Cognitive Connie
Vad är internetspelstörning?
Internetspelstörning (IGD) introducerades i DSM-5 (2013) som ett Tillstånd för Vidare Studier — en kategori reserverad för fenomen som förtjänar klinisk uppmärksamhet och ytterligare forskning innan möjligt formellt erkännande som störning. Det beskriver ett mönster av ihållande och återkommande internetspelande som resulterar i kliniskt signifikant försämring eller lidande.
01. Översikt
The nine DSM-5 proposed criteria for IGD.
DSM-5 requires five or more of these nine criteria over twelve months, causing clinically significant impairment. The criteria parallel those used for substance-use disorders.
Preoccupation
Persistent preoccupation with gaming — thinking about previous gaming activity or anticipating the next session when not playing. Gaming becomes the dominant activity in daily life, crowding out other thoughts and interests.
Withdrawal symptoms
Irritability, anxiety, sadness, or restlessness when gaming is taken away or is impossible. These symptoms are psychological, not pharmacological — the withdrawal-like state reflects disruption of a habitual behaviour rather than physical dependence.
Tolerance
A need to spend increasing amounts of time gaming in order to achieve the same level of enjoyment or engagement. Parallels the pharmacological concept of tolerance, but operationalised in terms of time investment rather than dosage.
Loss of control
Unsuccessful attempts to reduce or control participation in gaming. The individual recognises that their gaming is problematic and wishes to reduce it, but is unable to do so consistently — a hallmark feature of compulsive behaviour patterns across addiction models.
Nyckelpersoner
Mark Griffiths
1966–presentBritish psychologist and prolific researcher in behavioural addictions who has studied gaming disorder for over three decades. Griffiths developed the components model of addiction (salience, mood modification, tolerance, withdrawal, conflict, relapse) and has applied it extensively to gaming, arguing for the recognition of gaming disorder while emphasising that most heavy gamers are not disordered.
Christopher Ferguson
1970–presentAmerican psychologist and leading sceptic of IGD as a diagnostic category, arguing that the existing evidence is insufficient to support formal disorder recognition, that prevalence estimates are inflated, and that cultural moral panic around gaming has distorted the research agenda. His meta-analyses have consistently found smaller effect sizes for gaming-harm associations than those reported in primary studies.
Daria Kuss
active 2010s–presentPsychologist and researcher at Nottingham Trent University who has conducted systematic reviews and neuropsychological studies of IGD, contributing to the ICD-11 working group. Her work has emphasised the neurobiological similarities between IGD and substance addictions while advocating for rigorous, standardised assessment.
Nyckelbegrepp
DSM-5 Condition for Further Study status
IGD appears in DSM-5's Section III (Emerging Measures and Models) rather than as a formal disorder in Section II. This status indicates that the construct has sufficient clinical and research interest to warrant attention and further investigation, but does not yet meet the evidentiary threshold for official disorder recognition. The ICD-11 (2022) went further and included Gaming Disorder as a formal diagnosis, creating a notable divergence between the two major classification systems.
Two-factor model
A framework distinguishing disordered gaming from engaged (passionate but non-disordered) gaming. The model proposes that the nine DSM-5 criteria cluster into two dimensions: loss of control and preoccupation (core addiction features) versus other criteria that may reflect high engagement rather than disorder. Empirical support for the two-factor structure has been inconsistent, with some studies finding a unidimensional structure and others supporting a more complex factor model.
Prevalence and heterogeneity
Prevalence estimates for IGD vary enormously across studies — from under 1% to over 10% depending on the population, country, measurement instrument, and diagnostic threshold used. This heterogeneity is itself a major methodological concern: without standardised assessment criteria applied consistently, prevalence figures are not comparable across studies and may not reflect a single underlying clinical entity.
