Should Video Game Addiction Be Recognized as a Mental Illness?

Some psychologists say no.

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It’s easy to get sucked into a video game, whether you’re lost in a richly rendered world or still, for some reason, playing Pokémon Go.

But while gamers might think that the urge to game constantly is a normal side effect, there’s a growing movement within the mental health profession to label excessive gaming as an addiction.

Two organizations are advocating for video game addiction to be officially recognized as a diagnosis. The fifth edition of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders — the official resource that outlines criteria for diagnosing mental illnesses, referred to more commonly as DSM V — includes Internet gaming addiction as a condition recommended for further study.

And on the global scale, the World Health Organization, which produces the International Statistical Classification of Diseases and Related Health Problems — ICD for short — has proposed a “gaming disorder” entry in a beta draft of its upcoming 11th edition. The DSM is essentially the definitive source on what is and isn’t considered a mental disorder, while ICD is the coding system used across hospitals and insurance companies to track diagnoses and figure out whether your insurance covers you. With that being the case, officially recognizing video game addiction in either or both of these resources would entrench it pretty firmly as a legit diagnosis.

However, there is a rising tide of psychologists who dispute the notion that video games deserve to be singled out as a unique disorder or addiction.

Anthony Bean, Rune Nielsen, Antonius van Rooij, and Chris Ferguson recently collaborated to publish a dissenting opinion. Their scathing opinion piece, “Video Game Addiction: The Push To Pathologize, Not Recognize,” will be published in the journal Professional Psychology: Research and Practice and emphasizes the potential pitfalls of using the same diagnostic criteria for both substance use disorder and so-called video game addiction — or as it’s called in the DSM V, “Internet Gaming Disorder.”

Obsession isn't necessarily the same as addiction.

DeviantArt/ JoRgE-1987

“The decision was made by some scholars to assume that the criteria that the DSM used for substance abuse could simply be transferred over and applied to video games,” Ferguson, a psychology professor at Stetson University, tells Inverse. “So you could take the wording of different symptoms, simply remove the word ‘heroin,’ for instance, and put in the words ‘video games.’” He thinks this logic doesn’t make sense.

Ferguson agrees that some video game players’ behaviors could certainly be classified as worrisome, but he argues that there are serious problems with approaching a non-drug behavior as if it’s meaningfully similar to chemical dependence, as some of the proposed criteria under which a person might be diagnosed as having “Internet Gaming Disorder” seem to do.

“You get questions like, ‘I use X in order to make myself feel better when I’m stressed.’ Of course, if X is heroin, that’s bad,” says Ferguson. “But if X is gardening, most people would assume that’s a hobby. There’s nothing bad about gardening.” And the same could be said for gaming, that it’s a hobby. Ferguson argues that there’s nothing wrong with someone coming home after a stressful day and winding down with video games, even if their gaming habits might fit the DSM criteria for a disorder.

The DSM V proposes "Internet Gaming Disorder" as an area that merits further study.

American Psychiatric Association

The authors also address the concerns over video gaming that have been brought up in the academic literature, which focus on the tendency for internet games, specifically MMORPGs, to be isolating and habit-forming.

“There is such a thing as high engagement, and if we bastardize it, we actually create a problem that doesn’t really exist,” Bean, a clinical psychologist who focuses on video games, tells Inverse, suggesting that just because you do something a lot doesn’t mean you’re addicted to it. Furthermore, he and his colleagues argue that gaming can enrich the social lives of players by helping them form relationships with people who share their hobby.

The authors also say that when assessing gamers’ habits, it’s important to consider how their socialization is affected.

“Social aspects of video games, including MMORPGs, have been shown to be helpful for positive self-esteem development, appropriate social interaction engagements, and with the help of increasing social aspects of individuals with autism, a clinical population known for their difficulties with social engagement but increased video game-playing tendencies,” write the authors.

And while the paper’s authors generally argue against the addiction, they recognize that some people may indeed exhibit problematic use and need help. Even in that case, though, Ferguson argues that there’s no reason to separate video games from other behaviors that could be considered addictive, like sex, exercise, or work.

“They could possibly fit into a larger, broader category of behavioral addictions, but there doesn’t seem to be a clear theoretical platform for arguing that video games are special and deserve their own diagnosis,” Ferguson says.

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