The Clinical, Neurological and Behavioral Effects of Screens
Dr. Nicholas Kardaras
“Are we still in the game?”
Those 6 words were asked of me almost 10 years ago by a confused and delusional 16 year-old client who was a video-game addict having an episode of Video Game-Induced Psychosis. That exchange was the beginning of an eye-opening, decade-long exploration into the clinical and neurological impacts of screens on kids. What I discovered shocked me:
- Brain imaging research shows that stimulating glowing screens are as dopaminergic – dopamine-activating – to the brain’s pleasure center as sex.
Current clinical research correlates screen tech with disorders like ADHD, addiction, anxiety, depression, increased aggression, and even psychosis. Most shocking of all, recent brain imaging studies conclusively show that excessive screen exposure can neurologically damage a young person’s developing brain in the same way that drug addiction can.
Screens and Addiction
- Dr. Peter Whybrow, Director of Neuroscience at UCLA, calls computers “Electronic Cocaine” for the brain.
- Indiana University School of Medicine Brain Imaging Study finds that video game playing alters the brain in the same way that drug addiction does: In 2011, Dr. Yang Wang and his research associates at the Indiana University School of Medicine did brain-imaging research that indicated video gaming-induced brain changes as young adults in his study showed “less activation in certain frontal brain regions following one week of playing violent video games.” These frontal brain regions, associated with executive functioning, are also the same brain regions that are affected by drug addiction.
- According to a groundbreaking study conducted by Koepp et al in 1998, video games increase dopamine in the brain as much as sex does (approximately 100 percent increase).
- Glowing screens are such a powerful drug that the University of Washington has been using a virtual reality video game to help military burn victims with pain management during their treatments. Amazingly, while burn patients are immersed in the game, they experience a pain-reducing, morphine-like analgesic effect and thus don’t require any actual narcotics. A wonderful use of screen technology for pain-management medicine but, unfortunately, we are also unwittingly giving this digital morphine to kids.
- Commander Dr. Andrew Doan, head of Addiction Research for the U.S. Navy and the Pentagon, calls video games “Digital Pharmakeia” (Greek for “drugs”): “The problem is that video game playing (VGP) is estimated to increase brain dopamine levels equivalent to sex … in young minds that cannot say ‘no’ as VGP literally hijacks their thoughts.” He adds further: “Anytime that there’s arousal, there can be addiction because it feels good. Research shows that when the brain is stimulated, that arousal mechanism also stimulates the pituitary gland through the hypothalamus. So the hypothalamus-pituitary-adrenal axis (HPA) is also stimulated; that’s the adrenaline rush that’s essential with gaming. The kids’ blood pressure goes up, their palms get sweaty, their pupils constrict – they’re all revved up in a state of fight or flight mode. Then there’s also the dopamine response in the dopamine-reward pathway which makes the kid want to chase that adrenaline rush again.”
- In a 2015 University of Utah School of Medicine brain imaging study published in the journal Addiction Biology, brain changes were measured in video gamers that are correlated with increased distractability, impulsivity (hallmarks of addiction and ADHD), schizophrenia and autism: In what has been called the largest and most comprehensive brain study to date on video gamers, the brain scans of 200 adolescent boys described as video game addicts were examined. The researchers found indisputable evidence that the brains of video game–addicted boys are wired differently and that chronic video game playing was associated with increased hyperconnectivity between several pairs of brain networks that are often seen in addiction. The researchers point out that those with internet gaming disorder are so obsessed with and addicted to their video games that they often give up eating and sleeping in order to play them.
- A 2012 Brain Imaging Study finds that the brains of video-gamers mirror damage done by drug addiction: A research team led by Dr. Hao Lei of the Chinese Academy of Sciences discovered that the brains of people who had been diagnosed with “Internet Addiction Disorder” (IAD) had myelin (white matter) integrity abnormalities in brain regions involving executive attention, decision making, and emotional generation. Their study compared the brains of 17 IAD subjects and used as a control 16 healthy subjects. According to their findings, Dr. Lei further states: “The results … suggest that IAD may share psychological and neural mechanisms with other types of substance addiction and impulse control disorders.”
