It all depends on the arguments used. If we consider that the existence of a physiological withdrawal syndrome and a major risk of relapse are the determining elements of addiction, video gaming does not qualify. But if we consider that the determining element is the difficulty some players have in limiting their consumption, and the priority given to games over other activities, it is acceptable to place certain players in the category of people suffering from an addiction. This is what is known as gaming disorder.
But since medication is the most commonly used treatment for addictions worldwide, there is a great danger that our children who play a little too much will be prescribed various pills whose effects are still largely unknown: the rats on which they were tested do not play video games! That is why it is essential to recall three distinctions.
Addiction does not mean addictive.
The first distinction concerns the difference between an activity judged to be addictive, that is, capable of causing addiction, and an activity that may seem addictive without its medium being describable as addictive. Indeed, it has been shown that people who have lost impulse control, whether as a result of a mental disorder or of substance abuse, foremost among them tobacco, can develop various addictions to products or objects that are not in themselves addictive. Without such a distinction, it is to be feared that many parents will worry that their child who plays a lot – and not necessarily too much – is developing an addiction.
Children and adults: two very different situations
The second distinction that will have to be taken into account concerns the difference between children and adults. The neurological bases of impulse control are established at the end of adolescence, and the typical teenager cannot stop himself from doing what gives him pleasure, even if he knows it is problematic for him. Then, around 16-17 years old and at the latest by 25, completed brain maturation allows young adults to control their impulses and limit their consumption. Gaming disorder should therefore concern only adults.
Caring about the causes and not only the consequences
A third element to take into account is the existence of avoidance behaviours in response to problems that players do not think they can face. Today, this element is largely taken into account by psychotherapists. But if the diagnosis of addiction were to be confirmed, the temptation would be great not to try to understand what is being fled from… a situation of bullying at school, for example.
If pathological video game use is recognised as an addiction, and these three distinctions are not taken into account, our children risk being quickly overwhelmed by chemical prescription.
S.T.
Serge Tisseron is a psychiatrist, doctor of psychology with accreditation to supervise research, member of the Académie des technologies, and associate researcher at Université Paris VII Denis Diderot (CRPMS).
