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Science Unsure Whether Internet Gaming Is a Mental Disorder

Internet gaming disorder is the name of a proposed mental health condition designed to give mental health professionals the ability to diagnose a dysfunctional, addictive pattern of playing video games, especially games played over the Internet.

Tentatively, it belongs to a group of disorders known as behavioral addictions or process addictions. The American Psychiatric Association (APA), which provides the U.S. standard for mental health diagnoses, has not officially recognized Internet gaming disorder, but has designated the condition as a target for future research and consideration. In a report published in 2013 in the journal Addiction, a multi-institution research team explains some of the reasons Internet gaming disorder has not received official APA recognition.

Substance Addiction Vs. Process Addiction

In its classic definition, addiction is a physical and psychological condition that stems from the prolonged, excessive use of certain substances known to make long-term changes in normal brain function. Specifically, the substances in question change the brain’s chemical makeup and trigger increased sensations of pleasure. The process of addiction starts when the brain begins to physically depend on the presence of a given substance in order to work “normally.” It continues when the affected individual develops ongoing cravings for a substance and starts to center his or her daily life on substance acquisition and use, regardless of the negative outcomes. Common examples of the substances capable of producing physical dependence and addiction include alcohol, cocaine, amphetamine and methamphetamine, heroin and other opioid narcotics, sedative medications, marijuana and nicotine. In mental health terms, abuse/addiction issues related to substance use fall into a category of conditions called substance use disorders.

Doctors and other mental health professionals have long noted that some of the highly dysfunctional behaviors found in people affected by substance addiction are closely or precisely mirrored by the behaviors of certain people unaffected by substance use problems. Modern research strongly indicates that these behaviors, known as process addictions, stem from the same pleasure-seeking motivations and the same basic changes in brain chemistry as the various forms of substance addiction. As of 2013, the American Psychiatric Association has officially recognized only one specific form of process addiction: pathological gambling. This addiction is diagnosable by doctors as gambling disorder. In addition to addictive video gaming, other unrecognized process addictions include sex addiction, exercise addiction and shopping addiction.

Internet Gaming Disorder’s Current Status

In addition to creating the definitions for officially diagnosable disorders, the American Psychiatric Association sometimes designates proposed disorders as targets for future research efforts and future consideration as recognized conditions. It does this when members of the organization feel that they have enough scientific evidence to indicate that creation of a new condition might be warranted, but not enough evidence to fully validate an official recognition. Currently, the APA states that Internet gaming disorder fits this intermediate ground. It also states that, after reviewing additional evidence, it will make a final decision about the status of the proposed disorder at an undetermined point in time.

Reasons for This Status

In the report published in Addiction, researchers from the University of Pennsylvania and the University of Connecticut School of Medicine explored the current state of evidence regarding the existence of Internet gaming disorder and examined some of the obstacles that currently prevent the condition from receiving official American Psychiatric Association recognition. They note that, while research is fairly scant for certain forms of process addiction, more than 250 studies have focused on the issue of addictive video gaming. Some of these studies have specifically focused on online gaming, while others have taken a broader look at video gaming in general. Currently, most available research comes from Asia and Europe.

Despite the volume of research on Internet gaming disorder, several substantial obstacles remain in accurately documenting or verifying the condition. Chief among these obstacles is the fact that studies on the subject do not consistently define the terms of a video gaming addiction. There is also relatively little evidence about how the condition develops in any given individual or changes over an extended period of time. For these and other reasons, no one really knows how many people might be affected, or what shape such an addiction truly takes in everyday life. While some facilities in the U.S. have begun treating Internet gaming disorder under one name or another, these facilities do so without the strictly defined criteria and evidence of effectiveness that normally guide addiction treatment options.

Considerations

As part of its efforts, the American Psychiatric Association has put forth nine specific symptoms that might eventually come to define Internet gaming disorder. In order to meet the interim unofficial definition for the condition, an affected individual would need to have at least five of these symptoms, as well as an associated inability to function normally in one or more necessary aspects of a daily routine.

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