Study casts doubt on value of WHO’s “gaming disorder” diagnoses

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Stock photo of angry young men playing video games.
Enlarge / Two gamers with obvious unmet psychological needs.

Since the World Health Organization proposed new diagnoses for “hazardous gaming” and “gaming disorder” last year, there’s been an ongoing scientific debate about which way the causation for these issues really goes. Does an excessive or addictive relationship with gaming actually cause psychological problems, or are people with existing psychological problems simply more likely to have an unhealthy relationship with gaming?

A recent study by Oxford’s Internet Institute, published in the open access journal Clinical Psychological Science, lends some support to the latter explanation. But it also highlights just how many of the game industry’s most devoted players may also be driven by some unmet psychological needs.

Getting at the problem

To study how so-called “dysfunctional gaming” relates to psychological needs and behaviors, the Oxford researchers surveyed a nationally representative sample of 1,004 UK adolescents and their caregivers. They asked the caregivers to evaluate their adolescents’ levels of “psychosocial functioning:” how well the adolescents are able to internalize or externalize problems in their lives as evidenced by their behavior.

The adolescents, meanwhile, answered a 24-item survey focused on whether their psychological needs are being met in daily life (e.g., “I feel a sense of choice and freedom in the things I undertake” vs. “My daily activities feel like a chain of obligations”). The adolescents were also asked how much and which kinds of video games they played and took a survey regarding nine potential indicators of “Internet Gaming Disorder” (e.g., “I felt moody or anxious when unable to play,” or “I felt that I should play less but couldn’t”).

Of the 1,004 adolescents surveyed, 525 said they played online games daily for an average of about three hours per day. Among that group, over 55% showed at least one of the nine indicators for Internet Gaming Disorder, and even 23% showed at least three indicators.

Those reported “dysregulated gaming” effects showed a significant positive correlation with the amount of time spent playing, as well as a significant negative correlation with the reported psychosocial evaluations from caregivers. In other words, those with “dysregulated” gaming habits were more likely to spend more time playing each day and less likely to be able to handle problems in their lives in a healthy way.

Which way does the causation go?

That on its own might suggest there’s some value in studying this kind of dysregulated gaming as its own disorder. Crucially, though, the measured effect of the dysregulated gaming variable in the study “accounted for a practically insignificant share of variability in key outcomes… as compared with the role played by basic psychological needs,” as the study authors write. “This evidence suggests that having information about the extent to which an adolescent’s video-game play is dysregulated provides no practically useful incremental information when viewed in light caregivers’ assessments of emotional, behavioral, peer, or conduct difficulties.”

So while so-called adolescent “problem gamers” are more likely to show behavioral problems, that fact in and of itself is much less important in predicting those problems than other measures of whether those adolescents’ psychological needs are being met, according to the study. That suggests that both dysregulated gaming and psychosocial behavior problems are both potential signs of more fundamental underlying psychological frustrations rather than excessive gaming causing problems in and of itself.

Addressing the value of WHO’s potential gaming diagnoses directly, the authors say their work “strongly suggest[s] that dysregulated gaming is unlikely to be a practically significant route by which psychological-need frustration undermines psychosocial functioning.”

The researchers conclude by asking rhetorically “if the attention that researchers and clinicians give this immensely popular activity is empirically justified. Judged on the basis of the evidence reported in this study, we would conclude it is not.”

https://arstechnica.com/?p=1589633