, 2014). Furthermore, Dutcher & Cresswell (2018) highlight the role of dopaminergic reward pathways in the regulation of stress. Given that these pathways also feature in the development of behavioural addiction (Poisson et al., 2021), it is important to learn more about the relative benefits and risk of activities such as gaming, which have the potential to be both stress-relieving and addictive.
Reinecke (2009) demonstrates that using interactive media such as games has a “significant recovery potential and are frequently used after stress and strain for recovery reasons” (pg. 26). Furthermore, this research finds that work-related stressors are a reliable predictor for the usage of video games, and that individuals can adapt their use of video and computer games to their individual circumstances. The research covered so far demonstrates that video game players walk a fine line between enjoyable and problematic use of games depending on their primary motivations for use.
Some video game players exhibit symptoms of video game addiction, which has been clinically recognised in previous literature and the criteria for diagnosis published within the International Classification of Diseases, eleventh edition (Griffiths et al., 2012, 2017; Kuss & Griffiths, 2012). The clinical criteria for gaming disorder include losing control over the amount of time spent playing games, conflicts with friends and family members over their habits, and the increased prioritisation on gaming as opposed to work or academic performance (Jo et al., 2019; Kuss & Griffiths, 2012). Previous research has attributed this, in part, to the rise of addiction in gaming towards the failure to either recognise emotions (alexithymia) or manage emotions, using video gaming to experiment with and correct emotional availability (Gaetan et al., 2016). However, it may be that a small minority of video game players are inefficiently regulating mood or over-relying on the game to regulate their mood for them, which has been observed in other modes of technology such as mobile phone apps (Kwon et al., 2016).
Within the video game psychology literature, there are several research papers that investigate the role of video game usage as a way of creating and promoting emotional regulation strategies (Villani et al., 2018). Emotional regulation is the process of people achieving targeted changes or fluctuations in mood by engaging with specific behaviours, leading to changes in positive and negative affect. It is posited by Villani and colleagues that people may use video games as a way of “enhancing their emotional lives and protecting themselves from psychopathologies” (pg. 2). It could be plausible that video gaming is being used as a psychological ‘mood enhancer’ and may explain why it has the potential to become a cathartic relief to the stresses of everyday life.
Previous research suggests that individuals who have problems with emotional regulation are more likely to engage in addictive behaviours to escape from, or minimize, negative moods (Yu et al., 2013). It is possible that players who adopt maladaptive coping strategies (e.g., increased play time, neglect of social responsibility, etc.) become dependent on positive video game effects such as psychological need satisfaction (Allen & Anderson, 2018) or mood regulation (Greenwood & Long, 2009) to escape from and regulate the negative psychological impact of offline stress.
However, it has become a source of debate over whether behaviours such as gaming and problematic Internet usage should be classified as an addiction in the same way as substance disorders (Bean et al., 2017; Wood, 2008). It has been suggested that these share similar characteristics in terms of tolerance, mood modification, relapse rates, and withdrawal symptoms (Griffiths, 1999). However, alternative theoretical frameworks could be better suited to explain Internet Gaming Disorder.
Kardefelt-Winther responded to the discourse on Internet addiction by suggesting that Internet usage could be explained as a compensatory mechanism (2014a). In theory, users experience a lack of social resources (e.g., social capital or cognitive arousal) offline, and therefore increasingly depend on the Internet and the online stratosphere to provide experiences that provide the resources which they lack. This is opposed to an addiction framework, as the compensatory usage model conceptually defines problematic usage as a way of fulfilling a need in a highly engaging way or can develop as a result of a maladaptive response to stress (Kardefelt-Winther, 2014). This particular model highlights the importance of stress as a unique risk factor, as opposed to the myriad of other factors commonly associated with Internet addiction, such as personality traits (Leung, 2007), and psychological well-being (Young & Abreu, 2010).
