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The Role of Context in Online Gaming Excess and Addiction: Some Case Study Evidence

• Published: 07 July 2009
• Volume 8 , pages 119–125, ( 2010 )

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• Mark D. Griffiths 1  

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Research into online gaming addiction is a relatively new area of psychological study. Furthermore, there are studies that have claimed that online gaming addiction may be addictive because of self-report accounts of very excessive use of up to 80 h a week. This study uses data from two case studies to highlight the role of context in distinguishing excessive gaming from addictive gaming. Both of the gamers in this study claimed to be playing for up to 14 h a day yet and although they were behaviorally identical in terms of their game playing, they were very different in terms of psychological motivation and the meaning and experience of gaming within their lives. It is argued that one of the players appears to be genuinely addicted to online gaming but that the other player is not based on context and consequences. The two cases outlined highlight the importance of context in the life of a gamer and demonstrates that excessive gaming does not necessarily mean that a person is addicted. It is argued that online gaming addiction should be characterized by the extent to which excessive gaming impacts negatively on other areas of the gamers’ lives rather than the amount of time spent playing. It is also concluded that an activity cannot be described as an addiction if there are few (or no) negative consequences in the player’s life even if the gamer is playing 14 h a day.

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Griffiths, M.D. The Role of Context in Online Gaming Excess and Addiction: Some Case Study Evidence. Int J Ment Health Addiction 8 , 119–125 (2010). https://doi.org/10.1007/s11469-009-9229-x

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Received : 22 May 2009

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Published : 07 July 2009

Issue Date : January 2010

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Video Gaming Addiction: A Case Study of China and South Korea

Posted by Ryan, Amanda | Dec 13, 2021 | American Politics(B) , Asia(B) , China(B) , U.S.(B) | 0 |

To wrap up summer vacation, the two leading countries combating internet and gaming addiction—China and South Korea—took a step in diverging directions. This raises the issue of which country serves as a better model for the U.S. government and American gaming companies. With both countries entering the year enforcing similar policies of reducing the amount of play time available to minors, it came as a surprise when China’s increase in limitations was met alongside South Korea’s plan to abolish the harsh restraints. Ultimately, South Korea recognized the flaws in their previous law and is modifying their game plan to include less restrictions and encourage more self-regulation. After reviewing scholarship and research studies which analyzed the previous laws enacted by China and South Korea, the latter’s new, more flexible approach appears to be most promising for the U.S. to take into consideration.

Douglas Gentile, developmental psychologist and the Director of Research for the National Institute on Media and the Family, estimated that over 8.5 percent of children and teenagers—roughly 3 million Americans—exhibit multiple signs of gaming addiction [1]. Currently in the Western world, video game-related regulations are limited to rating systems which evaluate content and maturity-levels rather than the overuse of gaming [2]. As video game addiction becomes increasingly prevalent, understanding, and ultimately comparing, the different prevention approaches is vital in protecting the health and development of younger generations.

What is Gaming Addiction?

Video gaming has beneficial and adverse effects on the cultural attitudes, psychological development, and lifestyle choices of young gamers [3]. For instance, a 2009 study in the Annual Review of Cybertherapy and Telemedicine found gaming can alleviate stress and depression; Dr. Daphen Maurer of the Visual Development Lab discovered gaming can improve eyesight and increase dopamine levels; and cognitive neuroscientists at the University of Rochester found video games can enhance decision-making skills [4]. Especially during the recent pandemic, where isolation and a lack of social interaction was prominent, the ability to engage with others via gaming provided much needed “social connection, escapism and relief for millions of kids and teens” [5].

Although the evolution of technology and the internet has brought numerous benefits, many negative ramifications have been uncovered as well. One of the most significant impacts of problematic internet-use gaining momentum is the onslaught of video gaming addiction. As a subset of internet addiction, video gaming addiction is often when gaming is taken to the extreme—ultimately impairing an individual’s ability to function either socially, academically, or financially [6]. In 2014, a study by Zhejiang Normal University discovered that gaming addiction can lead to “lower volumes of gray and white brain matter,” which can cause impairment in decision-making, regulating emotions, and impulse control [7]. Likewise, the comorbidity rate of the gaming disorder with depression, anxiety, and ADHD is significantly high, as many young gamers use gaming as a coping mechanism [8].

While the classification of video gaming addiction as a mental illness is somewhat controversial, organizations have recently spoken up about the issue. In 2013, the American Psychiatric Association (APA) included an Internet Gaming Disorder in the DSM-5 , and, in 2018, the World Health Organization (WHO) stated Gaming Disorder (GD) will be listed in the 11 th addition of the International Classification of Diseases [9]. With nearly three billion people playing video games worldwide, 3-4 percent of them—more than 60 million gamers—are likely to be suffering from gaming disorder [10].

In China, problematic video gaming has been recognized as a public health crisis [11]. In 2007, around 14 percent of Chinese adolescent internet users—about 10 million teenagers—met the diagnostic criteria for internet addiction [12]. According to the China Internet Network Information Center, this number increased 16 percent by 2018, with over 30 percent of minors suffering from gaming disorder [13]. With the issue growing in severity, China placed video gaming addiction on par with substance-abuse and drug addictions, labeling the activity as “spiritual opium” [14].

Similarly, South Korea considers internet addiction as one of the country’s most critical health issues [15]. By 2015, internet usage in South Korean households rose to 85.1 percent across all ages [16]. Comparable to the duration of a part-time job, the average South Korean teen spends over 23 hours per week playing video games [17]. In Seoul, the capital of South Korea, a common leisure activity for youths is to stop by a ‘PC bang’—an internet gaming room or cafe, typically open 24 hours, where players have access to comfortable seating and fast computers for a dollar an hour [18].

Following trend lines for the addiction in South Korea, in 2012, an estimated 2.55 million people were addicted to their smartphones and the internet [19]. For adolescents in particular, around 12.5 percent of teenagers were at risk for internet addiction disorder in 2014 [20]. And in 2019, the latest government-issued survey revealed over 20 percent of South Korea’s population—nearly 10 million citizens—were now at risk for the addiction [21]. Due to the isolating nature of the COVID-19 pandemic, many countries have reported an uptake in the amount of time minors spent gaming, suggesting a probable increase in problematic gaming for South Korean adolescents [22].

Initial Prevention Response Plans

International response and prevention plans vary, with some countries authorizing harsher, more hands-on restrictions than others. But how effective are these various responses in curbing behavioral addictions? China and South Korea provide case studies of possible responses and their likely consequences.

From 2000 until 2015, China banned the production and sale of popular gaming consoles—including Xbox and PlayStation—in an attempt to reduce the likelihood of children developing addictions [23]. However, many players worked around this obstacle by illegally purchasing consoles, or simply turning towards PC and mobile games instead. Shortly after the ban was lifted, their government placed restrictions and censors on the “harmful attributes” in video games, including the addictive qualities of in-game rewards and achievements, as well as the portrayal of violence [24]. Specifically, China introduced an Online Game Addiction Prevention System (Fatigue System) in 2007, which targeted the addictive qualities of games [25]. In this system, as the time a person spent gaming increased, the number of rewards they could obtain decreased and pop-up warnings of unhealthy playtime appeared in an effort to limit the gamer’s desire to keep playing. However, as mentioned in sections below, this system proved largely ineffective and was ultimately discarded [26].

As for treatment measures, China established centers aimed at rehabilitation to address problematic gaming, such as at the General Hospital of Beijing Military Region’s Internet Addiction Treatment Center [27]. Likewise, to further reduce the negative impact of the internet on minors, China passed the Minors Internet Protection Ordinance in 2016, which limited nighttime gaming, provided education to guide players, and required gaming companies to adhere to anti-addiction parameters [28]. Yet, with more minors continuing down a path towards addiction, a revision for the law was required [29]. In 2019, China went a step further and created tighter time restraints on how long minors were allowed to play video games—limiting players to 1.5 hours on weekdays, 3 hours on weekends and holidays, and only during daytime hours [30].

With over 720 million gamers by 2021, gaming culture prospered in China, leading the country towards becoming the largest market in the video gaming industry [31]. By having such a substantial portion of the population active in gaming, and with many of the previous restrictions easily circumvented, the need for an effective method in China to stop addiction became even more crucial.

South Korea:

In response to the rise in internet-related addictions, South Korea established the Internet Addiction Prevention & Resolution Comprehensive Plan in 2010 [32]. Led by the National Safety Administration-affiliated agency of the MSIP, the primary goal was to establish intervention systems for problematic game and internet use before addiction manifested [33]. Although, while posing many benefits for minors at risk, these approaches were also criticized for the lack of “inter-agencies collaboration and clinical conceptualization” [34].

To assist those already effected, many treatment centers were founded to support the recovery of youths suffering from gaming addiction [35]. One of these programs is the Jump Up Internet Rescue School, where internet or online gaming addicted children are sent to a camp designed for rehabilitation—guiding minors in their journey through adapting healthier hobbies and learning new coping mechanisms [36].

In 2011, South Korea passed the Youth Protection Act, also known as the Shutdown Law or “Cinderella Law,” restricting the hours minors could play video games [37]. Under this law, those under the age of 16 were unable to access online games between midnight and 6am in an effort to promote healthy sleeping habits, increase productivity and attentiveness in the classroom, and prevent the likelihood of addictions to develop [38].

2021 Modifications in Gaming Prevention

Although both countries enforced strict video gaming strictions in the past, their policies deviated in 2021: China pushing for even stricter regimens on gaming, while South Korea is tearing down their shutdown law in favor of more flexible moderating and a stronger emphasis on health services. For China, authorities claim that rolling out firmer measures to limit minors’ gaming exposure come from a desire to safeguard their physical and mental health—as well as to satisfy a concern from parents that the old policy was insufficient [39]. On the other hand, South Korea is moving in the opposite direction in hopes of “respecting the rights of the youth and encourage[ing] healthy home education,” and to break away from the shutdown law’s ineffectiveness [40].

Released by the National Press and Publication Association (NPPA), China tightened the 2019 restrictions of online gaming for minors to one hour per day—8 PM to 9 PM—on Friday, weekends, and public holidays [41]. In addition to strict time restrictions, identification systems were installed to ensure the rules are followed, essentially forcing minors to enter identification—such as real names, government-issued ID documents, or identification numbers—before playing [42]. However, since many gamers under 18 attempt to bypass this limitation by acquiring fake ID numbers or using VPNs, the policy also requires gamers to register their ID number for fact-checking in the national citizen database [43]. Following suit, gaming companies have launched new methods to increase the likelihood of player cooperation. Tencent, one of China’s major gaming companies, recently introduced “facial recognition technology and an algorithm that identifies underage players” [44].

Issues with China’s 2021 Modification

China is asserting a strong association of high playing time with addiction—where more hours spent gaming equals addiction. However, China’s emphasis on time as the determining factor leading to addiction is misguided [45]. In 2018, a study published in the Journal of Behavioral Addictions by Kiraly et al., analyzed the effectiveness of policy responses on problematic video game use. The study argued that the strict policy and regulation approaches limiting playtime “were not sufficiently effective” and henceforth called for more “integrative approaches” for improvement [46]. Additionally, another data set found that gaming time is “weakly associated with negative psychological factors” often found in problematic use [47].

According to WHO, the diagnostic criteria for the “gaming disorder” does not include a specific amount of playtime [48]. Rather, that gaming must cause distress, impairment in the gamer’s life and ability to function, and typically last for at least one year [49]. Like with many behaviors, there is a substantial difference between those who are simply enthusiastic about the activity and want to dedicate time towards it with those who are addicted to it. Ultimately, all behaviors exist on a continuum, and the point where an individual falls isn’t fully decided according to the amount of time allotted to the behavior.

Instead, the threshold differentiating regular gaming (unproblematic behavior) from a gaming disorder (problematic behavior) resides with the effect the activity has on the gamer—as well as the gamer’s response to those outcomes [50]. In other words, the amount of time a person spends breaking blocks in Minecraft , farming crops in Stardew Valley , or leading revolutions in Homefront doesn’t guarantee the development of an addictive behavioral disorder. Alternatively, if a person is so absorbed in their gaming that they repeatedly forget to pick up their kids from daycare, sneak in round after round of solitaire in the office instead of finishing a report, or demonstrate their gaming is negatively impacting their life on another significant level—and continue to game regardless—then that behavior can enter the realm of addiction. By itself, the amount of time spent gaming isn’t a reliable predictor of problematic use; therefore, for China to implement harsher time restraints as the primary driver of their response plan to video gaming addiction demonstrates their shortcomings in addressing the heart of this issue.

