The prose and cons: A brief look at ‘poetry addiction’

Back in May 2014, I gave a whole afternoon of talks on behavioural addictions (including gambling and gaming addiction) at Castle Craig, an inpatient addiction treatment centre in Scotland. One of the most interesting people I met there was the psychotherapist Christopher Burn who on the back of his latest book Poetry Changes Lives describes himself as “a history addict, grandfather, recovering alcoholic, and poetry fanatic”. Maybe I’ll write a blog on what it is to be a “history addict” in a future blog, but this article will briefly look at an article just published by Burn on ‘poetry addiction’.

Anyone that knows me will tell you that writing is an important activity in my life. Many of my friends and colleagues describe me as a ‘writaholic’ and that I am addicted to writing because of the number of articles that I have published. Regular readers of my blog will also know that I have written articles on obsessional writing (graphomania), obsessional erotic writing (erotographomania), diary writing, excessive blog writing, and excessive (productive) writing.

Although I wouldn’t describe myself as a ‘poetry fanatic’ I do love writing poetry myself and have had a number of my poems published. In fact, in 1997, I won a national Poetry Today competition for the best (20 lines and under) poem for An Alliteration of Life. Burn’s article on ‘addiction to the act of writing poetry (like his latest book) is an interesting read. Burn has even coined a new term for addiction to poetry – ‘poesegraphilia’. Burn notes that the Irish dramatist George Farquar said that poetry was a “mere drug” and that:

“Many poets, great and not so great, have suffered from addiction to mood altering substances – Coleridge, Rimbaud and Dylan Thomas (‘the Rimbaud of Cwmdonkin Drive’) spring to mind. Many great poems have been written about addiction too. It seems however that very little attention has been given to the addictive power generated by the act of writing poetry itself. One thing is for sure – poetry has a power to alter our mood – not normally in the pernicious or directly physical manner of say, a line of cocaine, but in a pervasive and generally enjoyable way that can usually only be helpful. This mood changing effect can come from either reading or writing poetry but of the two, it is poetry writing that is the most dramatic”.

As an amateur poet myself, I know only too well the emotional power of words and that words can have a mood altering effect (both positive and negative). There is even ‘poetry therapy’ and (in the USA) a National Association for Poetry Therapy and an Institute for Poetic Medicine that advocates the “intentional use of poetry and other forms of literature for healing and personal growth”. (For a concise overview of ‘poetry therapy’ check out this article on the GoodTherapy website). Burn says that “writing poetry may not affect a person’s life with the degree of powerlessness and unmanageability that say, alcohol does, but it can still have a very marked influence”. He then includes part of an interview transcript from BBC Radio 4’s Desert Island Discs programme with Les Murray, an Australian poet:

“It’s wonderful, there’s nothing else like it, you write in a trance. And the trance is completely addictive, you love it, you want more of it. Once you’ve written the poem and had the trance, polished it and so on, you can go back to the poem and have a trace of that trance, have the shadow of it, but you can’t have it fully again. It seemed to be a knack I discovered as I went along. It’s an integration of the body-mind and the dreaming-mind and the daylight-conscious-mind. All three are firing at once, they’re all in concert. You can be sitting there but inwardly dancing, and the breath and the weight and everything else are involved, you’re fully alive. It takes a while to get into it. You have to have some key, like say a phrase or a few phrases or a subject matter or maybe even a tune to get you started going towards it, and it starts to accumulate. Sometimes it starts without your knowing that you’re getting there, and it builds in your mind like a pressure. I once described it as being like a painless headache, and you know there’s a poem in there, but you have to wait until the words form”.

I’ve always argued that anything can be addictive if it is something that can constantly reinforce and reward behaviour. Theoretically, there is no reason why writing poetry could not be mood modifying and potentially addictive. As Burn observes:

“Many poets talk about the dream-like trance that envelops them during the act of creating poetry and how this can last sometimes for days. This is not a simple cathartic event, which can happen too, but a state that affects mind, body and spirit. Here is poet and author Robert Graves on the subject: ‘No poem is worth anything unless it starts from a poetic trance, out of which you can be wakened by interruption as from a dream. In fact, it is the same thing’. All this trance-like sensation sounds to me a bit like the effect that certain mood altering substances can have, and we know how addictive they can be”.

Burn then goes on to question whether the act of writing poetry can be clinically classed as an addiction. To do this, he uses criteria from the Diagnostic and Statistical Manual of Mental Disorders [DSM] and argues that the act of writing poetry could potentially meet some of the criteria for addiction including: (i) persisting with the habit to the detriment of other activities and relationships, (ii) increased tolerance, (iii) unsuccessful attempts to stop, (iv) increase in time spent on the activity, and (v) persisting with the habit despite knowledge of negative consequences. Based on this he then goes on to argue:

“It seems to me that there is enough anecdotal evidence to indicate that for some people, poetry, in particular the act of writing poetry, is a powerful and addictive behaviour that meets at least a few of these [DSM] criteria…Problem gamblers often talk of the trance-like state they get into when for example, playing slot machines; reality and awareness of the world around them disappears and everything is focused on them to and the moment. As in poetry writing. British poet JLS Carter describes poetic creation as ‘An addiction – you can go for days thinking of nothing else, in a kind of trance where all other thoughts and considerations are sidelined. That way madness lies’. By its very nature, poetry puts a special power into words that affects us in a way that most conversation or written narrative does not. Poetry gets under our skin, alters our moods and stays in our head in a special way”.

Much of Burn’s admittedly anecdotal argument that poetry can be addictive all comes down to how addiction is defined in the first place and also takes the implicit view that some activities can be what Dr. Bill Glasser would call ‘positive addictions’ in that there are some behaviours that can have positive as well as negative consequences. However, for me, there is also the question of whether positive addictions are “addictions” at all. Have a quick look at Glasser’s criteria for positive addictions below. For an activity to be classed as a positive addiction, Glasser says the behaviour must be:

• Non-competitive and needing about an hour a day
• Easy, so no mental effort is required
• Easy to be done alone, not dependent on people
• Believed to be having some value (physical, mental, spiritual)
• Believed that if persisted in, some improvement will result
• Involve no self-criticism.

Most of these could apply to ‘poetry addiction’ but to me, these criteria have little resemblance to the core criteria or components of addictions (such as salience, withdrawal, tolerance, mood modification, conflict, relapse, etc.). My own view is that ‘positive addiction’ is an oxymoron and although I am the first to admit that some potential addictions might have benefits that are more than just short-term (as in the case of addictions to work or exercise), addictions will always be negative for the individual in the long run. Although no-one is ever likely to seek treatment for an addiction to writing poetry, it doesn’t mean that we can’t use activities like writing poetry to help us define and refine how we conceptualize behavioural addictions.

Dr. Mark Griffiths, Professor of Behavioural Addiction, International Gaming Research Unit, Nottingham Trent University, Nottingham, UK

Further reading

Burn, C. (2015). Poetry Changes Lives. Biggar: DHH Publishing.

Burn, C. (2016). Poesegraphilia – Addiction to the act of writing poetry. Poetry Changes Lives, May 27. Located at: http://www.poetrychangeslives.com/addiction-to-the-act-of-writing-poetry/

Glasser, W. (1976), Positive Addictions, Harper & Row, New York, NY.

GoodTherapy.Org (2016). Poetry therapy. Located at: http://www.goodtherapy.org/learn-about-therapy/types/poetry-therapy

Griffiths, M.D. (1996). Behavioural addictions: An issue for everybody? Journal of Workplace Learning, 8(3), 19-25.

Griffiths, M.D. (2005). A ‘components’ model of addiction within a biopsychosocial framework. Journal of Substance Use, 10, 191-197.

Griffiths, M.D. (2011). Behavioural addiction: The case for a biopsychosocial approach. Trangressive Culture, 1, 7-28.

Klein. P. (2006). The therapeutic benefit of poetry. The Therapist. Located at: http://phyllisklein.com/writing-for-healing/the-therapeutic-benefit-of-poetry/

Larkin, M., Wood, R.T.A. & Griffiths, M.D. (2006). Towards addiction as relationship. Addiction Research and Theory, 14, 207-215.

Watch this space: Another look at box-set bingeing

Regular readers of my blog will know that I have both a professional and personal interest in ‘box set binging’ – people like myself who sit and watch a whole television series at once either on DVD or on television catch-up services (see my two previous articles on the topic here and here). In my previous blogs on the topic I noted there was a lack of published academic research on the topic. However, a new study on the phenomenon – ‘Just one more episode’: Frequency and theoretical correlates of television binge watching’ – has just been published by Emily Walton-Pattison and her colleagues in the Journal of Health Psychology. The paper argues that binge watching may have detrimental health implications and that binge watching has impulsive aspects. As the authors noted in their paper:

“With the emergence of online streaming television services, watching television has never been so easy and a new behavioural phenomenon has arisen: television binge watching, that is, viewing multiple episodes of the same television show in the same sitting. Watching television is the most widespread leisure-time sedentary activity in adults (Wijndaele et al., 2010), involving little metabolic activity (Hu et al., 2003). In the United Kingdom, over one-third of adults spend at least four hours a day watching television (Stamatakis et al., 2009). Up to 33% of men and 45% of women in the United Kingdom fail to achieve recommended physical activity levels (Craig and Mindell, 2014). As lack of physical activity is the fourth leading mortality risk factor (World Health Organization, 2010), identifying factors that pre- vent achieving health-protective levels of physical activity remains important Furthermore, sedentary behaviour is linked with adverse health outcomes independently of physical activity (Veerman et al., 2012). Time spent watching television is also linked with obesity and reduced sleep time (Vioque et al., 2000). Understanding the factors that lead to watching television at ‘binge’ levels may help to target interventions to reduce sedentary activity and obesity rates and improve sleep hygiene”.

