What is the status of Internet Gaming Disorder in the DSM-5?
A: A fully established disorder in the main body of the manual
B: A condition listed in Section III as warranting further research
C: A specifier under Impulse-Control Disorders
D: Removed from consideration after insufficient evidence
Correct: A condition listed in Section III as warranting further research
IGD appears in DSM-5 Section III ("Conditions for Further Study"), meaning it is recognised as clinically significant but not yet supported by sufficient evidence to be a fully fledged disorder. This placement reflects genuine scientific caution — the criteria are proposed, not finalised — and signals a call for more research rather than a dismissal of the phenomenon.
How many of the nine proposed IGD criteria must be met over a 12-month period to meet the diagnostic threshold?
A: 3 or more
B: 4 or more
C: 5 or more
D: 7 or more
Correct: 5 or more
The DSM-5 proposes that five or more of the nine criteria must be present within a 12-month period. This threshold mirrors the approach taken with other substance use and behavioural disorders, where a cluster of symptoms — rather than any single feature — indicates clinically significant impairment.
Match each IGD criterion to its correct description.
Which IGD criterion describes the inability to reduce or stop gaming despite repeated attempts?
A: Preoccupation
B: Loss of interest
C: Unsuccessful attempts to control
D: Deception
Correct: Unsuccessful attempts to control
"Unsuccessful attempts to control" captures the loss of volitional control that is central to addiction models. It is not simply that the person plays a lot — it is that they have tried to cut down or quit and failed. This criterion distinguishes problematic use from high-level but voluntary engagement.
According to the DSM-5 criteria, a person can meet the threshold for IGD even if gaming has not caused them to lose interest in previous hobbies, as long as five other criteria are met.
Answer: True
Because five of nine criteria are required — not all nine — any combination reaching that threshold qualifies. "Loss of interest in previous hobbies" is one of nine equally weighted criteria; its absence does not rule out a diagnosis if the other criteria are sufficiently present. This dimensional approach reflects the heterogeneity of presentations seen clinically.
What is the estimated prevalence of Internet Gaming Disorder in the general population?
A: Less than 0.5%
B: Around 2%
C: Around 8%
D: Around 15%
Correct: Around 2%
Estimates suggest approximately 2% of the general population may meet criteria for IGD, though rates vary considerably across studies depending on the criteria and methods used. Prevalence is notably higher among young individuals and men — a pattern consistent with broader data on gaming behaviour and with other externalising or impulse-control conditions.
Which of the following best describes the "deception" criterion in IGD?
A: Believing that more time spent gaming will improve real-world outcomes
B: Deceiving family members or others about the amount of time spent gaming
C: Misrepresenting one's identity or age within online gaming environments
D: Falsely believing one can stop gaming at will
Correct: Deceiving family members or others about the amount of time spent gaming
The deception criterion refers specifically to concealment of gaming behaviour from others — typically family members — about the actual amount of time spent. This mirrors the secrecy seen in other addictive behaviours and often reflects shame, anticipated conflict, or a protective response to previously unsuccessful control attempts.
IGD is thought to exist on a continuum, which is why identifying at-risk groups is considered clinically important even before a full diagnosis is warranted.
Answer: True
Like other addictive behaviours — and consistent with dimensional models in psychopathology more broadly — IGD is not conceptualised as a binary presence or absence. Problematic gaming exists on a spectrum from casual use through risky patterns to clinically significant disorder. This continuum view means that sub-threshold presentations still carry clinical relevance, and that prevention and early intervention with at-risk groups (young men, those using gaming to cope with negative affect) is meaningful work, even without a formal diagnosis.
Burén et al. (2021) replicated a two-factor structure for IGD. Which of the following correctly identifies a symptom that belongs to the "negative consequences" factor — not the "heavy involvement" factor?
A: Preoccupation
B: Tolerance
C: Escape
D: Jeopardising career or relationships
Correct: Jeopardising career or relationships
Burén et al. (2021) replicated a two-factor structure first identified by Wichstrøm et al. The heavy involvement factor comprises: Preoccupation, Tolerance, Withdrawal, Unsuccessful attempts to control, and Escape. The negative consequences factor comprises: Loss of interest in previous hobbies, Continued excessive use, Deception, and Jeopardising career or relationships. Jeopardising career or relationships is a negative consequence symptom — it reflects real-world harm caused by gaming, rather than the pattern of excessive use itself. This distinction matters clinically: heavy involvement symptoms are common even among non-disordered gamers, while negative consequence symptoms are rarer but far more diagnostic when present.
According to Burén et al. (2021), what does it mean that "heavy involvement" symptoms show high sensitivity but low positive predictive value (PPV) for IGD?
