"As soon as the holiday is over, I can't wait to hold my mobile phone from morning to night, the meal is not delicious, the sleep is not good, and the homework is not in the heart to write." Mentioning her son's addiction to games during the summer vacation, Li Yan (pseudonym) couldn't help sighing. In this game of competing with the game for children's time, there are many parents with similar troubles to Li Yan.
The topic of games has repeatedly aroused social discussions, and the addictive behavior of games has also attracted the attention of the medical community. In 2019, the World Health Assembly adopted the eleventh revision of the International Classification of Diseases (ICD-11). Among them, "gaming disorder" is included as a new disease in the disease unit "disorder caused by addictive behavior". Subsequently, the National Health Commission issued the Expert Consensus on the Prevention and Treatment of Gaming Disorder (2019 Edition).
With the increasing popularity of the Internet and the younger age of users, the impact of gaming disorders caused by gaming addiction on the physical and mental health of children and adolescents is expanding. So, what exactly is gaming disorder? How can it be prevented and responded? With these questions, the reporter interviewed relevant experts.
Addicted to games, is it sick
Su Wei (pseudonym) has loved to play games since he was a child, but he has always been able to control himself until high school and his grades are good. But after entering high school, he played games longer and longer, coupled with the difficulty of high school courses, Su Wei's grades plummeted, psychological pressure also increased, and finally developed to the point that he could not continue his studies, and could only take a break from school and go home. He began to close himself off, became reticent, refused to communicate with his parents, and after some time, he was diagnosed with gaming disorder. Teens like Su Wei who are affected by gaming disorder are increasing.
Relevant research shows that in China, the prevalence of game-related diseases can reach 17%. Based on previous studies, the prevalence of gaming disorder averaged about 5% and remained relatively stable. People with gaming disorders are mainly male, children and adolescents.
"Whether in outpatient or inpatient units, the number of cases of gaming disorder among children and adolescents is increasing." Liu Yan, a psychotherapist at the Addiction Medical Center of Beijing Huilongguan Hospital, said.
"According to the ICD-11 diagnostic criteria, gaming disorder is manifested as a persistent or repetitive pattern of gaming behavior, with core manifestations including out-of-control play, gaming behavior becoming a priority in life, and unstoppable even with negative consequences; Gaming behavior patterns can be persistent or episodic and last for 12 months, but can last less than 12 months if symptoms are severe enough to meet other diagnostic points; Patterns of gaming behavior lead to significant personal, family, interpersonal, academic, occupational, or other functional impairments. Yang Kebing, director of the Addiction Medicine Center of Beijing Huilongguan Hospital, introduced.
"Gaming disorder will seriously affect people's normal life, in addition to serious impairment of social functions, it may also bring malnutrition, vision loss and other physical problems, wrist, finger joints related problems are also very common; Irregular work and rest, day and night reversal can also lead to depression, anxiety and other emotional problems, which have a huge impact on both body and mind. Yang Kebing said.
"Gaming disorder is something to be aware of, but not just playing games is a gaming disorder." Yang Kebing prompted, "If repeated gaming behavior is aimed at promoting socialization, alleviating boredom, regulating emotions, etc., and does not have other necessary characteristics of gaming disorder, it cannot be diagnosed as gaming disorder." Many teenagers will have longer or more frequent gaming behaviors during the holidays, if it is only a stage problem, it does not constitute a gaming disorder, parents do not need to be overly nervous, and can balance the use of mobile phones or computers during the holiday by adding other activities. In addition, for individuals involved in the gaming industry, high-intensity gaming behavior may be part of their professional content and should not be diagnosed as gaming disorder. ”
"Although most children in life are addicted to games, they have not reached the level of game disorder, which is a harmful game behavior, which refers to the risk of health damage, but has not yet appeared health damage. In this regard, parents should maintain observation and intervene in a timely manner to avoid developing gaming disorder. If you find that your child's game behavior is out of control, such as playing games for longer and longer, affecting daily life and learning, even when not playing, always think about things related to games. If you can't play the game, you will lose your temper and fidget; You are aware of the many disadvantages of playing games, but still can't reduce the time you play, so it is recommended to seek professional help. The Gaming Disorder Questionnaire can be used as an aid to self-testing your gaming addiction, but the final diagnosis needs to be completed by a professional doctor. Yang Kebing introduced.
