Category Archives: Addiction

Watch this space: Another look at box-set bingeing

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

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

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

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

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

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

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

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

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

Further reading

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Further reading

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

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

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

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

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

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

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

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

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

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

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

Pressing the right buttons: The positives of playing video games

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

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

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

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

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

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

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

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

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

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

Further reading

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

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

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

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

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

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

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

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

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

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

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

Griffiths, M.D. & Sutton, M. (2013). Proposing the Crime Substitution Hypothesis: Exploring the possible causal relationship between excessive adolescent video game playing, social networking and crime reduction. Education and Health, 31, 17-21.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Further reading

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

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

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

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

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

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

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

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

Sole love: A brief look at shoe fetishism

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Further reading

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

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

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

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

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

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

Scorolli, C., Ghirlanda, S., Enquist, M., Zattoni, S. & Jannini, E.A. (2007). Relative prevalence of different fetishes. International Journal of Impotence Research, 19, 432-437.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Further reading

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

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

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

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

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

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

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

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

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

Tech your time: 12 top tips for a digital detox

Over the last few years there has been increasing use of the term ‘digital detox’. According to the Oxford Dictionary, digital detox is a period of time during which a person refrains from using electronic devices such as smartphones or computers, regarded as an opportunity to reduce stress or focus on social interaction in the physical world”. I have to admit that I often find it hard to switch off from work (mainly because I love my job). Given that my job relies on technology, by implication it also means I find it hard to switch off from technology. Today’s blog is as much for me as anyone reading this and provides some tips on how to cut down on technology use, even if it’s just for the weekend or a holiday. I have compiled these tips from many different online articles as well as some of my own personal strategies. 

Digitally detox in increments: For some people, going a few minutes without checking their smartphone or emails is difficult. For many, the urge is reflexive and habitual. If you are one of those people, then ‘baby steps’ are needed. Such individuals need to learn to digitally detox in small increments (i.e., go on a ‘digital diet’). Start by proving to yourself that you can go 15 minutes without technology. Over time, increase the length of time without checking (say) Twitter, Facebook and emails (e.g., 30 minutes, 60 minutes, a couple of hours) until you get into a daily habit of being able to spend a few hours without the need to be online. Another simple trick is to only keep mobile devices partially topped up. This means users have to be sparing when checking their mobile devices.

Set aside daily periods of self-imposed non-screen time: One of the secrets to cutting down technology use to acceptable levels is to keep aside certain times of the day technology-free (meal times and bedtime are a good starting place – in fact, these rooms should be made technology-free). For instance, I rarely look at any emails between 6pm and 8pm as this is reserved for family time (e.g., cooking and eating dinner with the family). Another strategy to try is having a technology-free day at the weekends (e.g., not accessing the internet at all for 24 hours). However, watching television or using an e-reader is fine. Another simple strategy is to have technology-free meal times (at both home and work). Don’t bring your smartphone or tablet to the table.

Only respond to emails and texts at specific times of the day: Only a few individuals are ‘on call’ and have to assume that the message they receive will be an emergency. Looking at emails (say) just three times a day (9am, 1pm, 4pm) will save lots of time in the long run. Turning off email and social media, disabling push notifications, or simply turning the volume setting to silent on electronic devices will also reduce the urge to constantly check mobile devices.

Don’t use your smartphone or tablet as an alarm clock: By using a standard alarm clock to wake you in the morning, you will avoid the temptation to look at emails and texts just as you are about to go to sleep or just wake up (or in the middle of the night if you are a workaholic!).

Engage in out-of-work activities where it is impossible (or frowned upon) to use technology: Nowadays, leisure activities such as going to the pub, having a meal, or going to the cinema, don’t stop people using wireless technology. By engaging in digitally incompatible activities where it is impossible to access technology simultaneously (e.g., jogging, swimming, meditation, outdoor walks in wi-fi free areas) or go to places where technology is frowned upon (e.g., places of worship, yoga classes, etc.) and individual will automatically decrease the amount of screen time. In social situations, you can turn people’s need to check their phones into a game. For instance, in the pub, you could have a game where the first one to check their phone has to buy a round of drinks for everyone else.

Tell your work colleagues and friends you are going on a digital detox: Checking emails and texts can become an almost compulsive behaviour because of what psychologists have termed ‘FOMO’ (fear of missing out) that refers to the anxiety that an interesting or exciting event may be happening elsewhere online. By telling everyone you know that you will not be online for a few hours, they will be less likely to contact you in the first place and you will be less likely check for online messages in the first place. Alternatively, Put your ‘out-of-office’ notification on for a few hours and do something more productive with your time.

Reduce your contact lists: One way to spend less time online is to reduce the number of friends on social networking sites, stop following blogs (but not mine, of course!), delete unused apps, and unsubscribe from online groups that have few benefits. Also, delete game apps that can be time-consuming (e.g., Angry Birds, Candy Crush Saga, etc.).

Get a wristwatch: One of the most common reasons for looking at a smartphone or a tablet is to check the time. If checking the time also leads to individuals noticing they have a text, email or tweet, they will end up reading what has been sent. By using an old fashioned wristwatch (as opposed to new smart watches like the Apple Watch), the urge to reply to messages will decrease.

Think about the benefits of not constantly being online: If you are the kind of person that responds to emails, texts and tweets as they come in, you will write longer responses than if you look at them all in a block. The bottom line is that you can save loads of time to spend on other things if you didn’t spend so long constantly reacting to what is going on in the online world.

Enjoy the silence: Too many people fail to appreciate being in the moment and allowing themselves to resist the urge to log onto their laptops, mobiles and tablets. It is at these times that some people might interpret as boredom that we can contemplate and be mindful. This could be made more formal by introducing meditation into a daily routine. There are also many places that run whole weekends and short breaks where technology is forbidden and much of the time can be spent in quiet contemplation. 

Fill the void: To undergo digital detox for any length of time, an individual has to replace the activity with something that is as equally rewarding (whether it is physically, psychologically or spiritually). When I’m on holiday, I catch up on all the novels that I’ve been meaning to read. In shorter spaces of time (such as sitting in boring meetings) I doodle, write ‘to do’ lists, generate ideas to write about, or simply do nothing (and be mindful, aware of the present moment). In short, I try to productive (or unproductive) without having to resort to my technology. 

Use technology to beat technology: One thing that can shock technology users is how much time they actually spend on their mobile devices. Working out how much time is actually spent online can be the first step in wanting to cut down. (For instance, someone I once worked with was shocked to find he had spent 72 [24-hour] days in one year playing World of Warcraft). Tech users can download apps that tell them how much time spending online, (e.g., Moment). Being made aware of a problem is often the first step in enabling behavioural change.

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

Further reading

Goodnet (2013). 7 steps to planning your next digital detox. October 22. Located at: http://www.goodnet.org/articles/7-steps-to-planning-your-next-digital-detox

Hosseini, M.D. (2013). Top 10 tips to unplug this summer with a digital detox. Advertising Week Social Club, June 28. Located at: http://www.theawsc.com/2013/06/28/top-10-tips-to-unplug-this-summer-with-a-digital-detox/

Huffington Post (2013). 10 digital detox vacation hacks to help you truly unplug. July 31. Located at: http://www.huffingtonpost.com/2013/07/31/vacation-hacks-_n_3676474.html

Levy, P. (2015). 15 tips for a total digital detox. Mind Body Green, January 15. Located at: http://www.mindbodygreen.com/0-17030/15-tips-for-a-total-digital-detox.html

Lipman, F. (2015). 12 tips for your next digital detox. March 2. Located at: http://www.drfranklipman.com/shake-it-off-12-tips-for-your-next-digital-detox/

Lipman, F. (2014). 8 ways to disconnect from technology and get more done. November 5. Located at: http://www.drfranklipman.com/8-ways-to-disconnect-from-technology-and-get-more-done/

South China Morning Post (2015). Five tips for a digital detox. Located at: http://www.scmp.com/lifestyle/technology/article/1673273/five-tips-digital-detox

Vozza, S. (2013). A realistic digital detox in 5 easy steps. Entrepreneur, November 12. Located: http://www.entrepreneur.com/article/229783

Game over-view: A brief overview of our recent papers on gaming addiction

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

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.

  • Despite the large growth on gaming behaviour research, little has been done to overcome the problem stemming from the heterogeneity of gaming addiction nomenclature and the use of non-standardised measurement tools. Following the recent inclusion of Internet Gaming Disorder [IGD] as a condition worthy of future studies in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders [DSM-5], researchers have now an opportunity to reach consensus and unification in the field. The aim of this study was to develop a new nine-item short-form scale to assess Internet Gaming Disorder (IGDS-SF9) and to further explore its psychometric properties. A sample of 1060 gamers (85.1% males, mean age 27 years) recruited via online gaming forums participated. Exploratory factor analysis [EFA], confirmatory factor analysis [CFA], analyses of the criterion-related and concurrent validity, reliability, standard error of measurement [SEM], population cross-validity, and floor and ceiling effects were performed to assess the instrument’s psychometric properties. The results from the EFA revealed a single-factor structure for IGD that was also confirmed by the CFA. The nine items of the IGDS-SF9 are valid, reliable, and proved to be highly suitable for measuring IGD. It is envisaged that the IGDS-SF9 will help facilitate unified research in the field.

Benrazavi, S.R., Teimouri, M. & Griffiths, M.D. (2015). Utility of parental mediation model on youth’s problematic online gaming. International Journal of Mental Health and Addiction, 13, 712-727.

  • The Parental Mediation Model (PMM) was initially designed to regulate children’s attitudes towards the traditional media. In the present era, because of prevalent online media there is a need for similar regulative measures. Spending long hours on social media and playing online games increase the risks of exposure to the negative outcomes of online gaming. This paper initially applied the PMM developed by European Kids Online to (i) test the reliability and validity of this model and (ii) identify the effectiveness of this model in controlling problematic online gaming (POG). The data were collected from 592 participants comprising 296 parents and 296 students of four foreign universities, aged 16 to 22 years in Kuala Lumpur (Malaysia). The study found that the modified model of the five-factor PMM (Technical mediation, Monitoring mediation, Restrictive mediation, Active Mediation of Internet Safety, and Active mediation of Internet Use) functions as a predictor for mitigating POG. The findings suggest the existence of a positive relation between ‘monitoring’ and ‘restrictive’ mediation strategies and exposure to POG while Active Mediation of Internet Safety and Active mediation of Internet use were insignificant predictors. Results showed a higher utility of ‘technical’ strategies by the parents led to less POG. The findings of this study do not support the literature suggesting active mediation is more effective for reducing youth’s risky behaviour. Instead, parents need to apply more technical mediations with their children and adolescents’ Internet use to minimize the negative effects of online gaming.

Hussain, Z., Williams, G. & Griffiths, M.D. (2015). An exploratory study of the association between online gaming addiction and enjoyment motivations for playing massively multiplayer online role-playing games. Computers in Human Behavior, 50, 221–230.

  • Massively multiplayer online role-playing games (MMORPGs) are a popular form of entertainment used by millions of gamers worldwide. Potential problems relating to MMORPG play have emerged, particularly in relation to being addicted to playing in such virtual environments. In the present study, factors relating to online gaming addiction and motivations for playing in MMORPGs were examined to establish whether they were associated with addiction. A sample comprised 1167 gamers who were surveyed about their gaming motivations. Latent Class Analysis revealed seven classes of motivations for playing MMORPGs, which comprised: (1) novelty; (2) highly social and discovery-orientated; (3) aggressive, anti-social and non-curious; (4) highly social, competitive; (5) low intensity enjoyment; (6) discovery-orientated; and (7) social classes. Five classes of gaming addiction-related experiences were extracted including: (1) high risk of addiction, (2) time-affected, (3) intermediate risk of addiction, (4) emotional control, and (5) low risk of addiction classes. Gender was a significant predictor of intermediate risk of addiction and emotional control class membership. Membership of the high risk of addiction class was significantly predicted by belonging to a highly social and competitive class, a novelty class, or an aggressive, anti-social, and non-curious class. Implications of these findings for assessment and treatment of MMORPG addiction are discussed.

Király, O., Griffiths, M.D. & Demetrovics Z. (2015). Internet gaming disorder and the DSM-5: Conceptualization, debates, and controversiesCurrent Addiction Reports, 2, 254–262.

  • Scientific interest in behavioral addictions (such as Internet gaming disorder [IGD]) has risen considerably over the last two decades. Moreover, the inclusion of IGD in Section 3 of DSM-5 will most likely stimulate such research even more. Although the inclusion of IGD appears to have been well received by most of the researchers and clinicians in the field, there are several controversies and concerns surrounding its inclusion. The present paper aims to discuss the most important of these issues: (i) the possible effects of accepting IGD as an addiction; (ii) the most important critiques regarding certain IGD criteria (i.e., preoccupation, tolerance, withdrawal, deception, and escape); and (iii) the controversies surrounding the name and content of IGD. In addition to these controversies, the paper also provides a brief overview of the recent findings in the assessment and prevalence of IGD, the etiology of the disorder, and the most important treatment methods.

Király, O., Urbán, R., Griffiths, M.D., Ágoston, C., Nagygyörgy, K., Kökönyei, G. & Demetrovics, Z. (2015). Psychiatric symptoms and problematic online gaming: The mediating effect of gaming motivation. Journal of Medical Internet Research, 17(4) :e88.

  • Background: The rapid expansion of online video gaming as a leisure time activity has led to the appearance of problematic online gaming (POG). According to the literature, POG is associated with different psychiatric symptoms (eg, depression, anxiety) and with specific gaming motives (ie, escape, achievement). Based on studies of alcohol use that suggest a mediator role of drinking motives between distal influences (e.g., trauma symptoms) and drinking problems, this study examined the assumption that there is an indirect link between psychiatric distress and POG via the mediation of gaming motives. Furthermore, it was also assumed that there was a moderator effect of gender and game type preference based on the important role gender plays in POG and the structural differences between different game types. Objective: This study had two aims. The first aim was to test the mediating role of online gaming motives between psychiatric symptoms and problematic use of online games. The second aim was to test the moderator effect of gender and game type preference in this mediation model. Methods: An online survey was conducted on a sample of online gamers (N=3186; age: mean 21.1, SD 5.9 years; male: 2859/3186, 89.74%). The Brief Symptom Inventory (BSI), the Motives for Online Gaming Questionnaire (MOGQ), and the Problematic Online Gaming Questionnaire (POGQ) were administered to assess general psychiatric distress, online gaming motives, and problematic online game use, respectively. Structural regression analyses within structural equation modeling were used to test the proposed mediation models and multigroup analyses were used to test gender and game type differences to determine possible moderating effects. Results: The mediation models fitted the data adequately. The Global Severity Index (GSI) of the BSI indicated that the level of psychiatric distress had a significant positive direct effect (standardized effect=.35, P<.001) and a significant indirect (mediating) effect on POG (standardized effect=.194, P<.001) via 2 gaming motives: escape (standardized effect=.139, P<.001) and competition (standardized effect=.046, P<.001). The comparison of the 2 main gamer types showed no significant differences in the model. However, when comparing male and female players it was found that women had (1) slightly higher escape scores (on a 5-point Likert scale: mean 2.28, SD 1.14) than men (mean 1.87, SD 0.97) and (2) a stronger association between the escape motive and problematic online gaming (standardized effect size=.64, P<.001) than men (standardized effect size=.20, P=.001). Conclusions: The results suggest that psychiatric distress is both directly and indirectly (via escape and competition motives) negatively associated with POG. Therefore, the exploration of psychiatric symptoms and gaming motives of POG can be helpful in the preparation of prevention and treatment programs.

