Category Archives: Alcohol

Higher and higher: Can psychoactive substance use enhance creativity?

In a previous blog I examined whether celebrities are more prone to addictions. In that article I argued that many high profile celebrities have the financial means to afford a drug habit like cocaine or heroin. For many in the entertainment business such as being the lead singer in a famous rock band, taking drugs may also be viewed as one of the defining behaviours of the stereotypical ‘rock ‘n’ roll’ lifestyle. In short, it’s almost expected. There is also another way of looking at the relationship between celebrities and drugs and this is in relation to creativity, particularly as to whether the use of drugs can inspire creative writing or music. For instance, did drugs like cannabis and LSD help The Beatles create some of the best music ever such as Revolver? Did the Beach BoysBrian Wilson’s use of drugs play a major role in why the album Pet Sounds is often voted the best album of all time? Did the use of opium by Edgar Allen Poe create great fiction? Did William S. Burroughs’ use of heroin enhance his novel writing?

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To investigate the question of whether drug use enhances creativity, I and my research colleagues Fruzsina Iszáj and Zsolt Demetrovics have just published a review paper in the International Journal of Mental Health and Addiction examining this issue. We carried out a systematic review of the psychological literature and reviewed any study that provided empirical data on the relationship between psychoactive substance use and creativity/artistic creative process that had been published in English in peer-reviewed journals or scientific books. Following a rigorous filtering process, we were surprised to find only 19 studies that had empirically examined the relationship between drug use and creativity (14 empirical studies and five case studies).

Six of the 19 studies (four empirical papers and two case reports) were published during the 1960s and 1970s. However, following the peak of psychedelia, only three papers (all of them empirical) were published in the following 20 years. Since 2003, a further 10 studies were published (seven empirical papers and three case studies). The majority of the studies (58%) were published in the USA. This dominance is especially true for the early studies in which six of the seven empirical papers and both case studies that were published before mid-1990s were written by US researchers. However, over the past 14 years, this has changed. The seven empirical papers published post-2000 were shared between six different countries (USA, UK, Italy, Wales, Hungary, Austria), and the three case studies came from three countries (USA, UK, Germany).

Seven empirical papers and two case studies dealt with the relationship between various psychoactive substances and artistic creation/creativity. Among the studies that examined a specific substance, six (three empirical papers and three case studies) focused on the effects of either LSD or psilocybin. One empirical study focused on cannabis, and one concerned ayahuasca.

With the exception of one study where the sample focused on adolescents, all the studies comprised adults. More non-clinical samples (15 studies, including case studies) were found than clinical ones (four studies). Three different methodological approaches were identified. Among the empirical studies, seven used questionnaires comprising psychological assessment measures such as the Torrance Test of Creative Thinking (TTCT).

According to the types of psychoactive substance effect on creativity, we identified three groups. These were studies that examined the effect of psychedelic substances (n=5), the effect of cannabis (n=1), and those that did not make a distinction between substances used because of the diverse substances used by participants in the samples (n=7). In one study, the substances studied were not explicitly identified.

The most notable observation of our review was that the findings of these studies show only limited convergence. The main reason for this is likely to be found in the extreme heterogeneity concerning the objectives, methodology, samples, applied measures, and psychoactive substances examined among the small number of studies. Consequently, it is hard to draw a clear conclusion about the effect of psychoactive substance use on creativity based on the reviewed material.

Despite the limited agreement, most of the studies confirmed some sort of association between creativity and psychoactive substance use, but the nature of this relationship was not clearly established. The frequently discussed view that the use of psychoactive substances leads to enhanced creativity was by no means confirmed. What the review of relevant studies suggests is that: (i) substance use is more characteristic in those with higher creativity than in other populations, and (ii) it is probable that this association is based on the inter-relationship of these two phenomena. At the same time, it is probable that there is no evidence of a direct contribution of psychoactive substances to enhanced creativity of artists.

It is more likely that substances act indirectly by enhancing experiences and sensitivity, and loosening conscious processes that might have an influence on the creative process. This means the artist will not be more creative but the quality of the artistic product will be altered due to substance use. On the other hand, it appears that psychoactive substances may have another role concerning artists, namely that they stabilize and/or compensate a more unstable functioning.

Beyond the artistic product, we also noted that (iii) specific functions associated with creativity appear to be modified and enhanced in the case of ordinary individuals due to psychoactive substance use. However, it needs to be emphasized that these studies examined specific functions while creativity is a complex process. In light of these studies, it is clear that psychoactive substances might contribute to a change of aesthetic experience, or enhanced creative problem solving. One study (a case study of the cartoonist Robert Crumb) showed that LSD changed his cartoon illustrating style. Similarly, a case study of Brian Wilson argued that the modification of musical style was connected to substance use. However, these changes in themselves will not result in creative production (although they may contribute to the change of production style or to the modification of certain aspects of pieces of arts). What was also shown is that (iv) in certain cases, substances may strengthen already existing personality traits.

In connection with the findings reviewed, one should not overlook that studies focused on two basically different areas of creative processes. Some studies examined the actual effects of a psychoactive substance or substances in a controlled setting, while others examined the association between creativity and chronic substance users. These two facets differ fundamentally. While the former might explain the acute changes in specific functions, the latter may highlight the role of chronic substance use and artistic production.

It should also be noted that the studies we reviewed differed not only regarding their objectives and methodology, but also showed great heterogeneity in quality. Basic methodological problems were identified in many of these studies (small sample sizes, unrepresentative samples, reliance on self-report and/or non-standardized assessment methods, speculative research questions, etc.). Furthermore, the total number of empirical studies was very few. At the same time, the topic is highly relevant both in order to understand the high level of substance use in artists and in order to clarify the validity of the association present in public opinion. However, it is important that future studies put specific emphasis on adequate methodology and clear research questions.

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

Further reading

Belli, S. (2009). A psychobiographical analysis of Brian Douglas Wilson: Creativity, drugs, and models of schizophrenic and affective disorders. Personality and Individual Differences, 46, 809-819.

Dobkin de Rios, M. & Janiger, O. (2003). LSD, spirituality, and the creative process. Rochester, VT: Park Street Press.

Edwards, J. (1993). Creative abilities of adolescent substance abusers. Journal of Group         Psychotherapy, Psychodrama & Sociometry, 46, 52-60.

Fink, A., Slamar-Halbedl, M., Unterrainer, H.F. & Weiss, E.M. (2012). Creativity: Genius, madness, or a combination of both? Psychology of Aesthetics, Creativity, and the Arts, 6(1), 11–18.

Forgeard, M.J.C. & Elstein, J.G. (2014). Advancing the clinical science of creativity. Frontiers in Psychology, 5, 613.

Frecska, E., Móré Cs. E., Vargha, A. & Luna, L.E. (2012). Enhancement of creative expression and entoptic phenomena as after-effects of repeated ayahuasca ceremonies. Journal of Psychoactive Drugs, 44, 191-199

Holm-Hadulla, R.M. & Bertolino, A. (2014). Creativity, alcohol and drug abuse: The pop icon Jim Morrison. Psychopathology, 47,167-73

Iszáj, F. & Demetrovics, Z. (2011). Balancing between sensitization and repression: The role of opium in the life and art of Edgar Allan Poe and Samuel Taylor Coleridge. Substance Use and Misuse, 46, 1613-1618

Iszaj, F., Griffiths, M.D. & Demetrovics, Z. (2016). Creativity and psychoactive substance use: A systematic review. International Journal of Mental Health and Addiction. doi: 10.1007/s11469-016-9709-8

Jones, M.T. (2007). The creativity of crumb: Research on the effects of psychedelic drugs on the comic art of Robert Crumb. Journal of Psychoactive Drugs, 39, 283-291.

