10 ms·

WHO to recognize gaming disorder as mental health condition

117 points by emacsgifs 9y ago

mjburgess 9y ago
Before the sceptics get in: 1. The purpose of DSM/ICD is often to justify financing treatment: > Chris Ferguson, a professor of psychology at Stetson University ... described the ICD as "the book of real diseases that you can get insurance payments for." 2. Treatment has to be mindful of the specific form of addiction: > "These are co-morbid conditions," he said. "If you just treat the depression and not gaming, the gaming is likely to come back." This suggests it's a unique condition, he said. 3. No we are not "medicializing everything": > But Ferguson argued that, if it is a disorder, it seems to be very rare. NB. Before criticizing modern psychiatry keep in mind: 1. mental health patients are extreme in their dysfunction, never common. 2. the operation of the brain (, nervous system, etc.) in its interaction with its environment is as liable to breaking as any other part of the body 3. modern clinical psychiatry is an evidenced-based, research-driven field which treats and forms diagnoses on the basis of decades of research into any particular condition. It isnt the 1950s.
- DanBC 9y ago
  > Before criticizing modern psychiatry keep in mind: > 1. mental health patients are extreme in their dysfunction, never common. I agree with what you're saying, but the US does have a problem of over-testing, over-diagnosis, and over-treating illness. Not just mental ill health, but everything. In the US about 10% of children have ADHD https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3489818/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3489818/ > Based on the Heath Resources and Services Administration's National Survey of Children's Health, the percentage of children aged 4–17 years diagnosed with ADHD increased from 7.8% in 2003 to 9.5% in 2007, representing a 21.8% increase in just 4 years (Centers for Disease Control and Prevention 2010). An estimates 3million US children take stimulant medication: > Experts estimate that approximately 60% of children with ADHD are treated with prescription stimulants (Center for Disease Control and Prevention 2005a); therefore, approximately three million children in this country take stimulants for problems with focusing. At the same time, many studies have revealed the numerous adverse effects associated with prescription stimulants when they are used inappropriately. These numbers are a bit worrying, especially if medication alone is being used, and it's not provided as a package of bio-psycho-social treatment.
  - mjburgess 9y ago
    Ahh, sigh. I was writing with ADHD in mind actually. Up to 10% children really do have ADHD which is a delay in the development of the frontal lobe. Such a delay seems "somewhat common" amongst humans. More than half catch up, leaving upto 5% of adults with some form of ADHD. ADHD is serious. It is a severe impairment to planning, self-management, emotional regulation, etc. You are likely to be impoverished without substantial resources to rely on (family, etc.). > are a bit worrying > it's not provided as a package of bio-psycho-social treatment. ADHD researchers (serious neuroscientists & clinical psychiatrists) have for DECADES tried "biosocial blah blah". It has failed. ADHD is not a failure of child training (ie., parents "Raising Their Child Right!!!"). Overwhelmingly the effective treatment for ADHD is pharmocological. At this point comments like yours, along with the media hysteria, are doing real harm to children actually getting treatment. The problem we have with ADHD is significant under treatment and under diagnosis. It turns out all those "useless" people joked about in human history have not just been failures of character: in need of "social" intervention. They have had a physical impairment, a delay in their brain's development. Not Fixable by a good beating, or whatever the touchy-feely equivalent is. The suggestion that a child with a broken leg not receive crutches would be absolutely outrageous. Or a person with cancer not receive a daily pill treatment. The very same outrage should be felt here in the suggestion that people with ADHD not receive medication vital to their ability to even pay attention to their lessons (goals, etc.). Vital to their ability to socailize (ie., control their frustation in ways that doesnt alientate other children). And therefore vital to their future success. Yes there does need to be a fundamental reorganization to western education systems to, from the ground up, be aware of how wide-spread developmental issues are -- and to build in fundamental support structures. However this isnt a "treatment" for ADHD. There is no cure. This is just bracing the crutches. Overwelmingly the research over the last 30 years has shown the only significant impact on ADHD is pharmocological.
    - xena 9y ago
      Honestly I think about half the problem is that psychiatric illnesses don't make people bleed, so there's no way to universally tell something is wrong.
- algesten 9y ago
  > 3. modern clinical psychiatry is an evidenced-based, research-driven field which treats and forms diagnoses on the basis of decades of research into any particular condition. It isnt the 1950s. But isn't modern clinical psychiatry marred by the same problems social or economic sciences are? Ultimately you are studying/interpreting human behaviour, which doesn't lend itself well to quantisation or categorising.
  - mjburgess 9y ago
    The most reasonable thing to think about any mental health disorder is whatever the consensus in clinical psychiatry is. That is the point. It is so overwhelmingly well-researched, that even if its conclusions are wrong, no lay person is going to be in a position to have "an argument" that hasn't already been considered and researched and folded into the consensus. This isnt the case with social sciences, and it isnt the case with macroeconomic policy. Both of these are about groups of humans, not individual humans, and are fundamentally about behaviour in the face of cultural/economic/social changes. That kind of analysis is purely speculative and historically accidental in the way that giving people adderall and measuring their cognitive performance isn't. A man on the street may well have good reasons to speculate differently about the evolution of his society that those speculations produced in some university in a foreign country. A man on the street can have no good reason to act against the consensus of research-based medicine. To do so is to fly blindly into an area of profound research depth and consideration. We have a problem today of these domains being equivocated. About people believing they are experts because the "Experts" they see are really political speculators and commentators of macro-cultural changes. And so everyone thinks everything is speculation. This is profoundly not the case for, let's say, what the best treatment plan for bipolar disorder, adhd, autism, clincial depression, psychosis, etc. etc. etc. is. ...which has folded in lifetimes of research on the way the brain works, the way that drugs work, CBT, social therapies, counselling, etc. etc. etc. ... An opinion on what "should be done" about a family member with bipolar disorder may as well be an opinion about what should be done about their thyroid problem, carpal fracture, lymphoma, etc.
