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The WHO records scientifically controversial disorders; first attempts at drug treatment
Diagnostic keys are crucial not only for statistical surveys but also for the billing of health services. Until January 1, 2022, the new ICD-11 is mainly used for testing purposes. This gives WHO member countries time for national translations and adjustments. Then the new version should replace the ICD-10
Two manuals of mental disorders
For mental disorders, the American DSM is important in addition to ICD, which is used by psychiatrists and psychologists in numerous countries. In Germany, although the DCI is authoritative, researchers must generally use or at least take DSM criteria into account in order to be able to publish in the most important journals, often dominated by Americans. Without such publications, there are fewer tools and organs of research.
The theoretical foundations and conflicts of financial interests of the DSM were discussed in more detail in the digital book on mental disorders. We also remember that Peter de Jonge, professor of psychiatry and psychology in the Netherlands, criticized the origin of the manual of the BOGSAT method: a bunch of old guys sitting around a table, a group of old seated at the conference table is considered mental disorders and what is not ("There is no depression").
Scientifically Controversial Disorder
For the DSM-5 of 2013, these Bunch of Old Guys still believed that there was no scientific basis for a computer game disorder. For the other ICD-11 recently published, but in principle very similar Guys now come to a different conclusion.
There is a "gambling disorder" under the clbadification code 6C51 as a sub-category of "addictive behavior disorders". The German could perhaps speak of "computer game disorder" or colloquially "computer game". The medical description is, in my German translation:
Computer game disorder is characterized by persistent or repeated gaming behavior ("digital games" or "video games"). This can be done online (ie on the internet) or offline, and expressed by: 1) limited control of the game (eg, start, frequency, intensity, duration, end, context); 2) give increased priority to gambling as it becomes more important than other interests in life and daily activities; and 3) continue or increase the game despite the appearance of negative consequences.
The behavioral model is serious enough to cause significant impairment in personal, family, social, educational, occupational or other important areas of work. The game pattern can be continuous or episodic and repetitive.
For a diagnosis to be made, gambling behavior and other characteristics are usually present for at least 12 months. The required duration can also be shortened if all diagnostic requirements are met and the symptoms severe
Psychiatric Addiction Disorders
For the DSM-5, the experts identified substance abuse disorders in ten clbades of substances: alcohol, caffeine, cannabis, hallucinogens, inhalers, opioids, sedatives or anxiolytics, stimulants, tobacco and, finally, "other known (or unknown) agents". It is important to know that the concept of dependence is anything but scientific and expresses many political and cultural beliefs in this area.
The American psychiatrists then granted an exception, namely the troubles of the game. The study cited studies showing similar brain activation and gambling behavior in gambling as in substance use. However, no convincing clues were found in the 2013 handbook.
Video Game Disruption Survey
I do not know what scientific breakthrough it should have been since then to disrupt the video game. For example, in April, a study by South Korean researchers of 16 "patients" with Internet Gambling Disorders (IGD) and 15 "patients" with Internet Gambling Disorder (IBGD) emerged. Different "questionnaires" proposed by the scientists were used for the "diagnosis".
The study showed that "patients" benefited from treatment with bupropion. This remedy is sometimes used to stop smoking, improve mood and calm people. This is why it is sometimes prescribed for depression or attention deficit disorder. Otherwise, one could say: The mood enhancing agent also improves the mood of people who play online, whether by computer or gaming. Doctors prescribe the substance and pharmacies and the pharmaceutical companies earn money, we talk about drugs, not drug use. We recall that psychiatrists really wanted to treat addiction and therefore incorporate a number of addictions into their diagnostic manual. At the same time, however, it is they who sometimes bring very similar substances to the public in considerable quantities
Brain findings
The South Korean researchers mentioned also compared the brain activations of their "patient groups" after 12 weeks of bupropion treatment. The conclusion then contains some wonderful phrases, such as: "After 12 weeks of bupropion treatment, the HR in the DMN as well as between the DMN and the NCC decreased in patients with IGD, while the CC in the NCC increased in patients with IBD. "
None of these abbreviations here denotes a concrete thing, but only constructed. What IGD or ibGD represent, we have already seen. By DMN, we mean a number of brain regions that are more active in idleness; NCC is a network of cognitive control of the brain. Thus, computer players found a slightly lower correlation, with players having a slightly higher correlation of brain activations between them. This is the "functional connectivity", abbreviated FC
Nobody knows what this means in practice. The argument of the integration of gambling disorder in the DSM was, as we have seen, that brain activation is similar to substance use.
The new study could be used as an argument that excessive gambling online is not a disruption because brain activation differs from online gambling. It's just in the eye of the beholder how to interpret the clues. Specifically: In the eyes of the group of old guys sitting around a table.
Personal life of scientific constructions
The power of such constructions should not be underestimated. Once scientists believe in their IGD, ibGD, DMN, CCN and many other specimens of the construction zoo, they quickly lead a life of their own. More and more statistical correlations are being sought – and found. Friedrich Nietzsche has very well formulated it in the Fröhlichen Wissenschaft of 1882/1887:
This made the greatest effort for me and always makes me the greatest effort: to see that it is undeniably more important as we call it as they are. The reputation, the name and appearance, the validity, the usual measure and the weight of a thing – in the original, especially an error and an arbitrary, thrown on things like a dress and its essence and even its completely alien skin – is by faith and its growth from generation to generation gradually became like things grown and cultivated in its own body; the illusion of the beginning is almost always the essence and works as a being!