The study involved 86 people who completed an online survey that assessed (among other things) outcome expectations (assessed via six attitudinal items such as ‘Watching more than two episodes of the same TV show in the same sitting over the next 7 days will lead me to be physically healthier’), proximal goals (assessed via one question ‘On how many days do you intend to watch more than two episodes of the same TV show in the same sitting over the next 7 days?’), self-efficacy (assessed via five attitudinal items such as ‘I am confident that I can stop myself from watching more than two episodes of the same TV show if I wanted to’), anticipated regret (assessed via two items – ‘If I watched more than two episodes of the same TV show in the same sitting in the next 7 days, I would feel regret’ and ‘If I watched more than two episodes of the same TV show in the same sitting in the next 7 days I would later wish I had not’), goal conflict (with two items such as ‘How often does it happen that because of watching more than two episodes of the same TV show in the same sitting, you do not invest as much time in other pursuits as you would like to?’), goal facilitation (assessed via three items such as ‘Watching more than two episodes of the same TV show in the same sitting in the next 7 days will help/facilitate my participation in regular physical activity’), and self-reported binge watching over the last week (defined as “watching more than two episodes of the same TV show in one sitting”), as well as noting various demographic details (age, gender, marital status, number of children, and body mass index).

The study found that their participants reported binge watching at least once a week (an average of 1.42 days/week) and that binge watching was predicted most by intention and outcome expectations. Automaticity, anticipated regret, and goal conflict also contributed to binge watching. Based on their results, the authors noted:

“The findings have implications for theory development and intervention…The role of automaticity suggests that interventions aiming to address problematic binge watching (e.g. due to increased sedentary activity) could consider techniques that address automaticity. For example, some online streaming services include in-built interruptions after a number of consecutive episodes have been viewed. There would be opportunities to harness these interruptions. Goal conflict findings indicated that participants who reported more binge watching also reported that binge watching undermined other goal pursuits. Linking such findings to an intervention addressing anticipated regret could provide a useful opportunity…Drawing upon the addiction literature in relation to other types of binge behaviours may further refine potential appetitive and loss of control features that may extend from addictive behaviours with a binge potential, such as eating, sex and drugs, to binge watching”.

Obviously the study relied on self-reports among a small sample of television viewers but given that this is the first-ever academic study of binge watching, it provides a basis for further research to be carried out. As in my own research into gambling where we have begun to use tracking data provided by gambling companies, the authors also note that such objective measures could also be used in the field of researching into television binge watching:

“[Future research] could include using objective measures of binge watching including ecological momentary assessment, ambient sound detection, recording and/or partnering with streaming firms or software-based monitoring. Further insight into binge watching could make a distinction between television show-specific factors, such as genre, length, real-time versus on-demand services, as well as contextual factors (e.g., where binge watching occurred, with whom and when) and assess the association between binge watching and health outcomes including physical activity, eating and sleep hygiene”.

This is one of the first times I can end one of my articles by saying that this is literally a case of “watch this space”!

Dr Mark Griffiths, Professor of Behavioural Addictions, International Gaming Research Unit, Nottingham Trent University, Nottingham, UK

Further reading

Bates, D. (2015). Watching TV box-set marathons is warning sign you’re lonely and depressed – and will also make you fat. Daily Mail, January 29. Located at: http://www.dailymail.co.uk/health/article-2931572/Love-marathon-TV-session-warning-sign-lonely-depressed.html

Craig, R. & Mindell, J. (2014). Health Survey for England 2013. London: The Health & Social Care Information Centre.

Daily Edge (2014). 11 signs of you’re suffering from a binge-watching problem. Located at: http://www.dailyedge.ie/binge-watching-problem-signs-1391910-Apr2014/

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

Hu, F.B., Li, T.Y., Colditz, G.A., et al. (2003) Television watching and other sedentary behaviors in rela- tion to risk of obesity and type 2 diabetes mellitus in women. JAMA, 289, 1785–1791.

Kompare, D. (2006). Publishing flow DVD Box Sets and the reconception of television. Television & New Media, 7(4), 335-360.

Spangler, T. (2013). Poll of online TV watchers finds 61% watch 2-3 episodes in one sitting at least every few weeks. Variety, December 13. Located at: http://variety.com/2013/digital/news/netflix-survey-binge-watching-is-not-weird-or-unusual-1200952292/

Stamatakis, E., Hillsdon, M., Mishra, G., et al. (2009) Television viewing and other screen-based entertainment in relation to multiple socioeconomic status indicators and area deprivation: The Scottish Health Survey 2003. Journal of Epidemiology & Community Health, 63, 734–740.

Sussman, S., & Moran, M.B. (2013). Hidden addiction: Television. Journal of Behavioral Addictions, 2(3), 125-132.

Veerman, J.L., Healy, G.N., Cobiac, L.J., et al. (2012) Television viewing time and reduced life expec- tancy: A life table analysis. British Journal of Sports Medicine, 46, 927–930.

Vioque, J., Torres, A. & Quiles, J. (2000) Time spent watching television, sleep duration and obesity in adults living in Valencia, Spain. International Journal of Obesity, 24, 1683–1688.

Walton-Pattison, E., Dombrowski, S.U. & Presseau, J. (2016). ‘Just one more episode’: Frequency and theoretical correlates of television binge watching. Journal of Health Psychology, doi:1359105316643379

Wijndaele, K., Brage, S., Besson, H., et al. (2010) Television viewing time independently predicts all-cause and cardiovascular mortality: The EPIC Norfolk study. International Journal of Epidemiology, 40, 150–159.

Running up debt: A brief overview of our recent papers on exercise and shopping addictions

Following my recent blogs where I outlined some of the papers that my colleagues and I have published on mindfulness, Internet addiction, gaming addiction, youth gambling and other addictive behaviours, here is a round-up of recent papers that my colleagues and I have published on exercise addiction and shopping addictions (i.e., compulsive buying).

Griffiths, M.D., Urbán, R., Demetrovics, Z., Lichtenstein, M.B., de la Vega, R., Kun, B., Ruiz-Barquín, R., Youngman, J. & Szabo, A. (2015). A cross-cultural re-evaluation of the Exercise Addiction Inventory (EAI) in five countries. Sports Medicine Open, 1:5.

• Research into the detrimental effects of excessive exercise has been conceptualized in a number of similar ways, including ‘exercise addiction’, ‘exercise dependence’, ‘obligatory exercising’, ‘exercise abuse’, and ‘compulsive exercise’. Among the most currently used (and psychometrically valid and reliable) instruments is the Exercise Addiction Inventory (EAI). The present study aimed to further explore the psychometric properties of the EAI by combining the datasets of a number of surveys carried out in five different countries (Denmark, Hungary, Spain, UK, and US) that have used the EAI with a total sample size of 6,031 participants. A series of multigroup confirmatory factor analyses (CFAs) were carried out examining configural invariance, metric invariance, and scalar invariance. The CFAs using the combined dataset supported the configural invariance and metric invariance but not scalar invariance. Therefore, EAI factor scores from five countries are not comparable because the use or interpretation of the scale was different in the five nations. However, the covariates of exercise addiction can be studied from a cross-cultural perspective because of the metric invariance of the scale. Gender differences among exercisers in the interpretation of the scale also emerged. The implications of the results are discussed, and it is concluded that the study’s findings will facilitate a more robust and reliable use of the EAI in future research.

Mónok, K., Berczik, K., Urbán, R., Szabó^, A., Griffiths, M.D., Farkas, J., Magi, A., Eisinger, A., Kurimay, T., Kökönyei, G., Kun, B., Paksi, B. & Demetrovics, Z. (2012). Psychometric properties and concurrent validity of two exercise addiction measures: A population wide study in Hungary. Psychology of Sport and Exercise, 13, 739-746.

• Objectives: The existence of exercise addiction has been examined in numerous studies. However, none of the measures developed for exercise addiction assessment have been validated on representative samples. Furthermore, estimates of exercise addiction prevalence in the general population are not available. The objective of the present study was to validate the Exercise Addiction Inventory (EAI; Terry, Szabo, & Griffiths, 2004), and the Exercise Dependence Scale (EDS; Hausenblas & Downs, 2002b), and to estimate the prevalence of exercise addiction in general population. Design: Exercise addiction was assessed within the framework of the National Survey on Addiction Problems in Hungary (NSAPH), a national representative study for the population aged 18–64 years (N = 2710). Method: 474 people in the sample (57% males; mean age 33.2 years) who reported to exercise at least once a week were asked to complete the two questionnaires (EAI, EDS). Results: Confirmatory Factor Analysis (CFA) indicated good fit both in the case of EAI (CFI = 0.971; TLI = 0.952; RMSEA = 0.052) and EDS (CFI = 0.938; TLI = 0.922; RMSEA = 0.049); and confirmed the factor structure of the two scales. The correlation between the two measures was high (r = 0.79). Results showed that 6.2% (EDS) and 10.1% (EAI) of the population were characterized as nondependent-symptomatic exercisers, while the proportion of the at-risk exercisers were 0.3% and 0.5%, respectively. Conclusions: Both EAI and EDS proved to be a reliable assessment tool for exercise addiction, a phenomenon that is present in the 0.3–0.5% of the adult general population.

Szabo, A., Griffiths, M.D., de La Vega Marcos, R., Mervo, B. & Demetrovics, Z. (2015). Methodological and conceptual limitations in exercise addiction research. Yale Journal of Biology and Medicine, 86, 303-308.

