A few hours of video games a day can improve mental health

In a recently published study Nature Human BehaviorResearchers are investigating the effects of video games on mental health in Japan during the coronavirus disease 2019 (COVID-19) pandemic.

Study: Causal effects of video games on mental well-being in Japan 2020–2022. Image source: Gorodenkoff / Shutterstock.com

Public health concerns related to gaming

The increasing use of video games has raised concerns about their potential harmful influence on mental health. Public scepticism and controversial health policy decisions, such as the World Health Organization debate on gaming addiction, have reinforced negative attitudes towards gaming.

The eleventh edition of the International Classification of Diseases (ICD-11), which includes gambling addiction, has also contributed to the stigmatization of young people and those treating them. Politicians, scientists and public stakeholders are concerned about gambling addiction and its negative impact on mental health.

Correlational results largely support the harmful influence of video games on mental health. However, further studies are needed to identify the mechanisms underlying this association. In addition, many published experimental investigations have been limited due to methodological problems, such as insufficient causal data and external validity checks.

About the study

The present study used credible causal assumptions to examine the relationship between video games and mental health in real-world situations. For this purpose, game console lotteries were used as a natural experiment.

Causal inference was applied to observational data collected from December 2020 to March 2022 from 97,602 Japanese adults aged between 10 and 69 years. Study participants were administered questionnaires to assess lottery participation, video game ownership, gaming preferences, life satisfaction, mental health, and sociodemographic characteristics. Of the 97,602 survey participants, 8,192 participated in the lottery.

The most important aspect was video game usage, with respondents reporting that they own Nintendo Switch or PlayStation 5 (PS5) and have spent time playing these games in the last 30 days.

Key study outcomes included psychological well-being and satisfaction. The Japanese version of the Kessler Screening Scale (K6) measured psychological distress, while the Satisfaction with Life Scale (SWLS) assessed life satisfaction.

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

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

Instrumental variables (IV) were used to assess the local average treatment effect (LATE) of PS5 or Switch ownership, gaming in the study month, and gaming duration. IV-Forest algorithms calculated the conditional local average treatment effect (CLATE) estimates for video game ownership. Natural experiment validity was based on standard differences and pseudoscore tests assessing baseline characteristics and pre-lottery well-being scores.

Study results

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

Despite the psychological benefits of playing on Nintendo Switch or PS5, these benefits were less evident among young PS5 users than adult Nintendo Switch users. Owning a PS5 had a stronger impact on men, while owning a Nintendo Switch provided similar benefits for both men and women. The impact of PS5 use was more evident among those living in households without children or with full-time jobs, while Nintendo Switch use had a stronger impact on non-gamers.

Using the Nintendo Switch improved mental health symptoms by 0.8 standard deviations (SD), while using the PS5 was only associated with a 0.2 SD improvement. Winning the PS5 lottery increased video game time, but not smartphone play time.

The evaluation of the baseline characteristics and pseudo-outcome tests confirmed that the lottery results did not contain any confounding factors. The support and balance checks confirmed the validity of the PSM estimates.

Conclusions

Video games appear to improve mental health, but when playing for more than three hours, the psychological benefits diminish. Sociodemographic characteristics such as gender, age, occupation and family structure also affect the effects of gaming.

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

The effects of the modification on the Nintendo Switch were significantly different from those of the PS5, highlighting the need for further studies to elucidate the mechanisms underlying the effects of video games on mental health. The present study was conducted during the COVID-19 pandemic, a time characterized by high levels of psychological distress and limited opportunities for physical activity. Therefore, the positive mental health effects associated with gaming may be context-dependent, necessitating further research in a post-pandemic setting.