Monthly Archives: May 2013

Fuddy study: A brief overview of Brain Fag Syndrome

Over the last year I have examined a number of culture-bound syndromes that comprise a combination of psychiatric and/or somatic symptoms viewed as a recognizable disease within specific cultures or societies. One of the more interesting types is Brain Fag Syndrome (BFS). The first cases of BFS were described in 1960 by Dr. Raymond Prince in the British Journal of Psychiatry. He reported on a very common psychoneurotic syndrome occurring among the students of southern Nigeria” that is typically initiated after intensive periods of intellectual activity. More specifically he wrote that:

“The symptoms are such as to prevent the student from carrying on with his work and include various unpleasant head symptoms accompanied by inability to grasp what he reads or what he hears in a lecture, memory loss, visual difficulties, inability to concentrate, inability to write, etc.”

Other researchers (such as a team led by Dr. Bolanie Ola – writing in a 2009 issue of the African Journal of Psychiatry) have noted that BFS comprises a wide range of somatic complaints (as noted by Dr. Prince) but can also include cognitive and sleep-related impairments, as well as localized pain in the head and neck. BFS is seen as an interesting phenomenon in the field of transcultural psychiatry. For some researchers, BFS was controversially included (for the first time) in the fourth edition of American Psychiatric Association’s 1994 Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), and included as a culture bound syndrome such as the Koro (the genital retraction syndrome that I reviewed in two previous blogs examining male Koro and female Koro).

Since the publication of Prince’s seminal paper over 50 years ago, BFS has been documented among non-Caucasians in various African countries (Ethiopia, Liberia, Ivory Coast, South Africa, and Uganda), and a few countries outside of Africa (Brazil, India, Malaysia, China). However, the number of cases from those countries outside of Africa are exceedingly rare. There also appear to be similar syndromes such as the Trinidadian illness ‘studiation madness’ that has similar symptoms to BFS.

The term ‘brain fag’ was the name of the disorder that the students themselves called it (and appears to be a shortened version of ‘brain fatigue’). Based in his early research, Dr. Prince believed that BFS was not caused and/or associated to genetic predisposition, general intelligence, parental literacy, study habits or family responsibilities. He believed that BFS was related to:

“The imposition of European learning techniques upon the Nigerian personality [and that] European learning techniques emphasize isolated endeavour, individual responsibility and orderliness – activities and traits which are foreign to the Nigerian by reason of the collectivistic society from which he derives, with its heightened ‘orality’ and permissiveness”.

Dr. Ola and his colleagues questioned the extent to which BFS is an objective or subjective phenomenon. They asked a number of pertinent questions: Is BFS one phenomenon or a variant of other known disorders? Is BFS a mental illness? Ola and colleagues described the case of a young male student from Yoruba. 

“When studying for an exam [he] began to have sharp pains in his head and could not grasp what he was reading. He slept more than usual, and had difficulty forcing himself to go to school in the morning. When writing the examinations, he felt he knew the answers, but was unable to recall them; his mind was blank. His right hand was weak and shook so that he couldn’t write. Because of these symptoms, he was forced to postpone the writing examinations for several years. His symptoms improved greatly with Largactil (an antipsychotic medication) and reassurance”.

Much like the early findings of Prince, Ola and his colleagues suggest that BFS may in sufferers be “the somatic manifestation of the rather sudden Westernization of African education”. The authors also claimed that between 6% and 54% of Nigerian university students may experience brain fag symptoms although those with the “full-blown syndrome” appear to be significantly lower. However, a more recent paper in the ASEAN Journal of Psychology claimed that among secondary school students, BFS is prevalent in 20-40% of students.

A more recent paper by Bolanie Ola and David Igbokwe in a 2011 issue of Africa Health Sciences, cites some work carried out on the etiology of BFS by Guinness in 1992 (although no reference is provided for the study itself). Guinness reported five independent factors associated with the syndrome: (a) the financial implications of education which represented the change from subsistence to cash economy; (b) fear of envy and bewitchment which represented the intense cultural response to education; (c) parenting in the pre-school years which was the independent family variable; (d) academic ability; (e) attributes of the school.

In a paper examining the factorial validation and reliability analysis of the Brain Fag Syndrome Scale (BFSS) by Ola and Igbokwe, it was argued by the authors that there was a lack of consistent findings relating to the etiology, pathophysiology and risk factors of BFS. This, they argued, reflected the “lack of standardized reproducible diagnostic criteria” for the syndrome. In short, they asserted that different studies had used different instruments to assess BFS and that only a few followed the description first formulated by Prince. They claimed that 60% of the BFS studies they reviewed simply reported the rates of BF symptoms rather than BFS. Following psychometric evaluation on 234 participants (aged 11- to 20-years), Ola and Igbokwe claimed that the BFSS is a valid and reliable two-dimensional instrument to assess BFS and can therefore be used in future studies. At least there is now an instrument that can be used to carry out empirical research more systematically.

Dr Mark Griffiths, Professor of Gambling Studies, International Gaming Research Unit, Nottingham Trent University, Nottingham, UK

Further reading

Fatoye, F.O. (2004). Brain fag syndrome among Nigerian undergraduates: present status and association with personality and psychosocial factors. Ife Psychologia, 12, 74-85.

Fatoye, F.O. & Morakinyo, O. (2003). Study difficulty and the ‘Brain Fag’ syndrome in south western Nigeria. Journal of Psychology in Africa, 13, 70-80.

Igbokwe, D.O. & Ola, B.A. (2011). Development and validation of the Brain Fag Propensity Scale. ASEAN Journal of Psychiatry, 12, 1-13.

Morakinyo, O. (1980). Psychophysiological theory of a psychiatric illness (the Brain Fag syndrome) associated with study among Africans. Journal of Nervous and Mental Disease, 168, 84-89.

Morakinyo, O. & Peltzer, K. (2002). Brain Fag symptoms in apprentices in Nigeria. Psychopathology, 35, 362-366.

Ola, B.A. & Igbokwe, D.O. (2011). Factorial validation and reliability analysis of the brain fag syndrome scale. African Health Sciences, 11, 334-339.

Ola, B.A., Morakinyo, O. & Adewuya, O. (2009). Brain Fag Syndrome – a myth or a reality. African Journal of Psychiatry, 12,135-43.

Peltzer, K. & Woldu, S. (1990). The brain fag syndrome in female Nigerian students: intercultural analysis and intervention of gender change. Curare, 13, 141-146.

Prince, Raymond (1960). The “Brain Fag” Syndrome in Nigerian students. British Journal of Psychiatry, 106, 559-570.

Wikipedia (2012). Brain fag. Located at:

Spelling tests: A brief look at wiccaphilia and witches’ sexuality

“For years I have had a real fetish for witches – I believe its called wiccaphillia – or something like that! My wife indulges my interest and she has sixteen sexy witch outfits!” (from the Sexy Witch website)

There are various websites that list hundreds of different types of sexual paraphilias. Many of these paraphilias are simply the names of specific phobias with the suffix ‘-phobia’ replaced by the suffix ‘-philia’. Examples of this include: agoraphobia and agoraphilia (fear of the outdoors; sexual arousal from the outdoors), cremnophobia and cremnophilia (fear of steep cliffs and precipices; sexual arousal from steep cliffs and precipices), and kynophobia and kynophilia (fear of getting rabies; sexual arousal from getting rabies). Another sexual paraphilia that often appears in these lists (such as the one at the Sensual Swingers website) is wiccaphilia (sexual arousal from witches and witchcraft) that I assumed was just based on the opposite phobia (wiccaphobia – fear of withes) and didn’t really exist (especially as it doesn’t appear in either Dr. Anil Aggrawal’s Forensic and Medico-legal Aspects of Sexual Crimes and Unusual Sexual Practices or Dr. Brenda Love’s Encyclopedia of Unusual Sex Practices. Furthermore, there is not a single reference to wiccaphilia in any academic article or book that I am aware of.

I obviously tried to look up wiccaphilia on (…ahem) Wikipedia but there was surprisingly nothing. The Wikipedia entry on ‘wicca’ noted that wicca is a modern pagan religion (developed here in England in the first half of the twentieth century) concerning witchcraft, drawing on a diverse set of ancient pagan rituals. In relation to sexual behaviour, the article noted:

“A central aspect of Wicca…often sensationalised by the media is the traditional practice of working in the nude, also known as skyclad. This practice seemingly derives from a line in Aradia, Charles Leland’s supposed record of Italian witchcraft. Other traditions wear robes with cords tied around the waist or even normal street clothes. In certain traditions, ritualized sex magic is performed in the form of the Great Rite, whereby a High Priest and High Priestess invoke the God and Goddess to possess them before performing sexual intercourse to raise magical energy for use in spellwork. In nearly all cases it is instead performed ‘in token’, thereby merely symbolically, using the athame to symbolise the penis and the chalice to symbolise the womb”

In the course of my research for this article, I came across lots of references to witches’ sexuality but these were light-hearted and non-academic including photographic sites of the 25 sexiest witches, artistic sites of the sexiest witch pin-ups (i.e., drawings and paintings rather than photographs), the sexiest witches seen in the movies, articles on having sex with witches and ‘wiccan sex’, and articles on the application of make-up for sexy witches. There is also the Sex. Fetish, Witch, Artphotograph website run by a woman who claims: I’m a 50+ year old average everyday woman who still likes ‘Sex’, is a ‘Fetishist’, identifies strongly with my natural ‘Witch’ instincts and gets off on ‘Art’. I see myself as a type of Carnal Muse”. All of these sites make the assumption that witches are female but one thing that surprised me when researching this blog was an article in The Frisky online magazine that noted male witches are not called warlocks but are also witches. The article claims that the term ‘warlock’ actually refers to an oath breaker, or someone who was banished from a witches’ coven.