• The aim of this brief analytical review is to highlight and disentangle research dilemmas in the field of exercise addiction. Research examining exercise addiction is primarily based on self-reports, obtained by questionnaires (incorporating psychometrically validated instruments), and interviews, which provide a range of risk scores rather than diagnosis. Survey methodology indicates that the prevalence of risk for exercise addiction is approximately 3 percent among the exercising population. Several studies have reported a substantially greater prevalence of risk for exercise addiction in elite athletes compared to those who exercise for leisure. However, elite athletes may assign a different interpretation to the assessment tools than leisure exercisers. The present paper examines the: 1) discrepancies in the classification of exercise addiction; 2) inconsistent reporting of exercise addiction prevalence; and 3) varied interpretation of exercise addiction diagnostic tools. It is concluded that there is the need for consistent terminology, to follow-up results derived from exercise addiction instruments with interviews, and to follow a theory-driven rationale in this area of research.

Andreassen, C.S., Griffiths, M.D., Pallesen, S., Bilder, R.M., Torsheim, T. Aboujaoude, E.N. (2015). The Bergen Shopping Addiction Scale: Reliability and validity of a brief screening test. Frontiers in Psychology, 6:1374. doi: 10.3389/fpsyg.2015.01374.

• Although excessive and compulsive shopping has been increasingly placed within the behavioral addiction paradigm in recent years, items in existing screens arguably do not assess the core criteria and components of addiction. To date, assessment screens for shopping disorders have primarily been rooted within the impulse-control or obsessive-compulsive disorder paradigms. Furthermore, existing screens use the terms ‘shopping,’ ‘buying,’ and ‘spending’ interchangeably, and do not necessarily reflect contemporary shopping habits. Consequently, a new screening tool for assessing shopping addiction was developed. Initially, 28 items, four for each of seven addiction criteria (salience, mood modification, conflict, tolerance, withdrawal, relapse, and problems), were constructed. These items and validated scales (i.e., Compulsive Buying Measurement Scale, Mini-International Personality Item Pool, Hospital Anxiety and Depression Scale, Rosenberg Self-Esteem Scale) were then administered to 23,537 participants (Mage = 35.8 years, SDage = 13.3). The highest loading item from each set of four pooled items reflecting the seven addiction criteria were retained in the final scale, The Bergen Shopping Addiction Scale (BSAS). The factor structure of the BSAS was good (RMSEA=0.064, CFI=0.983, TLI=0.973) and coefficient alpha was 0.87. The scores on the BSAS converged with scores on the Compulsive Buying Measurement Scale (CBMS; 0.80), and were positively correlated with extroversion and neuroticism, and negatively with conscientiousness, agreeableness, and intellect/imagination. The scores of the BSAS were positively associated with anxiety, depression, and low self-esteem and inversely related to age. Females scored higher than males on the BSAS. The BSAS is the first scale to fully embed shopping addiction within an addiction paradigm. A recommended cutoff score for the new scale and future research directions are discussed.

Davenport, K., Houston, J. & Griffiths, M.D. (2012). Excessive eating and compulsive buying behaviours in women: An empirical pilot study examining reward sensitivity, anxiety, impulsivity, self-esteem and social desirability. International Journal of Mental Health and Addiction, 10, 474-489.

• ‘Mall disorders’ such as excessive eating and compulsive buying appear to be increasing, particularly among women. A battery of questionnaires was used in an attempt to determine this association between specific personality traits (i.e., reward sensitivity, impulsivity, cognitive and somatic anxiety, self-esteem, and social desirability) and excessive eating and compulsive buying in 134 women. Reward sensitivity and cognitive anxiety were positively related to excessive eating and compulsive buying, as was impulsivity to compulsive buying. Somatic anxiety and social desirability were negatively related to compulsive buying. These preliminary findings indicate that excessive behaviours are not necessarily interrelated. The behaviours examined in this study appear to act as an outlet for anxiety via the behaviours’ reinforcing properties (e.g., pleasure, attention, praise, etc.). As a consequence, this may boost self-esteem. The findings also appear to indicate a number of risk factors that could be used as ‘warning signs’ that the behaviour may develop into an addiction.

Maraz, A., Eisinger, A., Hende, Urbán, R., Paksi, B., Kun, B., Kökönyei, G., Griffiths, M.D. & Demetrovics, Z. (2015). Measuring compulsive buying behaviour: Psychometric validity of three different scales and prevalence in the general population and in shopping centres. Psychiatry Research, 225, 326–334.

• Due to the problems of measurement and the lack of nationally representative data, the extent of compulsive buying behaviour (CBB) is relatively unknown. The validity of three different instruments was tested: Edwards Compulsive Buying Scale, Questionnaire About Buying Behavior and Richmond Compulsive Buying Scale using two independent samples. One was nationally representative of the Hungarian population (N=2710) while the other comprised shopping mall customers (N=1447). As a result, a new, four-factor solution for the ECBS was developed (Edwards Compulsive Buying Scale Revised (ECBS-R)), and confirmed the other two measures. Additionally, cut-off scores were defined for all measures. Results showed that the prevalence of CBB is 1.85% (with QABB) in the general population but significantly higher in shopping mall customers (8.7% with ECBS-R, 13.3% with QABB and 2.5% with RCBS-R). Conclusively, due to the diversity of content, each measure identifies a somewhat different CBB group.

Maraz, A., Griffiths, M.D., & Demetrovics, Z. (2016). The prevalence of compulsive buying in non-clinical populations: A systematic review and meta-analysis. Addiction, 111, 408-419.

• Aims: To estimate the pooled prevalence of compulsive buying behaviour (CBB) in different populations and to determine the effect of age, gender, location and screening instrument on the reported heterogeneity in estimates of CBB and whether publication bias could be identified. Methods: Three databases were searched (Medline, PsychInfo, Web of Science) using the terms ‘compulsive buying’, ‘pathological buying’ and ‘compulsive shopping’ to estimate the pooled prevalence of CBB in different populations. Forty studies reporting 49 prevalence estimates from 16 countries were located (n = 32 000). To conduct the meta-analysis, data from non-clinical studies regarding mean age and gender proportion, geographical study location and screening instrument used to assess CBB were extracted by multiple independent observers and evaluated using a random-effects model. Four a priori subgroups were analysed using pooled estimation (Cohen’s Q) and covariate testing (moderator and meta-regression analysis). Results: The CBB pooled prevalence of adult representative studies was 4.9% (3.4–6.9%, eight estimates, 10 102 participants), although estimates were higher among university students: 8.3% (5.9–11.5%, 19 estimates, 14 947 participants) in adult non-representative samples: 12.3% (7.6–19.1%, 11 estimates, 3929 participants) and in shopping-specific samples: 16.2% (8.8–27.8%, 11 estimates, 4686 participants). Being young and female were associated with increased tendency, but not location (United States versus non-United States). Meta-regression revealed large heterogeneity within subgroups, due mainly to diverse measures and time-frames (current versus life-time) used to assess CBB. Conclusions: A pooled estimate of compulsive buying behaviour in the populations studied is approximately 5%, but there is large variation between samples accounted for largely by use of different time-frames and measures.

Dr. Mark Griffiths, Professor of Behavioural Addiction, International Gaming Research Unit, Nottingham Trent University, Nottingham, UK

Further reading

Allegre, B., Souville, M., Therme, P. & Griffiths, M.D. (2006). Definitions and measures of exercise dependence, Addiction Research and Theory, 14, 631-646.

Allegre, B., Therme, P. & Griffiths, M.D. (2007). Individual factors and the context of physical activity in exercise dependence: A prospective study of ‘ultra-marathoners’. International Journal of Mental Health and Addiction, 5, 233-243.

Berczik, K., Szabó, A., Griffiths, M.D., Kurimay, T., Kun, B. & Demetrovics, Z. (2012). Exercise addiction: symptoms, diagnosis, epidemiology, and etiology. Substance Use and Misuse, 47, 403-417.

Berczik, K., Griffiths, M.D., Szabó, A., Kurimay, T., Kökönyei, G., Urbán, R. and Demetrovics, Z. (2014). Exercise addiction – the emergence of a new disorder. Australasian Epidemiologist, 21(2), 36-40.

Berczik, K., Griffiths, M.D., Szabó, A., Kurimay, T., Urban, R. & Demetrovics, Z. (2014). Exercise addiction. In K. Rosenberg & L. Feder (Eds.), Behavioral Addictions: Criteria, Evidence and Treatment (pp.317-342). New York: Elsevier.

Griffiths, M.D. (1997). Exercise addiction: A case study. Addiction Research, 5, 161-168.

Griffiths, M.D., Szabo, A. & Terry, A. (2005). The Exercise Addiction Inventory: A quick and easy screening tool for health practitioners. British Journal of Sports Medicine, 39, 30-31.

Kurimay, T., Griffiths, M.D., Berczik, K., & Demetrovics, Z. (2013). Exercise addiction: The dark side of sports and exercise. In Baron, D., Reardon, C. & Baron, S.H., Contemporary Issues in Sports Psychiatry: A Global Perspective (pp.33-43). Chichester: Wiley.

Szabo, A. & Griffiths, M.D. (2007). Exercise addiction in British sport science students. International Journal of Mental Health and Addiction, 5, 25-28.

Terry, A., Szabo, A. & Griffiths, M.D. (2004). The Exercise Addiction Inventory: A new brief screening tool, Addiction Research and Theory, 12, 489-499.

Warner, R. & Griffiths, M.D. (2006). A qualitative thematic analysis of exercise addiction: An exploratory study. International Journal of Mental Health and Addiction, 4, 13-26.

