E3 Gaming Excitement Outplays Gaming Addiction Concerns

Does anyone care that WHO thinks gaming addiction is a disease?

Keanu Reeves in front of a CyberPunk 2077 banner onstage at Xbox Event
Keanu Reeves, Cyberpunk 2077 Actor, unveils the release date at the Xbox E3 2019 Briefing at the Microsoft Theater at L.A. Live, Sunday, June 9, 2019 in Los Angeles.

Casey Rodgers/Invision for Xbox/AP Images

With his black hair, dark beard, athletic build, squinty eyes and valley guy delivery, Keanu Reeves, arguably one of the world’s biggest movie stars, is the perfect modern-day console game character. It’s almost as if game developers dreamed Reeves up first and he somehow escaped into real life.

That’s why Reeves' appearance at Microsoft’s E3 keynote and in a new game, Cyberpunk: 2077, was both surprising and inevitable. It was also a big deal, reported breathlessly across the news and social media. In fact, virtually every one of Microsoft’s major gaming announcements got huge play in the media, as people pondered a more powerful Xbox Console (Project Scarlett), a new “Elite” controller, and the return of both Microsoft Flight Simulator and Master Chief in Halo Infinite.

I’m not even a gamer (I dabble), and I found the news exciting, but also far removed from some other gaming news that passed virtually unnoticed a few weeks ago.

Gaming as an Addiction

After voting last year to include gaming disorder as an official condition, the World Health Organization (WHO) officially designated gaming addiction as a disease. The designation is part of WHO’s 11th revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-11), the WHO’s medical coding system created by for documenting diseases and symptoms, which goes into effect in 2022.

The WHO defines gaming disorder as:

“a pattern of gaming behavior (“digital-gaming” or “video-gaming”) characterized by impaired control over gaming, increasing priority given to gaming over other activities to the extent that gaming takes precedence over other interests and daily activities, and continuation or escalation of gaming despite the occurrence of negative consequences.”

A person playing Minecraft on an Xbox
Obsessing over Minecraft may not actually be an addiction. Chesnot / Getty Images

I looked over at my adult children, who, as I monitored the Microsoft E3 keynote on my phone, were busy playing Minecraft on my son’s Xbox One. It’s not unusual for one or both of them to spend hours on one or more games, their bodies leaving permanent impressions on our den furniture.

Gaming is clearly one of their top three activities, but I would hesitate to call them addicted. Aside from, perhaps, a little less exercise-induced muscle tone, I couldn’t point to any specific “negative consequences” stemming directly from gaming for either of them.

I turned my attention back to the stream and watched the rapturous response to Reeves and then a cavalcade of “World Premiere” gaming titles. The crowd, on occasion, sounded like they were on the edge of hysteria.

Are all these people addicted? Probably not. The audience at E3 events is filled primarily with adults, many of whom have built successful careers around gaming.

The WHO’s classification goes on to note that in order to diagnosis a gaming disorder, the sufferer needs to display a pattern of impairment in family, social, education, and occupational areas of activity that lasts at least a year.

Too Fast

While many gamers and parents of gamers might have missed the news, the Entertainment Software Association (ESA), a trade group representing the video game industry, has been warning the WHO not to take this action for over a year. When the WHO finally pulled the trigger on May 25, 2019, the ESA urged them to reverse their decision. “The WHO is an esteemed organization and its guidance needs to be based on regular, inclusive, and transparent reviews backed by independent experts. ‘Gaming disorder’ is not based on sufficiently robust evidence to justify its inclusion in one of the WHO’s most important norm-setting tools,” the ESA wrote in a statement.

During the E3 keynote, Microsoft, naturally, made no mention of the ESA's concern or the WHO’s decision, but that doesn’t mean the company hasn’t taken note nor that it has no plan for addressing adverse gaming activity, especially among young people.

It’s a sentiment I heard echoed by others in the video game space, who want more research and are concerned that, by targeting video gaming as a cause, they might be inadvertently masking other mental health issues, some of which could contribute to “gaming addiction.”

Control Partner

Gears 5 screen at Xbox event during E3 in Los Angeles
Many hotly anticipated games like Gears of War 5 contain violence.  

Christian Petersen / Staff

A few weeks before the WHO decided on including gaming disorder in ICD-11, Microsoft walked me through some of the steps it's taken in current and upcoming console gaming technology to at least offer parents some degree of control over their children’s gaming activity. The company has more or less aligned itself with the ESA on the WHO’s gaming disorder classification decision, but it also isn’t shy about giving parents all the tools they think parents need to manage their children’s gaming activities and protect them as they game.

Sony PlayStation has a number of similar controls, but Microsoft is hoping for more collaboration across competitive lines as they start to share research and usage measurements. The company doesn’t wasn’t gaming safety to be a competitive advantage.

In recent years, Microsoft has sought to lower hurdles for parents on-boarding children and managing their accounts, doing things like removing the need to add credit card information when adding a child, and making it less likely that a child could end up using an adult’s account.

Microsoft’s new Community Standards (published in May) address the kind of behavior, conduct, and shared values Microsoft expects on the Xbox platform. It even includes examples. Break a rule and Microsoft will suspend you, but also point to one of those examples: “For example, don't threaten someone with physical assault after an intense game.”

Sony PlayStation, unsurprisingly, has a similar code of conduct document.

However, as gaming moves off hardware, into the cloud, and arrives on other screens and platforms, companies like Microsoft will have to work twice as hard to manage access and ensure that parental controls and the ability to deliver safe game environments exists on all platforms. Microsoft’s cloud gaming platform, Project xCloud, will, the company notes, support all existing parental controls. In addition, if a parent uses Microsoft’s launcher, they’ll also have those controls on Android, as well.

As with most tech solutions, much of the responsibility for managing a child’s safety falls on the user’s shoulders. Parents have to use the tools and they often have to battle their own children to enforce them, especially as their pre-teen kids campaign to play the latest Rated M game. Most of the top games of the last year, Red Dead Redemption II, Gods of War, Call of Duty, andGears of War, are rated M for violence, blood, language and sometimes sexuality. There are also a lot of Rated Teen titles, but then how many kids playing them are actually teens?

Keanu Reeves with a rare smile on the Xbox stage at E3 2019
Keanu Reeves seemed almost as excited as the crowd during his appearance at E3. Christian Petersen / Getty Images

Keanu Reeve’s game, Cyperpunk 2077, will have its share of stylized violence, cursing, and nudity. It’s also the game that every gamer (except, maybe, the youngest ones) will want to play.

In my own home, the battle to control screen time and gaming content is already lost. They’re adults making adult content decisions. But I have to wonder if any parent of any child of any age really has any control. The lure of this entertainment is too strong. The excitement too big. The consequences, even with the mostly ignored WHO designation, likely seen as inconsequential.

As always, the game wins.