Professor Walter Stephens published a 2002 book entitled Demon Lovers: Witchcraft, Sex, and the Crisis of Belief where he describes alleged sex between witches and demons, and the mechanics of their lovemaking (and also confirmed that some witches were male). Dale Keiger interviewed Stephens for the John Hopkins Magazine where it was noted that:

“Before 1400, tales of sex with demons existed but were almost always accounts of rape; in the 15th century, the sex becomes consensual, and more. Accused witches speak not just of sex, but of good sex, the kind that brought them back for more and seduced them into forswearing God and agreeing to do the Devil’s bidding. Not only women were seduced by demons; men, too, were lured into sex with beings who turned out to be something other than just willing village girls. (Scholars estimate that 20 percent of the people accused of witchcraft during this time were male.)”

In another article in The Frisky, one article claimed that medieval witches inserted magic potions or ‘flying ointment’ into their vaginas with a special dildo or ‘broomstick’ (i.e., ”getting high and pleasuring themselves”) that may explain the origins of the flying broomstick. In response to this claim, one person under the pseudonym ‘Snagglez’ wrote:

“I wrote my Masters’ thesis on the appearance of demonic creatures and witches in 16th century wood block prints in Germany and I can completely verify this theory. One of the reasons female witches were seen as so scary was because of their rampant sexuality which was a threat to society – basically sex for pleasure rather than procreation. They would subvert the natural order of life and become the sexual aggressor instead of the man. They were often attended by male witches but women were in charge. Part of the satanic ritual involved the unholy mass which culminated in group sex with the devil on an altar. But, witches were believed to be unable to bear children because of the polluted nature of their bodies. That is why there were often depicted as crones – mainly because post-menopausal women could also not bear children. In fact it was believed that some of their spells required the blood of small children (completely perverting their gender’s purpose) so witches were often blamed if babies died for unexplained reasons. I really suggest reading ‘The Witch as Muse’ by [Linda] Hults”

Most reference to witches’ sex is usually made in relation to ‘sex magic’ (or ‘sex magick’ as it is often spelled, and which I will look at in a future blog). A 2010 online article by “herbalist, writer and artist” Sarah Lawless examined sex magic in traditional witchcraft (but wiccaphilia was not mentioned). She made some interesting observations:

“Our animistic ancestors believed that the earth was a fertile woman and the sky god her lover. When it rained, it was the god’s semen fertilizing the earth goddess. Worship of the phallus is found the world over, as is worship of the Sacred Whore…In etymology the proto-Germanic root word for Witchcraft – weik – from which wicce, wicca, wiccaecrafte and related sorcerous words stem from literally translates as ‘cunning and guile’. This possibly explains the use of sexual initiation for certain traditions, especially within Medieval and modern traditional witchcraft. Sex is a way to connect with the Gods of both the Upper and Lower Worlds. There are accounts from the witch trials of women having sex with the devil himself to be initiated into a coven and into the mysteries…Sex magic has multiple uses within Witchcraft. It can be used as an offering for deity worship, for acting out the mysteries of the gods, to attain knowledge/ awareness /inspiration, to be initiated into a tradition or mystery, to raise energy for workings, to empower sexual fluids for magical uses, to conceive, to act as Sacred Whore, to empower a working or sigil, for healing, or for flying”.

Arguably one of the best websites discussing witches’ sexuality is the Sexy Witch blog. The website is one of the very few that go beyond an informational definition of wiccaphilia and attempts (in an admittedly speculative way) to provide an insight into different types of wiccaphilia from a witch’s perspective. The female author notes:

“Curiously, Wiccaphilia seems to be a lot less common than Wiccaphobia. At least, if you Google the two terms the ratio is 3:18,500 (or about 1:6000). But I am sceptical: everyone loves witches, don’t they?…Someone suffering from mild Wiccaphilia might, for example, take particular pleasure in accidently finding pictures or descriptions of witches or Wiccans on the internet. Someone with moderate Wiccaphilia might search the web for images witches and take particular pleasure in locating a blog dealing with Sexy Witches. Severe Wiccaphilia might result in the victim spending a small fortune on books and objects featuring witches and then shamelessly parade their affliction by starting a blog about Sexy Witches. Sad, but true”.

Given the complete lack of academic and/or clinical research on wiccaphilia, I am not in a position to either conform or dispute such claims. I came across a book written by LaSara Firefox (simply called Sexy Witch) but from the summaries on various bookseller sites (e.g., Employing a unique blend of feminism and magick, this refreshing guide to female self-empowerment helps women acknowledge the beauty, strength, and sexiness within themselves…LaSara FireFox banishes the damaging misconceptions and shame often associated with female sexuality and sheds light on what it truly means to be a Sexy Witch”) is not an academic tome (but appeared to get lots of positive feedback from those who had read the book). Given the lack of empirical data, there is nothing known about whether the paraphilia really exists, and if it does what the incidence, prevalence or etiology of wiccaphilia is. If it does exist, there could perhaps be some psychological crossover with those who have specific uniform fetishes (that I covered in a previous blog).

Dr Mark Griffiths, Professor of Gambling Studies, International Gaming Research Unit, Nottingham Trent University, Nottingham, UK

Further reading

Farsaci, L. (2009). I’ll get you, my pretty: Sexy women and witchcraft. Carnal Nation, October 20. Located at:

The Frisky (2012). 5 things you probably didn’t know about witches. October 5. Located at:

Keiger, D. (2002). Sexy devils. John Hopkins Magazine, 53(4). Located at:

Lawless, S. (2010). Sex magic in traditional witchcraft, July 30. Located at:

Stephens, W. (2002). Demon Lovers: Witchcraft, Sex, and the Crisis of Belief. Chicago, IL: University of Chicago Press.

Wikipedia (2013). Sex magic. Located at:

Wikipedia (2013). Wicca. Located at:

Mind the App: The psychosocial impact of gambling applications

Most regular gamblers will be well aware that technology is revolutionizing the way they can gamble and access gambling. One of the most notable innovations has been the proliferation of various gambling applications (‘apps’) for smartphones and computer tablets. A majority of the British bookmakers have launched sports betting apps including Betfred Mobile Sportsbook, William Hill iPhone, Ladbrokes Mobile, Betfair iPhone Client, and Paddy Power Mobile. Most of the apps allow sports bettors to gamble via their mobile phones and/or tablets (e.g., iPad) with all the same options that gamblers can get offline, and additionally keep track of the bets made. Combined with this, many operators have introduced iPhone compatible websites. Bookmakers have also launched similar apps and services for Android (i.e., non-Apple) products (e.g., Unibet’s mobile sports betting app). In short, mobile sports betting has gone mainstream.

There are also apps for games like Fantasy Football (such as the one offered by Betfred) but most gambling operators are moving into the mobile social betting market because it provides greater flexibility in predicting score lines and by making it easier to share the result outcomes with friends. Such services include Unibet Social Betting, SideBets Social BETworking, Bodugi Social Betting, King of Predictions, and Bet Tracker Pro. Gamblers also have access to a wide range of betting tips and betting odds apps via both iPhone and Android handsets. Gambling apps can also provide access to potentially useful information for the player (e.g., tips, strategy articles, the latest updates, etc.). In addition to he bookmaking industry, casino operators have followed suit and have also moved into the gambling app market on both iPhone and Android.

Once casino apps have been installed, players can instantly access their favourite casinos and casino games without searching for them via a web browser. A quick look at the commercially available gambling apps shows that almost all gaming operators offer attractive bonuses in an attempt to attract new clientele to download their gambling app software and spend some money (e.g., first deposit bonuses, reload bonuses, and various other seasonal promotions). The psychosocial impact of real money gambling apps is likely become a hot topic among those of us who carry out research in the gambling studies field.

As with online gambling more generally, the introduction of gambling apps and mobile gambling eliminates time and place constraints, allows 24/7 access all year round, provides convenience and flexibility, provides a wide range of games (e.g., slots, blackjack, video poker, roulette, etc.) and potentially increased gambling opportunities, and means that anyone can gamble anywhere at anytime providing there is network connection. Real money gambling apps arguably make gambling even easier for players. Whilst there are clearly many advantages for gamblers, these advantages may have a negative psychosocial impact on a small minority of gamblers.

The gambling app market is likely to be very lucrative for both game developers and gaming operators. In a recent report by Juniper Research, it was estimated that users of smartphones and tablets are expected to wager $100 billion annually on the devices by 2017, up from about $20 billion in 2011. However, Juniper Networks’ Mobile Threat Centre also reported that gambling apps pose the biggest security risk to smartphone users after over 1.7 million apps on the Google Play Store were analyzed between March 2011 and September 2012. Another study by German researchers at the Leibniz University (Hannover) and the Philipps University (Marburg) found that apps (including gambling apps) were leaking personal data, including bank account information. The study tested the 13,500 most popular free apps from the Google Play Store and found that 1074 of them (8%) used incorrect or inadequate coding. These studies also found that the gambling apps “blatantly overstepped permissions that were more than adequate for normal use” and that with malware they accessed a number of features of the users’ smartphones and tablets without justification. Racing apps were reported as causing the most concern with 99% of paid racing apps and 92% of free racing game apps being able to send SMS; half of free downloaded apps were able to use the camera; and 94 per cent of free games could make outgoing phone calls.

From a psychosocial impact perspective, one of the areas where gambling apps appear to be having most impact currently is in relation to in-play betting. For instance, Bet365 (the most successful gaming operator in the in-play market) have a free betting app that players can use for any of their ‘in-play’ markets (most notably football) from a smartphone. I argued in a previous blog that what the ‘in-play’ markets have done is take what was traditionally a discontinuous form of gambling like football betting – where gamblers made one bet every Saturday on the result of a football game – to one where consumers can gamble again and again and again. What’s more, gaming operators have quickly capitalized on the increasing amount of televised sport. In contemporary society, where there is a live sporting event, there will always be a betting consumer. ‘In-play’ betting companies using gambling apps have catered for both the natural betting demand and have initiated new clientele in the process.

