Excessive Spending in a “Free‐to‐Play” Smartphone Game

Abstract

Background and Objectives Although gaming disorder is increasingly recognized, there has been limited consideration of the impact of free‐to‐play games with in‐game purchases, also called microtransactions. Methods Case report (n = 1). Results A patient with posttraumatic stress disorder, major depressive disorder in remission, polysubstance use disorders in remission, and opioid use disorder on buprenorphine/naloxone developed gaming disorder (based on International Classification of Diseases, 11th revision) and spent up to 40% of his monthly income on microtransactions within a smartphone game. Treatment consisted of relinquishing access to electronic payment mechanisms, motivational interviewing, and couples therapy. Discussion and Conclusions The case highlights how in‐game purchases may cause patients with gaming disorder to experience financial consequences, and the need for further characterization of the clinical ramifications of microtransactions. Scientific Significance To the best of our knowledge, this is the first report in the medical literature of a patient with gaming disorder developing excessive in‐game spending from expenditures on microtransactions. (Am J Addict 2020;29:528–530)

“These People Had Taken Advantage of Me”: A Grounded Theory of Problematic Consequences of Player Interaction with Mobile Games Perceived as “Designed to Drive Spending”

“…Indeed, our sample demonstrates some behaviours which correspond to the DSM criteria for gaming disorder: for example, preoccupation with gaming, deceiving family members, and giving up other activities. Our findings are also similar to previous explorations of rich data, such as the Kleinman and Das [50] case study of a patient with PTSD and depression, who felt achievement and pride from advancing in Candy Crush via in-game spending, resulting in increasing expenses. The patient experienced emotional consequences (shame and guilt), social (problems in his marriage), and financial.…”

“…The patient experienced emotional consequences (shame and guilt), social (problems in his marriage), and financial. Interestingly, Kleinman and Das Human Behavior and Emerging Technologies [50] discuss their beliefs that the patient in question had several features of gaming disorder and links the design of microtransaction-based models to financial consequences particularly for such individuals.…”