Behind the love of play, hidden their psychological needs
"Most of the people with gaming disorder are children and adolescents aged 10~18, especially adolescent children." Yang Kebing introduced, "This is closely related to the younger age of the game audience. Data show that in 2021, the scale of minor Internet users in China will reach 1 million, the Internet penetration rate of minors will reach 91.96%, and the Internet penetration rate of primary school students will reach 8%, an increase of 95.2020 percentage points over 2. Children and adolescents have not yet completed brain development, their outlook on life, world view, and values have not yet matured, their curiosity is strong, their self-control is limited, and they are more likely to be affected by games and addicted to them. ”
"Almost all of my friends around me play games, and we often go out together." Xiaofei (pseudonym) in the second year of junior high said. During the interview, the reporter found that games have become an important part of teenagers' social interaction, which undoubtedly strengthens the sense of existence of games in teenagers' lives.
Adolescent emotional and psychological problems can also lead to dependence on games. "Especially in adolescence, rapid physical and mental development, as the pressure of academics increases, they desire to be recognized by others, and the game within reach becomes their emotional outlet. For adolescents who are not confident due to academic, physical or interpersonal setbacks, the evaluation anxiety caused by face-to-face communication can also be avoided in the game and can be relaxed to express. Yang Qingyan, deputy chief physician of the Addiction Medical Center of Beijing Huilongguan Hospital, said.
"For parents, indulging in gaming is a behavioral bias; But for children, it may be a self-help method and a distress signal. Liu Yan told reporters, "As one of the vulnerable groups in society, the emotional problems of children and adolescents are not only personal problems, but also the embodiment of social pressure and family problems transmitted to children." Many parents are particularly angry when they see their children addicted to games, thinking that games developed by game companies make their children like this. But why do children keep playing games for so long? Even if you know that there will be a lot of negative consequences, you still have to play? Repeated gaming behavior means that the thing is valuable to them. They may have gained things that are difficult to obtain in life in the game, such as a sense of achievement, companionship, pleasure, etc.; Or hide in the game, avoid all kinds of pressure, undesirable social relationships, etc. Therefore, instead of blindly accusing, parents should think about how to meet these psychological needs in life and help children return from games to reality. ”
"A good parent-child relationship is a protective factor for gaming disorder, and conversely, conflict, strained family relationships can push children into play." Liu Yan reminded, "Especially after entering adolescence, adolescents have increased self-awareness, easy to be impulsive and rebellious, if parents cannot respect their independent development needs during this period, and still require children to obey themselves, it is easy to produce conflicts, children will resist parental control by playing games, and refuse to communicate with parents." ”
"In terms of individual characteristics, poor delayed gratification is also a risk factor for gaming disorder, and the formation of this situation is often related to parents' excessive pampering and failure to effectively cultivate children's relevant abilities." Yang Kebing said, "In terms of the type of game, online games have a higher risk of causing gaming disorders than offline games, and massively multiplayer online role-playing games, first-person shooters, fighting and real-time strategy games are more addictive. Studies have found that offline gaming modes can significantly improve online addiction behavior. ”
To deal with gaming disorder, professional treatment is indispensable
"I also tried hiding my mobile phone and disconnecting the Internet, but in the end it didn't work, now mobile phones, tablets and other electronic devices can be seen everywhere, take away the child's mobile phone, he can still use his grandparents, we can't watch him, what we can do is take him out more activities, and also signed up for a swimming class, hoping to minimize his time to play games." Faced with her son's addiction to games, Li Hong (pseudonym) told reporters about her troubles.
"We oppose parents using violent and punitive behaviors to counter children's gaming behaviors, such as disconnecting the Internet, dropping computers, and even kicking children out, which often leads to greater resistance, and forced withdrawal may cause parent-child conflicts to escalate, and even cause harmful consequences." Liu Yan said, "The development of the family should also keep up with the development of the child, parents can understand the psychological characteristics of adolescents at different stages, learn to identify and deal with the child's psychological problems, and adjust the education method according to the child's development needs." When the family cannot deal with the child's problems, do not shy away from medical treatment, and actively seek professional help. ”
From a medical point of view, how to deal with gaming disorder? "Treatment modalities for gaming disorder include psychosocial therapy, medication, and physical therapy, of which psychosocial therapy is the main modality, including individual therapy, family therapy, group therapy, behavior replacement therapy, etc." Yang Kebing introduced.
