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The lived experience of gamers: a comparative qualitative investigation of treatment-seekers and esports players

based on reviews by Malte Elson and Peter Branney
A recommendation of:

Phenomenological Strands for Gaming Disorder and Esports Play: A Qualitative Registered Report

Submission: posted 11 June 2022
Recommendation: posted 21 September 2022, validated 21 September 2022

This is a stage 2 based on:


Since 2018, the inclusion of “gaming disorder” in the ICD-11 has been met with a mixture of interest, confusion and controversy (Van Rooij et al, 2018), mirroring broader debates about the effects of gaming on mental health. One of the major gaps in understanding the validity of gaming disorder as an identifiable mental illness is the absence of qualitative studies comparing the lived experience of gamers who seek treatment with esports players who do not report health problems.
Here, Karhulahti et al. (2022) tackle this question in the first of two Stage 2 Registered Reports associated with their previous programmatic Stage 1 submission. Using interpretative phenomenological analysis in gamers and medical experts, they find that treatment-seekers and esports players differ in how gaming is associated with the sense of self, either interfering with the self for treatment-seekers or successfully integrating into the self for esports players. These findings help to identify the key characteristics of problematic and non-problematic gaming and call for more intensive and wide-reaching qualitative research in this area.
Following one round of in-depth review and revision, the recommender judged that the manuscript met the Stage 2 criteria and awarded a positive recommendation.
URL to the preregistered Stage 1 protocol:
Level of bias control achieved: Level 4. At least some of the data/evidence that was used to answer the research question existed prior to in-principle acceptance(IPA) but the authors certify that they did not access any part of that data/evidence prior to IPA.
List of eligible PCI RR-friendly journals:
1. van Rooij AJ, Ferguson CJ, Carras MC, Kardefelt-Winther D, Shi J, Aarseth E, Bean AM, Bergmark KH, Brus A, Coulson M, Deleuze J, Dullur P, Dunkels E, Edman J, Elson M, Etchells PJ, Fiskaali A, Granic I, Jansz J, Karlsen F, Kaye LK, Kirsh B, Lieberoth A, Markey P, Mills KL, Nielsen RKL, Orben A, Poulsen A, Prause N, Prax P, Quandt T, Schimmenti A, Starcevic V, Stutman G, Turner NE, Looy J van, Przybylski AK (2018) A weak scientific basis for gaming disorder: Let us err on the side of caution. Journal of Behavioral Addictions, 7, 1–9.
2. Karhulahti V-M, Siutila M, Vahlo J, Koskimaa R (2022) Phenomenological Strands for Gaming Disorder and Esports Play: A Qualitative Registered Report. Stage 2 Registered Report, acceptance of Version 2 by Peer Community in Registered Reports.
Cite this recommendation as:
Chris Chambers (2022) The lived experience of gamers: a comparative qualitative investigation of treatment-seekers and esports players. Peer Community in Registered Reports, .
Conflict of interest:
The recommender in charge of the evaluation of the article and the reviewers declared that they have no conflict of interest (as defined in the code of conduct of PCI) with the authors or with the content of the article.


Evaluation round #1

DOI or URL of the report:

Author's Reply, 06 Sep 2022

Download author's reply Download tracked changes file

Dear Recommender,

In addition to the attached reply file, we note the following:

- We have corred a few small technical language points in the Stage 1 part to improve readability. They are all marked in the tracked changes document.

- Because of the longitudinal design, we cannot provide direct data upload even via the FSD until the pseudonym key has been destroyed (this is a GDPR state of affairs for pseudonymous data). All data accesses must be confirmed by pseudonym key holder (me). The data sharing statement has been adjusted to this with a clear statement of what requests will be accepted, and the Recommender will hold the authority to oversee these decisions if ever needed.

- We have received a publication offer from Collabra Psychology.

- PCI RR image added: it's the logo of the institution that funded the research (Finnish Work Environment Fund).

Veli-Matti Karhulahti

Decision by , posted 16 Aug 2022

First of all, thank you for your patience during the (northern hemisphere) summer. Two of the three reviewers who assessed the Stage 1 submission kindly returned to evaluate the Stage 2 submission, and the good news is that both are resoundingly positive about the completed manuscript.

The reviewers offer some helpful recommendations for consideration in revision (primarily to the Discussion), including anticipation of the plans for the second Stage 2 output of this programmatic submission, consideration of potential hypotheses the work may generate, and therapeutic reflections. I am happy for you to decide how best to to respond to these points. From a technical point of view, it was correct to omit the red text from the Stage 2 manuscript as these sections will form part of the eventual second output.

One point noted in the reviews is that the preregistered Stage 1 manuscript is not directly referenced (even though you do refer to the Stage 1 recommendation). Consistent with section 2.18 of the PCI RR author guidelines, please add the following to the existing statement: “Preregistered Stage 1 protocol: (date of in-principle acceptance: 24/09/2021)”.

Provided you are able to respond comprehensively to all points raised, full acceptance of the Stage 2 manuscript should be forthcoming without requiring further in-depth review.

