청소년 게임중독의 의료화 현상에 대한 연구
Medicalizing adolescent gaming addiction
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세계보건기구(WHO)는 2022년 1월 발효된 국제질병분류 11차 개정안에서 ‘게임이용 장애(gaming disorder)’를 등재했다. 이 결정으로 인해, 게임중독은 정식 질병코드를 부여받고 정신적 질병의 한 종류로 지정되었다. 특정상태나 행동을 의학적 틀을 적용해 판단하는 ‘의료화’(medicalization)는 고통 받는 사람들을 위한 치료의 근거를 마련할 수 있지만, 동시에 정상적으로 여겨질 수 있는 일상생활의 문제를 병리적으로 해석한다는 비판을 받는다. 이러한 논의들에 근거해 본 연구는 게임중독의 의료화가 특히 청소년시기에 적용될 경우 발생할 잠재적 문제점들을 문헌연구를 중심으로 살펴보았다. 연구결과 세계보건기구의 국제질병표준분류기준(ICD-11)가 제시한 게임중독 진단은 기능적 손상을 강조하여 게임에 대한 ‘몰입’과 ‘병적인 중독’ 간의 경계를 구분하기 어렵게 만드는 등 기준이 모호하고, 게임중독의 문제가 청소년 시기에만 발생하는 일시적인 문제일 가능성이 있고, 게임중독이 다른 근본적인 정신 장애에 의해 발생하는 것인지 아니면 게임 자체로 인한 결과인지에 대한 실증적 근거가 충분하지않음을 알 수 있었다. 이를 통해, 게임중독을 별도의 장애로 구분하여 명명하는 실익은 높지않으며 그 타당성이 확보되지 않았음을 제시했다. 의료화 현상의 발달과 변화과정을 비판적으로 검토하고, 이에 대한 향후 전망을 서술하였다
Abstract
In January 2022, the World Health Organization (WHO) officially recognized “gaming disorder” as a mental illness and included it in the 11th revision of the International Classification of Diseases (ICD-11). This decision categorized gaming as a form of addictive behavior disorder, thereby medicalizing it. Although medicalization can provide treatment options for individuals affected by gaming addiction, concerns about pathologizing normal behaviors and everyday problems arise. This study focused on the potential issues associated with medicalizing gaming addiction, particularly among adolescents by summarizing previously published studies. Findings highlight several key points. First, the ICD-11 gaming addiction diagnosis is unclear and lacks specificity because it distorts the distinction between excessive immersion in gaming and pathological addiction. Second, gaming addiction tends to be transient and primarily occurs during adolescence, suggesting that it may not persist in adulthood. Finally, a lack of empirical evidence determines whether problematic gaming behaviors stem from underlying mental disorders or are a direct consequence of the games. Labeling gaming addiction as a separate disorder lacks practical utility, and its validity remains uncertain. This study critically examines the medicalization process and its development and changes over time. Potential future directions regarding the medicalization phenomenon are also discussed.
참고문헌 (89)
- 경장재, "국민건강보험 데이터베이스를 이용한 한국의 소아와 성인에서 주의력결핍 과잉행동장애의 진단율 및 약물 사용 추세 연구", 신경정신의학, 60(4), pp.320~328 (2021), 대한신경정신의학회[DOI]
- 아동·청소년의 정신건강 현황, 지원제도 및 개선방향, "국회입법조사처", ~ (2021)
- 2016 정신질환 실태조사, "보건복지부", 보건복지부, ~ (2016)
- 정연식, "질병 없는 질환", 비평과이론, 27(1), pp.195~216 (2022), 한국비평이론학회
- 2020 게임과몰입 종합 실태조사, "한국콘텐츠진흥원", ~ (2020)
- Aarseth, E., "Scholars’ open debate paper on the world health organization ICD-11 gaming disorder proposal", Journal of Behavioral Addictions, 6(3), pp.267~270 (2017)[DOI]
- Akbari, M., "The Big Five personality traits and online gaming : A systematicreview and meta-analysis", Journal of Behavioral Addictions, 10(3), pp.611~625 (2021)[DOI]
- American Psychiatric Association, "Diagnostic and Statistical Manual of Mental Disorders (DSM-5®)" (2013), American Psychiatric Publishing
- Andreassen, C. S., "The relationship between addictive use of social media and video games and symptoms of psychiatric disorders : A large-scale cross-sectional study", Psychology of Addictive Behaviors, 30(2), pp.252~262 (2016)[DOI]
- Billieux, J., "Functional impairment matters in the screening and diagnosis of gaming disorder", Journal of Behavioral Addictions, 6(3), pp.285~289 (2017)[DOI]
- Blüml, V., "Personality factors and suicide risk in a representative sample of the German generalpopulation", PLoS ONE, 8(10) (2013)[DOI]
- Borges, G., "(Internet)Gaming Disorder in DSM-5 and ICD-11 : A Case of the Glass Half Empty or Half Ful", Canadian journal of psychiatry, 66(5), pp.477~484 (2021)[DOI]
