Category Archives: Addiction

Myth world: A brief look at some myths about Gaming Disorder

Earlier this year, the World Health Organisation announced that ‘Gaming Disorder’ (GD) was to be officially been included in the latest (eleventh) edition of the International Classification of Diseases (ICD-11). The announcement received worldwide media coverage alongside many debates as to whether its inclusion was justified based on the scientific evidence. The extensive media coverage raised many questions but also appeared to give rise to a number of myths. In this blog, I address these myths in the British context but some of these myths also have resonance outside the UK.

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Myth 1 – Gaming Disorder equates to gaming addiction. Almost all of the worldwide press coverage for GD in June 2018 was equated with gaming addiction. However, the World Health Organization (WHO) does not describe GD as an addiction and the WHO criteria for GD do not include criteria that I believe are core to being genuine addictions (such as tolerance and withdrawal symptoms). Confusingly, the criteria for Internet Gaming Disorder (IGD) in the latest (fifth) edition of the Diagnostic Manual of Mental Disorders (DSM-5) does include all my core criteria of addiction. However, to be diagnosed with IGD, an individual does not necessarily have to endorse all the core addiction criteria. In short, all genuine gaming addicts are likely to be diagnosed as having GD and/or IGD but not all those with GD and/or IGD are necessarily gaming addicts.

Myth 2 – Gaming has many benefits so should not be classed as a disorder as it will create a ‘moral panic’: Predictably, the videogame industry has not welcomed the WHO’s decision to include GD in the ICD-11 and issued a statement to say gaming has many personal benefits and that GD will create moral panic and ‘abuse of diagnosis’. None of us in the field dispute the fact that gaming has many benefits but many other activities such as work, sex, and exercise can be disordered and addictive for a small minority, and is not a good basis for denying the existence of GD. The videogame industry also claims the empirical basis for GD is highly contested but then ironically uses non-empirical claims (i.e., that the introduction of GD will cause a moral panic and lead to diagnostic abuse by practitioners) as a core argument for why GD should not exist.

Myth 3 – Gaming Disorder is associated with other comorbidities so is not a separate disorder. In coverage concerning GD, those denying the existence of GD sometimes resort to the argument that problematic gaming is typically comorbid with other mental health conditions (e.g., depression, anxiety disorders, etc.) and therefore should not be classed as a separate disorder. However, such an argument is not applied (for instance) to those with alcohol use disorder or gambling disorder which are known to be associated with other comorbidities. In fact, we recently published some case studies in the International Journal of Mental Health and Addiction highlighting those attending treatment for GD included individuals both with and without underlying comorbidities. Consequently, diagnosis of disorders should be based on the external symptomatic behavior and consequences, not on the underlying causes and etiology.

Myth 4 – Gaming Disorder can now be treated for free by the National Health Service: Unlike many other countries, the UK has a National Health Service (NHS) whose treatment services can be accessed free of charge. A number of British newspapers reported that inclusion of GD in the ICD-11 meant that those with GD can now get free treatment. However, this claim is untenable and is unlikely to happen. All health trusts in the UK have a finite budget and allocate resources to those conditions considered a priority. Treating individuals with GD will rarely (if ever) be given priority over treatment for cancer, heart disease, schizophrenia, depression, etc. In countries where private health insurance is the norm, GD is likely to be a condition excluded for treatment on such policies even though it is now in the ICD-11. 

Myth 5 – The inclusion of Gaming Disorder as a mental disorder will lead to ‘millions’ of children being stigmatized for their videogame playing: This myth has been propagated by a group of scholars (mainly researchers working in the media studies field) but is completely unsubstantiated. The number of children who would ever be officially be diagnosed as having GD is extremely low and – as noted above – millions of children play videogames for enjoyment without any problems or stigma.

(Please note: This article is based on an editorial that I first published earlier this year: Griffiths, M.D. (2018). Five myths about gaming disorder. Social Health and Behavior Journal, 1, 2-3)

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

Further reading

Aarseth, E., Bean, A. M., Boonen, H., Colder Carras, M., Coulson, M., Das, D., … & Haagsma, M. C. (2017). Scholars’ open debate paper on the World Health Organization ICD-11 Gaming Disorder proposal. Journal of Behavioral Addictions, 6(3), 267-270.

Gentile, D.A., Bailey, K., Bavelier, D., Funk Brockmeyer, J., … & Young, K. (2017). The state of the science about Internet Gaming Disorder as defined by DSM-5: Implications and perspectives, Pediatrics, 140, S81-S85. doi: 10.1542/peds.2016-1758H

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

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

Griffiths, M.D. (2018). Conceptual issues concerning internet addiction and internet gaming disorder. International Journal of Mental Health and Addiction, 16, 233-239.

Griffiths, M.D., Kuss, D.J., Lopez-Fernandez, O., & Pontes, H.M. (2017). Problematic gaming exists and is an example of disordered gaming. Journal of Behavioral Addictions, 6, 296-301.

European Games Developer Foundation. Statement on WHO ICD-11 list and the inclusion of gaming. 2018 June 15. Available from: http://www.egdf.eu/wp-content/uploads/2018/06/Industry-Statement-on-18-June-WHO-ICD-11.pdf

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

Király, O., Griffiths, M.D., King, D., Lee, H-K., Lee, S-Y., Bányai, F., Zsila, A. Demetrovics, Z. (2018). An overview of policy responses to problematic videogame use. Journal of Behavioral Addictions, 7, 503-517.

Kuss, D.J., Griffiths, M.D. & Pontes, H.M. (2017). Chaos and confusion in DSM-5 diagnosis of Internet Gaming Disorder: Issues, concerns, and recommendations for clarity in the field. Journal of Behavioral Addictions, 6, 103-109.

Kuss, D.J., Pontes, H.M. & Griffiths, M.D. (2018). Neurobiological correlates in Internet Gaming Disorder: A systematic review. Frontiers in Psychiatry, 9, 166. doi: 10.3389/fpsyt.2018.00166

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.

Rumpf, H. J., Achab, S., Billieux, J., Bowden-Jones, H., Carragher, N., Demetrovics, Z., … & Saunders, J. B. (2018). Including gaming disorder in the ICD-11: The need to do so from a clinical and public health perspective: Commentary on: A weak scientific basis for gaming disorder: Let us err on the side of caution (van Rooij et al., 2018). Journal of Behavioral Addictions, 7(3), 556-561.

Torres-Rodriguez, A., Griffiths, M.D., Carbonell, X. Farriols-Hernando, N. & Torres-Jimenez, E. (2018). Internet gaming disorder treatment: A case study evaluation of four adolescent problematic gamers. International Journal of Mental Health and Addiction, https://doi.org/10.1007/s11469-017-9845-9.

Trait expectations: Another look at why addictive personality is a complete myth

In the 30 years that I have been carrying out research into addiction, the one question that I have been asked the most – particularly by those who work in the print and broadcast media – is whether there is such a thing as an ‘addictive personality’? In a previous blog I briefly reviewed the concept of ‘addictive personality’ but since publishing that article, I have published a short paper in the Global Journal of Addiction and Rehabilitation Medicine on addictive personality, and in this blog I review I outline some of the arguments as to why I think addictive personality is a complete myth.

Psychologists such as Dr. Thomas Sadava have gone as far to say that ‘addictive personality’ is theoretically necessary, logically defensible, and empirically supportable. Sadava argued that if ‘addictive personality’ did not exist then every individual would vulnerable to addiction if they lived in comparable environments, and that those who were addicted would differ only from others in the specifics of their addiction (e.g., alcohol, nicotine, cocaine, heroin). However, Sadava neglected genetic/biological predispositions and the structural characteristics of the substance or behaviour itself.

There are many possible reasons why people believe in the concept of ‘addictive personality’ including the facts that: (i) vulnerability is not perfectly correlated to one’s environment, (ii) some addicts are addicted to more than one substance/activity (cross addiction) and engage themselves in more than one addictive behaviour, and (iii) on giving up addiction some addicts become addicted to another (what I and others have referred to as ‘reciprocity’). In all the papers I have ever read concerning ‘addictive personality’, I have never read a good operational definition of what ‘addictive personality’ actually is (beyond the implicit assumption that it refers to a personality trait that helps explain why individuals become addicted to substances and/or behaviours). Dr. Craig Nakken in his book The Addictive Personality: Understanding the Addictive Process and Compulsive Behaviour argued that ‘addictive personality’ is “created from the illness of addiction”, and that ‘addictive personality’ is a consequence of addiction and not a predisposing factor. In essence, Nakken simply argued that ‘addictive personality’ refers to the personality of an individual once they are addicted, and as such, this has little utility in understanding how and why individuals become addicted.

