Tag Archives: addiction

Push For “Gaming Disorder” to be an Official Diagnosis

Through the sheer coincidence of getting new furniture & thus having nowhere else to sit in the house but at the dinning room table, I had a rare viewing of CNN last night just in time to see a bit about the World Health Organization (WHO) drafting the definition of “Gaming Disorder” to be included in upcoming 11th edition of the International Classification of Diseases (ICD-11).

According to Dr. Vladimir Poznyak, the representative from WHO’s  Department of Mental Health & Substance Abuse, there are three key diagnostic features of Gaming Disorder:

  1. “Gaming behavior takes precedence over other activities to the extent that other activities are taken to the periphery.”
  2. “Impaired control of these behaviors.”
  3. “The condition leads to significant distress and impairment in personal, family, social, educational or occupational functioning.”

The gist of the “disorder” is that the person in question chooses gaming over all other activities, including those that are necessary for their well-being, such as proper personal care & family/career/educational responsibilities.  And even though the person knows there’s a problem, they not only continue to engage in the problematic habits, but actively seek ways to streamline their lives further to devote even more time to gaming.

Regardless of my feelings both professionally as a psychologist or personally as a gamer, I will applaud WHO on their intent.  Rather than looking toward studies that try to blame social ills on gaming, they’re more concerned with the overall health of the individual.  They’re not saying video games shouldn’t exist or even dictate what should be allowed in the games, but rather pushing for a healthy balance, which is not an unreasonable goal.  Dr. Poznyak made a point of stating in the article that, even among avid gamers, it’s actually rare for their hobby to reach the stage where it’s dangerous.  According to the CNN article, the goal of the Department of Mental Health & Substance Abuse 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 “people who suffer from these conditions can get appropriate help.”

For those of you lucky enough to never have to deal with the insurance, the ICD-9 (current version) is what most insurance companies look to when deciding what they will & won’t pay for.  Unless you have an officially recognized diagnosis & are following one of the agreed up treatments for said condition, insurance won’t pay.  It’s only recently that insurance will even pay for regular psychological therapy or substance abuse treatment.  If you really want them to pay for people to receive treatment for “gaming disorder” it needs to be a medical diagnosis.  So from that perspective, I appreciate what WHO is trying to do.

And, if we’re being honest, we could all probably point to stories that illustrate gaming gone too far.  I’ve read news articles where someone’s gaming caused real problems for them, either because they were so fanatically devoted that their health & finances deteriorated, or a child was neglected, or even lashing out at others in real life.  I’m sure most of us, if we knew these people, would say, “Dude, you need help.”

However, some psychologists are hesitant about grouping this as a medical diagnosis.  The consensus among this group isn’t that there aren’t people who need help with their overwhelming habit, but that the gaming itself isn’t the problem.  Rather, it’s a symptom of another problem.  According to Dr. Anthony Bean, a clinical psychologist who’s a bit of an expert on working with gamers (including having written a book on the subject that I’m eager to read), problematic gaming is actually a coping mechanism to deal with anxiety & depression.  It’s an escape from other problems, & as the problems aren’t addressed, the person loses themselves in their games.  For anyone familiar with substance abuse, this shouldn’t come as a surprise.  People rarely become substance abusers just for the hell of it.  Often, it occurs comorbidly with other issues.  Treating the underlying cause is crucial for real recovery.

I’d also argue that, on a fundamental level, I don’t agree with calling it an addiction.  People throw around the term “addiction” without really understanding medically what it means.  Without going into too much jargon, “addiction” is when you’ve altered your brain structure by the repeated use of some substance to the point that your body cannot function properly without it + generally requires an increasing dosage of said substance to maintain equilibrium + if you stop you’ll experience withdrawal symptoms, & thus you continue to engage in behaviors to seek out said substance.  As an easy example, when you drink alcohol, you’re chemically altering your brain, & if you do it enough you can permanently change its very structure so that you can’t function without it in your system.  (For the record, WHO uses “dependence” instead of “addiction” but means the same process.)

Now, with that knowledge in mind, do you think you can become “addicted” to gaming?  Does gaming physiologically alter you?  It’s hard to say.  Certainly gaming stimulates the pleasure centers of you mind, as does anything you do that gives you joy.  But can enough of it actually come to mean your body will stop producing endorphins (the chemicals in your brain that make you feel good) without games?  Would you go through actual withdrawal symptoms without it?  Even accepting terms like gambling addiction, I find it’s a hard sell.

Furthermore, who’s to decide what’s “problematic”?  Gaming is one of my biggest hobbies, & I can honestly say in a lot of cases I’d rather stay home & play video games than socialize with people.  My mom certainly questions why I prefer to play games versus anything else.  Would she say I have a disorder?

In the end, I agree with Dr. Bean that it’s a slippery slope, regardless of intent.  Why stop just at gaming?  Maybe I think it’s a disorder to pay thousands of dollars every year on sports tickets.  It’s certainly a disorder when you get so mad your team lost (or so happy they won?) that you start a riot.  By the WHO’s own logic, anything can be a disorder.  And that’s not a road I want to go down, because then everything will be a problem.

