The World Health Organisation (WHO) is seemingly unwilling or unable to explain its research behind the decision to make “gaming disorder” an addictive behaviour.
This comes as professor Andrew Przybylski – a social science researcher at Oxford University with a focus on video games – reached out to WHO in an attempt to understand how it came to classify gaming disorder, and the specific research the organisation conducted.
Przybylski shared WHO’s email response with NME, which reads: “It is challenging if not impossible, to document and communicate the rationale and justification for [the gaming disorder] decision.”
WHO links to a minimal amount of research – found here – and Przybylski is concerned that this isn’t nearly enough publicly available data to justify the decision blanketing gaming disorder as an addictive behaviour, as it appears to completely ignore his and others work that disputes the decision.
“Moving from [a] research construct to formal disorder requires a much stronger evidence base than we currently have,” said a co-authored paper from Przybylski in 2018. The paper also urged “WHO to err on the side of caution for now and postpone the formalization” of the term, due to this informed understanding of a lack of research on the topic of gaming disorder as an addiction.
Thinking a bit about #gamingdisorder and #internetgamingdisorder research lately and came back across this excellent editorial by @CJFerguson1111 & @patmarkey. I really wish that @WHO were receptive to the arguments here.
— Andrew Przybylski (@ShuhBillSkee) November 10, 2021
“I would think that if a decision is important, you would have a list of articles that you’ve read,” Przybylski added. “Or a list of books, or datasets”. As a player himself Przybylski doesn’t even know what WHO defines video games as, saying: “What someone thinks games are – or aren’t – is a really important question, if you want to study or understand or make claims about the effects that games might have on mental health.
Przybylski also criticised “the idea that games are all uniformly in some way addictive,” adding that he is unaware how WHO defines an activity “a third of the planet does all the time”, or how it decides that activity is unsafe.
Gaming disorder is deemed a “clinically recognisable and clinically significant syndrome,” by WHO, which added the addictive behaviour to the ICD-11 in 2018. It adds: “When the pattern of gaming behaviour is of such a nature and intensity that it results in marked distress or significant impairment in personal, family, social, educational or occupational functioning.”
The ICD-11 (International Classification of Diseases 11th Revision) is used by medical practitioners around the world to diagnose conditions, and the inclusion of a disorder therein aims to help countries form public health strategies to combat them.
Whilst Przybylski agrees with WHO and understands that gaming addiction is a real issue for some, he is critical of the inclusion and definition of “gaming disorder” as a term. Saying the WHO is “either not willing, or they’re not able to” justify it as an addiction, and provide him with the breadth of research it cited above as supporting its introduction into the ICD-11.
— Andrew Przybylski (@ShuhBillSkee) November 12, 2021
The WHO said to Przybylski in that same email that it “encouraged experts involved in the WHO’s work in this area to publish in the peer-reviewed literature,” and was “confident that you are aware of numerous publications on this matter.”
“I am, I’ve seen hundreds of articles,” Przybylski told NME in response. “I don’t know which ones are the convincing ones to that point […] What are the ones that merit the creation of a new psychiatric disorder?”
— Andrew Przybylski (@ShuhBillSkee) November 12, 2021
A question and answer webpage concerning gaming disorder as an addictive behaviour has also been removed from the WHO website, with the reason for this unclear. Whilst other data and information about the inclusion of gaming disorder as an addictive behaviour is available from the WHO, the original link leads to a dead page. It has been archived by the Wayback Machine, however, which says it was still online as of November 6 this year.
NME reached out to the WHO prior to the publication of this story, and received a response on November 18. The FAQ section on Addictive Behaviours: Gaming Disorder was moved, and not removed, it can be found here.
Vladimir Poznyak, the unit head of alcohol, drugs, and addictive behaviours at the WHO added that when speaking to Przybylski he said that “the latest edition of the International Classification of Diseases (ICD-11) contains tens of thousands of diagnostic entities, including multiple new entities or substantially-revised diagnostic categories, and it is challenging, if not impossible, to document and communicate through WHO channels the rationale and justification for each decision.”
“Every decision was taken by a very thorough process of review of the evidence, needs and practices,” which includes thousands of articles and work from the academic press.
Poznyak concluded by saying adding gaming disorder to the ICD-11 will “result in the increased attention of health professionals to the risks of development of this disorder, its appropriate diagnosis while avoiding overdiagnosis, and also relevant prevention and treatment measures.”