This and associated concepts have been the subject of considerable research, debate, and discussion among experts in several disciplines and has generated controversy within the medical, scientific, and gaming communities.

Such disorders can be diagnosed when an individual engages in gaming activities at the cost of fulfilling daily responsibilities or pursuing other interests without regard for the negative consequences.

[27] This test includes 20 questions designed to assess the extent of problems caused by disordered gaming and the degree of symptoms experienced by gamers.

Individuals with low self-esteem use MMORPGs to compensate by creating an avatar that is powerful and competent in these online environments, which allows the player to overcome anxieties that may be impaired in the real world.

[52][53] Some theories focus on the presumed built-in reward systems of video games, such as compulsion loops, to explain their potentially addictive nature.

[56] A meta-analytic review of the research concluded the evidence suggests video game addiction arises out of other mental health problems, rather than causing them.

[58] As concern over video game addiction grows, the use of psychopharmacology, psychotherapy, twelve-step programs, and use of continuing developing treatment enhancements have been proposed to treat this disorder.

[50] However, the clinical trials of potential treatments remain of low quality, except for cognitive-behavioral therapies, which shows efficacy to reduce gaming disorder and depressive symptoms but not total time spent.

[60][61] Although there is a scientific consensus that cognitive-behavioral therapy is preferable to pharmacological treatment, it remains difficult to make definitive statements about its benefits and efficiency due to methodological inconsistencies and lack of follow-up.

[50] Some countries, such as Singapore, South Korea, China, the Netherlands, Germany, Canada, and the United States, have responded to the perceived threat of video game addiction by opening treatment centres.

Many rely on self-surveys from university students and also lack time frames making it difficult to study the impact, if any, of addiction on a long term scale.

[96] Daria Joanna Kuss and Mark D. Griffiths have argued the current scientific knowledge on internet gaming addiction is copious in scope and complexity.

[99][100] The evidence of video game addiction to create withdrawal symptoms is very limited and thus debated, due to different definitions and low quality trials.

[102][103][104] Despite the lack of a unified definition, there is an emerging consensus among studies that Internet gaming disorder is mainly defined by three features: 1) withdrawal, 2) loss of control, and 3) conflict.

[102][104] Michael Brody, M.D., head of the TV and Media Committee of the American Academy of Child and Adolescent Psychiatry, stated in a 2007 press release that "there is not enough research on whether or not video games are addictive."

[108] A suggested method of research called autoethnography is introduced by Xiao Hu and Hongzhi Zhang that may be a solution to the challenges of current studies on video game addiction.

The autoethnographic research is based on the first author's life experience which goes over his reflection on the behavior and the possible solutions that aided in his ability to overcome the addiction.

A model that displays motivation/functional needs and prevention/harm reduction factors from a study by Xu et al proposes ways to reduce the symptoms of video game addiction is included in the article to highlight similar methods the author himself had used.

[109] In 2022, two studies by Jiaxing Chen, Guangling Zhang, and Qinfang Hu were conducted to test their hypothesis of "the integration of social responsibility with gaming strategies from the psychological perspective of game withdrawal, and the incorporation of social responsibility as an element in gamification design to reduce user withdrawal behaviour, thereby increasing individual’s environmentally sustainable behaviour".

From an evolutionary standpoint, play serves multiple adaptive functions—such as honing skills, managing stress, and building social bonds—and video games offer a novel, virtual environment for these activities.

By simulating probable ancestral challenges (like cooperation, exploration, and threat-response), games can activate ingrained psychological and emotional systems that reward in-game achievements, even when real-world benefits are minimal.

[111] This “mismatch”[112] between evolved drives and contemporary digital settings may help explain why many people find games so compelling, potentially leading to habitual or compulsive play.

Massively Multiplayer Online Role-Playing Games, for instance, feature teamwork and shared goals that resemble hunter-gatherer band structures, reinforcing social ties and group identity.

[52] Walter Bright recalled that "Some people ... disliked Empire" when others at Caltech began playing his creation in the 1970s, "even blaming it for a couple students flunking out because they got addicted to the game and neglected their studies.

[3] For gaming disorder to be diagnosed, the behavior pattern must be of sufficient severity to result in significant impairment in personal, family, social, educational, occupational or other important areas of functioning and would normally have been evident for at least 12 months.

He said evaluating a disorder for inclusion is nominally done without any external feedback "to avoid interference from commercial and other entities which may have vested interest in the outcome of the process".

Causes of deaths are mostly associated through exhaustion from playing games for excessive periods of time leading to heart-related diseases, or affect one's emotions and behavior patterns.

[157][158] In 2005, 28-year old industrial repairman Seungseob Lee (Hangul: 이승섭) visited an Internet cafe in the city of Daegu and played StarCraft almost continuously for fifty hours.

In a sentencing hearing after the teen was found guilty of aggravated murder, the judge said, "I firmly believe that Daniel Petric had no idea at the time he hatched this plot that if he killed his parents they would be dead forever", in reference to his disconnection from reality allegedly caused by playing violent video games.

[168] A dispute between two gamers, Casey Viner and Shane Gaskill, over the video game Call of Duty: WWII led to a Swatting on an uninvolved person, Andrew Finch in December 2017.