A. Persistent and recurrent use of the Internet to engage in games, often with other players, leading to clinically significant impairment or distress, as indicated by five (or more) of the following in a 12-month period:
- Preoccupation with Internet games. (The individual thinks about previous gaming activity or anticipates playing the next game; Internet gaming becomes the dominant activity in daily life). (Note: This disorder is distinct from Internet gambling, which is included under gambling disorder.)
- Withdrawal symptoms when Internet gaming is taken away. (These symptoms are typically described as irritability, anxiety, or sadness, but there are no physical signs of pharmacological withdrawal.)
- Tolerance - the need to spend increasing amounts of time engaged in Internet games.
- Unsuccessful attempts to control the participation in Internet games.
- Loss of interests in previous hobbies and entertainment as a result of, and with the exception of, Internet games.
- Continued excessive use of Internet games despite knowledge of psychosocial problems.
- Has deceived family members, therapists, or others regarding the amount of Internet gaming.
- Use of Internet games to escape or relieve a negative mood (e.g., feelings of helplessness, guilt, anxiety).
- Has jeopardized or lost a significant relationship, job, or educational or career opportunity because of participation in Internet games.
Note: Only nongambling Internet games are included in this disorder. Use of the Internet for required activities in a business or profession is not included; nor is the disorder intended to include other recreational or social Internet use. Similarly, sexual Internet sites are excluded.
Specify current severity:
Internet gaming disorder can be mild, moderate, or severe depending on the degree of disruption of normal activities. Individual with less severe Internet gaming disorder may exhibit fewer symptoms and less disruption of their lives. Those with severe Internet gaming disorder will have more hours spent on the computer and more severe loss of relationships or career or school opportunities.
There are no well-researched subtypes for Internet gaming disorder to date. Internet gaming disorder most often involves specific Internet games, but it could involve non-Internet computerized games as well, although these have been less researched. It is likely that preferred games will vary over time as new games are developed and popularized, and it is unclear if behaviors and consequences associated with Internet gaming disorder vary by game type.
Excessive use of the Internet not involving playing of online games (e.g., excessive use of social media, such as Facebook; viewing pornography online) is not considered analogous to Internet gaming disorder, and future research on other excessive uses of the Internet would need to follow similar guidelines as suggested herein. Excessive gambling online may qualify for a separate diagnosis of gambling disorder.