Extending classic anthropological “idioms of distress” research, we argue that intensive online videogame involvement is better conceptualized as a new global idiom, not only of distress but also of wellness, especially for emerging adults (late teens through the 20s). Drawing on cognitive anthropological cultural domain interviews conducted with a small sample of U.S. gamers ( N = 26 free-list and 34 pile-sort respondents) (Study 1) and a large sample of survey data on gaming experience ( N = 3629) (Study 2), we discuss the cultural meaning and social context of this new cultural idiom of wellness and distress. Our analysis suggests that the “addiction” frame provides a means for gamers to communicate their passion and commitment to online play, even furthering their enthusiasm for the hobby and community in the process, but also a way for players to express and even resolve life distress such as depression and loneliness. The American Psychiatric Association (APA) has recently included “Internet gaming disorder” (IGD) as a possible behavioral addiction, akin to gambling, warranting further consideration for eventual formal inclusion in the next iteration of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Our study leads us to suggest that clinicians only sparingly use IGD as a clinical category, given that medical and gamer understandings of “addictive” play differ so markedly. This includes better distinguishing positive online gaming involvement—also sometimes framed by gamers as “addictive”—from other play patterns more clearly entailing distress and dysfunction.
Background
Firearms are common in the households of persons with Alzheimer disease and related dementias (ADRD). Safety in Dementia (SiD) is a free web-based decision aid that was developed to support ADRD caregivers in addressing firearm access.
Objective
We aimed to evaluate the feasibility and acceptability of SiD among a web-based sample of ADRD caregivers.
Methods
SiD was tested in 2 phases by using participants who were recruited from a web-based convenience sample (Amazon Mechanical Turk participants). In phase 1, caregivers were randomized to view either the intervention (SiD) or the control (Alzheimer’s Association materials), and the blinding of participants to the study arms was conducted. In phase 2, caregivers of individuals with ADRD and firearm access were recruited; all of these participants viewed the firearm section of SiD. In both phases, participants viewed SiD independently for as long as they wanted. Measures for evaluating decision-making and SiD acceptability were used, and these were assessed via a self-administered web-based questionnaire.
Results
Participants were recruited for phases 1 (n=203) and 2 (n=54). Although it was feasible to collect the study outcome data in a web-based format, in phase 1, there were no significant differences between SiD and the control in terms of decision-making and self-efficacy. The majority (137/203, 67.5%) of phase 1 participants spent between 5 and 10 minutes reviewing the resources. In phase 2, 61% (33/54) of participants spent 5 to 10 minutes viewing the firearm section, and 31% (17/54) spent 10 to 20 minutes viewing this section. Usability and acceptability were high across the phases.
Conclusions
SiD represents a new resource for promoting safety among people with dementia, and high acceptability was achieved in a pilot trial. In this sample, SiD performed similarly to Alzheimer’s Association materials in supporting decision-making and self-efficacy.
to improve safety, offering both information to make decisions and practical suggestions for next steps. Additional testing of SiD is needed to evaluate its effects on behavior change and outcomes for both caregivers and people with dementia, as well as to identify the best methods for dissemination to at-risk populations. The development of tools like SiD offers the potential to support caregivers, the people they care for, and the community in promoting health while respecting independence and individual rights.
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