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When teaching my own students about the concept of ‘addictive personality’ I always tell them that operational definitions of constructs in the addictive behaviours field are critical. Given that I have never seen an explicit definition of ‘addictive personality’ I provide my own definition and argue that ‘addictive personality’ (if it exists) is a cognitive and behavioural style which is both specific and personal that renders an individual vulnerable to acquiring and maintaining one or more addictive behaviours at any one time. I also agree with addiction experts that the relationship between addictive characteristics and personality variables depend on the theoretical considerations of personality. According to Dr. Peter Nathan there must be ‘standards of proof’ to show valid associations between personality and addictive behaviour. He reported that for the personality trait or factor to genuinely exist it must: (i) either precede the initial signs of the disorder or must be a direct and lasting feature of the disorder, (ii) be specific to the disorder rather than antecedent, coincident or consequent to other disorders/behaviours that often accompany addictive behaviour, (iii) be discriminative, and (iv) be related to the addictive behaviour on the basis of independently confirmed empirical, rather than clinical, evidence. As far as I am aware, there is no study that has ever met these four standards of proof, and consequently I would argue on the basis of these that there is no ‘addictive personality’.

Although I do not believe in the concept of ‘addictive personality’ this does not mean that personality factors are not important in the acquisition, development, and maintenance of addictive behaviours. They clearly are. For instance, a paper in the Psychological Bulletin by Dr. Roman Kotov and his colleagues examined the associations between substance use disorders (SUDs) and higher order personality traits (i.e., the ‘big five’ of openness to experience, conscientiousness, agreeableness, extraversion, and neuroticism) in 66 meta-analyses. Their review included 175 studies (with sample sizes ranged from 1,076 to 75,229) and findings demonstrated that SUD addicts were high on neuroticism (and was the strongest personality trait associated with SUD addiction) and low on conscientiousness. Many of the studies the reviewed also reported that agreeableness and openness were largely unrelated to SUDs.

Dr. John Malouff and colleagues carried published a meta-analysis in the Journal of Drug Education examining the relationship between the five-factor model of personality and alcohol. The meta-analysis included 20 studies (n=7,886) and showed alcohol involvement was associated with low conscientiousness, low agreeableness, and high neuroticism. Mixed-sex samples tended to have lower effect sizes than single-sex samples, suggesting that mixing sexes in data analysis may obscure the effects of personality. Dr. James Hittner and Dr. Rhonda Swickert published a meta-analysis in the journal Addictive Behaviors examining the association between sensation seeking and alcohol use. An analysis of 61 studies revealed a small to moderate size heterogeneous effect between alcohol use and total scores on the sensation seeking scale. Further analysis of the sensation seeking components indicated that disinhibition was most strongly correlated with alcohol use.

Dr. Marcus Munafo and colleagues published a meta-analysis in the journal Nicotine and Tobacco Research examining strength and direction of the association between smoking status and personality. They included 25 cross-sectional studies that reported personality data for adult smokers and non-smokers and reported a significant difference between smokers and non-smokers on both extraversion and neuroticism traits. In relation to gambling disorder, Dr. Vance MacLaren and colleagues published a meta-analysis of 44 studies that had examined the personality traits of pathological gamblers (N=2,134) and non-pathological gambling control groups (N=5,321) in the journal Clinical Psychology Review. Gambling addiction was shown to be associated with urgency, premeditation, perseverance, and sensation seeking aspects of impulsivity. They concluded that individual personality characteristics may be important in the aetiology of pathological gambling and that the findings were similar to the meta-analysis of substance use disorders by Kotov and colleagues.

More recently, I co-authored a study with Dr. Cecilie Andreassen and her colleagues in the Journal of Behavioral Addictions. We carried out the first ever study investigating the inter-relationships between the ‘big five’ personality traits and behavioural addictions. They assessed seven behavioural addictions (i.e., Facebook addiction, video game addiction, Internet addiction, exercise addiction, mobile phone addiction, compulsive buying, and study addiction). Of 21 inter-correlations between the seven behavioural addictions, all were positive (and nine significantly so). More specifically: (i) neuroticism was positively associated with Internet addiction, exercise addiction, compulsive buying, and study addiction, (ii) extroversion was positively associated with Facebook addiction, exercise addiction, mobile phone addiction, and compulsive buying, (iii) openness was negatively associated with Facebook addiction and mobile phone addiction, (iv) agreeableness was negatively associated with Internet addiction, exercise addiction, mobile phone addiction, and compulsive buying, and (v) conscientiousness was negatively associated with Facebook addiction, video game addiction, Internet addiction, and compulsive buying and positively associated with exercise addiction and study addiction. However, replication and extension of these findings is needed before any definitive conclusions can be made.

Overall these studies examining personality and addiction consistently demonstrate that addictive behaviours are correlated with high levels of neuroticism and low levels of conscientiousness. However, there is no evidence of a single trait (or set of traits) that is predictive of addiction, and addiction alone. Others have also reached the same conclusion based on the available evidence. For instance, R.G. Pols (in Australian Drug/Alcohol Review) noted that findings from prospective studies are inconsistent with retrospective and cross-sectional studies leading to the conclusion that the ‘addictive personality’ is a myth. Dr. John Kerr in the journal Human Psychopharmacology: Clinical and Experimental noted that ‘addictive personality’ had long been argued as a viable construct (particularly in the USA) but that there is simply no evidence for the existence of a personality type that is prone to addiction. In another review of drug addictions, Kevin Conway and colleagues asserted (in the journal Drug and Alcohol Dependence) there was scant evidence that personality traits were associated with psychoactive substance choice. Most recently, Maia Szalavitz in her book Unbroken Brain: A Revolutionary New Way of Understanding Addiction noted that:

“Fundamentally, the idea of a general addictive personality is a myth. Research finds no universal character traits that are common to all addicted people. Only half have more than one addiction (not including cigarettes)—and many can control their engagement with some addictive substances or activities, but not others”.

Clearly there are common findings across a number of differing addictions (such as similarities in personality profiles using the ‘big five’ traits) but it is hard to establish whether these traits are antecedent to the addiction or caused by it. Within most addictions there appear to be more than one sub-type of addict suggesting different pathways of how and way individuals might develop various addictions. If this is the case – and I believe that it is – where does that leave the ‘addictive personality’ construct?

‘Addictive personality’ is arguably a ‘one type fits all’ approach and there is now much evidence that the causes of addiction are biopsychosocial from an individual perspective, and that situational determinants (e.g., accessibility to the drug/behaviour, advertising and marketing, etc.) and structural determinants (e.g., toxicity of a specific drug, game speed in gambling, etc.) can also be influential in the aetiology of problematic and addictive behaviours. Another problem with ‘addictive personality’ being an explanation for why individuals develop addictions is that the concept inherently absolves an individual’s responsibility of developing an addiction and puts the onus on others in treating the addiction. Ultimately, all addicts have to take some responsibility in the development of their problematic behaviour and they have to take some ownership for overcoming their addiction. Personally, I believe it is better to concentrate research into risk and protective factors of addiction rather than further research of ‘addictive personality’.

As I have argued in a number of my papers and book chapters, not every addict has a personality disorder, and not every person with a personality disorder has an addiction. While some personality disorders appear to have an association with addiction including Antisocial Personality Disorder and Borderline Personality Disorder, just because a person has some of the personality traits associated with addiction does not mean they are, or will become, an addict. Practitioners consider specific personality traits to be warning signs, but that’s all they are. There is no personality trait that guarantees an individual will develop an addiction and there is little evidence for an ‘addictive personality’ that is predictive of addiction alone. In short, ‘addictive personality’ is a complete myth.

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

Further reading

Andreassen, C.S., Griffiths, M.D., Gjertsen, S.R., Krossbakken, E., Kvan, S., & Ståle Pallesen, S. (2013). The relationships between behavioral addictions and the five-factor model of personality. Journal of Behavioral Addictions, 2, 90-99.

Conway, K. P., Kane, R. J., Ball, S. A., Poling, J. C., & Rounsaville, B. J. (2003). Personality, substance of choice, and polysubstance involvement among substance dependent patients. Drug and Alcohol Dependence, 71(1), 65-75.

Griffiths, M.D. (1994). An exploratory study of gambling cross addictions. Journal of Gambling Studies, 10, 371-384.

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

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

Griffiths, M.D. (2009). The psychology of addictive behaviour. In: M. Cardwell, M., L. Clark, C. Meldrum & A. Waddely (Eds.), Psychology for A2 Level (pp. 236-471). London: Harper Collins.

Griffiths, M.D. (2017). The myth of ‘addictive personality’. Global Journal of Addiction and Rehabilitation Medicine, 3(2), 555610.

Hittner, J. B., & Swickert, R. (2006). Sensation seeking and alcohol use: A meta-analytic review. Addictive Behaviors, 31(8), 1383-1401.

Kerr, J. S. (1996). Two myths of addiction: The addictive personality and the issue of free choice. Human Psychopharmacology: Clinical and Experimental, 11(S1), S9-S13.

Kotov, R., Gamez, W., Schmidt, F., & Watson, D. (2010). Linking “big” personality traits to anxiety, depressive, and substance use disorders: a meta-analysis. Psychological Bulletin, 136(5), 768-821.

MacLaren, V. V., Fugelsang, J. A., Harrigan, K. A., & Dixon, M. J. (2011). The personality of pathological gamblers: A meta-analysis. Clinical Psychology Review, 31(6), 1057-1067.

