ESA pushes back against World Health Organization’s gaming disorder classification

In case you missed it over the holiday break, but the World Health Organization announced it would be adding “gamer disorder” and “hazardous gaming” to the latest edition of its International Compendium of Diseases, a move many academics treated with skepticismAccording to WHO, “Gaming disorder is characterized by a pattern of persistent or recurrent gaming behaviour, which may be online or offline, manifested by: 1) impaired control over gaming; 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 industry isn’t taking this classification lightly, with the Electronic Software Association predictably pushing back against the move and saying that it misrepresents a hobby billions enjoy.

“The World Health Organization knows that common sense and objective research prove video games are not addictive,” the ESA said in a statement. “And, putting that official label on them recklessly trivializes real mental health issues like depression and social anxiety disorder, which deserve treatment and the full attention of the medical community. We strongly encourage the WHO to reverse direction on its proposed action.”

As gaming science researcher Dr Rachel Kowert pointed out to us, the American Psychological Association does not formally recognize gaming addiction as an addiction, for good reason. “There is a large amount of research just now coming out questioning whether or not it is a distinctive behavioral addiction deserving of its own classification,” she told us, referring to recent journalism on the topic as “moral panic-y.”

Source: Gamasutra
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Zora

Isn’t the WHO that body of people repeating us every other year that we are all about to die horribly to some global epidemic/catastrophe hoping to illicit (often successfully) donations from our governments, which are traditionally very generous with tax money?

I somehow suspect anytime money are involved it’s about politics and agendas rather than any scientific or let alone health concerns. ESA are pushing their own, who’s agenda is WHO pushing?

Leontes
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Leontes

In direct reply to your question I’d like to add though, that there are those who would argue that the pharma lobby – to a significant degree US-based – very “generously donates” in answer to WHO pleas, as governments tend to drastically cut back on their support. Guess whose agenda might be at an advantage here…

Leontes
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Leontes

I would not know, who’s agenda they are pushing, I just know among other things they’re trying to coordinate health efforts worldwide. In Germany we are insofar tied to the WHO, as our healthcare system is closely bound to their regulations, and specifically to the ICD. If I want to treat anyone for anything and expect to get paid for it, I have to do so based on an ICD-10 (and in the future probably on an ICD-11) diagnosis. The diagnostic system is usually discussed and updated by a multinational committee of researchers, renowned professionals and healthcare representatives for the respective field of expertise (e.g. chapter 6/F : Mental and Behavioral Disorders) – I do not know the specifics here, so take this with a grain of salt, it’s been a while since I learned this. That said, I’m actually a fan of the DSM, but for us that is mostly relevant for research…

As far as I know (not sure, though), many a nation’s healthcare systems are bound to WHO policy – other than you guys in the US (you pretty much have your own thing for everything). It strikes me as somewhat strange, that the UN and its bodies are seen so …disconnected from the US, given the weight the USA carries in UN policies and politics.

Estranged
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Estranged

“The World Health Organization knows that common sense and objective research prove video games are not addictive,”

Don’t know how anyone can type that with a straight face.

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Peregrine Falcon

A study cited by the New York Times says that video games aren’t addictive. If you disagree please show your work.

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Melissa McDonald

I’m addicted to games. Therefore the New York Times is wrong.

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Utakata

I thought that when World Health Organization try to make Robert Mugabe their goodwill ambassador. I really hope they’re not as poor in judging things that can actually kill us. o.O

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jay

The only thing this does is add a billable diagnosis for therapists to the WHO’s database. People are making this out to be a much bigger issue than it really is. It was already part of the ISDN, which is the codes uses to bill insurance providers, and what is used to diagnose mental disorders. It has been in the ISDN for some time now, so this isn’t new.

The WHO is just trying to raise awareness of it.

Andrew Ross
Staff
Andrew Ross

I’m not familiar with the ISDN. Googling it just shows stuff for the Integrated Services Digital Network. Did you mean ICD?

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jay

It’s just another variation of the DSM IV used to categorically diagnoses mental health disorders for billing and treatment. https://en.wikipedia.org/wiki/DSM-IV_codes Is more commonly used, and also has a gaming addiction diagnosis.

