AN EXAMINATION OF MASSIVELY MULTIPLAYER ONLINE ROLE-PLAYING GAMES AS A FACILITATOR OF INTERNET ADDICTION

ABSTRACT
Researchers have indicated that Internet addiction is a wide-spread problem, impacting the lives of an estimated 4-10% of all Internet users. Researchers have also indicated that Internet addiction has a social component, with Internet addicts using the
Internet to build and maintain new social relationships at a much higher rate than nonaddicts.
This study explored Internet addiction in the context of Massively Multiplayer
Online Role-Playing Games (MMORPGs). Data were drawn from MMORPG players and from mental health counselors to determine incidence rates of Internet addiction among MMORPG players, social needs that were predictive of Internet addiction, rates of treatment seeking behaviors by MMORPG players for Internet addiction, and how
Internet addiction is diagnosed and treated by mental health counselors.
For this study, the MMORPG Player Survey and the Counselor Surve y were used to collect data from MMORPG players and mental health counselors. The MMORPG
Player Survey was administered to 513 MMORPG players. The Counselor Survey was administered to 80 mental health counselors.
Results from the MMORPG Player Survey indicated that approximately 15%
(n=78) of MMORPG players met criteria for Internet addiction, as defined by the
Diagnostic Questionnaire (DQ). A stepwise regression analysis of loneliness, online confidence, online liberation, validation, and support found that loneliness and online confidence were both positively predictive of Internet addiction among participants. Of
MMORPG players surveyed, less than 1% (n=3) indicated that they have sought professional help for Internet addiction. Mental health counselors reported that Internet addiction was most likely to be diagnosed as depression, obsessive-compulsive disorder, or impulse control disorder. Furthermore, mental health counselors reported that they were most likely to treat Internet addiction using one of the following theoretical orientations: cognitive, reality, family systems, or solution focused.
These findings highlight a subpopulation of the online community who are in need of mental health services and are not receiving them. Recommendations for future research include qualitative studies exploring the social aspects of MMORPG gaming among Internet addicts, as well as research exploring potential deterrents to mental health services among this population.

CHAPTER I
INTRODUCTION
Advances in Internet technologies have resulted in an unprecedented level of accessibility to informatio n, products, services, communication, and entertainment. The opportunities offered by the Internet are accompanied by unique psychosocial phenomena, many of which challenge the counseling profession. These phenomena are unique in the sense that they are relatively new to the lives of clients, leaving clinicians with a limited base of experience from which to draw when dealing with these issues.
One psychosocial concern that arises with the advent of the Internet is problematic Internet use (Young, 1996). Problematic Internet use can occur in a variety of settings, impacting the social, vocational, and academic functioning of affected
Internet users (Beard, 2002; Browne, 2002; Griffiths, 2000; Hansen, 2002). Problematic
Internet use is characterized by a core set of attributes, including a pre-occupation with
Internet use, mood modification, need for increasing amounts of Internet use, withdrawal, conflict, and relapse (Griffiths, 1998). The effects of problematic Internet use are varied but often include loss of sleep, strained relationships, and reduced levels of productivity in vocational and academic settings. These effects are associated with not only the amount of Internet use, but the prioritization of Internet use over other life commitments
(Griffiths, 2000; Kandell, 1998; Morahan-Martin & Schumacher, 2000; Young & Case,
2004).
Research indicates that some forms of problematic Internet use may be driven by a desire for social interaction and an increased level of social visibility (Amichai2
Hamburger, Wainapel, & Fox, 2002; Weiser, 2001). Unlike face-to-face social interactions, the Internet allows for unparalleled anonymity and control when communicating with others (Kandell, 1998). These factors allow individuals to engage in social relationships that carry minimal risk, while allowing them to adopt roles or characteristics that may not be representative of their face-to-face relationships (Amichai-
Hamburger et al., 2002; Peris et al., 2002; Sanders, Field, Diego, & Kaplan, 2000;
Scealy, Phillips, & Stevenson, 2002).
Massively multiplayer online role-playing games, commonly referred to as
MMORPGs, provide a unique platform for developing social interactions on the Internet.
