Monthly Archives: January 2014

Self-expression of interest: A brief look at extreme body modification

One of the more noticeable ‘extreme’ trends is that of body modification. Arguably the most common (and socially acceptable) forms of body modification are ear piercing and tattoos, followed by various other types of piercings (e.g., nipple piercings) and various types of plastic surgery (e.g., rhinoplasty [nose jobs] and breast augmentation [boob jobs]). More extreme types include foot binding, extreme corseting, branding, amputation, and genital cutting. Such types of actions are known as ‘acquired characteristics’ as they cannot be genetically passed on to the individuals’ children. As the body modification section of the Wikipedia entry on acquired characteristics notes:

“Body modification is the deliberate altering of the human body for any non-medical reason, such as aesthetics, sexual enhancement, a rite of passage, religious reasons, to display group membership or affiliation, to create body art, shock value, or self-expression. The frequency of occurrence depends on the location, extent, and number of modifications, and, perhaps most importantly, on the mind of each individual being asked to accept the modifications on another”.

In a recent issue of the Archives of Sexual Behavior, Dr. David Veale and Dr. Joe Daniels added that:

“Body modification is a term used to describe the deliberate altering of the human body for non-medical reasons (e.g., self-expression). It is invariably done either by the individual concerned or by a lay practitioner, usually because the individual cannot afford the fee or because it would transgress the ethical boundaries of a cosmetic surgeon. It appears to be a lifestyle choice and, in some instances, is part of a subculture of sadomasochism. It has existed in many different forms across different cultures and age”.

These definitions of body modification would also appear to include such practices as circumcision (although this may of course be done for legitimate medical reasons as well as cultural and/or religious rites of passage). Other ‘extreme’ forms of body modification include:

  • Earlobe stretching: This refers to the gradual stretching of the earlobe through the gradual increase in size of piercing rings. This is typically carried out for aesthetic reasons, self-expression and/or group membership.
  • Branding: This refers to the deliberate burning of the skin to produce an irreversible symbol, sign, ornament and/or pattern on human skin. This is typically carried out for group membership reasons (but can also be carried out for aesthetics and/or self-expression).
  • Subdermal Implants (pocketing): This refers to a type of body jewelry placed underneath the skin and often used in conjunction with other forms of body modification. The body then ‘heals’ over the implant leading to a raised (sometimes 3-D) design. This is almost always done for aesthetic reasons and/or shock value.
  • Extraocular implants: This refers to the placing of small pieces of jewelry in the eye by cutting the surface layer of the eye following a surgical incision. Again, this is almost always done for aesthetic reasons and/or shock value.
  • Corneal tattooing: This is the practice of injecting a colour pigment into the eye. As with the previous two examples, this is almost always done for aesthetic reasons and/or shock value.
  • Tongue splitting: This refers to the splitting of the tongue so that the tongue looks like (for instance) a serpent’s tongue.
  • Tooth filing: This refers to the practice of filing teeth (often into the shape of sharp pointed fangs). This may be done for a variety of reasons including group membership, aesthetics and/or self-expression.
  • Tightlacing (waist training, corset training): This refers to the use of incredibly tight fitting corsets (typically by women) to produce an archetypal ‘hourglass’ figure. This is typically carried out for aesthetic reasons.
  • Pearling (genital beading): This refers to the permanent insertion of small beads beneath the skin of the genitals (such as the labia in women or the foreskin in men). Most of those who engage in pearling do it for aesthetic and/or sexual enhancement reasons (e.g., to increase sexual stimulation during vaginal or anal intercourse).
  • Anal stretching: This refers to the gradual stretching of the anus with the use of specialized built for purpose ‘butt plugs’ (typically carried out for sexual enhancement and stimulation).
  • Penis splitting (penile bisection): This is the cutting and splitting of a person’s penis from the glans towards the penis base (and which I covered at length – no pun intended – in a previous blog). This is typically done for reasons of sexual stimulation and fetishistic enhancement for either the self and/or sexual partner (although it has also been done for both religious and/or aesthetic reasons).

A really great 2007 review paper by Dr. Silke Wohlrab and colleagues in the journal Body Image examined all the known motivations for body modification (including tattoos and piercings) based on scientific studies and concluded almost all motivations fell into one or more of the following ten categories:

  • Beauty, art, and fashion (i.e., body modification as a way of embellishing the body, achieving a fashion accessory and/or as a work of art).
  • Individuality (i.e., body modification as a way of being special and distinctive, and creating and maintaining self-identity).
  • Personal narratives (i.e., body modification as a form of personal catharsis, and/or self-expression. For instance, it was claimed that some abused women “create a new understanding of the injured part of the body and reclaim possession through the deliberate, painful procedure of body modification and the permanent marking”).
  • Physical endurance (i.e., body modification as a way of testing a person’s own threshold for pain endurance, overcoming personal limits, etc.).
  • Group affiliations and commitment (i.e., body modification as part of sub-cultural membership or the belonging to a certain social circle).
  • Resistance (body modification as a protest against parents or society).
  • Spirituality and cultural tradition (i.e., body modification as part of a spiritual or cultural movement).
  • Addiction (i.e., body modification as a physical and/or psychological addiction due to (i) the release of endorphins associated with the pain of undergoing the practice, and/or (ii) the association with memories, experiences, values or spirituality).
  • Sexual motivations (i.e., body modification as a way of enhancing sexual stimulation).
  • No specific reason (i.e., body modification as an impulsive act without forethought or planning).

The review paper was incredibly thorough and these ten motivations cover everything they came across in the academic study of body modification. Unsurprisingly, the most frequently mentioned motivation was the expression of individuality and the embellishment of the own body. Hopefully I’ll cover some of the more specific body modifications in future blogs.

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.

Lemma, A. (2010). Under the skin: A psychoanalytic study of body modification. London: Routledge.

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

Rowanchilde, R. (1996). Male genital modification. Human Nature, 7, 189-215.

Veale, D. & Daniels, J. (2012). Cosmetic clitoridectomy in a 33-year-old woman. Archives of Sex Behavior, 41, 725-730.

Wikipedia (2012). Acquired characteristic. Located at:

Wikipedia (2012). Body modification. Located at:

Wikipedia (2012). Penile subincision. Located at:

Wohlrab, S., Stahl, J., & Kappeler, P. M. (2007). Modifying the body: Motivations for getting tattooed and pierced. Body image, 4, 87-95.

Hot dogs: A bizarre case of zoophilic exhibitionism and frotteurism

In previous blogs, I have separately examined zoophilia (sexual arousal from animals), exhibitionism (sexual arousal from exposing one’s genitals to one or more people), and frotteurism (sexual arousal from rubbing one’s genitals against other people). Today’s blog examines the only case ever published in the scientific literature of zoophilic exhibitionism and zoophilic frotteurism.

The case in question dates back to a paper published in 1991 by Dr. Richard McNally and Dr. Brian Lukach in the Journal of Behavioral Therapy and Experimental Psychiatry. Their case study involved a white 33-year old “mildly mentally retarded man” (who they called ‘Mr. Z’) who was the only child of separated parents – an alcoholic father and a schizophrenic mother who also suffered from epilepsy (and who died when he was 12 years old). Mr. Z’s preferred sexual behaviour was to expose himself and masturbate in front of large dogs of either sex, and who also liked to rub his penis on large dogs. He had no sexual interest in small dogs or other animals (and would therefore be classed as an exclusive canophile that I  examined in a previous blog on cynophilia). Unlike most exhibitionists, he never exposed his genitals in front of women, and he never had sexual intercourse with the dogs. Mr. Z had engaged in a series of “satisfactory sexual relationships with women” (and also had a three-year marriage but had ended)

Mr. Z also engaged in zoophilic voyeurism (which in Mr. Z’s case involved sexual arousal from watching dogs). Various publications have noted situations where people may have voyeuristic fantasies about sexual contact with animals without actually wanting to have sex with them. Nancy Friday in her book My Secret Garden, included 190 fantasies from different women (of which 23 involved zoophilic activity). Friday argued that zoophilic fantasies had the capacity to provide an escape from cultural expectations, restrictions, and judgments in relation to sex. R.E.L. Masters in his 1962 book Forbidden Sexual behavior and Morality also noted that interest in and sexual excitement at watching animals mate may be an indicator of latent zoophilia.

