Addiction is a term that we hear all the time but it's a surprisingly tricky concept to pin down. Orally, we might say things like:" Oh, I downloaded this new game on my phone and I'm totally addicted to it." But from a clinical perspective, we think of addiction as occurring when someone has found that their life whether it's their relationships with friends or family, their ability to perform their jobs, or something else has been knocked off-kilter (冲昏头脑) by desire to perform behavior.
Prof Robert West, editor-in-chief of the journal Addiction, defines addiction "a psychological condition that involves repeated powerful motivation to engage in a behavior that's learnt through experience, and that has either actual or potential harmful consequences". Under this definition, it is possible to be addicted to anything—not just substances—if it turns from a want for it to a need for it, and it puts a person at risk of harm.
In 2008, Bowden-Jones set up the National Problem Gambling Clinic. To date, this is the only NHS-funded treatment center for people with problem gambling (赌博). Despite seeing some of the most severe cases of gambling addiction in the country in her clinic, she is keen to point out that the scale of the problem might not be as extreme as some would think. Despite lots of people gambling and the pervasive (遍布的) nature of gambling advertising, problem gamblers make up less than one per cent of the population.
Yet she wonders whether there is something about how modern technology has become increasingly risky. "The more you have availability, the more you uncover vulnerability," she says. And there's concern among researchers from several different countries that online games and apps are taking inspiration from gambling to keep people playing, and paying. These include what are known as "loot boxes". These are prizes, paid for with real money, where the contents are not known until they're purchased. Recent research has suggested purchase of these prizes is linked to higher levels of problematic gambling behavior.
However, Bowden-Jones points out that technological advances have also improved support for some people with problematic gambling. Software now exists to block gambling-related websites across people's devices. Banking apps can allow a person to disable any ability to spend money on gambling, cautiously, by just toggling (切换) a switch. She believes that this is a big step forward -historically people were encouraged to hand their finances to their partners. This can put pressure on relationships and there is strong evidence to show it can increase domestic violence.
It's hard to tell addiction is on the increase, partly because as yet there aren't standardized measures by which to assess things like problematic gaming, and large-scale surveys have not been done. But just because we might see people glued to their phones while they're on buses or trains or while walking down the street, it doesn't mean we've become nation who are addicted to the Internet.
Nonetheless, in 2018 the World Health Organization announced that it was classifying gaming disorder as a mental health condition, decision they based on a review of the evidence and after discussion with experts. However, some researchers worry that this classification will lead to overdiagnosis of gaming The NHS does not offer treatment for gaming disorder, and a pilot treatment clinic has been delayed. It's clear that we know very little about how many people have gaming disorder, and it's likely that the vast majority of people who play games do so with no harm to their health whatsoever. Having said that, for those who are worried, it is possible to spot the warning signs of pleasurable activity becoming compulsion (强迫力), either in yourself or in those around you.
Robert West has some final words of advice for those individuals who are trying to reduce their need for a behavior. "Self-control is much easier when you set fixed boundaries than when you leave the rules more flexible," he explains. Be strict with yourself and don't allow your boundaries to slide, then even if you do slip up, you can get back on track.
