What was true in the past is never necessarily so in the future. Thus, each new home entertainment technology produces deep fears and wrung hands regarding its potentially harmful effects on the young.
The current technology-driven mental condition du jour is called internet gaming disorder, or IGD. Evidence gathered from around the world in 2013 was strong enough for IGD to be included in the new fifth edition of psychiatry’s standard reference, the Diagnostic and Statistical Manual of Mental Disorders, or DSM-5. The editors stopped short of giving the disorder full recognition, calling for more research instead.
IGD, according to the literature, arises in some people who spend large amounts of time playing video games, especially online multiplayer games such as World of Warcraft. Sufferers, say the DSM authors, ‘‘play compulsively, to the exclusion of other interests, and their persistent and recurrent online activity results in clinically significant impairment or distress’’.
IGD can result in damage to career and family. Logging off from the game can invoke severe withdrawal behaviours.
It sounds like nasty stuff, but the current state of the research leaves some critical questions still unanswered. How precisely are the symptoms to be measured? Is internet gaming the cause of the behavioural problems, or a strategy employed to deal with pre-existing matters. In short, does internet gaming disorder actually exist?
‘‘I don’t care what it’s called,’’ says Jocelyn Brewer, a psychologist with the non-profit thinktank Network for Internet Investigation Research Australia. ‘‘If it’s negatively affecting your life, then we need to treat it.’’
Brewer, among other researchers, notes that people in the grips of attention deficit hyperactivity disorder, obsessive-compulsive disorder and other conditions will turn to immersive internet games as a way of managing their symptoms. It is crucial, she says, that therapies related to IGD first look for other factors.
‘‘While games might be the ‘thing’ they’re ‘addicted’ to,’’ she says, ‘‘I would suggest there is probably a level of vulnerability to biological, psychological or social factors which predispose people to become hardcore gamers. The underlying factor is the key, not blaming game mechanics and design.’’
There is also another matter, possibly more fundamental, in the IGD mix. At present, despite more than 250 academic papers published on the subject, there is nothing even close to a consensus among researchers regarding the condition’s definition or measurement.
An editorial late in 2013 in the prominent journal Addiction called urgent attention to the matter. Vastly different classification systems across the studies, the journal noted, meant estimates of the prevalence of IGD among gamers ranged from less than 1 per cent to more than 50 per cent.
The journal warned that without an urgent and agreed set of diagnostic criteria, the inclusion of IGD in the DSM would be ‘‘highly controversial’’. There was a risk that it would be likened to trivial conditions, such as chocolate addiction, ‘‘thereby undermining the seriousness of psychiatric disorders.’’
Two of the leading researchers in the IGD arena are based at the University of Adelaide’s School of Psychology. Associate professor Paul Delfabbro and his colleague, Dr Daniel King, published their latest findings in the Journal of Clinical Psychology in April this year.
The pair reported there was a significant lack of understanding among researchers and clinicians regarding the thought processes of hardcore gamers. They also found that current treatment methods were applied despite little or no evidence that they worked.
Many psychologists, they noted, used a method called cognitive behaviour therapy (CBT) to treat IGD cases. The use of that therapy has shown some benefit for compulsive gamblers, but, Delfabbro said at the time, ‘‘gamers aren’t like gamblers’’.
‘‘For a start,’’ he continued, ‘‘the games involve skill, whereas most CBT for gamblers focuses on addressing mistaken beliefs about chance and randomness.’’
For Jocelyn Brewer at NIIRA it is the skill involved in playing internet games that might eventually provide a way through the jumble of claims and wayward measurements that comprise the current debate about treating IGD.
‘‘Gaming isn’t a relaxing pursuit,’’ she says. ‘‘Gaming solid for 10 hours is hard work."
She suggests that in some cases anti-social behaviours linked to long periods of gaming develop because the games themselves deliver inappropriate messages about resolving social issues. You don’t like someone? You shoot them. Simple.