The situation with my legs is much worse. It is now over four months since my operation and I am still in a wheelchair as I am still unable to walk (more specifically I am still unable to lift my right foot because my right knee will not bend when I am standing upright). Strangely, I can bend my right knee when I am sitting down or lying down. I just can’t do it when I am standing. I have had lots of physiotherapy but very little of it has improved the functionality of my right leg. My left leg isn’t great either but it does have all its basic functionality. I do not know the long-term prognosis. One of my physiotherapists said that some of the muscles in my leg appear to be “paralyzed”. When she said the ‘P-word’ (i.e., ‘paralysis’) she could see that it visibly upset me. No-one had ever said that to me since my operation. She then said “we can call it something else” (and used the word “inactive” instead).
As with any paralysis, whether it is temporary or permanent is unknown. I learned how to “walk” on crutches while in hospital but since leaving hospital I’ve discovered that walking on crutches around the house is not very practical. I can’t make a drink or a snack and carry it from the kitchen to the breakfast room table or the lounge on crutches. I bought myself a walking frame which is not good for me physiotherapeutically (because it’s not good for my body posture) but I feel sturdier than I do on crutches and I feel like I am “walking” more properly compared to doing it on crutches.
During my time in hospital I had daily physiotherapy (apart from weekends), occupational therapy a couple of times a week, and a weekly session with a psychologist. As the weeks went on, I started doing more and more work and fitted my therapies around my work. Work helped me get through the weeks and weeks I was in hospital. Compared to many of the others I was in hospital with, I was one of the lucky ones. Some of the in-patients had horrific injuries and had limited cognitive faculties (most of the patients had brain injuries). I was one of the very few given ‘independent’ status. I could shower on my own, wash and dress myself, eat and drink without help, etc. In short, I needed little help from any of the medical and nursing staff.
To get discharged from hospital, I had to show my occupational therapist and physiotherapist that I could get around independently in my own house. On June 14, I had a ‘home visit’ where I underwent a series of challenges to see how easily I could do things that most of us take for granted. I had to do the tasks either in my wheelchair or on crutches. The first task was to get into my house and get up a few steps on my crutches. It was difficult (and I now have some ‘grab rails’ on the house exterior that the British Red Cross kindly installed for me). Inside the house I had to show my therapists how easily I could get on and off the toilets in the house. I had to show them how I could get out of bed on my own. I had to show them how I could get from my bed to the bathroom on my crutches. I had to show them how I could get in and out of the shower (which was incredibly difficult as there is a 23cm step to get into the shower).
Upstairs, I have no wheelchair use so I had to demonstrate I could do everything on my crutches. The real test was getting up and down the 13 stairs in my house. Thankfully, using the holding on to the bannister, I could get up and downstairs. Going up the stairs, I could lead with my good(ish) left leg and then drag the right one after it. It doesn’t look pretty but I could do it. Coming down the stairs, I have to lead with my (bad) right leg but there’d no real effort on my part so coming down was a lot easier than going up. Another way they got me to go upstairs was going up step-by-step on my bottom. I found that incredibly difficult (but I did it). By the end of the hour’s home visit my legs were shattered. That hour was probably the most intense physiotherapy I’d had since my operation. Eight days later (June 22) I was discharged from hospital and back home.
Since coming home, I have a maximum of two physiotherapy sessions a week and nothing else. Sometimes I feel like I am going backwards. The exercises I do are difficult and (in all honesty) boring. I am really trying to make a recovery but my (right) leg doesn’t seem to want to join me in my quest to become independently mobile again. I’ve had a couple of falls in the house. A couple of weeks ago, I was doing some ‘squatting’ exercises when my right knee buckled and I landed painfully on my right elbow and right buttock. My bursitis was back. I’ve found things difficult to do since then. Just getting in and out of bed feels like an assault course.
Dr. Mark Griffiths, Professor of Behavioural Addiction, International Gaming Research Unit, Nottingham Trent University, Nottingham, UK
I was taken to the operating theatre at about 8.30am. My surgery lasted about three hours and at about midday I woke up in the recovery room. The nurse asked me if I felt OK and after realising my surgery was over, I told her I was OK. I then realised I could speak. I could also wiggle my fingers and toes so I also knew I wasn’t paralysed. My very first thought was “If I can talk and I can type, I still have a job”. Within an hour I had drunk water and ate a sandwich and could do both without difficulty or being in pain. However, it became very clear very quickly that I wasn’t in full control of my own hands as well as being unable to walk at all (my right leg could do very little – wiggling my toes was about the limit of my movement). I was also catheterised for the first time in my life.
