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gaming disorder

Contributor(s): Matthew Haughn

Gaming disorder is the obsessive and compulsive overuse of internet games and video games as an escape from life, resulting in the prioritization of gaming over daily activities and interests and the continuation of gaming despite the negative consequences that may occur. In other words, gamers know that they need to stop playing and attend to other daily requirements, such as social obligations or getting a good night's sleep, but they feel unable to control themselves and do so.

Gaming disorder might be classified as a form of technology addiction, like the more rampant internet and smartphone addiction. The disorder is also known as video gaming addiction or internet gaming disorder.

In 2018, the World Health Organization (WHO) added gaming disorder as a disease in the 11th revision of the International Classification of Diseases (ICD-11). The ICD is a collection of medical conditions and diseases that is used by health professionals to make diagnoses and treatment plans. The addition of gaming disorder in the eleventh revision includes both online and offline gaming; it is listed as a disorder due to addictive behavior.

There are two major types of video game addiction, corresponding to the two types of video games. The two types are:

  • Standard video games - Standard video games are designed to be played by one person and incorporate a specific goal or mission. The addiction to these games is caused by the need to complete the goal, beat a high score or defeat another preset standard.
  • Online multiplayer video games - Online multiplayer video games are played online with other gamers. These games are especially addictive because they have no clear ending and they allow gamers to create and temporarily become an online character. The multiplayer atmosphere allows all users to create relationships and a community which sometimes feels like the place where they are most comfortable and accepted.

While gaming disorder is suspected to be most pervasive amongst males and research has been conducted primarily on adolescents, teenagers and young adults, it is not limited to these age groups. The disordered behavior can affect people of all ages and gender.

Those who game need not necessarily be concerned, as gaming disorder affects only a small percentage of individuals. However, caution is advised when gaming time becomes inordinate or affects daily life and health.

Causes of gaming disorder

According to various studies, gaming disorder may co-occur with other mental health issues, such as depression, anxiety and stress. Users suffering from these underlying issues may fall into the habit of excessive gaming because it provides an escape from the negative feelings that impact them; it may be the only thing that is making them feel better. Furthermore, people who are found to meet the criteria for gaming disorder often have poorer emotional, physical, social and mental health.

However, one of the major reasons why video games can become so addictive is that they are specifically designed to be that way. Video game designers draw a profit from their games and, as a result, they are constantly looking for ways to get more people to buy and play. This is often accomplished by making the game just challenging enough that it keeps the gamer interested, but not so challenging that the gamer becomes aggravated and gives up. Video game designers create an environment where success for the user seems just out of reach, making gaming disorder very similar to the more widely recognized gambling addiction.

Furthermore, video game designers create an environment that is fully immersive and makes the user feel safe and in control while visibly measuring their progress. As a result, it is possible for a gamer to spend hours playing a game without even realizing that any time has passed.

Signs and symptoms of gaming disorder

Gaming disorder is qualified by problematic avoidance of life duties and antisocial behaviors stemming from overuse of gaming as a distraction. Those who have the disorder often exhibit volatile moods, are less imaginative and may obsess over events and achievements in game while ignoring what they need to do in life to negative effect, sometimes resulting in poor hygiene or excessive weight loss or gain.

Other symptoms may include:

  • feelings of restlessness and/or irritability if unable to play;
  • lying to friends and family about the amount of time spent gaming;
  • a desire to isolate oneself from others in order to have more time to play;
  • fatigue due to lack of sleep;
  • carpal tunnel syndrome resulting from the overuse of a controller or computer mouse and
  • migraines resulting from eye strain and/or intense concentration.

Diagnosis of gaming disorder

The addiction is diagnosed by psychologists when gaming impinges on normal life. While some gamers may occasionally have the odd binge, gaming disorder is characterized by severity and duration. In order for a mental health professional to diagnosis gaming disorder, the patient's behaviors must display severe impacts in areas such as personal, social, family, occupation and education. The impairments must be noticeable for at least one year.

Some specific characteristics that would lead to a diagnosis include:

  • lack of control over gaming habits;
  • the need to spend more and more time playing just to feel good;
  • problems at work, school or home due to time spent gaming and continuing to play despite these problems;
  • using gaming to relieve negative emotions and
  • no longer wanting to do other activities that were previously desirable.

Although these qualifications have been defined by the WHO in the ICD-11, it is still unsure how mental health professionals will assess these behaviors. It is possible that experts will need to design diagnostic tests to administer to patients they believe to be at risk. Experts may also utilize something similar to the K-Scale for Internet Addiction which was designed as a checklist to measure computer and video game addiction.

Risks, concerns and negative impacts of gaming disorder

Although most of the symptoms that have been listed seem to hold only short-term effects on people suffering from gaming disorder, they can turn into long-term consequences if the addiction is left untreated. For example, while avoiding sleep and a failure to eat properly may at first manifest as short-term fatigue and hunger or weight gain, these symptoms can evolve into much more serious sleeping disorders or diet-related health issues if they persist. Furthermore, the social isolation experienced by addicted gamers can eventually cause them to destroy relationships and lose all their friends.

Gaming disorder also creates financial, occupational and academic consequences. The equipment is expensive and the cost of the necessary high speed internet can also become a steep financial burden. Also, the time spent focused on playing the games can take away from time that should be dedicated to academics or careers.

Another big risk for people suffering from gaming disorder is drug addiction. Since there is a strong correlation between depression and gaming disorder, many addicts may find themselves being prescribed and taking antidepressants. A possible addiction to these drugs may occur because they are hard to stop taking due to the resulting withdrawal symptoms like nausea, anxiety, irritability and, in serious cases, increased depression. The addict's lack of concern in their health may also result in additional substance abuse issues.

How to help a gaming addict

Since gaming disorder is a relatively new classification, there is no cut and dry treatment plan in place yet. However, it can be approached like most other addictive behaviors with treatment plans including therapy, self-help groups and medication.

Studies show that it may be most beneficial to combine various treatment techniques, including psychoeducation, family intervention, development of a new lifestyle and cognitive behavioral therapy (CBT).

Psychoeducation involves teaching the addict about their gaming disorder and the effects it has on their mental health, physical health and life.

Developing a new lifestyle encourages addicts to examine the other skills they have, discover other enjoyable activities and set goals for themselves.

CBT is a type of mental health counseling that can be used to teach addicts how to replace thoughts about gaming and alter their detrimental behaviors.

This was last updated in July 2019

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