Pressing the right buttons: The positives of playing video games

Whether playing video games has negative effects is something that has been debated for 30 years, in much the same way that rock and roll, television, and even the novel faced much the same criticisms in their time. Purported negative effects such as gaming addiction, increased aggression, and various health consequences such as obesity and repetitive strain injuries tend to get far more media coverage than the positives. I know from my own research examining both sides that my papers on video game addiction receive far more publicity than my research into the social benefits of, for example, playing online role-playing games.

However there is now a wealth of research which shows that video games can be put to educational and therapeutic uses, as well as many studies which reveal how playing video games can improve reaction times and hand-eye co-ordination. For example, research has shown that spatial visualisation ability, such as mentally rotating and manipulating two- and three-dimensional objects, improves with video game playing.

To add to this long line of studies demonstrating the more positive effects of video games is a study in the Proceedings of the National Academy of Sciences by Vikranth Bejjanki and colleagues. Their paper demonstrates that the playing of action video games – the sort of fast-paced, 3D shoot-em-up beloved of doomsayers in the media – confirms what other studies have revealed, that players show improved performance in perception, attention, and cognition.

In a series of experiments on small numbers of gamers (10 to 14 people in each study), the researchers reported that gamers with previous experience of playing such action video games were better at perceptual tasks such as pattern discrimination than gamers with less experience. In another experiment, they trained gamers that had little previous experience of playing action games, giving them 50 hours practice. It was showed that these gamers performed much better on perceptual tasks than they had prior to their training. The paper concludes:

“The enhanced learning of the regularity and structure of environments may act as a core mechanism by which action video game play influences performance in perception, attention, and cognition”.

In my own papers, I have pointed out many features and qualities that make video games potentially useful. For instance, in an educational context, video games can be fun and stimulating, which means it’s easier to maintain a pupil’s undivided attention for longer. Because of the excitement, video games may also be a more appealing way of learning than traditional methods for some.

Video games have an appeal that crosses many demographic boundaries, such as age, gender, ethnicity, or educational attainment. They can be used to help set goals and rehearse working towards them, provide feedback, reinforcement, self-esteem, and maintain a record of behavioural change. Their interactivity can stimulate learning, allowing individuals to experience novelty, curiosity and challenge that stimulates learning. There is the opportunity to develop transferable skills, or practice challenging or extraordinary activities, such as flight simulators, or simulated operations. Because video games can be so engaging, they can also be used therapeutically. For instance, they can be used as a form of physiotherapy as well as in more innovative contexts. A number of studies have shown that when children play video games following chemotherapy they need fewer painkillers than others.

Video games can have great educational potential in addition to their entertainment value. Games specifically designed to address a specific problem or teach a specific skill have been very successful, precisely because they are motivating, engaging, interactive, and provide rewards and reinforcement to improve. But the transferability of skills outside the game-playing context is an important factor. What’s also clear from the scientific literature is that the negative consequences of playing almost always involve people that are excessive video game players. There is little evidence of serious acute adverse effects on health from moderate play.

A version of this article was first published in The Conversation.

Dr. Mark Griffiths, Professor of Behavioural Addiction, International Gaming Research Unit, Nottingham Trent University, Nottingham, UK

Further reading

Bejjanki, V. R., Zhang, R., Li, R., Pouget, A., Green, C. S., Lu, Z. L., & Bavelier, D. (2014). Action video game play facilitates the development of better perceptual templates. Proceedings of the National Academy of Sciences, 111(47), 16961-16966.

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

Griffiths, M.D. (1997). Video games and clinical practice: Issues, uses and treatments. British Journal of Clinical Psychology, 36, 639-641.

Griffiths, M.D. (2002). The educational benefits of videogames Education and Health, 20, 47-51.

Griffiths, M.D. (2003). The therapeutic use of videogames in childhood and adolescence. Clinical Child Psychology and Psychiatry, 8, 547-554.

Griffiths, M.D. (2004). Can videogames be good for your health? Journal of Health Psychology, 9, 339-344.

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

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

Griffiths, M.D. (2010). Adolescent video game playing: Issues for the classroom. Education Today: Quarterly Journal of the College of Teachers, 60(4), 31-34.

Griffiths, M.D., Kuss, D.J., & Ortiz de Gortari, A. (2016). Videogames as therapy: An updated selective review of the medical and psychological literature. International Journal of Privacy and Health Information Management, in press.

Griffiths, M. D., Kuss, D.J., & Ortiz de Gortari, A. (2013). Videogames as therapy: A review of the medical and psychological literature. In I. M. Miranda & M. M. Cruz-Cunha (Eds.), Handbook of research on ICTs for healthcare and social services: Developments and applications (pp.43-68). Pennsylvania: IGI Global.

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.

Griffiths, M.D. & Sutton, M. (2015). Screen time and crime: The ‘Crime Substitution Hypothesis’ revisited. Education and Health, 33, 85-87.

The eat is on: Cannibalism and sexual cannibalism (revisited)

Recently, I was approached by Ben Biggs, the editor of the Real Crime magazine, who was running an article on the practicalities and psychology of cannibalism, with expert commentary running through it (and with me as the “expert”). The article has just been published in the May 2016 issue and I was assured that the feature would “highlight how nasty cannibalism is, not glorify it”. I responded to the questions as part of an email interview and today’s blog contains the unedited responses to the questions that I was asked.

What are the main reasons a human might eat another human being?

There are a number of possible reasons including:

Out of necessity – For instance, in 1972, a rugby team from Uruguay was in a plane crash in the Andes. Fifteen people died and the only way they prevented themselves starving to death was to eat the flesh of the deceased (which given the fact it took 72 days for them to be rescued, was one of the few viable options to prevent starvation).

As a way of controlling population size – The Aztecs were said to have eaten no less than 15,000 victims a year as – some have argued – a form of population control).

As part of a religious belief – There are some religious beliefs involving the need to eat human flesh as a way of sustaining the universe or as part of magical and ritualistic ceremonies.

As part of the grieving process – Some acts of cannibalism are where dead people’s body parts are eaten as either part of the grieving process, as a way of guiding the souls of the dead into the bodies of the living, and/or as a way of imbibing the dead person’s ‘life force’ or more specific individual characteristics.

As part of tribal warfare – Cannibalistic acts were most often carried out as part of a celebration victory after battles with rival tribes.

For sexual gratification – Some individuals have claimed to get sexually aroused from eating (or thinking about eating) the flesh of others. When it comes to sexual cannibalism in humans, there are arguably different subtypes (although this is based on my own personal opinion and not on something I’ve read in a book or research paper). Most of these behaviours I have examined in previous blogs:

• Vorarephilia is a sexual paraphilia in which individuals are sexually aroused by (i) the idea of being eaten, (ii) eating another person, and/or (iii) observing this process for sexual gratification. However, most vorarephiles’ behaviour is fantasy-based, although there have been real cases such as Armin Meiwes, the so-called ‘Rotenburg Cannibal’.
• Erotophonophilia is a sexual paraphilia in which individuals have extreme violent fantasies and typically kill their victims during sex and/or mutilate their victims’ sexual organs (the latter of which is usually post-mortem). In some cases, the erotophonophiles will eat some of their victim’s body parts (usually post-mortem). Many lust murderers – including Jack the Ripper – are suspected of engaging in cannibalistic and/or gynophagic acts, taking away part of the female to eat later. Other examples of murderers who have eaten their victims (or parts of them) for sexual pleasure include Albert Fish, Issei Sagawa, Andrei Chikatilo, Ed Gein, and Jeffrey Dahmer.
• Sexual necrophagy refers to the cannibalizing of a corpse for sexual pleasure. This may be associated with lust murder but Brenda Love in her Encyclopedia of Unusual Sex Practices says that such cases usually involve “one whose death the molester did not cause. Many cases of reported necrophilia include cannibalism or other forms of sadism and it is believed that many others fantasize about doing it”.
• Vampirism as a sexual paraphilia in which an individual derives sexual arousal from the ingestion of blood from a living person.
• Menophilia is a sexual paraphilia in which an individual (almost always male) derives sexual arousal from drinking the blood of menstruating females.
• Gynophagia is a sexual fetish that involves fantasies of cooking and consumption of human females (gynophagia literally means “woman eating”). There is also a sub-type of gynophagia called pathenophagia. This is the practice of eating young girls or virgins. Several lust murderers were known to consume the flesh of young virgins, most notably Albert Fish).
• ‘Sexual autophagy’ refers to the eating of one’s own flesh for sexual pleasure (and would be a sub-type of autosarcophagy).

A recent 2014 paper by Dr. Amy Lykins and Dr. James Cantor in the Archives of Sexual Behavior entitled ‘Vorarephilia: A case study in masochism and erotic consumption’ referred to the work of Dr Friedemann Pfafflin (a forensic psychotherapist at Ulm University, Germany): 

“Pfafflin (2008) commented on the many phrases that exist in the English language to relate sex/love and consumption, including referring to someone as ‘looking good enough to eat’, ’that ‘the way to a man’s heart is through his stomach’, and describing a sexually appealing person as ‘sweet’, ‘juicy’, ‘appetizing’, or ‘tasty’. Christian religions even sanction metaphorical cannibalism through their sacrament rituals, during which participants consume bread or wafers meant to represent the ‘body of Christ’ and wine intended to represent the ‘blood of Christ’ – a show of Jesus’s love of his people and, in turn, their love for him, by sharing in his ‘blood’ and ‘flesh’. This act was intended to ‘merge as one’ the divine and the mortal”.

It’s not unusual for a serial killer to cannibalise parts of their victims. Why is this, and what can cause that behaviour? 