Mr. Z was first caught at the age of 20 years rubbing his penis on the back fur of a neighbour’s dog. He was consequently hospitalized in a psychiatric institution and while there was taught to masturbate by another male patient. On leaving psychiatric care Mr. Z first began to masturbate in front of dogs (i.e., he exchanged zoophilic frotteurism for zoophilic exhibitionism). His usual pattern of behaviour was to use food to attract stray dogs in his neighbourhood and to take the dog back to his grandmother’s house (if she was not in). if the house was occupied he would simply take the dog to a nearby wooded area and masturbate in front of the dog. Once he had ejaculated, he would get the dog to lick his penis. However, Mr. Z never attempted to have sex with any of the dogs he masturbated in front of. Mr. Z was also of the opinion that the dogs enjoyed him masturbating in front of them, and based his opinion on an incident where a dog had rubbed its penis on his leg after a masturbatory session in front of the dog.

Mr. Z’s paraphilic behaviour dated back to a specific incident in childhood when at the age of just four years old, a male cousin told him that it was “fun” to rub a penis on the fur of a dog’s back. Following an arrest for masturbating in front of neighbour’s dogs, Mr Z was referred for treatment to address his “compulsive sexually deviant behaviour” after a neighbour had discovered him masturbating in front of her dog in her garden. In 1991, McNally and Lukach  treated Mr. Z using masturbatory satiation, covert sensitization, and contingency management procedures (avoiding setting that may provoke the behaviour) over a six-month period. After 15 sessions, Mr. Z’s rated interest in his most exciting zoophilic scenario dropped from 10 to 0, and that his sexual arousal to non-deviant scenes increased from 5 to 10 after 12 sessions. The treatment resulted in a reduction in his sexual arousal to dogs with no more reported incidents of him masturbating in front of dogs (although as far as I can ascertain there was no long-term follow-up).

Dr. Anil Aggrawal in his 2009 book Forensic and Medico-legal Aspects of Sexual Crimes and Unusual Sexual Practices classified exhibitionists into four different types of exhibitionism:

  • Fantasizing Exhibitionists: This type comprises people that fantasize about exhibiting their genitals to other people but don’t actually do it.
  • Pure Exhibitionists: This type comprises people that expose their genitals to other people from a distance.
  • Exhibitionistic Criminals: This type typically comprises sexual offenders that are primarily exhibitionists, but may engage in other sexual crimes (e.g., paedophilia).
  • Exclusive Exhibitionists: This type typically comprises offenders that cannot form normal romantic and sexual relationships with other people. Here, exhibitionism is the sole outlet for sexual gratification.

Dr. Aggrawal specifically mentions zoophilic exhibitionists as belonging to the group of fantasizing exhibitionists and “may turn to zoophilic exhibitionism to fulfill their fantasies, since it apparently is a safer activity”. In a separate paper (in the Journal of Forensic and Legal Medicine) presenting a new typology of zoophilia, Mr. Z would most likely be classed as a tactile zoophile who gets sexual excitement from touching, stroking or fondling an animal or their genitals but do not actually have sex with the animal. Aggrawal mentioned that that some tactile zoophiles engage in zoophilic frotteurism, and that for sexual pleasure rub their genitals against animals. Here, he seemed to be implicitly making reference to the case study by McNally and Lukach.

The paper by McNally and Lukach concluded that their case study was “especially unusual” for two specific reasons. Firstly, unlike most other zoophiles, “Mr. Z neither fantasized nor engaged direct sexual contact with dogs” but simply exposed himself in front of them. Secondly, his sexual preference was zoophilic exhibitionism over sexual intercourse with women.

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.

Duffield, G., Hassiotis, A., & Vizard, E. (1998). Zoophilia in young sexual abusers. Journal of Forensic Psychiatry, 9, 294-304.

Friday, N. (1973). My Secret Garden. New York, NY; Simon & Schuster

Hensley, C., Tallichet, S. E., & Singer, S. D. (2006). Exploring the possible link between childhood and adolescent bestiality and interpersonal violence. Journal of Interpersonal Violence, 21, 910-923.

Masters, R.E.L. (1962). Forbidden Sexual behavior and Morality. New York, NY: Lancer Books.

McNally, R.J. & Lukach, B.M. (1991). Behavioral treatment of zoophilic exhibitionism. Journal of Behavioral Therapy and Experimental Psychiatry, 22, 281-284. A brief look at gambling and spot-fixing

Match-fixing is nothing new. There’s always been big money to make on the outcome of sporting events. However, spot-fixing (i.e., the action or practice of dishonestly determining the outcome of a specific part of a match or game before it is played) is a more recent phenomenon. The situation escalated in December 2013 when six men (including Blackburn Rovers’ DJ Campbell) were arrested after an investigation into spot-fixing in football by the National Crime Agency. According to the British newspaper The Sun On Sunday, one of their undercover investigators reported that ex-Portsmouth footballer Sam Sodje could arrange for professional football league players to get themselves yellow cards in return for large amounts of money (i.e., tens of thousands of pounds). Consequently, the UK Government is believed to be considering whether match-fixing should be a criminal offence.

Over the past few years, allegations and convictions relating to spot-fixing have been made in many different sports including football, cricket, snooker and horse-racing. In all honesty, this doesn’t surprise me in the least – particularly because sport and gambling have always been inextricably linked. Matt Scott made a number of interesting observations on the issue in a December 2013 article for Inside World Football:

“Betting has a tradition of accompanying football in England in the same way custard goes with English puddings. It just adds a bit of flavour to the proceedings. It is a guilty pleasure, nothing more. No harm done…[However] now is the time to reappraise the complicated English relationship with the ‘harmless’ flutter. 
The ubiquity of the betting companies whose advertisements fill the half-time breaks of every match covered on television has been very lucrative for football. Figures from the website suggest that in title sponsorships alone, Premier League clubs earn £13m a year from betting companies…Investigations by the ‘Sun on Sunday’ and the ‘Daily Telegraph’ have shown how professional footballers appear to be fixing events in matches…Whether they know it or not, players who fix matches or events within them are the foot soldiers of international match-fixing rings who, according to sports anticorruption experts, have links with serious organised crime. The fixers do not place the bulk of their bets with onshore UK bookmakers but in Asian markets where the liquidity is deeper and where the regulatory scrutiny is much lighter…As the National Crime Agency’s arrests have shown, it is high time for law makers and enforcers to act. For if not, it will be easier to deliver yellow cards to order on the football pitch than for miscreant bookmakers to be issued with cautions about their activities”.

Personally, I think the rise of match-fixing and spot-fixing has mirrored the rise in the use of betting exchanges like Betfair, and the rise of in-play betting. Back in 2005, I published an article on betting exchanges and argued that they had radically altered the shape of gambling particularly because – for the first time – gamblers could bet on individuals and/or teams losing (in contrast to traditional bookmakers that would only take bets on who was going to win). Betting shop operators got worried because their clientele could use betting exchanges to become bookmakers themselves. As a consequence, I argued that betting exchanges had potentially opened the door to fraud, corruption, and crime. As Matt Scott reported:

“In 2006 a whistleblower who had previously worked for the bookmaker Victor Chandler claimed to have data from accounts belonging to Premier League players and managers. The account holders had allegedly bet on matches in their own competitions, in breach of football’s regulations. But Victor Chandler International [VCI] obtained a high-court injunction preventing the release of information about the accounts…There is no way of knowing if the alleged breaches of regulations relating to the VCI accountholders amounted to anything more sinister. (And it is fair to say that Chandler would be unlikely to have exposed himself repeatedly to bets on matches involving account holders’ teams, given the substantial risk of manipulation)”.

More recently, in-play betting has become very popular among sports bettors and plays into the hands of the spot-fixers. As the CEO of OpenBet commented:

“The periodic ritual of predicting a daily or weekly series of events is no longer the mainstay. Today’s punter wants to be able to turn on their gadget of choice and instantly be offered an array of real-time betting opportunities with immediate results…Sports betting is growing in what is offered, how it is offered, when it is offered, where it is offered, and to whom it is offered…Like the financial markets, volatile events produce increased liquidity and increased liquidity produces greater revenue to the operator”.

We can now bet on dozens of ‘in-play’ markets while watching almost any sporting event. Should I wish to, during any football match I can bet on everything from who is going to score the first goal, what the score will be after 30 minutes of play, how many yellow cards will be given during them game, who will get a red card, and/or in what minute of the second half will the first free kick be awarded. Money talks – and there is big money to be made. Paying sports men and women relatively large amounts of money to lose a point (in tennis), get a yellow card (in football), go down in the ninth round (in boxing), or lose a frame (in snooker) can result in even more money for those paying the sports players in the first place.

But maybe technological advance will be the solution to the problem. Technology makes it easier to spot betting cheats and criminal activity. Betting exchange and in-play betting technology means that every bet made through their systems can be tracked and leave an audit trail. Unusual betting patterns can be identified and shared with the relevant sporting and criminal authorities. While prevention is better than detection, betting audit trails do at least give us the chance to crack down on the cheats – even if it’s after the fact. The more sports cheats that are caught, the bigger the deterrent. While we would never want to stop people having an enjoyable punt on their favourite team, we do need to make sure that gambling is as fraud-free as possible. In Matt Scott’s article, the English football Premier League’s general secretary, Nic Coward, summarized what is required of the UK government.