Another failure with China’s law is that it only effects the gameplay of minors. However, recent data has proven that the median age of gamers is 24, and a growing demographic in gaming addiction is people in their 20s and 30s [51]. According to a specialist in gaming addiction, adults often turn to video gaming for the same reason teens do: to escape the harshness of reality—unemployment, isolation, and relationship issues [52]. Hence, to properly address all vulnerable groups susceptible to gaming addiction, an approach geared towards more than just minors is needed.

Similar Issues with South Korea’s 2011 Law

Regarding South Korea’s shutdown law, Jiyun Choi et al. in the Journal of Adolescent Health analyzed data collected from the Korea Youth Risk Behavior Web-based survey from 2011 to 2015, concluding the “shutdown policy had practically insignificant effects in reducing Internet use for target adolescents” [53]. Among middle school students, the effects of the initiative were null on internet abuse, and only increased sleep duration by a mere 2 minutes [54]. In fact, the shutdown law’s strategy was indicated to have an overall damaging effect—both on the average player’s experience and leaving “the players wanting more,”—consequently raising the potential for addiction [55].

Mainly, as explained with China’s new law, the shortcomings may be linked to the fact that the policies outlined “only address or influence specific aspects of the problem” and fail to recognize the individual differences between gamers [56]. For instance, the forementioned 2018 study by Kiraly et al. revealed that the policies by China and South Korea tended to focus on only one of the following: (i) reducing time spent gaming, (ii) changing the addictive potential, (iii) trying to help gamers by looking at psychological and motivation factors behind their desire to game [57]. Tackling video gaming addiction through only one of the forementioned approaches isn’t sufficient to properly address the issue, rather the most efficient mode of attack requires a cohesive regulation approach that targets multiple aspects. Additionally, according to the study, another method to solve this issue is through a targeted prevention approach: where warnings can be customized to target problem behaviors without encroaching on the “non-problematic gamers’ enjoyment of a largely healthy pastime activity” [58].

South Korea’s 2021 Plan

Ten years after the controversial shutdown law, South Korea is removing government-controlled time restraints in gaming to stay up to date on digital trends, respect young people’s rights, and allow households to enforce limitations themselves [59]. By the end of the year, following the modification of the Youth Protection Act, South Korea will be relying on the “choice permit system,” where parents and underage gamers can request a permit to designate their own playing hours [60]. The Korea Association of Game Industry is in favor of the decision, expecting the new plan to release the hold the previous law held over their gaming industry and children’s rights, as well as reducing the likelihood for addiction to significantly manifest [61].

Notably, one of China’s concerns and motivators behind their aforementioned time restrictions revolve around the misdirection of priorities. It is true that children repeatedly opting to game over completing their algebra homework, or game late into the night instead of getting a full eight hours of sleep, can hinder their ability to learn and satisfy academic responsibilities—as studies in China have shown that problematic video gaming interferes with “sleep, mood, and social learning in children and adolescents” [62].

However, forcibly removing gamers from the gaming environment ‘cold turkey’ can cause considerable distress and negate the benefits that games have demonstrated [63]. It’s important to acknowledge that gaming can generate positive impacts as well. In a study exploring the benefits of gaming, published by the National Center for Biotechnology Information, it was discovered that children who regularly play video games in healthy doses develop an improvement in cognitive abilities—such as deductive reasoning, processing speeds, mathematical intelligence, and skills pertaining analogy—over those who do not game [64].

The notion of time constraints isn’t completely invalid, but should be executed on a moderate level according to each case—and in combination with education and treatment programs—to keep individuals focused on their priorities while demonstrating safe ways to game. To achieve this goal, South Korea’s abolishment of the restriction is paired with a shift in attention: one that focuses on “strengthening the monitoring of harmful game content,” supporting “media and game-use education,” and increasing the implementation of prevention and recovery methods—such as counseling and rehabilitation camps [65]. Moreover, with an aim to raise awareness of problematic gaming habits, outreach programs pertaining the nature of gaming culture, media literacy, and the risks for addiction are included in this renewed focus on education [66].

Hwang Hee, Minister of Culture, Sports and Tourism in South Korea, expressed that gaming is an important avenue for youths to release stress and connect with others; therefore, the new measures strive to encourage these benefits by “establish[ing] a healthy culture of gaming and leisure for teenagers in a flexible manner” [67]. This revised system is more permissive than China’s reinforced gaming restrictions, subsequently leaving “China as the only nation to restrict gaming hours by law” [68].

Technology will only continue to evolve and integrate into our daily routines. There’s no going back to an age where smart phones and online platforms aren’t essential to everything we do, whether that be flaunting vacation pictures on social media, calculating a tip at the end of a meal, buying the latest Barbie on Amazon for Christmas, or paying taxes at the touch of a button. We have the world at our fingertips; however, as with every device or tool at our disposal, there is a potential for abuse.

And with the gaming industry booming, there’s no denying video gaming addiction is becoming an increasingly significant threat—especially amidst the youngest generation. By identifying the best ways to approach the issue, backed by relevant strategies that don’t take away from the benefits and experience of gaming, the ramifications can be better contained and predicted in the United States. Particularly in the wake of the recent pandemic, where gaming, streaming, and other forms of content consumption on the internet have risen exponentially to fill the void of stimulus in people’s lives.

With South Korea’s newfound direction in their efforts against video gaming addiction, and WHO adding the problematic behavior on the list of addictions, the international awareness regarding the consequences of overusing technology can receive the attention it deserves. Additionally, by analyzing these two contrasting policies, the United States can determine which aspects are most effective and gear similar techniques towards their own prevention plans. While political and cultural differences may limit the capacity for the U.S. government to fully implement all of the policies previously mentioned, gaming companies have more control on a self-regulatory basis. This could include providing built-in parental controls, warning messages for high levels of playtime, and rating systems to evaluate the addictive potential of games.

Above all, there’s a collective responsibility for parents, educators, clinicians, game developers, and the U.S. government to recognize the issue for what it is and work towards protecting all vulnerable demographics. For policymakers and community members to pay attention, take this addiction seriously, identify addict-risk teens, introduce the necessary information, and provide effective treatment programs for those in recovery.

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[45] Plavevski, A. (August 31, 2021). China’s new rules allow kids on video games just 3 hours a week—but gaming addiction isn’t about time, it’s about attitude. United States: The Conversation. Retrieved from https://theconversation.com/chinas-new-rules-allow-kids-on-video-games-just-3-hours-a-week-but-gaming-addiction-isnt-about-time-its-about-attitude-167104#:~:text=It’s%20clear%20China%20is%20associating,person%20brings%20to%20the%20gaming .

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New study reveals the power of online gaming communities in fostering social support and mental health

by George Hale, Texas A&M University

For millions of Americans playing some type of video game is a daily occurrence. Games can be a welcome form of entertainment and relaxation for many, and the internet can even make gaming a social activity. However, excessive video game playing to the point of isolation, addiction or changes in mood or behavior are growing concerns with this pastime. These possible negative effects may also contribute to anxiety and depression in some people and gaming may have varying effects on social connections.

A new study published in Sociological Focus builds on existing research hinting at the importance of social connectivity and support for online gamers. In this study, Tyler Prochnow, Ph.D., and Megan Patterson, Ph.D., of the Department of Health Behavior at the Texas A&M University School of Public Health, and colleagues from the University of North Carolina and Baylor University, used social network analysis to examine the social structure of an online gaming site at two points in time. The goal of this analysis was to see how social support , sense of community and symptoms of depression affect social connections over time.

The research team analyzed a social network consisting of members of an online football simulation gaming site, surveying members at the beginning and end of the game's season. In the game, players play as the head coach of a football team and compete against other members of the site over 10 months. Members are able to communicate directly with each other through the site's forums, chat and direct messaging capabilities.

"We wanted to showcase the community building and informal relationships built through these online settings," Prochnow said. "Many people feel a sense of community, support and comfort through online gaming, and I think we need to do a better job measuring these connections and fostering them to improve mental health in today's digital age."

There were 37 members who responded to the survey at the beginning and 40 who responded at the end, with 30 members represented in both samples. The researchers collected data on age, sex and other demographic factors as well as the number of hours members spent on the gaming site and playing other video games. Members also answered survey items on depressive symptoms and perceived ability to talk to someone about problems. The researchers also asked members to list people in real life and on the gaming site that they talked to about important life matters.

Research has found correlations between social network strength and depression, with stronger social networks giving people more opportunities to find support. Informal social networks, such as those found in online gaming, could play a crucial role in coping with stressors and seeking formal help for anxiety or depression. This, combined with research finding that people turn to social networks for help in times of trouble, add to the relevance of this study.

The study found that social support, sense of community and depressive symptoms played a role in changes to the game's social structure over time. The researchers observed that people who reported more social support online, and those who reported less real-life support, were more likely to reach out to other members. They also found that communication ties were more likely to form when communications were reciprocated or transitive (involving three people groups or clusters). In addition, players who spent more time on the site were more likely to have communication ties.

The researchers also found that members who reported feeling a greater sense of community and placing value in being a part of the site were more likely to form communication ties over time. In addition to being more likely to connect, these members might feel more comfortable with conversations about real life issues. This points to the importance of a sense of community in online gaming sites; however, online communities can carry some downsides such as the potential for sites to serve as political and ideological echo chambers.

The study noted that although members with less real-life support were more likely to form communication ties, those reporting greater depressive symptoms were less likely to send communication ties over time. This could indicate a need for more formal support for members experiencing depressive symptoms , including telehealth mental health care options.

This study's findings reinforce existing research on connections between mental health, social support and online gaming and point to the need for more research into the complicated relationships in these areas. More research into these areas and their interactions could help inform interventions to improve social connection and mental health for socially isolated communities and populations living in socially isolating times such as the early stages of the COVID-19 pandemic.

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• Open access
• Published: 09 February 2022

Learning in digital play: a dual case study of video gamers’ independent play

• Weimin Toh   ORCID: orcid.org/0000-0002-6468-227X 1 &
• Fei Victor Lim   ORCID: orcid.org/0000-0003-3046-1011 2  

Research and Practice in Technology Enhanced Learning volume  17 , Article number:  6 ( 2022 ) Cite this article

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This paper explores the implications of youths’ out-of-school gaming practices for teaching and learning in formal and informal learning contexts. We report on a study where we examined the video game play of two youths using a case study approach. User experience approaches, e.g. the think-aloud protocol and interviews, were grounded in the theoretical framework of social semiotics to analyse the gameplay videos and to discuss the implications for the youths’ learning. The paper contends that youths are demonstrating critical thinking, empathy, and multimodal literacy through their gameplay. We offer suggestions for how adults can use video games for youths’ learning.

Introduction

People learn as they play (Oliver & Carr, 2009 ). Digital play involves the use of technology, including computers and laptops, tablets, smartphones, electronic toys, and console games for playing and learning activities (Marsh et al., 2016 ). The boundaries between online and offline spaces have become blurred in digital play as communication and play move across physical and virtual domains and integrate material and immaterial practices (Garcia, 2020 ; Giddings, 2014 ; Marsh et al., 2016 ). Digital play is rooted in children’s everyday experiences and can promote cognitive and imaginative development (Edwards, 2011 ). Engagement with video games is a type of digital play that can bring about learning (Toh & Lim, 2021 ; Squire, 2011 ) as they incorporate sound learning principles, such as “just in time learning” that can be used for teaching various subjects in schools (Gee, 2003 ).

Digital play motivates learning because it engages with the students’ “lifeworld” (New London Group, 1996 ). Digital play can be integrated into schools to intrinsically motivate students for their self-directed (Karakas & Manisaligil, 2012 ) and peer-to-peer learning (Butler, 2017 ). For example, Beavis et al. ( 2015 ) reported that teachers were able to improve students’ learning and engagement by connecting teaching to students’ lifeworlds and redesigning their English and literacy curriculum to leverage the joy of gameplay to build students’ literacy proficiency over time. Digital play can also be an effective way for students to demonstrate new literacies needed for the future workforce (Apperley & Walsh, 2012 ). Playing video games is a common pastime of many people, especially amongst males (Jansz, 2005 ). Video game play has also been described as a literacy practice (Steinkuehler, 2010 ; Steinkuehler & King, 2009 ). When video games are used in the school curriculum, it can motivate students (Deng et al., 2016 ) and draw on their funds of knowledge (Risko & Walker‐Dalhouse, 2007 ) for the learning activities. Digital play has been integrated into formal educational contexts for STEM learning (e.g. Ibáñez & Delgado-Kloos, 2018 ) and to motivate L2 vocabulary learning (e.g. Butler, 2017 ), argumentation and persuasion writing (e.g. Dickey, 2011 ), as well as social skills (e.g. Craig et al., 2015 ), creativity (e.g. Ott & Pozzi, 2012 ), critical thinking (e.g. Barab et al., 2012 ), ethical thinking (e.g. Schrier, 2015 ), and mathematical thinking and problem-solving skills (e.g. Kiili et al., 2015 ).