- Brezo, J., "Personality traits as correlates of suicidalideation, suicide attempts, and suicide completions : A systematic review", ActaPsychiatrica Scandinavica, 113(3), pp.180~206 (2006)[DOI]
- Brunborg, G. S., "Gaming addiction, gaming engagement, and psychological health complaints among Norwegian adolescents", Media Psychology, 16(1), pp.115~128 (2013)[DOI]
- Casey, B. J., "Beyond Simple Models of Self-Control to Circuit-Based Accounts of Adolescent Behavior", Annual Review of Psychology, 66(1), pp.295~319 (2015)[DOI]
- Charlton J. P., "Distinguishing addiction and high engagement in the context of online game playing", Computers in Human Behavior, 23(3), pp.1531~1548 (2007)[DOI]
- Charlton J. P., "Validating the distinction between computer addiction and engagement : Online game playing and personality", Behaviour & Information Technology, 29(6), pp.601~613 (2010)[DOI]
- Conrad P., "International Encyclopedia of the Social & Behavioral Sciences", pp.105~109 (2015), Elsevier Science &Technology
- Conrad, P., "Medicalization and social control", Annual Review of Sociology, 18(1), pp.209~232 (1992)[DOI]
- Conrad, P., "The medicalization of society : On the transformation of human conditions into treatable disorders" (2007), Johns Hopkins University Press
- Conrad, P., "Estimating the Costs of Medicalization", Social Science and Medicine, 70, pp.1943~1947 (2010)
- Coyne, S. M., "Pathological video game symptoms from adolescence to emerging adulthood : A 6-year longitudinal study of trajectories, predictors, and outcomes", Developmental Psychology, 56(7), pp.1385~1396 (2020)[DOI]
- Demetrovics, Z., "Why do you play? The developmentof the motives for online gaming questionnaire(MOGQ)", Behavior Research Methods, 43(3), pp.814~825 (2011)[DOI]
- Dreger, A., "One of Us : Conjoined Twins and the Future of Normal" (2004), Harvard University Press
- Erevik, E. K., "Problem gaming and suicidality : A systematic literature review", Addictive Behaviors Reports, 15, pp.100419~ (2022)[DOI]
- Fam, J. Y., "Prevalence of internet gaming disorder in adolescents : A meta-analysis across three decades", Scandinavian Journal of Psychology, 59(5), pp.524~531 (2018)[DOI]
- Fauth-Bühler M., "Neurobiological correlates of Internet gaming disorder : similarities to pathological gambling", Addictive Behaviors, 64, pp.349~356 (2017)[DOI]
- Freidson, E., "The Profession of Medicine" (1970), Dodd, Mead
- Griffiths, M. D., "The role of context in online gaming excess and addiction : Some case study evidence", International Journal of Mental Health and Addiction, 8(1), pp.119~125 (2010)[DOI]
- Han, D. H., "Dopamine genes and reward dependence in adolescents with excessive internet video game play", Journal of Addiction Medicine, 1(3), pp.133~138 (2007)[DOI]
- Higuchi S., "Inclusion of gaming disorder criteria in ICD-11 : A clinical perspective in favor", Journal of Behavioral Addictions, 6(3), pp.293~295 (2017)[DOI]
- Horwitz, A. V., "The Loss of Sadness : How Psychiatry Transformed Normal Sorrow into Depressive Disorder" (2007), Oxford University Press
- James R. J. E., "The relationship between gaming disorder and addiction requires a behavioral analysis", Journal of Behavioral Addictions, 6(3), pp.306~309 (2017)[DOI]
- Jeon, H. G., "Exploring the Mechanism of Pathological Gaming in Adolescents : Focused on the Mediation Paths and Latent Group Comparison", Frontiers in psychology, 12, pp.756328~ (2022)[DOI]
- Jo, Y. S., "Clinical Characteristics of Diagnosis for Internet Gaming Disorder : Comparison of DSM-5 IGD and ICD-11 GD Diagnosis", Journal of clinical medicine, 8(7), pp.945~ (2019)[DOI]
- Kaczmarek, E., "How to distinguish medicalization from over-medicalization?", Medicine, Health Care, and Philosophy, 22(1), pp.119~128 (2019)[DOI]