- Several brain imaging studies have shown gray matter shrinkage or loss of tissue volume for internet/gaming addicts (Zhou 2011, Yuan 2011, Weng 2013, and Weng 2012). Brain areas affected included the important frontal lobe, which governs executive functions such as planning and impulse control, critical in addiction and ADHD).
- Brain imaging research also indicate a loss of integrity to the brain’s white matter in people with Internet Addiction Disorder (IAD) (Lin 2012, Yuan 2011, Hong 2013 and Weng 2013). White matter – or myelination – is involved with brain “connectivity”; compromised or “spotty” white matter translates into loss of communication within the brain. These impaired connections may slow down signals or “short-circuit” them and have been associated with various psychiatric disorders such as ADHD, autism, addiction, and even schizophrenia.
- Professor Gunter Schumann, chair of biological psychiatry at King’s College in London, told the BBC: “For the first time … studies show changes in the neuronal connections between brain areas as well as changes in brain function in people who are frequently using the internet or video games.”
- Neurologist and Oxford professor Baroness Susan Greenfield believes that video game addiction can cause a form of what she describes as “dementia” in children.
Screens and Psychosis
Other clinical research is pointing towards video games contributing to psychiatric disorders such as schizophrenia and psychosis:
- Researchers Professor Dr. Mark Griffiths and Dr. Angelica Ortiz de Gortari at Nottingham Trent University develop the term “Game Transfer Phenomenon” (GTP) to describe hallucinatory or psychotic-like symptoms that chronic video gamers experience. In three studies with more than 1,600 video-gamers, all had, at some point, experienced GTP. Their symptoms included involuntary sensations, thoughts, actions and/or reflexes in relation to the video game – sometimes hours or even days after they had stopped playing.
- In 2011, researchers at Tel Aviv University published what they believe were the first documented cases of “internet-related psychosis.” The researchers indicated that tech was generating “true psychotic phenomena” and that “the spiraling use of the internet and its potential in psychopathology are new consequences of our times.”
- Dr. Joel Gold, a psychiatrist at NYU, and his brother, Ian, a psychiatrist at McGill University, are investigating whether the reality-severing aspects of technology can lead to hallucinations, delusions and genuine psychosis.
- Stanford psychiatrist and author Dr. Elias Aboujaoude is studying whether some digital avatars, popular in games such as Second Life, could clinically qualify as a form of alter ego. Such “alters” have been associated with what was formerly known as “multiple personality disorder,” now known as dissociative identity disorder in the DSM.
Screens, ADHD and Other Clinical Disorders
- Author and adolescent psychiatrist Dr. Vicoria Duncley has developed the term “Electronic Screen Syndrome” (ESS), wherein she hypothesizes that interacting with screens overstimulates the child and shifts the nervous system into fight-or-flight mode, which then leads to dysregulation and disorganization of the various biological and hormonal systems. These disrupted systems can then create – or exacerbate – disorders such as ADHD, depression, oppositional defiant disorder, and anxiety. She attributes the “environmental toxin” of hyper-rousing glowing screens as a possible cause for the 40-fold incraese in pediatric bipolar disorder from 1994 to 2003, and the 800 percent increase in ADHD between 1980 and 2007.
- In a 2010 Iowa State University study published in the journal Pediatrics, viewing television and playing video games each are associated with increased subsequent attention problems in childhood. Six to twelve-year-olds who spent more than two hours a day playing video games or watching TV had trouble paying attention in school and were 1.6 to 2.1 times more likely to have attention problems.
- According to Dr. Dimitri Christakis, ADHD researcher and co-author of the Iowa State study: “The reality is that we’re seeing ten times more ADHD then we were seeing twenty years ago … I think that the concern is that the pacing of the program, whether it’s video games or TV, is overstimulating and contributes to attention problems.”
- In an earlier study from 2004 published in the journal Pediatrics, Dr. Christakis found that the more TV a child watches between the ages of one and three, the greater the likelihood that they would develop an attention problem by age seven. In fact, the study showed that for each hour of television viewing, the risk of attention problems increased by 10 percent over that of a child who didn’t stare at a screen.
