Arne Poulsen

A weak scientific basis for gaming disorder: Let us err on the side of caution

We greatly appreciate the care and thought that is evident in the 10 commentaries that discuss our debate paper, the majority of which argued in favor of a formalized ICD-11 gaming disorder. We agree that there are some people whose play of video games is related to life problems. We believe that understanding this population and the nature and severity of the problems they experience should be a focus area for future research. However, moving from research construct to formal disorder requires a much stronger evidence base than we currently have. The burden of evidence and the clinical utility should be extremely high, because there is a genuine risk of abuse of diagnoses. We provide suggestions about the level of evidence that might be required: transparent and preregistered studies, a better demarcation of the subject area that includes a rationale for focusing on gaming particularly versus a more general behavioral addictions concept, the exploration of non-addiction approaches, and the unbiased exploration of clinical approaches that treat potentially underlying issues, such as depressive mood or social anxiety first. We acknowledge there could be benefits to formalizing gaming disorder, many of which were highlighted by colleagues in their commentaries, but we think they do not yet outweigh the wider societal and public health risks involved. Given the gravity of diagnostic classification and its wider societal impact, we urge our colleagues at the WHO to err on the side of caution for now and postpone the formalization.

Modernity and the Upgrading of Psychological Reflectivity

The societal dynamism of modernity results in the theoretical upgrading and the actual development of personal reflective capacities, for example abstract reasoning, Kantian morality, and the development of the idiocentered perspective. These capacities are created in the disembedding of prereflective capacities, for example context-sensitive intelligence, care-morality, and mundocenteredness. The reflective capacities become the prerequisite of further modernization. The development-potential offered by the demands of modernity is accompanied by a risk of assimilative stress, for example pseudological reasoning, varieties of postmodernism, making a fetish of the medium, and the forfeit of the morality of care.

When Belief Ascriptions Are About More Than What Is on Someone Else's Mind

The third-person belief ascription, “Marie believes that the contract is in the cabinet,” may engender two interpretations: (1) It neutrally describes what is on Maries mind and (2) it offers indirect evidence about reality, committing the speaker to the cabinet as the most likely location. The circumstances that lead to the evidential interpretation are at present not well documented in the case of belief verbs. In the case of belief-dependent verbs with and without embedding clause syntax, for example, “Marie says that the contract is in the archive,” and “Marie is lookingfor the contract in the archive,” it has been claimed that they eschew the evidential interpretation altogether. We explore the influence of the pragmatic context on the third-person, present tense and first-person, past tense use of the verbs, believe, say, and look for. In three experiments that manipulated the discourse context, 258 adults rated written vignettes. Regardless of the verb and the tense, when presented in discourse contexts without prior shared knowledge of the location of the object in question, the belief ascription was interpreted as indirect evidence. The results illuminate the border area between semantics and pragmatics, particularly regarding evidential uses of belief and belief-dependent verbs.