- Kardefelt-Winther, D., "Conceptualizing internet use disorders : Addiction or coping process? : Conceptualizing internet use disorders", Psychiatry and Clinical Neurosciences, 71(7), pp.459~466 (2017)[DOI]
- Király O., "Inclusion of gaming disorder in ICD has more advantages than disadvantages", Journal of Behavioral Addictions, 6(3), pp.1~15 (2017)[DOI]
- Klonsky, E. D., "Suicide, suicide attempts, and suicidalideation", Annual Review of Clinical Psychology, 12, pp.307~330 (2016)[DOI]
- Public Health Response to Health Problems Related to Excessive Use of Game, "Korean Addiction Form", Korean Association Medical Law, ~ (2019)
- Krossbakken, E., "A cross-lagged study of developmental trajectories of videogame engagement, addiction, and mental health", Frontiers in Psychology, 9, pp.2239~ (2018)[DOI]
- Kuss, D. J., "Chaos and confusion in DSM-5 diagnosis of Internet Gaming Disorder : Issues, concerns, and recommendations for clarity in the field", Journal of Behavioral Addictions, 6(2), pp.103~109 (2017)
- Landrault, H., "Suicidal ideation in elite schools : A test of the interpersonal theory and the escapetheory of suicide", Suicide and Life-Threatening Behavior, 50(1), pp.201~210 (2020)[DOI]
- Lane. C., "Shyness : How a Normal Behavior Became a Sickness" (2007), Yale University Press
- Lemmens, J. S., "Addictive online games: Examining the relationship between game genres and Internet gaming dis order", Cyberpsychology, Behavior, and Social Networking, 19(4), pp.270~276 (2016)[DOI]
- Li, D., "Examining the influence of actual-ideal self-discrepancies, depression, and escapism, on pathological gaming among massively multiplayer online adolescent gamers", Cyberpsychol Behav Soc Netw, 14, pp.535~539 (2011)
- Liau, A. K., "Pathological videogaming among youth : A prospective study examining dynamic protective factors", Addiction Research & Theory, 23(4), pp.301~308 (2015)[DOI]
- Liu, L., "The comorbidity between internet gaming disorder and depression : interrelationship and neural mechanisms", Front Psychiatry, 9, pp.154~ (2018)[DOI]
- Liu, L., "Activation of the ventral and dorsal striatum during cue reactivity in internet gaming disorder : Activation of the ventral and dorsal striatum", Addiction Biology, 22(3), pp.791~801 (2017)[DOI]
- Long, J., "Prevalence and correlates of problematic online gaming : A systematic review of the evidence published in chinese", Current Addiction Reports, 5(3), pp.359~371 (2018)[DOI]
- Luciana, M., "Dopaminergic modulation of incentive motivation in adolescence : agerelated changes in signaling, individual differences, and implications for the development of self-regulation", Developmental psychology, 48(3), pp.844~861 (2012)[DOI]
- Markey, P. M., "Internet gaming addiction : Disorder or moral panic", The American Journal of Psychiatry, 174(3), pp.195~196 (2017)[DOI]
- McDannald, M. A., "Ventral striatum and orbitofrontal cortex are both required for model-based, but not model-free, reinforcement learning", The Journal of neuroscience : the official journal of the Society for Neuroscience, 31(7), pp.2700~2705 (2011)[DOI]
- Metcalf O., "Impulsivity and related neuropsychological features in regular and addictive first person shooter gaming", Cyberpsychology, Behavior, and Social Networking, 17(3), pp.147~152 (2014)[DOI]
- Montag, C., "Psychopathological symptoms and gaming motives in disordered gaming : Apsychometric comparison between the WHO and APA diagnostic frameworks", Journal of Clinical Medicine, 8(10), pp.1691~ (2019)[DOI]
- Na, E., "The influence of game genre on Internet gaming disorder", Journal of behavioral addictions, 6(2), pp.1~8 (2017), Advance online publication[DOI]
