A weak scientific basis for gaming disorder: Let us err on the side of caution

Abstract

We greatly appreciate the care and thought that is evident in the ten 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 in particular 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.

Face validity evaluation of screening tools for gaming disorder: Scope, language, and overpathologizing issues

“…A major problem identified across most tests (56 items, 20 tests), and which has been raised by researchers who criticize gaming disorder as a mental disorder (Aarseth et al, 2017;Bean, Nielsen, Van Rooij, & Ferguson, 2017;Billieux, Schimmenti, Khazaal, Maurage, & Heeren, 2015;Przybylski, Weinstein, & Murayama, 2016;van Rooij et al, 2018), is the potential for tests to "overpathologize" normal and adaptive gaming behaviors and consequences. The VASC was found to include 11 items that refer to the benefits of gaming (e.g., "I think playing video games is a very enjoyable activity"; "I feel happy when I play video games"; "I always talk about video games with my friends").…”

Video games, aggression and addiction

“…Društvo za psihologiju medija i tehnologija pri Američkoj asocijaciji psihologa (APA) je tim povodom i ovako obrazlažući upravo dalo zvaničnu izjavu u kojoj iskazuju protivljenje uvođenju ove dijagnoze. I drugi članci sa velikim brojem autora iz ove oblasti su takođe pozivali na oprez i potencijalne neželjene efekte uvođenjem ove dijagnoze [26,27], kao naravno i oni koji se zalažu za dijagnozu [28]. Prva grupa navodi da nema dovoljno dokaza za postojanje distinktnog poremećaja, a posebno naglašavaju potencijal za patologizovanje normalne upotrebe i lažno pozitivne slučajeve, te da se na taj način može stvoriti negativan efekat na potencijalne pacijente.…”

Multimodality and Expressivity in Videogames

“…A consensus is so far from being reached on the issue that the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) decided not to list the behavior -playing games -as a mental problem in its latest edition, because of the lack of unquestionable evidence (Kuss, Griffiths, & Pontes, 2017). Further regarding the WHO decision, a group of 36 researchers have presented a paper, in pre-print form, entitled -"A Weak Scientific Basis for Gaming Disorder: Let us err on the side of caution" (van Rooij, A. J., Ferguson, C. J., Colder Carras, M., Kardefelt-Winther, D., Shi, J., & Przybylski, 2018) -calling for the same cautionary attitude as that presented by the DSM, and conversely highlighting the possible stigmatization such actions can create in society.…”