Should Video Game Disorders be Classified as a Disease?
As the 21st century advances, the world becomes increasingly reliant on technology. With that, different forms of tech emerge constantly, and are constantly pushing the boundaries of what is possible. This is what makes markets such as the gaming industry such a profitable and mainstream world. As consumers are constantly looking for more and more content to engage in, video games have become one of the most common hobbies and ways to pass time to date. Unfortunately, this can often lead to extreme cases of addiction and behavioral changes to individuals, if held long enough from games. Recently, the World Health Organization has officially recognised gaming disorder as an international disease. For many, this begs the question; should video game addiction be classified as a disease? What separates video games from physical sports, and what constitutes these disorders and addictions?
What Is Video Game Disorder?
For a very long time, video games have been a controversial subject. There have been debates about whether video games cause violent tendencies in children, and whether they can have detrimental effects on children’s brains. However, in 2018, the World Health Organization made a revision to the International Classification of Diseases(ICD) regarding video games. The ICD is a set of rules based on global health trends and statistics for reporting health conditions which is used by medical practitioners and researchers to treat and categorize a number of health conditions. In this 11th revision to the ICD, gaming disorder was classified as a diagnosable health condition. In an article written by the WHO titled Gaming Disorder, the organizations states “A decision on inclusion of gaming disorder in ICD-11 is based on reviews of available evidence and reflects a consensus of experts from different disciplines and geographical regions that were involved in the process of technical consultations undertaken by WHO in the process of ICD-11 development. The inclusion of gaming disorder in ICD-11 follows the development of treatment programmes for people with health conditions identical to those characteristic of gaming disorder in many parts of the world, and will result in the increased attention of health professionals to the risks of development of this disorder and, accordingly, to relevant prevention and treatment measures.”(WHO). This is why the WHO states it is reasonable to classify and include gaming disorder within the IDC-11. As soon as this revision was released, it sparked debate with psychiatrists as to whether there had been enough research to classify it as a disease. According to the WHO, the definition of gaming disorder is a pattern of uncontrollable gaming for at least 12 months, behavior that has increased priority for gaming over other interests and activities, and increased amounts of gaming despite the negative consequences on relationships and other aspects of the person’s life. These symptoms may seem ambiguous but as of now they are enough to diagnose someone with gaming disorder. Interestingly, this is not the first time that gaming was recognized as an actual disorder. The Diagnostic and Statistical Manual of Mental Disorders, or the DSM, is similar to the ICD in that it a classification system for diseases in patients. However, as the name suggests, the DSM only deals with psychiatric disorders rather than all diseases. In 2013, the 5th edition of the DSM(DSM-5) was published, and it included “internet gaming disorder” as a mental disorder in one of its sections. Though this did not gain as much attention as when the WHO declared it a disorder, it still set the basis for the claim that excessive gaming could indeed be considered a mental health issue. For the addition to internet gaming disorder in the DSM-5, researchers and clinicians from all over the world began their studies starting in 2007. They were divided into several work groups to compile data on different aspects on how people can become addicted to gaming. One of these work groups was the substance abuse disorder group. It attempted to examine internet games and gaming itself as a “substance” that a person could become addicted to. This group consulted articles and literature about gaming addictions. However,there were many inconsistencies and different criteria for every study. The article Internet Gaming Disorder: Trends In Prevalence 1998 – 2016 by James Bourgeois, states “A study displays only 0.6% of a sample showed signs of gaming disorder, while another sample shows 52.8%.”(Bourgeois et al 1). This is further supported by figure 2 of the article, which shows the large number of outliers in the graph. This is why so many inconsistencies occur amidst research of these topics. For each year, there is a large deviation between each point indicating the prevalence of gaming disorder. There were inconsistencies in those as well because different areas of brain activity was recorded in different individuals who were believed to have gaming disorder.
Despite all the inconsistencies, gaming disorder was still included in the DSM-5, which shows that even though it was classified by an official organization there is still much research to be done in this area. The DSM-5 classification of gaming disorder follows the same set of rules as the WHO definition. These symptoms can be seen in a very large number of people, mostly adolescents, however it does not always mean that the person has gaming disorder. For this reason it has fueled many parents fears about their child being addicted to video games, even though the WHO claims that only three percent of gamers are actually affected by this disease. Many children may just be attempting to play a few games online with their friends while their parents worry that they are seriously addicted. This fear and lack of understanding makes the situation more dangerous than it already is and makes video games all the more controversial than they had already been.