    - xapata 9y ago
      Sounds like you're not familiar with sociology nor macroeconomics literature.
- StanislavPetrov 9y ago
  >3. modern clinical psychiatry is an evidenced-based, research-driven field which treats and forms diagnoses on the basis of decades of research into any particular condition. It isnt the 1950s. Your post was okay until your last point. While it isn't the 1950s, its absurd to contend that "modern clinical psychiatry" isn't massively subjective in terms of both treatment and diagnosis. The fact is that the vast majority of psychiatrists reflexively shovel pills at those perceived to be afflicted with poorly-understood mental disorders. In reality, we are only beginning to scratch the surface when it comes to understanding how the brain works, let alone the human psyche. One of the most egregious illustrations of this fact are the over 1 million children under the age of 5 taking psychiatric drugs. We still don't know the long term outcomes of our tinkering with the developing brains of infants and small children, and its hubris (or worse) to pretend that we do. https://www.cchrint.org/psychiatric-drugs/children-on-psychiatric-drugs/ https://www.cchrint.org/psychiatric-drugs/children-on-psychi...
  - rendaw 9y ago
    On the subject, I remember reading recently that most psychology studies are observational, and when attempts to duplicate the findings are made they mostly can't. I realize that GP's statement is qualified with 'clinical', and decisions based on observational studies are probably better than just making things up, but how much have we actually progressed?
- numismatex 9y ago
  Let's take a history of the DSM using trivia here: 1) By context it states still that drugs like LSD and MDMA will lead to psychosis. 2) It directly stated that Marijuana causes psychosis up until some years back (less than a decade). 3) Psychosis NOS (None Otherwise Specified) is used to categorize undesirables when nothing else fits. 4) People were still being forcibly sterilized in California up until less than a decade ago. 5) Modern clinical psychiatry is checklist-based, not evidence-based. If it were evidence-based they'd be basing it on bloodwork and MRI. 6) Recent findings regarding genetics, as well as astrocyte-damage being responsible for schizophrenia trump Freudian-based lunacy. 7) Psychiatric abuse has been common for over 100 years. If you're homosexual, anti-establishment, communist, atheist, Wiccan and more, you've likely been a victim of bias and discrimination. The cold-water baths and ECT to treat such terrible conditions as not being "like everyone else" are true. 8) It's delusional to think that the DSM represents fact -- for instance, the APA has stated that any group of people, large enough, holding a belief, is a religion and thus a protected class -- yet Wiccans, Rastafari and alternative religions are still persecuted like addicts and cults. As someone who survived the psychiatric establishments in Texas, finally meeting a doctor who started at square one, asking me questions, and rediagnosing me to PTSD and a victim of abuse from the slew of ever-changing diagnoses that my parents lied to the doctors to achieve, I think it's all barbarism, plain and simple. Times are changing, but mental institutions and Big Pharma pushing pills hasn't. Actual therapeutics and investigation are nonexistent. People don't ask the patients and instead rely on testimony from others. Full workups aren't done. Inspection for head trauma, meningitis and more isn't done. And you can pick this apart, and say that "hey those are just isolated possible situations" but the reality is, just like the prison systems, psychiatry is 100% flawed and biased. For fucks sake, my first doctor around year 2000 had been trained in fucking Russia in the fucking 1950s. You want psychiatry to be true? Give it 20 years for the tech to catch up and doctors to adopt it, then give it to AI to manage rather than flawed, biased humans with motives that aren't in line with the best treatment for a patient.
raziel2p 9y ago
I hope this doesn't get abused. Also, maybe a social media disorder is next on the list?
- ak39 9y ago
  Without a doubt. This should have been a far more serious consideration than gaming addiction.
  - deleted 9y ago
    [deleted]
  - DaveSapien 9y ago
    I wish I could upvote this more. Compulsion addiction and those companys (FaceBook,Twitter,EA,King, ect) that promote and profit from it are a dangerous threat to society. And obviously destructive to the individuals they target.
    - pwaai 9y ago
      Let's regulate ads that show unrealistic body images of people about men and women. They already done so in France.
deleted 9y ago
[deleted]
mfukar 9y ago
This isn't going to be misused at all.
75dvtwin 9y ago
my personal reaction is 2 fold WRT >In one study, he found that when kids stopped being addicted to games, their depression and anxiety got better. ( 1 ) Is this study repeatable? (or does it suffer the fate of many (75%) psychology experiments that cannot be replicated [1] ( 2 ) Instagram, Facebook , -- would those, potentially, addiction-fueled activities, ever become subject to the WHO recommendation ? [ 1 ] https://www.theguardian.com/science/2015/aug/27/study-delivers-bleak-verdict-on-validity-of-psychology-experiment-results https://www.theguardian.com/science/2015/aug/27/study-delive...
- amelius 9y ago
  The replication claim has never been replicated either.
  - zerostar07 9y ago
    they have. repeatability problems have been found in various domains , including medicine and psychology which is of concern here
retox 9y ago
https://www.nytimes.com/2016/07/27/health/who-transgender-medical-disorder.html https://www.nytimes.com/2016/07/27/health/who-transgender-me...
- nukeop 9y ago
  This is basically a subset of body integrity identity disorder, a mental illness that creates a strong desire to alter the body surgically, often by removing body parts.
  - pwaai 9y ago
    It is not a mental illness for somebody to feel discomfort from living in a body that's not congruent with their gender identity which lies in their head, not genitals.
    - nukeop 9y ago
      And yet it is a mental disorder to feel that you should have a different body in non-sexual regard. The treatment of that disorder is also not to proceed with the desired surgical alterations.
- ashleyn 9y ago
  A man isn't disordered simply for wanting the same things an ordinary woman would want.
nukeop 9y ago
WHO recognizing things as diseases or not diseases is becoming largely politicized. They have already removed many obvious mental disorders from their lists due to political pressures and now they're starting to add some bizarre entries. I wouldn't be surprised if they add "investing in cryptocurrencies" or "thinking Russia is an ok place" next, considering current trendy topics.
- RobertoG 9y ago
