Category Archives: Addiction

General selection: Is voluntary self-exclusion a good proxy measure for problem gambling?

A couple of months ago, Dr. Michael Auer and I published a short paper in the Journal of Addiction Medicine and Therapy (JAMT) critically addressing a recent approach by researchers that use voluntary self-exclusion (VSE) by gamblers as a proxy measure for problem gambling in their empirical studies. We argued that this approach is flawed and is unlikely to help in developing harm-minimization measures.

For those who don’t know, self-exclusion practices typically refer to the possibility for gamblers to voluntarily ban themselves from playing all (or a selection of) games over a predetermined period. The period of exclusion can typically be chosen by the gambler although some operators have non-negotiable self-exclusion periods. Self-exclusion in both online sites and offline venues has become an important responsible gambling practice that is widely used by socially responsible operators.

There are many reasons why players self-exclude. In a 2011 study in the Journal of Gambling Studies by Dr. Tobias Hayer and Dr. Gerhard Meyer, players frequently reported excluding as a preventive measure and annoyance with the gambling operator as reasons for VSE. Furthermore, only one-fifth of self-excluders reported to be problem gamblers (21.2%). A recent 2016 (conference) paper by Dr. Suzanne Lischer (2016) reported that in a study of three Swiss casinos, 29% of self-excluders were pathological gamblers, 33% were problem gamblers, and 38% were recreational gamblers. Given that many voluntary self-excluders do not exclude themselves for gambling-related problems, Dr. Lischer concluded that self-exclusion is not a good indicator of gambling-related problems. In line with these results, a 2015 study published in International Gambling Studies led by Simo Dragicevic compared self-excluders with other online players and reported no differences in the (i) mean number of gambling hours per month or (ii) minutes per gambling session. The study also reported that 25% of players self-excluded within one day of their registration with the online operator. This could also be due to the fact that online players can self-exclude with just a few mouse-clicks.


Most studies to date report that the majority of voluntary self-excluders tend to be non-problem gamblers. Additionally, in 2010, the Australian Productivity Commission reported 15,000 active voluntary self-exclusions from 2002 to 2009 and that this represented only 10-20% of the population of problem gamblers. This means that in addition to most self-excluders being non-problem gamblers, that most problem gamblers are not self-excluders. This leads to the conclusion that there is little overlap between problem gambling and self-excluding.

Over the decade, analytical approaches to harm minimization have become popular. This has led to the development of various tracking tools such as PlayScan (developed by Svenska Spel), Observer (developed by, and mentor (developed by neccton and myself). Furthermore, regulators are increasingly recognizing the importance of early risk detection via behavioural tracking systems. VSE also plays an important role in this context. However, some systems use VSE as a proxy of at-risk or problem gambling.

Based on the findings from empirical research, self-exclusion is a poor proxy measure for categorizing at-risk or problem gamblers and VSE should not be used in early problem gambling detection systems. The reasons for this are evident:

  • There is no evidence of a direct relationship between self-exclusion and problem gambling. As argued above, self-excluders are not necessarily problem gamblers and thus cannot be used for early risk detection.
  • There are various reasons for self-exclusion that have nothing to do with problem gambling. Players exclude for different reasons and one of the most salient appears to be annoyance and frustration with the operator (i.e., VSE is used as a way of venting their unhappiness with the operator). In this case, an early detection model based on self-exclusion would basically identify unhappy players and be more useful to the marketing department than to those interested in harm minimization
  • Problem gamblers who self-exclude are already actively changing their behaviour. The trans-theoretical ‘stages of change’ model (developed by Dr. Carlo DiClemente and Dr. James Prochaska) argues that behavioural change follows stages from pre-contemplation to action and maintenance. One could argue that the segment of players who self-exclude because they believe their gambling to be problematic are the ones who already past the stages where assistance is usually helpful in triggering action to cease gambling. These players are making use of a harm-minimization tool. The ones actually in need of detection and intervention are the ones who have not yet reached this stage of change yet and are not thinking about changing their behaviour at all. This is one more argument for the inappropriateness of self-exclusion as a proxy for problem gambling.

But what could be done to prevent the development of gambling-related problems in the first place? For the reasons outlined above, we would argue that the attempt to identify problem gambling via playing patterns that are derived from self-excluders does not assist harm minimization. Firstly, this approach does not target problem gamblers, and secondly it does not provide any insights into the prevention of such problems.

It is evident that any gambling environment should strive to minimize gambling-related harm and reduce the amount of gambling among vulnerable groups. It is also known that information that is given to individuals to enable behavioural change should encourage reflection because research has shown that self-monitoring can enable behavioural change in the desired direction. Dr. Jim Orford has also stated that attempts to explain such disparate gambling types from a single theoretical perspective are essentially a fool’s errand. This also complements the notion that problem gambling is not a homogenous phenomenon and there is not a single type of problem gambler (as I argued in my first book on gambling back in 1995). This also goes in line with the belief of Dr. Auer and myself that gambling sites have to personalize communication and offer the right player the right assistance based on their individual playing history. Recent research that Dr. Auer and I have carried out supports this line of thinking.

Studies have also shown that dynamic feedback in the form of pop-up messages has a positive effect on gambling behaviour and gambling-related thoughts. For instance, research from Dr. Michael Wohl’s team in Canada have found that animation-based information enhanced the effectiveness of a pop-up message related to gambling time limits. Our own research has found that an enhanced pop-up message (that included self-appraisal and normative feedback) led to significantly greater number of players ending their session than a simple pop-up message. In a real-world study of online gamblers, we also found that personalized feedback had a significant effect in reducing the time and money spent gambling.

Personalized feedback is a player-centric approach and in addition to gambling-specific research, there is evidence from many other areas that shows the beneficial effects on behavioural change. For instance, personalized messages have shown to enable behavioural change in areas such as smoking cessation, diabetes management, and fitness activity. Contrary to the self-exclusion oriented detection approach, we concluded in our recent JAMT paper that personalized feedback aims to prevent and minimize harm in the first place and is a much better approach to the prevention of problem gambling than using data from those that self-exclude from gambling.

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

 Further reading

Auer, M. & Griffiths, M. D. (2014). Personalised feedback in the promotion of responsible gambling: A brief overview. Responsible Gambling Review, 1, 27-36.

Auer, M. Griffiths, M.D. (2015). The use of personalized behavioral feedback for online gamblers: an empirical study. Frontiers in Psychology, 6, 1406.  doi:10.3389/fpsyg.2015.01406

Auer, M., Griffiths, M.D. (2015). Testing normative and self-appraisal feedback in an online slot-machine pop-up in a real-world setting. Frontiers in Psychology. 6, 339 doi: 10.3389/fpsyg.2015.00339

Auer, M., Littler, A., Griffiths, M. D. (2015). Legal Aspects of Responsible Gaming Pre-commitment and Personal Feedback Initiatives. Gaming Law Review and Economics. 19, 444-456.

DiClemente, C. C., Prochaska, J. O., Fairhurst, S. K., Velicer, W. F., Velasquez, M. M., & Rossi, J. S. (1991). The process of smoking cessation: an analysis of precontemplation, contemplation, and preparation stages of change. Journal of Consulting and Clinical Psychology, 59, 295-304.

Dragicevic, S., Percy, C., Kudic, A., Parke, J. (2015). A descriptive analysis of demographic and behavioral data from Internet gamblers and those who self-exclude from online gambling platforms. Journal of Gambling Studies. 31, 105-132.

Gainsbury, S. (2013). Review of self-exclusion from gambling venues as an intervention for problem gambling. Journal of Gambling Studies, 30, 229-251.

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

Griffiths, M.D. & Auer, M. (2016). Should voluntary self-exclusion by gamblers be used as a proxy measure for problem gambling? Journal of Addiction Medicine and Therapy, 2(2), 00019.

Hayer, T., & Meyer, G. (2011). Self-exclusion as a harm-minimization strategy: Evidence for the casino sector from selected European countries. Journal of Gambling Studies, 27, 685-700

Kim, H. S., Wohl, M. J., Stewart, M. K., Sztainert, T., Gainsbury, S. M. (2014). Limit your time, gamble responsibly: setting a time limit (via pop-up message) on an electronic gaming machine reduces time on device. International Gambling Studies, 14, 266-278.

Lischer, S. (2016, June). Gambling-related problems of self-excluders in Swiss casinos. Paper presented at the 16th International Conference on Gambling & Risk Taking, Las Vegas, USA.

Suurvali, H., Hodgins, D. C., Cunningham, J. A. (2010). Motivators for resolving or seeking help for gambling problems: A review of the empirical literature. Journal of Gambling Studies, 26, 1-33

Don’t blame the game: Parents, videogame content, and age ratings

Back in March 2015, BBC News reported that parents of children in 16 Cheshire county schools had been sent a letter saying that head teachers would report them to the authorities if they allowed their children to play videogames that are rated for adults (i.e., games that have an ‘18’ rating). The teachers claimed that popular games like Grand Theft Auto and Call of Duty are too violent to be played by those under the age of 18 years. They also stated that such games increased sexualised behaviour and left children vulnerable to sexual grooming. The schools also threatened to report parents who let their children play such games because it was a form of parental neglect. The author of the letter, Mary Hennessy Jones, was quoted as saying that:

“We are trying to help parents to keep their children as safe as possible in this digital era. It is so easy for children to end up in the wrong place and parents find it helpful to have some very clear guidelines”.

I’m sure the letter to parents was written with the best of intentions but as a parent of three ‘screenagers’ and someone that has spent almost three decades researching the effects of video games on human behaviour, this appears to be a very heavy-handed way to deal with the issue. Although it is illegal for any retailer to sell ‘18’ rated games to minors, it is not illegal for children to play such games, or illegal for parents to allow their children to play such games. Many parents need to be educated about the positives and negatives of playing video games but reporting them to the “authorities” is not the right way forward.


Back in the early 1990s I was probably the only academic in the UK carrying out scientific research on children’s video game playing. In fact, I was proud of my role in getting age ratings onto all video games in the first place, and for writing the text for educational information leaflets for parents (outlining the effects of excessive playing of such games) sponsored by the National Council for Educational Technology. There are many positive benefits of playing video games (something that I wrote about in a previous article for The Conversation).

