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ISU professor's research shows importance of gaming addiction classification in treatment

Ames Tribune - 1/5/2018

Jan. 05--For Iowa State University Psychology Professor Douglas Gentile, the term "video game addict" is not taken lightly; it is not a funny term for a "gamer," but a real issue he believes can be linked to other mental health disorders such as depression and anxiety.

But with the World Health Organization (WHO) considering recognizing the term as a legitimate mental health disorder in the next International Classification of Disease (ICD), Gentile hopes that the stigma surrounding video game addiction will be set straight, and people will use it to get to the root of mental health disorders.

"Because it's not recognized as a mental health disorder, it doesn't get any real recognition from parents, or from gamers, or from the medical field, so no one even looks to see whether it's a problem, and when people do think it's a problem they don't have anywhere to turn for help," Gentile said. "That's why I think the World Health Organization considering listing it as a real disorder in their next edition of the ICD is actually really important because it will get people talking about it, and recognizing that this can be a serious problem."

Gentile has been researching video game addiction since 1999, after he heard parents referring to their kids as having video game "addictions," which he initially responded to with disbelief.

"I started studying it with a much more clinical lens, and it turns out I was wrong," Gentile said. "There are people for whom that seemed to actually happen."

In the nearly 20 years he has been studying the issue, he said the main question he receives when discussing video game addiction, is about what separates an addict from a "gamer." Gentile acknowledges video games' popularity, and that there is an entire culture surrounding the industry. However, he said that the simple way to determine an addict is through a list of nine questions that determine whether or not gaming is having a negative effect on a person's life in multiple areas.

"All parents mean when they say their kids are addicted to games is that they spend a lot of time playing, and they don't understand why, but that's not an addiction," Gentile said. "Addiction doesn't mean you do something a lot; addiction means that you do something that damages your ability to function in the real world."

If people are spending a majority of their time gaming, to a point where it interferes with time spent sleeping, working, studying, socializing, or otherwise maintaining a healthy lifestyle, Gentile said that's when an addiction has formed.

"Anything you're passionate about, you will sacrifice some other things for," Gentile said. "When it stops being normal is when you start sacrificing too much."

Through his work, Gentile said that in all addictions the number one factor is access, and he said with games ranging from consoles to our phones, there has never been a time with more access. With any addiction, Gentile said it starts as a coping strategy, usually resulting from several aspects of people's life. Gentile referred to the "ABC" of human motivations, with A being autonomy or the desire to be in control, B is belonging or feeling connected to other people, and C is competence or feeling good in what we do.

"If your job gives you autonomy, lets you connect with other people, and you feel competent, you love you job. It really is that simple," Gentile said.

In 2009 Gentile published his first study on the issue based on national data, which found that 92 percent of 8 to 18-year-olds play video games, and of those, 8.5 percent would classify as addicted by that clinical definition. According to Gentile, those numbers indicate that a majority of children and teens can play video games without showing traits of addition, which he said is a positive. However, Gentile also said that with roughly 40 million children in the country, there is roughly 3 million children who are addicted to video games, which can lead to and be the result of other mental health disorders.

Gentile hopes that the research he has done can help doctors diagnose these disorders in children and adolescents, which is why he has been in talks with YSS to use a questionnaire when interviewing children with other mental health disorders, or are showing signs of other addictions. With YSS having the state's first adolescent substance use disorder addiction treatment program, CEO Andrew Allen said using Gentile's research can provide different insight into how clinicians diagnose mental health disorders in youth.

"As we look to enhance that program and take it to the next level, we started to think about other addictions," Allen said. "Many of these kids have underlying issues and trauma that are leading towards substance use disorder, and as we sit down to think about how best to provide treatment to kids, you can't not look at behavior, and prevalent behavior we're seeing is exposure to tablets, devices and video games."

According to YSS Clinical Director of Outpatient Services Katherine Dinges, Gentile's research and the questionnaire he created is currently being implemented at YSS, and will be fully integrated by mid-February. Dinges said she has been very impressed with Gentile's work, and that the research he has collected is consistent with what she sees as a practitioner.

"What we suspected was probably kind of a connection there, he is helping verify that," Dinges said.

One major comparison that Gentile made is with alcoholism in the 1950s, prior to it being classified as a disease. At the time, Gentile said the fault or blame often went to the person suffering from alcoholism, who were considered to be moral failures. With video games, he Gentile said that those moral failures tend to be placed on the parents, and he hopes that with the more research that becomes available about video game addiction, the easier those suffering from the disorder will be able to receive help.

"Once the major public health organizations see the evidence and acknowledge that this is a real problem, then insurance companies and the medical profession will take it more seriously, and they will start having resources available for people," Gentile said.

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(c)2018 the Ames Tribune, Iowa

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