Well it’s official: ‘Gaming Disorder’ is a bona fide medical condition. Back in May, the World Health Organization (WHO) agreed to adopt ‘Gaming Disorder’ as yet another behavior addiction disorder on the 11th edition of the International Statistical Classification of Diseases (ICD-11).
From a public health perspective, including ‘Gaming Disorder’ in the ICD-11 allows medical professionals to universally diagnose video game addiction and develop effective treatment plans should the need arise.
However, this move was implemented despite a growing amount of controversy and industry pushback. Indeed, experts, the gaming industry and gamers themselves have all contested that the inclusion of ‘Gaming Disorder’ is irresponsible as it marks gaming as a media scapegoat while simultaneously trivializing widely-recognized mental illnesses such as depression and social anxiety disorder (whew, that sentence took forever).
The reality is, most gamers that criticize the validity of ‘Gaming Disorder’ would not have experienced anything close to addiction themselves. As is true for most other addictive activities and substances, the great majority of people who play video games are not going to be addicted and, therefore, cannot fully grasp the influence gaming has on those who truly are addicted.
Furthermore, by carelessly ranting on the WHO making ‘Gaming Disorder’ official (just because it is popular to do so), these armchair experts fail to understand that incorporating ‘Gaming Disorder’ in the ICD-11 allows video game addiction to be taken seriously by the medical community; this in turn allows afflicted individuals to properly receive benefits such as insurance for treatment.
Be that as it may, I, too, believe that the ratification of ‘Gaming Disorder’ is premature and sets a harmful precedent for both gaming and other recognized mental health disorders.
Let me make myself clear: video game addiction is real, rare and poorly misunderstood, which is not helped by the predatory practices of the gaming industry (see: Loot Boxes). Yet, the WHO may have jumped the gun on classifying ‘Gaming Disorder’ without sufficient empirical evidence or a firm understanding of the etiology of video game addiction.
To clarify, let’s examine the history of ‘Gaming Disorder’ and the resulting problematic implications of the WHO’s hasty diagnosis:
Defining ‘Gaming Disorder’
Video game addiction is characterized on the ICD -11 as follows:
Gaming Disorder – a pattern of persistent or recurrent gaming behavior (‘video-gaming’), which may be online (i.e., over the internet) or offline, manifested by:
1. Impaired control over gaming
2. Increasing priority given to gaming to the extent that gaming takes precedence over other life interests and daily activities
3. Continuation or escalation of gaming despite the occurrence of negative consequences (e.g., social, occupational, educational)
The gaming behavior and other features are normally evident over a period of at least 12 months in order for a diagnosis to be assigned, although the required duration may be shortened if all diagnostic requirements are met and symptoms are severe.
Usually administered via cognitive-behavioral therapy or one-on-one counseling with a psychiatrist or a therapist, the treatment of ‘Gaming Disorder’ (like other behavior addiction disorders) involves changing the thoughts that contribute to unhealthy gaming habits and also modifying one’s actions to slowly reduce the amount of time spent playing video games.
According to several research measures, ‘Gaming Disorder’ is prevalent in about 3.1% of gamers overall (i.e., about tens of millions of gamers worldwide).
Support for ‘Gaming Disorder’ being officially recognized
By incorporating ‘Gaming Disorder’ into the ICD-11, the WHO just made it clear to the international medical community that video game addiction is a medical condition that requires both healthcare and treatment due to the compulsive and rewarding behaviors that gaming can elicit.
In fact, the WHO maintains that their decision was adapted from the “reviews of available evidence and reflects a consensus of experts from different disciplines and geographical regions.”
According to Game Quitters, a support community for video game addiction, the WHO’s classification of ‘Gaming Disorder’ as an official mental disorder allows for the possibility of:
“1. Improved accessibility to professional services [and facilitating further research], including the potential for services to be covered by insurance. More professionals will specialize in ‘Gaming Disorder.”
“2. Improved quality control. Currently there is no standard protocol for mental health professionals to follow for prevention and treatment of gaming disorder. Quality care begins with an official diagnosis and means of assessment.”
