Gaming addiction to be added to DSM!?

Vaclav

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Gaming disorder is going to be named a mental health condition for the first time

Not much more I care to say on it, just shocking that I've not seen it discussed here yet, figure this would be an interesting forum to discuss it.

Only thing more I'll say, is I'm mixed on it. Saying that as someone that will definitely say that gaming desire has complicated my life at times, but has always been manageable for me.
 
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Gravel

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I mean, how is gaming any different than TV? Or books? Or solo hobbies?

What makes ignoring reality okay for one but not the other?

Basically I think it comes back to gaming is still not considered main stream, and people don't like what they don't understand.
 
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Tenks

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With how much indulgence regulation there is in KR and CN I was pretty sure it was only a matter of time before EU adopts something similar and then eventually that will spill into USA. Right now EU is dealing with all the "Forget Me" stuff on the internet and after that I think anti-indulgence will be the next thing. I agree heavily with the "Forget Me" legislature but I disagree with indulgence regulation.
 

Tenks

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I mean, how is gaming any different than TV? Or books? Or solo hobbies?

What makes ignoring reality okay for one but not the other?

Basically I think it comes back to gaming is still not considered main stream, and people don't like what they don't understand.

TV generally doesn't capitalize on dopamine feedback loops to get you physically addicted to the action.
 

zombiewizardhawk

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Vladimir Poznyak, a member of the WHO’s Department of Mental Health and Substance Abuse...“Health professionals need to recognise that gaming disorder may have serious health consequences,” he said.
“Contrary to what was predicted, the study did not find a clear link between potential addiction and negative effects on health; however, more research grounded in open and robust scientific practices is needed to learn if games are truly as addictive as many fear.”

It might be bad for you! The studies don't show any negative effects but we just need more research with "open and robust science" then maybe it'll show what we want it to show.

"Most people who play video games don’t have a disorder, just like most people who drink alcohol don’t have a disorder either. However, in certain circumstances overuse can lead to adverse effects.

Well no shit. In certain circumstances, overuse of anything can lead to 'adverse effects'.

It's a joke. People always looking for a way to label something as a disability or disorder or sickness that they don't like (or as an excuse to justify why they do something). Is television watching a mental health condition? How about reading? Watching porn for 10 hours a day would probably be classified as one but how is that any different from watching 10 hours of random shitty tv programming or doing anything else for 10 hours a day? Oh, it's because porn has a negative stigma attached to it and television/reading/whatever don't, and a lot of people out there are constantly trying to attach that same kind of negativity to video gaming any way they can. "Video games lead to kids growing up to be violent murderers!" fell on it's ass. "Video games make guys rapists!" flopped hard, now it's "playing video games means you have mental health issues!".
 

j00t

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addiction disorders are fundamentally mental health issues. this is a really interesting point of view on the topic. it's not perfect, but it really identifies how someone people can use drugs without becoming addicts and some can't. for the exact same reason i fully believe that "gaming addiction" is a very real thing. I can't remember who said it, but there's a quote that i always remember when talking about video games. "What does it say about real life when millions of people continually choose to spend their time in a pretend world?"
 

Kiroy

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TV generally doesn't capitalize on dopamine feedback loops to get you physically addicted to the action.

All social media (and even this forum) with any sort of 'like' feature should be added to the DSM if this is the criteria.
 
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j00t

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You got any research study links to showing actual physical addiction to video games and the resultant withdrawal symptoms?

speaking strictly from a substance use perspective, withdrawal is one of twelve criteria of addiction. you need 2 of those twelve to be clinically diagnosed with a substance use disorder.
 

zombiewizardhawk

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speaking strictly from a substance use perspective, withdrawal is one of twelve criteria of addiction. you need 2 of those twelve to be clinically diagnosed with a substance use disorder.

And almost all of them except actual withdrawal are completely arbitrary.
 

Kiroy

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Next someone's going to tell me that if I consume 3oz of spirits a day i'm an alcoholic.
 
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j00t

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For what it's worth, quantity of consumption is not one if the criteria; only in relation to whether or not it's increasing over time. And even that is subject to clinical exploration.

