Science Isn't Sure Yet If Gaming Addiction Is A Real Mental Disorder

What is gaming addiction, exactly? There is an easy answer to that question, but there is also, naturally, much debate about whether or not it is even a thing. Psychology can at times be an inexact science, and it seems as though there is always room for debate within that world.

As of today, gaming addiction is not a condition for which your insurance company will reimburse mental health professionals who treat you for it, and that is because the very definition of addiction is still in the process of evolving to the point where problematic gaming can be included under its umbrella. And so in order to fully understand gaming addiction and the debate over its validity, we must start at the root of the term.

In the grand scheme of time, addiction has only relatively recently become a medical concept. Before doctors started saying that folks were "addicted" to opium less than two centuries ago, the word "addiction" meant something different. From that point, the scientists and doctors of the world took that word to mean a physical dependence on a substance.

Even more recently, we — the normal, non-scientist humans — have come to use "addicted" within the context of behaviours. We find a thing we like to do, and we partake in that thing more than other people do — perhaps to an emotionally unhealthy degree — and we call ourselves addicted to that activity. But that is not scientific.

In 2010, the American Psychiatric Association revealed the first draft of revisions to its new edition of the psychological bible, the Diagnostic and Statistical Manual of Mental Disorders (DSM). Among those changes was a new category of disorders: "behavioural addictions". Within that category we would find a single disorder, gambling addiction.

Behavioural addictions are still a very contentious issue, and that the category was even included in a proposed draft is a big step toward acceptance.

This was the first sign that the idea that addiction could refer to something other than a physical dependence was beginning to be accepted within the scientific community. Of course, there was still much opposition to this proposal. Many psychiatrists and psychologists were afraid that making such a category would start us down a slippery slope, that it would open the door to too many normal activities being labelled disorders.

As such, there was no mention of the behavioural addiction category in the final draft summary of changes for the DSM-V in December 2012. I'm told that's because that category will not be in the published edition of the manual, but we will find out for sure when it is released in May of this year. That this idea may not be included is not a huge deal, given its small scope in this edition. It isn't as though pathological gambling won't still be in the book. But behavioural addictions are still a very contentious issue, and that the category was even included in a proposed draft is a big step toward acceptance. Even if it doesn't go in now, it will come up again in the next revision within a decade. Big changes to a standard like the DSM come slowly.

***

"Gaming addiction" will definitely not be in the new DSM, at least not as an official disorder. But some version of that idea will be contained within the Section 3 appendix, which is where the APA describes concepts that need further study before receiving an official disorder. There we will be able to find a nebulous idea called "Internet use gaming disorder." Right now, we do not know exactly what that means, but logic dictates it is a combination of Internet addiction and online gaming addiction.

Since behavioural addictions are not yet full accepted within the psychological community, we don't usually use the term "gaming addiction" in official chatter. Instead, we take a cue from what previous editions of the DSM called problem gambling and refer to it as "pathological gaming". You will have seen this term in my last article here on Kotaku. As we move forward with the new DSM, I expect use of that term will continue but be mixed with other terms like "gaming addiction" or "gaming disorder".

That "Internet use gaming disorder" will be in the DSM-V appendix is a big step for scientific development of the pathological gaming concept, as there aren't currently many published studies on the subject, and the APA is quite right to not give that problem a full classification at this time because of that. But now our psychological researchers will have a mandate to study this issue, and we should in the coming years have a better grasp on the idea.

As I have established above, there is no officially recognised definition for pathological gaming at this time, but in the existing studies the concept is only slightly variant. Thus far, researchers have usually taken the pathological gambling diagnostic criteria in the DSM-IV and applied it to gaming. The study "Pathological Video Game Use Among Youths: A Two-Year Longitudinal Study" published in the journal Pediatrics explains this applications in detail:

Studies on the brain have shown that behavioural addictions cause the same changes in neural activity that substance addiction does.

"Pathological use of video games in empirical research is generally measured in the main elements of addictive behaviour, such as [R.I.F.] Brown's core facets of addiction: salience (the activity dominates the person's life, either cognitively or behaviourally), euphoria/relief (the activity provides a ‘high' or relief of unpleasant feelings), tolerance (greater activity is needed to achieve the same ‘high'), withdrawal symptoms (the experience of unpleasant physical effects or negative emotions when unable to engage in the activity), conflict (the activity leads to conflict with others, work, obligations, or the self) and relapse and reinstatement (the activity is continued despite attempts to abstain from it)."

