Internet Gaming Disorder and the DSM-5: Conceptualization, Debates, and Controversies

Current Addiction Reports

Volumn 2, Issue 3, 2015, Pages 254-262

  Király, Orsolya ^a   Griffiths, Mark D ^b   Demetrovics, Zsolt ^a  

^a EÖTVÖS LORÁND UNIVERSITY   (Hungary)

^b NOTTINGHAM TRENT UNIVERSITY   (United Kingdom)

Author keywords

Assessment; Behavioral addiction; Controversies; Debates; DSM 5; Etiology; Gaming addiction; Internet gaming disorder; Online gaming; Prevalence; Treatment

Indexed keywords

EID: 84951827937     PISSN: None     EISSN: 21962952     Source Type: Journal    
DOI: 10.1007/s40429-015-0066-7     Document Type: Review

References (91)

1. Entertainment Software Association. Facts about the computer and video game industry. 2014. http://www.theesa.com/wp-content/uploads/2014/10/ESA_EF_2014.pdf. Accessed 31 Jan 2015.
2. International Telecommunication Union. The world in 2014. ICT facts and figures. Geneva, Switzerland. 2014. http://www.itu.int/en/ITU-D/Statistics/Documents/facts/ICTFactsFigures2014-e.pdf. Accessed 31 Jan 2015.
3. Wallace P. The psychology of the Internet. Cambridge: University Press; 2001.
4. Keepers GA. Pathological preoccupation with video games. J Am Acad Child Adolesc Psychiatry. 1990;29:49–50.
5. Griffiths MD. Internet addiction: an issue for clinical psychology? Clin Psychol Forum. 1996;97:32–6.
6. Young KS. Psychology of computer use: XL. Addictive use of the Internet: a case that breaks the stereotype. Psychol Rep. 1996;79:899–902.
7. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders—Text Revision. 5th ed. DC: American Psychiatric Association; 2013.
8. Rehbein F, Kleimann M, Mößle T. Prevalence and risk factors of video game dependency in adolescence: results of a German nationwide survey. Cyberpsychol Behav Soc Netw. 2010;13:269–77.
9. van Rooij AJ, Schoenmakers TM, van de Eijnden RJ, van de Mheen D. Compulsive internet use: the role of online gaming and other internet applications. J Adolesc Health. 2010;47:51–7.
10. Király O, Nagygyörgy K, Griffiths MD, Demetrovics Z. Problematic online gaming. In: Rosenberg K, Feder L, editors. Behavioral addictions: criteria, evidence and treatment. New York: Elsevier; 2014. p. 61–95.
11. Demetrovics Z, Griffiths MD. Behavioral addictions: past, present and future. J Behav Addict. 2012;1:1–2.
12. Petry NM, Rehbein F, Gentile DA, Lemmens JS, Rumpf HJ, Mossle T, et al. An international consensus for assessing internet gaming disorder using the new DSM-5 approach. Addiction. 2014;109:1399–406. doi:10.1111/add.12457.
13. Blaszczynski A. Internet use: in search of an addiction. Int J Ment Heal Addict. 2006;4:7–9.
14. Shaffer HJ, Hall MN, Vander BJ. "Computer addiction": a critical consideration. Am J Orthopsychiatry. 2000;70:162–8.
15. Wood RTA. The problem with the concept of video game “addiction”: some case examples. Int J Ment Heal Addict. 2008;6:169–78.
16. Griffiths MD, King DL, Demetrovics Z. DSM-5 internet gaming disorder needs a unified approach to assessment. Neuropsychiatry. 2014;4:1–4.
17. Starcevic V. Is Internet addiction a useful concept? Aust N Z J Psychiatry. 2013;47:16–9.
18. Pies R. Should DSM-V designate “Internet addiction” a mental disorder? Psychiatry (Edgmont). 2009;6:31.
19. Heller A. Short Takes. In: Boston Globe. 2008. http://www.boston.com/ae/books/articles/2008/11/02/short_takes_boston_globe/. Accessed 31 Jan 2015.
20. Van Rooij AJ, Prause N. A critical review of “Internet addiction” criteria with suggestions for the future. J Behav Addict. 2014;3:203–13.
21. Dowling NA. Issues raised by the DSM‐5 internet gaming disorder classification and proposed diagnostic criteria. Addiction. 2014;109:1408–9.
