ICD-11 proposal for gaming disorder has no basis

World Health Organization has a new proposal in the ICD-11 category, one which would add ‘Gaming disorder’ as a valid disease. The definition for this disease would be the impaired control over daily life in which video games would gain priority despite negative consequences. This is tied to Hazardous gaming, where a pattern of gaming that causes physical or mental harm to the individual or to people around of this individual. Hazardous gaming is essentially just a step towards gaming disorder.

I’m calling bullshit on this proposal as it is now.

You probably clicked the link above and read the short description for gaming disorder. Just from that alone we can surmise few problems the proposal has. First of all, the proposal includes only video games, leaving arcade and PC gaming alone, and hazardous gaming simply refers it as ‘gaming.‘ Granted, the terminology I’m using is more old fashioned in comparison, but using video game as an umbrella term for all electronic gaming is weak at best and shows the authors have little knowledge of the industry’s history. Because of this the proposal ignores the fact that games like pachislot, that is undeniably a video game if we were to use the modern umbrella term, are more dependent on gambling addiction than on the proposed form of gaming disorder.

To add to this, those who are playing video games as a career in some form would be singled out to have this disorder. Psychology as a soft science struggles with things like this, as case studies may not apply to the larger population and vice versa. Furthermore, what is considered harmful in these cases is somewhat open question again. The discussion about what is normal behaviour falls into behavioural psychology a bit too heavily and would be a discussion on its own. I would argue in this case that a person who would have symptoms of gaming disorder may simply be a person who is a hermit and finds solitude in his hobby instead of mingling with people. Whether or not he has a disorder would be questioned. Furthermore, if we were to change the hobby in an individual case like this to something like watching movies, would he then have movie viewing disorder? Such disorder does not exist in the papers and has never been proposed thus far.

There are no long-term studies that would support gaming disorder as proposed. Even short-term studies are hard to come by, and the few examples I had in my mind have eluded for me for the time being. However, the addictive action that electronic games offer is not much any different from other forms of similar activities, but these are not singled out as separate diseases for whatever reason. No other leisure activity like video games, or electronic gaming if you’re an old fart like me, has been singled out like this. While some could argue that gambling falls into this category as a singled out, the psychology of gambling is a bit too much to open here and has proper research basis to back it up.

Furthermore, 26 scholars have written an open letter, rebutting this proposal. You can read the whole thing at Research Gate. Their arguments is that inclusion for gaming disorder, even as a proposal, would have economic effects on the industry. Singling a media out like this would be akin to showcasing the harmful effects of tobacco, the difference here being tobacco’ negative effects had solid evidence behind them. Possible effects of this proposal would be adverse limitations on the industry at large. At worst, possible prohibitions and limitations of what sort of games and what content games could have could be realised. South Korea already employs harsh limitations on games as it is. Last UN’s CEDAW (Committee on the Elimination of Discrimination Against Women) wanted to ban Japanese media that depicted sexual violence against women. Kumiko Yamada, the representative of Japanese wing of Women’s Institute of Contemporary Media Culture, responded to CEDAW’s proposal by stating that their view on the matter was an absolute No. Translated version on Niche Gamer. The reasoning to Japan’s response was that first of all, they are fiction and do not threaten real people. Second reason was that these fields are filled with women, and such ban would do the exact opposite what CEDAW’s aimed at, as disallowing these women to portray fiction whatever they wished would create new venues of sexism towards women. If this proposal about gaming disorder would pass, it would mean limitations and even bans similar to this would come to pass under the guise of population health concerns.

As the open letter states, passing the proposal could lead into a moral panic. Gaming in general is no foreign to these, as the industry’s history is well marked with controversies regarding violent games, and more recently about games with sexual content. This would tie itself to the aforementioned limitations and bans, when in reality no good evidence is backing up.

As such, if the proposal would to pass, it would be met with harsh criticism and high scepticism from both common population and scholars. The open letter goes even further and states that passing gaming disorder would harm WHO’s reputation and medical community in general, would dramatically reduce the utility of such a diagnosis, especially when it is not grounded in proper evidence base. Singling games out from the rest of the media out there would open a Pandora’s box of behavioural disorders, where any and all activities from sports to gardening could be diagnosed as a behavioural disorder, saturating and demeaning the whole field at large.

The question you may have now whether or not I am deluded enough to say that there is no disordered gaming. That answer would be No. There are numerous ways a person may end up playing games more that it is healthy, but in numerous researched I’ve read the core reason is more often than not somewhere else. An action in itself can be just a symptom, and singling our excessive gaming in itself disorder would put a patient in possible danger if the underlying reasons are not solved and properly treated. The proposal’s worst case scenario considering health could be treating a symptom while completely disregarding the cause.