At its latest assembly, the World Health Organization endorsed the decision to introduce a diagnosis of “Gaming Disorder” in its next International Classification of Diseases (ICD-11). From 2022, when ICD-11 comes into force, it will therefore be possible to be diagnosed as a “video game addict”, since this disorder is classified among the addictions without a substance. In a very recently published article (Billieux et al., 2019), some of the authors from the WHO’s working group clarified that the criteria of pathological gaming should be distinguished from the practice of passionate gamers.
In order to avoid over-pathologisation, the authors therefore recommend taking a dualistic model as a reference. According to this model, the criteria usually central to addiction (withdrawal, conflict and relapse or loss of control) are accompanied by more peripheral criteria (such as being focused on a single subject, the need to seek ever more play, and a feeling of euphoria during gaming phases). Indeed, according to the authors, failing to take this distinction between criteria into account would result in arbitrarily mixing problem gamers with healthy gamers. The diagnosis proposed by ICD-11 therefore does not include some of the peripheral criteria. For example, the notion of tolerance is difficult to apply, since there are all sorts of different reasons for playing and these can vary from one session to the next. This factor is therefore easily found in a healthy gamer too. The WHO thus relies only on the central criteria to define pathological gaming behaviour. Finally, to ensure the assessment, the symptoms must be accompanied by the player’s inability to fulfil their everyday obligations for twelve months.
Although it is reassuring that such a moderate view can exist, the WHO’s decision can nonetheless leave one speechless. Until now, there was no need at all for such a diagnosis in order to work in therapy with the population of gamers in distress. I certainly consider it richer and more coherent to view excessive video game playing as the symptom and not the disorder itself. The fear of over-pathologising everyday life remains very present, notably because of a mistaken reading of these criteria, itself based on a lack of understanding of how video games work and of their customs. Excessive video game playing is then to be understood as a signal from the player that they suffer from poor self-esteem and are trying to make up for this lack of recognition. Such a diagnosis risks not only stigmatising gamers, but also, once again, crystallising family situations in which discussion about screens is already not easy. While the question of suffering must not be minimised, it is important to consider that of the player as much as that of those around them. Indeed, it is very often relatives who express this concern and distress.
Billieux, J., Flayelle, M., Rumpf, HJ.et al. Curr Addict Rep (2019). https://doi.org/10.1007/s40429-019-00259-x
He works in Switzerland on the subject of excessive screen use, notably with families. He uses the video game as a therapeutic tool and keeps a watchful eye on news about the medium (new releases, trends, impacts, etc.). Alongside his professional activities, he volunteers to run a game review site (www.semperludo.com), as well as a national association of gamers (www.gamingfederation.ch), through which they aim for responsible video game practice.
Twitter: @niels_weber, @semperludo, @GamingFed