MMORPGs allow for simultaneous text-based and graphical communication with others and provide well defined structures that encourage a variety of social interactions. While some forms of Internet use encourage two-way communication, MMORPGs often require high levels of social interaction and facilitate the adoption of new personas and styles of interaction. There is limited research on the relationship between MMORPGs and problematic Internet use (Griffiths , Davies, & Chappell, 2003). However, certain characteristics of MMORPGs and their users indicate that this form of Internet use may be a powerful facilitator and enabler of problematic Internet use.
This study will expand the counseling profession’s understanding of problematic
Internet use by examining the role of MMORPGs as facilitators of problematic Internet use. Specifically, this study will explore incidence rates of problematic Internet use among MMORPG players, social predictors of problematic Internet use, and the rate at which gamers seek treatment for the condition of problematic Internet use. Problematic
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Internet use will be contextualized in terms of counselor diagnostic and treatment attitudes toward the phenomena. This study will also extend the counseling profession’s understanding of problematic Internet use by broadening research beyond traditional college populations to a broader range of MMORPG users.
Problematic Internet Use as Internet “Addiction”
Theorists have struggled to clearly define the phenomena of problematic Internet use. The most accepted conceptualization of problematic Internet use is that of Internet addiction (Griffiths, 1998). While some theorists are critical of defining problematic
Internet use as an addiction (Griffiths, 1998; Grohol, 1995), the concept of non-chemical behavioral addictions is gaining increasing support among mental health professionals
(Marks, 1990). Examples of this acceptance are found in the common use of terms such as “eating addiction,” “sexual addiction,” and “gambling addiction” within the counseling profession, as well as increasing references to Internet addiction as a legitimate phenomenon (Kennedy, 2005; Marks, 1990).
The increasing acceptance for behavior addictions is manifest in research literature that examines problematic Internet use. Almost without exception, literature regarding problematic Internet use frames the phenomena in terms of Internet addiction
(Brenner, 1997; Griffiths, 2000; Morahan-Martin & Schumacher, 2000; Pratarelli &
Browne, 2002; Young, 1996). As a profession, it appears that counselors have defined a common, if unofficial, language for talking about Internet use that interferes with the lives of clients.
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In order to accommodate the common language of the counseling profession and work within the confines of the professional literature, this study will address problematic
Internet behaviors in terms of Internet addiction. This use does not preclude the possibility that there are alternative descriptions of problematic Internet behaviors, nor does it imply a belief in any chemical basis for the addictive behavior.
The two primary models for conceptualizing Internet addiction are Pathological
Internet Use (PIU) and Internet Addiction Disorder (IAD) (Goldberg, 1996; Young,
1996). Pathological Internet Use conceptualizes Internet addiction using adapted criteria for pathological ga mbling. Under this model, individuals suffer from PIU if they meet five of eight designated criteria (Young, 1996). Similarly, Internet Addiction Disorder conceptualizes Internet addiction using adapted criteria for substance dependence. While the diagnosis for IAD was originally offered as a joke, others have expanded IAD’s original premise, introducing scales for assessing IAD (Brenner, 1997; Goldberg, 1996;
Griffiths, 2000).
PIU and IAD share common characteristics, including the inability to reduce amounts of Internet use, disruptions in daily living (e.g., work, family, school), and dependence on Internet use to maintain psychological well-being (Griffiths, 1998). In addition, Internet addicts often suffer from reduced social interactions with friends, family, and co-workers (Kraut et al., 1998; Kubey, Lavin, & Barrows, 2001; Weiser,
2001). While competing conceptualizations and conflicting diagnoses frustrate attempts to formally recognize Internet addiction as a disorder, there is general consensus that excessive Internet use is interfering in the daily functioning of a significant subset of
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populations worldwide (Chou, 2001; Griffiths, 2000; Grohol, 1995; Lin & Tsai, 1999;
Oravec, 2000).
There is consistent evidence of addictive behaviors among Internet users. While early studies of Internet addiction found incidence rates as high as 80% (Brenner, 1997;
Young, 1996), these studies may have limited generalizability as a result of sampling bias
(Griffiths, 2000; Grohol, 1995; Hall & Parsons, 2001). In recent studies of Internet addiction among college students, researchers have established a 4-10% incident rate of
Internet addiction, with conservative estimates using both the criteria for PIU and IAD establishing a 6% rate of addiction (Anderson, 1999; Chou, 2001; Lin & Tsai, 1999,
2000; Wang, 2001). These lower rates of Internet addiction are supported in non-college populations, with one researcher determining that approximately 6% (n=17,251) of participants in a national study met the criteria for Internet addiction (Greenfield, 1999).
