Center for Health Behaviours Research, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, Hong Kong.
Department of Clinical Research, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China.
J Med Internet Res. 2021 Feb 24;23(2):e22393. doi: 10.2196/22393.
The Eleventh Revision of International Classification of Diseases (ICD-11) newly listed gaming disorder, including internet gaming disorder (IGD), as a disease. The level of awareness and potential positive and negative impacts of this medicalization among adolescents were unknown.
This study investigated the levels, associated factors, and potential positive and negative impacts of awareness of the medicalization of IGD among adolescents in China.
In a cross-sectional survey, 1343 middle school students in Guangzhou, China, self-administered an anonymous questionnaire in classrooms (October to December 2019). Three risk subgroups were identified: those who scored ≥5 items in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition checklist (IGD-S), those who self-perceived having IGD currently (IGD-PC), and those who self-perceived having IGD within 12 months (IGD-P12M).
Of the internet gamers, 48.3% (460/952) were aware of the medicalization of IGD; they were more likely to belong to the IGD-P12M/IGD-S risk subgroups. Within the IGD-PC/IGD-P12M (but not IGD-S) risk subgroups, IGD medicalization awareness was positively associated with favorable outcomes (reduced internet gaming time in the past 12 months, seeking help from professionals if having IGD, and fewer maladaptive cognitions). After being briefed about the ICD-11 inclusion of IGD, 54.2% (516/952) and 32.8% (312/952) expressed that it would lead to the reduction of gaming time and help-seeking behaviors, respectively; however, 17.9% (170/952), 21.5% (205/952), 15.9% (151/952), and 14.5% (138/952) perceived self-doubt for being diseased, stronger pressure from family members, negative emotional responses, and labeling effect, respectively. With a few exceptions, such perceived positive or negative impacts were stronger among the IGD-S, IGD-PC, and IGD-P12M risk subgroups.
The exploratory study shows that the medicalization of IGD may have benefits that need maximization and potentially harmful effects that need minimization. Future studies should test the efficacies of health promotion that increases IGD medicalization awareness.
第十一版《国际疾病分类》（ICD-11）将游戏障碍，包括网络游戏障碍，列为一种疾病。公众对这一医学化的认知程度及其潜在的积极和消极影响尚不清楚。
本研究旨在调查中国青少年对网络游戏障碍医学化的认知水平、相关因素及其潜在的积极和消极影响。
采用横断面调查方法，对广州市 1343 名中学生进行课堂问卷调查（2019 年 10 月至 12 月）。根据《精神疾病诊断与统计手册》第五版检查表中得分≥5 项（网络游戏障碍筛查量表，IGD-S）、自我报告目前患有网络游戏障碍（IGD-PC）和自我报告在过去 12 个月内患有网络游戏障碍（IGD-P12M），将被试分为三个风险亚组。
在互联网游戏者中，48.3%（460/952）了解网络游戏障碍的医学化；他们更有可能属于 IGD-P12M/IGD-S 风险亚组。在 IGD-PC/IGD-P12M（而非 IGD-S）风险亚组中，对网络游戏障碍医学化的认知与积极结果相关（过去 12 个月减少上网游戏时间、如果患有网络游戏障碍寻求专业帮助、减少适应不良认知）。在简要介绍 ICD-11 将网络游戏障碍纳入其中后，分别有 54.2%（516/952）和 32.8%（312/952）的人表示这将减少游戏时间和寻求帮助的行为；然而，分别有 17.9%（170/952）、21.5%（205/952）、15.9%（151/952）和 14.5%（138/952）的人认为自己会怀疑患病、来自家庭成员的压力更大、负面情绪反应和标签效应。除了少数例外，IGD-S、IGD-PC 和 IGD-P12M 风险亚组的人对这些感知到的积极或消极影响的看法更强。
这项探索性研究表明，网络游戏障碍的医学化可能既有好处需要最大化，也有潜在的有害影响需要最小化。未来的研究应检验提高对网络游戏障碍医学化认知的健康促进效果。
