When gaming takes over your life

The introduction of the diagnosis can make it easier for people with gaming-related problems to get help, says Philip Lindner, associate professor and research group leader at Karolinska Institutet, and a psychologist in addiction care in Stockholm.

“The fact that gaming disorder is formally classified as a behavioural addiction suggests that addiction care will have a clearer responsibility for treatment. And it creates a clear place for people to turn to,” he says.

Persistent pattern of gaming

According to the ICD-11, an international diagnostic manual, gaming disorder is defined as a persistent pattern of gaming that the person finds difficult to control. The behaviour must also lead to significant distress and considerable impairment in daily life.

“But it is not possible to set a fixed time limit, because the amount of time you need for other things in life varies from person to person,” says Philip Lindner, who has also evaluated a rating scale for gaming disorder that is now being introduced nationally.

When the diagnosis was first proposed, critics argued that it risked medicalising a normal part of youth culture. Philip Lindner believes the research field has now reached a consensus that computer games may have an addictive component and, like other behavioural addictions, can lead to symptoms resembling addiction and negative consequences.

One concern, however, is that the diagnosis may fail to capture girls’ problematic screen habits. While a large proportion of boys aged 16–17 play video games, 40–50 per cent of girls in the same age group spend more than three hours a day on social media.

“Perhaps a broader diagnosis, or an additional one, is needed for other types of screen habits that better match girls’ symptom patterns,” says Philip Lindner.

Virtual cosmetic items

Approximately one to two per cent of the population is estimated to be affected by gaming disorder, but prevalence varies by age and gender.

“The vast majority are men. Extensive gaming is most common around the age of fifteen, but that is not necessarily when problems are the greatest. They tend to become more serious in your mid-twenties to around thirty, when gaming starts to compete with other responsibilities in life,” he says.

One development that worries him is that gaming today is not only about playing but also involves money or gambling-like features. Players can pay for in-game advantages or random rewards, similar to gambling. Many games also allow the purchase of so-called “skins”, virtual cosmetic items that change the appearance of weapons or characters.

“As this becomes more common and attracts children and teenagers at increasingly younger ages, I think the symptoms among those who develop problems may emerge faster and become more severe than we have seen before,” says Philip Lindner, and continues:

“It is also becoming clear that there is an increased risk of developing traditional gambling addiction later in life if you play a lot of computer games.”

Carefully map your gaming

Treatment for gaming disorder often relies on cognitive behavioural therapy (CBT), and usually does not require complete abstinence, but rather focuses on reducing the amount of time spent gaming.

“You carefully map your gaming: when you play, what you play and why, and try to find a way of setting boundaries that works for you,” says Philip Lindner.

This might include using technical tools to limit gaming time, removing certain programmes, and finding alternative activities to turn to when the risk of playing too much is highest.

“In general, the treatment is effective, reducing both time spent gaming and its negative consequences. For example, a pilot study of a Swedish CBT-based treatment indicates a halving of patients’ symptoms,” he says.