The Benefits of Playing Video Games

Isabela Granic, Adam Lobel, and Rutger C. M. E. Engels

Radboud University Nijmegen

Video games are a ubiquitous part of almost all children’s pulses out urgent warnings against the perils of addiction
and adolescents’ lives, with 97% playing for at least one to these games and their inevitable link to violence and ag-
hour per day in the United States. The vast majority of gression, especially in children and adolescents. Indeed,
research by psychologists on the effects of “gaming” has the vast majority of psychological research on the effects
been on its negative impact: the potential harm related to of “gaming” has been focused on its negative impact: the
violence, addiction, and depression. We recognize the potential harm related to aggression, addiction, and depres-
value of that research; however, we argue that a more sion (e.g., Anderson et al., 2010; Ferguson, 2013; Lemola
balanced perspective is needed, one that considers not et al., 2011). It is likely that this focus will not diminish in
only the possible negative effects but also the benefits of the near future, in part because of the enormous media
playing these games. Considering these potential benefits attention garnered when mass killings (e.g., the Columbine
is impor- tant, in part, because the nature of these games High School slayings in 1999) are associated with youth
has changed dramatically in the last decade, becoming in- who play violent video games (Ferguson, 2007). Most
creasingly complex, diverse, realistic, and social in nature. recently (December 2012), the revelation that the Sandy
A small but significant body of research has begun to Hook Elementary School gunman played shooter games
emerge, mostly in the last five years, documenting these directly resulted in President Obama requesting Congress
benefits. In this article, we summarize the research on the to allocate $10 million for research on the effects of
positive effects of playing video games, focusing on four violent media, especially video games (Obama & Biden,
main domains: cognitive, motivational, emotional, and so- 2013).
cial. By integrating insights from developmental, positive, Decades of valuable research on the effects of violent
and social psychology, as well as media psychology, we video games on children’s and adolescents’ aggressive
propose some candidate mechanisms by which playing behavior already exists, and this is indeed an important
video games may foster real-world psychosocial benefits. body of work to consider. However, we argue that in order
Our aim is to provide strong enough evidence and a the- to understand the impact of video games on children’s and
oretical rationale to inspire new programs of research on adolescents’ development, a more balanced perspective is
the largely unexplored mental health benefits of gaming. needed, one that considers not only the possible negative
Finally, we end with a call to intervention researchers and effects but also the benefits of playing these games. Con-
practitioners to test the positive uses of video games, and sidering these potential benefits is important, in part, be-
we suggest several promising directions for doing so. cause the nature of these games has changed dramatically
Keywords: video games, mental health, adolescents, in the last decade, becoming increasingly complex,
social, motivation diverse, realistic and social in nature (Ferguson & Olson,
2013). A small but significant body of research has begun
The game of Chess is not merely an idle amusement. Several to emerge, mostly in the last five years, documenting these
very valuable qualities of the mind, useful in the course of human
benefits. We propose that, taken together, these findings
life, are to be acquired or strengthened by it, so as to become
habits, ready on all occasions . . . we learn by Chess the habit of
suggest that video games provide youth with immersive
not being discouraged by present bad appearances in the state of and compelling social, cognitive, and emotional
our affairs, the habit of hoping for a favourable change, and that experiences. Further, these experiences may have the
of persever- ing in the search of resources. potential to enhance mental health and well-being in
—Benjamin Franklin, “The Morals of Chess” children and adolescents.

T
In this article, we summarize the research on the
oday, in the United States, 91% of children between benefits of playing video games, focusing on four main
the ages of 2 and 17 play video games (NPD Group, domains: cognitive (e.g., attention), motivational (e.g., re-
2011), and a nationally representative study of U.S. silience in the face of failure), emotional (e.g., mood man-
teenagers found that up to 99% of boys and 94% of girls agement), and social (e.g., prosocial behavior) benefits. By
play these games (Lenhart et al., 2008). In the United
States alone, video games brought in over $25 billion in
This article was published Online First December 2, 2013.
2010, more than doubling Hollywood’s 2010 box office Isabela Granic, Adam Lobel, and Rutger C. M. E. Engels, Developmental
sales of Psychopathology Department, Behavioural Science Institute, Radboud
$10.8 billion in the United States and Canada (Motion University Nijmegen, Nijmegen, The Netherlands.
Picture Association of America, 2011). Against this back- Correspondence concerning this article should be addressed to Isa-
bela Granic, Developmental Psychopathology Department, Behavioural
drop of nearly ubiquitous play, the popular press regularly Science Institute, Radboud University Nijmegen, Montessorilaan 3, 6525
HR Nijmegen, The Netherlands. E-mail: i.granic@pwo.ru.nl