I think it’s a rare behaviour, even among serial killers. As noted above, in these instances the eating (or the thought of eating) others is sexually arousing. It has also been claimed that the sexual cannibal may also release sexual frustration or pent up anger when eating human flesh. Some consider sexual cannibalism to be a form of sexual sadism and is often associated with the act of necrophilia (sex with corpses). Others have claimed that cannibals feel a sense of euphoria and/or intense sexual stimulation when consuming human flesh. All of these online accounts cite the same article by Clara Bruce (‘Chew On This: You’re What’s for Dinner’) that I have been unable to track down (so I can’t vouch for the veracity of the claims made). Bruce’s article claimed that cannibals had compared eating human flesh with having an orgasm, and that flesh eating caused an out-of-body-experience experience with effects comparable to taking the drug mescaline.

In the case of Japanese cannibal Issei Sagawa, he said that he might have been satisfied with consuming some, non-vital part of his victim Renee Hartevelt, such as her pubic hair, but he couldn’t bring himself to ask her for it. Does the murder and the consumption of flesh stem from the same mental disorder, or is murder just a necessary evil? 

I have not seen these claims. I have only read that his desire to eat women was to “absorb their energy”.

Do you think Issei Sagawa would have been satisfied with eating her hair?

Again, I have never read about this. He seems to have claimed that he had cannibalistic desires since his youth and that his murder of women was for this reason and no other.

Serial Killer Jeffrey Dahmer said he liked to eat mens’ biceps, because he was a ‘bicep guy’. Does the body part consumed necessarily bear a direct relation to the part of the victim’s anatomy the cannibal has a sexual preference for?

Not that I am aware of. Most people that are partialists (i.e., derive sexual arousal from particular body parts such has hands, feet, buttocks, etc.) would be unlikely to get aroused if the body part was not attached to something living.

There are rarer cases where, rather than having a fantasy of eating a sexual partner, the ‘victim’ consents to being eaten by the killer. Does this stem from the same psycho-sexual disorder that leads to a cannibal killing?

This is something entirely different and is part of vorarephilia (highlighted earlier). My understanding is that the flesh eating would only occur consensually (as in the case of Armin Meiwes and Bernd Jürgen Brand).

What reason would there be for someone to eat their own body parts? 

The practice is very rare and has only been documented a number of times in the psychological and psychiatric literature (and all are individual case studies). It has sometimes been labeled as a type of pica (on the basis that the person is eating something non-nutritive) although personally I think this is misguided as it could be argued that human flesh may be nutritious (even if most people find the whole concept morally repugnant). However, there are documented cases of autosarcophagy where people have eaten their own skin as an extreme form of body modification. Some authors argue that auto-vampirism (i.e., the practice of people drinking their own blood) should also be classed as a form of autosarcophagy (although again, I think this is stretching the point a little).

The practice has certainly come to the fore in some high profile examples in the fictional literature. Arguably the most infamous example, was in Thomas Harris’ novel Hannibal (and also in the film adaptation directed by Ridley Scott), where Hannibal ‘the Cannibal’ Lecter psychologically manipulates the paedophile Mason Verger into eating his own nose, and then gets Verger to slice off pieces of his own face off and feed them to his dog. In what many people see as an even more gruesome autosarcophagic scene, Lecter manages to feed FBI agent Paul Krendler slices of his own brain. In real life (rather than fiction), autosarcophagy is typically a lot less stomach churning but in extreme examples can still be something that makes people wince.

Depending on the definition of autosarcophagy used, the spectrum of self-cannibalism could potentially range from behaviours such as eating a bit of your own skin right through eating your own limbs. There are many reasons including for art, for the taste, for body modification, for protest (associated to mental illness), because they had taken mind-altering drugs, and for sexual pleasure. Here are four autosarcophagic examples that have been widely reported in the media but are very different in scope and the public’s reaction to them.

• Example 1: Following a liposuction operation in 1996, the Chilean-born artist Marco Evaristti held a dinner party for close friends and served up a pasta dish with meatballs made from beef and the fatty liposuction remains. The meal was claimed by Evaristti to be an artistic statement but was highly criticized as being “disgusting, publicity-seeking and immoral”.
• Example 2: On a February 1998 episode of the Channel 4 British cookery programme TV Dinners, a mother was shown engaging in placentophagy when she cooked her own placenta (with fried garlic and shallots), made into a pate and served on foccacia bread. The programme received a lot of complaints that were upheld by the British Broadcasting Standards Commission who concluded that the act of eating placenta pate on a highly watched TV programme had  “breached convention”.
• Example 3: In 2009, Andre Thomas, a 25-year old murderer on Texas death row (and with a history of mental problems) pulled out his eye in prison and ate it.
• Example 4: The German man Bernd Jürgen Brande who engaged in self-cannibalism (cutting off and then eating his own cooked penis) before being killed and eaten by Armin Meiwes, the ‘Rotenburg Cannibal’ (who also shared in the eating of Brande’s cooked penis).

Dr Friedemann Pfafflin (a forensic psychotherapist at Ulm University, Germany) and who has written about Armin Meiwes, the ‘Rotenburg Cannibal’ asserts that “apart from acts of cannibalism arising from situations of extreme necessity…the cannibalistic deeds of individuals are always an expression of severe psychopathology”.

Dr Mark Griffiths, Professor of Behavioural Addiction, 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.

Ahuja, N. & Lloyd, A.J. (2007). Self-cannibalism: an unusual case of self-mutilation. Australian and New Journal of Psychiatry, 41, 294-5.

Arens, William (1979). The Man-Eating Myth: Anthropology and Anthropophagy. Oxford: Oxford University Press.

Beier, K. (2008). Comment on Pfafflin’s (2008) “Good enough to eat”. Archives of Sexual Behavior, 38, 164-165.

Beneke M. (1999). First report of nonpsychotic self-cannibalism (autophagy), tongue splitting, and scar patterns (scarification) as an extreme form of cultural body modification in a western civilization. American Journal of Forensic Medicine and Pathology, 20, 281-285.

Benezech, M., Bourgeois, M., Boukhabza, D. & Yesavage, J. (1981). Cannibalism and vampirism in paranoid schizophrenia. Journal of Clinical Psychiatry, 42(7), 290.

Beier, K. (2008). Comment on Pfafflin’s (2008) “Good enough to eat”. Archives of Sexual Behavior, 38, 164-165.

Betts, W.C. (1964). Autocannibalism: an additional observation. American Journal of Psychiatry 121, 402-403.

Cannon, J. (2002). Fascination with cannibalism has sexual roots. Indiana Statesman, November 22. Located at: http://www.indianastatesman.com/vnews/display.v/ART/2002/11/22/3dde3b6201bc1

de Moore, G.M. & Clement, M. (2006). Self-cannibalism: an unusual case of self-mutilation. Australian and New Zealand Journal of Psychiatry, 40, 937.

Gates, K. (2000). Deviant desires: Incredibly strange sex. New York: Juno Books.

Huffington Post (2009). Andre Thomas, Texas Death Row inmate, pulls out eye, eats it. TheHuffington Post, September 9. Located at: http://www.huffingtonpost.com/2009/01/09/andre-thomas-texas-death-_n_156765.html

Krafft-Ebing, R. von (1886). Psychopathia sexualis (C.G. Chaddock, Trans.). Philadelphia: F.A. Davis.

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

Lykins, A.D., & Cantor, J.M. (2014). Vorarephilia: A case study in masochism and erotic consumption. Archives of Sexual Behavior, 43, 181-186.

Mikellides, A.P. (1950). Two cases of self-cannibalism (autosarcophagy). Cyprus Medical Journal, 3, 498-500.

Mintz, I.L. (1964). Autocannibalism: a case study. American Journal of Psychiatry, 120, 1017.

Monasterio, E. & Prince, C. (2011). Self-cannibalism in the absence of psychosis and substance use. Australasian Psychiatry, 19, 170-172.

Pfafflin, F. (2008). Good enough to eat. Archives of Sexual Behavior, 37, 286-293.

Pfafflin, F. (2009). Reply to Beier (2009). Archives of Sexual Behavior, 38, 166-167.

Prins, H. (1985). Vampirism: A clinical condition. British Journal of Psychiatry, 146, 666-668.

Reuters (1997). Meatballs made from fat, anyone? May 18. Located at: http://uk.reuters.com/article/2007/05/18/oukoe-uk-chile-artist-idUKN1724159420070518

Sunay, O. & Menderes, A. (2011). Self cannibalism of fingers in an alzheimer patient. Balkan Medical Journal, 28, 214-215.

Unlimited Blog (2007). Sexual cannibalism and Nithari murders. November. Located at: http://sms-unlimited.blogspot.co.uk/2007/11/sexual-cannibalism-and-nithari-murders.html

Wikipdia (2012). Cannibalism. Located at: http://en.wikipedia.org/wiki/Cannibalism

Wikipedia (2012). Sexual cannibalism. Located at: http://en.wikipedia.org/wiki/Sexual_cannibalism

Loud and proud: A psychological (and personal) look at the ‘Sin of Pride’

A number of years ago, I was asked to write an article on “The Sin of Pride” for the British Psychological Society. Before writing that article, I knew very little about the topic. To me it was the title of an record album by The Undertones that I bought in 1983 when I was 16 years old from Castle Records in Loughborough. I perhaps learned a bit more about it when I watched 1995 film ‘Seven’ directed by David Fincher and starring Brad Pitt (which coincidentally just happens to be one of my all-time favourite films).

