World Health Organization Announces Addition to ICD Manual 2018
The World Health Organization, after reviewing the breadth of scientific research has now, for the first time, listed Internet Gaming Addiction (IGA) in the 11th International Classification of Diseases (ICD-11) as a mental health disorder. This has been considered for many years by the WHO. With consistent evidence that this form of compulsive addiction can develop with or without predisposing factors and can contribute to depression, anxiety, personality changes, social phobia and poor grades, causing serious life consequences, they have finally added this classification to the psychiatric disease code. It is estimated that about 70% of households play video games with an average video game play time of 20 hours per week.
Digital Media and Developing Minds Congress
Note: October 15-18, 2018, the second annual “Digital Media and Developing Minds Congress and Exposition” will be held in Long Island, New York. This meeting is sponsored by Children and Screens: Institute of Digital Media and Child Development and Cold Spring Harbor Lab. Information to attend is here. The Digital Media and Developing Minds meeting is accompanied by a special edition of Pediatrics highlighting impacts of digital media on child development. This supplement is a collaboration of over 130 researchers spanning topics of psychiatry, psychology, neuroscience, pediatrics, sociology, education, public health, law and more.
See also Physicians for Safe Technology: Addiction to Technology at https://mdsafetech.org/technology-addiction/
Prevalence is Significant
The prevalence of gaming addiction in the population is about 2% and studies show about 9% of “gamers” have this disorder. The WHO states, “Studies suggest that gaming disorder affects only a small proportion of people who engage in digital- or video-gaming activities. However, people who partake in gaming should be alert to the amount of time they spend on gaming activities, particularly when it is to the exclusion of other daily activities, as well as to any changes in their physical or psychological health and social functioning that could be attributed to their pattern of gaming behaviour.”
American Academy of Pediatrics Study Shows Gaming Can Contribute to Poor Mental Health Outcomes
In an American Academy of Pediatrics Journal article in 2011 (Gentile et al), researchers looked at Internet Gaming Disorder in elementary and secondary school children in Singapore. They concluded “The prevalence of pathological gaming was similar to that in other countries ( 9%). Greater amounts of gaming, lower social competence, and greater impulsivity seemed to act as risk factors for becoming pathological gamers, whereas depression, anxiety, social phobias, and lower school performance seemed to act as outcomes of pathological gaming.” They noted that addictive behaviors can last for years. Integrative Psychiatrist Dr. Victoria Dunckley, has written about dysregulation with excessive interactive screen time that does not seem to accompany television viewing, which is passive. Her book “Reset Your Child Brain” (2015) discusses signs and symptoms of what she terms “Electronic Screen Syndrome” along with steps to guide parents out of addiction and into healthier habits.
Gaming and Shrinkage of Brain Gray and White Matter
In a review article looking at brain imaging studies and gaming addiction, Weinstein (2017) found consistent atrophy in gray matter in areas of executive function, attention and perception as well as in other areas of the brain involved in decision-making, behavioral inhibition and emotional regulation, i.e. inferior frontal gyrus, amygdala and the anterior cingulate. Hundreds of gaming addition treatment centers have sprouted, especially in China, Korea and the US. Many are combined with other substance abuse clinics already established.
Designed for Addiction: Health Consequences
Computer games are designed for addiction through mechanisms of classic and operant conditioning via dopaminergic reward experiences. Like alcohol and drugs, a computer addicted individual can experience withdrawal symptoms, due to the depletion of dopamine during abstinence. Some parents interpret this behavior to mean that “gaming” is helpful to their condition. Adverse health effects reported with gaming addiction include contributions to ADD/ADHD, learning disabilities, weight gain, lowered metabolism, aggressive thoughts, lack of cooperation and light induced seizures (triggered by flashing, fast-moving images).
Symptoms of Addiction
1) Excessive use of video games, even at night, with the person only experiencing happiness if on a video game
2) It takes precedence over work, school or friendships
3) Increased use of video games over time (tolerance), despite negative consequences
4) Withdrawal symptoms of irritability, anger anxiety or social withdrawal if not allowed to play or the technology malfunctions
Parents Recommendations Include
- Limit video games to one hour per day or on weekends only
- Monitor carefully video play time
- Be sensitive to personality or mood changes in your child after playing video games
- If your child becomes angry, aggressive or depressed after the allotted time limit for the game, you may need stricter controls or eliminate video games all together
The Children and Screens Institute for Digital Media and Child Development has developed Guidelines for parents.
Cognitive Dissonance In Industry
Wired magazine notes Apple, as well as other Silicon Valley companies, are now committed to helping users lower screen time with apps to reduce distractions and monitor screen use. More immersive Apple apps, such as Memoji, however, are constantly being developed and offered, which do just the opposite.
ABC News:’Gaming disorder’ now designated as mental health condition
- Gaming disorder. World Health organization. January 2018. http://www.who.int/features/qa/gaming-disorder/en/
- Gaming addiction classified as disorder by WHO. BBC. Jane Wakefield. January 2, 2018. https://www.bbc.com/news/technology-42541404
- Tech Addiction and the Paradox of Apple’s “Screen Time Tools”. Rielle Pardes. June 5, 2018. https://www.wired.com/story/apple-screen-time-digital-wellness-tech-addiction/
- An Update Overview on Brain Imaging Studies of Internet Gaming Disorder. (2017) Weinstein AM. Front Psychiatry. 2017; 8: 185. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5626837/
- Altered functional connectivity in default mode network in Internet gaming disorder: Influence of childhood ADHD. (2017) Lee D. Prog Neuropsychopharmacol Biol Psychiatry. 2017 Apr 3;75:135-141. https://www.ncbi.nlm.nih.gov/pubmed/28174127
- Younger men play video games, but so do a diverse group of other Americans.PEW Research. Anna Brown.Sept 11, 2017. http://www.pewresearch.org/fact-tank/2017/09/11/younger-men-play-video-games-but-so-do-a-diverse-group-of-other-americans/
- Reset Your Child’s Brain: A Four-Week Plan to End Meltdowns, Raise Grades and Boost Social Skills by Reversing the Effects of Electronic Screen-Time. (2015). Victoria Dunkley.
- Video Game Addiction Treatment Centers in California. Psychology Today. https://www.psychologytoday.com/us/treatment-rehab/video-game-addiction/california
- Internet and Gaming Addiction: A Systematic Literature Review of Neuroimaging Studies.(2012) Kruss DJ and Griffiths MD. Brain Sci2(3); 2012 Sep. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4061797/
- Pathological Video Game Use Among Youths: A Two-Year Longitudinal Study. Gentile DA et al. Pediatrics. January 2011. http://pediatrics.aappublications.org/content/early/2011/01/17/peds.2010-1353
- Discovery of Video Game-Induced Seizures Transforms a Teen’s Health: A Mother’s Story. Mother warns video game-induced seizures may go undetected. https://www.psychologytoday.com/us/blog/mental-wealth/201112/discovery-video-game-induced-seizures-transforms-teens-health-mothers-stor