In 2013, the DSM-5 proposed that Internet Gaming Disorder (IGD) was a potential behavioral addiction that required further study. While IGD is the terminology suggested by the DSM, there lacks a consensus by the medical community. Our suggested term is Problematic Interactive Media Use (PIMU). PIMU often presents in one of the following four ways:

  1. Video gaming–including excessive gaming on a computer, console, or mobile device, where the child or teen plays for hours on end, often only taking breaks when forced.
  2. Social media–including using social media as a primary way to connect with others instead of through face-to-face communication.
  3. Pornography–including pornography use that results in sexual dysfunction.
  4. Information-seeking–including spending hours of time online surfing websites and binge-watching videos in place of other activities.
What the Evidence Says
Nomenclature and diagnostic criteria vary significantly.
Names range from Internet Addiction Disorder, Problematic Internet Use, Internet Gaming Disorder, Pathological Internet Use, and Compulsive Internet Use. While each term incorporates the idea of dysregulated media use, there is still no clinical consensus on diagnosing the disorder

Prevalence of dysregulated uses of interactive media vary. Given the lack of consensus on diagnosis, it is estimated that anywhere from 9% to 14% of individuals are affected, representing hundreds of millions of individuals. Types of media use can also differ between populations, as adolescent boys are more likely to engage in uncontrolled gaming, while adolescent girls are more likely to engage in excessive social media use.

During the Visit
If your patient screens “positive” on the media use survey and is experimenting problems with media use, it is important to discuss these issues with the patient and his/her family.
  • Incorporate a multidisciplinary treatment team in order to address the breadth of underlying problems presented as PIMU.
  • Do not promote the abstinence of all screen media as that is unsustainable given that children and adolescents must often use technology for school. Instead, promote mindful media use with practical tips.
  • Contact our experts at the Clinic for Interactive Media and Internet Disorders (CIMAID) for more information and resources.
Future Directions
As the body of research grows, there is more evidence that suggests that the media can play a role as to whether a child or teen will have. We need to consider more innovative ways to reach youth with anti-substance campaigns, and to use media to promote practical skills for dealing with peer pressure.


  • Rich, M., Tsappis, M., & Kavanaugh, JR. (2017). Problematic Interactive Media Use Among
    Children and Adolescents: Addiction, Compulsion, or Syndrome? In Young, KS, & Abreu, CN
    (Eds.). Internet addiction in children and adolescents: Risk factors, assessment, and treatment.
    New York, NY: Springer Publishing Company, p. 3-28

This toolkit was created with funding from Harvard Pilgrim Health Care