I know from first-hand experience that children often play games that are age-inappropriate. Two years ago, my (then) 13-year old son said he was the only boy in his class that did not play or own the Call of Duty video game. This is also borne out by research evidence. One study that I was involved in found that almost two-thirds of children aged 11- to 13-years of age (63%) had played an 18+ video game. Unsurprisingly, boys (76%) were more likely than girls (49%) to have played an 18+ video game. Children were also asked about how often they played 18+ video games. Of the two-thirds who had played them, 8% reported playing them “all the time”, 22% reported playing them “most of the time”, 50% reported playing them “sometimes”, 18% reported playing them “hardly ever”. Again, boys were more likely than girls to play 18+ video games more frequently. Children were asked how they got access to 18+ plus video games. The majority had the games bought for them by family or friends (58%), played them at a friend’s house (35%), swapped them with friends (27%), or bought games themselves (5%). This research certainly appears to suggest that parents and siblings are complicit in the playing of age-inappropriate games.

There is a growing amount of scientific literature that has examined the content of video games designed for adults. For instance, a study led by Dr. Kimberley Thompson and published in the Archives of Pediatric and Adolescent Medicine attempted to quantify the depiction of violence, blood, sexual themes, profanity, substances, and gambling in adult (18+) video games and to assess whether the actual game content matched the content descriptor on the packaging. Although content descriptors for violence and blood provided a good indication of content in the 36 games examined, the authors concluded that 81% of the games studied (n=29) lacked content descriptors of other adult content. Other studies carried out by the same research team have found that adult content can be found in lots of games aimed at young children and teenagers.

Another study led by Dr. David Walsh published in Minerva Pediatrica tested the validity of media rating systems (including video games). Results showed that when the entertainment industry rated a product as inappropriate for children, parents also agreed that it was inappropriate. However, parents disagreed with many industry ratings that were designated as containing material as suitable for children. The products rated as appropriate for adolescents by the industry were of the greatest concern to parents.

The issue of children and adolescents playing 18+ games is no different from the debates about children and adolescents watching 18+ films. However, based on anecdotal evidence appears that parents are more likely to adhere to age ratings on films than they are on video games. This is one area that both media researchers and media educators need to inform parents to be more socially responsible in how they monitor their children’s leisure activity. A school sending out a threatening letter to parents is unlikely to change parental behaviour. Education and informed debate is likely to have a much greater effect in protecting our children from the potential harms of video game playing.

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

 Further reading

Anderson, C.A., Gentile, D.A., & Dill, K.E. (2012). Prosocial, antisocial and other effects of recreational video games. In D.G. Singer, & J.L. Singer (Eds), Handbook of Children and the Media, Second Edition, (pp. 249-272). Thousand Oaks, CA: Sage.

Anderson, C. A., Shibuya, A., Ihori, N., Swing, E. L., Bushman, B.J., Sakamoto, A., Rothstein, H.R., & Saleem, M. (2010). Violent video game effects on aggression, empathy, and prosocial behavior in eastern and western countries: a meta-analytic review. Psychological Bulletin, 136, 151-173.

Bartlett, C. P., Anderson, C.A. & Swing, E.L. (2009). Video game effects confirmed, suspected and speculative: A review of the evidence. Simulation and Gaming, 40, 377-403.

Ferguson, C. J. (2007). Evidence for publication bias in video game violence effects literature: A meta analytic review. Aggression and Violent Behavior, 12, 470-482.

Ferguson, C. J. (2013). Violent video games and the supreme court: Lessons for the scientific community in the wake of Brown v. Entertainment Merchants Association. American Psychologists, 68, 57-74.

Ferguson, C. J., San Miguel, S. & Hartley, T. (2009).  Multivariate analysis of youth violence and aggression: The influence of family, peers, depression and media violence. Journal of Paediatrics, 155, 904-908.

Gentile, D. A. & Stone, W. (2005). Violent video game effects in children and adolescents: A review of the literature. Minerva Pediatrics, 57, 337-358.

Griffiths, M.D. (1998). Video games and aggression: A review of the literature. Aggression and Violent Behavior, 4, 203-212.

Griffiths, M.D. (2000). Video game violence and aggression: Comments on ‘Video game playing and its relations with aggressive and prosocial behaviour’ by O. Weigman and E.G.M. van Schie. British Journal of Social Psychology, 39, 147-149.

Griffiths, M.D. (2010). Age ratings on video games: Are the effective? Education and Health, 28, 65-67.

Griffiths, M.D. & McLean, L. (in press). Content effects: Online and offline games. In P. Roessler (Ed.), International Encyclopedia of Media Effects. Chichester: Wiley.

Grüsser, S.M., Thalemann, R. & Griffiths, M.D. (2007). Excessive computer game playing: Evidence for addiction and aggression?  CyberPsychology and Behavior, 10, 290-292.

Ivory, J.D., Colwell, J., Elson, M., Ferguson, C.J., Griffiths, M.D., Markey, P.M., Savage, J. & Williams, K.D. (2015). Manufacturing consensus in a divided field and blurring the line between the aggression concept and violent crime. Psychology of Popular Media Culture, 4, 222–229.

McLean, L. & Griffiths, M.D. (2013). The psychological effects of videogames on young people. Aloma: Revista de Psicologia, Ciències de l’Educació i de l’Esport, 31(1), 119-133.

McLean, L. & Griffiths, M.D. (2013). Violent video games and attitudes towards victims of crime: An empirical study among youth. International Journal of Cyber Behavior, Psychology and Learning, 2(3), 1-16.

Mehroof, M. & Griffiths, M.D. (2010). Online gaming addiction: The role of sensation seeking, self-control, neuroticism, aggression, state anxiety and trait anxiety. Cyberpsychology, Behavior, and Social Networking, 13, 313-316.

The words and the we’s: When is a new addiction scale not a new addiction scale?

“The words you use should be your own/Don’t plagiarize or take on loans/There’s always someone, somewhere/With a big nose, who knows” (Lyrics written by Morrissey from ‘Cemetry Gates’ (sic) by The Smiths)

Over the last few decades, research into ‘shopping addiction’ and ‘compulsive buying’ has greatly increased. In 2015, I along with my colleagues, developed and subsequently published (in the journal Frontiers in Psychology) a new scale to assess shopping addiction – the 7-item Bergen Shopping Addiction Scale (BSAS) which I wrote about in one of my previous blogs.

We noted in our Frontiers in Psychology paper that two scales had already been developed in the 2000s (i.e., one by Dr. George Christo and colleagues in 2003, and one by Dr. Nancy Ridgway and colleagues in 2008 – see ‘Further reading’ below), but that neither of these two instruments approached problematic shopping behaviour as an addiction in terms of core addiction criteria that are often used in the behavioural addiction field including salience, mood modification, tolerance, withdrawal, conflict, relapse, and problems. We also made the point that new Internet-related technologies have now greatly facilitated the emergence of problematic shopping behaviour because of factors such as accessibility, affordability, anonymity, convenience, and disinhibition, and that there was a need for a psychometrically robust instrument that assessed problematic shopping across all platforms (i.e., both online and offline). We concluded that the BSAS has good psychometrics, structure, content, convergent validity, and discriminative validity, and that researchers should consider using it in epidemiological studies and treatment settings concerning shopping addiction.


More recently, Srikant Amrut Manchiraju, Sadachar and Jessica Ridgway developed something they called the Compulsive Online Shopping Scale (COSS) in the International Journal of Mental Health and Addiction (IJMHA). Given that we had just developed a new shopping addiction scale that covered shopping across all media, we were interested to read about the new scale. The scale was a 28-item scale and was based on the 28 items included in the first step of BSAS development (i.e., initial 28-item pool). As the authors noted:

“First, to measure compulsive online shopping, we adopted the Bergen Shopping Addiction Scale (BSAS; Andreassen, 2015). The BSAS developed by Andreassen et al. (2015), was adapted for this study because it meets the addiction criteria (e.g., salience, mood modification, etc.) established in the DSM-5. In total, 28 items from the BSAS were modified to reflect compulsive online shopping. For example, the original item – ‘Shopping/buying is the most important thing in my life’ was modified as ‘Online shopping/buying is the most important thing in my life’… It is important to note that we are proposing a new behavioral addiction scale, specifically compulsive online shopping … In conclusion, the scale developed in this study demonstrated strong psychometric, structure, convergent, and discriminant validity, which is consistent with Andreassen et al.’s (2015) findings”.

Apart from the addition of the word ‘online’ to every item, all initial 28 items of the BSAS were used identically in the COSS. Therefore, I sought the opinion of several research colleagues about the ‘new’ scale. Nearly all were very surprised that an almost identical scale had been published. Some even questioned whether such wholescale use might constitute plagiarism (particularly as none of the developers of the COSS sought permission to adapt our scale).

According to the website, several forms of plagiarism have been described including: “Copying so many words or ideas from a source that it makes up the majority of your work, whether you give credit or not” (p.1). Given the word-for-word reproduction of the 28 item–pool, an argument could be made that the COSS plagiarizes the BSAS, even though the authors acknowledge the source of their scale items. According to Katrina Korb’s 2012 article on adopting or adapting psychometric instruments:

“Adapting an instrument requires more substantial changes than adopting an instrument. In this situation, the researcher follows the general design of another instrument but adds items, removes items, and/or substantially changes the content of each item. Because adapting an instrument is similar to developing a new instrument, it is important that a researcher understands the key principles of developing an instrument…When adapting an instrument, the researcher should report the same information in the Instruments section as when adopting the instrument, but should also include what changes were made to the instrument and why” (p.1).