“It [is] true of any regulated sector that there need to be clear regulations in place so that the sector and stakeholders with an interest in the sector understand what they are…That they are monitored; that there is an effective compliance regime; and that there are real enforcement provisions behind it”.

Note: This blog is a much extended version of an article that first appeared in Nottingham Trent University’s Expert Opinion column

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

Griffiths, M.D. (2006). All in the game. Inside Edge: The Gambling Magazine, July (Issue 28), p. 67.

Griffiths, M.D. (2010). Gambling addiction among footballers: causes and consequences. World Sports Law Report, 8(3), 14-16.

Scott, M. (2013). Time to overhaul football’s betting relationship. Inside World Football. December 12. Located at:

Episodic memories: The psychology of ‘box set bingeing’

I apologise in advance for the somewhat arguably frivolous nature of my blog but earlier this week I was interviewed by my local radio station (BBC Radio Nottingham) about the seeming increase in ‘binge watching’ of DVD box sets of television series. I have to admit that one of the reasons that I did the interview (even though I have not personally researched the topic) was that this is actually something I do myself. Also, I often appear on my local radio station talking about excessive use of technology and this topic loosely fitted that criterion.

I did actually check on a couple of academic databases to see whether there was any scientific research on ‘binge watching’ of television of box sets (but unsurprisingly there was nothing specific). I have written academic papers on various technological addictions (including addiction to watching television). However, one of my research colleagues (Dr. Steve Sussman) recently published a paper (with Meghan Moran) on television addiction in a 2013 issue of the Journal of Behavioral Addictions. Based on a review of the academic literature they claimed that 5% to 10% of the US population is addicted to television (although much of this depends on how ‘addiction’ is defined in the first place). Sussman and Moran’s review concluded that:

“There does appear to be a phenomenon of television addiction, at least for some people. TV addicts are likely watch TV to satiate certain appetitive motives, demonstrate preoccupation with TV, report lacking control over their TV viewing, and experience various role, social, or even secondary physical (sedentary lifestyle) consequences due to their out of control viewing. These consequences are in part contextually driven, due to amount of viewing time contrasted with competing time demands…Much research is needed to better understand this addiction which prima facie seems relatively innocuous but in reality may incur numerous life problems”.

In addition to reports of television being potentially addictive, the concept of bingeing has been applied to other behaviours including ‘binge drinking’ and ‘binge gambling’ (a topic that I have written on academically – see ‘Further reading’ below), although the binge watching of DVD box sets is highly unlikely to cause too many negative side effects apart from (maybe) a lack of sleep (that may impact on work productivity).

So why might people engage in the binge watching of television box set? Obviously – at a basic level – individuals do not engage in repeated leisure behaviours unless they are psychologically and/or behaviourally reinforced (i.e., rewarded) in some way. People watch particular shows because they like the show and experience emotional connections that may lead to a change in mood state. However, this goes for any leisure behaviour and is not specific to binge watching television shows. When it comes to ‘box set binging’, I think there are many possible reasons both psychological and practical (most of which I can say I have personally experienced so there’s probably good face validity for all these reasons):

  • A sign of the times: Over the past couple decades, the way we experience our disposable leisure time has dramatically changed. All my children are the archetypal ‘screenagers’ that spend a disproportionate amount of their leisure time sat in front of screen-based technology (and to be honest I am no different). Technological excess has arguably become the norm and ‘binge watching’ of television (via ‘on demand’ services and/or DVDs) is simply a sign of the times.
  • Instant gratification: Another noticeable change that has occurred over the last couple of decades is a move towards what I describe as ‘instant culture’ in which individuals expect to receive instant gratification in almost any situation. Almost everything that we want and/or desire can be done at the click of a button. Who wants to wait up to a week to find out what has happened in your favourite television drama shows? Watching episode after episode of a television show inhibits the frustration we might feel having to wait hours, days, and in some cases weeks for the resolution of a ‘cliffhanger’. In short, binge watching (DVD and/or television ‘on demand’) box sets provides instant ‘closure’ to a drama that increases emotional involvement.
  • No adverts: On a very practical level, one great thing about television box sets is that they don’t have any adverts. Most hour-long television shows on commercial channels include 15 minutes of adverts. Personally, I love the fact that I can watch episode after episode knowing that the only breaks will be of my choosing.
  • The ultimate in personal choice: Television viewing has evolved considerably over the last decade. When I grew up as a child and adolescent there were only three television channels and I had to watch whatever my parents watched (or what they would let me watch). It was also a very passive experience. We now have almost unlimited choice to watch whatever we want, when we want, and how we want. DVD box sets are the ultimate in personal choice. No more sitting through dross to get to the television programme you really want to watch.
  • Completist/collector heaven: Anyone that is a regular reader of my blog will know that when it comes to collecting (especially music) I am a completest and aim to collect everything I can that relate to the artists I love and admire. (For instance, have a read of my blog on the psychology of Hannibal Lecter where I describe how I have acquired all the books and films on Hannibal Lecter including the latest 12-episode television box set that I sat and watched in a couple of sittings including all the DVD extras). The DVD box set is part of the whole collecting experience.

As a psychologist, I would also argue that my DVD box set collection says something about me as an individual – it is an extension of the self. My favourite box sets (e.g., The Sopranos, Prison Break, 24, Columbo, Hannibal, DexterThe West Wing, etc.) are all regularly re-watched. I once spent a whole weekend while my children and partner were away watching every episode from every series of Prison Break). It was a guilty pleasure that happens only occasionally and that I loved doing.

Bingeing on box sets shares many psychosocial commonalities of the collecting experience. In a 1991 issue of the Journal of Social Behavior and Personality, Dr. Ruth Formanek suggested five common motivations for collecting that I think mirror the kind of people that can be engrossed in watching their favourite television shows. These were: (i) extension of the self (e.g., acquiring knowledge, or in controlling one’s collection); (ii) social (finding, relating to, and sharing with, like-minded others); (iii) preserving history and creating a sense of continuity; (iv) financial investment; and (v), an addiction or compulsion. Formanek claimed that the commonality to all motivations to collect was a passion for the particular things collected. I would argue this holds for binge watching too.

In her book Museums, Objects, and Collections, Dr. Susan Pearce argues collecting falls into three distinct (but sometimes overlapping) types. As Professor Kevin Moist summarized in a 2008 issue of the journal Studies in Popular Culture:

“One of these she calls ‘souvenirs’, items or objects that have significance primarily as reminders of an individual’s or group’s experiences. The second mode is what she calls ‘fetish objects’ (conflating the anthropological and psychological senses of the term), relating primarily to the personality of the collector; the collector’s own desires lead to the accumulation of objects that feed back into those desires, with the collection playing a central role in defining the personality of the collector, memorializing the development of a personal interest or passion. The third mode, ‘systematics’, has the broader goal of creating a set of objects that expresses some larger meaning. Systematic collecting involves a stronger element of consciously presenting an idea, seen from a particular point of view and expressed via the cultural world of objects”.

When it comes to DVD box sets, I appear to most fit the second (i.e., fetish) type. The box sets that I collect are an extension of my own personality and say something about me. My tastes are diverse and eclectic (to say the least) and range from the obvious ‘classic’ series (Columbo), the not so obvious (A Very Peculiar Practice), and the arguably obscure (Spiral). Unless ‘binge watching’ of television series ever becomes problematic, it is unlikely to be a subject of academic research but that won’t stop me in engaging in my guilty pleasure.

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

Further reading

Belk, R. W. (1982). Acquiring, possessing, and collecting: fundamental processes in consumer behavior. Marketing Theory: Philosophy of Science Perspectives, 185-190.

Belk, R. W. (1992). Attachment to possessions. In: Place attachment (pp. 37-62). New York: Springer.

Belk, R. W. (1994). Collectors and collecting. Interpreting objects and collections, 317-326.

Belk, R.W. (1995). Collecting as luxury consumption: Effects on individuals and households. Journal of Economic Psychology, 16(3), 477-490.

Belk, R.W. (2001). Collecting in a Consumer Society. New York: Routledge.

Formanek, R. (1991). Why they collect: Collectors reveal their motivations. Journal of Social Behavior and Personality, 6(6), 275-286.

Griffiths, M.D. (1995). Technological addictions. Clinical Psychology Forum, 76, 14-19.

Griffiths, M.D. (2006). A case study of binge problem gambling. International Journal of Mental Health and Addiction, 4, 369-376.

Moist, K. (2008). “To renew the Old World”: Record collecting as cultural production. Studies in Popular Culture, 31(1), 99-122.

