28,  Klinična psihologija in psihoterapija,  Kognitivna psihologija,  Obča psihologija

Internet gaming, gambling and loot boxes: how are they all connected?

The growing popularity of internet gaming has started to raise concerns about excessive gaming behaviours and their impact on individual well-being, especially with the emergence of loot boxes in games that have prompted discussions about their resemblance to gambling. This article examines Internet Gaming Disorder (IGD) as a proposed addictive behaviour, sharing similarities with gambling and substance use disorders, yet possessing unique characteristics that warrant separate classification within the DSM. By analysing the reinforcement mechanisms and behaviours common to both gaming and gambling, this article highlights the potential risks associated with these overlapping behaviours. It also emphasises the importance of understanding the psychological drivers behind internet gaming, gambling, and loot box purchasing to hopefully establish preventative measures that protect gamers from gambling-related harm.

Introduction 

With the development of technology and the rising popularity of the internet, internet gaming has become a pastime, in which approximately 41.7 % of the global population engages  (Wijman et al., 2023). Internet games have become full of interactive activities urging players to get involved, which hasn’t been shown to be without its issues. Unlike offline gaming, internet gaming is characterised by its intrinsic social component, involving embeddedness in online communities and collaborative play, therefore involving strong social incentives to the game (Lemmens & Hendriks, 2016).

Although reasons may vary, motivation driving internet gaming behaviour typically revolves around three primary components: achievement, immersion, and social interaction (Wang & Cheng, 2022). Achievement-oriented players are primarily motivated by in-game rewards, immersion-driven players are drawn to the immersive experiences within virtual worlds, and social-oriented players seek interaction with fellow gamers during gameplay. However, the surge in popularity of gaming has also led to an increase in excessive internet gaming, characterised by harmful or disproportionate engagement that negatively impacts individuals’ health and well-being (Jouhki et al., 2022). Recognizing the prevalence and adverse effects of excessive gaming, the American Psychiatric Association (2013) has proposed Internet Gaming Disorder (IGD) as a potential new diagnosis for a behavioural addiction . Although not yet formally listed as a disorder in the Diagnostic and Statistical Manual of Mental Disorders (DSM), IGD is classified as a Category III behaviour, indicating it warrants further peer-reviewed research before being recognized as an independent clinical disorder (American Psychiatric Association, 2022; (Petry et al., 2015).

The proposed diagnostic criteria for IGD closely mirror those of established addictive behaviours, such as substance use disorders, and include preoccupation with and lack of control over gaming, escalating playtime to achieve the same effects, experiencing withdrawal symptoms, like agitation or aggression, when unable to play, persisting in gaming despite adverse consequences, such as deteriorating health, prioritising gaming over other activities, risking relationships and opportunities, lying about gaming habits, and using gaming as a means to alleviate negative moods (Kuss, 2013). Concerningly, individuals meeting the IGD diagnostic criteria have shown alterations in the prefrontal cortex linked to excessive gaming during adolescence (Lee et al., 2018). This is particularly noteworthy as the prefrontal cortex plays a critical role in executive function and consequently in the development and perpetuation of addictive behaviours (Coutlee & Huettel, 2012). The World Health Organization, however, has already recognized IGD in the International Classification of Diseases (ICD-11). Both the DSM-5 and ICD-11 highlight IGD as a persistent pattern of gaming behaviour with substantial negative effects on personal life, lasting at least 12 months. While ICD-11 provides diagnostic guidance, the DSM is a diagnostic standard and therefore requires further evidence before classifying IGD as a clinical condition (American Psychiatric Association, 2013; World Health Organization, 2019). With the novel and emerging evidence presented in the extensive body of literature on internet gaming disorder – its behavioural patterns, underpinnings and consequences – this article will argue it should be classified as an addiction within the DSM. This is especially due to the introduction of loot boxes into gaming environments, which offer players random desirable items in exchange for money or increased gaming time, therefore incentivising and perpetuating continual engagement with gaming (Brooks & Clark, 2019).