Dr. Manchiraju and his colleagues didn’t add or remove any of the original seven items, and did not substantially change the content of any of the 28 items on which the BSAS was based. They simply added the word ‘online’ to each existing item. Given that the BSAS was specifically developed to take into account the different ways in which people now shop and to include both online and offline shopping, there doesn’t seem to be a good rationale for developing an online version of the BSAS. Even if there was a good rationale, the scale could have made reference to the Bergen Shopping Addiction Scale in the name of the ‘new’ instrument. In a 2005 book chapter ‘Selected Ethical Issues Relevant to Test Adaptations’ by Dr. Thomas Oakland (2005), he noted the following in relation to plagiarism and psychometric test development:

Psychologists do not present portions of another’s work or data as their own, even if the other work or data source is cited … Plagiarism occurs commonly in test adaptation work (Oakland & Hu, 1991), especially when a test is adapted without the approval of its authors and publisher. Those who adapt a test by utilizing items from other tests without the approval of authors and publishers are likely to be violating ethical standards. This practice should not be condoned. Furthermore, this practice may violate laws in those countries that provide copyright protection to intellectual property. In terms of scale development, a measure that has the same original items with only one word added to each item (which only adds information on the context but does not change the meaning of the item) does not really constitute a new scale. They would find it really hard to demonstrate discriminant validity between the two measures”.

Again, according to Oakland’s description of plagiarism specifically in relation to the development of psychometric tests (rather than plagiarism more generally), the COSS appears to have plagiarized the BSAS particularly as Oakland makes specific reference to the adding of one word to each item (“In terms of scale development, a measure that has the same original items with only one word added to each item … does not really constitute a new scale”).

Still, it is important to point that I have no reason to think that this use of the BSAS was carried out maliciously. Indeed, it may well be that the only wrongdoing was lack of familiarity with the conventions of psychometric scale development. It may be that the authors took one line in our original Frontiers in Psychology paper too literally (the BSAS may be freely used by researchers in their future studies in this field”). However, the purpose of this sentence was to give fellow researchers permission to use the validated scale in their own studies and to avoid the inconvenience of having to request permission to use the BSAS and then waiting for an answer. Another important aspect here is that the BSAS (which may be freely used) consists of seven items only, not 28. The seven BSAS items were extracted from an initial item pool in accordance with our intent to create a brief shopping addiction scale. Consequently, there exists only one version of BSAS, the 7-item version. Here, Dr. Manchiraju and his colleagues seem to have misinterpreted this when referring to a 28-item BSAS.

(Please note: This blog is adapted using material from the following paper: Griffiths, M.D., Andreassen, C.S., Pallesen, S., Bilder, R.M., Torsheim, T. Aboujaoude, E.N. (2016). When is a new scale not a new scale? The case of the Bergen Shopping Addiction Scale and the Compulsive Online Shopping Scale. International Journal of Mental Health and Addiction, 14, 1107-1110).

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

Further reading

Aboujaoude, E. (2014). Compulsive buying disorder: a review and update. Current Pharmaceutical Design, 20, 4021–4025.

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

Christo, G., Jones, S., Haylett, S., Stephenson, G., Lefever, R. M., & Lefever, R. (2003). The shorter PROMIS questionnaire: further validation of a tool for simultaneous assessment of multiple addictive behaviors. Addictive Behaviors, 28, 225–248.

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

Griffiths, M.D., Andreassen, C.S., Pallesen, S., Bilder, R.M., Torsheim, T. Aboujaoude, E.N. (2016). When is a new scale not a new scale? The case of the Bergen Shopping Addiction Scale and the Compulsive Online Shopping Scale. International Journal of Mental Health and Addiction, 14, 1107-1110.

Korb, K. (2012). Adopting or adapting an instrument. Retrieved September 12, 2016, from:

Manchiraju, S., Sadachar, A., & Ridgway, J. L. (2016). The Compulsive Online Shopping Scale (COSS): Development and Validation Using Panel Data. International Journal of Mental Health and Addiction, 1-15. doi: 10.1007/s11469-016-9662-6.

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

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

Oakland, T. (2005). Selected ethical issues relevant to test adaptations. In Hambleton, R., Spielberger, C. & Meranda, P. (Eds.). Adapting educational and psychological tests for cross-cultural assessment (pp. 65-92). Mahwah, NY: Erlbaum Press.

Oakland, T., & Hu, S. (1991). Professionals who administer tests with children and youth: An international survey. Journal of Psychoeducational Assessment, 9(2), 108-120. (2016). What is plagiarism? Retrieved September 12, 2016, from:

Ridgway, N., Kukar-Kinney, M., & Monroe, K. (2008). An expanded conceptualization and a new measure of compulsive buying. Journal of Consumer Research, 35, 622–639.

Weinstein, A., Maraz, A., Griffiths, M.D., Lejoyeux, M. & Demetrovics, Z. (2016). Shopping addiction and compulsive buying: Features and characteristics of addiction. In V. Preedy (Ed.), The Neuropathology Of Drug Addictions And Substance Misuse (Vol. 3). (pp. 993-1008). London: Academic Press.

Surprise, surprise: A brief overview of our recent papers on strange addictions and behaviours

Following my recent blogs where I outlined some of the papers that my colleagues and I have published on mindfulness, Internet addiction, gaming addiction, youth gambling, workaholism, exercise addiction, and sex addiction, here is a round-up of recent papers that my colleagues and I have published on strange and/or surprising addictions and behaviours.

Foster, A.C., Shorter, G.W. & Griffiths, M.D. (2015). Muscle Dysmorphia: Could it be classified as an Addiction to Body Image? Journal of Behavioral Addictions, 4, 1-5.

  • Background: Muscle dysmorphia (MD) describes a condition characterised by a misconstrued body image in which individuals who interpret their body size as both small or weak even though they may look normal or highly muscular. MD has been conceptualized as a type of body dysmorphic disorder, an eating disorder, and obsessive–compulsive disorder symptomatology. Method and aim: Through a review of the most salient literature on MD, this paper proposes an alternative classification of MD – the ‘Addiction to Body Image’ (ABI) model – using Griffiths (2005) addiction components model as the framework in which to define MD as an addiction. Results: It is argued the addictive activity in MD is the maintaining of body image via a number of different activities such as bodybuilding, exercise, eating certain foods, taking specific drugs (e.g., anabolic steroids), shopping for certain foods, food supplements, and the use or purchase of physical exercise accessories). In the ABI model, the perception of the positive effects on the self-body image is accounted for as a critical aspect of the MD condition (rather than addiction to exercise or certain types of eating disorder). Conclusions: Based on empirical evidence to date, it is proposed that MD could be re-classified as an addiction due to the individual continuing to engage in maintenance behaviours that may cause long-term harm.

Griffiths, M.D., Foster, A.C. & Shorter, G.W. (2015). Muscle dysmorphia as an addiction: A response to Nieuwoudt (2015) and Grant (2015). Journal of Behavioral Addictions, 4, 11-13.

  • Background: Following the publication of our paper ‘Muscle Dysmorphia: Could it be classified as an addiction to body image?’ in the Journal of Behavioral Addictions, two commentaries by Jon Grant and Johanna Nieuwoudt were published in response to our paper. Method: Using the ‘addiction components model’, our main contention is that muscle dysmorphia (MD) actually comprises a number of different actions and behaviors and that the actual addictive activity is the maintaining of body image via a number of different activities such as bodybuilding, exercise, eating certain foods, taking specific drugs (e.g., anabolic steroids), shopping for certain foods, food supplements, and purchase or use of physical exercise accessories. This paper briefly responds to these two commentaries. Results: While our hypothesized specifics relating to each addiction component sometimes lack empirical support (as noted explicitly by both Nieuwoudt and Grant), we still believe that our main thesis (that almost all the thoughts and behaviors of those with MD revolve around the maintenance of body image) is something that could be empirically tested in future research by those who already work in the area. Conclusions: We hope that the ‘Addiction to Body Image’ model we proposed provides a new framework for carrying out work in both empirical and clinical settings. The idea that MD could potentially be classed as an addiction cannot be negated on theoretical grounds as many people in the addiction field are turning their attention to research in new areas of behavioral addiction.

Maraz, A., Király, O., Urbán, R., Griffiths, M.D., Demetrovics, Z. (2015). Why do you dance? Development of the Dance Motivation Inventory (DMI). PLoS ONE, 10(3): e0122866. doi:10.1371/ journal.pone.0122866

  • Dancing is a popular form of physical exercise and studies have show that dancing can decrease anxiety, increase self-esteem, and improve psychological wellbeing. The aim of the current study was to explore the motivational basis of recreational social dancing and develop a new psychometric instrument to assess dancing motivation. The sample comprised 447 salsa and/or ballroom dancers (68% female; mean age 32.8 years) who completed an online survey. Eight motivational factors were identified via exploratory factor analysis and comprise a new Dance Motivation Inventory: Fitness, Mood Enhancement, Intimacy, Socialising, Trance, Mastery, Self-confidence and Escapism. Mood Enhancement was the strongest motivational factor for both males and females, although motives differed according to gender. Dancing intensity was predicted by three motivational factors: Mood Enhancement, Socialising, and Escapism. The eight dimensions identified cover possible motives for social recreational dancing, and the DMI proved to be a suitable measurement tool to assess these motives. The explored motives such as Mood Enhancement, Socialising and Escapism appear to be similar to those identified in other forms of behaviour such as drinking alcohol, exercise, gambling, and gaming.

Maraz, A., Urbán, R., Griffiths, M.D. & Demetrovics Z. (2015). An empirical investigation of dance addiction. PloS ONE, 10(5): e0125988. doi:10.1371/journal.pone.0125988.

  • Although recreational dancing is associated with increased physical and psychological well-being, little is known about the harmful effects of excessive dancing. The aim of the present study was to explore the psychopathological factors associated with dance addiction. The sample comprised 447 salsa and ballroom dancers (68% female, mean age: 32.8 years) who danced recreationally at least once a week. The Exercise Addiction Inventory (Terry, Szabo, & Griffiths, 2004) was adapted for dance (Dance Addiction Inventory, DAI). Motivation, general mental health (BSI-GSI, and Mental Health Continuum), borderline personality disorder, eating disorder symptoms, and dance motives were also assessed. Five latent classes were explored based on addiction symptoms with 11% of participants belonging to the most problematic class. DAI was positively associated with psychiatric distress, borderline personality and eating disorder symptoms. Hierarchical linear regression model indicated that Intensity (ß=0.22), borderline (ß=0.08), eating disorder (ß=0.11) symptoms, as well as Escapism (ß=0.47) and Mood Enhancement (ß=0.15) (as motivational factors) together explained 42% of DAI scores. Dance addiction as assessed with the Dance Addiction Inventory is associated with indicators of mild psychopathology and therefore warrants further research.


