Author Archives: drmarkgriffiths

Term warfare: Internet Gaming Disorder and Internet Addiction Disorder are not the same

Over the last 15 years, research into various online addictions has greatly increased. Alongside this, there have been scholarly debates about whether internet addiction really exists. Some may argue that because internet use does not involve the ingestion of a psychoactive substance, then it should not be considered a genuine addictive behaviour. However, the latest (fifth) edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) re-classified ‘Gambling Disorder’ as a behavioural addiction rather than as a disorder of impulse control. The implications of this reclassification are potentially far-reaching. The most significant implication is that if an activity that does not involve the consumption of drugs (i.e., gambling) can be a genuine addiction accepted by the psychiatric and medical community, there is no theoretical reason why other problematic and habitual behaviours (e.g., shopping, work, exercise, sex, video gaming, etc.) cannot be classed as a bone fide addiction.

There have also been debates among scholars that consider excessive problematic internet use to be a genuine addiction as to whether the those in the field should study generalized internet addiction (the totality of all online activities) and/or specific addictions on the internet such as internet gambling, internet gaming and internet sex. Since the late 1990s, I have constantly argued that there is a fundamental difference between addictions on the internet, and addictions to the internet. I argued that the overwhelming majority of individuals that were allegedly addicted to the internet were not internet addicts but were individuals that used the medium of the internet as a vehicle for other addictions. More specifically, I argued that internet gambling addicts and internet gaming addicts were not internet addicts but were gambling and gaming addicts using the convenience and ubiquity of the internet to gamble or play video games.

Prior to the publication of the latest DSM-5, there had also been debates as to whether ‘internet addiction’ should be introduced into the text as a separate disorder. Following these debates, the Substance Use Disorder Work Group (SUDWG) recommended that the DSM-5 include a sub-type of problematic internet use (i.e., internet gaming disorder [IGD]) in Section 3 (‘Emerging Measures and Models’) as an area that needed future research before being included in future editions of the DSM. However, far from clarifying the debates surrounding generalized versus specific internet use disorders, the section of the DSM-5 discussing IGD noted that:

“There are no well-researched subtypes for Internet gaming disorder to date. Internet gaming disorder most often involves specific Internet games, but it could involve non-Internet computerized games as well, although these have been less researched. It is likely that preferred games will vary over time as new games are developed and popularized, and it is unclear if behaviors and consequence associated with Internet gaming disorder vary by game type…Internet gaming disorder has significant public health importance, and additional research may eventually lead to evidence that Internet gaming disorder (also commonly referred to as Internet use disorder, Internet addiction, or gaming addiction) has merit as an independent disorder” (p.796).

In light of what has been already highlighted in previous research, two immediate problematic issues arise from these assertions. Firstly, IGD is clearly seen as synonymous with internet addiction as the text claims that internet addiction and internet use disorder are simply other names for IGD. Secondly – and somewhat confusingly – it is asserted that IGD (which is by definition internet-based) can also include offline gaming disorders.

With regards to the first assertion, internet addiction and .addiction are not the same. A number of recent studies (including ones I’ve co-authored) clearly shows that to be the case. The second assertion that IGD can include offline video gaming is both baffling and confusing. Some researchers consider video games as the starting point for examining the characteristics of gaming disorder, while others consider the internet as the main platform that unites different addictive internet activities, including online games. For instance, I have argued that although all addictions have particular and idiosyncratic characteristics, they share more commonalities than differences (i.e., salience, mood modification, tolerance, withdrawal symptoms, conflict, and relapse), and likely reflects a common etiology of addictive behaviour. For me, IGD is clearly a sub-type of video game addiction. For people like Dr. Kimberley Young, ‘cyber-relationship addictions’, ‘cyber-sexual addictions’, ‘net compulsions’ (gambling, day trading) and ‘information overload’ are all internet addictions. However, many would argue that these – if they are addictions – are addictions on the internet, not to it. The internet is a medium and it is a situational characteristic. The fact that the medium might enhance addictiveness or problematic behaviour does not necessarily make it a sub-type of internet addiction.

However, recent studies have made an effort to integrate both approaches. For instance, some researchers claim that neither the first nor the second approach adequately captures the unique features of Massively Multiplayer Online Role-Playing Games (MMORPGs), and argue an integrated approach is a necessity. A common observation is that “Internet users are no more addicted to the Internet than alcoholics are addicted to bottles”. The internet is just a channel through which individuals may access whatever content they want (e.g., gambling, shopping, chatting, sex). On the other hand, online games differ from traditional standalone games, such as offline video games, in important aspects such as the social dimension or the role-playing dimension that allow interaction with other real players. Consequently, it could be argued that IGD can either be viewed as a specific type of video game addiction, or as a variant of internet addiction, or as an independent diagnosis. However, the idea that IGD can include offline gaming disorders does little for clarity or conceptualization.

Finally, it is also worth mentioning that there are some problematic online behaviours that could be called internet addictions as they can only take place online. The most obvious activity that fulfills this criterion is social networking as it is a ‘pure’ online activity and does not and cannot take place offline. Other activities such as gambling, gaming, and shopping can still be engaged in offline (as gamblers can go to a gambling venue, gamers can play a standalone console game, shoppers can go to a retail outlet). However, those engaged in social networking would not (if unable to access the internet) walk into a big room of people and start chatting to them all. However, even if social networking addiction is a genuine internet addiction, social networking itself is still a specific online application and could still be considered an addiction on the internet, rather than to it.

Based on recent empirical evidence, IGD (or any of the alternate names used to describe problematic gaming) is not the same as Internet Addiction Disorder. The gaming studies field needs conceptual clarity but as demonstrated, the DSM-5 itself is both misleading and misguided when it comes to the issue of IGD.

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

Further reading

Demetrovics, Z., Urbán, R., Nagygyörgy, K., Farkas, J., Griffiths, M. D., Pápay, O., . . . Oláh, A. (2012). The development of the Problematic Online Gaming Questionnaire (POGQ). PLoS ONE, 7(5), e36417.

Griffiths, M.D. (2000). Internet addiction – Time to be taken seriously? Addiction Research, 8, 413-418.

Griffiths, M. D. (2005). A ‘components’ model of addiction within a biopsychosocial framework. Journal of Substance Use, 10(4), 191-197.

Griffiths, M.D., King, D.L. & Demetrovics, Z. (2014). DSM-5 Internet Gaming Disorder needs a unified approach to assessment. Neuropsychiatry, under review.

Griffiths, M.D., Kuss, D.J. & King, D.L. (2012). Video game addiction: Past, present and future. Current Psychiatry Reviews, 8, 308-318.

Griffiths, M.D. & Pontes, H.M. (2014). Internet addiction disorder and internet gaming disorder are not the same. Journal of Addiction Research and Therapy, 5: e124. doi:10.4172/2155-6105.1000e124.

Kim, M. G., & Kim, J. (2010). Cross-validation of reliability, convergent and discriminant validity for the problematic online game use scale. Computers in Human Behavior, 26(3), 389-398.

King, D. L., Delfabbro, P. H., Griffiths, M. D., & Gradisar, M. (2011). Assessing clinical trials of Internet addiction treatment: A systematic review and CONSORT evaluation. Clinical Psychology Review, 31, 1110-1116.

King, D. L., Delfabbro, P. H., & Griffiths, M. D. (2012). Cognitive-behavioral approaches to outpatient treatment of Internet addiction in children and adolescents. Journal of Clinical Psychology, 68, 1185-1195.

King, D.L., Haagsma, M.C., Delfabbro, P.H., Gradisar, M.S., Griffiths, M.D. (2013). Toward a consensus definition of pathological video-gaming: A systematic review of psychometric assessment tools. Clinical Psychology Review, 33, 331-342.

Koronczai, B., Urban, R., Kokonyei, G., Paksi, B., Papp, K., Kun, B., . . . Demetrovics, Z. (2011). Confirmation of the three-factor model of problematic internet use on off-line adolescent and adult samples. Cyberpsychology, Behavior and Social Networking, 14, 657–664.

Kuss, D.J. & Griffiths, M.D. (2012). Internet and gaming addiction: A systematic literature review of neuroimaging studies. Brain Sciences, 2, 347-374.

Kuss, D.J., Griffiths, M.D., Karila, L. & Billieux, J. (2014).  Internet addiction: A systematic review of epidemiological research for the last decade. Current Pharmaceutical Design, 20, 4026-4052.

Pápay, O., Nagygyörgy, K., Griffiths, M.D. & Demetrovics, Z. (2014). Problematic online gaming. In K. Rosenberg & L. Feder (Eds.), Behavioral Addictions: Criteria, Evidence and Treatment. New York: Elsevier.

Petry, N.M., & O’Brien, C.P. (2013). Internet gaming disorder and the DSM-5. Addiction, 108, 1186–1187.

Pontes, H. & Griffiths, M.D. (2014). The assessment of internet gaming disorder in clinical research. Clinical Research and Regulatory Affairs, 31(2-4), 35-48.

Pontes, H. & Griffiths, M.D. (2015). Measuring DSM-5 Internet Gaming Disorder: Development and validation of a short psychometric scale. Computers in Human Behavior, 45, 137-143.

Pontes, H., Király, O. Demetrovics, Z. & Griffiths, M.D. (2014). The conceptualisation and measurement of DSM-5 Internet Gaming Disorder: The development of the IGD-20 Test. PLoS ONE, 9(10): e110137. doi:10.1371/journal.pone.0110137.

Pontes, H., Kuss, D. & Griffiths, M.D. (2015). The clinical psychology of Internet addiction: A review of its conceptualization, prevalence, neuronal processes, and implications for treatment. Neuroscience and Neuroeconomics, 4, 11-23.

Porter, G., Starcevic, V., Berle, D., & Fenech, P. (2010). Recognizing problem video game use. The Australian and New Zealand Journal of Psychiatry, 44, 120-128.

Young, K. S. (1998). Internet addiction: The emergence of a new clinical disorder. Cyberpsychology and Behavior, 1, 237-244.

