A coherent framework for addressing risk arising from new technologies is needed. In proposing a framework of broad application and future focus, where empirical evidence is scarce, reliance on strong theory becomes all the more important. Some technologies are more prone to excessive engagement than others (i.e. more addictive). Some users are also more susceptible to excessive engagement than others. Impulsivity theory emphasises the importance of reinforcement magnitude in determining the risk associated with a new technology, and that an individual's sensitivity to reinforcement (reward drive) and capacity to inhibit previously reinforced behaviour (rash impulsiveness) determines their susceptibility to problematic engagement. Online gaming provides a good example of how such theory can be applied to facilitate intervention efforts and develop policy.
Authors:Joël Billieux, Daniel L. King, Susumu Higuchi, Sophia Achab, Henrietta Bowden-Jones, Wei Hao, Jiang Long, Hae Kook Lee, Marc N. Potenza, John B. Saunders, and Vladimir Poznyak
This commentary responds to Aarseth et al.’s (in press) criticisms that the ICD-11 Gaming Disorder proposal would result in “moral panics around the harm of video gaming” and “the treatment of abundant false-positive cases.” The ICD-11 Gaming Disorder avoids potential “overpathologizing” with its explicit reference to functional impairment caused by gaming and therefore improves upon a number of flawed previous approaches to identifying cases with suspected gaming-related harms. We contend that moral panics are more likely to occur and be exacerbated by misinformation and lack of understanding, rather than proceed from having a clear diagnostic system.
Authors:John B. Saunders, Wei Hao, Jiang Long, Daniel L. King, Karl Mann, Mira Fauth-Bühler, Hans-Jürgen Rumpf, Henrietta Bowden-Jones, Afarin Rahimi-Movaghar, Thomas Chung, Elda Chan, Norharlina Bahar, Sophia Achab, Hae Kook Lee, Marc Potenza, Nancy Petry, Daniel Spritzer, Atul Ambekar, Jeffrey Derevensky, Mark D. Griffiths, Halley M. Pontes, Daria Kuss, Susumu Higuchi, Satoko Mihara, Sawitri Assangangkornchai, Manoj Sharma, Ahmad El Kashef, Patrick Ip, Michael Farrell, Emanuele Scafato, Natacha Carragher, and Vladimir Poznyak
Online gaming has greatly increased in popularity in recent years, and with this has come a multiplicity of problems due to excessive involvement in gaming. Gaming disorder, both online and offline, has been defined for the first time in the draft of 11th revision of the International Classification of Diseases (ICD-11). National surveys have shown prevalence rates of gaming disorder/addiction of 10%–15% among young people in several Asian countries and of 1%–10% in their counterparts in some Western countries. Several diseases related to excessive gaming are now recognized, and clinics are being established to respond to individual, family, and community concerns, but many cases remain hidden. Gaming disorder shares many features with addictions due to psychoactive substances and with gambling disorder, and functional neuroimaging shows that similar areas of the brain are activated. Governments and health agencies worldwide are seeking for the effects of online gaming to be addressed, and for preventive approaches to be developed. Central to this effort is a need to delineate the nature of the problem, which is the purpose of the definitions in the draft of ICD-11.
Authors:Susumu Higuchi, Yoneatsu Osaki, Aya Kinjo, Satoko Mihara, Masaki Maezono, Takashi Kitayuguchi, Takanobu Matsuzaki, Hideki Nakayama, Hans-Jürgen Rumpf, and John B. Saunders
Background and Aims
A definition of gaming disorder (GD) was introduced in ICD-11. The purpose of this study was to develop a short screening test for GD, utilizing a reference GD group. It also sought to estimate the prevalence of GD among individuals, representative of the general young population in Japan.
Two hundred eighty one men and women selected from the general population, aged between 10 and 29 years, and 44 treatment seekers at our center completed a self-reported questionnaire comprising candidate questions for the screening test. The reference group with ICD-11 GD was established, based on face-to-face interviews with behavioral addiction experts, using a diagnostic interview instrument. The questions in the screening test were selected to best differentiate those who had GD from those who did not, and the cutoff value was determined using the Youden index.
A nine-item screening test (GAMES test) was developed. The sensitivity and specificity of the test were both 98% and the positive predictive value in the study sample was 91%. The GAMES test comprised two factors, showed high internal consistency and was highly reproducible. The estimated prevalence of GD among the general young population was 7.6% (95% confidence interval; 6.6–8.7%) for males and 2.5% (1.9–3.2%) for females, with a combined prevalence of 5.1% (4.5–5.8%).
Discussion and Conclusion
The GAMES test shows high validity and reliability for screening of ICD-11 GD. The estimated prevalence of 5.1% among the general young population was comparable to the pooled estimates of young people globally.
Authors:Hans-Jürgen Rumpf, Sophia Achab, Joël Billieux, Henrietta Bowden-Jones, Natacha Carragher, Zsolt Demetrovics, Susumu Higuchi, Daniel L. King, Karl Mann, Marc Potenza, John B. Saunders, Max Abbott, Atul Ambekar, Osman Tolga Aricak, Sawitri Assanangkornchai, Norharlina Bahar, Guilherme Borges, Matthias Brand, Elda Mei-Lo Chan, Thomas Chung, Jeff Derevensky, Ahmad El Kashef, Michael Farrell, Naomi A. Fineberg, Claudia Gandin, Douglas A. Gentile, Mark D. Griffiths, Anna E. Goudriaan, Marie Grall-Bronnec, Wei Hao, David C. Hodgins, Patrick Ip, Orsolya Király, Hae Kook Lee, Daria Kuss, Jeroen S. Lemmens, Jiang Long, Olatz Lopez-Fernandez, Satoko Mihara, Nancy M. Petry, Halley M. Pontes, Afarin Rahimi-Movaghar, Florian Rehbein, Jürgen Rehm, Emanuele Scafato, Manoi Sharma, Daniel Spritzer, Dan J. Stein, Philip Tam, Aviv Weinstein, Hans-Ulrich Wittchen, Klaus Wölfling, Daniele Zullino, and Vladimir Poznyak
The proposed introduction of gaming disorder (GD) in the 11th revision of the International Classification of Diseases (ICD-11) developed by the World Health Organization (WHO) has led to a lively debate over the past year. Besides the broad support for the decision in the academic press, a recent publication by van Rooij et al. (2018) repeated the criticism raised against the inclusion of GD in ICD-11 by Aarseth et al. (2017). We argue that this group of researchers fails to recognize the clinical and public health considerations, which support the WHO perspective. It is important to recognize a range of biases that may influence this debate; in particular, the gaming industry may wish to diminish its responsibility by claiming that GD is not a public health problem, a position which maybe supported by arguments from scholars based in media psychology, computer games research, communication science, and related disciplines. However, just as with any other disease or disorder in the ICD-11, the decision whether or not to include GD is based on clinical evidence and public health needs. Therefore, we reiterate our conclusion that including GD reflects the essence of the ICD and will facilitate treatment and prevention for those who need it.