Video game addiction: Separating the true from the false!

Addiction Jeux Video Ecran Partage

Part I

We often hear about the term video game addiction on social media. This term may seem sensationalist and even scareful.

For parents who have little knowledge of video games, this association between addiction and games could resonate as a sign of danger and create a need to restrict or prohibit the use of video games.

A first question would be: “Can games cause addiction?”

A simple answer would be to say, “Yes.” Yes, video games can cause addiction.

On the other hand, let’s not stop at this simplified answer, because we could also say that: “No”, video games can not cause addiction.

Thus, it is a complex answer, because the diagnosis of addiction requires meeting several specific criteria, and there is such a great diversity of video games, that we can only answer with a simple “Yes” or “No”.

Understanding what addiction is, makes it possible to better prevent it

Let’s start by demystifying the term “addiction” in mental health.

First of all, addiction can be defined as intolerance, difficulties in managing lack and envy and excessive desire for a thing/person/stimulus that will lead to considerable difficulties and problems of daily functioning in the individual who ceases contact or consumption of the thing/person/stimulus (World Health Organization, 2018).

An important criterion to observe is then the level of social, relational, emotional functioning of the person that could result from the over-use of an object, here video games (Byun et al., 2009).

In mental health in Quebec, there are two main resources for diagnosis: the Diagnostic and Statistical Manual of Mental Disorders (DSM) of the American Psychiatric Association (APA) and the International Statistical Classification of Diseases and Related Health Problems (ICD).

The DSM is in its5th edition which was revised in 2013. In this new version, we find the name “Substance-related disorders” and “Addictive disorders” (behavioral addictions). A disorder recognized in Addictive Disorders isGambling disorder(Gazel, Fatséas and Auriacombe, 2014).

We speak of Disorder, when the behaviors interfere with the functioning of the young person in his daily life

So, what is Internet Video Game Disorder?

Thus, what we can call the “Internet Gaming Disorder”, or “Internet Gaming Disorder”, is not yet considered a disorder officially diagnosed in mental health, but is considered one of the disorders under study for future editions of the DSM.

Diagnosis would be possible when the video game would cause significant impairment or distress in several aspects of a person’s life. This condition would be limited to video games and would not include problems related to the use of the Internet, online gambling or the use of social media. The proposed symptoms of Internet gambling disorder are:

  1. a concern for gambling;
  2. Withdrawal symptoms when gambling is suppressed or impossible (sadness, anxiety, irritability);
  3. Tolerance, need to spend more time playing to satisfy the desire;
  4. The inability to reduce the game, unsuccessful attempts to stop playing;
  5. Abandonment of other activities, loss of interest in activities previously appreciated because of gambling;
  6. Continue to play despite the problems;
  7. Deceive family members or others about the time spent playing;
  8. The use of gambling to relieve negative moods, such as guilt or despair;
  9. Risk, have endangered or lost a job or relationship because of gambling.

According to the proposed criteria, a diagnosis of Internet Gambling Disorder would require experiencing at least five of these symptoms in a year.

However, the authors of DSM-5 considered that scientific research was insufficient to define Internet gaming disorder as an indisputable disorder, and introduced it in the section of pathologies requiring further study (APA, 2013; (Gazel, Fatséas and Auriacombe, 2014; Parekh 2018).

However, the concept of Internet video game disorder has been debated within the scientific community.

The implementation of the diagnosis ofGaming disorder

In 2018, the World Health Organization (WHO), in its 11th edition, proposed gaming disorder as a diagnosis in its own right (World Health Organization, 2018). Notably, in South Korea and China, video games have been recognized as a disorder and treatment programs have been put in place (Parekh, 2018).

Gaming disorder is defined in ICD-11 as:

“a game behavior characterized by a loss of control over that game, an increasing priority given to the game over other activities to the point that the game takes precedence over other interests and daily activities, and the continuation or intensification of the game despite the appearance of negative consequences.”

For this disorder to be diagnosed, the behaviours must be significant enough to cause a significant impairment of personal, family, social, educational, professional or other important functioning, and must have been present for at least 12 months. (World Health Organization, 2018).

The inclusion of Gambling Disorder in ICD-11 follows the development of treatment programs for people with health conditions similar to those that characterize Pathological Gambling Disorder in many parts of the world.

Less than 1% of the general population would have a real Gambling Disorder, which is a very small proportion.

A diagnosis that concerns few players

Nevertheless, studies of player populations suggest that Gambling Disorder (ICD-11) affects only a small proportion of video game players. Studies conducted in the United States, the United Kingdom, Canada and Germany have shown that 0.3 to 1.0% of the general population may respond to a potential diagnosis of Gambling Disorder.

There would then be an important distinction between passionate engagement (a person who is enthusiastic and focused on video games) and pathology (a person who suffers from an addiction) (Parekh, 2018; Zastrow 2017).

Despite the low statistically speaking probability of having a video game addiction, many parents and/or child-teens may be worried about having symptoms or even having a diagnosis of Gambling Disorder. The next article will discuss in more detail the diagnostic criteria and above all, how to properly identify them at home, to intervene at the right time!

Dr. Elsa Brais-Dussault/ LudiPsy

To read part 2 of this article, click here!

About Elsa Brais-Dussault, psychologue

Psychologue et passionnée de jeux! Les jeux vidéo, les jeux de société, les jeux de rôles et les GN... J'ai fondé la plateforme LudiPsy: santé mentale et ludification pour mettre de l'avant l'intégration de la ludification dans la pratique en santé mentale.

View all posts by Elsa Brais-Dussault, psychologue