Author Archives: drmarkgriffiths
I’ve been working in the area of gambling for nearly 30 years and over the past 15 years I have carrying out research into both online gambling and responsible gambling. As I have outlined in previous blogs, one of the new methods I have been using in my published papers is online behavioural tracking. The chance to carry out innovative research in both areas using a new methodology was highly appealing – especially as I have used so many other methods in my gambling research (including online and offline surveys, experiments in laboratories and ecologically valid settings, offline focus groups, online and offline case study interviews, participant and non-participation observation, secondary analysis of survey data, and analysis of various forms of online data such as those found in online forums and online diary blogs).
Over the last decade there has been a big push by gambling regulators for gambling operators to be more socially responsible towards its clientele and this has led to the use of many different responsible gambling (RG) tools and initiatives such as voluntary self-exclusion schemes (where gamblers can ban themselves from gambling), limit setting (where gamblers can choose how much time and/or money they want to lose while gambling), personalized feedback (where gamblers can get personal feedback and advice based on their actual gambling behaviour) and pop-up messages (where gamblers receive a pop-up message during play that informs them how long they have been playing or how much money that have spent during the session).
However, very little is known about whether these RG tools and initiatives actually work, and most of the research that has been published relies on laboratory methods and self-reports – both of which have problems as reliable methods when it comes to evaluating whether RG tools work. Laboratory experiments typically contain very few participants and are carried out in non-ecologically valid settings, and self-reports are prone to many biases (including social desirability and recall biases). Additionally, the sample sizes are also relatively small (although bigger than experiments).
The datasets to analyse player behaviour are huge and can include hundreds of thousands of online gamblers. Given that my first empirical paper on gambling published in the Journal of Gambling Studies in 1990 was a participant observational analysis of eight slot machine gamblers at one British amusement arcade, it is extraordinary to think that decades later I have access to datasets beyond anything I could have imagined back in the 1980s when I began my research career. The data analysis is carried with my research colleague Michael Auer who has a specific expertise in data mining and we use traditional statistical tests to analyse the data. However, the hardest part is always trying to work out which parameters to use in assessing whether the RG tool worked or not. The kind of data we have includes how much time and money that players are spending on the gambling website, and using that data we can assess to what extent the amount of time and money decreases as a result of using limit setting measures, or receiving personalized feedback or a pop-up message.
One of the biggest problems in doing this type of research in the gambling studies field is getting access to the data in the first place and the associated issue of whether academics should be working with the gambling industry in the first place. The bottom line is that we would never have been able to undertake this kind of innovative research with participant sizes of hundreds of thousands of real gamblers without working in co-operation with the gambling industry. (It should also be noted that the gambling companies in question did not fund the research but provided simply provided access to their databases and customers). In fact, I would go as far as to say the research would have been impossible without gambling industry co-operation. Data access provided by the gambling industry has to be one of the key ways forward if the field is to progress.
Unlike other consumptive and potentially addictive behaviours (smoking cigarettes, drinking alcohol, etc.), researchers can study real-time gambling (and other potentially addictive behaviours like video gaming and social networking) in a way that just cannot be done in other chemical and behavioural addictions (e.g., sex, exercise, work, etc.) because of online and/or card-based technologies (such as loyalty cards and player cards). There is no equivalent of this is the tobacco or alcohol industry, and is one of the reasons why researchers in the gambling field are beginning to liaise and/or collaborate with gambling operators. As researchers, we should always strive to improve our theories and models and it appears strange to neglect this purely objective information simply because it involves working together with the gambling industry. This is especially important given the recent research by Dr. Julia Braverman and colleagues published in the journal Psychological Assessment using data from gamblers on the bwin website showing that self-recollected information does not match with objective behavioural tracking data.
