Monday, July 2, 2018

Endless Gaming May Be a Bad Habit. That Doesn’t Make It a Mental Illness.

Endless Gaming

Endless Gaming could also be a nasty Habit. That Doesn’t Make It a mental disease.

The World Health Organization last month added “internet gaming disorder” to its manual of psychiatric diagnoses, and therefore the reaction was, we could say, muted.

At a time when many grown adults exchange one-liners with Siri or Alexa, the diagnosis seems years overdue, doesn’t it? Put down your phone and appearance around:

If half the people you see walking down the street or riding the bus with you're face-deep during a small screen, then it’s not a wild leap to think that some percentage of folks, particularly those younger and male, have fallen hard for “Fortnite” or “League of Legends” or “World of Warcraft” and can't rise up, except to fetch the occasional bowl of Lucky Charms.

They’re stuck. They roll in the hay their heads on keyboards. they might use a lover of the breathing, let’s-go-to-the-park variety. they might use some help.

Yet embracing I.G.D., as it’s known, as a replacement psychological state disorder has its own perils.

Many psychologists are skeptical that it exists in the least as a stand-alone problem.

The diagnostic criteria are still fuzzy, and therefore the potential for overdiagnosis is gigantic.

I.G.D. may be a case study in what happens when researchers become convinced that a nasty  habit has become something different: a disorder.

The studies compile and therefore the notion takes on the lifetime of its own — one which will or might not be persuasive to putative “patients.”

“The question is, what’s the difference between a nasty habit and a disorder, and where do you draw that line,” said Scott Lilienfeld, a professor of psychology at Emory University.

“Some, like me, believe there’s often no reliable thanks to doing this. Others disagree.

The point is, you would like to be very careful in doing so” for people that need help to shop for in.

The W.H.O.’s definition of gaming disorder may be a mouthful:

A pattern of gaming behavior characterized by impaired control over gaming, increasing priority given to gaming over other activities to the extent that gaming takes precedence over other interests and daily activities, and continuation or escalation of gaming despite the occurrence of negative consequences.

As a diagnosis, it’s a possible blockbuster. Estimates of its prevalence — up to 9 percent of all gamers — mean that tens of many mostly children worldwide may now be said to possess a mental disturbance.

Some of them surely do, whatever its underlying dynamics.

“The kids I see truly have a drag, and it's disastrous effects on many parts of their lives — school performance, social life, their moods,” said Dr. Clifford Sussman, a psychiatrist in Washington who treats compulsive gaming with psychotherapy.

“It doesn’t much matter what you call it, the purpose is to offer them tools” to regulate the habit, he added, and better integrate it into their lives.

Many other psychiatrists agree and say they need to treat the compulsion successfully.

But the American Psychological Association, among other groups, takes exception to the diagnosis.

The association argues that the definition remains too vague, which mood problems may actually precede excessive gaming, not the other way around.

The new label reflects a “moral panic,” the critics say — an unfounded fear of latest technology that years ago had parents and a few experts finger-wagging about the mentally corrosive effects of TV, and before that radio.

“There’s a kernel of truth in what the partisans are saying,” said Christopher Ferguson, a psychologist at Stetson University who has been a skeptic of the various ills attributed to gaming.

“There’s something to the present, although we actually don’t know enough to know  it entirely.”

Parts of the published science so far, he said, haven't been reassuring.

Take, for example, the look for a “signature” of the disorder within the brain.

In one recent study, a gaggle of scientists in China and Europe asked 38 people they identified as having I.G.D. put their heads inside an MRI scanner.

Compared to peers who had less compulsive gaming habits, the I.G.D. group “showed significantly decreased cortical thickness within the left the lateral orbitofrontal cortex, inferior parietal lobule, bilateral cuneus, central gyrus, and right middle gyrus,” the researchers announced.

Another report, also using brain imaging, concluded that folks with I.G.D. had “decreased connectivity between the left amygdala and left middle frontal and precentral gyrus.”

That’s tons of fancy-sounding brain regions.

But the conclusions are all virtually meaningless since nobody knows much about how those regions interact, or why one gamer’s bilateral cuneus happens to be thicker than another’s.

Another recent study focused on treatment: not just any treatment but bupropion, an antidepressant often utilized in smoking cessation.

The study found that, after 12 weeks, “depressive symptoms, attention and impulsivity improved,” then did scores, for some, on something called the Young Internet Addiction Scale.

No word on whether participants within the study actually learned to manage their gaming habits in a lasting way.

“Once you opt there’s a disorder, you begin trying to find it in people’s brains and trying to knock it out, such as you would a brain tumor,” Dr. Lilienfeld said.

But in fact, there's no tumor during this case.

Finally, yet one more recent study hinted that a method to interrupt the gaming trance is to place the screen junkies on horseback.

After seven days of “equine-assisted activities and therapies,” a gaggle of adolescents diagnosed with I.G.D. showed improvement in “avoidance and anxiety scores,” this study concluded.

Horse riding, usually with a therapist-guide riding alongside, giving instruction and encouragement has shown some benefit for people with autism, traumatic brain injury, and post-traumatic stress.


Whether W.H.O.’s inclusion of compulsive gaming eventually results in better research, or to standardized treatments that reliably change behavior is an open question.

But for now, it might be hard responsible anyone with a significant joystick jones for balking at the prospect of a “disorder.”

A bad habit could also be bad. But a minimum of fixing it doesn’t involve brain scans, antidepressant pills or clinging for dear life to some cantering Cheyenne or Misty.

The digital horses are tons safer to ride, after all. And you get to hold a sword.

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