Video games are enormously popular with children, teens, and even adults. Over the last forty years, video games have become more commonplace, more complex, more visually-appealing, more violent and, according to the American Psychological Association (APA), more addictive. Internet Gaming Disorder is now a recognized condition but what exactly is it, and what can be done to treat it?
Gaming Disorder Defined
Addiction to video games is becoming so common that the APA has included “Internet Gaming Disorder” in Section III of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). Section III is the part of the DSM that lists “Conditions for Further Study”. The very fact that video gaming addiction has found its way intothe premier diagnostic tool for psychiatric clinicians highlights the seriousness of the problem.
DSM-5 (American Psychiatric Association, 2013) defines Internet Gaming Disorder as “Persistent and recurrent use of the Internet to engage in games, often with other players, leading to clinically significant impairment or distress in several aspects of daily life.”
In 2018, the World Health Organization announced that it would also be including Gaming Disorder in the International Classification of Diseases (ICD-11). Although ICD-11 won’t be formally adopted by clinicians until 2022, the formal inclusion of gaming disorder has raised addiction to video games from something that needs to be studied further to a recognized mental disorder.
ICD-11 (World Health Organization, 2018) defines Gaming Disorder as “a pattern of gaming behavior (“digital-gaming” or “video-gaming”) characterized by impaired control over gaming, increasing priority given to gaming over other activities to the extent that gaming takes precedence over other interests and daily activities, and continuation or escalation of gaming despite the occurrence of negative consequences.”
What constitutes Gaming Disorder? Certainly, there’s some controversy about the point at which too much video gaming becomes a disorder, but both the DSM-5 and ICD-11 have some clearly-defined criteria to help clinicians make a diagnosis of gaming disorder.
ICD-11’s diagnostic criteria for a diagnosis of Gaming Disorder suggests that the following criteria be present for at least 12 months unless symptoms are particularly severe, in which case, diagnosis can be made prior to 12 months:
1. Impaired control over gaming (e.g., onset, frequency, intensity, duration, termination, context);
2. Increasing priority given to gaming to the extent that gaming takes precedence over other life interests and daily activities; and
3. Continuation or escalation of gaming despite the occurrence of negative consequences. The behavior pattern is of sufficient severity to result in significant impairment in personal, family, social, educational, occupational or other important areas of functioning. (WHO, 2018)
When the APA was considering Internet Gaming Disorder for inclusion in the DSM-5, the APA Substance-Related Disorders Work Group recognized the similarities between Gaming Disorder, Gambling Disorder, and Substance Use Disorders. DSM-5 highlights a number of potential criteria for making a diagnosis, including:
- Preoccupation with video games
- Withdrawal symptoms including irritability, sadness, or anxiety when unable to game
- Developing tolerance (i.e. more time needs to be spent gaming to satisfy ‘cravings’
- Deceiving others about the amount of time spent on gaming
- Using gaming to escape or cope with negative emotions
- Gaming interferes with everyday functioning
- Gaming jeopardizes relationships, employment, and/or education
- Lack of interest in all other activities
- Being unable to stop gaming, despite understanding the negative impact and/or attempting to stop
At least five of these signs of Gaming Disorder must be present for a diagnosis to be made.
If you’re worried that you — or someone you care about — may be experiencing Gaming Disorder, it’s important to recognize that having a passion for video games, or playing so-called addicting games (such as Minecraft or Fortnite), doesn’t necessarily mean that it’s a sign of Gaming Disorder.
A 2017 study, published in the American Journal of Psychiatry, investigated the prevalence of Gaming Disorder and discovered that only around 0.3-1.0% of the people would meet the criteria for Internet Gaming Disorder, so it’s more likely for someone to simply be passionate about gaming than it is for them to have an actual Gaming Disorder. It’s certainly not the epidemic that some newspaper headlines have made it out to be!
The Impact of Video Game Addiction
Teens and young adults are more likely to develop gaming disorder than adults in their 30s and 40s, so if you’re a parent of a teen that loves to game, you may be worried about the impact that addiction to gaming has on a young person’s life.
An article in The Washington Post in 2016 recounted the story of a 15-year-old boy who became violent and would throw glasses and other objects when his parents requested that he stop gaming, turn off his computer or Xbox and go to bed.