Video games incorporate a whole set of fundamentally sound learning principles that can be used for teaching and learning activities in schools (Gee, 2003 ). Gee ( 2005 ) also explicated the principles of learning that are built into successful games. These include empowering players as active agents who can co-design the learning experience as well as learning through well-ordered problems in which learners are scaffolded to learn how to proceed when they face harder problems later in the game. Squire ( 2002 ) also argued that examining how gameplay can be used to support learning in formal learning environments can be productive. Games like SimCity and Civilisation can mediate our understandings of other phenomena, and they can be used to support learning in formal and informal learning contexts. Pedagogical activities can be integrated into the game design or teachers can adapt the game to engage students in meaningful practices and critical thinking by using scaffolding questions for students to think about how games can be used as a tool for answering historical questions.

Shaffer et al. ( 2005 ) posited that video games are powerful contexts for learning because they make it possible to create virtual worlds and acting in such worlds help to develop the situated understandings, effective social practices, powerful identities, shared values, and ways of thinking of important communities of practice. For instance, Railroad Tycoon can help players to learn economic and geographic issues faced by railroad engineers in the 1800s by allowing them to engage in design activities when playing the game. However, the authors also highlighted that it was challenging to integrate game-based learning into institutional education because games encourage exploration, personalised meaning-making, individual expression, and playful experimentation with social boundaries, factors which conflict with institutional modes of teaching and learning that emphasise conformity, one size fits all curriculum, and standardised testing and assessment practices.

A game-based curriculum informed by the theoretical framework of digital play has been designed and integrated into classrooms to teach persuasion writing to seventh grade students (Barab et al., 2012 ). The results indicated statistically significant differences in learning and engagement between the control and experimental groups where the students in the game-based curriculum demonstrated significant improvements in their learning gains. The authors explained that the technological affordances of well-designed videogame play supported the students’ engagement and learning by allowing them to play out new possible selves, such as scientists, historians, or investigative reporters in the virtual world to enact disciplinary expertise.

Studies have also shown that commercial video games, such as The Walking Dead can be integrated into classrooms for teaching domain-specific content, such as ethical theories when teachers are able to orchestrate the learning activities with appropriate teaching approaches to support student learning and engagement (de Sousa et al., 2018 ). Playing commercial video games has been found to improve the desirable skills and competencies sometimes referred to as “graduate attributes” in higher education students. Using a laboratory-based randomised controlled trial, Barr ( 2017 ) reported that students in the gameplaying group obtained highly significant positive changes in their adaptability, resourcefulness, and communication skill.

The studies on digital play described here have been conducted in formal pedagogical contexts. However, there is a knowledge gap in terms of our understanding of youths’ gameplaying activities and the types of learning that are demonstrated in their gameplaying process in the informal space. As such, the goal of this study is to identify the types of learning, such as critical thinking, empathy, and multimodal literacy, that can be demonstrated from the players’ gameplaying activities. In our previous study (Toh & Kirschner, 2020 ), we have investigated how Participant 1 adopted an inquiry-based learning approach to progress the same game segment examined in this paper. The inquiry-based learning approach has been integrated into a self-directed learning framework in video games for that study. In an upcoming paper (Toh & Kirschner, 2022 ), we examine how Participant 2 exhibited resilience in his learning of the stealth option to progress the same game segment analysed in this paper. Resilience has been integrated into a social-emotional learning model in that paper. In this study, we adopt a case study approach through a multimodal discourse analysis of the gameplay videos to surface the types of learning that can be identified in two youths’ gameplay recordings. Our paper aims to answer the following research question: What is the learning that can be demonstrated through video gameplay?

The theoretical orientation of social semiotics informs our lenses on youths’ gaming practices (Kress, 2010 ; Kress & van Leeuwen, 2001 ). The participants’ gameplay interactions are described using social semiotic theory, which models meanings according to the sociocultural contexts where the interactions took place. Bezemer and Kress ( 2016 , p. 4) argue it is important to respond “theoretically to the social”, recognise the ways for making meaning, and describe the “semiotic work done”. From this argument, the tenets of multimodal social semiotics have been adopted in the analysis and interpretation of the data to understand youths’ gaming practices.

The first tenet recognises that youths communicate with multimodal ensembles, drawing from language, visual, and the verbal modes to constitute interactivity. The second tenet recognises signs of learning (Kress & Selander, 2012 ). Making meaning is guided by interest, and learning occurs as the learners’ entire set of resources is augmented and transformed when they integrate new ways of conceiving the world. The third tenet focuses on how semiotic modes and digital technologies facilitate different pedagogic relations in human–computer interaction and offer learning opportunities. From the participants’ gameplay interaction, we discuss the learning demonstrated by the participants in their gameplay, the affordances of the video games that supported their expression of these literacies, and pedagogical implications of digital play and learning.

Research design overview

This paper adopts a qualitative case study approach method (Creswell, 2013 ) through a multimodal discourse analysis of the gameplay videos produced by two youths. The qualitative case study approach involves the exploration of case(s) over time through detailed, in-depth data collection involving multiple sources of data. The rationale for a qualitative case study approach is that it allows for a holistic understanding of a phenomenon within real-life contexts from the perspective of those involved (Merriam, 1988 ; Stake, 1995 , 2005 ; Yin, 2009 ) and allows the researcher to grasp the intricacies of a phenomenon (Stake, 2005 ).

The think-aloud protocol (Hu & Gao, 2017 ; Li et al., 2012 ) was adapted for use in the study by asking participants to verbalise their gameplay experience. Participants were asked to explain how and why (Gillern, 2016 ) they made a specific choice or perform an action during and after gameplay. They were also instructed to record their natural reactions and comments in the game recordings. When they verbalised their experience as they played the game, the method used was concurrent think-aloud protocol (Kelley et al., 2015 ) that involved the participants thinking-aloud while simultaneously performing an activity in usability studies. When the participants discussed their experience after gameplay, retrospective think-aloud (Ji & Rau, 2019 ) was used to reflect on their game experience. The think-aloud protocol is an effective method to elicit the participants’ demonstration of their learning because of the prompt response of the participants when a problem is experienced (Ericsson & Simon, 1993 ), which shows how they overcome the problem to progress the game. As the participants were able to refer to their gameplay recordings during the interviews, stimulated recall (Dempsey, 2010 ) was also used to review their gameplay recordings.

The framework of multimodal discourse analysis (O’Halloran & Lim, 2014 ; Kress, 2012 ; O’Halloran, 2004 ) was adopted to analyse the video recordings of the participants. The multimodal discourse analysis approach integrates the tenets from social semiotics, discourse analysis, think-aloud protocol, and the interviews to examine the player experience in their video recordings. The multimodal combination of language, visual, verbal, and action semiotic modes in the gameplay recordings are combined to form the ludonarrative frame for video games, which conceptualises the gameplay, the narrative, and the player as a whole (Toh, 2018 ). A semiotic mode can be understood as a distinct way for meaning-making (Jewitt, 2009 ) and the multimodal discourse analysis approach to examining the gameplay recordings is relevant because video games are highly multimodal artefacts. A central tenet of multimodal discourse analysis is that a text is embedded within the sociocultural context (Guo, 2017 ) in which it is produced and the text’s meaning is never fixed but contingent on different external factors, such as the cultural background and prior gaming experience of the participants (Toh, 2018 ).

Data collection

Multiple sources of data were used to interpret the lived experience of the participants through the method of data triangulation and method triangulation. Data triangulation (Denzin, 2009 ) has been used to gather data from different players, and method triangulation (Bauwens, 2010 ) has been used for data gathering and analysis. The different methods of data collection include the interviews of the participants, the observation of the participants’ gameplay in the laboratory, and the gameplay recordings. Member checking has been adopted during the qualitative interviews to validate the interpretations of the participants’ gameplay recordings (Iivari, 2018 ).

Prior to the start of the study, the participants filled up a written survey to provide demographic information and gaming habits. During the first gameplay session, the participants played their selected game from the start for one to three hours in a computer laboratory. Their gameplay was streamed and recorded using Fraps (computer) and a PS3 recorder on a nearby computer whereby the researcher was using to observe their gameplay. At the end of the first gameplay session, the first author conducted a one-to-two-hour interview with the participants. The interview questions asked during the first gameplay session were more general and open-ended. Some of the questions that the interviewer asked the participants included whether they liked the scripted game sequences, whether they were clearly able to see a divide between narrative and gameplay in the game, and whether the information provided by the characters helped them to make decisions to progress the game.

The first author then instructed the participants to record their subsequent gameplay sessions at home. The participants incorporated their natural reactions with their think-aloud verbalisations in their gameplay recordings. A total of 15 and 14.8 h of think-aloud video recordings were collected and analysed for Participants 1 and 2, respectively. After they have completed the game, the first author arranged a final interview to review their gameplay recordings together with them and discuss their gaming experiences. A total of 7 and 6.7 h of interview recordings were collected for Participants 1 and 2, respectively. More specific interview questions were asked during the final session with the participants. For instance, the researcher asked Participant 1 to explain whether specific objects in the game world such as the spark plug and the pillow helped him to progress the game and how he figured out the sequential order to progress the game. For Participant 2, an example of a specific question the researcher asked him was whether playing as Joel after Ellie caused him to feel worried for Ellie’s safety and motivated him to progress the game to find out the story.

Participants

The data were obtained from the first author’s study on the player experience. The research aim for the study was to propose an original theoretical framework, the ludonarrative model for studying video games, and this model was grounded on the empirical data of a group of players in Singapore. For the study, participants were recruited through convenience and snowball sampling via advertisements posted on the university’s website. Consent was obtained from the participants to share their video recordings, which included their voices, for research purposes. This study was approved by the university’s Institutional Review Board.

The data from two of the participants were selected for analysis. The two participants were selected because they were experienced players (Soylu & Bruning, 2016 ). Participant 1 is a 22-year-old male undergraduate student with 11–15 years of gaming experience. He mentioned that he played a variety of games such as shooters, puzzle games, action games, and so on a few times a week. The game he chose for the study was The Walking Dead Season 1, Episodes 1–5. Participant 2 was a 24-year-old male undergraduate student with 11–15 years of gaming experience. He mentioned that he played a variety of games such as role-playing games, strategy games, shooters, and so on a few times a week. He chose The Last of Us .

Description and rationale of game choices

The Walking Dead (PC game) is set in a fictional world in which a zombie apocalypse has occurred. The player controls Lee Everett to explore the story world and is accompanied by several survivors, including Clementine, a young girl. The Last of Us (PS3 game) is set in a post-apocalyptic world in which a mutated strain of the Cordyceps fungus has infected humans and transformed them into zombie-like creatures. The player controls Joel to explore the story world and is accompanied by Ellie, a young girl.

Data analysis

The thematic analysis (Braun & Clarke, 2006 ) has been used to code the types of learning of Participants 1 and 2. Theoretical thematic analysis involves the use of theoretical frames in a deductive way to search across the data set in the form of the think-aloud verbalisations and players’ reflections in the gameplay recordings and the interviews to discover repeated patterns of meaning. The coding categories were developed a priori from relevant literature (e.g. Toh & Lim, 2021 ) and included the three main types of learning, namely, critical thinking, empathy, and multimodal literacy. During the thematic analysis, the researchers familiarised themselves with the data by watching the gameplay recordings and listening to the interviews multiple times. During each review of the data, the researchers generated initial codes and then collated these codes into themes. The themes were then reviewed and defined to arrive at the final analytic scheme (Braun & Clarke, 2006 ). The two authors of the paper coded the data, and they have received prior training to conduct the analysis. The data were independently coded by the two authors, and disagreements were discussed to reach a consensus.