  It's certainly a slippery slope. I suppose it's not a so big problem if "healing" is optional. Political dissidence has been categorize as an illness in the past. In the Soviet Union, for instance. The same with sexual preferences. In the science fiction novel "Distress", by Greg Egan, appears a character that it's a highly functioning autistic that don't want to be "healed". I have the book here. This idea has been with me since I read it: "What's the most patronising thing you can offer to do for people you disagree with, or don't understand? [..] Heal them. [..] Whoever claims the authority to define the boundary between health and disease claims...everything."
- nerdponx 9y ago
  This is thoroughly unempathetic. Video game addiction is absolutely real, and the WHO is well behind the curve on this, as other posters have already pointed out.
- pwaai 9y ago
  No, WHO has done an excellent job of recognizing the exact things which you invalidate. Please give evidence and examples to support your claim that they are politicizing by attempting to alleviate and bring more attention to previously neglected demographics. https://news.ycombinator.com/item?id=16035450 https://news.ycombinator.com/item?id=16035450 From your other comment in this thread, it is clear that you are not well educated on this subject to speak with such authority. Calling somebody who feels their gender identity doesn't match their body as mentally ill is offensive and inaccurate, how can someone who is born in the wrong body be at fault? Organizations like WHO are doing a great job.
  - 9y ago
saas_co_de 9y ago
Video games are obviously addictive. The way you make money off of games is to make them addictive. There is a direct feedback loop between more addictive games and more profits and so the addictiveness of games can be research, refined, and optimized over time. The WHO is way behind the curve here. If society treated video games the same as alcohol and drugs they would already be banned for minors. Eventually they probably will be.
- drdaeman 9y ago
  <sarcasm>We should also ban other dangerously addictive activities, such as fiction books, non-video games, sports, DIY hobbies (e.g. electrical engineering, painting or storywriting), pets, hanging out with other people and lots of other things.</sacrasm> I'm no expert on the matter, but I think you're completely missing the point. The keyword here is "gaming addiction" not "video games". Please, for the love of all the sanity that's still left out there, don't mistake one with another. There is a lot of things that one suffering from behavioral disorders could get addicted to. Unlike substance addictions (which are complicated matter), games (or overindulging in escapist fiction or having dozens of pets) are more of a symptom than an underlying cause. If you'd try to ban just about everything that one could get hooked onto, it won't help the person a little bit with their impulse control. It would just make their and everyone else's lives dull and boring, probably leading to much more unhealthy situations (just my guess, though).
  - SOLARSYSTEM 9y ago
    > We should also ban other dangerously addictive activities, such as fiction books, non-video games, sports, DIY hobbies These can be addicting too, but certain video games can be on an entirely different level, ie. they fulfill many more psychological needs.
    - drdaeman 9y ago
      I really believe this is really a matter of taste. Don't think there something special about video games - surely they're a very common retreat but by no means an special one. There are people who are addicted to other activities just as bad as some are hooked on games. And even for games - what some would find highly addictive, others would find boring or even disgusting. So I really think there is nothing wrong with video games on their own - the problem is in the heads and games are just what frequently happens to be there. What triggered my comment is a ban proposal for an extremely wide group, where a significant fraction doesn't have any particular issue with the subject at hand. Even if I'm unaffected by this particular proposal (I'm way past my teen years) I still find such ideas somewhat offensive. I may be naive or stupid but I don't fancy the very thought of someone being deprived of something fairly harmless to them just because others have issues.
mabbo 9y ago
I don't know whether what I had (have?) meets this WHO definition, but I can tell you that at points in my life, I've had an unhealthy relationship with video games. For me, and maybe others as well, it's about having control over something and feeling a sense of accomplishment, feeling like I'm achieving something. Video games give you that. For a small cost ($20-$50), you can have pure escapism from reality, think about things other than your shitty life and depression and instead feel yourself accomplish goals, achieve success, win. Unlike drugs or alcohol, it doesn't end- you can just keep coming back without paying anything. There's no chemical hangover, no blood test for it, no social stigma like drugs have. It's perfect. My underlying problems have been dealt with now, but I still have to limit how long I play games for. The high is still there and I recognize it well. I just don't need it like I once did. Looking back at my high school days, I had a good friend who was into drugs. I got him into EverQuest. I wish he'd gotten me into drugs instead- there are well understood paths out of drug addiction. And that game messed the both of us up.
- poisonarena 9y ago
  I did both drugs and Everquest in highschool and I have to say I would rather walk through the Qeynos Hills than the other option.
  - pwaai 9y ago
    There have been some publicized cases about Everquest... https://www.cbsnews.com/news/addicted-suicide-over-everquest/ https://www.cbsnews.com/news/addicted-suicide-over-everquest... I remember seeing the Everquest demo trailer video in an Electronic Boutique store and reading about it in PC magazine, I was astounded by the sheer level of depth. Especially the part where you could setup a physical real estate and sell stuff you gathered form the virtual world (I'm not sure if this existed in Everquest, just recall seeing bits of it in a magazine).
    - mabbo 9y ago
      The accusations against Verant Interactive/Sony Online were that the EverQuest was designed to make you get addicted, play endlessly- that they knew what the consequences of these design decisions were. An example: often bosses would spawn once every K hours- randomly. So you might have to wait a literal 24 hours in a row without ever seeing the boss you need to kill, and he has a 1 in X chance of dropping the item you actually wanted. There were no 'instance' dungeons- the whole server shared that one room with the boss, so maybe you go there to wait for the boss to spawn, and there's two other groups already waiting. There is a lot about it that was akin to a slot machine and those people who sit and put money into the machine over and over, all day. The same reward mechanism in the brain was being triggered. And from the perspective of players, that waiting, that fighting bosses, all of that was work that you put in to get the reward. And that feeling of putting in work and achieving something- even something that isn't real- that was the addiction when it felt like you couldn't ever get that in real life. Death in the game was a big deal too- you lost experience, lost maybe hours or days or work. You could lose a level! This triggered really complex fear-of-loss psychology, and for people already dealing with psychological issues (that's why they played EQ so much) there were always stories about the rage from dying. Just really unhealthy stuff all around. I don't personally think it was designed to do this to humans, no truly malicious intent, but it did mess with people.