Sources

WHO classifies ‘gaming disorder’ as mental health condition“, CNN

Addictions“, American Psychological Association

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AA For Gamers?

After reading a post on Too Much Gaming blog about a gamer who died due to a pulmonary embolism after playing his XBox for too long, I decided to do  some research to see how many deaths could be directly attributed to gaming.  The answer, however, is not so simple.  The reason being that I find it hard to directly attribute the deaths I found directly to gaming.  Sure, gaming was related to it, but I think the people involved were more at fault than the actual game.

Just to list a few of the more interesting cases:

  • South Korea, 2005: a man goes into cardiac arrest after playing StarCraft for fifty hours straight in an internet cafe.  His friends reported that several weeks prior his girlfriend had broken up with him & he’d been fired for repeated tardiness. Verdict: conceivably someone who continually engages in sedentary activities for long periods of time isn’t going to be in the best shape.  Also, why did no one say anything?  Fifty hours?  Where I live people will call the cops if you’ve been loitering for just a few hours.  If his friends knew he was an “addict” why didn’t they try to help him?
  • United States, 2005: two ten month old boys drown in a bathtub when their father left then unattended for 30 minutes to play his GameBoy Advance three rooms over.  Verdict: extremely neglectful parenting.  Also completely avoidable, as the point of GameBoy is that it’s portable.
  • Philadelphia, 2010: a sixteen year old boy beats his mother to death with a chair leg in her sleep (after beating her with a hammer & then trying to cremate her in the oven) for taking away his PlayStation.  Verdict: while I’m sure many anti-game advocates would like to cite this as evidence that gaming makes you violent, I find it hard to believe that this was the boy’s first time in trouble.  You don’t go from perfect angel to bludgeoning your parents to death overnight.
  • Ontario, 2008: a fifteen year old boy runs away from home after his parents take his 360 away for falling grades & stealing money.  He’s later found dead, & an autopsy reveals he died falling from a tree.  Verdict: the parents were correct in trying to correct the boy’s behavior, but realized they went about it in the wrong.  An article in the Times quoted the father as saying he understood now that he’d taken his son’s identity away.  Surprisingly, Microsoft offered a reward & manpower to find the boy.
  • Philadelphia, 2008: a man is convicted of third-degree murder of his seventeen month old daughter after she broke his XBox.  Verdict: articles also state that the daughter’s autopsy revealed she had a broken arm two weeks before her death, & that Child Protective Services were involved with the family.  Clearly this is a case of bad parents, rather than gaming addiction.
  • Florida, 2010: a woman is convicted of second-degree murder of her baby when she shook him to death because his crying interrupted her on Farmville.  Verdict: one article stated she shook the baby, stopped to smoke a cigarette, then shook him again.  Clearly this is a woman with low frustration tolerance, & as such, anything could’ve set her off.  She could have just as easily got frustrated while watching tv.
  • Vietnam, 2007: a thirteen year old boy murders an elderly woman by strangling her with string & then burying her head in the sand at his house.  His motive was to rob her for money so he could play a game online.  He ended up stealing the equivalent of $6.20 US.  Verdict: no background on the boy is given, but there’s clearly a violent tendency if you can strangle & bury someone.  It also appears spur of the moment.

There are other incidents, of course, but the point I’m trying to make is that it’s unfair to say video games caused any of these.  That’s like saying, “The Devil made me do it.”  An convenient scapegoat.  Certainly these behaviors are not the norm.

But the main underlying question is: is there such a thing as videogame addiction?  The short answer is, No.  There is no clinical definition for videogame addiction yet.  The issue was recently decided by the American Psychiatric Association when they were debating whether to include the diagnosis in the next version of the Diagnostic & Statistical Manual for Mental Disorders (which lists every mental disorder you can have, including addiction).  They determined that there weren’t enough studies to properly diagnose the addiction.  Looking at the research, I have to agree.  Some research says the addiction exists, but others don’t support it.

However, I do believe the addiction exists, it just hasn’t been properly identified.  Personally, I think you can become addicted to just about anything.  Clearly when you can be so focused on online gaming that your child dies from malnutrition, you have an addiction.  The most important criteria for any disorder is that it has to cause “significant problems to a person’s life.”  If you get fired for always being late because you stay up all night playing WoW, you have a problem.  If you don’t eat for three days because you’re too busy playing Call of Duty, you have a problem.  And if you kill someone in real life because of something that happened in a game, you definitely have a problem.

If you think you have an addiction to gaming, there are places to go for help.  Seek support at local addiction support center.  There’s also an organization called “Online Gamers Anonymous,” which is a twelve-step program specifically designed to help with gaming addiction.

Remember, no matter how realistic gaming may be, it’s no substitute for a real life.  Happy (& safe) gaming.

– GamerDame

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