What is Internet Gaming Disorder (IGD), specifically according to the DSM-5 criteria and other recognized diagnostic frameworks? Furthermore, what are the key behavioral symptoms, such as preoccupation, withdrawal, tolerance, and loss of control, that differentiate recreational gaming from problematic gaming indicative of IGD? Also, what are the known risk factors, potential long-term consequences (both psychological and physical), and current best-practice treatment approaches for IGD, considering the varying levels of severity and potential co-occurring mental health conditions?
Answer
Internet Gaming Disorder (IGD) is a proposed mental health condition characterized by persistent, recurrent online gaming that leads to significant impairment or distress in an individual’s life. It’s currently recognized in Section III of the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) as a condition warranting further research, rather than as a formal diagnosis.
The proposed diagnostic criteria for IGD, according to the DSM-5, include experiencing five or more of the following symptoms within a 12-month period:
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Preoccupation: Persistent and excessive thoughts about internet games, even when not playing, or planning the next gaming session. This can dominate an individual’s thinking.
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Withdrawal symptoms: Experiencing irritability, anxiety, sadness, or other negative emotions when attempting to reduce or stop gaming. These symptoms mirror those seen in substance withdrawal.
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Tolerance: Needing to spend increasing amounts of time gaming to achieve the same level of satisfaction or excitement. This signifies a need for increased "dosage" to obtain the desired effect.
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Unsuccessful attempts to control: Repeated failures to reduce, control, or stop internet gaming despite recognizing the negative impact on their life.
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Loss of interest: Giving up other activities or hobbies that were previously enjoyed, due to the allure of internet games.
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Continued excessive use despite knowledge of psychosocial problems: Persisting with excessive gaming even when aware of the detrimental effects on relationships, work, school, or physical health.
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Deception: Lying to family members, friends, or therapists about the amount of time spent gaming.
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Escape: Using internet games to escape or relieve negative moods, such as feelings of helplessness, guilt, anxiety, or depression. This reflects a maladaptive coping mechanism.
- Jeopardized or lost relationships, job, or educational opportunities: Putting relationships, career, or education at risk due to excessive gaming.
Factors Contributing to IGD:
Several factors are believed to contribute to the development of IGD:
- Psychological factors: Individuals with pre-existing mental health conditions, such as anxiety, depression, ADHD, or obsessive-compulsive disorder, may be more vulnerable to developing IGD. Gaming can provide a temporary escape from negative emotions or offer a sense of accomplishment and control that is lacking in other areas of their lives.
- Social factors: Social isolation, lack of real-world social support, and difficulty forming relationships can contribute to reliance on online gaming for social interaction and connection. Online games can offer a sense of belonging and community that may be absent in their offline lives.
- Neurobiological factors: Research suggests that IGD may be associated with changes in brain structure and function, particularly in areas related to reward processing, impulse control, and decision-making. Similar to substance addiction, gaming can trigger the release of dopamine in the brain, reinforcing the behavior and leading to compulsive use.
- Game design: The design of many online games is intentionally addictive. Features such as reward systems, competitive gameplay, social interaction, and constant updates are designed to keep players engaged and coming back for more.
- Availability and accessibility: The widespread availability of internet access and the increasing accessibility of online games on various devices (computers, consoles, smartphones) have made it easier for individuals to engage in excessive gaming.
Potential Consequences of IGD:
IGD can have a range of negative consequences across various domains of life:
- Mental health: Increased risk of depression, anxiety, social anxiety, loneliness, and suicidal ideation.
- Physical health: Sleep disturbances, eye strain, carpal tunnel syndrome, migraines, poor nutrition, obesity, and increased risk of cardiovascular problems.
- Academic/Occupational: Decreased academic performance, reduced work productivity, job loss, and difficulty concentrating.
- Social: Social isolation, strained relationships with family and friends, difficulty forming new relationships, and decreased participation in real-world activities.
- Financial: Excessive spending on gaming-related expenses, such as in-app purchases, subscriptions, and hardware upgrades.
- Behavioral: Aggression, impulsivity, and difficulty controlling anger.
Treatment:
Treatment for IGD typically involves a combination of therapeutic approaches:
- Cognitive Behavioral Therapy (CBT): Helps individuals identify and change negative thoughts and behaviors related to gaming. Focuses on developing coping skills, managing cravings, and setting realistic goals.
- Family therapy: Addresses family dynamics and communication patterns that may be contributing to the disorder. Involves educating family members about IGD and teaching them strategies for supporting the individual.
- Motivational interviewing: Helps individuals explore their ambivalence about changing their gaming behavior and identify their own motivations for seeking treatment.
- Medication: In some cases, medication may be prescribed to treat co-occurring mental health conditions, such as depression or anxiety.
- Support groups: Provide a safe and supportive environment for individuals to share their experiences and connect with others who are struggling with IGD.
- Lifestyle changes: Encouraging healthy habits such as regular exercise, proper sleep hygiene, and a balanced diet can also be beneficial.