
WHO to recognize gaming disorder as mental health condition - emacsgifs
http://lite.cnn.io/en/article/h_f8b1509f44a2e3b96999bb04d587e3ef
======
mjburgess
Before the sceptics get in:

1\. The purpose of DSM/ICD is often to justify financing treatment:

> Chris Ferguson, a professor of psychology at Stetson University ...
> described the ICD as "the book of real diseases that you can get insurance
> payments for."

2\. Treatment has to be mindful of the specific form of addiction:

> "These are co-morbid conditions," he said. "If you just treat the depression
> and not gaming, the gaming is likely to come back." This suggests it's a
> unique condition, he said.

3\. No we are not "medicializing everything":

> But Ferguson argued that, if it is a disorder, it seems to be very rare.

NB.

Before criticizing modern psychiatry keep in mind:

1\. mental health patients are extreme in their dysfunction, never common.

2\. the operation of the brain (, nervous system, etc.) in its interaction
with its environment is as liable to breaking as any other part of the body

3\. modern clinical psychiatry is an evidenced-based, research-driven field
which treats and forms diagnoses on the basis of decades of research into any
particular condition. It isnt the 1950s.

~~~
algesten
> 3\. modern clinical psychiatry is an evidenced-based, research-driven field
> which treats and forms diagnoses on the basis of decades of research into
> any particular condition. It isnt the 1950s.

But isn't modern clinical psychiatry marred by the same problems social or
economic sciences are? Ultimately you are studying/interpreting human
behaviour, which doesn't lend itself well to quantisation or categorising.

~~~
Grieverheart
Most recent studies in psychiatry and social sciences that I have read, even
those published in Nature, use sample sizes of around 50 people, which should
be considered insufficient. Instead they use various cooked up formulas for
correcting for gender/ethnicity etc. Instead, sample sizes should be much
bigger. Of course this is not practical or even perhaps impossible. I find
this to be a poor excuse, though.

The matter of fact is, we know very little about how the brain works. We
certainly have some big picture on how the brain functions, but we are very
far from grasping the chemistry.

~~~
mjburgess
psychiatry =/= psychology =/= social psychology

This is more "everything is the same" anti-expertism.

Clinical psychiatry is not about p-hacking groups of 50.

The treatment of bipolar disorder hasnt been decided on the basis of what
happened to the last dozen undergrad students.

>The matter of fact is, we know very little about how the brain works.

Profoundly untrue. Even if it were truth, its very truth would preclude your
ability to make this assertion. If we knew nothing, how are you estimating the
nothing we know?

It is no mystery what happens when you give a person lithium. Nor some
speculative game to know what the effect of MDMA on PTSD patients is. Nor
hocus pocus to identify the effects of repeated trauma.

How are you deciding what percentage of "how the brain works" we need to know
in order to do psychiatry in a reasonably well-informed way?

Suppose, even, we know now 0.1% of the entire story. Is this sufficient for an
evidence-based treatment of psychosis?

It clearly seems to be. Since the treatment of schizophrenia is overwhelmingly
more effective than anything based on a study of 50 people.

Your comment may very well apply to "journalistic science" ie., the
increasingly prevent, "ive just had an idea, lets get 50 undergrads and a
seminar room!".

That is a tiny percentage of science, even if it is the most commonly
popularized.

~~~
Grieverheart
I had a look at this review on bipolar disorder,
[https://doi.org/10.1136/bmj.e8508](https://doi.org/10.1136/bmj.e8508) .
According to a study referenced in it, 68 randomized trials where used to
determine the effect of different drugs compared to placebo. Again the sample
size is low and the statistical significance is also small, unless I'm missing
something.

You are correct in saying that we don't actually know how much we know about
the brain. But the brain is s much more complex than e.g. planets orbiting the
sun. There are many components that can get affected by chemical compounds in
the short term, but more importantly in the long term. I agree though that
only through testing can we get a better understanding. It is just the way
it's currently done that I disagree. I would gladly read some research you
think is good and does not have the shortcomings I describe.

------
mabbo
I don't know whether what I had (have?) meets this WHO definition, but I can
tell you that at points in my life, I've had an unhealthy relationship with
video games.