After agreeing to write the article I did a bit of research on the subject (which admittedly meant I did a quick Google search followed by a more considered in-depth search on Google Scholar). While I’m no expert on the topic I can at least have a decent pub conversation about it if anyone is prepared to listen. Just to show my complete ignorance, I wasn’t even aware that the sin of pride was the sin of all sins (although I could in a pub quiz be relied upon to name the seven deadly sins).

I was asked to write on this topic because I was seen as someone who is very proud of the work that I do (and for the record, I am). However, I have often realized that just because I am proud of things that I have done in my academic career it doesn’t necessarily mean others think in the same way. In fact, on some occasions I have been quite taken aback by others’ reactions to things that I have done for which I feel justifiably proud (but more of that later).

At a very basic level, the sin of pride is rooted in a preoccupation with the self. However, in psychological terms, pride has been defined by Dr. Michael Lewis and colleagues in the International Journal of Behavioral Development as “a pleasant, sometimes exhilarating, emotion that results from a positive self-evaluation” and has been described by Dr. Jessica Tracy and her colleagues (in the journal Emotion) as one the three ‘self-conscious’ emotions known to have recognizable expressions (shame and embarrassment being the other two). From my reading of the psychological literature, it could perhaps be argued that pride has been regarded as having a more positive than negative quality, and (according to a paper in the Journal of Economic Psychology by my PhD supervisors – Professor Paul Webley and Professor Stephen Lea) is usually associated with achievement, high self-esteem and positive self-image – all of which are fundamental to my own thinking. My reading on the topic has also led to the conclusion that pride is sometimes viewed as an ‘intellectual’ or secondary emotion. In practical (and psychological) terms, sin is either a high sense of one’s personal status or ego, or the specific mostly positive emotion that is a product of praise or independent self-reflection.

One of the most useful distinctions can be made about sin (and is rooted in my own personal experience), is what Lea and Webley distinguish as ‘proper pride’ and ‘false pride’. They claim that:

“Proper pride is pride in genuine achievements (or genuine good qualities) that are genuinely one’s own. False pride is pride in what is not an achievement, or not admirable, or does not properly belong to oneself. Proper pride is associated with the desirable property of self-esteem; false pride with vanity or conceit. Proper pride is associated with persistence, endurance and doggedness; false pride with stubbornness, obstinacy and pig-headedness.”

As I noted above, there have been times when I have been immensely proud of doing something only for friends and colleagues to be appalled. ‘Proper pride’ as Lea and Webley would argue. One notable instance was when I wrote a full-page article for The Sun on ‘internet addiction’ published in August 1997. I originally wanted to be a journalist before I became a psychologist, and my journalist friends had always said that to get a full-page ‘by line’ in the biggest selling newspaper in the UK was a real achievement. I was immensely proud – apart from the headline that a sub-editor had dubbed my piece ‘The Internuts’ – and showed the article to whoever was around.

I had always passionately argued (and still do) that I want my research to be disseminated and read by as many people as possible. What was better than getting my work published in an outlet with (at the time) 10 million readers? My elation was short-lived. One close colleague and friend was very disparaging and asked how I could stoop so low as to “write for the bloody Sun?” Similar comments came from other colleagues and I have to admit that I was put off writing for the national tabloids for a number of years. (However, I am now back writing regularly for the national dailies and am strong enough to defend myself against the detractors).

In 2006, I was invited to the House of Commons by the ex-Leader of the Conservative Party, Iain Duncan-Smith and invited to Chair his Centre For Social Justice Working Party on Gambling and write a report as part of the Conservative Party’s ‘Breakdown Britain’ initiative. Anyone who knows me will attest that my political leanings are left of centre and that I working with the Conservatives on this issue was not something I did without a lot of consideration. I came to the conclusion that gambling was indeed a political issue (rather than a party political issue) and if the Conservative Party saw this as an important issue, I felt duty bound to help given my research experience in the area. I spent a number of months working closely with Iain Duncan-Smith’s office and when the report was published I was again very proud of my achievement.

However, as soon as the report came out I received disbelieving and/or snide emails asking how I could have “worked with the Conservatives”. I have spent years trying to put the psychosocial impact of gambling on the political agenda. If I am offered further opportunities by those with political clout, I won’t think twice about taking them. I am still immensely proud of such actions despite what others may think.

Pride is ultimately a subjective experience and the two personal experiences that I outlined above will not put me off doing what I want to do. I shall continue to engage in activities where I think my work can have an impact and shall work with (and write for) those that can help me disseminate my research findings to as many people as possible.

Dr Mark Griffiths, Professor of Behavioural Addiction, International Gaming Research Unit, Nottingham Trent University, Nottingham, UK

Further reading

Averill, J.R. (1991). Intellectual emotions. In: C.D. Spielberger, I.G. Sarason, Z. Kulesar & G.L. van Heck (Eds.), Stress and Emotion: Anger, Anxiety and Curiosity [Vol. 14] pp.3-16. New York: Hemisphere.

Griffiths, M.D. (1997). The internuts (internet addiction). The Sun, August 13, p.6.

Griffiths, M.D. (2007). Gambling addiction in the UK. In K. Gyngell (Ed.), Breakdown Britain: Ending the Costs of Social Breakdown (pp.393-426). London: Social Justice Policy Group.

Kemper, T.D. (1987). How many emotions are there? Wedding the social and autonomic components. American Journal of Sociology, 93, 263-289.

Lawler, E.J. (1992). Affective attachments to nested groups: A choice-process theory. American Sociological Review, 57, 327-339.

Lea, S.E.G. & Webley, P. (1997). Pride in economic psychology. Journal of Economic Psychology, 18, 323-340.

Lewis, M., Takai-Kawakami, K., Kawakami, K., & Sullivan, M. W. (2010). Cultural differences in emotional responses to success and failure. International Journal of Behavioral Development, 34, 53-61

Tracy, J.L., Robins, R.W. & Schriber, R.A. (2009). Development of a FACS-verified set of basic and self-conscious emotion expressions. Emotion, 9, 554-559.

Sole love: A brief look at shoe fetishism

To me, shoes (and the psychology of them) have always been a trivial topic. However, maybe I just haven’t got my finger on the pulse (or should that be my foot on the pedal?) Here are a few quotes that I came across while researching this blog:

• “Shoes are totems of Disembodied Lust. They are candy for the eyes, poetry for the feet, icing on your soul. They stand for everything you’ve ever wanted: glamour, success, a rapier like wit, a date with the Sex God of your choice…They seem to have the magic power to make you into someone else, someone without skin problems, someone without thin hair, someone without a horsy laugh. And they do” (Mimi Pond, in her 1985 book Shoes Never Lie).
• “Almost every woman is not only conscious of her feet, but sex conscious about them” (Andre Perugia, shoe designer).
• “Shoes are seen by most of those studied as revealing age, sex, and personality and as creating moods and capturing memories. For adolescents, shoes are a key signifier of their identities, and the shoes they desire often conflict what their parents regard as appropriate. Shoes appear as a key vehicle through which adolescents and young adults work out issues of identity, individualism, conformity, lifestyle, gender, sexuality, ethnicity, and personality” (Dr. Russell Belk in a 2003 issue of Advances in Consumer Research).

According to Dr. Russell Belk (who has written lots of great papers on the psychology of collecting that I have referred to in a number of my previous blogs), the average woman in the USA owns over 30 pairs of shoes. Citing from William Rossi’s 1976 book The Sex Life of the Foot and Shoe, Belk also claimed that 80% of shoes are bought for purposes of sexual attraction. He also noted that:

“Shoes figure prominently in stories and fairytales, including Cinderella (a highly sexualized tale in it’s more original versions), Puss ‘n’ Boots, Seven League Boots, The Wizard of Oz, The Red Shoes, and The Old Woman Who Lived In A Shoe, as well a more contemporary tales. Shoes and our desire for them are the objects of art, satire, museum exhibitions, [and] films. And they are the objects of a growing number of histories, catalogs, essays, and tributes…As all of this attention suggests, what we wear on our feet is far from a matter of indifference or utilitarianism” (Please note that I removed all the academic references and just cited the text).

These selective quotes all seem to point to the special place that shoes seem to hold in some people’s lives, and that there can be a sexualized element to them. For a small minority of people, shoes can become a sexual fetish either on its own or overlapping with other sexual praphilias including clothing fetishes, foot fetishism (podophilia), pedal pumping, transvestite fetishism, sexual sadism, and sexual masochism. Obviously it is the restrictive types of clothing that are most associated with sadomasochistic activity. This includes very high heel shoes (which make it difficult to walk) and which I examined in a previous blog on altocalciphilia (a sexual paraphilia specifically related to high-heeled shoes). As Valerie Steele noted in her 1996 book Fetish, Fashion, Sex and Power, the shoe (like the corset), was one of the first items of clothing to be treated as a fetish.

In a previous blog on sexual fetishism more generally, I wrote about a study led by Dr G. Scorolli 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 5,000 fetishists (but was likely to be a lot more). Their results showed that there were 44,722 members of online fetish forums with a fetishistic and/or paraphilic sexual interest in feet (47% of all ‘body part’ fetishists that they encountered). Among those people preferring objects related to body parts, footwear (shoes, boots, etc.) was the second most preferred (26,739 online fetish forum members; 32% of all objects related to body parts) just behind objects wore on the legs and/or buttocks (33%).