66 January 2014 ● American Psychologist

© 2013 American Psychological Association 0003-066X/14/$12.00
Vol. 69, No. 1, 66 –78 DOI: 10.1037/a0034857
 context through which themes of power and dominance,
aggression, nurturance, anxiety, pain, loss, growth, and joy
can be enacted productively (e.g., Gottman, 1986). For
example, in his qualitative research on children’s play
conversations, Gottman (1986) showed how children use
play for emotional mastery in their real lives. Whereas
adolescents and adults often use self-disclosure and direct
discussion with close friends to resolve emotional issues,
children use play to work them out through pretend-based
narratives enacted either alone or with others. Links be-
tween children’s propensity to play and their development
of cooperative skills, social competence, and peer accep-
tance have also been empirically established (e.g., Con-
nolly & Doyle, 1984).
More recently, neuroscientific research with rats sug-
gests specific brain mechanisms that help explain how play
fighting in particular leads to the development of social
competence (for a review, see Pellis & Pellis, 2007). Ex-
perimental laboratory studies indicate that play fighting
results in the release of chemical growth factors in the
Isabela parts of the brain that are coordinated for highly social
Granic activities (e.g., the orbital frontal cortex), thus promoting
the growth and development of these areas. Given how
similar human and nonhuman animals are in terms of
several forms of play, there may be a similar mechanism
integrating insights from developmental, positive, and so- by which play experiences improve social competence in
cial psychology, as well as media psychology, we propose children (Pellis & Pellis, 2007). We propose that, in
some candidate mechanisms by which playing video addition to several unique factors, the same emotional
games fosters real-world benefits. Our hope is to provide
themes identified in children’s play experiences in general
strong enough evidence and a theoretical rationale to
(e.g., dominance, nurturance, anxiety, and growth) are also
inspire new programs of research on the largely
explored in video games, allowing for important cognitive,
unexplored mental health benefits of gaming. Finally, we
emotional, and social competencies to be acquired.
end with a call to intervention and prevention researchers
to test the potential positive uses of video games, and we Defining Our Terms
suggest several promising directions for doing so.
Before we go further, it is essential to specify what we
The Function of Play mean by the term video games and how they differ from
Although relatively little research has focused on the ben- other media (e.g., books, television, movies). The most
efits of playing video games specifically, the functions and essential distinguishing feature of video games is that they
benefits of play more generally have been studied for are interactive; players cannot passively surrender to a
decades. Evolutionary psychology has long emphasized game’s storyline. Instead, video games are designed for
the adaptive functions of play (for a review, see Bjorklund players to actively engage with their systems and for these
& Pellegrini, 2010), and in developmental psychology, the systems to, in turn, react to players’ agentive behaviors.
positive function of play has been a running theme for There are millions of video games, with vastly different
some of the most respected scholars in the field (e.g., themes and goals. These games can be played coopera-
Erikson, 1977; Piaget, 1962; Vygotsky, 1978). Erikson tively or competitively, alone, with other physically
(1977) proposed that play contexts allow children to ex- present players, or with thousands of other online players,
periment with social experiences and simulate alternative and they are played on various devices from consoles (e.g.,
emotional consequences, which can then bring about feel- Nin- tendo Wii, Playstation) to computers to cell phones.
ings of resolution outside the play context. Similarly, Pi- Be- cause of their diversity in terms of genres and the vast
aget (1962) theorized that make-believe play provides chil- array of dimensions on which video games can vary, a
dren opportunities to reproduce real-life conflicts, to work compre- hensive taxonomy of contemporary games is
out ideal resolutions for their own pleasure, and to amelio- exceedingly difficult to develop (many have tried).
rate negative feelings. Both Piaget (1962) and Vygotsky However, to provide a glimpse into this diversity, Figure 1
(1978) espoused strong theoretical links between play and depicts most of the genres (with examples) along two
a variety of elements that foster the development of social dimensions: the level of complexity and the extent of
cognition. social interaction. This tax- onomy is a necessary
Beyond social cognition, developmentalists have em- simplification; many games also differ on other important
phasized that play constitutes an emotionally significant dimensions, and increasingly, commercial games can be
played both socially and nonso-

January 2014 ● American 6

 tively, and so on. When we refer to gamers, we mean
individuals who play video games regularly, more than
one hour every day. We now turn to the literature on the
benefits of gaming.

Cognitive Benefits of Gaming

Contrary to conventional beliefs that playing video games
is intellectually lazy and sedating, it turns out that playing
these games promotes a wide range of cognitive skills.
This is particularly true for shooter video games (often
called “action” games by researchers), many of which are
violent in nature (e.g., Halo 4, Grand Theft Auto IV). The
most convincing evidence comes from the numerous
training studies that recruit naive gamers (those who have
hardly or never played shooter video games) and randomly
assign them to play either a shooter video game or another
type of video game for the same period of time. Compared
to control participants, those in the shooter video game
con- dition show faster and more accurate attention
allocation, higher spatial resolution in visual processing,
Adam Lobel and enhanced mental rotation abilities (for a review, see C.
S. Green & Bavelier, 2012). A recently published meta-
analysis (Uttal et al., 2013) concluded that the spatial skills
improvements derived from playing commercially
cially, cooperatively and competitively, and the available shooter video games are comparable to the
complexity of games often depends on the manner in effects of formal (high school and university-level) courses
which the player engages in these various gaming aimed at enhancing these same skills. Further, this recent
contexts. meta-analysis showed that spatial skills can be trained with
To describe only a small cross-section of 2011’s most video games in a relatively brief period, that these training
popular games (Entertainment Software Association, benefits last over an ex- tended period of time, and
2012): In World of Warcraft, 12 million players regularly crucially, that these skills trans- fer to other spatial tasks
log on to customize their fantasy personae, explore com- outside the video game context.
plex and ever-changing vistas, and collaboratively battle These training studies have critical implications for
human and computer opponents. In Starcraft 2, millions education and career development. A 25-year longitudinal
worldwide play a complex chess-like strategy game that study with a U.S. representative sample (for a review, see
demands perpetual multitasking between procuring re- Wai, Lubinski, Benbow, & Steiger, 2010) established the
sources, amassing an army, and penetrating opponents’ power of spatial skills in predicting achievement in
defenses. In The Sims 3, players cultivate a virtual exis- science, technology, engineering, and mathematics
tence where their character(s) socialize, learn new skills, (STEM). STEM areas of expertise have been repeatedly
work steady jobs, and develop complex relationships. In linked to long-term career success and are predicted to be
Halo 4, players take on the first-person perspective of a especially critical in the next century (Wai et al., 2010).
highly equipped supersoldier, violently killing alien races Preliminary research has also demonstrated that these
over the course of a narrative and, when online, competing cognitive advantages manifest in measurable changes in
and cooperating with peers. In FIFA 13, players take con- neural processing and efficiency. For example, a recent
trol of their favorite soccer teams, competing in realistic functional magnetic resonance imaging (fMRI) study
simulations against computer- or human-controlled teams. found that the mechanisms that control attention allocation
Finally, in Minecraft, millions of players use Lego-like (e.g., the fronto-parietal network) were less active during a
elements to construct their own unique structures and chal- lenging pattern-detection task in regular gamers than
mechanisms, sharing their creations with others in im- in nongamers, leading the researchers to suggest that
mense virtual worlds. shooter game players allocate their attentional resources
Given this vast diversity in video games, a single more ef- ficiently and filter out irrelevant information more
definition may not be useful. In fact, top scholars in the effec- tively (Bavelier, Achtman, Mani, & Föcker, 2012).
field have declared, “One can no more say what the effects As summarized recently in Nature Reviews Neuroscience:
of video games are, than one can say what the effects of “Video games are controlled training regimens delivered
food are” (Bavelier et al., 2011, p. 763). Thus, rather than in highly motivating behavioral contexts . . . because
define video games according to a convenient generality,
behav- ioral changes arise from brain changes, it is also no
we will be specific in defining the genre of games to which
surprise that performance improvements are paralleled by
we are referring when we can and whether they are single-
enduring physical and functional neurological remodeling”
or multiplayer games, played cooperatively or competi-
(Bavelier et al., 2011, p. 763). These changes in neural
6 January 2014 ● American
functioning