Malouff, J. M., Thorsteinsson, E. B., Rooke, S. E., & Schutte, N. S. (2007). Alcohol involvement and the Five-Factor Model of personality: A meta-analysis. Journal of Drug Education, 37(3), 277-294.

Munafo, M. R., Zetteler, J. I., & Clark, T. G. (2007). Personality and smoking status: A meta-analysis. Nicotine & Tobacco Research, 9(3), 405-413.

Nakken, C. (1996). The addictive personality: Understanding the addictive process and compulsive behaviour. Hazelden, Center City, MN: Hazelden.

Nathan, P. E. (1988). The addictive personality is the behavior of the addict. Journal of Consulting and Clinical Psychology, 56(2), 183-188.

Pols, R. G. (1984). The addictive personality: A myth. Australian Alcohol/Drug Review, 3(1), 45-47.

Sadava, S.W. (1978). Etiology, personality and alcoholism. Canadian Psychological Review/Psychologie Canadienne, 19(3), 198-214.

Szalavitz M (2016). Unbroken brain: A revolutionary new way of understanding addiction. St. Martin’s Press, New York.

Szalavitz M (2016). Addictive personality isn’t what you think it is. Scientific American, April 5.

Shirty money: A brief look at football’s relationship with the gambling industry

A couple of days ago, Simon Stevens, the Chief Executive of the British National Health Service (NHS) said that foreign-owned betting companies who sponsor British football clubs should financially contribute to paying for gambling addicts’ treatment. I am all in favour of this, although I think some money should also be allocated to education, prevention, and (predictably) research. This is also an area that I have written about recently.

More specifically, I and my colleague Dr. Hibai Lopez-Gonzalez published a paper earlier this year entitled ‘Betting, forex trading, and fantasy gaming sponsorships – A responsible marketing inquiry into the ‘gamblification’ of English football’ in the International Journal of Mental Health and Addiction. Using data about sponsorship deals from English Football Premier League, we demonstrated that gambling marketing has become firmly embedded in the financial practices of many Premiership football clubs. We argued that these associations are not trivial, and that the symbolic linkage of sport and newer gambling forms may become an issue of public health, especially affecting vulnerable groups such as minors and problem gamblers.

A major preoccupation regarding gambling intersection with sports has been the marketing of betting as an experience inherently associated with the symbolic culture of sport. By emphasising its connections with sports, the marketing and advertising of betting has been theorised to pursue the ‘sanitation’ of gambling, transferring the health-related symbolic attributes of sport and physical exercise to betting behaviour. In this regard, of great concern is the effects that an excessive volume of betting marketing might have on vulnerable groups such as minors and young adults and individuals suffering or recovering from gambling disorder. Furthermore, additional issues might arise in the event that those new categories that extend the definition of sports gambling (i.e., trading, other gambling forms such as poker, and fantasy games) seeking to market their products in alignment with (or appropriation of) sports’ core values and positive attributes. Early examples of this marketing strategy can be found in the sport stars’ endorsement of poker brands such as the footballers Neymar Jr. and Cristiano Ronaldo, and the tennis player Rafael Nadal.

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We asserted in our paper that football shirt sponsorship is arguably a good proxy to calibrate the volume of gambling marketing in English football. Table 1 shows the shirt sponsor evolution over a decade (from the 2007/2008 to 2016-2017 seasons). First team shirt sponsorship with gambling companies evolved from four deals in 2008, six deals in 2012, to ten deals in 2017, accounting for half of the 20 English Premier League teams. The saturation of shirt logos owned by gambling brands has evolved rapidly over a relatively short period of time. However, some industry voices have been anticipating a decline in the numbers of shirts being sponsored by gambling firms due to their incapacity to compete with other business sector, although such a decline has yet to materialise.

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In the same vein, it has been noted that most of the football teams with shirts sponsored by gambling companies are among the less powerful in the league, both in terms of economic profitability and sporting success. Analysing the data from end of season table positions indeed demonstrates a bias of gambling companies sponsoring teams towards the bottom of the table. Thus, the four teams (out of 20 in the English Premier League) with gambling logos in 2007/08 finished the league 6th, 7th, 11th, and 15th. In 2011-12, the six teams sponsored by gambling companies finished 10th, 11th, 13th, 16th, 18th, and 20th. In 2016/2017 season, the ten teams with gambling sponsors showed an almost perfect inverse correlation between table position and gambling-origin shirt sponsor, ranking 9th, 10th, 11th, 13th, 14th, 15th, 16th, 17th, 18th, and 20th (19th being a money loan company).

This could be interpreted as a nuanced strategy. More specifically, gambling operators might believe they have enough global exposure that the league as whole offers, without needing to pay premium sponsorship deals to attach their brand to the most supported and successful teams (because all the lower ranked teams have to play all the upper ranked teams and therefore get equal advertising exposure during televised games).

Table 2 shows the breadth of the gamblification process by focusing on sponsorship deals running through 2016-17 season in the English Premier League. As can be observed, all teams secured at least one official betting partner, with some of them having multiple partners due to regional deals in strategic markets to provide so-called ‘geo-targeted’ betting experience. An illustration example is Arsenal club’s deals with 12Bet company in Asia, Betfair in Europe, SportPesa in Kenya, and Tempobet in Oceania. Altogether, the 20 English Premier League teams totalled 20 different betting brands, with 12 brands sponsoring only one team, five brands sponsoring two teams, and three brands sponsoring three different teams. Despite how fragmented the betting market might look, these brands represent only a small fraction of the actual number operating in association with the English football. In fact, betting brands are generally considered to offer poorly differentiated products in highly competitive markets. Consequently, marketing plays a significant part in artificially creating singular attributes that facilitate the acquisition and maintenance of customers.

Screen Shot 2018-09-06 at 10.10.38Sponsorship deals with trading companies are not as prevalent as betting sponsorships. However, 14 out of 20 English Premier League teams have linked partnership deals with trading companies – most notably forex trading – for 2016/17 season. Only one trader (EZTrader) sponsors two different teams, while the rest are unique sponsors. Arguably, the same betting market attributes of low product differentiation and competitive environment also applies to trading firms.

Fantasy gaming is rapidly becoming a large component of sports appreciation, especially in the USA where fantasy sports appears to have partially absorbed the consumer base for online sports betting, an illegal activity in most states. Although still in its infancy in Europe, eight out of 20 English teams already have agreements in place with fantasy sports companies, some of which include a deal with DraftKings, the leading company along with FanDuel in USA’s fantasy gaming market. The concentration of brands here is slightly higher than in the case of betting and trading sponsorships, but six different brands still populate the growing fantasy gaming market in the English Premier League.

The detrimental effect on public health of an increase in the sports betting marketing volume is difficult to demonstrate. British data collected by the Gambling Commission is inconclusive due to the lack of definition of what constitutes gambling on sports. In general, research has found difficult to substantiate the causal association between gambling advertising exposure and behaviour, particularly when the effects of such exposure might take place weeks or months later. Despite the difficulties of finding empirical evidence of the real impact of marketing on betting behaviour, many authors have acknowledged that the association between marketing and gambling disorder is plausible, at least theoretically.

The sports betting marketing and advertising growth could be theorised to have two effects. First, an increase in gambling advertising exposure will lead to a higher prevalence rate of problem gambling. Many scholars have indicated that problem gamblers are usually more exposed to advertising (e.g., they visit more frequently gambling websites or watch more sport events), therefore it cannot be established whether they gamble more because they are exposed to more marketing instances or the are more exposed because they gamble more. However, a study I published with my Norwegian colleagues at the University of Bergen conducted among 6,034 Norwegian gamblers found that problem gamblers had a greater involvement with gambling advertising even when they were similarly exposed than regular non-problem gamblers.

Second, an overall rise in the consumption of gambling products following more aggressive marketing strategies, even while maintaining stable the percentage of people experiencing gambling-related harm, would lead to a rise in absolute numbers of people developing gambling problems. Simply put, keeping problem gambling rate constant, the more people that bet on sports, the more problem gamblers.

There is a wide consensus that sports betting marketing (and advertising) must be regulated, and is the case in most jurisdictions including the UK. However, there is no specific protection concerning the marketing of trading and fantasy gaming as a specific product category associated with sports. Finally, our paper noted that although there is no scientific evidence the marketing agreements between football clubs and the gambling industry are actually having a detrimental effect on the aforementioned vulnerable groups, it makes theoretical sense to think that they might potentially cause harm.

Note: This article was co-written with Hibai Lopez-Gonzalez

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

Further reading

Griffiths, M.D., Estévez, A., Guerrero-Solé F. & Lopez-Gonzalez, H. (2018). A brief overview of online sports betting advertising and marketing. Casino and Gaming International, 33, 51-55.

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

Lopez-Gonzalez, H., Estévez, A. & Griffiths, M.D. (2018). Controlling the illusion of control: A grounded theory of sports betting advertising in the UK. International Gambling Studies, 18, 39-55.

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

Lopez-Gonzalez, H. & Griffiths, M.D. (2018). Betting, forex trading, and fantasy gaming sponsorships – A responsible marketing inquiry into the ‘gamblification’ of English football. International Journal of Mental Health and Addiction, 16, 404-419.

Lopez-Gonzalez, H. & Griffiths, M.D. (2018). Understanding the convergence of online sports betting markets. International Review for the Sociology of Sport, in press.

Lopez-Gonzalez, H. Guerrero-Solé, F., Estévez, A. & Griffiths, M.D. (2018). Betting is loving and bettors are predators: A Conceptual Metaphor Approach to online sports betting advertising. Journal of Gambling Studies, in press.

Lopez-Gonzalez, H., Guerrero-Sole, F. & Griffiths, M.D. (2018). A content analysis of how ‘normal’ sports betting behaviour is represented in gambling advertising. Addiction Research and Theory, 26, 238-247.

The need to speed: A brief look at ‘speeding addiction’

“Starting to question myself here. Am I totally addicted to speed (not the drug)? [I] am middle age, dabbled a bit with drugs in the past nothing much never found them addictive, but all the time I need to go faster, not in stupid places, schools etc., just country lanes and motorways. I’ve done track days, bit of single stage rallying…But it’s never enough always want more. Trouble is I don’t have the money to spend on loads of track days or rallying again. So where do I get kicks from? Must be loads [on this online forum] in the same boat. So what’s the answer. Is it addictive? And can anything stop it or do I wait for the an inevitable conclusion?” (‘gsr8’ on pistonheads.com)

“There are many folks that love sports cars, super bikes and high speeds. It seems to be a growing trend in these decadent times we live in. I’m not ashamed to say, that I also have a bit of a fetish for exclusive Italian sports cars that I can barely afford. It’s the obvious sex appeal combined with the adrenaline rush of driving at breakneck speeds through a neon-lit city. This is something that can turn from a mere addiction into a lifestyle choice, and an expensive one at that. Are fast cars and high speeds appealing to you? Do you feel that you could ever be addicted?” (Damien Lee on talk.drugabuse.com)

“I discovered something over the past week. I have been addicted to speeding. Like 80% of all other drivers on the road, I have this urge to go 5-10 mph over the limit as if that was the limit. Passing people, sneering at them because they are going the speed limit as if it was so lame to only go 55” (Suso on Suso.org)

These opening quotes that I found online raise the issue of whether ‘speeding’ in cars can be addictive. There’s no shortage of the words ‘addiction’, ‘addictive’ and ‘addicted’ appearing in news articles including the headlines themselves. Examples I found within 60 seconds of online googling included ‘Why the US is addicted to fast cars and street racing?’, ‘Finding a cure for motorists’ addiction to speed’, ‘Driving ‘addict’ Shane Holmes led police car chase along Heworth footpaths’, and ‘Car addict’s 90mph chase’. This latter story reported the case of David Massey, a car salesman, a “banned driver with an ‘addiction’ to cars has been jailed after he led police on a high speed chase. [He] was caught speeding through winding roads while banned for a fourth time”. The case highlights that even being banned and the threat of going to prison if he drove a car while banned was not enough to deter him from driving.

Another story was headlined ‘Company car drivers’ speeding addiction’ based on a survey carried out by the UK RAC (Royal Automobile Club). The story asserted: “It’s been confirmed: company car drivers are addicted to speeding…they are more likely to exceed the 70mph motorway speed limit than private motorists. Almost 90% of company car drivers admitted to breaking the speed limit, compared with nearly 70% of people driving their own vehicle”. Here company car drivers are pathologised by the press and that their ‘need for speed’ is viewed as an addiction almost using it as a mitigating circumstance for their behaviour. In an article written for CNN, amateur car racer Brian Donovan wrote that:

“I’ll never forget that day, back in the 1970s, when I first experienced the intense – and probably addictive – state of mind that would become a powerful force in my life. No, I’m not talking about some drug. I’m remembering the first day I drove a racing car and the new level of consciousness I experienced as I sped down the curvy hill at the old Bridgehampton Race Circuit on Long Island. The experience, some drivers say, can be highly addictive”.

Donovan wrote a book Hard Driving: The Wendell Scott Story, a biography of NASCAR’s first African-American stock car driver. According to an interview with Scott: “Racing cars gets to be about like being a drug addict or an alcoholic. The more you do it, the more you like to do it”. Larry Frank, another NASCAR driver claimed that car racing was “like an addiction…there was many years that you just didn’t know anything existed outside this little racing circle”. However, I would argue that the quote could be as much about addiction to work as it is addiction to speed.

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Academically, there’s been little empirical research on the topic although quite a few scholars have claimed and/or made arguments that speeding can be addictive. (I ought to mention that I am not including academic research on joyriding being addictive as I reviewed this literature in a previous blog. Here, the criminality of the activity rather than the speed appears to provide rewards and reinforcements that for a small minority may be addictive). In 1997, René Diekstra (a clinical psychologist) and Martin Kroon (at the time senior policy advisor on Transport and Environment in the Dutch Ministry of the Environment) wrote a book chapter entitled ‘Cars and behaviour: Psychological barriers to car restraint and sustainable urban transport’. They asserted that:

“The car – and the motor bike – allow the individual to expose himself to exactly the level of danger he wants. It is not an overstatement to say that, at these times, drivers are experiencing a kind of narcotic effect, which can produce the same addictive response as more conventional drugs. There is sometimes a very fine line between ‘speeding’ and ‘speeding’! This addiction to speed among some drivers is excellently expressed in the term ‘speedaholics’.”

A few months ago, Gerry Forbes published a paper in the ITE Journal entitled ‘Is speeding an addiction? Saving lives through roadway planning and design’. He noted that “speeders not only break the law, they imperil themselves and other road users. Moreover, people who speed generally know it is against the law, believe that the risk is only to themselves, and do so for personal gain rather than any sort of community good”. For Forbes, this naturally begged the question: “Are chronic speeders addicted to speeding in the same way drug abusers are addicted to illicit drugs?” He then went on to argue:

“Addiction is persistent behavior despite knowledge of adverse consequences. The public perceives speeding as more dangerous than driver distraction and drinking-driving, yet motorists frequently drive faster than the speed limit. Speeding appears to be a behavioral addiction similar to gambling. However, this does not mean motorists are addicted to speeding”.

Forbes then went on to cite my criteria for behavioural addiction and said that if speeding is a genuine addiction, it would be an activity that dominates an individual’s daily life (salience), deliver a mood altering ‘high’ (mood modification), requires “greater doses over time” to achieve the same ‘high’ (tolerance), cause conflict in the individual’s life, and ceasing the activity would lead to withdrawal symptoms and/ or relapses. He then argued that speeding met some of the criteria for addiction: (i) “motorists select faster operating speeds as route familiarity increases” (tolerance); (ii) up to 20% of motorists “exhibit mood modification, stating they enjoy the feeling associated with driving fast and citing this as a reason for speeding” (mood modification), (iii) “speeders in residential areas create conflict with residents, and conflicts between motorists arise when speeders are impeded by slower-moving road users” (conflict); and (iv) over two-thirds of motorists have speeding relapses (relapse). He then went on to make some excellent comparisons between speeding and drug use in relation to the harm they cause on society (using the US as his example:

“Speeders and drug addicts can be compared by using the rational scale of harm – a tool used to compare the harm (of drugs) when considering the physical harm to the individual, the effect of the drug on society, and the tendency for the drug to induce dependence. With respect to personal harm, in the United States in 2015 motor vehicle speed was a factor in 9,557 fatal crashes, whereas overdoses by heroin and cocaine accounted for 12,989 deaths, and 6,784 deaths, respectively. With respect to dependence, 23 percent of individuals who use heroin develop opioid addiction and about 20 percent of motorists enjoy the feeling associated with driving fast. Similarly, 40 to 60 percent of drug addicts relapse, which is comparable to the 69 percent recidivism rate for speeders. Given this, the dependence and personal harm associated with speeding is arguably the same order of magnitude as cocaine or heroin”

However, based on the evidence cited, Forbes reached the same conclusion that I would have:

“Typical motorists are not dominated by a need for speed, precluding a clinical finding of speed addiction. Speeding, it seems, is a behavior that has addictive elements without being an addiction…In the end, while speeding is not necessarily an addiction, it is harmful to individuals and society. The harm produced by speeding is of the same order of magnitude as heroin and cocaine”.

Finally, based on a news report I read (‘The need for speed: Is it an addiction?’), there is a team of university researchers in Sydney (Australia) who began a project a couple of years ago to investigate the concept of speed addiction but I was unable to find any papers that have been published from it yet. The research is being led by Sarah Redshaw of the University of Western Sydney who has been publishing research into driving for many years. She was quoted as saying: “[Individuals who speed are] talking in terms of something they can’t control. That’s why it needs investigating, because it could be an uncontrollable impulse. If there could be such a thing as speed addiction, it would need to be dealt with like other addictions”. Also interviewed for the article was someone whose research I know well (and who I’ve co-published gambling papers with), the psychologist Alex Blaszczynski, who in the article described himself as a “self-professed speed lover”. He was also quoted as saying that:

“The thrill of speeding comes from neurochemical changes in the brain as the result of adrenaline. The question then is whether this particular behaviour leads to an addictive process or whether people just enjoy doing it. Is [speed] fulfilling some need, or is it something he wants? I think it’s something he wants”.