Thus far, the only non-substance-related addiction in the DSM is gambling, which involves risky actions to obtain something of value (Yau & Potenza, 2015). The main motivators for gambling have been identified as social – gambling to connect with people, monetary – gaining money through gambling, enhancement – gambling for the thrill it provides, recreational  – gambling for entertainment, and coping – gambling to alleviate feelings of distress (Wardle et al., 2011). This also includes trying to appear skillful in winning, demonstrating self-worth and gaining social approval (Meisel & Goodie, 2014). The gambling disorder diagnosis includes lack of control over and preoccupation with gambling, the need to increase risk to achieve desired outcomes, gambling to cope with feeling distressed, jeopardising significant relationships and opportunities because of gambling. There is, therefore, significant overlap between the motivations, consequences and diagnostic criteria for both internet gaming and gambling disorder, which further suggests IGD could be considered an independent clinical disorder on the same grounds gambling is.

Biological underpinnings of addiction

Moreover, there is no single theory explaining addiction, instead interconnected accounts are addressing different facets of addictive behaviours. Biological factors should not be overlooked when considering addiction, as neuroimaging and neurochemical studies have shown changes in brain structures and reward pathways, such as altered dopamine responses, contribute to the development and maintenance of addictive behaviours (Lubman et al., 2004). However, this article will approach addiction as a learned behaviour, as that is most pertinent for the topic. Therefore, the idea of addiction as learned behaviour rests on operant conditioning and gives further insight into the connection between gaming and gambling. It entails experiencing pleasurable feelings, learning what produces them and seeking to re-experience them by re-engaging in the initial behaviour associated with them (Skinner, 1938). Learning to anticipate and seek rewards, as well as predicting and avoiding negative experiences are strong behavioural drivers in all addictive disorders (Torregrossa et al., 2011).

Internet gaming (as well as gambling) offers hedonic enjoyment and is based on operant conditioning principles, wherein an individual experiences gaming-related positive feelings and is subsequently more inclined to re-engage in gaming (Hamari & Keronen, 2017). As building self-esteem, pursuing activities that increase self-worth and contribute to positive self-views are essential for well-being, this is regularly sought in online environments (Davis, 2001; Ryan & Deci, 2000). In gaming, self-esteem is often increased through competency and connectedness in gaming environments, which have been shown to be an important part of the gaming experience as well as motivators to continue gaming (King & Delfabbro, 2014). Belonging to a community and progressing within the game have been shown as crucial components of enjoyment and re-engagement, wherein the more involved a player is, the more they will want to maximise their chances of achieving those goals (Yee, 2006). This idea is supported by findings of a large-scale study showing players are more likely to re-engage in playing a particular game if they receive an ideal balance of personal engagement with the game and interaction with others during the gaming experience (Choi & Kim, 2004). Here, personal interaction encompasses any in-game feedback, such as achieving goals and acquiring items that contribute to the game’s objectives, while social interaction pertains to communication among players. Findings also suggest some of the most important attitudes predicting internet gaming disorder include seeking validation, reward orientation, competition focus and being affected by activities and interpersonal communication within the played games (Beard & Wickham, 2016). Therefore, being skillful, progressing within a game, belonging to a community, personal and social interactions, serve as rewards that reinforce and drive behaviour.

Like gaming, gambling is based on reward-seeking and learning; reinforced through operant conditioning, where winning is accompanied by an almost immediate reward and pleasurable feelings that propel individuals to re-engage in the behaviour (Delfabbro et al., 2023; Skinner, 1953). An individual, therefore, learns that winning is associated with positive affect and tangible rewards (e.g. money) but is equally propelled to re-engage in the behaviour when losing (Ramnerö et al., 2019). This is termed loss-chasing, one of the central initiation and maintenance factors of problem gambling (Zhang & Clark, 2020). It works through negative reinforcement, wherein the behaviour, i.e. gambling, is strengthened even when losing, because reengagement is chased to remove unpleasant feelings of loss (Banerjee et al., 2023). To obtain the desired win, people bet increasingly more even when it involves significant risk (Delfabbro et al., 2023). Secondly, the ‘near-win’ phenomenon observed in gamblers describes mistakenly applying logic to chance-based games and being more motivated to continue gambling after perceiving yourself as having almost won – despite the likelihood of winning largely or entirely being down to chance (Barton et al., 2017). It has also been suggested that near-wins are associated with winning because they elicit the same type of anticipatory response, therefore propelling further gambling engagement (Côté et al., 2003). 

