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The World Health Organization last month added "Internet Gambling Disorder" to its manual of psychiatric diagnoses, and the reaction was, we will say, muted.
At a time when millions of adult adults are trading one-liners with Siri or Alexa, the diagnosis seems late, is not it?
Put down your phone and look around: If half of the people you see walking down the street or taking the bus with you are face down in a small screen, it's not a coincidence to think that & # 039; A certain percentage of us especially the younger ones and the men, fell hard for " Fortnite" or "League of Legends" or "World of Warcraft" and can not get up, except to pick up the occasional bowl of Lucky Charms.
They are stuck. They sleep with their heads on keyboards. They could use a friend's breathing, let go-to-the-park variety. They could use help.
Yet to embrace I.G.D., as we know, as a new mental health disorder has its own perils. Many psychologists are skeptical about the fact that it exists as a stand-alone problem. The diagnostic criteria are still unclear, and the potential for overdiagnosis is enormous
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I.G.D. is a case study on what happens when researchers become convinced that a bad habit has become something different: a disorder. Studies accumulate and the notion takes on a life of its own – which may or may not be convincing to the putative "patients".
"The question is, what is the difference between a bad habit and a disorder, and where do you draw that line," said Scott Lilienfeld, professor of psychology at Emory University.
"Some , like me, believe that there is often no reliable way to do it. Others do not agree. The fact is that you have to be very careful to do this "for people who need help."
WHO's definition of gambling disorder is a mouthful:
A model of gambling behavior characterized by a deficient control over the game, the priority given to the game over other activities to the extent that the game takes precedence over other interests and daily activities, and the pursuit or l & # 39; 39, climbing the game despite the negative consequences.
As a diagnosis, it's a potential blockbuster. Estimates of its prevalence – up to 9 percent of all players – mean that dozens Millions of people, most of them young people in the world, can now be considered mentally disturbed.
"The children I see really have a problem, and it has disastrous effects on many aspects of their lives. life – school performance, social life the mood, "says Dr. Clifford Sussman, a Washington psychiatrist who deals with compulsive gambling with psychotherapy. 19659002] "No matter what you call, the goal is to give them tools" to control the habit, he added, and better integrate it into their lives.
Many other psychiatrists agree and say that they have treated the constraint successfully. But the American Psychological Association, among other groups, opposes the diagnosis.
The association argues that the definition remains too vague, and that mood problems may actually precede excessive gambling, and not the opposite. The new label reflects a "moral panic," critics say – an unfounded fear of new technology that years ago had parents and experts stirring up the corrosive effects of television, and before that, the radio
a core of truth in what supporters say, "said Christopher Ferguson, a psychologist at Stetson University who was a skeptic of the many evils attributed to the game." There is something to that although we really do not know enough to fully understand it. "
Parts of the science published so far, he said, have not been reassuring. Take, for example, looking for a "signature" disorder in the brain.
In a recent study, a group of scientists in China and Europe interviewed 38 people identified as having an I.G.D. put their head in an MRI scanner.
Compared to peers who had less compulsive gambling habits, I.G.D. The group "showed a significant decrease in cortical thickness in the left lateral orbitofrontal cortex, inferior parietal lobule, bilateral cuneus, pre-central gyrus and right middle temporal gyrus," the researchers said [19659038]. that people with IGD had "decreased the connectivity between the left amygdala and the frontal gyrus and precentral left left."
That's a lot of fancy-sounding brain regions. But the conclusions are all virtually meaningless, since no one knows much about how these regions interact, or why one player's bilateral cuneus gets to be thicker than another.
Another recent study has focused on treatment: not just a treatment, but bupropion, an antidepressant often used in smoking cessation.
The study found that after 12 weeks, " depressive symptoms, attention and impulsivity improved, "as did some, for some, on a scale called Young Internet Addiction Scale
. study actually learned to manage their habits in a sustainable manner.
"Once you decide that there is a disorder, you start looking for it in people's brains and try to knock it out, as you would a tumor at brain, "said Dr. Lilienfeld.
But of course, there is no tumor in this case.
Finally, another recent study hinted that one way to break the game's trance is to put the addicts on the screen on horseback.
After seven days of "activities and therapies with equine assistance", a group of adolescents diagnosed with I.G.D. showed an improvement in "avoidance and anxiety scores," concludes this study.
The practice of riding, usually with a guide-therapist on horseback, giving instructions and encouragement, has shown some benefits for people with autism, traumatic brain injury and post-traumatic stress.
Now … the players
The question of whether the inclusion of compulsive gambling by W.H.O. leads eventually to better research, or standardized treatments that reliably change behavior, is an open question.
But for the moment, it would be hard to blame anyone with a serious joystick for hesitating at the prospect of a "mess".
A bad habit can be bad. But at least, it is not brain scans, antidepressant pills or hanging on to the expensive life of some Cheyenne or Misty
. Digital horses are much safer to drive, after all. And you get to wear a sword.
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