Pearce, S. (1993). Museums, Objects, and Collections. Washington, D.C.: Smithsonian Institution Press.

Pearce, S. (1998). Contemporary Collecting in Britain. London: Sage.

Sussman, S., Lisha, N. & Griffiths, M.D. (2011). Prevalence of the addictions: A problem of the majority or the minority? Evaluation and the Health Professions, 34, 3-56.

Sussman, S. & Moran, M. (2013). Hidden addiction: Television. Journal of Behavioral Addictions, 2, 125-132.

Common markets: Has gambling advertising increased problem gambling in the UK?

Arguably the most noticeable change in the British gambling landscape since the 2005 Gambling Act came into force on September 1, 2007 is the large increase of gambling advertising on television. Prior to September 2007, the only gambling adverts allowed on television were those for National Lottery products, bingo, and the football pools. Back in January 2012, Liberal Democrat MP Tessa Munt told Parliament that there were almost 36 hours a week of gambling adverts on television. She called for a review of the situation by Ofcom (the independent regulator and competition authority for the UK communications industries). She asked Prime Minister David Cameron to “please protect consumers, children and the vulnerable from this kind of activity [especially] at a time when we are encouraging people to be moderate in their expectations and behaviour”. The PM acknowledged Munt’s plea and described the issue as “a question of responsibility by the companies concerned. Anyone who enjoys watching a football match will see quite aggressive advertisements on the television, and I think companies have to ask themselves whether they are behaving responsibly when they do that”.

The day-to-day responsibility for enforcing rules about advertising content (and its scheduling) rests with the Advertising Standards Authority. However, for radio and television, the 2005 Gambling Act requires Ofcom to set, review, and revise standards for gambling advertisements in these media. In short, Ofcom is the regulating watchdog for all communications and retains overall responsibility for the advertising rules that gaming operators have to adhere to. Earlier this year, Ofcom commissioned some research to examine the volume, scheduling, frequency and exposure of gambling advertising on British television.

In November 2013, Ofcom finally published their findings research and showed that there had been a 600% increase in gambling advertising in the UK in 2012 compared to 2006 (more specifically there were 1.39 million adverts on television in 2012 compared to 152,000 adverts in 2006). In 2005, the number of televised gambling adverts was 90,000 and rose to 234,000 by 2007, and 537,000 in 2008. The research findings were based on analysis of the Broadcasting Audience Research Board (BARB) viewing data by Zinc Research & Analytics that categorized gambling adverts into one of four types (i.e., online casino and poker services; sports betting; bingo; and lotteries and scratch cards).

The bingo sector had the largest proportion of adverts with bingo adverts accounting for 38.3% of all British gambling adverts (approximately 532,000). Online casino and poker adverts comprised 29.6% of all television gambling advertising (approximately 411,000) with lotteries and scratchcards in third place with 25.6% (approximately 355,000), and sports betting in fourth place with 6.6% (approximately 91,000). The report also reported that gambling adverts accounted for 4.1% of all advertising seen by viewers in 2012 (up from 0.5% in 2006; 1.7% in 2008).

As someone who has written two books on adolescent gambling (see ‘Further reading’ below), one of the more worrying statistics reported was that children under 16 years of age were exposed to an average of 211 gambling adverts a year each (compared to adults who saw an average of 630). I am a firm believer that gambling is an adult activity and that gambling adverts should be shown after the 9pm watershed.

In addition to the relaxation of the laws relating to television advertising, another reason for the large increase in the number of adverts is the increase in the number of digital television channels. Over the time period, he total amount of television advertising airtime doubled from 17.4m to 34.2m spots. The report also highlighted that the 1.39m television adverts for gambling produced 30.9bn ‘impacts’ in 2012 (i.e., the number of times a commercial was seen by viewers) – up from 8 billion in 2006.

So is the large increase in gambling advertising having any effect on gambling and problem gambling? Well, the most recent British Gambling Prevalence Survey (BGPS) published in 2011 showed that 73% of the British adult population (aged 16 years and over) participated in some form of gambling in the past year (equating to around 35.5 million adults). The most popular British gambling activity was playing the National Lottery (59%), a slight increase from the previous BGPS in 2007 (57%). There was an increase in betting on events other than horse races or dog races with a bookmaker (6% in 2007, 9% in 2010), buying scratchcards (20% in 2007, 24% in 2010), gambling online on poker, bingo, casino and slot machine style games (3% in 2007, 5% in 2010) and gambling on fixed odds betting terminals (3% in 2007, 4% in 2010), football pools (3% in 2007, 4% in 2010, 9% in 1999). There were some small but significant decreases in the popularity of slot machines (13% in 2010, 14% in 2007) and online betting (4% in 2007, 3% in 2010). For all other gambling activities, there was either no significant change between survey years or estimates varied with no clear pattern.

Men were more likely to gamble than women overall (75% men; 71% women). Among women, past year gambling increased from 65% in 2007 to 71% in 2010. Among men, past year gambling estimates were higher in 2010 than 2007 (75% and 71% respectively). Perhaps the most noteworthy statistic (particularly in relation to the substantial increase in televised gambling advertising) was that the prevalence of problem gambling was higher in 2010 (0.9%) than in 2007 (0.6%) equating to a 50% increase in problem gambling. One of the possible reasons for this statistically significant increase in problem gambling could well have been the increased exposure to gambling adverts on television.

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

Further reading

Banham, M. (2013). Gambling TV ads up nine-fold since laws relaxed. Brand Republic, November 19. Located at:

Griffiths, M.D. (1995). Adolescent Gambling. London: Routledge.

Griffiths, M.D. (2002). Gambling and Gaming Addictions in Adolescence. Leicester: British Psychological Society/Blackwells.

Press Association (2012). Gambling adverts soar. November 19. Located at:

Stradbrooke, S. (2011). UK puts TV gambling ads on notice; Ireland blames gambling for suicides., January 19. Located at:

Sweney, M. (2013). TV gambling ads have risen 600% since law change. The Guardian, November 19. Located at:

Wardle, H., Moody. A., Spence, S., Orford, J., Volberg, R., Jotangia, D., Griffiths, M.D., Hussey, D. and Dobbie, F. (2011).  British Gambling Prevalence Survey 2010. London: The Stationery Office.

Wardle, H., Sproston, K., Orford, J., Erens, B., Griffiths, M.D., Constantine, R. and Pigott, S. (2007). The British Gambling Prevalence Survey 2007. London: The Stationery Office.

Bad hair daze: A beginner’s guide to uncombable hair syndrome

I’m sure some of you reading the title of this blog will be thinking that I have made ‘uncombable hair syndrome’ (UHS) up as a way to describe London Mayor Boris Johnson. But it’s not April Fool’s Day and I’m not joking. UHS occurs as the result of a structural deformity in the hair itself and is very rare. UHS goes by a number of different names including ‘pili trianguli et canaliculi’, ‘spun-glass hair’, and ‘cheveux incoiffables’. The condition was first written about scientifically in the 1970s (although earlier reports of the condition had been reported but was not labelled as UHS).

For instance, a case matching contemporary descriptions of UHS by Dr. A.F. Le Double and Dr. F. Houssay was published in 1912. However, it is generally agreed that the syndrome was first formally identified forty years ago (in 1973), by Dr. Dupré, P. Rochiccioli and Dr. J.L. Bonafé in a French paper that described the condition as ‘cheveux incoiffables’. In the following year, two different English speaking doctors (Dr. J.D. Stroud and Dr. A.H. Mehregan) coined the called it ‘spun-glass hair’ in the published proceedings of the ‘First Human Hair Symposium’. By the 1980s, the condition was re-named UHS.

The syndrome is usually noticeable in childhood. Although most parents notice it in their children during their pre-school years, some parents have noticed it a few months after birth but also as late as 12 years of age. A description of UHS can be found in the Wikipedia entry on the condition:

“The hair is normal in quantity and is usually silvery-blond or straw-colored. It is disorderly, it stands out from the scalp, and cannot be combed flat. The underlying structural anomaly is longitudinal grooving of the hair shaft, which appears triangular in cross section. There usually is no family history, though the characteristic hair shaft anomaly can be demonstrated in asymptomatic family members by scanning electron microscopy. To be noticeable, 50% of hairs must be affected by the structural abnormality. Improvement often occurs in later childhood. An autosomal dominant mode of inheritance has been suggested though an autosomal recessive pattern with varying degrees of penetrance has also been noted. The stiffness of the uncombable hair has been reasoned to be due to the triangular form of the hair shaft in cross section. It has been suggested that the condition may result from premature keratinization of the inner root sheath”.

