This site uses cookies: Find out more

Okay, thanks
User content image
Play
Royal College of Psychiatrists - Logo
SKIP NAVIGATION
  • SKIP NAVIGATION
  • About the College
  • News and features
  • International
Logout MY CONTENT 
Login
DONATE
Search
  • Become a psychiatrist

    Become a psychiatrist

    • Choose Psychiatry

      Choose Psychiatry

      • What is psychiatry?
      • How to become a psychiatrist
      • Why choose psychiatry?
      • What next?
      • On a break from training?
      • Choose Psychiatry 2021 video
      • Continuing to choose psychiatry
      • Hear more from the stars of our 2022 film
    • Sixth formers and school students
    • Medical students

      Medical students

      • Becoming a student associate
      • Psychiatry attachments
      • Awards, prizes and bursaries
      • PsychSocs
      • National Student Psychiatry Conference
      • Summer and autumn schools
      • FuturePsych – the student associate magazine
      • The Student Psychiatry Audit and Research Collaborative (SPARC)
    • Foundation doctors

      Foundation doctors

      • Foundation doctor associates
      • Making the most of your psychiatry placement
      • Opportunities for foundation doctors
      • FuturePsych - the associate magazine
    • Help us promote psychiatry

      Help us promote psychiatry

      • How can I help?
      • Ideas to inspire you
      • Resources to help you promote psychiatry
      • RCPsych Recruitment Strategy 2022-2027
    • Choose Psychiatry: Guidance for Medical Schools
    • Supporting Medical Students: Medical Schools
    • Careers past events
    • Choose Psychiatry
      • What is psychiatry?
      • How to become a psychiatrist
      • Why choose psychiatry?
      • What next?
      • On a break from training?
      • Choose Psychiatry 2021 video
      • Continuing to choose psychiatry
      • Hear more from the stars of our 2022 film
    • Sixth formers and school students
    • Medical students
      • Becoming a student associate
      • Psychiatry attachments
      • Awards, prizes and bursaries
      • PsychSocs
      • National Student Psychiatry Conference
      • Summer and autumn schools
      • FuturePsych – the student associate magazine
      • The Student Psychiatry Audit and Research Collaborative (SPARC)
    • Foundation doctors
      • Foundation doctor associates
      • Making the most of your psychiatry placement
      • Opportunities for foundation doctors
      • FuturePsych - the associate magazine
    • Help us promote psychiatry
      • How can I help?
      • Ideas to inspire you
      • Resources to help you promote psychiatry
      • RCPsych Recruitment Strategy 2022-2027
    • Choose Psychiatry: Guidance for Medical Schools
    • Supporting Medical Students: Medical Schools
    • Careers past events
  • Training

    Training

    • Curricula and guidance

      Curricula and guidance

      • 2022 Curricula Implementation Hub
      • 2014 GMC approved curricula (ending July 2024)
      • Specialty guides
      • Dual Training
    • Your training

      Your training

      • Psychiatric Trainees' Committee: supporting you
      • Time out of training
      • Training resources
      • Run-through training
      • Prizes and bursaries for trainees
      • Training less than full time
      • Routes to Registration
      • Cost of Training
      • Leadership and Management Fellow Scheme
      • Understanding Career Choices in Psychiatry
    • Exams

      Exams

      • Can I take an exam?
      • Contact the exams team
      • Preparing for exams
      • Applying for your exam
      • Exam results
      • Special notices
      • Exam FAQs
      • A fair exam
      • Examiners and exam panels recruitment
      • FAQs about applying for exams
      • FAQs about preparing for exams
      • FAQs about the day of the exam
      • FAQs about assessment and results
      • Exams news and updates
    • Neuroscience in training

      Neuroscience in training

      • About the project
      • Neuroscience events
      • Who was on the commission?
      • Neuroscience history
      • Neuroscience resources
      • Multimedia learning
    • Deanery/LETB Hub
    • Medical training initiative (MTI)
    • Undergraduate education forum
    • International Medical Graduates

      International Medical Graduates

      • Shortage Occupation List
    • Quality Assurance in Training
    • Credentialing
    • CPD eLearning
    • Building Capacity in Perinatal Psychiatry

      Building Capacity in Perinatal Psychiatry

      • Perinatal 2023 Masterclass Programme application and process details
      • Perinatal Psychiatry Masterclass for New consultants resources
      • About the Building Capacity Project
      • Perinatal Psychiatry Masterclass for Senior Trainees resources
      • Perinatal Psychiatry Top - up masterclass for consultants resources
      • Perinatal Psychiatry Masterclass for Senior Trainees Jan 2023 resources
    • Dean's annual update
    • Curricula and guidance
      • 2022 Curricula Implementation Hub
      • 2014 GMC approved curricula (ending July 2024)
      • Specialty guides
      • Dual Training
    • Your training
      • Psychiatric Trainees' Committee: supporting you
      • Time out of training
      • Training resources
      • Run-through training
      • Prizes and bursaries for trainees
      • Training less than full time
      • Routes to Registration
      • Cost of Training
      • Leadership and Management Fellow Scheme
      • Understanding Career Choices in Psychiatry
    • Exams
      • Can I take an exam?
      • Contact the exams team
      • Preparing for exams
      • Applying for your exam
      • Exam results
      • Special notices
      • Exam FAQs
      • A fair exam
      • Examiners and exam panels recruitment
      • FAQs about applying for exams
      • FAQs about preparing for exams
      • FAQs about the day of the exam
      • FAQs about assessment and results
      • Exams news and updates
    • Neuroscience in training
      • About the project
      • Neuroscience events
      • Who was on the commission?
      • Neuroscience history
      • Neuroscience resources
      • Multimedia learning
    • Deanery/LETB Hub
    • Medical training initiative (MTI)
    • Undergraduate education forum
    • International Medical Graduates
      • Shortage Occupation List
    • Quality Assurance in Training
    • Credentialing
    • CPD eLearning
    • Building Capacity in Perinatal Psychiatry
      • Perinatal 2023 Masterclass Programme application and process details
      • Perinatal Psychiatry Masterclass for New consultants resources
      • About the Building Capacity Project
      • Perinatal Psychiatry Masterclass for Senior Trainees resources
      • Perinatal Psychiatry Top - up masterclass for consultants resources
      • Perinatal Psychiatry Masterclass for Senior Trainees Jan 2023 resources
    • Dean's annual update
  • Members

    Members

    • Workforce Wellbeing Hub

      Workforce Wellbeing Hub

      • Psychiatrists' Support Service
      • How the College supports workforce wellbeing
      • Top 10 tips for wellbeing
      • Mentoring and coaching
      • If a patient dies by suicide
      • If a patient commits homicide
    • Supporting your professional development

      Supporting your professional development

      • New consultants (StartWell)
      • Revalidation
      • Assessing and managing risk of patients causing harm
      • Leadership and management
      • Working less than full time
      • Writing clinic letters
    • CPD eLearning
    • Submitting your CPD

      Submitting your CPD

      • Alterations to CPD during coronavirus pandemic
    • Membership

      Membership

      • Members login
      • Receipts
      • Pay Your Subscription
      • Direct Debit
      • Your subscription
      • Grades of membership
      • Benefits of membership
      • Fellowship and other Honours
      • Applying for Fellowship
      • Nominations for Honorary Fellows
      • Nominations for National Honours
    • Your Faculties

      Your Faculties

      • Academic psychiatry
      • Addictions psychiatry
      • Child and adolescent psychiatry
      • Eating disorders psychiatry
      • Forensic Psychiatry Faculty
      • General adult psychiatry
      • Intellectual disability psychiatry faculty
      • Liaison psychiatry faculty
      • Medical psychotherapy faculty
      • Neuropsychiatry faculty
      • Old age psychiatry faculty
      • Perinatal psychiatry faculty
      • Rehabilitation and social psychiatry faculty
      • Faculty job descriptions
    • Specialist and Associate Specialty Doctors

      Specialist and Associate Specialty Doctors

      • A message from the Chair
      • Who are SAS Doctors?
      • How to enter the SAS grade
      • SAS career development
      • SAS doctors resources
      • College SAS training and events
      • Startwell and Staywell
    • Devolved Nations

      Devolved Nations

      • RCPsych in Scotland
      • RCPsych in Wales
      • Coleg Cymraeg
      • RCPsych in Northern Ireland
      • Executive Committee job descriptions
    • English Divisions

      English Divisions

      • Eastern
      • London
      • Northern and Yorkshire
      • North West
      • South Eastern
      • Trent
      • West Midlands
      • South West
      • Executive Committee job descriptions
      • NW and NY mentorship
    • International members
    • Special Interest Groups

      Special Interest Groups

      • How to join a SIG
      • Adolescent forensic psychiatry
      • Arts psychiatry
      • Digital psychiatry
      • Evolutionary psychiatry
      • History of psychiatry
      • Neurodevelopmental psychiatry
      • Occupational psychiatry
      • Philosophy
      • Private and independent practice PIPSIG
      • Rainbow SIG
      • Spirituality and Psychiatry 
      • Sport and exercise psychiatry (SEPSIG)
      • Transcultural psychiatry
      • Volunteering and international
      • Women and mental health
    • Committees of Council
    • RCPsych Insight magazine
    • Publications and books
    • Members' eNewsletters
    • Posts for members
    • Public members list
    • Jobs board
    • President's lectures

      President's lectures

      • Declaration of competing interests (President's lectures)
      • List of president's lectures competing interests
      • Past President's lectures
    • Retired members
    • New Members Ceremonies
    • Obituaries

      Obituaries

      • Submit an obituary
      • Remembering Dame Fiona Caldicott
    • 2021 membership survey
    • Mindmasters quiz

      Mindmasters quiz

      • About the quiz
      • Who won in 2022?
      • The rules of the quiz
      • Sample quiz questions 
    • eLearning Hub
    • Workforce Wellbeing Hub
      • Psychiatrists' Support Service
      • How the College supports workforce wellbeing
      • Top 10 tips for wellbeing
      • Mentoring and coaching
      • If a patient dies by suicide
      • If a patient commits homicide
    • Supporting your professional development
      • New consultants (StartWell)
      • Revalidation
      • Assessing and managing risk of patients causing harm
      • Leadership and management
      • Working less than full time
      • Writing clinic letters
    • CPD eLearning
    • Submitting your CPD
      • Alterations to CPD during coronavirus pandemic
    • Membership
      • Members login
      • Receipts
      • Pay Your Subscription
      • Direct Debit
      • Your subscription
      • Grades of membership
      • Benefits of membership
      • Fellowship and other Honours
      • Applying for Fellowship
      • Nominations for Honorary Fellows
      • Nominations for National Honours
    • Your Faculties
      • Academic psychiatry
      • Addictions psychiatry
      • Child and adolescent psychiatry
      • Eating disorders psychiatry
      • Forensic Psychiatry Faculty
      • General adult psychiatry
      • Intellectual disability psychiatry faculty
      • Liaison psychiatry faculty
      • Medical psychotherapy faculty
      • Neuropsychiatry faculty
      • Old age psychiatry faculty
      • Perinatal psychiatry faculty
      • Rehabilitation and social psychiatry faculty
      • Faculty job descriptions
    • Specialist and Associate Specialty Doctors
      • A message from the Chair
      • Who are SAS Doctors?
      • How to enter the SAS grade
      • SAS career development
      • SAS doctors resources
      • College SAS training and events
      • Startwell and Staywell
    • Devolved Nations
      • RCPsych in Scotland
      • RCPsych in Wales
      • Coleg Cymraeg
      • RCPsych in Northern Ireland
      • Executive Committee job descriptions
    • English Divisions
      • Eastern
      • London
      • Northern and Yorkshire
      • North West
      • South Eastern
      • Trent
      • West Midlands
      • South West
      • Executive Committee job descriptions
      • NW and NY mentorship
    • International members
    • Special Interest Groups
      • How to join a SIG
      • Adolescent forensic psychiatry
      • Arts psychiatry
      • Digital psychiatry
      • Evolutionary psychiatry
      • History of psychiatry
      • Neurodevelopmental psychiatry
      • Occupational psychiatry
      • Philosophy
      • Private and independent practice PIPSIG
      • Rainbow SIG
      • Spirituality and Psychiatry 
      • Sport and exercise psychiatry (SEPSIG)
      • Transcultural psychiatry
      • Volunteering and international
      • Women and mental health
    • Committees of Council
    • RCPsych Insight magazine
    • Publications and books
    • Members' eNewsletters
    • Posts for members
    • Public members list
    • Jobs board
    • President's lectures
      • Declaration of competing interests (President's lectures)
      • List of president's lectures competing interests
      • Past President's lectures
    • Retired members
    • New Members Ceremonies
    • Obituaries
      • Submit an obituary
      • Remembering Dame Fiona Caldicott
    • 2021 membership survey
    • Mindmasters quiz
      • About the quiz
      • Who won in 2022?
      • The rules of the quiz
      • Sample quiz questions 
    • eLearning Hub
  • Events

    Events

    • Conferences and training events

      Conferences and training events

      • Register your interest - CESR in Psychiatry Training
      • MHA Section 12 and Approved Clinician Training
      • Register your interest - Present State Examination Course 2022
      • Subscribe to receive the Events eNews
      • Register your interest - ICD-11 events
      • RCPsych Certificated Courses
      • Grand Rounds
    • International Congress 2022

      International Congress 2022

      • Congress 2022 FAQs
      • Congress Webinar Package
      • Poster Presentations 2022
      • Exhibition Opportunities 2022
      • Your guide to Congress
      • IC22 Keynote speakers
      • Programme
      • Speaker information
      • Travel and accommodation guidance 
      • Social and Fringe Events
      • #RCPsychIC
      • Rapid Fire and Poster Prize Winners
    • International Congress 2023

      International Congress 2023

      • Register your interest - Congress 2023 exhibitors
      • Travel and accommodation guidance 
      • Registration
      • Congress 2023 FAQs
      • Poster Presentations 2023
      • Programme
      • Social Media
    • In-house training

      In-house training

      • In house training: working with us
      • Health of Nation Outcome Scales
      • Competing interests
    • Events held by other organisations
    • Free webinars

      Free webinars

      • Free webinars for members
    • Recruitment events
    • Claiming Expenses
    • Terms and conditions
    • Speaker guidance for online events
    • Conferences and training events
      • Register your interest - CESR in Psychiatry Training
      • MHA Section 12 and Approved Clinician Training
      • Register your interest - Present State Examination Course 2022
      • Subscribe to receive the Events eNews
      • Register your interest - ICD-11 events
      • RCPsych Certificated Courses
      • Grand Rounds
    • International Congress 2022
      • Congress 2022 FAQs
      • Congress Webinar Package
      • Poster Presentations 2022
      • Exhibition Opportunities 2022
      • Your guide to Congress
      • IC22 Keynote speakers
      • Programme
      • Speaker information
      • Travel and accommodation guidance 
      • Social and Fringe Events
      • #RCPsychIC
      • Rapid Fire and Poster Prize Winners
    • International Congress 2023
      • Register your interest - Congress 2023 exhibitors
      • Travel and accommodation guidance 
      • Registration
      • Congress 2023 FAQs
      • Poster Presentations 2023
      • Programme
      • Social Media
    • In-house training
      • In house training: working with us
      • Health of Nation Outcome Scales
      • Competing interests
    • Events held by other organisations
    • Free webinars
      • Free webinars for members
    • Recruitment events
    • Claiming Expenses
    • Terms and conditions
    • Speaker guidance for online events
  • Improving care

    Improving care

    • College Centre for Quality Improvement (CCQI)

      College Centre for Quality Improvement (CCQI)

      • What we do in the CCQI
      • Quality Networks and Accreditation
      • National Clinical Audits
      • Multi-source feedback
      • CCQI resources
      • CCQI Who we are
      • Research and evaluation
      • CCQI news
    • Campaigning for better mental health policy

      Campaigning for better mental health policy

      • Five Year Forward View
      • Integrated care and mental health
      • Children and young people's mental health Green Paper
      • Cross-government mental health and wellbeing plan 
      • RCPsych in Parliament
      • Join our Research Panel
      • College Reports
      • Position Statements
      • Process for College publications
      • Other policy areas
      • Mental Health Watch
      • COVID-19: Guidance for clinicians
      • Reforming The Mental Health Act
      • Don't overlook mental health campaign
      • The Mental Health Policy Group (MHPG)
    • Planning the psychiatric workforce

      Planning the psychiatric workforce

      • About workforce
      • Job planning and recruitment
      • Our workforce census
      • Campaigning for the mental health workforce of the future
      • Workforce strategy
      • Job description approval process
    • Public Mental Health Implementation Centre

      Public Mental Health Implementation Centre

      • Our partners and first partnership activity 
      • How to work with the Public Mental Health Implementation Centre
      • Who's involved in the Public Mental Health Implementation Centre?
      • Aims and objectives
      • Reports
      • About public mental health
      • PMHIC Parliamentary Launch 
    • National Collaborating Centre for Mental Health

      National Collaborating Centre for Mental Health

      • About NCCMH and our work
      • Clinical guideline development
      • Competence frameworks
      • Quality improvement programmes
      • Reports and research
      • Service design and development
      • Work with us
    • Physician Associates

      Physician Associates

      • About Physician Associates
      • Employing Physician Associates
      • Becoming a Physician Associate
      • Support for Physician Associates
      • Physician Associates network
      • The Competence Framework for Physician Associates in Mental Health
    • Invited Review Service
    • Public Health and its role in mental heath
    • Sustainability and mental health

      Sustainability and mental health

      • In your community
      • In your practice
      • In your trust
      • Nature matters
      • Sustainability scholars
      • About sustainability in mental health care
      • Sustainability resources
      • College position on sustainability
      • Attending COP26
    • Using quality improvement
    • Net Zero Mental Health Care Research, Resources and Education
    • College Centre for Quality Improvement (CCQI)
      • What we do in the CCQI
      • Quality Networks and Accreditation
      • National Clinical Audits
      • Multi-source feedback
      • CCQI resources
      • CCQI Who we are
      • Research and evaluation
      • CCQI news
    • Campaigning for better mental health policy
      • Five Year Forward View
      • Integrated care and mental health
      • Children and young people's mental health Green Paper
      • Cross-government mental health and wellbeing plan 
      • RCPsych in Parliament
      • Join our Research Panel
      • College Reports
      • Position Statements
      • Process for College publications
      • Other policy areas
      • Mental Health Watch
      • COVID-19: Guidance for clinicians
      • Reforming The Mental Health Act
      • Don't overlook mental health campaign
      • The Mental Health Policy Group (MHPG)
    • Planning the psychiatric workforce
      • About workforce
      • Job planning and recruitment
      • Our workforce census
      • Campaigning for the mental health workforce of the future
      • Workforce strategy
      • Job description approval process
    • Public Mental Health Implementation Centre
      • Our partners and first partnership activity 
      • How to work with the Public Mental Health Implementation Centre
      • Who's involved in the Public Mental Health Implementation Centre?
      • Aims and objectives
      • Reports
      • About public mental health
      • PMHIC Parliamentary Launch 
    • National Collaborating Centre for Mental Health
      • About NCCMH and our work
      • Clinical guideline development
      • Competence frameworks
      • Quality improvement programmes
      • Reports and research
      • Service design and development
      • Work with us
    • Physician Associates
      • About Physician Associates
      • Employing Physician Associates
      • Becoming a Physician Associate
      • Support for Physician Associates
      • Physician Associates network
      • The Competence Framework for Physician Associates in Mental Health
    • Invited Review Service
    • Public Health and its role in mental heath
    • Sustainability and mental health
      • In your community
      • In your practice
      • In your trust
      • Nature matters
      • Sustainability scholars
      • About sustainability in mental health care
      • Sustainability resources
      • College position on sustainability
      • Attending COP26
    • Using quality improvement
    • Net Zero Mental Health Care Research, Resources and Education
  • Mental health

    Mental health

    • Problems and disorders

      Problems and disorders

      • ADHD in adults
      • Alcohol and depression
      • Alcohol and older people
      • Anorexia and bulimia
      • Anxiety and generalised anxiety disorder (GAD)
      • Anxiety, panic and phobias
      • Bereavement
      • Bipolar disorder
      • Cannabis
      • Catatonia
      • Club drugs
      • Coping after a traumatic event
      • Debt and mental health
      • Delirium
      • Depression
      • Depression in older adults
      • Feeling overwhelmed
      • Gambling disorder
      • Heroin dependence
      • Hoarding
      • Learning disabilities
      • Medically unexplained symptoms
      • Memory problems and dementia
      • Obsessive-compulsive disorder (OCD)
      • Perinatal OCD
      • Perinatal OCD for carers
      • Personality disorder
      • Physical illness
      • Postnatal depression
      • Postnatal depression key facts
      • Postnatal depression: information for carers
      • Postpartum psychosis
      • Postpartum Psychosis in Carers
      • Post-traumatic stress disorder (PTSD) 
      • Schizoaffective disorder
      • Schizophrenia
      • Seasonal Affective Disorder (SAD)
      • Self-harm
      • Shyness and social phobia
      • Sleeping well
      • Avoidant/restrictive food intake disorder (ARFID)
      • Cocaine dependence
    • Support, care and treatment

      Support, care and treatment

      • Alzheimers drug treatments
      • Antidepressants
      • Antipsychotics
      • Antipsychotics in pregnancy
      • Being sectioned
      • Benzodiazepines
      • Children's social services and safeguarding
      • Cognitive Behavioural Therapy (CBT)
      • Complementary and alternative medicines: herbal remedies
      • Complementary and alternative medicines: physical treatments
      • Depot medication
      • Deprivation of Liberty Safeguards
      • Electroconvulsive therapy (ECT)
      • Guide to mental health tribunals
      • Liaison psychiatry services
      • Lithium in pregnancy and breastfeeding
      • Mental capacity and the law
      • Mental health in pregnancy
      • Mental health rehabilitation services
      • Mental health services and teams in the community
      • Mother and baby units (MBUs)
      • Neuromodulation
      • Perinatal mental health services: what are they?
      • Planning a pregnancy
      • Psychotherapies and psychological treatments
      • Social prescribing
      • Spirituality and mental health
      • Stopping antidepressants
      • Valproate in women and girls who could get pregnant
      • What to expect of your psychiatrist in the UK
      • COVID-19: Medication for mental health
      • COVID-19: Remote consultations
      • COVID-19: Going to hospital for a physical illness or injury
      • COVID-19: Eating disorders
      • COVID-19: Perinatal care
      • Hypnosis and hypnotherapy
      • Benefits, financial support and debt advice
      • Caring for someone with a mental illness
    • Young people's mental health
    • Translations

