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

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.

Mental, behavioral and neurodevelopmental disorders in the ICD-11: an international perspective on key changes and controversies

“…The inclusion of gaming disorder in the ICD-11 forms a basis for the development and implementation of standardized diagnostic interviews and symptom measures, potentially leading to the discovery of effective interventions. However, this has generated a lively debate, with some authors expressing concern that the scientific basis for gaming disorder is currently too weak or that nonproblematic gamers could be stigmatized by its inclusion [102,103]. A series of commentaries published in the last year (reviewed in [98]) has largely favored the inclusion of gaming disorder in the ICD-11.…”

Verhaltenssüchte in der ICD-11

“…Die Entscheidung zur Aufnahme von Gambling und Gaming Disorder in der ICD-11 folgt dem Stand der Evidenz [9][10][11]. Dennoch gab es eine Reihe von Forschern, welche die Entscheidung kritisch gesehen und sich gegen die Aufnahme der Computerspielstörung in der ICD-11 ausgesprochen hatten [12,13]. Die eher formellen und nicht klinisch begründeten Kritikpunkte wurden zudem von der Spieleindustrie aufgenommen, um gegen die Einführung der Diagnose in der ICD-11 vorzugehen.…”

Impacts of technology use on children

“…not in the hours immediately preceding bedtime), or providing children with protective equipment such as blue light-blocking glasses may help prevent sleep disruptions. Evidence suggests that these glasses are effective in mitigating melatonin suppression in teenagers (van der Lely et al, 2015 [131]); therefore their use for late-night studying or scrolling through social media feeds before bed might be warranted. Research might be warranted in identifying whether activating features on mobile devices such "Night Shift" or "night mode" are effective in avoiding disruption in melatonin production.…”