Fuster, H., Carbonell, X., Pontes, H.M. & Griffiths, M.D. (2016). Spanish validation of the Internet Gaming Disorder-20 (IGD-20) Test. Computers in Human Behavior, 56, 215-224.

  • In recent years, problematic and addictive gaming has been a phenomenon of growing concern worldwide. In light of the increasing awareness about this issue, the latest (fifth) edition of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-5) included Internet Gaming Disorder (IGD) as an area in need of more empirical research. The Internet Gaming Disorder Test (IGD-20 Test) was developed as a valid and reliable tool to assess IGD. The aim of the present study was to validate the Spanish version of the IGD-20 Test, and analyze the different profiles found among a sample of 1074 Spanish-speaking gamers. A confirmatory factor analysis showed the validity of the Spanish version of the IGD-20 Test and its six factor structure (i.e., salience, mood modification, tolerance, withdrawal, conflict and relapse). The latent profile analysis (LPA) showed five different gamer classes. The ‘disordered gamers’ class comprised 2.6% of the participants. Based on this class, sensitivity and specificity analyses showed an adequate empirical cut-off point of 75 (out of 100). It is concluded that the Spanish version of the IGD-20 Test is valid and reliable and can be used in research into IGD among Spanish speaking populations.

Griffiths, M.D., Van Rooij, A., Kardefelt-Winther, D., Starcevic, V., Király, O…Demetrovics, Z. (2016). Working towards an international consensus on criteria for assessing Internet Gaming Disorder: A critical commentary on Petry et al (2014). Addiction, 111, 167-175.

  • This commentary paper critically discusses the recent debate paper by Petry et al. (2014) that argued there was now an international consensus for assessing Internet Gaming Disorder (IGD). Our collective opinions vary considerably regarding many different aspects of online gaming. However, we contend that the paper by Petry and colleagues does not provide a true and representative international community of researchers in this area. This paper critically discusses and provides commentary on (i) the representativeness of the international group that wrote the ‘consensus’ paper, and (ii) each of the IGD criteria. The paper also includes a brief discussion on initiatives that could be taken to move the field towards consensus. It is hoped that this paper will foster debate in the IGD field and lead to improved theory, better methodologically designed studies, and more robust empirical evidence as regards problematic gaming and its psychosocial consequences and impact.

Kim, N.R., Hwang, S.S-H., Choi, J-S., Kim, D-J., Demetrovics, Z., Király, O., Nagygyörgy, K., Griffiths, M.D., Hyun, S.Y., Youn, H.C. & Sam-Wook Choi, S-W. (2016). Characteristics and psychiatric symptoms of Internet Gaming Disorder among adults using self-reported DSM-5 criteria. Psychiatry Investigation, 13(1), 58-66.

  • Objective: The Section III of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) proposed nine diagnostic criteria and five cut-point criteria for Internet Gaming Disorder (IGD). We aimed to examine the efficacy of such criteria. Methods: Adults (n=3041, men: 1824, women: 1217) who engaged in internet gaming within last 6 months completed a self-report online survey using the suggested wordings of the criteria in DSM-5. Major characteristics, gaming behavior, and psychiatric symptoms of IGD were analyzed using ANOVA, chi-square, and correlation analyses. Results: The sociodemographic variables were not statistically significant between the healthy controls and the risk group. Among the participants, 419 (13.8%) were identified and labeled as the IGD risk group. The IGD risk group scored significantly higher on all motivation subscales (p<0.001). The IGD risk group showed significantly higher scores than healthy controls in all nine psychiatric symptom dimensions, i.e., somatization, obsession-compulsion, interpersonal sensitivity, depression, anxiety, hostility, phobic anxiety, paranoid ideation, and psychoticism (p<0.001). Conclusion: The IGD risk group showed differential psychopathological manifestations according to DSM-5 IGD diagnostic criteria. Further studies are needed to evaluate the reliability and validity of the specific criteria, especially for developing screening instruments.

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

Further reading

Beranuy, M., Carbonell, X., & Griffiths, M.D. (2013). A qualitative analysis of online gaming addicts in treatment. International Journal of Mental Health and Addiction, 11, 149-161.

Billieux, J., Deleuze, J., Griffiths, M.D., & Kuss, D.J. (2015). Internet addiction: The case of massively multiplayer online role playing games. In N. El-Guebaly, M. Galanter, & G. Carra (Eds.), The Textbook of Addiction Treatment: International Perspectives (pp.1516-1525). New York: Springer.

Griffiths, M.D., King, D.L. & Demetrovics, Z. (2014). DSM-5 Internet Gaming Disorder needs a unified approach to assessment. Neuropsychiatry, 4(1), 1-4.

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.