The great thing about online behavioural tracking data collected from gamblers is that it is totally objective (as it provides a true record of what every gambler does click-by-click), is collected from real world gambling websites (so is ecologically valid), and has large sample sizes (typically tens of thousands of online gamblers). There of course some disadvantages, the main ones being that the sample is unrepresentative of all online gamblers (as the data only comes from gamblers at one website) and nothing is known about the person’s gambling activity at other websites (research has shown that online gamblers typically gamble at a number of different websites and not just one). Despite these limitations, the analysis of behavioural tracking data (so-called ‘big data’) is a reliable and cutting-edge way to assess and evaluate online gambling behaviour and to assess whether RG tools actually work in real world gambling settings with real online gamblers in real time.
To get access to such data you have to cultivate a trusting relationship with the data providers. It took me years to build up trust with the gambling industry because researchers who study problem gambling are often perceived by the gambling industry to be ‘anti-gambling’ but in my case this wasn’t true. I am ‘pro-responsible gambling’ and gamble myself so it would be hypocritical to be anti-gambling. My main aim in my gambling research is to protect players and minimise harm. Problem gambling will never be totally eliminated but it can be minimised. If gambling companies share the same aim and philosophy of not wanting to make money from problem gamblers but to make money from non-problem gamblers, then I would be prepared to help and collaborate.
You also need to be thick-skinned. If you are analysing any behavioural tracking data provided by the gambling industry, then you need to be prepared for others in the field criticizing you for working in collaboration with the industry. Although none of this research is funded by the industry, the fact that you are collaborating is enough for some people to accuse you of not being independent and/or being in the pockets of the gambling industry. Neither of these are true but it won’t stop the criticism. Nor will it stop me from carrying on researching in this area using datasets provided by the gambling industry.
Dr. Mark Griffiths, Professor of Gambling Studies, International Gaming Research Unit, Nottingham Trent University, Nottingham, UK
Auer, M. & Griffiths, M.D. (2013). Behavioral tracking tools, regulation and corporate social responsibility in online gambling. Gaming Law Review and Economics, 17, 579-583.
Auer, M. & Griffiths, M.D. (2013). Voluntary limit setting and player choice in most intense online gamblers: An empirical study of gambling behaviour. Journal of Gambling Studies, 29, 647-660.
Auer, M. & Griffiths, M.D. (2014). Personalised feedback in the promotion of responsible gambling: A brief overview. Responsible Gambling Review, 1, 27-36.
Auer, M. & Griffiths, M.D. (2014). An empirical investigation of theoretical loss and gambling intensity. Journal of Gambling Studies, 30, 879-887.
Auer, M. & Griffiths, M.D. (2015). Testing normative and self-appraisal feedback in an online slot-machine pop-up message in a real-world setting. Frontiers in Psychology, 6, 339. doi: 10.3389/fpsyg.2015.00339.
Auer, M. & Griffiths, M.D. (2015). Theoretical loss and gambling intensity (revisited): A response to Braverman et al (2013). Journal of Gambling Studies, 31, 921-931.
Auer, M. & Griffiths, M.D. (2015). The use of personalized behavioral feedback for problematic online gamblers: An empirical study. Frontiers in Psychology, 6, 1406. doi: 10.3389/fpsyg.2015.01406.
Auer, M., Littler, A. & Griffiths, M.D. (2015). Legal aspects of responsible gaming pre-commitment and personal feedback initiatives. Gaming Law Review and Economics, 6, 444-456.
Auer, M., Malischnig, D. & Griffiths, M.D. (2014). Is ‘pop-up’ messaging in online slot machine gambling effective? An empirical research note. Journal of Gambling Issues, 29, 1-10.
Auer, M., Schneeberger, A. & Griffiths, M.D. (2012). Theoretical loss and gambling intensity: A simulation study. Gaming Law Review and Economics, 16, 269-273.
Braverman, J., Tom, M., & Shaffer, H. J. (2014). Accuracy of self-reported versus actual online gambling wins and losses. Psychological Assessment, 26, 865-877.
Griffiths, M.D. (1990). Addiction to fruit machines: A preliminary study among males. Journal of Gambling Studies, 6, 113-126.
Griffiths, M.D. & Auer, M. (2011). Approaches to understanding online versus offline gaming impacts. Casino and Gaming International, 7(3), 45-48.
Griffiths, M.D. & Auer, M. (2015). Research funding in gambling studies: Some further observations. International Gambling Studies, 15, 15-19.
While researching previous blogs on sexual piggybacking and ‘lift and carry’ fetishism, I noticed that when the words ‘shoulder’ and ‘fetish’ were in the same Google search, I came across a number of discussion sites where people were discussing their fetishes for shoulders. Here are a few of the cases that I came across:
- Extract 1 (male): “I’ve never been into women wearing make-up, loads of perfume, and all that jazz, but for some reason, seeing the bare shoulders of a woman really makes me excited. Not that I want to have sex with the shoulders, but that they simply look hot, sort of like the way most men view breasts. Is this normal, psychologically?”
- Extract 2 (male): “I love a woman’s exposed shoulders. I’m very attracted to them, my major turn on. I love how they look [and] how they feel. Talking about their shoulders really turns me on”
- Extract 3 (male): “I also get turned on by the sight of a woman’s bare shoulders. That is why I love to see women in tank tops, halter tops, sleeveless tops, and off-the-shoulder tops (my favorite)”
- Extract 4 (male): “Broad shoulders are a pretty common turn on for women anyway”.
- Extract 5 (male): “I’m not into panties, lingerie, or wearing make up, but I’ve always had an attraction to sexy female tops. I have always had a fetish about seeing a woman’s bare shoulders and got off many times fantasizing about them. Not taking it a step further, I’ve always loved wearing female sleeveless blouses and tops. I know they make tank tops for guys, but it’s not the same thrill as wearing a woman’s black, sleeveless, turtleneck jersey. I also enjoy wearing halter tops, tube tops, camies, one-shoulder tanks, and leotards, which I wear openly at the gym. I never feel as liberated as when I’m out in public with my shoulders bare. I’ve never met anyone else who’s into this with whom I could share my fantasy. But I would like to hear from anybody who is, be it man or woman, who may also have this fetish”
- Extract 6 (male): “I have a fetish of girls sitting on my shoulders…I’ve loved this ever since I can remember…even before I knew what sex was. I have a female friend, and one time me, her, and one of her friends were walking through a field at night, and her friend said she was afraid of getting ticks and asked to sit on my shoulders. I lifted her up, and after awhile she started like bossing me around, telling me where to stand, etc…I enjoyed this. Is this fetish healthy? Sometimes I wonder if I let people push me around in life because of this fetish”
- Extract 7 (male): “I find a sexual partner’s shoulders really arousing, on both men and women. Am I in the minority or is it pretty normal?”
- Extract 8 (male): “This will probably sound strange, but I have a shoulder fetish. A beautiful girl, in a cute pose, with her shoulder exposed, absolutely makes my heart race”
Admittedly, there is little detail in these extracts and I have no way of knowing to what extent any of the extracts I have selected are truthful (although I have no reason to suspect anyone was lying). As there is little detail here, there was almost nothing on how the interest developed apart from Extract 6 where the interest in shoulders was more to do with the act of a female sitting on his shoulders rather than fetishizing the shoulders themselves. Here, the fetish (if it really is a fetish) is more akin to ‘lift and carry’ fetishes with overtones of sexual masochism (i.e., being bossed around by a female and getting a sexual thrill from it).
All of the extracts were from males (presumably heterosexual apart from Extract 5 who may be bisexual and/or a transvestite based on the small amount of information provided). Although I could reasonably conclude that shoulder fetishes are primarily male-based, I did deliberately include the comment made by a male in Extract 4 who pointed out that women often remark on the sexiness and attractiveness of men that have broad shoulders. This observation made the implied point that it is almost the norm for some women to find men’s shoulders a sexual turn-on but may be rare for men to comment on the attractiveness of women’s shoulders. Basically, when women talk about the attractiveness of men’s shoulders it is normalized whereas when men talk about the attractiveness of women’s shoulders it is fetishized.