Greenhill, R. & Griffiths, M.D. (2015). Compassion, dominance/submission, and curled lips: A thematic analysis of dacryphilic experience. International Journal of Sexual Health, 27, 337-350.

  • Objectives: Dacryphilia is a non-normative sexual interest that involves enjoyment or arousal from tears and crying, and to date has never been researched empirically. The present study set out to discover the different interests within dacryphilia and explore the range of dacryphilic experience. Methods: A set of online interviews were carried out with individuals with dacryphilic preferences and interests (six females and two males) from four countries. The data were analyzed for semantic and latent themes using thematic analysis. Results: The respondents’ statements focused attention on three distinct areas that may be relevant to the experience of dacryphilia: (i) compassion; (ii) dominance/submission; and (iii) curled-lips. The data provided detailed descriptions of features within all three interests, which are discussed in relation to previous quantitative and qualitative research within emotional crying and tears, and the general area of non-normative sexual interests. Conclusions: The study suggests new directions for potential research both within dacryphilia and with regard to other non-normative sexual interests.

Atroszko, P.A., Andreassen, C.S., Griffiths, M.D. & Pallesen, S. (2015). Study addiction – A new area of psychological study: Conceptualization, assessment, and preliminary empirical findings. Journal of Behavioral Addictions, 4, 75–84.

  • Aims: Recent research has suggested that for some individuals, educational studying may become compulsive and excessive and lead to ‘study addiction’. The present study conceptualized and assessed study addiction within the framework of workaholism, defining it as compulsive over-involvement in studying that interferes with functioning in other domains and that is detrimental for individuals and/or their environment. Methods: The Bergen Study Addiction Scale (BStAS) was tested — reflecting seven core addiction symptoms (salience, mood modification, tolerance, withdrawal, conflict, relapse, and problems) — related to studying. The scale was administered via a cross-sectional survey distributed to Norwegian (n = 218) and Polish (n = 993) students with additional questions concerning demographic variables, study-related variables, health, and personality. Results: A one-factor solution had acceptable fit with the data in both samples and the scale demonstrated good reliability. Scores on BStAS converged with scores on learning engagement. Study addiction (BStAS) was significantly related to specific aspects of studying (longer learning time, lower academic performance), personality traits (higher neuroticism and conscientiousness, lower extroversion), and negative health-related factors (impaired general health, decreased quality of life and sleep quality, higher perceived stress). Conclusions: It is concluded that BStAS has good psychometric properties, making it a promising tool in the assessment of study addiction. Study addiction is related in predictable ways to personality and health variables, as predicted from contemporary workaholism theory and research.

Atroszko, P.A., Andreassen, C.S., Griffiths, M.D. & Pallesen, S. (2016). Study addiction: A cross-cultural longitudinal study examining temporal stability and predictors of its changes. Journal of Behavioral Addictions, 5, 357–362.

  • Background and aims: ‘Study addiction’ has recently been conceptualized as a behavioral addiction and defined within the framework of work addiction.  Using a newly developed measure to assess this construct, the Bergen Study Addiction Scale (BStAS), the present study examined the one-year stability of study addiction and factors related to changes in this construct over time, and is the first longitudinal investigation of study addiction thus far. Methods: The BStAS and the Ten Item Personality Inventory (TIPI) were administered online together with questions concerning demographics and study-related variables in two waves. In Wave 1, a total of 2,559 students in Norway and 2,177 students in Poland participated. A year later, in Wave 2, 1,133 Norwegians and 794 Polish who were still students completed the survey. Results: The test-retest reliability coefficients for the BStAS revealed that the scores were relatively stable over time. In Norway scores on the BStAS were higher in Wave 2 than in Wave 1, while in Poland the reverse pattern was observed. Learning time outside classes at Wave 1 was positively related to escalation of study addiction symptoms over time in both samples. Being female and scoring higher on neuroticism were related to an increase in study addiction in the Norwegian sample only. Conclusion: Study addiction appears to be temporally stable, and the amount of learning time spent outside classes predicts changes in study addiction one year later.

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

Further reading

Greenhill, R. & Griffiths, M.D. (2014). The use of online asynchronous interviews in the study of paraphilias. SAGE Research Methods Cases. Located at:

Greenhill, R. & Griffiths, M.D. (2016). Sexual interest as performance, intellect and pathological dilemma: A critical discursive case study of dacryphilia. Psychology and Sexuality, 7, 265-278.

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

Griffiths, M.D. (1999). Dying for it: Autoerotic deaths. Bizarre, 24, 62-65.

Griffiths, M.D. (2001). Stumped! Amputee fetishes. Bizarre, 44, 70-74.

Griffiths, M.D. (2001). Heaven can wait: The psychology of near death experiences. Bizarre, December, 63-66.

Griffiths, M.D. (2012). The use of online methodologies in studying paraphilia: A review. Journal of Behavioral Addictions, 1, 143-150.

Griffiths, M.D. (2013). Bizarre sex. New Turn Magazine, 3, 49-51.

Griffiths, M.D. (2013). Eproctophilia in a young adult male: A case study. Archives of Sexual Behavior, 42, 1383-1386.

Under the influence: Ten things I’ve learned from David Bowie

It’s now been a year since the tragic death of David Bowie and this is my fourth blog on him in that period (my others being my personal reflections on the psychology of Bowie, Bowie and the Beatles, and Bowie and the occult). Outside of my own friends and family, it’s still Bowie’s death that has affected me the most psychologically but at least I still have his music to listen to. Bowie inspired millions of people in many different ways. This blog looks at the things that I have learned from Bowie and how he influenced my career.

Persevere with your life goals – Most people are aware that it took years for Bowie to have has first hit single (‘Space Oddity’, 1969), five years after his first single (‘Liza Jane’, 1964). Even after the success of ‘Space Oddity’, it took another three years before he had his second hit single (‘Starman’, 1972) and in the early 1970s there were many who thought he would be a ‘one-hit wonder’ and a small footnote in music history. Bowie never gave up his quest for musical stardom and is arguably one of the best examples of the proverb If at first you don’t succeed, try, try again. I’ve often told others that they key to success is being able to learn from your mistakes and being able to handle rejection (which for academics is having papers rejected, grant bids rejected, and attempts at promotion rejected, etc.). Bowie personified perseverance and for this quality alone I am very grateful as it has been the bedrock of my career to date.

Encourage teamwork and collaboration – Despite being a solo artist for the vast majority of his post-1969 career (Tin Machine being the most high-profile notable exception), Bowie was (like me) a ‘promiscuous collaborator’ and much of his success would not have been possible without a gifted team around him whether it be his inner circle of musicians (Mick Ronson, Carlos Alomar, Robert Fripp, Mike Garson, etc.), his producers (Tony Visconti, Nile Rogers, Ken Scott, etc.), co-writers and inspirators (Iggy Pop, Lou Reed, Brian Eno, John Lennon, etc.), or those he jointly released music with (Mott The Hoople, Queen, Arcade Fire, Pet Shop Boys, Placebo, to name just a few). I have carried out and published research with hundreds of people during my 30-year academic career, and like Bowie, some are one-off collaborations and others are lifelong collaborations. Bowie taught me that although I can do some things by myself, it is the working with others that brings out the best in me.

Experiment to the end – Bowie was never afraid to experiment and try new things whether it was musical, pharmacological, spiritual, or sexual. Mistakes were part of the learning process and he pursued this – especially musically – until the very end of his life (for instance, on his ★ [Blackstar] album where he employed a local New York jazz combo led by saxophonist Donny McCaslin). Failure is success if we learn from it and this is one of the maxims that I live my life by. Bowie taught me that you can have lots of other interests that can be rewarding even if you are not as successful as your day job. Bowie liked to act (and obviously had some success in this area) and also liked to paint (but had much less success here than his other artistic endeavours). By any set of criteria, I am a successful academic but I also like to write journalistically and engage in a wide variety of consultancy (areas that I have had some success) and I like writing poetry (something that I have not been successful financially – although I did win a national Poetry Today competition back in 1997 and have published a number of my poems). Bowie taught me that success in one area of your life can lead to doing other more experimental and rewarding activities even if they are not as financially lucrative.


Push yourself (even in the bad times) – One of the things I love about Bowie was his ability to carry on working and being productive even when he was not at his physical best. Nowhere is this more exemplified than working on the ★ LP while undergoing chemotherapy for his liver cancer. There are also other times in his life such as when he was at the height of his cocaine addiction in 1975 where he produced some of the best music of his career (most notably the Young Americans and Station to Station LPs, the latter of which is one of my all-time favourite records). I have had a few low periods in my life due to various health, relationship and/or personal issues but I have learned through experience that work is a great analgesic and that even when you are at your lowest ebb you can still be highly productive.

Have a Protestant work ethic – Bowie was arguably one of the most hard-working musicians of all time and had what can only be described as a Protestant work ethic from the early 1960s right up until his heart attack in 2004. I am a great believer in the philosophy that “you get out what you put in” and Bowie exemplified this. Andy Warhol told Lou Reed while he was in the Velvet Underground that he should work hard, because work is all that really matters (and was the subject of the song ‘Work’ on the seminal Songs For Drella LP by Reed and John Cale). Bowie also appeared to live by this mantra and is something that I adhere to myself (and is why I am often described as being a workaholic). While Bowie isn’t my only role model in this regard, he’s certainly the most high-profile.

Lead by example but acknowledge your influences – Bowie had a unique gift in being able to borrow from his own heroes but turn it into something of his own (without ever forgetting his own heroes and influences – his Pin Ups LP probably being the best example of this). One of my favourite phrases is Don’t jump on the bandwagon, create it”, and this has as underpinned a lot of the research areas that I have initiated and is something that I learned from Bowie. Maybe Bowie is a case of the quote often attributed to Oscar Wilde that “talent borrows, genius steals”.