If the reward for gambling only happens once or twice a week, it is almost completely impossible for a gambler to develop problems and/or become addicted. ‘In-play’ betting using gambling apps has changed that because we now have football matches on almost every day of the week making a daily 2-hour plus period of betting seven days a week. ‘In-play’ has fundamentally changed the way that people view and bet on sporting events. The speed of a game also influences the prevalence of problem gambling. Based on the relationship between event duration, event frequency, bet frequency, and payout interval, empirical research has consistently shown that games that offer a fast, arousing span of play, frequent wins, and the opportunity for rapid replay are those most frequently cited as being associated with problem gambling. These potentially problem-inducing structural characteristics have the capacity to be enhanced via gambling apps and in-play betting. The actual prevalence rate of problem gambling will of course depend on many factors other than speed of the game alone, but games with high and rapid event frequencies are most likely to impact on increased rates of problem gambling. ‘In-play’ betting via gambling apps appears to be an activity that is starting to blur the lines between continuous and discontinuous forms of gambling.

Frequency of opportunities to gamble (i.e., event frequency) appears to be a major contributory factor in the development of gambling problems. The general rule is that the higher the event frequency, the more likely it is that the activity will result in gambling problems for vulnerable and susceptible gamblers. Gambling addiction has been shown to be associated with the rewards, the speed of rewards, and payout rates. Therefore, the more potential rewards there are, and the higher the amount of the rewards, the more problematic the activity is likely to be. Given the time, money and resources, a vast majority of gambling activities are now ‘continuous’ in that people have the potential to gamble again and again. Therefore, in relation to problem gambling, ‘in-play’ betting via gambling apps is an activity that we really need to keep an eye on.

Dr Mark Griffiths, Professor of Gambling Studies, International Gaming Research Unit, Nottingham Trent University, Nottingham, UK

Further reading

Griffiths, M.D. (2012). Gambling on Facebook? A cause for concern? World Online Gambling Law Report, 11(9), 10-11.

Griffiths, M.D. (2012b). Mind games (A brief psychosocial overview of in-play betting). i-Gaming Business Affiliate, June/July, 44.

Griffiths, M.D. & Auer, M. (2013). The irrelevancy of game-type in the acquisition, development and maintenance of problem gambling. Frontiers in Psychology, in press.

MacMillan, D. (2012). IPhones Become Mobile Casinos by Adding Real-Money Bets. Bloomberg Business Week, August 16. Located at:

Manning, J. (2012). Android apps leaking personal, banking details. Stuff, October 23. Located at:

Parke, J. & Griffiths, M.D. (2007). The role of structural characteristics in gambling.  In G. Smith, D. Hodgins & R. Williams (Eds.), Research and Measurement Issues in Gambling Studies. pp.211-243. New York: Elsevier.

Sharma, M. (2012). Free gambling apps top security risk list. Stuff, November 4. Located at:

Age concern: A brief look at chronophilic behaviours

As someone who is academically interested in sexual paraphilias, it never ceases to amaze me how people working in the sexology field (myself included) love to categorize and sub-categorize every nuance of human sexual behaviour. One of the ways in which sexual behaviour has been categorized relates to the age of the person to which the person has a sexual paraphilia. Most of you reading this blog will probably be thinking that when it comes to age preference, the world is broadly split into the minority of individuals who are involved in paedophilia (i.e., individuals who derive sexual pleasure and arousal from children) and those whose sexual preference is geared towards sex with adults. In fact, in researching this article I was surprised to learn that I am a teleiophile. Teleiophilia (and occasionally called ‘adultophilia’) refers to adult individuals whose primary sexual focus is other adult individuals. (As Dr. Anil Aggrawal reassuringly notes in his book, Forensic and Medico-legal Aspects of Sexual Crimes and Unusual Sexual Practices teleiophilia is not a sexual paraphilia). Those individuals whose primary sexual preference is for elderly adults are said to be engaging in gerontophilia (and sometimes called graeophilia).

According to the fourth edition of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), paedophilia is described as a form of sexual paraphilia whereby individuals experience intense sexual urges towards children (aged under 16 years of age), and experiences recurrent sexual urges towards (and fantasizes about) children that the individual has acted upon and/or causes distress and interpersonal difficulty. Technically, many child abusers would not be defined as paedophiles according to the DSM criteria as the behaviour may not be causing the abusers any psychological problems themselves. However, in day-to-day language, most people would define any adult who engages in any form of sexual behaviour with a minor as paedophilia.

Apologies for what you are about to read because anyone reading it is likely to feel revulsion by what I am about to write. One of the most disturbing and horrific cases that I am aware of involved two children who were systematically abused by their grandfather and their grandfather’s friends. The grandfather had sexually abused his daughter throughout her childhood, and then began abusing his daughter’s children from an early age. After the grandfather died, a video was played at the reading of the will that the family thought contained the grandfather’s verbal reading of his last will and testament. What the video actually contained was a short film of the grandfather having sexual intercourse with his two-year old granddaughter and his four-year old grandson.

The reason I recounted this story is that this is an example of what is known as nepiophilia (or infantophilia) and refers to individuals that have a sexual preference for very young children (usually aged between birth and three years). In the upcoming DSM-V, the term paedohebrephilia refers to the expansion and reclassification of paedophilia into subgroups such as the distinctions between paedophiles that prefer pubescent or post-pubescent children. More specifically, hebephilia refers to those individuals who have a sexual preference for pubescent youths (i.e., typically adolescents aged around 11 to 14 years of age). However, some authors – such as Dr. Anil Aggrawal – claim that hebephilia is a preference for pubescent children between 11 and 14 years for females and 11-16 years for males.

Ephebophilia refers to those individuals sexual preference for post-pubescent youths (mid-to-late adolescents aged around 15 to 19 years of age). Other researchers in the sexual studies field (such as Kurt Freund) have used the term ‘adolescentophilia’ as referring to individuals who have a sexual preference of pubescent and/or adolescent youths. According to the Wikipedia entry on hebephilia:

“In 1914, physician Kurt Boas described hebephilia as ‘an alleged form of female fetishism’. Anthropologist and ethnopsychiatrist Paul K. Benedict uses the term to distinguish pedophiles from sex offenders whose victims were adolescents. Forensic psychologist Karen Franklin traced the history of use of the term in a 2010 article. She states that it is a variation of ephebophilia used by Magnus Hirschfield in 1906 to describe homosexual attraction to males between puberty and their early 20s, who considered the condition normal and nonpathological. Historically, criminal hebephilic acts where victims were ‘biologically ready for coitus’ (i.e. statutory rape) were considered distinct from other forms of criminal sexuality such as rape and pedophilia, with wide variations within and across nations regarding what age was acceptable for adult-adolescent sexual contacts. Bernard Glueck, Jr. conducted research on sex offenders at Sing Sing prison in the 1950s, using ‘hebephilia’ as one of several classifications of subjects according to offense…The prevalence of hebephilia within the general population is unknown”.

In relation to ephebophilia, the Wikipedia entry notes that:

“Because mid-to-late adolescents usually have physical characteristics near (or in some cases, identical) to that of full-grown adults, some level of sexual attraction to persons in the age group is common among adults. Ephebophilia is used only to describe the preference for mid-to-late adolescent sexual partners, not the mere presence of some level of sexual attraction. Generally, the preference is not regarded by psychologists as a pathology when it does not interfere with other major areas of one’s life, and is not listed by name as a mental disorder in the [DSM-IV] or as a paraphilia”.

This also raises questions such as ‘Are some kinds of paedophilic behaviour worse than others?’ For instance, is a 25-year old man that has consensual sex with a 15-year old girl engaging in a sexual behaviour that is as morally repugnant as a 50-yer old man who has non-consensual sex with an 8-year old girl? Such questions have come to the fore over the last year concerning the sexual behaviour of radio and television presenters Jimmy Savile and John Peel. As Dr. Michael Seto notes in a 2008 book chapter on paedophilia in Sexual Deviance: Theory, Assessment and Treatment:

“An interesting theoretical question is whether sexual age preferences can be represented on a continuum, such that most adults are attracted to sexually mature persons, but some individuals are attracted to pubescent children, prepubescent children, or infants in varying degrees. These age preferences may instead represent different “taxa” (plural of “taxon” – i.e., natural group), and it is possible that each taxon involves a different etiological pathway. Thus the causes of pedophilia may differ from the causes of hebephilia, nepiophilia or gerontophilia. It is also plausible that there are multiple etiological pathways for atypical age preferences such as pedophilia, including the genetic transmission of predispositions, poor maternal health, fetal exposure to toxins or infections, and early head injuries”.

Encompassing all of these different types of age-related sexual paraphilias is the term chronophilia. This term was coined by Professor John Money in his 1986 book Lovemaps, and was defined as a form of sexual paraphilia in which individuals experience a sexual preference that is limited to individuals within particular age ranges. However, despite the fact the term was coined by one of the world’s best known sexologists, the term has arguably not been generally accepted, adopted and/or used by most people working in the field of abnormal sexual behaviours.

Dr Mark Griffiths, Professor of Gambling Studies, International Gaming Research Unit, Nottingham Trent University, Nottingham, UK

Further reading

Aggrawal A. (2009). Forensic and Medico-legal Aspects of Sexual Crimes and Unusual Sexual Practices. Boca Raton: CRC Press.

Blanchard, R. Blanchard, R., Lykins, A. D., Wherrett, D., Kuban, M.E., Cantor, J.M., Blak, T., Dickey, R., & Klassen, P. E. (2008). Paedophilia, hebephilia, and the DSM–V. Archives of Sexual Behavior.

