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

Antonius J van Rooij¹, Christopher J Ferguson², Michelle Colder Carras³, Daniel Kardefelt-Winther⁴, Jing Shi^{5

6}, Espen Aarseth⁷, Anthony M Bean⁸, Karin Helmersson Bergmark⁹, Anne Brus¹⁰, Mark Coulson¹¹, Jory Deleuze¹², Pravin Dullur¹³, Elza Dunkels¹⁴, Johan Edman¹⁵, Malte Elson¹⁶, Peter J Etchells¹⁷, Anne Fiskaali¹⁸, Isabela Granic¹⁹, Jeroen Jansz²⁰, Faltin Karlsen²¹, Linda K Kaye²², Bonnie Kirsh^{5

23

24}, Andreas Lieberoth²⁵, Patrick Markey²⁶, Kathryn L Mills²⁷, Rune Kristian Lundedal Nielsen⁷, Amy Orben²⁸, Arne Poulsen¹⁰, Nicole Prause²⁹, Patrick Prax³⁰, Thorsten Quandt³¹, Adriano Schimmenti³², Vladan Starcevic³³, Gabrielle Stutman³⁴, Nigel E Turner⁶, Jan van Looy³⁵, Andrew K Przybylski^{28

36}

Affiliations

¹ 1 Department of Children & Risky Behavior, Trimbos Institute , Utrecht, The Netherlands.
² 2 Department of Psychology, Stetson University , DeLand, FL, USA.
³ 3 Department of Mental Health, Johns Hopkins Bloomberg School of Public Health , Baltimore, MD, USA.
⁴ 4 Department of Clinical Neuroscience, Karolinska Institutet , Stockholm, Sweden.
⁵ 5 Rehabilitation Sciences Institute, University of Toronto , Toronto, Canada.
⁶ 6 Institute for Mental Health Policy Research, Centre for Addiction and Mental Health , Toronto, Canada.
⁷ 7 Center for Computer Games Research, IT University of Copenhagen , Copenhagen, Denmark.
⁸ 8 Department of Psychology, Framingham State University , Framingham, MA, USA.
⁹ 9 Department of Sociology, Stockholm University , Stockholm, Sweden.
¹⁰ 10 Department of People and Technology, Roskilde University , Roskilde, Denmark.
¹¹ 11 Department of Psychology, Middlesex University , London, UK.
¹² 12 Department of Psychology, Université Catholique de Louvain (UCL) , Louvain, Belgium.
¹³ 13 School of medicine, Western Sydney University , Penrith, NSW, Australia.
¹⁴ 14 Department of Applied Educational Science, Umeå University , Umeå, Sweden.
¹⁵ 15 Department of Criminology, Stockholm University , Stockholm, Sweden.
¹⁶ 16 Psychology of Human Technology Interaction Group, Ruhr University Bochum , Bochum, Germany.
¹⁷ 17 Department of Psychology, Bath Spa University , Bath, UK.
¹⁸ 18 Department of Psychology and Behavioural Sciences, Aarhus University , Aarhus, Denmark.
¹⁹ 19 Developmental Psychopathology, Radboud University Nijmegen , Nijmegen, The Netherlands.
²⁰ 20 Department of Media and Communication, ERMeCC, Erasmus University Rotterdam , Rotterdam, The Netherlands.
²¹ 21 Westerdals Department of Film and Media, Kristiania University College , Oslo, Norway.
²² 22 Department of Psychology, Edge Hill University , Ormskirk, UK.
²³ 23 Department of Occupational Science and Occupational Therapy, University of Toronto , Toronto, Canada.
²⁴ 24 Department of Psychiatry, University of Toronto , Toronto, Canada.
²⁵ 25 Department of Educational Psychology, Danish School of Education, Aarhus University , Aarhus, Denmark.
²⁶ 26 Department of Psychology, Villanova University , Villanova, PA, USA.
²⁷ 27 Department of Psychology, University of Oregon , Eugene, OR, USA.
²⁸ 28 Department of Experimental Psychology, University of Oxford , Oxford, UK.
²⁹ 29 Liberos LLC , Los Angeles, CA, USA.
³⁰ 30 Department of Game Design, Uppsala University , Visby, Sweden.
³¹ 31 Department of Communication, University of Münster , Münster, Germany.
³² 32 Department of Human and Social Sciences, UKE - Kore University of Enna , Enna, Italy.
³³ 33 Discipline of Psychiatry, University of Sydney , Sydney, Australia.
³⁴ 34 Clinical Psychologist/Neuropsychologist , New York, NY, USA.
³⁵ 35 Department of Communication Sciences, imec-mict-Ghent University , Ghent, Belgium.
³⁶ 36 Oxford Internet Institute, University of Oxford , Oxford, UK.