Slow pain coming: A brief look at benign masturbatory cephalalgia

In a previous blog, I examined the medical research on individuals that suffer severe headaches as a result of having sex (known in the clinical and medical literature as ‘coital cephalalgia’ and ‘benign coital headache’). In such circumstances, the headache typically occurs at the brink of orgasm. While researching that particular blog, I also came across a number of papers (mainly case studies) that reported that these types of headache could also occur during masturbation (known as ‘benign masturbatory cephalalgia’ (BMC). (Here, the term ‘benign’ defines a primary headache syndrome not caused by any intracranial disorder).

The first paper that I read on BMC was a case account by Dr. Frederick Vincent in a 1982 issue the Archives of Neurology. Although benign orgasmic cephalgia had already been well described in the medical literature (particularly among males), Dr. Vincent reported the case of a 28-year old woman with orgasmic cephalalgia that developed during masturbation. This was reported by Dr. Vincent as the first ever case of BMC. The young woman “suffered a sudden throbbing occipital headache as she became orgasmic by masturbation”. The headache lasted an hour accompanied by mild nausea, but no other neurologic symptoms. As a result of this case, Dr. Vincent argued that the term ‘coital cephalagia’ should be dropped and simply called ‘orgasmic cephalagia’ irrespective of whether the headache was self-induced (i.e., masturbatory) or caused by having sexual intercourse.

Following the publication of Vincent’s case study, Dr. James Lance immediately responded in the same journal saying that he had reported the cases of three of his patients whose headaches were brought on by masturbation. Lance also agreed that the term coital cephalalgia was too restrictive, but then argued that:

“Orgasmic cephalalgia ignores the premonitory headache that may build up as sexual excitement mounts before orgasm. Benign sex headache (using ‘sex’ in the popular sense) is an all-embracing, albeit unpoetic, term and is comparable with benign cough headache. It is worth emphasizing that neither condition is always benign”.

A 2004 case study published by Dr. Marcelo Valenca and colleagues in the journal Headache: The Journal of Head and Face Pain noted that only five cases of patients with thunderclap headache precipitated by sexual activity had been identified in the medical literature. In their paper, they reported the case of a 44-year-old woman that suffered both coital and masturbatory headaches during orgasm. After carrying out a number of medical tests they concluded that the women had experienced cerebral arterial narrowing shortly after her orgasmic headache attacks and that this “supported the hypothesis that segmental vasospasm may exert a role in the pathogenesis of this uncommon type of headache”.

A number of papers on orgasmic cephalagia have been published by Dr. Achim Frese and his colleagues. In a 2004 issue of the journal Neurology, Frese led a study examining the demography, clinical features, and comorbidity of headache associated with sexual activity (HSA) in interviews of 51 participants. They reported that HSA was not dependent on specific sexual habits and most often occurred during sexual activity with the usual partner (94%) and during masturbation (35%).

A 1998 paper by Dr. Daniel Jacome in Headache: The Journal of Head and Face Pain reported something slightly different but related to BMC. More specifically, Dr. Jacome reported the cases of two single men described as having masturbatory-orgasmic extracephalic pain (i.e., an ice-pick like pain that occurred in the neck of one of the men, and in the groin and genitalia of the other). Both men had pre-existing medical conditions (i.e., compressive spondylitic cervical myelopathy in the first case, and a tethered cord and intraspinal lipoma in the second case). These two unusual cases represent examples of extracephalic ice picklike pain triggered by sexual activity, in the absence of orgasmic cephalgia.

A more recent 2012 paper by Dr. Amy Gelfand and Dr. Peter Goadsby in the journal Pediatrics examined primary sexual headaches in two male adolescents. One of the two cases (a 16-year-old boy) developed headaches at the moment of orgasm, building up in intensity over 5 to 10 seconds, and then continuing for between 10 seconds to 2 minutes before stopping. The authors also reported that headaches occurred irrespective of whether orgasm was achieved through intercourse or masturbation. He was not formally treated because after several months, the patient no longer experienced the headaches with orgasm.

Finally, a 2006 paper by Dr. Ambar Chakravarty in the journal Cephalalgia examined data from 24 Indian patients (18 males and 6 females) over a 20-year period (1985–2004) that suffered preorgasmic headaches. Dr. Ambar reported that three of the youngest male patients (aged 19–23 years) had experienced masturbatory headache. One of the female patients (aged 30 years) only experienced orgasmic headache during masturbation (i.e., she never experienced headaches during sexual intercourse).

Summarizing the medical literature on orgasmic cephalagia as a whole (i.e., on coital and masturbatory cephalagia), the 2012 paper by Gelfand and Goadsby concluded that:

“The orgasmic subtype of primary sex headache is more common than the gradual onset pre-orgasm type and has received more attention in the medical literature…In the orgasmic subtype, headache onset is explosive and severe. Orgasms achieved through either sexual intercourse or masturbation can trigger the headache. The headache location is variable, although most often bilateral. The quality is typically pounding or throbbing. Duration of headache ranges from minutes to several hours. Age at onset is classically in the late thirties or early forties, and there is a male predominance. The natural history of the disorder is that after several months it typically remits, although some patients will have a chronic course lasting over a year, and recurrences are possible”.

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

Further reading

Chakravarty, A. (2006). Primary headaches associated with sexual activity—some observations in Indian patients. Cephalalgia, 26(2), 202-207.

Frese, A., Eikermann, A., Frese, K., Schwaag, S., Husstedt, I. W., & Evers, S. (2003). Headache associated with sexual activity: Demography, clinical features, and comorbidity. Neurology, 61(6), 796-800.

Gelfand, A.A., & Goadsby, P.J. (2012). Primary sex headache in adolescents. Pediatrics, 130(2), e439-e441.

Jacome, D.E. (1998). Masturbatory-orgasmic extracephalic pain. Headache: Journal of Head and Face Pain, 38(2), 138-141.

Lance, J. W. (1976). Headaches related to sexual activity. Journal of Neurology, Neurosurgery & Psychiatry, 39(12), 1226-1230.

Lance, J. W. (1983). Benign masturbatory cephalalgia. Archives of Neurology, 40(6), 393.

Østergaard, J. R., & Kraft, M. (1992). Benign coital headache. Cephalalgia, 12(6), 353-355.

Redelman, M. (2010). What if the ‘sexual headache’ is not a joke. British Journal of Medical Practitioners, 3(1), 40-44.

Valenca, M. M., Valenca, L. P., Bordini, C. A., Da Silva, W. F., Leite, J. P., Antunes‐Rodrigues, J., & Speciali, J. G. (2004). Cerebral vasospasm and headache during sexual intercourse and masturbatory orgasms. Headache: The Journal of Head and Face Pain, 44(3), 244-248.

Vincent, F. M. (1982). Benign masturbatory cephalalgia. Archives of Neurology, 39(10), 673.

Rush hour: Can you be addicted to adrenaline?

(N.B. A shorter version of this article was first published in Hopes & Fears magazine).

Conceptualising addiction has been a matter of great debate for decades. For many people the concept of addiction involves the taking of drugs. However, there is now a growing movement that views a number of behaviors as potentially addictive including those that do not involve the ingestion of a drug. These include behaviors diverse as gambling, eating, sex, exercise, videogame playing, love, shopping, Internet use, social networking, and work. The term ‘adrenaline junkies’ has now passed into popular usage and usually refers to potentially dangerous activities such as bungee jumping, sky diving, BASE jumping, etc. My own view is that any activity that features continuous rewards (i.e., constant reinforcement) could be potentially addictive. I have argued in many of my papers that all addictions – irrespective of whether they are chemical or behavioral – comprise six components (i.e., salience, mood modification, tolerance, withdrawal, conflict and relapse). More specifically:

  • Salience – This occurs when the activity becomes the single most important activity in the person’s life and dominates their thinking (preoccupations and cognitive distortions), feelings (cravings) and behavior (deterioration of socialized behavior). For instance, even if the person is not actually engaged in the activity they will be constantly thinking about the next time that they will be (i.e., a total preoccupation with the activity).
  • Mood modification – This refers to the subjective experiences that people report as a consequence of engaging in the activity and can be seen as a coping strategy (i.e., they experience an arousing ‘buzz’ or a ‘high’ or paradoxically a tranquilizing feel of ‘escape’ or ‘numbing’).
  • Tolerance – This is the process whereby increasing amounts of the activity are required to achieve the former mood modifying effects. This basically means that for someone engaged in the activity, they gradually build up the amount of the time they spend engaging in the activity every day.
  • Withdrawal symptoms – These are the unpleasant feeling states and/or physical effects (e.g., the shakes, moodiness, irritability, etc.) that occur when the person is unable to engage in the activity.
  • Conflict – This refers to the conflicts between the person and those around them (interpersonal conflict), conflicts with other activities (e.g., work, social life, hobbies and interests) or from within the individual (e.g., intra-psychic conflict and/or subjective feelings of loss of control) that are concerned with spending too much time engaging in the activity.
  • Relapse – This is the tendency for repeated reversions to earlier patterns of excessive engagement in the activity to recur, and for even the most extreme patterns typical of the height of excessive engagement in the activity to be quickly restored after periods of control.

In short, if any ‘adrenaline junkies’ fulfilled all my six criteria I would class them as an addict. However, I have come across very few adrenaline junkies that endorse all of my six criteria. My position is that it is theoretically possible for individuals to become addicted to adrenaline producing activities but in reality, very few actually are.

Addiction is an incredibly complex behavior and always result from an interaction and interplay between many factors including the person’s biological and/or genetic predisposition, their psychological constitution (personality factors, unconscious motivations, attitudes, expectations, beliefs, etc.), their social environment (i.e. situational characteristics such as accessibility and availability of the activity, the advertising of the activity) and the nature of the activity itself (i.e. structural characteristics such as the size of the stake or jackpot in gambling). This ‘global’ view of addiction highlights the interconnected processes and integration between individual differences (i.e. personal vulnerability factors), situational characteristics, structural characteristics, and the resulting addictive behavior. In respect to ‘adrenaline addicts’ the most important factors are likely to be the individual’s personality and the potential of the reinforcing nature of the activity to produce mood modifying experiences.

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

Further reading

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

Demetrovics, Z. & Griffiths, M.D. (2012). Behavioral addictions: Past, present and future. Journal of Behavioral Addictions, 1, 1-2.

