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World Health Assembly ICD-11 and Gaming Disorder

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Offline kat

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As of May 2019 the World Health Assembly (the political arm of the World Health Organisation) recently confirmed[1] "Gaming Disorder" (and companion disorder "Hazardous Gaming") is to be formally included as an diagnosable disease/disorder in the International Classification of Diseases directory, IDC11. Like other entries in the ICD, the text now defining gaming disorders will form the basis around which health organisations can develop diagnostic frameworks, the tools needed to track outbreaks globally.

With that said, whilst there are genuine concerns over games and the potential for promulgating addictive behaviours, and the exceptionally rare cases of deaths occurring due to extended periods of gaming[2], the data in this regard, on games and gaming being a demonstrable mechanism of addiction, that playing games cause addiction[3] rather their simply taking advantage of certain constituent elements of responses that might lead to addictive behaviours, is actually quite sparse.

This reality, and distinction, is important but rarely discussed or acknowledged, so much so it seems of little consequence because it doesn't make headlines nor support political and activist narratives that games are harmful for a variety of [reasons] in [current year] and should be regulated[4] for the betterment of society.

6C51 Gaming disorder
Parent: Disorders due to addictive behaviours

Description: Gaming disorder is characterized by a pattern of persistent or recurrent gaming behaviour (‘digital gaming’ or ‘video-gaming’), which may be online (i.e., over the internet) or offline, manifested by:

 - impaired control over gaming (e.g., onset, frequency, intensity, duration, termination, context);

 - increasing priority given to gaming to the extent that gaming takes precedence over other life interests and daily activities; and

 - continuation or escalation of gaming despite the occurrence of negative consequences. The behaviour pattern is of sufficient severity to result in significant impairment in personal, family, social, educational, occupational or other important areas of functioning.

The pattern of gaming behaviour may be continuous or episodic and recurrent. The gaming behaviour and other features are normally evident over a period of at least 12 months in order for a diagnosis to be assigned, although the required duration may be shortened if all diagnostic requirements are met and symptoms are severe.
And accompanying; 
QE22 Hazardous Gaming
Parent: Problems associated with health behaviours

Description: Hazardous gaming refers to a pattern of gaming, either online or offline that appreciably increases the risk of harmful physical or mental health consequences to the individual or to others around this individual. The increased risk may be from the frequency of gaming, from the amount of time spent on these activities, from the neglect of other activities and priorities, from risky behaviours associated with gaming or its context, from the adverse consequences of gaming, or from the combination of these. The pattern of gaming is often persists in spite of awareness of increased risk of harm to the individual or to others.

[1] version eleven of the International Classification of Diseases directory was launched June 2018 and did provisionally include gaming 'addiction' disorder and 'hazardous' gaming disorder. At the 72nd general meeting of the World Health Assembly (cf. A72/29) ICD11's adoption was voted for, it coming into effect for clinical and statistical use in 2022.

[2] in the absence of a global database covering 'gaming deaths' - age, location, etc. - headlines indicate a majority of those who do die as a consequence of gaming disproportionately reside in Asia Pacific countries, Korea and Japan most notably, and that deaths that have occurred typically involve prolonged or excessive use and/or sessions of greater intensity than might otherwise have been considered normal.

[3] as a principle 'addiction' is a fundamental mechanic of game design that at its core is simply a consequence of a stimuli/reward dynamic, typically manifest though item farming, collection and other repetitive activities. Exactly how this relationship is causal to addiction is not clearly explained in research literature absent the presence of other external (not game related) influences, flappybird (2014) for example was pulled by its creator over (faux) concerns raised by media and activists it might cause addiction, a headline grabbing assertion that was never demonstrated or evidenced.

[4] being blunt, the pathologising of games and gaming as an addiction serves a singular purpose, money. A cursory glace at the coverage of this topic over the years seems to indicate at least 90+% of the discussion being initiated by media outlets seeking stories, headlines (from both gaming and non-gaming outlets), and the institutions that potentially stand to gain from the classification and categorisation and treatment of gaming as a disorder, the psychological and mental health institutes and associations, who become authoritative sources that reinforce the media 'harms' narrative (to the detriment of those in opposition to the classification if not the overall narrative of harm), which in turn acts as justification for the concerns raised, little more than circular citation. It's less about (open, honest or frank) discussion than it is framing, laying out the data points that can be discussed, omitting those that cannot.