Kaul, A. & Duffy, S. (1991). Gerontophilia: A case report. Medicine, Science and the Law, 31, 110-114.

Seto, M.C. (2008). Pedophilia: Psychopathology and Theory. In Laws, D.R. & O’Donohue, W.T. (Eds.), Sexual Deviance: Theory, Assessment and Treatment (pp. 164-182). New York: Guildford Press.

Money, J. (1984). Paraphilias: Phenomenology and classification. American Journal of Psychotherapy, 38, 164-78.

Money, J. (1986). Lovemaps: Clinical Concepts of Sexual/Erotic Health and Pathology, Paraphilia, and Gender Transposition of Childhood, Adolescence, and Maturity. New York: Irvington Publishers.

Wikipedia (2012). Ephebophilia. Located at:

Wikipedia (2012). Hebephilia. Located at:

Art palpitations: A brief look at Ruben’s Syndrome

In a previous blog I examined Stendhal Syndrome where some people when exposed to the concentrated works of art, experience a wide range of symptoms including physical and emotional anxiety (rapid heart rate and intense dizziness, that often results in panic attacks and/or fainting), feelings of confusion and disorientation, nausea, dissociative episodes, temporary amnesia, paranoia, and – in extreme cases – hallucinations and temporary ‘madness’. While researching that article, I also came across another condition that would appear to be related to Stendhal Syndrome, namely ‘Rubens Syndrome’ based on a report published in 2000 by the Roman Institute of Psychology (RIOP).

The RIOP reported that 20% of people had engaged in an “erotic adventure” inside an art museum, and the findings were taken from a national Italian survey of 2000 people. Other places where the respondents said they had “erotic adventures” included beaches (43%), trains (22%), and nightclubs (18%). The report’s authors christened this state of emotional sexual arousal as ‘Rubens Syndrome’ named after the Flemish Old Master who painted many sensuous nudes throughout his career.

The researchers claim that the Rubens Syndrome is “a spontaneous response to the beauty of art and that those who are afflicted by it do not enter a museum with sex specifically on their minds”. The report also claims that art admirers are more predisposed towards erotic suggestion and that mythological sexual scenarios are more psychologically engaging than abstract art.  Although I don’t doubt that for most people abstract art is less engaging on a psychological level, I know of no empirical research demonstrating that art lovers are more predisposed towards erotic suggestion (although it wouldn’t surprise me if they were).

I have been unable to track down a copy of the report and as far as I can ascertain, the results of the study have not been published in a peer-reviewed academic journal (therefore I have no idea as to how robust the data are, how the data were collected, and how representative the data were of typical visitors to art museums). The study also claimed that Greek sculptures and works by Michelangelo Merisi da Caravaggio (1571-1610) were more likely to lead to sex than artworks by Paulo Veronese (1528-1588) or Giovanni Battista Tiepolo (1698-1770). The psychologists also compiled a list of the best Italian art museums based on their “ability to awaken Eros”, the Greek god of love.

(If you are really interested, the best seven art museums for erotic stimulation were the Palazzo Doria [Genoa], Pinacoteca di Brera [Milan], Gallery of Modern Art [Turin], Accademia [Florence], Villa Panza [Varese], Guggenheim [Venice], and Capodimonte Museum [Naples]. The psychologist Dr. Massimo Cicogna was asked why these particular art museums were the most erotically stimulating and his response was that the ideal art museum is “one that is not too busy, so it allows for the easy observation of the other visitors”).

It would appear that the main difference between Stendahl Syndrome and Ruben Syndrome is that Stendhal Syndrome provokes strong negative and (arguably) passive emotional reactions whereas Rubens Syndrome provokes strong positive and active emotional reactions that some people feel they have to act upon. Following the publication of the study, one of the daily Italian newspapers Il Gazzettino reported:

“Who would ever have said that the corridors of the Accademia Museum in Florence were more erotically charged than the atmosphere in a discotheque? That Botticelli’s Primavera instigates hard-core thoughts and actions, and that the rooms of the Guggenheim Museum in Venice are more stimulating than Viagra?”

According to Professor Willy Pasini (University of Milan, Italy): “Cultural seduction has existed since antiquity. Art has always activated an intensely erotic mechanism – otherwise what sort of art would it be?” Italian sexologist Serenella Salomoni was also interviewed by the Italian press about Rubens Syndrome and claimed it was more commonplace among non-Italian tourists than locals. Her reasoning was based on her claim that “Italians are expressive and less repressed by nature. For a more emotionally contained foreigner, it may take a beautiful painting to provoke strong, sexual feelings”.

Furthermore, according to politician, art critic, and self-confessed lothario Vittorio Sgarbi:

“To visit a museum, it is necessary to be able to love. Eroticism and the love of art, then, are perfectly compatible and interchangeable. Plus, it’s evident that someone who goes to a museum has considerable time available. At the end of the visit, there is a residue of amorous stimulation”.

In an online essay in a 2003 issue of the online magazine Frieze about both Stendhal Syndrome and Rubens’ Syndrome, Melinda Guy argued that both syndromes raise interesting questions about artists’ intentions and their audience’s response, and said: “Perhaps we could use these pathologies to determine cultural value: surely the work that provokes the most Stendhalian (or Rubensian) reactions is truly the most significant?”

As there is no empirical or clinical evidence confirming or denying the existence of Rubens’ Syndrome, I’ll leave you with the thoughts of psychologist Bruce Melnick who in a short article for the Institute for the Psychological Study of the Arts made these observations:

“There is also something in the museum setting, apart from what is actually being shown, that conduces to erotic adventure. The people you see in a museum have at least one interest in common with you…They have come to the museum, like you, for some kind of sensual stimulation…And above and beyond these specifics is the general awareness that museums are places, set apart from the normal world, where we go specifically for purposes of aesthetic contemplation, where, therefore, the usual social rules do not quite apply. This awareness in itself probably fosters erotic fantasy and contact…To oversimplify a bit, we go to museums to look and fantasize. It’s not surprising that some of that should carry over from the pictures on the walls to the people standing in front of them”.

Dr Mark Griffiths, Professor of Gambling Studies, International Gaming Research Unit, Nottingham Trent University, Nottingham, UK

Further reading

Guy, M.  (2003). The shock of the old. Frieze (Volume 72). Located at:

Magherini, G. (1989). La Sindrome di Stendhahl. Firenze: Ponte Alle Grazie.

Melnick, B. (2001). PSYART archives: Rubens’ Syndrome. August 4. Located at:

PervScan (2003). Rubens’ Syndrome. August 2. Located at:

Squires, N. (2010). Scientists investigate Stendhal Syndrome – fainting caused by great art. Daily Telegraph, July 28. Located at:

Turner, J. (2001). Museum visitors in Italy list the works most likely to inspire an “erotic adventure”. ARTnews, January 10. Located at:

Cock tales: A brief look at Penile Dysmorphic Disorder

In a previous blog, I examined Body Dysmorphic Disorder (BDD). At its simplest level, BDD is a distressing, handicapping, and/or impairing preoccupation with an imagined or slight defect in body appearance that the sufferer perceives to be ugly, unattractive, and/or deformed. BDD sufferers can think about their perceived defect for hours and hours every day. The International Classification of Diseases (ICD-10) criteria for BDD is:

  • Persistent belief in the presence of at least one serious physical illness underlying the presenting symptom(s), even though repeated investigations and examinations have identified no adequate physical explanation, or a persistent preoccupation with a presumed deformity or disfigurement.
  • Persistent refusal to accept the advice and reassurance of several different doctors that there is no physical illness or abnormality underlying the symptoms.

One particular body part that has been the focus of some research in the BDD field is that of genitalia. Many men worry about the size of their penis and think it is too small. This is perfectly normal and the worry or concern is highly unlikely to be a symptom of BDD. In a 2004 issue of the Postgraduate Medical Journal, British psychiatrist Dr David Veale reported that although there are broad similarities between the genders in BDD, there are some differences. For instance, men with BDD show a greater preoccupation with their genitals, and women with BDD are more likely to have a co-morbid eating disorder. Dr. David Sarwer (writing in a 2006 issue of Plastic and Reconstructive Surgery) asserted that the rate of body dysmorphic disorder should be examined among patients re-questing atypical procedures and cites the example of those individuals requesting genital surgery.

Back in 2008, Channel 4 in the UK had a television series called Penis Envy. The first episode (The Perfect Penis) featured a US psychology student who paid $4000 to have his penis lengthened by cutting the ligament in his pubis. Such actions might be indicative of BDD but the programme didn’t explore this facet. Following such operations, men then have to spend the following weeks suspending a weight from their penis for at least eight hours a day. For all the financial and physical burdens faced, the average increase in length is only 0.5-3cm (with official statistics being closer to 0.5cm than 3cm). Other methods of increasing genital size include the injection of silicon into the penis (although this is dangerous and can result in a silicon embolism).

Dr. Stephen Snyder (Associate Clinical Professor of Psychiatry, Mount Sinai School of Medicine, New York, US) was interviewed about (so-called) ‘Penile Dysmorphic Disorder’ (PDD) in an online Psychology Today article. He was quoted as saying:

I don’t know of any statistics on [PDD]. Anxiety or insecurity about penis size is extremely common in men. It would be difficult to determine how frequently the more serious condition of penis-focused BDD occurs. People with BDD tend to avoid mental health specialists…It’s much more likely I think that a man with penile BDD will purchase penis enlargement equipment or consult a surgeon than consult someone like me…Some people seem to have an innate tendency for obsessive thinking. Why some of these people develop BDD, and others OCD or Anorexia Nervosa is unknown…A man who begins to obsess about the size of his penis may begin to compulsively and repeatedly measure his erections, and to avoid dating because he’s convinced he’ll be humiliated. Then the whole thing can spiral out of control, until ultimately he’s online studying penis enlargement techniques”.

A 2006 study led by Dr. J. Lever and published by Psychology of Men and Masculinity reported that in an online survey of over 52,000 participants, most male participants rated their penis as average (66%) and only 22% as large and 12% as small. Among the female participants, around 85% of women were satisfied with their partners’ penile size, while only 55% of men were satisfied, with 45% wanting to be larger (and 0.2% to be smaller).

Just recently, Dr. Warren Holman highlighted the case of ‘Sam’, a 17-year-old white male from a middle-class Jewish family living in Midwest USA with penile dysmorphic disorder (in a 2012 issue of Social Work in Mental Health). As Dr. Holman reported:

“Sam had stopped attending school several weeks earlier, and on many days would not even leave his home. He said he wanted to remain at home and away from school because, ‘My penis is shrinking and people can tell.’ Sam reported he had had his anxiety about his penis for about a year, but until recently had been able to reason himself out of it…Sam was well related, and his mental status was unremarkable except for his belief about his penis”.

Dr. Holman believed that Sam’s conviction that his penis was shrinking (and people could tell) suggested three possible diagnoses (i.e., social phobia; BDD and/or delusional disorder of the somatic type; or schizophrenia). Holman eventually reached the conclusion that Sam’s beliefs were due to BDD although did say that it “may be in a prodromal phase of schizophrenia”. Sam was treated via a form of psychodynamic counselling (which much to the disappointment of Holman ultimately failed perhaps because of initial misdiagnosis).

In 2007, British urologists Dr. Kevan Wylie and Dr. Ian Eardley published a review on penile size in BJU International. They summarized all of the studies on penile size that have examined flaccid penis length, stretched penis length, erect penis length, flaccid penis girth and erect penis girth. They reported that:

“Stretched penile length in these studies was typically 12–13 cm, with an erect length of 14–16 cm. For girth, there was again remarkable consistency of results, with a mean girth of 9–10 cm for the flaccid penis and 12–13 cm for the erect penis…Concern over the size of the penis, when such concern becomes excessive, might present as the ‘small penis syndrome’ [SPS], an obsessive rumination with compulsive checking rituals, body dysmorphic disorder, or as part of a psychosis”.

However, they did also assert that more research was required on the effects of race and age on penile length. Wylie and Eardley speculate that SPS (or ‘locker room syndrome’ as they also call it) originates in childhood following the sight of their father’s, elder sibling’s and/or older friend’s penis. This appears to have support from a 2005 study (also published in BJU International). Dr. N. Mondaini and Dr. P. Gontero surveyed men who thought they had a small penis at an andrology clinic and reported that nearly two-thirds said their SPS had begun in childhood (63%) with the rest saying it began in adolescence (37%).

Wylie and Eardley also examined the treatment options of men with SPS and also examined the evidence of commercial penis extending techniques. They concluded that:

“It is recommended that the initial approach to a man who has SPS is a thorough urological, psychosexual, psychological and psychiatric assessment that might involve more than one clinician…Conservative approaches to therapy, based on education and self-awareness, as well as short-term structured psychotherapy [cognitive-behavioural therapy] are often successful, and should be the initial interventions in all men. Of the physical treatments available, there is poorly documented evidence to support the use of penile extenders. More information is need on the outcomes with these devices. Similarly, there is emerging evidence about the place of surgery and there are now several reports suggesting that dividing the suspensory ligament can increase flaccid penile length”.

Dr Mark Griffiths, Professor of Gambling Studies, International Gaming Research Unit, Nottingham Trent University, Nottingham, UK

Further reading

Goodman, M.P. (2009). Female Cosmetic Genital Surgery. Obstetrics and Gynecology, 113, 154-159.

Holman, W.D. (2012). “My Penis Is Shrinking and People Can Tell”: A Confusing Case of Apparent Body Dysmorphic Disorder. Social Work in Mental Health, 9, 319-335.

Morrison, T.G., Bearden, A., Ellis, S.R. & Harriman, R. (2005). Correlates of genital perceptions among Canadian post- secondary students. Electronic Journal of Human Sexuality, 8. Located at:

Lever, J., Fredereicjk, D.A. & Peplau, L.A. (2006). Does size matter? Men’s and women’s views on penis size across the lifespan. Psychology of Men and Masculinity, 3,129-143.

Mondaini, N. & Gontero, P. (2005). Idiopathic short penis: myth or reality? BJU International, 95, 8–9.

Sarwer, D.B. (2006). Body Dysmorphic Disorder and cosmetic surgery. Plastic and Reconstructive Surgery, December, 168e-180e.

Snyder, S. (2011). When size obsession gets out of hand. Psychology Today, June 11. Located at:

Sondheimer, A. (1988). Clomipramine treatment of delusional disorder-somatic type. Journal of the American Academy of Child and Adolescent Psychiatry, 27, 188-192.

Veale, D. (2004). Body dysmorphic disorder. Postgraduate Medical Journal, 80, 67-71.

Wylie, K.R. & Eardley, I. (2007). Penile size and the ‘small penis syndrome’. BJU International, 99, 1449–1455.

The tooth about love: A brief look at odontophilia

According to both Dr. Brenda Love’s Encyclopedia of Unusual Sex Practices and Dr. Anil Aggrawal’s book Forensic and Medico-legal Aspects of Sexual Crimes and Unusual Sexual Practices, odontophilia is a sexual paraphilia that refers to individuals who derive sexual pleasure and arousal involving teeth. The online Urban Dictionary goes a little further and describes it as a sexual fetish where individuals are sexually aroused by (i) licking a sexual partner’s teeth, (ii) leaving the imprint of teeth on their lover’s skin (or vice versa), (iii) pulling out a sexual partner’s teeth (or anything concerning dentistry). The online medical website Right Diagnosis defines odontophilia as referring to sexual urges, preferences or fantasies involving teeth. Given these definitions (particularly the one in the Urban Dictionary) they suggest an overlap with sexual biting fetishes (i.e., odaxelagnia, which I covered in a previous blog).

Brenda Love’s Encyclopedia of Unusual Sex Practices spends quite a lot of time looking at odontophilia from a historical and literary perspective and recounts the work of the Marquis de Sade. It is said that de Sade based his writings on the sex life of others, and Dr. Love selected one of de Sade’s passages to exemplify odontophilia relating to a tooth extraction:

“The passion of Bonifice is also singular. He loves pulling out the teeth of his victims, while fucking them and being simultaneously sodomized. One who becomes the victim of these gentlemen is Fosine, fourteen years old, with a beautiful form, and a rich family. She promises the ideal combination of lust and profit. Both Boniface and Chrysostome wish to indulge themselves with her, and after pulling out her thirsty two beautiful teeth, she is subjected to the Superior, who immolates her in his own fashion”.

Dr. Love then goes on to say that it’s highly doubtful whether anyone today would practice odontophilia in the form described by de Sade. She then says:

“However, it is possible that an occasional tooth extraction scene occurred in 1797 when de Sade wrote his book. Nitrous oxide and ether were not used to extract teeth until 1840 and Novocain was not produced until the beginning of this century; therefore people during de Sade’s lifetime were accustomed to having their teeth removed without effective painkillers. The pulling of teeth may be arousing even with the advent of anesthesia as noted in Erich von Stroheim’s film Greed. Here the beautiful patient is kissed by her dentist as the blood still flows from her mouth”.

In researching this blog, I only located a couple of articles on the topic. The Everyday Entropy website features a first-hand account by someone who claims that “teeth get me hot” but after reading their story, it was quite clear that the person writing the article is far from being an odontophile. A better article on odontophilia was written by Billie Rosie who links the condition with vampirism. He noted:

“Perhaps the closest we get to identifying an obsession with teeth is through vampire stories and films. These equate teeth, especially long canine teeth with danger. The vampire will pierce your vein and sip your blood straight from the jugular – if the vampire takes too much you will die and according to some vampire lore, you will become a vampire, roaming the night in search of prey. Vampires are sexy. Anne Rice, I think, made them sexy. Following the predatory Lestat, came True Blood, Twilight, The Vampire Diaries – the list goes on”.

Rosie also made heavy reference to the short story Berenice written in 1835 by Edgar Allen Poe. The story’s narrator (Egaeus) grows up with his cousin (Berenice):

“[Egaeus] suffers from a type of obsessive disorder, a monomania that makes him fixate on objects. She, originally beautiful, suffers from some unspecified degenerative illness, with periods of catalepsy a particular symptom, which he refers to as a trance…One afternoon, Egaeus sees Berenice as he sits in the library. When she smiles, he focuses on her teeth. His obsession grips him, and for days he drifts in and out of awareness, constantly thinking about the teeth. He imagines himself holding the teeth and turning them over to examine them from all angles. At one point a servant tells him that Berenice has died and shall be buried. When he next becomes aware, with an inexplicable terror, he finds a lamp and a small box in front of him. Another servant enters, reporting that a grave has been violated, and a shrouded disfigured body found, still alive. Egaeus finds his clothes are covered in mud and blood, and opens the box to find it contains dental instruments and ‘thirty-two small, white and ivory-looking substances’ – Berenice’s teeth”.

I’ve only come across one academic research paper that makes any mention of odontophilia. In a previous blog on fetishism, I wrote at length about a study led by Dr G. Scorolli (University of Bologna, Italy) on the relative prevalence of different fetishes using online fetish forum data. It was estimated (very conservatively in the authors’ opinion), that their sample size comprised at least 5000 fetishists (but was likely to be considerably more). Their results showed that there were 1697 fetishists (2% of all fetishists) with a sexual interest in odontophilia on the websites they studied (although their definition of odontophilia not only included teeth but also mouth and lips so the number of ‘true’ odontophiles was likely to be a lot lower).

