Internet Gaming Disorder is a Serious Issue that Warrants both Professional and Family Attention

Dr.Ajaz Ahmad Suhaff

Video gaming as a recreational activity was gaining popularity since 1970 but due to the advancements in information technology it became more and more popular. Studies have found that online/ offline gaming problem produce profound adverse changes in the individuals that undermine their psychological well-being over time. Internet Gaming disorder is defined as a persistent or recurrent pattern of gaming behavior which is characterized by impaired control over gaming, increased priority given to gaming over other interests, and continued playing game despite negative consequences. It includes both digital as well as video games, offline or online. The disorder affects no more than 3 percent of gamers, according to the WHO and more than 2 billion people worldwide regularly play video games.
Research has revealed that persons suffering from gaming disorder is associated with its interpersonal conflicts and social isolation as they started neglecting their significant others. Individuals indulging in offline or online gaming frequently lie about their excessive gaming, has regular arguments and deteriorations in interpersonal relations. A recent study showed that such individuals often fail to recognize facial expressions of disgust displayed by others, and continue their annoying behavior despite others’ non-verbal communication of disapproval. Gaming triggers the brain’s reward center, which releases dopamine, sometimes referred to as one of the “feel good hormones.” Dopamine is associated with feelings of euphoria, bliss, concentration, and motivation. When a video game gives a child a thrill by allowing them to reach a new high score or take down an opponent, dopamine can surge. This results in a temporary feeling of bliss.
Occasional online gamers tend to experience intrinsically pleasant feelings that raise their self-esteem with their counterparts having Internet gaming disorder who experiencing no such feelings. Some individuals indulge in online gaming as an attempt to regain self-esteem by making progress in games or beating their opponents, gratify their needs for relatedness in multiple ways, such as by making friends with other online players. There has been extreme cases of death related to video game as interest in online games has risen, for example, in 2002, a South Korean man was believed to be the first person to die from online game binge-playing after playing for 86 hours; in another incident , a 35-year-old Virginia Beach man died after a 24-hour session of the World of Tanks video game, broadcast on video game streaming service. Recently a death was related in Kashmir after a young man played a long session of new popular game (confirmation awaited).
Because of these reasons South Korea in 2011 passed a law prohibiting those under 16 from playing online games between midnight and 6 a.m. However in 2014, the country amended the law, allowing parents to lift the ban on their children.
Are there benefits to gaming?
Though parents are conditioned to worry about the potential pitfalls of gaming, there are some positives. One research review published in Frontiers found gamers show improvements in several types of attention, including sustained attention or selective attention. It should be noted, however, that gaming does not replace social skills development. It is one thing to use gaming to spark a connection over a shared activity, but it is problematic when kids can only connect to other kids through gaming.
There is now enough research literature suggesting that some heavy users of video games indeed develop dysfunctional symptoms that can result in severe detrimental effects on functional and social areas. Therefore concerns growing in public about potential detrimental effects, including the possibility that video game play may be “addicting.” The ICD-11 (International Classification of Diseases 11th Revision) categorizes gaming disorder as an addictive disorder in the same category as drug abuse. But instead of a substance—a thing one consumes—underlying the addiction, a behavior does—an activity one performs.
Gaming disorders share similar psychological symptoms and neurobiological mechanisms with other substance or behavioral addictions. It is also a well documented fact that people playing or watching online games have increase neuronal activities in the brain regions involved in craving for addictive substances or gambling.
Symptoms of internet gaming disorder include:
◆Preoccupation with gaming.
◆Withdrawal symptoms when gaming is taken away or not possible (sadness, anxiety, irritability).
◆Tolerance, the need to spend more time gaming to satisfy the urge.
◆Inability to reduce playing, unsuccessful attempts to quit gaming.
◆Giving up other activities, loss of interest in previously enjoyed activities due to gaming.
◆Continuing to game despite problems
◆Deceiving family members or others about the amount of time spent on gaming
◆The use of gaming to relieve negative moods, such as guilt or hopelessness.
◆Risk, having jeopardized or lost a job or relationship due to gaming.
Video games can be a lot of fun and can even be used as a learning tool in some cases. For many kids and teens, video games are a way to connect with peers and blow off steam. Gaming becomes problematic for kids and teens when the behavior negatively affects their daily living.
Is your child really addicted?(Ask yourself these questions)
Does gaming affect my child’s ability to complete homework, get to school on time, or focus on educational needs?
◆Does gaming negatively impact my child’s relationships with parents, siblings, other family members, or peers?
◆Does my child experience uncontrollable outbursts when told to stop gaming, including physical aggression?
◆Does gaming take precedence over other areas in my child’s life?
◆Does gaming impede healthy habits such as eating, hygiene, and exercise?
◆Does gaming result in significant changes in mood?
Important risk factors in addiction to online videogames to watch out for:
• Vulnerability to addictions
• Psychiatric comorbidity: depression, anxiety, ADHD, ASD, and so on.
• Immaturity
• Emotional instability
• Unconsolidated identity
• Low self-esteem and indecision
• Lack of self-control
• Frustration
• Low resilience
• High sensation search
• Deficit of social skills, inhibition and extreme shyness
• School environment with low performance, demotivation, and so on.
• Poor social environment
• Grief
• Major crises
• Drastic life changes
Treatment
Psycho-education: This involves educating the person about gaming behaviors and their effects on mental health. The treatment focuses on helping the person to control cravings, deal with irrational thoughts, and learn coping skills and problem-solving techniques.
Intrapersonal psychotherapy: This treatment helps people to explore their identity, build self-esteem, and enhance their emotional intelligence.
Interpersonal psychotherapy: During this treatment, the individual will learn how to interact with others by working on their communication skills and assertiveness.
Family intervention: If gaming disorder is negatively affecting relationships with others, family members may need to take part in some aspects of therapy.
Development of a new lifestyle: To prevent excessive gaming, people should explore their skills and abilities, set goals for themselves, and find activities other than gaming that they enjoy.

—The author, a Senior Resident at the Department of Psychiatry ,SKIMS Medical College, Bemina, can be reached at:
drsuhaff@gmail.com