• Jordan Hill

Asian Journal of Psychiatry

Letter to the Editor

Case report on implication of E-sport for changing platform of expression of bullying

Dear Sir,

Cyber bullying is currently becoming a major area of concern especially as internet is becoming the part and parcel of our lives. There seems to be a dearth in the literature for understanding cyber bullying in gaming environments (Cotler et al., 2017). Gaming behaviour, both online and offline has been defined as a disorder by World Health Or- ganization in the draft version of the International classification of diseases (ICD-11) (Saunders et al., 2017). In a very basic form bullying involves a bully and a victim. The mode of bullying has also taken a turn from real life bullying (traditional) to using technology as a medium for bullying. Although the prevalence of cyber bullying is lower than traditional bullying. However, both types of bullying highly correlate with each other (Modecki et al., 2014). The cyber bullying statistics in India reveal that 8% indulged in cyber bullying and 17% were victims of the same (Sharma et al., 2017). Studies find that cyber bullying has far more impact than traditional bullying as it reaches a wide range of individuals in the social network and stays in the online world for a long period of time. Both type of bullying leads to psy- chological disturbance in the victim (Nixon, 2014). A case presented to SHUT (Service for Healthy Use of Technology) clinic for management of excessive use of gaming and low mood states.

19 Year old user, dropped out from college, coming from upper socioeconomic status, nuclear family started playing Multiplayer online battle arena games from the age of 15 years. Initially user used to play 2 to 3 h a day. It was later increased to 8 to10 h a day. The reasons for playing games were boredom, loneliness and free time. It used to give him the feeling of worthiness which he was not getting from the en- vironment. He reported occasionally experience of bullying from other online gaming team members. It used to be in the form of passing sarcastic remarks about user’s game play, user’s previous failures in games; losing games due to user poor play; comments about user’s in- tellectual ability and advising user to quit. User informed it was common to have this type of bullying in online gaming. This bullying led to him feeling sad and lowered his self-esteem. User used strategies to manage the online bullying. It included muting their voice; ignoring them & continuing to play; distraction; change the team and not playing for some hours. Premorbidly, he had personality which was sensitive to criticism. He started feeling low secondary to bullying. Clinical as- sessment corroborated the same. The individual is currently undergoing weekly sessions of cognitive behavioral interventions which are focused on behavioral modification, cognitive restructuring and relapse pre- vention strategies. The individual has achieved substantial decrease in time spent on online gaming.

SHUT (Service for Healthy Use of Technology) Clinic gets 7–8 cases per week with problems of gaming. Every third treatment seeker for gaming problems reports experiencing cyberbullying from online gaming participants. Since India is an emerging market for E-sport, there is dearth of national increase seen in number of gamers in the young adult age group, cy- berbullying especially in online gaming formats puts young people at risk for developing psychiatric caseness (Holfeld and Sukhawathanakul, 2017). Trolling also happen in online gaming (Thacker and Griffith, 2012). It also implies development of interventions for promotion of cyber resilience among youth.

Compliance with ethical standard

There was no conflict of interest in relation to present work as well as informed consent of the human subjects had been taken prior to inclusion in the study.

Conflict of interest

Authors of the paper did not have any conflict of interest. All authors involved in this research communication do not have any financial and personal relationships with other people or organi- zations that could inappropriately influence (bias) their work.

Statement of human right

The studies have been approved by the Institutional and/or national research ethics committee.

Ethic statement

The paper has address the following headings:

Authorship of the paper: Authors made a significant contribution to the conception, design, execution, or interpretation of the reported Originality study. and plagiarism: It was author original work and other authors work has been appropriately cited or quoted. Data access and retention: I am willing to provide the raw data in connection Multiple, redundant with a paper or for editorial review in case asked for. concurrent publication: It has not been submitted Acknowledgement else where of for sources: publication. Proper acknowledgment of funding agency Disclosure mentioned and conflicts of interest: it was mentioned Fundamental errors in published works: I would report to editor in case of any error Reporting standards: It was followed Hazards and human or animal subjects: Not applicable Use of patient images or case details: Institute ethics committee approval and informed consent was documented.


Department of Health Research, Indian council of Medical Research,Delhi, India grant awarded to Dr Manoj Kumar Sharma.


Cotler, J.L., Fryling, M., Rivituso, J., 2017. Causes of cyberbullying in multi-player online

gaming environments: gamer perceptions. J. Inf. Syst. Appl. Res. 10 (1), 4. Holfeld, B., Sukhawathanakul, P., 2017. Associations between internet attachment cyber victimization, and internalizing symptoms among adolescents. Cyberpsychol. Behav. Soc. Netw. 20 (2), 91–96. Modecki, K.L., Minchin, J., Harbaugh, A.G., Guerra, N.G., Runions, K.C., 2014. Bullying prevalence across contexts: a meta-analysis measuring cyber and traditional bullying. J. Adolesc. Health 55 (5), 602–611. Nixon, C.L., 2014. Current perspectives: the impact of cyberbullying on adolescent health.

Adolesc. Health Med. Ther. 5, 143. Saunders, J.B., Hao, W., Long, J., King, D.L., Mann, K., et al., 2017. Gaming disorder: its delineation as an important condition for diagnosis: management and prevention. J. Behav. Addict. 6, 271–279. Sharma, D., Kishore, J., Sharma, N., Duggal, M., 2017. Aggression in schools: cyberbullying and gender issues. Asian J. Psychiatry 29, 142–145. Thacker, S., Griffith, M., 2012. An exploratory study of trolling in online video gaming.

Int. J. Cyber Behav. Psychol. Learn. 2 (4), 17–33.

Manoj Kumar Sharma⁎ Dept of Clinical Psychology, SHUT Clinic (Service for Healthy Use of Technology), National Institute of Mental Health & Neurosciences, Bengaluru, Karnataka, India E-mail address:

Nitin Anand Department of Clinical Psychology, National Institute of Mental Health & Neurosciences, Bengaluru, Karnataka, India E-mail address:

Varghese Mathew SHUT Clinic (Service for Healthy Use of Technology), National Institute of Mental Health & Neurosciences, Bengaluru, Karnataka, India E-mail address: