Video gaming addiction assessment tools

Summary

• Clinicians use validated gaming addiction assessment tools such as the IGDS9-SF, GDT, GAS, and POGQ to evaluate symptom severity, functional impairment, and risk of problematic gaming behavior.

• A structured evaluation supports accurate identification of Internet Gaming Disorder and Gaming Disorder by aligning assessment results with DSM-5-TR and ICD-11 criteria used in a formal video game disorder diagnosis process.

• Evidence-based approaches like CBT, ACT, and motivational interviewing are recommended to treat gaming addiction while addressing impulse control, values alignment, and ambivalence toward behavior change.

• Comprehensive assessment should also include comorbidity screening, family input for minors, and clinical judgment to ensure a full understanding of the client’s gaming behavior and its impact.

Video games have never been more popular. As of 2025, there are more than 3.5 billion gamers across the globe.

For most players, gaming is just a hobby or a way to have fun. But as gaming has become more prevalent, there’s also been a significant increase in video game addiction (also known as “gaming disorder” or “internet gaming disorder”), which research estimates impacts just over 3 percent of players.

But what, exactly, constitutes a video game addiction? As a therapist, what gaming addiction assessment tools determine if it’s an issue? And if there is a video game disorder diagnosis, what are the best treatment options—and how can you apply those options to help your clients overcome their addiction to gaming?

What is video game addiction? Clinical definitions

Before we jump into how to assess, diagnose, and treat video game addiction, let’s cover what, from a clinical perspective, video game addiction actually is. Establishing a clear video game disorder diagnosis requires understanding the formal diagnostic criteria outlined in both the DSM-5-TR and ICD-11 frameworks.

“Gaming itself isn’t inherently bad or addictive,” says Daniel Hochman, M.D., a psychiatrist with a private practice in Austin, Texas, and the creator of Self Recovery, a science-based online addiction recovery program. ”The clinical issue arises when gaming becomes a person’s primary regulator of mood, identity, or self-worth—displacing sleep, relationships, development, and agency.”

When it comes to clinical definitions of video game addiction, there are two main frameworks that help you differentiate between healthy vs. addictive gaming:

DSM-5-TR

The first is the Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR), where the condition is listed as Internet Gaming Disorder, or IGD.

“In the DSM-5-TR, Internet Gaming Disorder (IGD) appears in Section III as a condition for further study,” says Hochman. “While not an official diagnosis, it offers a useful clinical framework.”

While not yet an official standalone diagnosis, IGD is widely used as a clinical framework by practitioners.

The DSM-5-TR lists the following as symptoms of IGD:

• Preoccupation with gaming

• Withdrawal symptoms when unable to game (for example, irritability or anxiety)

• Tolerance (for example, needing to spend more time gaming to experience positive effects)

• Unsuccessful attempts to reduce gaming time or quit gaming altogether

• Loss of interest in other hobbies or activities as a result of gaming

• Continued gaming despite problems

• Deception regarding gaming (for example, lying about time spent gaming)

• Gaming as a way to escape a negative mood or challenging feelings

• Jeopardizing a significant job, relationship, or academic pursuits as a result of gaming

To meet the diagnostic criteria for IGD, you must have experienced at least five of these symptoms within the past year.  (“These criteria are polythetic, meaning that you can have a combination…to meet the proposed criteria,” says Charlotte Beard, PhD, clinical psychologist and executive director of Open World Treatment.) Gaming must also cause "significant impairment or distress" in several aspects of your life. In practice, therapists often use structured gaming addiction assessment tools aligned with these criteria to improve diagnostic accuracy and ensure consistent evaluation.

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ICD-11

The other framework for defining and diagnosing video game addiction is the World Health Organization’s (WHO)  International Classification of Diseases (ICD-11), which officially recognizes Gaming Disorder as a formal mental health condition.

The ICD-11 uses three main criteria to diagnose gaming disorder:

• A persistent pattern of gaming (typically 12 months or more) categorized by impaired control (for example, not being able to control the frequency or duration of gaming sessions)

• Prioritizing gaming over other activities

• Continuation/escalation of gaming behavior despite negative consequences

“From a clinical and educational standpoint, the ICD-11 framework offers a concise summary of the core difficulties seen in problematic gaming,” says Beard. “These often present clinically as ‘I want to stop, but I can’t,’ ‘everything else comes second,’ and ‘this is negatively affecting my life.’”

To qualify for a gaming disorder diagnosis, “you need to meet all of the criteria for diagnosis,” says Beard. The gaming behaviors must also be severe enough that they cause significant impairment to functioning (for example, negatively impacting personal relationships, educational opportunities, or job prospects). When working within the ICD-11 framework, clinicians may incorporate gaming disorder assessment tools that directly map onto these diagnostic criteria.

Assessing video game addiction

Now that you know the different ways to define video game addiction, let’s talk about how to assess clients for gaming addiction.A thorough assessment process is essential to determine whether a client meets the threshold for a video game disorder diagnosis. There are a number of validated video gaming addiction assessment tools designed to help clinicians evaluate clients, including:

For DSM-5-TR: Internet Gaming Disorder Scale–Short-Form (IGDS9-SF)

“For therapists using the DSM-5 framework, a very useful validated measure is the 9-item Internet Gaming Disorder Scale, Short Form,” says Beard—also known as IGDS9-SF.