Sensitivity and specificity
In diagnostic assessment, sensitivity is the ability of a test to correctly identify those who have the disorder (true positive rate); specificity is the ability to correctly identify those who do not (true negative rate). IGD screening instruments face a fundamental trade-off: thresholds sensitive enough to catch all cases tend to misclassify engaged but non-disordered gamers; thresholds specific enough to exclude false positives may miss genuine cases.
Executive functioning and impulse control
Multiple neuropsychological studies have found that individuals meeting IGD criteria show impairments in executive functions — particularly inhibitory control, cognitive flexibility, and decision-making under uncertainty. These deficits parallel findings in substance-use disorders and may reflect both a predisposing vulnerability and a consequence of prolonged heavy gaming. The prefrontal cortex, central to executive control, shows structural and functional differences in some IGD samples.
Emotion regulation
Heavy gaming frequently serves emotion-regulation functions: escapism from negative affect, anxiety, depression, or boredom. In individuals with IGD, gaming may function as a maladaptive coping mechanism that temporarily reduces distress but reinforces the pattern through negative reinforcement. High rates of comorbid depression, anxiety, ADHD, and social anxiety are consistently reported in IGD samples, raising the question of whether IGD is a primary disorder or a symptom of underlying emotional difficulties.
Behavioural addiction model
IGD has been conceptualised within the broader framework of behavioural (non-substance) addictions — a category that includes gambling disorder (the only formally recognised behavioural addiction in DSM-5). The addiction model holds that behavioural and substance addictions share common neurobiological mechanisms involving dopaminergic reward circuits, and that compulsive loss of control over an appetitive behaviour can constitute a disorder regardless of whether a psychoactive substance is involved.
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Vanliga frågor
Är internetspelstörning en riktig diagnos?+
Det beror på vilket klassifikationssystem man konsulterar. IGD finns i DSM-5 (2013) som ett "Tillstånd för Vidare Studier" — det erkänns inte formellt som en störning men flaggas för klinisk uppmärksamhet och forskning. ICD-11 (2022), som används internationellt, gick längre och inkluderade "Spelberoende" (Gaming Disorder) som en officiell diagnos. Debatten är levande och metodologiskt substantiell.
Vilka är DSM-5-kriterierna för internetspelstörning?+
DSM-5 föreslår nio kriterier: preoccupation med spelande; abstinenssymtom när spelandet upphör; tolerans (behov av mer tid för samma effekt); misslyckade försök att kontrollera spelandet; förlust av intresse för andra aktiviteter; fortsatt spelande trots vetskapen om att det orsakar problem; bedrägeri om mängden tid spenderad på spelande; användning av spelande för att undkomma eller lindra negativa stämningar; och riskerade relationer, jobb eller utbildningsmöjligheter. Fem eller fler kriterier under tolv månader med signifikant funktionsnedsättning föreslås som tröskel.
Hur vanligt är spelberoende?+
Prevalensuppskattningar varierar enormt — från under 1 % till över 10 % av spelande populationer — beroende på vilket screeninginstrument som används, vilken tröskel som tillämpas och vilket land eller åldersgrupp som studeras. Denna variabilitet är i sig ett centralt metodologiskt problem. De flesta forskare är överens om att den allvarliga ändan av spektrumet — där spelande orsakar tydlig funktionsnedsättning inom flera livsdomäner — drabbar en liten minoritet av spelare.
Källor
Senast granskad juli 2025- 1.
American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.). APA Publishing.
+Om den här källan
Includes Internet Gaming Disorder as a condition for further study, establishing provisional diagnostic criteria.
- 2.
World Health Organization. (2019). International Classification of Diseases, 11th Revision (ICD-11). WHO.
+Om den här källan
Formally included Gaming Disorder as a clinical diagnosis under addictive behaviours.
- 3.
Kuss D.J. & Griffiths M.D. (2012). Internet gaming addiction: A systematic review of empirical research. International Journal of Mental Health and Addiction, 10(2), 278–296.
+Om den här källan
Systematic review of empirical studies examining problematic gaming and its psychological correlates.