Promote yourself – If there is one thing that Bowie was gifted in as much as his songwriting, it was his own art of self-promotion. Bowie always had the knack to generate news stories about himself and his work without seemingly trying. By the end of his career, it was the act of not saying anything or doing any personal publicity that was just as newsworthy. Bowie intuitively knew how to garner media publicity on his own terms in a way that very few others can. (I also argued that another one of my heroes – Salvador Dali – did the same thing in one of my articles on him in The Psychologist back in 1994). I’d like to think I am good at promoting my work and Bowie is one of my role models in this regard.

Be opportunistic and flexible – If there is one thing besides working hard that sums up my career to date, it is being opportunistic and flexible. As a voracious reader of all things Bowie since my early teens, I always loved Bowie’s sense of adventure and just following paths because they might lead you to something unexpected. Whether it was his use of the ‘cut up’ technique for writing lyrics (developed by Brion Gysin and William S. Burroughs), his use of Brian Eno’s ‘oblique strategy’ cards, or his love of studio improvisation (such as on the Berlin trilogy albums and the Outside LP), Bowie showed that inspiration for his musical and lyrical ideas could come from anywhere – from a person, from a fleeting observation, from something he read, from something he heard or saw in film or TV programme, and from his own life experiences. I too have taken this approach to my work and believe I am a much better person for it.

Be a mentor to others – Whatever career path you follow, mentors are key in developing talent and Bowie was a mentor to many people that he personally worked with (including many of the artists I named in the section on encouraging teamwork and collaboration above) as well as being an inspirational influence to those he never met (including myself).

Learn from those younger and less experienced than yourself – Paradoxically, despite being an influence on millions of people across many walks of life, Bowie was never afraid to learn from those much younger than himself and exemplified the maxim that you’re never too old to learn new things. He loved innovation and ideas and would soak it up from whoever was around him. As I have got older, this is something that I value more and am never afraid to learn from those much younger or seemingly less experienced than myself – particularly my PhD students.

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

Further reading

Buckley, D. (2005). Strange Fascination: David Bowie – The Definitive Story. London: Virgin Books.

Cann, K. (2010). Any Day Now: David Bowie The London Years (1947-1974). Adelita.

Goddard, S. (2015). Ziggyology. London: Ebury Press.

Griffiths, M.D. (1994). Heroes: Salvador Dali. The Psychologist: Bulletin of the British Psychological Society, 7, 240.

Hewitt, P. (2013). David Bowie Album By Album. London: Carlton Books Ltd.

Leigh, W. (2014). Bowie: The Biography. London: Gallery.

Pegg, N. (2011). The Complete David Bowie. London: Titan Books.

Seabrook, T.J. (2008). Bowie In Berlin: A New Career In A New Town. London: Jawbone.

Spitz, M. (2009). Bowie: A Biography. Crown Archetype.

Trynka, P. (2011). Starman: David Bowie – The Definitive Biography. London: Little Brown & Company.

Betting kicks in flicks: A brief look at gambling on film

As a researcher in the gambling studies field and an avid watcher of films, it comes as little surprise that I love watching films where gambling is key to the plot. Occasionally, I write academic papers about gambling portrayals in film (most notably an in-depth look at my favourite gambling film, The Gambler – the original 1974 film starring James Caan in the title role and not the more recent 2014 remake starring Mark Wahlberg – which I published in a 2004 issue of the International Journal of Mental Health and Addiction). I wrote about this paper in a previous blog and I have also written a few blogs where gambling films are central to the articles such as my blog on Philip Seymour Hoffman and his film Owning Mahowny, my blog on the psychology of Columbo (where I argued that gambling and gamblers are central to many of the plot lines), and my blog on the psychopathology of Star Wars (where problem gambling is one of the many disorders that features in the film’s franchise).


The world of gambling and gamblers has been portrayed in many films and in many different ways throughout the years (e.g., The Sting, The Cincinnati Kid, Casino, Owning Mahoney, Rain Man). However, I argued (way back) in a 1989 issue of the Journal of Gambling Behavior that many of these film representations tend to cast gambling in an innocuous light, and often portray gamblers, largely male, as hero figures. I made this observation without doing any systematic review of films containing gambling and my thoughts were purely impressionistic.

A decade ago, Dr. Nigel Turner and his colleagues published a lovely study in the Journal of Gambling Issues examining ‘images of gambling’ in films. They built on Jeffrey Dement’s 1999 book Going for broke: The depiction of compulsive gambling in film. They noted that:

“Dement’s (1999) book, Going for Broke is a thorough examination of movies that depict pathological gambling. He examined a number of films in terms of the extent to which the portrayals delivered accurate and appropriate messages about problem gambling. Although some movies accurately portray the nature of pathological gambling at least during some segments, Dement found that many movies about pathological gambling had irresponsibly happy endings. Film images in some cases reflected societal views on gambling. However, images in films may also alter societal views of gambling (Dement, 1999)…Dement focused only on movies that were about problem and pathological gambling. Many films that depict gambling or have images of gambling that are not about pathological gambling per se. In [our] article we will extend Dement’s work by looking more broadly at films about gambling”.

In their study, Turner and colleagues content analysed 65 films (from an initial list of “several hundred films”) mainly from the two decades prior to the publication of the study. The authors recounted that:

Many of the films we discuss are personal favourites that we have watched several times (e.g., Rounders, The Hustler, Vegas Vacation, The Godfather). Some of the films reviewed in this article have been also discussed by [other scholars]. Some films were included because they were found listed as gambling films in film catalogues or by Web searches for ‘gambling movies’ (e.g., Get Shorty). Other films were suggested to us by recovering pathological gamblers, counsellors specializing in problem gambling, recreational gamblers, video rental store employees, and postings to the bulletin board of Gambling Issues International (a listserve for gambling treatment professionals). Our examination of movies was restricted to movies released in cinemas (i.e., not television), and filmed in English (with one exception, Pig’s Law)…In all cases, either the first or second author viewed each film. In some cases both authors viewed the same film separately. The authors then discussed the themes that they thought were depicted in the film. The authors then collected the descriptions of movies and organized them into general themes”. 

After viewing (and re-viewing) the films, the authors found eight themes (often overlapping) represented in the movies watched. More specifically these were the themes of: (1) pathological gambling (films such as Fever Pitch, The Gambler, Owning Mahowny, Pig’s Law, etc.), (2) the magical skill of the professional gambler (Rain Man, Two For The Money, The Cincinatti Kid, Maverick, etc.), (3) miraculous wins as happy endings (The Cooler, The Good Thief, Two For The Money, etc.), (4) gamblers are suckers (Casino, Croupier, Two For The Money, etc., (5) gamblers cheat (Rounders, The Sting, House of Games, The Grifters, etc.), (6) gambling is run by organized crime (The Godfather, Casino, Get Shorty, etc.), (7) the casino heist (Ocean’s Eleven, The Good Thief, Croupier, etc.), and (8) gambling as a symbolic backdrop to the story (Leaving Las Vegas, Pay It Forward, Fear and Loathing in Las Vegas, etc.).

After this initial content analysis, Dr. Turner and his colleagues organized these eight themes into a general taxonomy of films. They reported that:

“First these films can be divided into two categories: films in which gambling is a central focus of the film, and others where gambling is a relatively minor topic but serves a symbolic role in the film. The films that are about gambling can be further divided into those that present generally negative views of gambling (e.g., pathology, crime, cheating) and those that present a generally positive image of gambling (e.g., magical skills and miraculous wins). The positive image is mainly related to the ability of the player to win (by skill or by miracle), but some of these films also add additional positive images by hinting at a glamorous and exciting lifestyle (The Good Thief, James Bond films, Rounders). Negative images of gambling are more common than positive images of gambling. Negative images were further divided into pathological gambling, suckers, cheaters, organized crime, and robbing casinos”.

They also go on to note that: very few films show ordinary people gambling non-problematically:

“Throughout the history of movies, gambling-related stories have been present. Movies about gambling are most often inhabited by problem gamblers (e.g., The Gambler), cheats (e.g., Shade), criminals (e.g., The Godfather, Ocean’s Eleven), spies (e.g., Diamonds are Forever), people with incredible luck (e.g., Stealing Harvard), and professional gamblers (e.g., Rounders, The Hustler). With the exception of The Odd Couple (1968), we have come across few movies that show ordinary people gambling in a non-problematic manner”.

With regards to problem and pathological gambling they conclude that:

“Some movies provide important insights into the nature of pathological gambling (e.g., The Gambler, Owning Mahowny, The Hustler). However, others make light of the disorder or indulge in the wishful thinking common with pathological gamblers (e.g., Let It Ride, The Cooler, Fever Pitch, The Good Thief). In some movies people develop a problem too quickly (Viva Rock Vegas, Lost in America). Some films take the view that all gamblers are addicted (Croupier, Two for the Money)…Most films about pathological gambling depict a narrow segment of the problem gambling population focusing on the male “action” gambler (see also Griffiths, 2004). Most pathological gamblers simply do not embezzle millions of dollars as in Owning Mahowny or take stupid risks just for the thrill of it as in The Gambler. Films rarely show gamblers hooked on slot machines or other electronic gambling machines even though such machines, where they are available, now account for a majority of problem gamblers in treatment”.

Obviously the sample of films chosen was selective and there were over a hundred films that weren’t analysed. However, even though the study was published ten years ago I don’t think the results (if repeated on more contemporary films) would be particularly different.

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

Further reading

Dement, J.W. (1999) Going for broke: The depiction of compulsive gambling in film. Lanham, MD: The Scarecrow Press, Inc.

Griffiths, M.D. (1989). Gambling in children and adolescents. Journal of Gambling Behavior, 5, 66-83.

Griffiths, M. (2004). An empirical analysis of the film ‘The Gambler’. International Journal of Mental Health and Addiction, 1(2), 39-43.

Gluss, H.M. & Smith, S.E., (2002). Reel people: Finding ourselves in the movies. Keylight: Los Angeles.

Turner, N. E., Fritz, B., & Zangeneh, M. (2007). Images of gambling in film. Journal of Gambling Issues, 20, 117-143.

Aid and a bet: Can personalised feedback help online gamblers play more responsibly?