Seeing as how research shows a not-insignificant number of gamers fit those criteria, I'd say that's compelling evidence that pathological gaming is an actual thing. But it's more than just that. Studies on the brain have shown that behavioural addictions cause the same changes in neural activity that substance addiction does, and treatments for substance dependence often work on these impulse-control problems. Yes, there are addiction centres that treat conditions like pathological gaming.

***

As with most psychological evaluations, it can be difficult to determine if a person is addicted to gaming without studying that person's life. And so, as with most psychological evaluations, we must depend on self-report to help us out. And when dealing with large numbers of people at once, as researchers do, we need surveys. Here is an example of one such survey, given in the study quoted earlier. It's geared toward school-aged children, so keep that in mind.

In the past year...

  • Has your schoolwork suffered because you spent too much time playing computer- or video-games?
  • Have you ever skipped your studies or co-curricular activities to play more computer- or video-games?
  • Do you need to spend more and more time and/or money on VGs to feel the same amount of excitement?
  • Have you played VGs to escape from problems, bad feelings, or stress?
  • Are you thinking about computer- or video-games more and more?
  • Have you stolen a VG from a store or a friend, or stolen money in order to buy a VG?
  • Have you tried to play VGs less often or for shorter periods of time, but are unsuccessful?
  • Have you become restless or irritable when trying to cut down or stop playing computer- or video games?
  • Have you ever lied to family or friends about how much you play VGs?
  • Have you ever needed to borrow money so you could get or play computer- or video-games?

In the above survey, participants respond with yes, no, or sometimes, with a yes equal to 1, a sometimes equal to .5 and a no equal to 0. If the subject's points add up to 5, they are considered to be pathological for the purposes of the study. This questionnaire is based on the DSM criteria for pathological gambling, naturally, and the 5-point requirement for classification is a DSM standard. This is fairly standard for research into gaming addiction thus far.

Of course, pathological gaming is still on the frontier in the world of psychology, so the questions above are a standard but not the standard. There is no standard, officially, on this topic, but we will have a little better view once we can see the Section 3 appendix entry on "Internet use gaming disorder" in the DSM-V in May.

In the meantime, there are plenty of psychological and psychiatric professionals out there who will tell you that gaming addiction is a very real problem for some gamers — with research ,including the study I reference earlier, indicating that as many as 1 in 11 of us could be dealing with it — and inclusion in the DSM-V appendix means more studies are coming. The next few years should be very enlightening on this topic.

If mental illness is affecting you or someone you know, call Lifeline on 13 11 14.


Phil Owen is a freelance entertainment journalist whose work you might have seen at IGN, GameFront, Appolicious and many, many other places. You can follow him on Twitter at @philrowen.


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Comments

    *EDIT* Excuse the length, seems i have lost the ability to get to the point. All those 2000 words essays about a boys feelings towards his dog or some other equally ridiculous novel plot point. They never did like me be concise and to the point with essasys. All that padding just to reach a silly word minimum.

    As someone who has been physically addicted to pain killers (I live in extreme pain on a daily basis as part of my disability) I was never emotionally addicted. Which is a very distinct difference. Once the pain killers involved were no longer helping with my pain I weaned myself off (Cold turkey gave me severe anxiety and nausea, amongst other nasty side effects). Then like that it was done. I was on this drug for around 18 months easily exceeding the recommended maximums. My body was well and truly addicted to what the drugs did, i however was not. There was no "need" to take it, I took them when i was in pain and if i wasn't they didn't get taken. Until such a time as i was in in 24/7 pain then i had slow release dosages within my system for probably 8+ months straight. Yet still i was never psychologically addicted which is why i can still take that drug once or twice and be completely and utterly fine afterwards. Which is a big reason I'm sceptical of most substance addictions. (excuses for the weak minded)

    I honestly do not believe there to be such a thing as real behavioural addiction, only weak willed/minded people who blame their actions on this "disorder". So things like this piss me off to the extreme, the above question air is the most ridiculous I've seen in a while. The very possibility of people trying to get gaming as a possible addictive item angers me for its ludicrousness.