January 2014 ● American 6

 designers

Rutger
C. M.
E.
Engels

may be one means by which the cognitive skills gained

through video games generalize to contexts outside games.
It is important to stress that enhanced cognitive per-
formance is not documented for all video game genres. The
most robust effects on cognitive performance come from
playing shooter video games and not from, for example,
puzzle or role-playing games (C. S. Green & Bavelier
2012). These cognitive enhancements are likely a product
of the visually rich three-dimensional navigational spaces
and the fast-paced demands that require split-second deci-
sion making and acute attention to unpredictable changes in
context. These assumptions, however, remain somewhat
speculative because the vast majority of video games in-
clude an enormous number of game mechanics intertwined,
rendering specific hypothesis testing about these mecha-
nisms extremely difficult. Moreover, it is virtually impos-
sible to choose an appropriate control condition wherein all
aspects of a game (e.g., visual stimulation, arousal induc-
tion, gameplay) are kept constant across conditions and
only one cognitive challenge is manipulated (e.g., navigat-
ing three-dimensional space efficiently vs. inhibiting pre-
potent responses). Cognitive neuroscientists have just re-
cently put out a call to game developers to design new
games for testing hypotheses about the specificity of cog-
nitive advances and the particular mechanisms on which
they are based (Bavelier & Davidson, 2013).
In addition to spatial skills, scholars have also specu-
lated that video games are an excellent means for devel-
oping problem-solving skills (Prensky, 2012). Indeed,
problem solving seems central to all genres of video games
(including those with violent content). In-game puzzles
range in complexity from finding the quickest route from
A to B, to discovering complex action sequences based on
memorization and analytical skills. Further, game

7 January 2014 ● American

often provide very little instruction about how to solve in- allowed researchers
game problems, providing players with a nearly blank
palette from which to explore a huge range of possible
solutions based on past experience and intuitions. Prensky
(2012) has argued that exposure to these sorts of games
with open-ended problems (and other learning
experiences on the Internet) has influenced a generation
of children and adolescents growing up as “digital
natives.” Instead of learning through explicit linear
instruction (e.g., by reading a manual first), many
children and youth problem-solve through trial and error,
recursively collecting evidence which they test through
experimentation. Only two studies have explicitly tested
the relation between playing video games and problem-
solving abilities; in both, problem- solving was defined in
the reflective sense (e.g., taking time to gather
information, evaluate various options, formulate a plan,
and consider changing strategies and/or goals before
proceeding further). One study, with World of Warcraft
players, was correlational (Steinkuehler & Duncan,
2008), making it impossible to discern whether playing
the game improved problem solving or people with better
skills in the first place were drawn toward this type of
open-ended role-playing game. The other study (Adachi
& Willoughby, 2013) was longitudinal and showed that
the more adoles- cents reported playing strategic video
games (e.g., role- playing games), the more
improvements were evident in self-reported problem-
solving skills the next year. The same positive predictive
association was not found for fast-paced games such as
racing and fighting games. More- over, this latter study
showed an indirect mediation effect such that playing
strategic games predicted higher self- reported problem-
solving skills, which, in turn, predicted better academic
grades. More research is needed to tackle the causal
question of whether and to what extent video games teach
problem-solving skills and whether these skills generalize
to real-world contexts.
Finally, video games seem to be associated with an
additional cognitive benefit: enhanced creativity. New ev-
idence is emerging that playing any kind of video game,
regardless of whether or not it is violent, enhances chil-
dren’s creative capacities. For example, among a sample
of almost 500 12-year-old students, video game playing
was positively associated with creativity (Jackson et al.,
2012). Critically, children’s use of other forms of
technology (e.g., computer, Internet, cell phone) did not
relate to enhanced creativity. However, this study’s cross-
sectional design made it unclear whether playing video
games develops creative skills or creative people prefer
video games (or both).
The story behind a recent breakthrough in biology
research provides a nice illustration of how gamers’ supe-
rior spatial and problem-solving skills, as well as their
creativity, all came together to solve a real-world, previ-
ously insoluble problem. In 2008, researchers at the Uni-
versity of Washington created an online game called
Foldit (Cooper et al., 2010), allowing the public to play
games in which they model the genetic makeup of
proteins. At the end of a three-week competition in 2010,
top-scoring play- ers had generated phase estimates that
January 2014 ● American 7
Figure 1
Conceptual Map of the Main Genres of Video Games (With Examples) Organized According to Two
Important Dimensions: Level of Complexity and the Extent of Social Interaction Required