PMID: 29529886
PMCID: PMC6035022
DOI: 10.1556/2006.7.2018.19

Comment

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

Antonius J van Rooij et al. J Behav Addict. 2018.

. 2018 Mar 1;7(1):1-9.

doi: 10.1556/2006.7.2018.19. Epub 2018 Mar 13.

Authors

Affiliations

¹ 1 Department of Children & Risky Behavior, Trimbos Institute , Utrecht, The Netherlands.
² 2 Department of Psychology, Stetson University , DeLand, FL, USA.
³ 3 Department of Mental Health, Johns Hopkins Bloomberg School of Public Health , Baltimore, MD, USA.
⁴ 4 Department of Clinical Neuroscience, Karolinska Institutet , Stockholm, Sweden.
⁵ 5 Rehabilitation Sciences Institute, University of Toronto , Toronto, Canada.
⁶ 6 Institute for Mental Health Policy Research, Centre for Addiction and Mental Health , Toronto, Canada.
⁷ 7 Center for Computer Games Research, IT University of Copenhagen , Copenhagen, Denmark.
⁸ 8 Department of Psychology, Framingham State University , Framingham, MA, USA.
⁹ 9 Department of Sociology, Stockholm University , Stockholm, Sweden.
¹⁰ 10 Department of People and Technology, Roskilde University , Roskilde, Denmark.
¹¹ 11 Department of Psychology, Middlesex University , London, UK.
¹² 12 Department of Psychology, Université Catholique de Louvain (UCL) , Louvain, Belgium.
¹³ 13 School of medicine, Western Sydney University , Penrith, NSW, Australia.
¹⁴ 14 Department of Applied Educational Science, Umeå University , Umeå, Sweden.
¹⁵ 15 Department of Criminology, Stockholm University , Stockholm, Sweden.
¹⁶ 16 Psychology of Human Technology Interaction Group, Ruhr University Bochum , Bochum, Germany.
¹⁷ 17 Department of Psychology, Bath Spa University , Bath, UK.
¹⁸ 18 Department of Psychology and Behavioural Sciences, Aarhus University , Aarhus, Denmark.
¹⁹ 19 Developmental Psychopathology, Radboud University Nijmegen , Nijmegen, The Netherlands.
²⁰ 20 Department of Media and Communication, ERMeCC, Erasmus University Rotterdam , Rotterdam, The Netherlands.
²¹ 21 Westerdals Department of Film and Media, Kristiania University College , Oslo, Norway.
²² 22 Department of Psychology, Edge Hill University , Ormskirk, UK.
²³ 23 Department of Occupational Science and Occupational Therapy, University of Toronto , Toronto, Canada.
²⁴ 24 Department of Psychiatry, University of Toronto , Toronto, Canada.
²⁵ 25 Department of Educational Psychology, Danish School of Education, Aarhus University , Aarhus, Denmark.
²⁶ 26 Department of Psychology, Villanova University , Villanova, PA, USA.
²⁷ 27 Department of Psychology, University of Oregon , Eugene, OR, USA.
²⁸ 28 Department of Experimental Psychology, University of Oxford , Oxford, UK.
²⁹ 29 Liberos LLC , Los Angeles, CA, USA.
³⁰ 30 Department of Game Design, Uppsala University , Visby, Sweden.
³¹ 31 Department of Communication, University of Münster , Münster, Germany.
³² 32 Department of Human and Social Sciences, UKE - Kore University of Enna , Enna, Italy.
³³ 33 Discipline of Psychiatry, University of Sydney , Sydney, Australia.
³⁴ 34 Clinical Psychologist/Neuropsychologist , New York, NY, USA.
³⁵ 35 Department of Communication Sciences, imec-mict-Ghent University , Ghent, Belgium.
³⁶ 36 Oxford Internet Institute, University of Oxford , Oxford, UK.

PMID: 29529886
PMCID: PMC6035022
DOI: 10.1556/2006.7.2018.19

Abstract

We greatly appreciate the care and thought that is evident in the 10 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 particularly 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.

Keywords: International Classification of Diseases-11; World Health Organization; classification; diagnosis; gaming disorder; mental disorders; moral panic.