    I would score a 4.5 or a 5 depending on the first question, In a sense I neglected my years 11 and 12 (didnt do a single thing outside school, didn't study for exams once, always went home in my periods off and played video games (even left school carnivals to play guitar hero)

    Yet I still scored in the top 14% for the country (few points shy of have a score for medicine and Psych could have done ALOT better had i done any work), receiving full honours and what not at my school. Now did I neglect school Yes, but I did it because I wanted to. School was easy boring and wasting my time so I never bothered. So for the purposes of this study i am "Addicted" to gaming.

    Yet anyone who knows me in person would know i am most definitely not addicted to gaming. I can stop playing if i wish to, I don't get "withdrawal" symptoms if i stop playing. I don't have a Behavioural need to play or "else". I simply use video games as my main form of entertainment.

    If i did the same thing but with Tv no one would question if i was an addict which just proves what a joke this kind of thing is.

    AS a last bit specifically about the question air in the "study", i'll just go in order.

    1. I ignored school because it was boring and didn't challenge me, not because i "needed to play games. Its just what i chose to do to entertain myself.

    2. ^ + Skipped "house (school ones) meetings like organising "church events or carnivals" because im an introvert, constantly being around people is draining to me.
    3.NO

    4. I'm in constant physically pain i ALWAYS play to distract myself, or when in school to distract myself from that horrible English essay/book i had to write or read.
    5.No 6. No 7. No 8. No

    9.People are stupid and annoyingly judgemental (old people are especially ignorant about technology). So if my parents asked if i had played video games all day of course im going to tell them naw i only played a few hours. (They already assumed i was addicted because I preferred to game than go to "partys" or socialise constantly) The world almost forces the average joe to believe that if someone enjoys being alone (Or is an introvert) that there is something wrong with them.

    10. Sure i was a kid, who got a small allowance, i would leverage months of future pocket money to get a game i wanted now or borrow the money from my sister.

    But according to the powers that be, just because of my introvert personality I am an addict. Behavioural addictions are nothing more than excuses for the weak minded.

    Last edited 26/01/13 2:34 pm

      I honestly do not believe there to be such a thing as real behavioral addiction, only weak willed/minded people who blame their actions on this "disorder".

      Totally agree. Calling this kinda thing an "addiction" is an insult to people with real, chemical addictions.

        yeah just imagine walking up to some guy going through heroin withdrawal and say "yeah dude I know exactly how you feel, I'm addicted to videogames". You'd be destroyed!

      I'm sorry that you suffered from such an addiction, but you sir are an idiot. It's your kind of ridiculous logic that leads sufferers of things like depression to suicide. I guess you'd be the type to tell someone suffering depression to just suck it up.

      Congratulations, you were addicted to one of the extremely few vices that aren't also enjoyable. Which makes your attempt at sounding authoritive biased and ignorant.

        You are without a doubt the stupidest person i've yet seen on these forums Ianuniacke. Excusing your blatant ignorance and sheer stupidity at the fact that people buy prescription pain killers to get high all the time, as in the same reason they buy crack pot ice or any other kind of illicit drug.

        Your failure to understand the key difference between an alleged BEHAVIOURAL addiction such as video games and a CHEMICAL IMBALANCE IN THE BRAIN I.E. DEPRESSION and my god you should be put to death.

        Your the worst kind of stupid, wrong and stupid.

          The difference in causes behind depression and addiction has nothing to do with it. You're claiming, based on absolute and utter ignorance (I'm assuming you don't have the slightest training in psychology, let alone the obvious years of training and experience as the author of the article does) that people with gaming addiction are just weak willed people. This is THE EXACT same argument that leads people of depression to suicide. If you can't see that your comments are dangerous and completely baseless than I feel sorry for you. As a supposed "addict" you should of all people have more sympathy for those suffering these kinds of conditions.

            Also I appreciate the death threat over a disagreement on the internet. Any comments I make could not display you're complete idiotic persona better.

              Again thanks for showing your stupidity once again, A death threat would be im going to kill you.

              What i said was showing my distaste for stupid people, same as I do for paedophiles or morbidly obese people, though its more stupid people shouldnt pro create and fatties should be left to die when they get heart attakcs and need their limbs removed from diabetes kind of thing. So either way its not a death threat, its cute though that you think i care enough to actually threaten you over your lack of IQ points.

              SO in relation to the actual argument, there is a difference though because A. gaming addiction isn't real and B depression IS A REAL illness.

