An international consensus for assessing Internet gaming disorder using the new DSM-V approach

Addiction (Impact Factor: 4.74). 01/2014; 109(9):1399-1406. DOI: 10.1111/add.12457
Source: PubMed


For the first time, the Diagnostic and Statistical Manual for Mental Disorders (DSM-5) introduces non-substance addictions as psychiatric diagnoses. The aims of this paper are to (i) present the main controversies surrounding the decision to include internet gaming disorder, but not internet addiction more globally, as a non-substance addiction in the research appendix of the DSM-5, and (ii) discuss the meaning behind the DSM-5 criteria for internet gaming disorder. The paper also proposes a common method for assessing internet gaming disorder. Although the need for common diagnostic criteria is not debated, the existence of multiple instruments reflect the divergence of opinions in the field regarding how best to diagnose this condition.
We convened international experts from European, North and South American, Asian and Australasian countries to discuss and achieve consensus about assessing internet gaming disorder as defined within DSM-5.
We describe the intended meaning behind each of the nine DSM-5 criteria for internet gaming disorder and present a single item that best reflects each criterion, translated into the 10 main languages of countries in which research on this condition has been conducted.
Using results from this cross-cultural collaboration, we outline important research directions for understanding and assessing internet gaming disorder. As this field moves forward, it is critical that researchers and clinicians around the world begin to apply a common methodology; this report is the first to achieve an international consensus related to the assessment of internet gaming disorder.

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Available from: Florian Rehbein, Jun 02, 2014
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    • "Internet gaming disorder (IGD), the most prevalent subtype (57.5 percent) of Internet addiction disorder (IAD) (Chen et al. 2014), is defined as persistent and recurrent use of the Internet to engage in games (American Psychiatric Association 2013). As with other addictions, IGD is associated with numerous negative consequences across multiple domains, including physical health, academic performance, psychosocial functioning and interpersonal relationships (Kuss and Griffiths 2012; Petry et al. 2014). "
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    ABSTRACT: Studies conducted in drug addiction suggest a transition in processing of drug-related cues from the ventral to the dorsal component of the striatum. However, this process has not been studied in a behavioral addiction. Assessment of this process in a non-drug addiction can provide insight into the pathophysiology of both substance and behavioral addictions. Thirty-nine male Internet gaming disorder (IGD) subjects and 23 male matched healthy controls (HCs) participated in functional magnetic resonance imaging during performance of a cue-reactivity task involving alternating presentation of Internet gaming-related stimuli (game cues) and general Internet surfing-related stimuli (control cues). Cue-induced neural activations in the ventral and dorsal striatum (DS) were compared between IGD and HC participants. Associations between cue-reactivity within these regions and cue-induced craving and severity and duration of IGD were also explored. IGD participants exhibited higher cue-induced activations within both the ventral and DS when compared with HCs. Within the IGD group, activity within the left ventral striatum (VS) was correlated negatively with cue-induced craving; positive associations were found between activations within the DS (right putamen, pallidum and left caudate) and duration of IGD. Cue-induced activity within the left putamen was negatively associated with right VS volumes among IGD participants. Consistent with studies in substance addictions, our results suggest that a transition from ventral to dorsal striatal processing may occur among individuals with IGD, a condition without the impact of substance intake.
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    • "The instrument was developed theoretically via experts' discussion in an attempt to operationalize IGD using the nine DSM-5 criteria in a brief and simple way, and by adopting clear unambiguous wording for each item. In order to increase content validity, the diagnostic criteria of IGD based on DSM-5 were strictly followed, while also taking into consideration Petry et al.'s (2014) recommendations regarding item operationalization. Each criterion was operationalized using a single item, except for the last criterion referring to " jeopardy or losing a "
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    ABSTRACT: An online gamer sample of 4887 gamers (age range 14–64 years, mean age 22.2 years [SD = 6.4], 92.5% male) was collected through Facebook and a gaming-related website with the cooperation of a popular Hungarian gaming magazine. A shopping voucher of approx. 300 Euros was drawn between participants to boost participation (i.e., lottery incentive). Confirmatory factor analysis and a structural regression model were used to test the psychometric properties of the IGDT-10 and IRT analysis was conducted to test the measurement performance of the nine IGD criteria. Finally, Latent Class Analysis along with sensitivity and specificity analysis were used to investigate the cut-off threshold proposed in the DSM-5.
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    • "In DSM-5 (American Psychiatric Association, 2013), " need to gamble with increasing amounts of money in order to achieve the desired excitement " was used to define gambling disorder. A previous study refers to " feeling the need to play games for longer periods of time to experience excitement " to define tolerance of IGD (Petry et al., 2014). In our clinical experience , online gaming time usually reached a ceiling among chronic subjects of IGD. "
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