Is Video Game Addiction a Disease?

No, there is no conclusive scientific finding that video game addiction is a medical condition. Addiction to playing video games might be a sign of other mental illnesses or, simply, people might just have an intense passion for this hobby without suffering from any sickness. Not everything should be attributed to disease even if it is as obsessive as hyper-consumerism.

This is an inspection of scientific findings of the last decade on video game addiction. This should help people, especially parents, in understanding the video game addictions among children and teenagers. References are provided within the body of the article and also at the end of the article.

Back in 2018, the World Health Organization classified “video game addiction”  (labeled as “gaming disorder”) as a mental illness.[1]11th revision of the International Classification of Diseases (ICD-11) This sparked a rabid discussion not just in the video game industry but also in the scientific community.  Addiction, as conventionally known, is catalyzed by an introduction of a foreign substance to the human body. In short, addiction is chemically induced through an exogenous substance. 

Unless video game consoles and PCs start spraying addictive chemicals towards gamers, it seems like it is far-fetched that gaming causes addiction in its conventional meaning. However, there is another form of addiction that is analogous to video game addiction, a kind of addiction that is “behavioral” and does not involve the introduction of addictive chemicals to the addict–gambling addiction. As of this writing, only gambling addiction is the only behavioral addiction recognized under formal psychiatric nosology.

Behavioral Addiction: Gambling and Gaming Disorder

The classification of pathological gambling itself as an addiction was met with skepticism and even active opposition. Below are the reasons put forward by some members of the scientific community why pathological gambling is not an addiction:[2]Mann, K., Fauth-Bühler, M., Higuchi, S., Potenza, M. N., & Saunders, J. B. (2016). Pathological gambling: a behavioral addiction. World psychiatry: official journal of the World Psychiatric … Continue reading

  1. It is too soon to classify compulsive gambling as an addiction – Given the discovery of common genetic vulnerability characteristics between pathological gambling and serious depression, it is premature to conclude that self-destructive gamblers have an addiction to gambling. Pathological gambling may be a byproduct or a symptom of depression instead of an addiction by itself.
  2. There is no clear clinical utility in classifying pathological gambling as an addiction – The only parameter that can be used to categorize gambling as that of an addiction is that it shares some treatment options with substance abusers. For example, lithium has been found to be effective in reducing drug use cravings. The same therapy also shows success in controlling urges of excessive gambling. Yet, the effectiveness of lithium in pathological gamblers may be inferred that it treated the comorbid bipolar symptoms rather than the pathological gambling per se.
  3. There are preventive measures in substance abuse which gambling disorder does not have.

Just like substance abuse, gambling outcomes and video games stimulate the mesolimbic dopamine pathway.[3]Clark L. (2014). Disordered gambling: the evolving concept of behavioral addiction. Annals of the New York Academy of Sciences, 1327(1), 56.. However, substance abuse significantly changes the physiology of the brain. Structural brain changes are also detected in gambling disorders, but these are considered minor compared to say, the alteration of brain structure from meth addiction. There is still a need for longitudinal studies that observe changes in a gambler’s brain structure during the transition from casual to excessive gambling.

Given that there are no findings yet that establish the physiological effect of gambling addiction in the brain, the concern that it is premature to label compulsive gambling as a medical condition is valid. The study that criticizes the opposition even concluded that “Pathological gambling can best be understood as a “behavioral” addiction, in which the individual is not addicted to a rewarding chemical substance but to a behavior that is rewarding to him/her.[4]Grant, J. E., Atmaca, M., Fineberg, N. A., Fontenelle, L. F., Matsunaga, H., Janardhan Reddy, Y. C., Simpson, H. B., Thomsen, P. H., van den Heuvel, O. A., Veale, D., Woods, D. W., & Stein, D. J. … Continue reading The suggestion would be that it is the compulsive gambler that is both the cause and effect of the condition.

