Term warfare: Another look at ‘behavioural addiction’ and ‘selfitis’ as constructs

I recently published a response to a debate article by Dr. Vladan Starcevic and his colleagues in the Australian & New Zealand Journal of Psychiatry. Unfortunately, my response was restricted to a stringent word limit so I am using my personal blog to provide the original version of my response before it was edited. My published version can be found here. Below is the original version:

The article by Starcevic, Billieux and Schimmenti (2018) made a number of assertions concerning my research with various co-authors. While I am always grateful that my work is being read and cited, some of the assertions made were arguably unfair, misguided and/or not stated in context (and could therefore be construed as untrue). In this short article, I first address some of the claims made about our research into the construct of ‘selfitis’. I then address a few of the wider issues made by Starcevic et al. in relation to behavioural addictions more generally because they used some of my other research into various behavioural addictions to make their arguments.

The construct of ‘selfitis’

Starcevic et al. noted that there has been a trend “to medicalize problematic behaviours” (p.1) and used the example of ‘selfitis’ to make their point. The way the article was written it would appear to the naïve reader that I and my co-author (Janarthan Balakrishnan) had coined the term ‘selfitis’. For instance, the article by Starcevic et al. cites our paper in specific reference to the following assertion:

“Instead of labelling an excessive and sometimes dangerous practice of taking selfies a ‘selfie addiction’, this behaviour was conceptualised as an inflammation-like selfitis (Balakrishnan and Griffiths, in press)”.

This sentence clearly gives the impression that it was Dr. Balakrishnan and I who conceptualised ‘selfitis’ and that our conceptualisation was that it was “inflammation-like”. However, we made it very clear to readers in the very first paragraph of our paper that the concept of ‘selfitis’ originally started a hoax claiming that the ‘disorder’ was to be included in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders. The original hoax report defined selfitis as “the obsessive compulsive desire to take photos of one’s self and post them on social media as a way to make up for the lack of self-esteem and to fill a gap in intimacy” which we again made clear in the second sentence of our paper. The two studies in our paper were exploratory and merely set out to examine whether there were individuals who were ‘obsessive selfie-takers’. In many parts of their article, Starcevic et al. appear to insinuate that our paper equates ‘selfitis’ with ‘selfie addiction’. For instance, they wrote:

“Interestingly, the components of selfitis that were identified (environmental enhancement, social competition, attention seeking, mood modification, self-confidence and subjective conformity) have practically nothing in common with behavioural addiction…Therefore, selfitis appears to be a construct that is very different from ‘selfie addiction’, and its purported link with compulsivity also seems tenuous” (p.1).

The six components comprising selfitis in our new psychometric tool (the Selfitis Behavior Scale [SBS]) were correctly reported but at no point in our paper did we ever say that ‘selfitis’ was a behavioural addiction. What we did write was that (a) “selfitis is a new construct in which future researchers may investigate further in relation to selfitis addiction and/or compulsion” (p.8), and (ii) “the qualitative focus group data from participants strongly implied the presence of ‘selfie addiction’ although the SBS does not specifically assess selfie addiction” (p.11). They also noted that our published paper on selfitis:

“…did not go unnoticed by the media, always ready to exploit everything that is ‘novel’ and sensational. Thus, one newspaper reported that selfitis, ‘the obsessive need to post selfies’, was a ‘genuine mental disorder’ and quoted one of the authors of the aforementioned article that the existence of selfitis appeared to be confirmed (www.telegraph.co.uk/science/2017/12/15/selfitis-obsessiveneed-post-selfies-genuine-mental-disorder/)…The word has thus become enriched by one more ‘condition’, complete with an assessment tool to establish its severity and a suggestion that people with selfitis may need professional help” (p.2).

While it is true that our study did not go unnoticed by the media (and was reported in hundreds of news stories around the world), only one newspaper journalist ever interviewed me about the study and at no point either in our published paper or in any conversations with the broadcast media did we ever say that ‘selfitis’ was a mental disorder. Our paper simply concluded that obsessive selfie-taking was a condition that appears to exist and made the observation that selfitis has “psychological consequences (which may be both positive and negative)” (p.12). In fact, we talked about the positive aspects of selfitis throughout the discussion section of our paper. In short, I would like it to be made clear that (i) we did not coin the term ‘selfitis’, (ii) we have never anywhere in published print (academic papers or the print media) claimed selfitis is a mental disorder, (iii) we have never claimed selfitis is a behavioural addiction, and (iv) we have never equated ‘selfitis’ with ‘selfie addiction’ (although we have just published another paper briefly reviewing the studies that have examined the concept of ‘selfie addiction’ [i.e., Griffiths & Balakrishnan, 2018]).