After eight hours in the recovery room (I should have only been there 1-2 hours but there were no ward beds available) I was moved into a ward just after 8pm with some very serious cases (mostly with individuals who had gone through major brain surgery). All of us on the ward had to have our ‘obs’ (observations – blood pressure, heart rate, temperature, blood sugar, etc.) taken hourly right through the night (so I got no sleep at all). I also had horrendous spasms in both my legs (over 1000 a night for the first week). I was put onto a drug called Baclofen (which I’m still on now).
The day after my operation was not the best. Because of COVID-19 no patients could have visitors. I briefly spoke to my partner on the phone. That was the day’s only highlight. I realised that I couldn’t do basic things with my hands like eat with a knife and fork or hold a pen. The latter really upset me. I keep a very detailed hand-written diary so not being able to write in it was very upsetting for me. I was also unable to give myself a wash so for the next few days I was given a daily body wash by the hospital staff. I couldn’t even hold a toothbrush properly to brush my teeth. I found the whole experience demoralising and degrading. Not being able to shower was horrible. Anyone who knows me will tell you how important showering is to me and my mental health. I shower a minimum twice a day. Not being able to shower felt like an abuse of my human rights. I never felt clean after a body wash. On the day after my operation, it became clear I wouldn’t be going home that day and it soon became apparent that I would be in hospital at least a week.
After a few days, some of my hand functionality began to return. I could just about use a knife and fork and I could pick up a flannel to wash my own face. However, holding a pen and writing with a pen was impossible. Unlike the other patients on the ward (a couple of who were sedated almost 24 hours a day), once I had awoken, I spent the whole day out of bed sat in a chair. I had my iPod so listened to a lot of music but did little else. Couldn’t hold a book or magazine long enough with my hands to read.
On Tuesday (April 20) I had my catheter removed. That seemed like a huge step forward. My partner also dropped my laptop off. I was unable to see her but at least it meant I could Skype her and my children. I also realised that typing was something I could so with my hands relatively easily. Writing a few emails was also good therapy for my fingers and I had a link to the outside world (I don’t have a smartphone, gave up using one in 2019). The hospital physiotherapists had given me hand and leg exercises to do and I spent a lot of time using the ward rotunda as a mini-gym. No-one else was capable of using it (as they were all confined to bed) so I had it 24/7. I was moved to another ward which I was told was “good news” as it meant I needed less specialist care. On Wednesday (April 21) I begged the doctor to allow me to shower. He said I could have one as long as I didn’t get my post-surgery dressing wet. Had to shower in a wheelchair (surreal to say the least) but despite this, it was heavenly to wash my hair and feel clean after six days of humiliating body washes. My dressing was drenched but I didn’t care. I felt clean and alive. I felt co-operative and communicative.
Just after the shower, I had an unexpected visitor. A doctor visited me and told me that I would be leaving Queen’s Medical Centre and would be moving to another hospital (City Hospital) to a specialist rehabilitation unit (Linden Lodge). She said she would try to get me a bed there for that weekend and that I would probably be there for 4-6 weeks. My emotions were mixed. I was glad to be moving to a place with dedicated and specialist care, but was surprised to hear that I would be in hospital for another 4-6 weeks.
At lunchtime that day, I got the unexpected news that there was a bed at Linden Lodge that evening and I was told to pack up all my stuff (not that I had much to pack). At 7pm I was transported by ambulance (first time I had ever been in one) over to my new temporary home. I was given my own room (which was great) and I unpacked the few things I had. My partner had dropped off clothes at the unit but again I was unable to see her due to the COVID-19 visiting restrictions. At one point in the evening, I decided to sit on the floor rather than the bed to get undressed for bed (I found it easier than being on the bed). When the nurse came in and found me sitting on the floor, she thought I had fallen (I hadn’t) but recorded in her notes that I had fallen.
On the Thursday morning (April 22, one week after my operation) I began life in Linden Lodge. I wasn’t allowed to shower until I had been “assessed” by an occupational therapist. I finally managed to have an unsupervised shower (in a wheelchair) early afternoon even though I was not “assessed”. I also moved room nearer the nursing staff because I was deemed as someone who needed to be watched more closely because they thought I had fallen on the floor the first night I was in here. The more I protested the less they believed me. It was even written up outside my room that I was susceptible to falls (which was true prior to my operation but not something I had done in hospital).
Since then, things have gone slowly. I was told after my initial assessments that I would likely be here for three months (i.e., until August). However, I left hospital on June 22 (after 67 days in hospital). The hardest thing I had to deal with was (until about 40 days into my stay) the ‘no visitors’ policy. I did see my partner a couple of times outside the unit through the iron bars (which felt a bit like being in prison). Over the past 12 weeks, a lot of my hand functionality has returned although I still have some difficulties. There are things that I now consider easy (typing, eating with a knife and fork, sponging myself in the shower), some that I can do but have to focus (writing with a pen, putting socks on, washing my hair, brushing my teeth, doing a crossword), and some things which are very difficult but I can do (e.g., shaving, tying shoelaces).
The first Sunday I was in the unit, I found a sentence that had all letters of the alphabet (“Pack my box with five dozen liquor jugs”) and spent hours trying to write it out in upper and lower case letters with a pen. Very difficult and very time consuming (but I did it). Over the next few weeks, I started to write my diary again. I began by writing the days events in bullet points in capital letters (writing in upper case capitals was easier than writing in lower case letters). I then progressed to writing the whole day’s events but all in capital letters. On May 19, I started writing my diary “normally” again (i.e., in sentence case rather than in capital letters). I use the word “normally” advisedly. I’m still very slow writing with a pen and it’s not the most legible, but any activity I do with my hands I still call “therapy”. As I type this, I still do not have full functionality in either of my hands and I have resigned myself to the fact that I never will.
You can read Part 1 of this blog here.
Dr. Mark Griffiths, Professor of Behavioural Addiction, International Gaming Research Unit, Nottingham Trent University, Nottingham, UK
On April 15 I had an operation to decompress my spinal cord and to have the C5 disc in my neck replaced with a new titanium disc. I ended up in hospital for 67 days. Here’s the back story (no pun intended).
For the past 18 years I have lived with a compressed spinal cord. Although I had the condition since 2003, it wasn’t diagnosed until an MRI scan in 2007. The scan showed that the C5 disc in my neck was completely herniated and that the disc was pressing directly onto my spinal cord causing hundreds of electric shocks every single day. I was prescribed daily amitriptyline which significantly reduced the number of shocks I felt. I was also prescribed heavy duty painkillers (dihydrocodeine) but I soon realised that work was the best analgesic in the world. Instead of taking up to four doses of dihydrocodeine every day, I worked (and worked). I rarely took more than four doses of dihydrocodeine a year let alone a day. I was also given details of an operation I could have but just the very thought of it scared me – especially because of the risk of being left paralysed from the neck or chest down. I was told to come back if I changed my mind about having an operation.
I am not 100% sure what caused the complete herniation of the disc in my neck but I suspect it was a minor traffic collision I was involved in at the beginning of November 2003. I was sitting on the front seat on the top floor of a double decker bus when a taxi crashed into the right-hand side of the bus and I was propelled forward onto the bus’s front window where my head hit the glass window, smashed the glasses I was wearing, and left me concussed. I was highly stressed that day because I was on my way to have a CT scan to look at swollen lumps in my throat for suspected Hodgkin’s or non-Hodgkin’s lymphoma. Later that week I had a lymphadenectomy and the biopsy showed that I didn’t have cancer but was diagnosed with toxoplasma lymphadenitis. It was after this operation that I began to get the constant daily electric shocks (over 100 a day) every time I moved my neck. I assumed that the constant electric shocks were as a result of my operation but I was later told that the shocks were being caused by a compressed spinal cord and that my lymphadenectomy was not the cause.
Over the next decade or so, the pain caused the constant compression of my spinal cord got progressively worse. Walking became increasingly difficult but I used excessive work as the strategy to suppress the increasing physical pain. In short, work became the perfect distractor task. When I was 100% cognitively engaged (e.g., giving a paper or teaching, writing or editing papers, etc.) I was in no pain whatsoever. I returned to the workaholic tendencies that I had before I had children. One of my consultants also described me as having “unspent youthfulness” which masked my medical condition for years.
The lifestyle I was leading in the years leading up to my operation probably didn’t help. I was travelling excessively averaging 20-25 overseas trips a year for conferences, consultancy, and research meetings. Walking became increasingly difficult as I was unable to lift my right foot properly. During 2019, I had a number of really bad falls abroad (tripping over because my right foot wouldn’t lift) including three in Abu Dhabi and a couple in Auckland which left me with horrendous bursitis on both of my elbows.
During the lockdown period, my health deteriorated badly. I was not globe-trotting anymore and I was housebound for over a year. My working life (and social life) became increasingly sedentary. I was doing everything from home including all my teaching. I had not stepped foot in my university office since the end of February 2020 (and still haven’t).
In August 2020, I saw one of my consultants and told him that my health condition had got significantly worse and that I now wanted the operation. However, because my surgery was classed as ‘elective’ as opposed to ‘urgent’ a date for surgery never came as the Nottingham hospitals were full of very ill COVID-19 patients. At one point during the pandemic, Nottingham was the UK city with the most COVID-19 infections. By February 2020 I could hardly walk and was becoming increasingly immobile. I rang my consultant’s secretary every week asking if I could have an appointment. I finally got one at the end of March 2021 and after seeing how bad my mobility was, I got an operation date very quickly. Thursday April 15, 2021. I was told by my consultant who was performing the surgery that he expected my to be back home the next day if the surgery was successful.
I have to be honest and say that the operation still scared me. Although there was a small chance of dying, that didn’t worry me. It was the thought of waking up paralysed which dominated my thoughts for over a week prior to the operation. Loss of limb use. Loss of job and livelihood Loss of identity. Loss of salary. There are many risks with any operation but spinal surgery carries many extra risks. I was told that some of the consequences could be eating and drinking difficulties and voice loss (as they would be carrying out the surgical procedure through the front of my neck and having to decompress my spinal cord by going via my trachea and oesophagus). I told my consultant that I would rather be dead than paralysed from the chest or neck down.
As the day of the operation approached, I again used work to block out my fears and negative thoughts. On April 15, my partner dropped me off at the hospital at 7am in the morning. Before my operation I had talks with the anaesthetist and one of the surgical team. I then had to sign the consent form which included a very long list of all the things that could go wrong. However, the weeks prior to my operation were surviving not living. I felt I was in the last chance saloon.
Dr. Mark Griffiths, Professor of Behavioural Addiction, International Gaming Research Unit, Nottingham Trent University, Nottingham, UK
Anyone that has read my research on gambling will know that I am committed to player protection, harm-minimization, social responsibility, and responsible gambling. I was recently interviewed by Kindred Gaming for an article on their website. This blog contains the full unedited transcript of that interview.
Kindred: You have worked in the field for several years now, what are the biggest changes you have seen to the industry when it comes to responsible gambling and player protection?
MG: I’ve been working in the gambling studies field for 33 years and it was around 1996 that I first began to think about my research in terms of social responsibility issues. It was in the early 2000s that some of the more forward thinking gaming operators started to bring in socially responsible gambling features (particularly in countries such as Sweden, Norway, Canada and Australia although that might be more reflective of the clients who I had consultancy with at the time). It is over the past decade that responsible gambling has really come to the fore, and many gambling regulators around the world will not grant operating licences unless the gaming operators can demonstrate what they are doing in terms of player protection and harm-minimization. The biggest changes are arguably in the online medium because there are so many protective measures that can be initiated online such as various limit-setting features, temporary self-exclusions and cool-off periods, pop-up messaging, bespoke personalized feedback, mandatory play breaks, and the use of behavioural tracking tools.
Kindred: Focusing on your study “An Empirical Study of the Effect of Voluntary Limit-Setting on Gamblers’ Loyalty Using Behavioural Tracking Data” can you tell us a bit about the key findings, and how you view voluntary vs mandatory limits and other control tools?
MG: Kindred kindly gave us access to a dataset of 175,818 players who had placed at least one bet or gambled at least once during January 2016 to May 2017. In a nutshell we looked at active players over a one-year period and found that the percentage of active players in the first quarter of 2017 was significantly higher in the group of players who had set voluntary money limits in the first quarter of 2016 compared to players that did not. This suggests that players who set voluntary spending limits were more loyal to Kindred compared to those who do not. On the assumption that voluntary limit-setting should be part of a gaming operator’s corporate social responsibility strategy, our findings appear to underline the fact that CSR has a positive effect on business outcomes. With regards to the issue of voluntary vs. mandatory limit-setting, I’m personally in favour of it being mandatory for players to set their own time and money limits if they want to gamble. Many players don’t set their own limits but I think making it mandatory would help players in terms of managing their budgets. Some companies have default global monthly limits on how much money players can lose but that can become restrictive for those who can afford to gamble with larger amounts of money and can also be restrictive for some kinds of gambling (sports betting being the type of gambling most affected).
Kindred: How do you think operators and the academic world can work together for a safer and more sustainable gambling industry in the coming years?
MG: If both academics and the gambling industry have a shared goal of preventing and reducing problem gambling, I think there are good pragmatic reasons to work collaboratively. Personally, I think some of the best gambling research that I have done is working with gambling companies (and I would stress that I am working with gambling companies and not for them) simply because of the high quality data that gambling operators have. Obviously there are many academics who have criticized myself (and my colleagues) for such collaborations but I think the positives of working together outweighs the negatives. As long as we have complete independence to publish the results of what we find without interference from the operators, I do not have a problem in working together. My main area in this field is the evaluation of responsible gambling tools and whether the measures introduced by operators to help their players gamble more responsibly and/or can help prevent/reduce problem gambling. Over the past eight years, Dr. Michael Auer and myself have evaluated the efficacy of limit-setting, mandatory play breaks, pop-up messaging, personalized feedback, loss-limit reminders, and other gambling operator initiatives. Some of these appear to work and others less so. To move the field forward and to help maintain safe and sustainable gambling, collaborative research needs to continue. I have worked with and carried out consultancy with over 30 gambling companies around the world and am very proud of companies changing their practices and policies in relation to the findings of our research. If research findings cannot be applied to help the greater good, then what is the point of doing research if it has little practical benefit? For me, it’s a ‘win-win’ situation.
Kindred: Kindred has set an ambition to reach zero percent revenue from harmful gambling, what do you see as the key steps towards 100% enjoyable gambling?
MG: The aim is laudable but going to be difficult to achieve because harmful gambling (including problem gambling) can never be totally eliminated – although I do believe it can be kept to a minimum. I’ve always argued that problem gamblers have a relatively short customer life for gambling companies and that what sustainable companies need is long-term customer retention. Problem gamblers cannot give companies that and gambling operators need to think about lifetime customer value with decades of repeat business from those who gamble within their limits over a long period of time rather than relatively high spending from a minority of customers who may only gamble with the company for a few years. Customers will keep coming back to gambling operators if they have a product or products that customers feel is value for money and provides enjoyment – even if they lose money. There are a number of key steps that all gambling companies should take if they want sustainable and safe gambling including informed choice. These include (but are not limited to) (i) providing customers with all the information they need so that they can make an informed choice about whether they want to gamble, (ii) responsible marketing and advertising, (iii) robust age verification checks of customers, (iv) robust financial checks of customers, (v) mandatory limit-setting for customers, (v) using customer data to intervene and help high-risk gamblers via bespoke pop-up messaging and personalized messaging, (vi) partnering with gambling prevention and treatment agencies, and (vii) robust voluntary self-exclusion schemes.
Dr Mark Griffiths, Professor of Behavioural Addiction, International Gaming Research Unit, Nottingham Trent University, Nottingham, UK
Auer, M. & Griffiths, M.D. (2013). Voluntary limit setting and player choice in most intense online gamblers: An empirical study of gambling behaviour. Journal of Gambling Studies, 29, 647-660.
Auer, M. & Griffiths, M.D. (2014). An empirical investigation of theoretical loss and gambling intensity. Journal of Gambling Studies, 30, 879-887.
Auer, M. & Griffiths, M.D. (2015). Testing normative and self-appraisal feedback in an online slot-machine pop-up message in a real-world setting. Frontiers in Psychology, 6, 339.
Auer, M. & Griffiths, M.D. (2015). The use of personalized behavioral feedback for problematic online gamblers: An empirical study. Frontiers in Psychology, 6, 1406.
Auer, M. & Griffiths, M.D. (2016). Personalized behavioral feedback for online gamblers: A real world empirical study. Frontiers in Psychology, 7, 1875.
Auer, M. & Griffiths, M.D. (2020). The use of personalized messages on wagering behavior of Swedish online gamblers: An empirical study. Computers in Human Behavior, 110, 106402.
Auer, M. & Griffiths, M.D. (2020). Predicting limit-setting behavior of gamblers using machine learning algorithms: A real world study of Norwegian gamblers using account data. International Journal of Mental Health and Addictions. Advance online publication. https://doi.org/10.1007/s11469-019-00166-2
Auer, M., Hopfgartner, N. & Griffiths, M.D. (2018). The effect of loss-limit reminders on gambling behavior: A real world study of Norwegian gamblers. Journal of Behavioral Addictions,7(4), 1056-1067.
Auer, M., Hopfgartner, N. & Griffiths, M.D. (2018). The effect of loss-limit reminders on gambling behavior: A real world study of Norwegian gamblers. Journal of Behavioral Addictions,7(4), 1056-1067.
Auer, M., Hopfgartner, N. & Griffiths, M.D. (2020). The effects of voluntary deposit limit-setting on long-term online gambling behavior. Cyberpsychology, Behavior and Social Networking, 23, 113-118.
Auer, M., Hopfgartner, N. & Griffiths, M.D. (2020). An empirical study of the effect of voluntary limit setting on gamblers’ loyalty using behavioral tracking data. International Journal of Mental Health and Addiction. Advance online publication. https://doi.org/10.1007/s11469-019-00084-3.
Auer, M., Malischnig, D. & Griffiths, M.D. (2014). Is ‘pop-up’ messaging in online slot machine gambling effective? An empirical research note. Journal of Gambling Issues, 29, 1-10.
Ukhov, I., Bjurgert, J., Auer, M. & Griffiths, M.D. (2020). Online problem gambling: A comparison of casino players and sports bettors via predictive modeling using behavioral tracking data. Journal of Gambling Studies. Advance online publication. https://doi.org/10.1007/s10899-020-09964-z
Over the past few weeks there have been a number of academics who have accused me of self-plagiarism. Here, I briefly outline what I have done and have not done in relation to the allegations I have seen. I think we would all agree with the definition dictionary definition of ‘plagiarism’, i.e., “the process or practice of using another person’s ideas or work and pretending that it is your own” (Cambridge Dictionary). Logically, based on this definition, ‘self-plagiarism’ would equate to the process or practice of using one’s own ideas and pretending that they are your own, but this is of course ludicrous.