“This is a real problem…People are starting to realize this is a real addiction.” says Dr Judith Joseph, a Board Certified Child and Adolescent Psychiatrist. In a brief interview with MedCircle in their video Gaming Addiction: When Does Video Gaming Become a Problem, Dr Judith compares the issue with gambling and alcohol addiction, and states “People are starting to realize that addiction doesn’t just apply to just drugs and substances, but it applies to certain behaviors – like gaming.”. Dr Judith essentially states that when an individual places gaming as a priority over other behavior that puts them in harm. When people play a video game, they sort of leave reality and forget about their world, where it is easy to exhibit states such as anxiety, depression, ADHD, but not acknowledge it because gaming seems like a remedy, which she explains, is anything but. Often, gaming disorder is the culprit behind certain behavior, when most parents would think it is depression or a lack of social skills. “By definition you’ve got to have some impairment in functioning.” said Dr Judith when questioned about it being possible to game for ten hours a day but also maintain good grades and having healthy relationships. So while it may be possible for someone to play video games for ten hours a day and still function, this usually isn’t the case. To Dr Judith and the APA, this is what classifies an addiction and why gaming disorder is a major issue, since it is possible to have extended sessions of gaming and still function without any impairment, but for many, this simply isn’t possible.
Links Between Video Games and Other Things
For a long time the internet has been associated with attention deficit hyperactivity disorder(ADHD) in adolescents. However, there have also been links found between ADHD and video games. According to an article by Rabinowitz and Chan; A cross-sectional analysis of video games and attention deficit hyperactivity disorder symptoms in adolescents, a study was done in order to test whether there was a connection between playing video games and changes in attention span, social activities, and academics. “This study was completed with 72 adolescents and 72 parents. Their time using the internet, television, and video games was monitored. The adolescents took a test called the Young’s Internet Addiction Survey (YIAS) and the parents took a test called the Conners Parent Rating Scale (CPRS), which is commonly used to identify whether children display symptoms of ADHD…The results of this study showed that there was an association with children playing video games for more than an hour a day and grade point average, and “inattention”.”(Rabinowitz et al 2). Students who played for more than an hour a day had slightly lower grades than their peers, and according to the parents’ responses to the CPRS, the attentiveness of their children was not as high as children who did not play for an hour a day or more. Another article written by Bouvard, Arfi, and Bioulac tested the effect of video games on hyperactive children and control children. This article was titled Video Game Performances Are Preserved in ADHD Children Compared With Controls. This article was written with the intended purpose of exploring the performance of children with ADHD on playing video games to find a correlation. This was done using a scale known as the Problem Videogame Playing Scale (PVP scale) was used. This scale is used to determine whether someone is addicted to video games or not. “Researchers noted that there were no significant differences between the hours played by either groups of children. However, there was a large difference in the results of the PVP test. The PVP test consists of only 9 yes or no questions, and the highest number of affirmative answers by the control group was four. For the children with ADHD, all of them answered yes to at least 5 questions, with many of them answering yes to even more. The ADHD children that played video games displayed a greater intensity of their condition as opposed to the ones that did not.”(Bioulac et al 5).This supports the idea that video games can exacerbate the condition of children with ADHD, and as shown in the first study they may cause children without ADHD to have lower attention spans and subsequently cause their grades to get lower. In addition to these concerns, there are also other detrimental effects that excessive gaming can have on people. For example, when people give more attention to video games than the people in their lives, this causes relationships to degrade, which can have further negative effects on a person’s mental health. When people play video games for long periods of time, continuous exposure to the screen can have negative effects on eyesight, such as blurred vision, eye discomfort, and even headaches. Not only the eyes can be affected, as most of the time while playing, gamers will be fully engaged with using their hands. They may become fatigued and in extreme cases may develop carpal tunnel.
Behavioral Changes
Often, the most damaging and noticeable symptoms in regards to disease and addictions are behavior changes in individuals. “Numerous studies have been performed to demonstrate the effects of video games on subjects behavior to initiate a change in the individual’s demeanor, ranging from simple habit changes, to extreme emotional instability as a result of being deprived of video game, or experiencing events within a video game that desensitizes players from the real world.”(How Playing Video Games Affects Your Body and Brain, Kevin Loria). The most common conclusion that studies display are exposure to media increases aggression and mental temperament is easily skewed to anger in common situations. “While the specific mechanisms that correlate to these changes are unknown, one theory is that constant exposure to content with violence or easily accessible gaming features decreases patience for players, as they’re desensitized to violence, accept it as normal, and are always ready to exhibit events that are successful.”(Loria 2). Players are conditioned because of the normalization of violence, and how easily feats are achieved in game, opposed to life beyond the virtual world.
