Any experienced video game player knows what it’s like to play until the sun rises.
As fun as this may seem, at what point does it become an unhealthy habit?
The World Health Organization (WHO) has added gaming disorder into its beta draft of the 11th Revision of the International Classification of Diseases (ICD-11), which is set for a mid-2018 publication date.
The internationally written ICD is a broad catalog that records the prevalence and spreading patterns of diseases and disorders worldwide.
It also helps influence hospital billing and potential insurance coverage, said Information Systems and Decision Sciences professor Ofir Turel, Ph.D.
Gaming disorder would feature “persistent or recurring gaming behaviour” according to the draft. These behaviors would be characterized by players lacking control over how much they play, prioritizing games over daily life and continuing to escalate how much time is dedicated to games despite negative consequences.
These symptoms, unless they’re especially severe, would need to be evident continuously or in frequent episodic bursts over at least a year.
“The most important one is conflict. It has to conflict with other activities or have negative impacts on others lives’,” Turel said. “If you’re on vacation or unemployed, playing video games may be okay if you play 10 hours a day, that’s fine. But if it conflicts with your studying, your social life and so on, then it becomes an issue.”
Cal State Fullerton School of Nursing lecturer, Cynthia Grauvogl, whose research focuses include behavioral disorders, addiction nursing and substance abuse, said gaming addiction would be considered a “process” or “soft addiction” if it is officiated as a proper diagnosis.
Soft addictions refer to those based around activities like shopping or objects like food, rather than something like heroin or other hard drugs. Grauvogl said despite the differences, both kinds of addiction act on the brain the same way.
“I think people who have soft addictions would tell you that it’s just as difficult to deal with as if they were addicted to alcohol or drugs, especially with the psychological component of it,” she said.
Turel said if this addition to the ICD-11 is finalized, it would be the first time a technology-based addiction or disorder would be recognized in this manner.
However, this is not the first time video games have been examined due to their potential health benefits or detriments.
In 2005 the National Institutes of Health published Mark Griffiths’ article “Video games and health,” which stated video games can be helpful distractions from pain during therapy, despite potentially adverse effects such as wrist or neck pain.
Olivia and Kurt Bruner’s 2006 book “Playstation Nation,” and studies like 2016’s “Video gaming in school children: How much is enough?” have also examined the potential positive and negative sides of video games.
However, probably the biggest example came in 2013 when the American Psychiatric Association (APA) published the fifth edition of their Diagnostic and Statistical Manual of Mental Disorders (DSM-5), which included internet gaming disorder in Section III.
One reason internet gaming disorder was not officially put in the DSM-5 was that there could be “huge implications” if the disease were to be formalized, Turel said.
As an example, he pointed to the possibility of abusing the system by using doctor’s notes for video game cravings as a way of getting out of school or work.
“The key is, until we find out how to classify people as having a serious addiction needing treatment, it’s very risky to put this thing in the book,” Turel said. “This is why the DSM did not pull the trigger and call it an addiction or disorder yet.”
When classifying someone as the victim of a particular affliction like gaming disorder there is also concern regarding the interaction of multiple concurrent disorders.
“It could be that someone has depression and one way to deal with it is to play video games, so the addiction to video games could develop as a result of depression. Or it could be the other way around, you could develop an addiction to video games and then develop depression because you lose your friends, your school performance drops and so on,” Turel said.
Another potential consequence of officiating a disorder is the resulting stigmatization that comes with terms like addiction.
“It really doesn’t matter where in the psychiatric lexicon you look, most people are pretty hesitant to tell. We don’t speak very openly because we’re afraid of that stigma and it’s unfortunate,” Grauvogl said.
While studies suggest gaming disorder would only affect a small portion of the gaming population, everyone should be alert of how long they spend playing video games and any potential changes in physical or psychological health, according to a WHO online question and answer archive.
“It’s like food. We need it, we’re going to use it, but we need to learn to control ourselves, otherwise we’re going to get into the equivalent of obesity issues, cardiovascular issues and so on,” Turel said.