Abstract
Background and aims: Following the recognition of ‘internet gaming disorder’ (IGD) as a condition requiring further study by the DSM-5, ‘gaming disorder’ (GD) was officially included as a diagnostic entity by the World Health Organization (WHO) in the 11th revision of the International Classification of Diseases (ICD-11). However, the proposed diagnostic criteria for gaming disorder remain the subject of debate, and there has been no systematic attempt to integrate the views of different groups of experts. To achieve a more systematic agreement on this new disorder, this study employed the Delphi expert consensus method to obtain expert agreement on the diagnostic validity, clinical utility and prognostic value of the DSM-5 criteria and ICD-11 clinical guidelines for GD. Methods: A total of 29 international experts with clinical and/or research experience in GD completed three iterative rounds of a Delphi survey. Experts rated proposed criteria in progressive rounds until a pre-determined level of agreement was achieved. Results: For DSM-5 IGD criteria, there was an agreement both that a subset had high diagnostic validity, clinical utility and prognostic value and that some (e.g. tolerance, deception) had low diagnostic validity, clinical utility and prognostic value. Crucially, some DSM-5 criteria (e.g. escapism/mood regulation, tolerance) were regarded as incapable of distinguishing between problematic and non-problematic gaming. In contrast, ICD-11 diagnostic guidelines for GD (except for the criterion relating to diminished non-gaming interests) were judged as presenting high diagnostic validity, clinical utility and prognostic value. Conclusions: This Delphi survey provides a foundation for identifying the most diagnostically valid and clinically useful criteria for GD. There was expert agreement that some DSM-5 criteria were not clinically relevant and may pathologize non-problematic patterns of gaming, whereas ICD-11 diagnostic guidelines are likely to diagnose GD adequately and avoid pathologizing.
| Original language | English |
|---|---|
| Journal | Addiction |
| Volume | 116 |
| Issue number | 9 |
| Pages (from-to) | 2463-2475 |
| Number of pages | 13 |
| ISSN | 0965-2140 |
| DOIs | |
| Publication status | Published - 09.2021 |
Funding
S.R.C.'s research is funded by a Welcome Trust Clinical Fellowship (110 049/Z/15/Z). Z.D. was supported by the Hungarian National Research, Development and Innovation Office (grant numbers: KKP126835, NKFIH‐1157‐8/2019‐DT). O.K. was supported by the János Bolyai Research Scholarship of the Hungarian Academy of Sciences and by the ÚNKP‐20‐5 New National Excellence Program of the Ministry for Innovation and Technology from the source of the National Research, Development and Innovation Fund. M.N.P. received support from the Connecticut Department of Mental Health and Addiction Services, the National Center for Responsible Gaming and the Connecticut Council on Problem Gambling. M.Y. has received funding from Monash University, and Australian Government funding bodies such as the National Health and Medical Research Council (NHMRC; including Fellowship no. APP1117188), the Australian Research Council (ARC), Australian Defence Science and Technology (DST) and the Department of Industry, Innovation and Science (DIIS). He has also received philanthropic donations from the David Winston Turner Endowment Fund and the Wilson Foundation. This article is based upon work from COST Action CA16207 ‘European Network for Problematic Usage of the Internet’, supported by COST (European Cooperation in Science and Technology); http://www.cost.eu
Research Areas and Centers
- Academic Focus: Center for Brain, Behavior and Metabolism (CBBM)