Reviewed by , 12 Aug 2022

This is a phase-2 registered report, following up on a registered protocol proposing a study on the phenomenology of gaming disorder. The authors report how they carried out the proposed study and its most important results. 


Overall, I like the manuscript a lot. The authors have taken care to report the sampling and interview procedure diligently and with much attention to detail. In fact, I think they have done an outstanding job compared to much other qualitative studies, which often lack the detail to comprehensively understand the data-generating process (and quantitative studies too, though I find this difficult to compare to the present manuscript).


With regards to the analysis, the authors chose the liberty to illustrate each identified theme with quotes from one participant each. Strictly speaking, their preregistration did (I think) not state they would do so, but this is probably largely due to the fact that the authors preregistered a relatively wide range of possible sample sizes. I do not consider it an actual violation of the preregistration protocol, but I can see how others might reasonably arrive at a different conclusion.


Concerning the results, I think the authors appropriately exercise restraint in generalising their observations. That is, the language with which they discuss their findings is carefully chosen not to make undue causal claims, and the authors also do not present their findings as “universal truths” applicable to the gaming population. Well done! That being said, as a quantitative researcher, I do think the great value of qualitative studies like this one is to generate hypotheses for further studies. I would encourage the authors to do so (even) more explicitly than is already done in the discussion of their findings, if possible.


The analysis of the expert interviews fell a little short compared to the gamer interviews (hardly more than a page in total). Was this intentional? I would have expected there to be a more in-depth integration of the group 1/2 interviews with the remarks of the experts, but I’m not sure whether it might be distracting from the purpose of the manuscript.


I had one final thought that I’d also like the authors to respond to, as I’m simply not certain whether they have given it any consideration already: one phenomenon that, I believe, many will recognize as they interact with people before and after (psycho)therapy is the dramatic change in the language patients use to describe their own experiences. That is, therapy, with its academic terminology and standardised manuals, can sometimes provide patients with a new and distinct vocabulary to reflect their sense of their condition.


I want to make clear here that I do not wish to suggest that the experiences they reported are in any way less “real” because of this potential effect; merely that the themes articulated by the participants might be shaped by the therapeutic process they went through, and not alone by their own subjective construction of their experiences with addiction. 


On page 25, the authors speculate whether the experience reports might have been different had they interviewed their subjects five years ago – I think this is an important reflection, which could be further explored by considering that aside from “interpreting the world with and through gaming”, their participants in group 1 also interpret their experiences with gaming addiction (and, thus, the world) through the lens of a therapeutic process (successful or not) that might not have begun five years ago (and which those in group 2 also probably did not experience).


This might, in fact, also explain some of the commonalities between statements by group 1 and the experts. If devices from psychotherapy shape the language of those seeking it, then it should be little surprise that those offering the devices express similar accounts of their functions and effects.


I hope this was not too convoluted. I noticed I found it difficult to express this in my second language – apologies if I added more confusion than clarity here. 



Malte Elson

Reviewed by , 14 Jul 2022

This is my first time reviewing a Stage 2 submission, so I am being guided (and will use subheadings to emphasise) the five key issues to consider (3.2) in the Peer Reviewers In 'Guide for Reviewers' ( Overall, I really enjoyed reading this paper. The findings, in particular, helped me to understand this complex phenomena and see it through the perspectives of different people.


Have the authors provided a direct URL to the approved protocol in the Stage 2 manuscript? Did they stay true to their protocol? Are any deviations from protocol clearly justified and fully documented?

I cannot see a link to the approved protocol. As far as I know, this will be the first Registered Report for a qualitative study. As such, is it worth editing the method section (and perhaps also the abstract) to mention this and provide appropriate links?


The Stage 2 stays true to the Stage 1 submission except for the longitudinal part of the study (the text that is red in the protocol/Stage 1 manuscript), which is absent. Is it worth asking that the longitudinal part is submitted as a linked Stage 1? I appreciate this assumes the researchers have the resources, so perhaps it could be a recommendation along with a requirement to add a note about the plans for the longitudinal aspect?


Is the Introduction in the Stage 1 manuscript (including hypotheses) the same as in the Stage 2 manuscript? Are any changes transparently flagged?

As far as I can tell, they are the same except for the longitudinal part of the study (the text that is red in the protocol/Stage 1 manuscript), which is absent.


Did any prespecified data quality checks, positive controls, or tests of intervention fidelity succeed?

NA. I note that the manuscript talks about data being shared on the Finnish Data Archive. This archive was easy to find and, coincidentally, the data has just been published (Karhulahti, Veli-Matti (University of Jyväskylä) & Nerg, Henri (University of Jyväskylä) & Päivinen, Antti (University of Jyväskylä): Interviews on Playing Video Games during the COVID-19 Pandemic 2020 [dataset]. Version 1.0 (2021-06-17). Finnish Social Science Data Archive [distributor].


Are any additional post hoc analyses justified, performed appropriately, and clearly distinguished from the preregistered analyses? Are the conclusions appropriately centered on the outcomes of the preregistered analyses?

While I would not recommend any additional analyses, is it worth mentioning plans for the longitudinal analysis? The discussion and conclusions


Are the overall conclusions based on the evidence?



Peter Branney