Psychopathologie du jeu multi-joueurs en ligne (2013)

FRANÇAIS :
Sans limites et sans fin, les jeux en ligne multi-joueurs ont un fort potentiel addictogène, les modes de consommation dépassant souvent six heures par jour. Ils sont facilement accessibles puisqu'ils ne nécessitent qu'un accès Internet et sont disponibles en version d'essai gratuite. La surconsommation mène très rapidement à un isolement familial et social, à l'échec scolaire et au désinvestissement total d'autres formes d'activités. Les jeunes touchés se nomment entre eux « no life ». La surconsommation de jeux multi-joueurs en ligne et d'Internet touche principalement les adolescents et jeunes adultes, de préférence de sexe masculin. L'étude des facteurs psychopathologiques plaide en faveur de l'existence d'une fragilité psychopathologique prédisposant à l'apparition de la consommation excessive des jeux en ligne. Sont à privilégier notamment les troubles de l'humeur, les styles et schémas cognitifs dysfonctionnels, les prodromes du trouble psychotique. L'analyse des motivations permet de dégager trois facteurs principaux qui mènent les individus à consommer : le souhait de réussir, la création de lien social, l'immersion dans un environnement qui permet de s'extraire de sa propre existence. Les thérapies cognitives et comportementales permettent une prise en charge efficace de ces troubles, mais rien ne permet de dire aujourd'hui, étant donné le peu de littérature disponible, si elles sont les seules.
ENGLISH:
Objectives: Online multiplayer videogames have become one of the most addictive activities on the Internet. However, overconsumption of online videogames should be differentiated of Internet addiction since players do not report to experience to be on the Internet when they are playing.
Methods: The present article provides a comprehensive review of data on online multiplayer videogames overconsumption. This review highlights motivational factors of overconsumers and available therapeutic strategies will be described.
Results: Overconsumption of online videogames is considered as a behavioural addiction or a compulsive-impulsive disorder. Most of the articles highlight four criteria for this disorder: (1) excessive use, often associated with a loss of sense of time or a neglect of basic drives, (2) withdrawal, including feelings of anger, tension, and/or depression when the computer is inaccessible, (3) tolerance, including the need for better computer equipment, more software, or more hours of use, and (4) negative repercussions, including arguments, lying, poor achievement, social isolation, and fatigue. Online multiplayer videogames are endlessly addictive, with daily consumption commonly lasting more than six hours. These games are easily accessible, since they only require an Internet access and demonstration trials are free to download. However, overconsumption of these videogames leads quickly to social withdrawal, academic failure, and disinvestment in daily-life activities. Males play more often than women. Teenagers and young adults are principal overconsumers of online multiplayer videogames and of the Internet. Parental control influences overconsumption since parental control is negatively correlated with Internet consumption in non-depressed adolescents. Comorbidities of abusive consumption are mood disorders, depressive symptoms and suicidal thoughts, anxiety disorders (generalized anxiety disorder and social phobia), alexithymia, attention deficit hyperactivity disorder and personality disorders (avoidant, borderline and obsessive-compulsive). Overuse is also associated with cannabis and alcohol consumptions, sleep deprivation, compulsive eating disorder, carpal tunnel syndrome, ocular dryness, back- and headaches. Individuals with addictive behaviours for Internet and online videogames addiction tend to attribute the causes of events to the chance, they anticipate negatives consequences of their acts, demonstrate negativism, tendency to catastrophization, shame, low self-esteem and self-confidence. Three major desires lead to overconsumption in adolescents: the achievement of success, the creation of social relationships, and the immersion in an environment that differs from reality. French psychiatrists recommend treating overuse with a combination of pharmacologic and psychotherapeutic approaches. Among psychotherapeutic treatment, cognitive and behavioural therapies have demonstrated their efficacy with the disorder. Unfortunately, the literature does not provide information on other useful therapies.
Conclusions: Given the growing frequency of overconsumption of online videogames and of the Internet, motivations of players and comorbidities of the disorder must be known by the clinician. They are clues to orientate the therapeutic approaches.