With over 600 million Internet users worldwide, this equates to as many as 36 million
Internet addicts using conservative estimates (NUA, 2002).These findings suggest that excessive use of the Internet is problematic and worthy of the attention of counselors.
Internet addiction has potentially devastating implications for not only the addicts themselves, but also for their families, employers, and other social relations. Like other forms of addiction, Internet addiction consumes the time and energy of the addict, destroying interpersonal relationships and limiting the academic, vocational, and social potential of those afflicted (Eppright, Allwood, Stern, & Theiss, 1999; Kandell, 1998). In addition, Internet addiction provides a false sense of accomplishment and connection,
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substituting rich and meaningful face-to- face relationships with virtual relationships that may stunt the social development of the addict (Kraut et al., 1998; Kubey et al., 2001).
As discussed earlier, one of the defining characteristics found among Internet addicts is a desire for excessive amounts of synchronous communication. Unlike typical
Internet users, who maintain existing relationships using the Internet (e.g., emailing family, chatting with friends, etc.), Internet addicts use synchronous Internet media to establish and maintain new relationships. These new relationships often take precedence over existing face-to-face relationships, resulting in conflict in the individual’s life outside of the Internet (Griffiths, 2000; Kandell, 1998; Kubey et al., 2001; Seepersad,
2004; Weiser, 2001). Synchronous communication is achieved using numerous Internet technologies including chat rooms, instant messaging, and online gaming (Kubey et al.,
2001). This relational orientation among Internet addicts defies traditional stereotypes of technology addicts as loners and social isolates. Rather, it appears that Internet addicts are individuals who are using the Internet to meet social needs (Brenner, 1997; Kubey et al., 2001; Scealy et al., 2002; Shotton, 1991; Young, 1996).
Need for Additional Study
Massive Multiplayer Online Role-Playing Games (MMORPGs) offer a distinctive opportunity for the study of Internet addiction. First, like chat rooms and instant messaging systems, MMORPGs offer the ability to create and maintain new relationships while maintaining an element of anonymity. Online role-playing games take these elements a step further by requiring the generation of a new online personae (called an
“avatar” or “character”) and providing an environment and tools that encourage active,
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on-going socialization (Gamespy, 2003). These aspects of the gaming experience are reinforced by offering the possibility of growth, achievement, and social prestige within the online context in ways that are unique to MMORPGs (Griffiths et al., 2003; Yee,
2001b).
Second, participants in MMORPGs are online significantly greater amounts of time than non-MMORPG Internet users. While the average Internet user spends approximately four hours a week online (How americans are expanding their use of the internet, 2002; Nie & Erbring, 2000), the average participant in an MMORPG spends 20 or more hours a week playing online, above and beyond time spent on other activities such as email, web browsing, and shopping (Griffiths et al., 2003; Origin, 2003; Yee,
2001b). Researchers generally agree that Internet use becomes problematic when it exceeds 20 hours per week, placing the vast majority of MMORPG participants in an atrisk category for Internet addiction (Brenner, 1997; Chou, 2001; Chou, Chou, & Tyan,
1998; Lin & Tsai, 2000). The issue of addictive game play is further complicated by that fact that, unlike most other Internet services, MMORPGs are designed to encourage addictive behavior (Jen, Lee, Liu, & Manus, 2002; Staehlin, Schubert, McShaffry, &
Meunier, 2003).
Third, MMORPGs are an increasingly popular form of entertainment, impacting growing numbers of individuals. In 2000, the MMORPG industry reported that approximately 300,000 individuals participated in MMORPGs. By the end of 2003, this number exceeded 3,000,000 (Woodcock, 2003). Further support for the growth of
MMORPGs is evidenced in the number of MMORPGs currently available and under
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development, and the numbers of players engaging in this form of entertainment. For example, in late 2004, Blizzard launched a new MMORPG, World of Warcraft. Within six months of shipping this product, over 1,500,000 players had subscribed to the service worldwide (World of Warcraft Sets New Milestone With 1.5 Million Subscribers
Worldwide, 2005).