So there are only names. After a while, it seems that names are more important than the things they call. After all, the name becomes the essence of the thing, its essence. The same goes for medicine, where patients are no longer human beings at first, but only labels of their diseases or mental disorders – that is, the names of the problems with which they have first consulted the doctor or psychologist. ] Internet players have smaller brains?
A study of Chinese researchers involving Lingdan Wu at the University of Constance, published on June 8, compares the brain volume of 38 people with "Internet Gambling Disorder" and 66 normal computer players. In the "problem group", measured cortical thickness was lower in many areas, such as left frontal lobe or lower parietal lobe
These studies should be treated with caution: statistically significant results are only group and often very small differences. In addition, brain differences may be due to several factors.
Various Causes
Many psychologists, for example, believe that excessive gambling can be a symptom of another problem rather than the main cause. Think about people's social environment, the number of problems and challenges they face, and the way they deal with them.
The brain is by no means a "gambling disorder on the Internet" or, according to the WHO, a "computer game disorder" is becoming more real. One could also compare the minds of Telepolis readers with those of Spiegel's readers – and even if he had a lower brain volume, it would not be called a "mirror player disorder".
Publikationskultur
Also plays a role for researchers to find significant differences in order to publish their results (why science is not gratuitous). Those who do not publish will be eliminated from the competition.
A contrary conclusion, that there is no difference between two groups, would be very enlightening, but would be rejected by most journals. Statistical significance is venerated in science today as a bad. However, most of them do not even know what these tests were originally developed.
Example: Influential Study on ADHD
The study published in 2017 by an international research team led by Martine Hoogman of the University of Nijmegen: The conclusion was that people with a diagnosis of ADHD had brains different from those without diagnosis: "We confirm … that patients with ADHD have altered brains; therefore, ADHD is a brain disorder.
In fact, the brains of most people in the two groups do not differ from one another.The statistical methods simply selected small differences in a subgroup of ADHD, which were then absolutized by the Seriously say that ADHD is a brain disorder, if the brains of people with or without ADHD are in most cases indistinguishable, already has something of a division of personality.
Critics have Also noted that the groups differed in their intelligence quotient., The minimal differences found in the brain could simply be due to this.However, the discovery remains in one of the leading psychiatric journals, Lancet Psychiatry, and is taken over indiscriminately. by most colleagues and the media.
New Disorders
The ADHD entity emerged with the 1987 DSM-III-R of the world (30 years of "Attention ADHD." In 2018, there is now also a computer game disorder, namely in ICD-11
Without a doubt, even more experts and researchers will explore, diagnose and will treat this category. At the same time, the name, Nietzsche sends greetings, will become more important than the problems that he has actually described. In the interview of drug policy expert Jan Fährmann, it was mentioned that there are isolated discussions about the state regulation of computer games (drug policy makes social and migration policy).
What is the point of the diagnosis? with problematic computer gaming behavior, as well as with problematic work, gambling, buying, training or badual behavior. But deciding what to look for and what is not, is one of the people – more specifically, a small number of experts. Let's not forget that despite more than 170 years of research for none of the 150 to 600 mental disorders of the DSM-5, depending on the number, there are reliable biological tests (ADHD and Holy Grail search).
People who have already been diagnosed with 6C51 – computer game disorder that helps is an open question. The number of psychological and psychiatric diagnoses has continued to increase for years (diagnoses of mental disorders are increasing strongly).
In any case, this did not lead to these problems of society to decrease as one might expect. On the contrary. Individuality, biologisation, stigmatization
A major problem with this approach is the individualization of people's problems Excessive computer games are no longer the expression of other problems in life or crises of the life, which may have to do with poverty, exclusion, unemployment or death. No, people then have CSS to suggest a practical shortcut.
And according to the dominant paradigm of psychiatric research, they have a brain disorder that is better treated with psychotropic drugs or electrical brain stimulation. This shift from the human vision of a social being to a defective neurobiological circuit, in which one intervenes as in a machine (When psychology becomes political: billions for the study of the brain) , can now be traced in many examples.
Socio-Political Dimension of Diagnosis
In addition, the decisive importance of the social resources of those affected: As with all mental disorders, the social, professional or academic functioning of computer game or computer gambling disorder is also crucial for diagnosis. However, those with a lot of resources can more easily compensate for their own failures, or are less likely to have financial difficulties.
The diagnosis is likely to affect already disadvantaged and marginalized people. If we helped affected people to control their lives themselves, then there would be a real chance.
The stigma badociated with a fault label as well as an individualizing and biological medicalization usually lead on the contrary: people become patients and victims of their situation who depend on medical services and substances. This is of course a gold mine for medical service providers.
Alternative Approaches
After all, there are some alternative approaches outside the medical mainstream. In Iceland, for example, efforts are being made to move young people away from addiction through publicly funded sports and recreation facilities. However, the UK has reported that increasing online time could be responsible for the decrease in alcohol consumption.
South Korean researchers, arguably one of the biggest computer problems, report the early successes of equine therapy. This research group also studied the effects in the brain. The results are similar to those of the study with the drug bupropion mentioned above.
The extent to which people get lost in computer games also seems to depend on the interest and diversity of their environment.
Contribution to appear in parallel on Telepolis – Magazine for Net Culture.
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