The construct of ‘behavioural addiction’

Starcevic et al. also claimed in their article that the term ‘behavioural addiction’ is “vague, misused and applied to an exceptionally wide variety of activities” (p.1). I would argue that the far from being ‘vague’, behavioural addiction has clearly been defined as any addiction that does not involve the ingestion of a psychoactive substance (Griffiths, 1996, 2005). I agree that it is sometimes misused and I have written dozens of populist articles on my personal blog pointing this out. However, I totally disagree that behavioural addiction has been applied to an ‘exceptionally wide variety of activities’. As I noted in a recent paper: “Very few of the thousands of leisure activities that individuals engage in have ever been written about in terms of addiction in peer-reviewed scientific papers” (Griffiths, 2017; p.1719). Starcevic et al. would be hard pushed to name more than about 20 leisure activities that have ever been empirically examined as a possible behavioural addiction. Of the five activities named by Starcevic in an attempt to show the behavioural addiction is being misused three of them were actually just sub-types of more widely researched behavioural addictions (i.e., stock market addiction is a sub-type of gambling addiction, study addiction is a sub-type of work addiction, and dance addiction is a sub-type of exercise addiction) as made clear in my papers on these topics.

Starcevic et al. also noted that a group of scholars (Kardefelt-Winther et al., 2017) “recently made an effort to reach a consensus, promote conceptual rigour and avoid misuse by proposing an open (modifiable) definition of behavioural addiction” (p.1). More specifically, Kardefelt‐Winther et al. provided four exclusion criteria and argued that behaviours should not be classed as a behavioural addiction if:

1. “The behaviour is better explained by an underlying disorder (e.g. a depressive disorder or impulse-control disorder).
2. The functional impairment results from an activity that, although potentially harmful, is the consequence of a willful choice (e.g. high-level sports).
3. The behaviour can be characterized as a period of prolonged intensive involvement that detracts time and focus from other aspects of life, but does not lead to significant functional impairment or distress for the individual.
4. The behaviour is the result of a coping strategy” (p.1710)

I doubt anyone researching in the behavioural addiction would disagree with the third exclusion criterion because to have a genuine behavioural addiction, the behaviour has to comprise significant functional impairment or distress for the individual. However, I would point out that if these criteria were applied to substance abuse, very few substance users would ever be classed as addicted (Griffiths, 2017). More specifically, I have written elsewhere that three of the four exclusion criteria proposed by Kardefelt‐Winther et al. (2017) are simply untenable:

“For instance, it is proposed that any behaviour in which functional impairment results from an activity that is a consequence of wilful choice should not be considered an addiction. I cannot think of a single addictive behaviour that when the person first started engaging in the behaviour (e.g., drinking alcohol, illicit drug-taking, gambling) was not engaged in wilfully…Also, not being classed as an addiction if the behaviour is secondary to another comorbid behaviour (e.g., a depressive disorder) or is used as a coping strategy again means that some other substance addictions (e.g., alcoholism) would not be classed as genuine addictive behaviours using such exclusion criteria because many substance-based addictions are used as coping strategies and/or are symptomatic of other underlying pathologies” (Griffiths, 2017; pp.1718-1719).

Throughout my 30 years of research into behavioural addiction, I have never simply looked at a behaviour and claimed that it cannot be potentially addictive. Using my own operational criteria for what I believe constitutes a genuine addiction (i.e., salience, conflict, tolerance, withdrawal, mood modification, and relapse; Griffiths, 1966, 2005) very few individuals would be classed as being addicted to activities such as sex, work, exercise, or gaming. However, if there is evidence of what I consider to be the core components of addiction in activities that others believe should not be pathologised (e.g., dancing or academic study), I would not choose to ignore such evidence if such activities caused significant functional impairment and distress for the individuals concerned.

References

Balakrishnan, J. & Griffiths, M.D. (2018). An exploratory study of ‘selfitis’ and the development of the Selfitis Behavior Scale. International Journal of Mental Health and Addiction. Epub ahead of print. https://doi.org/10.1007/s11469-017-9844-x

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. (2017). Behavioural addiction and substance addiction should be defined by their similarities not their dissimilarities. Addiction 112: 1718-1720.

Griffiths, M.D. & Balakrishnan, J. (2018). The psychosocial impact of excessive selfie-taking in youth: A brief overview. Education and Health 36(1): 3-5.

Kardefelt-Winther D, Heeren A, Schimmenti A, et al. (2017) How can we conceptualize behavioural addiction without pathologizing common behaviours? Addiction 112: 1709–1715.

Starcevic, V., Billieux, J., & Schimmenti, A. (2018). Selfitis, selfie addiction, Twitteritis: Irresistible appeal of medical terminology for problematic behaviours in the digital age. Australian & New Zealand Journal of Psychiatry, Epub ahead of print. https://doi.org/10.1177/0004867418763532

‘Fanorexia’ and ‘ballimia’: Football fanaticism, brand loyalty, and addiction

As the 2018 World Cup kicks in, it’s an opportune time to ask why are we so loyal to our national and club football teams? Whatever the results, we tend to support them week in week out, all year round. They can cause us misery and heartache and yet still we support them. As a Sunderland fan, I know this only too well. In the season just ended I went from agony to even more agony as I saw Sunderland get relegated for the second season in a row.

Could it be that following our clubs is an addiction? It has been argued by academics working in the marketing field that commercial organisations would love to have the kind of brand loyalty shown by football fans – something that Ken Parker and Trish Stuart argued in their award winning paper ‘The ‘West Ham Syndrome’ published in the Journal of the Market Research Society (I’m not making this up, honest!).

Parker and Stuart, working at the time of the study for the company Discovery Research, surveyed 2000 adults and also carried out some focus group interviews with football fans (including some ardent West Ham United supporters). They found that 58% of males had made a commitment to club their team by the age of 11 years. (I just happen to be one of those men having supported Sunderland from the age of 7 years of age after watching them beat Leeds in the 1973 FA Cup Final). More than half of children whose parents supported a team went on to support the same one, while a third of all fans still followed their local team.

Marketeers would love to be able to take the seemingly unstinted loyalty of football fans and somehow transfer that loyalty to the products they are trying to sell. For instance, the brand of coffee we buy tends to be governed by many factors such as television advertising, the taste, the price, the packaging, etc. If we come across coffee that (for whatever reason) is better (cheaper, tastes better, etc.), we automatically switch our ‘allegiance’ to another brand of coffee. Parker and Stuart argued that wherever West Ham finish in the league, Hammers fans would not desert their club and/or switch to another club. So what’s the difference between football clubs as a brand and other commercial products as a brand? Maybe it’s passion and the fact that football can be such an emotional experience for the diehard fan.

Some working in the advertising industry claim many people working in marketing lack passion in their product. Apparently there are other products (such as cars) that consumers get very passionate about and this means that they repeatedly buy a particular make of car despite any acknowledged faults. However, one huge fault can damage a brand’s reputation almost overnight, as Toyota is only too aware. The good news for Toyota is that one of the most interesting things about research on the ‘West Ham Syndrome’ is that it can help to explain why leading brands are able to bounce back from PR disasters in similar ways to football clubs come back from being relegated to a lower division.

However, are football fans really as loyal as most of us assume? A paper by Alan Tapp examined the loyalty of football fans (in the Journal of Database Marketing and Customer Strategy Management) and wondered what it is about football clubs as a brand that makes them so successful – especially as the ‘product’ is so inconsistent and unpredictable? (‘Inconsistent’ and ‘unpredictable are certainly words I would associate with the England team and the England players!). Parker and Stuart claimed that levels of loyalty were “only marginally affected” by West Ham’s fortunes. However, Tapp says this is completely untrue. He cites analysis of football attendance figures since 1945 to show that crowd sizes are related to a team’s position in the league, and that teams lose support when they are doing poorly. Despite the fact that crowd attendance is linked to how well a football club is doing, it’s still probably true to say that football fans are still more loyal to their club than they are to most other products. All this goes to show is that most of us will continue to love England, warts and all.

Just before the 1998 World Cup, I began to carry out some research into football fanaticism and whether football fanatics could be considered ‘addicted’ to following their football team. This is easier said than done as it all depends upon how addiction is defined, and if ‘football fan addiction’ exists, what are people actually addicted to? I define addiction as any behaviour that features what I believe to be the six core components of addiction (i.e., salience, mood modification, tolerance, withdrawal symptoms, conflict and relapse). Throughout my career, I have consistently argued that any behaviour that fulfils these six criteria should be considered as a genuine addiction. If you were addicted to following your football team, this is what I would expect:

Salience – This occurs when following your football team (and doing things related to your football team) becomes the most important activity in your life and dominates your thinking (total preoccupation), feelings (cravings) and behaviour (deterioration of socialized behaviour). For instance, even if you are not actually engaged in something football-related, you will be thinking about the next time that you are.

