How do intensive gaming experiences evolve over time in clinical and non-clinical contexts?

ORCID_LOGO based on reviews by Peter Branney and Michelle Carras
A recommendation of:

Life Thinning and Gaming Disorder: A Longitudinal Qualitative Registered Report


Submission: posted 15 May 2023
Recommendation: posted 14 August 2023, validated 14 August 2023
Cite this recommendation as:
Chambers, C. (2023) How do intensive gaming experiences evolve over time in clinical and non-clinical contexts?. Peer Community in Registered Reports, 100466. 10.24072/pci.rr.100466

This is a stage 2 based on:


Over the last 5 years the inclusion of “gaming disorder” in the ICD-11 been controversial (Van Rooij et al, 2018), mirroring wider public debate 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. (2023) tackle this question in the second of two Stage 2 Registered Reports associated with their previous programmatic Stage 1 submission. Using interpretative phenomenological analysis, the authors undertook in-depth interviews over a 1-year period with treatment-seeking participants (N=5) and esports-playing participants (N=4) who did not experience gaming-related health problems. The authors sought to answer the folllwing primary question: How do the experiences and meanings of playing videogames—shaped by the individuals’ diverse sociocultural contexts—evolve in those with related health problems (as defined by treatment-seeking) and those who play esports games several hours per day while self-reporting no related health problems?
Both groups exhibited intense relationships with gaming that were cyclical over time across various dimensions, with fluctuations occurring in response to changes in health, occupation, and social networks. The observed variation over time was substantial, with individuals attaching and detaching from games involving hundreds or thousands of hours. The authors report treatment-seeking being followed by a search of new gaming and life meanings, while intensive gaming without related problems continued as an integrated part of the self, with resilience adapting and evolving in the face of unexpected life events. Taking into account their findings, the authors propose life thinning and resilience integration processes to help describe and explain how some individuals end up seeking treatment for their gaming, while for others gaming supports them and becomes integrated into their identity.
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 (2023). Life Thinning and Gaming Disorder: A Longitudinal Qualitative Registered Report [Stage 2 Registered Report], acceptance of Version 2 by 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:

Version of the report: 1

Author's Reply, 29 Jul 2023

Download author's reply Download tracked changes file

Please note that additional tracked changes made by an external proofreading expert are found here:

Decision by ORCID_LOGO, posted 21 Jun 2023, validated 21 Jun 2023

Two of the reviewers who evaluated your programmatic Stage 1 submission returned to assess this second Stage 2 output. Both reviews are positive and the submission is close to fully meeting the Stage 2 criteria. There are some useful comments to consider regarding data availability, various changes to the rationale and other study aspects relative to the Stage 1 submission (which are understandable given the programmatic qualitative nature of this work -- but still in need of clarification with the reviewer), and additional theoretical issues to consider in the Discussion. A thorough revision and response should be sufficient to achieve final Stage 2 acceptance.

Reviewed by , 06 Jun 2023

Please see attached

Download the review

Reviewed by ORCID_LOGO, 15 Jun 2023

Thanks for the opportunity to review this Registered Report at Stage 2. As a longitudinal study, this is the second Stage 2 report I have reviewed. The first Stage 2 report was the first set of data (DOI: 10.1525/collabra.38819) and this current report includes data from one-year follow up. 

I have two potential conflicts of interest that I want to declare. First, I have recently published with Karhulahti (10.12688/openreseurope.15532.1). Indeed, the topic of the publication - registered reports of qualitative research - was sparked from my role reviewing the Stage 1 and and first Stage 2 reports for this longitudinal study (DOI: 10.1525/collabra.38819). Second, I was a co-editor of a special section in the British Journal of Social Psychology (DOI: 10.1111/bjso.12628) in which Karhulahti published a paper (DOI: 10.1111/bjso.12573). If I recall correctly, Karhulahti and I discussed the risks of collaboration to the Stage 2 review and only worked on the 'primer' paper once the first Stage 2 paper had been completed and reviewed. I am tempted to share that the presence of conflicts of interest at this point of this longitudinal registered report is, for me, a happy coincidence. Nevertheless, it is perhaps less coincidence than a confluence of forces that sees qualitative researchers and open science taking an interest in each other and the new technologies of registered reports and open review, where reviewer and reviewed get to learn something about each others interests and perspectives at the early stage of a project. I share this information so that you, dear reader can judge my review.