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

Griffiths, M.D. (2009). Gambling addictions. In A. Browne-Miller (Ed.), The Praeger International Collection on Addictions: Behavioral Addictions from Concept to Compulsion (pp. 235-257). Westport, CT: Praeger.

Griffiths, M.D. (2010). Addicted to sex? Psychology Review, 16(1), 27-29

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

Griffiths, M.D. (2011). Workaholism: A 21st century addiction. The Psychologist: Bulletin of the British Psychological Society, 24, 740-744.

Griffiths, M.D., Kuss, D.J. & Demetrovics, Z. (2014). Social networking addiction: An overview of preliminary findings. In K. Rosenberg & L. Feder (Eds.), Behavioral Addictions: Criteria, Evidence and Treatment (pp.119-141). New York: Elsevier.

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

Király, O., Nagygyörgy, K., Griffiths, M.D. & Demetrovics, Z. (2014). Problematic online gaming. In K. Rosenberg & L. Feder (Eds.), Behavioral Addictions: Criteria, Evidence and Treatment (pp.61-95). New York: Elsevier.

Kuss, D.J., Griffiths, M.D., Karila, L. & Billieux, J. (2014).  Internet addiction: A systematic review of epidemiological research for the last decade. Current Pharmaceutical Design, 20, 4026-4052.

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.

Getting a leg up: A brief look at pantyhose fetishism

“As far as I can remember I have been easily aroused by women wearing pantyhose. At the age of about 14 or 15 [years] I started wearing pantyhose and masturbating with them. At the time I was ashamed to tell my girlfriend at the time about it. I continued this up until about 19 or 20, when I finally had a girlfriend who I told about my fetish. I thought that by sharing this with my significant other at the time that it would help but it did not. I would just want it more and more. Now I am in a long-term relationship with a woman that I love. I have told her about my fetish and how I masturbate with her pantyhose and she said that she did not have a problem with it. She wears pantyhose for me rather frequently because she knows that I really like them…My obsession has really intensified to the point that I am doing more to achieve a stronger orgasm…I really feel like my fetish is out of control. In general my fetish for pantyhose has lead me to do immoral things that I would not do unless pantyhose are involved” (Letter sent to Dr. Marie Hartwell-Walker)

For the benefit of my non-UK readers, here in the UK, ‘pantyhose fetishism’ is more commonly known as ‘tights fetishism’ (and is very similar to ‘stocking fetishism’, the commonality being the fact they are both clothing items worn on the legs that are often made of nylon and that have a silky veneer). The few online articles concerning pantyhose fetishism make similar claims although empirical evidence for such claims are generally lacking. For instance, the articles claim that pantyhose fetishism is (i) commonplace and (ii) usually first begins in childhood and/or early adolescence (after seeing pantyhose being worn by a significant person in the fetishist’s life such as their mother, sister, aunt, grandmother, family friend, neighbour and/or teacher).

One of the best studies published in a 2007 issue of the International Journal of Impotence Research by Dr G. Scorolli and his colleagues on the relative prevalence of different fetishes using online fetish forum data did not report the specific existence of pantyhose fetishism at all, although around 12% had fetishes concerning something associated with the body such as legs (which could have included pantyhouse). However, if you type ‘pantyhose fetishism’ into Google lots of dedicated pornographic photography and video sites can be found on the first few pages.

According to Wikipedia men may have a preference for pantyhose because unlike stocking, pantyhose has direct contact with female genitalia. An article on the Kinkly website claims individuals with a pantyhose fetish most commonly become sexually aroused by wearing pantyhose, watching other people wear (or undress wearing) pantyhose, or both. The Wikipedia article is a little more detailed and claims that the fetish manifests in one or more of the following ways (and which I have repeated verbatim):

  • “Tearing or cutting holes in pantyhose to modify the garment or gain access to the wearer’s body.
  • Wearing of pantyhose by either or both partners during sexual activity.
  • A male wearing pantyhose alone or in front of others who may praise or humiliate him.
  • Using pantyhose as bondage restraints.
  • Interacting with pantyhose in any other way or form during sexual activity.
  • Simply observing/admiring and experiencing heightened arousal/interest of females or males who are wearing pantyhose.
  • Viewing material from store catalogues to pornography of models and actors wearing pantyhose.
  • A man or woman in pantyhose encasement”.

As far as I am aware, only one paper solely devoted to pantyhose fetishism has ever been published in the psychological literature. This was a 1997 paper written from a psychodynamic perspective by Dr. L.M. Lothstein in the journal Gender and Psychoanalysis. In her paper, Lothstein describes this unique fetish” using clinical vignettes of gender dysphoric men (i.e., transgendered males). The paper claims the pantyhose served a number of different functions (such as the repairing of psychic structure, and an expression and defence against underlying aggression). More specifically, Lothstein refers to pantyhose as a functional ‘magic skin’ or ‘second skin’ in repairing a defective ego and acting as a transitional object to allay annihilation and separation anxiety.

The Wikipedia and Kinkly articles claim that there are many sub-types of pantyhose fetish and that such fetishes often co-occur with other fetishes and sexual paraphilias such as shoe fetishes, transvestism, sadomasochism, and schoolgirl fetishes. For instance, the Wikipedia article notes that pantyhose fetishism can include:

  • A focus on certain areas of the body while wearing pantyhose, [such as] feet, a variation of the very common foot fetishism.
  • Wearing pantyhose with other specific garments, e.g. shoes, boots, or skirts, uniforms that usually include pantyhose (girl at work, secretary, flight stewardess, policewoman, Hooters waitress, girl next door etc.)
  • Certain styles e.g. sheer-to-waist, opaque, patterned or specific deniers, certain brands or shades.
  • Simply admiring women who wear pantyhose (a mild form of voyeurism).
  • Finding the wearing of them to be a primarily sensual comforting experience, rather than sexual.
  • The act of purchasing pantyhose, especially when aided by a female assistant, can also generate a degree of arousal”.

One of the problems with the Wikipedia article as that it is included in the entry on underwear fetishism and the section concerning pantyhose fetishes specifically notes that the section “does not cite any references or sources”. It then goes on to claim:

“The pantyhose covered foot can be extremely arousing to men who often find satisfaction in just looking at or more in that of rubbing, sucking/licking, and massage of the penis with the nylon clad feet. Others find arousal in sniffing the sour and pungent smell of soles made by excessive sweat when in pantyhose. Foot-jobs can be very intense and stimulating and covering a woman in pantyhose in semen is a common fantasy with some men. Pantyhose fetish can also be linked to that of the women dressing as the schoolgirl where stockings, knee high socks and pantyhose can be worn with a short skirt”.

The same article also lists a number of reasons why females wear pantyhose and then claims that these reasons as to why women wear pantyhose provides possible reasons for the allure of pantyhose fetishism:

  • They remove the appearance of blemishes, making the legs ‘perfect’.
  • The reflectiveness of the material, coupled with the way they appear less transparent at the edges, often gives legs more contrast and definition, as though lit by dramatic lighting. This accentuates the curves of the legs, making them less ‘flat’, and can also make legs appear slimmer (with dark pantyhose).
  • They often have a silky texture which is pleasing to both the wearer and her partner.
  • They enhance the pleasure (and anticipation) associated with the removal of a woman’s clothes. Not only serving as an additional item to be removed; they allow the exciting moment of exposure to be drawn out much longer than other clothing items, as the pantyhose are slowly pulled down the legs. In addition to this, they do not actually hide what they cover.
  • The slipperiness and smoothness of sheer pantyhose and stockings also makes women’s low cut court shoes slip off more easily. This vulnerability is often sexually attractive, and can often result in the women engaging in shoe dangling or shoe play which is also appealing to shoe and foot fetishists”.

Although I mentioned above I only knew of one academic paper on pantyhose fetishism, there are a few academic writings that have mentioned it in passing. For instance, in a 1979 issue of the Journal of Applied Behavioral Analysis, Dr. W.L. Marshall reported the treatment of two male paedophiles with satiation therapy, one of who was also a pantyhose fetishist (but no detail was given on this aspect of their sexual behaviour except he was also a shoe fetishist). A paper by Dr. L.F. Lowenstein in a 2002 issue of Sexuality and Disability claimed that pantyhose fetishism was “very common” but the only evidence given for this was a reference to Lothstein’s paper (which contained no information on the prevalence of the fetish). Finally, in a 2008 book chapter on themes of sadomasochism self-expression by Dr. Charles Moser and Dr. Peggy Kleinplatz, they used the example of pantyhose to define and explain what fetishes are:

A fetish is characterized by sexual arousal to an inanimate object…Individuals who enjoy SM accessories often describe their interests as fetishes. They find wearing or touching the preferred articles highly arousing. The articles themselves are rarely arousing, but if they are worn by a partner, it heightens the partner’s attractiveness and heightens the eroticism of the sex. For example, pantyhose can be a fetish object, but brand new pairs, never worn, rarely become a focus of erotic interest. The same pantyhose worn by the participant or a partner can elicit a strong erotic response. Similarly an article of clothing that reminds the person of a partner or a specific erotic interlude can become a fetish object”.

Again, this simply confirms that pantyhose fetishes exist (or theoretically exist) but there is no information on incidence, prevalence, or their psychosocial impact. I did come across one online account written by someone who confesses to being a pantyhose fetishist on the Act Sensuous blog site, and which I found a lot more enlightening that anything academic that I have read on the topic:

I had tried several times before, but during my research to find scientific facts…I wanted to learn where pantyhose rank on a list of the most prevalent fetishes, but I couldn’t find credible material that could be documented.  I did find one thing I expected – that the foot fetish is still No. 1, apparently, the most common.  Suffice it to say that pantyhose are high up there somewhere. And, thankfully, pantyhose and foot fetishes seem to go hand-in-hand, or make that foot-in-hand…Obviously, there’s more to a pantyhose fetish than [what is on Wikipedia]…To me, pantyhose always have been about three things: the way they look, the way they feel to the touch, and the very concept of them in the first place. Maybe it’s just that they are designed to enhance the beauty of everything they cover. To me, there’s a profound dichotomy about pantyhose, which I find very exciting. Pantyhose possess enormous power, yet, by design, they are extremely delicate and feminine, causing an irresistible vulnerability for the wearer. This is never more evident than in the way the nylon fabric moves to the touch on a woman’s legs and feet. It’s almost as if she has a second, delicate, delicious skin. It’s as if the pantyhose are a living, breathing intimate part of the wearer. You can physically manipulate that lifeforce, and you have to be careful not to hurt it. Once on, any item of clothing a person wears, sort of disappears. You stop feeling it on your body. And even though you can touch the pantyhose on yourself, it isn’t the same as feeling them on someone else. Want your lover to feel what you feel when you caress her legs in pantyhose? All it takes is to move that delicate nylon fabric over her skin. The sensation is incredible for both parties”.

