The World Health Organisation (WHO) over the weekend finalised the eleventh revision of its International Statistical Classification of Diseases and Related Health Problems (ICD-11), which included a number of new additions to the list – some more controversial than others. The WHO’s official list now includes “gaming disorder” and “hazardous gaming” as part of its list of behavioural disorders and mental health conditions. Naturally, the gaming industry itself have been pushing back hard against the classification, but there’s plenty of anecdotal evidence that it exists.
While simply playing a lot of video games, competitively or casually isn’t exactly enough to count as a disorder. Rather, the disorder occurs when gaming interferes with people’s daily lives and changes the quality of their lives as a result. According to the WHO, gaming disorder is a “pattern of persistent or recurrent gaming behaviour” in which people lose control of their gaming behaviour, give priority to gaming over other interests and activities, and continue gaming despite negative consequences, such as impairments in their family relationships, social lives, work duties or other areas.
The topic of video game addiction has been controversial for quite some time now, despite many studies being conducted on the matter swaying in both directions. The American Psychiatric Association (APA) did not include video game addiction in its most recent edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published in 2013. At that time, the APA said there wasn’t enough evidence to determine whether gaming disorder is a unique mental health condition, but recommended further research in the area.
The video game industry also opposes the classification. In a statement released on Saturday (May 25), the Entertainment Software Association and others in the industry called on the WHO to reverse its decision, saying “gaming disorder” is not based on sufficiently robust evidence to justify inclusion.”
But some mental health experts are supportive of the classification. On Twitter, Dr. John Jiao, an emergency medicine doctor, said the diagnosis was “sorely needed.”
“Otherwise people with real, legitimate video game addiction can often have trouble with insurance paying for their therapy, especially if they don’t fit any other diagnosis,” Jiao tweeted. Dr. Shekhar Saxena, a mental health expert for WHO, noted that only a small minority of people who play video games will develop addiction problems, according to Reuters.
However, the International Classification of Diseases is a system for classifying diseases and disorders for purposes of epidemiological research, health care management and billing, and clinical treatment. It has a chapter set aside for “mental, behavioural or neurodevelopmental disorders,” where gaming disorder is listed.
Its language calls gaming disorder “a pattern of persistent or recurrent gaming behaviour (‘digital gaming’ or ‘video-gaming’), which may be online (i.e., over the internet) or offline.”
Those with gaming disorder may show “impaired control over gaming,” “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 occurence of negative consequences.”
While the ICD is not technically enforceable law, it is greatly influential in how professionals and policy makers study and propose treatment or intervention in public health matters, and the way they view the gaming industry as a whole. For many individuals, that influence can be felt at a patient level.
There are also a number of valid criticisms of the WHO’s description of gaming disorder, as mental health and gaming organisation Take This points out. While Jiao’s brainstorming thread provides some helpful context to the definition of the disorder, those details are not in the official diagnostic guide published by WHO.
The down side to the addiction is that the definition of the “illness” is rather ambiguous and vague, which leaves each individual case up to personal interpretation – at least until more research is done on the matter. Streamers and esports pros have to start somewhere, and while amateurs aren’t making a living off of gaming at the moment, they still have to put in that time and effort to get to that level. Their time spent playing could fit within the description of gaming disorder quite easily. Although with a little time and patience, we’ll know doubt be able to identify “symptoms” more clearly in the future.