      Translations

      • Arabic عربى
      • Bengali বাঙালি
      • Bulgarian български
      • Chinese 中文
      • French Français
      • German Deutsch
      • Greek Ελληνική γλώσσα
      • Gujurati ગુજરાતી
      • Hindi हिंदीहिंदी
      • Italian italiano
      • Japanese 日本語
      • Lithuanian Lietuvių kalba
      • Pashto پښتو
      • Persian (Farsi) فارسی
      • Polish Polski
      • Punjabi ਪੰਜਾਬੀ
      • Romanian Română
      • Russian Pусский
      • Somali
      • Spanish Español
      • Turkish
      • Tamil தமிழ்
      • Urdu اردو
      • Welsh Cymraeg
      • Sindhi سنڌي
      • Ukrainian украї́нська
      • Swahili Kiswahili
    • Mental health and psychiatry FAQs
    • Order mental health leaflets
    • About our mental health information
    • Disclaimer about our mental health information
    • Choosing Wisely - a national campaign
    • BSL translations
    • MindEd – free mental health eLearning
    • Order mental health packs for schools

      Order mental health packs for schools

      • Order form for mental health factsheets for young people
    • Audio resources
    • Veterans' mental health
    • Suicide resources
    • Problems and disorders
      • ADHD in adults
      • Alcohol and depression
      • Alcohol and older people
      • Anorexia and bulimia
      • Anxiety and generalised anxiety disorder (GAD)
      • Anxiety, panic and phobias
      • Bereavement
      • Bipolar disorder
      • Cannabis
      • Catatonia
      • Club drugs
      • Coping after a traumatic event
      • Debt and mental health
      • Delirium
      • Depression
      • Depression in older adults
      • Feeling overwhelmed
      • Gambling disorder
      • Heroin dependence
      • Hoarding
      • Learning disabilities
      • Medically unexplained symptoms
      • Memory problems and dementia
      • Obsessive-compulsive disorder (OCD)
      • Perinatal OCD
      • Perinatal OCD for carers
      • Personality disorder
      • Physical illness
      • Postnatal depression
      • Postnatal depression key facts
      • Postnatal depression: information for carers
      • Postpartum psychosis
      • Postpartum Psychosis in Carers
      • Post-traumatic stress disorder (PTSD) 
      • Schizoaffective disorder
      • Schizophrenia
      • Seasonal Affective Disorder (SAD)
      • Self-harm
      • Shyness and social phobia
      • Sleeping well
      • Avoidant/restrictive food intake disorder (ARFID)
      • Cocaine dependence
    • Support, care and treatment
      • Alzheimers drug treatments
      • Antidepressants
      • Antipsychotics
      • Antipsychotics in pregnancy
      • Being sectioned
      • Benzodiazepines
      • Children's social services and safeguarding
      • Cognitive Behavioural Therapy (CBT)
      • Complementary and alternative medicines: herbal remedies
      • Complementary and alternative medicines: physical treatments
      • Depot medication
      • Deprivation of Liberty Safeguards
      • Electroconvulsive therapy (ECT)
      • Guide to mental health tribunals
      • Liaison psychiatry services
      • Lithium in pregnancy and breastfeeding
      • Mental capacity and the law
      • Mental health in pregnancy
      • Mental health rehabilitation services
      • Mental health services and teams in the community
      • Mother and baby units (MBUs)
      • Neuromodulation
      • Perinatal mental health services: what are they?
      • Planning a pregnancy
      • Psychotherapies and psychological treatments
      • Social prescribing
      • Spirituality and mental health
      • Stopping antidepressants
      • Valproate in women and girls who could get pregnant
      • What to expect of your psychiatrist in the UK
      • COVID-19: Medication for mental health
      • COVID-19: Remote consultations
      • COVID-19: Going to hospital for a physical illness or injury
      • COVID-19: Eating disorders
      • COVID-19: Perinatal care
      • Hypnosis and hypnotherapy
      • Benefits, financial support and debt advice
      • Caring for someone with a mental illness
    • Young people's mental health
    • Translations
      • Arabic عربى
      • Bengali বাঙালি
      • Bulgarian български
      • Chinese 中文
      • French Français
      • German Deutsch
      • Greek Ελληνική γλώσσα
      • Gujurati ગુજરાતી
      • Hindi हिंदीहिंदी
      • Italian italiano
      • Japanese 日本語
      • Lithuanian Lietuvių kalba
      • Pashto پښتو
      • Persian (Farsi) فارسی
      • Polish Polski
      • Punjabi ਪੰਜਾਬੀ
      • Romanian Română
      • Russian Pусский
      • Somali
      • Spanish Español
      • Turkish
      • Tamil தமிழ்
      • Urdu اردو
      • Welsh Cymraeg
      • Sindhi سنڌي
      • Ukrainian украї́нська
      • Swahili Kiswahili
    • Mental health and psychiatry FAQs
    • Order mental health leaflets
    • About our mental health information
    • Disclaimer about our mental health information
    • Choosing Wisely - a national campaign
    • BSL translations
    • MindEd – free mental health eLearning
    • Order mental health packs for schools
      • Order form for mental health factsheets for young people
    • Audio resources
    • Veterans' mental health
    • Suicide resources
Menu   
  • Home
  • News and features
  • Blogs
Back to Blog

