For the first time, the World Health Organization has officially designated “gaming disorder” among its list of mental health addictive behaviors.
The move touches off a dispute among some researchers and clinicians over whether there is science to back the decision, and how it might impact children, families, and educators. Schools are increasingly embracing the use of gamification and digital gaming in the classroom to engage students. At the same time, there is growing debate among educators about students’ obsession with digital games such Fortnite. Some educators say the game has become a major classroom distraction, while others are finding ways to use it to better engage students.
On Monday, the WHO released the latest version of its International Classification of Diseases, which is used to track, identify, and designate health concerns around the globe. The new issue, which hadn’t been updated since 1993, defines gaming disorder as so severe that it causes significant impairment of social, educational, and interpersonal interactions. It is characterized by “impaired control over gaming” and prioritization of gaming so that it “takes precedence over other life interests and daily activities.”
A group of nearly 30 researchers who had anticipated the move published a paper earlier this year arguing that there wasn’t enough scientific research to reach that conclusion.
“The body of evidence doesn’t support that this should be designated as a mental disorder just yet,” said Michelle Colder Carras, a former fellow in psychiatric epidemiology at the Johns Hopkins Bloomberg School of Public health and a co-author of the paper. “We’re not saying people are not suffering...but a lot of clinicians are not that knowledgeable about gaming and how people can be engaged in a significant way” while not have it be problematic over the long term, she said.
Carras and others say what looks like video game addiction may instead be masking other disorders, such as anxiety or depression, that are officially listed in the ICD and are treatable. And some worry that classifying gaming disorder as a mental health addiction could lead to “moral panic over video games...that could get in the way of good faith educational programs using video games,” said Christopher Ferguson, a professor of psychology at Florida’s Stetson University.
But many adults and children are struggling with addictive behaviors related to video games, said David Greenfield, the founder and chief clinical offer at The Center for Internet and Technology Addiction and an assistant professor of psychiatry at the University of Connecticut School of Medicine. He has treated hundreds of patients for addiction to video games. Though Greenfield said addiction medicine is “not an exact” science, people are using gaming in a “way that is compulsive, impulsive, and causing deleterious consequences.”
He compared it with alcoholism, in which sufferers may also have underlying mental health issues that need treatment, but the behavior itself also must be addressed.
The new WHO classification may help those seeking treatment to get insurance coverage, for example, or prompt new grants and funding for studying the issue.
But Kurt Squire, a professor of social informatics at the University of California Irvine, said the change is mostly likely to play out in education as a way for parents and schools already looking for arguments against techniques like educational gaming to bolster their positions, he said. “Ultimately, it’s a political and social decision and not really a scientific one,” he said.
Educational Gaming Looks Different
As concerns about video games rise, some educational gaming proponents worry that there could be blowback on classroom gaming techniques that engage students, boost learning, and promote positive interactions.
Liz Kolb, a clinical associate professor of teacher education and learning technologies at the University of Michigan in Ann Arbor, said because students don’t have “frontal lobe impulse control to always be able to regulate” screens and gaming, the WHO designation could help parents and educators be more aware of red flags to look for when it comes to addictive behavior.
But she cautioned that video gaming addiction should not be lumped in with educational gaming and gamification techniques. “You have to separate out the fact that gamification is an approach to teaching,” she said. “We want to make sure to...recognize the positive things within gaming: the collaboration, problem solving, critical thinking skills.”
Some in the field worry that educators and parents will hear the words “gaming” and “addiction” and make incorrect generalizations.
Eric Klopfer, the director of MIT’s Teacher Education Program and the Education Arcade, said the world of gaming is much more nuanced than the WHO’s designation calls to mind. Playing hours of the shooter-game “Fornite: Battle Royale” is much different than playing hours of Minecraft, a creative exploration and adventure game which allows players to build, mine, and construct in their online world and which also comes in a strictly educational version called MinecraftEDU, he said. “Those games are radically different from each other with a different rewards system, ways of playing, media, and social structures,” he said. “Not all games are the same.”
Klopfer said he worries that some educators and parents will just hear that gaming is “a source of a disorder” so they will steer clear. In addition, educational games are designed around finite tasks and goals that are “easily managed and scoped out in that space,” he said, a very different structure from open-ended video games that are designed to keep students playing for hours.
“The kinds of games that people have problems with are not the same type as educational games,” he said.
In addition, gamification is a technique that can be used throughout education and doesn’t require a digital component, said Jeffrey Knutson, a senior producer and content strategist for education at Common Sense Education, which provides a digital citizenship curricula for schools and advice to parents and educators about children’s use of online media.
“Gamification is using the technique of game play, like competition, to make learning fun and engaging,” Knutson said. “Online games or video games might be played, but they also might not.”
Any concerns about gaming addiction all need to be put through the lens of helping students balance the digital media they consume, he said.
“There’s potential for some great conversations to be started here,” Knutson said, “but I don’t think the conversation about classroom games somehow becoming addictive is the conversation anyone is going to be having.”
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A version of this news article first appeared in the Digital Education blog.