Noting these mechanisms is important for understanding how internet gaming and gambling are further connected. The pursuit of rewarding experiences within gaming and gambling environments sustains addictive behaviours, highlighting the intricate interplay between reinforcement mechanisms and motivations for engagement. Similarly, because internet games (like e.g. slot machines with flashing lights) are designed to capture attention and promote further engagement, gaming providers use this to increase gaming time and through it increases chances of games being monetized through advertisements and in-game purchases (House of Commons Digital, Culture, Media and Sport Committee, 2019). One such purchasing option are loot boxes which appear to tap into the aforementioned psychological processes gambling does, therefore potentially bringing gaming and gambling even closer.

The problem of loot boxes 

A loot box is a virtual item e.g., a chest, which offers random content relevant to the game, e.g., weapons in a shooter video game, that players purchase either with real money, in-game currency they previously purchased with real money, or obtain through increased gaming activity (Montiel et al., 2022). The content of loot boxes matches the nature of the game and enables players to enhance their abilities, progress in the game, contribute to improved team outcomes. That ,increases enjoyment and social connection and improves the player’s perceived skill within the game – which have been identified as crucial for motivation to continue gaming as well as for success in gaming competitions and progression on league tables (Wang & Cheng, 2022). However, since loot box contents are random, there are elements of risk and investment of money or time, which are akin to gambling (Yau & Potenza, 2015). Indeed, researchers have started to question whether buying loot boxes – making in-game expenditures in hopes of obtaining desired non-guaranteed outcomes – can be compared to gambling and have found a positive relationship between higher rates of problem gambling and riskier involvement in loot box purchasing (Brooks & Clark, 2019; Delfabbro & King, 2020; Garea et al., 2021).

It has been found that loot box purchasers were significantly more likely to exhibit positive attitudes toward gambling, gamble more frequently, and experience more gambling-related problems than non-purchasers while mechanisms such as near-wins and the ability to gain gameplay advantages through loot box contents were shown to strengthen the relationship between loot box spending and problem gambling (Brooks & Clark, 2019; Drummond et al., 2020; Zendle et al., 2020). Namely, like gambling, loot box purchases have been shown to be driven by the thrill of uncertainty, the anticipation of a potential high-value reward, and the “near-win” effect, where players feel close to achieving something valuable, which motivates them to keep spending. The randomness of loot box outcomes taps into the same reinforcement mechanisms seen in gambling, offering the chance for rare in-game items that provide social status and gameplay advantages, amplifying their appeal. Both occurrences have been shown to intensify the relationship between spending money on loot boxes and problem gambling behaviours (Li et al., 2019). Furthermore, in qualitative studies investigating gamers’ views of loot box engagement, researchers identified the most important motives behind purchasing loot boxes as gaining in-game advantages, social influence and acceptance, excitement associated with opening and uncontrollable cravings to buy them (Nicklin et al., 2021; Zendle et al., 2019). Social influence plays a critical role because gamers often feel pressure to acquire loot boxes not just for personal gain but to stay relevant in social circles or gaming communities, much like how gamblers are swayed by the social environment of casinos or betting events (Beard & Wickham, 2016). Similarly, the uncontrollable cravings associated with loot box purchasing resemble the compulsive urges found in both gambling and IGD. The desire to unlock in-game advantages or experience the emotional high of “winning” drives players to make repeated purchases, despite potential financial consequences. This mirrors gambling’s pattern of loss-chasing and reward anticipation, which was further illustrated by a study investigating loot box purchasing in a game before and after it removed loot boxes, where it was found problem gamblers spent significantly less money in-game after loot boxes were removed compared to the general population (Zendle, 2019). This indicates it is not general dysregulation that drives gamblers to buy loot boxes, but specific loot box features and advantages that reinforce their purchasing.

