Chaos and confusion in DSM-5 diagnosis of Internet Gaming Disorder: Issues, concerns, and recommendations for clarity in the field

Abstract

BackgroundThe umbrella term “Internet addiction” has been criticized for its lack of specificity given the heterogeneity of potentially problematic behaviors that can be engaged in online as well as different underlying etiological mechanisms. This has led to the naming of specific online addictions, the most notable being Internet Gaming Disorder (IGD).MethodsUsing the contemporary literature concerning IGD and cognate topics, issues and concerns relating to the concept of IGD are examined.ResultsInternet addiction and IGD are not the same, and distinguishing between the two is conceptually meaningful. Similarly, the diagnosis of IGD as proposed in the appendix of the latest (fifth) edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) remains vague regarding whether or not games need to be engaged in online, stating that IGD typically involves specific Internet games, but can also include offline games, adding to the lack of clarity. A number of authors have voiced concerns regarding the viability of including the word “Internet” in IGD, and instead proposed to use the term “video gaming disorder” or simply “gaming disorder,” suggesting addiction to video gaming can also occur offline.ConclusionThe DSM-5 has caused more confusion than clarity regarding the disorder, reflected by researchers in the field contesting a supposedly reached consensus for IGD diagnosis.

Internet Gaming Disorder Treatment: A Case Study Evaluation of Four Different Types of Adolescent Problematic Gamers

“…However, there is still no consensus on some issues related to IGD diagnostic criteria (Griffiths et al 2016b;Király et al 2015). In addition, its psychological, social, and health consequences require further study (Király et al 2015;Kuss et al 2017). Much research has been carried out to define this disorder, clarify its most controversial aspects, and expand the evaluation of specialized treatments (Griffiths et al 2016a).…”

Game Addiction Scale Assessment Through a Nationally Representative Sample of Young Adult Men: Item Response Theory Graded�Response Modeling (Preprint)

“…Preoccupation is commonly reported among high achievers [26,63] and is supposed to be common for gamers because of the social features of the games and flow-related engagement [62,64].…”

“…-Escape: Despite the association between game involvement and escape motives [2,67,68], the specificity of this criterion and its link with possible primary disorders (ie, depression) have been discussed [4,26,61,63,69]. In some -but not all [62] -IGDrelated studies, low diagnostic accuracy was observed for this criterion [58,61].…”

“…IGD is defined as a "persistent and recurrent use of the Internet to engage in games….leading to clinically significant impairment or distress… during the past 12 months as indicated by 5 or more out of 9 criteria." These criteria are recycled from substance use disorder and gambling disorder criteria [26], and the adequacy of such adaptation was criticized [4,7,[27][28][29]. In particular, high engagement in video games may not always be considered an addiction but may simply reflect elevated healthy involvement [30].…”

A brief update on videogame play and flow experience: From addiction to healthy gaming

“…Given the current criticisms and debates surrounding the legitimacy of videogame addiction as a bona fide behavioral addiction [25][26][27], it is unlikely that official recognition will be achieved before (i) its defining features have been identified, (ii) reliability and validity of specific diagnostic criteria have been obtained cross-culturally, (iii) prevalence rates have been determined in representative epidemiological samples across the world, and (iv) etiology and associated biological features have been evaluated [28]. Regardless of existing debates, research has paid little attention to the role of flow experiences in videogame play, an area that still needs further investigation [29].…”