Gaming Disorder in Children and Teenagers

There is a new form of addiction that is affecting children and teenagers in droves. It is considered more addictive and challenging than alcohol and cigarette smoking. It is called gaming disorder. Whilst this addiction is not yet identified as a mental disorder in the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders), it has recently been included in the International Classification of Diseases (ICD-11) as a recognised mental disorder requiring medical/psychological intervention and treatment.

In 2019, the World Health Organization defined gaming disorder as “a pattern of gaming behaviour characterized by impaired control over gaming, increased priority given to gaming over other interests and priorities and continued or escalated gaming despite negative consequences from the behaviour.”

It is estimated that approximately 90 percent of kids play video games. Let’s be honest, the majority of video games are exciting, compelling, fun and research indicates there are many benefits of gaming. For example, gaming triggers the brain’s reward center which releases dopamine (the feel-good hormone) which makes one feel happy, euphoric, and motivated. Other benefits include:

  • Enjoyable and engaging
  • Boosts feelings of self worth
  • Triggers positive emotions
  • Escape from reality
  • Stress relief especially for children/teenagers who are isolated and/or living in a difficult family situation
  • Improvements in concentration and attention span e.g. sustained and selective
  • Increases the size and efficiency of areas of the brain responsible for visuospatial skills
  • Helps initiate conversations for kids who struggle in group settings

Challenges of gaming

Children are known to be particularly susceptible to video games due to under development of cognitive control. Research has proven that playing these games can actually alter the brain chemistry of a child/teenager. The physical and emotional responses triggered by the game (remember brain and body are one) mimic the responses to real life situations e.g. increased heart rate and blood pressure, adrenaline and dopamine (flight, fight, fright response). In addition, playing these games increases aggressive behaviours, moodiness and desensitizes the child/teenager to violence, inappropriate language, etc.

Furthermore, some research studies links video game addiction with disorders such as OCD, depression and ADHD. For example, some kids diagnosed with one of these disorders, might seek out gaming to cope with emotions, connect with others, or feel confident and successful. Unfortunately, many of these children/teenagers only connect with other kids through gaming and not face to face interaction in social settings which only exacerbates their feelings of isolation and loneliness.

A recent study amongst teens with problematic game use found more severe depression, conduct disorder, peer problems, emotional issues and stress, higher impulsiveness plus non suicidal self injury. Other problems include:

  • Increased mood swings, irritability, meltdowns, tantrums
  • Sleep problems
  • Change in eating habits and body weight e.g. junk food, caffeine drinks
  • Sneaky behaviour, lying, theft
  • Power struggles
  • School absenteeism, failing grades, late assignments
  • Increase risk of being cyberbullied and victimised

Gaming Disorder

To meet the classification of gaming disorder, the behaviour must be sufficient in severity to result in significant impairment in personal, family, social, and educational areas of functioning over a twelve-month period. An important point to remember is that gaming addiction is not defined by the number of hours played but the question is whether it seriously interferes with the child/teenager’s daily life. Gaming addiction may be identified by the following nine criteria. A score of five out of nine criteria in the past year indicates a very high probability of gaming addiction. The criteria are:

  1. Preoccupation with games e.g. it is the dominant activity in daily life
  2. Withdrawal symptoms when games are removed e.g. anger, anxiety, sadness, irritability
  3. Tolerance e.g. spending more and more time gaming
  4. Inability to control or reduce amount of time spent gaming
  5. Loss of interest in family time, social activities, friends
  6. Continued and excessive use of games despite awareness of detrimental impact on health and well being
  7. Deceives others about the amount of time spent gaming
  8. Turns to games to escape feelings of guilt, fear, anxiety, hopelessness
  9. School work suffers

If you think your child/teenager may have gaming disorder

  • Keep a record of symptoms, habits, emotions
  • List how many criteria child/teen exhibits
  • Make an appointment with physician/paediatrician

Treatment

Treatment for gaming disorder is tailored to the child/teens mental health state, education level and severity of addiction. Treatment options include:

  • Therapy with an addictions counsellor
  • Family therapy
  • Group therapy
  • Art therapy
  • Exercise therapy (increases serotonin levels which elevate mood)
  • Cognitive behavioural therapy (CBT) teaches the child/teen different ways to think, behave and respond to stressful situations
  • Wilderness camp or residential rehab (usually for more extreme cases)

What can parents do?

  • Talk with child/teenager about gaming, what do they enjoy, why do they spend so much time playing, etc.
  • Work with physician, therapist, etc. and follow treatment plan
  • Talk with family, school
  • Schedule family time and other social activities
  • Follow up with therapy, appointments
  • Schedule agreed upon time to game, do chores, homework, etc.
  • Monitor games child/teenager is playing
  • Encourage physical activity
  • Talk about cybersecurity
  • Adopt healthy lifestyle – diet, fluids, bedtime routine, practice mindfulness, gratitude
  • Spend quality time with child/teen, do fun activity, talk with and listen to him/her, be supportive, patient, non-judgemental and most importantly, show love and be there

In my next Blog #39

I will discuss Somatoform Disorders in Children and Teenagers

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