Moreover, individuals, who were engaged in gambling and who were higher in sensation seeking, gambling-related cognitions, internet gaming habits and impulsivity, were significantly more likely to engage in loot box purchasing (Spicer et al., 2022). Loot box purchasing individuals higher in sensation seeking, gambling-related cognitions, internet gaming habits and impulsivity were also significantly more likely to engage in gambling (Spicer et al., 2022). In other words, people with those traits were more likely to both purchase loot boxes and engage in gambling, which suggests a strong link between loot box purchasing and gambling tendencies, driven by similar underlying personality traits and behaviours. This further proposes loot box engagement is akin to gambling, as the reward-seeking incentive for buying loot boxes, appearing skillful, excitement and others, have been identified as motivations for gambling too (Wardle et al., 2011).  Additionally, loot box contents are frequently distributed according to a variable-ratio reward system where a reward is obtained after an unpredictable number of engagements (James et al., 2017). This reinforcement schedule is typical for traditional forms of gambling and is recognized for its ability to encourage repeated engagement in the behaviour (Drummond & Sauer, 2018).

Since internet games are environments where loot boxes are encountered, research has found more problematic internet gaming is associated with more problematic loot box behaviours (Montiel et al., 2022; Yokomitsu et al., 2021). Loot box purchasing individuals displayed higher levels of problem internet gaming along with increased levels of mental distress compared to non-purchasers (Brooks & Clark, 2019). Studies have also shown individuals with IGD symptoms spend significantly more money on loot boxes than casual gamers, possibly indicating an increased motivation in problem gamers to succeed and display competence in online environments by gaining competitive advantages loot boxes offer (Drummond et al., 2020; Neys et al., 2014). Negative effects on self-esteem can increase the use of loot boxes as status within online communities becomes associated with purchasing items rather than player skill, which may lead to continued reliance on loot box purchases to maintain social status (King & Delfabbro, 2014). In this way, loot boxes and gambling are further connected, because both outcomes are chance-based, despite there often being an illusion of control and a belief one can “win” through repeated engagement. The sheer presence of loot boxes can persuade players into gambling-like behaviours as the surge in reward and chance-based mechanisms adds gambling elements into gaming environments, which provides an incentive to engage in purchasing and gaming more, resulting in increased reliance on both behaviours. The lack of preventative measures and age restrictions on loot boxes in most countries makes them highly accessible to underage gamers and those with underlying addictive predispositions (Garea et al., 2021). High accessibility is problematic in itself, as the availability of gambling has been shown to significantly increase related problems, so the significant relationship between increased internet gaming and buying loot boxes suggests these problems could extend to loot boxes too (Gainsbury, 2015). To counter this and protect gamers from gambling-related harm it would be advisable to put legislative preventions in place. To prevent compulsive engagement with internet gaming, gambling, and loot boxes, clear boundaries should be established which could also include putting age restrictions on loot boxes, implementing cooldown periods after extended play, and providing in-game reminders that encourage players to step away. Gaming providers could also restrict the amount of money spent by each player or incorporate mandatory time limits on games to promote healthy engagement by encouraging regular breaks and limiting continuous play sessions.

It therefore appears as though loot boxes are one of the possible bridges between gaming disorder and problem gambling – through combining the gaming elements of interactivity, skill-based play and in-game progression, and the gambling components of excitement, betting and chance mechanisms involving risk. This shows there are commonalities between the three behaviours – gaming, gambling and buying loot boxes – and that individuals are compelled to engage in these activities repeatedly through seeking rewards, even if it poses risks.

Conclusion

To conclude, internet gaming, gambling, and loot box purchasing are intricately connected through shared psychological mechanisms that drive addictive behaviours, at the heart of which is the pursuit of reward, a craving for excitement, and a desire for social validation. Based on extensive research findings, this article proposes internet gaming disorder should be classified as an independent clinical condition in the DSM, and argues it should be recognized as a behavioural addiction like (but distinct from) gambling. Literature also provides evidence that loot boxes represent a convergence point between gaming and gambling through their chance-based mechanisms that trigger reward craving and re-engagement (Brooks & Clark, 2019; Garea et al., 2021). These findings are especially prescient as 78% of internet gamers worldwide have reportedly performed in-game transactions to obtain loot boxes (Zendle & Cairns, 2019), which is why this must be better understood.Future studies could investigate whether gaming-contingent self-worth mediates the relationship between gaming, gambling, and loot box purchasing among gamers. Findings would be important for better understanding the causality between these behaviours to uncover the psychological processes behind them and create limitations which gaming providers would have to adhere to when creating games.

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