What is Gaming Disorder?
Gaming disorder can be considered on a ‘continuum that extends from healthy to hazardous and harmful to pathological behavior.’ (King & Delfabbro, 2019).
How to Define Gaming Disorder
Without consistently using accurate terminology when referring to gaming disorder, clinicians and helping professionals will regularly miscommunicate with clients, leading to confusion and ineffective therapeutic alliances. Many terms have been assigned to gaming problems, but not all of them are appropriate or effective.
INTENTA uses gaming disorder, problematic gaming and at-risk gaming to describe the range of issues that may arise from excessive gaming. Other definitions, such as internet gaming disorder, online video gaming and internet addiction are markedly imprecise, and therefore not used in the Gaming Disorder Clinical Training program.
We categorize gaming into four types:
Recreational gaming: This is gaming for fun without any notable at-risk behaviors associated with or within the game. Individuals may game casually, e.g. infrequently or irregularly.
At-risk gaming: This term refers to gaming behavior that does not yet have a pattern of consequences. It indicates identifiable behaviors that, if continued over time, may result in problems and ultimately disordered gaming.
Problematic gaming: This type of gaming behavior is significant but does not meet diagnostic criteria.
Gaming disorder: This description refers to disordered gaming as met by the diagnostic criteria.
Other Definitions of Gaming Disorder
As a new diagnostic classification, gaming disorder continues to develop through ongoing research. Multiple organizations have provided their own definitions of problematic and disordered gaming, and this blog will review the most important of these. Please note: it not a comprehensive list of all definitions but represents the best understanding in the research and clinical communities to date.
World Health Organization Classification (ICD-11)
The most important recent classification is from the World Health Organization (WHO). Its eleventh iteration of the International Classification of Diseases (ICD-11), will come into effect at the beginning of 2022.
The WHO has defined gaming disorder as follows: ‘Gaming disorder is characterized by a pattern of persistent or recurrent gaming behavior (digital gaming or video-gaming), which may be online (i.e. over the internet) or offline, manifested by:
- impaired control over gaming (e.g. onset, frequency, intensity, duration, termination, context)
- increasing priority given to gaming to the extent that gaming takes precedence over other life interests and daily activities; and
- continuation or escalation of gaming despite the occurrence of negative consequences. The behavior pattern is of sufficient severity to result in significant impairment in personal, family, social, educational, occupational or other important areas of functioning.
The pattern of gaming behavior may be continuous or episodic and recurrent. The gaming behavior and other features are normally evident over a period of at least 12 months in order for a diagnosis to be assigned, although the required duration may be shortened if all diagnostic requirements are met and symptoms are severe.’
In the ICD-11, gaming disorder is classified next to gambling disorder as ‘addictive behaviors.’ At INTENTA, we sometimes refer to gaming disorder as a gaming addiction but generally refrain from this terminology as it has multiple other implications and emotional attachments.
American Psychiatric Association Classification (DSM-5)
The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM–5) released by the American Psychiatric Association includes a proposed criteria for internet gaming disorder. It is not an official disorder in the DSM. It suggests that more research is needed in order to classify gaming as an independent disorder.
According to the American Psychiatric Association, the proposed criteria for internet gaming disorder is the persistent and recurrent use of the internet to engage in games, often with other players, leading to clinically significant impairment or distress as indicated by five (or more) of the following in a 12-month period:
- Preoccupation with internet games. The individual thinks about previous gaming activity or anticipates playing the next game; internet gaming becomes the dominant activity in daily life. (This disorder is distinct from internet gambling, which is included under gambling disorder.)
- Withdrawal symptoms when internet gaming is taken away. These symptoms are typically described as irritability, anxiety or sadness, but there are no physical signs of pharmacological withdrawal.
- Tolerance—the need to spend increasing amounts of time engaged in internet games.
- Unsuccessful attempts to control the participation in internet games.
- Loss of interest in previous hobbies and entertainment as a result of, and with the exception of, internet games.
- Continued excessive use of internet games, despite knowledge of psychosocial problems.
- Has deceived family members, therapists or others regarding the amount of internet gaming.
- Use of internet games to escape or relieve a negative mood e.g. feelings of helplessness, guilt, anxiety.
- Has jeopardized or lost a significant relationship, job, or educational or career opportunity because of participation in internet games.
It is interesting to note the similarities between the American Psychiatric Association (DSM-5) and the World Health Organization (ICD-11) classifications.