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Expanding on the multidisciplinary stakeholder framework to minimize harms for problematic risk-taking involving emerging technologies. •

Commentary on: Problematic risk-taking involving emerging technologies: A stakeholder framework to minimize harms (Swanton et al., 2019)

Journal of Behavioral Addictions
Authors: Jing Shi, Mark van der Maas, Nigel E. Turner, and Marc N. Potenza


As new types of problematic behaviors and new forms of online risk-taking emerge, forming collaborative relationships while understanding complexities of motivations may help to promote harm reduction and intervention. While it may be too early to form a stakeholder framework without first conceptually understanding the problematic behaviors involved, we attempt to build upon a proposed multidisciplinary stakeholder framework to minimize harms for problematic risk-taking involving emerging technologies. We propose an expansion of roles for individual stakeholders and an expansion of proposed roles for family stakeholders to include partner/spouses, others living in the household, and/or those with close relationships with individuals who are experiencing problems. Empowering individuals who use emerging technologies through participatory action research and knowledge translation/dissemination may lead to improvements in the quality of research and a greater impact on policy and practice. Also, we discuss benefits of industry self-regulation and collaboration on data-sharing practices. We recommend approaches to promote global collaboration with a larger group of relevant stakeholders (including but not limited to individual consumers of technology, families, communities, treatment and welfare providers, researchers, industries, and governments) to address protection of vulnerable populations and reduce harms for users of rapidly advancing technologies.

Open access
Journal of Behavioral Addictions
Authors: Antonius J. van Rooij, Christopher J. Ferguson, Michelle Colder Carras, Daniel Kardefelt-Winther, Jing Shi, Espen Aarseth, Anthony M. Bean, Karin Helmersson Bergmark, Anne Brus, Mark Coulson, Jory Deleuze, Pravin Dullur, Elza Dunkels, Johan Edman, Malte Elson, Peter J. Etchells, Anne Fiskaali, Isabela Granic, Jeroen Jansz, Faltin Karlsen, Linda K. Kaye, Bonnie Kirsh, Andreas Lieberoth, Patrick Markey, Kathryn L. Mills, Rune Kristian Lundedal Nielsen, Amy Orben, Arne Poulsen, Nicole Prause, Patrick Prax, Thorsten Quandt, Adriano Schimmenti, Vladan Starcevic, Gabrielle Stutman, Nigel E. Turner, Jan van Looy, and Andrew K. Przybylski

We greatly appreciate the care and thought that is evident in the 10 commentaries that discuss our debate paper, the majority of which argued in favor of a formalized ICD-11 gaming disorder. We agree that there are some people whose play of video games is related to life problems. We believe that understanding this population and the nature and severity of the problems they experience should be a focus area for future research. However, moving from research construct to formal disorder requires a much stronger evidence base than we currently have. The burden of evidence and the clinical utility should be extremely high, because there is a genuine risk of abuse of diagnoses. We provide suggestions about the level of evidence that might be required: transparent and preregistered studies, a better demarcation of the subject area that includes a rationale for focusing on gaming particularly versus a more general behavioral addictions concept, the exploration of non-addiction approaches, and the unbiased exploration of clinical approaches that treat potentially underlying issues, such as depressive mood or social anxiety first. We acknowledge there could be benefits to formalizing gaming disorder, many of which were highlighted by colleagues in their commentaries, but we think they do not yet outweigh the wider societal and public health risks involved. Given the gravity of diagnostic classification and its wider societal impact, we urge our colleagues at the WHO to err on the side of caution for now and postpone the formalization.

Open access