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

Further reading

Alexander, H. (2016). The need for speed: Is it an addiction? Drive.com, October 3. Located at: https://www.drive.com.au/motor-news/the-need-for-speed-is-it-an-addiction-20100824-13p3i

Diekstra, R., & Kroon, M. (1997). Cars and behaviour: Psychological barriers to car restraint and sustainable urban transport. In Tolley, R.(ed.) The Greening of Urban Transport (pp.147-157). Chichester: Wiley.

Donovan, B. (2008). Hard Driving: The Wendell Scott Story. Hanover, NH: Steerforth Press.

Evans, J. (2014). Company car drivers’ speeding addiction. August 19. Located at: https://www.driving.co.uk/car-clinic/news-company-car-drivers-speeding-addiction-plus-5-quickest-repmobiles/

Forbes, G. (2018). Is speeding an addiction? Saving lives through roadway planning and design. ITE Journal, 88(6), 44-49.

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

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

Husted, D.S., Gold, M.S., Frost-Pineda, K., Ferguson, M.A., Yang, M. C., & Shapira, N.A. (2006). Is speeding a form of gambling in adolescents? Journal of Gambling Studies, 22(2), 209-219.

Redshaw, S., & Nicoll, F. (2010). Gambling drivers: regulating cultural technologies, subjects, spaces and practices of mobility. Mobilities, 5(3), 409-430.

Voyeurs and their lawyers: Can ‘upskirting’ be addictive?

Over the past few months, ‘upskirting’ has been in the British news, particularly in relation to making it a criminal offence. A campaign initiated by freelance writer Gina Martin was started after she became a victim of upskirting. For those who don’t know what I’m talking about, upskirting refers to taking a photograph (typically with a smartphone) up someone’s skirt without their permission. Martin published an account of her ordeal for the World Economic Forum in April 2018 and reported that:

“Last summer, I was standing in a crowd of 60,000, on a hot summer’s day in London, waiting for The Killers to come on stage, when a man – whose advances I’d rejected – took pictures of my crotch by putting his phone between my legs as I chatted to my sister blissfully unaware. A few minutes later, I saw one of his friends looking at an intrusive picture of a woman’s crotch covered by a thin strip of fabric. I knew it was me. I grabbed the phone off him and checked. Tears filled my eyes and I began drawing attention to him: ‘You guys have been taking pictures of my vagina! What is wrong with you!?’ He grabbed me and pushed his face in front of mine, bellowing that I give him his phone back. I didn’t…The police arrived and were lovely. I was, understandably, a mess and they patiently calmed me down. What the police then did was ask him to delete the images – my evidence – and then, they told me they couldn’t do anything. ‘We had to look at the image, and although it showed far more than you’d want anyone to see, it’s not technically a graphic image. There’s not much we can do. If you weren’t wearing knickers it would be a different story.’ I was completely humiliated and devastated”.

Following this incident, and because upskirting wasn’t an offence, Martin began a campaign to get the act criminalized. Upskirting is currently an offence in Scotland but not in England and Wales. Upskirting is one of many sexual acts that are present among those individuals that have a voyeuristic disorder. In an article for the Law Gazette in July 2017 (‘Fifty shades of sexual offending’), forensic psychologist Dr. Julia Lam made countless references to upskirting in an overview of voyeuristic disorder. She noted that:

“Voyeuristic Disorder is a paraphilic/psychosexual disorder in which an individual derives sexual pleasure and gratification from looking at naked bodies and genital organs, observing the disrobing or sexual acts of others…Instead of peeping in situ using high-powered binoculars, with advances in technology such as camera phones and pin-hole cameras, voyeurs can now record the private moments with their devices: taking upskirt photos of unsuspecting individuals on escalators, or filming women in various states of undress in toilets and changing rooms. Voyeuristic behaviour is on the rise…Learning theory suggests that an initially random or accidental observation of an unsuspecting person who is naked, in the process of disrobing, or engaging in sexual activity, may lead to sexual interest and arousal; with each successive repetition of the peeping act reinforcing and perpetuating the voyeuristic behaviour”.

She reported that voyeurism is the most common type of sexual offence and that voyeurs can be men or women but that “men are commonly the perpetrators in the peeping acts/upskirt, with women being the victims”. She noted that the lifetime prevalence of voyeuristic disorder is around 12% among men and 4% in women, and that the causes of voyeurism are unknown. She then went onto say:

“The new vocabulary ‘upskirt’ is both a verb (the practise of capturing an image/video of an unsuspecting and non-consenting person in a private moment) and a noun (i.e. the actual voyeuristic photos or videos made; referred as “voyeur photography”)…While most voyeurs film for self-gratification (i.e. using upskirt materials for fantasy and masturbation), there are offenders who make upskirt photos and videos specifically for uploading onto the internet (e.g. fetish and pornographic websites and video-sharing sites like YouTube) for monetary profit…Upskirt is considered a ‘serious’ crime in Singapore as it intrudes upon the privacy of unsuspecting and non-consenting individuals. Offences typically take place on escalators, in fitting rooms, public toilets or shower rooms; with the offenders trying to capture what is underneath the ‘skirts’ or private moments of the victims with a recording device which may or may not be disguise”.

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She also said that in recent years in Singapore, she had assessed “a considerable number” of voyeurs that had engaged in upskirting and who were arrested, prosecuted, and incarcerated for their actions. Most of these criminal voyeurs were ‘first-timers’ (i.e., arrested and charged with upskirting for the first time), had a long history of engaging in excessive masturbation and pornography use, and that the offences were non-violent. However, she did note that although they may have been arrested for the first time, their interest in peeping and upskirting usually stemmed from adolescence. Dr. Lam also claimed that:

“Getting apprehended for [upskirting] is more a norm than an exception in this group, as it is just a matter of time that the offender would be careless or daring enough to invite apprehension. Police arrest usually serves as a final ‘wake-up call’ that breaks the offending pattern, accompanied with a great sense of shame and embarrassment. Many of these voyeurs are amenable to treatment…Most of the sufferers of Voyeuristic Disorder who came for my assessment reported their urges to upskirt and use the materials to masturbate as overwhelming, to the extent that they gave in to temptation without considering the grave consequences of their acts”.

Dr. Lam also talked about her treating upskirting voyeurs and recounted one case which she claimed was a compulsion. The case involved a male university student who was very sport active but who masturbated excessively whenever major sporting events or important exams were imminent as a coping strategy to relieve stress. Upskirting was another one of his coping strategies and he was eventually arrested for his behaviour. Dr. Lam then went on to report” 

“Every morning after he woke up, he would feel the urge to go out to find his ‘targets’. Although he knew it was very risky to take upskirt [photos] on MRT escalators, he felt compelled to satiate his urges and gratification, and was oblivious to his surroundings (e.g. passers-by security staff and CCTV) and the risk of being arrested. He could still feel the thrill and excitement, but he no longer enjoyed the act. It had become more like a compulsion…He was prescribed medication to manage his mood and urges to act out, and attended psychotherapy to work on his voyeuristic behaviour and learn more effective coping skills. He has since graduated from university, and has not breached the law with [upskirting] behaviour again”.

Dr. Lam, like other practitioners who treat sex offenders, often view extreme cases of voyeurism as a compulsion, obsession and/or an addiction. If extreme voyeurism (in general) can be seen as an addiction, there is no theoretical reason why upskirting couldn’t be viewed similarly. As far as I am aware, the case described by Dr. Lam is the only one in the academic literature of outlining and treating an individual with an upskirting disorder. As with other sexually non-normative behaviours I went online to see if there were any anecdotal accounts of addiction to upskirting and came across a few self-confessed accounts (particularly on The Candid Forum website):

  • Extract 1: “I’m not sure if you could help me. I suppose it’s an addiction. I am obsessed with women’s knickers and constantly try to look up women’s skirts, even schoolgirls. I know it’s wrong but I love to see the secrets. One day I will be caught and arrested. Am I a pervert?” (‘Andy’).
  • Extract 2: “I’m really starting to feel overwhelmed by this ‘addiction’ I have to upskirt videos…I just can’t seem to get enough, even when in the big picture, most of them are all the same. I have well over 3000 videos on my computer of just upskirts (not including other types of videos)…It’s also stressful to know that I may very well not get through them all, at least for a very long time (I still have yet to watch 1800 of them). There’s a lot of time involved in downloading them (waiting due to file hosting sites telling you [that] you have reached your daily limit etc., entering captcha codes). But all these videos actually amaze me at the same time, due to just how many times guys have gotten away with it…There’s a certain ‘wow’ factor I guess, but that also derives from the entire voyeur aspect of it to begin with, where a guy is able to creep up on a woman and she doesn’t even realize it…Do any of you share the same addiction as me, and do you want to get rid of it? (‘GD102’).
  • Extract 3: I used to be really addicted [to upskirting] until I made myself understand something you already know – once you’ve seen 200 asses, you’ve pretty much seen them all. There’s no point in wasting your time overindulging in the same thrill over and over again. Yeah, the excitement of seeing something you’re not supposed to see is hot as hell, but you have to set limits for yourself, and not try to fantasize too much about the upskirts you haven’t seen, and spend more time enjoying, and maybe sorting, the upskirts you already have. That’s what I’ve been doing lately” (‘Agent Ika’).
  • Extract 4: “[Upskirting] really does get repetitive. For me the thrill now comes from pretending I’m a director of a film – getting new angles, upskirts from the front, whole body shots with the upskirt still showing, and always including faceshots” (‘Stimulus’).