singularity2001 9y ago
The underlying root cause often is loneliness. Many addictions are just symptoms of loneliness.
- hhmc 9y ago
  I'm unconvinced this is true for physiological addiction (e.g. opiates).
  - pantalaimon 9y ago
    You still need a reason to regularly take them in the first place, before the physical addiction kicks in.
    - hhmc 9y ago
      I still remain unconvinced that loneliness is the primary precursor for alcohol, opiates, etc.
      - H99189 9y ago
        I've heard from (a random Youtube video) that opiates mimic/activate some of the same brain circuits as pleasant socializing.
    - somenewacc 9y ago
      For opiates, the reason is often being prescribed them for pain.
- VoodooJuJu 9y ago
  There is some merit to this. The Rat Park experiment comes to mind: https://en.wikipedia.org/wiki/Rat_Park https://en.wikipedia.org/wiki/Rat_Park
  - laretluval 9y ago
    Lots of difficulties replicating Rat Park. https://www.ncbi.nlm.nih.gov/pubmed/9148292?dopt=Abstract https://www.ncbi.nlm.nih.gov/pubmed/9148292?dopt=Abstract
tjwii 9y ago
yep, and we have football disorder, coding disorder, watching television disorder, 40 hours a week job disorder, dying in poverty disorder, bla bla bla.
qwerty456127 9y ago
What about HN/Reddit/whatever F5-ing disorder? :-)
alangpierce 9y ago
I think that better acknowledgement of mental health conditions is generally a good thing. There's too much stigma around something being labeled as "mental health", when really I think everyone should view their own mental health as a work in progress, just like how physical health always has some room for improvement. For mild cases, I think it's fine to say that playing video games obsessively is potentially problematic (and in this case, I think "mental health" is the obvious category for that sort of problem), just like how not getting enough exercise can be problematic for physical health. When it gets bad enough to the point that people feel out of control of their lives, it absolutely deserves to be called a mental health problem, and it would be incredibly frustrating to seek professional help and hear "your problem isn't real", when it clearly is causing suffering. Acknowledging that you have a mental health problem and seeking professional help is already hard enough. Whether you use terms like "mental health disorder" or "mental illness" feels like just an issue of semantics, and my understanding is it's often more an indication of severity rather than being something fundamentally different. Just because you acknowledge a thing called "gaming disorder" doesn't mean it needs to be treated with medication or any kind of extensive treatment; you can still apply reason within any individual case about what the right course of action is. But if it's not even in the vocabulary, there's no reasonable way for the medical community to talk about it and understand it.
allcentury 9y ago
I think I would have met the qualifications for this as a 14 year old. My parents were going through a bad divorce and I spent all my time playing StarCraft to cope. I had all the signs of addiction, I stopped hanging out with friends, I stayed awake all night, ate poorly and gave up in school. More than once I recognized my issue and smashed the CD, even one time glued it to a piece of paper and put it on our bulletin board for my mom to see. Two weeks later I'd be back playing at 3am. I needed help but I don't think my parents knew what to do.
- EC1 9y ago
  My dad just took the computer and tossed it the moment I got a godawful report card. I cried for weeks. Doesn't change the fact that the next day I was physically forced to find something else to do just by virtue of not having it. Thanks to my Dad for having the strength to let me be angry at him for years before coming to the right conclusion myself.
- pwaai 9y ago
  > I spent all my time playing StarCraft to cope Stereotypes aside, a lot of Korean teenagers (for me, counter-strike and an early 2000 korean MMO called N-age ㅋㅋㅋ) went through this cycle. It was a form of escape, especially as a kid dealing with a stressful environment, I can see why some of us form a special bond with video games. Another contributing factor is if in that environment, the prospect of earning six digit salary as a pro gamer is very real with poor job prospects in a hyper competitive society. The industry is rife with health issues that is conveniently ignored and unfortunately "mental disorders" are still viewed with the stigma one would attach to institutionalized patients, although its improving thanks to organizations like WHO setting a standard.
Waterluvian 9y ago
Whether gaming addiction is a disease or just a symptom, we need to treat both the cause and the symptoms. I don't really care how we go about working the medical system to enable this.
pwaai 9y ago
I don't really care if it fits the definition of mental health disorder or not. What matters is that we recognize self harming addiction arising from digital toxins, optimized to release quick dopamine hits to the user, and help them rehabilitate. Similar to how some people believe depression is not a mental disorder because it's not "physical" and that they just need to think more "positive" like the non-depressed people, I think any sort of addiction, be it drugs or games needs to be addressed from a medical stand point of view.
goodroot 9y ago
Does anyone have any good books to recommend about gaming and mental health? Or, really, just gaming in general? Perhaps from a philosophical perspective?
xekc 9y ago
So, generally speaking, anything a large enough group of people would find themselves too passionately engaged in - can be considered at it's extremes as a disorder - from utilitarian, dominating "usefulness of the body" perspective? Ant world! Then extreme sports go next? "Base jumping addiction" (deadly!) or let's just go big and make "adrenaline junkie" a serious medical condition? Who in Sci-Fi got this right?
adrya407 9y ago
>The disorder is characterized by "impaired control" with increasing priority given to Oh please, then I assume every hobby in the world can be considered "hobby-name disorder". If it's something that help the millennium generation to relax and free their mind a few minutes /hours and if the society doesn't find something to come and reach the same level of satisfaction we found the "solution", it's a mental disorder... We really evolved... NOT

