Understanding Gaming Disorder

There has been much attention given to gaming disorders and online gaming in Australia this week in response to recent 60 minutes coverage specific to the current game thats on everyone’s lips, ‘Fortnite’. The show documented the lives of families who are struggling due to a gaming addiction that is playing out in their home. Families who didn’t know what to do or where to turn.
It is true that gaming addiction has become so serious that the World Health Organisation has now classified it as a disease. At South Pacific Private we treat and support invididuals with process addictions such as gambling and gaming and see how their addictive disorders have played out. In a recent interview with Professor John Saunders, the subject of gaming disorder was discussed and John provided an indepth overview of the psychology and biology of such disorders (see video below). Professor Saunder’s career as a clinician, service director, researcher and academic in the alcohol and drug field extends back over 35 years. He is experienced in all aspects of addictive disorders and is engaged in individual clinical work and in treatment programs together with service standards and evaluation. John has worked with the World Health Organization (WHO) for many years and was responsible for developing the AUDIT questionnaire (the standardized self-assessment test for alcohol use disorders). He is a member of WHO’s Expert Advisory Panel on Substance Abuse and the ICD 11 Substance-Related and Addictive Disorders Workgroup and was previously Co-Chair of the DSM V Substance Use Disorders Workgroup (2003-2007).
John would share the view that the nature of problematic psychoactive substance continues to be a matter for controversy among the public and politicians.Some have a view that repeated use of a substance (or gambling or gaming) represents personal choice (a “free-will decision”) even when problems are occurring. Some consider it reflects the social and interpersonal influences on consumption or that it provides pleasure when life is hard. Many schooled in the field of behavioural psychology recognise the important contribution of learned behaviour and also the more subconscious influences of classical conditioning. Some conclude that these social and psychological influences result in a habit, which can be unlearned just as other habits respond to this approach. Many, particularly those in recovery from a substance problem, consider it a disease with a biological foundation and that those affected will respond differently to substances than others and over time will develop an addictive disorder. No wonder people are confused!
How do we make headway through these conflicting notions? In truth, each of them contributes something to our understanding of the nature of addictive disorders and we should not summarily reject any of them. The key issue is that the nature of these conditions changes over time. On the first occasion somebody takes a substance or gambles or plays an on-line game, it is their choice. They may be encouraged to do so by their peer group or the people they are with at the time. Moving from occasional use to repeated use typically involves social and psychological processes whereby further use is encouraged by a positive experience of the substance but also by the interaction of others who are drinking, smoking marijuana, gaming or gambling together. Substance use and related activities can be labelled as ‘socially infectious’ conditions. 
Repeated use of a substance may not remain something that is a flexible behaviour which can be changed when circumstances change. The reason for this is that it affects nerve circuits and nuclei in the brain.  Psychoactive substances do this because they get through the blood-brain barrier and cause changes directly.  In the case of gambling, gaming and other repetitive behaviours, there is internal release within the nuclei of chemical transmitters. Repeated exposure to external substances and internal chemicals affects the vital functions of these nuclei (such as reward functions and survival responses such as the fight-flight reaction). As a result, adaptive changes occur in the nerve circuits in these nuclei, which mean they are in an altered state, which scientists call “allostasis”. The allostatic state means that a powerful internal drive develops which drives forward the use of that particular substance (or engagement in gambling or gaming ever onwards.
The driving force is the central feature of what becomes an addictive disorder. Watch Professor John Saunders talk in more detail about gaming disorder in this recent video where he outlays the challenges and realities.
If you wish to find out more or are concerned about someone you love, please call South Pacific Private 24/7 (including weekends) on 1800 063 332 or email info@southpacificprivate.com.au