Fourth, excessive MMORPG use, as a form of Internet addiction, is growing in prevalence among clients seeking counseling. While no detailed studies are available on exact incidence rates, anecdotal reports indicate that this is an increasing issue among therapists in numerous settings (Griffiths et al., 2003; Oravec, 2000; Whiteley, 1999).
Popular media and news have also reported difficulties with addictive behavior in
MMORPG users, relating incidents of child neglect, suicide, and failing marriages as a result of excessive MMORPG involvement (Becker, 2002; Bersten, 2002; Patrizio,
2003). Further research is needed to determine the extent to which these anecdotal reports are representative of counselor experiences working with clients.
Finally, the growing body of literature on Internet addiction is largely focused on conceptualizing Internet addiction and defining the impact that it has on addicts. There is a lack of substantive research on counselor attitudes and practices in response to Internet addiction, MMORPG-based or otherwise. Given the relatively new phenomenon of
Internet addiction, a greater exploration of how counselors view this phenomena is warranted (Chou, 2001; Griffiths, 2000; Griffiths et al., 2003; Hall & Parsons, 2001).
In sum, MMORPGs represent a unique form of Internet use that lends itself toward addictive online behaviors. While the impact of these addictive patterns are
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beginning to be seen in counseling settings, there is a limited body of literature defining the addictive experience, its incidence rates, or counselor attitudes toward this phenomena in clients. Given the noteworthy growth of this area of Internet use,
MMORPGs warrant a serious investigation of the phenomena of Internet addiction.
Purpose
The purpose of this study was to examine MMORPGs as facilitators of Internet addiction. This study sought to answer the following questions:
1. What is the incidence rate of Internet addiction among MMORPG players? 2. Which of the following social needs predict Internet addiction among
MMORPG players: loneliness, support, validation, confidence, and liberation? 3. To what degree are players of MMORPGs seeking treatment for Internet addiction? 4. How are counselors diagnosing Internet addiction?
5. What theoretical approaches are counselors using to treat Internet addiction? What are MMORPGs?
This section provides an overview of the history, characteristics, and language of
MMORPGs. This background is necessary in order to fully understand the context of the addictive behavior.
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History
MMORPGs find their origins in the late 1970’s and were originally referred to as
Multi-User Dungeons, or MUDs. The first MUD was developed by Roy Trubshaw and
Richard Bartle during their studies at the University of Essex. Titled “MUD,” their game was text-based, and operated on a mainframe computer. Players connected to the game using dumb terminals (“computers” that consist of a keyboard and monitor that lack storage and processing capabilities and are directly linked to a computer server). The title for this early venture into multiplayer gaming was later generalized as a reference to all text-based multi- user games. Establishing a pattern for the majority of future MUDs and
MMORPGs, Trubshaw and Bartle’s game was fantasy based, and allowed users to create an online persona, explore a virtual dungeon, kill creatures, gain experience and abilities, group with or against others, and gather loot (Gamespy, 2003).
The number of MUDs has expanded over the past two decades. Approximately
1,670 MUDs are available online today (Gamespy, 2003). The modern MUD bears many similarities to Trubshaw and Bartle’s early work. Modern MUDs are text-based, typically contain a fantasy theme, use a mainframe/terminal architecture, and are free of charge
(Gamespy, 2003).
As computer and Internet capabilities increased, software developers gained the ability to extend the features of MUDs, eventually creating the possibility of profitable online gaming systems. In 1996, 3DO Games shipped the first commercially viable
MMORPG, dubbed Meridian 59, to stores across the United States. Unlike MUDs, which do not require special software to operate, Meridian 59 operated on a client/server
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architecture that required users to purchase game software to install on their personal computers. Then, for a monthly fee of $9.99, users could connect to the Merdian 59 servers, and play in the game’s interactive online world. Meridian 59 was graphics-based and could support up to 250 players on one server. Players interacted in a “2.5D” environment that simulated a first person view but used two-dimensional graphics. While
Meridian 59 is no longer a mainstream product, it remains commercially available today
(Meridian 59 frequently asked questions, 2004).
In the fall of 1997, Origin Studios released Ultima Online, the game that ultimately popularized MMORPGs. Like Meridian 59, Ultima Online used a client/server model, had a graphical interface, and charged a monthly fee. However, Ultimate Online was established from an existing franchise and was an immediate commercial success, with a user base that quickly exceeded 200,000 players. Using a top-down view, Ultima
Online allows users to create unique characters, own homes, explore, gain abilities and items, and form “guilds” or online player associations. While Ultima Online is considered outdated by today’s standards, the game remains popular and has maintained a membership of approximately 200,000 players (Gamespy, 2003).