Andrew Ross
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Andrew Ross

…but the DSM-IV is not only outdated, but doesn’t include a game disorder (even in the 2013 DSM-V) as anything beyond a subject in need of further study:

http://www.techaddiction.ca/internet-gaming-disorder-dsm-5.html

We’ve covered this in several editorials, book/research reviews, interviews with researchers in the field, and in the comments section. If you can give me the name of whatever the ISDN is, I could better understand this.

Reader
Dread Quixadhal

When you go down this path, you can start calling EVERYTHING a mental health disorder. Anything that you enjoy can be addictive, but that doesn’t mean it’s an inherently addictive activity. A thing is addictive when your normal day-to-day activities are impaired by you not getting your “fix”.

Our brains are wired to reinforce pathways that generate pleasure, and make them more desirable. If you like coffee, your brain will become wired to remember the taste and smell of coffee, so you are more likely to want it again. That, alone, isn’t addiction. If you start refusing to do your work unless you have coffee, neglecting your kids and pets without it, or stealing to pay for it… that’s addiction.

We live in a generation that has taught people to deny taking personal responsibility for their own actions, and always look for someone else to blame for things. As a result, many people lack the willpower to step away from the game when they know they should. You could call THAT a mental disorder, but it’s one that can only be fixed by teaching our kids to be less like ourselves.

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MrNastyButler

Are video games addictive? I’d say yes and no really. I do agree that there are aspects about video games that can be addictive and companies can distill their products to make those features even more addictive. And that there is the problem. Companies play on aspects of games that can make them addictive.

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A Dad Supreme

Are video games addictive? I’d say yes and no really.

I think this adds up to a “I don’t know”.

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MrNastyButler

No, but I’m willing to let people interpret what they wish from it.

Reader
Schmidt.Capela

If countries around the world start recognizing this proposed diagnostic it can spell doom to certain monetization strategies that explicitly aim to cause dependence in order to keep players playing and spending money. This could give legal cause to treat games featuring those as if they were gambling, potentially even including fines for any publisher that can’t prevent minors from playing said games.

It might also wreck havoc with marketing; where I live, for example, marketing of any substance known to cause dependence is heavily restricted (there’s an extensive list of things you can’t feature on alcoholic beverage advertisements, and advertisement of tobacco-based products is outright banned).

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Ashfyn Ninegold

I’m cautiously skeptical. Playing video games has always been seen in a negative light. Always. Remembering that this is the World Health Organization, which conducted online peer review with the countries that participate in formulating the ICD-11, you could say that video gaming continues to have a bad rep around the world.

Compare “gaming disorder” to soccer or football fans. Is it not weird that people paint their faces, wear strange clothing, shout incoherently and attack others for differing loyalties? Violence at soccer games is well documented. Also well-documented is the rise in domestic violence on Super Bowl Sunday. Is “crazed sport fanatic” also in the ICD-11? That seems far more destructive and wide-spread than gaming disorder.

In short, video gaming doesn’t have the same place of honor in most societies that sport fanatic does. It is okay to be mindlessly belligerent about your sport team, even if specific acts of violence are against the law. Yet all three of the indicators for gaming and gambling used by the ICD (which are almost exactly the same) applies to fanatical sports behavior as well :

1) impaired control over sports watching;
2) increasing priority given to sports to the extent that sports takes precedence over other life interests and daily activities; and
3) continuation or escalation of sport activities despite the occurrence of negative consequences.

Am I bashing sports? Nope. Just pointing out that if sports were viewed as negatively as video gaming always has been, being a sports fan could also be classified as a “disorder”.

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rafael12104

Well said! Thank you. And btw, I’m a sports fan.

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wonderrat

I always like to look back on that classic image of a 1950’s family sitting down to breakfast. The kids are eating toast and dad’s at the table with the newspaper. Perfect family.

Replace that newspaper with an iPhone. Now dad’s an asshole neglecting his kids.

Society is super arbitrary about what’s good and bad.

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A Dad Supreme

“And, putting that official label on them recklessly trivializes real mental health issues like depression and social anxiety disorder, which deserve treatment and the full attention of the medical community

Everything is potentially addictive to the right (or wrong) person. Even stealth lurking/reading or posting on a forum’s site every day. :P

It’s just that many of the possible, unlimited “addictions” are considered by most people to be stupid, “weird” or silly (hoarding cats/animals, pornography, tanning booths, home shopping buying, etc) so it’s not viewed as an addiction since it only deals with a couple hundred or thousand rather than millions.