There are also a number of medically recognized conditions where sufferers have the characteristics of UHS. This includes those with ectodermal dysplasia syndrome (these are heritable conditions in which there are abnormalities of two or more ectodermal structures such as the hair, teeth, nails, sweat glands, cranial-facial structure, digits and other parts of the body), retinal dysplasia/pigmentary dystrophy, juvenile cataracts, digit abnormalities, tooth enamel anomalies, oligodontia, and phalangoepiphyseal dysplasia. Both inherited (autosomal dominant and recessive with variable levels of penetrance) and sporadic forms of UHS (i.e., genetic are unclear) have been identified in the medical literature. Most academic papers note that UHS alone is not associated with neurologic, physical, or mental abnormalities. Most of the academic papers in the medical literature are single case studies. Here are a few typical cases that I have found in various medical journals:

  • Case 1: A 4-year-old boy was noted to have unruly, spangled hair, which could not be combed flat. His mother reported that his hair had always had that texture and that it seemed to grow slowly. A hair pull test demonstrated that hairs could not be easily extracted, and light microscopic examination of the hair revealed pathognomonic characteristics of uncombable hair syndrome, including a triangular cross-sectional shape and canal-like longitudinal depressions” (Pediatric Dermatology, 2007).
  • Case 2: “The case was a 5-year-old girl. Her whole hair became sparse, and it became a condition, which was immediately formed, when it was held, and the decompression was done. One piece was a condition of curly hair. The scanning electron microscope view showed the pit, which was gentle in the length in paralleling the hair shaft with the hair of about the half. The cross section of a part of hair showed triangle or kidney-shape of which the angle was round. Thus she was diagnosed with uncombable hair syndrome” (Rinsho Derma, 2004).
  • Case 3: 
”The patient is a 7 year old Chinese girl who was born vaginally at full term…There was no significant perinatal events and her developmental milestones were normal. She presented with coarse hair since birth, associated with multiple white hairs. There was difficulty with combing. There was no brittleness of hair and no skeletal, nail or skin abnormalities. There was no family history of note…On examination, her hair was coarse, especially over the frontal area of the scalp. There were multiple white hairs interspersed among black hairs. The scalp was normal. The rest of the skin, teeth and skeletal system were normal. Samples of her hair were examined. Under light microscopy the hair shaft appears normal. Under scanning electron microscopy, a longitudinal gutter was seen running the length of the hair shaft. Cross sections of the hair shafts appear triangular or elliptical in shape” (Bulletin For Medical Practitioners, 1995).
  • Cases 4-7: “Four children had short, unmanageable, pale blond hair. They had no associated abnormalities and no family histories of abnormal hair. Light microscopy of the hair was normal in three patients, with piii torti present in the fourth. Electron microscopy of hairs from all four children revealed longitudinal grooves in the hair shaft, diagnostic of uncombable-hair syndrome” (Pediatric Dermatology, 1987).
  • Cases 8-10: “Three children are reported with uncombable hair syndrome, consisting of slow-growing, straw-colored scalp hair that could not be combed flat. The hairs appeared normal on light microscopy but on scanning electron microscopy were triangular in cross section, with canal-like longitudinal depressions. Oral biotin, 0.3 mg three times a day, produced significant improvement after 4 months in one patient, with increased growth rate and with strength and combability of the hair, although the triangular shape remained. The other two patients were unique in having associated ectodermal dysplasia. Their hair slowly improved in appearance and combability over 5 years without biotin therapy” (Journal of the American Academy of Dermatology, 1985).

According to a review by Dr. P. Calderon and colleagues in a 2009 issue of the Journal of the American Academy of Dermatology, less than 100 cases ever have been reported. They also note that there is no definitive treatment, but that most cases improve with the onset of puberty.

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

Further reading

Calderon, P., Otberg, N., & Shapiro, J. (2009). Uncombable Hair Syndrome. Journal of the American Academy of Dermatology, 61, 512-515.

Hicks, J., Metry, D.W., Barrish, J., & Levy, M. (2001). Uncombable hair (cheveux incoiffables, pili trianguli et canaliculi) syndrome: Brief review and role of scanning electron microscopy in diagnosis. Ultrastructural Pathology, 25, 99-103.

Ishii, N., Mori, O., & Hashimoto, T. (2004). Uncombable Hair Syndrome. Rinsho Derma (Tokyo), 46, 540-541.

Jarrell, A.D., Hall, M.A., & Sperling, L.C. (2007). Uncombable hair syndrome. Pediatric Dermatology, 24, 436-438.

Matis, W.L., Baden, H., Green, R., Boiko, S., Lucky, A. W., Homstein, L., Ashraf, M. & Hood, A.F. (1987). Uncombable‐hair Syndrome. Pediatric Dermatology, 4, 215-219.

Por, A. (1995). Uncombable Hair Syndrome. Bulletin For Medical Practitioners. Located at:

Rochiccioli, D.A. Bonafé J.L. (1973). Cheveux incoiffables: anomalie con genitale des cheveux. Bull Soe Fr Dermatol Syph, 80, 111-112.

Rest, E.B., & Fretzin, D.F. (1990). Quantitative assessment of scanning electron microscope defects in uncombable‐hair syndrome. Pediatric Dermatology, 7(2), 93-96.

Shelley, W.B., & Shelley, E.D. (1985). Uncombable hair syndrome: observations on response to biotin and occurrence in siblings with ectodermal dysplasia. Journal of the American Academy of Dermatology, 13(1), 97-102.

Stroud, J.D. & Mehregan, A.H. (1974). Spun glass hair: A clinicopathologic study of an unusual hair defect. In: Brown, A.C. (Ed.) The first human hair Symposium. New York: Medcom Press.

Fake’s progress: A beginner’s guide to Münchausen syndrome

One of the most interesting psychological disorders is Münchausen Syndrome (MS) and is sometimes referred to more colloquially as ‘hospital addiction syndrome’, ‘hospital hopper syndrome’ and ‘thick chart syndrome’. MS is currently classified in the most recent International Classification of Diseases under ‘other disorders of adult personality’. The primary characteristic of people suffering from MS is that they deliberately pretend to be ill in the absence of external incentives (such as criminal prosecution or financial gain). MS has been called a factitious disorder because sufferers feign illness, pretend to have a disease, and/or fake psychological trauma typically to gain attention and/or sympathy from other people. Doctors often nickname such people as ‘frequent flyers’. The name of the syndrome was coined in 1951 by Dr. Richard Asher (in a paper he published in The Lancet about people who fabricated illnesses) and derives from German Karl Friedrich Hieronymus Freiherr von Münchhausen (aka Baron Münchausen), a renowned eighteenth century nobleman, who was reported as telling many fantastical and impossible stories about himself.

A related condition is Münchausen Syndrome by Proxy refers to the abuse of someone else (quite often a child son or daughter), also as a way of seeking attention and/or sympathy for the sufferer. Some members of the medical community believe that this related MS condition should simply be re-named ‘medical abuse’). There are also some specific sub-types of MS. For instance, a 2011 paper in the Journal of Electrocardiology, by Dr. Joseph Vaglio reported a female case of Arrhythmogenic Münchausen Syndrome who intentionally simulated and stimulated irregular cardiac activity to gain medical attention by drinking (and overdosing) on caffeine.

According to Dr. A.J. Giannini and Dr. H.R. Black in the Psychiatric, Psychogenic and Somatopsychic Disorders Handbook, one of the most common signs among MS sufferers is that they may have multiple scars on their abdomen because of repeated exploratory or emergency operations. Other ‘warning signs’ listed on the Web MD website of MS include: (i) dramatic but inconsistent medical history, (ii) predictable relapses following improvement in the condition, (iii) detailed knowledge of hospitals and/or medical terminology, (iv) appearance of new or additional symptoms following negative test results, (v) willingness or eagerness to have medical procedures, (vi) history of seeking treatment at numerous hospitals, clinics, and doctors offices, possibly even in different cities, and (vii) problems with identity and self-esteem.

There has been a debate about whether MS should have been re-classified in the fifth edition of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders. For instance, in a 2008 issue of the journal Psychosomatics, Dr. Lois Krahn and her colleagues argued that MS should be classed as a somatoform disorder because MS sufferers may not be conscious that they are drawing attention to themselves. [According to Wikipedia, a somatoform disorder “is a mental disorder characterized by symptoms that suggest physical illness or injury – symptoms that cannot be explained fully by a general medical condition or by the direct effect of a substance, and are not attributable to another mental disorder”]. More specifically, Krahn and her colleagues noted:

Factitious and somatoform-disorder patients are alike in that they both organize their lives around seeking medical services in spite of having primarily a psychiatric condition. In DSM–IV, the key difference is that factitious-disorder patients feign illness, and somatoform disorder patients actually believe they are ill. Although patients may not be conscious of their motivation or even their behaviors, deliberately embellishing history or inducing symptoms exemplifies behaviors designed to enhance a self-concept of being ill. For DSM–V, we propose reclassifying factitious disorder as a subtype within the somatoform-spectrum disorders or the proposed physical-symptom disorder, premised on our belief that deliberate deceptions serve primarily to portray to treaters the sense of being ill”.