For me, and maybe others as well, it's about having control over something and
feeling a sense of accomplishment, feeling like I'm achieving something. Video
games give you that. For a small cost ($20-$50), you can have pure escapism
from reality, think about things other than your shitty life and depression
and instead feel yourself accomplish goals, achieve success, _win_. Unlike
drugs or alcohol, it doesn't end- you can just keep coming back without paying
anything. There's no chemical hangover, no blood test for it, no social stigma
like drugs have. It's perfect.

My underlying problems have been dealt with now, but I still have to limit how
long I play games for. The high is still there and I recognize it well. I just
don't _need_ it like I once did.

Looking back at my high school days, I had a good friend who was into drugs. I
got him into EverQuest. I wish he'd gotten me into drugs instead- there are
well understood paths out of drug addiction. And that game messed the both of
us up.

~~~
poisonarena
I did both drugs and Everquest in highschool and I have to say I would rather
walk through the Qeynos Hills than the other option.

~~~
pwaai
There have been some publicized cases about Everquest...

[https://www.cbsnews.com/news/addicted-suicide-over-
everquest...](https://www.cbsnews.com/news/addicted-suicide-over-everquest/)

I remember seeing the Everquest demo trailer video in an Electronic Boutique
store and reading about it in PC magazine, I was astounded by the sheer level
of depth. Especially the part where you could setup a physical real estate and
sell stuff you gathered form the virtual world (I'm not sure if this existed
in Everquest, just recall seeing bits of it in a magazine).

~~~
mabbo
The accusations against Verant Interactive/Sony Online were that the EverQuest
was designed to make you get addicted, play endlessly- that they knew what the
consequences of these design decisions were.

An example: often bosses would spawn once every K hours- randomly. So you
might have to wait a literal 24 hours in a row without ever seeing the boss
you need to kill, and he has a 1 in X chance of dropping the item you actually
wanted. There were no 'instance' dungeons- the whole server shared that one
room with the boss, so maybe you go there to wait for the boss to spawn, and
there's two other groups already waiting.

There is a lot about it that was akin to a slot machine and those people who
sit and put money into the machine over and over, all day. The same reward
mechanism in the brain was being triggered. And from the perspective of
players, that waiting, that fighting bosses, all of that was _work_ that you
put in to get the reward. And that feeling of putting in work and achieving
something- even something that isn't _real_ \- that was the addiction when it
felt like you couldn't ever get that in real life.

Death in the game was a big deal too- you lost experience, lost maybe hours or
days or work. You could lose a level! This triggered really complex fear-of-
loss psychology, and for people already dealing with psychological issues
(that's why they played EQ so much) there were always stories about the _rage_
from dying. Just really unhealthy stuff all around.

I don't personally think it was _designed_ to do this to humans, no truly
malicious intent, but it _did_ mess with people.

------
singularity2001
The underlying root cause often is loneliness. Many addictions are just
symptoms of loneliness.

~~~
VoodooJuJu
There is some merit to this. The Rat Park experiment comes to mind:
[https://en.wikipedia.org/wiki/Rat_Park](https://en.wikipedia.org/wiki/Rat_Park)

~~~
laretluval
Lots of difficulties replicating Rat Park.

[https://www.ncbi.nlm.nih.gov/pubmed/9148292?dopt=Abstract](https://www.ncbi.nlm.nih.gov/pubmed/9148292?dopt=Abstract)

------
pwaai
I don't really care if it fits the definition of mental health disorder or
not. What matters is that we recognize self harming addiction arising from
digital toxins, optimized to release quick dopamine hits to the user, and help
them rehabilitate.

Similar to how some people believe depression is not a mental disorder because
it's not "physical" and that they just need to think more "positive" like the
non-depressed people, I think any sort of addiction, be it drugs or games
needs to be addressed from a medical stand point of view.

------
raziel2p
I hope this doesn't get abused.

Also, maybe a social media disorder is next on the list?

~~~
ak39
Without a doubt. This should have been a far more serious consideration than
gaming addiction.

~~~
DaveSapien
I wish I could upvote this more. Compulsion addiction and those companys
(FaceBook,Twitter,EA,King, ect) that promote and profit from it are a
dangerous threat to society. And obviously destructive to the individuals they
target.