Conversely, when you chuck in things like OCD or autistic behavior where someone might have a driven need to “finish” things (ala “The Accountant”) playing a game that can’t ever be “finished” (MMOs), that might seem like video games are addictive but really aren’t; they are just dangerous to that one person.

Unless an addiction to something puts someone else who doesn’t have one at mortal risk like alcoholism (drunk driving or stealing/robbing to buy drugs, etc), it’s generally written off as not worthy of inspection or study.

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Stephen Donohue

“Video games aren’t addictive!” screams an industry obsessed with lockboxes designed to prey on people with gambling addictions.

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A Dad Supreme

with lockboxes designed to prey on people with gambling addictions.

I doubt many people who have gambling addictions are spending their money on video games. They are more likely spending money on lottery tickets or going to casinos and such, not lockboxes.

I think game companies target people with OCD/completionist issues with lockbox sales more likely. They know those people want these things, and if they offered the item in the game free just from grinding, people would do that instead.

They cashed-in for them to have that need to “finish” a set or item look for cash with the possibility they might get it.

Fun fact: Now up to $415 million and $460 million respectively.

http://www.megamillions.com/
http://www.powerball.com/pb_home.asp

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KumiKaze

The problem isn’t the people who have gambling addictions and go to casinos, betting, etc. It’s the people that don’t know they have a gambling addiction because they haven’t been in a situation yet to know.

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A Dad Supreme

It’s the people that don’t know they have a gambling addiction because they haven’t been in a situation yet to know.

If I ran a company, I wouldn’t focus or worry about people who may or may not know themselves they have a gambling problem. That would be silly as a focus.

I mean, why worry about my hamburger stand selling burgers to obese people because they may or may not know that they have an eating problem?

What if they don’t have an eating problem but are naturally “big boned” or “thick” as we said back in the day?

What if they do have an eating problem but it’s not from my burgers, it’s predominantly from Italian and Mexican food and they just eat burgers once in awhile?

I’m selling hamburgers to anyone who wants to eat one, not “I’m not selling burgers to that guy because he might be addicted to food in general”.

Likewise, I don’t think a gaming company should worry/focus on people who might have gambling addictions from casinos and lotteries that play their games.

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rafael12104

ESA is full of it. What a crock of shit. Their concern for those who suffer from “real” social anxiety and depression is laughable.

ESA tacitly supports predatory business practices that make some games a gambling addiction. Might as well pay rent for an opium den.

ESA, stop being hypocrites and get your own house in order. Then, and only then, can you speak on what you think is trivial.

Zeph
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Zeph

The ESA is just freaked out by anything that threatens to further erode the industry’s self-regulation.

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Simon F

I can see why it could be good, but I also get why people are against it. Still, addiction is addiction, no matter what you’re addicted to. Being addicted has negative consequences, and if it is treated seriously, just like any mental illness would, getting help for it would also be easier.
Some claim it would devalue other diagnoses such as depression and whatever, but as someone who has several diagnoses, I can say that diagnoses are tools. I don’t do stupid shit and point at a diagnosis as an excuse. They explain why I am like I am in order for me to get assistance.
If you don’t experience any issues in your daily life, you also have no reason to diagnose yourself. So basically, if you don’t have any problems to solve or that you can’t solve on your own, chances are you don’t have a diagnosis, and because of that, you also won’t get any assistance if you suddenly require it. Unless family, friends, relatives, neighbours or whoever it may be helps you of course.

Basically, I’d rather change the title to game addiction instead of gamer disorder, because that just leaves a really bad taste.

Leontes
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Leontes

Agreed :)

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Utakata

/reefer madness

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Bryan Correll

Eh, you just don’t like how evil you look in the header image.

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Utakata

Who says I don’t like it? <3

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Knox Harrington

Just what humans need: another excuse to not be disciplined and exercise moderation.

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Sally Bowls

a move actual academics treated with skepticism.