A Master’s thesis by Ash Sancaktar explored the “many paradoxes inherent in shoes in collecting, consuming, fashioning, representing, and wearing them”. The thesis also examined the significance of shoes in a number of different disciplines i.e., history, fashion, sociology, psychology and dance) as well as sexuality (with a large part of one chapter devoted to shoe fetishism). The chapter noted:

“Foot fetishism has been a powerful sub-division of sex since shoes were first created. Many scholars accept feet were used as convenient metaphors for the genitalia. Keen, perhaps, to downplay emphasis on the generative process, the belief set of many pagan religions, the ancient Hebrews took the foot and made it a gender icon. According to Brame, the definition of foot fetishism is a pronounced sexual interest in the lower limb or anything that covers portions of them. The allure normally attributed to erogenous zones is literally translocated downward and the fetishist response to the foot is the same as a conventional person’s arousal at seeing genitals. (Brame & Jacobs 1996). Freud considered foot binding as a form of fetishism…Foot fetishists tend to keep their inclination concealed for fear of social ridicule or other apprehensions. Published research indicates fetishists have poorly developed social skills, are quite isolated in their lives and have a diminished capacity for establishing intimacy. Rossi (1990) reported the majority of male fetishists were married, living perfectly conventional lives with their spouse, who in turn was fully aware of partner’s behaviours and preferences”.

Unsurprisingly, Sancaktar asserts that shoe fetishists are similar to foot fetishists but their stimulus (the shoe) becomes the total focus for arousal (rather than the foot within it). He cites Freud and says that he considered the shoe as symbolically representing female genitalia and that the foot symbolically represented a male phallus and when the foot entered the shoe, the union was symbolically complete. (Annoyingly, Freud doesn’t appear in the references so I am unsure which of Freud’s works is being referred to). Quoting from Valerie Steele’s book, he also notes that “The naked foot itself is not as erotically appealing, the shoe raises up the foot and gives it mystery and allure so it’s not just a piece of meat”. He then goes on to say that:

“According to [Steele], since the 1880s, high heeled shoes have been almost entirely associated with femininity with the exception of cowboy boots. Retifists usually collect women’s shoes and have exquisite taste for elegant style. Their preference covers the seven basic shoe styles described by Rossi (1993) and materials such as leather and furs often influence their choice. Retifists will personalize their collection by giving names to their favourite shoes. Freud was convinced all women were clothes fetishist, and believed clothes were worn to provocatively shield the erotic body. Most authorities now acknowledge there is a difference between foot and shoe fetishism and someone who innocently collects shoes…There are degrees of fetishes, according to Steele. Using the example of high heeled shoes, she said that most people are level one or two, finding them appealing. Her example of level three was a French writer who followed women in Paris wearing high heeled shoes. She gave for an example of level four, Marla Maples’ ex-publicist, who was found guilty of stealing Maples’ shoes. ‘He denied being a fetishist, but admitted that he had a sexual relationship with Marla’s shoes’, Steele said”.

Sancaktar uses the work of McDowell (and more specifically his 1989 book Shoes, Fashion and Fantasy) and briefly explores the alleged aphrodisiac qualities of some shoewear including the use of tight lacing:

“Tight lacing excites desire not just because it has a constraining effect but also because it carries the promise of release. This is why stays have always been such a powerful aphrodisiac. Both the tying and untying can have a strong sexual charge – a fact that shoe makers have been aware of for a very long time [McDowell, 1989]”.

Sancaktar also talks about the rise of mules and why they are considered the most seductive shoes and a rival for the traditional sexiest footwear (i.e., the stiletto):

“There are so many kinds of fetish shoes over a long period of time. Mules were originally simple, flat, backless slippers. Originally it evolved as a form of footwear for the boudoir, worn by the most fashionable of ladies and the most exclusive of courtesans. In the Rococo period mules were popular also for men and they had the romantic connotations. By the eighteenth century they had evolved into backless shoes on high heels. Today mules, which are known also as ‘slides’ are believed to be among the most seductive of all shoes, because they leave the foot half undressed. Fetish mules stand tall with the stiletto heel, and are decorate with an unexpected pattern. It is worn by women who don’t entirely realize what they say, historically and presently, to admirers yet know they look sexy”.

As with many other fetishes that I have covered in my blog, there is little empirical research on shoe fetishism. I know of no research that has pathologized the behavior and as such is unlikely to be the focus of scientific and/or clinical enquiry.

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

Further reading

Belk, R. W. (2003). Shoes and self. Advances in Consumer Research, 30, 27-33.

Brame, G.G. & Jacobs J. (1996). Different loving: A Complete Exploration of the World of Sexual Dominance and Submission. New York: Villard.

McDowell, C. (1989). Shoes, Fashion and Fantasy. London: Thames and Hudson Ltd.

Pond, Mimi (1985). Shoes Never Lie. New York: Berkley Publishing Group.

Rossi, W.A. (1976). The Sex Life of the Foot and Shoe. Malabar, FL: Krieger Publishing.

Sancaktar, A. (2006). An analysis of shoe within the context of social history of fashion (Doctoral dissertation, İzmir Institute of Technology).

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.

Steele, V, (1996). Fetish, Fashion, Sex and Power. Oxford: Oxford University Press.

Weinberg, M.S., Williams, C.J. & Calhan, C. (1995). “If the shoe fits…” Exploring male homosexual foot fetishism. Journal of Sex Research, 32, 17-27.

You bet! A brief overview of our recent papers on youth gambling

Following my recent blogs where I outlined some of the papers that my colleagues and I have published on mindfulness, Internet addiction, and gaming addiction, here is a round-up of recent papers that my colleagues and I have published on adolescent gambling.

Calado, F., Alexandre, J. & Griffiths, M.D. (2014). Mom, Dad it’s only a game! Perceived gambling and gaming behaviors among adolescents and young adults: An exploratory study. International Journal of Mental Health and Addiction, 12, 772-794.

• Gambling and gaming are increasingly popular activities among adolescents. Although gambling is illegal in Portugal for youth under the age of 18 years, gambling opportunities are growing, mainly due to similarity between gambling and other technology-based games. Given the relationship between gambling and gaming, the paucity of research on gambling and gaming behaviors in Portugal, and the potential negative consequences these activities may have in the lives of young people, the goal of this study was to explore and compare the perceptions of these two behaviors between Portuguese adolescents and young adults. Results from six focus groups (comprising 37 participants aged between 13 and 26 years) indicated different perceptions for the two age groups. For adolescents, gaming was associated with addiction whereas for young adults it was perceived as a tool for increasing personal and social skills. With regard to gambling, adolescents associated it with luck and financial rewards, whereas young adults perceived it as an activity with more risks than benefits. These results suggest developmental differences that have implications for intervention programs and future research.

Delfabbro, P.H., King, D.L. & Griffiths, M.D. (2014). From adolescent to adult gambling: An analysis of longitudinal gambling patterns in South Australia. Journal of Gambling Studies, 30, 547-563.

• Although there are many cross-sectional studies of adolescent gambling, very few longitudinal investigations have been undertaken. As a result, little is known about the individual stability of gambling behaviour and the extent to which behaviour measured during adolescence is related to adult behaviour. In this paper, we report the results of a 4-wave longitudinal investigation of gambling behaviour in a probability sample of 256 young people (50 % male, 50% female) who were interviewed in 2005 at the age of 16–18 years and then followed through to the age of 20–21 years. The results indicated that young people showed little stability in their gambling. Relatively few reported gambling on the same individual activities consistently over time. Gambling participation rates increased rapidly as young people made the transition from adolescence to adulthood and then were generally more stable. Gambling at 15–16 years was generally not associated with gambling at age 20–21 years. These results highlight the importance of individual-level analyses when examining gambling patterns over time.

Canale, N., Vieno, A., Griffiths, M.D., Rubaltelli, E., Santinello, M. (2015). Trait urgency and gambling problems in young people: the role of decision-making processes. Addictive Behaviors, 46, 39-44.

• Although the personality trait of urgency has been linked to problem gambling, less is known about psychological mechanisms that mediate the relationship between urgency and problem gambling. One individual variable of potential relevance to impulsivity and addictive disorders is age. The aims of this study were to examine: (i) a theoretical model associating urgency and gambling problems, (ii) the mediating effects of decision-making processes (operationalized as preference for small/immediate rewards and lower levels of deliberative decision-making); and (iii) age differences in these relationships. Participants comprised 986 students (64% male; mean age = 19.51 years; SD = 2.30) divided into three groups: 16–17 years, 18–21 years, and 22–25 years. All participants completed measures of urgency, problem gambling, and a delay-discounting questionnaire involving choices between a smaller amount of money received immediately and a larger amount of money received later. Participants were also asked to reflect on their decision-making process. Compared to those aged 16–17 years and 22–25 years, participants aged 18–21 years had a higher level of gambling problems and decreased scores on lower levels of deliberative decision-making. Higher levels of urgency were associated with higher levels of gambling problems. The association was mediated by a lower level of deliberative decision-making and preference for an immediate/small reward. A distinct pathway was observed for lower levels of deliberative decision-making. Young people who tend to act rashly in response to extreme moods, had lower levels of deliberative decision-making, that in turn were positively related to gambling problems. This study highlights unique decision-making pathways through which urgency trait may operate, suggesting that those developing prevention and/or treatment strategies may want to consider the model’s variables, including urgency, delay discounting, and deliberative decision-making.

Carran, M. & Griffiths, M.D. (2015). Gambling and social gambling: An exploratory study of young people’s perceptions and behavior. Aloma: Revista de Psicologia, Ciències de l’Educació i de l’Esport, 33(1), 101-113.