Note. The figure is not empirical but conceptual and is intended to demonstrate the variety of ways video games engage their users. Some genres have been
necessarily excluded. The same game (Halo 4) was intentionally repeated to illustrate that many games have the option of being played in either a single- or
a multiplayer mode. *MMORPG = massive multiplayer online role-playing game.

to identify a rapid solution of the crystal structure for a tangle. Thus, research programs in these latter areas are
monkey virus related to AIDS. The structure had eluded
only now beginning to gather steam. As a result, our
researchers for over 10 years; however, the nonlinear,
claims about these latter benefits are more speculative, but
cooperative, and creative problem-solving techniques used
by these gamers seemed to be precisely the skills needed the nascent research suggests immense promise for both
to finally solve this elusive problem. theory development and practice.
In summary, specific types of video games seem to
enhance a suite of cognitive functions, some of which
Motivational Benefits of Gaming
appear to generalize to real-world contexts. These data Game designers are wizards of engagement. They have
suggest that agendas to ban shooter games may be too mastered the art of pulling people of all ages into virtual
simplistic. At the very least, the research on the negative environments, having them work toward meaningful goals,
impact of these games needs to be balanced with evidence persevere in the face of multiple failures, and celebrate the
for the cognitive benefits of these same games. rare moments of triumph after successfully completing
We now turn to the motivational, emotional, and so- challenging tasks. In this section, we do not focus on the
cial benefits of playing video games. It is important to motivations children and youth have for playing video
highlight an across-the-board difference in the amount, games (see Ferguson & Olson, 2013). Instead, we aim to
breadth, and quality of research that can be found on these identify several characteristics of video games that seem to
topics. Whereas cognitive mechanisms may be more easily promote an effective motivational style both in and outside
isolated and tested, the motivational, emotional, and social gaming contexts. Specifically, decades of research in de-
effects of gaming are more complex and harder to disen- velopmental and educational psychology suggest that mo-

7 January 2014 ● American

tivational styles characterized by persistence and continu- often do feel these neg-
ous effortful engagement are key contributors to success
and achievement (for a review, see Dweck & Molden,
2005).
According to Dweck and her colleagues (Dweck &
Molden, 2005), children develop beliefs about their intel-
ligence and abilities, beliefs that underlie specific motiva-
tional styles and directly affect achievement. Children who
are praised for their traits rather than their efforts (e.g.,
“Wow, you’re such a smart boy”) develop an entity theory
of intelligence, which maintains that intelligence is an
innate trait, something that is fixed and cannot be im-
proved. In contrast, children who are praised for their
effort (e.g., “You worked so hard on that puzzle!”)
develop an incremental theory of intelligence; they believe
intelligence is malleable, something that can be cultivated
through effort and time. We propose that video games are
an ideal training ground for acquiring an incremental
theory of intelligence because they provide players
concrete, imme- diate feedback regarding specific efforts
players have made.
Immediate and concrete feedback in video games
(e.g., through points, coins, dead ends in puzzles) serves to
reward continual effort and keep players within what Vy-
gotsky (1978, p. 86) coined the “zone of proximal devel-
opment.” This motivational “sweet spot” balances optimal
levels of challenge and frustration with sufficient experi-
ences of success and accomplishment (Sweetser & Wyeth,
2005). Importantly, in the best games available on the
market, this “sweet spot” is so effective because it adjusts
itself dynamically; the difficulty level is continuously
being calibrated to players’ abilities through increasingly
more difficult puzzles demanding more dexterity, quicker
reac- tion times, and more clever and complex solutions.
Further, research has shown that the extent to which
individuals endorse an incremental versus entity theory of
intelligence reliably predicts whether individuals in chal-
lenging circumstances will persist or give up, respectively
(Dweck & Molden, 2005). Thus, these implicit theories of
intelligence have implications for how failure is processed
and dealt with. If one believes that intelligence or ability is
fixed, failure induces feelings of worthlessness. But if
intelligence or ability is presumed to be a mark of effortful
engagement, failure signals the need to remain engaged
and bolster one’s efforts. In turn, this positive attitude
toward failure predicts better academic performance (e.g.,
Black- well, Trzesniewski, & Dweck, 2007).
Notably, video games use failure as motivational
tools and provide only intermittent chances for large-scale
suc- cess. As behaviorists have documented for decades
(e.g.,
S. B. Kendall, 1974), the kinds of intermittent reinforce-
ment schedules that are doled out to video game players
are the most effective for “training” new behaviors. We
pro- pose that being immersed in these gaming
environments teaches players an essential basic lesson:
Persistence in the face of failure reaps valued rewards
(Ventura, Shute, & Zhao, 2013). Moreover, contrary to
what we might expect, these experiences of failure do not
lead to anger, frustra- tion, or sadness, although players

January 2014 ● American 7

 ative emotions intermittently. Instead, or as well, gamers often report seeking and experiencing. Flow or
players respond to failures with excitement, interest, transpor-
and joy (Salminen & Ravaja, 2008). When faced with
failure, play- ers are highly motivated to return to the
task of winning, and they are “relentlessly optimistic”
about reaching their goals (McGonigal, 2011). The
development of a persistent motivational style charged
with positive affect may, in turn, lead to lasting
educational success (Ventura et al., 2013). Almost no
empirical studies have directly tested the relation
between playing video games, persistence in the face of
failure, and subsequent “real-world” success. How- ever,
one recent study indicates that these relations may
indeed exist. Ventura and colleagues (2013) used an
ana- gram-riddle task and demonstrated that the extent of
video game use predicted how long participants would
(outside of a gaming context) persistently attempt to
solve difficult anagrams. Of course, a great deal more
research is required to establish causal relations between
regular gaming and persistence in the face of failure.
It may be particularly fruitful to examine,
longitudinally, whether gaming pre- dicts school
achievement and whether this effect is medi-
ated by increases in persistence.
In summary, although playing games is often consid-
ered a frivolous pastime, gaming environments may actu-
ally cultivate a persistent, optimistic motivational style.
This motivational style, in turn, may generalize to school
and work contexts. It is also probably the case that certain
types of games will more likely foster these healthy moti-
vational styles, while others may not. Moreover,
individual differences in players’ personalities and
preferences for game genres may also have a differential
impact on moti- vational outcomes. New studies that are
designed to take these complexities into consideration are
necessary to move the field forward significantly.