C’mon, that does not seem to me as “fair and balanced”.
Certainly, there are “actual academics” who do not agree with this.
However, there are actual academics who do agree with this. The WHO is not updating their ICD or gaming disorder getting mentioned in DSM V due to the opinion of plumbers or chefs.

Bree Royce
Staff
Bree Royce

The WHO has a long history of allowing non-scientists to make erroneous science claims that have unfortunate ripple effects in our lives. However, I will edit the sentence to be more neutral. I look forward to hearing from more science-rigorous organizations on this topic.

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Sally Bowls

Oh I agree. And I certainly meant a gentle chide in defense of what hereabouts is the underdog than a scathing indictment. (And ofc I would not want some ******* parsing every sentence I wrote for nuance.) Nor would I want to defend WHO (After Ted Turner donated $1B to the UN, George Will said the good thing was just how little the UN could accomplish with a billion dollars.) I was just pointing out that there are certainly a lot of academics on the other i.e. both sides. And for a lot of hot-button topics like climate change, vaccinations, tobacco, cellphone radiation, GMO, … you – or an organization with money – can usually come up with academics for your point of view.

What is “true”, what is the consensus of the best scientists, what the UN says and what Western politicians run for election on can be four distinct things. The one constant, from me down to the lowliest of politicians, is that the academics that favor their POV get quoted more.

Bree Royce
Staff
Bree Royce

Sally, you are not just some *******. You are my favorite *******. :P

(Honestly, we keep quoting Kowert because she’s written books on this and was willing to be interviewed, repeatedly, over the last few years as we’ve explored the topic. Her position is basically the one I see from every wise scientist: “we don’t know; needs more research.” When policy bodies start making bold assertions that we know academics in this tiny field haven’t got the data to back up – yet – that should trigger alarms.)

Leontes
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Leontes

Well, that depends on what kind of epistemologic traditions you are willing to accept as science. While I cauteously agree with your general sentiment (I’ll always take evidence- over eminence-based), in the academic community of social and cultural sciences there is a predominance of a very strict and exclusive set set of scientific paradigms, that do not always work in our favor. Under attack as being “non-scientific”, important traditions have been driven to near-extinction in the academic landscape. Case in point being the psychoanalytic tradition, that you’ll find vastly absent at universities in Germany, only to be recently backed by advances in neurosciences, and vast efforts in recent psychotherapy research. While there is merit in asking for “evidence-based” policy, it is questionable to dismiss certain positions or traditions as erraneous or non- science. That is a very slippery slope there.

Seriously, I cannot help but looking back on my years of academic training and research as bordering on brainwashing, after getting a little bit of more extensive experience under my belt… Still, I hold my profession in high regard – that I grew more critical in some points does not mean that I reject the principles I learned and that are very much part of my professional identity.

Bree Royce
Staff
Bree Royce

I was being quite literal: The WHO has a history of literally making up data to suit its policy. It is a self-avowed policy body, not an academic institution. I have no personal position on gaming addiction per se. I just don’t trust WHO whatsoever.

Leontes
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Leontes

Hmmm, ok, granted. Albeit I wouldn’t know whom to trust on those grounds.

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Melissa McDonald

Yes, and Phillip Morris will tell you that people don’t get addicted to cigarettes, either.

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Utakata

False equivalency. Nicotine is known addictive narcotic in cigarettes. Games have no said properties.

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rafael12104

You are right Uta, but even as late as the 1950s Melissa’s words were exactly Big Tobacco’s party line. And then they added “there is no link to cancer”.

They knew it wasn’t true and that is what lead to the massive lawsuits they faced in the 90s.

IMO, soon we will see studies of gaming habits in games that use lootbox schemes specifically, and there results will validate addiction.

And this is something that is already well know to EA and the like. They know it well because they are banking on it.

BTW, I ended up working until 1am so I couldn’t get back to the BnS fun. Sorry about that.

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Utakata

It’s a question of substance versus users. If it’s a substance that has properties to become physically addicted, then yeah…that should be regulated. This is where cigarettes and opiates fall into this equation.

When it’s something such as a game, then is become the user who is “psychologically” addicted to it…but there’s nothing inherent in a game itself that causes addiction. Unless you can demonstrate it’s that Ktarian game from TNG, where its developers designed the said game so the users become hypnotically dependent for nefarious purposes…then you can’t claim video games are a substance issue.

