A weak scientific basis for gaming disorder: Let us err on the side of caution

van Rooij, Antonius J. and Ferguson, Christopher J. and Colder Carras, Michelle and Kardefelt-Winther, Daniel and Shi, Jing and Aarseth, Espen and Bean, Anthony M. and Bergmark, Karin Helmersson and Brus, Anne and Coulson, Mark and Deleuze, Jory and Dullur, Pravin and Dunkels, Elza and Edman, Johan and Elson, Malte and Etchells, Peter J. and Fiskaali, Anne and Granic, Isabela and Jansz, Jeroen and Karlsen, Faltin and Kaye, Linda K. and Kirsh, Bonnie and Lieberoth, Andreas and Markey, Patrick and Mills, Kathryn L. and Nielsen, Rune Kristian Lundedal and Orben, Amy and Poulsen, Arne and Prause, Nicole and Prax, Patrick and Quandt, Thorsten and Schimmenti, Adriano and Starcevic, Vladan and Stutman, Gabrielle and Turner, Nigel E. and van Looy, Jan and Przybylski, Andrew K. (2018) A weak scientific basis for gaming disorder: Let us err on the side of caution. Journal of Behavioral Addictions, 7 (1). pp. 1-9. ISSN 2062-5871 (print); 2063-5303 (online)

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Abstract

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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