We use ethnographically informed survey and interview data to explore therapeutic and problematic play in the online World of Warcraft (WoW). We focus on how game-play in WoW is driven by shared and socially transmitted models of success that we conceptualize as cultural ideals. Our research reveals associations between having higher online compared to offline success, on the one hand, and gamers’ reports about how their play both adds to and subtracts from their mental wellness, on the other. Fusing William Dressler’s notion of “cultural consonance” (an individual’s relative consistency with his or her culture) with Leon Festinger’s “cognitive dissonance” (the tendency of individuals to suffer distress when they cannot eliminate incompatibilities in conflicting beliefs and attitudes), we develop the notion of “cultural dissonance,” which in this context refers to how conflicts between online and offline lives, and also subsequent attempts to minimize the conflicts through psychological negotiations, impact gamers’ mental health.
Jeffrey Snodgrass is a professor of cultural anthropology at Colorado State University. He is currently investigating the cultural therapeutics of inhabiting enchanted and sacred places. He is exploring the therapeutic and addictive dimensions of Internet-based virtual game-worlds to understand how these online environments facilitate immersive and even altered “dissociative” experiences, which, by promoting or relieving stress, are linked to both positive and negative health outcomes. His lab is currently in the online game, Guild Wars 2, developing an ethnographically-sensitive measure of “Intensive MMO Involvement.” In contrast to other online “addiction” scales, this measure will include both positive benefits of such involvement alongside negative consequences. In addition, in India, he is working to understand how loss of access to forest spaces and resources impact Indigenous peoples’ health and systems of healing, research funded by the National Science Foundation.
Francois Dengah is an assistant professor of cultural anthropology at Utah State University, specializing in biocultural medical anthropology. His interests include the relationship between cultural expectations, behaviors, and health outcomes. Along these lines, he conducts research with Brazilian Pentecostals, examining how religion (as a cultural system) shapes coping resources and communal expectations which contribute to both salubrious and deleterious health outcomes. Additionally, he has been exploring how computer and video gamers negotiate the cultural demands placed on them by virtual communities and the “real world,” and how such involvement can lead to differential psychological health outcomes.
Michael G. Lacy is an associate professor of sociology at Colorado State University, who specializes in research methods and statistical analysis.
Selected additional publications by the authors
Online Virtual Worlds:
Snodgrass, J.G. (2014). “Ethnography of Online Cultures.” In: Handbook of Methods in Cultural Anthropology, 2nd Edition. Pp. 465-495. Eds., H. Russell Bernard and Clarence C. Gravlee. London: Rowman & Littlefield.
Snodgrass, J. G., Lacy, M. G., Dengah II, H. J. F., Eisenhauer, S., Batchelder, G., & Cookson, R. J. (2014). A Vacation from Your Mind: Problematic Online Gaming Is a Stress Response. Computers in Human Behavior, 38, 248-260.
Snodgrass, J. G., Dengah II, H. J. F., Lacy, M. G., & Fagan, J. (2013). An Anthropological View of “Motivation” Models of Problematic MMO Play: Achievement, Social, and Immersion Factors in the Context of Culture. Transcultural Psychiatry , 50(2), 235-262.
Snodgrass, J. G., Dengah II, H. J. F., Lacy, M. G., Fagan, J., Most, D., Blank, M., Howard, L., Kershner, C. R., Krambeer, G., Leavitt-Reynolds, A., Reynolds, A., Vyvial-Larson, J., Whaley, J., & Wintersteen, B. (2012). Restorative magical adventure or Warcrack?: Motivated MMO play and the pleasures and perils of online experience. Games and Culture, 7(1), 3-28.
Snodgrass, J. G., Dengah II, H. J. F., Lacy, M. G., & Fagan, J. (2011). Cultural Consonance and Mental Wellness in the World of Warcraft: Online Games as Cognitive Technologies of “Absorption-Immersion.” Cognitive Technology, 16(1), 11-23.
Snodgrass, J. G., Lacy, M. G., Dengah II, H. J. F., & Fagan, J. (2011). Enhancing One Life Rather than Living Two: Playing MMOs with Offline Friends. Computers in Human Behavior, 27(3), 1211-1222.
Snodgrass, J. G., Dengah II, H. J. F., Lacy, M. G., Fagan, J., & Most, D. (2011). Magical flight and monstrous stress: Technologies of absorption and mental wellness in Azeroth. Culture, Medicine, and Psychiatry, 35(1), 26-62.
Culture and health:
Dengah II, H.J.F. (2014). How Religious Status Shapes Psychological Well-being: Cultural Consonance as a Measure of Subcultural Status. Social Science and Medicine, 114, 18-25.