Drinking an ounce 10 years ago, but drinking 3 oz now doesn't really mean anything by itself
 

zombiewizardhawk

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Arbitrary in what way?

https://www.danya.com/dlc/bup/pdf/Dependence_DSM.PDF

5. A great deal of time is spent in activities necessary to obtain the substance
What's the cut-off for a "great deal of time"? Is driving an hour each way to play at a golf course you like enough to classify it as an addiction?

6. Important social, occupational, or recreational activities are given up or reduced because of substance use.
Who determines what is "important" enough to classify it as an addiction? Occupational is a bit easier because if you quit your job just to play a video game (and not because you hate your job and had a high likelihood of quitting it for another reason, it just so happens you also play video games) then I can see the argument. What is an important social or recreational acitivity? Oh I decided to stay home and play video games (or smoke weed ala substance addiction) instead of go meet the guys from work at the bar, I must have a problem!

4. There is a persistent desire or unsuccessful efforts to cut down or control substance use
Only the person themselves can say whether or not they are actually attempting to cut down on the use of something (and people suck at self-control in every area, just look at dieting).

This thing only has 7 and most of the others couldn't be related to anything other than substance abuse (tolerance etc.).


My main point is: If there is not an actual physical withdrawal effect, all it means is that someone likes one thing more than they like other things. If that classifies a mental health issue then literally everything constitutes a mental health issue.
 

Binks

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Unless things have changed, the emphasis is normally on clinically significant impairment and less on if you engage in the behavior. For example, from DSM-IV-TR substance abuse:

A maladaptive pattern of substance use leading to clinically significant impairment or distress, as manifested by one (or more) of the following, occurring within a 12-month period:
  1. recurrent substance use resulting in a failure to fulfill major role obligations at work, school, or home
  2. recurrent substance use in situations in which it is physically hazardous
  3. recurrent substance-related legal problems
  4. continued substance use despite having persistent or recurrent social or interpersonal problems caused by or exacerbated by the effects of the substance
So, it's technically not abuse to drink/game if the previous conditions aren't met; although, some can comically lack insight into their behavior.

One can't have dependence without withdrawal, which can make alcohol dependence a complicated diagnosis because: 1) some can get diagnosed with dependence without ever experiencing withdrawal, 2) some endorse alcohol dependence and it best describes the person's behavior, but they have yet to experience withdrawal, 3) and some never stop drinking long enough to experience withdrawal.

Diagnoses tend to be shorthand for clinicians relaying/characterized behavior.
 
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j00t

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https://www.danya.com/dlc/bup/pdf/Dependence_DSM.PDF

5. A great deal of time is spent in activities necessary to obtain the substance
What's the cut-off for a "great deal of time"? Is driving an hour each way to play at a golf course you like enough to classify it as an addiction?

6. Important social, occupational, or recreational activities are given up or reduced because of substance use.
Who determines what is "important" enough to classify it as an addiction? Occupational is a bit easier because if you quit your job just to play a video game (and not because you hate your job and had a high likelihood of quitting it for another reason, it just so happens you also play video games) then I can see the argument. What is an important social or recreational acitivity? Oh I decided to stay home and play video games (or smoke weed ala substance addiction) instead of go meet the guys from work at the bar, I must have a problem!

4. There is a persistent desire or unsuccessful efforts to cut down or control substance use
Only the person themselves can say whether or not they are actually attempting to cut down on the use of something (and people suck at self-control in every area, just look at dieting).

This thing only has 7 and most of the others couldn't be related to anything other than substance abuse (tolerance etc.).


My main point is: If there is not an actual physical withdrawal effect, all it means is that someone likes one thing more than they like other things. If that classifies a mental health issue then literally everything constitutes a mental health issue.


while i appreciate your hesitation to identify it as a mental health issue... the fact of the matter is that smarter men than you and i HAVE ALREADY identified it as a mental health issue.

i'll attempt to address some of your points.
4. simply put, wanting and/or trying to quit but you can't. it's really easy for someone who doesn't understand addiction to just say, "if you REALLY wanted to quit, you would." same way someone who doesn't understand depression would say "just cheer up!" some kid who gets his first DWI and tells everyone he wants to quit doesn't really qualify for this because we all know better. he really DOESN'T want to quit, he just doesn't want to get caught. a mother who is facing jailtime and getting her kids taken away because she shot up in the car while they were in the backseat? she doesn't WANT to keep doing that. she doesn't WANT to be in the situation she's in. she knows that everytime she uses, heck, everytime she even THINKS about using, she's literally risking everything she has but does it anyway... she qualifies for 4.