Emotional Benefits of Gaming

Based on the uses and gratifications theory, one of the
oldest and most well-validated theories in
communications research (Ruggiero, 2000), among the
top reasons individ- uals cite for using diverse forms of
media are to manage their moods and to enhance their
emotional states. Gaming may be among the most
efficient and effective means by which children and youth
generate positive feelings. Sev- eral studies have shown a
causal relation between playing preferred video games
and improved mood or increases in positive emotion (e.g.,
Russoniello, O’Brien, & Parks, 2009; Ryan, Rigby, &
Przybylski, 2006). For example, studies suggest that
playing puzzle video games— games with minimal
interfaces, short-term commitments, and a high degree of
accessibility (e.g., Angry Birds, Bejewled II)— can
improve players’ moods, promote relaxation, and ward
off anxiety (Russoniello et al., 2009).
It has further been suggested that some of the most
intense positive emotional experiences are triggered in the
context of playing video games (McGonigal, 2011). For
instance, fiero, the Italian word for intense pride after
succeeding against great adversity, is a feeling that
7 January 2014 ● American
tation is another positive emotional experience described (1986) research has shown on the function of traditional
by gamers, during which they are immersed in an intrinsi- play, the pretend context of video games may be real
cally rewarding activity that elicits a high sense of control enough to make the accomplishment of goals matter but
while simultaneously evoking a loss of self-consciousness also safe enough to practice controlling, or modulating,
(Sherry, 2004). In psychology, flow experiences have re- negative emotions in the service of those goals. Adaptive
peatedly been linked to a host of positive outcomes for regulation strategies such as acceptance, problem solving,
adolescents, including commitment and achievement in and reappraisal have repeatedly been linked to less
high school (e.g., Nakamura & Csikszentmihalyi, 2002), negative affect, more social support, and lower levels of
higher self-esteem, and less anxiety (Csikszentmihalyi, depressive symptoms (Aldao, Nolen-Hoeksema, &
Rathunde, & Whalen, 1993). Experiencing flow or trans- Schweizer, 2010). These same adaptive regulation
portation in games may lead to similar positive real-world strategies seem to be re- warded in gaming contexts
outcomes; however, this hypothesis remains untested. because their use is concretely and clearly linked to goal
Although not specific to game playing, the achievement. For example, re- appraisal (a cognitive
importance of experiencing positive emotions on a daily “habit” involving reevaluations of a situation or of one’s
basis has been elaborated in Fredrickson’s (2001) broaden- ability to cope with that situation) is a well-established
and-build the- ory of positive emotions. She demonstrates
emotion-regulation strategy (Gross & John, 2003) that
that experienc- ing positive emotions may help broaden
appears to be fundamental for many video games. Games
the number of behaviors one perceives as both possible
continuously provide novel challenges, de- manding
and motivating and may build social relationships that
players to shift already established appraisals to new ones
provide support for goal pursuit and coping with failure.
in order to most efficiently reach goals. For example,
Further, Fredrickson and colleagues propose that positive
Portal 2, an immensely popular first-person puz- zle game,
emotions help undo the detrimental and de-motivating
challenges the player to solve intricate maze-like problems
results of negative emo- tions. Positive emotions are thus
by exploiting physics-based rule structures. As soon as a
the bedrock for well- being, crucial not only as end states
player masters one type of puzzle, however, the rules
but as sources of inspiration and connectivity. If playing
change drastically, frustrating players and often trig-
games simply makes people happier, this seems to be a
fundamental emotional benefit to consider. gering anxiety while also forcing players to “unlearn” their
Although it is clear that games are fun and that they previous strategies and flexibly switch their appraisal sys-
elicit positive emotions, there remain unanswered ques- tems to uncover the new rule structure. Without applying
tions regarding the consequences of positive emotional reappraisal strategies, anxiety and frustration would likely
experiences during video game play. For instance, puzzle be amplified. This continual switching of whole systems of
games have been empirically shown to trigger positive rules is also evident in certain role-playing games (e.g.,
emotions, but these games are designed for brief, intermit- World of Warcraft, Pokémon, Final Fantasy) in which
tent play. The extent to which games designed for long- players cultivate an array of avatars, each with its own
term engagement also foster positive changes in mood is unique skill set (e.g., healers, warriors, sorcerers), alle-
unclear. Further, although correlational studies suggest giances, associated social behaviors, advantages, and vul-
that individuals consciously turn to these games to nerabilities. Many players switch among these avatars,
regulate their emotions (Olson, 2010), it may simply be forcing themselves to fluidly adjust to unique social and
that positive moods and game playing co-occur, and emotional goals. Thus, game playing may promote the
players report retrospectively that experiencing positive ability to flexibly and efficiently reappraise emotional ex-
emotions was a conscious motivation that preceded play. periences, teaching players the benefits of dealing with
We therefore need temporally sensitive designs (e.g., diary frustration and anxiety in adaptive ways. In contrast, less
studies) to more rigorously assess whether youth in adaptive strategies, such as rumination (Aldao et al.,
negative moods play games because they want to stop 2010), are less likely to be rewarded by video games
feeling badly and, crucially, the extent to which playing because they impede players from reacting quickly and
these games predicts their mood improvements at flexibly to con- stantly changing, often frustrating,
subsequent time points. Fi- nally, it is important to study challenges.
the extent to which turning to video games to feel better is The extent to which adaptive emotion-regulation
adaptive and at what point using games becomes an skills are learned through gaming remains speculative at
avoidant strategy that leads to more negative outcomes. this point, but testing these ideas seems like an exciting
Evaluating the emotional benefits of video games new area for future programs of research. Importantly, the
leads to the study of emotion regulation in these contexts. type of contexts that most often pull for effective emotion-
Simple up-regulation of positive emotions is one emotion- regulation strategies—such as reappraisal—are social in
regulation strategy that has been linked to beneficial out- nature.
comes (e.g., Fredrickson, 2001), but there may be addi-
tional emotion-regulation benefits of playing video games. Social Benefits of Gaming
Games do not elicit only positive emotions; video games Perhaps the biggest difference in the characteristics of
also trigger a range of negative ones, including frustration, video games today, compared to their predecessors of 10
anger, anxiety, and sadness. But similar to what Gottman’s to 20 years ago, is their pervasive social nature. Contrary
to stereotypes, the average gamer is not a socially isolated,