Thus the industry does need to be regulated in this department. (Nor should we want it to be regulated in this department.)

Leontes
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Leontes

Talking about false equivalency – the term addiction has been around long before we had a better understanding of what said substances actually do, so in fact it does encompass behaviour (probably depending on which definition and conceptualization you are willing to accept). There is a reason why the proposed diagnosis is classified as “Disorders due to addictive behaviours” as opposed to “Disorders due to substance use”, which does recognize there’s a difference there, that doesn’t just reflect your choice of poison. Diagnoses are foremost desriptive – they aim at accurately describing a clinically relevant phenomenon, which may or may not point to underlying dynamics, or “real causes” for a disorder. They ask whether something is there, not why it is there.

While I am – yes, a “real” academic – who is (sorry, fellow gamers) not opposed to the move to include mental problems related to gaming behaviors in the ICD, I certainly do not like the choice of wording. Plus, most researchers that overcritically target gaming lack solid methods and findings to back their not-so-well-founded opinions, but that’s a whole different issue. In the end, however, there is a substancial number of people whose rather serious problems center around gaming behavior – thus I think the matter deserves a place in our diagnostic system. I agree with Simon, though – games themselves are not the issue.

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Simon F

Games in general, no. Some games have the same mechanics that make people addicted to gambling though. That’s hardly what they are targeting here though.
I have been addicted to games at one point, but the problem wasn’t really the games. The problem was that my mental health was horrible at the time, and games was an escape from reality.

Andrew Ross
Staff
Andrew Ross

And this is exactly why I don’t think “gaming disorder” or “gaming addiction” is even helpful as a label. Let’s take a look a local news station’s coverage of the events:

Listen to the ladies at the end complaining about men who play games. Replace the game references with sports references and the problem is the same. It’s not unique to gaming, at all, but is easier to attack because it doesn’t have the prestige status passive-sports “participation” does.

Now try the same exercise with this BBC article: http://www.bbc.com/news/world-us-canada-41701718

It doesn’t realistically work. There’s a core difference at play, and the only vague comparisons I can think of are:

1. http://massivelyop.com/2016/12/13/a-cautionary-tale-on-video-game-addiction/- Kid was diagnosed with severe anxiety and ADD. It even mentions he had trouble picking bedtime books at age 4. No one attacked books because “books make you smarter” (though there’s multiple studies by researchers like Sundqvist and Sylven noting that online gamers did better than non-gamers in learning English as a second/foreign language). In fact, the kid plays games at the end still because he clearly needed social skills and gaming gave him a safe place to practice his skills.

2. https://www.reddit.com/r/FFBraveExvius/comments/7jmezv/a_whale_of_a_tale/ Clearly a gambling problem, and not a surprising one, as the actual industry is looking at games to get millenials into gambling- http://beta.latimes.com/business/la-fi-casino-video-games-20170427-story.html

TLDR; Most non-substance abuse addictions are symptoms of deeper issues. Blaming games without properly addressing those issues is irresponsible. The exception is gambling, and even the gambling industry is trying to get in on video games because of that.

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Utakata

Same goes for obsessive compulsive disorder, where repetition becomes it’s own escape mechanism. But washing your hands after every time you go to the bathroom is not considered to have any addictive properties.

To my understanding gaming and gambling addictions are a result of some underlying anxiety and obsession issues (as mentioned for this article). That is what needs to be treated. Not instead MMO’s, slot machines or your average bar of soap. Just saying.

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Simon F

Being addicted to washing your hands can be extremely damaging to the skin though.
That aside, yes, you’re for the most part correct. Although some people just get addicted either way. It’s kind of like people who get addicted to watching sports. Games are just as addicting if not even more addicting, even if they have no particular addictive mechanic or so.

However, regarding things like gambling mechanics in games, I think they should at least be looked at by PEGI, ESRB and whoever else does ratings. Star Wars: Battlefront 2 EA got a lot of attention due to gambling mechanics and so on, but the PEGI rating is 16 years and above, which I think is a fair rating, even if a game has gambling aspects to it.
I mean, I still think the game is shit, but the age rating to me is fair. Still, that game isn’t something I want to discuss here, as it’s irrelevant to the subject, and it’s not like we have much to discuss to begin with.