5. the site you quoted missed the key parts of this, but that's okay because most people do. "excessive amounts of time are spent USING, RECOVERING from use, or OBTAINING the drug (or habit or whatever it is). let's say you go out and drink everynight. is that excessive? it's every night right? that would "seem" excessive right? what if it's only for an hour? well... that's less than 5% of your day. by very definition that's not excessive. oh, but what about OBTAINING? and RECOVERING from using? i knew a guy who drank every night with his friends. for about an hour or so. not a lot of time actually drinking respectively. but he'd wake up in the morning hung over, spend all day at work miserable until one of his buddies would say "hey, where we going and who's driving?" then he'd sit and count the minutes until he could get done with work, take care of house stuff and then go out. THAT is what i would call excessive.

6. clearly put, the person themselves decides what's important. i might say, it's important that you vote, but you might say, no it's not. screw that noise i'm going drinking. clinically, i can't count that because YOU didn't think it was important in the first place. but if you say to me, i missed my dad's funeral because i was drunk... i just couldn't see him... well, that's a different story.

as to your other point about the other ones not counting, i can assure you, they do. sure, there is a section on "pharmacological effects" (tolerance and withdrawal) that are not going to have any place in the discussion, but things like "hazerdous use/using in dangerous situations" sure counts. what about all those dudes in china who keep dying in internet cafes because they stop eating? stop drinking? what about "continued use despite physical or psychological side effects such as depression," what about "cravings?" yeah you're not craving a line of coke, but you can't stop thinking about how cool it would be to make a skyrim mod that let's you be a unicorn.

my point is that the wording needs to be adjusted and certain things don't make sense in the context of video games, but not nearly as much as you want and even then, the things most people think are incredibly important, aren't. you know how many times i hear people say "i'm not an addict because i don't have withdrawal. guess what, most cocaine users never experience withdrawal. but also guess what, that headache you get in the morning that isn't really that big of a deal but it's there anyway? that attitude you get until you get your morning cup of coffee? that's caffeine withdrawal.

just because you have withdrawal doesn't need you need to go to treatment.
 
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j00t

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Unless things have changed, the emphasis is normally on clinically significant impairment and less on if you engage in the behavior. For example, from DSM-IV-TR substance abuse:

A maladaptive pattern of substance use leading to clinically significant impairment or distress, as manifested by one (or more) of the following, occurring within a 12-month period:
  1. recurrent substance use resulting in a failure to fulfill major role obligations at work, school, or home
  2. recurrent substance use in situations in which it is physically hazardous
  3. recurrent substance-related legal problems
  4. continued substance use despite having persistent or recurrent social or interpersonal problems caused by or exacerbated by the effects of the substance
So, it's technically not abuse to drink/game if the previous conditions aren't met; although, some can comically lack insight into their behavior.

One can't have dependence without withdrawal, which can make alcohol dependence a complicated diagnosis because: 1) some can get diagnosed with dependence without ever experiencing withdrawal, 2) some endorse alcohol dependence and it best describes the person's behavior, but they have yet to experience withdrawal, 3) and some never stop drinking long enough to experience withdrawal.

Diagnoses tend to be shorthand for clinicians relaying/characterized behavior.

be careful with that information, dsm 4 is outdated. it had A LOT of overly complicated messy stuff in it. the DSM5 is the current version and it vastly simplifies things. the dsm4 wanted to identify use vs abuse vs dependence. dsm 5 just identifies how severe a use disorder is "mild is 2-3, moderate is 4-5, severe is 6 or more. (out of the 12)

and currently? diagnoses are given almost exclusively to get insurance to pay for treatment.
 

Binks

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Not wrong. Glossing over the new criteria, it seems to puts things more on a single continuum; although, grossly, it's the same thought process but a different way of presenting/organizing the criteria/information + adding cravings. The legal issues are no longer a criterion, which is understandable as the diagnosis may best describe the behavior but, lacking legal issues as they haven't been caught, it would be technically inappropriate to force a diagnosis.
 

j00t

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Yeah, the 12th criteria is just a catch all, "continued use despite personal repercussions." legal fits in there but so does "I keep getting grounded by my mom"
 
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