As far as I am aware, not only is there no academic or clinical research on the topic of shoulder fetishes, but there aren’t even any articles (this I believe is the first ever article on the topic). There was nothing between ‘shaving’ and ‘showers’ in Dr. Brenda Love’s Encyclopedia of Unusual Sex Practices and nothing in Dr. Anil Aggrawal’s Forensic and Medico-legal Aspects of Sexual Crimes and Unusual Sexual Practices. Shoulders weren’t even mentioned in the list of fetishized body parts in Dr. C. Scorolli and colleagues’ excellent paper on the prevalence of fetishes in their 2007 paper in the International Journal of Impotence Research (a study I have cited countless times in relation to my blogs on other sexualized body parts). Given the complete lack of scientific study relating to shoulder fetishes I have decided to name a new paraphilia based on traditional nosology using the Greek words for ‘shoulder’ (omos) and ‘love’ (philia) – thus this ‘new’ paraphilia is called omosophilia (not to be confused with ‘osmophilia’ – where individuals derive sexual pleasure from certain smells and odours).
Dr Mark Griffiths, Professor of Behavioural Addiction, International Gaming Research Unit, Nottingham Trent University, Nottingham, UK
Aggrawal A. (2009). Forensic and Medico-legal Aspects of Sexual Crimes and Unusual Sexual Practices. Boca Raton: CRC Press.
Gates, K. (2000). Deviant desires: Incredibly strange sex. New York: Juno Books.
Love, B. (2001). Encyclopedia of Unusual Sex Practices. London: Greenwich Editions.
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.
A few weeks ago, my colleagues and I received a lot of media coverage around the world for our latest study on workaholism that was published in the journal PLoS ONE. The study involved researchers from the University of Bergen (Norway) and Yale University USA) and is probably the largest ever study done on the topic as it included 16,426 working Norwegian adults. Our study got a lot of press attention because we examined the associations between workaholism and a number of different psychiatric disorders.
We found that workaholics scored higher on all the psychiatric symptoms than non-workaholics. For instance we found that among those we classed as workaholics (using the Bergen Work Addiction Scale that we published in the Scandinavian Journal of Psychology four years ago and which I talked about in a previous blog), we found that:
- 32.7% met ADHD (attention-deficit/hyperactivity disorder) criteria (12.7 per cent among non-workaholics).
- 25.6% met OCD (obsessive-compulsive disorder) criteria (8.7 per cent among non-workaholics).
- 33.8% met anxiety criteria (11.9 per cent among non-workaholics).
- 8.9% met depression criteria (2.6 per cent among non-workaholics).
These were all statistically significant differences between workaholics and non-workaholics.
I think a lot of people wondered why we looked at the relationship between workaholism and ADHD to begin with. Firstly, research has consistently demonstrated that Attention-Deficit/Hyperactivity Disorder (ADHD) increases the risk of various chemical and non-chemical addictions. ADHD is prevalent in 2.5–5% of the adult population, and is typically manifested by inattentiveness and lack of focus, and/or impulsivity, and excessive physical activity. Individuals with ADHD may often stop working due to their disorder, and may have trouble in getting work health insurance as they are regarded as a risk group. For this reason, we thought that individuals with ADHD may compensate for this by over-working to meet the expectations required to hold down a job. Although this is a contentious issue, there are a number of reasons why ADHD may be relevant to workaholism.
Firstly, we argued that the inattentive nature of individuals with ADHD causes them to spend time beyond the typical working day (i.e., evenings and weekends) to accomplish what is done by their fellow employees within normal working hours (i.e., the compensation hypothesis). In addition, as they may have a hard time concentrating while at work due to environmental noise and distractions (especially office work in open landscape environments), they might find it easier to work after co-workers have left their working environment or work from home. Their attentive shortcomings may also cause them to overly check for errors on the tasks given, since they often experience careless mistakes due to their inattentiveness. This may cause a cycle of procrastination, work binges, exhaustion, and – in some cases – a fear of imperfection. Although ADHD is associated with lack of focus, such individuals often have the ability to hyper-focus once they find something interesting–often being unable to detach themselves from the task.
Secondly, we argued that the impulsive nature of individuals with ADHD causes them to say ‘yes’ and taking on many tasks without them thinking ahead, and taking on more work than they can realistically handle–eventually leading to workaholic levels of activity. Thirdly, we also argued that the hyperactive nature of individuals with ADHD and the need to be constantly active without being able to relax, causes such individuals to keep on working in an attempt to alleviate their restless thoughts and behaviors. Consequently, work stress might act as a stimulant, and they may choose active (and often multiple) jobs with high pressure, deadlines and activity (e.g., media, sales, restaurant work) – where they have the opportunity to multitask and constantly shift between tasks (e.g., Type-A personality behavior).
In line with this, Type-A personality has often been associated – and sometimes used inter-changeably – with workaholism in previous research. This line of reasoning also relates to the workaholic type portrayed by Dr. Bryan Robinson (in his 2014 book Chained to the desk: A guidebook for workaholics, their partners and children, and the clinicians who treat them), in which he actually denoted “attention-deficit workaholics” (who tend to start many projects but become bored easily and need to be stimulated at all times). His description of the “relentless” type also corresponds well with ADHD symptoms (i.e., unstoppable in working fast and meeting deadlines, often with many projects going on simultaneously). In other words, these types may utilize work pressure to obtain focus, constantly seeking stimulation, crisis, and excitement – and therefore like risky jobs.
Finally, people with ADHD are often mistaken as being lazy, irresponsible, or unintelligent because of their difficulties with planning, time management, organizing, and decision-making. Feeling misunderstood might cause individuals with ADHD to push themselves to prove these misconceptions as wrong – and resulting in an excessive and/or compulsive working pattern. Such individuals are often intelligent, but may feel forced or motivated to start up their own business (i.e., entrepreneurs), as they find it troubling to adjust to standard work schedules or organizational boundaries. Previous research has highlighted that workaholism is prevalent among entrepreneurs and the self-employed. Often failing in other aspects of life (e.g., family), work for such individuals may become even more important to them (e.g., self- efficacy). This is why we hypothesized that ADHD symptoms will be positively associated with workaholism in our study (and that is what we found).
Obsessive-Compulsive Disorder (OCD) is another underlying psychiatric disorder that increases the likelihood of developing an addiction. Full-blown OCD occurs in approximately 2-3% of children and adults, and is commonly manifested by intrusive thoughts and repetitive behaviors of checking, obsessing, ordering, hoarding, washing, and/or neutralizing. It has been suggested that addictive behaviors might represent a coping and/or escape mechanism of OCD symptoms, or as an OCD-behavior that eventually becomes an addiction in itself. Previous workaholic typologies such as those described by Dr. Kimberly Scotti and her colleagues in the journal Human Relations have incorporated the ‘compulsive-dependent’ and ‘perfectionistic’ workaholic types, and some empirical studies have demonstrated that obsessive-compulsive traits are present among workaholics. The OCD tendency of having the need to arrange things in a certain way (i.e., a strong need for control) and obsessing over details to the point of paralysis – may predispose workers with such traits to develop workaholic working patterns. Again we found in our study that OCD symptoms were positively related to workaholism.