King, D.L., Delfabbro, P.H., Griffiths, M.D. (2013). Trajectories of problem video gaming among adult regular gamers: An 18-month longitudinal study. Cyberpsychology, Behavior and Social Networking, 16, 72-76.

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.

Király, O., Griffiths, M.D., Urbán, R., Farkas, J., Kökönyei, G. Elekes, Z., Domokos Tamás, D. & Demetrovics, Z. (2014). Problematic internet use and problematic online gaming are not the same: Findings from a large nationally representative adolescent sample. Cyberpsychology, Behavior and Social Networking, 17, 749-754.

Lopez-Fernandez, O., Honrubia-Serrano, M.L., Baguley, T. & Griffiths, M.D. (2014). Pathological video game playing in Spanish and British adolescents: Towards the Internet Gaming Disorder symptomatology. Computers in Human Behavior, 41, 304–312.

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., 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.

Spekman, M.L.C., Konijn, E.A, Roelofsma, P.H.M.P. & Griffiths, M.D. (2013). Gaming addiction, definition, and measurement: A large-scale empirical study, Computers in Human Behavior, 29, 2150-2155.

Arrive without travelling: A brief look at “destination addiction”

Today’s blog has absolutely nothing to do with one of my previous blogs on being “addicted to travel”. The other day I was on Facebook when one of my friends posted a graphic with the following quote:

“Beware of Destination Addiction – a preoccupation with the idea that happiness is in the next place, the next job and with the next partner. Until you give up the idea that happiness is somewhere else, it will never be where you are”

Not only did I like the quote but it also caught my attention because the word “addiction” was used in it. I quickly Googled the term ‘destination addiction’ and was surprised to find a number of articles on the topic (but unfortunately nothing published in an academic journal). The term ‘destination addiction’ was coined by Dr. Robert Holden (a British psychologist the Director of The Happiness Project and Success Intelligence) in his 2011 book Authentic Success: Essential Lessons and Practices from the World’s Leading Coaching Program on Success Intelligence (an updated version of his 2009 book Success Intelligence). In a blog extracted from his book, Dr. Holden wrote:

“Do you live your life only to get to the end of it? Most people answer this question with a ‘no’, but not everyone lives like they mean it. In the manic society that most of us experience, people exhibit a frantic, neurotic behavior I call ‘Destination Addiction’. This addiction is a major block to success. People who suffer from Destination Addiction believe that success is a destination. They are addicted to the idea that the future is where success is, happiness is, and heaven is. Each passing moment is merely a ticket to get to the future. They live in the ‘not now’, they are psychologically absent, and they disregard everything they have. Destination Addiction is a preoccupation with the idea that happiness is somewhere else. We suffer, literally, from the pursuit of happiness. We are always on the run, on the move, and on the go. Our goal is not to enjoy the day, it is to get through the day. We have always to get to somewhere else first before we can relax and before we can savor the moment. But we never get there. There is no point of arrival. We are permanently dissatisfied. The feeling of success is continually deferred. We live in hot pursuit of some extraordinary bliss we have no idea how to find”.

From an addiction perspective, there is little in the description that would lead me to call this behaviour an addiction by my own criteria apart from the idea of being totally preoccupied with the behaviour (which for me is one of the core components of addiction that I term ‘salience’). Holden then goes on to list some of the symptoms of destination addiction which I’ve reproduced below verbatim:

  • “Whatever you are doing, you are always thinking about what comes next.
  • You cannot afford to stop because you always have to be somewhere else.
  • You are always in a hurry even when you don’t need to be.
  • You always promise that next year you will be less busy.
  • Your dream home is always the next home you plan to buy.
  • You don’t like your job but it has good prospects for the future.
  • You never commit fully to anything in case something better comes along.
  • You hope the next big success will finally make you happy.
  • You always think you should be further ahead of where you are now.
  • You have so many forecasts, projections, and targets that you never enjoy your life”.

There is nothing in this list ‘symptoms’ that relates to symptoms of addiction in any way but that doesn’t mean that Holden has not hit upon something – it’s just not something that I would call an addiction. Holden also claims that destination addicts “celebrate the end of the day”, and look forward to the weekends so that they can recover (in short, they are the kind of people who say to themselves “Thank God it’s Friday”). Holden also notes:

“The life we dream of is in the future somewhere, and we hope to catch up with it any day now. Destination Addiction causes us to rush through as many experiences as quickly as possible. We like to be able to say ‘Been there, done that!’… Surely, life is not all about endings. If it were, we would read only abridged novels; we would attend only the final act of a play at the theater; the last note of a symphony would be best of all; the best restaurants would serve only petits fours; and sex would have no foreplay. Destination Addiction is an attempt to get on with life faster in the hope that we will enjoy our lives better. And yet our constant speeding means we frequently run past golden opportunities for grace and betterment…We seek, but we do not find…Our Destination Addiction often works against us, however, because we are too busy running to be receptive. Hence, we always feel empty…The other meaning is “the purpose,” i.e., your vision, your values, etc. The trouble with Destination Addiction is that it focuses purely on finishes and not on purpose. To live intelligently is to live with purpose, to make the means the end, and also the end the means. The end is in every moment”.