117 points by emacsgifs 9y ago

Before the sceptics get in: 1. The purpose of DSM/ICD is often to justify financing treatment: > Chris Ferguson, a professor of psychology at Stetson University ... described the ICD as "the book of real diseases that you can get insurance payments for." 2. Treatment has to be mindful of the specific form of addiction: > "These are co-morbid conditions," he said. "If you just treat the depression and not gaming, the gaming is likely to come back." This suggests it's a unique condition, he said. 3. No we are not "medicializing everything": > But Ferguson argued that, if it is a disorder, it seems to be very rare. NB. Before criticizing modern psychiatry keep in mind: 1. mental health patients are extreme in their dysfunction, never common. 2. the operation of the brain (, nervous system, etc.) in its interaction with its environment is as liable to breaking as any other part of the body 3. modern clinical psychiatry is an evidenced-based, research-driven field which treats and forms diagnoses on the basis of decades of research into any particular condition. It isnt the 1950s.

DanBC 9y ago
> Before criticizing modern psychiatry keep in mind: > 1. mental health patients are extreme in their dysfunction, never common. I agree with what you're saying, but the US does have a problem of over-testing, over-diagnosis, and over-treating illness. Not just mental ill health, but everything. In the US about 10% of children have ADHD https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3489818/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3489818/ > Based on the Heath Resources and Services Administration's National Survey of Children's Health, the percentage of children aged 4–17 years diagnosed with ADHD increased from 7.8% in 2003 to 9.5% in 2007, representing a 21.8% increase in just 4 years (Centers for Disease Control and Prevention 2010). An estimates 3million US children take stimulant medication: > Experts estimate that approximately 60% of children with ADHD are treated with prescription stimulants (Center for Disease Control and Prevention 2005a); therefore, approximately three million children in this country take stimulants for problems with focusing. At the same time, many studies have revealed the numerous adverse effects associated with prescription stimulants when they are used inappropriately. These numbers are a bit worrying, especially if medication alone is being used, and it's not provided as a package of bio-psycho-social treatment.
- mjburgess 9y ago
  Ahh, sigh. I was writing with ADHD in mind actually. Up to 10% children really do have ADHD which is a delay in the development of the frontal lobe. Such a delay seems "somewhat common" amongst humans. More than half catch up, leaving upto 5% of adults with some form of ADHD. ADHD is serious. It is a severe impairment to planning, self-management, emotional regulation, etc. You are likely to be impoverished without substantial resources to rely on (family, etc.). > are a bit worrying > it's not provided as a package of bio-psycho-social treatment. ADHD researchers (serious neuroscientists & clinical psychiatrists) have for DECADES tried "biosocial blah blah". It has failed. ADHD is not a failure of child training (ie., parents "Raising Their Child Right!!!"). Overwhelmingly the effective treatment for ADHD is pharmocological. At this point comments like yours, along with the media hysteria, are doing real harm to children actually getting treatment. The problem we have with ADHD is significant under treatment and under diagnosis. It turns out all those "useless" people joked about in human history have not just been failures of character: in need of "social" intervention. They have had a physical impairment, a delay in their brain's development. Not Fixable by a good beating, or whatever the touchy-feely equivalent is. The suggestion that a child with a broken leg not receive crutches would be absolutely outrageous. Or a person with cancer not receive a daily pill treatment. The very same outrage should be felt here in the suggestion that people with ADHD not receive medication vital to their ability to even pay attention to their lessons (goals, etc.). Vital to their ability to socailize (ie., control their frustation in ways that doesnt alientate other children). And therefore vital to their future success. Yes there does need to be a fundamental reorganization to western education systems to, from the ground up, be aware of how wide-spread developmental issues are -- and to build in fundamental support structures. However this isnt a "treatment" for ADHD. There is no cure. This is just bracing the crutches. Overwelmingly the research over the last 30 years has shown the only significant impact on ADHD is pharmocological.
  - xena 9y ago
    Honestly I think about half the problem is that psychiatric illnesses don't make people bleed, so there's no way to universally tell something is wrong.
algesten 9y ago
> 3. modern clinical psychiatry is an evidenced-based, research-driven field which treats and forms diagnoses on the basis of decades of research into any particular condition. It isnt the 1950s. But isn't modern clinical psychiatry marred by the same problems social or economic sciences are? Ultimately you are studying/interpreting human behaviour, which doesn't lend itself well to quantisation or categorising.
- mjburgess 9y ago
  The most reasonable thing to think about any mental health disorder is whatever the consensus in clinical psychiatry is. That is the point. It is so overwhelmingly well-researched, that even if its conclusions are wrong, no lay person is going to be in a position to have "an argument" that hasn't already been considered and researched and folded into the consensus. This isnt the case with social sciences, and it isnt the case with macroeconomic policy. Both of these are about groups of humans, not individual humans, and are fundamentally about behaviour in the face of cultural/economic/social changes. That kind of analysis is purely speculative and historically accidental in the way that giving people adderall and measuring their cognitive performance isn't. A man on the street may well have good reasons to speculate differently about the evolution of his society that those speculations produced in some university in a foreign country. A man on the street can have no good reason to act against the consensus of research-based medicine. To do so is to fly blindly into an area of profound research depth and consideration. We have a problem today of these domains being equivocated. About people believing they are experts because the "Experts" they see are really political speculators and commentators of macro-cultural changes. And so everyone thinks everything is speculation. This is profoundly not the case for, let's say, what the best treatment plan for bipolar disorder, adhd, autism, clincial depression, psychosis, etc. etc. etc. is. ...which has folded in lifetimes of research on the way the brain works, the way that drugs work, CBT, social therapies, counselling, etc. etc. etc. ... An opinion on what "should be done" about a family member with bipolar disorder may as well be an opinion about what should be done about their thyroid problem, carpal fracture, lymphoma, etc.
  - xapata 9y ago
    Sounds like you're not familiar with sociology nor macroeconomics literature.
StanislavPetrov 9y ago
>3. modern clinical psychiatry is an evidenced-based, research-driven field which treats and forms diagnoses on the basis of decades of research into any particular condition. It isnt the 1950s. Your post was okay until your last point. While it isn't the 1950s, its absurd to contend that "modern clinical psychiatry" isn't massively subjective in terms of both treatment and diagnosis. The fact is that the vast majority of psychiatrists reflexively shovel pills at those perceived to be afflicted with poorly-understood mental disorders. In reality, we are only beginning to scratch the surface when it comes to understanding how the brain works, let alone the human psyche. One of the most egregious illustrations of this fact are the over 1 million children under the age of 5 taking psychiatric drugs. We still don't know the long term outcomes of our tinkering with the developing brains of infants and small children, and its hubris (or worse) to pretend that we do. https://www.cchrint.org/psychiatric-drugs/children-on-psychiatric-drugs/ https://www.cchrint.org/psychiatric-drugs/children-on-psychi...
- rendaw 9y ago
  On the subject, I remember reading recently that most psychology studies are observational, and when attempts to duplicate the findings are made they mostly can't. I realize that GP's statement is qualified with 'clinical', and decisions based on observational studies are probably better than just making things up, but how much have we actually progressed?
numismatex 9y ago
Let's take a history of the DSM using trivia here: 1) By context it states still that drugs like LSD and MDMA will lead to psychosis. 2) It directly stated that Marijuana causes psychosis up until some years back (less than a decade). 3) Psychosis NOS (None Otherwise Specified) is used to categorize undesirables when nothing else fits. 4) People were still being forcibly sterilized in California up until less than a decade ago. 5) Modern clinical psychiatry is checklist-based, not evidence-based. If it were evidence-based they'd be basing it on bloodwork and MRI. 6) Recent findings regarding genetics, as well as astrocyte-damage being responsible for schizophrenia trump Freudian-based lunacy. 7) Psychiatric abuse has been common for over 100 years. If you're homosexual, anti-establishment, communist, atheist, Wiccan and more, you've likely been a victim of bias and discrimination. The cold-water baths and ECT to treat such terrible conditions as not being "like everyone else" are true. 8) It's delusional to think that the DSM represents fact -- for instance, the APA has stated that any group of people, large enough, holding a belief, is a religion and thus a protected class -- yet Wiccans, Rastafari and alternative religions are still persecuted like addicts and cults. As someone who survived the psychiatric establishments in Texas, finally meeting a doctor who started at square one, asking me questions, and rediagnosing me to PTSD and a victim of abuse from the slew of ever-changing diagnoses that my parents lied to the doctors to achieve, I think it's all barbarism, plain and simple. Times are changing, but mental institutions and Big Pharma pushing pills hasn't. Actual therapeutics and investigation are nonexistent. People don't ask the patients and instead rely on testimony from others. Full workups aren't done. Inspection for head trauma, meningitis and more isn't done. And you can pick this apart, and say that "hey those are just isolated possible situations" but the reality is, just like the prison systems, psychiatry is 100% flawed and biased. For fucks sake, my first doctor around year 2000 had been trained in fucking Russia in the fucking 1950s. You want psychiatry to be true? Give it 20 years for the tech to catch up and doctors to adopt it, then give it to AI to manage rather than flawed, biased humans with motives that aren't in line with the best treatment for a patient.