January 2014 ● American 7

inept nerd who spends most of his (or her) time
alone

7 January 2014 ● American

loafing on the couch (Lenhart et al., 2008). Over 70% of ative play, but they point to potential long-term benefits as
gamers play their games with a friend, either cooperatively
or competitively (Entertainment Software Association,
2012). For example, World of Warcraft—a multiplayer
fantasy game set in a massive virtual world— boasts12
million regular players, and Farmville— one of the most
popular social networking games on Facebook— hosted
over 5 million daily users in 2012 (Gill, 2012). In these
virtual social communities, decisions need to be made on
the fly about whom to trust, whom to reject, and how to
most effectively lead a group. Given these immersive so-
cial contexts, we propose that gamers are rapidly learning
social skills and prosocial behavior that might generalize
to their peer and family relations outside the gaming
environ- ment (Gentile & Gentile, 2008; Gentile et al.,
2009).
Players seem to acquire important prosocial skills
when they play games that are specifically designed to
reward effective cooperation, support, and helping behav-
iors (Ewoldsen et al., 2012). One study that summarized
international evidence from correlational, longitudinal, and
experimental studies found that playing prosocial video
games consistently related to, or predicted, prosocial be-
haviors (Gentile et al., 2009). More specifically, playing
prosocial games led to causal, short-term effects on “help-
ing” behaviors, and longitudinal effects were also found, in
that children who played more prosocial games at the
beginning of the school year were more likely to exhibit
helpful behaviors later that year. It may be tempting to
conclude from this work that games with exclusively non-
violent, prosocial content lead to prosocial behavior. But
compelling work is just emerging that seems to refute this
simple interpretation, suggesting that violent games are
just as likely to promote prosocial behavior. The critical
dimen- sion that seems to determine whether violent
games are associated with helping, prosocial behavior
versus malev- olent, antisocial behavior is the extent to
which they are played cooperatively versus competitively.
For example, players who play violent games that
encourage cooperative play are more likely to exhibit
helpful gaming behaviors online and offline than those
who play nonviolent games (Ferguson & Garza, 2011),
and playing violent video games socially (in groups)
reduces feelings of hostility compared with playing alone
(Eastin, 2007). Likewise, violent video games played
cooperatively seem to decrease players’ access to
aggressive cognitions (Schmierbach, 2010; Velez,
Mahood, Ewoldsen, & Moyer-Gusé, 2012). Two recent
studies have also shown that playing a violent video game
cooperatively, compared with competitively, increases
subsequent prosocial, cooperative behavior out- side of the
game context (Ewoldsen et al., 2012) and can even
overcome the effects of outgroup membership status
(making players more cooperative with outgroup members
than if they had played competitively; Velez et al., 2012).
Conversely, recently published experimental studies (Tear
& Nielsen, 2013) suggest that even the most violent video
games on the market (Grand Theft Auto IV, Call of Duty)
fail to diminish subsequent prosocial behavior. All of these
studies examined immediate, short-term effects of cooper-

January 2014 ● American 7

well. The social benefits of cooperative versus Several reviews already exist on the learning outcomes
competitive game play need to be studied longitudinally,
with repeated assessments, to have clearer implications
for policy and practice.
Social skills are also manifested in forms of civic
engagement: the ability to organize groups and lead like-
minded people in social causes. A number of studies have
focused on the link between civic engagement and
gaming. For example, one large-scale, representative U.S.
study (Lenhart et al., 2008) showed that adolescents who
played games with civic experiences (e.g., Guild Wars 2,
an MMORPG, or massive multiplayer online role-playing
game) were more likely to be engaged in social and civic
movements in their everyday lives (e.g., raising money
for charity, volunteering, and persuading others to vote).
Un- fortunately, as is the case with most survey studies in
the field, this study did not differentiate the causal
direction of effects.