Jones, K.A., Blagrove, M. & Parrott, A.C. (2009). Cannabis and ecstasy/ MDMA: Empirical measures of creativity in recreational users. Journal of Psychoactive Drugs. 41(4), 323-329

Kerr, B. & Shaffer, J. & Chambers, C., & Hallowell, K. (1991). Substance use of creatively talented adults. Journal of Creative Behavior, 25(2), 145-153.

Knafo, D. (2008). The senses grow skilled in their craving: Thoughts on creativity and addiction. Psychoanalytic Review, 95, 571-595.

Lowe, G. (1995). Judgements of substance use and creativity in ’ordinary’ people’s everyday lifestyles. Psychological Reports. 76, 1147-1154.

Oleynick, V.C., Thrash, T. M., LeFew, M. C., Moldovan, E. G. & Kieffaber, P. D. (2014). The scientific study of inspiration in the creative process: challenges and opportunities. Frontiers in Human Neuroscience, 8, 436.

Plucker, J.A., McNeely, A. & Morgan, C. (2009). Controlled substance-related beliefs and use: Relationships to undergraduates’ creative personality traits. Journal of Creative Behavior, 43(2), 94-101

Preti, A. & Vellante, M. (2007). Creativity and psychopathology. Higher rates of psychosis proneness and nonright-handedness among creative artists compared to same age and gender peers. Journal of Nervous and Mental Disease, 195(10), 837-845.

Schafer, G. & Feilding, A. & Morgan, C. J. A. & Agathangelou, M. & Freeman, T. P. &      Curran, H.V. (2012). Investigating the interaction between schizotypy, divergent thinking and cannabis use. Consciousness and Cognition, 21, 292–298

Thrash, T.M., Maruskin, L.A., Cassidy, S. E., Fryer, J.W. & Ryan, R.M. (2010). Mediating between the muse and the masses: inspiration and the actualization of creative ideas. Journal of Personality and Social Psychology, 98, 469–487.

No joking on smoking: My top ten tips for giving up smoking this Stoptober

Although most of my academic research is on behavioural addiction, I have published quite a few papers on more traditional addictions such as alcohol addiction and nicotine addiction (see ‘Further reading’ below). In 2012, I had to watch my mother fight a losing battle with smoking-related lung cancer and chronic obstructive pulmonary disease. She died in September 2012 aged 66 years, and had chain-smoked most of her adult life. This followed the death of my father who also died of smoking-related heart disease, aged just 54.

In my previous blog I looked at ways to reduce alcohol intake as part of the ‘Go Sober For October‘ campaign. In today’s blog I provide my advice for giving up smoking as part of the annual ‘Stoptober’ campaign. In the UK smoking accounts for approximately one in four cancer deaths, and as I said, it’s something I’ve witnessed first-hand. I’m sure most people reading this are aware of the addictive nature of nicotine. As soon as nicotine is ingested via cigarettes, it can pass from lungs to brain within ten seconds and stimulates the release of the neurotransmitter dopamine. The release of dopamine into the body provides reinforcing mood modifying effects. Despite nicotine being a stimulant, many people use cigarettes for both tranquillising and euphoric effects.

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Most authorities accept that nicotine is one of the most addictive drugs on the planet and that smokers can become hooked quickly. One of the reasons my own parents were never able to give up was because of the prolonged withdrawal effects they experienced whenever they went more than a few hours without smoking. This would lead to intense cravings for a cigarette. Watching both my parents’ die of smoking-related diseases is enough incentive for me to never smoke a cigarette. Hopefully, others can find the incentives they need to help them give up permanently. Here are my top ten tips to help you (or someone you know and love) stop smoking:

  • (1) Develop the motivation to stop smoking: Many smokers say they would like to stop but don’t really want to. When you take stock, make sure you are clear as to why you want to give up. It may be to save money, to improve your health, to prevent yourself getting a smoking-related disease, or to protect your family from passive smoking. (It could of course be all of the above). Really wanting to give up is the best predictor of successful smoking cessation.
  • (2) Get all the emotional support you can: Another good predictor of whether someone will overcome their addiction to nicotine is having a good support network. You need people around you that will support your efforts to quit. Tell as many people that you know that you are trying to quit. It could be the difference between stopping and starting again.
  • (3) Avoid ‘cold turkey’: Although some people can stop through willpower alone, most people will need to reduce their nicotine intake slowly. The best way of doing this is to replace cigarettes with a safe form of nicotine such as those available from the pharmacy, or on prescription from the doctor.
  • (4) Get support from a professional: Even if you are using a safe form of nicotine from your pharmacist or doctor, cutting out cigarettes completely can be hard. Getting support from a trained NHS stop smoking adviser can double your chances of stopping smoking. To find your nearest free NHS stop smoking service (in the UK call 0300 123 1044) or visit the Smokefree website.
  • (5) Use non-nicotine cigarette shaped substitutes: Smoking is also a habitual behaviour where the feel of it in your hands may be as important as the nicotine it contains. The use of plastic cigarettes or e-cigarettes will help with the habitual behaviour associated with smoking but contain none of the addictive nicotine.
  • (6) Use relaxation techniques: When cravings strike, use relaxation exercises to help overcome the negative feelings. At the very least take deep breaths. There are dozens of relaxation exercises online. Practice makes perfect.
  • (7) Treat yourself: One of the immediate benefits of stopping smoking will be the amount of money you save. At the start of the cessation process, treat yourself to rewards with the money you save.
  • (8) Focus on the positive: Giving up smoking is one of the hardest things that anyone can do. Write down lists of all the positive things that will be gained by stopping smoking. Constantly remind yourself of what the long-term advantages will be that will outweigh the short-term benefits of smoking a cigarette. In short, focus on the gains of stopping rather than what you will miss about cigarettes.
  • (9) Know the triggers for your smoking: Knowing the situations in which you tend to smoke can help in overcoming the urges. Lighting up a cigarette can sometimes be the result of a classically-conditioned response (e.g. having a cigarette after every meal). These often occur unconsciously so you need to break the automatic response and de-condition the smoking. You need to replace the unhealthy activity with a more positive one and re-condition your behaviour.
  • (10) Fill the void: One of the most difficult things when cigarette craving and withdrawal symptoms strike is not having an activity to fill the void. Some things (like engaging in physical activity) may help you in forgetting about the urge to smoke. Plan out alternative activities and distraction tasks to help fill the hole when the urge to smoke strikes (e.g. chew gum, eat something healthy like a carrot stick, call a friend, occupy your hands, do a word puzzle, etc.). However, avoid filling the void with other potentially addictive substances (e.g. alcohol) or activities (e.g. gambling).

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

Further reading

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

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

Griffiths, M.D. (2012). First person: Highly-addictive drug killed both of my parents. Nottingham Post, October 1, p.13.

Griffiths, M.D., Parke, J. & Wood, R.T.A. (2002). Excessive gambling and substance abuse: Is there a relationship? Journal of Substance Use, 7, 187-190.

Griffiths, M.D., Wardle, J., Orford, J., Sproston, K. & Erens, B. (2010). Gambling, alcohol consumption, cigarette smoking and health: findings from the 2007 British Gambling Prevalence Survey. Addiction Research and Theory, 18, 208-223.

Griffiths, M.D., Wardle, J., Orford, J., Sproston, K. & Erens, B. (2011). Internet gambling, health. Smoking and alcohol use: Findings from the 2007 British Gambling Prevalence Survey. International Journal of Mental Health and Addiction, 9, 1-11.

Resnick, S. & Griffiths, M.D. (2010). Service quality in alcohol treatment: A qualitative study. International Journal of Mental Health and Addiction, 8, 453-470.

Resnick, S. & Griffiths, M.D. (2011). Service quality in alcohol treatment: A research note. International Journal of Health Care Quality Assurance, 24, 149-163.

Resnick, S. & Griffiths, M.D. (2012). Alcohol treatment: A qualitative comparison of public and private treatment centres. International Journal of Mental Health and Addiction, 10, 185-196.

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.

Umeh, K. & Griffiths, M.D. (2001). Adolescent smoking: Behavioural risk factors and health beliefs. Education and Health, 19, 69-71.

