Monthly Archives: October 2017

Blocking out the pain: Tetris, trauma, and Game Transfer Phenomena

Unwanted visual intrusions are characteristic of Post-Traumatic Stress Disorder (PTSD). According to Dr. Emily Holmes and her colleagues in a 2009 paper in the journal PLoS ONE, one innovative intervention for inhibiting unwanted intrusions is playing the Tetris videogame, described as a ‘cognitive vaccine’ in preventing intrusions after traumatic events. Playing Tetris consumes heavy visuospatial working memory resources that potentially compete with cognitive resources required for elaboration of visual imagery. Since Holmes and colleagues’ study, other studies have used Tetris to inhibit intrusive imagery including more studies by Holmes and her colleagues and others by Ella James’ research group, as well as some innovative studies using Tetris to reduce drug cravings by Jessica Storka-Brown and her colleagues (see ‘Further reading’ below). However, none of these studies assessed the role of videogame content after playing in relation to Game Transfer Phenomena (GTP), an area that we have carried out a lot of research into (see ‘Further reading’ below).

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GTP research has investigated non-volitional experiences (e.g., altered sensorial perceptions and automatic mental processes/behaviours) mostly experienced after gaming. Gamers often report sensorial (visual/auditory) intrusions after playing (e.g., visual and auditory imagery, hallucinations). In a survey of 2,362 gamers that we published in a 2016 issue of the International Journal of Human-Computer Interaction, most (77%) had visualized images from a variety of videogames (including tile-puzzle games) with closed-eyes, and one-third (31%) had visualized images with open-eyes. Other studies have experimentally induced videogame-related visualizations at sleep onset (including studies by Stickgold and colleagues [2000], Wamsley and colleagues [2010], Kusse and colleagues [2012] – see ‘Further reading’).

James and colleagues’ 2015 study in the journal Psychological Science was the first to make explicit reference to GTP (referred to as the ‘Tetris effect’ [TE]). In 2012, we argued the TE term is misleading as it suggests repetition is the core of transfer effects. However, other factors are involved. Research concerning GTP makes the distinction between sensorial modalities facilitating non-volitional phenomena with videogame content that occur along the continuum from mild to severe. Moreover, the descriptive constructs of GTP are empirically based on our analysis of 3,500+ gamers and have been examined via confirmatory factor analysis demonstrating good reliability and validity.

James and her colleagues tested if playing Tetris offered a protective mechanism against re-experiencing traumatic events. Healthy participants (n=56) were randomly assigned to either playing Tetris for 11 minutes, or doing nothing before exposure to a 12-minute traumatic film. Image-base memories about the film were then registered in a one-week dairy. However, playing Tetris as a proactive interference task before watching the film did not show significant results. James and colleagues offered different explanations including: (i) duration of the task in relation to film length, (ii) temporal contingencies between the tasks, (iii) differences between the task types, (iv) videogame types used, and (v) reactivation of gameplay during the film for aided interference. In a commentary paper published in a 2016 issue of Frontiers in Psychology, we discussed these findings and some of its shortcomings in relation to GTP literature.

  • Duration of task in relation to film length: Playing Tetris for 11 minutes may not have been long enough to compete with the consolidation of memory of the 12-minute film. GTP are significantly more likely to occur when playing 3-6 hours. Our research reported only 4% of gamers reported GTP when playing sessions shorter than one-hour. Laboratory experiments have taken days of playing to induce game-related visualizations at sleep onset.
  • Temporal contingencies between gaming and film watching: The tasks were performed minutes apart from each other. GTP mostly occur soon after stopping playing but our research has found that gamers have also reported GTP days after playing. In most cases, duration of experience is very short (seconds/minutes) but in some cases hours or longer.
  • Differences between the tasks: Previous studies have demonstrated that similar tasks aid interference. However, watching a film is a passive activity while gaming is interactive requiring additional perceptual/motor skills. Therefore, it may be expected that gaming is more potent as interference task, particularly because inducing the subjective sense of presence in the virtual world may strengthen the interference.
  • Type of videogame used as interference task and emotional content of film: The unrealistic (geometric) Tetris content may have been overwritten by the film’s traumatic images. Visualization of stereotypical games induced at sleep onset are characterized by lack of emotion, assuming that the amygdala and the reward system are not involved. In GTP research, emotions in tile-matching puzzle-games are incomparable to emotions in realistic videogames.
  • Reactivation of gameplay during the film for aided interference: The use of cue reminders may have potential in reviving videogame content. In many cases, thoughts and altered perceptions are triggered by game-related cues. Selective attention toward game-related cues has been demonstrated in experiments. GTP have been reported in variety of videogame genres particularly those that have very realistic graphics and settings. Therefore, more realistic games may aid associations between real life stimuli and videogame content, and may be more effective in competing with memories of traumatic events.

In our Frontiers paper, we noted that playing Tetris is not only an effective visuospatial task (overloading working memory resources needed for imagery-formation while playing), but as demonstrated in our GTP studies, videogame content stays active after playing (e.g., mental imagery, sensory perceptions), and may offer additional benefits for managing unwanted intrusions. GTP may potentially strengthen effects of interference tasks but should be used cautiously, because videogame content not only targets unwanted intrusions, but also influences individual cognitions, perceptions, and behaviours in day-to-day contexts (e.g., attention bias, lack of task awareness, control inhibition failures). Moreover, our studies have shown distress and dysfunction have been reported with GTP.

Consequently, further research needs conducting to identify: (i) videogames that are most effective, (ii) playing duration, (iii) factors that reduce intervention efficacy and strategies to control them, and (iv) individuals that may benefit the most from such intervention. While using videogames as intervention tools for preventing unwanted imagery from traumatic experiences has potential, therapeutically it is still at an early stage.

  • (Please note: This blog was co-written with Dr. Angelica Ortiz de Gortari and is based on an article we published in Frontiers in Psychology: Ortiz de Gortari, A.B. & Griffiths, M.D. (2016). Playing the computer game Tetris prior to viewing traumatic film material and subsequent intrusive memories: Examining proactive interference. Frontiers in Psychology, 7, 260. doi: 10.3389/fpsyg.2016.00260)

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

Further reading

Holmes, E. A., James, E. L., Kilford, E. J., & Deeprose, C. (2010). Key steps in developing a cognitive vaccine against traumatic flashbacks: Visuospatial Tetris versus Verbal Pub Quiz. PloS ONE, 5(11), e13706.

James, E. L., Bonsall, M. B., Hoppitt, L., Tunbridge, E. M., Geddes, J. R., Milton, A. L., & Holmes, E. A. (2015a). Computer game play reduces intrusive memories of experimental trauma via reconsolidation-update mechanisms. Psychological Science. doi: 10.1177/0956797615583071

James, E. L., Zhu, A. L., Tickle, H., Horsch, A., & Holmes, E. A. (2015b). Playing the computer game Tetris prior to viewing traumatic film material and subsequent intrusive memories: Examining proactive interference. Journal of Behavior Therapy and Experimental Psychiatry. doi: 10.1016/j.jbtep.2015.11.004

Kusse, C., Shaffii-Le Bourdiec, A., Schrouff, J., Matarazzo, L., & Maquet, P. (2012). Experience-dependent induction of hypnagogic images during daytime naps: A combined behavioural and EEG study. Journal of Sleep Research, 21(1), 10-20.

Ortiz de Gortari, A. B., Aronsson, K., & Griffiths, M. D. (2011). Game Transfer Phenomena in video game playing: A qualitative interview study. International Journal of Cyber Behavior, Psychology and Learning 1(3), 15-33.

Ortiz de Gortari, A. B., & Griffiths, M. D. (2012). An introduction to Game Transfer Phenomena in video game playing. In J. I. Gackenbach (Ed.), Video Game Play and Consciousness (pp. 223-250). Hauppauge, NY: Nova Publisher.

Ortiz de Gortari, A. B., & Griffiths, M. D. (2014a). Altered visual perception in Game Transfer Phenomena: An empirical self-report study. International Journal of Human-Computer Interaction, 30(2), 95-105.

Ortiz de Gortari, A. B., & Griffiths, M. D. (2014b). Auditory experiences in Game Transfer Phenomena: An empirical self-report study. International Journal of Cyber Behavior, Psychology and Learning 4(1), 59-75.

Ortiz de Gortari, A. B., & Griffiths, M. D. (2014c). Automatic mental processes, automatic actions and behaviours in Game Transfer Phenomena: An empirical self-report study using online forum data. International Journal of Mental Health and Addiction, 12(4), 1-21.

Ortiz de Gortari, A. B., & Griffiths, M. D. (2015a). Game Transfer Phenomena and its associated factors: An exploratory empirical online survey study. Computers in Human Behavior, 51, 195-202.

Ortiz de Gortari, A.B. & Griffiths, M.D. (2016). Prevalence and characteristics of Game Transfer Phenomena: A descriptive survey study. International Journal of Human-Computer Interaction, 32, 470-480.

Ortiz de Gortari, A.B., Oldfield, B. & Griffiths, M.D. (2016). An empirical examination of factors associated with Game Transfer Phenomena severity. Computers in Human Behavior, 64, 274-284.

