AMA Weighing Addictive Nature of Video Gaming

Medical experts may recommend 'mental disorder' status for video game addiction.

January 8, 2009, 12:29 AM

June 24, 2007— -- Since she first discovered the online game in May 2005, Mary (who requested that we not reveal her last name) estimates that she has spent well over 4,000 hours playing World of Warcraft -- roughly 25 percent of her life during that time.

The 36-year-old mother of two from Memphis, Tenn., said that she plays constantly and often thinks about the game when she is not playing.

She has only taken two major breaks from the game -- a month each time, for sickness and surgery.

"I obsess about it," she said. "I can't quit. If I don't have it, I think about it. I want it."

It is this type of obsession that has many doctors worried that gamers like Mary may actually be addicted to video games.

At their annual policy conference, which begins this weekend, the American Medical Association (AMA) will discuss whether or not to recommend that video game addiction be added to the Diagnostic and Statistical Manual of Mental Disorders (DSM), the guide consulted by psychiatrists when diagnosing patients.

But for Mary, the answer is already clear.

"As a person who has been addicted to cigarettes and addicted to food, I can say that I see a lot of the same aspects of addiction when I think of online video games," she said.

World of Warcraft is among a group of newer games known as Massive Multiplayer Online Role Playing Games, in which players control a character and complete tasks while interacting with characters controlled by other players around the world.

For Hal Halpin, director of the gamers' advocacy group the Entertainment Consumers Association, the degree of interactivity of these games may have more to do with why people play them so much than any inherent problems with the games themselves.

With the dynamically changing worlds established by games like World of Warcraft, he said, gamers are potentially exposed to an infinitely expanding array of challenges and rewards. The gaming experience is more engaging, more entertaining, and for some, possibly more addictive.

"People with addictive personalities are more prone to doing things compulsively no matter what it is," Halpin said. "Whether it's media, or drugs or whatever else, they are more prone than anyone else.

"If there is research to be done, I would love to see it, but for all media, not just games."

Halpin, who previously worked with video game manufacturers, also said that the video game industry would likely act defensively against any suggestion that gaming addiction is a medical condition.

And any recommendation by the AMA may be interpreted as just that -- a suggestion. The real power to classify video gaming addiction as a mental disorder lies in the hands of the American Psychiatric Association (APA), the organization in charge of revising the DSM.

Dr. James Scully, medical director of the APA, said representatives would attend this weekend's meeting, but the organization has not yet decided where they stand on video game addiction.

"This is a little further ahead of where we're at," he said, adding that the earliest that the DSM would be updated to include such a classification is 2012.

For all of the mental disorders that will be added for the next edition of DSM, Scully said, "We want to make sure that there is enough science; we want to make sure there is scientific usefulness and clinical usefulness."

Those sentiments were backed up by Thomas McLellan of the University of Pennsylvania's Center for Studies of Addiction, who sits on the committee for the next edition of DSM.

"I'd have to have a little more evidence that it meets the criteria [for addiction]," said.

In order for something to be addictive, McLellan explained, it must produce withdrawal symptoms when it is taken away. Furthermore, as someone who is addicted continues to use it, he or she needs more and more to reach a level of temporary satisfaction.

But others are already convinced.

Jeff Georgi, clinical director of the Duke Addictions Program at Duke University, said he has already seen several patients whose overuse of video games has led their lives down the same path as alcohol and drug addicts.

"We are seeing people, particularly 20-something and 30-something folks, who have what looks to be an addictive relationship with computer games … Whether that has been scientifically documented is up in the air," he said, "[but] behaviorally, it sure looks like it … It feels like an addiction to me, from a clinical point of view."

At the same time, Georgi said, because video game addiction is not documented, people who suffer from it have less support than an alcoholic or a drug addict would.

Because of the relative newness of the proposal to classify video game addiction as a medical condition, both the AMA and the Entertainment Software Association declined to comment as of press time.

But for some, kicking the gaming habit goes farther than breaking free of its addictive pull. Mary, for example, said that though she has some regrets about playing the game, she has also benefited from it.

"I met my fiancé on an ogre mound in the Arathi Highlands in Azeroth," she said. "How many people can say that?"'s Dan Childs and Ashley Phillips contributed to this report.

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