22. King DL, Delfabbro PH. The cognitive psychology of Internet gaming disorder. Clin Psychol Rev. 2014;34:298–308.
23. Blum K, Cull JG, Braverman ER, Comings DE. Reward deficiency syndrome. Am Sci. 1996;84:132–45.
24. Kardefelt-Winther D. A conceptual and methodological critique of internet addiction research: towards a model of compensatory internet use. Comput Hum Behav. 2014;31:351–4.
25. Tao R, Huang XQ, Wang J, Zhang H, Zhang Y, Li M. Proposed diagnostic criteria for internet addiction. Addiction. 2010;105:556–64.
26. Beard KW, Wolf EM. Modification in the proposed diagnostic criteria for Internet addiction. Cyberpsychol Behav. 2001;4:377–83.
27. Griffiths MD. Nicotine, tobacco and addiction. Nature. 1996;384:18.
28. Hollander E, Stein DJ. Clinical manual of impulse-control disorders. Arlington: American Psychiatric Publishing; 2006.
29. Ko CH, Yen JY, Chen CC, Chen SH, Yen CF. Proposed diagnostic criteria of Internet addiction for adolescents. J Nerv Ment Dis. 2005;193:728–33.
30. Shapira NA, Goldsmith TD, Keck Jr PE, Khosla UM, McElroy SL. Psychiatric features of individuals with problematic internet use. J Affect Disord. 2000;57:267–72.
31. Young KS. Caught in the net: how to recognize the signs of internet addiction and a winning strategy for recovery. New York: Wiley; 1998.
32. Young KS. Internet addiction: the emergence of a new clinical disorder. Cyberpsychol Behav. 1998;1:237–44.
33. Kardefelt-Winther D. Meeting the unique challenges of assessing internet gaming disorder. Addiction. 2014;109:1568–70.
34. Ko CH. Internet gaming disorder. Curr Addict Rep. 2014;1:177–85.
35. King DL, Haagsma MC, Delfabbro PH, Gradisar M, Griffiths MD. Toward a consensus definition of pathological video-gaming: a systematic review of psychometric assessment tools. Clin Psychol Rev. 2013;33:331–42. The paper reviews all the IGD measurement instruments developed since 2000, identifying the common points and shedding light on all the inconsistencies. Provides a very good overview of the assessment of IGD.
36. American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 4th ed. Washington: Author; 1994.
37. Ko CH, Yen JY, Chen SH, Wang PW, Chen CC, Yen CF. Evaluation of the diagnostic criteria of Internet gaming disorder in the DSM-5 among young adults in Taiwan. J Psychiatr Res. 2014;53:103–10. The paper aims to clinically validate the nine IGD criteria proposed in DSM-5 and the criteria of craving and irritability. Study participants and control participants underwent a diagnostic interview and completed standardized questionnaires. The findings suggest that ‘deceiving’, ‘escape’, and ‘craving’ have the lowest diagnostic accuracy and the proposed cut-off point of IGD criteria in the DSM-5 (i.e., fulfilling 5 or more criteria) is the best cut-off point for diagnosis of IGD.
38. King DL, Delfabbro PH. Video-gaming disorder and the DSM-5: some further thoughts. Aust N Z J Psychiatry. 2013;47:875–6.
39. Lemmens JS, Valkenburg PM, Gentile DA. The internet gaming disorder scale. Psychol Assess. 2015. doi:10.1037/pas0000062. The authors tested four different instruments measuring IGD (as proposed in DSM-5): two polytomous scales (a 27-item and a 9-item version) and two dichotomous scales (also a 27-item and a 9-item version). Of all four instruments, the 9-item dichotomous scale appeared to be the most practical scale for diagnostic purposes. ‘Escape’ criterion showed the lowest diagnostic accuracy in this particular study.
40. Griffiths MD, Pontes H. Internet addiction disorder and internet gaming disorder are not the same. J Addict Res Ther. 2014;5:e124.