Ortiz de Gortari, A. B., Pontes, H. M. & Griffiths, M. D.  (2015). The Game Transfer Phenomena Scale: An instrument for investigating the nonvolitional effects of video game playing. Cyberpsychology, Behavior, and Social Networking 10, 588-594

Skorka-Brown, J., Andrade, J., & May, J. (2014). Playing ‘Tetris’ reduces the strength, frequency and vividness of naturally occurring cravings. Appetite, 76 , 161-165.

Skorka-Brown, J., Andrade, J., Whalley, B., & May, J. (2015). Playing Tetris decreases drug and other cravings in real world settings. Addictive Behaviors, 51, 165-170.

Stickgold, R., Malia, A., Maguire, D., Roddenberry, D., & O’Connor, M. (2000). Replaying the Game: Hypnagogic images in normals and amnesics. Science, 290(5490), 350-353.

Wamsley, E. J., Perry, K., Djonlagic, I., Reaven, L. B., & Stickgold, R. (2010). Cognitive replay of visuomotor learning at sleep onset: Temporal dynamics and relationship to task performance. Sleep, 1(33), 59-68.

 

Ad-ding to the gambling literature: A brief overview of our recent papers on sports gambling advertising

Over the last 18 months I have been working with Dr. Hibai Lopez-Gonzalez on a project examining online sports betting and online sports betting advertising. We have already had eight papers accepted for publication and today’s blog briefly rounds up the ones that specifically relate to online sports betting. If you would like copies of them, please click on the hyperlinks. If you are unable to access them, then drop me an email and I will send you a copy (mark.griffiths@ntu.ac.uk).

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Lopez-Gonzalez, H., Estevez, A. & Griffiths, M.D. (2017). Marketing and advertising online sports betting: A problem gambling perspective. Journal of Sport and Social Issues, 41, 256-272.

  • In this article, online sports betting is explored with the objective of critically examining the potential impact on problem gambling of the emerging product features and advertising techniques used to market it. First, the extent of the issue is assessed by reviewing the sports betting prevalence rates and its association with gambling disorders, acknowledging the methodological difficulties of an unambiguous identification of what exactly constitutes sports-related gambling today. Second, the main changes in the marketization of online betting products are outlined, with specific focus on the new situational and structural characteristics that such products present along with the convergence of online betting with other adjacent products. Third, some of the most prevalent advertising master narratives employed by the betting industry are introduced, and the implications for problem gamblers and minors are discussed.

Guerrero-Solé, F., Lopez-Gonzalez, H., Griffiths, M.D. (2017). Online gambling advertising and the Third-Person Effect: A pilot study. International Journal of Cyber Behavior, Psychology and Learning, 7(2), 15-30.

  • Gambling disorder is known to have a negatively detrimental impact on affected individual’s physical and psychological health, social relationships, and finances. Via remote technologies (e.g., Internet, mobile phones, and interactive television), gambling has come out of gambling venues and has brought the potential for online gambling to occur anywhere (e.g., the home, the workplace, and on the move). Alongside the rise of online gambling, online gambling advertising have spread throughout all type of media. In a sample of 201 Spanish university students, the present study explored the perceived influence of online gambling advertising. More specifically it examined the Third-Person Effect (TPE), and its consequences on individuals’ willingness to support censorship or public service advertising. The findings demonstrate that despite the difference on the perception of the effects of online gambling advertising, it scarcely accounts for the behavioural outcomes analysed. On the contrary, awareness of problem gambling and, above all, paternalistic attitudes appear to explain this support

Lopez-Gonzalez, H. & Griffiths, M.D. (2017). Betting, forex trading, and fantasy gaming sponsorships – A responsible marketing inquiry into the ‘gamblification’ of English football. International Journal of Mental Health and Addiction. doi: 10.1007/s11469-017-9788-1

  • Environmental stimuli in the form of marketing inducements to gamble money on sports have increased in recent years. The purpose of the present paper is to tackle the extended definition of the gamblification of sport using sponsorship and partnership deals of gambling, forex trading, and fantasy gaming as a proxy for assessing its environmental impact. Using data concerning sponsorship deals from English Football Premier League, the paper builds on the evidence of English football’s gamblification process to discuss the impact that the volume, penetration, and marketing strategies of sports betting might have on public health and wellbeing. Findings demonstrate that gambling marketing has become firmly embedded in the financial practices of many English Premiership football clubs. It is argued that such associations are not trivial, and that the symbolic linkage of sport and newer gambling forms may become an issue of public health, especially affecting vulnerable groups such as minors and problem gamblers. The present study is the first to explore in-depth the relationship and potential consequences and psychosocial impacts of sports-related marketing, particularly in relation to football.

Lopez-Gonzalez, H., Guerrero-Sole, F. & Griffiths, M.D. (2017). A content analysis of how ‘normal’ sports betting behaviour is represented in gambling advertising. Addiction Research and Theory, in press.