It has also been reported that other psychiatric disorders such as anxiety and depression may also increase the risk of developing an addiction. Approximately 30% of people will suffer from an anxiety disorder in their lifetime, and 20% will have at least one episode of depression. These conditions often occur simultaneously, as most people who are depressed also experience acute anxiety. Consequently, anxiety and/or depression can lead to addiction, and vice versa. A number of studies have previously reported a link between anxiety, depression, and workaholism. Furthermore, we know that workaholism (in some instances) develops as an attempt to reduce uncomfortable feelings of anxiety and depression. Working hard is praised and honored in modern society, and thus serves as a legitimate behavior for individuals to combat or alleviate negative feelings – and to feel better about themselves and raise their self-esteem. This is why we hypothesized that there would be a positive association between anxiety, depression, and workaholism (and that is what we found). In relation to our study’s findings as a whole, the lead author of our study (Dr. Cecilie Andreassen) told the world’s media:
“Taking work to the extreme may be a sign of deeper psychological or emotional issues. Whether this reflects overlapping genetic vulnerabilities, disorders leading to workaholism or, conversely, workaholism causing such disorders, remain uncertain…Physicians should not take for granted that a seemingly successful workaholic does not have ADHD-related or other clinical features. Their considerations affect both the identification and treatment of these disorders”.
Our findings clearly highlighted the importance of further investigating neurobiological differences related to workaholic behaviour. Finally, in line with our previous research published two years ago (also in the PLoS ONE journal) using a nationally representative sample, 7.8% of the participants in our latest study were classed as workaholics compared to 8.3% in our previous study.
Dr. Mark Griffiths, Professor of Behavioural Addiction, International Gaming Research Unit, Nottingham Trent University, Nottingham, UK
Andreassen, C.S., Griffiths, M.D., Hetland, J., Kravina, L., Jensen, F., & Pallesen, S. (2014). The prevalence of workaholism: A survey study in a nationally representative sample of Norwegian employees. PLoS ONE, 9(8): e102446. doi:10.1371/journal.pone.0102446.
Andreassen, C.S., Griffiths, M.D., Hetland, J. & Pallesen, S. (2012). Development of a Work Addiction Scale. Scandinavian Journal of Psychology, 53, 265-272.
Andreassen, C.S., Griffiths, M.D., Sinha, R., Hetland, J. & Pallesen, S. (2016). The relationships between workaholism and symptoms of psychiatric disorders: A large-scale cross-sectional study. PLoS ONE, 11(5): e0152978. doi:10.1371/journal. pone.0152978.
Griffiths, M.D. (2005). Workaholism is still a useful construct. Addiction Research and Theory, 13, 97-100.
Griffiths, M.D. (2011). Workaholism: A 21st century addiction. The Psychologist: Bulletin of the British Psychological Society, 24, 740-744.
Griffiths, M.D. & Karanika-Murray, M. (2012). Contextualising over-engagement in work: Towards a more global understanding of workaholism as an addiction. Journal of Behavioral Addictions, 1(3), 87-95.
Karanika-Murray, M., Duncan, N., Pontes, H. & Griffiths, M.D. (2015). Organizational identification, work engagement, and job satisfaction. Journal of Managerial Psychology, 30, 1019-1033.
Karanika-Murray, M., Pontes, H.M., Griffiths, M.D. & Biron, C. (2015). Sickness presenteeism determines job satisfaction via affective-motivational states. Social Science and Medicine, 139, 100-106.
Orosz, G., Dombi, E., Andreassen, C.S., Griffiths, M.D. & Demetrovics, Z. (2016). Analyzing models of work addiction: Single factor and bi-factor models of the Bergen Work Addiction Scale. International Journal of Mental Health and Addiction, in press
Quinones, C. & Griffiths, M.D. (2015). Addiction to work: recommendations for assessment. Journal of Psychosocial Nursing and Mental Health Services, 10, 48-59.
Quinones, C., Griffiths, M.D. & Kakabadse, N. (2016). Compulsive Internet use and workaholism: An exploratory two-wave longitudinal study. Computers in Human Behavior, 60, 492-499.
Robinson, B.E. (2014). Chained to the desk: A guidebook for workaholics, their partners and children, and the clinicians who treat them. New York: New York University Press.
