Gaming Disorder: Classification, mechanisms, treatment and prevention

Introduction In 2013, Internet Gaming Disorder was introduced as a condition for further study in the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). The International Classification of Diseases in its 11threvision (ICD-11) now includes gaming disorder as a behavioral addiction. In this presentation the state of the art evidence of this disorder with respect to classification, mechanisms, treatment and prevention will be reviewed

Methods The evidence will be summarized on the basis of a narrative review of the literature with a special focus on reviews published recently.

Results In the ICD-11, gaming disorder is defined by fulfilling three core criteria including impaired control over gaming, increasing priority given to gaming, and continuation of gaming despite the occurrence of negative consequences. In addition the behavior pattern should be of sufficient severity to result in significant impairment of functioning. Currently, specific assessment instruments based on the ICD-11 approach are missing. Neurobiological findings confirm that the disorder is comparable to other addictive disorders. These findings include changes in the neuronal functioning of the reward system, poorer response-inhibition and emotional control as well as impaired functioning of the prefrontal cortex. Studies on treatment approaches are mostly characterized by poor methodology. Nevertheless, cognitive behavioral approaches are quite promising. There is a paucity with respect to research on prevention approaches in the area of gaming disorder. Only very few studies have focused on the efficacy of early intervention approaches. Preliminary data might suggest to use concepts including the principles of Motivational Interviewing.

Discussion On the one side, there is evidence suggesting that gaming disorder can be regarded as a behavioral addiction. On the other side, treatment and prevention are based on week evidence and further studies are needed.