“3. Reduced stigma and moral panic. Research shows stigma – the fear of being judged, dismissed, or misunderstood – to be the biggest barrier to gaming addicts seeking help.”
In addition to validating the experiences of actual gaming addicts, the facilitation of further research on the significance and etiology of ‘Gaming Disorder’ is a remarkable result that must be commended.
Previously, Gaming Disorder’s twin brother, Internet Gaming Disorder (ISD), was also deemed by the America Psychiatric Association (APA) as a subject worthy of more research in the DSM-5.
What makes the APA’s classification different from the WHO’s, however, is that the APA does not currently recognize IGD (i.e., video game addiction) as an official condition.
Igniting controversy
Did you really expect gamers (like myself) and the entire gaming industry to just sit back and ride the wave?
Most critics condemning ‘Gaming Disorder’ hone in on the frustrating inevitability that disorders due to addictive behavior can be very difficult to pinpoint and quantify. This is not to mention that it is unclear if excessive gaming itself is a disease or the underlying symptom of other mental health disorders.
Indeed, some researchers argue that the people who are addicted to video games can receive psychiatric treatment under broader diagnoses such as depression and anxiety. Soon enough, the rush to include ‘Gaming Disorder’ to the ICD-11 can cause unnecessary mistakes that could take years to correct.
Moreover, many gamers feel that this classification is the latest attack on such a harmless and beloved hobby. They perceive gaming to be no more behaviorally addictive than other common daytime activities: if there were to be a ‘Gaming Disorder’, we also would need a ‘Netflix Disorder’, a ‘Gym Disorder‘, a ‘Wikipedia-scrolling Disorder’, an ‘Instagram Disorder‘ and a ‘Pug-lover Disorder’.
Absolutely, these skeptics are fundamentally asking, “on what basis is gaming considered pathologic while other addictive distractions (e.g., smartphones) are not?”
Because of the WHO’s reluctance to address these debates, many believe the WHO needs to reconsider their take on video game addiction.
Significant research gaps remain
As previously mentioned, the WHO justifies their ICD-11 classification of ‘Gaming Disorder’ by proclaiming that the inclusion is “based on reviews of available evidence,” and reflects on the general agreement among experts around the world.
Yet, many skeptics contend that the proclamation could not be further from the truth. The aforementioned evidence appears to be insufficient and statistically underpowered: the studies employ small sample sizes, and does little to illustrate whether video games cause psychological problems or are merely associated with them.
Also, there is practically no consensus in the academic community (even amongst ‘Gaming Disorder’ supporters) on the symptomatology and assessment of ‘Gaming Disorder’. The scholars assert that the clinical definition for ‘Gaming Disorder’ does not clarify what types or mechanics of games might be addicting, and so the classification is too broad to be effective.
On an interesting note, more skeptics have pointed out that the medicalization of ‘Gaming Disorder’ can be applied to any activity in everyday life (cue the talk of ‘Crazy Cat Lady’ syndrome). As it stands, this ambiguous pathology of gaming does not inspire confidence in the WHO’s current classification of ‘Gaming Disorder’.
How ‘Gaming Disorder’ further stigmatizes gamers
While some gaming behaviors can be very questionable, ‘Gaming Disorder’ affects only a very small percentage compared to the 2.5+ billion gamers currently found anywhere in the world. By globally introducing ‘Gaming Disorder’ (which does little to ensure that healthy gamers are not pathologized or misdiagnosed), the entirety of gaming culture will be further stigmatized because of a select few in the community.
As with any psychiatric diagnosis, classifying ‘Gaming Disorder’ as an official mental illness practically guarantees a corresponding stigma that will irreversibly harm the gaming community.
Therefore, the ICD-11 classification on video game addiction has tremendous potential to contribute to the existing misguided beliefs and misconceptions surrounding video games. While there ARE negative consequences in gaming, there is not enough dialogue discussing the benefits provided by gaming.
Many gamers are quick to point out the advantages of gaming, such as faster reflexes, improved hand-eye coordination, and increased peripheral vision. In addition, video games are a way for some to fulfill social needs while reinforcing social skills along the way. Yet, these effects are not going to grab the media’s attention unlike prominent headlines such as, say, ‘Video games are digital heroin.’
