he possibility that the next edition of the World Health Organizations (WHO's) standard for health data and trends will cite a "gaming disorder" for the first time is not sitting well with a group of researchers. One of the co-authors of a published debate paper that questions the move believes strong opposition to the proposed classification's inclusion in the 11th edition of the International Classification of Diseases (ICD-11) has surprised WHO leaders, but he believes the organization remains committed to the move.
"It sounds like the WHO is determined to make it happen," says Christopher J. Ferguson, PhD, a Stetson University professor of psychology who has researched topics related to video game participation for around a decade. Ferguson and more than a dozen colleagues internationally co-authored the paper published in the Journal of Behavioral Addictions, stating that the research basis for a gaming disorder is sparse and that those who advocate it are wrongly applying substance use criteria to gaming participation.
"In the variation they have now in the ICD-11, they didn't even bother with listing symptoms," says Ferguson. "They don't even delineate boundaries."
The ICD is the global health information standard for morbidity and mortality statistics, and is used to determine reimbursement and resource allocation for about 70% of the world's health expenditures. ICD-11 is expected to be finalized in 2018.
TENDENCY TO PATHOLOGIZE
The proposed description for gaming disorder does offer some sense of the parameters that the WHO envisions. It opens with:
"Gaming disorder is manifested by a persistent or recurrent gaming behavior (i.e., 'digital gaming' or Video-gaming') characterized by an impaired control over gaming, increasing priority given to gaming over other activities to the extent that gaming takes precedence over other interests and daily activities, and continuation of gaming despite the occurrence of negative consequences."
It goes on to state that a pattern of gaming and accompanying negative consequences should be evident for at least 12 months for a diagnosis to be assigned, although this can be shortened in cases where symptoms are severe.
In their paper criticizing the proposal, Ferguson and his co-authors cited two main areas of concern. First, they wrote that there is a lack of consensus in the research regarding patterns of gaming. Sound clinical studies have been scarce to this point, they stated, and there has been evidence of inflated prevalence estimates due to misleading responses among some survey participants.
The lack of a firm consensus is responsible in part for the delay to render a final decision on whether "Internet gaming disorder" should be listed as a disorder in the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM). …