In recent years, online gambling has become a more common leisure time activity. Research around the world suggests around 8-16% of adults have gambled online during the past year. Research has also demonstrated that there are a number of situational and structural characteristics that make online gambling potentially risky for susceptible and vulnerable individuals. Such factors include increased accessibility, affordability, anonymity and specific structural features of online games such as high event frequency. In addition, some forms of online gambling may be more problematic than others (e.g., online poker, online casino games).

A number of scientific studies have also shown that there are typically more problematic gamblers among those that gamble on the internet compared to those that only gamble in land-based venues. However, problem gambling severity is associated with overall engagement and that when the volume of gambling is controlled for, Internet gambling is not predictive of problems. Furthermore, most online gamblers are also offline gamblers and gamble on many different activities and across different gambling platforms.

Given the increasing number of people gambling online and issues surrounding problem gambling, many of the more socially responsible gambling companies around the world have started to use responsible gambling tools to help their clientele gamble more safely (such as the option to set time and money spending limits or to temporarily self-exclude from gambling for a day, week, month, or longer). In fact, one of our own studies recently demonstrated that the use of both time and money spending limits are most effective among gamblers that play most frequently, and that the effects are differential. For instance, time spending limits were most useful for online poker players and monetary spending limits were most useful for online casino players.

In addition, gamblers can now access and/or are given general advice on healthy and responsible gambling, as well as information about common misbeliefs and erroneous perceptions concerning gambling. However, findings on the effectiveness of providing gamblers with information in correcting or changing erroneous beliefs have been mixed. Some outcomes support the display of information, while other studies have reported non-significant results.

Studies have also shown that the way information is presented can significantly influence behaviour and thinking. Several studies have investigated the effects of interactive versus static pop-up messages during gambling sessions. Static messages do not appear to be effective, whereas interactive pop-up messages and animated information have been shown to change both irrational belief patterns and behaviour of gamblers. It has also been suggested that informational warning signs should promote the application of self-appraisal and self-regulation skills rather than the simple provision of information.

In one of our more recent studies, we investigated the effect of a pop-up message that appeared after 1,000 consecutive online slot machine games had been played during a single gambling session using behavioural tracking data. Our study analysed 400,000 gambling sessions (200,000 sessions before the pop-up had been introduced and 200,000 after the pop-up had been introduced). We found that the pop-up message had a limited effect on a small percentage of players. Although the study reported nine times as many gamblers stopped after 1000 consecutive plays compared to those gamblers before the introduction of the pop-up message, the number of gamblers that actually stopped after viewing the pop-up message was less than 1%.

In a follow-up study, we investigated the effects of normative and self-appraisal feedback in a slot machine pop-up message compared to a simple (non-enhanced) pop-up message. The study compared two representative random samples of 800,000 gambling sessions (i.e., 1.6 million sessions in total) across two conditions (i.e., simple pop-up message versus an enhanced pop-up message). The results indicated that the additional normative and self-appraisal content doubled the number of gamblers who stopped playing after they received the enhanced pop-up message (1.39%) compared to the simple pop-up message (0.67%). Like our previous study, the findings suggested that pop-up messages influence only a small number of gamblers to cease long playing sessions but that enhanced messages are slightly more effective in helping gamblers to stop playing within-session. Our two studies evaluating pop-up messages are the only published studies that examine the impact of messaging on actual gamblers in a real world online gambling environment.

In order to make individuals gamble more responsibly using behavioural tracking data, we believe that player feedback should also be presented in a motivational way. In practical terms, this means presenting messages in a non-judgmental way alongside normative data so that gamblers can evaluate their actions compared to other like-minded individuals. One of our most recent studies examined personalised feedback and information given to players during real world gambling sessions. We hypothesized that gamblers receiving tailored feedback about their online gambling behaviour would be more likely to change their behaviour (as measured by the amount of time and money spent) compared to those who did not receive tailored feedback.

We were given access to the behavioural tracking data of 1,358 gamblers at a European online gambling website that had voluntarily signed up to a behavioural feedback system that we developed (called mentor) that is offered to all customers on the website. The system is an opt-in system (i.e., gamblers can voluntarily choose to use it and the system is not mandatory). Once gamblers have enrolled to use the system, they can retrieve detailed visual and numerical feedback about their gambling behaviour via a button on the website. Player feedback is displayed in a number of ways (numerical, graphical, and textual) and provides information about wins and losses, playing duration, number of playing days, and games played. The system can also display personal gambling behaviour over time. For instance, Figure 1 shows the playing time information for a hypothetical player in the form of a graph over time.

At the top of the screen, players receive information about playing time over the previous 4-week and 24-week period. The white line in Figure 1 indicates that the player shows an upward trend and is steadily increasing the amount of time spent gambling. During the previous 4-week period, the player spent 25.75 hours gambling online. The upper line in Figure 1 is the average playing time for all other comparable online players (depending upon what types of game are typically played) and provides the gambler both normative and comparative feedback. Such feedback has been emphasized as an important aspect in facilitating behavioural change. Players are either assigned to ‘lottery’ type players or ‘casino’ type players based on their playing patterns.

Of the daily active players, 10% (n=1,358) opted into the system. Players could opt-in via a clearly visible button on the post-login website page which appeared immediately after they logged into their account. The personalised information appeared in a new pop-up window. This typically led to a break in play, as gamblers who viewed the information are unlikely to play and view information simultaneously. The system tracks those players who sign up and therefore the opt-in date is known and can also be used for analytical purposes.

All the visual, numerical, and textual information can be accessed by the gambler via a user-friendly on-screen dashboard. Responsiveness means that interactive content automatically adapts to technical environments. The player front end thus looks similar on different devices such as desktops, laptops, mobile phones, or tablets and also across different browsers and operating systems such as Windows, Android or iOS.

We investigated whether players’ behaviour changed after they have registered for the mentor system and saw the personalised feedback for the first time. We then compared their gambling behaviour with over 15,000 online gamblers displaying the same types of gambling behaviour (i.e., matched controls). Our results indicated that the personalised feedback system achieved the hypothesised effect and that the time and money spent gambling was significantly reduced compared to the online gambler control group that did not utilize the mentor system. The results suggest that responsible gambling tools such as mentor may help the clientele of gambling companies gamble more responsibly, and may be of help those who gamble excessively.

To our knowledge, this study was the first real world study investigating the effects of behavioural feedback on actual gambling behaviour within a real online gambling website. However, there were a number of limitations. For instance, all of the players in the target population had voluntarily registered to use the mentor system and were therefore not selected randomly from the population of players (but we tried to overcome this by using a control group of matched pairs). In addition, the reliability of our findings is limited because our data were only collected from one online gambling environment. It may also the case that players who voluntarily signed up to receive personalised messages about their gambling were different in other ways from controls (i.e., gamblers who voluntarily signed up to receive personalised messages may have already been interested in reducing their gambling and would be likely to gamble less).

Another limitation is that we did not know whether any of the gamblers who voluntarily opted to use the mentor system were problem gamblers. Therefore we do not know whether the system captures gamblers most in need of such interventions. Based on the findings, one explanation may be that the tool may simply be curtailing gambling in those who already play responsibly. Although our study was performed in a real world setting utilising objective behavioural data, it is limited because the motivations and thoughts of the players were unknown and can only be inferred.

Online gambling operators have the technical capabilities to introduce behavioural feedback systems such as the one we described in our paper, and our findings suggest that a system like mentor can help players limit the amount of time and money spent gambling can be achieved. However, the findings are preliminary and future research should focus on investigating at which point in time players should receive personalised messages to optimize behavioural change.

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

Further reading

Auer, M. & Griffiths, M. D. (2013). Voluntary limit setting and player choice in most intense online gamblers: An empirical study of gambling behaviour. Journal of Gambling Studies, 29, 647-660.

Auer, M. & Griffiths, M. D. (2014). Personalised feedback in the promotion of responsible gambling: A brief overview. Responsible Gambling Review, 1, 27-36.

Auer, M. & Griffiths, M. D. (2015). Testing normative and self-appraisal feedback in an online slot-machine pop-up message in a real-world setting. Frontiers in Psychology, 6, 339. doi: 10.3389/fpsyg.2015.00339.

Auer, M. & Griffiths, M. D. (2015). The use of personalized behavioral feedback for problematic online gamblers: An empirical study. Frontiers in Psychology, 6, 1406. doi: 10.3389/fpsyg.2015.01406.

Auer, M. & Griffiths, M.D. (2016). Personalized behavioral feedback for online gamblers: A real world empirical study. Frontiers in Psychology, 7, 1875. doi: 10.3389/fpsyg.2016.01875. 

Auer, M., Littler, A. & Griffiths, M.D. (2015). Legal aspects of responsible gaming pre-commitment and personal feedback initiatives. Gaming Law Review and Economics, 6, 444-456.

Auer, M., Malischnig, D. & Griffiths, M.D. (2014). Is ‘pop-up’ messaging in online slot machine gambling effective? An empirical research note. Journal of Gambling Issues, 29, 1-10.

Leisure pleasure treasure: A brief look at gambling within videogames

Over the last decade, gambling and gaming technologies have begun to converge with video games featuring gambling-like elements, and gambling games featuring video gaming-like elements. Many of the newer convergent gambling-gaming convergent forms include such activities as online penny auctions and gambling-type activities on social networking sites, so-called ‘social gaming’. With regard to video gaming including gambling-like elements, a paper that I co-wrote in 2012 with Dr. Daniel King in the journal International Gambling Studies noted that simulated gambling activities and gambling themes have a substantial presence in many modern video games. We noted that gambling content in video games can be categorized according to the following three categories:

  • Standard gambling simulation, a digitally simulated interactive gambling activity that is structurally identical to the standard format of an established gambling activity, such as blackjack or roulette;
  • Non-standard gambling simulation, an interactive gambling activity that involves the intentional wagering of in-game credits or other items on an uncertain outcome, in an activity that may be partially modelled on a standard gambling activity but which contains distinct player rules or other structural components that differ from established gambling games;
  • Gambling references, the appearance of non-interactive gambling material or gambling-related paraphernalia/materials within the context of the video game.