41. Király O, Griffiths MD, Urbán R, Farkas J, Kökönyei G, Elekes Z, et al. Problematic internet use and problematic online gaming are not the same: findings from a large nationally representative adolescent sample. Cyberpsychol Behav Soc Netw. 2014;17:749–54. The paper examines the interrelationship and the overlap between Internet addiction disorder (IAD) and Internet gaming disorder (IGD) in a nationally representative sample of adolescent gamers. Based on the differences in terms of gender and preferred online activities IGD appears to be a conceptually different behavior than IAD.
42. Montag C, Bey K, Sha P, Li M, Chen YF, Liu WY et al. Is it meaningful to distinguish between generalized and specific Internet addiction? Evidence from a cross‐cultural study from Germany, Sweden, Taiwan and China. Asia‐Pacific Psychiatry. 2014
43. Rehbein F, Mößle T. Video game and internet addiction: is there a need for differentiation? Sucht. 2013;59:129–42. The paper suggests that Internet addiction disorder (IAD) and Internet gaming disorder (IGD) can be regarded as two distinct nosological entities. This differentiation is supported by differences in sociodemographic variables (i.e., gender, age) and types of online activities the adolescents engage in (i.e., playing video games, using social networking sites). The findings also suggest that subjective suffering seems to be higher among adolescents with IGD than among adolescents with IAD.
44. Huang XQ, Zhang CH, Li M, Wang J, Zhang Y, Tao R. Mental health, personality, and parental rearing styles of adolescents with Internet addiction disorder. Cyberpsychol Behav Soc Netw. 2010;13:401–6.
45. Király O, Nagygyörgy K, Koronczai B, Griffiths MD, Demetrovics Z. Assessment of problematic internet use and online video gaming. In: Aboujaoude E, Starcevic V, editors. Mental health in the digital age: grave dangers, great promise. Oxford: Oxford University Press; 2015. in press.
46. King DL, Delfabbro PH. Issues for DSM-5: video-gaming disorder. Aust N Z J Psychiatry. 2013;47:20–2.
47. Starcevic V. Video-gaming disorder and behavioural addictions. Aust N Z J Psychiatry. 2013;47:285–6.
48. Brenner V. Psychology of computer use: XLVII. Parameters of internet use, abuse and addiction: the first 90 days of the internet usage survey. Psychol Rep. 1997;80:879–82.
49. Laconi S, Rodgers RF, Chabrol H. The measurement of internet addiction: a critical review of existing scales and their psychometric properties. Comput Hum Behav. 2014;41:190–202.
50. Lemmens JS, Valkenburg PM, Peter J. Development and validation of a game addiction scale for adolescents. Media Psychology. 2009;12:77–95.
51. van Rooij AJ, Schoenmakers TM, van den Eijnden RJ, Vermulst AA, van der Mheen D. Video game addiction test (VAT): validity and psychometric characteristics. Cyberpsychol Behav Soc Netw. 2012;15:507–11.
52. Kim MG, Kim J. Cross-validation of reliability, convergent and discriminant validity for the problematic online game use scale. Comput Hum Behav. 2010;26:389–98.
53. Demetrovics Z, Urbán R, Nagygyörgy K, Farkas J, Griffiths MD, Pápay O, et al. The development of the Problematic Online Gaming Questionnaire (POGQ). PLoS ONE. 2012;7:e36417.
54. Pápay O, Urbán R, Griffiths MD, Nagygyörgy K, Farkas J, Elekes Z, et al. Psychometric properties of the Problematic Online Gaming Questionnaire Short-Form (POGQ-SF) and prevalence of problematic online gaming in a national sample of adolescents. Cyberpsychol Behav Soc Netw. 2013;16:340–8.
55. Pontes HM, Király O, Demetrovics Z, Griffiths MD. The conceptualisation and measurement of DSM-5 Internet gaming disorder: the development of the IGD-20 test. PLoS ONE. 2014;9:e110137. The paper presents the rigorous psychometric development of a 20-item scale measuring IGD (called IGD-20 Test) reflecting the nine IGD criteria included in DSM-5 incorporated in the theoretical framework of the components model of addiction (i.e., salience, mood modification, tolerance, withdrawal, conflict, and relapse).