This appears to be part of the same debate that says MS is distinct from hypochondriasis in that MS patients are said to be aware that they are exaggerating their illness or disease, whereas hypochondriasis sufferers actually believe they have an illness or disease. Another way of looking at it is that MS sufferers want to be a patient whereas those with hypochondriasis don’t. One of the more unusual consequences of MS is that the affected individual will often undergo unnecessary medical procedures, treatments and/or exploratory operations to prolong hospital stay and gain sympathy and attention from those around them including the medical and nursing staff. It is also known that some MS patients have very good medical knowledge and use this as a way of creating and/or producing symptoms of known medical conditions.

Some of the reported risk factors for individuals that develop MS include (i) a history of childhood traumas and (ii) emotional deprivation (e.g., having parents or guardians that were emotionally unavailable due to illness and/or emotional problems while the individual was a child). In relation to treatment and prognosis, the Wikipedia entry on MS asserts:

“Providers need to acknowledge that there is uncertainty in treating suspected Münchausen patients so that real diseases are not under-treated. Then they should take a careful patient history and seek medical records, to look for early deprivation, childhood abuse, or mental illness. If a patient is at risk to himself or herself, inpatient psychiatric hospitalization should be initiated…Therapeutic and medical treatment should center on the underlying psychiatric disorder: a mood disorder, an anxiety disorder, or borderline personality disorder. The patient’s prognosis depends upon the category under which the underlying disorder falls; depression and anxiety, for example, generally respond well to medication and/or cognitive-behavioral therapy, whereas borderline personality disorder, like all personality disorders is presumed to be pervasive and more stable over time, thus offers the worst or best prognosis”.

Unfortunately there are no reliable statistics regarding the number of people who suffer from MS. Research suggests that both males and females are affected in roughly equal numbers and that the mean age of presentation is 36-years old. This is certainly one behaviour that we could do with more empirical research.

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

Further reading

Asher, R. (1951). Munchausen’s syndrome. The Lancet, 1, 339–341.

Bhugra D. (1988). Psychiatric Munchausen’s syndrome. Literature review with case reports. Acta Psychiatrica Scandinavica, 77, 497–503.

Feldman, M.D., Hamilton, J.C & Deemer, H.N. (2001). Factitious Disorder. In K.A. Phillips (Eds.), Somatoform and Factitious Disorders. Washington D.C.: American Psychiatric Association.

Giannini A.J. & HR Black, H.R. (1978). Psychiatric, Psychogenic and Somatopsychic Disorders Handbook (pp.194-195). New Hyde Park, NY. Medical Examination Publishing.

Krahn, L.E., Bostwick, J.M. & Stonnington, C.M. (2008). Looking toward DSM-V: Should factitious disorder become a subtype of somatoform disorder? Psychosomatics, 49, 277–282.

Vaglio, J. C., Schoenhard, J. A., Saavedra, P. J., Williams, S. R., & Raj, S. R. (2011). Arrhythmogenic Munchausen syndrome culminating in caffeine-induced ventricular tachycardia. Journal of Electrocardiology, 44, 229-231.

Wikipedia (2013). Münchausen syndrome. Located at:ünchausen_syndrome

Blown away: A beginner’s guide to inflation fetishes

In previous blogs I have briefly mentioned various forms of inflation fetishes. In my blogs on fat fetishes and alvinophilia (belly fetishism) I noted that some fat admirers encourage their sexual partners to engage in inflation activities (where individuals inflate their abdomen with air or liquid so their abdomen is distended). Belly inflation is part of the wider practice of body inflation, and involves the practice of inflating (or sometimes pretending to inflate) a part of one’s body typically for sexual gratification. For some, this may be connected with sexual arousal from the receiving of enemas (i.e., klismaphilia). According to a Wikipedia entry on fat fetishism:

“Inflation refers to the practice of inflating (typically with air or liquid), until the abdomen is distended, in such a way that it simulates a stuffing or bloating, but without food”.

In my blog on scrotal infusion I described the sexual practice in which fluid (usually saline solution) is injected into the scrotal sac as a way of making it balloon in size (which is why the practice is sometimes referred to as ‘ballooning’). A very similar practice is scrotal inflation in which air (or other gases) are injected into the scrotal sac. As I noted in my previous blog, both scrotal infusion and inflation are potentially dangerous, and individuals engaging in such acts are at risk of scrotal cellulitis, subcutaneous emphysema, Fournier’s gangrene (a type of necrotizing infection or gangrene usually affecting the perineum), and/or air embolism. As far as I am aware, there is no academic or clinical research on the practice although there are a number of websites dedicated to this practice (e.g., Here are a few online accounts I came across:

Extract 1: “Ever since I was pregnant, I constantly fantasized about having that big round belly again. I used to watch pregnant porn and try to push my belly out and rub it but obviously wasn’t the same. I recently came across inflation. I never heard of it before nor thought it was possible, and it turned me on so much. I just tried air inflation with a fish pump for the first time yesterday, and it was such an amazing feeling to have a hard tummy again. I rubbed it up and down it was amazing but it was a bit crampy at times. I loved the pressure, my tight belly…I know I’m going to have to practice at it more…I want to get to a point were my belly looks pregnant with out all the cramping…I haven’t been able to talk about this to any one nor my husband. I think he’d find it extremely weird”.

Extract 2: I have an inflation fetish myself. Every now and then – which is starting to become daily – I usually inflate my stomach with air or water. I occasionally chug [almost] a gallon of milk or water with salt in it – chugging too much water can be poisonous, so always put some salt in it to balance your electrolytes. I find it very arousing to get a rock-hard stomach and I want to continue to make my stomach bloat bigger and rounder, yet maintain my abs. It’s a fun challenge”.

Extract 3: “I have the same fetish. I’m a gay guy, and I prefer belly expansion in particular. I think this fetish is somehow tied to the weight gain fetish that the internet and media has exposed in recent years. I, too, have a weight gain fetish. However, I enjoy helping or watching a partner partake in weight gain, but not myself. Getting back on the subject, though I do enjoy inflating myself. Whether it be through bloating with water, air enemas, or water enemas. Water enemas have become my personal favorite method, plus they’re actually healthy and cleanse your colon. I have noticed a lot of people with similar fetishes though. Everyone has their own niche of what turns them on”.

Obviously I can’t verify the veracity of the claims made by these individuals but assuming they are true and accurate admissions, they demonstrate that inflation fetishes exist and that there appear to be overlaps with other sexual fetishes and sexual paraphilias (such as fat fetishes). However, we know nothing about the incidence, prevalence, and the development of the fetish. In one of the many online fetish lists, one of them on the Thumbpress website (’10 strange fetishes that don’t make sense’) said that one of the inflation fetishes (‘air pumping’) was “quite disturbing…perhaps as disturbing as klismaphilia” and involves pumping air into the anus to the point that it expands the belly. The website’s critique was the practice was “unhealthy, dangerous and ridiculous”. On another fetish list on the Cracked website (‘5 ridiculous [safe for work] fetishes’), the article notes that:

“[Inflation fetish] is kind of like the balloon fetish, but with a fun twist. Instead of blowing air into a party favor, you stick a bicycle pump inside your danger zone and inflate your own body until you feel like you’re going to burst. You get the farts for hours after you do it, and these guys talk about that like it’s a plus. Normal people get a stomachache after swallowing air and trying to burp, so we think it’s pretty easy to see what these guys are going through. Besides having massive online communities dedicated to the practice of filling tummies with air, there are also millions (OK, tens) of YouTube accounts whose sole purpose is to show videos of stomachs growing slightly larger”.

One aspect of air pumping that should never be attempted is vaginal air pumping. On one sexual ‘agony aunt’ website (Go Ask Alice), one man asked whether blowing air into his girlfriend’s vagina could kill her. The response by ‘Alice’ asserted:

Yes, it’s a true but very rare occurrence. When air is blown or forced directly into a vagina – without allowing any air to escape – an air embolism (the abnormal presence of air in the cardiovascular system) could form, which can be fatal. Women who are more at risk for this unlikely possibility are those whose pelvic vessels are enlarged (meaning, increased blood supply to the vagina) due to a condition such as trauma and possibly pregnancy. So, if a very large amount of air were to be blown or forced into their vaginal canals, it’s possible that the air could enter their bloodstream, causing a blockage in a blood vessel. As a result, some of these women, perhaps including the pregnant women’s fetus, may experience complications. In extraordinary cases, some of these women (and the fetus) may die if the embolism travels to the heart or lungs”.