~~~
pwaai
Let's regulate ads that show unrealistic body images of people about men and
women. They already done so in France.

------
alangpierce
I think that better acknowledgement of mental health conditions is generally a
good thing. There's too much stigma around something being labeled as "mental
health", when really I think everyone should view their own mental health as a
work in progress, just like how physical health always has some room for
improvement.

For mild cases, I think it's fine to say that playing video games obsessively
is potentially problematic (and in this case, I think "mental health" is the
obvious category for that sort of problem), just like how not getting enough
exercise can be problematic for physical health.

When it gets bad enough to the point that people feel out of control of their
lives, it absolutely deserves to be called a mental health problem, and it
would be incredibly frustrating to seek professional help and hear "your
problem isn't real", when it clearly is causing suffering. Acknowledging that
you have a mental health problem and seeking professional help is already hard
enough.

Whether you use terms like "mental health disorder" or "mental illness" feels
like just an issue of semantics, and my understanding is it's often more an
indication of severity rather than being something fundamentally different.
Just because you acknowledge a thing called "gaming disorder" doesn't mean it
needs to be treated with medication or any kind of extensive treatment; you
can still apply reason within any individual case about what the right course
of action is. But if it's not even in the vocabulary, there's no reasonable
way for the medical community to talk about it and understand it.

------
allcentury
I think I would have met the qualifications for this as a 14 year old. My
parents were going through a bad divorce and I spent all my time playing
StarCraft to cope.

I had all the signs of addiction, I stopped hanging out with friends, I stayed
awake all night, ate poorly and gave up in school. More than once I recognized
my issue and smashed the CD, even one time glued it to a piece of paper and
put it on our bulletin board for my mom to see. Two weeks later I'd be back
playing at 3am.

I needed help but I don't think my parents knew what to do.

~~~
pwaai
> I spent all my time playing StarCraft to cope

Stereotypes aside, a lot of Korean teenagers (for me, counter-strike and an
early 2000 korean MMO called N-age ㅋㅋㅋ) went through this cycle. It was a form
of escape, especially as a kid dealing with a stressful environment, I can see
why some of us form a special bond with video games.

Another contributing factor is if in that environment, the prospect of earning
six digit salary as a pro gamer is very real with poor job prospects in a
hyper competitive society. The industry is rife with health issues that is
conveniently ignored and unfortunately "mental disorders" are still viewed
with the stigma one would attach to institutionalized patients, although its
improving thanks to organizations like WHO setting a standard.

------
75dvtwin
my personal reaction is 2 fold

WRT

>In one study, he found that when kids stopped being addicted to games, their
depression and anxiety got better.

( 1 )

Is this study repeatable? (or does it suffer the fate of many (75%) psychology
experiments that cannot be replicated [1]

( 2 )

Instagram, Facebook , -- would those, potentially, addiction-fueled
activities, ever become subject to the WHO recommendation ?

[ 1 ] [https://www.theguardian.com/science/2015/aug/27/study-
delive...](https://www.theguardian.com/science/2015/aug/27/study-delivers-
bleak-verdict-on-validity-of-psychology-experiment-results)

~~~
amelius
The replication claim has never been replicated either.

~~~
zerostar07
they have. repeatability problems have been found in various domains ,
including medicine and psychology which is of concern here

------
xekc
So, generally speaking, anything a large enough group of people would find
themselves too passionately engaged in - can be considered at it's extremes as
a disorder - from utilitarian, dominating "usefulness of the body"
perspective? Ant world!

Then extreme sports go next? "Base jumping addiction" (deadly!) or let's just
go big and make "adrenaline junkie" a serious medical condition? Who in Sci-Fi
got this right?

------
Waterluvian
Whether gaming addiction is a disease or just a symptom, we need to treat both
the cause and the symptoms.

I don't really care how we go about working the medical system to enable this.

------
saas_co_de
Video games are obviously addictive. The way you make money off of games is to
make them addictive. There is a direct feedback loop between more addictive
games and more profits and so the addictiveness of games can be research,
refined, and optimized over time.

The WHO is way behind the curve here.

If society treated video games the same as alcohol and drugs they would
already be banned for minors. Eventually they probably will be.