  • Previous research has suggested that motives play an important role in several potentially addictive activities including online gaming. The aims of the present study were to (i) examine the mediation effect of different online gaming motives between psychiatric distress and problematic online gaming, and (ii) validate Italian versions of the Problematic Online Gaming Questionnaire, and the Motives for Online Gaming Questionnaire. Data collection took place online and targeted Italian-speaking online gamers active on popular Italian gaming forums, and/or Italian groups related to online games on social networking sites. The final sample size comprised 327 participants (mean age 23.1 years [SD=7.0], 83.7% male). The two instruments showed good psychometric properties in the Italian sample. General psychiatric distress had both a significant direct effect on problematic online gaming and a significant indirect effect via two motives: escape and fantasy. Psychiatric symptoms are both directly and indirectly associated with problematic online gaming. Playing online games to escape and to avoid everyday problems appears to be a motivation associated with psychiatric distress and in predicting problematic gaming.

Lopez-Gonzalez, H. Estevez, A., Jimenez-Murcia, S. & Griffiths, M.D. (2017). Alcohol drinking and low nutritional value food eating behaviour of sports bettors in gambling adverts. International Journal of Mental Health and Addiction. doi: 10.1007/s11469-017-9789-0

  • The prevalence of sports betting advertising has become a major concern for gambling regulators, particularly since the legalization of online gambling in many European jurisdictions. Although the composition of gambling advertisement narratives has received some limited attention, nothing is known regarding how betting advertisements (often referred to as ‘adverts’ or ‘commercials’) might be associating gambling with other potentially risky behaviors. The present paper examines the representation of alcohol drinking and low nutritional value food eating in sports betting advertising. By means of a mixed-methods approach to content analysis, a sample of British and Spanish soccer betting adverts was analyzed (N=135). The results suggest that betting advertising aligns drinking alcohol with sports culture, and significantly associates emotionally-charged sporting situations such as watching live games or celebrating goals with alcohol. Additionally, alcohol drinking is more frequent in betting adverts with a higher number of characters, linking friendship bonding and alcohol drinking (especially beer) in the context of sports gambling.

Lopez-Gonzalez, H., Estévez, A. & Griffiths, M.D. (2017). Controlling the illusion of control: A grounded theory of sports betting advertising in the UK. International Gambling Studies, in press.

  • Sports betting advertising has arguably permeated contemporary sport consumption in many countries. Advertisements build narratives that represent situations and characters that normalize betting behaviour and raise public concerns regarding their detrimental effect on vulnerable groups. Adopting a grounded theory approach, the present study examined a British sample of sports betting advertisements (N = 102) from 2014 to 2016. The analysis revealed that individual themes aligned in a single core narrative, constructing a dual persuasive strategy of sports betting advertising: (i) to reduce the perceived risk involved in betting (with themes such as betting with friends, free money offers, humour, or the use of celebrities) while (ii) enhancing the perceived control of bettors (including themes of masculinity and sport knowledge). In addition, new technological features of sports betting platforms (e.g. live in-play betting) were used by advertisers to build narratives in which the ability to predict a sports outcome was overlapped by the ability of bettors to use such platforms, equalizing the ease of betting with the ease of winning. Based on the data analysed, it was concluded that the construction of a magnified idea of control in sports betting advertising is a cause for concern that requires close regulatory scrutiny.

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

Further reading

Griffiths, M.D. (1997). Children and gambling: The effect of television coverage and advertising. Media Education Journal, 22, 25-27.

Griffiths, M.D. (2005).  Does advertising of gambling increase gambling addiction? International Journal of Mental Health and Addiction, 3(2), 15-25.

Griffiths, M.D. (2010). Media and advertising influences on adolescent risk behaviour. Education and Health, 28(1), 2-5.

Hanss, D., Mentzoni, R.A., Griffiths, M.D., & Pallesen, S. (2015). The impact of gambling advertising: Problem gamblers report stronger impacts on involvement, knowledge, and awareness than recreational gamblers. Psychology of Addictive Behaviors, 29, 483-491.

Lopez-Gonzalez, H. & Griffiths, M.D. (2016). Is European online gambling regulation adequately addressing in-play betting advertising? Gaming Law Review and Economics, 20, 495-503.

Lopez-Gonzalez, H. & Griffiths, M.D. (2017). ‘Cashing out’ in sports betting: Implications for problem gambling and regulation. Gaming Law Review: Economics, Regulation, Compliance and Policy, 21(4), 323-326.

Lopez-Gonzalez, H. & Griffiths, M.D. (2017). Understanding the convergence of online sports betting markets. International Review for the Sociology of Sport, in press.