 Mood modification – This is the subjective experience that you would feel as a consequence of following your football team (i.e. you experience an arousing ‘buzz’ or a ‘high’ – or the exact opposite – a tranquilizing feeling of ‘escape’ or ‘numbing’ when following your team).

Tolerance – This is the process whereby increasing amounts of activity related to your football team are needed to get mood modifying effects. This basically means that if you were engaged in activities related to following your football team, you would gradually build up the amount of the time you spend engaged in those activities.

Withdrawal symptoms – These are the unpleasant feeling states and/or physical effects (e.g., the shakes, moodiness, irritability etc.) that occur when you are prevented from following your football team or stopped from engaging in football-related activities.

Conflict – This refers to the conflicts between following your football team and those around you (interpersonal conflict), conflicts with other activities (your job, schoolwork, social life, hobbies and interests) or from within yourself (knowing you are doing too much of the activity and/or subjective feelings of loss of control) which are concerned with spending too much time following your football team.

 Relapse – This is the tendency to revert back to earlier patterns of behaviour (following your football team and engaging in football-related activity) after a period of abstinence.

Using these criteria, I have come across very few genuine examples of someone addicted to a football team. The most extreme case I have come across was one woman who left her husband because of his ‘addiction’ to Chelsea football club. She told me that their bedroom was a shrine to Chelsea, he watched almost every Chelsea game home and away (including European away matches), spent all their joint savings and ran up huge debts following Chelsea, and eventually got sacked from his job because he kept ringing in sick whenever Chelsea were playing hundreds of miles from home during midweek games. Out of season he would be constantly depressed and would try to alleviate his mood by endlessly watching videos of Chelsea’s greatest games. Once the football season started, his depression would lift. I never met this individual but he appears to have fulfilled my criteria for addiction.

For most people, enthusiastically following your team – even to excess – is unlikely to be an addiction. The main difference between a healthy excessive enthusiasm and an addiction is that healthy enthusiasms add to life and addictions take away from it.

(Please note that a version of this article was originally published in The Conversation)

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

Further reading

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. (2017). Behavioural addiction and substance addiction should be defined by their similarities not their dissimilarities. Addiction, 112, 1718-1720.

Parker, K., Stuart, T. 1997. The West Ham syndrome. Journal of the Market Research Society, 39(3), 509-517.

Tapp, A. (2004). The loyalty of football fans – We’ll support you evermore? Journal of Database Marketing and Customer Strategy Management, 11, 203-215.

Me, myself-itis: A brief overview of obsessive selfie-taking

According to the Oxford English Dictionary, a selfie is a “photograph that one has taken of oneself, typically one taken with a smartphone or webcam and shared via social media”. From a psychological perspective, the taking of selfies is a self-oriented action that allows users to establish their individuality and self-importance; it is also associated with personality traits such as narcissism.

However, selfie-taking is more than just the taking of a photograph. It can include the editing of the color and contrast, the changing of backgrounds, and the addition of other effects before uploading. These added options and the use of integrative editing have further popularized selfie-taking behavior, particularly amongst teenagers and young adults.

On March 31, 2014, a story appeared on a website called the Adobo Chronicles that claimed that the American Psychiatric Association (APA) had classed “selfitis” as a new mental disorder. According to the author, the organization had defined selfitis as “the obsessive compulsive desire to take photos of one’s self and post them on social media as a way to make up for the lack of self-esteem and to fill a gap in intimacy”. The same article also claimed there three levels of the disorder: borderline (“taking photos of one’s self at least three times a day but not posting them on social media”), acute (“taking photos of one’s self at least three times a day and posting each of the photos on social media”), and chronic (“uncontrollable urge to take photos of one’s self round the clock and posting the photos on social media more than six times a day”).

The story was republished on numerous news sites around the world, but it soon became clear the story was a hoax. However, one of the reasons that so many news outlets republished the story – other than that it seemingly fit certain preexisting stereotypes in people’s minds – was that the criteria used to delineate the three levels of selfitis (i.e., borderline, acute, and chronic) seemed believable.

