A critical account of DSM-5 criteria for internet gaming disorder

The inclusion of assessment criteria for internet gaming disorder in the DSM-5 appendix means that research in this area is likely to increase. However, a standardized assessment instrument is contingent on identifying criteria that adequately captures the phenomenon. I argue in this article that issues with the proposed criteria are consistently overlooked. First, there has been a tendency to adhere to DSM-4 criteria for substance use disorders or pathological gambling when defining the assessment criteria, rather than aiming to capture the unique determinants of internet gaming disorder. Furthermore, a diagnostic instrument for gaming in particular needs to account for cultural and social divides that are a non-issue when assessing substance use. Finally, some of the proposed criteria make little sense within the context of gaming and seem to be included as residuals from existing disorders. In this article, I discuss critically each proposed criterion. I conclude that deception is socially or culturally subjective and depends on people close to the player, rather than the player himself. Symptoms like preoccupation, withdrawal, tolerance and a loss of interest in other activities may all be preceded by legitimate explanations for excessive use following widespread popularity of online gaming, which makes them unreliable in an assessment instrument. Finally, I argue that tolerance does not make sense within a gaming context and is a residual criterion from substance use disorders. A reappraisal of these criteria would benefit the development of a standardized assessment instrument for internet gaming disorder.