raziel2p 9y ago

I hope this doesn't get abused. Also, maybe a social media disorder is next on the list?

ak39 9y ago
Without a doubt. This should have been a far more serious consideration than gaming addiction.
- deleted 9y ago
  [deleted]
- DaveSapien 9y ago
  I wish I could upvote this more. Compulsion addiction and those companys (FaceBook,Twitter,EA,King, ect) that promote and profit from it are a dangerous threat to society. And obviously destructive to the individuals they target.
  - pwaai 9y ago
    Let's regulate ads that show unrealistic body images of people about men and women. They already done so in France.

deleted 9y ago

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mfukar 9y ago

This isn't going to be misused at all.

75dvtwin 9y ago

my personal reaction is 2 fold WRT >In one study, he found that when kids stopped being addicted to games, their depression and anxiety got better. ( 1 ) Is this study repeatable? (or does it suffer the fate of many (75%) psychology experiments that cannot be replicated [1] ( 2 ) Instagram, Facebook , -- would those, potentially, addiction-fueled activities, ever become subject to the WHO recommendation ? [ 1 ] https://www.theguardian.com/science/2015/aug/27/study-delivers-bleak-verdict-on-validity-of-psychology-experiment-results https://www.theguardian.com/science/2015/aug/27/study-delive...

amelius 9y ago
The replication claim has never been replicated either.
- zerostar07 9y ago
  they have. repeatability problems have been found in various domains , including medicine and psychology which is of concern here

retox 9y ago

https://www.nytimes.com/2016/07/27/health/who-transgender-medical-disorder.html https://www.nytimes.com/2016/07/27/health/who-transgender-me...

nukeop 9y ago
This is basically a subset of body integrity identity disorder, a mental illness that creates a strong desire to alter the body surgically, often by removing body parts.
- pwaai 9y ago
  It is not a mental illness for somebody to feel discomfort from living in a body that's not congruent with their gender identity which lies in their head, not genitals.
  - nukeop 9y ago
    And yet it is a mental disorder to feel that you should have a different body in non-sexual regard. The treatment of that disorder is also not to proceed with the desired surgical alterations.
ashleyn 9y ago
A man isn't disordered simply for wanting the same things an ordinary woman would want.

nukeop 9y ago

WHO recognizing things as diseases or not diseases is becoming largely politicized. They have already removed many obvious mental disorders from their lists due to political pressures and now they're starting to add some bizarre entries. I wouldn't be surprised if they add "investing in cryptocurrencies" or "thinking Russia is an ok place" next, considering current trendy topics.