While some exhibit more aggressive behavior after continuously indulging in video game media, others reap more positive results from repeated sessions. In relation to a book, video games are much more engaging to the player than a book is to the reader. In the text Children and Video Games: Addiction, Engagement, and Scholastic Achievement written by Marko M. Skoric, Linda Lay Ching Teo, and Rachel Lijie Neo it states “Studies report that brain scans display an average of 43% more of the brain being utilized during focused gaming when compared to readers.”(Skoric et al 2). To add on “a far greater amount of dopamine is released when playing video games for long periods of time when compared to reading a book, for a lasting period of time.”(Seth Schiesel, The Real Problem With Video Games). This seems obvious as dopamine is produced as a result of reward motivated behavior, as objectives in video games often have the player achieve. While both positives and negative behavioral changes can be apparent during extensive video game sessions opposed to actions such as reading, in comparison, video games fail over longer periods of time, and acts almost like a drug to the player. For those who receive a dopamine rush from gaming, there is a steep plateau after a high rush of dopamine. It can be difficult to achieve that level of dopamine again, or when the brain is conditioned to tolerate higher levels of dopamine over shorter periods of time, video games easily convert those initial “happy” people into aggressive, or even experience depressive states when it can’t be achieved again. Despite this, players return to the game in hopes of achieving it, but their mind reaches an exhaustion state of stress and results in different behavior changes. This is why over time video game disorders take form, and can change the behavior of a player, which is inevitably harmful to the consumer if not done over controlled periods of time.
Video games can have a multitude of benefits beyond the simply enjoyment of gameplay and story, there is no doubt that addiction is extremely possible. This is why video games can be classified as a disease. One of the reasons why this is possible for video games, opposed to other hobbies such as sports, is: one, because of how extensive games have become (they’re available on consoles, laptops, cellphones), and two, because of the limitations that don’t exist. Video game disorders occur primarily because individuals prioritize games over necessities, such as food and sleep. The same can’t be said for a sport, as many require the body to have energy, while video games aren’t as physically consuming. This, and a plethora of other reasons are why video games disorders are classified as an international disease.
Works Cited
“Gaming Disorder.” World Health Organization, World Health Organization, 14 Sept. 2018, www.who.int/features/qa/gaming-disorder/en/.
Bourgeois, James, et al. “Internet Gaming Disorder: Trends in Prevalence 1998-2016.” Addictive
Behaviors, U.S. National Library of Medicine, Dec. 2017,
www.nbi.nlm.nh.gov/pmc/artices/PMC5821/.
Philip A Chan, and Terry Rabinowitz. “A Cross-Sectional Analysis of Video Games and
Attention Deficit Hyperactivity Disorder Symptoms in Adolescents.” Annals of General
Psychiatry, BioMed Central, 24 Oct. 2006,
annals-general-psychiatry.biomedcentral.com/articles/10.1186/1744-859X-5-16
Skoric, Marko M, et al. “Children and Video Games: Addiction, Engagement, and Scholastic
Achievement.” Mary Ann Liebert, Inc., Publishers, 9 Oct. 2009,
www.liebertpub.com/doi/abs/10.1089/cpb.2009.0079.
Bioulac, Stephanie, et al. “Video Game Performances Are Preserved in ADHD Children Compared With Controls.” Sagepub, 24 May 2012, journals.sagepub.com/doi/abs/10.1177/1087054712443702.
Loria, Kevin. “How Playing Video Games Affects Your Body and Brain.” Business Insider, Business Insider, 19 June 2018, www.businessinsider.com/video-games-and-violence-2018-3#the-release-of-games-like-grand-theft-auto-didnt-seem-to-increase-crime-rates-and-may-do-the-opposite-4.
Schiesel, Seth. “The Real Problem With Video Games.” The New York Times, The New York Times, 13 Mar. 2018, www.nytimes.com/2018/03/13/opinion/video-games-toxic-violence.html.
Joseph, Judith,. Gaming Addiction: When Does Video Gaming Become a Problem? YouTube, MedCircle, 16 Apr. 2019, www.youtube.com/watch?v=u3avMv4v-j0.