Case 1 Footnote 1 involved Participant 1, who played The Walking Dead Season 1, Episode 1. The selected gameplay segment was set at the Travelier Motel. In a previous scene, Glenn, the non-player character (NPC), had gone searching for supplies and gas at the motel for Lee’s group. He noticed a woman, Irene, in a boarded-up room on the upper level of the motel. When Glenn tried to talk to her, she asked him to leave. Walkers emerged from the forest, and Glenn was forced to hide in an icebox until Lee and Carley arrived to rescue him. The trio then decided to rescue Irene together.

The analysis of this gameplay segment indicated that Participant 1 adopted a problem-solving and inquiry-based approach (Toh & Kirschner, 2020 ; cf. Squire & Jan, 2007 ) to reach Irene. Participant 1 performed the following actions sequentially and iteratively: understand (orientate), plan (conceptualise), act (apply), and reflect (evaluate). First, Participant 1 understood how to proceed by listening to the characters. For example, Lee hinted that stealth was important to proceed by saying that “Noise attracts these things”. At 3:16, Participant 1 demonstrated his understanding of using stealth to reach the objective by repeating that “noise attracts these things”.

At 4:12, the game hinted to Participant 1 that peeking too long will result in a “game over” if the zombies detected him. The linguistic text warned Participant 1: “Peek too long, and you will be seen”. Simultaneously, Participant 1 saw the visual display turning red and heard the heartbeat sound as he peeked over the wall to observe the setting. In his first attempt, Participant 1 peeked too long, so a “game over” occurred. Participant 1 laughed loudly at 4:22 as Lee died comically (Newman, 2016 ). Participant 1’s unsuccessful first attempt demonstrated how he experimented with the game rules to understand and plan his actions to progress the game. After his first failure, he understood that one specific condition that could result in a “game over” for him was his exposure to the zombies beyond a specific time limit.

Participant 1 continued to understand and plan the correct sequential order to reach the objective. As he crossed the road to go towards the recreational vehicle (5:05), the game hinted to him that he needed a weapon to kill the zombies by having Lee verbalise that he was not sure whether he could take out the zombies even if he had a weapon. This was followed by the camera’s zooming in on the zombies who were obstructing Lee. The game also hinted to Participant 1 by having Lee verbalise, while being shown the car and the zombie, that he could use the car to kill the zombies (6:10). However, before Participant 1 can use the car, he must remove the zombie who was lurking near the front of it.

Participant 1 then noticed an awl inside a locked vehicle, which he assumed can be used to kill the zombie lurking near the car (6:25). Participant 1 chose to hit the glass but was unsuccessful (6:33). Glenn hinted to Participant 1 that his action had attracted the zombie’s attention. At 6:50, Participant 1 reflected that the awl was the weapon that he needed and he must find some way to get it quietly. He planned his next action by commenting that he had to kill the zombie with the awl before using the car to kill something else (7:05).

When Participant 1 returned to the brick wall, he found a pillow on the other side of the wall. He planned to use the pillow to smother the zombie and kill him quietly with some other implement. Carley reaffirmed Participant 1’s plan by hinting, “Good luck smothering them to death”. Returning to the front of the vehicle, he killed the zombie quietly by smothering him with the pillow and asking Carley to shoot him with her gun. Participant 1 then reflected that the action will not work in real life because the gun did not have a silencer.

After removing the zombie, Participant 1 opened the car’s door, retrieved a spark plug, unlocked the gear shift, and opted to push the vehicle towards the wall to immobilise a zombie there (10:34). Returning to the car with the awl inside it, Participant 1 used the porcelain on the spark plug to break the car window to retrieve the awl (11:42). Finally, Participant 1 reflected that he can use the awl to kill the other three zombies (12:12). He then killed these zombies with the awl (13:25, 14:00) and retrieved the axe from the wall (14:27). Finally, Participant 1 reflected that he felt safer with the axe (14:32). He easily killed the last two zombies to reach the trapped survivor (15:22).

Case 1 demonstrates how Participant 1 adopted a problem-solving and inquiry-based approach to reach the game goal. Participant 1’s ability to perform his actions in the correct sequential order in an iterative manner enabled him to remove the zombies obstructing him from reaching the woman trapped on the upper level of the house across the street. Our analysis of his think-aloud shows how he safely removed the zombies through critical thinking and reflection before he succeeded in reaching the trapped woman to save her.

Case 2 Footnote 2 involved Participant 2, who played The Last of Us . The segment that we analysed occurred in the winter chapter when Ellie escaped from David, the antagonist, after his failure to recruit her into his group. Joel was searching for Ellie when she escaped from David. This gameplay segment involved Participant 2’s alternating control of Joel and Ellie. This alternating control allowed Participant 2 to demonstrate empathy for both characters, the understanding of their thoughts, feelings, and actions through embodied play and perspective shifting (Toh & Lim, 2021 ; Elliott et al., 2011 ).

Ellie killed James (David’s partner) with the chopper on the table when he was distracted while talking with David. She escaped and grabbed a knife from a nearby table for protection as David attempted to shoot her but missed. The cutscene ended as Ellie escaped into the snow, and Participant 2 was given control of Ellie in the snow outside (19:10). He controlled her to take shelter in a nearby building. Ellie’s verbal utterance and subtitles informed Participant 2 that Ellie needed to find a gun to protect herself (19:28). Inside the building, Participant 2 overheard David ordering his people to find Ellie (20:20). He controlled Ellie to sneak into another building and planned to wait for David’s people to come inside for him to kill them individually (21:17). When the first man came in, Participant 2 stealthily stabbed him and obtained a revolver (21:45). He repeated his action on the other man who entered the building (22:09).

As the game progressed, the video showed that he faced difficulties when Ellie had to fight two or more men simultaneously. This led to Ellie’s being surrounded and killed. In a later gameplay segment, he planned to distract and kill David’s men inside another building (34:20). He succeeded (34:48), but Ellie was killed by a nearby enemy who detected Ellie and shot her (35:05). This heightened Participant 2’s feeling of vulnerability when he played as Ellie. He said that he had to retry the game segment (35:07). When he replayed this segment, he was killed again as he controlled Ellie to fight the two men directly instead of stealthily (36:30). He reflected that he had to sneak into that room (36:40). During the third (37:30), fourth (38:24), and fifth attempts (39:47), he failed again when Ellie was surrounded and killed. He reflected: “The idea was there—the execution (39:50)”. Finally, on the sixth try, he cleared this segment by separating David’s men and stealthily killing them one at a time (40:30).

Participant 2 entered the open area in a restaurant and triggered the fight with David (45:58). During the fight, Participant 2 used Ellie’s stealth ability to track David’s location and planned his attacks. Participant 2’s ability to use Ellie’s ability to track David’s movements by sound was key to performing a stealth attack on him.

After Participant 2 stabbed David thrice, the game changed perspective and allowed him to control Joel to search for Ellie (56:25). When Participant 2 entered a nearby building, he heard David’s men searching for Ellie (57:05). It was easier for Participant 2 to play as Joel because he could choose to engage in close combat and kill enemies with a single blow of the axe (57:29, 57:48) or use stealth attacks. With Ellie, he could only use stealth attacks. As Participant 2 cleared several gameplay segments, he entered the slaughterhouse and found Ellie’s backpack (1:09:04). From Joel’s verbalisation, “What is this? Why is Ellie’s stuff here?”, Participant 2 understood that Joel was worried about Ellie (1:09:19). He picked up a meat ledger note that indicated the amount of meat that David’s men, who were cannibals, had collected for supplies (1:09:30). This note, along with the human corpses in the meat locker (1:09:50) and Joel’s utterance “I gotta find her”, (1:09:55) further underscored Participant 2’s understanding of Joel’s concern for Ellie’s safety. Participant 2 had just played as Ellie and understood the danger Ellie faced as she fought against David and his men.

Case 2 shows how Participant 2’s ability to control 2 characters allowed him to demonstrate empathy by understanding their thoughts, feelings, and actions through embodied play and perspective shifting. Our analysis of his think-loud and observation of his actions during the gameplay shows how Participant 2’s empathetic concern for Ellie motivates him to find her when he played as Joel.

Critical thinking

In the field of education, Bloom’s ( 1956 ) taxonomy is the most widely cited source when it comes to teaching and assessing higher-order thinking skills. Bloom’s ( 1956 ) taxonomy consists of the lower-order thinking skills, such as remember (recall, recognise), understand, and apply as well as the higher-order thinking skills, such as analyse, evaluate, and synthesis, which are frequently said to represent critical thinking (Kennedy et al., 1991 ). The analysis of Participant 1’s gameplay recording showed his ability to select information from the game world, reflect on it (e.g. failure to progress the game), and integrate it into a coherent whole in a mental model to gain a deeper understanding of the story, rules, and mechanics (Toh, 2018 , Buckingham, 2015 ). When he played the game, we observed that he was applying his critical thinking: the selection, evaluation, and integration/synthesis of information provided by digital texts (Salmerón et al., 2018 ) by adopting the inquiry-based learning approach (Toh & Kirschner, 2020 ) to reach the objective.

Participant 1 demonstrated an iterated approach of using a mixture of lower and higher-order critical thinking skills to progress the game. At the start of this gameplay segment, Participant 1 demonstrated lower-order critical thinking skills, such as recognising through his counting of the number of zombies that must be overcome to reach the objective. He demonstrated understanding by explaining what he had to do for this gameplay segment through his think-aloud “Ya, so basically, we are here rescuing Glenn from [the zombies]”. He also demonstrated recall by commenting on what happened previously in the game “He [Glenn] came to top up petrol from the motel but he got into a bit of trouble and now we have to rescue this survivor upstairs over here, yes.”, which is followed by understanding as he explained what he had to do to achieve the gameplay objective “So, we have to kill all the zombies to rescue her. So, let’s find some way to kill them quietly”.

At 4:10, Participant 1 experienced how the losing condition of the game could happen by peeking over the wall at the zombie eating the dead person on the ground. However, he spent too long peeking and Lee ended up being eaten by the zombie. On his second attempt, he demonstrated his understanding (a lower-order critical thinking skill) of the losing condition of the game by commenting that “Oh, it looks like a timed thing” and controlled his character not to long too long over the wall. At 5:36, Participant 1 demonstrated the use of evaluate, a higher-order critical thinking skill as he reflected on how Lee can see over the wall but not when he was running.

At 7:05, from Participant 1’s verbalisation that he had to kill a zombie in front of the vehicle with an awl (“the screwdriver”) before using the car to kill another zombie, he demonstrated planning and analysis, which is a higher-order critical thinking skill. At 8:54, Participant 1 demonstrated the use of the lower-order critical thinking skills when he applied his plan and chose the action in the dialogue option to kill the zombie quietly by covering him with the pillow and asking Carley to shoot him with her gun. Finally, Participant 1 demonstrated a higher-order critical thinking skill, such as evaluation from his verbalisation that the action would not have worked in real life because the gun did not have a silencer.

Likewise, a learning observed from the participants’ gameplay is empathy, that is the ability to understand and share the feelings of others (CASEL, 2015 ). This was observed in Participant 2’s gameplay. For example, when the game allowed Participant 2 alternate control of Ellie and Joel, he used embodied action to gain a better understanding of both characters’ playstyle through situated and just-in-time learning (Gee, 2005 ). Another example observed in the gameplay recordings was when Participant 2 discovered Ellie’s backpack, the meat ledger, and the hanging corpses, and he showed his concern for Ellie’s safety. For instance, in 1:09:19, Participant 2 verbalised that Joel felt worried for Ellie when he found her backpack in the slaughterhouse. He appreciated that Joel’s actions had been driven by his fear for Ellie’s safety. Participant 2 demonstrated his empathy in an interview:

So later on, when you shift to Joel to control him to save Ellie, did you feel an even more urgent need to save her? Because you discovered Ellie’s backpack.

Because you played what Ellie’s going through right? So, you know that she needs help. So, in that sense, you can empathise more with what Joel is feeling, as in Joel doesn’t know what is happening to Ellie, but you know the emergency. So …

When you discover all her objects, huh?

And then the slaughterhouse.

Um-hmm. So, he knows that she’s not in a good place.

In the above interview, Participant 2 explained how his ability to control two different player characters one after the other during the gameplay allowed him to understand both characters’ thoughts, feelings, and actions. Because Participant 2 was given control of Ellie early in the Winter chapter of The Last of Us , he was able to feel Joel’s sense of fear for Ellie’s safety when the game later offered him control of Joel to look for her. As Participant 2 had been able to play as Ellie, he could understand her precarious situation in the game world when she met the antagonist, David with his group of cannibals while searching for supplies to take care of Joel. David appeared to Ellie as a compassionate man who looked out for her needs and he even fought together with Ellie against waves of Infected enemies during their initial encounter.