- A 2012 Missouri State University study of 216 kids showed that 30 percent of internet users showed signs of depression and that the depressed kids were the most intense web users.
- A 2014 study in the journal Comprehensive Psychiatry that looked at 2,293 seventh-graders found that internet addiction exacerbated depression, hostility, and social anxiety.
- A 2014 study done in Pakistan with 300 graduate students found that there is positive correlation between internet addiction and depression and anxiety: “This result shows that excessive use of internet makes students addicted to it and consequently causes anxiety and stress among users. The more one is addicted to it the more one is psychologically depressed.”
- A 2006 Korean study found a correlation with internet addiction, depression, and increased suicidal ideation. The participants were 1,573 high school students living in a city who completed the self-reported measures of the Internet Addiction Scale, the Korean version of the Diagnostic Interview Schedule for Children-Major Depression Disorder-Simple Questionnaire and the Suicidal Ideation Questionnaire-Junior.
- A 1998 Carnegie Mellon study found that web use over a two-year period was linked to increased depression, loneliness, and the loss of “real world” friends.
The Social Media Effect
- A 2015 University of Houston study published in the Journal of Social and Clinical Psychology confirmed that Facebook usage can lead to depressive symptoms. The mechanism for this increase in depressed mood? A psychological phenomenon known as “social comparison.”
- A 2014 study called “Facebook’s Emotional Consequences: Why Facebook Causes a Decrease in Mood and Why People Still Use It,” showed that the longer people are actually on Facebook, the more negative their mood is afterward.
- In a 2010 Case Western Reserve University School of Medicine study found that “hypernetworking” teens – those who spend more than three hours per school day on social networking sites – were linked to higher rates of depression, substance abuse, poor sleep, stress, poor academics and suicide. Hypernetworking teens were found to be 69 percent more likely to have tried sex, 60 percent more likely to report four or more sexual partners, 84 percent more likely to have used illegal drugs, and 94 percent more likely to have been in a physical fight.
- According to a 2015 Pew Research Center study of millennial communication habits, published in the American Psychological Association’s journal Psychology of Popular Media, “Text messaging has increased dramatically over the past 10 years,” and many teenage texters share addict-like symptoms and behaviors. The researchers indicated that such teens have a lot in common with compulsive gamblers including loss of sleep because of the activity, problems cutting back on the activity, and a tendency to lie to cover up the amount of time they are doing it. The study of more than 400 eighth- and 11th-graders found that only 35 percent of teens socialize face-to-face anymore, compared with a whopping 63 percent of teens who now communicate mostly via text message and average 167 texts per day.
- In a 2014 study published in the journal Social Indicators Research, Dr. Jean M. Twenge, a San Diego State University psychology professor, analyzed data from nearly seven million teenagers and adults from across the country and found that more people reported symptoms of depression than in the 1980s. According to that study, teens are 74 percent more likely to have trouble sleeping and twice as likely to see a professional for mental health issues than their 1980s counterparts.
Screens and Phones in the Classroom
- A 2016 study published by the Centre for Economic Performance at the London School of Economics showed that grades improved when phones were removed from the classroom. The comprehensive study covered 130,000 pupils at 91 schools, and the researchers found that following a ban on phone use, the schools’ test scores improved by 6.4 percent. The impact on underachieving students – mostly poor and special education – was even more significant: their average test scores rose by 14 percent.
- An exhaustive 2012 meta-analysis, in systematically reviewing 48 studies that examined technology’s impact on learning, found that “technology-based interventions tend to produce just slightly lower levels of improvement when compared with other researched interventions and approaches.” The researchers concluded: “Taken together, the correlational and experimental evidence does not offer a convincing case for the general impact of digital technology on learning outcomes.”
- Dr. Kentaro Toyama, an associate professor at the University of Michigan’s School of Information and a fellow of the Dalai Lama Center of Ethics and Transformation Values at MIT, discusses the limitations of tech in the classroom in a commentary called, “Why Technology Will Never Fix Education,” for the Chronicle of Higher Education. “Unfortunately, there is no technological fix, and that is perhaps the hardest lesson of amplification. More technology only magnifies socioeconomic disparities, and the only way to avoid that is non-technological.”
