A weak scientific basis for gaming disorder: Let us err on the side of caution
Open accessAbstract
We greatly appreciate the care and thought that is evident in the 10 commentaries that discuss our debate paper, the majority of which argued in favor of a formalized ICD-11 gaming disorder. We agree that there are some people whose play of video games is related to life problems. We believe that understanding this population and the nature and severity of the problems they experience should be a focus area for future research. However, moving from research construct to formal disorder requires a much stronger evidence base than we currently have. The burden of evidence and the clinical utility should be extremely high, because there is a genuine risk of abuse of diagnoses. We provide suggestions about the level of evidence that might be required: transparent and preregistered studies, a better demarcation of the subject area that includes a rationale for focusing on gaming particularly versus a more general behavioral addictions concept, the exploration of non-addiction approaches, and the unbiased exploration of clinical approaches that treat potentially underlying issues, such as depressive mood or social anxiety first. We acknowledge there could be benefits to formalizing gaming disorder, many of which were highlighted by colleagues in their commentaries, but we think they do not yet outweigh the wider societal and public health risks involved. Given the gravity of diagnostic classification and its wider societal impact, we urge our colleagues at the WHO to err on the side of caution for now and postpone the formalization.
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Weaker studies have relied extensively on self-selected samples that do not necessarily include regular and/or problematic gamers, have used unvalidated or psychometrically poor self-report assessment instruments, or have made causal inferences based on insufficient evidence.
“Weaker studies have relied extensively on self-selected samples that do not necessarily include regular and/or problematic gamers, have used unvalidated or psychometrically poor self-report assessment instruments, or have made causal inferences based on insufficient evidence 167,169,170 .”
From Emerging experience with selected new categories in the <scp>ICD</scp>‐11: complex <scp>PTSD</scp>, prolonged grief disorder, gaming disorder, and compulsive sexual behaviour disorder (2022) · cites this paper as [167]
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References 72 · Cited by 346
Research works printed but not linked: 1
- Bowman N. D. (2016). The rise (and refinement) of moral panic. In Kowert R. Quandt T. (Eds.), The video game debate: Unraveling the physical; social; and psychological effects of digital games (pp. 22– 38). New York, NY: Routledge.
- Authors
- van Rooij, A. J., Ferguson, C. J., Colder Carras, M., Kardefelt-Winther, D., Shi, J., Aarseth, E., Bean, A. M., Bergmark, K. H., Brus, A., Coulson, M., Deleuze, J., Dullur, P., Dunkels, E., Edman, J., Elson, M., Etchells, P. J., Fiskaali, A., Granic, I., Jansz, J., Karlsen, F., Kaye, L. K., Kirsh, B., Lieberoth, A., Markey, P., Mills, K. L., Nielsen, R. K. L., Orben, A., Poulsen, A., Prause, N., Prax, P., Quandt, T., Schimmenti, A., Starcevic, V., Stutman, G., Turner, N. E., van Looy, J., & Przybylski, A. K.
- Affiliations
- Department of Children & Risky Behavior, Trimbos Institute, Utrecht, The Netherlands
- Stetson University (US)
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Centre for Addiction and Mental Health (CA)
- IT University of Copenhagen (DK)
- Framingham State University (US)
- Stockholm University (SE)
- Roskilde University (DK)
- Middlesex University London (GB)
- UCLouvain (BE)
- Western Sydney University (AU)
- Umeå University (SE)
- Ruhr University Bochum (DE)
- Bath Spa University (GB)
- Aarhus University (DK)
- Radboud University Nijmegen (NL)
- Erasmus University Rotterdam (NL)
- Høyskolen Kristiania (NO)
- Edge Hill University (GB)
- University of Toronto (CA)
- Villanova University (US)
- University of Oregon (US)
- University of Oxford (GB)
- Liberos LLC, Los Angeles, CA, USA
- Uppsala University (SE)
- University of Münster (DE)
- Università degli Studi di Enna Kore (IT)
- Discipline of Psychiatry, University of Sydney, Sydney, Australia
- Clinical Psychologist/Neuropsychologist, New York, NY, USA
- Department of Communication Sciences, imec-mict-Ghent University, Ghent, Belgium
- Corresponding author
- Ferguson, Christopher J.
- Shi, Jing
- Przybylski, Andrew K.
- ORCID
- Ferguson, Christopher J.
- Shi, Jing
- Aarseth, Espen
- Bean, Anthony M.
- Bergmark, Karin Helmersson
- Brus, Anne
- Coulson, Mark
- Deleuze, Jory
- Dullur, Pravin
- Dunkels, Elza
- Edman, Johan
- Elson, Malte
- Etchells, Peter J.
- Fiskaali, Anne
- Granic, Isabela
- Jansz, Jeroen
- Karlsen, Faltin
- Kaye, Linda K.
- Kirsh, Bonnie
- Lieberoth, Andreas
- Markey, Patrick
- Mills, Kathryn L.
- Nielsen, Rune Kristian Lundedal
- Orben, Amy
- Prause, Nicole
- Quandt, Thorsten
- Schimmenti, Adriano
- Turner, Nigel E.
- Przybylski, Andrew K.
- Venue
- Journal of Behavioral Addictions
- Publisher
- Akademiai Kiado Zrt.
- Published
- 2018-03
- Volume
- 7
- Issue
- 1
- Pages
- 1-9
- ISSN
- 2062-5871 (ISSN-L)
- 2063-5303
- PMC
- PMC6035022
- OpenAlex
- W2793076804
- Cited by
- 346
- References
- 72
- Citations by year
- 2026: 16 · 2025: 33 · 2024: 37 · 2023: 43 · 2022: 37 · 2021: 52 · 2020: 57 · 2019: 48 · 2018: 19 · 2017: 2 · 2016: 2
- FWCI
- 99.97
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Journal of Behavioral Addictions (publishedVersion, cc-by-nc)
- Europe PMC (PubMed Central) (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- Middlesex University Research Repository (Middlesex University Of London) (acceptedVersion)
- IT University Of Copenhagen (IT University of Copenhagen) (submittedVersion, cc-by-nc)
- Edge Hill University Research Information Repository (Edge Hill University) (submittedVersion, cc-by-nc-nd)
- Research Space (submittedVersion)
- Radboud Repository (Radboud University) (submittedVersion, other-oa)
- EUR Research Repository (Erasmus University Rotterdam) (submittedVersion, other-oa)
- RePub (Erasmus University Rotterdam) (submittedVersion, other-oa)
- DiVA at Umeå University (Umeå University) (submittedVersion, other-oa)
- KTH Publication Database DiVA (KTH Royal Institute of Technology) (submittedVersion, other-oa)
- RUCforsk (Roskilde University) (submittedVersion, cc-by-nc)
- Radboud Repository (Radboud University) (submittedVersion)
- UEA Digital Repository (University of East Anglia) (submittedVersion)
- Funders
- National Institute of Mental Health (T32MH014592)
- Topics
- Social Sciences › Sociology and Political Science › Impact of Technology on Adolescents
- Social Sciences › Psychology › Clinical Psychology › Gambling Behavior and Treatments
- Social Sciences › Psychology › Clinical Psychology › Sexuality, Behavior, and Technology
- Keywords
- gaming disorder, ICD-11, diagnostic classification, gaming addiction, behavioral addiction, diagnostic criteria, evidence base, unnecessary testing, depressive mood, social anxiety
- MeSH terms
- Humans, World Health Organization, Behavior, Addictive, Video Games, International Classification of Diseases, Diagnostic and Statistical Manual of Mental Disorders
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