Zeph
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Zeph

But people use plenty of things as a crutch to deal with emotional or physical problems. That’s how addictions start in many cases. We don’t just ignore alcoholism as a problem and instead tell alcoholics to deal with their underlying problems.

Recognizing gaming compulsion as a real thing alongside gambling and other behavioral compulsions is a good thing for those struggling. The only people it’s bad for are games industry orgs like the ESA who fear stricter regulation.

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Tanek

Regulation in and of itself does not have to be a bad thing for games, even if it is seen as a bad thing by the ESA. The problem with this specific issue, though, is perception and how a new classification would be seen and used.

Yes, alcoholism is a thing, but how many people, when asked to list their hobbies would have “drinking” on the list? And gambling addiction is a thing, but how many of us would conflate “gambling” with, say, “baseball”? Yet betting on sports is a big part of that addiction.

I don’t think anyone is saying that a person can’t be addicted to gaming, or that games don’t have addictive qualities in general. But, given how some have seen gaming in the past and how some lawmakers still do see it, a classification like this can feed into the fear without, I think, providing the help that some might hope. even if the change was made with the best intentions.

In a perfect world, this could be good. But we are human and, if recent history is any indication, we will mess it up big time.

Zeph
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Zeph

It’s a good point, but I still think this classification is preferable to no classification. Folks who have a problem with gaming addiction are often dismissed or outright attacked. This is a step toward solidifying it as an actual existing thing in the culture.

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MesaSage

I think they’d be better off spending time studying the underlying social conditions which make gaming worlds, (despite being full of monsters, fighting, death and destruction) preferable to what they choose to call reality.

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Melissa McDonald

is boredom a social condition? honest question.

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MesaSage

By social conditions, I mean corruption.

deekay_plus
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deekay_plus

to be blunt, drinking alcohol is an activity billions of people enjoy in quite healthy and responsible manner too.

it doesn’t mean that alcoholism isn’t a thing.

any activity/hobby can have addicitive properties. working can become problematic for the individual if they spend too much time at work and not enough time balancing with other parts of their life. it doesn’t mean we classify all work as problematic.

in general alot of this rhetoric with games and “screen time” on mobile devices reminds me of growing up in the 80s and 90s and hearing how addicted kids were to tv. and ofc relevant murder cases where some kid was allegedly copying some movie or tv show in their act of violence.

which ofc we now have the 24 hour news cycle and alot of effort to fill those hours every single day.

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Simon F

“1) impaired control over gaming; 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.”
Switch gaming to alcohol. It’s basically the same criteria.

Andrew Ross
Staff
Andrew Ross

Excellent point that often comes up in these discussions. However, as I mentioned in another article ( http://massivelyop.com/2015/10/22/exploring-the-video-game-debate-online-games-and-internet-addiction/ ), the problem with the basis of this is that when you apply this to, well, anything, they’re also signs of high engagement and can be seen negatively depending on one’s perception.

Take “work addiction.” A hard working mother may be a great provider for her family at the cost of her hobbies, personal health, and bonding time with her family, despite her family telling her they miss her. However, the company will promote her, she’ll buy the family a bigger home, send the kids to a nicer school, and society will see her as a model citizen based on her work ethic, which may be masking issues such as depression, social anxiety, inability to form close personal relationships, and obsession with needing to feel in control.

There’s no easy answer to defining what addiction is, but its why addiction in psychology mostly addresses substance abuse by name and everything else (TV, internet, sex) as misuse.

deekay_plus
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deekay_plus

yes that’s my point.

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Simon F

Not sure if you misunderstood my intentions, I replied more as an extention to your comment rather than anything else. Simply something to further solidify your point.

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Wanda Clamshuckr

I was going to write something similar. Well said.

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Jeff Mauney

“real mental health issues like depression and social anxiety disorder”

/eyeroll

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Utakata

“And, putting that official label on them recklessly trivializes real mental health issues like depression and social anxiety disorder, which deserve treatment and the full attention of the medical community.”

…for the actual quote in context. Perhaps the /eyerolling missed those parts on the upswing. o.O

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