Photo by Steven Lilley

Attention must be given to the fact that gambling, as an activity, exposes participants to various addictive substances: alcohol and tobacco. In extreme cases, drugs are involved. It is also found that gamblers are often suffering from depression. Gambling may be a result of everything else that has a direct and immediate effect on brain chemistry such as excessive alcohol.

The “behavioral” aspect of labeling activity-based addiction like gambling and gaming should be met with further scrutiny. Gambling disorder is often described as “patterns of gambling activity that are harmful to themselves and society.” One of the characteristics of gambling disorder is the “inappropriate amount of time and money” that “personal relationships, financial assets, status or other important aspects of life are significantly impaired.”[5]Molde, H., Holmøy, B., Merkesdal, A. G., Torsheim, T., Mentzoni, R. A., Hanns, D., Sagoe, D., & Pallesen, S. (2019). Are Video Games a Gateway to Gambling? A Longitudinal Study Based on a … Continue reading

The above descriptors are incredibly broad and wide open for interpretation. It could be concluded that these types of addiction are medical conditions that have their symptoms tied to one’s societal position and financial capacity. A rich person is less likely to suffer from gambling addiction because he has that much money and time to spare. The definition of “inappropriate amount” needs to be expounded and clarified. Gambling addiction looks like a condition that mostly affects poor people just because they cannot afford it if this line of rationalization is followed. Being harmful to one’s well-being is a legitimate symptom of a medical condition. Having “harmful to society” as a symptom should have no place in the medical field. Is criminal behavior a disease now?

Having “harmful to society” as a symptom should have no place in the medical field. Is criminal behavior a disease now?

Since a “behavior” can be a source of addiction, does this mean hobbyists are addicted too? Gambling and video games are not popular sources of addiction hence their searing mainstream media coverage. However, replacing these sources with considerably sensitive scenarios paints a questionable foundation of this categorization–A fat person may be diagnosed as having a food addiction; a person who, disproportionately collects books to the time that he can read any of them, should have book collecting addiction; a person who protests in a country with a tyrannical government, exposing himself to danger and losing his employ or profession, can be attributed to social justice addiction. All of the illustrations above are indeed ridiculous but this is in line with “behavioral” addiction parameters set forth by the studies.

As regards gambling in video games, an entire and separate article will be published for that topic.

DSM-5 Criticism

Photo by CCAC North Library

The Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5), which established behavioral addiction as a separate entity from substance addiction, is criticized for going “overboard in pathologizing normal human distress”.[6]Wakefield J. C. (2016). Diagnostic Issues and Controversies in DSM-5: Return of the False Positives Problem. Annual review of clinical psychology, 12, 105–132. Psychiatry today, as a discipline, should walk on eggshells given its dark history.

Decades ago, psychiatry was embroiled in so much controversy for its inhumane methods like lobotomy, shock therapy, among others. People with odd behavior and nonconformist attitudes were thrown into horrific “medications” for being mentally ill when today they are normal.

A person’s character should not be made a disease. A person who is labeled to be addicted to video games may just be lazy or irresponsible. They may have a personal struggle that only playing video games makes them feel better. They may be just having a ton of fun.

This goes the same for those who are usually labeled as gambling addicts. Maybe the gambler is just a spendthrift and is not suffering from any psychological condition needed to be subjected to medication. A person can be a degenerate without being mentally ill.

A person can be a degenerate without being mentally ill.

DSM-5 broadens the scope of what comprises mental disorders and will misdiagnose normal distress or problems into something that they are not. Yet with the all-encompassing reach of the manual, the DMS-5 is lacking adequate documentation and is covered with secrecy in its process. [7]Ibid. This is the very antithesis of a “scientific” paper when there is no transparency on how the task force behind the creation of DSM-5 arrived at its conclusions. The members of the task force behind this controversial manual also have ties to the pharmaceutical industry. It begs the question of who, aside from the medical practitioners, will benefit from the rise in the number of diagnoses? It is certainly not the potential patients but rather those who peddle the cure.

