# Does the loot box open the door to addiction? A case report of gaming disorder with high charges for loot box purchases

## TL;DR

This paper reports a case of gaming disorder linked to excessive spending on loot boxes, highlighting their addictive nature and financial impact.

## Contribution

The paper presents a novel case report connecting loot box use to gaming disorder and significant financial burden.

## Key findings

- Loot box purchases can lead to substantial financial costs and gaming disorder.
- The randomness of loot boxes activates reward systems similar to gambling.
- Understanding motivations and developmental factors is key to effective treatment.

## Abstract

A loot box is a gaming term for an electronic lottery that randomly provides items that enhance the gaming experience. In recent years, loot boxes have been increasingly discussed as a risk factor of gaming disorder (GD). While they may be purchased for a few dollars at a time, the cumulative expenses resulting from their addictive use have become a social problem.

This paper presents a case of GD involving a substantial financial burden incurred through the use of a Japanese loot box called Gacha.

The randomness in the selection of virtual items in loot boxes resembles gambling, triggering the reward system and contributing to an addiction to purchasing more loot boxes. For therapeutic purposes, understanding the motivations behind purchasing loot boxes and considering individual developmental characteristics are crucial to helping patients find satisfaction and a sense of achievement in activities besides gaming.