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      Functional impairment matters in the screening and diagnosis of gaming disorder : Commentary on: Scholars’ open debate paper on the World Health Organization ICD-11 Gaming Disorder proposal (Aarseth et al.)

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          Abstract

          This commentary responds to Aarseth et al.’s (in press) criticisms that the ICD-11 Gaming Disorder proposal would result in “moral panics around the harm of video gaming” and “the treatment of abundant false-positive cases.” The ICD-11 Gaming Disorder avoids potential “overpathologizing” with its explicit reference to functional impairment caused by gaming and therefore improves upon a number of flawed previous approaches to identifying cases with suspected gaming-related harms. We contend that moral panics are more likely to occur and be exacerbated by misinformation and lack of understanding, rather than proceed from having a clear diagnostic system.

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          Most cited references 20

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          Are we overpathologizing everyday life? A tenable blueprint for behavioral addiction research

          Background Behavioral addiction research has been particularly flourishing over the last two decades. However, recent publications have suggested that nearly all daily life activities might lead to a genuine addiction. Methods and aim In this article, we discuss how the use of atheoretical and confirmatory research approaches may result in the identification of an unlimited list of “new” behavioral addictions. Results Both methodological and theoretical shortcomings of these studies were discussed. Conclusions We suggested that studies overpathologizing daily life activities are likely to prompt a dismissive appraisal of behavioral addiction research. Consequently, we proposed several roadmaps for future research in the field, centrally highlighting the need for longer tenable behavioral addiction research that shifts from a mere criteria-based approach toward an approach focusing on the psychological processes involved.
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            Comorbidity of DSM-IV pathological gambling and other psychiatric disorders: results from the National Epidemiologic Survey on Alcohol and Related Conditions.

            To present nationally representative data on lifetime prevalence and comorbidity of pathological gambling with other psychiatric disorders and to evaluate sex differences in the strength of the comorbid associations. Data were derived from a large national sample of the United States. Some 43,093 household and group quarters residents age 18 years and older participated in the 2001-2002 survey. Prevalence and associations of lifetime pathological gambling and other lifetime psychiatric disorders are presented. The diagnostic interview was the National Institute on Alcohol Abuse and Alcoholism Alcohol Use Disorder and Associated Disabilities Interview Schedule-DSM-IV Version. Fifteen symptom items operationalized the 10 pathological gambling criteria. The lifetime prevalence rate of pathological gambling was 0.42%. Almost three quarters (73.2%) of pathological gamblers had an alcohol use disorder, 38.1% had a drug use disorder, 60.4% had nicotine dependence, 49.6% had a mood disorder, 41.3% had an anxiety disorder, and 60.8% had a personality disorder. A large majority of the associations between pathological gambling and substance use, mood, anxiety, and personality disorders were overwhelmingly positive and significant (p .05). Pathological gambling is highly comorbid with substance use, mood, anxiety, and personality disorders, suggesting that treatment for one condition should involve assessment and possible concomitant treatment for comorbid conditions.
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              Bupropion sustained release treatment decreases craving for video games and cue-induced brain activity in patients with Internet video game addiction.

              Bupropion has been used in the treatment of patients with substance dependence based on its weak inhibition of dopamine and norepinephrine reuptake. We hypothesized that 6 weeks of bupropion sustained release (SR) treatment would decrease craving for Internet game play as well as video game cue-induced brain activity in patients with Internet video game addiction (IAG). Eleven subjects who met criteria for IAG, playing StarCraft (>30 hr/week), and eight healthy comparison subjects (HC) who had experience playing StarCraft (<3 days/week and <1 hr/day). At baseline and at the end of 6 weeks of bupropion SR treatment, brain activity in response to StarCraft cue presentation was assessed using 1.5 Tesla functional MRI. In addition, symptoms of depression, craving for playing the game, and the severity of Internet addiction were evaluated by Beck Depression Inventory, self-report of craving on a 7-point visual analogue scale, and Young's Internet Addiction Scale, respectively. In response to game cues, IAG showed higher brain activation in left occipital lobe cuneus, left dorsolateral prefrontal cortex, and left parahippocampal gyrus than HC. After a 6 week period of bupropion SR, craving for Internet video game play, total game play time, and cue-induced brain activity in dorsolateral prefrontal cortex were decreased in the IAG. We suggest that bupropion SR may change craving and brain activity in ways that are similar to those observed in individuals with substance abuse or dependence. PsycINFO Database Record 2010 APA, all rights reserved.
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                Author and article information

                Journal
                jba
                JBA
                Journal of Behavioral Addictions
                J Behav Addict
                Akadémiai Kiadó (Budapest )
                2062-5871
                2063-5303
                27 June 2017
                September 2017
                : 6
                : 3
                : 285-289
                Affiliations
                [ 1 ]Institute for Health and Behaviour, Integrative Research Unit on Social and Individual Development (INSIDE), University of Luxembourg , Esch-sur-Alzette, Luxembourg
                [ 2 ]Internet and Gambling Disorders Clinic, Department of Adult Psychiatry, Cliniques universitaires Saint-Luc , Brussels, Belgium
                [ 3 ]Laboratory for Experimental Psychopathology, Psychological Sciences Research Institute, Université catholique de Louvain , Louvain-la-Neuve, Belgium
                [ 4 ]School of Psychology, The University of Adelaide , Adelaide, SA, Australia
                [ 5 ] National Hospital Organization Kurihama Medical and Addiction Center , Yokosuka, Kanagawa, Japan
                [ 6 ]Specialized Program in Behavioural Addictions, Addiction Division, Department of Mental Health and Psychiatry, University Hospitals of Geneva , Geneva, Switzerland
                [ 7 ]Research Unit Addictive Disorders, Department of Psychiatry, Faculty of Medicine, University of Geneva , Geneva, Switzerland
                [ 8 ]National Problem Gambling Clinic, and Faculty of Medicine, Imperial College London , London, UK
                [ 9 ]Mental Health Institute of the Second Xiangya Hospital, Central South University , Changsha, China
                [ 10 ]Department of Psychiatry, College of Medicine, The Catholic University of Korea , Seoul, South Korea
                [ 11 ]Departments of Psychiatry and Neuroscience, Child Study Center, and The National Center on Addiction and Substance Abuse, Yale University School of Medicine and Connecticut Mental Health Center , New Haven, CT, USA
                [ 12 ]Centre for Youth Substance Abuse Research, The University of Queensland , Brisbane, QLD, Australia
                [ 13 ]Department of Mental Health and Substance Abuse, WHO Headquarters , Geneva, Switzerland
                Author notes
                [* ]Corresponding author: Prof. Joël Billieux, PhD; Institute for Health and Behaviour, Integrative Research Unit on Social and Individual Development (INSIDE), University of Luxembourg, Maison des Sciences Humaines, 11, Porte des Sciences, L-4366 Esch-sur-Alzette, Luxembourg; Phone: +352 46 66 44 9207; Fax: +352 46 66 44 39207; E-mail: Joel.Billieux@ 123456uni.lu
                Article
                10.1556/2006.6.2017.036
                5700712
                28816514
                © 2017 The Author(s)

                This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium for non-commercial purposes, provided the original author and source are credited.

                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 24, Pages: 5
                Funding
                Funding sources: Nothing declared in relation to this article.
                Categories
                COMMENTARY

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