However, as the chapter progressed, Ellie discovered that David and his group were cannibals. David captured Ellie and offered her a place in his group. When she rejected his offer, David and his man attempted to slaughter Ellie for food, but she managed to escape. The game then switched control to allow Participant 2 to play as Joel after playing as Ellie. He could then feel a greater connection to both player characters because he possessed more information than either of the player characters possessed on their own in the game world. The perspective shift (Toh & Lim, 2021 ) in the game therefore allowed Participant 2 to demonstrate empathy when playing the game.

Multimodal literacy

We also observed that the participants demonstrated multimodal literacy in their engagement with the multimodal orchestration in the game, such as the verbal mode of the NPCs, the linguistic mode of the game hints, the visual representations of the characters, and the characters’ actions and gestures to gain an overall idea of how to progress the game. Multimodal literacy (Jewitt & Kress, 2003 ; van Leeuwen, 2017 ) involves both critical and creative engagement with multimodal representations that reflect a semiotic awareness (Lim, 2021a ; Lim, 2021b ). Multimodal literacy also involves an understanding of the affordances of the different meaning-making resources and how they work together to produce a coherent and cohesive multimodal text (Mills, 2016 ). The player’s multimodal literacy refers to their sensitivity to the design features in the video games, including knowing how to work across different semiotic modes, such as language, visuals, audio, music, and action to perform critical and creative actions in the game.

Participant 1’s multimodal literacy can be observed at the beginning of the gameplay segment. He demonstrated verbal awareness by listening to the characters’ verbal interactions in the cutscene before commenting through his think-aloud to show his understanding that he must rescue the survivor in the house across the street, to achieve the winning condition of this gameplay segment. We see how he showed a visual awareness of the objective, by pointing at the house across the street with the mouse pointer to indicate his understanding that he must reach the objective, the house to progress the game. He showed us his linguistic awareness by following the game hints provided through the linguistic prompts, such as “peek over the wall”, “push car”, “look at truck”, “open door”, “examine window”, amongst others to perform the micro actions of the gameplay so that he can reach the gameplay objective. He also demonstrated an action awareness, which refers to his understanding of the dynamic interplay between game and player (Toh, 2018 ; Apperley & Beavis, 2013 ; Beavis, 2014 ) by selecting the specific actions in the correct sequential manner to interact with the zombies and overcome them to reach the woman in the house across the street. He combined his verbal awareness, visual awareness, linguistic awareness, and action awareness in the gameplay to reach the objective and progress the story.

Participant 1 also demonstrated his multimodal literacy in quickly making sense of the orchestration of multimodal meanings through the semiotic resources. He combined the visual mode of the entire screen turning red, the auditory mode of a pulsating heartbeat, the linguistic mode of a text that warned him not to peek for too long, and the verbal mode of the player character’s announcing that the zombie had discovered him to come to his understanding of the losing condition of this gameplay segment. Participant 1 verbalised his reading of the situation through his think-aloud that “it looks like a timed thing” to reflect his understanding that his peeking over the wall beyond a certain time limit resulted in the losing condition whereby his character was killed when the zombies discovered where he was hiding.

The findings of this study affirm the findings from previous studies that playing video games can allow players to demonstrate critical thinking (e.g. Gumulak & Webber, 2011 ) and empathy (e.g. Hilliard et al., 2018 ). Additionally, our study adds to the field of knowledge by showing that players can demonstrate multimodal literacy (Lim, 2021b ) during gameplay by learning how to combine information from semiotic modes, such as the language, verbal, visual, and aural modes to come to an overall understanding of the game. Their demonstration of their multimodal literacy is evidenced in their think-aloud verbalisations where they articulated how they understood, planned, acted, and reflected on how to progress the game by selecting and integrating information from multiple semiotic modes, such as language and visuals during the gameplay process. From an educational standpoint, we have noted that there is a difference between demonstrating these skills within a game context and having the players transfer skills such as critical thinking in digital play to academic subjects or real-world situations. We recognise that the demonstration of these skills in video gameplay does not mean that players are able to transfer the critical thinking to academic subjects or empathy to real-world situations. With this in mind, we have explored ways in which educators can design for digital play in the classrooms, such as introducing a pedagogic metalanguage for digital play (Toh & Lim, 2021 ; Lim & Toh, 2022 ) which teachers can use to guide players in transferring their critical thinking and empathy through reflection questions during classroom activities.

The affordances of video games that can facilitate the expression of these multiliteracies include immediate feedback from semiotic resources in the game world (Nadolny et al., 2020 ) and a safe space (LaFleur et al., 2017 ) that allows the player to retry again after failing the gameplay segment. Additionally, scaffolded learning in the form of virtual learning companions (Calvert, 2017 ) and multilinear pathways (Roswell & Wohlwend, 2016 ) in the gameplay can allow players to try out different approaches of solving a problem to demonstrate their critical thinking. Finally, the player’s ability to take control of two player characters during gameplay to understand their thoughts, emotions, and actions (Toh & Lim, 2021 ) can support their demonstration of empathy.

In contrast to empirical studies that suggest learning occurs in stages (e.g. Luft & Buitrago, 2005 ), our findings showed that learning is a nonlinear and iterated process where sometimes the learner may experience progress in their learning, but at other times, they may experience failure if they uncritically applied one approach that worked in a previous context on a different context. For instance, Participant 2 failed when he tried to play Ellie using Joel’s direct approach of attacking enemies in the open instead of adopting stealth when fighting multiple enemies.

Digital play is arguably attractive to people from all ages but is especially appealing to children and youths because of design features, such as immediate feedback, social affordances, and the presence of multisensory stimuli when using mobile devices and games to interact with others (Marlatt, 2018 ; Oliver & Carr, 2009 ). Notwithstanding the value of digital games, concerns have also been raised about the risks, such as exposure to sexual (Tompkins & Lynch, 2018 ) and violent content (Elson & Ferguson, 2014 ) as well as potential addiction (Grüsser et al., 2007 ) and health issues (Saunders & Vallance, 2017 ) related to the prolonged screen time with mobile devices. While these concerns are understandable, it is also acknowledged that studies have found no evidence of negative effects that playing violent video games has on youths (e.g. Ferguson & Olson, 2014 ). In addition, to mitigate the concerns on the possible ills of digital play, strategies of integrating digital play and learning into pedagogical context, such as the use of metacognitive scaffolding for inquiry-based learning activities (Ibáñez & Delgado-Kloos, 2018 ) and reflection questions to allow teachers to guide students’ digital play (Toh & Lim, 2021 ) have been proposed.

With the increasing ubiquity of mobile devices and gaming activities amongst youths and children, we argue that adults should not disregard youths’ use of video games. Instead, they can design learning experiences with video games using a series of learning activities and scaffolding questions structured by theoretical frameworks, such as Cope and Kalantzis’ ( 2015 ) learning by design framework or the metalanguage that we have developed for digital play (Toh & Lim, 2021 ; Lim & Toh, 2022 ). The framework allows adults to design learning using guided inquiry techniques, such as reflection and conversational prompts after gameplay for youths’ learning.

Given the resistance typical schools may have towards the use of video games for learning (Bourgonjon et al., 2013 ; Gee, 2005 ), we recognise that the degree of integration of video games into formal learning contexts will depend on the receptiveness and attitude of the educators, parents, and students (Mifsud et al., 2013 ). Nonetheless, video games can be used well in the classrooms for teaching and learning STEM subjects (e.g. Ormsby et al., 2011 ) or content subjects involving ethical thinking (e.g. Schrier, 2015 ), decision-making (Toh, 2021 ), and narrative concepts (Ostenson, 2013 ) in many schools.

In this study, we have explored the digital play of two players using a qualitative case study approach to examine the display of critical thinking, empathy, and multimodal literacy in their gameplay. These are important life skills that overlap with the skills required in school and the workplace. Through this study, we hope to advance the call for educators to harness video games in teaching, given how it can bring about different types of learning in the youths.

We also acknowledge that the limitations of the study include the male gender bias of the subjects recruited for the study due to the snowball and convenience sampling method used. Additionally, the qualitative research methods used, such as interviews, think-aloud protocol, and observations in the laboratory can be complemented with more objective measures in future studies, such as galvanic skin conductance, eye tracking, and brain scans to triangulate the findings. Future studies can also use a broader range of games to elicit the different types of learning that are demonstrated by gameplayers.

Availability of data and materials

The video recordings of the data analysed in the study have been provided in the endnotes of the manuscript for case study 1: https://tinyurl.com/Case00001 and case study 2: https://tinyurl.com/Case000002 .

The analysis of the scene started at 1:10 and ended at 16:40. https://tinyurl.com/Case00001 .

The analysis of the scene started at 17:54 and ended at 1:10:45. https://tinyurl.com/Case000002 .

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This work was supported by the National Youth Council’s National Youth Fund (NYF) grant and the National Institute of Education, Nanyang Technological University, Singapore’s Planning Grant PG 03/20 VLF “Multimodality and Pedagogy (MaP): A Systematic Review” (2020–2021).

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Idea: FVL and WT; Literature review: WT; Methodology: WT; Data analysis: WT; Case studies: WT; Findings and conclusions: FVL and WT; Writing (original draft): WT and FVL; Final revisions: FVL and WT; Project design and funding agency: FVL. Both authors read and approved the final manuscript.

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Weimin Toh is Research Fellow at the National Institute of Education, Nanyang Technological University, Singapore. His research interests are social semiotics, multimodal discourse analysis/multimodality, game studies, and game-based learning.

Fei Victor Lim is Assistant Professor at the National Institute of Education, Nanyang Technological University, Singapore. He researches and teaches multiliteracies, multimodal discourse analyses, and digital learning. He is editor of Multimodality and Society and author of the book Designing Learning with Embodied Teaching: Perspectives from Multimodality published in the Routledge Studies in Multimodality.

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Toh, W., Lim, F.V. Learning in digital play: a dual case study of video gamers’ independent play. RPTEL 17 , 6 (2022). https://doi.org/10.1186/s41039-022-00182-2

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The Online Gaming Industry in India [Case Study]

Manav Makhija

We all like to play games, as it is considered to be one of the most intriguing activities for amusement and leisure. Be it Candy crush or PUB-G the craze for games in India has been on top. It is often said that this fun activity has the power to make you happy as it increases your brain function, releases serotonin which is a chemical that makes us feel delightful.

Well, the allure of playing games is not new, be it board games or virtual games, the excitement of it has always increased in India. After the technological advancement and the history of gaming has completely changed and transformed.

The one prominent area which did not get relatively affected by the Covid-19 pandemic was the gaming industry all over the world. In fact, the pandemic lockdown gave a boost to this industry since people were forced to sit at their homes and explore some leisure activities.

According to a survey, there was a 30% increased in traffic in online mobile gaming in India during this period. Also, Paytm First Games reported that they saw an increase of 200% in the users of this online gaming platform.

Timeline of Gaming Industry The Current Gaming Scenario in India Gamers and their Preferences Top 10 online games in India Future of Gaming Industry in India FAQ

Timeline of Gaming Industry

18th Century: It was those times when people first discovered the concept of games in the Egyptian Dynasties. Later on in the 18th century as people started evolving the invention of card games and board games began to happen.

19th Century: People realized this leisure activity can be commercialized. Also this time people became advanced with the facilities of printing and manufacturing and hence started to produce the more vibrant and rich card and board games. For the first time, Monopoly was introduced in the year 1902 which is still a big sensation today when it comes to board games.

In the late 1930s, when computers were built the gaming advancements also began. The simple card games and board games were thought to be converted in the form of electronic means as well.

1950s–1990s: This was the era when the very first computer games and video games started becoming popular. Home computers had built-in games and portable video games became trendy. When mobile phones were released in the late 1990’s people in India were crazy about games like ‘Snakes’ on Nokia phones.

2000 – 2010: As the technology started upgrading and the mobile phones became better and better, the digital gaming industry valued around $5 billion.

2011 – 2016: When the technology rapidly started growing, VR games were introduced to people. The evolution of cameras, graphics, and sound quality enhanced the user experience in the gaming industry.