RobertoG 9y ago
It's certainly a slippery slope. I suppose it's not a so big problem if "healing" is optional. Political dissidence has been categorize as an illness in the past. In the Soviet Union, for instance. The same with sexual preferences. In the science fiction novel "Distress", by Greg Egan, appears a character that it's a highly functioning autistic that don't want to be "healed". I have the book here. This idea has been with me since I read it: "What's the most patronising thing you can offer to do for people you disagree with, or don't understand? [..] Heal them. [..] Whoever claims the authority to define the boundary between health and disease claims...everything."
nerdponx 9y ago
This is thoroughly unempathetic. Video game addiction is absolutely real, and the WHO is well behind the curve on this, as other posters have already pointed out.
pwaai 9y ago
No, WHO has done an excellent job of recognizing the exact things which you invalidate. Please give evidence and examples to support your claim that they are politicizing by attempting to alleviate and bring more attention to previously neglected demographics. https://news.ycombinator.com/item?id=16035450 https://news.ycombinator.com/item?id=16035450 From your other comment in this thread, it is clear that you are not well educated on this subject to speak with such authority. Calling somebody who feels their gender identity doesn't match their body as mentally ill is offensive and inaccurate, how can someone who is born in the wrong body be at fault? Organizations like WHO are doing a great job.
- 9y ago

saas_co_de 9y ago

Video games are obviously addictive. The way you make money off of games is to make them addictive. There is a direct feedback loop between more addictive games and more profits and so the addictiveness of games can be research, refined, and optimized over time. The WHO is way behind the curve here. If society treated video games the same as alcohol and drugs they would already be banned for minors. Eventually they probably will be.

drdaeman 9y ago
<sarcasm>We should also ban other dangerously addictive activities, such as fiction books, non-video games, sports, DIY hobbies (e.g. electrical engineering, painting or storywriting), pets, hanging out with other people and lots of other things.</sacrasm> I'm no expert on the matter, but I think you're completely missing the point. The keyword here is "gaming addiction" not "video games". Please, for the love of all the sanity that's still left out there, don't mistake one with another. There is a lot of things that one suffering from behavioral disorders could get addicted to. Unlike substance addictions (which are complicated matter), games (or overindulging in escapist fiction or having dozens of pets) are more of a symptom than an underlying cause. If you'd try to ban just about everything that one could get hooked onto, it won't help the person a little bit with their impulse control. It would just make their and everyone else's lives dull and boring, probably leading to much more unhealthy situations (just my guess, though).
- SOLARSYSTEM 9y ago
  > We should also ban other dangerously addictive activities, such as fiction books, non-video games, sports, DIY hobbies These can be addicting too, but certain video games can be on an entirely different level, ie. they fulfill many more psychological needs.
  - drdaeman 9y ago
    I really believe this is really a matter of taste. Don't think there something special about video games - surely they're a very common retreat but by no means an special one. There are people who are addicted to other activities just as bad as some are hooked on games. And even for games - what some would find highly addictive, others would find boring or even disgusting. So I really think there is nothing wrong with video games on their own - the problem is in the heads and games are just what frequently happens to be there. What triggered my comment is a ban proposal for an extremely wide group, where a significant fraction doesn't have any particular issue with the subject at hand. Even if I'm unaffected by this particular proposal (I'm way past my teen years) I still find such ideas somewhat offensive. I may be naive or stupid but I don't fancy the very thought of someone being deprived of something fairly harmless to them just because others have issues.

mabbo 9y ago

I don't know whether what I had (have?) meets this WHO definition, but I can tell you that at points in my life, I've had an unhealthy relationship with video games. For me, and maybe others as well, it's about having control over something and feeling a sense of accomplishment, feeling like I'm achieving something. Video games give you that. For a small cost ($20-$50), you can have pure escapism from reality, think about things other than your shitty life and depression and instead feel yourself accomplish goals, achieve success, win. Unlike drugs or alcohol, it doesn't end- you can just keep coming back without paying anything. There's no chemical hangover, no blood test for it, no social stigma like drugs have. It's perfect. My underlying problems have been dealt with now, but I still have to limit how long I play games for. The high is still there and I recognize it well. I just don't need it like I once did. Looking back at my high school days, I had a good friend who was into drugs. I got him into EverQuest. I wish he'd gotten me into drugs instead- there are well understood paths out of drug addiction. And that game messed the both of us up.

poisonarena 9y ago
I did both drugs and Everquest in highschool and I have to say I would rather walk through the Qeynos Hills than the other option.
- pwaai 9y ago
  There have been some publicized cases about Everquest... https://www.cbsnews.com/news/addicted-suicide-over-everquest/ https://www.cbsnews.com/news/addicted-suicide-over-everquest... I remember seeing the Everquest demo trailer video in an Electronic Boutique store and reading about it in PC magazine, I was astounded by the sheer level of depth. Especially the part where you could setup a physical real estate and sell stuff you gathered form the virtual world (I'm not sure if this existed in Everquest, just recall seeing bits of it in a magazine).
  - mabbo 9y ago
    The accusations against Verant Interactive/Sony Online were that the EverQuest was designed to make you get addicted, play endlessly- that they knew what the consequences of these design decisions were. An example: often bosses would spawn once every K hours- randomly. So you might have to wait a literal 24 hours in a row without ever seeing the boss you need to kill, and he has a 1 in X chance of dropping the item you actually wanted. There were no 'instance' dungeons- the whole server shared that one room with the boss, so maybe you go there to wait for the boss to spawn, and there's two other groups already waiting. There is a lot about it that was akin to a slot machine and those people who sit and put money into the machine over and over, all day. The same reward mechanism in the brain was being triggered. And from the perspective of players, that waiting, that fighting bosses, all of that was work that you put in to get the reward. And that feeling of putting in work and achieving something- even something that isn't real- that was the addiction when it felt like you couldn't ever get that in real life. Death in the game was a big deal too- you lost experience, lost maybe hours or days or work. You could lose a level! This triggered really complex fear-of-loss psychology, and for people already dealing with psychological issues (that's why they played EQ so much) there were always stories about the rage from dying. Just really unhealthy stuff all around. I don't personally think it was designed to do this to humans, no truly malicious intent, but it did mess with people.