~~~
drdaeman
<sarcasm>We should also ban other dangerously addictive activities, such as
fiction books, non-video games, sports, DIY hobbies (e.g. electrical
engineering, painting or storywriting), pets, hanging out with other people
and lots of other things.</sacrasm>

I'm no expert on the matter, but I think you're completely missing the point.
The keyword here is "gaming addiction" not "video games". Please, for the love
of all the sanity that's still left out there, don't mistake one with another.
There is a lot of things that one suffering from behavioral disorders could
get addicted to. Unlike substance addictions (which are complicated matter),
games (or overindulging in escapist fiction or having dozens of pets) are more
of a symptom than an underlying cause.

If you'd try to ban just about everything that one could get hooked onto, it
won't help the person a little bit with their impulse control. It would just
make their and everyone else's lives dull and boring, probably leading to much
more unhealthy situations (just my guess, though).

~~~
saas_co_de
All I said is that if video games were treated the same as drugs and alcohol
they would be banned for minors.

Video games are just as addictive as alcohol, cigarettes, or cocaine and just
as destructive in terms of seriously impairing the ability of addicts to
function in a socially acceptable way.

If you think books or hobbies are as addictive or destructive as video games
that is a matter of opinion, but I think most reasonable people (like mental
health professionals) would disagree with you.

Even if any of the things you listed were as addictive or destructive as video
games they are all missing one crucial aspect: the ability to optimize and
enhance addictive properties over time.

There are billions of dollars being poured into enhancing and refining video
games (making them more addictive) every year and the technology to do this
(tracking player responses at a minute level and adapting games to maximize
profits) can not be applied to any of the other things you listed the same as
it can to video games.

~~~
drdaeman
> All I said is that if video games were treated the same as drugs and alcohol
> they would be banned for minors.

Sorry, I had possibly misinterpreted this as you not just comparing but
actually suggesting treating video games similarly to alcohol and banning
those to minors. My apologies if you didn't mean that.

If you did - I strongly disagree.

> Video games are just as addictive as alcohol, cigarettes

Sorry but this is nonsense. No video game binds with receptors in the brain
and cause physical dependence. Please, let's not equate gaming with substance
addictions.

> If you think books or hobbies are as addictive or destructive as video games
> that is a matter of opinion

There are people who lost their friends, jobs or have other problems in their
lives because of their hobbies or obsessions. I knew some hardcore anime
otakus who had some personal issues - shall we ban Japanese animation and
comics?

But you missed the point, again. Let me reiterate: video games are retreat,
not a cause. Banning them won't help the person who can't control their urges
a single little bit. You would either leave them empty, concealing the issue,
or they'll divert to something else.

Adding games to DSM is a good idea, though. If someone has addiction and it
manifests into video gaming addiction, it's easy to measure this. I could be
wrong but as I get it, that's the whole point, having a concept of unhealthy
obsession - not that games are something undesirable on their own.

I believe you perceive video games as something special only because they're
easiest thing available out there, making them the common retreat. That, plus
existence of some games that specifically concentrate on abuse of the
addictions (see my next point).

> tracking player responses at a minute level and adapting games to maximize
> profits

Sorry, but if I got you right - you're talking about some specific niche (or
several niches) of video games, generalizing this to the whole industry. You'd
probably want to complain about in-game purchases and microtransactions (or
whatever else this stuff is called).

Upd: Sorry for edits - I re-read my comment and did some edits to it to better
clarify what I've meant. Finished editing now.

------
goodroot
Does anyone have any good books to recommend about gaming and mental health?
Or, really, just gaming in general? Perhaps from a philosophical perspective?

------
qwerty456127
What about HN/Reddit/whatever F5-ing disorder? :-)

------
tjwii
yep, and we have football disorder, coding disorder, watching television
disorder, 40 hours a week job disorder, dying in poverty disorder, bla bla
bla.

------
adrya407
>The disorder is characterized by "impaired control" with increasing priority
given to

Oh please, then I assume every hobby in the world can be considered "hobby-
name disorder". If it's something that help the millennium generation to relax
and free their mind a few minutes /hours and if the society doesn't find
something to come and reach the same level of satisfaction we found the
"solution", it's a mental disorder... We really evolved... NOT