Below, I have structured my review according to the criteria for assessing a Registered Report at Stage 2 from PCI RR (accessed 2023-05-27; [PCI Registered Reports (](

# 2A. Whether the data are able to test the authors’ proposed hypotheses (or answer the proposed research question) by passing the approved outcome-neutral criteria, such as absence of floor and ceiling effects or success of positive controls or other quality checks.

** This criterion addresses whether the data quality is sufficient to be able to test the stated hypotheses, according to the pre-specified conditions in 1E. Since not all protocols are able to pre-specify outcome-neutral tests, this assessment is not relevant to all forms of RRs. Where it is relevant and pre-specified, it is possible that the failure of a crucial outcome-neutral test could, in severe circumstances, lead to the rejection of a Stage 2 manuscript. **

The paper reports that the data has been submitted to an archive but no citation is provided, so it is presumably not available at the time of this Stage 2 report was submitted. The Stage 2 baseline report has a data availability statement clarifying that the data is published in a Finish Social Science Data Archive and commenting on access requests. As far as I can tell, the Stage 2 baseline report does not provide bibliographic information (i.e. the citation) on this data archive. I appreciate that the review of the submission of the data to the Finish archive is a separate process to this Registered Report and it may well be a lengthy process. Nevertheless, the bibliographic information is important in making sure the data is accessible. Indeed, providing this bibliographic information in this Stage 2 registered report of the longitudinal data helps make the data accessible to its readers. Consequently, can I request the authors find a way to delay the final publication of this paper until the full bibliographic information of the data is available?

# 2B. Whether the ** introduction, rationale and stated hypotheses (where applicable) are the same as the approved Stage 1 submission.** 

**This criterion assesses whether the authors have remained consistent in their framing of the study at Stage 2. Aside from changes in tense (e.g. future tense to past tense), correction of typographic and grammatical errors, and correction of clear factual errors, the introduction, rationale and hypotheses of the Stage 2 submission must remain identical to those in the approved Stage 1 manuscript. To make any changes clear, authors are required to submit a tracked changes version of the manuscript at Stage 2.**

This paper mostly has the same rationale as the Stage 1 report but I would recommend elaborating on the differences.

First, I would recommend you elaborate that this is a 'new' Stage 2 report rather than an update to the original Stage 1 report. What I've learnt from my limited experience with registered reports is that the Stage 1 and Stage 2 reports are the same 'report' but that new unknown information is added at Stage 2. That is, the Stage 1 report comprises 1) the methodology and 2) the rationale for this before before we learned about the findings. In the Stage 2 report, the researchers put the methodology into practice and therefore add 1) what we found when we tried to do what we planned to do and 2) what we have learnt from these findings. The recommendation of PCI RR for the inclusion of a tracked changes version highlights that the researchers should be showing, and the reviewers should be mindful of, any changes between Stage 1 and 2. Indeed, I can look back at my comment on the revised Stage 1 submission and I am reminded that I mistakenly thought the 'final article' would be something new; "*You do mention about the challenge of word limit. I imagine that the final article will be much shorter but readers will benefit incredibly from access to your RR*" ([Phenomenological Strands for Gaming Disorder and Esports Play: A Qualitative Registered Report (]( Nevertheless, this Stage 2 report is a new document and I can understand that this is so because the baseline Stage 2 report has been completed and published (DOI: [10.1525/collabra.38819]( As such, we are in new territory, figuring out how to do Stage 2 reports when we are used to persuading journals to publish our work after study completion and we have little ability to change what we did. I do think this issue crops up throughout the paper as it's difficult a time to see if new detail is a posthoc addition. Consequently, can you succinctly explain why this Stage 2 report is as it is, perhaps ensuring you provide enough clarity that someone unfamiliar with, and indeed those familiar with, the Registered Report format?