In this gaming addiction assessment, the therapist asks the client nine questions about their gaming activity over the past year, each of which speaks to a different DSM-5-TR diagnostic criteria for IGD. The therapist then asks clients to rank how frequently they experience the symptom outlined in each question: Never (1 point), Rarely (2 points), Sometimes (3 points), Often (4 points), or Very Often (5 points). 

Therapists can use the client’s response to assess for the likelihood and severity of IGD; if the client answers “Very Often” to at least five questions (which indicates they meet at least five of the diagnostic criteria), they qualify for a gaming disorder diagnosis—and the higher their score, the more severe their addiction. While screening tools cannot replace clinical judgment, they can provide valuable data to support or rule out a video game disorder diagnosis.

If you’re using the DSM-5-TR model as a gaming addiction assessment tool, “the IGDS9-SF is usually the most efficient first screen,” says Hochman. “It’s brief, DSM-aligned, and can be used on intake and progress tracking.”

Plus, the IGDS9-SF “is freely available in 15 languages and is widely used in cross-cultural research,” says Beard. 

For ICD-11: Gaming Disorder Test (GDT)

For therapists using the ICD-11 approach in gaming disorder diagnosis, “the Gaming Disorder Test is a 4-item measure that is another strong option,” says Beard.

The GDT is structured exactly like the IGDS9-SF—just with four questions that speak directly to the ICD-11 diagnostic criteria for gaming disorder.

Additional video gaming addiction assessment tools

While the IGDS9-SF and/or ICD-11 can help you determine if a client meets diagnostic criteria for IGD or gaming disorder, they don’t necessarily tell the whole story. There are additional gaming addiction assessment tools that can help you get a deeper perspective into a client’s gaming, including:

• Gaming Addiction Scale (GAS): A 7-item self-reported questionnaire designed to measure the following criteria (in relation to gaming): salience, tolerance, mood modification, relapse, withdrawal, conflict, and problems.

• Gaming Addiction Scale for Adolescents (GASA): A 21-item self-reported questionnaire designed to measure the same criteria as the GAS, but specifically tailored to adolescents. Use the GASA over the GAS when your client is under 18, as it accounts for the developmental and social contexts more relevant to younger players.

• Problematic Online Gaming Questionnaire (POGQ). An 18-item self-reported tool that measures different elements of gaming addiction—specifically preoccupation, overuse, immersion, social isolation, interpersonal conflicts, and withdrawal.

How a client answers the questions on these assessments—as well as their overall score—can offer key insights into not only whether they’re experiencing gaming addiction, but how severe that addiction currently is and how and where their problematic gaming use is impacting their life. Together, these gaming addiction assessment tools provide a more comprehensive clinical picture than any single screener alone.

Which screening tools work best?

When it comes to assessing video game addiction, there’s no one-size-fits-all approach.The goal is not simply to administer a questionnaire, but to gather enough information to make an informed and defensible video game disorder diagnosis. Which screening tools will work best will depend on what diagnostic criteria you’re screening for, what type of client you’re working with, and what information you’re hoping to get from your assessment.

For example, if your goal is to determine if your new client meets the criteria for Internet Gaming Disorder outlined in the DSM-5-TR, the IGDS9-SF would be a helpful place to start—while if you were working off the ICD-11 definition, it would be better to start with the GDT. Or maybe you already know your client meets the diagnostic criteria and you want to know more about the severity of their addiction and the impact their gaming is having on their life—in which case the POGQ could provide helpful insight.

Whatever gaming addiction assessment tools you decide to use, remember that they’re just one piece of the puzzle. “These scales are best used alongside a clinician's existing judgment—not as a number to replace it,” says Hochman.

Once gaming addiction assessment tools indicate that a client meets diagnostic criteria or is experiencing significant impairment, treatment planning becomes the next priority.

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What treatment approaches show the best outcomes for video game addiction?

Now that you understand how to assess and diagnose video game addiction with the best screening tools, the next big question is: how do you treat it?

There are a number of different treatment approaches that have been found to be helpful in treating video game addiction, including:

• Cognitive behavioral therapy (CBT): CBT, which is designed to help clients identify and change negative thought patterns and behaviors, has been shown to be an effective treatment for video game addiction. “CBT can help with impulse control, cognitive distortions, and habit restructuring,” says Hochman. For example, one meta-analysis that reviewed 12 independent studies found that CBT demonstrated high efficacy at decreasing symptoms of IGD. 

• Acceptance and commitment therapy (ACT): ACT—which encourages mindfulness and choosing value-aligned behaviors, even when there’s a desire to behave differently—can also help people struggling with video game addiction change problematic gaming behaviors. “ACT exercises work…to help clients reflect on their time spent gaming and whether it aligns with their values,” says Andrew Fishman, a licensed clinical social worker who specializes in treating video game addiction and author of the upcoming book Parenting a Gamer. “[This method can] also help clients determine a course of action and find their own motivation to change.”

