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High Involvement Versus Pathological Involvement in Video Games: a Crucial Distinction for Ensuring the Validity and Utility of Gaming Disorder

  • ICD-11 (D King, S Higuchi and V Poznyak, Section Editors)
  • Published:
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Abstract

Purpose of review

The year 2018 was marked by the official recognition of Gaming Disorder (GD) as a mental condition with its inclusion in the proposed eleventh edition of the International Classification of Diseases (ICD-11). Recently, a group of scholars has repeatedly criticized the notion of GD proposed by the World Health Organization (WHO), arguing that its inclusion in ICD-11 would pathologize highly involved but healthy gamers. It is therefore of crucial importance to clarify the characteristics of high involvement versus pathological involvement in video games, the boundaries between these constructs, and the implementation of screening and diagnostic GD tools that distinguish the two.

Recent findings

Increasing evidence supports the view that intense video game playing may involve patterns of gaming that are characterized by high involvement but that are non-pathological. Furthermore, some criteria for addictive and related disorders may reflect peripheral features that are not necessarily indicative of pathology, whereas others may reflect core features that are more likely to adequately identify pathological behavior and so have diagnostic validity. Finally, it is key to assess functional impairment associated with gaming, so that a GD diagnosis has clinical utility.

Summary

Available evidence supports the crucial need to distinguish between high and pathological involvement in video games, in order to avoid overdiagnosis and pathologization of normal behavior. The definition of GD adopted in ICD-11 has clinical utility and diagnostic validity since it explicitly mentions the functional impairment caused by problem gaming and its diagnostic guidelines refer to core addiction features, reflecting pathological involvement.

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Authors and Affiliations

  1. Addictive and Compulsive Behaviours Lab, Institute for Health and Behaviour, University of Luxembourg, Esch-sur-Alzette, Luxembourg

    Joël Billieux & Maèva Flayelle

  2. Department of Psychiatry and Psychotherapy, Research Group S :TEP, University of Lübeck, Lübeck, Germany

    Hans-Jürgen Rumpf

  3. SAMRC Unit on Risk & Resilience in Mental Disorders, Department of Psychiatry and Neuroscience Institute, University of Cape Town, Cape Town, South Africa

    Dan J. Stein

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  1. Joël Billieux
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  2. Maèva Flayelle
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  4. Dan J. Stein
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Correspondence to Joël Billieux.

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Conflict of Interest

Joël Billieux and Hans-Jürgen Rumpf have participated in consultation meetings convened by WHO from 2014 onward. Participants in these meetings have received travel support from WHO or their national organizations or institutions. In the past 3 years, Dan J. Stein has been a member of ICD-11 Working Groups, and has received honoraria from Lundbeck, and Sun. Maèva Flayelle declares no conflict of interest. The authors declare that they have not received any remuneration from commercial, educational, or other organizations in relation to this paper. The statements made and views expressed in this paper by those of this group of authors neither necessarily reflect those of the organizations to which they are affiliated nor do they necessarily represent policies or decisions of WHO.

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Billieux, J., Flayelle, M., Rumpf, HJ. et al. High Involvement Versus Pathological Involvement in Video Games: a Crucial Distinction for Ensuring the Validity and Utility of Gaming Disorder. Curr Addict Rep 6, 323–330 (2019). https://doi.org/10.1007/s40429-019-00259-x

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