Second, this one-year follow up Stage 2 report briefly paraphrases the rationale for this study (in the first Stage 1 report and the published Stage 2 report on the baseline data) that there is 1) contested notion that it is possible to diagnose people who have a 'gaming disorder' despite 2) a dearth of research about people who seek treatment for such a diagnosis. What is new to the rationale - and is highlighted in yellow - is the addition of the notions i) that gaming behaviour may be cyclical rather than continuous and ii) that gaming habits develop slowly. In addition, the term 'because' ("==because== ... we expect" and "==because== ... we do not expect"), indicates a chronological, linear logic that belies the retrospective way in which you learned this new information and updated your hypotheses. While highlighting these in yellow does to some extent help to indicate that they are new or distinct, I would challenge the wisdom of a posthoc update to your Stage 1 qualitative hypotheses in this particular way. I appreciate that in raising this point, I risk a response that you remove this update to your hypothesis, which will in turn be another posthoc change to your now Stage 2 report (i.e., if you delete the addition and make no mention of it, somehting about how this research developed will be hidden). I hope you can find a compromise where you keep the update while elaborating on why you made it in such a way that stays true to your Stage 1 report and is understandable to both those familiar and unfamiliar with Stage 2 reports.

# 2C. Whether the authors adhered precisely to the registered study procedures.

** This criterion assesses compliance with protocol. In cases where the preregistered protocol is altered after IPA due to unforeseen circumstances (e.g. change of equipment or unanticipated technical error), the authors must consult the PCI RR recommender immediately for advice, prior to the completion of data collection. Minor changes to the protocol may be permitted per recommender’s discretion. In such cases, IPA would be preserved and the deviation reported in the Stage 2 submission. If the authors wish to alter the study procedures more substantially following IPA but still wish to publish their article as a Registered Report then the manuscript must be withdrawn and resubmitted as a new Stage 1 submission. The outcome of all preregistered analyses must be reported in the manuscript, except in rare instances where a preregistered and approved analysis is subsequently shown to be logically flawed or unfounded. In such cases, the authors, reviewers, and recommender must agree that a collective error of judgment was made and that the analysis is inappropriate. In such cases the analysis would still be mentioned in the Stage 2 method but omitted with justification from the results. Additional unregistered analyses can also be included in a final manuscript (see 2D).

The description of the methodology mirrors the original Stage 1 report. From what I can tell - though apologies if I have missed it in the original Stage 1 report - the 1) detail of the types of changes (narrative change, etc.) and 2) the meeting of the coders are both new additions. Following my comment above about elaborating on the nature of this Stage 2 report, this is one area were the Stage 2 format risks suggesting that this detail was known in advance of the data collection. A deviation to the plan is noted in the methodology and I wonder if this is one way of explaining the way in which the research and researchers have developed since the original Stage 1 and Stage 2 baseline reports. It would be useful to ensure the elaboration resolves issues - the addition of new information that may or may not have been known in advance - such as these.

In the findings, where you write "(it was calculated)" can you provide a little more detail? Who, and how, was quitting Heikki's job calculated?

It is worth highlighting that cyclicity features in one of the themes and cyclicity was one of the additions to the qualitative hypothesis. Consequently, it is important to elaborate on how this new information featured in the development of the research after the Stage 1 report was given accepted-in-principle.

# 2D. Where applicable, whether any unregistered exploratory analyses are justified, methodologically sound, and informative.

** This criterion addresses the quality and value of any additional data analyses that are reported at Stage 2 but were not included in the registered Stage 1 submission. Such analyses are often highly valuable. For instance, a new analytic approach might become available between IPA and Stage 2 review, or a particularly interesting and unexpected finding may emerge. Alternatively, some unexpected characteristic of the data might suggest that the preregistered analyses, while bias-free, are not as sensitive as planned, and therefore a more sensitive post hoc analysis could be informative. Such analyses are admissible but must be clearly identified (e.g. through a separate heading in the Results for “Exploratory Analyses” or “Unregistered analyses”), justified, and appropriately caveated. Authors should also be careful not to base their conclusions entirely on the outcome of unregistered analyses.**

A deviation to the plan is noted in the methodology as arising from the Stage 2 baseline review as seems justified.

# 2E. Whether the authors’ conclusions are justified given the evidence.

** This criterion addresses whether the claims drawn by the authors in their conclusions (including in the Discussion, Abstract, and anywhere else in the paper) are warranted by the data or evidence in hand. 

Note that PCI RR recommendation decisions will never be based on the perceived importance, novelty, or conclusiveness of the results.**


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