"We will first understand the past medical history of the patient with gaming disorder, determine the patient's state through medical history collection, psychiatric examination, physical examination, auxiliary examination, etc., and determine whether it is a simple gaming disorder or a comorbid disease with other mental problems." In terms of treatment, it is generally necessary to start with the patient's individual psychotherapy to further understand the patient's condition. If it is found that there are problems between children and parents and need family intervention, family members will be guided to discover their own problems through family therapy, prompting them to adjust their words and deeds, construct common family goals, and eliminate conflicts; Group therapy is also a great way to get patients with similar problems together and share their experiences, in the process they will find that they are not alone and gain some psychological energy through mutual understanding and support. In addition, there are behavioral alternative therapies, such as jumping rope, hula hoops, painting, handmade origami and other activities, hoping that people with gaming disorder can find interesting and persistent projects in it, feel happy in the process, and realize that life is diverse, not just games. In general, doctors will use appropriate treatment methods at different stages according to the characteristics of each patient. Yang Qingyan introduced.
"If hospitalization is required, then the time is generally 6~8 weeks, if the intervention is effective, when the patient recognizes that the past behavior pattern is not desirable, and the mood remains basically stable, and is willing to return to the basic regular life, he can switch from inpatient to outpatient follow-up, further recovery in the family environment, and finally return to normal life." Yang Qingyan said.
"In terms of drug treatment, because gaming disorder often coexists with other emotional problems, drug treatment is generally used for symptomatic treatment of certain emotional and behavioral disorders in patients. At present, there are no drugs approved by the National Medical Products Administration for the treatment of gaming disorder, which means that there is no specific drug for gaming disorder, and parents should be wary of related marketing scams. Yang Kebing reminded, "Physical therapy is mainly some non-invasive brain stimulation methods, such as transcranial direct current stimulation, transcranial magnetic stimulation, etc., these stimulation methods are non-invasive, painless non-invasive treatment, the basic principle of which is to improve the patient's synaptic plasticity through stimulation to achieve the purpose of improving the symptoms of game addiction." ”
"Gaming-related issues are increasing rapidly, and we still provide too little professional support for gaming disorders. This requires relevant academic institutions and groups to improve the identification, assessment and diagnosis system of gaming disorder, and carry out relevant training, so as to improve the professional ability of gaming disorder diagnosis and treatment. Yang Kebing said.
On the way to growth, it is important to learn science games
"For gaming addiction, prevention is a more effective and less impactful means than treatment. As a parent, first of all, actively pay attention to the child's state and life situation, and prevent gaming disorder as soon as possible; secondly, help children develop the ability to control impulses and delay gratification. From a child's early age, exercise his ability to achieve satisfaction through hard work to prevent excessive spoiling of the child and a decline in delayed gratification. Finally, guide children to establish a variety of hobbies, start from their own interests, develop chess, ball, piano and other specialties, and increase the diversity of leisure activities. Yang Kebing suggested.
Almost all professionals emphasize the importance of the home environment for gaming disorder prevention.
"The life of children and adolescents is mainly composed of five basic systems: the family system based on family affection, the school system based on academics, the peer system based on belonging, the network system based on preferences, and the situation system based on community, of which family and school are the two most important systems. Maintaining a good parent-child relationship, respecting children, and communicating smoothly can effectively prevent gaming disorder. When there is a problem with the parent-child relationship, it is necessary to prioritize repairing the parent-child relationship, only in a well-communicated parent-child relationship, children are willing to come out of the game, and as the reality link is gradually repaired, their dependence on the network is not so strong. Liu Yan said.
"Schools are also important places for the prevention of gaming disorder, and can help students and parents understand gaming disorder by organizing class meetings and expert lectures, and carry out some mental health knowledge and coping skills publicity." In addition, the friendly atmosphere provided by the school, good teacher-student relationship, classmate relationship, etc. can reduce adolescents' loneliness, depression and other emotions, and have a positive effect on the prevention of gaming disorder. Yang Kebing said.
"Playing games is also a normal need for children and adolescents, and preventing gaming disorder does not mean completely rejecting games." In Liu Yan's view, "The ultimate goal of preventing and intervening in gaming disorder is to help young people learn to play scientifically, use the Internet healthily, and enjoy the joy brought by games." As a generation that grew up in the online information society, this is also an important issue in the growth of teenagers. ”
(Guangming Daily reporter Chen Tong)