2016 – Today: Since 2016 till date, the global mobile gaming industry has never seen a huge downfall. Along with mobile phones, tablets, and laptops, people started purchasing specialized PCs that are designed to play heavy games with the most effective graphics and user interface. The trend of playing games professionally has also increased a lot in the Indian market.

The Current Gaming Scenario in India

In the past few years, the gaming industry in India is flourishing tremendously. From $62 billion in 2019 to $90 billion in 2020, the market continues to grow in robust ways. During the lockdown, the major segments that contributed to the growth were esports, mobile gaming, and real money gaming. The gaming industry has also been very significant in creating numerous job opportunities for people.

Today mobile gaming in India has reached millions of people. There are more than 600 million gamers around us and this is not going to stop anytime soon. India ranks 5th in engagement and awareness of gaming around the globe and this shows that people are totally involved in this segment.

Gaming firms have now started earning handsome revenues from this sector by generating a huge volume of game downloads, shooting advertisements, and elevating user experience. These companies also charge their customers some amount for premium game packs, subscriptions, purchases of coins, and other such chargeable extensions.

Gamers and their Preferences

Even though many games are considered to be gender-neutral, but there are games that are specifically designed for males or females. Today over 80% of the gamers population is below the age of 24 years while only 8% of the people age above 40. Youngsters tend to your internet more and play online games. According to the statistics, over 83% of the gamers’ population is male while only 17% is female.

While categorizing the genre of games, females prefer games that are related to puzzle or arcade games, whereas males prefer games that have action, sports, and thrill. Usually, such games are heavy in usage and require efficient devices. India has world-class infrastructure, IT skills, and more than that, the talent which has advanced gaming technology. The gamers enjoy the games developed by gaming centers like Microsoft , Disney, Sony , Playdom, UbiSoft, etc.

Top 10 online games in India

Here is the list of Top 10 games that Indians have absolutely loved and have been most trendy to date –

• PUB-G (now banned)
• Candy Crush
• Clash of Clans
• Call of Duty
• Subway Surfer
• 8 ball pool
• Counter-Strike

And a few more like Ludo, Rummy, Teen Patti, etc.

Future of Gaming Industry in India

1. Age and gender dominance is likely to improve in the near future. Online gaming will soon see a shift in the age and gender composition of the total population since the huge untapped market is likely to experience this world of gaming

2. Cloud gaming is going to get very popular especially in India. All people would need to have is a stable internet connection and they could get an experience of gaming like never before.

3. Freemium companies will help the industry to get better economic conditions. We are a very price-sensitive market and freemium gamers would continue to search for alternatives if the companies start charging for premium services.

4. Emerging technologies will help our country to uplift the gaming industry even more. The use of artificial intelligence augmented reality in games, virtual reality , modular technology, and cloud based gaming infrastructure will be the key drivers of the gaming industry in the future.

How big is the gaming industry in India?

The online gaming industry in India is expected to grow up to $2.8 billion till 2022.

How much does the gaming industry make 2020?

Global gaming industry is expected to surge $179 billion in 2020.

Which country has the most gamers?

According to Statista, Vietnam is the country with most number of gamers as of 2020.

The Indian online gaming industry is growing every month these days. Especially after the pandemic, when kids have more time and even the adults got introduced to this world of gaming. Moreover, it has even given opportunities to entrepreneurs to find more ways to market their products. Additionally, there are startups emerging in this industry and even investors are heavily funding these startups seeing their potential to grow in the country.

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Does Video Gaming Have Impacts on the Brain: Evidence from a Systematic Review

Denilson brilliant t..

1 Department of Biomedicine, Indonesia International Institute for Life Sciences (i3L), East Jakarta 13210, Indonesia

2 Smart Ageing Research Center (SARC), Tohoku University, Sendai 980-8575, Japan; pj.ca.ukohot@iur (R.N.); pj.ca.ukohot@atuyr (R.K.)

3 Department of Cognitive Health Science, Institute of Development, Aging and Cancer (IDAC), Tohoku University, Sendai 980-8575, Japan

Ryuta Kawashima

4 Department of Functional Brain Imaging, Institute of Development, Aging and Cancer (IDAC), Tohoku University, Sendai 980-8575, Japan

Video gaming, the experience of playing electronic games, has shown several benefits for human health. Recently, numerous video gaming studies showed beneficial effects on cognition and the brain. A systematic review of video gaming has been published. However, the previous systematic review has several differences to this systematic review. This systematic review evaluates the beneficial effects of video gaming on neuroplasticity specifically on intervention studies. Literature research was conducted from randomized controlled trials in PubMed and Google Scholar published after 2000. A systematic review was written instead of a meta-analytic review because of variations among participants, video games, and outcomes. Nine scientific articles were eligible for the review. Overall, the eligible articles showed fair quality according to Delphi Criteria. Video gaming affects the brain structure and function depending on how the game is played. The game genres examined were 3D adventure, first-person shooting (FPS), puzzle, rhythm dance, and strategy. The total training durations were 16–90 h. Results of this systematic review demonstrated that video gaming can be beneficial to the brain. However, the beneficial effects vary among video game types.

1. Introduction

Video gaming refers to the experience of playing electronic games, which vary from action to passive games, presenting a player with physical and mental challenges. The motivation to play video games might derive from the experience of autonomy or competing with others, which can explain why video gaming is pleasurable and addictive [ 1 ].

Video games can act as “teachers” depending on the game purpose [ 2 ]. Video gaming has varying effects depending on the game genre. For instance, an active video game can improve physical fitness [ 3 , 4 , 5 , 6 ], whereas social video games can improve social behavior [ 7 , 8 , 9 ]. The most interesting results show that playing video games can change cognition and the brain [ 10 , 11 , 12 , 13 ].

Earlier studies have demonstrated that playing video games can benefit cognition. Cross-sectional and longitudinal studies have demonstrated that the experience of video gaming is associated with better cognitive function, specifically in terms of visual attention and short-term memory [ 14 ], reaction time [ 15 ], and working memory [ 16 ]. Additionally, some randomized controlled studies show positive effects of video gaming interventions on cognition [ 17 , 18 ]. Recent meta-analytical studies have also supported the positive effects of video gaming on cognition [ 10 , 11 , 12 , 13 ]. These studies demonstrate that playing video games does provide cognitive benefits.

The effects of video gaming intervention are ever more widely discussed among scientists [ 13 ]. A review of the results and methodological quality of recently published intervention studies must be done. One systematic review of video gaming and neural correlates has been reported [ 19 ]. However, the technique of neuroimaging of the reviewed studies was not specific. This systematic review reviewed only magnetic resonance imaging (MRI) studies in contrast to the previous systematic review to focus on neuroplasticity effect. Neuroplasticity is capability of the brain that accommodates adaptation for learning, memorizing, and recovery purposes [ 19 ]. In normal adaptation, the brain is adapting to learn, remember, forget, and repair itself. Recent studies using MRI for brain imaging techniques have demonstrated neuroplasticity effects after an intervention, which include cognitive, exercise, and music training on the grey matter [ 20 , 21 , 22 , 23 , 24 ] and white matter [ 25 , 26 , 27 , 28 , 29 ]. However, the molecular mechanisms of the grey and white matter change remain inconclusive. The proposed mechanisms for the grey matter change are neurogenesis, gliogenesis, synaptogenesis, and angiogenesis, whereas those for white matter change are myelin modeling and formation, fiber organization, and angiogenesis [ 30 ]. Recent studies using MRI technique for brain imaging have demonstrated video gaming effects on neuroplasticity. Earlier imaging studies using cross-sectional and longitudinal methods have shown that playing video games affects the brain structure by changing the grey matter [ 31 , 32 , 33 ], white matter [ 34 , 35 ], and functional connectivity [ 36 , 37 , 38 , 39 ]. Additionally, a few intervention studies have demonstrated that playing video games changed brain structure and functions [ 40 , 41 , 42 , 43 ].

The earlier review also found a link between neural correlates of video gaming and cognitive function [ 19 ]. However, that review used both experimental and correlational studies and included non-healthy participants, which contrasts to this review. The differences between this and the previous review are presented in Table 1 . This review assesses only experimental studies conducted of healthy participants. Additionally, the cross-sectional and longitudinal studies merely showed an association between video gaming experiences and the brain, showing direct effects of playing video games in the brain is difficult. Therefore, this systematic review specifically examined intervention studies. This review is more specific as it reviews intervention and MRI studies on healthy participants. The purposes of this systematic review are therefore to evaluate the beneficial effects of video gaming and to assess the methodological quality of recent video gaming intervention studies.

Differences between previous review and current review.

CT, computed tomography; fMRI, functional magnetic resonance imaging; MEG, magnetoencephalography MRI, magnetic resonance imaging; PET, positron emission tomography; SPECT, single photon emission computed tomography; tDCS, transcranial direct current stimulation; EEG, electroencephalography; NIRS, near-infrared spectroscopy.

2. Materials and Methods

2.1. search strategy.

This systematic review was designed in accordance with the PRISMA checklist [ 44 ] shown in Appendix Table A1 . A literature search was conducted using PubMed and Google Scholar to identify relevant studies. The keywords used for the literature search were combinations of “video game”, “video gaming”, “game”, “action video game”, “video game training”, “training”, “play”, “playing”, “MRI”, “cognitive”, “cognition”, “executive function”, and “randomized control trial”.

2.2. Inclusion and Exclusion Criteria

The primary inclusion criteria were randomized controlled trial study, video game interaction, and MRI/fMRI analysis. Studies that qualified with only one or two primary inclusions were not included. Review papers and experimental protocols were also not included. The secondary inclusion criteria were publishing after 2000 and published in English. Excluded were duration of less than 4 weeks or unspecified length intervention or combination intervention. Also excluded were studies of cognition-based games, and studies of participants with psychiatric, cognitive, neurological, and medical disorders.

2.3. Quality Assessment

Each of the quality studies was assessed using Delphi criteria [ 45 ] with several additional elements [ 46 ]: details of allocation methods, adequate descriptions of control and training groups, statistical comparisons between control and training groups, and dropout reports. The respective total scores (max = 12) are shown in Table 3. The quality assessment also includes assessment for risk of bias, which is shown in criteria numbers 1, 2, 5, 6, 7, 9, and 12.

2.4. Statistical Analysis

Instead of a meta-analysis study, a systematic review of the video game training/video gaming and the effects was conducted because of the variation in ranges of participant age, video game genre, control type, MRI and statistical analysis, and training outcomes. Therefore, the quality, inclusion and exclusion, control, treatment, game title, participants, training period, and MRI analysis and specification of the studies were recorded for the respective games.

The literature search made of the databases yielded 140 scientific articles. All scientific articles were screened based on inclusion and exclusion criteria. Of those 140 scientific articles, nine were eligible for the review [ 40 , 41 , 42 , 43 , 47 , 48 , 49 , 50 , 51 ]. Video gaming effects are listed in Table 2 .

Summary of beneficial effect of video gaming.

Duration was converted into weeks (1 month = 4 weeks); DLPFC, dorsolateral prefrontal cortex; GM, grey matter; FPS, first person shooting. * Participants were categorized based on how they played during the video gaming intervention.

We excluded 121 articles: 46 were not MRI studies, 16 were not controlled studies, 38 were not intervention studies, 13 were review articles, and eight were miscellaneous, including study protocols, non-video gaming studies, and non-brain studies. Of 18 included scientific articles, nine were excluded. Of those nine excluded articles, two were cognitive-based game studies, three were shorter than 4 weeks in duration or were without a specified length intervention, two studies used a non-healthy participant treatment, and one was a combination intervention study. A screening flowchart is portrayed in Figure 1 .

Flowchart of literature search.

3.1. Quality Assessment

The assessment methodology based on Delphi criteria [ 45 ] for the quality of eligible studies is presented in Table 3 . The quality scores assigned to the studies were 3–9 (mean = 6.10; S.D. = 1.69). Overall, the studies showed fair methodological quality according to the Delphi criteria. The highest quality score of the nine eligible articles was assigned to “Playing Super Mario 64 increases hippocampal grey matter in older adult” published by West et al. in 2017, which scored 9 of 12. The scores assigned for criteria 6 (blinded care provider) and 7 (blinded patient) were lowest because of unspecified information related to blinding for those criteria. Additionally, criteria 2 (concealed allocation) and 5 (blinding assessor) were low because only two articles specified that information. All articles met criteria 3 and 4 adequately.

Methodological quality of eligible studies.