This study investigates the impact of a short-term video gaming session upon both biological and self-reported stress levels. Stress has been used in previous work as an ecologically valid way of measuring affective change to repair mood and prevent negative physiological consequences (Russoniello et al., 2009b). If the motivations of users are to decrease negative affect and increase positive mood, we hypothesise that it would be reflected in decreased stress scores. Whilst Kardefelt-Winther established this effect in the domain of Internet usage, it will be the purpose of this study to test whether these effects are applicable to video game players. If these effects can be demonstrably exhibited in video game players, it would have implications on how video gaming can be used in both ‘healthy’ and ‘unhealthy’ ways.
This research is based on the theory that emotional regulation strategies through video game play act as positive psychosocial compensation, which for moderately engaged players can be a healthy coping strategy (Gaetan et al., 2016). However, it would also be of interest to investigate potential correlations between more problematic video game use and mood shift after video game exposure, as a way of clarifying possible motivations for video game playing in those who score highly on Internet Gaming Disorder (IGD) criteria (Király et al., 2017). To investigate these assertions, an experimental task will be employed to compare stress before and after exposure to a commercial video game, with the expected effects of positive affective changes after video game exposure.
An Internet Gaming Disorder (IGD) scale will be used to assess self-reported levels of gaming disorder in participants. In accordance with Kardefelt-Winther’s research on Internet addiction (2014a) that demonstrated a mediated link between problematic internet use and affect, it is expected that those scoring highly on problematic gaming behaviours will also exhibit a higher affect shift. This will therefore be assessing whether those who register positive for several IGD criteria experience an elevation of mood and decrease of stress, which may be able to explain why players show problematic patterns of behaviour. Regardless of the motivations for play, we expect to find that video game play has a positive physiological impact on players.
To summarise, this research will be investigating the correlations between stress (at both a biological and a self-reported level), video gaming, and (self-reported) problematic video gaming behaviours, grounded in Kardefelt-Winther’s compensatory Internet use theory (2014a). This is in response to a lack of established research exploring these interactions, and with a wealth of research currently dedicated to addiction models of video game play, it would be suitable to entertain alternative explanations for motivations behind problematic video game play.
Considering the evaluation of relevant literature and the aims of the study, we predict that:
H1 – Exposure to video game play will decrease biological measures of stress.
H2 – Exposure to video game play will improve positive affect scores.
H3 – Exposure to video game play will reduce negative affect scores.
H4 – Higher scores on a gaming disorder scale will be associated with a greater increase in positive affect.
H5 – Differences in biological stress scores after video game play compared to before video game play will be associated with higher gaming disorder scores.
4. Discussion
The aim of this study was to test hypotheses, based on previous findings, that video game play would decrease biological indicators of a stress response (H1), encourage positive mood states (H2), and regulate negative mood states (H3). It was also expected that the degree of increase in positive mood states after gaming would be associated with higher scores on a gaming disorder questionnaire (H4), and that there would be an association between a biomarker of stress and gaming disorder scores (H5), providing support to compensatory use accounts of video game play and illustrating why video gamers may engage in problematic use behaviours. This research used an experimental research design featuring widely accessible technology to measure biological markers of stress and a popular video game that would be accommodating of any game player, regardless of previous gaming experience. This study also provided a unique methodological perspective of measuring both biological and self-report measures of stress to partially mitigate some criticisms of biases involved in these techniques (Zendle et al., 2023).
The results of this study suggest that video gaming has a measurable effect on biological stress, isolated to a short gaming session within a laboratory environment. Exposure to the video game decreased stress levels compared to pre-experimental levels, which supports H1. This also supports a growing evidence base from previous literature that suggests video game play has been observed to measurably decrease experiences of stress (Koban et al., 2021; Pallavicini et al., 2021; Reinecke, 2009; Russoniello et al., 2009b). Indeed, in a casual form, video gaming has been previously compared to guided relaxation or meditation (Stanhope et al., 2016).
Results suggest that video game had a measurable effect on participant mood states. Self-reported positive mood scores increased by roughly 3 points per participant on average after the video gaming session, whereas self-reported negative mood scores decreased by roughly 2 points per participant on average after the video gaming session. The results therefore support H2 and H3.
