The pending announcement had already been controversial. The American Psychological Association’s Media Psychology and Technology division released a policy statement opposing the WHO’s decision.
Twenty eight scholars who study problematic gaming also wrote an open letter to the WHO opposing the decision. The opposition of these scholars tends to take three forms.
First, the available research does not support a diagnosis of “gaming disorder.” The criteria for what constitutes problematic gaming is notoriously muddled and unclear. One recent paper in the American Journal of Psychiatry found individuals who score high in problematic gaming actually are just as mentally well as those who score low — suggesting the concept lacks clinical value.
Other research finds over-gaming is merely a symptom of underlying mental health issues such as depression, not a stand-alone disorder. For instance, many depressed people oversleep but we don’t diagnose “bed addiction.”
By considering something a diagnosis without evidence it exists, there is risk of more harm than good. Kids may be diagnosed with mental health conditions they don’t have. People with real conditions may have their coping mechanisms (gaming) taken away without their real issues (depression, anxiety, ADD) receiving treatment. And predatory clinics can bilk families or insurance out of thousands for a false condition.
The second concern is the WHO diagnosis will cause unintended harms. “Gaming disorder” could result in people with real mental health issues receiving poor treatment for symptoms rather than effective treatment for actual problems. There’s also the issue of free speech concerns.
In an email exchange I had with WHO officials one official acknowledged that the WHO was under pressure, primarily from Asian countries, to make the diagnosis happen. This raises the specter that the diagnosis could be used by authoritarian countries like China to further suppress free speech.
China has also become notorious for brutal boot-camp treatment centers for game and internet “addiction”. South Korea has an internet “shut down” law for minors, although research suggests it is ineffective.
It is alarming to see politics become one element of the WHO’s decision making on mental health. Further, there are already suggestions that efforts to use gaming in education, despite promising potential, may be scaled back to avoid controversy from panicking parents.
Last there is the concern that “gaming disorder” both results from and fuels moral panic over new technology. In a response to the 28 scholars’ letter, the WHO and supporters claimed that “gaming disorder” would ease moral panic.
Given the furor of alarm that has greeted the WHO’s announcement, including one article suggesting that treating “gaming disorder” could reduce mass shootings, it’s abundantly clear the WHO were wrong on this score.
Many of the narratives about “gaming disorder” are simply pseudo-science. Parents seem intent to connect it with their dislike of technology thinking there is an epidemic of tech addiction. But even taking “gaming disorder” at face value, evidence suggests it is exceedingly rare.
The American Journal of Psychiatry study found a prevalence of 1 percent or less among gamers. And we hear lots of nonsense about gaming releasing dopamine in the brain just like cocaine does. That’s technically true, but only in the sense that everything fun releases dopamine in the brain. However, research makes clear that drugs like cocaine affect dopamine receptors much differently from gaming. A normal process is being used to sound scary.
The same arguments for “gaming disorder” could be made to make anything an “addiction.” Why not “cat addiction?” Given that dopamine release is normal for pleasant activities one could claim that stroking a cat release dopamine “just like cocaine does.”
Many of the symptoms used for gaming addiction such as using the thing to feel better after a bad day can certainly be applied to cats. And we can find anecdotes of people who clearly overdo cats, living in houses full of diseased cats, and persisting in the behavior despite legal consequences. If “gaming disorder” is real, then so is “cat addiction.”
Unfortunately, with “gaming disorder” the WHO have made a serious mistake, pathologizing normal behavior despite a weak scientific basic for their decision. This opens the door for predatory clinics, free speech curtailment and the disparagement of gamers, while reducing technology in education.
It also reduces confidence in how mental illness, in general, are classified. Ultimately, it will be people with real mental illnesses who will pay the costs.
Chris Ferguson is a professor of psychology at Stetson University in Florida. He is coauthor of the book Moral Combat: Why the War on Violent Video Games is Wrong.