The lack of empirical research into inflation fetishes is either because they (i) are viewed by the academic and clinical communities as a trivial research topic, or (ii) have not (as yet) caused any problems among its adherents. If papers do end up being published it may be as a result of when things go horribly wrong (i.e., someone dying).

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.

Cipriano, A. (2009). 5 ridiculous (safe for work) fetishes. Cracked, March 17. Located at:

Encyclopedia Dramatica (2012). Fat furry. Located at:

Thumbpress (2011). 10 strange fetishes that don’t make sense. April 20. Located at:’t-make-sense/

Wikipedia (2012). Body inflation. Located at:

Wikipedia (2012). Fat fetishism. Located at:

Time out: Are voluntary self-exclusion services about responsible gambling or problem gambling?

Responsible gambling practices have now become the norm within the gaming industry. One of the first types of responsible gambling practice introduced by gaming companies was the introduction of self-exclusion schemes for problem gamblers, particularly in offline casinos. More recently, online gaming companies have begun to introduce self-exclusion schemes. This blog briefly examines the question of whether such schemes should be underpinned by concerns around problem gambling or whether they should be about responsible gambling more generally. This is a particularly important issue for accreditation agencies who typically recommend to online gaming companies very specific periods that online gamblers should be excluded for.

Self-exclusion initiatives are now very common and although these contracts have some value in containing the harms to established problem gamblers, they could certainly be a lot more effective. There is little research demonstrating whether they stop gambling in either the short-term or long-term as exclusion from one or more venues still leaves opportunities to gamble elsewhere. However, a small proportion of problem gamblers appreciate the opportunity to self-exclude and this is clearly a valuable service for them.

In a 2007 report by Dr. Robert Williams and his Canadian colleagues, they noted that the effectiveness of offline self-exclusion programs can be measured in three ways. These are the: (i) utilization rate, (ii) percentage of self-excluders who successfully refrain from entering the gaming venue during the self-exclusion period, and (iii) impact self-exclusion has on overall gambling behaviour. Utilization rates are typically very low across most jurisdictions (0.5% to 7%) although countries with a proactive self-exclusion program (e.g., Holland) are typically much higher.

There has been only a limited amount of research examining how many self-excluders refrain from gambling at a venue where they have excluded themselves. According to researchers like Dr. Robert Ladouceur, typical rates suggest around 20-25% of self-excluders attempt to re-gain access to the gambling venue they excluded themselves from, although higher compliance rates have been reported in Holland. There have been very few empirical reports of whether self-excluders curtail their gambling behaviour. Some studies report that when gamblers have self-excluded from one venue, they simply go and gamble elsewhere.

The most positive evaluation was a 2007 Canadian study published in the Journal of Gambling Studies led by Dr. Ladouceur and colleagues who examined 161 self-excluders. A year later, researchers from the same university (including Dr. Ladouceur) also reported in the Journal of Gambling Studies some success with an ‘improved’ self-exclusion program but the number of self-excluders in the data set (n=39) was very small. After two-year follow-up, most had significant reductions in urge to gamble, the intensity of negative consequences, and pathological gambling scores using the criteria of the American psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders. Research examining offline self-exclusion has almost exclusively viewed self-exclusion schemes as being about protecting problem gamblers. However, this is not the necessarily the case with online gambling.

Compared to offline self-exclusion, there has been even less research on online self-exclusion schemes. Here, most of the research has examined what online gamblers actually think about self-exclusion schemes and/or their use of them. The Global Online Gambler Survey (led by Dr. Jonathan Parke and published by my International Gaming Research Unit, 2007) collected data from 10,865 online gamblers. The survey specifically asked about the use of online social responsibility tools. Although no single feature stood out as critically important, 58% stated that they considered self-exclusion as ‘quite useful’ (with 23% saying it was ‘very’ or ‘extremely’ useful).

In a 2009 survey of 2,348 online gamblers published in the journal CyberPsychology and Behavior that I and my colleagues carried out (all clientele of the Swedish gaming operator Svenska Spel) examining online social responsibility tools via the PlayScan behavioural tracking system, we reported that a quarter of our sample used PlayScan. Over one-third of respondents (42%) reported the self-exclusion features to be ‘quite useful’ or ‘very useful’. Just under one in five PlayScan users (17%) had actually used one of the self-exclusion features. In a 2010 study of online gamblers published in the International Journal of Mental Health and Addiction, Dr. Tobias Hayer and Gerhard Meyer carried out a follow-up survey one year after the initiation of self-exclusion with a small sub-sample (n=20). They reported that the restriction of access to a single online gambling site had favourable psychosocial effects.

Despite the limited empirical evidence showing whether self-exclusion schemes are effective, gamblers (particularly those online) appear to appreciate short-term self-exclusion facilities even if they do not have a problem with gambling. For instance, in the 2009 study we carried out, online gamblers reported that the most useful self-exclusion feature was the 7-day self-exclusion rated as ‘quite/very useful’ by just under half of respondents (46%). This was followed by 1-month self-exclusion (24%), 24-hour self-exclusion (24%), and permanent self-exclusion (16%). These types of self-exclusion are likely to be associated with non-problem gamblers who may want to restrict their gambling behaviour to a very specific instance.

Given the (presumed) unproblematic nature of internet gambling among respondents, it was unsurprising that only 16% thought permanent self-exclusion would be useful to them personally. If anything, this might appear to be a slightly higher figure than might have been predicted as it could be argued that non-problem gamblers would be unlikely to make use of a permanent self-exclusion.

As noted above, the seven-day exclusion period was the most useful with almost a half of participants endorsing this as their most favoured. This may have been especially useful for those who do not want to gamble for a particular period such as the week before a monthly ‘pay day’. One-month and one-day self-exclusion periods were most popular for around half the participants (approximately 25% each). These types of self-exclusion are more likely to be associated with non-problem gamblers who may want to restrict their gambling behaviour to a very specific instance such as preceding a night of heavy drinking (e.g., 24-hour self-exclusion) or a particular time of the year like the run up to Christmas (e.g., one-month self-exclusion).

Overall, these results suggest that self-exclusion is not a tool for problem gamblers but more generally a tool for responsible gambling This is particularly important point to bear in mind for those agencies that currently accredit online gaming companies in relation to socially responsible practices and procedures. For instance, GamCare will not accredit online gaming companies unless there is a minimum 6-month online exclusion facility. The empirical evidence outlined above clearly shows that short-term self-exclusion options of less than six months are beneficial to online gamblers. Therefore, accreditation agencies need to base their recommendations about self-exclusion on empirical evidence and what is most useful to online gamblers.

Any online gaming company should allow gamblers the opportunity to self-exclude themselves from their gambling site for any period whether it is one day, one week, one month or one year. Compared to offline schemes, online self-exclusion is relatively easy to introduce, and should run for the period requested by the gambler and not an arbitrary limit set by an accreditation agency.

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

Further reading

Griffiths, M.D. (2012). Self-exclusion services for online gamblers: Are they about responsible gambling or problem gambling? World Online Gambling Law Report, 11(6), 9-10.

Griffiths, M.D., Wood, R.T.A. & Parke, J. (2009). Social responsibility tools in online gambling: A survey of attitudes and behaviour among Internet gamblers. CyberPsychology and Behavior, 12, 413-421.

Hayer, T. & Meyer, G. (2010). Internet self-exclusion: Characteristics of self-excluded gamblers and preliminary evidence for its effectiveness. International Journal of Mental Health and Addiction, 9, 296-307

International Gaming Research Unit (2007). The global online gambling report: An exploratory investigation into the attitudes and behaviours of internet casino and poker players. Report for eCOGRA (e-Commerce and Online Gaming Regulation and Assurance).

Ladouceur, R., Jacques, C., Girous, I., Ferland, F., & LeBlond, J. (2000). Analysis of a casino’s self-exclusion program. Journal of Gambling Studies, 16, 453-460.

Ladouceur, R., Sylvain, C., Gosselin, P. (2007). Self-exclusion program: A longitudinal evaluation study. Journal of Gambling Studies, 23, 85-94.

O’Neil, M., Whetton, S., Doman, B., Herbert, M., Giannopolous, V., OíNeil, D., & Wordley, J. (2003). Part A – Evaluation of self-exclusion programs in Victoria and Part B – Summary of self-exclusion programs in Australian States and Territories. Melbourne: Gambling Research Panel.

Steinberg, M., & Velardo, W. (2002). Preliminary evaluation of a casino self-exclusion program. Paper presented at the Responsible Gambling Council of Ontarioís Discovery 2002 Conference, April 2002, Niagara Falls, Canada.