Dengah II, H.J.F. (2013). The Contract with God: Patterns of Cultural Consensus across Two Brazilian Religious Communities. Journal of Anthropological Research, 69(3), 347-372.
Snodgrass, J.G. (2015). “Festive Fighting and Forgetting: Ritual and Resilience among Indigenous Indian ‘Conservation Refugees.’” In: Global Mental Health: A Narrative Reader. Eds., Brandon Kohrt and Emily Mendenhall. Walnut Creek: Left Coast Press.
Zahran, S., Snodgrass, J.G., Maranon, D., Upadhyay, C., Granger, D., & Bailey, S. (2015). “Stress and Telomere Shortening Among Central Indian Conservation Refugees.” Proceedings of the National Academy of Sciences. Online in Early Edition Feb. 16th, 2015.
If you liked this article, you might also be interested in the previously published articles in Medical Anthropology Quarterly on cultural consonance by William Dressler (2001) Medical Anthropology: Toward a Third Moment in Social Science?, Dennis Wiedman’s (2012) Native American Embodiment of the Chronicities of Modernity: Reservation Food, Diabetes, and the Metabolic Syndrome among the Kiowa, Comanche, and Apache, Thomas W. McDade’s (2002) Status Incongruity in Samoan Youth: A Biocultural Analysis of Culture Change, Stress, and Immune Function, and Benjamin Blakely Brooks’ (2014) Chucaque and Social Stress among Peruvian Highlanders.
In addition, consider the previously published Medical Anthropology Quarterly articles on addiction by Marcus Aurin (2000) Chasing the Dragon: The Cultural Metamorphosis of Opium in the United States, 1825-1935, Gilbert Quintero and Sally Davis’ (2002) Why Do Teens Smoke? American Indian and Hispanic Adolescents’ Perspectives on Functional Values and Addiction, Mimi Nichter’s (2004) Smoking as a Weight-Control Strategy among Adolescent Girls and Young Women: A Reconsideration, and John F. Garrity’s (2000) Jesus, Peyote, and the Holy People: Alcohol Abuse and the Ethos of Power in Navajo Healing.
Interview with the authors
1. There is a distinction in the effects of gaming between men and women. How do you interpret this? You hypothesize that for women they don’t experience the same levels of dissonance as they experience identity freedom in the gaming world. Might there be other factors that cause men and women to respond differently to online gaming?
An important question. The more we research these online worlds, the more we realize how deeply patriarchal they are. One only need consider the current Gamergate controversy as evidence of this, or that MMOs gamers are typically male, approximately 75%. As such, both the online and the offline cultural norms we discuss in this paper are patriarchal as well, and non-male gamers – women and transgendered individuals – would not experience them in the same way as men. This gives rise to all sorts of complications and interesting new questions. For example, straightforwardly, women might feel excluded from these online worlds, and thus not be driven to succeed in them in the same manner as men. Or, they might see new opportunities, playing male avatars and trying to more or less “pass” as male, with potential status benefits but also hidden costs. Our data didn’t show substantial associations between gender and cultural dissonance (see Tables 3 & 4 and footnote 3). This could be related to the size and particular composition of our non-random sample. These gender issues could be explored using the techniques we discuss in our paper. The topic is on our lab’s radar, a frequent focus of student research in Snodgrass’ virtual worlds methods classes, and we would also encourage others to pursue the matter.
Questions for classroom discussion
1. How might the results of this study be different, or the same, if data were collected in a non-North American setting?
2. It is known that many non-Western gamers in East Asia and other parts of the world play MMOs and other games in Internet cafes. How might such contexts shape the manner these games impact mental health and well-being?
3. This article focuses more on the negative effects of Internet gaming. Could Internet gaming be used as a tool for healing, as therapy, and in what regard?
4. Do you agree with the researchers that Internet gamers share a distinct culture? What are the unique attributes of this culture and how are they distinct from your own? Is “sub-culture” a better term?
5. The authors discuss stress in this article – both the manner that online games produce and also can relieve stress and distress. What methods did the authors use to assess gamers’ stress levels? What other methods might they have employed?
6. Biomarkers such as galvanic skin response, pulse, blood pressure, and even cortisol levels can be used to assess and measure stress. How might such measures have been integrated into this project? Might these more “objective” measures have further enhanced the ethnographic findings?
Ethnographies and book-length case studies of online gaming and closely related topics:
Bainbridge, W. S. (2012). The Warcraft civilization: social science in a virtual world. Cambridge, MA: MIT Press.
Boellstorff, T. (2008). Coming of age in Second Life: An anthropologist explores the virtually human. Princeton, NJ: Princeton University Press.
Boellstorff, T., Nardi, B., Pearce, C., & Taylor, T. L. (2012). Ethnography and virtual worlds: A handbook of method. Princeton, NJ: Princeton University Press.
