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Consequently, this highlights the importance of protecting children and adolescents who engage in both video gaming and loot box activities regularly from potential harms. Yellow squares represent an rating that was 'Maybe' in relation to the criterion assessed. Table 7 Mean difference analysis for Drummond et al. Issues in Mental Health Nursing. The bite of Pac-Man.
Webinars Practice guides Policy and practice papers. These may prove to be important targets for cognitive behavioural interventions Dong and Potenza, , Yokomitsu et al. As these cannot be compared to the other studies conducting similar regression analyses that reported standardised coefficients, they were not extracted. However, gambling disorder was more consistently assessed across studies when compared to IGD and microtransaction engagement. Neither review included an inter-rater assessment and therefore it is unclear how much variance in opinion attributed to the quality ratings. When examining the characteristics of participants, the majority of studies were dominated by Caucasian individuals mostly from North America, the United Kingdom, Australia, and other countries in Europe. Firstly, positive mood could emerge as an anticipatory response to the purchasing and potential reward associated with the loot box i. L, Russell A. Adolescent simulated gambling via digital and social media: An emerging problem. Loot boxes remain largely unregulated, with the exception of some European nations McCaffrey, While causality cannot be established in this relationship due to the cross-sectional nature of the existing evidence, future research should further explore the relationships identified in the present study in order to ascertain the need for regulatory actions within the industry. Spicer et al. The adolescent brain. Additionally, the database search was conducted in September of While it would have been optimal to re-run these searches and integrate newly published studies into the review, this was not possible due to time constraints. This required studies to explicitly state the statistical methods, software packages, and significance levels that were used. Media enquiries. Journal of Behavioral Addictions. Conclusion In conclusion, this review identified a clear positive relationship between microtransactions with IGD and gambling disorder with evidence to suggest that the gambling-like nature of loot boxes may underlie this relationship. Therefore, the role of these variables has not been accounted for in the present review. Drummond et al. A pathways model of problem and pathological gambling. Prevalence rates of IGD varied drastically between studies and were higher than the prevalence rates recently reported by Stevens et al. The association with positive mood, negative mood, and psychological distress may appear counter intuitive but plausible nevertheless if considered within an engagement process. A review of the evidence. Therefore, it is possible that new data is available on this topic which has not been included in this review. Digital Australia Brooks G. Associations between loot box use, problematic gaming and gambling, and gambling-related cognitions. Additionally, it is important that future research investigate the relationship between microtransactions with IGD and gambling disorder in other cultures to ensure that appropriate recommendations can be made regarding policy and intervention that are culturally and clinically sensitive rather than based solely on Western individualistic populations. The studies where microtransactions and both IGD and gambling disorder were investigated simultaneously found significant positive relationships between IGD and gambling disorder. References Abbott, M. The epidemiology and impact of gambling disorder and other gambling-related harm [Discussion Paper]. Akbari M. The Big Five personality traits and online gaming: A systematic review and meta-analysis. It is important to note that given its narrow focus, the findings reported in this study may not be generalisable to the broader microtransaction context in other video games. To improve understanding and inform policy and regulatory responses, we conducted an evidence review to: assess what types of harms, if any, are associated with engagement with these products identify which groups may be most at-risk or vulnerable to experiencing harm, and identify recommendations for responses to reduce harm related to these products. Addict Behav Rep. Published online Feb Pontes: moc. Following this, negative mood and psychological distress could ensue, particularly in cases where the reward did not present high psychological and in-game value i. Most studies used convenience sampling, which resulted in very few studies having samples that represented the target population, thus limiting the external validity of the body of evidence reviewed. Abstract Recently there has been increased interest in understanding the relationship between microtransactions, gaming, and gambling. It is possible that the difference in quality assessment may be caused by using different assessment measures or due to difference in rater opinions. Results 3. Media releases. Inclusion criteria A set of strict inclusion criteria was adopted when deciding if a study should be included in the review or not. One study A. It is evident that there is little consistency among researchers about what tools should be used in the assessment of IGD and microtransaction engagement. Billieux J. Are we overpathologizing everyday life? Our researchers Research programs Policies and compliance. Furthermore, IGD was also found to significantly predict greater RLI scores and loot box expenditure, and loot box expenditure significantly predicted higher levels of IGD and problem gambling severity. Furthermore, researchers should adopt a more consistent and standardised method of assessment for both microtransaction engagement and IGD to ensure accurate measurement of these variables and improve the internal validity of the body of evidence. International Journal of Mental Health and Addiction. There was also a significant positive relationship between the RLI and IGD, gambling