In a recent study published in Nature Human Behavior, researchers investigate the impact of video gaming on psychological health in Japan during the coronavirus disease 2019 (COVID-19) pandemic.

Study: Causal effect of video gaming on mental well-being in Japan 2020–2022. Image Credit: Gorodenkoff / Shutterstock.com

Public health concerns about gaming

The growing use of video games has raised concerns about their possible harmful influence on mental health. Public skepticism and contentious health policy choices, such as the World Health Organization’s debate on gaming disorders, have increased unfavorable attitudes toward gaming.

The eleventh edition of the International Classification of Diseases (ICD-11), which includes gaming disorders, has also contributed to stigma among young people and their treatment providers. Policymakers, scholars, and public stakeholders are worried about gaming addiction and its negative impact on psychological health.

Correlational findings largely support the harmful influence of video games on mental health; however, additional studies are needed to identify the mechanisms involved in this association. Furthermore, many published experimental investigations have been limited due to methodological issues, such as insufficient causal data and external validity checks.

About the study

The present study used credible causal assumptions to assess the relationship between video gaming and mental health in real-world settings. To this end, gaming console lotteries were utilized as a natural experiment.

The causal inference was applied to observational data collected from 97,602 Japanese adults between 10 and 69 years of age from December 2020 to March 2022. Surveys were provided to the study participants to assess lottery involvement, video game ownership, gaming preferences, life satisfaction, mental health, and sociodemographic characteristics. Of the 97,602 survey respondents, 8,192 participated in the lottery.

The primary exposure was video game engagement. Respondents mentioned Nintendo Switch or PlayStation 5 (PS5) ownership and time spent playing these games in the previous 30 days.

Primary study outcomes included mental wellness and satisfaction. The Japanese version of the Kessler Screening Scale (K6) measured psychological distress, whereas the Satisfaction with Life Scale (SWLS) assessed life satisfaction.

Statistical analyses included multivariate regressions, propensity score matching (PSM), and instrumental variables (IV). The primary intention-to-treat (ITT) analysis used multivariable regressions and PSM to estimate the causal effects of winning console lotteries.

Machine learning (ML)-based causal forest or generalized random forest (GRF) algorithms examined the moderating effects of sociodemographic variables on the association between playing video games and wellness. Study covariates included age, gender, occupation, employment, marital status, number of children, residence, and video gaming preferences.

Instrumental variables (IV) were used to evaluate the local average treatment effect (LATE) of owning a PS5 or Switch, playing them in the surveying month, and gaming duration. IV forest algorithms calculated the conditional local average treatment effect (CLATE) estimates for video game ownership. The validity of the natural experiment was based on standard differences and pseudo-outcome tests that evaluated baseline characteristics and pre-lottery well-being values.

Study findings

Among the lottery participants, 39% were between 45 and 69 years old, 21% were students, 39% were employed full-time, 11% were unemployed, 35% were dedicated gamers, and 20% were core gamers.  

Despite the psychological advantages associated with playing a Nintendo Switch or PS5, these benefits were less apparent among young PS5 users than adult Nintendo Switch users. PS5 ownership had a more profound influence on men, whereas Nintendo Switch ownership provided similar benefits for both men and women. The effects of PS5 use were more evident in those residing in homes without children or with full-time jobs, whereas Nintendo Switch use more significantly affected non-gamers. 

Using the Nintendo Switch improved psychological symptoms by 0.8 standard deviations (SD), whereas PS5 use was only associated with an improvement of 0.2 SD. Winning the PS5 lottery increased video game play time but not smartphone gaming time.

The evaluation of baseline features and pseudo-outcome tests validated the lottery results’ lack of confounding factors. The support and balance checks confirmed the validity of the PSM estimates.

Conclusions

Video gaming appears to improve mental health; however, gaming for more than three hours reduces its psychological benefits. Sociodemographic characteristics such as gender, age, work, and family structure also impact the effects of gaming.

All our estimates indicated positive correlations between video gaming and life satisfaction – a finding that, while counterintuitive given certain public perceptions around gaming, is consistent with recent studies.”

The impact modification on the Nintendo Switch significantly differed from that of the PS5, thus emphasizing the need for additional studies to elucidate the mechanisms involved in the effects of video gaming on mental health. The current study was conducted during the COVID-19 pandemic, which was a period marked by high levels of mental distress and limited opportunities for physical activity. Therefore, the positive mental health benefits associated with gaming may be context-dependent, which necessitates additional research in a post-pandemic setting.