Modern MMORPGs operate using true three-dimensional graphics. Popular titles include Everquest, Dark Age of Camelot, Ultima Online, Star Wars Galaxies, Final
Fantasy XI, and World of Warcraft. Despite advances in technology and wide-spread growth among Internet users, all MMORPGs build upon a common set of characteristics, allowing players to transition from one game to another with an understanding of fundamental game mechanics, purpose, and function (MMORPG, 2004).
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Common Characteristics
A wide range of genres are represented in MMORPGs, including fantasy, science fiction, historical, and authentic war settings. Several key underlying technologies and characteristics are shared by these products. Most of the characteristics of MMORPGs stem from their roots in the MUDs of the 1980s and 1990s, though the technology is significantly advanced.
Client/Server Architecture
The creation and maintenance of virtual online worlds require a significant investment in equipment. All MMORPGs provide game content on one or more servers.
The technical requirements of modern MMORPGs typically involve multiple highly customized computers (called clusters) to support one gaming “world” or server. Most titles support multiple gaming servers, allowing users to create “characters” or avatars on one or more of these servers. While commercial companies provide the servers on which game content is located, users must purchase client software that resides on their personal computers. This software provides the interface that allows connectivity to the game servers and interaction with other players. While there is some variation among games, the typical MMORPG can support between 2,000 and 4,000 simultaneous users per game server, with larger titles often hosting dozens of game servers from which players can choose. Servers are frequently tied to geographic location. This localization process allows North American, European, and Asia n populations to participate on servers with others who share the same general time zone.
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Monthly Fee
Unlike MUDs, which are traditionally free of charge, MMORPGs have an initial cost to purchase the game’s client software and an additional monthly fee to maintain an account. These recurring costs range from $9.99 for older titles such as Ultima Online to
$14.99 for newer titles such as Star Wars Galaxies and World of Warcraft. Some companies, such as Sony (2004), offer package deals wherein players can pay a higher single rate and access multiple MMORPG titles offered by the same company.
Avatars
All MMORPGs require users to create at least one game avatar (commonly referred to as a “character”). The game avatar is a graphical representation of the being the user desires to play in the gaming world. Avatars are controlled by users through a combination of mouse and keyboard commands, and can navigate the virtual world provided by the game. As technology advances, users have increasing flexibility in determining the appearance of their avatars. At a minimum, most MMORPGs allow for selection of race, gender, and general features such as skin tone, height, and weight.
Some newer MMORPGs allow for detailed control of facial features and body composition to the degree that users can often visually recreate themselves online
(Gamespy, 2003).
Character Development
MMORPGs provide either skill or class based means for advancing one’s avatar.
In a skill-based system, the avatar gains abilities by performing tasks. For example, to advance in a hunting skill, one “hunts” through mechanics provided within the game. To
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gain skills in combat an avatar engages in combat against computer generated opponents
(often referred to as “mobs” or “npcs”) or other players. Skill-based systems allow avatars to mix and match skills that suit their interests. These skills usually have some predefined limit to prevent avatars from becoming too powerful in relation to the gaming environment. The alternative to a skill-based system is a class-based system. Class-based systems allow avatars to choose a profession such as warrior, sorcerer, mechanic, pilot, spy, or other role, depending on the genre. Each class has levels that require increasing numbers of “experience points” to achieve. At each level, the avatar gains additional abilities that are associated with that class. In most class-based MMORPGs, levels of skill are gained by combating creatures in the gaming world. A “level 1” character might require an hour or so of combat in order to gain “level 2.” However, upper levels in classbased games typically require dozens, or even hundreds, of hours to achieve (Lynn,
2001).
Material Advancement
While avatars have the ability to increase their skills within the gaming world, they also have the ability to amass wealth and powerful items to further enhance their personas. Most MMORPGs provide some form of monetary system, as well as items that can be owned. These items may include armor, weapons, mounts, vehicles, homes, furniture, and any number of other artifacts that either enhance the player’s abilities or increase their prestige among other players. Wealth is typically obtained by killing
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computer opponents and removing valuables from them, or by crafting and selling valuables to other players.
