Is “Gaming Addiction” For Real?

Scott Wallace PhD
Sep 19, 2019 · 4 min read
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Following the formal categorization of “Gaming Disorder” by the World Health Organization, a number of prominent addictions and mental health experts loudly voice disagreement…worrying that this categorization is grounded more in moral concerns that evidence-based science, the symptoms are not clearly defined, and there is no designation treatment.

The World Health Organization earlier this year classified “gaming disorder” as a diagnosable condition, officially classifying “Gaming Disorder” as an “addictive behavior” included under the umbrella of “mental, behavioral, or neurodevelopmental disorders” in the ICD-11. Overall, the main characteristics are very similar to the diagnostic features of substance use disorders and gambling disorder, another category of clinical conditions which are not associated with a psychoactive substance use but at the same time being considered as addictions.

But it’s a stance contested by some mental health professionals.

“There was a fairly widespread concern that this is a diagnosis that doesn’t really have a very solid research foundation,” says Christopher Ferguson, a psychologist and media researcher at Stetson University in DeLand, Fla. And psychologist Anthony Bean, executive director at The Telos Project, a non-profit mental health clinic in Fort Worth, Texas, counts himself as a member of the camp that opposes inclusion of gaming disorder in the ICD, claiming that people who obsessively game may be using it “more as a coping mechanism for either anxiety or depression.”

The ICD diagnosis is not “appropriately informed,” Dr. Bean said, since most clinicians — and the mental health field as a whole — do not understand the gaming population.

The criteria being used by WHO to define gaming disorder in the ICD are “too broad,” while the mild, moderate or severe versions of the disorder have not been adequately delineated. Diagnosing a patient with gaming disorder, then, would be based on the “very subjective experience of clinicians…and most clinicians would probably agree that they don’t understand the concept for video games because they’re not immersed in that world or experience.”

The American Psychiatric Association held to its earlier position that there was not “sufficient evidence” to consider gaming addiction as a “unique mental disorder.” So did the The Society for Media Psychology and Technology, a division of the American Psychological Association, which earlier this year released a policy statement expressing concern about the WHO’s proposal, saying, “the current research base is not sufficient for this disorder.”

Medical professionals are more focused on the reason causing the behaviour than the behaviour of playing video games itself, said Heather Senior Monroe, director of program development at Newport Academy, which has treatment centers for teens struggling with mental health issues in California, Connecticut and Pennsylvania. “The main characteristics are very similar to substance abuse disorder and gambling,” she said.

The behaviour is like any other self-harming behavior — a way to escape reality…the treatment is then about why. Why does that person want to escape their reality so much?

The issue reflects one of the broader controversies around new ICD versions — they’ve been getting more and more specific (the previous iteration, ICD-10, contained a whopping 68,000 billing codes, or more than five times the number in ICD-9.)

Consider some of these (quite unusual, and hopefully rare?) ICD-11 codes:

  • V97.33XD: Sucked into jet engine, subsequent encounter. (note: “subsequent”? Meaning it happened before??)
  • V00.01XD: Pedestrian on foot injured in collision with roller-skater, subsequent encounter.
  • W55.41XA: Bitten by pig, initial encounter.

Ultimately, WHO hopes that inclusion of gaming disorder in the classification will stimulate debate as well as further research and international collaboration. The expectation is that the classification of gaming disorder means health professionals and systems will be more alerted to the existence of this condition while boosting the possibility that those who suffer from these conditions can get appropriate help.

Whatever the therapy, it should be based on understanding the nature of the behaviour and what can be done in order to improve the situation.

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Scott Wallace PhD

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