A: They reliably distinguish disordered from non-disordered gamers
B: They are common in the population but not specific to those with a serious problem
C: They are rare but strongly indicate a severe addiction when present
D: They are only observed in individuals who also meet the negative consequences factor
Correct: They are common in the population but not specific to those with a serious problem
High sensitivity means the symptom is present in most people who meet the IGD cut-off — but low PPV means that many people without a serious problem also endorse it. In plain terms: preoccupation, tolerance, and escape are common experiences among heavy gamers in general, not just disordered ones. By contrast, negative consequences symptoms (e.g. jeopardising relationships) show the opposite pattern — low sensitivity (few people report them) but high PPV (when someone does, it strongly predicts a genuine addiction problem). This asymmetry has real implications for screening: heavy involvement items catch people early but produce many false positives, while negative consequence items are more specific but may miss milder cases.
From a theoretical perspective, researchers such as Brand et al. (2019) and Dong & Potenza (2014) have argued that behavioural addictions like IGD should be understood as what kind of conditions?
A: Homogeneous conditions explained by a single reward-pathway deficit
B: Heterogeneous conditions related to multiple cognitive, emotional, and motivational mechanisms
C: Purely motivational disorders driven primarily by reward-seeking
D: Cognitive disorders best explained by executive function impairment alone
Correct: Heterogeneous conditions related to multiple cognitive, emotional, and motivational mechanisms
Theoretical frameworks emphasise that behavioural addictions are heterogeneous — meaning they do not arise from a single pathway or mechanism. Instead, cognitive factors (such as attentional bias and impaired inhibitory control), emotional factors (such as using gaming to regulate negative affect), and motivational factors (such as reward sensitivity and goal-directed behaviour) all contribute, and their relative weight may differ across individuals. This has important clinical implications: a one-size-fits-all treatment is unlikely to be optimal, and assessment should attempt to identify which mechanisms are most prominent for a given person.
Which neuropsychological functions have been most strongly linked to Internet Gaming Disorder and Social Media Disorder?
A: Processing speed and verbal fluency
B: Executive functioning (working memory and inhibition) and emotion regulation
C: Visuospatial ability and long-term memory consolidation
D: Sustained attention and procedural learning
Correct: Executive functioning (working memory and inhibition) and emotion regulation
Research has consistently implicated two broad neuropsychological domains in IGD and social media disorder. First, executive functioning — particularly working memory (Ioannidis et al., 2019) and inhibitory control (Argyriou et al., 2017) — reflecting difficulties in regulating and stopping goal-directed behaviour. Second, emotion regulation (Kuss et al., 2018; Yang et al., 2022) — the capacity to manage negative affect adaptively. These two domains connect back to the heterogeneity framework: for some individuals, problematic use may be driven more by poor impulse control, while for others the primary driver is using gaming or social media to cope with negative emotional states. Identifying which profile predominates has direct implications for treatment targeting.
Which of the following best describes the range of negative outcomes associated with problematic gaming and social media use in the research literature?
A: Primarily academic difficulties and reduced sleep quality
B: Depression, anxiety, low self-esteem, psychosomatic symptoms, and poor social relations
C: Mainly aggression and reduced empathy
D: Cognitive decline and impaired long-term memory
Correct: Depression, anxiety, low self-esteem, psychosomatic symptoms, and poor social relations
Studies consistently link both gaming disorder and problematic social media use to a broad cluster of negative outcomes: depression and anxiety (internalising symptoms), low self-esteem, physical complaints without clear medical cause (psychosomatic symptoms), and difficulties in real-world social relationships. This breadth matters theoretically — it suggests that problematic digital media use does not affect a single domain but cuts across emotional, physical, and social functioning. It also raises a key methodological question that the research cannot always resolve: does problematic use cause these outcomes, or do individuals who are already struggling with depression, poor self-esteem, or social difficulties turn to gaming and social media as a coping mechanism? Directionality is rarely established from cross-sectional data.
Internet Gaming Disorder: DSM-5 Criteria
What is the status of Internet Gaming Disorder in the DSM-5?
About this quiz
Internet Gaming Disorder (IGD) is not a fully established diagnosis in the DSM-5 — it is listed in Section III as a condition warranting further research. However, the ICD-11 (2019) went further: it formally recognised Gaming Disorder as a clinical diagnosis under "Disorders Due to Addictive Behaviours." This reflects both the clinical significance of the phenomenon and the recognition that the evidence base is still developing.
The DSM-5 proposes nine criteria for IGD, drawing parallels with other behavioural addictions. A person must meet five or more of these criteria over a 12-month period for the diagnosis to apply. Estimates suggest around 2% of the general population may be affected, with notably higher rates among young individuals and men.
Importantly, like other addictive behaviours, IGD is thought to exist on a continuum — making the identification of at-risk groups a key clinical priority, even before a full diagnosis is warranted.