According to the Right Diagnosis website, treatment is generally not sought for odontophilia unless it becomes problematic for the individual and they feel compelled to address the condition. As I have noted in my previous blogs, the majority of sexual fetishists and paraphiliacs simply learn to accept their condition and manage to achieve sexual gratification in an appropriate manner with no problem for the individual or their sexual partners.

Dr Mark Griffiths, Professor of Gambling Studies, International Gaming Research Unit, Nottingham Trent University, Nottingham, UK

Further reading

Aggrawal A. (2009). Forensic and Medico-legal Aspects of Sexual Crimes and Unusual Sexual Practices. Boca Raton: CRC Press.

Everyday Entropy (2009). Odontophilia. July 12. Located at:

Love, B. (2001). Encyclopedia of Unusual Sex Practices. London: Greenwich Editions.

Rosie, B. (2012). Odontophilia: A fetish for teeth. November 30. Located at:

Scorolli, C., Ghirlanda, S., Enquist, M., Zattoni, S. & Jannini, E.A. (2007). Relative prevalence of different fetishes. International Journal of Impotence Research, 19, 432-437.

Making the cut: A beginner’s guide to Klingsor Syndrome

In one of my previous blogs, I looked at one of the world’s rarest behaviours – male genital self-mutilation (GSM). As I noted in that article, there have only been about 125 cases ever recorded in the clinical and/or medical literature. (Having said that, it may be that this number of cases relates to those published in the English language as I did come across a Japanese case study of male GSM by M. Tomita and colleagues published in 2002 in the Japanese journal Hinyokika Kiyo, that noted that their case study was the 24th case of male GSM in the Japanese scientific literature). A 1988 study by Dr. C. Tobias and colleagues published in the South Medical Journal reported that self-mutilators (including all types of self-mutilation not just GSM) were most likely to suffer from schizophrenia, religious preoccupation, substance abuse, and/or social isolation.

Today’s blog specifically looks at genital self-mutilators who engage in the behaviour because of a religious belief, and are typically diagnosed as having Klingsor Syndrome. The name of the syndrome was derived from the character Klingsor in Parsifol (a Wagner opera) who engaged in an act of self-castration to gain entry into the Brotherhood of the Knights of the Holy Grail.

In a 1990 issue of the Australian and New Zealand Journal of Psychiatry, Dr. I. Schweitzer wrote a paper called ‘Genital self-amputation and the Klingsor syndrome’. In his paper, he described two psychotic individuals, who had carried out GSM on themselves (one of which had done it in an attempt to kill himself). He noted that those most at risk from committing GSM were similar to self-mutilators more generally and comprised:

“Psychotic patients with delusions (often religious), sexual conflict associated with guilt, past suicide attempts or other self-destructive behaviour and depression, severe childhood deprivation, and major premorbid personality disorder”.

Dr. Schweitzer tried to argue that ‘Klingsor syndrome’ should be applied to anyone that carries out GSM as a result of psychotic illness and not just those with religious delusions. However, this does not appear to have been taken up that widely in more recent published case studies. A couple of (seemingly) genuine cases of the ‘archetypal’ Klingsor Syndrome, were reported in the Indian Journal of Psychiatry. The first one was by Malay Dave and colleagues in 1997, and described the case of a 22-year old unmarried schizophrenic Muslim male:

“[He] was admitted in the urology department with self-inflicted traumatic amputation of the penis At that time some Muslim men accosted him and told him not to be seen in that locality again. After this incident the patient became fearful, started hearing voices belonging to the devil and Allah which would tell him that he was not… At the initial interview the patient was uncommunicative and rapport was difficult to establish. He had a perplexed affect…As the patient gradually became more controlled delusions of persecution, reference and control were elicited along with thought insertion and broadcast. His concept formation was average and auditory hallucinations (2 voices belonging to the God and the devil talking amongst themselves and to him, saying derogatory things) were elicitable. These voices had initially commanded the patient to cut off his penis”.

The second one was published in 2001 by Dr. Subhash Bhargava and colleagues. They wrote that:

A 25-year old unmarried male presented to the emergency services as he had severed off his penis with a knife. Patient reported of feeling no pain at that time and explained this act as carrying out the orders given to him by the goddess. The voice had assured him that by doing so his sins would be expiated and that he would attain sainthood. His family reported that he had disturbed sleep, a decline in work performance, increased talking, mainly religious in content and disinhibited behaviour off and on for the past seven months…Mental status examination revealed bizarre sexual and religious delusions and auditory hallucinations. The latter were accusatory as well as commanding in nature and mainly religious in content. A diagnosis of schizophrenia was made”.

A 2010 paper in the Israel Journal of Psychiatry and Related Sciences by Turkish clinicians led by Dr. Erol Ozan outlined four cases of GSM (three schizophrenics, and one with psychotic bipolar depression) forwarded some other symptoms that appear to put men at risk of GSM including (i) failures in the male role, (ii) problems in the early developmental period, (iii) such as experiencing difficulties in male identification and persistence of incestuous desires, (iv) depression, and (v) having a history of GSM. They also proposed a new concept in formulating religiously themed psychotic male GSM – atonement.

Another more recent (2012) paper in the Israel Journal of Psychiatry and Related Sciences by Indian researchers Dr. Ranjan Bhattacharyya and colleagues described a case of male GSM who was a paranoid schizophrenic who castrated himself at a time when no psychotic symptoms were present (but were enacted during a period of what the authors described as “post-psychotic depression”). Following a review of the psychological literature on male GSM, they considered that their case “best [fitted] the description for Klingsor Syndrome” probably because their case study was of a man “recovering from a psychotic episode with possible sexual guilt, religiosity and intense hatred towards women”. The religiosity in this case didn’t seem to be as pronounced as the two cases published in the Indian Journal of Psychiatry (outlined above). Given the rarity of any kind of GSM, it would appear that Klingsor Syndrome is arguably one of the world’s rarest syndromes. Every new case study appears to add to our knowledge of this strange (and potentially life threatening) behaviour.

Dr Mark Griffiths, Professor of Gambling Studies, International Gaming Research Unit, Nottingham Trent University, Nottingham, UK

Further reading

Ajape, A.A., Issa, B.A., Buhari, O.I.N., Adeoye, P.O., Babata, A.L. & Abiola, O.O. (2010). Genital self-mutilation. Annals of African Medicine, 9, 31-34.

Bhargava, S.C., Sethi, S., & Vohra, A.K. (2001). Klingsor syndrome: a case report. Indian Journal of Psychiatry, 43, 349-350

Bhattacharyya, R., Sanyal, D. & Roy, K. (2011). A case of Klingsor Syndrome: when there is no longer psychosis. Israel Journal of Psychiatry and Related Sciences, 48, 30-33.

Dave, M., Apte, J., Dhavale, H.S. & Pinto, C. (1997). The Klingsor Syndrome. Indian Journal of Psychiatry, 39, 341-342.

Martin, T. & Gattaz, W.F. (1991). Psychiatric aspects of male genital mutilations. Psychopathology, 24, 170.

Murota-Kawano, A, Tosaka, A. & Ando, M. (2001). Autohemicastration in a man without schizophrenia. International Journal of Urology, 8, 257-259.

Ozan, E., Deveci, E., Oral, M., Yazici, E., & Kirpinar, I. (2010). Male genital self-mutilation as a psychotic solution. Israel Journal of Psychiatry and Related Sciences, 47, 297-303.

Rao, K.N., Bharathi, G., & Chate S. (2002). Genital self-mutilation in depression: A case report. Indian Journal of Psychiatry. 44, 297-300.

Russell, D.B., McGovern, G. & Harte, F.B. (2005). Genital self-mutilation by radio frequency in a male-to-female transsexual. Sexual Health, 2, 203-204.

Schweitzer, I. (1990). Genital self-amputation and the Klingsor syndrome. Australian and New Zealand Journal of Psychiatry, 24, 566-569.

Stunnell, H., Power, R.E., Floyd, M., & Quinlan, D.M. (2006). Genital self-mutilation. International Journal of Urology, 13, 1358-1360.

Tobias, C.R., Turns, D.M., Lippmann., S., Pary, R. & Oropilla, T.B. (1988) Evaluation and management of self-mutilation. South Medical Journal, 81(10), 1261-1263.

Tomita, M., Maeda, S., Kimura, T., Ikemoto, I. & Oishi, Y. (2002). [A case of complete self-mutilation of penis]. Hinyokika Kiyo, 48, 247-249.

Waugh, A.C. (1986). Autocastration and biblical delusions in schizophrenia. British Journal of Psychiatry, 149, 656-658.

Pig in a poke: A brief look at porcinophilia

In my previous blogs I have examined various human-animal sexual relationships including zoophiles that have sexual relationships with horses, lizards, dolphins, birds and insects. Today’s blog examines something I am calling ‘porcinophilia’ (i.e., a sexual paraphilia where humans are sexually attracted to and aroused by pigs). Although there are a number of scientific papers that have made reference to humans having sexual relationships with pigs (both sows and boars), the behaviour has (surprisingly) never been given a name.

I don’t know about you, but before I researched the material for this blog, my only “evidence” that humans would want to have sex with a pig was an infamous scene in the 1972 film Deliverance starring Burt Reynolds, Jon Voight, and Ned Beatty. In the film, the scene concerns Ned Beatty’s character (Bobby Trippe) being violently and anally raped by a two shotgun-wielding hillbillies and Bobby being forced to “squeal like a pig” as it was happening. However, this is nothing compared to the Belgian film Vase de Noces.