Maybe we will never know how common pantyhose fetish is but there appears to be a lot of anecdotal evidence that it exists, is male-dominated, and that there is some crossover with other more (empirically) established fetishes (such as foot fetishes).

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

Further reading

The Act Sensuous Blog (2010). What drives our pantyhose fetish? April 11. Located at:

Kinkly (2015). Pantyhose fetish. Located at:

Lothstein, L.M. (1997). Pantyhose fetishism and self cohesion: A Paraphilic Solution? Gender and Psychoanalysis, 2(1), 103-121.

Lowenstein, L.F. (2002). Fetishes and their associated behaviour. Sexuality and Disability, 20, 135-147.

Moser, C., & Kleinplatz, P.J. (2007). Themes of SM expression. In D. Langbridge, & Meg Barker (Eds.), Safe, sane and consensual: Contemporary perspectives on SM (pp.35-54). Hampshire, UK: MacMillan.

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.

Wikipedia (2015). Underwear fetishism. Located at:

Cured meets: Treating addictive behaviours

Addiction is a highly prevalent problem within today’s society and there is a lot of time and many spent in trying to prevent and treat the behaviour. There has also been a move towards getting addicts motivated to want to change their behaviour. The most influential model worldwide is probably the ‘stages of change’ model by Dr. James Prochaska and Dr, Carlo Di Clemente that identifies an individual’s ‘readiness for change’ and tries to get a person to a position where they are highly motivated to change their behaviour. The individual stages of this model are:

  • Precontemplation – This is where the person unaware of the consequences of his or her own behaviour and no change in behaviour is foreseeable.
  • Contemplation – This is where the person aware problem exists and is contemplating change.
  • Preparation – This is where the person has decided to change in the near future (e.g., New Year resolution).
  • Action – This is where the person effects change (e.g., gets rid of all association items related to the behaviour).
  • Maintenance – This is where the person consolidates behaviour change over time.
  • Relapse – This where the person reverts to a former behaviour pattern (e.g., contemplation, preparation).

People can stay in one stage for a long time and it is also possible for unassisted change such “maturing out” or “spontaneous remission”. Various techniques can be used to help people prepare for readiness include motivational techniques, behavioural self-training, skills training, stress management training, anger management training, relaxation training, aerobic exercise, relapse prevention, and lifestyle modification. The goal of treatment can be either abstinence or simply to cut down.

The intervention and treatment options for the treatment of addiction include, but are not limited to counselling/psychotherapies, behavioural therapies, cognitive-behavioural therapies, self-help therapies, pharmacotherapies, residential therapies, minimal interventions and combinations of these (i.e., multi-modal treatment packages). The most important of these are outlined below.

Pharmacotherapy: Pharmacological interventions basically consist of addicts being given a drug to help overcome their addiction. These are mainly given to those people with chemical addictions (e.g., nicotine, alcohol, heroin, etc.) but are increasingly being used for those with behavioural addictions (e.g., gambling, sex, work, exercise, etc.). For instance, some drugs produce an unpleasant reaction when used in combination with the drug of dependence, replacing the positive effects of the drug of dependence with a negative reaction. For instance, alcoholics are sometimes prescribed disulfiram (more commonly known as Antabuse), that when combined with alcohol may produce nausea and vomiting. Other common therapies include methadone and the use of opioid antagonists (such as nalaxone or naltrexene) for heroin addiction. The methadone prevents withdrawal symptoms, block the effects of heroin use, and decreases craving. The main criticism of all these treatments is that although the symptoms may be being treated, the underlying reasons for the addictions may be being ignored. On a more pragmatic level, what happens when the drug is taken away? Often, the addicts return to their addiction if this is the only method of treatment used.

Behavioural therapy: Behavioural therapies are based on the view that addiction is a learned maladaptive behaviour and can therefore be ‘unlearned’. These have mainly been based on the classical conditioning paradigm and include aversion therapy, in vivo desensitisation, imaginal desensitisation, systematic desensitisation, relaxation therapy, covert sensitisation, and satiation therapy. All of these therapies focus on cue exposure, and relapse triggers (like the sight and smell of alcohol/drugs, walking through a neighbourhood where casinos are abundant, pay day, arguments, pressure, etc.). The theory is that through repeated exposure to ‘relapse triggers’ in the absence of the addiction, the addict learns to stay addiction free in high-risk situations. It could be argued that if the addiction is caused by some underlying psychological problem, (rather than a learned maladaptive behaviour), then behavioural therapy would at best only eliminate the behaviour but not the problem. This therefore means that the addictive behaviour may well have been curtailed but the problem is still there so the person will perhaps engage in a different addictive behaviour instead.

Cognitive-behavioural therapy: A more recent development in the treatment of addictive behaviours is the use of cognitive-behavioural therapies (CBT). There are many different CBT approaches that have been used in the treatment of addictive behaviours including rational emotive therapy, motivational interviewing, and relapse prevention. The techniques assume that addiction is a means of coping with difficult situations, dysphoric mood, and peer pressure. Treatment aims to help addicts recognise high-risk situations and either avoid or cope with them without use of the addictive behaviour. In relapse prevention, the therapist helps to identify situations that present a risk for relapse (both intrapersonal and interpersonal). Relapse prevention provides the addict with techniques to learn how to cope with temptation (positive self statements, decision review, and distraction activities), coupled with the use of covert modelling (i.e., practicing coping skills in one’s imagination). It also provides skills for coping with lapses (by redefining what is happening), and utilizes graded practice (a desensitization technique where addicts encounter real life situations slowly). Overall, CBT approaches are better researched than the other psychological methods in addiction but are probably no more effective (Luty, 2003).

Psychotherapy: Psychotherapy can include everything from Freudian psychoanalysis and transactional analysis, to more recent innovations like drama therapy, family therapy and minimalist intervention strategies. The therapy can take place as an individual, as a couple, as a family, as a group and is basically viewed as a ‘talking cure’ consisting of regular sessions with a psychotherapist over a period of time. Most psychotherapies view maladaptive behaviour as the symptom of other underlying problems. Psychotherapy often is very eclectic by trying to meet the needs of the individual and helping the addict develop coping strategies. If the problem is resolved, the addiction should disappear. In some ways, this is the therapeutic opposite of pharmacotherapy and behavioural therapy (which treats the symptoms rather than the underlying cause). There has been little evaluation of its effectiveness although most addicts go through at least some form of counselling during the treatment process.

Self-help therapy: The most popular self-help therapy worldwide is the Minnesota Model 12-Step Programme (e.g., Alcoholics Anonymous, Gamblers Anonymous, Narcotics Anonymous, Overeaters Anonymous, Sexaholics Anonymous, etc.). This treatment programme uses a group therapy technique and uses only ex-addicts as helpers. Addicts attending 12-Step groups involves them accepting personal responsibility and views the behaviour as an addiction that cannot be cured but merely arrested. To some it becomes a way of life both spiritually and socially and compared with almost all other treatments it is especially cost-effective (even if other treatments have greater success rates) as the organization makes no financial demands on members or the community. For the therapy to work, the 12-Step Programme asserts that the addict must come to them voluntarily and must really want to stop engaging in their addictive behaviour. Further to this, they are only allowed to join once they have reached “rock bottom”. To date there has been little systematic study of 12-Step groups but drop out rates are very high (typically 80-90%). There are a number of problems preventing evaluation, particularly anonymity, sample bias, and what the criterion for success is. The empirical evidence suggests that self-help support groups’ complement formal treatment options and can support standardized psychosocial interventions.

When examining all the literature on the treatment of addiction, there are a number of key conclusions that can be drawn. These include that: (i) treatment must be readily available, (ii) no single treatment is appropriate for all individuals., (iii) it is better for an addict to be treated than not to be treated, (iv) it does not seem to matter which treatment an addict engages in as no single treatment has been shown to be demonstrably better than any other, (v) a variety of treatments simultaneously appear to be beneficial to the addict, (vi) individual needs of the addict have to be met (i.e., the treatment should be fitted to the addict including being gender-specific and culture-specific), (vi) clients with co-existing addiction disorders should receive services that are integrated, (vii) remaining in treatment for an adequate period of time is critical for treatment effectiveness, (viii) medications are an important element of treatment for many patients, especially when combined with counselling and other behavioural therapies, (ix) recovery from addiction can be a long-term process and frequently requires multiple episodes of treatment, (x) there is a direct association between the length of time spent in treatment and positive outcomes, and (xi) the duration of treatment interventions is determined by individual needs, and there are no pre-set limits to the duration of treatment.

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

Further reading

Griffiths, M.D. (1996). Pathological gambling and its treatment. British Journal of Clinical Psychology, 35, 477-479.

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.

Griffiths, M.D. & H.F. MacDonald (1999). Counselling in the treatment of pathological gambling: An overview. British Journal of Guidance and Counselling, 27, 179-190.

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

King, D.L., Delfabbro, P.H., Griffiths, M.D. & Gradisar, M. (2012). Cognitive-behavioural approaches to outpatient treatment of Internet addiction in children and adolescents. Journal of Clinical Psychology, 68, 1185-1195.

Luty, J. (2003). What works in drug addiction? Advances in Psychiatric Treatment, 9, 280–288.

National Institute on Drug Abuse (1999). Principles of drug addiction treatment: A research-based guide. NIDA.

Potenza, M. & Griffiths, M.D. (2004). Prevention efforts and the role of the clinician. In J.E. Grant & M. N. Potenza (Eds.), Pathological Gambling: A Clinical Guide To Treatment (pp. 145-157). Washington DC: American Psychiatric Publishing Inc.

