Psych Vivas · Addiction psychiatry — behavioural addictions
Gaming and internet addiction — structured clinical viva
Fellowship viva on gaming disorder vs special interest, ICD-11/DSM status, risk after forced limits, CBT/family care, and realistic pharmacotherapy.
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Target exams
Interpretation
Reveal interpretation
This viva tests dual formulation skill: neurodevelopmental special interest / ADHD dysregulation can co-exist with ICD-11 gaming disorder when control is lost and school function collapses. Candidates must not choose a false dichotomy ("only ASD" vs "only addiction"). Name I-PACE as the mechanism frame and distinguish ICD-11 clinical GD from DSM-5-TR Section III research IGD.[1][2][5]
Risk. Self-harm threats after forced limits require structured assessment, safety planning, and careful negotiated boundaries — not pure punishment. Family refusal of sessions is a therapeutic problem to engage, not ignore; school liaison is essential.[4]
Treatment hierarchy. CBT adapted for youth/ASD communication style, ADHD treatment optimisation, sleep rescue, and harm-reduction contracts. Naltrexone is not the evidence default for pure GD (contrast gambling literature); do not invent a licensed anti-gaming opioid antagonist pathway here. No pure "detox admission" without risk indication.[3][1]
Key points
[2] [3] [4]References
- [1]Saunders JB, et al. Gaming disorder: Its delineation as an important condition for diagnosis, management, and prevention J Behav Addict, 2017.PMID 28816494
- [2]Brand M, et al. Integrating psychological and neurobiological considerations... (I-PACE) model Neurosci Biobehav Rev, 2016.PMID 27590829
- [3]Stevens MWR, et al. Cognitive-behavioral therapy for Internet gaming disorder: A systematic review and meta-analysis Clin Psychol Psychother, 2019.PMID 30341981
- [4]Paulus FW, et al. Internet gaming disorder in children and adolescents: a systematic review Dev Med Child Neurol, 2018.PMID 29633243
- [5]Petry NM, et al. An international consensus for assessing internet gaming disorder using the new DSM-5 approach Addiction, 2014.PMID 24456155