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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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The Ever-Growing “Threat” of Video Games

Another month, another societal problem that videogames take the blame for.  If only problems truly could be solved by simply not playing videogames.  Not only are they making kids violent, but they’re apparently making our young men into bums.  An article published by The Washington Post made a bold claim last month that recent research “attributes one-third to one-fifth of the decline in work hours by less-educated young men to the rising use of technology for entertainment — mainly video games.”  You read that correctly.  Videogames are actually luring people away from meaningful career choices.

Even as the unemployment rate has fallen to low levels, an unusually large percentage of able-bodied men, particularly the young and less-educated, are either not working or not working full-time.  Most of the blame for the struggle of male, less-educated workers has been attributed to lingering weakness in the economy, particularly in male-dominated industries such as manufacturing.  Yet in the new research, economists from Princeton, the University of Rochester and the University of Chicago say that an additional reason many of these young men — who don’t have college degrees — are rejecting work is that they have a better alternative: living at home and enjoying video games…

Young men without college degrees have replaced 75 percent of the time they used to spend working with time on the computer, mostly playing video games, according to the study, which is based on the Census Bureau’s time-use surveys…

The researchers are not merely saying that young men, out of work, are turning to video games.  They’re saying that increasingly sophisticated video games are luring young men away from the workforce.

‘Tis a bold claim, & not one I could swallow at face value.  Popular culture and media just loves to take insignificant claims & blow them completely out of proportion — even assuming they get the claims right.  Thus how I found myself researching employment trends.

This research initially came to my attention via an article on Destructoid.  It essentially parrots the same claims as The Washington Post article but, if the title of “Studies show our large, unemployed sons are playing hella video games to feel better” wasn’t a dead give-away, with a somewhat more ironic tone.  Unfortunately, I wasn’t able to review the research data myself, which is my preference in these cases.  The Washington Posts’ hyperlink leads to the agenda of the Center for Human Capital Studies Annual Employment Conference on unemployment, wages & productivity.  Doesn’t that sound like a riveting good time?  I actually feel bad for whoever got this story for The Washington Post.

But despite not being able to look into the study myself, there are several ways I can pick the supposed argument to pieces.  Firstly, the title of the lecture was “Leisure Luxuries and the Labor Supply of Young Men,” which alone started raising some red flags.  Based on the name, it’s possible the researchers studied a variety of leisure activities, but The Washington Post chose to ignore the findings & instead decided to sensationalize a link with videogames.  Without evidence, I’m not even sure what was directly claimed by Aguiar, Charles & Hurst (the researchers).  The only direct quotes in the article were related to young men showing increased happiness despite the lack of income & the rapid increase of use in all areas of technology.  It would hardly be the first time a news outlet misfocused for ratings/views.

Also suspect is the fact that “Leisure Luxuries and the Labor Supply of Young Men” is the only presentation during the 2-day conference that doesn’t have a PDF of the research article linked.  To their credit, The Washington Post does state that this research hadn’t been peer reviewed yet, meaning it hasn’t been scrutinized or attempts made to recreate results.  So other economists might not even agree with the results.

But, let’s assume that what The Washington Post reported was indeed exactly the claims  Aguiar, Charles & Hurst made.  Do the claims themselves stand up to scrutiny?

Well, firstly, they aren’t incorrect about the growing trend of unemployment.  Studies show that, even with the improvement in the economy, unemployment rates remain uncomfortably high.  Those particularly hard hit are men with high school level education or lower, matching the claims of the article.  However, these studies also show that all areas of the workforce have been affected.  While Aguiar, Charles & Hurst’s study showed that 22% of men with less than a B.A. aged 21-30 aren’t working, a study just a few years prior conducted by the US Census showed a decline of 21% in employment for men aged 30-50 with just a high school diploma, as well as a general drop in employment rates for all groups, though none as steep.

Interestingly, according to recent research into gaming trends, 42% of Americans play videogames at least three hours per week.  Also, the average age of those who play videogames most frequently was older than the demographic apparently afflicted by games, at 35 for men & 43 for women.  This fact, combined with the general ubiquitousness  of games in the population at large, suggests that videogames cannot be the main culprit behind the decline in employment.

So what might really be going on here?

Well, given that those without a college degree are the most affected, it seems clear to me that this remains a key factor.  The job market has changed considerably even over the past few years.  It isn’t like when my parents were growing up & those with just a diploma or less could expect to get a decent, steady job in manufacturing.  With most manufacturing jobs going overseas, it’s almost a requirement to have some level of college education to get something half decent.  However, I don’t feel comfortable blaming it entirely on the job market, as distribution warehouses have sort of taken over that role.  There’s still a place for unskilled workers, but given that the minimum wage has barely moved despite the spike in cost of living, even these options might not be viable for making a living.

I would also suggest, from personal experience, that changes in the way employers treat their employees might also be a factor.  Going back to warehouses, many of them have a mostly temporary staff to avoid paying full benefits, & rotate people out or hire on more to fulfill holiday demands.  Contract work has also become increasingly popular as a way for employers to hire people part-time while saving on benefits.  Even I only work maybe 20 hours every pay period as a contractor.  It’s an attractive way to both hire staff for a high wage while avoiding extra costs.

I also blame a large part of this trend on the welfare system itself.  I won’t try to explain how the system is messed up, but the long-&-short of it is that most people have correctly assumed that it’s pointless to work a low-paying job that doesn’t give you enough to live comfortably on while not negatively affecting your state benefits.  If the difference between working a crappy job & not working all together is only a few thousand dollars, not much by today’s standards, what’s the point?

As an article from The Brookings Press put it, quite simply, it’s complicated.

If videogames have impacted working habits, at worst they’ve offered a form of escape for gamers, at best they might even open up new opportunities.  I tried to find statistics on the number of people who partner to earn money through gaming in sites like Youtube & Twitch, but while I’m sure most channels don’t make enough for it to become a living, such new avenues might provide supplemental income for those stuck in low-paying, part-time positions.

So let’s stop demonizing gaming for a while, shall we?

-GamerDame

Resources:

“Studies show our large, unemployed sons are playing hella video games to feel better” by Steven Hansen from Destructoid
“Why amazing video games could be causing a big problem for America” by Ana Swanson from The Washington Post
“The Problem with Men: A Look at Long-term Employment Trends” by Michael Greenstone & Adam Looney from The Brookings Press
“The Vanishing Male Worker: How America Fell Behind” by
“Here’s how many people are playing games in America” by Colin Campbell from Polygon

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