Psychiatrists’ Perceptions of World of Warcraft and Other MMORPGs by Eric Lis, Carl Chiniara, Megan A. Wood, Robert Biskin, and Richard Montoro was published in Psychiatr Q in 2016. This is a strange bit of research and I am not really sure why it was even conducted in the first place. The researchers created an opinion survey, sent it out to a group of psychiatrists, collected the results and attempted to quantify it scientifically.

For starters, the researchers set out to do “exploratory research” into the “perceptions” psychiatrists have about MMORPGs in general, and World of Warcraft in particular, and also of social media and blogging sites Facebook and Google Plus, Twitter and This piece deals with the MMORPGs and WoW while a separate publication addresses the rest of the original study’s social media and blogging sites.

This would only mean something to a WoW player. Not sure how anyone could assign a psychopathology to players when they have no experience with the game.

It is important to note that the researchers were interested in “the preconceptions of mental health professionals may have” about “a population of millions of individuals, an unknown percentage of whom will eventually come into contact with mental health services for reasons both related and unrelated to gaming behavior…

The researchers note how MMO/MMORPG players are depicted in pop culture (“socially isolated and inept, obese and suffering from one or more psychiatric disorders“) and then say “which may or may not reflect an actual public perception“. It is as though the researchers think that “actual public perception” equals scientific fact. It does not; it never has, this is why the Scientific Method exists as a process and Science as a field.

The social sciences have established en entire body of knowledge about how humans create mental shortcuts about each other and how these mental shortcuts become biases and stereotypes. These mental shortcuts, biases and stereotypes are the result of “actual public perception” and become prejudices. Prejudices are never based in factual reality; they are assumptions based on lack of knowledge and perhaps willful delusion.

None of the WoW players I ever knew were basement dwellers. Stereotypes are not factual.

The researchers created an online questionnaire “by consensus between the authors” that was not validated before they administered it to a group of 160 English speaking psychiatrists over the age of 18 who were currently employed in a system of six hospitals within a University hospital network. Of the 160 psychiatrists that received this questionnaire through a listserv, only 48 (30%) responded.

The researchers had two hypotheses:

  • 1. MMOs/MMORPGs will be perceived by a majority of participants as being associated with at least one DSM-IV-TR diagnosis.
  • 2. Age will predict psychiatrists perceptions of psychopathology associated with MMOs/MMORPGs.

Out of the 63 question non-validated questionnaire, 12 questions pertained to MMOs/MMORPGs. The rest involved questions pertaining to Facebook, Google Plus, Twitter, LiveJournal and non-computer table-top role-play games. The questions referred to use of the games or sites, knowledge about the games or sites, and specific psychiatric disorders perceived to be associated with these games or sites.

No demographic information other than age was collected at the time the questionnaire was distributed. Of the sample of 48 psychiatrists, only 32 had ever played video games before, 19 in the previous six month period, and only 3 had ever played MMORPGs, only 1 in the previous six month period. In other words, 45 of 48 psychiatrists polled in this questionnaire had never played a MMORPG before.

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Token LiveJournal meme.

And yet out of the 48 respondents out of the 160 individuals polled (30% of 160), 36.7% perceive a link between mental illness and MMOs/MMORPGs. Of that same sample, 37% associate Facebook (as a social networking site, or SNS) with a psychopathology and 33% Twitter and LiveJournal (as social update sites or SUS) with a psychopathology.

So a little over 1/3 of 1/3 of the total sample size perceives a link between a psychopathology and MMO/MMORPGs, Facebook and Google Plus, Twitter and LiveJournal. The data did not support the hypotheses of the researchers which should be unsurprising given that perception is extremely difficult, if not virtually impossible to measure, even with Likert scales because of individual differences in perception itself.

People do not perceive anything in the exact same way; there are so many individual differences in how people operationally define things that it makes it virtually impossible to standardize measurement instruments which is why it is important that they be validated in the first place. The whole point of a validation process is try and ensure that questions are interpreted as close to sameness across all respondents.

Because of individual differences.

Most people look at the sky above them and perceive that it is blue or gray (perhaps the person is color-blind, perhaps its a cloudy day). But the sky actually has no color; we perceive color that is not there because of our eyes and the effects of light rays bouncing around in the atmosphere full of various gases. But who is to say we all perceive the same shade of blue or gray?

Individual differences in genetics or environment may cause slight differences in the perception of a shade of color. It is common for medical professionals to ask patients to rate their level of pain on a scale from 1 to 10, because one person’s pain threshold is not the same as the next person’s; one person’s pain might be a 5 and another’s an 8. One person”s experience of depression or anxiety may be normal while another’s is not.

Because humans are not carbon copies of one another. No two people will have an entire lifetime full of the exact same experiences in the exact same environments, with the exact same people unless they only live for a couple of days or hours.

Do you see the problem with asking 48 people to essentially diagnose people they have never seen as having a psychopathology if they play an MMO or an MMORPG, or if they use Facebook, or Google Plus, Twitter or LiveJournal? Especially when only 3 individuals out of those 48 people have first-hand experience playing an MMO or an MMORPG?

The listed limitations of this study are extensive to say the least. They do not even include some serious problems with the non-validated questionnaire, the overall design of this study, the very small sample size which limits generalization to larger populations of psychiatrists never mind the rest of the physical and mental health industry.

Because demographic characteristics are lacking and the sample population comes from one single hospital network it is likely the sample is too similar to generalize to larger populations of anyone at all. In fact, because of the limitations involved if this study could be duplicated by independent researchers, it would be a complete waste of time and resources to bother with it.

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Sadly, this study strikes me as a case of researchers hoping to use the trappings of a research study in order to further opinion based biases.

The opinions of psychiatrists in this study are about as useful as the opinions of truck drivers or waitresses when only 3 of them have even experienced an MMO or an MMORPG. They may know psychopathology, but they don’t know MMOs or MMORPGs, and even if they did, that does not qualify them to diagnose millions of people they have never even met as having a psychopathology.

But don’t take my word for it. You can find this research study here: Psychiatrists’ Perceptions of World of Warcraft and Other MMORPGs. Next week I will take a closer look at the other half of this “research study” and the journal that published them, involving Facebook, Google Plus, Twitter and LiveJournal. Thanks for reading!