Gaming disorder: Discuss

[sue_frantz]

"Wes, 21, an Eagle Scout and college student from Michigan, played video games 80 hours a week, only stopping to eat every two to three days. He lost 25 pounds and failed his classes" (Irvine, 2018).

The World Health Organization (WHO) recently announced the addition of “gaming disorder” to the next edition of the International Classification of Diseases.

Gaming disorder is defined in the 11th Revision of the International Classification of Diseases (ICD-11) as a pattern of gaming behavior (“digital-gaming” or “video-gaming”) characterized by impaired control over gaming, increasing priority given to gaming over other activities to the extent that gaming takes precedence over other interests and daily activities, and continuation or escalation of gaming despite the occurrence of negative consequences (World Health Organization, 2018).

For your reference, internet gaming disorder appeared in DSM-V in the section identifying areas in need of research. While it’s called internet gaming disorder, the internet part is not required. As it’s currently written, a person would need five of these symptoms to be diagnosed:

• Preoccupation with gaming
• Withdrawal symptoms when gaming is taken away or not possible (sadness, anxiety, irritability)
• Tolerance, the need to spend more time gaming to satisfy the urge
• Inability to reduce playing, unsuccessful attempts to quit gaming
• Giving up other activities, loss of interest in previously enjoyed activities due to gaming
• Continuing to game despite problems
• Deceiving family members or others about the amount of time spent on gaming
• The use of gaming to relieve negative moods, such as guilt or hopelessness
• Risk, having jeopardized or lost a job or relationship due to gaming (“Internet gaming,” 2018)

The symptoms, as it true for (almost?) all DSM-V diagnoses, must cause “significant impairment or distress” (“Internet gaming,” 2018).

Following WHO’s announcement, 25 researchers co-authored a short and freely-available paper published in the Journal of Behavioral Addictions (Aarseth et al., 2017) outlining their concerns with the inclusion of gaming disorder in ICD-11. Their six concerns are:

1. “The quality of the research base is low.”
2. “The current operationalization of the construct leans too heavily on substance use and gambling criteria.”
3. “There is no consensus on the symptomatology and assessment of problematic gaming.”
4. “Moral panics around the harm of video gaming might result in premature application of a clinical diagnosis and the treatment of abundant false-positive cases, especially among children and adolescents.”
5. “Research will be locked into a confirmatory approach rather than an exploration of the boundaries of normal versus pathological.”
6. “The healthy majority of gamers will be affected by stigma and perhaps even changes in policy.”

In the same journal volume, also freely-available, a couple researchers (Király & Demetrovics, 2017) address each of those concerns.

Discussion

After your coverage of psychological disorders, divide your students into six groups – or if you have a large class, divide students into groups that are multiples of six. Give each group a copy of both articles.  Assign one of the six concerns to each group. The group is to:

1. Summarize the concern as it was raised in the Aarseth article.
2. Summarize the response to that concern given by Király and Demetrovics.
3. Decide, as a group, which of the two arguments is more persuasive. In other words, based on that concern alone, should ICD-11 include gaming disorder? Explain the group’s reasoning.

Ask three different group members to take on the responsibility of being prepared to speak to the class about one of those three tasks. In other words, one student would address #1, another would address #2, and another would address #3.

Following discussion, ask the group that was assigned the first concern to offer their responses to the three questions. If you have more than one group looking at the first concern, ask the other groups for their response to the third question.

Repeat with the remaining five concerns.

Conclude this activity with a summary of how difficult it is to determine if a set of behaviors rises to the point of a diagnosable disorder and that there are real consequences for creating a diagnosis.

Expansion

If you would like to expand this exploration, the journal volume, September 2017 issue of the Journal of Behavioral Addictions, these two articles came from has another 10 articles on the topic, all freely available. Create 11 groups. Give each group the Aarseth article that opens the volume, plus one additional article from the remaining 11 commentaries. To start the discussion, you can summarize the Aarseth article. This will ensure everyone starts on the same page, and this will model what their summaries should look like. After the groups have had time to discuss the commentary article they’ve been given, ask each group to report out. After all the groups have reported, by a show of hands (or through an audience response system), ask students to decide if gaming disorder should be included in ICD-11. Ask volunteers to share their reasoning.

References

Aarseth, E., Bean, A. M., Boonen, H., Colder Carras, M., Coulson, M., Das, D., … Van Rooij, A. J. (2017). Scholars’ open debate paper on the World Health Organization ICD-11 Gaming Disorder proposal. Journal of Behavioral Addictions, 6(3), 267–270. https://doi.org/10.1556/2006.5.2016.088

Internet gaming. (2018, June). https://doi.org/10.1176/appi.pn.2018.12a20

Irvine, M. (2018). ‘Hi, my name is ___, and I’m addicted to tech’. Retrieved December 27, 2018, from https://www.seattletimes.com/seattle-news/hes-a-tech-addict-who-works-in-the-tech-industry/

Király, O., & Demetrovics, Z. (2017). Inclusion of Gaming Disorder in ICD has more advantages than disadvantages. Journal of Behavioral Addictions, 6(3), 280–284. https://doi.org/10.1556/2006.6.2017.046

World Health Organization. (2018). WHO | Gaming disorder. Retrieved December 25, 2018, from https://www.who.int/features/qa/gaming-disorder/en/