Boyd, D. (2014). It’s Complicated: the social lives of networked teens. Yale, CT: Yale University Press.
Castronova, E. (2008). Synthetic worlds: The business and culture of online games. Chicago, IL: University of Chicago Press.
Corneliussen, H., & Rettberg, J. W. (2008). Digital culture, play, and identity: A World of Warcraft reader. Cambridge, MA: MIT Press.
McGonigal, J. (2011). Reality is broken: Why games make us better and how they can change the world. London: Penguin.
Nardi, B. (2010). My life as a night elf priest: An anthropological account of World of Warcraft. Ann Arbor: University of Michigan Press.
Pearce, C., Boellstorff, T., & Nardi, B. A. (2011). Communities of play: Emergent cultures in multiplayer games and virtual worlds. Cambridge, MA: MIT Press.
Schüll, N. D. (2012). Addiction by design: Machine gambling in Las Vegas. Princeton, NJ: Princeton University Press.
Stromberg, P. (2009). Caught in play: How entertainment works on you. Redwood City, CA: Stanford University Press.
Taylor, T. L. (2009). Play between worlds. Cambridge, MA: MIT Press.
To better understand how the psychiatric establishment is currently thinking about “Internet Gaming Disorder,” see:
American Psychiatric Association. (2013). Internet Gaming Disorder, DSM 5.
Block, J. (2008). Issues for DSM-V: Internet addiction. American Journal of Psychiatry, 165(3), 306–307.
Caplan, S., Williams, D., & Yee, N. (2009). Problematic Internet use and psychosocial well-being among MMO players. Computers in Human Behavior, 25(6), 1312–1319.
Cecilia, C., & Yee-lam, L. A. (2014). Internet Addiction Prevalence and Quality of (Real) Life: A Meta-Analysis of 31 Nations Across Seven World Regions. Cyberpsychology, Behavior, and Social Networking, 17(12), 755-760. doi:10.1089/cyber.2014.0317.
Charlton, J. P., & Danforth, I. D. (2007). Distinguishing addiction and high engagement in the context of online game playing. Computers in Human Behavior, 23(3), 1531–1548.
Chee, F., & Smith, R. (2005). Is electronic community an addictive substance? An ethnographic offering from the EverQuest community. In: Interactive Convergence in Multimedia – Probing the boundaries, Volume 10. Pp. 137-156. Eds., S. Schaffer & M. Price. Freeland: The Inter-Disciplinary Press.
Davis, R. A. (2001). A cognitive-behavioral model of pathological Internet use. Computers in Human Behavior, 17(2), 187–195.
Freddolino, P. P., & Blaschke, C. M. (2008). Therapeutic Applications of Online Gaming. Journal of Technology in Human Services, 26(2-4). doi: 10.1080/15228830802099998.
Griffiths, M. (1999). Internet addiction: fact or fiction? The Psychologist.
Griffiths, M. (2005). A ‘components’ model of addiction within a biopsychosocial framework. Journal of Substance Use, 10(4), 191–197.
Kardefelt-Winther, D. (2014a). A conceptual and methodological critique of internet addiction research: Towards a model of compensatory internet use. Computers in Human Behavior, 31, 351–354.
Kardefelt-Winther, D. (2014b). The moderating role of psychosocial well-being on the relationship between escapism and excessive online gaming. Computers in Human Behavior, 38, 68–74.
Orsolya, K., Mark D., G., Róbert, U., Judit, F., Gyöngyi, K., Zsuzsanna, E., Domokos, T., & Zsolt, D. (2014). Problematic Internet Use and Problematic Online Gaming Are Not the Same: Findings from a Large Nationally Representative Adolescent Sample. Cyberpsychology, Behavior, and Social Networking, 17(12), 749-754. doi:10.1089/cyber.2014.0475.
Seay, A. F., & Kraut, R. E. (2007). Project massive: self-regulation and problematic use of online gaming. In: Proceedings of the SIGCHI conference on Human factors in computing systems, (pp. 829–838).