Media’s Crusade Against Video Games

It can be observed in the United States, when a child commits a violent crime or a school shooting happens, the first thing the media will point out, aside from the perpetrator’s race, is that these dissolute offenders are influenced by violent games or films. Gun control is also raised by some news outlets. Everything else is blamed except the most obvious: terrible parenting.

Admittedly, there should be some influence on the criminal’s psyche by being exposed to violent games. However, there are already rating systems for video games in Entertainment Software Rating Board (ESRB) in North America and Pan European Game Information (PEGI) in Europe to guide parents on the degree of maturity required for a particular game due to its content. Video game consoles also employ parental locks in their systems. It is also up to the parents to have the foresight to explain to their children these things in cases that the latter get access to violent games.

In a study of video games coverage from the year 1970 to 2000 across popular news magazines Times, Newsweek, and US World News Report,[8] Williams, D. (2003). The videogame lightning rod. Information, Communication, & Society, 6, 523–550. journalists initially raised concerns that video games are taking away children’s activities that are “worthwhile” as if video gaming is a negative distraction. This concern turned into fearmongering by highlighting adverse health effects.

It was also observed in an evaluation of the coverage on the topic of video games in The New York Times in the 2000s that the newspaper blames the obesity pandemic during that decade on video games.[9]McKernan, B. (2013). The Morality of Play: Video Game Coverage in The New York Times From 1980 to 2010. Games and Culture, 8(5), 307–329. It is not farfetched to pin on the allure of video games to a sedentary lifestyle. Yet, it has been established in all studies, or even in basic physics, that caloric intake dictates a person’s weight. Playing video games does not make a person fat per se.

The introduction of new media also had unfavorable narratives from journalists–from nickelodeon to television in the distant past, from social media platforms to NFT in the current times.

Those who struggle from any ailment, notwithstanding that indeed video game addiction is a medical condition, that has one of its symptoms irresponsible use of time and money playing video games do not need a pill as a cure but ample attention from the parents should have spent instilling discipline. If that person is an adult, they should bear that responsibility for themselves. If that person is truly suffering from mental illness, and one of their condition is an insatiable urge in consuming video games, then the remedy for mental illness should be taken instead of unfounded demonization of a hobby.

References

References
1 11th revision of the International Classification of Diseases (ICD-11)
2 Mann, K., Fauth-Bühler, M., Higuchi, S., Potenza, M. N., & Saunders, J. B. (2016). Pathological gambling: a behavioral addiction. World psychiatry: official journal of the World Psychiatric Association (WPA), 15(3), 297–298.
3 Clark L. (2014). Disordered gambling: the evolving concept of behavioral addiction. Annals of the New York Academy of Sciences, 1327(1), 56.
4 Grant, J. E., Atmaca, M., Fineberg, N. A., Fontenelle, L. F., Matsunaga, H., Janardhan Reddy, Y. C., Simpson, H. B., Thomsen, P. H., van den Heuvel, O. A., Veale, D., Woods, D. W., & Stein, D. J. (2014). Impulse control disorders and “behavioural addictions” in the ICD-11. World psychiatry: official journal of the World Psychiatric Association (WPA), 13(2), 125–127.
5 Molde, H., Holmøy, B., Merkesdal, A. G., Torsheim, T., Mentzoni, R. A., Hanns, D., Sagoe, D., & Pallesen, S. (2019). Are Video Games a Gateway to Gambling? A Longitudinal Study Based on a Representative Norwegian Sample. Journal of gambling studies, 35(2), 545–557.
6 Wakefield J. C. (2016). Diagnostic Issues and Controversies in DSM-5: Return of the False Positives Problem. Annual review of clinical psychology, 12, 105–132.
7 Ibid.
8 Williams, D. (2003). The videogame lightning rod. Information, Communication, & Society, 6, 523–550.
9 McKernan, B. (2013). The Morality of Play: Video Game Coverage in The New York Times From 1980 to 2010. Games and Culture, 8(5), 307–329.

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