Obviously I have no way of knowing whether these online forum confessions are true (but they seem to be). Based on these extracts, there is certainly the possibility raised that upskirting may be addictive to a very small minority of individuals. Extract 2 was particularly interesting in that the individual had never engaged in upskirting himself but his ‘addiction’ to watching upskirting videos takes up so much time in his life.

Another source suggesting that upskirting may be an addictive activity comes from the details of those arrested and prosecuted. For instance, one infamous example in the UK (in 2015) was the case of Paul Appleby who managed to take 9000 upskirting photos in the space of just five weeks (suggesting that he was doing it all day every day to have taken so many photos). Appleby was finally caught when he was caught bending over to take a photo up a woman’s skirt in a Poundland shop. The Daily Mirror reported that:

“The tubby pervert, who was ‘addicted’ to snapping upskirts, fled the store after he was spotted…when [police] officers found his camera and iPhone a staggering 9,000 ‘upskirt’ images were discovered. The photos had been taken between November 1 and December 4 last year. [Appleby] admitted two counts of committing an act of outraging public decency…and was given a three-year community order…[Appleby] had been prosecuted for a ‘similar matter’ of outraging public decency in London in 2010. Alistair Evans, defending claimed Appleby had committed the crime for ‘sexual gratification’ and his behaviour was a ‘compulsion and an addiction’ he needed treatment for”.

Here, the mitigating factor for Appleby’s behaviour was that he was addicted to upskirting. The fact that Appleby did not receive a custodial sentence suggests the excuse of being ‘addicted’ to the behaviour led to the judge being more lenient. Another individual who avoided a custodial sentence for upskirting offences was Andrew MacRae who claimed he was addicted to sex. MacRae had amassed 49,000 upskirt photos and videos using hidden cameras at his workplace, on trains, and at the beach. He pled guilty to three counts of outraging public decency and seven counts of voyeurism. The judge said he would spare him jail if he was treated for his “compulsive voyeurism”. A report in the Daily Mail recounted what that Judge Jeremy Donne said:

“This was undoubtedly a sophisticated, organised, planned and long-running campaign of voyeurism – again with a significant degree of planning – and members of the general public, female commuters in the main, were caught by your voyeuristic activities. Your activities were undoubtedly despicable and will cause deep revulsion in all who hear them.  Women will undoubtedly feel a need to be protected from such behaviour by the knowledge that the courts will deal with offenders severely, and men will thereby be deterred from committing such offences. On the other hand, you suffer from an illness that can be treated and you have submitted to that treatment. You have features of sexual addiction disorder with disorders of sexual preference, namely voyeurism and fetishistic transvestism – all defined in the international classification of diseases. You continue to receive treatment from psychiatrists who consider you to be at low risk of re-offending”.

Another recent British case highlighted the ingenious methods used to aid upskirting. Here, Stafford Cant used spy cameras hidden inside one of his trainers, his key fob, and his wrist watch to engage in upskirting women (as well as filming the backs of their legs) who were shopping in a Cheshire village. Acting on a tip-off, his house was raided and the police found 222,000 videos and pictures dating back seven years. ‘Addiction’ was again used as a mitigating factor in the crimes (along with depression and anxiety disorders) but this time it was not addiction to voyeurism but an addiction to collecting things. However, unlike the two cases above, Cant was jailed for three years after pleading guilty to outraging public decency, voyeurism and possessing and distributing indecent images.

Although there is little psychological literature on upskirting, there appears to be anecdotal evidence that the behaviour (in the extreme) could perhaps be conceptualized as an addiction and/or compulsion among a minority of individuals. The cases of those that have been arrested and prosecuted demonstrate that upskirting behaviour was time-consuming given the sheer number of photos and videos amassed, and that the behaviour was ultimately problem-inducing and undesirable. Given that the relatively recent rise of upskirting appears to mirror the rise in the use of smartphones and spy equipment available at affordable prices, I expect to see more such cases to be written about in psychological and criminological journals in the years to come.

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

Further reading

Fight The New Drug (2018). What’s “upskirting”, and how does porn culture feed this twisted trend? July 5. Located at: https://fightthenewdrug.org/whats-upskirting-and-how-does-porn-culture-feed-this-twisted-trend/

Jolly, B. (2015). Upskirt pervert who took 9,000 secret photos in just five weeks avoids jail. Daily Mirror, January 28. Located at: https://www.mirror.co.uk/news/uk-news/upskirt-pervert-who-took-9000-5058048

Keay, L. (2018). Live Nation executive who built-up sordid library of 49,000 upskirt pictures by filming women on trains, the beach and at work is spared jail as his wife stands by him. Daily Mail, January 5. Located at: http://www.dailymail.co.uk/news/article-5239815/LiveNation-executive-Andrew-MacRae-avoids-jail-upskirt.html

Lam, J. (2017). Fifty shades of sexual offending – Part 1. The Law Gazette, July. Located at: http://v1.lawgazette.com.sg/2017-07/1910.htm

Martin, G. (2018). What happened to me was wrong. Time to make it illegal, too. World Economic Forum, April 9. Located at: https://www.weforum.org/agenda/2018/04/what-happened-to-me-was-wrong-time-to-make-it-illegal-too/

Petter, O. (2018). Upskirting: What is it and why are people trying to make it illegal” The Independent, June 18. Located at: https://www.independent.co.uk/life-style/upskirting-explained-law-rules-criminal-offence-photos-skirt-consent-women-gina-martin-a8401011.html

Shepherd, R. & Smithers, D. (2018). The public school pervert who spent years secretly filming up women’s skirts in one of Britain’s wealthiest villages. Manchester Evening News, March 29. Located at: https://www.manchestereveningnews.co.uk/news/greater-manchester-news/alderley-edge-upskirt-film-pervert-14470375

The Strait Times (2016). Taking upskirt photos may be symptomatic of voyeuristic disorder. July 30. Located at: https://adelphipsych.sg/straits-times-taking-upskirt-photos-may-be-symptomatic-of-voyeuristic-disorder/

Wilson, H. (2004). Peeping Tom’s secret weapon. The Independent, July 8. Located at: https://www.independent.co.uk/news/science/peeping-toms-secret-weapon-552402.html

Teenage pics: A brief look at ‘selfie addiction’

In March 2014, the Daily Mirror published the story of Danny Bowman, a teenage ‘selfie addict’ who allegedly took up to 10 hours a day taking 200 selfies, dropped out of school, and tried to kill himself when he was unable take the perfect photo of himself. Taking selfies has become a very popular activity, particularly amongst teenagers and young adults. However, selfie-taking is more than just the taking of a photograph and can include the editing of the colour and contrast, changing backgrounds, and adding other effects, before uploading the picture onto a social media platform. These added options and the use of integrative editing has further popularized selfie-taking behaviour. From a psychological perspective, the taking of selfies is a self-oriented action which allows users to establish their individuality and self-importance and is also associated with personality traits such as narcissism. In an interview for the Daily Mirror, Bowman said that:

“I was constantly in search of taking the perfect selfie and when I realised I couldn’t I wanted to die. I lost my friends, my education, my health and almost my life. The only thing I cared about was having my phone with me so I could satisfy the urge to capture a picture of myself at any time of the day. “I finally realised I was never going to take a picture that made the craving go away and that was when I hit rock bottom. People don’t realise when they post a picture of themselves on Facebook or Twitter it can so quickly spiral out of control. It becomes a mission to get approval and it can destroy anyone. It’s a real problem like drugs, alcohol or gambling. I don’t want anyone to go through what I’ve been through. People would comment on [my selfies], but children can be cruel. One told me my nose was too big for my face and another picked on my skin. I started taking more and more to try to get the approval of my friends. I would be so high when someone wrote something nice but gutted when they wrote something unkind. [Taking lots of selfies sounds trivial and harmless but that’s the very thing that makes it so dangerous. It almost took my life, but I survived and I am determined never to get into that position again.”

Unknown

While Bowman’s case is extreme, it doesn’t mean that obsessive selfie-taking is a trivial condition. Bowman was diagnosed as having (and eventually treated for) body dysmorphic disorder (BDD) which at its simplest level, is a distressing, handicapping, and/or impairing preoccupation with an imagined or slight defect in body appearance that the sufferer perceives to be ugly, unattractive, and/or deformed. Bowman’s psychiatrist, Dr. David Veale (one of the world’s most foreknown experts on BDD) said that: “Danny’s case is particularly extreme. But this is a serious problem. It’s not a vanity issue. It’s a mental health one which has an extremely high suicide rate.”