Scale 1: WoW Consonance (Cronbach’s Alpha = 0.86), Model and Cultural Consensus Answer Key
(7-point Likert Scale; 1:Not at all important, 7:Very Important)
- Plays their character, character class, and the game more generally with knowledge and skill 6.28
- Has succeeded, or will succeed, in some challenging game context—this could be “end-game” 25-man raids, PVP arena competitions, or winning an exalted reputation with multiple factions 4.90
- Intelligently “specs” their characters, wisely distributing points in class-specific talent trees that help them meet their particular game goals 6.17
- Acquires good gear for their characters—this could include epic gear that allows their characters to excel in arena competitions or raids, epic mounts, or some other type of gear 5.62
- Is adaptable, flexible, and a quick learner—this could include possessing the ability to make wise decisions under pressure 6.20
- Is a cooperative, respectful, and responsible team player—this means being attentive and responsive to other players’ goals and needs 6.13
- Is generous and helpful in ways that help their fellow players (such as those in one’s guild) meet their goals 5.41
- Excels at their chosen role, which they can play well in a variety of solo or cooperative group situations 6.38
- Demonstrates some degree of autonomy in the game—a good player of WoW is able and interested to independently solve some problems 5.22
- Is dedicated and committed to the game 3.63
- Plays a lot, putting in the hours necessary to succeed in the game 3.17
- Plays efficiently—a successful player uses their time in the game wisely so as to more efficiently achieve their goals 5.10
- Puts in the necessary hours of out-of-game research in order to succeed in their goals—this could mean visiting game websites in order to prepare for challenging game content 4.00
- Displays a healthy competitive spirit and a will to succeed 5.21
- Plays with confidence 5.44
- Plays with a positive attitude—this could mean remaining funny, courteous, and sociable in difficult game situations 5.99
- Enjoys the game 6.23
Scale 2: Real Life Success Scale (Cronbach’s Alpha = 0.91), Model and Answer Key
(5 point Likert-Scale; 1:Very Important, 5:Not at all Important)
Is smart and knowledgeable 1.66
- Is well educated 2.32
- Is wealthy and materially prosperous 3.36
- Is economically secure 2.54
- Has a good job and a satisfying career path 2.18
- Is dedicated and determined in pursuing their life goals 1.45
- Is well-liked and respected 2.39
- Has a good personality 2.34
- Has a good sense of humor 2.46
- Is generous 2.21
- Has satisfying family relationship 1.65
- Has a rich social life and network of friends 2.27
- Is responsible 1.63
- Is happy and satisfied with life 1.19
- Is healthy 1.62
- Is in good phsyical condition 2.15
- Enjoys a range of hobbies and leisure activites 2.28
- Finds tme to play and relax 1.72
- Lives everyday to its fullest 1.21
Scale 3: Valuing WoW vs. Real Life (Cronbach’s Alpha = 0.90)
- Some of my WoW friendships are as important to me as my real life friendships.
- I feel like I can be more “myself” with other people when I play WoW.
- I feel more comfortable making friends in WoW than I do in real life.
- People judge one another less in WoW.
- I get more support from my WoW friends than from my out-of-game friends.
- I feel greater obligations to my friends in WoW than to my out-of-game friends.
- Playing WoW has made me more comfortable in out-of-game social situations.
- Playing WoW has made me smarter in social situations.
- I have more power and influence over people in the WoW game-world than I do over people in the real world.
- I feel freer to take risks in WoW than in real life.
- WoW is more fair than the real world.
- The goals and social roles in WoW are clearer and more well-defined than those in the out-of-game world.
- As compared to the out-of-game world, WoW provides me with more opportunities to learn and grow.
- WoW is more colorful and exciting than the out-of-game world.
- WoW promotes values that are less common in the out-of-game world–such as honor, heroism, and generosity.
- Successes come more easily or more quickly in WoW than they do in real life.
- I feel that others appreciate me for my competence (knowledge, skills, and experience) more in WoW than they do in real life.
Scale 4: Problematic WoW Play Scale (Cronbach’s Alpha = 0.94)
- How often do you neglect household chores to spend more time WoW?
- How often do you prefer the excitement of WoW to intimacy with your partner?
- How often do you form new relationships with fellow WoW users?
- How often do others in your life complain to you about the amount of time you spend on WoW?
- How often do your grades or school work suffer because of the amount of time you spend on WoW?
- How often do you regret the amount of time you spend on WoW?
- How often does your job performance or productivity suffer because of WoW?
- How often do you become defensive or secretive when anyone asks you about WoW?
- How often do you block out disturbing thoughts about your life with positive thoughts related to WoW?
- How often do you find yourself anticipating when you will go on WoW again?
- How often do you fear that life without WoW would be boring, empty, and joyless?
- How often do you snap, yell, or act annoyed if someone bothers you while you are playing WoW?
- How often do you lose sleep due to late-night WoW playing?
- How often do you feel preoccupied with WoW when off-line, or fantasize about being on WoW?
- How often do you find yourself saying “just a few more minutes” when on WoW?
- How often do you try to cut down the amount of time you spend on WoW and fail?
- How often do you try to hide how long you are on WoW?
- How often do you choose to spend more time on WoW over going out with others?
- How often do you feel depressed, moody, or nervous when you are not playing WoW, which goes away once you are back on-line?