Tremblay, N., Boutin C. & Ladouceur, R. (2008). Improved self-exclusion program: Preliminary results. Journal of Gambling Studies, 24, 505–518

Williams, R.J., Simpson, R.I. and West, B.L. (2007). Prevention of problem gambling. In G. Smith, D. Hodgins & R. Williams (Eds.), Research and Measurement Issues in Gambling Studies. pp.399-435. New York: Elsevier.

No time for the crime: Excessive adolescent video game playing, social networking and crime reduction

On Sunday February 9, 1964, The Beatles made their debut on US television. Their appearance on the Ed Sullivan Show drew an estimated audience of 73 million people. One of the most quoted consequences associated with this particular show was that between 8pm and 9pm when the show was aired, a number of news reports claimed that there was no reported incidence of juvenile crime across America during the time of the broadcast.  The editor of Newsweek, B.F. Henry, went as far as to claim that “there wasn’t so much as a hubcap stolen” during the hour that The Beatles were on the show.

This apocryphal tale, at the very least, shows the apparent compelling logic in the argument that when an activity is so engrossing it has the capacity to stop people engaging in other types of activity such as crime. Inspired by a speculative blog post on the topic, my friend and research colleague Dr. Mike Sutton failed to disconfirm what Dr. Sutton and I have called the Crime Substitution Hypothesis. We recently published a small paper in the journal Education and Health that examined the extent to which popular youth activity (namely video gaming and social networking) may be having an effect on youth offending and victimization.

Young people’s use of technology (the so called ‘screenagers’ and ‘digital natives’) has increased greatly over the last two decades and a significant proportion of daily time is spent in front of various screen interfaces most notably videogames, mobile phones (e.g., SMS) and the internet (e.g., social networking sites like Bebo, Facebook). These ‘digital natives’ have never known a world without the internet, mobile phones and interactive television, and are therefore tech-savvy, have no techno-phobia, and very trusting of these new technologies.

One of the most empirically researched areas is in the area of adolescent video gaming. Negative consequences of gaming have included addiction, increased aggression, and a variety of medical consequences, such as repetitive strain injuries, obesity, and photosensitive epilepsy. There is certainly evidence that when taken to excess, videogame playing can in some cases be addictive, especially online videogame playing where the game never pauses or ends, and has the potential to be a 24/7 activity. However, there are many reported benefits that adolescents can get from playing videogames. These can be educational, social and/or therapeutic.

Another positive benefit of playing video games along with activities like social networking may be the capacity to reduce youth crime. The reason why videogames may have implications for crime reduction is their use as ‘distractors’ (such as in the role of pain management). The reasoning is that ‘distractor tasks’ consume some degree of the attentional capacity that would otherwise be devoted to pain perception. I have noted in a number of my academic papers that the main reasons that videogames make good distractors are because they:

  • Are likely to engage much of a person’s individual active attention because of the cognitive and motor activity required.
  • Allow the possibility to achieve sustained achievement because of the level of difficulty (i.e. challenge) of most games during extended play.
  • Appear to appeal most to adolescents

For instance, one study reported the case of an eight-year-old boy with neurodermatitis being given a handheld videogame to prevent him from picking at his face. Where previous treatments had failed, the use of the game kept his hands occupied and within two weeks the affected area had healed. A number of studies have demonstrated that videogames can provide cognitive distraction for children undergoing chemotherapy. All these studies have reported that distracted child patients report less nausea after treatment (when compared with control groups), and that playing videogames reduced the amount of painkillers the children needed during treatment. The very reasons why video games may be of benefit therapeutically may also be applied to video games in a crime reduction context (i.e., the playing of video games is so cognitively distracting that that there is little time to do or think about anything else).

Consequently, there is a developing school of thought arguing that peoples’ participation (especially excessive use) in video gaming and social networking may be contributory factors that may partly explain the fall in crime rates in recent years. For instance, the economist Larry Katz was quoted in a 2010 issue of The Economist suggesting that the playing of video games may be playing a role in crime reduction. Katz’ reasoning is simple – keeping people busy keeps them out of trouble. There appears to be some statistical support for such a hypothesis as the decrease in US crime rates appears to show an inverse correlational relationship with increased sales of video game consoles and video games. Clearly this correlational evidence should be treated with caution as it says nothing about causation. However, it does provide a hypothesis that could be the subject of future empirical testing.

Could the rise in video game playing and social networking be a major cause of what criminologists claim is an unfathomable drop in crime, and if not, then why not? Routine Activity Theory predicts that if a substantial numbers of young people are not on the streets either as victims or offenders then overall high volume ‘crime opportunities’ would diminish, resulting in an overall drop in high volume crime rates. We have no idea yet whether what we might call the ‘crime substitution hypothesis’ is plausible. Therefore, in our recent paper, Dr. Sutton and I set out some ideas that support it as something possibly worthy of further exploration.

As highlighted above, research suggests some young people are spending many hours playing video games or social networking. Research also suggests that video games can be engrossing, addictive and in some cases compulsive. Additionally, research has failed to establish that violent media is either a necessary or sufficient condition for causing crime. Therefore, taking a Routine Activity Approach, it would seem that an increase in video gaming might feasibly lead to a rise in the illicit market for stolen computers and games consoles. However, there might be fewer thieves to supply it if:

  • Fewer potential offenders are getting addicted to opiates and other drugs, and/or misusing alcohol out of boredom because they have escaped boredom in the real world by entering the more exciting world of cyberspace to play and interact with others.
  • Potential offenders and victims are gaming excessively and/or compulsively checking Facebook and/or other social networking sites.
  • The game players and other ‘netizens’ are playing at home so (a) fewer potential offenders on the streets and fewer potential victims, and (b) houses are occupied for longer and so less susceptible to burglary.
  • Immersion and gaming prowess and reputation may be sufficient substitutes for the same things in the offline (real) world
  • The Internet allows more people to work from home so teleworking may reduce the pool of “available” victims on the street and also ensure fewer homes are empty during the day.

The evidence provided for the ‘crime substitution hypothesis’ in our paper was anecdotal and/or correlational in nature but we would argue that this would provide a fruitful avenue for further research. Such research into ‘crime substitution’ and gaming/social networking might involve: (i) measuring time spent gaming and social networking by groups that empirical research predicts are at greater risk of becoming offenders, (ii) conducting ethnographic studies with young people to gauge whether, and if so to what extent, gaming and social networking are used as a substitute for risky activities in the offline (real) world, and do this in relation to both potential offending and victimization, (iii) examining issues of offline and online peer status and how this may impact on consequent behaviour (including criminal activity), and (iv) further examining the correlation between console and game sales – and any data on playing time and type of games – with the general crime trend over the past 20 years.

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

Further reading

Cole, H. & Griffiths, M.D. (2007). Social interactions in Massively Multiplayer Online Role-Playing gamers. CyberPsychology and Behavior, 10, 575-583.

De Freitas, S. & Griffiths, M.D. (2008). The convergence of gaming practices with other media forms: what potential for learning? A review of the literature. Learning, Media and Technology, 33, 11-20.

Griffiths, M.D. (2005). Video games and health. British Medical Journal, 331, 122-123.

Griffiths, M.D. (2005b). The therapeutic value of videogames. In Goldstein J. & Raessens J. (eds.) Handbook of Computer Game Studies (pp. 161-171). Boston: MIT Press.

Griffiths, M.D. (2008). Internet and video-game addiction. In C. Essau (Ed.), Adolescent Addiction: Epidemiology, Assessment and Treatment (pp.231-267).  San Diego: Elselvier.

Griffiths, M.D. (2010). Trends in technological advance: Implications for sedentary behaviour and obesity in screenagers. Education and Health, 28, 35-38.

Griffiths, M.D. & Kuss, D. (2011). Adolescent social networking: Should parents and teachers be worried? Education and Health, 29, 23-25.

Griffiths, M.D. & Sutton, M. (2013). Proposing the Crime Substitution Hypothesis: Exploring the possible causal relationship between excessive adolescent video game playing, social networking and crime reduction. Education and Health, 31, 17-21.

Kuss, D.J. & Griffiths, M.D. (2011). Online social networking and addiction: A literature review of empirical research. International Journal of Environmental and Public Health, 8, 3528-3552.

Kuss, D.J. & Griffiths, M.D. (2011). Excessive online social networking: Can adolescents become addicted to Facebook? Education and Health, 29. 63-66.

Kuss, D.J. & Griffiths, M.D. (2012). Online gaming addiction in adolescence: A literature review of empirical research. Journal of Behavioral Addictions, 1, 3-22.

Sutton, M (2010) Routine Activities Theory, the Internet and the 15-Year crime drop. Criminology: The Blog of Mike Sutton. Best Thinking:,9634