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Game Over: Is ‘gaming disorder’ real?

While long suspected to be addictive, gaming that interferes with one’s daily life has now been designated as a “disorder” by the World Health Organization (WHO).

Importantly, a “gaming disorder” diagnosis isn't based on how much time someone spends on gaming: like other addictions, it is the effect the disorder has on a person's daily activities, interests and relationships, among other factors, that is the determining factor.

Individuals need to show these symptoms for 12 months to receive an official diagnosis.

Predictably, the booming gaming industry – which made nearly $44 billion in sales last year – has challenged the legitimacy of the diagnosis, arguing that gaming addiction doesn’t exist and the new designation “recklessly trivialises real mental health issues”.

However, mental health professionals have welcomed WHO’s move, with The American Psychiatric Association estimating that upwards of 75 million suffer from the condition globally.

Dr John Jiao, an emergency doctor in the US, explained on Twitter that gaming disorder was not about how much time someone spent playing. Instead, “It's when gaming takes precedence over health, hygiene, relationships, finances, etc.”

He did, however, have a problem with the term "gaming disorder".

Several of the University of Sydney’s academics have weighed in on the diagnosis. Professor Alex Blaszczynski, Director of the University of Sydney’s Gambling Treatment Clinic, worries about how the diagnosis will pathologise “normal” behaviour.

“Although gaming disorder can lead to harms through excessive play interfering with study, work and relationships, the concept of it representing a behavioural addiction remains to be established,” he said.

“An important question is the causal connection between a range of social-environmental factors and personality traits and the emergence of excessive gaming.

“Are we pathologising normal behaviours, given some forms of video gaming are popular and promote social peer group interactions, by labelling them an addictive disease process?”

While unconvinced of the diagnosis’s legitimacy, Professor Blaszyznski said treatment options are appearing around the world.

“Treatment of gaming disorders remain in their infancy. Programs have been developed in China and Korea, some of which entail residential courses designed to ‘de-tox’ the addiction and deal with withdrawal symptoms.

“Cognitive therapies based on gambling addictions need to be evaluated for their effectiveness, and the role of parents needs further assessment. The role of regulators in providing sufficient information to players of how games operate is important in respect of in-app purchases. “

Dr Marcus Carter, a lecturer in digital cultures at Sydney University, also takes issue with gaming ‘addiction’ being pathologised as a “disease”.

“A key issue with the overzealous and unfounded designation of gaming addiction as a disease by WHO is its impacts on children, for whom gaming is nothing but a rich, rewarding and positive experience,” Dr Carter said.

Renowned Head of the Department of Psychiatry, Associate Professor Vladan Starcevic, similarly repudiated the basis for the classification.

In a co-authored paper entitled ‘Internet gaming disorder does not qualify as a mental disorder’, the expert in obsessive-compulsive disorders and gaming addiction deals with the topic.

“In our view, problematic online gaming and its ‘offshoots’ such as [Internet gaming disorder] and gaming disorder should not be conceptualised as a mental disorder,” the paper states.

However, a survey of Australian and New Zealand psychiatrists in 2017 found that 35 per cent believed that “Internet gaming disorder” may be common with their practice.

Despite WHO’s new classification, it appears the jury is still out on this diagnosis.

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