“Serious” Games in Health

and Education
Up to this point, we have reviewed a diverse set of
potential benefits of gaming relevant to children’s
cognitive, moti- vational, social, and emotional
development. The medical field has picked up on these
positive effects and become increasingly interested in
“gamifying” medical interven- tions (Ritterfeld, Cody, &
Vorderer, 2009), as evidenced by the emergence of a new
journal (Games for Health Jour- nal), calls for proposals
from major granting agencies (e.g., the National Science
Foundation, the European Research Council), and some
highly successful “serious games” that have made
international headlines for their promising out- comes.
Researchers and practitioners alike in the medical field
have begun to harness the power of video games to
motivate patients and, ultimately, to improve their health
outcomes (for a review, see Kato, 2010).
Perhaps the most celebrated success story of a game
that had a significant impact on health-related behaviors
is the case of Re-Mission (Kato, Cole, Bradlyn, &
Pollock, 2008), a video game designed for child cancer
patients. By allowing the player to control a nanobot who
shoots cancer cells, overcomes bacterial infections, and
manages signs of nausea and constipation (common
barriers to cancer pa- tients’ treatment adherence), the
game aimed to teach chil- dren how best to adhere to their
cancer treatments. A randomized controlled study
conducted internationally in
34 medical centers compared children assigned to play
Re-Mission to a control group of children playing
another computer game (Kato et al., 2008). Adherence to
treatment protocol, self-efficacy, and cancer-related
knowledge were all significantly greater in the
intervention group. The game has now been distributed to
over 200,000 patients and continues to be viewed as a
successful treatment approach.
The promise of video games has also made a great
stir in the field of education. Space limitations preclude a
review of the myriad games developed to improve educa-
tional outcomes in almost every subject taught in schools.
7 January 2014 ● American
associated with educational games (e.g., O’Neil, Wainess, reliable even after controlling for a variety of potential
& Baker, 2005), and a meta-analysis concluded that games confounding factors, such as socioeconomic status, IQ,
can make important advances in the educational reform and previous aggressive behavior problems. Ultimately,
necessary to deal with the learning challenges of the next both camps have valid points, and perhaps the most
century (Vogel et al., 2006). important lesson from these conflicting meta-analyses is
Despite the emerging hype regarding the “gamifica- that the picture is much more complex than popular press
tion” of interventions in the health and educational sci- headlines suggest (Ferguson, 2013).
ences, caution is also warranted. The most important If the popular press simplifies the effects of video
reason is that very few of the games developed to improve games, it is no less true for most psychological research.
health and learning outcomes are ever scientifically By dichotomizing video games into either “good” or
evaluated. As a result, it is still unknown how much more “bad,” “violent” or “prosocial,” psychologists are largely
effective these games are in changing behavioral and (with the exception of media psychologists) overlooking
health outcomes than are conventional approaches. The the com- plex new playground of contemporary video
second shortcoming is that medical practitioners, teachers, games and the varied landscape of virtual interactions
and researchers are not game designers, and as a result, taking place in those games. Players are drawn toward
they often develop prod- ucts that miss the most essential different types of games based on individual differences
mechanism of engagement in games—the fun. In an effort on a variety of factors including personality differences,
to pull together a set of valid principles or lessons, games their own needs assessments, their mood, and so on (e.g.,
for health and education often end up with the “chocolate- Tamborini, Bow- man, Eden, Grizzard, & Organ, 2010).
covered broccoli” prob- lem—the games look great, they The games people choose to play, in turn, exert diverse
are good for you, but they ultimately fail to work because influences on players’ motivations, emotional states, and
the creative game dynamics that induce transportation and social interactions. Moreover, most popularly played
immersion are missing, mak- ing them simply not fun. We games today are complex and change dynamically (see the
highlight these shortcomings in the domain of games for top half of Figure 1), which means that players’ in-game
health in particular because the same cautionary notes behaviors change how the game itself progresses, feeding
should be taken seriously if (and when) psychologists back to, and constrain- ing, how the player continues to
consider developing games for mental health. We now turn adapt to these changes in subsequently updated game
to a discussion of more general limitations of the gaming contexts (Klimmt, Vorderer, & Ritterfeld, 2007). Games
literature and attempt to address these limitations with that are fundamentally social and rely on varied social
suggestions for novel research direc- tions. partners also provide a large amount of variability in game
experiences, depending on who the player encounters each
Challenges and Future Research time she or he enters the gaming world. Ultimately, these
Directions dynamic features mean that there is a certain element of
By highlighting the positive effects of playing a wide uniqueness to each player’s experi- ence, each time she or
range of video games, it is not our intention to gloss over he plays even the very same game. Thus, the question for
their very real potential for harm. Indeed, important psychological research on gaming is not what games are
research has already been conducted for decades on the “good” or “bad” for us; rather, it seems important to start
negative effects of gaming, including addiction, by acknowledging the growing complex- ity and
depression, and aggression (Anderson et al., 2010; interactivity and, from there, to develop equally complex
Ferguson, 2007), and we are cer- tainly not suggesting that models to explain how gaming influences players in
this body of research should be ignored. For example, two relevant cognitive, social, and emotional domains.
Toward that aim, there are several methodological
large-scale survey studies have found that 3% of Dutch drawbacks to gaming research that, if addressed, provide
(van Rooij, Schoenmakers, Ver- mulst, van den Eijnden, & novel concrete directions for future research. First, there
van de Mheen, 2011) and about 8% of U.S. youth (Gentile, are very few, if any, well-designed published studies that
2009) who play video games exhibit pathological examine both the positive and negative effects of the same
symptoms of addiction (i.e., damage to family, school, or games and the conditions under which these effects are
psychological functioning). Also, two major meta-analyses most likely manifested, whether they are violent in nature
have been published on the series of studies on aggressive or otherwise. Second, the majority of studies on video
behavior and violent video games (Anderson et al., 2010; games (on both the negative and positive effects) continue
Ferguson, 2007). Unfortunately, these meta-analyses, to depend on survey assessments. Although self-report and
which dealt with almost the same data pool, reached very retrospective assessments are useful, relying exclusively
different conclusions. Ferguson and his group (see on these data limits our understanding. Instead, a more
Ferguson, 2013) have argued that the effect sizes are so mul- timethod approach seems to be warranted in which
small, they provide little meaningful predictive power, and objec- tive observations of in-game behaviors are
the methodological weaknesses in the field make it almost associated with immediate and long-term “real-world”
impossible to come to any conclusion. In stark contrast, effects. These meth- ods can also fruitfully incorporate
Anderson, Bushman, and their colleagues (Anderson et al., psychophysiological and neural assessments that may be
2010; Bushman & Anderson, 2002) coun- ter that, better able to identify the emotional, cognitive, and neural
although the effect sizes may be small, they are changes associated with playing video games (Bavelier et

January 2014 ● American 7

al., 2011).

