ICD-11 video game addiction is being pushed without proper backing

Without a doubt certain percentage of people who play electronic games overdo their hobby. However, this is only for a small percentage of the overall enthusiasts and hobbyists. Furthermore, it would seem that problematic gaming, that is the consumption of electronic gaming that is detrimental to everyday life, itself grows itself thin in time and dissipates on its own. A longitudinal study showed this with 112 adolescents. I’ve already covered why the proposal for gaming disorder has no basis, but it would appear pushing for its suggestions into ICD-11 has merit to it. Merit that wouldn’t serve science, culture, markets or consumers.

Ferguson wrote that less than 1% of people experience video game addiction. His writing is a good read. Game addiction in itself is a very different nature from e.g. gambling. I’ve actually covered issues with pairing electronic gaming and gambling with each other previously, but to make short story even shorter, video game addiction is far more often a symptom of an underlying problem than the cause in itself. Ferguson’s own study supports this. Hell, there’s even a paper arguing against the very concept of video game addiction.

In a discussion between Ferguson and an administrator at the World Health Organisation acknowledged political pressure from countries, particularly from Asian ones, factoring in the inclusion of video game addiction into ICD-11. If countries are pushing its inclusion, that means scientific basis comes second at best and whatever political stance these nations have come in first. That is extremely dangerous, as adding video game addiction opens doors for other far more intrusive and harmful suggestions to be included under its umbrella. Considering video game addiction is extremely loosely defined and would require far more research than what it has, there’s no guarantee any of the future additions would have better research behind it.

You may be asking yourself what nations would have need or use for this sort of addition to the ICD-11. Some nations have reported more deaths from non-stop gaming than others, and mostly we hear these reports from either China or South Korea. In 2005 a 28-years old man died because his heart failed during a session of Starcraft, BBC reports. It is interesting to note from that article that despite Starcraft being a real-time strategy game, professor Mark Griffith only talks about MMORPGs, a very different genre of game. You have far less interaction with your opponent in Starcraft that you have in e.g. World of Warcraft.

South Korea has seen drastic changes in its electronic game landscape, and one of the more worrisome changes came around 2014, when some members of the government began to regard games as a detrimental pastime. South Korea has discussed to enact game addition bill to limit not only the amount of time people should be allowed to play, but also games themselves. However, when you have legislators directly comparing video games to tobacco and alcohol, there is something amiss. South Korean gaming culture is far different from any other, e.g. you can actually graduate to be an e-Sports player. However, much like any other person who has a career in “sports,” e-Sports players suffer from injuries as well. Seeing how the South Korean culture has almost twisted games and e-Sports into a national pastime, it’s no wonder a lot of young people are willing to give a chance to become a player worth millions of wons.

The thing is, South Korea does have a problem with gaming, but rather as we are lacking in evidence for gaming addiction (we have more researches saying against it as linked above), it is far more probable that the South Korean gaming problem is a symptom from an underlying social and cultural troubles. Putting legislation that equates games with drugs and alcohol won’t cure the problem, it will manifest itself some other way later down the line.

Passing a law based on game addiction is hard when you have nothing to base it on. However, if ICD-11 would recognize video game addiction as a valid illness, there would be no need for debating or researching the issue much further; after all, you can simply point out that it’s in the books. That would be injustice.

One of the gaming limiting laws has already passed. The Shutdown law was passed in 2011 and limits people aged under 16 from playing online games during the night between 00:00 and 06:00. While this would sound decent in principle, it is not the government’s job to do what parents should be doing. Furthermore, this law challenged in few occasions as unconstitutional. However, the law is still in effect, albeit nowadays parents can request the ban being lifted from their child.

China’s following this South Korean example with similar legislation that would ban gaming outright from people aged under 18 between 00:00 and 08:00, and would necessitate computers and smartphones to be fitted software that would track down law breakers. Both South Korea and China require their people to use their real IDs when accessing their gaming accounts. In case of South Korea, this is a necessity with many of their websites in general. However, in 2012 Real Name Rule was struck down and rejected by court. The law requiring the usage of users’ real names was introduced in 2007 to combat cyber-bullying. Again, this is treating the symptom, not the cause. Furthermore, as gaming is a million-dollar business, by accusing game industry creating addictive products, governments could push forwards for harsher taxations and other underhanded shenanigans to gain more from the revenues. This may sound like a foil-hat idea, but seeing how few years back we found game journalism colluding and attacking their consumers and recently CIA spying everyone everywhere, this isn’t far fetched.

Games of any kind, be it sports, card games or anything else, are addictive in their own way. For modern electronic games, it’s a whole mess to open why they could be addictive outside the usual action-reward scheme. This is because electronic games have more dimensions than gambling. After all, games are a tool to give leeway for people from their everyday life in an electronic way that supports social interaction through cultural landscape and aims to both challenge and please the players at the same time. They are not gambling, except Complete Gacha in Japan, as gambling quite literally requires wagering money or something else valuable under uncertain conditions for higher gains. Of course, games are designed to pull the player in and be enjoyable, but that is what every form of entertainment does.

If video game addiction would have something to be tied to, it would be escapism. Escapism is always tied to something else than the tool people escape through, and the question I must ask here; what are people escaping from if they are willing to kill and die because of video games?

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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.