In regard to the second of these categories, it could be argued that some online video games feature mini-games that are non-standard gambling simulations. For instance, in February 2014, the mini-game Treasure Hunter (TH) was introduced into the online video game Runescape. To get in-game prizes, players have to get keys to open chests. Originally, to participate in TH, players had to play in a members’ world. Players that tried to play TH in a free world are given the message: “As a member, you are eligible for improved prizes, so please play Treasure Hunter on a members’ world instead.” However, in April 2014, TH was reformulated and for the first time, members’ prizes could be claimed by those playing in a free world also.


In TH, five chests can be opened, each containing one of five different gems (going from most common to least common – white, yellow, orange, red, or purple gem – with white being the most common and purple being the rarest). After obtaining a key, players select a chest (not knowing what gem is inside the chest), and open it. The player is then given the option of storing the prize in the bank, discarding the prize, collecting the prize later, or cashing out for a small number of coins. There are a number of different ways to gain TH keys (free daily keys, keys obtained through skilful gameplay, and buying keys). Members get two free keys a day and those playing in free worlds only get one free key a day. Those players paying to be in the silver or gold Premier Club get three free keys a day.

It should also be noted that (i) TH is reset every night at midnight, (ii) free keys have to be used on the day, (iii) one monthly free key can be earned by playing ‘Troll Invasion’, (iv) players can buy bonds for gold coins or money, and (v) a random number generator is used to determine the winners. After completing any daily challenge, players receive an extra key, and after completing any in-game quest, players receive two additional keys. Keys can be bought in bundles of 15 (€3.99), 35 (€8.00), 75 (€16.00), 200 (€39.99) or 450 keys (€79.99). The maximum number of keys that could be bought is $200 (US) a day and $500 (US) a week. Keys can also be earned by watching advertisements, buying products, and completing surveys (and accessed via the ‘Earn keys’ option). TH prizes include in-game skilling items, weapons, bonus experience stars, etc. or can be converted to coins.

The legal definition of gambling in Great Britain is contained in the Gambling Act 2005. It notes that gambling includes “gaming”, “betting” or “participating in lottery”. Gaming is defined in the 2005 Act as “playing a game of a chance for a prize” while betting involves the process of placing or accepting a bet on anything other than financial services that remains uncertain to at least one party of the transaction at the time of the bet. By this definition alone, it would appear that Treasure Hunter is a form of gambling if purchases to participate are made (rather than being given free spins or keys, or earning them through skilful gameplay).

In 2015, the UK Gambling Commission highlighted that they believe the mini-games within Runescape to be ‘social gaming’ and not a game of chance and therefore out of their jurisdiction in relation to the regulation of the game. They have also claim that RuneScape bonds have no intrinsic value outside of Runescape under the terms of the British Gambling Act and therefore is not gambling. The Gambling Commission also note on their website that:

“We are not saying there are no risks in social gaming, nor are we saying that this ends our interest in the issue. We are simply saying that our current assessment of the available evidence is that there is no persuasive reason for us to take regulatory action, in effect to change from maintaining a watching brief. We will continue to monitor emerging evidence, and we are prepared to change this position if the evidence warrants it”.

However, there are instances when the bonds and prizes won do have value outside of the game. Bonds that are purchased with real life currency can be sold to another player for an in-game sum of money. Bonds and prizes can also be redeemed within the game for real-life services. These services are not just limited to the buying of game-related merchandise, such as the buying of card games like Top Trumps, but also includes attendance at offline RuneScape events, such as RuneFest, hotel rooms, and even plane tickets. The bonds can also be used to pay for postage and packing of items bought outside the game. Players can also donate the bonds to charity (in which Jagex contributes the full value of the bond to the charity chosen by the player). These examples clearly demonstrate that the bonds do have specific financial value outside the game in some circumstances, and an impact on real-world activities. More specifically, they demonstrate that the financial value of the bonds and prizes can be used outside the game itself.

Mini-games like Treasure Hunter within the online game RuneScape are not uncommon and are another example of convergence between gambling and video gaming. These games appear to meet the criteria for gambling found in the gambling studies literature and should be regulated as such.

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

Further reading

Gambling Commission (2015). Explaining our approach to social gaming. Located at:

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

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

Griffiths, M.D. & Carran, M. (2015). Are online penny auctions a form of gambling? Gaming Law Review and Economics, 19, 190-196.

Griffiths, M.D., King, D.L. & Delfabbro, P.H. (2009). Adolescent gambling-like experiences: Are they a cause for concern? Education and Health, 27, 27-30.

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

Griffiths, M.D. & King, R. (2015). Are mini-games within RuneScape gambling or gaming? Gaming Law Review and Economics, 19, 64-643.

King, D.L., Delfabbro, P.H., Derevensky, J. & Griffiths, M.D. (2012). A review of Australian classification practices for commercial video games featuring simulated gambling. International Gambling Studies, 12, 231-242.

Gore-ist information: A brief look at virtual reality horror games

“I recently played ‘The Visitor’ in VR. In front of an audience of drunken friends egging on my high pitch outbursts. I lasted seven out of the ten minutes, finally succumbing after a close encounter with a pixelated pillow. The Visitor’s story is about an unexpected guest calling to your house in the middle of the night. Developed by ‘NostalgicBear VR’ for the ‘Oculus Rift’ and ‘HTC Vive’ it relies on atmosphere to unsettle players, using visual cues in the form of intermittent flickering lights to inform the player where to look. Paralysed and lying in bed, you can only wait and watch as the strange occurrences culminate in one of the biggest jump scares I’ve ever experienced. As virtual reality goes, this particular experience has a high creep factor. It’s one of those new VR ‘games’ that really should come with a free pair of pants…In the wake of the PlayStation VR release, headed up by the dark and psychological Here They Lie, pretty much every major gaming outlet slashed their prices on horror games and gamers all over the world have been celebrating Halloween with their first exposure to a virtual reality freak out…VR grips the gamer with such a suspension of disbelief; when the headset is on there is seemingly no escape. Do developers take into account the psychological differences between previous gaming horror experiences and that of VR?”

The opening quote in today’s blog is from an article by Gareth May published last month for the Wareable website (‘Could VR horror be too…horrifying?’). I was interviewed by May for the story and is one of a number of media stories that I have been interviewed over the last year concerning virtual reality. Regular readers of my blog will know that I have a personal interest in horror films and a professional interest in excessive use of virtual reality so it was an interview I enjoyed doing (in fact, May interviewed me for two stories simultaneously, the other being on mechanophilia – sexual arousal from machines – which also was published last month in an article in the Daily Telegraph).

In his article on VR horror, May wanted to know about whether the playing of VR horror games could be problematic in any way (or as May asked me, ‘Is it possible that VR is just a bit too ‘real’?’). I pointed out that there had been little empirical research on the topic and that almost everything that I said was speculative. I noted that while VR is certainly more immersive than usual, we should remember that immersion can occur even without being in an VR environment. For instance, a lot of my research into video gaming demonstrates that gaming can be immersive (particularly the research I have been carrying out with Dr. Angelica Ortiz de Gortari on game transfer phenomena and some research I co-authored in the mid-2000s on time loss in video game play). I did point out to May that for most people, there’s not going to be a problem with playing VR horror games. Those that already enjoy watching horror films, the vast majority will probably love it even more in VR and it’s not going to have a negative impact on them. I told May that I loved gore in horror films and said that I would probably be fine playing an immersive horror VR game and that seeing somebody being disembowelled in front of me would have little effect on me psychologically. (However, I ought to point out that my few experiences of VR have left me feeling sick as I suffer from motion sickness). However, you can never rule out a small minority of individuals that it may negatively affect either psychologically or traumatically. In short, I don’t have many concerns about this until scientific evidence proves otherwise.

May also interviewed Professor Tanya Krzywinska, Director of the Games Academy at Falmouth University who thinks that VR and horror video games are a good match:

“VR is the next natural step for one of gaming’s most popular genres. Horror made its way into video games very early on [such as] the 1995 point and click ‘Phantasmagoria’ [was] an early breakthrough game due to its use of video snippets to show a ‘real’ actress reacting to the horrific events as they unfolded around her…’Silent Hill’ [was also] a game-changer for its use of sound and its surreal ‘Twin Peak-ish twist’ on survival horror. Both these games utilise a particular emotional palette that I regard as central to games: a sense of claustrophobia and the sense of being unable to act effectively on a situation…VR can make very good use of this palette because of its immersive nature and I think horror is one of the few genres that VR really suits…Horror is very inclined to want to take advantage of new formats to refresh the palette and work with the cache that the novelty provides. Without that novelty, repetition occurs and you then only manage to engage younger audiences who haven’t been around the horror block. Horror is a very suitable place to take a good, long, critical look at ethics and I hope that some game designers see that”.

So is the introduction of VR for the horror genre a game-changer? May also interviewed the independent games developer Sergio Hidalgo, creator of the creepy dungeon game Dreadhalls. He was quoted as saying:

“VR can work as an immersion multiplier, and given that the horror genre is built on immersion, it simply opens more opportunities to create experiences that take advantage of that sense of physicality it can provide. Simply being in a scary environment can be a very engaging experience in VR on its own. This was already true when I started ‘Dreadhalls’ but the technology keeps moving forward and improving with new developments such as room scale or motion tracked controllers…In ‘Dreadhalls’ there are monsters that react to the player’s gaze direction, forcing the player to either not look at them directly or the opposite. This is a much richer interaction when the player is performing it herself rather than via a mouse or controller. ‘Dreadhalls would never have gathered such attention if it weren’t for the new types of interactions and features made possible by VR tech…The main ethical recommendation I have in this regard is that of not betraying the player’s trust. When the player enters a VR experience and surrenders control over their senses to the developer, it’s important that [the players are] aware of exactly what to expect, and that this promise isn’t broken by the developer”.