Q1, Random allocation; Q2, Concealed allocation; Q3, Similar baselines among groups; Q4, Eligibility specified; Q5, Blinded assessor outcome; Q6, Blinded care provider; Q7, Blinded patient; Q8, Intention-to-treat analysis; Q9, Detail of allocation method; Q10, Adequate description of each group; Q11, Statistical comparison between groups; Q12, Dropout report (1, specified; 0, unspecified).

3.2. Inclusion and Exclusion

Most studies included participants with little or no experience with gaming and excluded participants with psychiatric/mental, neurological, and medical illness. Four studies specified handedness of the participants and excluded participants with game training experience. The inclusion and exclusion criteria are presented in Table 4 .

Inclusion and exclusion criteria for eligible studies.

i1, Little/no experience in video gaming; i2, Right-handed; i3, Sex-specific; e1, Psychiatric/mental illness; e2, Neurological illness; e3, Medical illness; e4, MRI contraindication; e5, experience in game training.

3.3. Control Group

Nine eligible studies were categorized as three types based on the control type. Two studies used active control, five studies used passive control, and two studies used both active and passive control. A summary of the control group is presented in Table 5 .

Control group examined eligible studies.

3.4. Game Title and Genre

Of the nine eligible studies, four used the same 3D adventure game with different game platforms, which were “Super Mario 64” original and the DS version. One study used first-person shooting (FPS) shooting games with many different game titles: “Call of Duty” is one title. Two studies used puzzle games: “Tetris” and “Professor Layton and The Pandora’s Box.” One study used a rhythm dance game: Dance Revolution. One study used a strategy game: “Space Fortress.” Game genres are presented in Table 6 .

Genres and game titles of video gaming intervention.

* West et al. used multiple games; other games are Call of Duty 2, 3, Black Ops, and World at War, Killzone 2 and 3, Battlefield 2, 3, and 4, Resistance 2 and Fall of Man, and Medal of Honor.

3.5. Participants and Sample Size

Among the nine studies, one study examined teenage participants, six studies included young adult participants, and two studies assessed older adult participants. Participant information is shown in Table 7 . Numbers of participants were 20–75 participants (mean = 43.67; S.D. = 15.63). Three studies examined female-only participants, whereas six others used male and female participants. Six studies with female and male participants had more female than male participants.

Participant details of eligible studies.

3.6. Training Period and Intensity

The training period was 4–24 weeks (mean = 11.49; S.D. = 6.88). One study by Lee et al. had two length periods and total hours because the study examined video game training of two types. The total training hours were 16–90 h (mean = 40.63; S.D. = 26.22), whereas the training intensity was 1.5–10.68 h/week (mean = 4.96; S.D. = 3.00). One study did not specify total training hours. Two studies did not specify the training intensity. The training periods and intensities are in Table 8 .

Periods and intensities of video gaming intervention.

The training length was converted into weeks (1 month = 4 weeks). ns, not specified; n/a, not available; * exact length is not available.

3.7. MRI Analysis and Specifications

Of nine eligible studies, one study used resting-state MRI analysis, three studies (excluding that by Haier et al. [ 40 ]) used structural MRI analysis, and five studies used task-based MRI analysis. A study by Haier et al. used MRI analyses of two types [ 40 ]. A summary of MRI analyses is presented in Table 9 . The related resting-state, structural, and task-based MRI specifications are presented in Table 10 , Table 11 and Table 12 respectively.

MRI analysis details of eligible studies.

* Haier et al. conducted structural and task analyses. + Compared pre-training and post-training between groups without using contrast. TFCE, Threshold Free Cluster Enhancement; FEW, familywise error rate; FDR, false discovery rate.

Resting-State MRI specifications of eligible studies.

Structural MRI specifications of eligible studies.

Task-Based MRI specifications of eligible studies.

All analyses used 3 Tesla magnetic force; TR = repetition time; TE = echo time, ns = not specified.

4. Discussion

This literature review evaluated the effect of noncognitive-based video game intervention on the cognitive function of healthy people. Comparison of studies is difficult because of the heterogeneities of participant ages, beneficial effects, and durations. Comparisons are limited to studies sharing factors.

4.1. Participant Age

Video gaming intervention affects all age categories except for the children category. The exception derives from a lack of intervention studies using children as participants. The underlying reason for this exception is that the brain is still developing until age 10–12 [ 52 , 53 ]. Among the eligible studies were a study investigating adolescents [ 40 ], six studies investigating young adults [ 41 , 42 , 43 , 47 , 49 , 51 ] and two studies investigating older adults [ 48 , 50 ].

Differences among study purposes underlie the differences in participant age categories. The study by Haier et al. was intended to study adolescents because the category shows the most potential brain changes. The human brain is more sensitive to synaptic reorganization during the adolescent period [ 54 ]. Generally, grey matter decreases whereas white matter increases during the adolescent period [ 55 , 56 ]. By contrast, the cortical surface of the brain increases despite reduction of grey matter [ 55 , 57 ]. Six studies were investigating young adults with the intention of studying brain changes after the brain reaches maturity. The human brain reaches maturity during the young adult period [ 58 ]. Two studies were investigating older adults with the intention of combating difficulties caused by aging. The human brain shrinks as age increases [ 56 , 59 ], which almost invariably leads to declining cognitive function [ 59 , 60 ].

4.2. Beneficial Effects

Three beneficial outcomes were observed using MRI method: grey matter change [ 40 , 42 , 50 ], brain activity change [ 40 , 43 , 47 , 48 , 49 ], and functional connectivity change [ 41 ]. The affected brain area corresponds to how the respective games were played.

Four studies of 3D video gaming showed effects on the structure of hippocampus, dorsolateral prefrontal cortex (DLPFC), cerebellum [ 42 , 43 , 50 ], and DLPFC [ 43 ] and ventral striatum activity [ 49 ]. In this case, the hippocampus is used for memory [ 61 ] and scene recognition [ 62 ], whereas the DLPFC and cerebellum are used for working memory function for information manipulation and problem-solving processes [ 63 ]. The grey matter of the corresponding brain region has been shown to increase during training [ 20 , 64 ]. The increased grey matter of the hippocampus, DLPFC, and cerebellum are associated with better performance in reference and working memory [ 64 , 65 ].

The reduced activity of DLPFC found in the study by Gleich et al. corresponds to studies that showed reduced brain activity associated with brain training [ 66 , 67 , 68 , 69 ]. Decreased activity of the DLPFC after training is associated with efficiency in divergent thinking [ 70 ]. 3D video gaming also preserved reward systems by protecting the activity of the ventral striatum [ 71 ].

Two studies of puzzle gaming showed effects on the structure of the visual–spatial processing area, activity of the frontal area, and functional connectivity change. The increased grey matter of the visual–spatial area and decreased activity of the frontal area are similar to training-associated grey matter increase [ 20 , 64 ] and activity decrease [ 66 , 67 , 68 , 69 ]. In this case, visual–spatial processing and frontal area are used constantly for spatial prediction and problem-solving of Tetris. Functional connectivity of the multimodal integration and the higher-order executive system in the puzzle solving-based gaming of Professor Layton game corresponds to studies which demonstrated training-associated functional connectivity change [ 72 , 73 ]. Good functional connectivity implies better performance [ 73 ].

Strategy gaming affects the DLPFC activity, whereas rhythm gaming affects the activity of visuospatial working memory, emotional, and attention area. FPS gaming affects the structure of the hippocampus and amygdala. Decreased DLPFC activity is similar to training-associated activity decrease [ 66 , 67 , 68 , 69 ]. A study by Roush demonstrated increased activity of visuospatial working memory, emotion, and attention area, which might occur because of exercise and gaming in the Dance Revolution game. Results suggest that positive activations indicate altered functional areas by complex exercise [ 48 ]. The increased grey matter of the hippocampus and amygdala are similar to the training-associated grey matter increase [ 20 , 64 ]. The hippocampus is used for 3D navigation purposes in the FPS world [ 61 ], whereas the amygdala is used to stay alert during gaming [ 74 ].

4.3. Duration

Change of the brain structure and function was observed after 16 h of video gaming. The total durations of video gaming were 16–90 h. However, the gaming intensity must be noted because the gaming intensity varied: 1.5–10.68 h per week. The different intensities might affect the change of cognitive function. Cognitive intervention studies demonstrated intensity effects on the cortical thickness of the brain [ 75 , 76 ]. A similar effect might be observed in video gaming studies. More studies must be conducted to resolve how the intensity can be expected to affect cognitive function.

4.4. Criteria

Almost all studies used inclusion criteria “little/no experience with video games.” The criterion was used to reduce the factor of gaming-related experience on the effects of video gaming. Some of the studies also used specific handedness and specific sex of participants to reduce the variation of brain effects. Expertise and sex are shown to affect brain activity and structure [ 77 , 78 , 79 , 80 ]. The exclusion criterion of “MRI contraindication” is used for participant safety for the MRI protocol, whereas exclusion criteria of “psychiatric/mental illness”, “neurological illness”, and “medical illness” are used to standardize the participants.

4.5. Limitations and Recommendations

Some concern might be raised about the quality of methodology, assessed using Delphi criteria [ 45 ]. The quality was 3–9 (mean = 6.10; S.D. = 1.69). Low quality in most papers resulted from unspecified information corresponding to the criteria. Quality improvements for the studies must be performed related to the low quality of methodology. Allocation concealment, assessor blinding, care provider blinding, participant blinding, intention-to-treat analysis, and allocation method details must be improved in future studies.

Another concern is blinding and control. This type of study differs from medical studies in which patients can be blinded easily. In studies of these types, the participants were tasked to do either training as an active control group or to do nothing as a passive control group. The participants can expect something from the task. The expectation might affect the outcomes of the studies [ 81 , 82 , 83 ]. Additionally, the waiting-list control group might overestimate the outcome of training [ 84 ].

Considering the sample size, which was 20–75 (mean = 43.67; S.D. = 15.63), the studies must be upscaled to emphasize video gaming effects. There are four phases of clinical trials that start from the early stage and small-scale phase 1 to late stage and large-scale phase 3 and end in post-marketing observation phase 4. These four phases are used for drug clinical trials, according to the food and drug administration (FDA) [ 85 ]. Phase 1 has the purpose of revealing the safety of treatment with around 20–100 participants. Phase 2 has the purpose of elucidating the efficacy of the treatment with up to several hundred participants. Phase 3 has the purpose of revealing both efficacy and safety among 300–3000 participants. The final phase 4 has the purpose of finding unprecedented adverse effects of treatment after marketing. However, because medical studies and video gaming intervention studies differ in terms of experimental methods, slight modifications can be done for adaptation to video gaming studies.

Several unresolved issues persist in relation to video gaming intervention. First, no studies assessed chronic/long-term video gaming. The participants might lose their motivation to play the same game over a long time, which might affect the study outcomes [ 86 ]. Second, meta-analyses could not be done because the game genres are heterogeneous. To ensure homogeneity of the study, stricter criteria must be set. However, this step would engender a third limitation. Third, randomized controlled trial video gaming studies that use MRI analysis are few. More studies must be conducted to assess the effects of video gaming. Fourth, the eligible studies lacked cognitive tests to validate the cognitive change effects for training. Studies of video gaming intervention should also include a cognitive test to ascertain the relation between cognitive function and brain change.

5. Conclusions

The systematic review has several conclusions related to beneficial effects of noncognitive-based video games. First, noncognitive-based video gaming can be used in all age categories as a means to improve the brain. However, effects on children remain unclear. Second, noncognitive-based video gaming affects both structural and functional aspects of the brain. Third, video gaming effects were observed after a minimum of 16 h of training. Fourth, some methodology criteria must be improved for better methodological quality. In conclusion, acute video gaming of a minimum of 16 h is beneficial for brain function and structure. However, video gaming effects on the brain area vary depending on the video game type.

Acknowledgments

We would like to thank all our other colleagues in IDAC, Tohoku University for their support.

PRISMA Checklist of the literature review.

For more information, visit: www.prisma-statement.org .

Author Contributions

D.B.T., R.N., and R.K. designed the systematic review. D.B.T. and R.N. searched and selected the papers. D.B.T. and R.N. wrote the manuscript with R.K. All authors read and approved the final manuscript. D.B.T. and R.N. contributed equally to this work.

Study is supported by JSPS KAKENHI Grant Number 17H06046 (Grant-in-Aid for Scientific Research on Innovative Areas) and 16KT0002 (Grant-in-Aid for Scientific Research (B)).