Other articles on destination addiction talk about it being obsessive and compulsive. For instance, an article by Beverley Glick says that “people who have destination addiction are compulsively trying to get somewhere or something that’s perpetually in the future” whereas an article on the Elements Behavioral Health website notes that musings on the choices we have made in our day-to-day life can turn to obsession and that our “daydreams can become self-sabotaging”. The article also claims that:

“For those prone to addictive thought patterns and behaviors, destination addiction is the perfect setup for failure. Trading short-term gratification for the eventual fallout is a component of destination addiction. Getting lost in destination addiction can be as easy as plugging your goals into [Dr. Robert Holden’s] description that ‘happiness is the next hit, the next high, the next acquisition, the next drink, the next orgasm, the next hot-fudge sundae, the next 10-pound weight loss’. Is your mind overactive with ‘the grass is greener’ thinking? Do you sigh in frustration that you aren’t living the life you imagined?”

Dr. Holden claimed on The Oprah Winfrey Show in 2008 that destination addiction affects “millions” of individuals and in another blog on destination addiction entitled ‘Are you the tortoise or the hare?’, Holden claimed:

“[Destination addicts] are hypercritical and are forever ‘should-ing’ on themselves – ‘I should be further in my career by now’, ‘I should have gotten married by now’, or ‘I should have achieved more by now’. Destination Addiction causes us to be permanently impatient with ourselves. The schedule we set for ourselves is so demanding that we end up driving ourselves harder and faster. We refuse to forgive ourselves if we cannot keep up…We have no time for ourselves, and we are permanently impatient with everyone else…We are permanently impatient because we are addicted to the pursuit of progress. What is progress? According to Destination Addiction, to progress is to move along a timeline from ‘here’ to ‘there’ as quickly as possible. But to what end? Impatience impedes real progress if the focus is only on getting to the future faster. Real progress is a real-time goal that is about the here and now – living well today, being more present, caretaking this moment, and enjoying the time of your life”.

To me, what Holden is trying to promote is living in the now, living in the moment, in other words a form of mindfulness (something I have discussed in a number of my previous blogs and something which I have been carrying out research into with Dr. Edo Shonin and William Van Gordon). Another online article about destination addiction (on the Frugal Dad website) implies that shopping addiction might be symptomatic of destination addiction:

“[Destination addiction] is this never-ending pursuit of happiness that drives us to spend more and more money on things. But things do not bring joy. Things bring worry. Things bring temporary happiness that masks some deeper pain.  For instance, those who consider themselves ‘emotional spenders’ don’t really have a spending problem. They are using shopping as a way of putting on an emotional Band-Aid to make some other kind of pain go away, much in the same way someone who overeats does so to combat depression, or loneliness.  It usually isn’t about the enjoyment of overindulging in foods, or purses”.

The article then goes on to describe so-called “destination dealers” that have helped the addiction “spread quickly” (i.e., those on television trying to sell you products that can help you “totally change your life” or “make you happier than you ever dreamed possible”. More specifically:

“Cars are often depicted as the path to a happier life in commercials, as if the built-in navigation system, iPod docking station, and push-button ignition will really make you happier than the $600 monthly payments.  But, we get hooked at an early age and chase these various ‘destinations’ our entire lives.  A bigger home, a newer car, fancier clothing, more exquisite jewelry–nothing is ever simply enough. Fortunately, there is an excellent home remedy for destination addiction, but it is often hard to find. When we declare ourselves content with what we have and who we are we can beat the addiction of waiting to be happy.  We can live quite happily in the now. Through contentment we can be happy with this house, and this car, and these clothes, and beat the cravings for more”…happiness comes from within; it is not something that can be pursued”.

This is echoed in an online article on destination addiction by Connie Mann:

“Happiness never comes from a destination. Happiness is a choice we make, every day, no matter where we are. It comes from recognizing that circumstances don’t bring happiness, things don’t bring happiness, achievements don’t bring happiness. Happiness comes from inside us, from an attitude of thanksgiving…If we get too focused on tomorrow, we can fall into a dangerous trap”.

Another recent online article on destination addiction by Toya Sharee claimed that “social media and an era of excess make a major contribution to this epidemic of destination addiction”. She also said (in line with some of the other comments mentioned above) that:

“None of us are immune to destination addiction and we all have times where we have to convince ourselves that better times are ahead just to make it through the day. But the key to defeating destination addiction is to find happiness with the life you have and to achieve the goals that are important to YOU, not the ones you think will impress everyone else”.

I’ll leave you with the words of philosopher and author Henry David Thoreau that also recalls the concept of mindfulness but who Beverley Glick cited in her article on whether there is a cure for destination addiction: “You must live in the present, launch yourself on every wave, find your eternity in each moment”.

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

Further reading

Elements Behavioral Health (2016). Destination addiction. Located at: https://www.elementsbehavioralhealth.com/addiction/destination-addiction/

Frugal Dad (2009). Do you suffer from destination addiction. January 5. Located at: http://www.frugaldad.com/do-you-suffer-from-destination-addiction/

Glick, B. (2011). Is there a cure for destination addiction. Pearl Within. Located at: http://pearlwithin.tumblr.com/post/17710986467/is-there-a-cure-for-destination-addiction

Holden, R. (2010). Are you the tortoise of the hare? Heal Your Life, August 30. Located at: http://www.healyourlife.com/are-you-the-tortoise-or-the-hare

Holden, R. (2011). Authentic Success: Essential Lessons and Practices from the World’s Leading Coaching Program on Success Intelligence. London: Hay House.