The Merriam-Webster Dictionary defines ‘self-plagiarism as “the reuse of one’s own words, ideas, or artistic expression (as in an essay) from preexisting material especially without acknowledgment of their earlier use”. On the same page as this definition is a quote from the journalist Taylor Wofford who notes “Borrowing your own words is a tricky issue. Writers and publishers tend to rank self-plagiarism as a lesser offense than – what should we call it? – ‘real’ plagiarism? Still, they mostly agree it’s a no-no”.
On July 10 (2020), Dr Annie Brookman-Byrne (Deputy Editor of The Psychologist) emailed me:
“At The Psychologist, we are considering writing a piece on the concept and practice of self-plagiarism. We have seen Brendan O’Connor and others on Twitter highlighting concerns over some of your published output. Might you or your institution be interested in making a statement for us around whether you think there is actually a practice here that needs to change?”
I immediately responded to her email and said:
“I’ve not read all the comments on Twitter (and I am not going to respond to anything on Twitter as that is not the place to do it) but the alleged instances of self-plagiarism primarily revolve around my use of journal text in populist non-refereed non-journal outputs. For instance, when I write for magazines like ‘Education and Health’ (a magazine for teachers) or in newspaper or magazine articles I will use text from my journal papers…I write for many different audiences. Obviously I write and co-write refereed journal papers but I am also a freelance journalist, a prolific blogger, and write articles for the trade press (e.g., gambling and gaming magazines) as well as articles in professional publications that are not peer-reviewed. Personally I see nothing wrong in using material from my refereed papers in these other types of article as I am a prolific disseminator and want to get my ideas and thoughts to as many people and to as big an audience as possible. The alleged examples of self-plagiarism that I have seen directed towards me comprise less than 1% of my refereed journal papers. I am very proud of my publication record in many different spheres. For the record, most of those accusing me of alleged self-plagiarism are citing papers that I wrote 15 or more years ago and are making no distinction between what I have published in peer-reviewed journal papers and articles that have not been peer-reviewed and which I would describe as populist outlets”.
I make no secret of using text from my refereed papers in my blogs, newspaper and magazine articles, press releases, trade press publications, consultancy reports, and reports for third parties (e.g., calls for evidence from parliamentary committees). Those who have been using plagiarism software on my refereed papers have included results from text that is not from refereed papers.
For instance, a number of examples I saw of my alleged self-plagiarism concerned the magazine Education and Health. Education and Health is a magazine for teachers and parents and is produced by the School Health Education Unit in Exeter focusing on adolescent health and education issues. Education and Health has no copyright (i.e., no author has to sign a copyright form), is not peer-reviewed, and articles do not have a doi, contain keywords, or have an abstract). I have published in it regularly for three decades. In some of the articles I have written for Education and Health, I have taken an academic review paper (6000-11000 words) and then turned it into a dumbed down ‘pop’ article (1000-1500 words). I’ve done this a number of times over the past 30 years. An example that I saw online last week was in relation to a 2011 open access paper by Daria Kuss and myself (i.e., Kuss, D. J. & Griffiths, M. D. (2011). Online social networking and addiction: A literature review of empirical research. International Journal of Environmental Research and Public Health, 8, 3528-3552).
This was an 11,000-word systematic literature review on social networking addiction. It has become one of our most cited papers (1,528 citations on Google Scholar as of this morning). After publishing this refereed paper, I then turned this into a 1500-word ‘pop’ version for Education and Health (Kuss, D.J. & Griffiths, M.D. (2011). Excessive online social networking: Can adolescents become addicted to Facebook? Education and Health, 29. 63-66.). In the first paragraph, the Education and Health article clearly states:
“As a consequence of the increased media attention to headlines about ‘Facebook addiction’, we recently reviewed all the scientific evidence on the topic (Kuss & Griffiths, 2011a). This article briefly summarises what we found”.
This sentence cites the paper from which all the material in the article comes from. I have not tried to hide anything or pretend that the article contains original material. The article was for teachers and parents. It contains a summary of the key things found in our refereed paper and uses text from that paper. If others want to view it as ‘self-plagiarism’ I have no problem with that. I view it as dissemination of our work to an audience outside of academia.
Any of us in British academia knows how important the Research Excellence Framework (REF) impact agenda is. My own research was rated as having 4* world-leading impact at the last REF and I’m hoping to repeat it this time. One of the ways I have gone about this is to disseminate my work to as many non-academic audiences as possible. My articles in the gambling trade press have been instrumental in the research and consultancy monies that I have generated for my university in the area of responsible gambling, player protection, and harm-minimization.
Almost all of the examples I have seen of my alleged self-plagiarism comes from this type of practice where I have turned pure academic papers into something more populist. Occasionally it has worked the other way (i.e., I’ve written a populist piece and then worked it up into an academic paper although the instances of this are much fewer). As I said above, personally I see nothing wrong in using material from my refereed papers in these other types of article as I am a prolific disseminator and want to get my ideas and thoughts to as many people and to as big an audience as possible.
