If a game becomes so unputdownable that students demand it be banned, describing it as worse than drugs and others end up in a hospital, is it still just a game?
On Wednesday, the Jammu Kashmir Students Association (JKSA) reportedly asked Governor Satya Pal Naik to immediately ban Player Underground’s Battle Ground (PUBG). “More concerning than addiction to drugs,” said deputy chairman Raqif Mahkhdooi while demanding the immediate ban of the game.
Schools in Bengaluru have already warned parents about the game’s addictive properties, while cases of addiction to the game have been reported to the National Institute of Mental Health and Neuro Sciences (NIMHANS). Six cases, so far, of PUBG addiction have been reported in Jammu and Kashmir, while a fitness trainer was admitted to the hospital in Jammu.
That video games can seem addictive wouldn’t surprise any parents who has had to claw their kids off the gaming console. But when in 2018 the World Health Organisation added “gaming disorder” as a diagnosis to the International Classification of Diseases (ICD), alongside substance use disorders and pathological gambling, many were shocked.
What is gaming disorder?
The WHO defines gaming disorder as a pattern of gaming behavior – either digital gaming or video gaming – characterised 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.”
In other words, for a diagnosis of gaming disorder, the behavior pattern must be sufficiently severe to result in impairment in personal, family, social, educational, occupation or other important areas of functioning that would normally be evident for at least a year.
What makes gaming so addictive?
In the past decades, there has been a critical paradigm shift in the field of addiction – one that has large scale implications for assessment and treatment. Historically, addiction has been associated with either drugs or alcohol. But advancements in neuroscience has made it increasingly evident that different which are repeatedly reinforcing reward, motivation and memory circuitry are all part of the disease.
The American Society of Addiction Medicine (ASAM) formally expanded their definition of addiction in 2011 to include both behaviors and substances and said, “Addiction is a primary, chronic disease of brain reward, motivation, memory and related circuitry. Dysfunction in these circuits leads to characteristic biological, psychological, social and spiritual manifestations. This is reflected in an individual pathologically pursuing reward and/or relief by substance use and other behaviors.”
In the case of games, the American Psychiatric Association (APA) said, “The studies suggest that when these individuals are engrossed in Internet games, certain pathways in their brains are triggered in the same direct and intense way that a drug addict’s brain is affected by a particular substance. The gaming prompts a neurological response that influences feelings of pleasure and reward, and the result, in the extreme, is manifested as addictive behavior.”
What evidence is there and should everyone who likes gaming worry?
The decision by the WHO took into account evidence and also “reflects a consensus of experts from different disciplines and geographical regions that were involved in the process of technical consultations undertaken by WHO in the process of ICD-11 development.”
The WHO adds that this would allow the treatment for people with health conditions in many parts of the world and result “in the increased attention of health professionals to the risks of development of this disorder and, accordingly, to relevant prevention and treatment measures.”
As per studies, the disorder affects only a small proportion of people who engage in digital or video gaming activities. “However, people who partake in gaming should be alert to the amount of time they spend on gaming activities, particularly when it is to the exclusion of other daily activities, as well as to any changes in their physical or psychological health and social functioning that could be attributed to their pattern of gaming behavior,” warns the WHO.
Experts says that depression is the leading co-morbid disorder with internet addiction and that self-esteem is a core component here. Individuals with negative self-esteem are potential candidates who engage in addictive internet behaviors.
Social isolation caused by the addiction could also lead to increase depressive symptoms, with research suggesting that depression can lead to addictive use of internet and vice-versa.
What kind of impact can it have on lives?
A study published in September 2018, “Internet use patterns, internet addiction and psychological distress among engineering students: A study from India” looked at addiction among university engineering students and its association with academic competence, educational progress and long-term career goals.
Of the total students, almost a third (27.1%) fell under the ambit of mild addictive internet use, 9.7% for moderate addictive internet use and 0.4% had severe internet use. The study concluded, “A substantial proportion of engineering students have IA which can be detrimental for their educational progress in university studies and long-term career goals. Early identification and management of IA and psychological distress among engineering students is crucial.”