June 29, 2022

… err, let’s discuss Gaming Disorder.

You may have seen a bit of a reaction to the World Health Organisation (WHO) classifying Gaming Disorder as a thing that they will be putting into their Classification of Diseases and Disorders, starting in 2022.

And here’s something you might not be expecting someone who has a video games blog to say but… that’s okay.

The reactions and over-reactions were predictable but let’s be really, REALLY clear on this; you’re not going to suddenly find hundreds of thousands of people being diagnosed with Gaming Disorder starting on January 1st 2022. The whole point of a disorder of this kind is not simple overuse, or even long-term enjoyment. It’s about obsession, addiction, a pattern of behaviour where someone neglects interpersonal relationships and other things that pose a threat to their own safety and well-being. Gaming Disorder is, to use the right term, an “Extreme Behavioural Disorder”. A pattern of events that suggest that such an obsession is severely impacting on their lives.

If the definitions are so loose and flabby that they apply to millions of people who enjoy video games, then the World Health Organisation will have spectacularly failed in their remit… and they know that.

… and this will be the end result.

The term that will be used a lot is “False Positives”, and that’s the bane of the medical profession the world over.

It is why doctors don’t just order a battery of tests for everything. If something can affect one in a thousand people, and you test a thousand and one people, you’ll find one person who definitely has a condition you’re looking for… as well as one person who comes up as a False Positive. The extra “one” in the equation is for the flipside – false negatives are also a thing, where a person with a condition doesn’t show it. So when doctors test, they have to be somewhat confident in that justification in order to identify something specifically.

In terms of mental health and behavioural disorders, it gets harder because of individual circumstance. Again, take three people who might exhibit “overuse” of video games. One person is otherwise healthy and exhibits that obsession. A second is healthy and video game reviews/reactions are their job on a website/YouTube. A third person is bedbound/housebound, and is using video games to manage the otherwise daily drudgery of their circumstances and to combat boredom. There is a valid necessity to avoid a damaging and embarrassing diagnosis where it is neither needed nor warranted.

Professionals in the field of mental health are having and will continue to still have vicious, argumentative debates about the specifics and semantics of this decision by the World Health Organisation. For what seems like a foregone conclusion, the details are still far from clear and many might not pay any actual heed of guidelines if they are made deliberately vague and/or obtuse. Again, this is something I’m sure the World Health Organisation is desperate to avoid.

We do know SOME people have problems; we’ve seen news articles over the years that can be used in evidence. Kids who become so addicted to an app that they spend money that isn’t theirs, bleeding their parents bank accounts dry. Parents who become so obsessed that they neglect their duties to the point that it becomes child abuse. Individuals in China who have spent such extreme lengths of time playing games that they keel over and die through a lethal combination of exhaustion and dehydration. These are the instances that the World Health Organisation wants to cover; not the general use of, but the extreme cases. To head off the otherwise damaging effects on and potential death of individuals.

But in our current Outrage Culture, it’s easy to miss the underlying subtleties and skip straight into the worst-case scenario. Gamers who have been fighting stigmatisation for decades now see threats in every shadow, every thing and… that’s not healthy, but equally it’s a natural reaction based on the available evidence. Going from zero to a hundred and one is just the done thing in 2019.

And maybe that’s okay; expect the worst, and hope for the best. I’m reasonably confident after time with my own psychiatrist and mental health nurse that this isn’t a big Nerfbat which doctors and professionals will be smacking any “Gamer” with. But at least we’re having the debate, the discussion… and maybe people who are reacting quite badly will take an honest look at their personal usage of video games and consider if they might need to dial it back a notch or two. For all the toxicity and anger, there’s a really good underpinning to this for people to talk about.

Except that. We don’t talk about that.

That said, Sony and Microsoft; you’re not helping.

For all their talk of “doing something to curb overuse”, the basic ideas are knee-jerk and poorly thought-through. If you limit time per machine or account… you’ll get someone who probably only spent $600 on the hardware and game now spending $1200-$1800 for multiple consoles and a PC and multiple accounts to bypass those limitations as best they can. You only increase the financial aspect of that problem.

Equally, if you limit time per account… then how do you track multiple accounts? Again, someone could have a small public account with a few hours a day and a private account with more hours per day… cumulativly an issue, but one that isn’t as easy to identify when you force people to split their time in such a manner.

The best that games companies can do is pay attention, listen, join the actual medical discussion and ultimately be open to the idea that some doctors or psychiatric professionals may request themselves to have a stricter “time limit” put in place, like Parental Controls.

Remember, Gaming Disorder likely won’t be a widespread thing; you’ll be talking a handful of cases maybe in a year, not a widespread deluge.

And putting widespread and restrictive rules in place based on the actions and behaviours of a minority of people is, as usual, a pretty bad idea in business…


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