In an interview that May had with Ben Tester, the games developer of VR horror game Don’t Knock Twice, Tester noted:

“Developers are in a strange predicament where it’s now possible to make a game that’s too scary. For that reason, ‘Don’t Knock Twice’ includes traditional adventure gameplay elements, such as puzzle solving and environmental props, to aid storytelling and remind the player every once in a while that they are still playing a game. We want to make a great horror game that people will remember for sure but we don’t want to make it so uncomfortable that it makes it unplayable. In ‘Don’t Knock Twice’, we want to avoid the player going through a constant stream of scares one after another and instead, create an interesting and atmospheric environment which will creep out any horror enthusiast. It’s about finding the right balance between having a solid gaming experience and immersing the player in a terrifying horror situation…In the VR demo of ‘Don’t Knock Twice’, players can break down a door with an axe. [This often leads to players] leaning their heads forward and triggering the classic ‘Here’s Johnny’ moment [from ‘The Shining’], which only amplifies the jump scare which follows. A scare that wouldn’t have been half as effective if it was in traditional gaming style”.

Finally, May asked me for some advice for those who were scared witless by playing VR horror games. My quoted response? “Just shut your eyes”.

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

Further reading

Ashcroft, S. (2015). VR revenue to hit $21.8 billion by 2020. Wareable, July 29. Located at:

Griffiths, M.D. (2016). Can virtual reality be addictive? Virtual Reality News, June 28. Located at:

Juniper Research (2016). White paper: The rise of virtual reality. Available from:

May, G. (2016). Could VR horror be too…horrifying? Wareable, November 3. Located at:

Ortiz de Gortari, A.B. & Griffiths, M.D. (2015). Game Transfer Phenomena and its associated factors: An exploratory empirical online survey study. Computers in Human Behavior, 51, 195-202.

Ortiz de Gortari, A.B., Oldfield, B. & Griffiths, M.D. (2016). An empirical examination of factors associated with Game Transfer Phenomena severity. Computers in Human Behavior, 64, 274-284.

Ortiz de Gortari, A.B., Pontes, H.M. & Griffiths, M.D. (2015). The Game Transfer Phenomena Scale: An instrument for investigating the non-volitional effects of video game playing. Cyberpsychology, Behavior and Social Networking, 18, 588-594.

Stables, J. (2016).  Gambling, gaming and porn: Research says VR is set to blast off. Wareable, September 15. Located at:

Sung, D. (2015). VR and vice: Are we heading for mass addiction to virtual reality fantasies? Wareable, October 15. Located at:

Tractica (2015). Virtual reality for consumer markets. Available at:

Wood, R.T.A. & Griffiths, M.D. (2007). Time loss whilst playing video games: Is there a relationship to addictive behaviours? International Journal of Mental Health and Addiction, 5, 141-149.

Wood, R.T.A., Griffiths, M.D. & Parke, A. (2007). Experiences of time loss among videogame players: An empirical study. CyberPsychology and Behavior, 10, 45-56.

More mass debating: Compulsive sexual behaviour and the internet

The issue of sex addiction as a behavioural addiction has been hotly debated over the last decade. A recent contribution to this debate is a review by Shane Kraus and his colleagues in the latest issue of the journal Addiction that examined the empirical evidence base for classifying compulsive sexual behaviour (CSB) as a behavioural (i.e., non-substance) addiction. The review raised many important issues and highlighted many of the problems in the area including the problems in defining CSB, and the lack of robust data from many different perspectives (epidemiological, longitudinal, neuropsychological, neurobiological, genetic, etc.).

As my regular blog readers will know, I have carried out empirical research into a wide variety of different behavioural addictions (gambling, video gaming, internet use, exercise, sex, work, etc.) and have argued that some types of problematic sexual behaviour can be classed as sex addiction depending upon the definition of addiction used. I was invited by the editors of Addiction to write a commentary on the review and this has just been published in the same issue as the paper by Kraus and colleagues. This blog briefly looks at the issues in that review that I highlighted in my commentary.

For instance, there are a number of areas in Kraus et al.’s paper that were briefly mentioned without any critical evaluation. For instance, in the short section on co-occurring psychopathology and CSB, reference was made to studies claiming that 4%-20% of those with CSB also display disordered gambling behaviour. I pointed out that a very comprehensive review that I published with Dr. Steve Sussman and Nadra Lisha (in the journal Evaluation and the Health Professions) examining 11 different potentially addictive behaviours also highlighted studies claiming that sex addiction could co-occur with exercise addiction (8%-12%), work addiction (28%-34%), and shopping addiction (5%-31%). While it is entirely possible for an individual to be addicted to (say) cocaine and sex concurrently (because both behaviours can be carried out simultaneously), there is little face validity that an individual could have two or more co-occurring behavioural addictions because genuine behavioural addictions consume large amounts of time every single day. My own view is that it is almost impossible for someone to be genuinely addicted to (for example) both work and sex (unless the person’s work was as an actor/actress in the pornographic film industry).

The paper by Kraus et al also made a number of references to “excessive/problematic sexual behavior” and appeared to make the assumption that ‘excessive’ behaviour is bad (i.e., problematic).  While I agree that CSB is typically excessive, excessive sex in itself is not necessarily problematic. Preoccupation with any behaviour in relation to addiction obviously needs to take into account the context of the behaviour, as the context is far more important in defining addictive behaviour than the amount of the activity undertaken. As I have constantly argued, the fundamental difference between a healthy excessive enthusiasms and addictions is that healthy excessive enthusiasms add to life whereas addictions take away from them.

The paper also appeared to have an underlying assumption that empirical research from a neurobiological and genetic perspective should be treated more seriously than that from a psychological perspective. Whether problematic sexual behaviour is described as CSB, sex addiction and/or hypersexual disorder, there are thousands of psychological therapists around the world that treat such disorders. Consequently, clinical evidence from those that help and treat such individuals should be given greater credence by the psychiatric community.


Arguably the most important development in the field of CSB and sex addiction is how the internet is changing and facilitating CSB. This was not even mentioned until the concluding paragraph yet research into online sex addiction (while comprising a small empirical base) has existed since the late 1990s including sample sizes of up to almost 10,000 individuals. In fact, there have been a number of recent reviews of the empirical data concerning online sex addiction including its treatment including ones by myself in journals such as Addiction Research and Theory (in 2012) and Current Addiction Reports (in 2015). My review papers specifically outlined the many specific features of the Internet that may facilitate and stimulate addictive tendencies in relation to sexual behaviour (accessibility, affordability, anonymity, convenience, escape, disinhibition, etc.). The internet may also be facilitating behaviours that an individual would never imagine doing offline such as cybersexual stalking.

Finally, there is also the issue of why Internet Gaming Disorder was included in the DSM-5 (in Section 3 – ‘Emerging measures and models’) but sex addiction/hypersexual disorder was not, even though the empirical base for sex addiction is arguably on a par with IGD. One of the reasons might be that the term ‘sex addiction’ is often used (and arguably misused) by high profile celebrities as an excuse to justify their infidelity (e.g., Tiger Woods, Michael Douglas, David Duchovny, Russell Brand), and is little more than a ‘functional attribution’. For instance, the golfer Tiger Woods claimed an addiction to sex after his wife found out that he had many sexual relationships during their marriage. If his wife had never found out, I doubt whether Woods would have claimed he was addicted to sex. I would argue that many celebrities are in a position where they are bombarded with sexual advances from other individuals and have succumbed. But how many people would not do the same thing if they had the opportunity? Sex only becomes a problem (and is pathologised) when the person is found to have been unfaithful. Such examples arguably give sex addiction a ‘bad name’, and provides a good reason for those not wanting to include such behaviour in diagnostic psychiatry texts.

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

Further reading

Bocij, P., Griffiths, M.D., McFarlane, L. (2002). Cyberstalking: A new challenge for criminal law. Criminal Lawyer, 122, 3-5.

Cooper, A., Delmonico, D.L., & Burg, R. (2000). Cybersex users, abusers, and compulsives: New findings and implications. Sexual Addiction and Compulsivity, 6, 79-104.

Cooper, A., Delmonico, D.L., Griffin-Shelley, E., & Mathy, R.M. (2004). Online sexual activity: An examination of potentially problematic behaviors. Sexual Addiction and Compulsivity, 11, 129-143.

Cooper, A., Galbreath, N., Becker, M.A. (2004). Sex on the Internet: Furthering our understanding of men with online sexual problems. Psychology of Addictive Behaviors, 18, 223-230.

Cooper, A., Griffin-Shelley, E., Delmonico, D.L., Mathy, R.M. (2001). Online sexual problems: Assessment and predictive variables. Sexual Addiction and Compulsivity, 8, 267-285.

Dhuffar, M. & Griffiths, M.D. (2015). A systematic review of online sex addiction and clinical treatments using CONSORT evaluation. Current Addiction Reports, 2, 163-174.

Griffiths, M.D. (2000).  Excessive internet use: Implications for sexual behavior. CyberPsychology and Behavior, 3, 537-552.

Griffiths, M.D.  (2001).  Sex on the internet: Observations and implications for sex addiction. Journal of Sex Research, 38, 333-342.

Griffiths, M.D. (2004). Sex addiction on the Internet. Janus Head: Journal of Interdisciplinary Studies in Literature, Continental Philosophy, Phenomenological Psychology and the Arts, 7(2), 188-217.

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

Griffiths, M.D. (2012). Internet sex addiction: A review of empirical research. Addiction Research and Theory, 20, 111-124.

Griffiths, M.D. (2016). Compulsive sexual behaviour as a behavioural addiction: The impact of the Internet and other issues. Addiction, 111, 2107-2109.

Griffiths, M.D. & Dhuffar, M. (2014). Treatment of sexual addiction within the British National Health Service. International Journal of Mental Health and Addiction, 12, 561-571.

Kraus, S., Voon, V., & Potenza, M. (2016). Should compulsive sexual behavior be considered an addiction? Addiction 111, 2097-2106.

Orzack M.H., & Ross C.J. (2000). Should virtual sex be treated like other sex addictions? Sexual Addiction and Compulsivity, 7, 113-125.

Sussman, S., Lisha, N. & Griffiths, M.D. (2011). Prevalence of the addictions: A problem of the majority or the minority? Evaluation and the Health Professions, 34, 3-56.

Van Gordon, W., Shonin, E., & Griffiths, M.D. (2016). Meditation Awareness Training for the treatment of sex addiction: A case study. Journal of Behavioral Addictions, 5, 363–372.