56. Griffiths MD. A ‘components’ model of addiction within a biopsychosocial framework. J Subst Abus. 2005;10:191–7.
57. Pontes HM, Griffiths MD. Measuring DSM-5 internet gaming disorder: development and validation of a short psychometric scale. Comput Hum Behav. 2015;45:137–43.
58. Rehbein F, Kliem S, Baier D, Mößle T, Petry NM. Prevalence of Internet Gaming Disorder in German adolescents: diagnostic contribution of the nine DSM‐5 criteria in a statewide representative sample. Addiction. 2015. doi:10.1111/add.12849. The study aims to estimate the prevalence rates of IGD based on DSM-5 IGD criteria and to assess how the specific criteria contribute to diagnosis. The prevalence rate of IGD in the nationally representative sample of German adolescents was 1.16%. Conditional inference trees showed that the criteria ‘give up other activities’, ‘tolerance’ and ‘withdrawal’ were most relevant for IGD diagnosis in this age group.
59. Mentzoni RA, Brunborg GS, Molde H, Myrseth H, Skouveroe KJ, Hetland J, et al. Problematic video game use: estimated prevalence and associations with mental and physical health. Cyberpsychol Behav Soc Netw. 2011;14:591–6.
60. Brunborg GS, Mentzoni RA, Melkevik OR, Torsheim T, Samdal O, Hetland J, et al. Gaming addiction, gaming engagement, and psychological health complaints among Norwegian adolescents. Media Psychology. 2013;16:115–28.
61. Haagsma MC, Pieterse ME, Peters O. The prevalence of problematic video gamers in the Netherlands. Cyberpsychol Behav Soc Netw. 2012;15:162–8.
62. van Rooij AJ, Schoenmakers TM, Vermulst AA, van den Eijnden RJ, van de Mheen D. Online video game addiction: identification of addicted adolescent gamers. Addiction. 2011;106:205–12.
63. Gentile DA. Pathological video-game use among youth ages 8 to 18: a national study. Psychol Sci. 2009;20:594–602.
64. Gentile DA, Choo H, Liau A, Sim T, Li DD, Fung D, et al. Pathological video game use among youths: a two-year longitudinal study. Pediatrics. 2011;127:319–29.
65. Müller K, Janikian M, Dreier M, Wölfling K, Beutel M, Tzavara C, et al. Regular gaming behavior and internet gaming disorder in European adolescents: results from a cross-national representative survey of prevalence, predictors, and psychopathological correlates. Eur Child Adolesc Psychiatry. 2014. doi:10.1007/s00787-014-0611-2.
66. King DL, Delfabbro PH, Griffiths MD. Video game structural characteristics: a new psychological taxonomy. Int J Ment Heal Addict. 2010;8:90–106.
67. Wood RTA, Griffiths MD, Chappell D, Davies MNO. The structural characteristics of video games: a psycho-structural analysis. Cyberpsychol Behav. 2004;7:1–10.
68. Westwood D, Griffiths MD. The role of structural characteristics in video-game play motivation: a Q-methodology study. Cyberpsychol Behav Soc Netw. 2010;13:581–5.
69. King DL, Delfabbro PH, Griffiths MD. The role of structural characteristics in problematic video game play: an empirical study. Int J Ment Heal Addict. 2011;9:320–33.
70. Hull DC, Williams GA, Griffiths MD. Video game characteristics, happiness and flow as predictors of addiction among video game players: a pilot study. J Behav Addict. 2013;2:145–52.
71. Griffiths MD, Wood RTA. Risk factors in adolescence: the case of gambling, videogame playing, and the Internet. J Gambl Stud. 2000;16:199–225.
72. Starcevic V, Berle D, Porter G, Fenech P. Problem video game use and dimensions of psychopathology. Int J Ment Heal Addict. 2011;9:248–56.
73. Lemmens JS, Valkenburg PM, Peter J. Psychosocial causes and consequences of pathological gaming. Comput Hum Behav. 2011;27:144–52.