Scotti, K.A., Moore, K.S., & Miceli, M.P. (1997). An exploration of the meaning and consequences of workaholism. Human Relations, 50, 287–314.
Shonin, E., Van Gordon, W., & Griffiths M.D. (2014). The treatment of workaholism with Meditation Awareness Training: A case study. Explore: Journal of Science and Healing, 10, 193-195.
Sussman, S., Lisha, N. & Griffiths, M.D. (2011). Prevalence of the addictions: A problem of the majority or the minority? Evaluation and the Health Professions, 34, 3-56.
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, exercise addiction, and shopping addiction, here is a round-up of recent papers that my colleagues and I have published on sex addiction.
Griffiths, M.D. & Dhuffar, M. (2014). Treatment of sexual addiction within the British National Health Service. International Journal of Mental Health and Addiction, 12, 561-571.
- At present, the prevalence of rates of sexual addiction in the UK is unknown. This study investigated what treatment services were available within British Mental Health Trusts (MHTs) that are currently provided for those who experience compulsive and/or addictive sexual behaviours within the National Health Service (NHS) system. In March and April 2013, a total of 58 letters were sent by email to all Mental Health Trusts in the UK requesting information about (i) sexual addiction services and (ii) past 5-year treatment of sexual addiction. The request for information was sent to all MHTs under the Freedom of Information Act (2001). Results showed that 53 of the 58 MHTs (91 %) did not provide any service (specialist or otherwise) for treating those with problematic sexual behaviours. Based on the responses provided, only five MHTs reported having had treated sexual addiction as a disorder that took primacy over the past 5 years. There was also some evidence to suggest that the NHS may potentially treat sexual addiction as a secondary disorder that is intrinsic and/or co-morbid to the initial referral made by the GP. In light of these findings, implications for the treatment of sex addiction in a British context are discussed.
Dhuffar, M. & Griffiths, M.D. (2014). Understanding the role of shame and its consequences in female hypersexual behaviours: A pilot study. Journal of Behavioural Addictions, 3, 231–237.
- Background and aims: Hypersexuality and sexual addiction among females is a little understudied phenomenon. Shame is thought to be intrinsic to hypersexual behaviours, especially in women. Therefore, the aim of this study was to understand both hypersexual behaviours and consequences of hypersexual behaviours and their respective contributions to shame in a British sample of females (n = 102). Methods: Data were collected online via Survey Monkey. Results: Results showed the Sexual Behaviour History (SBH) and the Hypersexual Disorder Questionnaire (HDQ) had significant positive correlation with scores on the Shame Inventory. The results indicated that hypersexual behaviours were able to predict a small percentage of the variability in shame once sexual orientation (heterosexual vs. non-heterosexual) and religious beliefs (belief vs. no belief) were controlled for. Results also showed there was no evidence that religious affiliation and/or religious beliefs had an influence on the levels of hypersexuality and consequences of sexual behaviours as predictors of shame. Conclusions: While women in the UK are rapidly shifting to a feminist way of thinking with or without technology, hypersexual disorder may often be misdiagnosed and misunderstood because of the lack of understanding and how it is conceptualised. The implications of these findings are discussed.
Dhuffar, M. & Griffiths, M.D. (2015). A systematic review of online sex addiction and clinical treatments using CONSORT evaluation. Current Addiction Reports, 2, 163-174.
- Researchers have suggested that the advances of the Internet over the past two decades have gradually eliminated traditional offline methods of obtaining sexual material. Additionally, research on cybersex and/or online sex addictions has increased alongside the development of online technology. The present study extended the findings from Griffiths’ (2012) systematic empirical review of online sex addiction by additionally investigating empirical studies that implemented and/or documented clinical treatments for online sex addiction in adults. A total of nine studies were identified and then each underwent a CONSORT evaluation. The main findings of the present review provide some evidence to suggest that some treatments (both psychological and/or pharmacological) provide positive outcomes among those experiencing difficulties with online sex addiction. Similar to Griffiths’ original review, this study recommends that further research is warranted to establish the efficacy of empirically driven treatments for online sex addiction.