• Motivational interviewing: Motivational interviewing is a treatment approach that allows clients to tap into their own internal motivation to make positive changes—which can help them address problematic gaming behaviors in a way that feels manageable and authentic, not forced. “Motivational interviewing is the best method to address ambivalence and bring out their own motivations for change,” says Hochman.

In addition to individual therapy approaches like these, “group therapy, community support groups like Online Gamers Anonymous, medication management, and even residential programs are also available,” says Beard.

Treating video game addiction: Best practices for therapists

Want more insights on how to effectively treat video game addiction? Effective intervention begins with accurate identification, and well-chosen gaming addiction assessment tools lay the groundwork for targeted care.

Here are some best practices to keep in mind when working with clients with video game addiction:

How to engage resistant gamers

Some gamers show up to therapy knowing they have a problem and are ready and willing to make a change. But for others, there may be more resistance. 

If you find yourself working with a resistant gamer, the key is to meet them where they’re at. If they tell you they’re not ready to stop gaming, don’t suggest abstinence. If they say their gaming isn’t an issue, don’t insist that it is. Instead, encourage them to collect data on their gaming habits.

 “Many clients…respond well to data-based approaches,” says Beard. 

For example, “I ask clients to rate how they feel about areas of their life they care about on a scale from 1-10,” says Fishman. “When they’ve finished, we look for low numbers and how gaming might have impacted those areas.”

Taking this data-driven approach can help build awareness for and engage resistant gamers—and offer irrefutable proof that their gaming actually is causing issues in their life

Assess and treat comorbidities

Video game addiction can often go hand-in-hand with other mental health disorders, like depression, anxiety, or ADHD. Accurately identifying comorbid conditions is essential, as they can complicate or even mimic a video game disorder diagnosis. So, if you want to provide the most effective treatment for your client’s video game addiction, you should also be screening and treating any comorbidities that may exist.

“If clients aren’t ready to address addictive gaming, working on comorbid conditions that contribute can also be helpful,” says Beard. “For example, treating depression with behavioral activation beyond gaming can be a helpful first step in addressing behavior broadly and moving your client toward change.”

Assessing a minor? Get families involved 

Children can struggle to understand the impact problematic gaming is having on their life. For example, “people with gaming disorder—especially minors—may not realize the extent to which their gaming impacts their relationships with others or may downplay it,” says Fishman.

Which is why, if you’re assessing a minor for video game addiction, getting the family involved in the assessment process is a must.

“For minors, it is important to involve the family in the diagnostic process, as parents and caregivers can provide supplementary information,” says Fishman—information that can help you better assess and treat the child.

For example, let’s say, during an assessment, a child reports that they rarely experience withdrawal symptoms from video games—but the parent reports that the child throws tantrums any time they turn off the video game console. If all you had was the child’s perspective, you wouldn’t necessarily think they meet that particular criteria for addiction; you needed the parent’s perspective to get an accurate view of the child’s behavior—and to determine the best treatment path forward.

Sources

• Buijisman, M. 2025. Global games market to hit $189 billion in 2025 as growth shifts to console. Newzoo.

• Demetrovics, Z., Urbán, R., Nagygyörgy, K., Farkas, J., Griffiths, M.D. et al. (2012). The development of the Problematic Online Gaming Questionnaire (POGQ). PLoS One.

• Ding, D., Pan, M., & Wang, W. (2023). Online Self-Help Acceptance and Commitment Therapy Module for College Students with Higher Gaming Disorder During COVID-19: A Pilot Study. Behaviour Change.

• Giordano, A.L., Chung, Y., Kim, S.W., & Adams, H. (2025). Using Motivational Interviewing to Address Internet Gaming Disorder. Journal of Addictions & Offender Counseling.

• Halley, M.P., Mark, D.G. (2015). Measuring DSM-5 internet gaming disorder: Development and validation of a short psychometric scale. Computers in Human Behavior.

• Khazaal, Y., Breivik, K., Billieux, J., Zullino, D., Thorens G. et al. (2018). Game Addiction Scale Assessment Through a Nationally Representative Sample of Young Adult Men: Item Response Theory Graded-Response Modeling. J Med Internet Res. 

• Musetti A., Floros G, Chiappedi, M., Stavropoulos, V. (2025). Gaming disorder in the ICD-11: the state of the game. BMC Psychiatry.

• Pontes, H.M., Schivinski, B., Sindermann, C. et al. (2019). Measurement and Conceptualization of Gaming Disorder According to the World Health Organization Framework: the Development of the Gaming Disorder Test. Int J Ment Health Addiction.

• Scherer, J. (2023). Internet Gaming. Psychiatry.

• Stevens, M.W., Dorstyn, D., Delfabbro, P.H., King, D.L. (2021). Global prevalence of gaming disorder: A systematic review and meta-analysis. Aust N Z J Psychiatry. 

• Stevens, M.W.R., King, D.L., Dorstyn, D., Delfabbro, P.H. (2018). Cognitive-behavioral therapy for Internet gaming disorder: A systematic review and meta-analysis. Clin Psychol Psychother.

• World Health Organization. (N.D.) Gaming Disorder.

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