Prochaska, J.O. and DiClemente, C.C. (1984). The transtheoretical approach: Crossing the traditional boundaries of therapy. Melbourne, Florida: Krieger Publishing Company

Rigbye, J. & Griffiths, M.D. (2011). Problem gambling treatment within the British National Health Service. International Journal of Mental Health and Addiction, 9, 276-281.

United Nations Office on Drugs and Crime/World Health Organization (2008). Principles of Drug Dependence Treatment: Discussion paper. UN/WHO.

Against all odds: The rise and rise of gambling

In many areas of the world, gambling has become a popular activity. Almost all national surveys into gambling have concluded that most people have gambled at some point in their lives, there are more gamblers than non-gamblers, but that most participants gamble infrequently. Commissions and official government reviews in a number of countries including the United States, United Kingdom, Australia and New Zealand have all concluded that increased gambling availability has led to an increase in problem gambling. Estimates of the number of problem gamblers vary from country to country but most countries that have carried out national prevalence surveys suggest around 0.5%-2% of individuals have a gambling problem.

In May 2013, the new criteria for problem gambling (now called ‘Gambling Disorder’) were published in the fifth edition of the American Psychiatric Association’s Diagnostic and Statistical Manual for Mental Disorders (DSM-5), and for the very first time, problem gambling was included in the section ‘Substance-related and Addiction Disorders’ (rather than in the section on impulse control disorders). Also included in the Appendix of the DSM-5 as a potential addiction was Internet Gaming Disorder (i.e., online video game addiction). Although most of us in the field had been conceptualizing problematic gambling and video gaming as addictions for many years, this was arguably the first time that an established medical body had described them as such. For me, gambling and gaming addictions should not be considered any differently from other more traditional chemical addictions (e.g., alcohol addiction, nicotine addiction). Consequently, there is no theoretical reason why other problematic and excessive activities that do not involve the ingestion of a psychoactive substance cannot be deemed as legitimate behavioural addictions in the years to come (e.g., shopping addiction, sex addiction, work addiction, exercise addiction, etc.).

Gambling is a multifaceted rather than unitary phenomenon. Consequently, many factors are involved in the acquisition, development and maintenance of gambling behaviour. Such factors include an individual’s biological and genetic predisposition, their social environment, psychological variables (personality characteristics, attitudes, expectations, beliefs, etc.), macro-situational characteristics (how much gambling is marketed and advertised, the number of gambling venues within a jurisdiction, where the gambling venue is located), micro-situational characteristics of the gambling environment (on-site cash machine, provision of free alcohol, floor layout etc.), and the structural characteristics of the gambling activity itself (jackpot size, stake size, the number of times a individual can gamble in a given time frame, etc.). Most research has tended to concentrate on individual characteristics (personality, genetics, family and peer influence) rather than situational and structural characteristics.

The introduction of national lotteries, the proliferation of slot machines, the expansion of casinos, and the introduction of new media in which to gamble (e.g., Internet gambling, mobile phone gambling, interactive television gambling, gambling via social networking sites), has greatly increased the accessibility and popularity of gambling worldwide, and as a result, the number of people seeking assistance for gambling-related problems. In addition, the rise of remote gambling via the internet and mobile phones has arguably changed the psychosocial nature of gambling. I have also published a number of studies showing that to vulnerable and susceptible individuals (e.g., problem gamblers, minors, the intoxicated, etc.), the medium of the internet may facilitate and fuel problematic and addictive behaviours.

There are many known factors that make online activity potentially problematic to a minority of individuals. This includes factors such as easy accessibility, affordability, anonymity, convenience, escape, and disinhibition. Some of these factors can change the psychological experience of gambling. For instance, gambling with virtual representations of money online lower the psychological value of the money and people tend to spend more with virtual representations of money than if they were gambling with physical money. Also, when people lose money online it is a different psychological experience because no-one can see anyone losing face-to-face. As a result, there is less guilt and embarrassment about losing and vulnerable individuals may be tempted to spend more time and money than they had originally intended.

One very salient trend that has implications for gambling (and arguably problem gambling) is that technology hardware is becoming increasingly convergent (e.g., internet access via smartphones and interactive television) and there is increasing multi-media integration such as gambling and video gaming via social networking sites. As a consequence, people of all ages are spending more time interacting with technology in the form of internet use, playing videogames, watching interactive television, mobile phone use, social networking, etc. In addition to convergent hardware, there is also convergent content. This includes some forms of gambling including video game elements, video games including gambling elements, online penny auctions that have gambling elements, and television programming with gambling-like elements.

One of the key drivers behind the increased numbers of people gambling online and using social networking sites is the rise of mobile gambling and gaming. Compared to internet gambling, mobile gambling is still a relatively untapped area but the functional capabilities of mobile phones and other mobile devices are improving all the time. There are now hundreds of gambling companies that provide casino-style games to be downloaded onto the gambler’s smartphone or mobile device (e.g., tablet or laptop). This will have implications for the psychosocial impact of gambling and will need monitoring. Like online gambling, mobile gaming has the capacity to completely change the way people think about gambling and betting. Mobile phones provide the convenience of making bets or gambling from wherever the person is, even if they are on the move.

One of the most noticeable changes in gambling over the last few years – and inextricably linked to the rise of mobile gaming – has been the large increase of in-play sports betting. Gamblers can now typically bet on over 60 ‘in-play’ markets while watching a sports event (such as a soccer match). For instance, during a soccer game, gamblers can bet on who is going to score the first goal, what the score will be after 30 minutes of play, how many yellow cards will be given during them game and/or in what minute of the second half will the first free kick be awarded. Live betting is going to become a critical activity in the success of the future online and mobile gambling markets.

The most salient implication of ‘in-play’ sports betting is that it has taken what was traditionally a discontinuous form of gambling – where an individual makes one bet every Saturday on the result of the game – to one where an individual can gamble again and again and again. Gaming operators have quickly capitalized on the increasing amount of televised sport. In contemporary society, where there is a live sporting event, there will always be a betting consumer. ‘In-play’ betting companies have both catered for the natural betting demand but introduced new gamblers in the process. If the reward for gambling only happens once or twice a week, it is completely impossible to develop problems and/or become addicted. ‘In-play’ has changed that because there are soccer matches on almost every day of the week making a daily two-hour plus period of betting seven days a week.

New technologies in the form of behavioural tracking have helped online gambling companies keep track of players by noting (among many other things) what games they are playing, the time spent playing, the denomination of the gambles made, and their wins and losses. Although such technologies can potentially be used to exploit gamblers (e.g., targeting the heaviest spenders with direct marketing promotions to gamble even more), such technologies can also be used to help gamblers that may have difficulties stopping and/or limiting their gambling behaviour. Over the past few years, innovative social responsibility tools that track player behaviour with the aim of preventing problem gambling have been developed. These new tools are providing insights about problematic gambling behaviour. A number of European jurisdictions (such as Germany and The Netherlands) are now considering whether such tools should be mandatory for gaming operators to use especially as such tools are already being used in Sweden, Norway, Finland and Austria.

Although gamblers are ultimately responsible for their own behaviour, gambling can be minimised via both governmental policy initiatives (age restrictions, marketing and advertising restrictions, no gaming licenses unless operators display the highest standards of social responsibility to their clientele, etc.) and gaming operator initiatives (self-exclusion programs, information about games so gamblers can make informed choices, limit-setting tools that allow gamblers to set time and money loss limits, staff training on responsible gambling, referral to gambling treatment providers, etc.). Problem gambling can never be totally eliminated but harm minimisation practices can be put in place to keep the problem to a minimum. Treatment for gambling addiction should be free and paid for by gambling industry profits (either in the form of voluntary donations to a charitable trust or – if that doesn’t work – a statutory levy). In short, any jurisdiction that has legalised and liberalised gambling has a duty of care to put a national social responsibility infrastructure in place to prevent, minimise, and treat problem gambling as they would with any other consumptive and potentially addictive behaviour (e.g., drinking alcohol, smoking cigarettes, etc.)

Please note: A version of this article first appeared in Science and Technology (Pan European Networks) magazine (Volume 15, pages 153-155).

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

Further reading

Griffiths, M.D. (2003). Internet gambling: Issues, concerns and recommendations. CyberPsychology and Behavior, 6, 557-568.

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

Griffiths, M.D. (2011). Gaming convergence: Further legal issues and psychosocial impact. Gaming Law Review and Economics, 14, 461-464.

Griffiths, M.D. (2012). Mind games (A brief psychosocial overview of in-play betting). i-Gaming Business Affiliate, June/July, 44.

Griffiths, M.D. (2012). Internet gambling, player protection and social responsibility. In R. Williams, R. Wood & J. Parke (Ed.), Routledge Handbook of Internet Gambling (pp.227-249). London: Routledge.

Griffiths, M.D., King, D.L. & Delfabbro, P.H. (2014). The technological convergence of gambling and gaming practices. In Richard, D.C.S., Blaszczynski, A. & Nower, L. (Eds.). The Wiley-Blackwell Handbook of Disordered Gambling (pp. 327-346). Chichester: Wiley.

Griffiths, M.D. & Parke, J. (2003). The environmental psychology of gambling. In G. Reith (Ed.), Gambling: Who wins? Who Loses? (pp. 277-292). New York: Prometheus Books.

Kuss, D.J. & Griffiths, M.D. (2012).  Internet gambling behavior. In Z. Yan (Ed.), Encyclopedia of Cyber Behavior (pp.735-753). Pennsylvania: IGI Global.

McCormack, A. & Griffiths, M.D. (2013). A scoping study of the structural and situational characteristics of internet gambling. International Journal of Cyber Behavior, Psychology and Learning, 3(1), 29-49.

Meyer, G., Hayer, T. & Griffiths, M.D. (2009). Problem Gaming in Europe: Challenges, Prevention, and Interventions. New York: Springer.

Parke, J. & Griffiths, M.D. (2007). The role of structural characteristics in gambling. In G. Smith, D. Hodgins & R. Williams (Eds.), Research and Measurement Issues in Gambling Studies (pp.211-243). New York: Elsevier.

Pontes, H. & Griffiths, M.D. (2014). The assessment of internet gaming disorder in clinical research. Clinical Research and Regulatory Affairs, 31(2-4), 35-48.