- Steve Jobs was a low-tech parent. In 2010, when a reporter suggested that his children must love the just-released iPad, he replied: “They haven’t used it. We limit how much technology our kids use at home.” (New York Times September 10, 2014).
- In a 1996 interview for Wired magazine, Steve Jobs expressed a very clear anti-tech-in-the-classroom opinion: “I’ve probably spearheaded giving away more computer equipment to schools than anybody on the planet. But I’ve come to the conclusion that the problem is not one that technology can hope to solve. What’s wrong with education cannot be fixed with technology. No amount of technology will make a dent.”
- Education psychologist and author of Failure to Connect: How Computers Affect Our Children’s Minds, Dr. Jane Healy spent years doing research into computer use in schools and had expected to find that computers in the classroom would be beneficial for learning; yet she found exactly the opposite and was dismayed by the lack of research indicating any benefit. She now feels strongly that “time on the computer might interfere with development of everything from the young child’s motor skills to his or her ability to think logically and distinguish between reality and fantasy.”
- Many tech execs and engineers in Silicon Valley put their kids in no-tech Waldorf Schools (The New York Times October 22, 2011).
- The Los Angeles School District spent $1.3 billion on tablets for every one of their 640, 000 kindergarten through twelfth grade students; the project is now being investigated by the FBI and the SEC for improper bidding, and the district is asking for a refund from Apple and Pearson as the devices were easily hacked by students and the software woefully incomplete.
- Dr. John Vallance is headmaster of the top school in Australia, Sydney Grammar, and has removed technology from his prestigious school – which has produced three prime ministers. Dr. Vallance said that the $2.4 billion spent by Australia on education technology was a “really scandalous situation” … where Australia was “spending more on education than ever before and the results are gradually getting worse and worse.” He concluded by saying: “I think when people come to write the history of this period in education … this investment in classroom technology is going to be seen as a huge fraud.”
- In a study published in January 2013 in the International Journal of Educational Research, Professor Anne Mangen of the University of Stavanger in Norway found that students who read text on computers performed worse on comprehension tests than students who read the same text on paper.
Video Games and Aggression
- Iowa State University Distinguished Professor of Psychology Dr. Craig Anderson, in the most comprehensive meta-study review ever conducted in this area, exhaustively analyzed 130 research studies with over 130,000 participants worldwide, and stated that this “proves conclusively that exposure to violent video games makes more aggressive, less caring kids – regardless of their age, sex or culture.” Published in 2010 in the APA Journal Psychological Bulletin, the study concluded that violent games are not just a correlation but a causal risk factor for increased aggressive thoughts and behavior.
- At the Congressional Public Health Summit in July of 2000, the heads of the country’s six leading public health groups – the American Medical Association, the American Psychiatric Association, the American Academy of Pediatrics, the American Psychological Association, the American Academy of Family Physicians, and the American Academy of Child & Adolescent Psychiatry – all signed a “Joint Statement on the Impact of Entertainment Violence on Children”: “At this time, well over 1000 studies – including reports from the Surgeon General’s office, the National Institute of Mental Health, and numerous studies conducted by leading figures within our medical and public health organizations – our own members – point overwhelmingly to a causal connection between media violence and aggressive behavior in some children. The conclusion of the public health community, based on over 30 years of research, is that viewing entertainment violence can lead to increases in aggressive attitudes, values and behavior, particularly in children.” The statement went on to say, “Viewing violence may lead to real life violence.”
- In the United States, there have been more than ten cases of matricide or patricide that were the result of a parent taking away their child’s video game. Other acts of violence against parents (i.e. kicking, punching, etc.) number in the thousands.
- Adam Lanza, the school shooter responsible for the Newtown, Conn., massacre was an addicted video-gamer who showed all the symptoms of a gamer psychotically lost in the delusions of his violent video games. Law enforcement authorities have speculated that his shootings were the result of his video game psychosis.
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