- Parens, E., "on good and bad forms of medicalization", Bioethics, 27(1), pp.28~35 (2013)[DOI]
- Jeong-Ha Park, "Correlations among Social Anxiety, Self-Esteem, Impulsivity, and Game Genre in Patients with Problematic Online Game Playing", PSYCHIATRY INVESTIGATION, 13(3), pp.297~304 (2016), 대한신경정신의학회[DOI]
- Park, S., "Association between screening and the thyroid cancer"epidemic"in south korea : Evidence from a nationwide study", BMJ(Online), 355, pp.i5745~i5745 (2016)[DOI]
- Peeters, M., "Normative, passionate, or problematic? Identification of adolescent gamer subtypes over time", Journal of Behavioral Addictions, pp.1~12 (2019)[DOI]
- Petry, N. M., "Internet gaming disorder in the DSM-5", Current Psychiatry Reports, 17(9), pp.72~72 (2015)[DOI]
- Pitts, J., "International Encyclopaedia of the Social Sciences" (1968), Macmillan
- Przybylski, A. K., "Internet gaming disorder : Investigating the clinical relevance of a new phenomenon", The American Journal of Psychiatry, 174(3), pp.230~236 (2017)[DOI]
- Richards, J. M., "A systematic review of fMRI reward paradigms used in studies of adolescents vs. adults: the impact of task design and implications for understanding neurodevelopment", Neuroscience and biobehavioral reviews, 37(5), pp.976~991 (2013)[DOI]
- Salvarl, S. I., "The association between internet gaming disorderand impulsivity : A systematic review of literature", International Journal of MentalHealth and Addiction, pp.1~27 (2019)[DOI]
- Saunders, J. B., "Gaming disorder : Its delineation as an important condition for diagnosis, management, and prevention", Journal of Behavioral Addictions, 6(3), pp.271~279 (2017)[DOI]
- Starcevic, V., "Internet gaming disorder:Inadequate diagnostic criteria wrapped in a constraining conceptual model: Commentary on: Chaos and confusion in DSM-5 diagnosis of internet gaming disorder: Issues, concerns, and recommendations for clarity in the field (kuss et al.)", Journal of Behavioral Addictions, 6(2), pp.110~113 (2017)[DOI]
- Matthew WR Stevens, "Global prevalence of gaming disorder: A systematic review and meta-analysis", Australian & New Zealand Journal of Psychiatry, 55(6), pp.553~568 (2020), SAGE Publications[DOI]
- Szasz, T., "The Myth of Mental Illness" (1961), Hoerber-Harper
- Van Rooij, A. J., "A weak scientific basis for gaming disorder : Let us err on the side of caution", Journal of Behavioral Addictions, 7(1), pp.1~9 (2018)[DOI]
- Wang, J., "The association between mobile game addiction and depression, social anxiety, and loneliness", Frontiers in Public Health, 7, pp.247~247 (2019)[DOI]
- The ICD-11Classification of Mental and Behavioral Disorders: Diagnostic Criteria for Research, "World Health Organization", World Health Organization, ~ (2018)
- Wu, A. M. S., "Prevalence and associated factors of internet gaming disorder among community dwelling adults in macao, china", Journal of Behavioral Addictions, 7(1), pp.62~69 (2018)[DOI]
- Zola, I., "Medicine as an institution of social control", Sociological Review, 20(4), pp.487~504 (1972)
- Zola, I., "Socio-Medical Inquiries" (1983), Temple University Press
- "최근 5년(2017∼2021년) 우울증과 불안장애 진료현황 분석", 건강보험심사평가원[URL]
- "과잉진단 논란 갑상선암, 주로 검진으로발견", 국립암센터[URL]
- "게임이용 장애 질병코드국내도입 문제 관련 민관 협의체 제6차 회의 개최", 문화체육관광부[URL]
- "우리는 모두 환자가 되는 것일까", 민족의학신문[URL]
- "2021년 정신건강실태조사 결과 발표", 보건복지부[URL]
- "학회·의사회 “WHO 게임사용장애 질병분류지지”", 의협신문[URL]
- "대형·인디 개발자 “WHO 게임질병분류 국내 도입 반대”", 이코노믹 리뷰[URL]
- "심야시간대 청소년의 인터넷 게임 이용제한이 폐지되었습니다", 찾기쉬운생활법령정보[URL]
- "ADHD 캠페인 지속하며 소아청소년정신건강 돕는다"[URL]
- "ICD-11 for Mortality and Morbidity Statistics (Version: 01/2023), 6C51Gaming disorder"[URL]
- "MedicalTimes"[URL]
- "All About Gaming Disorder"[URL]
- "Gaming Addiction in ICD-11:Issues and Implications"[URL]
- "Video gaming can benefit mental health, find Oxford academics"[URL]
