Gaming and internet addiction — structured clinical viva

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]