The violent outbursts grew worse as the boy grew increasingly more addicted to the virtual worlds online. The boy’s parents took drastic action and sent their son to a wilderness therapy program and then a boarding school, both places with strict routines and no access to video games.
While this is an extreme case, the effects of addiction to video games are far-reaching. Researchers have investigated the way that video games affect the brain — with one study (Koepp et al., 1998) showing that continued video gaming can increase dopamine in the brain by up to 100%, which is the same level of increase as is usually experienced during sex. It’s easy to see, then, why young people find video games so addictive.
Other ways in which young people may be affected by this kind of disorder include:
- Changes in the brain that negatively affect cognitive function and emotional control
- Auditory hallucinations, otherwise known as Game Transfer Phenomena (GTP), where the boundaries between games and reality start to blur
- Social withdrawal
- Poor academic performance
- Depression and anxiety linked to game withdrawal
- Desensitization to violence
- Seizures and repetitive stress injuries
- Increased aggression and violence
- Delayed development due to avoidance of developmental tasks
Christian Counseling for Gaming Disorder
At the heart of gaming disorder or video game addiction is a desire to fill some kind of void in your life. Like all addictions, it’s possible to overcome gaming disorder through counseling with an experienced Christian counselor. Unlike secular counseling, Christian counseling focuses on helping you to fill the void in your life with God rather than with video gaming.
Secular treatment for gaming addiction tends to rely on Cognitive Behavioral Therapy (CBT) for behavioral modification, as well as group and/or family counseling. However, these types of treatment focus on changing obsessive thoughts and behavior rather than offering something other than gaming to fill the void that caused the addiction in the first place. Without something to fill that void, relapse is more likely.
Christian counseling aims to help build a close and intimate relationship with God. This is something that can replace video gaming. Working with a Christian counselor can allow a person with gaming disorder to:
- Explore fears and doubts about God
- Talk about past experiences that may have contributed to them seeking to numb emotions through gaming
- Explore their spiritual needs
- Develop dependency on God instead of on video gaming
- Learn to understand the roots of gaming disorder
- Explore wisdom from Scripture that can help in recovery
- Connect with God to find peace, love, and security
- Develop strategies to prevent relapse
Video Games Don’t Have to Take Over
Not everyone who enjoys playing video games has a gaming disorder, but there’s no doubt that gaming disorder does exist and is potentially on the rise. Addicting video games such as Fortnite continue to capture the attention of young people, with over 250 million Fortnite users registered and at least 80 million people playing each month.
Educating your teens about the risks of excessive gaming and putting strategies in place, such as restrictions on the time spent gaming, can prevent Gaming Disorder from becoming a problem in the future. If, however, you have a teen who’s already exhibiting signs of having Gaming Disorder, seek the help of a qualified Christian counselor before the problem becomes too severe.
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VAKoepp, M. J., R. N. Gunn, A. D. Lawrence, V. J. Cunningham, A. Dagher, T. Jones, D. J. Brooks, C. J. Bench, and P. M. Grasby. (1998) ‘Evidence for Striatal Dopamine Release during a Video Game’. Nature 393, no. 6682Przybylski, AK, Weinstein, N, Murayama, K. (2017.) Internet Gaming Disorder: Investigating the Clinical Relevance of a New Phenomenon. American Journal of Psychiatry, 174:230-236.
World Health Organization. (2018). International classification of diseases for mortality and morbidity statistics (11th Revision). Retrieved from https://icd.who.int/browse11/l-m/en
Gibson, C. (2016) The Next Level, The Washington Post, December 7, 2016; https://www.washingtonpost.com/sf/style/2016/12/07/video-games-are-more-addictive-than-ever-this-is-what-happens-when-kids-cant-turn-them-off/
“A Study in Blue”, Courtesy of Daniel Korpai, Unsplash.com, CC0 License; “Nintendo”, Courtesy of Sara Kurfeß, Unsplash.com, CC0 License; “Coding”, Courtesy of Adam Nowakowski, Unsplash.com, CC0 License; “Black Game Controller”, Courtesy of Lukenn Sabellano, Unsplash.com, CC0 License