Most of those accusing me of alleged self-plagiarism are citing papers that I wrote 10-15 years ago (although I did see one from 2015, again with Education and Health being the source of alleged self-plagiarism) and no-one appears to be making any distinction between what I have published in peer-reviewed journal papers and articles that have not been peer-reviewed and which I would describe as populist outlets. Plagiarism software does not indicate whether the text it finds comes from a refereed paper or non-refereed article. No-one who has accused me of self-plagiarism has contacted me personally and asked my about the source material and whether a particular piece of writing was refereed or not. There appears to be an assumption that all alleged self-plagiarised sources were from refereed papers (but they weren’t).
I should also add that there are other examples of my work that have been reproduced with permission from the publishers and/or copyright holders. For instance, the publisher IGI Global regularly republishes my work in other guises. Here’s an example I received this week from them (the words in bold were by the publisher and not me):
“I hope this message finds you well, especially during this turbulent time. It is with great pleasure that I am informing you that your contribution titled “UK-Based Police Officers’ Perceptions of, and Role in Investigating, Cyber-Harassment as a Crime,” previously published in an IGI Global publication, was carefully assessed and selected by IGI Global’s executive editorial board for inclusion as a reprinted chapter (100% completely unchanged from the original) in the recently published IGI Global research anthology titled Police Science.
IGI Global’s research anthologies, also called “Critical Explorations”, were created after an extensive survey was conducted with academic librarians, who requested to have a cost-effective and timely way to enhance their collections with the highest quality, timely research. This line of publications allows our publishing house to hand-select the highest quality research content (book chapters and journal articles of which IGI Global owns the copyright), to be reprinted in a research anthology format. This format also allows the author’s research to become more accessible and visible to a larger community of researchers around the world so that they can benefit from additional exposure (i.e. citations) for their work.
Please note that there is no intent to deceive anyone. We execute the highest level of transparency, as every single chapter that appears in these publications are labeled with a special notation indicating that it is reprinted content and listing the original source of the material. Additionally, because we are maintaining the integrity of the original published work, no changes have been made nor can be made to the chapter”.
I fully understand that my explanation for how and why I publish with different audiences will not be accepted by detractors, but that’s not why I wrote this. All I can do is give my side of how I disseminate my work and ideas to as many people as possible.
Last week I was contacted by a journalist at the Red Bulletin Magazine who was “looking for an expert in gaming psychology to talk to for a piece on the mental benefits of endless running games, i.e. ‘the gameplay building strong reward learning in players’. It should be a fun and practical guide…Just let me know if you’d be interested.” I was interested. I had been teaching in the morning so I didn’t get the email until a couple of hours after it had been sent. I scribbled down a few notes, got back in touch, but by the time I did, the journalist had already interviewed someone else for the feature. Since I’d already made a few bullet points, I thought I would use them for the basis of a blog. (I really don’t like things going to waste).
Although much of my research examines problematic gaming, I am not anti-gaming (and never have been), and I have published many papers on the benefits of gaming including therapeutic benefits, educational benefits, and psychological (cognitive) benefits (see ‘Further reading’ below). Some of you reading this may not know what endless running games are, so here is the Wikipedia definition from its entry on platform games:
“‘Endless running’ or ‘infinite running’ games are platform games in which the player character is continuously moving forward through a usually procedurally generated, theoretically endless game world. Game controls are limited to making the character jump, attack, or perform special actions. The object of these games is to get as far as possible before the character dies. Endless running games have found particular success on mobile platforms. They are well-suited to the small set of controls these games require, often limited to a single screen tap for jumping. Games with similar mechanics with automatic forward movement, but where levels have been pre-designed, or procedurally generated to have a set finish line, are often called “auto-runners” to distinguish them from endless runners”.
Endless running games are incredibly popular and played by millions of individuals around the world (including myself on occasions). One of the best things about endless running games is that because they can be played on smartphones and other small hand-held devices they can be played anywhere at any time. Like any good game, the rules are easy to understand, the gameplay is deceptively simple, but in the end, it takes skill to succeed. The simplicity of endless running games is one of the key reasons for their global success in terms player numbers. For successful games, the mechanics should be challenging but not impossible. Such games can lead to what has been described as a state of ‘flow’ (coined by Mihaly Csíkszentmihályi in his seminal books Flow: The Psychology of Optimal Experience  and Flow: The Psychology of Happiness ).
With the flow experience, a game player derives intense enjoyment by being immersed in the gaming experience, the challenges of the game are matched by the player’s skills, and the player’s sense of time is distorted so that time passes without it being noticed. For some video game players, this may then mean repeatedly seeking out similar experiences on a regular basis to the extent that they can escape from their concerns in the ‘real world’ by being continually engrossed in a flow-inducing world. However, something like flow – viewed largely as a positive psychological phenomenon – may be less positive in the long-term for some video game players if they are craving the same kind of emotional ‘high’ that they obtained the last time that they experienced flow when playing a video game.
