Gaming Disorder, Internet

Gaming Disorder, Internet is a topic covered in the 5-Minute Clinical Consult.

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Basics

Description

  • Internet gaming disorder (IGD) is where the “gamers” play compulsively, to the exclusion of other interests resulting in clinically significant impairment or distress.
  • For gaming disorder to be diagnosed, the behavior pattern must be of sufficient severity and would be evident for at least 12 months.
  • IGD is identified in section III of DSM-5 as a condition warranting more clinical research and experience before it might be considered for inclusion in the main book as a formal disorder.
  • On June 18, 2018, WHO recognized gaming disorder as a mental health condition.
  • Gaming disorder (digital or video) is included in ICD-11.

Epidemiology

Incidence
  • Predominant age—adolescence
  • Predominant sex—male

Prevalence
  • Median prevalence of 2.0%
  • Prevalence rates are highest in Eastern Asian countries and male adolescents aged 12 to 20 years (1).

Etiology and Pathophysiology

  • On the molecular level, Internet addiction is characterized by an overall reward deficiency that entails decreased dopaminergic activity (2).
  • On the level of neural circuitry, Internet and gaming addiction lead to neuroadaptation and structural changes that occur as a consequence of prolonged increased activity in brain areas associated with addiction (2).
  • On a behavioral level, Internet and gaming addicts appear to be constricted with regards to their cognitive functioning in various domains (2).
  • IGD shares multiple features with drug addictions, including elevated impulsivity, cognitive inflexibility, and attentional biases.

Risk Factors

The following risk factors were found to be significantly associated with IGD (3):

  • Functional and dysfunctional impulsivity
  • Belief self-control
  • Anxiety
  • Pursuit of desired appetitive goals
  • Money spent on gaming
  • Weekday game time
  • Offline community meeting attendance
  • Game community membership
  • Gaming motives play a role as well.
  • Gamers with psychiatric distress use it a coping strategy to improve their mood and/or attain emotional stability.
  • Achievement-related motives may be related to the lack of real-life achievements that are compensated by virtual victories and successes.

Commonly Associated Conditions

  • Anxiety disorder
  • Mood disorder
  • Autism spectrum disorder
  • Attention deficit hyperactivity disorder
  • Personality disorder
  • Behavioral disorder

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