Social Systems
MMORPG developers provide players with increasingly sophisticated arrays of tools for interacting socially. Common MMORPG communication/social tools include:
Spatial Communication: Spatial communication is achieved by typing text that is directly observable by other players within a limited vicinity. Spatial communication is intended to simulate speech, and often contains “shout” or “whisper” modes to further increase the immersive process.
Chat Channels: Chat channels allow for communication across distances within a game server (or in some cases, across game servers). Players can send each other messages, or communicate on channels with groups of players who have banded together.
This allows players to find friends or associates and arrange group activities.
Email: Email allows players to leave one another messages that can be read once the recipient logs back into the server. Some MMORPGs allow players to mail items to one another as well.
Emotes: Emotes allow players to express non-verbal behaviors and emotions with other players. Some emotes display strictly text-based imagery, while other emotes may invoke visual changes in the player avatar to simulate some experience. For example, the text command “/shrug” may initiate the text “Fred shrugs his head dejectedly” while invoking a visible shrug from the player’s avatar.
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Weddings: As MMORPGs progressed and matured, some players participated in simulated online weddings between characters. Over time this ritual has evolved to the degree that some MMORPGs have institutionalized weddings as a game mechanic that is available for interested players.
Guilds: Guilds are formal alliances between players who share a common cause.
Joining a guild is voluntary, and usually results in the guild name appearing above the player’s avatar for easy identification. It is common for MMORPGs to provide guild specific chat channels to facilitate communication between guild members.
Vocabulary
MMORPG’s have a distinct vocabulary. This vocabulary includes general terms that apply across games, as well as game specific language used to describe unique elements found only in one setting. The following list of terms is not all- inclusive, but provides insight into some of the terminology common to MMORPG gaming
(Kronocide, 2004).
AFK – An abbreviation commonly used to indicate that a player will be away from the keyboard.
AGGRO – A reference to any non-player character or creature that may be hostile to players.
ALT – A term used to refer to a secondary avatar. For example, if John has an avatar named “Fred,” his ALT might be a second character called “Todd.”
BRB – Abbreviation for “Be right Back.”
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Buff – A term for any temporary skill or power boost a character might receive in the game.
Camper – A derogatory term for individuals that stay in one spot in order to control a specific spawn (See below).
Class – A term referencing the skill set of a character. For example “What class are you? I’m a warrior.”
CON – An abbreviation referring to the danger level of a computer controlled opponent. Many MMORPGs allow players tools to evaluate how hard a potential opponent might be. CONs are typically color codes indicating opponent difficulty. If an entity “cons red” it is likely too difficult for the character to fight.
DING – A term used to let others know when a player has received enough experience points to gain a new level or ability.
Grinding – A derogatory term describing the process of performing an action repeatedly over an extended amount of time for the purpose of gaining a level or item.
Healer – A term for any character that can heal the wounds of another character.
LFG – An abbreviation for “Looking for a Group,” indicating that a player wants to join others for hunting or other activities.
Nerf – A derogatory term referring to changes that game developers make to an
MMORPG that diminishes some ability of a class within the game. “Nerfs” are typically done to correct some game imbalance that gives unfair advantage to a select group of players. 18
OOC – An abbreviation used by role players who wish to talk about something not related to the game.
Pull – References a tactic used to draw one computer controlled creature from a pack, so that the creatures can be fought one by one, instead of as a group.
Root – Reference to a spell or ability that holds a creature in place.
Spawn – Reference to a computer controlled creature or group of creatures that reappears in a set location repeatedly after being “killed.” There is typically an interval of several minutes or hours between reappearances.
WB – An abbreviation for welcome back.
WTB – An abbreviation indicating the desire to buy an item from another player.
Typically used in locations where many players are selling items.
Summary
Internet addiction is a growing phenomenon which is new to the experience of counselors. Given the tendencies of Internet addicts to engage in online synchronous communication, MMORPGs offer a unique setting for the examination of Internet addiction. MMORPGs require synchronous communication and provide a variety of tools for building and maintaining relationships with others. In addition, the high growth rate and high use of MMORPGs indicate that a significant population of Internet addicts may be using this medium. This study will seek to answer fundamental questions about the addictive experience of MMORPG players, from the experience of both MMORPG players and from the counselors who treat them.