Gaming Disorder

 

·         Gaming disorder is recently recommended by World Health Organisation (WHO) for inclusion in the 11th revision of the International Classification of Diseases (ICD-11). ICD is used by medical practitioners around the world to diagnose conditions and by researchers to categorize conditions.

·         Use of the internet, computers, smartphones and other electronic devices has excessively increased over recent decades. While the increased use in certain fields such as real-time information exchange is associated with benefits to users, excessive use in some other fields such as gaming may result in health problems. For some countries, the gaming disorder has become a significant public health concern.

·         WHO defines gaming disorder as a pattern of gaming behavior (“digital-gaming” or “video-gaming”) characterized by 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 or escalation of gaming despite the occurrence of negative consequences.

·         For the diagnosis of gaming disorder the behaviour pattern must be of sufficient severity to result in significant impairment in personal, family, social, educational, occupational or other important areas of functioning and would normally have been evident for at least 12 months. However, if symptoms are severe and all requirements are met, health care professionals may include people who have been playing for shorter periods of time.

·         The inclusion of gaming disorder in ICD-11 means health care workers and doctors can now diagnose people with health conditions identical to those characteristic of gaming disorder in many parts of the world and accordingly countries would take into consideration this disorder when planning public health strategies for treatment and prevention.

·         With increasing use of cyber space by children and students in the form of playing online games, making friends, and using social networking sites, shopping etc., they are more vulnerable to cyber-crimes.

SYMPTOMS:

·         As with any other addictions, there are emotional and physical symptoms suggestive of gaming disorder.

·         Emotional symptoms of video game addiction include:

o    Feelings of restlessness and/or irritability when unable to play

o    Preoccupation with thoughts of previous online activity or anticipation of the next online session

o    Lying to friends or family members regarding the amount of time spent playing

o    Isolation from others in order to spend more time on gaming

·         Physical Symptoms includes

o    Poor personal hygiene

o    Video gamers’ thumb (repetitive use injury resulting in to tendonitis)

o    Weight gain ( due to sedentary life style and  eating processed foods and beverages)

o    Fatigue

CAUSES:

·         Various factors may be responsible for gaming disorder.

·         There are two types of video games. One is standard video game which is designed to play by a single player. The game is completed with a mission or clear goal hence addiction in these games is related to completing that mission or beating a high score or preset standard.

·         Other type of videogame is associated with online multiplayer games. Gamers with this type of addiction enjoy creating and temporarily becoming an online character. They often build relationships with other online players as an escape from reality. An intelligent child who is unpopular at school can become dominant in the game. The virtual life becomes more appealing than real life.

·         Video game addiction may be a clinical impulse disorder. Those with certain personality disorders or disabilities are at greater risks than others. Compulsive gamers enjoy to a fantasy world to escape their real life troubles and unpleasant emotions. A report indicates that 41% of those play online videogames wants to escape from reality.

·         Many video games satisfy basic psychological needs, and players often continue to play because of rewards, freedom, and a connection to other players. It takes away from physical activity and time to be spent on studies, with friends, and even with family. Children who play four to five hours per day have no time for socializing, doing homework, or playing sports and it interferes with normal social development.

·         Selective risk factors for gaming disorders could be-

o    Biological factors

§  Co-morbid disorders (psychiatric problem like depression, anxiety)

§  Vulnerability to addictions

o    Personality and psychological factors

§  Deficit of social skills and extreme shyness

§  Low self-esteem and indecision

§  Low resilience

§  Frustration

o    Environmental factors

§  Poor social environment

§  Family environment: conflicts, poor communication and affection, lack of supervision

§  School environment with low performance

o    Stress factors

§  Grief

§  Drastic life change

DIAGNOSIS

·     Assessment for gaming disorder can be done by observing the different symptoms associated with video game addiction. These are significant changes in behaviour of an individual resulting into severe impairment of personal, family, social, educational, occupational or other important areas of functioning for at least 12 months.

·    However, if symptoms are severe and all requirements are met, people who have been playing for shorter periods of time may be considered for gaming disorder by health care professionals.

·    The warning signs of video game addiction include:

o    Gaming to escape from real life problems like anxiety/depression or difficult life situations

o    Playing for longer periods as time goes on

o    Skipping showers and meals to play

o    Poor performance at work or school

o    Lying to friends/ family to hide gaming activities

o    Exhibiting signs of irritation when forced to stop gaming

·    In addition, video game addicts tend to become isolated, dropping out of their social networks and giving up other hobbies.

MANAGEMENT

·     Integrated and comprehensive approach with consideration of co-morbid disorders and other risk factors would improve treatment outcome of such individuals.

·     Psychotherapy-One to one counseling and family counseling are effective in treating a gaming disorder. Psychotherapist tries to help the addict understand how gaming is related to their family, school or job, emotions or mood and sense of life goals and rewards.

·    Cognitive behavioral therapy (CBT)-This helps the addict to shift their thoughts, replacing those that lead to compulsive gaming with healthier thinking patterns. It allows the person to modify their thoughts, feelings and ultimately behaviour for the better.

·    Medication-Certain medications help video game addicts by altering their brain chemistry to reduce the urge to play. Many videogame addicts suffer from mental health problems such as depression or anxiety disorder, treating these problems will also help to overcome addictions as well.

·     Sometimes by placing the addicts in a natural environment, free of distractions of modern life allows them to learn to comfortable with their own emotions.

PREVENTION:

·  People who are involved in gaming should be alert to the amount of time they spend on gaming activities, particularly when it is affecting other daily activities, as well as to any changes in their physical or psychological health and social functioning that could be attributed to their pattern of gaming behavior.

·   People can be motivated to pursue other activities, such as outdoor sports, reading books, housework, or spending time with friends and family, instead of playing video games.

·    Parents should keep good documents of the child's gaming behavior, including:

o    Details such as when the child plays and for how long

o    Problems resulting from gaming

o    How the child reacts to time limits

·   Studies suggest that gaming disorder affects only a small proportion of people who engage in digital- or video-gaming activities. If there is a problem don't delay seeking professional help.