disorder, and loot box expenditure. The body of evidence reviewed in this paper is largely correlational and therefore causality has not been robustly established regarding the relationships between microtransactions, risky loot box use, IGD, and gambling disorder. A tenable blueprint for behavioral addiction research. However, it is unclear why there is such a difference between Yokomitsu et al. Effects of self-isolation and quarantine on loot box spending and excessive gaming-results of a natural experiment. Therefore, the current research on this topic measures clinical symptomology and not clinically diagnosed samples. This may explain some of the difference in quality appraisal between their assessment and the current review as only newer studies published after were included. Moreover, the positive relationship found between loot boxes and gambling disorder was stronger than for other types of microtransactions e. Credit authorship contribution statement Phillip C. Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. Discussion The present study encompassed a preregistered systematic review on the existing literature to clarify the relationship between microtransactions, IGD, and gambling disorder within the context of different types of in-game microtransactions. American Psychologist. It is important to acknowledge that the validity of the methods used to examine such rapidly evolving technology may also need to be updated to enable greater levels of validity and reliability. The current systematic review also identified a lack of generalisability and cross-cultural validity within the currently body of evidence due to sampling practices and the nature of online surveys resulting in very few representative samples. Table 2 Study design and characteristics. Loot box and microtransaction expenditure and the RLI were also used to measure microtransaction engagement. While it is evident that there is a positive relationship between microtransaction expenditure with both IGD and gambling disorder, it is important to also understand the impact that this relationship may have on the lives of individuals. Moreover, Drummond et al.In-game purchases may be purely aesthetic e. In relation to the ethical design of video games, Montag et al. Additionally, as is the nature of online survey studies, many studies were unable to address or categorise non-responders in their survey. Table 3 Correlation Coefficients for studies only including gambling disorder. Three studies investigated the association between the RLI and loot box expenditure Brooks and Clark, , Drummond et al. Thus, interpretation of the findings reported must take the search date into consideration.
F statistic has been rounded to 2 decimal places. Diagnostic and statistical manual of mental disorders 5th ed. In conclusion, this review identified a clear positive relationship between microtransactions with IGD and gambling disorder with evidence to suggest that the gambling-like nature of loot boxes may underlie this relationship. Furthermore, using clinically diagnosed samples may provide a clearer picture on the relationships identified in the present review and improve the overall quality of the evidence.
These results support the positive link between gambling disorder and loot boxes specifically. This is unsurprising considering that only two studies had representative samples. However, Brooks and Clark's second study was the only study that did not identify a significant relationship between loot box expenditure with IGD and gambling disorder. Loot boxes in Spanish adolescents and young adults: Relationship with internet gaming disorder and online gambling disorder. World Health Organization Forum on alcohol, drugs and addictive behaviours, , Geneva, Switzerland.
Significant positive relationships were also identified between microtransaction expenditure and both IGD and gambling disorder. Developmental Review. However, five different methods of assessment were used across seven studies which may also have contributed to the observed heterogeneity in prevalence rates reported among the reviewed studies as this is a known issue likely to bias prevalence estimates Stevens et al.
Additionally, the studies reviewed found that the amount of money individuals spend on microtransactions increased as the risk of gambling disorder also increased. Predatory monetization schemes in video games e. Three studies investigated the association between loot box expenditure and IGD Brooks and Clark, , Zendle, Two of these found a positive correlation of. Limitations of the evidence The body of evidence reviewed in this paper is largely correlational and therefore causality has not been robustly established regarding the relationships between microtransactions, risky loot box use, IGD, and gambling disorder.
A cognitive-behavioral model of Internet gaming disorder: Theoretical underpinnings and clinical implications. Literature search and selection process Brooks and Clark's article reported the findings of two separate studies in terms of samples. Additionally, most samples had a majority of male participants. Ferris, J. Garea S. Meta-analysis of the relationship between problem gambling, excessive gaming and loot box spending.
In reference to the general design and study characteristics, all studies but one Zendle, were cross-sectional. Consequently, this can result in increased risk taking and negative outcomes Casey et al. Thank you to Michaela Venn, academic librarian from the University of Tasmania, for her support in developing the search strategy used in this study. Additionally, it may be beneficial for future reviews to include an inter-rater assessment regarding the quality of the evidence to improve transparency and review quality.
Nature Human Behaviour. Essential facts about the computer and video game industry. Introduction Electronic gaming has become extremely prevalent in the modern world. Interestingly, this relationship was stronger than in other studies that included adult samples Brooks and Clark, , Zendle, , Zendle and Cairns, , Zendle et al. Moreover, modern video games feature other gambling-like practices that are associated with both gaming and gambling disorder Zendle et al.
