A study found that purchasing loot boxes in video games is associated with real-world gambling, video game addiction, and other mental health concerns.
The research, published in Computers in Human Behaviour, surveyed more than 1,400 adults who gamble and play online video games. It found that loot box buying shares similarities with other behavioural addictions, such as compulsive gambling and internet gaming disorder.
Loot boxes, which provide randomised virtual rewards in video games, have sparked debate over their similarities to gambling. Researchers from Flinders University, Nottingham Trent University, the University of Gibraltar, and ELTE Eötvös Loránd University in Hungary contributed to the study.
Professor Zsolt Demetrovics, co-author and Matthew Flinders professor in mental health and wellbeing, noted the growing concern surrounding loot box spending. “Players usually spend real-world money to get random virtual items, which may or may not yield a reward,” he said. “Many experts are already calling for loot box buying to be regulated by existing gambling laws.”
The study also examined the relationship between loot box purchases and mental health. It found that anxiety and impulsivity significantly strengthened the link between risky loot box buying and gambling symptoms. However, depression had a mixed effect on this relationship.
While few previous studies have explored loot box purchases and psychological distress, this global online survey provided new insights. Of the participants, 73% were male, and 64% reported playing video games more than once a week. A significant majority (96%) had bought loot boxes in the past year, with 41% making purchases more than once a week and 12.9% buying loot boxes four or more times a week.
Professor Mark Griffiths, director of the International Gaming Research Unit at Nottingham Trent University, said the findings could have implications for policy and clinical practice. “The data shows a clear relationship between depression and anxiety, both as a precursor or as an outcome of gambling severity, and this may also be similar for loot box buying because, although weaker, anxiety and depression were both associated with riskier loot box buying,” he said.
Cristina Villalba-Garcia from the University of Gibraltar added that further research into loot box spending and mental health is needed. “Although these findings should be interpreted with caution, we recommend that further research into these behaviours would ultimately be of great social and clinical relevance when it comes to minimising damage and regulating loot box buying under laws like those applied to gambling,” she said.
Researchers emphasised the importance of considering the impact of loot box purchases on mental health, particularly among vulnerable individuals. They also highlighted the need for increased public health awareness regarding behavioural addictions, such as gambling, gaming disorders, compulsive shopping, and problematic social media use.
A separate article in the American Journal of Psychiatry by Professor Demetrovics and colleagues warned that the rise of online accessibility has contributed to behavioural addictions, potentially worsening psychiatric conditions. The review outlined five types of behavioural addictions: gambling, internet gaming disorder, compulsive sexual behaviour, compulsive shopping, and excessive social media use.