Zangeneh, M., Griffiths, M.D. & Parke, J. (2008). The marketing of gambling. In Zangeneh, M., Blaszczynski, A., and Turner, N. (Eds.), In The Pursuit Of Winning (pp. 135-153). New York: Springer.

Write back: A brief look at Oshouji and sexual calligraphy

Anyone that has followed my blogs will know that I have more than a passing interest in Japanese sexual culture. For instance, in previous blogs I have briefly examined various Japanese sexual practices and sex-related topics including Tamakeri (i.e., the masochistic practice of getting sexual pleasure and arousal from being kicked in the testicles), Hentai (i.e., Japanese hardcore Manga cartoon pornography), Shokushu Goukan (i.e., tentacle rape), Nyotaimori (i.e., eating a variety of foods or a whole meal off somebody’s naked body), Omorashi (i.e., deriving sexual pleasure from having a full bladder or a sexual attraction to someone else experiencing the discomfort of a full bladder), and Burusera (i.e., Japanese shops that sell [amongst other things] soiled female undergarments and fetishist school uniforms). There are also some sexually paraphilic behaviours that have their own names within the Japanese sexual culture (such as frotteurism being known as chikan)

While reading an online article on ‘[Ten] sex fetishes you won’t believe exist’ I spotted one on the list that I had not written about before – Oshouji – the other nine being: dendrophilia (sexual arousal from trees), exophilia (sexual attraction for aliens and non-human life forms), objectum sexuality (sexual attraction to inanimate objects), eproctophilia (sexual arousal from flatulence), hybristophilia (sexual arousal from criminals), menophilia (sexual arousal from menstruation), acrotomophilia (sexual arousal from amputees), dacryphilia (sexual arousal from crying), and lactophilia (sexual arousal from breast feeding). In fact, not only had I not written about oshouji in a previous blog but I had never even heard of it before.

Oshouji is a calligraphy fetish (calligraphy being the art of producing decorative handwriting or lettering with a pen or brush). Oshouji specifically involves calligraphy where the decorative writing is done on a person’s (usually naked) body. According to many online websites (that all basically use the same defintion), oshouji is “an ancient tradition and refers to the writing of degrading words in calligraphy on your partner [and is] one of the more artistic fetishes Japan has to offer”. As sex blog writer Coco La More notes: “I am intrigued. Such rich beauty and absolute pleasure. The artistic passion the calligrapher must be feeling. I can just imagine the intense emotion felt by both. I will be adding this one to my list”

According to the Exapamicron website, oshouji dates back to the Edo period of feudal Japan (the Edo period – sometimes referred to as the Tokugawa period – being the period between 1603 and 1868 in the history of Japan). Like other Edo forms of eroticism (such as Shunga, a Japanese term for erotic art) oshouji is considered traditional, rich and decadent. The website also claims that oshouji is “not a fetish in the sense that the painted person becomes aroused by the paint, it’s more about the thrill of degrading someone”.

As far as I am aware there is no academic writing or research on the topic (although there are academics with the surname ‘Oshouji’ which was annoying having to wade through paper after paper to see if there was anything written on the practice). Like me, someone else (Zichao) was researching into this topic and was finding the same things as me online. His research questioned whether the word ‘oshouji’ even existed (although he did admit that the act of sexual calligraphy existed):

“I’m writing a catalogue/book for an exhibition on modern Chinese calligraphy, including references to work by Zhang Qiang…This got me interested in trying to work out the history of writing on girls in Chinese, Japanese [and] Korean culture. On various non-Japanese language sites it’s referred to as ‘oshouji’ and described as something that goes back to Edo times, but these all seem to be cribbing the information from the [Tokyo Damage Report] Hentai Dictionary…Making the idea look even more dubious is the fact that typing おしょうじ, オショウジ or even (last-ditch attempt) お書字 into Japanese Google brings up nothing helpful as far as I can see. This makes me suspect that if there’s a name for the practice it’s something else…Obviously it’s something that people do – not just Zhang Qiang, but also the characters in rape and S&M manga (though in magic marker) and there’s even a film about it [The Pillow Book]. It doesn’t help that I know very little about classical Chinese [and] Japanese porn/erotica. Does the writing-on-girls-fetish have a name and a history, or is it just something that crops up spontaneously now and then?”

Another online Hentai dictionary (the Yuribou Hentai Dictionary) noted that the

“Oshouji ‘calligraphy character’ fetish [is] fairly commonly seen in Domination-submissive play in which the Dominant writes characters on the submissive’s body in order to inflict shame and embarrassment to heighten the submissive role. Commonly seen is the writing of “niku” (“meat”) on the forehead”.

As noted in the extract from Zichao above, the most high profile example of oshouji body calligraphy is the 1996 film The Pillow Book film (directed by Peter Greenaway) in which a Japanese model (Nagiko) “goes in search of pleasure and new cultural experience from various lovers. The film is a rich and artistic melding of dark modern drama with idealised Chinese and Japanese cultural themes and settings, and centres on body painting (Wikipedia entry on The Pillow Book)

Sexual calligraphy has also crept into the world of modern art via the work of Pokras Lampas. Lampras has a background in graffiti and street art. As an online Wide Walls profile piece on him notes:

“Lampas works in various spaces and using different mediums, from canvas and walls to the naked body. To a certain extent, the artist is involved in the art of tattoo, providing council and creating sketches when it comes to calligraphy work. However, the aspect of the artist’s practice which is most interesting, resonates the new possibilities of calligraphy within the world of digital urban art. This notion is part of one of his biggest projects…Recently, the artist became involved in a project called Calligraphy on Girls, which aims to show his calligraphy skills to a wider audience through sessions of body painting and photography. The project is an exploration of the female human form, executed with a particular aesthetics and a unique visual language of the artist”.

Whether Lampas’ work can be called an example of oshouji is debatable because it doesn’t appear to involve the use of degrading words (in fact there are few words at all as far as I can see). Oshouji (if it really exists) appears to be a much less prevalent activity than some of the other Japanese sexual practices I have written about although in the absence of any research papers on most forms of Japanese sexual subculture no-one can be really sure how widespread any of these activities are.

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

Further reading

Aggrawal A. (2009). Forensic and Medico-legal Aspects of Sexual Crimes and Unusual Sexual Practices. Boca Raton: CRC Press.

Tokyo Damage Report (2009). Hentai dictionary. February 27. Located at:

Wide Walls (2014). Calligraphy on girls, February 1. Located at:

Wikipedia (2015). Shunga. Located at:

Yuribou Hentai Dictionary (2008). Welcome to the Yuribou Hentai Dictionary! July 11. Located at:

Packed punch: A very brief look at “gastergastrizophilia”

One of the weirdest sounding sexual paraphilias that I have come across is gastergastrizophilia in which individuals allegedly derive sexual pleasure and arousal from bellypunching. I use the word ‘allegedly’ as I have never seen this sexual paraphilia listed in any reputable academic source (and it certainly does not appear in either Dr. Anil Aggrawal’s Forensic and Medico-legal Aspects of Sexual Crimes and Unusual Sexual Practices or Dr. Brenda Love’s Encyclopedia of Unusual Sex Practices). The lengthiest article on that I have come across on gastergastrizophilia is on the Full Wiki website. The article claims that:

“Bellypunchers, as they are known, derive erotic and/or aesthetic pleasure from the sight of and sensation associated with a woman physically struck in the stomach usually with a bare fist. The specifics associated with this paraphilia vary considerably, sometimes with the woman possessing a toned and muscular stomach, other with the woman possessing a soft and even chubby stomach. Often fetishists desire her to receive blows to the lower stomach specifically; other times, to the upper stomach. Often the woman is struck by other women, but many times the fetishists will fantasize about doing the beating themselves. With the rise of the internet, a wide variety of websites and online groups have risen which house related fiction, photos, stories, and videos, the latter either custom-made or copied from a variety of films and videos. The male-to-male variety of the fetish is frequently called gutpunching, or abspunching”

The fact that someone has written about sexual bellypunching in no way proves that the behaviour exists. In a previous blog I examined a hoax paraphilia called emysphilia (sexual arousal from turtles). In researching that blog, I came to the conclusion that the paraphilia simply didn’t exist as there was no evidence of any kind except the originally published article (plus the fact that the author later admitted it was a hoax). Sexual bellypunching as a fetish or paraphilia is something that I do not think can easily be so dismissed. I managed to collect a few first-hand accounts of sexual bellypunching (such as those at the online at the Dark Fetish website). For instance:

  • Extract 1: “[I am a] masochist [and] let people thump me in my belly. Although it hurts (and it hurts like hell sometimes) the pain does give me an erotic buzz. BUT (and this is the other side of the coin) I do get to punch other women and that also gives me a buzz – it turns me on.
  • Extract 2: “There is a difference between a ‘friendly’ (I use the word advisedly) punch up between two women (which might even end in sex) and a really heated contest where there maybe some prize, physical or emotional. Then it’s a pure pain contest… just to see which woman can take the most pain in her guts. In such contests there is a moment when having delivered a punch, I watch my opponent’s face crease in agony, watch her fight the pain, watch her desperately trying to keep her hands from going to her belly… hear her panting for breath as she tries to control the agony in her guts. Oh so delicious…it’s a real turn-on for me. The downside is that I have to take and absorb the punishment too. [However], that turns me on too!!”
  • Extract 3: My ex-boyfriend loved being punched in the belly. We both went to couples therapy and [this is] how the psychologist explained it to me…The physical flow-on effect of bellypunching is peptic reflux, which triggers the brain to release a sudden adrenalin rush to cope with the shock of (temporarily) depriving the brain of oxygen. This adrenalin rush can be experienced as sexual arousal for those with a fetish complex for feeling ‘subverted’ or ‘abused’”

Based on the research I did for this blog, it would appear that there used to be a Wikipedia entry on sexual bellypunching but it was removed back in 2006. Some people claimed that the information provided in the original webpage was unable to be verified, and that it might even have been made up by the person who created the original Wikipedia entry. As one person noted in the Wikipedia discussion, the original author of the bellypunching article had:

“…added a bunch of links, but they consist of Yahoo! groups, personal websites, and a couple [of] porn sites which themselves are non-notable. None of these are reliable sources, none of them help with the fact that this article still violates Wikipedia’s verifiability. Unverifiable content can’t stay on Wikipedia, no matter how much some people might like said content”.