Time to get specific – an interview with Dr Linda Kaye on gaming disorder

Cultural blog, Gaming the mind

05 October, 2021

  • Print this page
  • Share this page
    • facebook
    • twitter
    • linkedin
  • Email this page
Dr Linda Kaye

A couple of years have passed since Gaming the Mind last published an article on gaming disorder, so I spoke to Dr Linda Kaye, a specialist in Cyberpsychology at Edge Hill University, and Chair of the British Psychological Society’s Cyberpsychology Section, to get her take on the issue.

Her work includes publications on social identity within games and gaming culture, alongside other things, and she was one of the voices on the disorder-critical side of the gaming disorder debate.

Kaye doesn’t believe that much has changed in the field since gaming disorder’s inclusion in the ICD-11. Several issues still need refining, and she feels the diagnosis has led to a confirmation bias in research, rather than encouraging academics and clinicians to understand the problem on a deeper level. She worries that, for many people, their first exposure to gaming research will leave a negative impression of gaming, because there is more visibility to research that suggests problems with games, so they are unlikely to see the positive side of gaming or the on-going debates around the diagnostic labels.

The World Health Organisation (WHO) uses the broad term ‘gaming’ in its ICD-11 gaming disorder diagnostic criteria. For Kaye, this leads to issues with specificity and shows a lack of understanding of games on part of the WHO. She states that this is a phenomenon that also occurs in the gaming disorder research world: very different games are lumped together as if they’re one homogenous category. Even the term ‘online-games’ can arguably include anything, from a puzzle game on a mobile phone, to a game where the basis of play involves meeting up in online social spaces such as in massively multiplayer online games (MMORPGs).

Kaye suggests that to understand someone’s gaming behaviour, it is critical to clearly establish the types of games a person is playing and what their patterns of play are. She believes that some games seem very unlikely to cause problems with control over use, whereas those with loot box or other gambling-like mechanics are more likely to be problematic. Yet even when there are clearly elements within games designed to keep people glued to them, many people will have a healthy engagement with those games.

Moving on from diagnosis to treatment, Kaye believes it would be hard to recommend a treatment to someone experiencing problems with their gaming, until the constituent behaviours of such game play are known. Different games will elicit different gaming behaviours, so clinicians need to understand specific patterns for specific games.

For example, how does the person feel invested in the game? Monetarily? Socially? As a coping strategy? What are the game’s structural components, such as reward systems? Some games are going to lead to more engagement by the very nature of how they are played. One example that Kaye gives is an MMORPG which might involve membership to a guild, where loyalty and a meaningful contribution to the guild’s goals are critical. So, the thing that keeps a player playing is being with friends and gaining a sense of belonging, achievement, and mastery.

A player might feel they will let their guild down if they leave the game right in the middle of a big raid. What needs further exploration are the factors driving a player’s participation in such games, how they affect engagement, and the presence of risk factors for gaming behaviours to become problematic.

“Time is a game played beautifully by children.” ― Heraclitus, Fragments

For Kaye, many of the perceived problems with technology, including gaming, start from how some of us choose to spend our time and how society believes time is best spent. There is often concern from parents about the quantity of time spent online or playing a game, but the function of that time is disregarded. Kaye suggests that simply looking at limiting gaming time isn’t the best way to set boundaries. Time is an easy target because it’s quantifiable, but understanding the quality of gameplay is more challenging. On a surface level, a player may seem to be playing a game for hours on their own, but they might be exhibiting more functional and adaptive behaviours than is immediately apparent. Kaye highlights positive reasons why someone may play games: to stay in contact with friends; to meet new people; to build social networks and social capital around games. Such factors aren’t relevant for every type of game, but for some, they’re key.

So, rather than talking about gaming as an umbrella term, there needs to be advice around specific games and specific behaviours. Kaye likes to remind us that many video games are just a contemporary version of the games people played in the pre-digital era, like board games. Such games are unlikely to be problematic, despite the moral panics they have provoked in the past. On the other hand, some online games offer sophisticated social elements or are fully integrated into existing social media platforms. There can be a synergism between online marketing and game design which may drive engagement and lead to problems with control over gaming. Such games are qualitatively different from discrete, predominately offline, gaming experiences. Again, there needs to be more focus on the structural components in games, e.g., online elements.

