NAME: AGE: GENDER: ADDRESS: 1. Are you playing computer games? 2. How many ours !i! you spen! playing computer games a !ay? 1"2 ours #"$ ours 2.%ours oters %. &at type o' computer game you are intereste! in? (. &at !o you play games on? Des)top computer &e*"ena*le me!ia player +suc as ,-o!/aptop Mo*ile pone 0a*let oter #. Do you a e intense 'eeling wile gaming? es No $. Do you 'eel irrita*le an! restless wen away 'rom te game 'or some !ays? es No 3. Do you get angry wen someone stop or interrupts you wile you4re in a game? es No 5. Do you *ecome irritate! an! !e'ensi e wen some people suggest you migt *e gamming too muc? ,' 6yes7 state wy. 8. Ha e you stolen money 'or gaming? es No 19.&en controlling your computer usage a e you e er 'elt any o' te 'ollowing? An;iety oter Restless ,rrita*ility ,nsomnia Hea!ace Depression 11.Do you tin) your relationsip to your 'amily is a<ecte! wen you play computer games? &y? 12.Do you want to spen! more time in computer games rater tan to a e a =uality time wit your 'rien!s an! 'amily? Always Sometimes Ne er 1%.Do you agree tat playing computer game will a<ect your *ea ior? &y? 1(.&at !o you get 'rom playing computer games? Sel' en>oyment Sel' satis'actory ter +pls. speci'y
1. Are you playing computer games?2. How many hours did you
spend playing computer games a day? 1-2 hours 5-6 hours2-3 hours
others3. What type of computer game you are interested in?4. What
do you play games on? Desktop computer Web-enable media player
(such as IPod) Laptop Mobile phone Tablet other5. Do you have
intense feeling while gaming? Yes No6. Do you feel irritable and
restless when away from the game for some days? Yes No7. Do you get
angry when someone stop or interrupts you while youre in a game?
Yes No8. Do you become irritated and defensive when some people
suggest you might be gamming too much? If yes state why.
9. Have you stolen money for gaming? Yes No10. When controlling
your computer usage, have you ever felt any of the following?
Anxiety other Restless Irritability Insomnia Headache Depression11.
Do you think your relationship to your family is affected when you
play computer games? Why?
12. Do you want to spend more time in computer games rather than
to have a quality time with your friends and family? Always
Sometimes Never 13. Do you agree that playing computer game will
affect your behavior? Why?
14. What do you get from playing computer games? Self enjoyment
Self satisfactory Other (pls. specify)
15. Do you consider yourself as a computer games addict?
Why?