Therefore, we thought it would be interesting to examine whether there was any substance to the claims that taking selfies can be a time-consuming and potentially obsessive behavior – the stereotype underlying many people’s credulity about the fake story. We empirically explored the concept of selfitis across two studies and collected data on the existence of selfitis with respect to the three alleged levels (borderline, acute, and chronic), ultimately developed our own psychometric scale to assess the sub-components of selfitis (the Selfitis Behaviour Scale).

We used Indian students as participants in our research because India has the largest total number of users on Facebook by country. We also knew India accounts for more selfie-related deaths in the world compared to any other country. with a reported 76 deaths reported out of a total of 127 worldwide since 2014. (Those deaths usually occur when people attempt to take selfies in dangerous contexts, such as in water, from heights, in the proximity of moving vehicles, like trains, or while posing with weapons).

Our study began by using focus group interviews with 225 young adults with an average age of 21 years old to gather an initial set of criteria that underlie selfitis. Example questions used during the focus group interviews included ‘What compels you to take selfies?’, ‘Do you feel addicted to taking selfies?’ and ‘Do you think that someone can become addicted to taking selfies?’ It was during these interviews that participants confirmed there appeared to be individuals who obsessively take selfies — or, in other words, that selfitis does at least exist. But, since we did not collect any data on the negative psychosocial impacts, we cannot yet claim that the behavior is a mental disorder; negative consequences of the behavior is a key part of that determination.

The six components of selfitis, tested on the further participants, were: environmental enhancement (e.g., taking selfies in specific locations to feel good and show off to others); social competition (e.g., taking selfies to get more ‘likes’ on social media); attention-seeking (e.g., taking selfies to gain attention from others); mood modification (e.g., taking selfies to feel better); self-confidence (e.g., taking selfies to feel more positive about oneself); and subjective conformity (e.g., taking selfies to fit in with one’s social group and peers).

Our findings showed that those with chronic selfitis were more likely to be motivated to take selfies due to attention-seeking, environmental enhancement and social competition. The results suggest that people with chronic levels of selfitis are seeking to fit in with those around them, and may display symptoms similar to other potentially addictive behaviours. Other studies have also suggested that a minority of individuals might have a ‘selfie addiction’ (see ‘References and further reading’ below).

With the existence of the condition apparently confirmed, we hope that further research will be carried out to understand more about how and why people develop this potentially obsessive behaviour, and what can be done to help people who are the most affected. However, the findings of our research do not indicate that selfitis is a mental disorder based on the findings of this study – a claim made in many of the news reports about our study, possibly demonstrating how deep the stereotypes about selfie-takes run – only that selfitis appears to be a condition that requires further research to fully assess the psychosocial impacts that the behaviour might have on the individual.

If you are interested in assessing your own behavior, click here to download where you can complete the self-assessment test in the Appendix of our paper.

Please note: This article was co-written with Dr. Janarthanan Balakrishnan (Thiagarajar School of Management, India)

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

Further reading

Balakrishnan, J. & Griffiths, M.D. (2018). An exploratory study of ‘selfitis’ and the development of the Selfitis Behavior Scale. International Journal of Mental Health and Addiction, https://doi.org/10.1007/s11469-017-9844-x.

Gaddala, A., Hari Kumar, K. J., & Pusphalatha, C. (2017). A study on various effects of internet and selfie dependence among undergraduate medical students. Journal of Contemporary Medicine and Dentistry, 5(2), 29-32.

Griffiths, M.D. & Balakrishnan, J. (2018). The psychosocial impact of excessive selfie-taking in youth: A brief overview. Education and Health, 36(1), 3-5.

Kaur, S., & Vig, D. (2016). Selfie and mental health issues: An overview. Indian Journal of Health and Wellbeing, 7(12), 1149

Khan, N., Saraswat, R., & Amin, B. (2017). Selfie: Enjoyment or addiction? Journal of Medical Science and Clinical Research, 5, 15836-15840.

Lee, R. L. (2016). Diagnosing the selfie: Pathology or parody? Networking the spectacle in late capitalism. Third Text, 30(3-4), 264-27

Senft, T. M., & Baym, N. K. (2015). Selfies introduction – What does the selfie say? Investigating a global phenomenon. International Journal of Communication, 9, 19

Singh, D., & Lippmann, S. (2017). Selfie addiction. Internet and Psychiatry, April 2. Located at: https://www.internetandpsychiatry.com/wp/editorials/selfie-addiction/

Singh, S. & Tripathi, K.M. (2017). Selfie: A new obsession. SSRN, Located at: http://dx.doi.org/10.2139/ssrn.2920945