• Background and aims: Gambling-type games that do not involve the spending of money (e.g., social and ‘demo’ [demonstration] gambling games, gambling-like activities within video games) have been accused in both the legal and psychological literature of increasing minors’ propensity towards prohibited forms of gambling thus prompting calls for gambling regulation to capture address such games and subject them to age restrictions. However, there is still a shortage of empirical data that considers how young people experience monetary and non-monetary gambling, and whether they are sufficiently aware of the differences. Methods: Data was collected from 23 qualitative focus groups carried out with 200 young people aged between 14 and 19 years old in schools based in London and Kent. As the study was exploratory in nature, thematic analysis was adopted in order to capture how pupils categorise, construct, and react to gambling-like activities in comparison to monetary forms of gambling without the constrains of a predetermined theoretical framework. Results: Despite many similarities, substantial differences between monetary and non-monetary forms of gambling were revealed in terms of pupils’ engagement, motivating factors, strengths, intensity, and associated emotions. Pupils made clear differentiation between non-monetary and monetary forms of gambling and no inherent transition of interest from one to the other was observed among participants. Only limited evidence emerged of ‘demo’ games being used as a practice ground for future gambling. Conclusion: For the present sample, non-monetary forms of gambling presented a different proposition to the real-money gambling with no inherent overlap between the two. For some the ‘softer’ form minimised the temptation to try other forms of gambling that they were not legally allowed to engage in, but ‘demo’ games may attract those who already want to gamble. Policy implications: Regulators must recognise and balance these two conflicting aspects.

Griffiths, M.D. (2015). Adolescent gambling and gambling-type games on social networking sites: Issues, concerns, and recommendations. Aloma: Revista de Psicologia, Ciències de l’Educació i de l’Esport, 33(2), 31-37.

• Research indicates that compared to the general population, teenagers and students make the most use of social networking sites (SNSs). Although SNSs were originally developed to foster online communication between individuals, they now have the capability for other types of behaviour to be engaged in such as gambling and gaming. The present paper focuses on gambling and the playing of gambling-type games via SNSs and comprises a selective narrative overview of some of the main concerns and issues that have been voiced concerning gambling and gambling-type games played via social network sites. Overall, there is little empirical evidence relating to the psychosocial impact of adolescents engaging in gambling and gambling-type activities on SNSs, and the evidence that does exist does not allow definitive conclusions to be made. However, it is recommended that stricter age verification measures should be adopted for social games via SNSs particularly where children and adolescents are permitted to engage in gambling-related content, even where real money is not involved.

Canale, N., Vieno, A., Griffiths, M.D., Marino, C., Chieco, F., Disperati, F., Andriolo, S., Santinello, M. (2016). The efficacy of a web-based gambling intervention program for high school students: A preliminary randomized study. Computers in Human Behavior, 55, 946-954.

• Early onset in adolescent gambling involvement can be a precipitator of later gambling problems. The aim of the present study was to test the preliminary efficacy of a web-based gambling intervention program for students within a high school-based setting. Students attending a high school in Italy (N= 168) participated in the present study (58% male – age, M = 15.01; SD = 0.60). Twelve classes were randomly assigned to one of two conditions: intervention (N = 6; 95 students) and control group (N = 6; 73 students). Both groups received personalized feedback and then the intervention group received online training (interactive activities) for three weeks. At a two-month follow-up, students in the intervention group reported a reduction in gambling problems relative to those in the control group. However, there were no differences in gambling frequency, gambling expenditure, and attitudes toward the profitability of gambling between the two groups. In addition, frequent gamblers (i.e., those that gambled at least once a week at baseline) showed reductions in gambling problems and gambling frequency post-intervention. Frequent gamblers that only received personalized feedback showed significantly less realistic attitudes toward the profitability of gambling post-intervention. The present study is the first controlled study to test the preliminary efficacy of a web-based gambling intervention program for students within a high school-based setting. The results indicate that a brief web-based intervention delivered in the school setting may be a potentially promising strategy for a low-threshold, low-cost, preventive tool for at-risk gambling high school students.

Canale, N., Griffiths, M.D., Vieno, A., Siciliano, V. & Molinaro, S. (2016). Impact of internet gambling on problem gambling among adolescents in Italy: Findings from a large-scale nationally representative survey. Computers in Human Behavior, 57, 99-106.

• Aims: The primary aim of the present study was to understand the impact of online gambling on gambling problems in a large-scale nationally representative sample of Italian youth, and to identify and then further examine a subgroup of online gamblers who reported higher rates of gambling problems. Design: Data from the ESPAD^®Italia2013 (European School Survey Project on Alcohol and Other Drugs) Study were used for analyses of adolescent Internet gambling. Setting: Self-administered questionnaires were completed by a representative sample of high school students, aged 15–19 years. Participants: A total of 14,778 adolescent students. Measurements: Respondents’ problem gambling severity; gambling behavior (participation in eight different gambling activities, the number of gambling occasions and the number of online gambling occasions, monthly gambling expenditure); Socio-demographics (e.g., family structure and financial status); and control variables were measured individually (i.e., use of the Internet for leisure activities and playing video games). Findings: Rates of problem gambling were five times higher among online gamblers than non-online gamblers. In addition, factors that increased the risk of becoming a problem online gambler included living with non-birth parents, having a higher perception of financial family status, being more involved with gambling, and the medium preferences of remote gamblers (e.g., Internet cafes, digital television, and video game console). Conclusions: The online gambling environment may pose significantly greater risk to vulnerable players. Family characteristics and contextual elements concerning youth Internet gambling (e.g., remote mediums) may play a key role in explaining problem online gambling among adolescents.

Pallesen, S., Hanss, D., Molde, H., Griffiths, M.D. & Mentzoni, R.A. (2016). A longitudinal study of factors explaining attitude change towards gambling among adolescents. Journal of Behavioral Addictions, 5, 59–67

• Background and aims: No previous study has investigated changes in attitudes toward gambling from under legal gambling age to legal gambling age. The aim of the present study was therefore to investigate attitudinal changes during this transition and to identify predictors of corresponding attitude change. Methods: In all 1239 adolescents from a national representative sample participated in two survey waves (Wave 1; 17.5 years; Wave 2; 18.5 years). Results: From Wave 1 to Wave 2 the sample became more acceptant toward gambling. A regression analysis showed that when controlling for attitudes toward gambling at Wave 1 males developed more acceptant attitudes than females. Neuroticism was inversely related to development of acceptant attitudes toward gambling from Wave 1 to Wave 2, whereas approval of gambling by close others at Wave 1 was positively associated with development of more acceptant attitudes. Continuous or increased participation in gambling was related to development of more acceptant attitudes from Wave 1 to Wave 2. Conclusions: Attitudes toward gambling became more acceptant when reaching legal gambling age. Male gender, approval of gambling by close others and gambling participation predicted development of positive attitudes toward gambling whereas neuroticism was inversely related to development of positive attitudes toward gambling over time.

Ciccarelli, M., Griffiths, M.D., Nigro, G., & Cosenza, M. (2016). Decision-making, cognitive distortions and alcohol use in adolescent problem and non-problem gamblers: An experimental study. Journal of Gambling Studies, in press.

• In the psychological literature, many studies have investigated the neuropsychological and behavioral changes that occur developmentally during adolescence. These studies have consistently observed a deficit in the decision-making ability of children and adolescents. This deficit has been ascribed to incomplete brain development. The same deficit has also been observed in adult problem and pathological gamblers. However, to date, no study has examined decision-making in adolescents with and without gambling problems. Furthermore, no study has ever examined associations between problem gambling, decision-making, cognitive distortions and alcohol use in youth. To address these issues, 104 male adolescents participated in this study. They were equally divided in two groups, problem gamblers and non-problem gamblers, based on South Oaks Gambling Screen Revised for Adolescents scores. All participants performed the Iowa gambling task and completed the Gambling Related Cognitions Scale and the alcohol use disorders identification test. Adolescent problem gamblers displayed impaired decision-making, reported high cognitive distortions, and had more problematic alcohol use compared to non-problem gamblers. Strong correlations between problem gambling, alcohol use, and cognitive distortions were observed. Decision-making correlated with interpretative bias. This study demonstrated that adolescent problem gamblers appear to have the same psychological profile as adult problem gamblers and that gambling involvement can negatively impact on decision-making ability that, in adolescence, is still developing. The correlations between interpretative bias and decision-making suggested that the beliefs in the ability to influence gambling outcomes may facilitate decision-making impairment.

Dr. Mark Griffiths, Professor of Behavioural Addiction, International Gaming Research Unit, Nottingham Trent University, Nottingham, UK

Further reading

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

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

Griffiths, M.D. (2003). Adolescent gambling: Risk factors and implications for prevention, intervention, and treatment. In D. Romer (Ed.), Reducing Adolescent Risk: Toward An Integrated Approach (pp. 223-238). London: Sage.

Griffiths, M.D. (2010). Asian national adolescent gambling surveys: Methodological issues, protocols, and advice. Asian Journal of Gambling Issues and Public Health, 1, 4-18.

Griffiths, M.D. (2011). Adolescent gambling. In B. Bradford Brown & Mitch Prinstein (Eds.), Encyclopedia of Adolescence (Volume 3) (pp.11-20). San Diego: Academic Press.

Griffiths, M.D. (2013). Adolescent gambling via social networking sites: A brief overview. Education and Health, 31, 84-87.

Griffiths, M.D. & Linsey, A. (2006). Adolescent gambling: Still a cause for concern? Education and Health, 24, 9-11.

Griffiths, M.D. & Parke, J. (2010). Adolescent gambling on the Internet: A review. International Journal of Adolescent Medicine and Health, 22, 59-75.

Hayer, T. & Griffiths, M.D. (2015). The prevention and treatment of problem gambling in adolescence. In T.P. Gullotta & G. Adams (Eds). Handbook of Adolescent Behavioral Problems: Evidence-based Approaches to Prevention and Treatment (Second Edition) (pp. 539-558). New York: Kluwer.