Vase de Noces is arguably one of the most disturbing and controversial movies ever made (known as Wedding Trough in the UK and often referred to as The Pig F**king Movie), and concerns the sexual relationship between a man and his pig. A number of film censors (including those in Australia) have labeled the film as an obscenity because of its animal killings (some real, some simulated) and depictions of coprophagia and urophilia (i.e., the eating of faeces and drinking of urine which I examined in previous blogs). The film revolves around an autistic man who becomes fixated on a female pig and ends up having a sexual relationship with it, and is psychologically devastated when the pig dies.

In my search for literature relating to porcinophilia, I came across a book chapter entitled ‘The Sex Lit You Probably Haven’t Read: Obscure and Expunged Material Dealing With Everyone’s Favorite Activity’ by Russ Kick. He made reference to the ‘feminist classic’ Our Bodies, Ourselves and described by Kick as “perhaps the most important women’s health book ever published”, and is currently in its eighth edition. Kick managed to track down some of the deleted fantasies from the original 1973 edition that presented sexual fantasies in the women’s own words. One of the extracts, mentioned sexual activity with pigs although in the context of being lower down the bestial hierarchy. The deleted quote read: “I fantasize about making love with horses, because they are very sensuous animals, more so than cows or pigs. They are also very male animals – horse society is very chauvinist”. 

A paper written by Margret Grebowicz concerning online bestiality pornography entitled “When Species Me(a)t” in a 2010 edition of the online journal Humanalia (the journal of human/animal interface studies). Grebowicz made a passing reference to bestiality involving pigs in a section on ‘animal rape’ based on what she had found on the internet. More specifically she claimed:

“Numerous sites advertise photo galleries accompanied by narratives of dogs ‘raping’ innocent girls or other ‘first timers’. In all of the sites classified as ‘animal rape’, the animal, usually a dog, is present as the perpetrator, not the victim, of a rape. This rape narrative sometimes depends on claims about the animal’s intelligence, as in, which shows photos of a woman having intercourse with a pig. The accompanying narrative states that she was raped by the pig in a shed, a claim which is then supported by the following sentence, which explains that pigs are among the most intelligent animals on the planet, comparable to dogs. The trajectory from intelligence to sexuality is clear: the more intelligent the animal, the more credible the narrative in which the animal is a sexual agent”.

But now for something a little bit more academic. Dr. Anil Aggrawal in his 2009 book Forensic and Medico-legal Aspects of Sexual Crimes and Unusual Sexual Practices reported that the first ever legal reference concerning the punishment for bestiality was in the Hittite compendium of laws. These laws stated that bestial acts carried out by men (but not women) with pigs, sheep, cattle, and/or dogs were punishable with death. He also noted that court records available in Europe and the USA between the fourteenth century and the present day, nearly always show males (as opposed to females) as most likely to be charged with bestial offences, and that the most common animals that humans had engaged in sexual activity were in these court cases were horses, pigs and sheep.

In the scientific literature there are a couple of case studies relating to human-porcine sexual relationships. In 1976, Dr. P. H. Blondel reported in a French medical journal that a 46-year old French farmer had to undergo surgery for peritonitis after anal sex with a boar (i.e., a male pig). Later in 2002, Dr. G.K. Kirov and his colleagues reported in Injury (the International Journal of the Care of the Injured) that a 62-year old Bulgarian farmer was treated for a torn rectum after sex with a male pig. The authors noted that: A transmural tear occurred when pressure exceeded the rectal wall compliance at a fixed point of contact”. The farmer had presented at hospital suffering from abdominal pain. Following medical tests, it was discovered that the cause of the pain was a small (half a centimetre) ragged tear of the rectal wall. Initially, the farmer was understandably reluctant to tell the medical staff how the injury had been obtained, but eventually he revealed that one of his male pigs had anally penetrated him. Science writer Darren Naish (in an article covering this case on his Tetrapod Zoology blog) described the anatomy of a pig’s penis, and from this description it is easy to see how being anally penetrated by a pig would cause a rectal tear:

“The pig penis is somewhat different from the sort of anatomy that we’re more familiar with. For one thing, the organ is twisted, with the right corpus cavernosum more strongly developed than the left. The retractor muscle is also attached asymmetrically…Believe it or don’t, by contracting its retractor muscles, a boar makes its penis move in a semi-rotary fashion, and by causing this movement a mating boar can achieve ejaculation even when not thrusting the pelvis in the normal fashion. A glans is absent, and instead the tip of the organ is twisted with a curved and pointed end”.

I also read in Frances Twinn’s book The Miscellany of Sex that the pig’s corkscrew-shaped penis can provide orgasms that last for 30 minutes. Finally, a 2000 study of 32 male zoophiles by Dr. Andrea Beetz (and also reported in a number of her later publications including the 2002 book Love, Violence, and Sexuality in Relationships between Humans and Animals) reported that 14% of her participants were most attracted to pigs. However, compared to other form of animal sexual attraction, pigs were the least sexually attractive animals when compared to dogs (87%), horses (81%), cows (32%), goats (28%), sheep (27%) and cats (15%).

Both court reports and scientific medical papers prove the existence of humans having sexual relationships with pigs, and Dr. Beetz’ research with self-confessed zoophiles also shows that among the zoophile community, pigs are among a number of household pets and farm animals that humans have had sexual relationships with. We know nothing about the prevalence or etiology of such behaviour, but the incidence is likely to be very low.

Dr Mark Griffiths, Professor of Gambling Studies, International Gaming Research Unit, Nottingham Trent University, Nottingham, UK

Further reading

Aggrawal A. (2009). Forensic and Medico-legal Aspects of Sexual Crimes and Unusual Sexual Practices. Boca Raton: CRC Press.

Aggrawal, A. (2011). A new classification of zoophilia. Journal of Forensic and Legal Medicine, 18, 73-78.

Beetz, A.M. (2000, June). Human sexual contact with animals: New insights from current research. Paper presented at the 5th Congress of the European Federation of Sexology, Berlin.

Beetz, Andrea (2002). Love, Violence, and Sexuality in Relationships between Humans and Animals. Germany: Shaker Verlag.

Beetz, A. M. (2004). Bestiality/zoophilia: A scarcely investigated phenomenon between crime, paraphilia, and love. Journal of Forensic Psychology Practice, 4, 1-36.

Bering, J. (2012). Porky pig. Slate, January 6. Located at:

Blondel, P. H. 1976. Perforations digestives d’etiologie insolite: deux cas. Nouv Presse Med 5, 915.

Grebowicz, M. (2010). When species Me(a)t: Confronting bestiality pornography. Humanalia, 1(2). Located at: 

Kick, R. (2005). The sex lit you probably haven’t read: Obscure and expunged material dealing with everyone’s favorite activity. In R. Kick (Ed.), Everything You Know About Sex is Wrong (pp.260-267).  New York: The Disinformation Company.

Kirov, G. K., Losanoff, J. E. & Kjossev, K. T. (2002). Zoophilia: A rare cause of traumatic injury to the rectum. Injury, 33, 367-368.

Naish, D. (2008). Traumatic anal intercourse with a pig. Tetrapod Zoology, February 22. Located at:

Twinn, F. (2007). The Miscellany of Sex: Tantalizing Travels Through Love, Lust and Libido. London: Arcturus.

A word to the wise: A brief look at obsessive cruciverbalism

“Sixty-four million people do it at least once a week. Nabokov wrote about it. Bill Clinton even did it in the White House” (Marc Romano, 2005).

I’m sure many of you reading this opening quote will think that it refers to sexual infidelity but it doesn’t. I was also deliberately obtuse in the title of today’s blog to throw you off the scent of what today’s blog is about. Well, to put some of you out of your misery, the topic under the microscope today is crossword puzzles. For those who don’t know, a cruciverbalist is an enthusiast of word games (especially of crosswords). According to Michael Quinion in his excellent World Wide Words website:

“[The word ‘cruciverbalist’] seems to have appeared in English about 1980 (the first reference I can find is to the Compleat Cruciverbalist of 1981 by Stan Kurzban and Mel Rosen, subtitled ‘how to solve, compose and sell crossword puzzles for fun and profit’). However, Stan Kurzban tells me that Mel Rosen had encountered the word some years earlier in the title of a directory of crossword puzzle notables that was not widely circulated. Whatever its origin, cruciverbalist has spread into the wider language as a result of their efforts to the extent that it now appears in some larger recent US dictionaries. The word is a modern mock-Latin invention, being a translation back into Latin of the English crossword (using Latin crucis, cross, as in words like cruciform, plus verbum, word, as in verbose or verbatim).There is also cruciverbalism, for the art of crossword compilation or crossword fandom generally, but that is much rarer”.

The opening quote comes from Marc Romano’s 2005 book The Crossword Obsession: The History and Lore of the World’s Most Popular Pastime who asserted that: the crossword puzzle has arguably been our national obsession since its birth almost a century ago”. Seeing the word ‘obsessive’ was enough to make me think it was a topic worthy of consideration of writing a blog about it (especially when reading the accompanying blurb for Romano’s book):

“Saying this is a book about puzzles is to tell only half the story. It is also an explanation into what crosswords tell us about ourselves – about the world we live in, the cultures that nurture us, and the different ways we think and learn. If you’re a puzzler, Crossworld will enthrall you. If you have no idea why your spouse send so much time filling letters into little white squares, Crossworld will tell you – and with luck, save your marriage”.

On a personal note, I ought to declare a vested self-interest in that I been doing cryptic crosswords since I was taught to do them by my father in my mid-teens. In the early 1990s until the late 1990s I did (or rather attempted) The Guardian’s cryptic crossword almost every day (the birth of my daughter put a stop to daily crosswords and what little spare time I had outside of my job). On the way to a conference in Bristol in 1998, I had a race on the train with one of my departmental colleagues (Bob Rotheram) as to who could complete that day’s Guardian crossword first. I even got a letter in The Guardian (November 26, 2002) about a crossword puzzle set by my favourite crossword setter (John Galbraith Graham, better known under his crossword compiling pseudonym ‘Araucaria’). Many of the clues in the prize crossword I had just completed related to an anagram of the word ‘presbyterians’. The letter I had published said:

“I don’t know what is worse. The fact that some clues in the prize crossword related to Britney Spears and her hit singles, or the sad fact that I knew the answers to them all!”