To date, there has been very little research on ‘selfie addiction’ and most of what has been academically published (both theorizing and empirical research studies) has tended to come from psychiatrists and psychologists in India. The main reasons for this are that (i) no other country has more Facebook users than India, and (ii) India accounts for more selfie deaths in the world compared to any other country with 76 deaths reported from a total of 127 worldwide. For instance, the death on February 1, 2016, of the 16-year old Dinesh Kumar killed by a train in Chennai while taking a selfie was reported widely in the media.

In 2014, there were a handful of separate media reports all reporting that ‘selfie addiction’ had been recognized by psychologists and psychiatrists as a genuine mental disorder. On March 31, 2014, a news story appeared in the Adobo Chronicles website that the American Psychiatric Association (APA) had classed ‘selfitis’ (i.e., the obsessive taking of selfies) as a new mental disorder.

The article claimed that selfitis was “the obsessive compulsive desire to take photos of one’s self and post them on social media as a way to make up for the lack of self-esteem and to fill a gap in intimacy”. The same article also claimed there three levels of the disorder – borderline (“taking photos of one’s self at least three times a day but not posting them on social media”), acute (“taking photos of one’s self at least three times a day and posting each of the photos on social media”), and chronic (“uncontrollable urge to take photos of one’s self round the clock and posting the photos on social media more than six times a day”). The story was republished on numerous news sites around the world but it soon became clear the story was a hoax. However, many of the academic papers exploring the concept of ‘selfie addiction’ have reported the story as genuine.

Other academics claim in a rather uncritical way that ‘selfie addiction’ exists. For instance, in 2015, in an article in theInternational Journal of Emergency Mental Health and Human Resilience, Shah claimed that selfie-taking behaviour “classically fits” the criteria of addiction but then fails to say what these criteria are. He then goes on to argue that anyone taking more than 3-5 selfies a day “may be considered as a disease” and that spending more than 5 minutes taking a single selfie or more than 30 minutes per day may also be “considered as disease”. Such proposals add little to the credence of excessive selfie-taking being potentially addictive.

In a 2017 editorial entitled ‘Selfie addiction’ (in the journal Internet and Psychiatry), Singh and Lippmann asserted that knowing about the psychology of selfies and their consequences is important for both individuals and the communities in which they live. They claim that the taking of selfies can sometimes be “inconsiderate of other people, especially when ‘getting the perfect shot’ becomes an obsession”. They claim that excessive selfie clicking can become “a troublesome obsession and may be related to different personality traits” such as psychopathy, narcissism, and Machiavellianism. More specifically, the argue that:

“Narcissistic people exhibit feelings of superiority and perfection, but also often harbor self-doubt. Those with psychopathy have little compassion about harming others. Persons with Machiavellian traits fulfill their wishes with diminished ethics. All three utilize social websites that allow posting and amending pictures. Individuals with low self-esteem, obsession, and/or hyperactivity also sometimes exhibit high rates of “snapping” selfies”.

In a very brief review of the literature on selfie-taking and mental health in a 2016 issue of the Indian Journal of Health and Wellbeing, Kaur and Vig concluded that selfie addiction was most associated with low self-esteem, narcissism, loneliness and depression. Also in 2016, Sunitha and colleagues also reported similar findings based on their review of selfie-taking in theInternational Journal of Advances in Nursing Management. In an online populist article in 2017 on the rise of the ‘selfie generation’, Tolete and Salarda interviewed a teen development specialist, Dr. Robyn Silverman about how and why adolescents might get hooked on selfie-taking. He said that teens “crave positive feedback to help them see how their see how their identity fits into their world. Social media offers an opportunity to garner immediate information…the selfie generation ends up agonizing over very few likes or one or two negative comments, as if these are the only metrics that will prove they matter. One can only imagine the vulnerability of their still fragile self-esteem in such an environment”.

Other academics have claimed that while the evidence for ‘selfie addiction’ being a social problem is lacking, it does not mean that it could not be a ‘primary pathology’ in times to come. However, there has been very few empirical studies that have examined ‘selfie addiction, and those that have been published suffer from many methodological weaknesses.

For instance, in a 2017 issue of the Journal of Contemporary Medicine and Dentistry, Gaddala and colleagues examined the association between Internet addiction and ‘selfie addiction’ among 402 Indian medical students (262 females). They reported a significant association between selfie dependence and internet dependence. However, they used Shah’s operationalization of ‘selfie addiction’ (the taking of three or more selfies a day; 4% of the total sample), therefore it is unlikely that very few of the participants would have been genuinely addicted to taking selfies.

Singh and Tripathi carried out a very small study on 50 Indian adolescents aged 12-18 years of age (28 females; average age 14.6 years) in 2017 (in the journal SSRN). They found that narcissism and hyperactivity were positively correlated with ‘selfie addiction’ whereas self-image was negatively correlated with ‘selfie addiction’. However, in addition to the very small sample size, the instrument used to assess selfie tendencies had little to do with addiction and simply asked questions about typical selfie behaviour (e.g., how many selfies a day/week are taken, how much time a day is spent taking selfies, are the selfies posted onto social media, etc.)

Finally, a 2017 study in the Journal of Medical Science and Clinical Research by Kela and colleagues examined the more medical effects of excessive selfie-taking. In a survey of 250 Indian students aged 18-25 years (56% females), it was reported that 30% reported lower back ache, 15% suffered stress, 20%, suffered from cervical spondylitis, 25% suffered from headache, and 10% suffered from ‘selfie elbow’ (a tendonitis condition). However, it was unclear from the methodology described to what extent these effects were specifically attributable to selfie-taking.

Taking the academic literature as a whole, there is little evidence – as yet – that ‘selfie addiction’ exists although if stories like Danny Bowman are to be believed, it does appear at least theoretically possible for an individual to become addicted to such an activity.

(Note: some of this material first appeared in the following paper: Griffiths, M.D. & Balakrishnan, J. (2018). The psychosocial impact of excessive selfie-taking in youth: A brief overview. Education and Health, 36(1), 3-5).

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

Further reading

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

Barakat, C. (2014). Science links selfies to narcissism, addiction, and low self esteem. Adweek, April 16. Located at: www.adweek.com/socialtimes/selfies-narcissism-addiction-low-self-esteem/147769

Bhattacharyya, R. (2017). Addiction to modern gadgets and technologies across generations. Eastern Journal of Psychiatry, 18(2), 27-37.

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

Grossman, S. (2014). Teenager reportedly tried to kill himself because he wasn’t satisfied with the quality of his selfies. Time, March 24. Located at: http://time.com/35701/selfie-addict-attempts-suicide/

Gupta, R. & Pooja, M. (2016). Selfie an infectious gift of IT to modern society. Global Journal for Research Analysis, 5(1), 278-280.

Kaur, S., & Vig, D. (2016). Selfie and mental health issues: An overview. Indian Journal of Health and Wellbeing, 7(12), 1149-1152.

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

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

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

Shah, P.M. (2015). Selfie – a new generation addiction disorder – Literature review and updates. International Journal of Emergency Mental Health and Human Resilience, 17, 602.

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

Singh, S. & Tripathi, K.M. (2017). Selfie: A new obsession. SSRN, 1-3. Located at: https://papers.ssrn.com/sol3/papers.cfm?abstract_id=2920945

Sunitha, P. S., Vidya, M., Rashmi, P., & Mamatha, M. (2016). Selfy [sic] as a mental disorder – A review. International Journal of Advances in Nursing Management, 4(2), 169-172.

If phonely: Are you addicted to your mobile phone?

A couple of weeks ago I was interviewed by Debating Europe (DE) about smartphone addiction. I was asked four questions and my responses were transcribed, edited, and published on the DE website on July 11. Only the responses to two of the questions were published, so my blog today provides the full transcript of my interview. I have emboldened each of the four questions and my response follows each question.

Vicki worries about the impact of smartphones on children. She thinks that parents nowadays are too prone to buying the latest phones for their kids, without taking into consideration possible alternatives. What are the risks of children being addicted to their phones?

Well, first thing to say is that children and adults are no more addicted to their smartphones than alcoholics are addicted to a bottle. What we’re really talking about here is the application that people have on smartphones. Obviously, children now seem to getting smartphones at a younger and younger age. I’m often asked what is an appropriate age to give children smartphones. There is no right answer on this, but I certainly don’t advocate giving smartphones to children under the age of 11 years.

I think when children move to their secondary schools, most children in the class will have a smartphone, and to not give your child a smartphone can ostracise them from the class. The issue about smartphones in terms of excessive use is that sometimes parents do actually pathologise their children’s excessive smartphone use, particularly if they don’t use a smartphone much themselves. For me, the issue is whether their smartphone use interferes with the other important things in their lives?