Comments were also made along the lines that Wikipedia does not need to have a separate page for every single obscure fetish. Personally, I don’t see this as an argument for not having a Wikipedia entry. However, the original author of the page countered by saying:

It’s not about liking (or in your case, disliking) [the bellpunching] entry, but about showing diligence in mapping out within Wikipedia all these various concepts that exist in the world. Some concepts are better cited than others, it’s true. However that doesn’t mean that some things, which are perhaps more ephemeral, or which came into their own with the rise of the internet, can’t be listed…I suggest that if one can prove that a lot of people are involved in a concept, and that this concept exists as such, then the concept must surely merit some inclusion, even if that inclusion is limited only to what one can source…I have shown that thousands of people have taken it upon themselves to join public groups around this [bellypunching] fetish; and found any number of websites, most which have been around for years, creating a sort of community…It would be a mistake to make an article called bellypunching videos on the basis of the fact of such videos existing, because that would ignore the evident existence of the concept of the fetish”.

I have to admit that having done my own search on the internet, I can certainly vouch for the fact that there are hundreds of sexual bellypunching videos available online (e.g., websites such as Belly Punching Fetish, Heroine Movies, and Teen Bellypunch – please be warned that these are sexually explicit sites), and there are online discussion groups that discuss bellypunching as a sexual preference and/or sexual fetish. Personally, I think there’s enough to suggest that the activity exists and that there is no reason why a separate Wikipedia page should not exist. The fact that sexual bellypunching videos are for sale online suggests there is a market for it. I also came across some Japanese anime that featured sexual bellypunching (along with anecdotal evidence that bellypunching is part of Japanese sexual culture). However, I am the first to admit that such videos might appeal to sadists and masochists who are simply sexually turned on by the giving or receiving of pain (rather than being sexually aroused by bellypunching per se. The author of the original Wikipedia entry on sexual bellypunching then goes on to say:

“If [someone] starts a blog on any obscure fetish, it can’t be included [on Wikipedia]; but if 30 or 40 different organizations and people start websites, both personal websites and business websites, combined with free public groups that require membership (membership to which groups as I’ve stated reaches the thousands) I suggest that a certain minimum has been reached to make it a bona fide concept that some people hold…If you really believe that only things that show up in journals are worthy of existence in Wikipedia, I think Wikipedia will be much the poorer for it. It seems unreasonable to ignore the existence of something that is obvious and evident, from the links I’ve found (which were incidentally only a small percentage)”.

My guess is that the original article on sexual bellypunching was removed because the evidence base did not fulfil Wikipedia’s minimum evidence threshold. As the Wikipedia page on verifiability points out:

“Posts to bulletin boards, Usenet, and wikis, or messages left on blogs, should not be used as primary or secondary sources. This is in part because we have no way of knowing who has written or posted them, and in part because there is no editorial oversight or third-party fact-checking…The threshold for inclusion in Wikipedia is verifiability, not truth”.

Another contributor to the debate on whether sexual bellypunching should have its own Wikipedia entry shares my own view on this topic and stated:

Our inability to find gastergastrizophilia on the net neither proves nor disproves anything – detailed texts on sexual paraphilia aren’t left around laying open on the net, and a mild amount of Googling for ‘erotic punching’, ‘belly punishment’ or ‘rough body play”’… will show that the practice is neither ‘unlikely’ nor even uncommon. Some of it is obviously sex play with a consenting partner; some is not so consensual, and there is a shaded continuum…Even in this supposedly liberated age, nobody has any real numbers, in part because the participants themselves don’t know where the line actually divides consent and abuse. I think it’s an important topic, and a research failure isn’t a good reason to have no article in this instance”

The one thing that is made up is the name given to describe the love of sexual bellypunching (‘gastergastrizophilia’). The author if the original Wikipedia article (who goes by the pseudonym ‘Brokerthebank’) wrote that:

“I made up the word gastergastrizophilia, since I’ve studied classical languages a lot (in this case Greek) and it seemed like the appropriate move to put this article in the list of sexual paraphilias on such a page. Maybe I should have not done that; in any case bellypunching still is a known term”.

However, as regular readers of my blog will know, I too have coined the names of at least three sexual paraphilias (porciniphilia – sexual arousal from pigs, epiplophilia, sexual arousal from furniture, and glossophilia – sexual arousal from tongues) so I can’t really complain if someone also created the name of a sexual paraphilia based on their own anecdotal observations.

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

Further reading

Aggrawal A. (2009). Forensic and Medico-legal Aspects of Sexual Crimes and Unusual Sexual Practices. Boca Raton: CRC Press.

The Full Wiki (2013). Bellypunching. Located at:

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

Sowing the seeds of love: A brief look at impregnation fetishes

In a previous blog I examined maieusiophilia that according to Dr. Anil Aggrawal’s 2009 book Forensic and Medico-legal Aspects of Sexual Crimes and Unusual Sexual Practices, is defined as gaining sexual arousal from pregnant women and /or female childbirth. However, other sources define maieusiophilia more broadly to include sexual attraction to women who also appear pregnant, attraction to lactation and/or attraction to particular stages of pregnancy from impregnation through to childbirth. This blog briefly examines impregnation fetishes that may or may not (depending upon the definition used) be a sub-type of maieusiophilia.

In researching this article I was unable to locate a single academic paper that had examined impregnation fetishes (not even a passing reference) so all of this blog is based on non-academic (and mainly online) sources. The following three definitions – not identical but all having overlaps – were found on the Kinkipedia website, the online Free Dictionary, and the Psychology Wiki website:

  • “Impregnation fetish is where an individual (generally a male) has a fetish for impregnating someone, with this end result being all they think of during the act of sex. Similarly related fetishes would involve an individual having a sexual interest in pregnant women, or in some cases even having a fetish for being pregnant themselves” (Kinkopedia)
  • “Impregnation fantasies are characterized by the arousal or gratification from the possibility, consequences or risk of impregnation through unprotected vaginal sex. Impregnation fantasies are often indulged by reading erotic literature and role playing with a partner” (Free Dictionary)
  • “An impregnation fetish is a paraphilia characterized by arousal or gratification from the possibility or risk of impregnation through unprotected vaginal sex. Those with an impregnation fetish may indulge in their fantasy through erotic stories, chat with like-minded persons or actually act out the fantasy with a partner. Role-playing is often a large part of this sexual fetish, as many do not actually wish to have a child but rather are aroused by the possibility during intercourse. Responsibility for birth control in this case is usually accepted by the female, as condom use destroys the impregnation fantasy” (Psychology Wiki)

The Psychology Wiki also claims that impregnation fetish should not be confused with maiesiophilia because people that have a “pure” impregnation fetish are only interested in conception, and “have no interest in a woman who is already pregnant, as there is no possibility of impregnating her”. However, the article does go on to say that “a number of impregnation fetishists are aroused by pregnant women as well, and indulge in pregnant sex or pregnant sex fantasy as part of their gratification” (although I have no idea on what evidence such an assertion is made, even though it appears to have good face validity). In a short article on pregnancy fetishism at the Heart and Soul Midwifery website, it argues that “there are no particular or preferred elements within maiesiophilia that are common to all maiesiophiliacs”. This would at least suggest that the thought of impregnation alone might be enough for impregnation fetishes to be a sub-type of maiesiophilia.

Having spent an idle Sunday afternoon scouring lots of ‘adult’ websites in the name of research for this article, I am in no doubt that there is a niche market for impregnation fetishes. There are a number of dedicated websites that cater specifically for such fetishists, the most popular (at least in terms of number of visitors) appears to be the ImpregNation website. There are also general fetish sites (such as the Dark Fetish website) that contain dedicated groups such as the ‘Breeding and Forced Impregnation’ group. There are also a number of dedicated erotic fiction websites and blogs that have dedicated impregnation fetish stories such as the Kristen Archives and Breeder’s Erotica (please be warned that if you click on the hyperlinks they feature words and pictures of sexual activity). For instance:

“Breeder’s Erotica is a blog which has a high-focus on the idea of ‘Breeders’, dominant men inseminating breedee women. The webmistress Kitty has compiled tons of high-end pictures, videos, articles, and has her story universes ‘The Farm’ and ‘The Colony” posted for your viewing pleasure”.

I also visited lots of online forums and found dozens of people admitting that they had an impregnation fetish. While I can’t guarantee the veracity of the claims, they appeared genuine and heartfelt to me. Here is a selection:

  • Extract 1: “Lately I have been thinking about getting impregnated more and more and it turned into a deep obsession for me. It appeals to me on so many different levels. For one I’d love to have a family and kids but I also find pregnancy highly erotic and I want to make the experience but I also want to get used by a strong man who would take me and fill me with his seed”
  • Extract 2: “I am 24 [years of age and female] and I know my biological clock is ticking but for four or so years now I have had an extreme interest in sex that would get me pregnant. I DONT actually want to GET pregnant, I just like thinking about it when I’m having sex with my [boyfriend]. Do any other girls think like this??”
  • Extract 3: One of my first [role-playing] experiences was part of a ‘knocked up’ fetish. I was role-playing with a guy that I thought just had a pregnancy fetish but turns out he was more interested in the actual aspect of making me pregnant, which was fine. We role-played a fantasy where he got me pregnant, but sadly it ended there. His fantasy was just the knocking up part, after all – mine was the actual being pregnant part. Oh well… still an interesting experience”
  • Extract 4: “Pregnancy/impregnation role-play. Any takers? Please be 18-26 years old…. Looking for a MAN to do this with…maybe girls”.
  • Extract 5: “I’m 19 and have thoughts about [impregnation] a lot. It makes me feel like a mindless animal but at the same time entices me. Am I too young to be thinking like this? I’m a guy”.
  • Extract 6: “I’m 22 and very passionate. I’d love to impregnate someone. The thought drives me insane, I just want your legs wrapped around me pulling me in. I want to feel that wanted and desired to make someone a mommy. I’d do anything for that, even if it’s role play”
  • Extract 7: “Well I’m a girl who has this weird [impregnation] fetish that I have only met a few other guys who have it, but never any women. I wish to know how common it is for both women and men, what the reasons are for developing such a fetish, and how to help with how ashamed I feel”
  • Extract 8: “I’m 21 and live in Sydney but I’ve had these irrepressible [impregnation] desires and fantasies probably since when I was around 17…I love sex and intimacy, the feeling of touching and exploring each other’s body and my ultimate desire of laying with a young, fertile woman who can conceive my children. I’ve got an extreme desire when I am and not sleeping with a woman to impregnate them, to breed them and just deposit as much semen as possible inside her to guarantee probability of conception…I have no child yet but I want to see a woman carrying my baby and seeing it grow inside her”.
  • Extract 9: “I got a bad fetish for impregnation [seriously]. It first started almost seven years when I read this story on Kristin’s Impregnation Forum about impregnating women and I ended up making a Yahoo name and contacting women with a fake name. This led to meeting several women and I impregnated one of themThis only emboldened me and led me to knocking up three more women…I am currently seeing a girl who is about to move back home and I feel like I should knock her up. Is this insane?”
  • Extract 10: “I love the animalistic nature of thinking of getting pregnant, like being told ‘I’m filling you with my seed’ or ‘I want to breed with you’ really gets me excited. I don’t want children in the slightest, but sperm and egg diagrams in doctor’s offices will turn me on. I’m embarrassed to be like this especially as a woman and having no desire to have a child, like I’m unworthy of liking the thought of pregnancy because I don’t actually want to be pregnant. I only feel excited when I believe the guy actually wants to breed with me…The intense need I feel for having no contraceptives is a big part of what worries me because I’ve developed a hatred for condoms and an aversion to birth control. Most guys I tell this to think I’m weird or a needy baby-crazed lady, though my fetish has nothing to do with having a living being inside me”
  • Extract 11: “I’m a 20 year-old woman and I think I’m crazy. I have a fetish that revolves around pregnancy. I get massively turned on by the idea of getting pregnant. I also get turned on by the idea of my sexual partner sucking on my breasts and drinking my milk. In my deepest fantasies I am a perpetually pregnant woman who exists for no other purpose than to be knocked up and milked by anyone who cares to breed me. Basically, a broodmare. This fantasy is beyond degrading to women and I hate that I have it. I also should point out that I am totally infertile (I had a hysterectomy when I was in my very early teens), so I will never actually be pregnant in my life. What should I do? Am I insane?”

Based on the many accounts that I read, it would appear that both young men and women can have impregnation fetishes but there was little to explain the etiology. On the Is It Normal? website, 15 out of 16 people that participated in a discussion thread on impregnation fetishes said that such fetishes are ‘normal’. In fact one discussion participant went as far as to claim If you look like it from an evolutionary point of view, it’s probably the most normal fetish thinkable” that certainly has some face validity. Unfortunately, we can only speculate as to how such fetishes develop. Most fetishistic behaviour begins in childhood or adolescence and many appear to be rooted in early associative pairings (e.g., classical conditioning). There is no reason to suggest that is not the case here, but few of the accounts I came across mentioned early formative experiences. The jury is still out on whether impregnation fetishes are a sub-type of pregnancy fetishism but my own reading is that they may overlap within individuals but are two separate phenomena.

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

Further reading

Aggrawal A. (2009). Forensic and Medico-legal Aspects of Sexual Crimes and Unusual Sexual Practices. Boca Raton: CRC Press.

Bastion Works (2012). Maieusiophilia. Located at:

Gates, K. (1999). Deviant Desires: Incredibly Strange Sex. Juno Books.

Kinkipedia (2013). Impregnation fetishes. January 21. Located at:

Psychology Wiki Impregnation fetish. Located at:

Wikipedia (2012). Pregnancy fetishism. Located at:

Word up: The phonetics of branding in marketing

Although I have published a number of papers on the psychology of gambling advertising, branding, and marketing, I cannot claim to be in expert in the more general area of branding psychology. However, I feel more knowledgeable about the area having just read a fascinating paper by Sascha Topolinski, Michael Zürn and Iris Schneider recently published in the journal Frontiers in Psychology. Their paper examines the biomechanical connection between articulation and ingestion-related mouth movements to introduce a novel psychological principle of brand name design”. Now I’m sure a lot of you will be none-the-wiser from that description but keep with me because I think what they have done is ingenious. Before I get to the heart of their research findings, I ought to add that I also learned a lot in their paper’s introduction. For instance:

  • Repeated exposure to brands increase positive attitudes and the likelihood of eventual brand choice, and also increases the fluency of a brand name.
  • Repetition-induced high fluency due to advertising depends upon subtle mouth exercises. Activities that stop this happening (such as eating popcorn while watching an advert in the cinema) inhibit the effect of the advertising.
  • Easier to pronounce brand names (unsurprisingly) increases fluency. The easier the brand name is to pronounce, the more positive individual’s attitudes are towards the brand.
  • Consumer responses to brands can be influenced by how the name of brand sounds (so-called ‘phonetic symbolism’). In these instances “the sound of a word conveys certain characteristics of the denoted object or product, such as size, color, or touch. For instance, some vowels sound high (for instance [i] as in SWEET), and other vowels sound low, (for instance [u] as in LOOP). High vowels are associated with little, fast, or light objects, while low vowels are associated with large, steady, or heavy objects”. Research has shown that fictitious brand names for hammers (that are heavy items) are preferred by consumers when they contain low vowels whereas fictitious brand names for knives (that are light items) are preferred by consumers when they contain high vowels.

Based on these research findings, Dr. Topolinski and colleagues reached the conclusion that in relation to brand names, consumer choice can be influenced by word sounds and articulation fluency. However, their new research studies (seven studies in one paper) went beyond this by examining consumer behaviour towards brands based on the muscle movements while saying the name of the brand. The studies constructed brand names for diverse products that are spoken inwardly (from the front to the rear of the mouth, such as the fictitious brand name ‘BODIKA’), or are spoken outwardly (from the rear to the front, such as the brand name ‘KODIBA’). Here is the authors’ easy-to-understand explanation:

‘[It] is possible to construe words that feature consonant sequences that wander either from the front to the rear (inward) or from the rear to the front (outward) of the mouth. Take, for instance, the three consonants K, D, and P. Arranged in the word KADAP, first the rear back of the tongue is pressed against the soft palate to generate K, then the tip of the tongue is pressed against the soft palate to generate D, and then the lips are pressed together to generate P. These muscle tensions thus wander from the rear to the front of the mouth, this is, outward. Reversely, arranged in the word PADAK, first the lips are pressed together, then the tip of the tongue touches the soft palate, and then the rear back of the tongue touches the soft palate. These muscle tensions wander from the front to the rear, of the mouth, that is, inward. Combining such articulatory patterns with the muscle patterns of ingestion and expectoration, it is obvious that inward consonantal wanderings (PADAK) resemble the muscular dynamics during ingestion, and outward consonantal wanderings (KADAP) resemble the muscular dynamics during expectoration…Since ingestion is positively associated, and expectoration is negatively associated…consonantal wanderings may feel positive and outward wanderings may feel negative”.

The seven studies that were carried out (comprising a total of 1,261 participants) compared the fictitious inward speaking brand name (e.g., ‘BODIKA’) with the fictitious outward speaking brand name (e.g., ‘KODIBA’). The results of the seven studies (using a variety of different methodologies including laboratory experiments and surveys, and including participants that spoke different languages [German and English]) were very revealing. In summary, the participants (i) preferred the inward name product to the outward name, and (ii) reported higher likelihood to purchase the inward named product, and (iii) reported higher willingness-to-pay for the inward named brand (participants said they would pay 4-13% more for the inward name brand). The same effects were found in both English and German language. The authors concluded:

“[The] present approach exploits the biomechanical connection between articulation and ingestion to introduce a novel psychological principle for brand name design. Brands for which the consonantal articulation spots wander inwards in the mouth compared to outwards are preferred, elicit higher purchase intentions, and even trigger higher willingness-to-pay with a substantial possible monetary gain”.

The paper did make me wonder about implications for brand names in the gambling industry. All things being equal, it suggests that gamblers may prefer to spend their money with companies such as PKR and Bet 365 than Corals and 888.

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

Further reading

Baker, W. E. (1999). When can affective conditioning and mere exposure directly influence brand choice. Journal of Advertising, 28, 31–46.

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

Griffiths, M.D. (2007). Brand psychology: Social acceptability and familiarity that breeds trust and loyalty. Casino and Gaming International, 3(3), 69-72.

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. (2013). Responsible marketing and advertising of gambling. i-Gaming Business Affiliate, August/September, 50.

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.

Janiszewski, C. & Meyvis, T. (2001). Effects of brand logo complexity, repetition, and spacing on processing fluency and judgment. Journal of Consumer Research, 28, 18–32.

Laham, S.M., Koval, P., & Alter, A. L. (2012). The name-pronunciation effect: why people like Mr. Smith more than Mr. Colquhoun. Journal of Experimantal Social Psychology, 48, 752–756.

Lodish, L. M., Abraham, M., Kalmenson, S., Livelsberger, J., Lubetkin, B., Richardson, B., et al. (1995). How TV advertising works: a meta-analysis of 389 real world split cable TV advertising experiments. Journal of Marketing Research, 32, 125–139.

Lowrey, T. M., and Shrum, L. J. (2007). Phonetic symbolism and brand name preference. Journal of Consumer Research, 34, 406–414.

Rozin, P. (1999). Preadaptation and the puzzles and properties of pleasure. In D. Kahneman, E. Diener, & N. Schwarz (Eds.), Well-being: The Foundations of Hedonic Psychology (pp.109-133). New York, NY: Russell-Sage).

Song, H. & Schwarz, N. (2009). If it’s difficult-to-pronounce, it must be risky: fluency, familiarity, and risk perception. Psychological Science, 20, 135–138.

Topolinski, S., Lindner, S. & Freudenberg, A. (2014a). Popcorn in the cinema: oral interference sabotages advertising effects. Journal of Consumer Psychology, 24, 169–176.

Topolinski, S., Zürn, M. & Schneider, I.K. (2015) What’s in and what’s out in branding? A novel articulation effect for brand names. Frontiers in Psychology 6, 585. doi: 10.3389/fpsyg.2015.00585


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