May of 2019, the World Health Organization (WHO) voted to pass its 11th Revision of the International Classification of Diseases (ICD-11). In this revision, WHO introduced a new condition: “Gaming Disorder.” Beyond the polarized opinions on this decision, it is important to take a closer look at what the decision actually entails, what each side are saying, and what does all of this mean for fellow gamers.
In this multi-part series, we will explore
- Part 1: What “Gaming Disorder” is
- Part 2: Controversies Surrounding the Gaming Disorder Classification
- Part 3: Historical Context
- Part 4: Future Implications
Part 3: Historical Context
As the heated debate around video game addiction and gaming disorders continues, it is easy to wonder: How did all of this even begin? Believe it or not, discussions around video game addiction has quite a comprehensive historical background that spans across several decades!
The “Space Invaders” Debate (1980s)
“That is what is happening to our young people. They play truant, miss meals, and give up other normal activity to play ‘space invaders.’ They become crazed, with eyes glazed, oblivious to everything around them, as they play the machines.”
“I make no apology for the fact that before I came to the House early this afternoon I had an innocent half pint of beer in a pub with a couple of friends, put lop in a machine, and played a game of “space invaders”. Many young people derive innocent and harmless pleasure from “space invaders”. The machines—in amusement arcades, in seaside resorts and even in pubs—provide genuine, harmless entertainment for young people.” 
The excerpts above are from a transcript of a parliamentary debate in Britain in 1983. Bear in mind that compared to the multi-billion industry it is today, video games were still at their infancy. However, that did not stop concerned individuals from bringing up video game addiction as a potential hazard, and the ridicules from oppositions that follow.
It becomes evident at first glance that the talking points involved are not that much different from the more recent ones. They generally revolved around how playing video games is an activity many can healthily enjoy, versus how some cannot. It’s amazing how these same talking points for and against gaming disorder, have been repeated over and over for more than 30 years to this day!
Video Games and…Gambling? (1990s)
The 1990s were a good time for video games, thanks to the various technical and graphical improvements that occurred. In the academic field, video games were also becoming a more alluring topic for research. On the other hand, developments in the psychiatric field led to modifications on diagnostic criteria for Gambling Disorder, previously known as Pathological Gambling…
Wait a minute, you may ask, what does gambling have to do with video games? Well, it turns out that some of the first studies on video game addiction and gaming disorder, as a potential clinical condition were done using a set of diagnostic criteria very similar to the one used for Gambling Disorder. The major difference was that “Gambling” was replaced with “Space Invaders.”
“As far as I have been able to ascertain, the world’s first prevalence study of video game addiction in children was conducted in Scotland in 1986 by Brown and Robertson (1993), who asked 134 school children aged 12–16 years of age the following five questions adapted from the Gamblers Anonymous’ ‘Twenty Questions’:
1) Can you pass a Space Invaders machine without wanting to play?
2) When you have played a game do you always want to play another?
3) Do you sometimes spend more money than you were going to?
4) Do you often leave only when all of your money has run out?
5) Do you often borrow money in order to play the machine?
Based on this questionnaire, the researchers suggest that “a sizable percentage of
the general population of school children may have a significant addiction to video
gaming alone” (Brown & Robertson 1993: 453).” 
This approach would return with WHO’s classification of Gaming Disorder. In fact, if you were to take a look at WHO’s classification of Gambling Disorder in 6C50, right before Gaming Disorder, you will notice that the two lists of criteria are literally carbon copies of each other. 
The MMO Boom (2000s)
The early 2000s saw a massive growth in the MMO genre, with well known titles such as World of Warcraft, RuneScape, and EverQuest leading the charge. Many regard the MMO genre to be some of the most immersive (and for some, addictive) experiences they had with video games, and it is easy to see why. Unlike most single-player titles, developers support the game with ongoing updates to expand upon existing content. The fact that you can create your own avatar, watch it grow and prosper, and use it to directly interact with other players was also a major selling point. With MMOs gaming also became more social.
It was also during this time that mainstream news really began to pick up on horror stories of people who took video games way too seriously. EverQuest in particular had an infamous case which led to the founding of Online Gamer Anonymous.
“On-Line Gamers Anonymous® was founded by Liz Woolley in May of 2002 after her son, Shawn, committed suicide as a direct result of being addicted to an online game [EverQuest].” 
Fortunately, some video game companies have taken steps to provide more tools and incentives to encourage healthy gaming. Some of these examples range from parental controls  to game design elements .
APA: “Further Research Required” (2013)
In 2013, the American Psychiatric Association released their 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). One of the new updates to the manual was the inclusion of “Internet Gaming Disorder.” The proposed guidelines for diagnosis are as follows. 
1) Preoccupation with gaming
2) Withdrawal symptoms when gaming is taken away or not possible (sadness, anxiety, irritability)
3) Tolerance, the need to spend more time gaming to satisfy the urge
4) Inability to reduce playing, unsuccessful attempts to quit gaming
5) Giving up other activities, loss of interest in previously enjoyed activities due to gaming
6) Continuing to game despite problems
7) Deceiving family members or others about the amount of time spent on gaming
8) The use of gaming to relieve negative moods, such as guilt or hopelessness
9) Risk, having jeopardized or lost a job or relationship due to gaming
It is important to note that the condition to this day is listed as one that “requires further research.” While video game addiction has caught the attention of medical professionals, whether the condition would actually be recognized as legitimate remains unclear. That is until…
Challenger Approaching: WHO (2017)
In late 2017, beta draft of World Health Organization’s 11th revision of International Classification of Diseases (ICD-11) began to make its circulation in the news   , and with that we now arrive at the present.
We have extensively talked about the ongoing debates in part 2 [Link], but in a nutshell, the conversation has not changed much. Just like with the “Space Invaders” debates back in the 1980s, arguments are still fixated on how playing video games is an activity many can healthily enjoy, versus how some cannot.
Part 4: Future Implications
Now that we have a firm grasp of the past and present of how video game addiction came to be, what does all of this mean for us in the future? Continue to part 4 to learn more about the future implications of “Gaming Disorder,” and how you can be a part of it. [Link]
: (1983). Control of Space Invaders and Other Electronic Games. Commons and Lords Hansard. [Link]
: Nielsen, R. (2018). The Genealogy of Video Game Addiction. Nordicom. [Link]
: World Health Organization. (2019). Disorders due to Addictive Behaviors. ICD-11 for Mortality and Morbidity Statistics. [Link]
: Woolley, L. (2019). Who we are. On-Line Gamer Anonymous. [Link]
: Parental Controls. Blizzard Entertainment Inc. [Link]
: Rest. Wowpedia. [Link]
: Parekh, R. (2018). Internet Gaming. American Psychiatry Association. [Link]
: Scutti, S. (2017). WHO to recognize gaming disorder as mental health condition in 2018. CNN. [Link]
: (2017). Excessive video gaming to be recognized as mental health disorder. CBS News. [Link]
: May, A. (2017). Video gaming disorder could soon be recognized by the World Health Organization. USA Today. [Link]