Flow has been proposed (by Jackson and Eklund, 2006) as comprising nine elements that include: (i) striking a balance between the challenges of an activity and one’s abilities; (ii) a merging of performance of actions with one’s self-awareness; (iii) possessing clear goals; (iv) gaining unambiguous feedback on performance; (v) having full concentration on the task in hand; (vi) experiencing a sense of being in control; (vii) losing any form of self-consciousness; (viii) having a sense of time distorted so that time seems to speed up or slow down; and (ix) the undergoing of an auto-telic experience (e.g., the goals are generated by the person and not for some anticipated future benefit). Endless running games are one of many types of videogame that can result in ‘flow’ experiences (which for the vast majority of gamers is going to result in something more positive (psychologically) than negative.
There are many studies showing that playing video games can improve reaction times and hand-eye co-ordination. For example, research has shown that spatial visualisation ability, such as mentally rotating and manipulating two- and three-dimensional objects, improves with videogame playing. Again, endless running videogames rely very heavily on hand-eye co-ordination and fast reaction to on-screen events. In this specific area, I see endless running games as having nothing but positive benefits in terms of improving hand-eye co-ordination skills, reflexes, and attention spans.
Although I’m not a neuroscientist or a neuropsychologist, I know that on a neurobiological level, when we engage in pleasurable activity, our bodies produce its own opiate-like neurochemicals in the form of endorphins and dopamine. The novelty aspects of endless running games will for many players result in the production of neurochemical pleasure which is rewarding and reinforcing for the gamer.
I also believe that endless running games have an appeal that crosses many demographic boundaries, such as age, gender, ethnicity, or educational attainment. They can be used to help set goals and rehearse working towards them, provide feedback, reinforcement, self-esteem, and maintain a record of behavioural change in the form of personal scores. Beating one’s own personal high scores or having higher scores than our friends and fellow gamers can also be psychologically rewarding.
Because video games can be so engaging, they can also be used therapeutically. For instance, research has consistently shown that videogames are excellent cognitive distractors and can help reduce pain. Because I have a number of chronic and degenerative health conditions, I play a number of cognitively-engrossing casual games because when my mind is 100% engaged in an activity I don’t feel any pain whatsoever. Again, endless running games tick this particular box for me (and others). Also, on a personal level, I am time-poor because I work so hard in my job. Endless running games are ideal for individuals like myself who simply don’t have the time to engage in playing massively multiplayer online games that can take up hours every day but will quite happily keep myself amused and pain-free on my commute into work on the bus.
As I have pointed out in so many of my research papers and populist writings over the years, is that the negative consequences of playing almost always involve a minority of individuals that are excessive video game players. There is little evidence of serious acute adverse effects on health from moderate play, endless running games included.
Csíkszentmihályi, M. (1990). Flow: The Psychology of Optimal Experience. New York: Harper and Row
Csíkszentmihályi, M. (1992). Flow: The psychology of happiness. London: Random House.
Griffiths, M.D. (2002). The educational benefits of videogames Education and Health, 20, 47-51.
Griffiths, M.D. (2003). The therapeutic use of videogames in childhood and adolescence. Clinical Child Psychology and Psychiatry, 8, 547-554.
Griffiths, M.D. (2004). Can videogames be good for your health? Journal of Health Psychology, 9, 339-344.
Griffiths, M.D. (2005). Video games and health. British Medical Journal, 331, 122-123.
Griffiths, M.D. (2005). The therapeutic value of videogames. In J. Goldstein & J. Raessens (Eds.), Handbook of Computer Game Studies (pp. 161-171). Boston: MIT Press.
Griffiths, M.D. (2010). Adolescent video game playing: Issues for the classroom. Education Today: Quarterly Journal of the College of Teachers, 60(4), 31-34.
Griffiths, M.D. (2019). The therapeutic and health benefits of playing videogames. In: Attrill-Smith, A., Fullwood, C. Keep, M. & Kuss, D.J. (Eds.). The Oxford Handbook of Cyberpsychology. (pp. 485-505). Oxford: Oxford University Press.
Griffiths, M.D., Kuss, D.J., & Ortiz de Gortari, A. (2017). Videogames as therapy: An updated selective review of the medical and psychological literature. International Journal of Privacy and Health Information Management, 5(2), 71-96.
Jackson, S.A. & Eklund, R.C. (2006). The flow scale manual. Morgan Town, WV: Fitness Information Technology.
Nuyens, F., Kuss, D.J., Lopez-Fernandez, O., & Griffiths, M.D. (2019). The experimental analysis of non-problematic video gaming and cognitive skills: A systematic review. International Journal of Mental Health and Addiction, 17, 389-414.