The World Health Organization (WHO) has classified video game disorder as an official mental health disorder, which will go into effect in January 2022. It's defined in the 11th Revision of the International Classification of Diseases (ICD-11) as a pattern of gaming behavior characterized by impaired control over gaming, increasing priority given to gaming over other activities to the extent that gaming takes precedence over the interests and daily activities and continuation or escalation of gaming despite the occurrence of negative consequences.
The ICD is used by medical practitioners worldwide to diagnose conditions, and also by researchers to categorize conditions.
I had a chance to interview Chris Ferguson, Ph.D., professor of psychology at Stetson University, video game expert and researcher.
What led to the classification of gaming addiction as a mental disorder by the WHO?
It's been part of an ongoing debate that stretches back decades about how best to conceptualize behavioral overuse issues and whether gaming should be singled out (as opposed to the many other things some people overdo). The WHO acknowledged being under pressure from "Asian Countries" to make this happen, so there was definitely some politics involved in this. Ultimately, a lot of scholars were quite critical of the decision by the WHO, feeling research evidence doesn't support it. For instance the media psychology divisions of the American Psychological Association and Psychological Society of Ireland wrote a public statement opposing the WHO. So it remains very controversial.
What are the implications of this classification?
Well, it opens the door for insurance reimbursement for those diagnosed with the condition, particularly outside the US (the US mainly uses the American Psychiatric Association's system.) Each country will have to decide if they want to adopt this, so that could still take years. Given that, in most cases, people who overdo gaming (or other behaviors) tend to have another mental illness such as depression or anxiety, it's not clear how many people this actually "helps."
On the other hand, there are other implications that are less clear. This is the first time a routine hobby got declared a mental illness, so I suspect this will revive criticisms of psychiatry more widely, that psychiatry is ever encroaching into normal life. There are free speech implications. Will schools stop using technology in teaching because they're worried about panicky parent complaints? Will this push people toward predatory clinics with high expenses and dubious treatments? We just don't know.
How can people know when they've crossed the line into addiction?
Probably addiction is the wrong word, as that conveys similarity to substance abuse, and these are two very different things. But anytime an activity interferes with things like school work or work-work, decreases sleep regularly, limits exercise or social interaction, it may be a problem. Even if the thing being overdone isn't the core problem, it can be a red flag for other mental health issues like depression.
What are some steps to help prevent becoming so involved in gaming?
Being heavily involved in gaming isn't necessarily a bad thing. There are a lot of what we call "engaged" gamers who spend a ton of time gaming but are otherwise doing just fine. Monitoring other aspects of life and making sure that functioning there is being maintained is key in ensuring that gaming is kept in balance with other needs and responsibilities.
How can parents set appropriate limits to avoid video game addiction in their household?
Each family is going to be different. There's no magic number of hours. Parents should generally structure things so that kids do required activities first (homework, chores, some exercise) and are rewarded with game time. Parents should also take some time to play some of the games at least occasionally. A lot of misunderstandings and conflict arise from parents' unfamiliarity with games. For instance, many parents think kids can just shut off a game immediately when the parent asks. But many games are story-based and social, meaning kids need 15-20 minutes to finish what they're doing and *then* log off, otherwise the parents are quite literally asking them to be rude and let down the people they're playing with.
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