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      Identifying individuals in need of help for their uncontrolled gaming: A narrative review of concerns and comments regarding gaming disorder diagnostic criteria

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          Abstract

          Objective

          In 2013, the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) included the diagnostic criteria of Internet gaming disorder (IGD). Then, in 2019, the 11th Revision of the International Classification of Diseases (ICD-11) categorized gaming disorder (GD) as an addictive disorder. This review aimed to review the raised concerns, debate, and research of IGD or GD criteria and provide suggestions to resolve them.

          Methods

          A narrative review was conducted, and PubMed was searched for articles mentioning concerns and research on the DSM-5 criteria for IGD, ICD-11 criteria for GD, or criteria for other synonyms, such as problematic gaming or gaming addiction. A total of 107 articles were identified.

          Results

          Concerns were organized into three categories: conceptual framework, moral panic, and diagnostic validity. Most argumentations supported the proposition that GD and other substance use disorders have similar presentations. A clear definition of GD and adequate public education could prevent rather than exacerbate moral panic. Several researchers reported concerns regarding the nosology, diagnostic validity, and wording of each criterion. However, the threshold, five of the nine criteria with impaired function, demonstrated adequate validity in interview studies.

          Conclusion

          The current findings support the addiction framework, functional impairment, and validity of the GD criteria. However, further prospective, experimental, and clinical studies validating these findings are warranted. Moreover, an integrative review or debate conference could contribute to the organization of the available results and concept development. Aggregating adequate scientific information could allay or resolve concerns related to the diagnosis of GD.

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          Most cited references139

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          An international consensus for assessing internet gaming disorder using the new DSM-5 approach.

          For the first time, the Diagnostic and Statistical Manual for Mental Disorders (DSM-5) introduces non-substance addictions as psychiatric diagnoses. The aims of this paper are to (i) present the main controversies surrounding the decision to include internet gaming disorder, but not internet addiction more globally, as a non-substance addiction in the research appendix of the DSM-5, and (ii) discuss the meaning behind the DSM-5 criteria for internet gaming disorder. The paper also proposes a common method for assessing internet gaming disorder. Although the need for common diagnostic criteria is not debated, the existence of multiple instruments reflect the divergence of opinions in the field regarding how best to diagnose this condition. We convened international experts from European, North and South American, Asian and Australasian countries to discuss and achieve consensus about assessing internet gaming disorder as defined within DSM-5. We describe the intended meaning behind each of the nine DSM-5 criteria for internet gaming disorder and present a single item that best reflects each criterion, translated into the 10 main languages of countries in which research on this condition has been conducted. Using results from this cross-cultural collaboration, we outline important research directions for understanding and assessing internet gaming disorder. As this field moves forward, it is critical that researchers and clinicians around the world begin to apply a common methodology; this report is the first to achieve an international consensus related to the assessment of internet gaming disorder. © 2014 Society for the Study of Addiction.
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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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              How can we conceptualize behavioural addiction without pathologizing common behaviours?

              Following the recent changes to the diagnostic category for addictive disorders in DSM-5, it is urgent to clarify what constitutes behavioural addiction to have a clear direction for future research and classification. However, in the years following the release of DSM-5, an expanding body of research has increasingly classified engagement in a wide range of common behaviours and leisure activities as possible behavioural addiction. If this expansion does not end, both the relevance and the credibility of the field of addictive disorders might be questioned, which may prompt a dismissive appraisal of the new DSM-5 subcategory for behavioural addiction. We propose an operational definition of behavioural addiction together with a number of exclusion criteria, to avoid pathologizing common behaviours and provide a common ground for further research. The definition and its exclusion criteria are clarified and justified by illustrating how these address a number of theoretical and methodological shortcomings that result from existing conceptualizations. We invite other researchers to extend our definition under an Open Science Foundation framework.
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                Author and article information

                Contributors
                Journal
                2006
                Journal of Behavioral Addictions
                JBA
                Akadémiai Kiadó (Budapest )
                2062-5871
                2063-5303
                12 October 2020
                03 October 2020
                : 9
                : 3
                : 572-588
                Affiliations
                [1 ] Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung Medical University , 100 Tzyou 1st Rd., 807, Kaohsiung City, Taiwan
                [2 ] Department of Psychiatry, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University , 482 San-Ming Rd., 812, Kaohsiung City, Taiwan
                [3 ] Department of Psychiatry, Faculty of Medicine, College of Medicine, Kaohsiung Medical University , 100 Shi-Chuan 1st Rd., 807, Kaohsiung City, Taiwan
                [4 ] Institute of Psychology, ELTE Eötvös Loránd University , Budapest, Hungary
                [5 ] Department of Psychology, Minnan Normal University , China
                [6 ] Department of Psychiatry, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University , Kaohsiung City, 812, Taiwan
                Author notes
                [* ]Corresponding author. E-mail: chihhungko@ 123456gmail.com
                Author information
                https://orcid.org/0000-0001-8034-0221
                Article
                10.1556/2006.2020.00058
                8943683
                33011711
                43a7a18f-428b-4702-851b-beff46a6550e
                © 2020 The Author(s)

                Open Access. This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License ( https://creativecommons.org/licenses/by-nc/4.0/), which permits unrestricted use, distribution, and reproduction in any medium for non-commercial purposes, provided the original author and source are credited, a link to the CC License is provided, and changes – if any – are indicated.

                History
                : 02 April 2020
                : 28 July 2020
                : 21 August 2020
                Page count
                Tables: 3, Equations: 0, References: 139, Pages: 17
                Funding
                Funded by: Taiwan Ministry of Science and Technology
                Award ID: MOST105-2314-B-037-027-MY2
                Award ID: MOST107-2314-B-037-101-MY2
                Funded by: Kaohsiung Municipal Hsiao-Kang Hospital
                Award ID: KMHK-104-006
                Award ID: KMHK-103-008
                Funded by: Kaohsiung Medical University Hospital
                Award ID: KMUH105-5R54
                Award ID: KMUH106-6R71
                Funded by: Hungarian National Research, Development and Innovation Office
                Award ID: KKP126835
                Categories
                Review Article

                Medicine,Psychology,Social & Behavioral Sciences,Clinical Psychology & Psychiatry
                criteria,DSM-5,ICD-11,Internet Gaming Disorder,Gaming Disorder,validity

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