Moreover, some gamers even claim that video games are a necessary distraction and an outlet for widely-recognized disorders such as depression and anxiety.
Ultimately, I believe that the addictive behaviors associated with gaming may be signaling society’s problematic dependence on technology as a whole as opposed to a specific dependence on video games themselves.
In any case, without conclusive empirical evidence, defining and diagnosing video game addiction should be handled with more caution and responsibility; else, the WHO will inevitably cause a moral panic from people who do not understand video games that will stigmatize even typical gamers with healthy habits.
Why ‘Gaming Disorder’ sets a troubling precedent to other recognized disorders
Formalizing an official health disorder usually requires a high level of robust and unequivocal evidence, which ‘Gaming Disorder’ ultimately lacks. For the WHO to responsibly label ‘Gaming Disorder’ as a behavioral addiction, a greater amount of research is required to adequately support such a serious diagnosis.
As addiction in general is already unfortunately misunderstood, ‘Gaming Disorder’ can allow for the illogical medicalization of other addicting activities. The criteria and symptoms required to diagnose ‘Gaming disorder’ are too broad (e.g., there is no existing blueprint for clinicians to detect manifestations of “impaired control” in different contexts) and ambiguous; therefore, they can dangerously pathologize normal behaviors into addiction.
In addition, the ambiguity behind ‘Gaming Disorder’ has the possibility to undergo over-diagnosing and misdiagnosis, all of which is prevalent in already established mental disorders. This is not helped by the fact that clinicians have a general negative perception of games and a lack of experience.
Mental health disorders, in reality, cannot be easily distinguished as different people have different experiences to mental illnesses. Thus, misdiagnoses has been such an extensive problem in the medical community that introducing a novel mental disorder that is both under-researched and too generalized can cause great harm to the gaming community while also undermining established mental disorders.
Indeed, grouping behaviors into video game addiction can overshadow serious underlying conditions such as depression, anxiety disorders and stress-related disorders.
By classifying symptoms as ‘Gaming Disorder,’ medical professionals can fail to treat patients from the precursors that led to the video game addiction in the first place.
These diagnosed individuals will be told that they have mental illnesses they may not have and, thus, public health resources that can be allocated to more pressing concerns are being ultimately wasted because of an insufficient definition of video game addiction.
This harmful precedent set by the current iteration of ‘Gaming Disorder’ cannot be taken lightly. The WHO must exercise more caution when it comes to defining video game addiction on the ICD-11; Else, the mishandling of diagnosing video game addiction can cast both the practice of psychiatry and the ‘litmus test’ of diagnosing medical disorders in a negative light.
What should be done about video game addiction
While video game addiction is a very real phenomenon, more empirical research is required that delves into the different kinds of gaming and investigates the alluring video game mechanics (again, see: Loot Boxes) that evoke the obsessive behaviors that contribute to addiction .
As priorly discussed, the etiology of the disorder is currently poorly defined and not well understood; therefore, it is apparent that the WHO may been premature in incorporating ‘Gaming Disorder’ into the ICD-11.
Indeed, it could very well be possible that the addictive behaviors in gaming arise not just from video games but from our increasing dependence on technology as a whole (but that is a story for another day).
Promoting our understanding of technology’s potential for addiction as opposed to just singling out gaming individually can prevent gamers’ suffering from further stigma.
For example, would you like at me the same way if I told you I was an avid gamer as opposed to an avid book reader or rock-climber? I don’t think so.
With the demonstration above, we can avidly foresee that labeling video game addiction in a way that does not protect healthy gamers can cause the media to further demonize video games (which, in turn, can cause more psychological harm in children).
Unfortunately, there are many people who are suffering from video game addiction that would want their stories to be validated as serious medical disorders; however, if we are too hasty in our approach, then the ‘Gaming Disorder’ diagnosis will certainly do far more public harm than good.
Let’s hope to fight against video game addiction, the responsible way.
What are your thoughts on ‘Gaming Disorder’? Is it all Because the Internet? Give a like if you agreed with the post and thanks for reading!