Holden, R. (2015). What is destination addiction? How to stop thinking about what comes next. Located at: http://www.robertholden.org/blog/what-is-destination-addiction/

Mann, C. (2014). Beware of destination addiction. August 2. http://www.conniemann.com/beware-of-destination-addiction/

Sharee, T. (2016). Are you suffering destination addiction? XoNecole, February 16. Located at: http://xonecole.com/destination-addiction/

Substance For You (2016). Destination addiction. Located at: http://substanceforyou.com/destination-addiction/

Whyte, D. (2016). Destination addiction. January 13. Located at: http://pearlwithin.tumblr.com/post/17710986467/is-there-a-cure-for-destination-addiction

Net gains: A brief overview of our recent papers on Internet addiction

Following my recent blogs where I outlined some of the papers that I and my colleagues have published on mindfulness, I got a couple of emails asking if I could do the same thing on other areas that we have been researching into. So, here it is.

Pontes, H.M., Szabo, A. & Griffiths, M.D. (2015). The impact of Internet-based specific activities on the perceptions of Internet Addiction, Quality of Life, and excessive usage: A cross-sectional study. Addictive Behaviors Reports, 1, 19-25.

  • Introduction: Recent research has examined the context in which preference for specific online activities arises, leading researchers to suggest that excessive Internet users are engaged in specific activities rather than ‘generalized’ Internet use. The present study aimed to partially replicate and expand these findings by addressing four research questions regarding (i) participants’ preferred online activities, (i) possible expected changes in online behavior in light of hypothetical scenarios, (iii) perceived quality of life when access to Internet was not possible, and (iv) how participants with self-diagnosed Internet addiction relate to intensity and frequency of Internet use. Methods: A cross-sectional design was adopted using convenience and snowball sampling to recruit participants. A total of 1057 Internet users with ages ranging from 16 to 70 years (Mean age= 30 years, SD = 10.84) were recruited online via several English-speaking online forums. Results: Most participants indicated that their preferred activities were (i) accessing general information and news, (ii) social networking, and (iii) using e-mail and/or online chatting. Participants also reported that there would be a significant decrease of their Internet use if access to their preferred activities was restricted. The study also found that 51% of the total sample perceived themselves as being addicted to the Internet, while 14.1% reported that without the Internet their life would be improved. Conclusions: The context in which the Internet is used appears to determine the intensity and the lengths that individuals will go to use this tool. The implications of these findings are further discussed.

Pontes, H.M., Kuss, D.J. & 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.

  • Research into Internet addiction (IA) has grown rapidly over the last decade. The topic has generated a great deal of debate, particularly in relation to how IA can be defined conceptually as well as the many methodological limitations. The present review aims to further elaborate and clarify issues that are relevant to IA research in a number of areas including: definition and characterization, incidence and prevalence rates, associated neuronal processes, and implications for treatment, prevention, and patient-specific considerations. It is concluded that there is no consensual definition for IA. Prevalence rates among nationally representative samples across several countries vary greatly (from 1% to 18.7%), most likely reflecting the lack of methodological consistency and conceptual rigor of the studies. The overlaps between IA and other more traditional substance-based addictions and the possible neural substrates implicated in IA are also highlighted. In terms of treatment and prevention, both psychological and pharmacological treatments are examined in light of existing evidence alongside particular aspects inherent to the patient perspective. Based on the evidence analyzed, it is concluded that IA may pose a serious health hazard to a minority of people.

Lai, C-L., Mak, K-K., Cheng, C., Watanabe, H., Nomachi, S., Bahar, N., Young, K.S., Ko, H-C., Kim, D. & Griffiths, M.D. (2015). Measurement invariance of Internet Addiction Test among Hong Kong, Japanese, and Malaysian adolescents: An item response analysis. Cyberpsychology, Behavior and Social Networking, 18, 609-617.

  • There has been increased research examining the psychometric properties on the Internet Addiction Test (IAT) in different populations. This population-based study examined the psychometric properties and measurement invariance of the IAT in adolescents from three Asian countries. In the Asian Adolescent Risk Behavior Survey (AARBS), 2,535 secondary school students (55.9% girls) aged 12-18 years from Hong Kong (n=844), Japan (n=744), and Malaysia (n=947) completed a survey in 2012-2013 school year. A nested hierarchy of hypotheses concerning the IAT cross-country invariance was tested using multigroup confirmatory factor analyses. Replicating past findings in Hong Kong adolescents, the construct of the IAT is best represented by a second-order three-factor structure in Malaysian and Japanese adolescents. Configural, metric, scalar, and partial strict factorial invariance was established across the three samples. No cross-country differences on Internet addiction were detected at the latent mean level. This study provided empirical support for the IAT as a reliable and factorially stable instrument, and valid to be used across Asian adolescent populations.

