“Controlled by the game”– interviews on why regaining control over gaming is difficult for patients with gaming disorder

Abstract Background Research on gaming disorder has grown substantially over the past two decades, but few studies have used qualitative methods. The focus on quantitative studies risks overlooking nuances of gaming disorder. For treatment purposes it is important to have knowledge about the full range of factors maintaining gaming disorder. The aim of this study was to explore how individuals with gaming disorder experience their gaming, with a particular focus on factors that make it difficult to control the amount of time spent gaming. Methods Twelve patients diagnosed with gaming disorder were recruited at an outpatient clinic treating gaming disorder in Gothenburg, Sweden. Semi-structured interviews were conducted to examine factors that hindered them from reducing their gaming. The interviews were transcribed verbatim and analysed using thematic analysis. Results Thirteen subthemes were identified, forming five main themes: Being committed , Enjoying the game , Filling the void , Climbing an eternity ladder and Being controlled by the game . The themes represent a wide range of reasons why it is difficult to control the amount of gaming, including aspects of the games, individual characteristics of the gamers and their life circumstances outside the games. Conclusions The results highlight that gaming disorder is multifaceted and maintained by a combination of reduced self-control, structural game characteristics and the fact that gaming satisfies many basic human needs. For clinical purposes, it is important to address game-specific challenges, individual vulnerabilities and factors related to everyday life outside gaming to deliver effective treatments.