Table 8 Regression coefficients for studies including both gaming disorder and gambling disorder. The relationship between problem gambling, excessive gaming, psychological distress and spending on loot boxes in Aotearoa New Zealand, Australia, and the United States-A cross-national survey. A descriptive survey of online gaming characteristics and gaming disorder in Ireland.
The present study encompassed a preregistered systematic review on the existing literature to clarify the relationship between microtransactions, IGD, and gambling disorder within the context of different types of in-game microtransactions. Methods of assessing IGD and microtransaction engagement were inconsistent across studies and may account for some of the variance in the evidence.
Search AIFS. Access the full report on the DITRDCA website: Harms associated with loot boxes, simulated gambling and other in-game purchases in video games: a review of the evidence. Resource sheets Short articles Evidence and evaluation support. Four studies conducted regression analyses and each study used different outcome variables Brooks and Clark, , Drummond et al.
Additionally, only two studies justified their sample sizes, making it difficult to interpret the results meaningfully and limits the quality of the evidence. For instance, the Parliament of Australia has identified that loot boxes fall into a legal grey area as to whether they are constituted as gambling, however has pushed for further regulations and inquiry Australian Parliament House, Additionally, they call for clear disclosure of the odds of loot box outcomes and the development of an ethical framework to guide video game production.
Furthermore, there is evidence to suggest that adolescents who purchase loot boxes may be at greater risk of developing gambling disorder. Across all studies that investigated only gambling disorder, a significant and positive relationship was found between greater severity of gambling disorder symptoms and increased in-game microtransaction expenditure. A closer analysis of the questions that were adopted to assess the studies reviewed showed some common methodological issues that were consistent throughout many of the studies.
Mean difference analysis for Drummond et al. Four studies examined the relationship between loot box expenditure and gambling disorder Brooks and Clark, , Drummond et al. These findings may suggest that adolescents who purchase loot boxes are at a higher risk of developing gambling disorder symptoms. Thus, there is overall convincing evidence for a positive relationship between microtransaction expenditure with both IGD and gambling disorder.
Amusement machine playing in childhood and adolescence: A comparative analysis of video games and fruit machines. Therefore, the links between microtransactions such as loot boxes with IGD and gambling disorder, as well as their associated risk of harm to an individual, have significant implications for policy-making decisions.
Two studies Kristiansen and Severin, , Zendle et al. Carey, Delfabbro, and King identified that IGD was associated with higher levels of general harm to an individual and were six times more likely to experience risk of both physical harm e. It is important to note that these findings are largely correlational in nature and that causality has not been established. CFCA information exchange View all practice resources.
This made it impossible for the most part to rule out non-response bias as contributing to the results found in most studies. Further, this study assessed loot box expenditure within a single game i. Journal of Psychiatric Research. However, the way an individual engages with loot boxes may contribute to this relationship. The spreading impact of playing violent video games on aggression. Table 6 Correlation Coefficients for studies including both gaming disorder and gambling disorder.
The results of these studies revealed that IGD was found to significantly predict RLI scores, loot box expenditure, and loot box purchasing behaviours. Additionally, significant relationships were found between loot box expenditure with both IGD and gambling disorder. Three of these Brooks and Clark, , Drummond et al. Interestingly, the quality assessment conducted in this review varied to some extent from other reviews Spicer et al.
Six studies investigated the relationship between microtransactions and both IGD and gambling disorder Brooks and Clark, , Drummond et al. Video game loot boxes are psychologically akin to gambling. The way microtransaction engagement was measured across studies was also variable, and there was little consistency between studies in how this was assessed. Table 5 Mean difference analyses for studies only including gambling disorder.
Additionally, there is evidence to suggest that the way an individual engages with loot boxes, such as risky loot box use, could mediate or moderate the relationship between microtransactions with IGD and gambling disorder. Measurement and psychometric assessment All studies investigated loot boxes, with five studies also investigating non-random microtransactions in addition to loot boxes A.
Microtransactions and gambling disorder A total of seven studies investigated the relationship between microtransactions and gambling disorder alone Kristiansen and Severin, , Macey and Hamari, , Zendle, , Zendle and Cairns, , Zendle and Cairns, , Zendle et al. To this end, new standardised tools assessing disordered gaming according to the latest WHO framework e.