              I dont care if depressed people kill themselves because someone tells them its all in thier head. Depression isn't a "fake" illness. If you have depression (not just depressed) you need drugs and therapy to help you cope with it. All of that has nothing to do with what i said about alleged gaming addiction because its not real.

              Its like saying there is Tv addiction too, since its the same medium. Or better yet, being addicted to work oh no thats not a real acknowledged addiction either hey. No its not the same thing and it has no bearing on depression at all.

                Hello again kingpotato...if that is indeed your REAL name. I just wanted to follow up on your comments. Did you know that what you are displaying here is in fact called "hate speech" (for instance, "fatties should be left to die when they get heart attakcs and need their limbs removed from diabetes kind of thing") and is illegal in many states and countries including Australia? So once again, thanks for your comments I'll yet again leave your own comments to speak for themselves.

                  Lol again, you seem to have a funny way with words, nothing in there is hate speech. Saying fat people should be left to their own devices is nothing but logic. Their inability to lead a healthy lifestyle cost billions a year, same goes for smokers but they pay a tax for that. If they want surgery to take a foot for type 2 diabetes (which is their own fault, both in getting it(in most cases) and not being smart about it) they should be made to pay for it. Doesn't constitute anything near hate speech. Now were i to say all fatties deserve to die because they are sub human that would be another thing entire, alas that is not the case

                  So please get off your soap box and stop trying to twist words, you have been wrong on every single point you've made and its apparent to every single person who has literacy skills. ITs why you talk about hate speech and death threats instead of offering a real counter argument to your backwards way of thinking.

        I agree with ianuniacke for the most part. Saying unilaterally that behavioural addictions don't exist and dismissing it as 'weak will' based soly on your own very specific experience and opinion isn't really a convincing argument. Althoug Kingpotato seems pretty bent on their opinion, so having a constructive conversation about it probably isn't going to work here.

    I play games because I like playing games. Games don't force me to like them. Calling that an addiction seems rather silly.

    Let's try changing the subject of this addiction.

    - Has your social life suffered because you spent too much time working?
    10 hrs a day, 3 hrs travel... Most definitely.

    - Have you ever skipped a celebration or event to work?
    Too many.

    - Do you need to spend more and more time at work to feel the same amount of excitement?
    Not so much excitement, but I need to spent more time so I can get enough don't to not miss deadlines.

    - Have you gone to work to escape from problems, bad feelings, or stress?
    I stress because of work, I work because I'm stressed.

    - Are you thinking about work more and more?
    Realised yesterday I forgot something and will be remotely connecting to work to get it done today... Yes

    - Have you stolen someone else's ideas, to complete your project work?
    Not yet... That I can remember... Hmm maybe 'borrowed' :P

    - Have you tried to work less often or for shorter periods of time, but are unsuccessful?
    I would but I need money.. house, car...

    - Have you become restless or irritable when trying to cut down how much you work?
    if I leave early, I'll think about how much extra I'll have to do the next day. Restless, yes.

    - Have you ever lied to family or friends about how much you work?
    Nope, it's a good excuse to get out of something you don't want to do :P

    - (removed as it didn't make sense in a work environment)

    Apparently according to this survey I'm addicted to work, as is I'm sure nearly every full time employee.

      So long as we can agree that nothing you just said makes any sense what so ever, then we're totally in agreement.

        Ponton here has showed how ridiculous the above questions are, work is just like playing games so its more or less a reasonable comparison. So according it he is addicted to work, which is obviously not the case. Its proving a point as to how ridiculous the idea is that one can even be addicted to video games.

        So once again Ianuniacke thanks for showing the forums why you should never post again, how 1 person can be so wrong and so stupid twice on one piece of news astounds us normal folk.

        Last edited 29/01/13 2:35 pm

          "Have you ever lied to family or friends about how much you work?
          Nope, it's a good excuse to get out of something you don't want to do :P"

          So answering NO = answering YES? Even his ridiculous "comparison questions" don't make ANY sense. Like not even from a purely logical perspective: forget about the actual reasoning.

    Psychology isn't a science at all, it's a belief system. Review the curriculum. Therefore, psychologists, like Catholics or Scientologists, are entitled to see the world as they choose. Anything, really, can be an addiction, as the brain is highly geared toward pleasure, and a lot of our choices are mindless and harmful to our general wellbeing (obesity, gaming, drinking, Facebook in, whatever, could fall into that category).. Personal choice.

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