Conflicts of Interest

None of the other authors has any conflict of interest to declare. Funding sources are not involved in the study design, collection, analysis, interpretation of data, or writing of the study report.

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About online gaming

The world of online gaming is extensive and comes in so many textures and flavors, it could easily be the subject of endless discussion. But what is online gaming? Who likes to play? Who has been ignored? What are the risks associated with online gaming? Online gaming is the use of video games across a network which utilizes the Internet allowing simultaneous interactive play between multiple remote users on a computer or a game console, located adjacently or anywhere in the world.

Online gaming history

Online gaming has been in existence as far back as 1973, with the advent of a game called Empire created by John Daleske (Daleske). The game is arguably considered to be the first in its and was a space craft game of war where players entered their commands through keystrokes (Hachman).

The environment used by Daleske, a student at Iowa State University, was called PLATO, a pre-Facebook educational social network which had instant messaging, email, network games and a notes system (Daleske). Maze War, by Steve Colley, was the first peer-to-peer (P2P), 3D first person shooter multiplayer game, and possibly the first frames per second (FPS) (Hachman). Since PLATO, social media has grown in popularity and influences our culture .

The game had a major impact on subsequent titles. Other titles that operated on the PLATO network in the 70s were Spasim, Moria, and Dubliette, and Multi-User Dungeon (MUD). The 1980s saw the birth of Multi-Access Dungeon (MAD), the first global access game, so popular that it was prohibited from residing on its network, BITNET, after only two years of operation.

In 1984, the Islands of Kesmai was the first online role playing game. The game was part of the Compuserve internet provider service, a predecessor of AOL, Verizon, and Xfinity. Additional gaming players in the 80s included Habitat, SGI Dogfight, Air Warrior, Netrek, and Federation (Hachman).

The 1990s saw the creation of Meganet, a console-based online gaming choice, dropped in Japan due to failure to launch and was consequently never introduced to the North American market. The 1990s had a healthy birth of online games offering unique contributions to the evolution of the class, notably, NeverWinter Nights, on AOL in 1991, the first three-dimensional MMORPG (massively multiplayer online role-playing game).

Microgaming, the first online casino in 1996, Intertops, Everquest by Sony, brags the first game to sell in-game virtual products with real money and the first with over 100,000 concurrent users, and Snake II, the first multiplayer mobile access game (Hachman). In the new millennium, online gaming transitioned to even greater heights than previously known. The 2000s have spawned the enhancement of online games to a level that millions of players around the world are obsessed with.

Online gaming demographics

The demographics age for gamers is quite stunning! The average gamer is 31 years old (Grubb). Not what you were thinking? Next shocker – there are more gamers over 36 than there are within the age bracket of 18 to 35 or under 18 (Grubb).

Let’s continue with the astonishing statistics:

• 58% of gamers are men
• 48% are women
• 64% of online gamers are women

There is a difference between most of the online favorites for women (Witkop). Cake Shop 2, World of Warcraft, Bejeweled 2, Crosswords and Sudoku and Farmville are the top five favorites for women. Men are more drawn to fighting games, role-play, action and strategy games (Phan, Jardina Hoyle).

Sadly, some women are experiencing sexual harassment, a form of cyber bullying , in online gaming (Rosen). Perhaps it should not be so surprising because it is a reality in the real world. It is likely that when a person believes that they are under the cover of anonymity, as is the case in online gaming, that they might be more likely to do what they would not do normally since they have a false sense of limited consequences or meaningful retribution. Some women have reported threats of rape and death.

Actually, threats in the online gaming world are not limited to women. A former Microsoft Xbox expert stated that he regularly fielded reports of threats from other players, and they were not all women.

There are over half a billion people who play online games around the world (Singh). Daily online players are geographically distinguished, with those located in Asia Pacific having the highest representation, at 47.9 million; Europe is not far behind with 45.6 million; North Americans are no slackers – with 30.3 million online gamers playing daily. Latin American has 14.9 million, while Middle East Africa comes in at 6.2 million (Singh).

Socioeconomics

There is not a lot of socioeconomic data regarding online gamers and their backgrounds. In fact, MacCallum-Stewart, in her book entitled Online Games, Social Narratives, balks at the notion that we can identify the socioeconomic standing of the online gamer and says:

The ". . . often repeated definition of the 'average gamer' as 35, lower middle class, white . . . is . . . virtually meaningless" (2014).

Yet, if you look at the Microsoft Xbox Live page, which is an invitation to consumers who visit the page to become a Microsoft online subscriber, the advertisements stereotype particular genders ; and all images appear to be young whites (“Microsoft”). It is reasonable to assume that the key demographic, the broadest cross-section of people who purchase their online live product, would be fairly represented in their advertising.

It is also reasonable to assume that Microsoft is a smart company who understands the importance of ensuring their imaging is appropriately directed to their key demographic, so, it is fair to say that the majority of subscribers for Microsoft’s online gaming are probably young, white males and females, who have enough disposable income to purchase their subscription consistently, and who can afford to purchase their games and other accessories.

Online gaming genres

There are a number of online gaming genres. They are categorized to aid players in identifying the type of game they would enjoy playing most. Some of the major online gaming genres are:

• Action Adventure – like Crimson Skies: High Road to Revenge – adventures of the leader of a fortune hunter gang
• Card Board – like Scrabble – the classic board game
• Family – like Rockstar Table Tennis – game of tennis
• Fighting – like Prison Break – prisoner reconnaissance inside penitentiary
• Racing Flying – like Project Gotham Racing 2 – auto racing
• Role Playing – like Phantasy Star Online Episodes I II – investigative hunters embark on the search for missing pioneers a new planet
• First Person Shooter – like Tom Clancy's Rainbow Six 3– close combat, sniping, terrorism and counter-terrorism, where the villain tries to create an international Fascist movement
• Sports Recreation - like ESPN NHL Hockey - hockey
• Strategy Simulation – like Battle Stations Pacific – action strategy directing air, sea and undersea units (Goldstein)
• Video gameplay is fun, but online gaming intensifies the stakes, and it's fun playing against or with others who share the same passion.

Online Gambling

While people still play the lottery more than online gambling, another type of gaming is found in online games of chance or online gambling. In 1994, Antigua and Barbuda passed legislation that allowed companies to apply to establish online casinos (“The History”). Then number of online casinos mushroomed from 15 to over 200 within a very short period of time, with revenues in excess of $830 million in 1998. In 1999, multiplayer online gambling was introduced, allowing gambling, communication through chat, and interactive interplay (“The History”).

Sports Book

In 1996, the first sports book made its appearance online (“The History”). Sports book allows a gambler to place bets on sports competition outcomes, including horse racing, basketball, football, baseball, boxing, and others. The sports book is legal in Delaware, Oregon, Nevada, and Montana. Online sports book wagering sites have matured and achieved great success.

In addition to the standard approach, in the year 2000, the industry introduced peer-to-peer wagering, where gamblers create their own betting topic and bet amongst themselves. The next iteration in the category was live sports book, where players could place their bets while the sports event was actually occurring (“The History”). The most recent development has been mobile betting by phone or by tablet.

Other Online Gambling

Other online gambling categories include poker which represents approximately 21.43% of gambling-type games, bingo which represents 13.47%, lottery which represents 4.68%, horse race betting, and mobile gambling. (Church-Sanders).

Online gaming addiction

All fun and exciting things, when taken too far create problems. If you eat too much, you’ll get fat, if you drink too much, you could become an alcoholic, and similarly, if you are obsessed by video games or online gaming, you can also develop an addiction . This is the dark, often hidden side of online gaming. We are used to hearing about drug addictions and understand the devastating effects, but online gaming addiction has an odd ring to it. South Korea is one of the world’s most technologically advanced countries from a broadband perspective and a leader in diagnosing and treating online gaming addiction (Sutter).

A government report indicates approximately eight percent of the country have experienced gaming or online gaming addiction. In the United States, although the problem is not yet recognized as a disorder, the American Psychiatric Association has proposed to include "Internet Use Disorder" in the official Diagnostic and Statistical Manual of Mental Disorders, the next time the manual is revised, as needing additional study (Sutter). Today, Dr. Han Doug-hyun, from South Korea, is a noted leader in the field. His treatment process for the addiction is similar to the way that alcoholics are treated. He incorporates counseling and virtual-reality therapy.

Dr. Han suggests the following warning signs:

• Disrupted regular life pattern. If a person plays games all night long and sleeps in the daytime, that can be a warning he or she should seek professional help
• The potential gaming or Internet addict loses his or her job or stops going to school in order to be online or to play a digital game
• Need for a bigger fix. Does the gamer have to play for longer and longer periods in order to get the same level of enjoyment from the game?
• Withdrawal. Some Internet and gaming addicts become irritable or anxious when they disconnect, or when they are forced to do so
• Cravings. Some Internet and gaming addicts experience cravings, or the need to play the game or be online when they are away from the digital world (Sutter)

Online gaming is fun. It’s especially great because you can access it at your convenience any time of day, under any circumstances. There seems to be an online gaming genre that can appeal to everyone’s proclivities. Though with all enjoyable and entertaining choices, we must learn to implement controls, otherwise, addictions could be in-store.

Works Cited

Church-Sanders, Rachel. "Special Report: Online Poker – Industry Trends." IGB Affiliate . Web. 4 April 2016. http://www.igbaffiliate.com/resources/articles/special-report-online-poker-%E2%80%93-industry-trends.

Daleske, John. "PLATO for Education and Training." PLATO . John Daleske. 2008. Web. 4 April 2016. http://www.daleske.com/plato/.

Goldstein, Hilary. "The Top 10 Xbox Live Games." IGN. Ziff Davis, LLC . 23 April 2004. Web. 4 April 2016. http://www.ign.com/articles/2004/04/22/the-top-10-xbox-live-games?page=4.

Grubb, Jeff. "Gaming advocacy group: The average gamer is 31, and most play on a console." VB. Venture Beat . 29 April 2014. Web. 4 April 2016. http://venturebeat.com/2014/04/29/gaming-advocacy-group-the-average-gamer-is-31-and-most-play-on-a-console/.

Hachman, Mark. Infographic: A Massive History of Multiplayer Online Gaming." PC. Ziff Davis, LLC. PCMag Digital Group . 11 August 2011. Web. 4 April 2016. http://www.pcmag.com/article2/0,2817,2390917,00.asp.

Klepek, Patrick ."Study: 64% of Online Gamers are Women." 1Up.com . IGN Entertainment Games. 10 June 2006. Web. 4 April 2016. http://www.1up.com/news/study-64-online-gamers-women.

MacCallum-Stewart, Esther. Online Games, Social Narratives . London: Routledge, 2014. Print.

"Microsoft Xbox Live Gold." Microsoft . Web. 4 April 2016. http://www.xbox.com/en-US/live/gold?xr=shellnav.

Phan, M. H., Jardina, J. R. and Hoyle, W. S. "Video Games: Males Prefer Violence while Females Prefer Social.' SURL. Software Usability Research Laboratory. Wichita State Universit y. 23 August 2012. Web. 4 April 2016. http://usabilitynews.org/video-games-males-prefer-violence-while-females-prefer-social/.

Rosen, Christopher. "The Awful Truth Behind Sexual Harassment Of Women Gamers." Huffington Post . TheHuffintonPost.com Inc. 13 March 2015. Web. 4 April 2016. http://www.huffingtonpost.com/2015/03/13/gtfo-sexism-in-gaming_n_6804106.html.

Singh, Amarpal. "Asia Pacific Has Largest Daily Online Gaming Audience." ComScore . comScore, Inc. 11 June 2013. Web. 4 April 2016. https://www.comscore.com/Insights/Data-Mine/Asia-Pacific-Has-Largest-Daily-Online-Gaming-Audience.

Sutter, John, D. "5 warning signs of gaming addiction." CNN. Turner Broadcasting System, Inc. 6 August 2012. Web. 4 April 2016. http://www.cnn.com/2012/08/05/tech/gaming-gadgets/gaming-addiction-warning-signs/.

"The History of Online Gambling." OnlineGambling.com. 11 June 2013. Web. 4 April 2016. http://www.onlinegambling.com/online-gambling-history.htm.

Witkop, Lorie . "Top 5 Most Popular Online Games for Women." Love to Know. LoveToKnow Corp. Web. 4 April 2016. http://online.lovetoknow.com/wiki/Top_5_Most_Popular_Online_Games_for_Women.

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