8 January 2014 ● American

 Another limitation of past approaches is the almost based interventions in this field are based on cognitive-
exclusive focus on the short-term impact of games; very behavioral principles (see P. C. Kendall, 2011). Despite
few longitudinal studies have been conducted in this area. optimistic conclusions about the effectiveness of
Moreover, no studies have assessed the daily patterns of cognitive- behavioral therapy (CBT), overarching
gaming and the function that these patterns of use may limitations have also been pointed out (see Kazdin, 2011,
serve. Diary studies, combined with observational and sur- for a review). We propose that video games can uniquely
vey methods that are repeated over months and years, and significantly address these limitations and, in turn,
would be immensely useful to clarify the details of daily improve intervention effects across a broad spectrum of
playing and its long-term impact. These studies would be disorders.
especially helpful if they began their baseline assessments The first limitation of a number of evidence-based
in childhood, prior to children’s exposure to games. These approaches, particularly those oriented around CBT prin-
types of developmental designs can yield some substantive ciples, is that they largely rely on imparting psychoeduca-
data about how much game playing is too much, informa- tional information, usually in some didactic style (albeit
tion urgently sought after by parents, teachers, and clini- with efforts to make these lessons interactive). Learning
cians alike. We also need information on whether different about cognitive biases, the extent to which our feelings are
types of games are not only beneficial but also appropriate intricately linked to our thoughts and how this interaction
to play at specific developmental stages and whether there underpins behavior and effective problem-solving strate-
are specific benefits that are obtained during specific de- gies, is, indeed, critical. However, children and adoles-
velopmental windows and not others. As it stands, the cents, especially those who do not recognize that they have
suitability ratings ascribed to games by the entertainment a mental health problem or are not motivated to change,
industry (e.g., E for “everyone,” M for “not appropriate for often find these lessons boring. Engaging children and
children under the age of 18”) are based on little to no youth is one of the most challenging tasks faced by clini-
scientific evidence regarding potential harms or benefits. cians (Crenshaw, 2008). A video game that can impart this
Finally, without longitudinal designs that are explicitly same knowledge but use elements of play and game me-
designed to disentangle selection from influence effects as chanics that have proven immensely engaging may help to
much as possible, it is impossible to know whether games address this barrier. Indeed, a fantasy role-playing game
directly cause changes in emotions, cognitions, and social based on CBT for depression was recently developed
functioning or whether children with certain characteristics (SPARX) to explicitly increase engagement, and a random-
select particular games that match these characteristics. ized controlled trial showed it to be as effective in treating
Finally, the vast majority of previous work has exam- depression as a therapist-administered CBT program
ined children’s and adolescents’ experiences with single- (Merry et al., 2012).
player games, ignoring the fact that more than 70% of A second, related barrier to the majority of CBT
individuals play games socially, online or in person, with approaches is that these programs do an adequate job of
friends and acquaintances (Entertainment Software Asso- imparting new knowledge, but they leave a large gap
ciation, 2012). Although studies that track multiplayer so- between what youth actually know and what they do in
cial interactions on- and offline are vastly more complex their everyday lives. This gap between knowledge and
than studies focusing on single-player experiences, they behavior has long been recognized as a problem in the
are also far more ecologically valid given that these are the field, and thus many interventions incorporate role-
games in which youth are increasingly immersed. playing, problem-solving exercises and homework
assignments (e.g., P. C. Kendall, 2011). But these are
Implications for Mental Health mostly de-con- textualized exercises that rarely involve the
Intervention authentic emo- tional experiences during which most
conflicts arise. De- veloping therapeutic video games can
Given that video games have permeated almost all house- address this gap because they engage players in immersive
holds, across almost all countries, it is striking how little emotional expe- riences (eliciting a range of emotions) and
attention has been paid to using this medium for purposes provide oppor- tunities to practice new regulatory skills
that go beyond entertainment and beyond demonstrated until they are automatized, canalizing new neural patterns
benefits for education and health care. Although we have that can lead to generalization outside the game.
chosen to avoid taking part in the debate regarding the A third challenge faced by many intervention pro-
harms versus benefits of gaming, there is one point that grams is access to care. Many people, often those most in
both sides are advocating with which we fervently agree: need of care, have a difficult time accessing treatment
Video games hold immense potential to teach new forms programs because they either live in hard-to-reach rural
of thought and behavior. We argue that this learning locations, work or go to school during treatment hours, or
potential has been left largely untapped in the mental are physically or psychologically unable to commute. Ad-
health arena, and addressing this gap holds a great deal of olescents, minority youth, and the elderly are particularly
promise for a radical new approach to intervention. likely to face these challenges. Games designed for mental
Our expertise is in the area of developmental psycho- health interventions can reach these populations because
pathology, where we contend video games can have a they can be delivered to wherever clients reside, with little
particularly large impact. The vast majority of evidence- cost and effort. Moreover, it is likely that games are asso-
ciated with less stigma than conventional therapy, address-

January 2014 ● American 8

ing another barrier. Finally, the cost-effectiveness of deliv- have been developed with these aims in mind. Given
ering mental health interventions is often a barrier to how enthralled most children and adolescents are with
treatment delivery. Many children and families cannot af- video games, we believe that a multidisciplinary team of
ford individual or group therapy, and schools worldwide psychologists, clinicians, and game designers can work
are facing cuts in funding that have significantly decreased together to develop genuinely innovative approaches to
the number of programs that can be offered as part of the mental health interventions.
curriculum. Games are simply cheaper, given that they
have no costs associated with therapists’ time and training,
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