Results did not support the prediction that problematic gaming scores would be associated with a more pronounced changed in affect as a result of playing the game, which was unexpected and does not support H4. The results also did not support the prediction that there would be an association between the difference in IPR scores measured after exposure to video game play and gaming disorder scores, which refuted H5.
One possible explanation for this is that the data set used for analysis did not have sufficient power to identify small effect sizes. Whilst an a priori power analysis indicated that the study was sufficiently powered to detect medium effect sizes, it is possible that the predicted relationship is only evident when measuring for smaller effect sizes, as discussed in previous literature on video game research (Johannes et al., 2021). Whilst it may be possible that video gaming’s ability to moderate affect plays a role in problematic gaming behaviours, the present study did not detect a disproportionate effect of gaming on the affect of those with higher IGDS9-SF scores.
4.1. Interpretations of Results
A confounding variable that could explain these results may have been the difficulty level of the game. The ‘Grand Prix’ game mode was set to ‘Easy’ as a default option, to cater for a variety of experience levels in the target population. However, one might expect that individuals that exhibit higher levels of problematic gaming would be more experienced or skilled at the game used in the present study; for some participants it was observed that this setting represented little-to-no challenge. Whilst these individuals may experience a small increase in mood, it is plausible that any mood increase would be attenuated by the easiness of the game by frustrating the players’ ability to experience achievement or competence from the gaming session.
This may also provide an explanation for the lack of association between IPR difference scores and gaming disorder scores (H5); individuals who exhibit higher levels of problematic gaming may be ‘desensitised’ to a short video gaming session that provided little to no challenge – it may be the case that excitation of the nervous system (such as increased heart rate) simply would not occur unless certain goals are being met within the gaming session. This has been referred to as ‘gaming tolerance’ in previous literature (King et al., 2017), however, there is a need to emphasise that this is more than players needing more time to engage with a video game. Indeed, it appears that there are several complex emotional and motivation-based factors to consider for those with gaming disorder, such as craving, fear of missing out, and the intense need to fulfil psychological needs (King et al., 2017; Przybylski et al., 2010; Yee, 2006).
For inexperienced players, an easy game allowed for a greater possibility of success, which may have improving feelings of competency, which has been associated with levels of psychological well-being (Lemmens et al., 2011). However, the opposite was also true for more experienced players, which may have unintentionally created diametrically opposed ceiling and floor effects on the PANAS. It may also be the case that participants with less gaming experience would naturally experience more negative affect as levels of competency decrease by having to ask for instructions at an increased rate or experiencing feelings of helplessness. Nevertheless, if the study was replicated with the inclusion of controls for video game difficulty and prior gaming experience, it may be easier to observe the effects predicted in H4.
This may be explained through the lens of Self-determination theory (Ryan & Deci, 2000) which suggests that individuals engage in behaviours that encourage the fulfilment of three basic psychological needs – Autonomy, Competence, and Relatedness. As the video game fulfilled all or some of the three psychological needs, participants may have experienced a greater positive affect. As these needs may have been frustrated by a lack of experience with the game, participants may have experienced a greater negative affect shift. However, the degree to which this was experienced and whether it can truly be asserted that experience would be a significantly moderating factor as to shift self-reported affect scores remains to be seen. Further research should endeavour to explore the nature of the relationships between the variables observed and theorised in this study.
The changes in mood in this experiment imply that video games can have a short-term stress-relief effect; this is similar to the theoretical principles of compensatory internet use, examined by Kardefelt-Winther (2014a). It could be suggested that problematic gaming behaviours are driven by the need to attenuate the effects of stress by interacting with video games, ameliorating this stress for a short while. It could be in this small time zone in which the overall experience of video gaming remains positive; it could be argued that the continued use and therefore over-reliance of gaming effects is what contributes to negative experiences and potential addiction (King & Delfabbro, 2014).