PubMed Disclaimer

Comment in

Including gaming disorder in the ICD-11: The need to do so from a clinical and public health perspective.
Rumpf HJ, Achab S, Billieux J, Bowden-Jones H, Carragher N, Demetrovics Z, Higuchi S, King DL, Mann K, Potenza M, Saunders JB, Abbott M, Ambekar A, Aricak OT, Assanangkornchai S, Bahar N, Borges G, Brand M, Chan EM, Chung T, Derevensky J, Kashef AE, Farrell M, Fineberg NA, Gandin C, Gentile DA, Griffiths MD, Goudriaan AE, Grall-Bronnec M, Hao W, Hodgins DC, Ip P, Király O, Lee HK, Kuss D, Lemmens JS, Long J, Lopez-Fernandez O, Mihara S, Petry NM, Pontes HM, Rahimi-Movaghar A, Rehbein F, Rehm J, Scafato E, Sharma M, Spritzer D, Stein DJ, Tam P, Weinstein A, Wittchen HU, Wölfling K, Zullino D, Poznyak V. Rumpf HJ, et al. J Behav Addict. 2018 Sep 1;7(3):556-561. doi: 10.1556/2006.7.2018.59. Epub 2018 Jul 16. J Behav Addict. 2018. PMID: 30010410 Free PMC article.

Comment on

Scholars' open debate paper on the World Health Organization ICD-11 Gaming Disorder proposal.
Aarseth E, Bean AM, Boonen H, Colder Carras M, Coulson M, Das D, Deleuze J, Dunkels E, Edman J, Ferguson CJ, Haagsma MC, Helmersson Bergmark K, Hussain Z, Jansz J, Kardefelt-Winther D, Kutner L, Markey P, Nielsen RKL, Prause N, Przybylski A, Quandt T, Schimmenti A, Starcevic V, Stutman G, Van Looy J, Van Rooij AJ. Aarseth E, et al. J Behav Addict. 2017 Sep 1;6(3):267-270. doi: 10.1556/2006.5.2016.088. Epub 2016 Dec 30. J Behav Addict. 2017. PMID: 28033714 Free PMC article.

References

1. Aarseth E., Bean A. M., Boonen H., Colder Carras M., Coulson M., Das D., Deleuze J., Dunkels E., Edman J., Ferguson C. J., Haagsma M. C., Helmersson Bergmark K., Hussain Z., Jansz J., Kardefelt-Winther D., Kutner L., Markey P., Nielsen R. K. L., Prause N., Przybylski A., Quandt T., Schimmenti A., Starcevic V., Stutman G., Van Looy J., Van Rooij A. J. (2017). Scholars’ open debate paper on the World Health Organization ICD-11 gaming disorder proposal. Journal of Behavioral Addictions, 6(3), 267–270. doi:10.1556/2006.5.2016.088 - DOI - PMC - PubMed
1. Bean A. M., Nielsen R. K. L., Van Rooij A. J., Ferguson C. J. (2017). Video game addiction: The push to pathologize video games. Professional Psychology: Research and Practice, 48(5), 378–389. doi:10.1037/pro0000150 - DOI
1. Billieux J., Blaszczynski A., Colder Carras M., Edman J., Heeren A., Kardefelt-Winther D., Khazaal Y., Thege B. K., Maurage P., Schimment A., Van Rooij A. J. (2017). Behavioral addiction: Open definition development. Open Science Framework. doi:10.17605/OSF.IO/Q2VVA - DOI - PubMed
1. Billieux J., King D. L., Higuchi S., Achab S., Bowden-Jones H., Hao W., Long J., Lee H. K., Potenza M. N., Saunders J. B., Poznyak V. (2017). Functional impairment matters in the screening and diagnosis of gaming disorder. Journal of Behavioral Addictions, 6(3), 285–289. doi:10.1556/2006.6.2017.036 - DOI - PMC - PubMed
1. Billieux J., Schimmenti A., Khazaal Y., Maurage P., Heeren A. (2015). Are we overpathologizing everyday life? A tenable blueprint for behavioral addiction research. Journal of Behavioral Addictions, 4(3), 119–123. doi:10.1556/2006.4.2015.009 - DOI - PMC - PubMed

Publication types

Actions

MeSH terms

Actions
Actions
Actions
Actions
Actions
Actions

Grants and funding

T32 MH014592/MH/NIMH NIH HHS/United States

LinkOut - more resources

Full Text Sources
Other Literature Sources
- scite Smart Citations

Save citation to file

Email citation

Add to Collections

Add to My Bibliography

Your saved search

Create a file for external citation management software

Your RSS Feed

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

Affiliations

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

Authors

Affiliations

Abstract

Comment in

Comment on

References

Publication types

MeSH terms

Grants and funding

LinkOut - more resources

Full Text Sources

Other Literature Sources