singularity2001 9y ago

The underlying root cause often is loneliness. Many addictions are just symptoms of loneliness.

hhmc 9y ago
I'm unconvinced this is true for physiological addiction (e.g. opiates).
- pantalaimon 9y ago
  You still need a reason to regularly take them in the first place, before the physical addiction kicks in.
  - hhmc 9y ago
    I still remain unconvinced that loneliness is the primary precursor for alcohol, opiates, etc.
    - H99189 9y ago
      I've heard from (a random Youtube video) that opiates mimic/activate some of the same brain circuits as pleasant socializing.
  - somenewacc 9y ago
    For opiates, the reason is often being prescribed them for pain.
VoodooJuJu 9y ago
There is some merit to this. The Rat Park experiment comes to mind: https://en.wikipedia.org/wiki/Rat_Park https://en.wikipedia.org/wiki/Rat_Park
- laretluval 9y ago
  Lots of difficulties replicating Rat Park. https://www.ncbi.nlm.nih.gov/pubmed/9148292?dopt=Abstract https://www.ncbi.nlm.nih.gov/pubmed/9148292?dopt=Abstract

tjwii 9y ago

yep, and we have football disorder, coding disorder, watching television disorder, 40 hours a week job disorder, dying in poverty disorder, bla bla bla.

qwerty456127 9y ago

What about HN/Reddit/whatever F5-ing disorder? :-)

alangpierce 9y ago

I think that better acknowledgement of mental health conditions is generally a good thing. There's too much stigma around something being labeled as "mental health", when really I think everyone should view their own mental health as a work in progress, just like how physical health always has some room for improvement. For mild cases, I think it's fine to say that playing video games obsessively is potentially problematic (and in this case, I think "mental health" is the obvious category for that sort of problem), just like how not getting enough exercise can be problematic for physical health. When it gets bad enough to the point that people feel out of control of their lives, it absolutely deserves to be called a mental health problem, and it would be incredibly frustrating to seek professional help and hear "your problem isn't real", when it clearly is causing suffering. Acknowledging that you have a mental health problem and seeking professional help is already hard enough. Whether you use terms like "mental health disorder" or "mental illness" feels like just an issue of semantics, and my understanding is it's often more an indication of severity rather than being something fundamentally different. Just because you acknowledge a thing called "gaming disorder" doesn't mean it needs to be treated with medication or any kind of extensive treatment; you can still apply reason within any individual case about what the right course of action is. But if it's not even in the vocabulary, there's no reasonable way for the medical community to talk about it and understand it.

allcentury 9y ago

I think I would have met the qualifications for this as a 14 year old. My parents were going through a bad divorce and I spent all my time playing StarCraft to cope. I had all the signs of addiction, I stopped hanging out with friends, I stayed awake all night, ate poorly and gave up in school. More than once I recognized my issue and smashed the CD, even one time glued it to a piece of paper and put it on our bulletin board for my mom to see. Two weeks later I'd be back playing at 3am. I needed help but I don't think my parents knew what to do.

EC1 9y ago
My dad just took the computer and tossed it the moment I got a godawful report card. I cried for weeks. Doesn't change the fact that the next day I was physically forced to find something else to do just by virtue of not having it. Thanks to my Dad for having the strength to let me be angry at him for years before coming to the right conclusion myself.
pwaai 9y ago
> I spent all my time playing StarCraft to cope Stereotypes aside, a lot of Korean teenagers (for me, counter-strike and an early 2000 korean MMO called N-age ㅋㅋㅋ) went through this cycle. It was a form of escape, especially as a kid dealing with a stressful environment, I can see why some of us form a special bond with video games. Another contributing factor is if in that environment, the prospect of earning six digit salary as a pro gamer is very real with poor job prospects in a hyper competitive society. The industry is rife with health issues that is conveniently ignored and unfortunately "mental disorders" are still viewed with the stigma one would attach to institutionalized patients, although its improving thanks to organizations like WHO setting a standard.

Waterluvian 9y ago

Whether gaming addiction is a disease or just a symptom, we need to treat both the cause and the symptoms. I don't really care how we go about working the medical system to enable this.

pwaai 9y ago

I don't really care if it fits the definition of mental health disorder or not. What matters is that we recognize self harming addiction arising from digital toxins, optimized to release quick dopamine hits to the user, and help them rehabilitate. Similar to how some people believe depression is not a mental disorder because it's not "physical" and that they just need to think more "positive" like the non-depressed people, I think any sort of addiction, be it drugs or games needs to be addressed from a medical stand point of view.

goodroot 9y ago

Does anyone have any good books to recommend about gaming and mental health? Or, really, just gaming in general? Perhaps from a philosophical perspective?

xekc 9y ago

So, generally speaking, anything a large enough group of people would find themselves too passionately engaged in - can be considered at it's extremes as a disorder - from utilitarian, dominating "usefulness of the body" perspective? Ant world! Then extreme sports go next? "Base jumping addiction" (deadly!) or let's just go big and make "adrenaline junkie" a serious medical condition? Who in Sci-Fi got this right?

adrya407 9y ago

>The disorder is characterized by "impaired control" with increasing priority given to Oh please, then I assume every hobby in the world can be considered "hobby-name disorder". If it's something that help the millennium generation to relax and free their mind a few minutes /hours and if the society doesn't find something to come and reach the same level of satisfaction we found the "solution", it's a mental disorder... We really evolved... NOT