The results of this study implies that anyone wishing to experience a stress-relief impact from video gaming should already be at a moderately stress-free cognitive stage (Nahum & Bavelier, 2020). This also provides some explanation as to why problematic gaming has such a strong association with stress (Király et al., 2015, Rikkers et al., 2016); the compensatory internet use theory (Kardefelt-Winther, 2014a) posits that external social stressors contribute to an increased investment in resources (time, etc.) by gaming more to escape the negative consequences of this stress. However, it has been theorised that escapism is only effective as a short-term method of stress-relief (by dissipating some stress), with the potential to become both a new source of stress, and individuals developing an addictive behavioural relationship with gaming as a result (Király et al., 2015).
4.2. Limitations & Considerations
A limitation of this study is that the experiment was conducted without a control group, so it is not possible to be certain whether the mood state effects observed were solely due to the influence of the video game. Indeed, a control group would have established whether changes in mood or biological stress were influenced by any natural relaxation effects as the participants became more comfortable with the laboratory environment and could have used an unrelated activity as a comparable measure. However, the experimental protocol did partially account for relaxation effects by allowing participants to ‘settle in’ to the laboratory space, allowing for a short amount of time in which the participant’s heart rate would normalise before the first set of PPG readings. Enforcing a brief rest period before readings were taken allowed for a more natural baseline heart rate measurement in participants and would potentially mitigate any environmental stressors.
Previous research with similar research methodology found that changes in affect measured by the PANAS in the gaming condition were larger, whereas the control condition reported only mild changes in affect (Stanhope et al., 2016). It appears that whilst the results in the present study may have captured a relaxation effect occurring, the positive affect shift was more pronounced than in a comparative study. Regarding stress, previous research has established that video games, regardless of content, are able to reduce stress (Desai et al., 2021; Roy & Ferguson, 2016), which the results of the present study further supports. However, previous research suggests that biomarkers of stress increased slightly from pre-gameplay levels to post-gameplay levels (HRV; Porter & Goolkasian, 2019), which was not observed in the present study. This suggests that the results of the present study go beyond an expected general relaxation effect and that a short session of video gaming may provide tangible stress-relief benefits for the player.
One limitation of this study is the use of a student sample. Whilst this was convenient for the fulfilment of the study aims, the use of a more heterogeneous sample may be more impactful to the wider discussion of video games research. The results of this study provide further insights as to the video gaming behaviours of university students but are not necessarily generalisable to a wider population.
Another limitation of this study was the length of time used to play the video game chosen. Whilst the ‘Grand Prix’ mode was appropriate to experience a wide range of aesthetic or enjoyable experiences within the video game, it is unclear whether a 20–30-minute session of video gaming is sensitive enough from a methodological perspective to identify any significant stress-relief or mood regulation changes compared to before the session. Although, a systematic review of video gaming for the relief of stress and anxiety noted that even one to five minute sessions of game play were effective at reducing stress (Pallavicini et al., 2021), which was supported in this study. Therefore, duration may not be a major limitation to observing stress-health relationships.
Finally, this study used PPG as a measure of Instantaneous Pulse Rate, which is an alternative to materials used to measure Heart Rate Variability. This was chosen based on accessibility and convenience as the author did not have access to Electrocardiogram (ECG) equipment that produces the signal necessary to measure HRV. It is acknowledged that whilst the signal used during IPR measurement “exists between ECG and PPG signals” (Huang & Hsiao, 2022; pg. 2), it is not the most ideal proxy for measuring heart rate. Using a measure such as Instantaneous Pulse Rate Variability (Gil et al., 2010; Kiran kumar et al., 2021) may have been a better alternative considering the resources available. For future research or replication efforts, where resources allow, using ECG or HRV measures would be considered the gold standard for biological measures of stress.
4.3. Conclusion
In conclusion, video games have the potential to reduce biological measures of stress, whilst generally improving mood states (lowered negative state, higher positive state), after a short session in experimental laboratory conditions. Whilst this study cannot make any assumptions or claims as to the nature of problematic video game behaviours, the results support previous literature that asserts video gaming as comparable to alternative methods of stress-relief (Pallavicini et al., 2021). The observed changes in mood state and stress have implications towards wider health effects, mainly that video games have the potential to positively influence physical and psychological well-being in short durations. However, the findings are limited by some methodological design flaws and would benefit from replication with the addition of a control group.