Microtransactions, IGD, and gambling disorder Six studies investigated the relationship between microtransactions and both IGD and gambling disorder Brooks and Clark, , Drummond et al. The overall mean expenditure was Simple effects analysis revealed significant differences in expenditure between all groups of gamblers, except for non-problem gamblers and low-risk gamblers see Table 7.
As a library, NLM provides access to scientific literature. In: The Oxford Handbook of Cyberpsychology. Sold loot box or LB item? What we found Our review found reliable evidence that: Loot box engagement, including viewing, opening, and especially purchasing, was associated with problem gambling and internet gaming disorder. Doi: Doi: Australian Parliament House Gaming micro-transactions for chance-based items.
It is possible that the discrepancy in prevalence rates may be due to non-representative samples and selection bias stemming from the recruitment of convenience and self-selected samples. View all publications. However, such recommendations are yet to be implemented. Risky loot box use was found in multiple studies to be positively associated with both gambling disorder, IGD, and loot box expenditure. Gambling disorder prevalence rates also varied significantly between studies and were different to general prevalence rates, ranging from.
Based on these fundings, the current review calls for policies and industrial changes to be made regarding loot boxes in video games to protect vulnerable individuals from harm. Content type. The mean percentage on the AXIS tool was Additionally, question 13 'Does the response rate raise concerns about non-response bias? Specifically, this relationship appears to be stronger with loot boxes compared to other non-random microtransactions.
To support the push for policy development, implementation, and better regulation of loot boxes, it is paramount that future studies investigate causality within the relationships between microtransactions and both IGD and gambling disorder as this will encourage and guide policy-makers on what type of regulations may prove beneficial.
Computers in Human Behavior. Footnotes 1 While non-responding authors may have had different valid reasons for not responding to our email, we would like to emphasise that sharing of such research information is critical to improving the quality of research in general and increase replicability in Psychology. Commissioned reports Journal articles Family Matters journal.
Objectives The current review aims to synthesise and evaluate the literature on microtransactions and their relationships with both IGD and gambling disorder. Additionally, gambling disorder was found to significantly predict loot box expenditure and loot box expenditure was found to predict both IGD and gambling disorder symptoms see Table 8. Addictive Behaviors. Nevertheless, it is likely that the variance in prevalence rates is also attributed to the non-representative samples and selection bias.
Furthermore, while the studies included assessed IGD using diagnostic or screening measures, no studies conducted clinical interviews. Often these were researcher developed ad hoc questions about whether an individual had obtained a loot box, used a loot box, bought a loot box or loot box key, or sold virtual items they obtained from a loot box.
The introduction of policies such as these, in cooperation with video game production companies, would help protect vulnerable individuals from loot box related harms and are further supported by the findings of this study. Used loot box but not paid for loot box? S elling virtual items from loot box? The nature of loot boxes, which is akin to gambling McCaffrey, , may be underlying the relationship between microtransaction expenditure and gambling disorder symptoms.
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Open in a separate window. Attrill-Smith A. Oxford University Press; The therapeutic and health benefits of playing video games; pp. However, neither of these studies included a comparison between adolescent and adults. Additionally, the sampling methods employed have resulted in non-representative samples across most studies and impacts the external validity of the evidence. A brief overview of Internet Gaming Disorder and its treatment.
Interestingly, a recent review on the characteristics of gamers who purchase loot boxes Yokomitsu et al. Sample characteristics and demographic information See Table 1 for sample and demographic information. Acknowledgements Thank you to Michaela Venn, academic librarian from the University of Tasmania, for her support in developing the search strategy used in this study. Moreover, one study A. One study Drummond et al. This work demonstrated sound psychometric properties and may prove useful in further research to better understand what motivates loot box usage.
This study only assessed these variables in a single game i. Australian Clinical Psychologist. There is also a clear need for more consistency between researchers in how to assess both IGD and microtransaction engagement. Future directions To support the push for policy development, implementation, and better regulation of loot boxes, it is paramount that future studies investigate causality within the relationships between microtransactions and both IGD and gambling disorder as this will encourage and guide policy-makers on what type of regulations may prove beneficial.
The benefits of playing video games. No Study design and sampling methods All studies included in this review were cross-sectional in design, except for one study Zendle, which was a prospective cohort study. Research reports Research snapshots Facts and figures. Journal of Adolescence. This may provide invaluable information on factors that contribute to this relationship and may also help highlight potential targets for therapeutic intervention.
Irish Journal of Psychological Medicine. International Gambling Studies. Phillip C. Halley M. The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. Table 1 Sample and demographic information. Grey squares represent the criterion in question was not assessable. IGDS-9 Lemmens et al.
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