The online social aspect of certain games is critical for Kaye and generates further important areas for research. What do we mean by being social in online gaming? How can we understand levels of socialness? Being social looks different in online gaming spaces compared to the traditional physical world, so there needs to be a better understanding of what’s healthy and what isn’t. Kaye suggests we should be curious about the different kinds of social behaviours players engage in when they play specific games.

For example, the prosocial role of spectatorship in Twitch streams is a new and under-researched phenomenon, and is similar, Kaye believes, to the kind of community people get from watching and supporting their favourite football team. Kaye points out that playing and watching a game gives people an easy common topic to talk about and can reduce perceived stakes in social interaction. She believes it can create a social glue which leads to commonality within broad communities.

More [high quality] research is needed

Gaming disorder research needs to improve in quality, according to Kaye, who believes the field relies too heavily on self-reported data. This is a problem because often gaming behaviours can be quite impulsive or unconscious, so the player might be less aware of doing them and so find it difficult to report. To get round this problem, she believes implicit measures of game-related biases need to be advanced, to quantify the in-game cues that promote attentional bias over others. Knowing whether there are certain game-related cues which draw attention, promote expectancies, and in turn, encourage engagement can be a basis for understanding how these vary for different types of games, structural components and different types of players.

Kaye feels strongly that games companies should grant researchers access to data concerning patterns of play that might be deemed excessive or problematic. This would help to address issues with self-report, as a more objective measurement of behaviour. Such data may even prove useful clinically: in the future, a clinician might be able to use metrics from a patient's play data to monitor aspects of their well-being. Another key issue with gaming research, highlights Kaye, is that despite the concerns around the effects of gaming on children, less research is done with them compared to adult populations, and even less so in co-creation with them.

WHO’s criteria?

Kaye agrees that, despite considerable reluctance from some to agree that gaming disorder, as it stands, is a valid diagnostic entity, most people would agree that a minority of players can develop problems with their gaming use. However, for Kaye, most of those players are likely to have a primary problem, from which disordered gaming is a secondary manifestation.

In January of this year, a study was published in the journal Addiction using a Delphi method to review the clinical utility of the criteria for diagnosing gaming disorder. This included a panel of 29 experts, 11 of whom were on the WHO ICD-11 gaming disorder committee, who were asked to judge the DSM-5 ‘internet gaming disorder’ (IGD) criteria and the ICD-11 ‘gaming disorder’ criteria according to clinical relevance. Four criteria, all from the ICD-11 diagnosis, were deemed to meet high clinical relevance: loss of control, gaming despite harms, conflict/interference due to gaming, and functional impairment. However, three of the DSM-5 IGD criteria (tolerance, deception, and escape/mood modulation) were felt to be unhelpful. I asked Kaye what she thought of these findings.

She agrees that the tolerance criterion for the DSM-5 IGD diagnosis has limited validity, as people can engage healthily with games in an intense fashion. This suggests that the application of such new diagnostic criteria needs to be conducted by specialists in the field with sufficient knowledge of games, gamers and addictions, and an awareness of the limitations of the current evidence base for the disorder.

Several key messages are worth highlighting from our conversation. Kaye believes the ICD-11's description of gaming is too broad and lacks game reference points, which leads to the issue that we need to be specific about what types of games are problematic, perhaps even down to the level of individual games. If we focus in further, we need to understand which elements within games are problematic and why. Time isn’t the only way to establish a boundary, and when anyone has problematic gaming behaviours, we need to carefully describe and explore the function of those behaviours without resorting to unnecessary pathologisation.

Authored by Dr Stephen Kaar

Blog Author
Gaming the mind team

Previous post Next post
  • Mental health
  • Members
  • Improving care
  • About the College
  • News and features
  • Contact the College
  • Work for us
  • Jobs Board for Members
  • Data protection
  • Disclaimer
  • Permissions
  • Web accessibility
SEE MAP

London Office
21 Prescot Street London E1 8BB
0208 618 4000

stonewall-silver-logo-small

disability-confident-logo-small

european-diversity-awards-winner-charity-of-the-year-badge-small

memcom-best-edi-campaign-winner-2022-small

Royal College of Psychiatrists

© 2023 Royal College of Psychiatrists.

Registered charity no. 228636 (England and Wales)

Charity registration no. SC038369 (Scotland)

  • Become a psychiatrist
  • Training
  • Events
  • Facebook
  • Twitter
  • YouTube
  • LinkedIn
  • Instagram