Dhuffar, M. & Griffiths, M.D. (2015). Understanding conceptualisations of female sex addiction and recovery using Interpretative Phenomenological Analysis. Psychology Research, 5, 585-603.
- Relatively little research has been carried out into female sex addiction. There is even less regarding understandings of lived experiences of sex addiction among females. Consequently, the purpose of the present study was to examine the experiences of female sex addiction (from onset to recovery). This was done by investigating the experiences and conceptualisations of three women who self-reported as having had a historical problem with sex addiction. An interpretative phenomenological analysis (IPA) methodology was applied in the current research process in which three female participants shared their journey through the onset, progression, and recovery of sex addiction. The IPA produced five superordinate themes that accounted for the varying degrees of sexual addiction among a British sample of females: (1) “Focus on self as a sex addict”; (2) “Uncontrollable desire”; (3) “Undesirable feelings”; (4) “Derision”; and (5) “Self help, treatment and recovery”. The implications of these findings towards the understanding and the need for the implementation of treatment are discussed.
Dhuffar, M., Pontes, H.M. & Griffiths, M.D. (2015). The role of negative mood states and consequences of hypersexual behaviours in predicting hypersexuality among university students. Journal of Behavioural Addictions, 4, 181–188.
- The issue of whether hypersexual behaviours exist among university students is controversial because many of these individuals engage in sexual exploration during their time at university. To date, little is known about the correlates of hypersexual behaviours among university students in the UK. Therefore, the aims of this exploratory study were two-fold. Firstly, to explore and establish the correlates of hypersexual behaviours, and secondly, to investigate whether hypersexuality among university students can be predicted by variables relating to negative mood states (i.e., emotional dysregulation, loneliness, shame, and life satisfaction) and consequences of hypersexual behaviour.
Van Gordon, W., Shonin, E., & Griffiths, M.D. (2016). Meditation Awareness Training for the treatment of sex addiction: A case study. Journal of Behavioral Addictions, in press.
- Sex addiction is a disorder that can have serious adverse functional consequences. Treatment effectiveness research for sex addiction is currently underdeveloped, and interventions are generally based on guidelines for treating other behavioural (as well as chemical) addictions. Consequently, there is a need to clinically evaluate tailored treatments that target the specific symptoms of sex addiction. It has been proposed that second-generation mindfulness-based interventions (SG-MBIs) may be an appropriate treatment for sex addiction because in addition to helping individuals increase perceptual distance from craving for desired objects and experiences, some SG-MBIs specifically contain meditations intended to undermine attachment to sex and/or the human body. To date, no study exploring the utility of mindfulness for treating sex addiction has been conducted. This paper presents an in-depth clinical case study of a male individual suffering from sex addiction that underwent treatment utilising an SG-MBI known as Meditation Awareness Training (MAT). Following completion of MAT, the participant demonstrated clinically significant improvements regarding the addictive sexual behaviour, as well less depression and psychological distress. The MAT intervention also led to improvements in sleep quality, job satisfaction, and non-attachment to self and experiences. Salutary outcomes were maintained at six-month follow-up. The current study extends the literature exploring the applications of mindfulness for treating behavioural addiction, and findings of this case study indicate that further clinical investigation into the role of mindfulness for treating sex addiction is warranted.
Dr. Mark Griffiths, Professor of Behavioural Addiction, International Gaming Research Unit, Nottingham Trent University, Nottingham, UK
Griffiths, M.D. (2000). Excessive internet use: Implications for sexual behavior. CyberPsychology and Behavior, 3, 537-552.
Griffiths, M.D. (2001). Addicted to love: The psychology of sex addiction. Psychology Review, 8, 20-23.
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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
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/
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GoodTherapy.Org (2016). Poetry therapy. Located at: http://www.goodtherapy.org/learn-about-therapy/types/poetry-therapy
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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
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