There are typically four things I ask parents: One, is smartphone use affecting your child’s education and homework? Two, is their smartphone use affecting their physical education? Three. is their smartphone use affecting the chores you expect your children to do around the house? And, finally, does the smartphone use affect their face-to-face interaction with their friends? Typically, most parents, if they’ve answered honestly, will answer that the smartphone doesn’t affect any of those four domains. But if a parent does feel it’s affecting those four domains, then it is the parent’s responsibility to do something about it.

As a parent myself, I know that taking a smartphone off a child can be very difficult sometimes and can lead to negative reactions by the child. But at the end of the day, a parent is there to parent. They’re there to oversee their child’s development into – hopefully – a thriving adult who’s got all the capacities to go on in the world. Using smartphones, unfortunately or fortunately – depending upon your viewpoint – is now a natural thing and, particularly in teenage years, that is what children do. So I think it comes down to everything in moderation and parents absolutely have the right to restrict screen time and in extreme circumstances actually take the smartphones away.

smartphone-addiction

Stella thinks we’re being too negative about mobile phones. She thinks technology such as smartphones actually increases the sense of community and allows for expression of opinions. What would you say to her? Is she right to be so optimistic or should it be tempered?

It’s all about moderation. I personally think the advantages of smartphones far outweigh the disadvantages. I’m actually an unusual person. I actually gave using up my mobile phone a number of years ago, and I’ve now learned to live without one. But – to be honest – particularly for most teenagers, this is absolutely essential in their day-to-day social armoury. I don’t think there’s any argument that there should be a ban or a prohibition on smartphones because, as I said, the advantages far outweigh the disadvantages.

The scientific research says that a very small minority seem to overuse their smartphones, particularly young people aged between 14-to-25 years. We’ve got teenagers, older adolescents and emerging adults who heavily use their smartphones. I think most of that use is what I call ‘habitual use’. It’s not ‘problematic use’, it’s just something that people get into a habit of doing, always looking at their mobile phones even when there hasn’t been a ‘ping’ or a beep to say there’s been a notification or a message. People still automatically look at their smartphone even if there’s no sound. It’s almost like a classically conditioned response.

I think more people pathologise use. For most people, their smartphone use is not pathological in any way, shape, or form. It’s just that, sometimes, excessive use is pathologised by people who don’t like mobile phones. I notice mobile phones when I’m in a restaurant or a pub, because I don’t have one myself. I’m actually very conscious when somebody else is looking at their mobile phone during mid-conversation, and that has led to this phrase ‘phubbing’, which is ‘phone snubbing’ and which goes on all the time. But that, in and of itself, is not an addiction and is not excessive.

I certainly think that in terms of the question asked, I do think there’s a lot of good things to say about mobile phones and I wouldn’t want to be in a position where they’re not around because for some people they’re life-savers and for some it’s part of their social armoury. I do think that the way social media operators use their psychological hooks to get people to look at their phones is something where the onus is on the social media operators rather than the individuals.    

Reader ‘Randomguy2017’ is sceptical of the benefits of technological progress. He argues that depression and anxiety are higher than ever, as our addiction to smartphones grow. Is there a link between the two?

As far as I’m aware – and I may be wrong – there is no scientific longitudinal study that has looked at the relationship between smartphone use, depression and anxiety. I certainly think it’s a case where it’s a bit of a ‘chicken and egg’ thing. If you’re somebody that’s prone to anxiety or depression, you’re more likely to use smartphones or the Internet as a way masking depression and anxiety. There’s also some research that suggests excessive use of smartphones and the Internet can lead to social anxiety and depression. So, like I said before, there’s a bit of ‘chicken and the egg’ here. It may be also be that there is a bit of both.

Again, I would really stress that the number of people that would be genuinely addicted to applications on their smartphone are very few and far between. I think what we’ve got more now is that the excessive smartphone use sometimes leads to problematic behaviour. It could be that you’re looking at your smartphone while you’re driving, or you prefer to look at your smartphone rather than talk to somebody in front of you face-to-face. Those kind of things, they are what I would say are ‘problematic’ and annoying and, in the case of driving, could actually be fatal, but none of those are necessarily addictive or pathological.

However, I do think we have to put these things into perspective. The vast majority of people that use smartphone-based technologies, it’s something that’s life-affirming, life-enhancing, that adds to their life. But that doesn’t take away the fact that small minority out there that their use of smartphones takes away from other important things in their life. And in a tiny minority of cases the application that people are engaging in online whether its social networking, gaming, or gambling might be potentially addictive. But I take a holistic approach in this, in that the advantages far outweigh the disadvantages.

Emil is concerned about the privacy implications of our reliance on phones. Is he correct in assuming hackers can easily access what we do on our phones?

This is not my research area as I don’t look at privacy issues in relation to Internet and smartphone use. However, I’ve got access to people’s data from gambling companies and we do research on that data. I think that people have got to realise that anything they do online, when you’ve signed up to do anything, whether it’s a gambling service, a gaming service, a social networking site, is that you are – in effect – giving your data away.

When my kids come to me and say to me, ‘Can I do this, it’s free?’ I have to educate my children when anything is free, via smartphone or the Internet, then you yourself are the product that’s actually being sold. It’s very hard to educate a 12 or 13-year-old about that, but I think you can say to adults that their data is being used and sold in ways that they never imagined.

But I do think that this ‘big data’ revolution that we’ve got now can result in very good potential uses of that data, particularly at an aggregate level. But I certainly know that on an individual level, I don’t like my own data being used. If I sign up and buy things from Amazon, I know they’re going to use my data. If I sign up to use Facebook, I know my data is being used some way. So it’s a bit of give and take. In Europe, we’ve just had new regulation regarding data privacy. Obviously governments are trying to get on top of this, but we now live in a digital world, we leave digital footprints, and our data is going to be used in ways we never thought it might be used in the first place. That is the trade-off between having all these advantages of new technologies versus those privacy issues.

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

Further reading

Balakrishnan, J. & Griffiths, M.D. (2018). ‘Addictive’ smartphone games and their features: A largescale qualitative study using online reviews by videogame players. International Journal of Mental Health and Addictions, in press.

Billieux, J., Maurage, P., Lopez-Fernandez, O., Kuss, D.J. & Griffiths, M.D. (2015). Can disordered mobile phone use be considered a behavioral addiction? An update on current evidence and a comprehensive model for future research. Current Addiction Reports, 2, 154-162.

Csibi, S., Griffiths, M.D., Cook, B., Demetrovics, Z., & Szabo, A. (2018). The psychometric properties of the Smartphone: Applications-Based Addiction Scale (SABAS). International Journal of Mental Health and Addiction, 16, 393-403.

Griffiths, M.D. (2013). Adolescent mobile phone addiction: A cause for concern? Education and Health, 31, 76-78.

Hussain, Z., Griffiths, M.D. & Sheffield, D. (2017). An investigation in to problematic smartphone use: The role of narcissism, anxiety, and personality factors. Journal of Behavioral Addictions, 6, 378–386.

Lopez-Fernandez, O., Kuss, D.J., Griffiths, M.D., & Billieux, J. (2015). The conceptualization and assessment of problematic mobile phone use. In Z. Yan (Ed.), Encyclopedia of Mobile Phone Behavior (Volumes 1, 2, & 3) (pp. 591-606). Hershey, PA: IGI Global.

Lopez-Fernandez, O., Kuss, D.J., Pontes, H.M., Griffiths, M.D., Dawes, C., … Billieux, J. (2018). Measurement invariance of the short version of the Problematic Mobile Phone Use Questionnaire (PMPUQ-SV) across eight languages. International Journal of Environmental Research and Public Health, 15, 1213. doi:10.3390/ijerph15061213

Lopez-Fernandez, O., Männikkö, N., Kääriäinen, M., Griffiths, M.D., & Kuss, D.J. (2018). Mobile gaming does not predict smartphone dependence: A cross-cultural study between Belgium and Finland. Journal of Behavioral Addictions, 7, 88-99.

Richardson, M., Hussain, Z. & Griffiths, M.D. (2018). Problematic smartphone use, nature connectedness, and anxiety. Journal of Behavioral Addictions, 7, 109-116.

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

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

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

The construct of ‘selfitis’

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

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

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

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

Screen Shot 2018-06-13 at 18.12.52The six components comprising selfitis in our new psychometric tool (the Selfitis Behavior Scale [SBS]) were correctly reported but at no point in our paper did we ever say that ‘selfitis’ was a behavioural addiction. What we did write was that (a) “selfitis is a new construct in which future researchers may investigate further in relation to selfitis addiction and/or compulsion” (p.8), and (ii) “the qualitative focus group data from participants strongly implied the presence of ‘selfie addiction’ although the SBS does not specifically assess selfie addiction” (p.11). They also noted that our published paper on selfitis:

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

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

The construct of ‘behavioural addiction’

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

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

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

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

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

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

References

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

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

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

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

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

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

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

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

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

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

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

Screen Shot 2018-06-18 at 08.08.28

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Further reading

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Further reading

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

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

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

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

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

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

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

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

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