The fact that ‘presbyterians’ is an anagram of singer ‘Britney Spears’ I found amazing (although my favourite anagram in one of Araucaria’s crosswords was ‘synthetic cream’ being an anagram of the football team ‘Manchester City’). I am also a huge fan of crossword homophones (words that are pronounced the same but are completely different in definition and meaning) and on which most forms of punning are based. This includes many of my blog titles such as my articles on body dysmorphic disorder (‘Flaw management’), biting fetishes (‘Bit sighs’), pandrogyny (‘A gender setting’), and gambling spending (‘Stake and chips’), as well as my blogs on the psychology of revulsion (‘Disgust discussed’), Exploding Head Syndrome (‘A noise that annoys’) and Jerusalem Syndrome (‘Wholly holy’). I love crosswords so much that I even have an all-time favourite clue (“Late opening” [seven letters]; Answer: AUTOPSY). Total genius!

Doing crosswords appears to be a very popular hobby. According to Dean Olsher in his 2009 book, From Square One: A Meditation, with Digressions, on Crosswords, about 50 million American people do crosswords. Olsher says that for some, crosswords are a pastime and for others it is a form of escapism (suggesting that crosswords may produce psychological feelings and motivations associated with addictive behaviours). Olsher noted that some people like the film director Alfred Hitchcock “didn’t get” crosswords. Hitchcock told film actor, director and screenwriter Francois Truffaut that:

“I don’t really approve of whodunits because they’re rather like a jigsaw or crossword puzzle. No emotion. You simply wait to found out who committed the murder”

Olsher claims Hitchcock fell prey to a common false dichotomy that thinking and feeling are an either/or proposition. Olsher claims they are inextricable, and that cerebral and emotional satisfaction are not at odds with each other. For Olsher, crosswords can be an exhilarating experience and akin to seated meditation. However, he also notes that doing crosswords (based on his own personal experience) could be an addiction:

“It is more honest, though, to think of crosswords as a habit, like smoking. It’s just something to do, every day, because it’s there. When finished with a puzzle, I don’t pump my fists in triumph or congratulate myself for my perseverance. I solve crosswords because they bring on a feeling of emptiness, and paradoxically, that feeling seems to fill a hole deep inside. It’s not a release, it’s not a flushing out, although both those terms grasp at some aspect of it. Norman Mailer said that for him, solving the crossword every day was like combing his brain. This simile is strong because it has nothing to do with usual mental fitness. It’s not about intelligence or holding onto memory. Crosswords bring about a focused state of mind, the elusive ‘flow state’. Then there are days when I decide that this is all an elaborate self-deception. That the puzzle is indeed an escape mechanism. The crossword addiction is not a metaphor but a destructive literal truth”

I was surprised to find there has been quite a lot of academic research on the benefits of doing crosswords (although very little on whether doing crosswords can be obsessive and/or addictive). However, the psychologist Dr. Howard Rachlin does mention in a number of his writings on addiction that there are many activities that could be described as ‘positive addictions’ including listening to classical music, collecting stamps, exercise, reading novels, doing crossword puzzles”. Dr. Rachlin also noted in a paper published in a 2002 issue of the journal Behavioral and Brain Sciences (BBS):

“Patterns of behavior may be maintained without extrinsic rewards. For example, on a relatively small scale, activities such as solving jigsaw or crossword puzzles are valuable in themselves. People, like me, who like to do crossword puzzles, find value in the whole act of doing the puzzle. When I sit down on a Sunday morning to do the puzzle I am not beginning a laborious act that will be rewarded only when it is completed. Yet, despite the lack of extrinsic and intrinsic reward for putting in that last particular letter, completing the puzzle is, for me, a necessary part of its value. Like listening to symphonies, the pattern is valuable only as a whole. Extrinsic rewards may initially put together the elements of these patterns but the patterns, once formed, are maintained by their intrinsic value. The cost of breaking the pattern is the loss of this value – even that of the parts already performed”.

However, Rachlin is not without his critics. In responses to the BBS paper, Dr. Stephen Kaplan and Dr. Raymond De Young claimed that Rachlin’s interpretation of intrinsic motivation as arising from a string of habits was far from convincing. More specifically, they noted that the “fascination with crossword and jigsaw puzzles seems far more likely to be an expression of the human inclination to solve problems, a tendency humans share with nonhuman primates”. Another response to the BBS paper by Dr. Thomas R. Zentall claimed that the concept of intrinsic reinforcement is needed to explain the variety of behaviour that has no extrinsic material or social reward, such as crossword puzzle solving. He argues that:

“Intrinsic reinforcers are difficult to assess. They are what [are] left once you have ruled out extrinsic reinforcers, and in the case of humans, typically we assess them by means of verbal behavior (e.g., ‘I just like doing it’). But this sort of definition can easily become circular, especially when we are talking about behavioral patterns that are themselves not clearly defined. One can hypothesize that extrinsic reinforcers become internalized, but that does not explain, it only describes”.

Doing crosswords may even be of psychological and practical benefit. For instance, Dr. Mike Murphy and Dr. Roisin Cunningham published a paper last year in the Irish Journal of Psychology claiming that: “a crossword a day improves verbal fluency”. More specifically they examined ‘semantic verbal fluency’ (SVF) an important contributor to general communication ability. In their study, 34 final year students completed a daily crossword for one month and compared this to a control group of 40 students who did not do any crosswords. Their results indicated that the crossword group experienced greater improvement in SVF than the control group. They concluded that doing simple crosswords may be a relatively straightforward way improving SVF among students who are about to enter the job market and need good transferable skills.

Dr. Graham Pluck and Dr. Helen Johnson writing in a 2011 issue of Education Science and Psychology claim that stimulating curiosity (with activities such as crosswords) can enhance learning. They drew on the work of Dr. Ludwig Lowenstein who noted that many features of human behaviour appear counter-productive on the surface but are not. For instance:

“Lowenstein discusses the interest that many people have in completing puzzles such as crosswords, or why soap operas end on cliff-hangers. According to the theory, the information gaps that people are exposed to act to motivate them to obtain the missing information, either by persevering to complete the puzzle or tuning in to watch the next episode of the soap opera”.

Another study led by Dr. Joshua Jackson and published in a 2012 issue of the journal Psychology and Aging claimed doing crosswords could change some aspects of personality among old-aged people. More specifically, they examined whether an intervention aimed to increase cognitive ability in older adults (i.e., doing crossword and Sudoku puzzles) affected the personality trait of openness to experience (i.e., being imaginative and intellectually oriented). In their study, old-aged adults completed a 4-month program in inductive reasoning training that included weekly crossword and Sudoku puzzles. They were then assessed continually over the following 30 weeks. Their findings showed that those who did crossword and Sudoku puzzles increased their openness scores compared to the control group. The authors claimed that this study is one of the very first to demonstrate that personality traits can change through non-psychopharmocological interventions.

Although there are a number of people online who have confessed as to being ‘crossword addicts’, (including the US rock singer and record producer Todd Rundgren in a June 2013 interview with Uncut magazine), I have yet to find any empirical evidence that it is negatively detrimental in people’s lives. For most, even those who describe themselves as ‘crossword obsessives’, it is a behaviour that adds to and enhances their lives.

Dr Mark Griffiths, Professor of Gambling Studies, International Gaming Research Unit, Nottingham Trent University, Nottingham, UK

Further reading

Amende, C. (2001). The Crossword Obsession: The History and Lore of the World’s Most Popular Pastime. New York: Berkeley.

Davis, T.M., Shepherd, B. & Zwiefelhofer, T. (2009). Reviewing for exams: Do crossword puzzles help in the success of student learning? Journal of Effective Teaching, 9, 4-10.

Jackson, J.J., Hill, P.L., Payne, B.R., Roberts, B.W., & Stine-Morrow, E.A. L. (2012). Can an old dog learn (and want to experience) new tricks? Cognitive training increases openness to experience in older adults. Psychology and Aging, 27, 286-292.

Kaplan, S. & De Young, R. (2002). Toward a better understanding of prosocial behavior: The role of evolution and directed attention Behavioral and Brain Sciences, 25, 263-264.

Murphy, M. & Cunningham, R.K. (2102). A crossword a day improves verbal fluency: A report of an intervention study. Irish Journal of Psychology, 133, 193-198.

Olsher, D. (2009). From Square One: A Meditation, with Digressions, on Crosswords. New York: Simon & Schuster.

Pluck, G. & Johnson, H. (2011). Stimulating curiosity to enhance learning. Education Science and Psychology, 2(19), 24-31.

Rachlin, H. (2002). Altruism and selfishness. Behavioral and Brain Sciences, 25, 239-250.

Rachlin, H. (2003). Economic concepts in the behavioural study of addiction. In R.E. Vuchinich & N. Heather (Eds.), Choice, Behavioural Economics and Addiction. (pp.129-149). Oxford, UK: Pergamon Press.

Romano, M. (2005). Crossworld: One Man’s Journey into America’s Crossword Obsession. Blackpool: Broadway.

Underwood, G., Deihim, C. & Batt, V. (1994). Expert performance in solving word puzzles: From retrieval cues to crossword clues. Applied Cognitive Psychology, 8, 531-548.

Zentall, T.R. (2002). A potentially testable mechanism to account for altruistic behavior Behavioral and Brain Sciences, 25, 282.