Griffiths, M.D., Kuss, D.J., Billieux J. & Pontes, H.M. (2016). The evolution of internet addiction: A global perspective. Addictive Behaviors, 53, 193–195.

  • Kimberly Young’s initial work on Internet addiction (IA) was pioneering and her early writings on the topic in- spired many others to carry out research in the area. Young’s (2015) recent paper on the ‘evolution of Internet addiction’ featured very little European research, and did not consider the main international evidence that has contributed to our current knowledge about the conceptualization, epidemiology, etiology, and course of Internet-related disorders. This short commentary paper elaborates on important literature omitted by Young that the present authors believe may be of use to researchers. We also address statements made in Young’s (2015) commentary that are incorrect (and therefore misleading) and not systematically substantiated by empirical evidence.

Stavropoulos, V., Kuss, D.K., Griffiths, M.D. & Motti-Stafanidi, F. (2016). A longitudinal study of adolescent internet addiction: The role of conscientiousness and classroom hostility. Journal of Adolescent Research, in press.

  • Over the last decade, research on Internet addiction (IA) has increased. However, almost all studies in the area are cross-sectional and do not examine the context in which Internet use takes place. Therefore, a longitudinal study examined the role of conscientiousness (as a personality trait) and classroom hostility (as a contextual factor) in the development of IA. The participants comprised 648 adolescents and were assessed over a 2-year period (while aged 16-18 years). A three-level hierarchical linear model was carried out on the data collected. Findings revealed that (a) lower conscientiousness was associated with IA and this did not change over time and (b) although being in a more hostile classroom did not initially have a significant effect, it increased girls’ IA vulnerability over time and functioned protectively for boys. Results indicated that the contribution of individual and contextual IA factors may differ across genders and over time. More specifically, although the protective effect of conscientiousness appeared to hold, the over-time effect of classroom hostility increased the risk of IA for girls. These findings are discussed in relation to the psychological literature. The study’s limitations and implications are also discussed.

Ostovar, S., Allahyar, N., Aminpoor, H. Moafian, F., Nor, M. & Griffiths, M.D. (2016). Internet addiction and its psychosocial risks (depression, anxiety, stress and loneliness) among Iranian adolescents and young adults: A structural equation model in a cross-sectional study. International Journal of Mental Health and Addiction, in press.

  • Internet addiction has become an increasingly researched area in many Westernized countries. However, there has been little research in developing countries such as Iran, and when research has been conducted, it has typically utilized small samples. This study investigated the relationship of Internet addiction with stress, depression, anxiety, and loneliness in 1052 Iranian adolescents and young adults. The participants were randomly selected to complete a battery of psychometrically validated instruments including the Internet Addiction Test, Depression Anxiety Stress Scale, and the Loneliness Scale. Structural equation modeling and Pearson correlation coefficients were used to determine the relationship between Internet addiction and psychological impairments (depression, anxiety, stress and loneliness). Pearson correlation, path analysis, multivariate analysis of variance (MANOVA), and t-tests were used to analyze the data. Results showed that Internet addiction is a predictor of stress, depression, anxiety, and loneliness. Findings further indicated that addictive Internet use is gender sensitive and that the risk of Internet addiction is higher in males than in females. The results showed that male Internet addicts differed significantly from females in terms of depression, anxiety, stress, and loneliness. The implications of these results are discussed.

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

Further reading

Billieux, J., Deleuze, J., Griffiths, M.D., & Kuss, D.J. (2015). Internet addiction: The case of massively multiplayer online role playing games. In N. El-Guebaly, M. Galanter, & G. Carra (Eds.), The Textbook of Addiction Treatment: International Perspectives (pp.1516-1525). New York: Springer.

Griffiths, M.D. (2010). Internet abuse and internet addiction in the workplace. Journal of Workplace Learning, 7, 463-472.

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.

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

Kuss, D.J. & Griffiths, M.D. (2015). Internet Addiction in Psychotherapy. Basingstoke: Palgrave Macmillan.

Kuss, D.J., Griffiths, M.D. & Binder, J. (2013). Internet addiction in students: Prevalence and risk factors. Computers in Human Behavior, 29, 959-966.

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.

Kuss, D.J., Shorter, G.W., van Rooij, A.J., Griffiths, M.D., & Schoenmakers, T.M. (2014). Assessing Internet addiction using the parsimonious Internet addiction components model – A preliminary study. International Journal of Mental Health and Addiction, 12, 351-366.

Kuss, D.J., van Rooij, A.J., Shorter, G.W., Griffiths, M.D. & van de Mheen, D. (2013). Internet addiction in adolescents: Prevalence and risk factors. Computers in Human Behavior, 29, 1987-1996.

Widyanto, L. & Griffiths, M.D. (2006). Internet addiction: Does it really exist? (Revisited). In J. Gackenbach (Ed.), Psychology and the Internet: Intrapersonal, Interpersonal and Transpersonal Applications (2nd Edition), (pp.141-163). New York: Academic Press.

Widyanto, L. & Griffiths, M.D. (2011). Unravelling the Web: Adolescents and Internet Addiction. In Virtual Communities: Concepts, Methodologies, Tools and Applications (pp. 2433-2453). Hershey, Pennsylvania: Idea Publishing.

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