74. Kuss DJ, Louws J, Wiers RW. Online gaming addiction? Motives predict addictive play behavior in massively multiplayer online role-playing games. Cyberpsychol Behav Soc Netw. 2012;15:480–5.
75. Kwon J-H, Chung C-S, Lee J. The effects of escape from self and interpersonal relationship on the pathological use of internet games. Community Ment Health J. 2011;47:113–21.
76. Yee N. Motivations for play in online games. Cyberpsychol Behav. 2006;9:772–5. doi:10.1089/cpb.2006.9.772.
77. Zanetta Dauriat F, Zermatten A, Billieux J, Thorens G, Bondolfi G, Zullino D, et al. Motivations to play specifically predict excessive involvement in massively multiplayer online role-playing games: evidence from an online survey. Eur Addict Res. 2011;17:185–9.
78. Khantzian EJ. The self-medication hypothesis of addictive disorders: focus on heroin and cocaine dependence. Am J Psychiatry. 1985;142:1259–64.
79. Király O, Urbán R, Griffiths MD, Ágoston C, Nagygyörgy K, Kökönyei G, et al. Psychiatric symptoms and problematic online gaming: the mediating effect of gaming motivation. J Med Internet Res. 2015;17:e88. The paper tests the mediating role of online gaming motives between psychiatric distress and IGD. The results suggest that psychiatric distress is both directly and indirectly (via Escape and Competition motives) negatively associated with IGD, suggesting that exploring the motives of gamers can be helpful in the preparation of prevention and treatment programs.
80. Griffiths MD. Diagnosis and management of video game addiction. New directions in addiction treatment and prevention. 2008;12:27-41.
81. Griffiths MD, Meredith A. Videogame addiction and its treatment. J Contemp Psychother. 2009;39:247–53.
82. Huang XQ, Li MC, Tao R. Treatment of internet addiction. Curr Psychiatry Rep. 2010;12:462–70.
83. Thorens G, Achab S, Billieux J, Khazaal Y, Khan R, Pivin E, et al. Characteristics and treatment response of self-identified problematic Internet users in a behavioral addiction outpatient clinic. J Behav Addict. 2014;3:78–81.
84. Jäger S, Müller KW, Ruckes C, Wittig T, Batra A, Musalek M, et al. Effects of a manualized short-term treatment of internet and computer game addiction (STICA): study protocol for a randomized controlled trial. Trials. 2012;13:43.
85. King DL, Delfabbro PH, Griffiths MD. Clinical interventions for technology-based problems: excessive Internet and video game use. J Cogn Psychother. 2012;26:43–56.
86. Leahy RL. Cognitive therapy techniques: a practitioner's guide. New York: Guilford Press; 2003.
87. King DL, Delfabbro PH, Griffiths MD. Cognitive behavioral therapy for problematic video game players: conceptual considerations and practice issues. J Cybertherapy Rehabil. 2010;3:261–73.
88. Kuss DJ, Griffiths MD. Internet and gaming addiction: a systematic literature review of neuroimaging studies. Brain Sci. 2012;2:347–74.
89. King DL, Delfabbro PH. Internet gaming disorder treatment: a review of definitions of diagnosis and treatment outcome. J Clin Psychol. 2014;70:942–55. The authors systematically review current IGD treatment studies in terms of definitions of diagnosis and treatment outcomes. They conclude that IGD treatment literature is scarce and it has several methodological weaknesses, therefore it cannot be concluded that trialed IGD interventions confer a long-term therapeutic benefit.
90. Cha AE. In China, stern treatment for young internet 'Addicts'. In: The Washington Post. 2007. http://www.washingtonpost.com/wp-dyn/content/article/2007/02/21/AR2007022102094.html. Accessed 31 Jan 2015.
91. Fackler M. In Korea, a Boot Camp Cure for Web Obsession. In: The New York Times. The New York Times Company. 2007. http://www.nytimes.com/2007/11/18/technology/18rehab.html?pagewanted = all&_r = 0. Accessed 31 Jan 2015.