Go sober this October: How to lower your alcohol intake this month

Last week I was interviewed by the Daily Telegraph about this year’s  ‘Go Sober For October‘ (“Octsober”) campaign. In addition to wanting some tips on how to cut down alcohol intake (see below), they wanted to know why people are so reliant on alcohol to relieve stress, socialise and escape. On a very simple level, alcohol is a pharmacological depressant that enhances disinhibition (i.e., a disregard for social conventions) and which is both physiologically and psychologically rewarding. Like most addictive behaviours it is a mood modifier that can either get individuals high, excited, buzzed up and aroused or (somewhat paradoxically) do the exact opposite and help them escape, numb, relax and de-stress. The fact that it’s socially condoned and widely available make it a perfect substance for individuals to use and misuse.

go-sober

The remainder of today’s blog provides some tips on the simplest ways to cut down on alcohol intake. They are not aimed at problem drinkers as they require extra external support and interventions from family, friends, doctors and/or therapists. The tips below come from a variety of sources (listed in ‘Further reading’). I don’t claim to be an expert on alcohol addiction (although I have published more than a few papers on alcohol problems over the years – again, see some of these in ‘Further reading’ below) but most of these tips are practical and common sense:

Don’t go it alone: If you really want to cut down your alcohol intake, try do it with your friends and family together. Doing it with others rather than on your own means you will have others around you going through the same thing as yourself as well as having a ready made support group.

Don’t buy rounds of drinks in pubs and clubs: If you’ve ever been out on a pub crawl with friends, you will know that you tend to drink at the pace of the quickest drinker in the group (and this may be at a quicker rate than you would ideally prefer). If you do want to drink in rounds, then try opting out every other round and/or try to drink with a smaller group of friends (as larger groups typically lead to more alcohol being drunk over the course of an evening).

Spread out your drinking and drink more slowly: Sounds obvious but it’s true. (As I noted above, in places where alcohol is very expensive this becomes a natural option). A related option is to have one alcoholic drink followed by one non-alcoholic drink throughout the evening.

Don’t buy pints, doubles or large glass drinks: When you do drink in pubs and clubs, order smaller measures (wine in a small glass rather than a large one, halves instead of pints, a bottle of lager rather than a pint of lager). All of these smaller options mean a reduced ‘alcohol by volume’ ratio (i.e., less alcohol actually consumed). If you are the kind of person who says to yourself ‘I never have more than two glasses of wine a night’, then changing to a smaller glass will have an immediate and appreciable effect in lowering overall alcohol intake.

Where possible choose non–alcoholic drinks: When you eat out or dine at home, have a soft drink, juice or water rather than wine or beer with your meal.

Dilute alcoholic drinks: If the option of a non-alcoholic drink isn’t always possible or simple doesn’t appeal, then dilute your drinks. Have a lager shandy or a white wine spritzer.

Have ‘alcohol-free’ days: If you drink every day, start by trying to drink alcohol every other day. If you drink alcohol a few times a week, try to drink just once a week. Just cutting down on your normal weekly pattern will help you to realise that you can go without alcohol.

Avoid cocktails: Cocktails often contains a lot more alcohol than people think.

Drink alcohol free beers and lagers: If you love the taste of lager or beer, there are alcohol free options. There are also an increasing number of fake cocktails (‘mocktails’).

Reward yourself for not drinking alcohol: Many people drink as a way to alleviate the stresses and strains of every day life (or to do the exact opposite – to celebrate the fact that you’ve done something well or because it is a special occasion). The money not spent on alcohol could go towards giving yourself another kind of treat or reward (a massage, the new CD you wanted, watching a film at the cinema, etc.).

Tell everyone in your social circle you’re cutting down alcohol intake: By telling everyone you know including family, friends and work colleagues, you will be more committed to not drinking alcohol than if you told no-one.

Avoid temptation: One of the key factors in any potentially addictive activity is knowing what the ‘triggers’ are (e.g., walking past a pub, watching television, having an argument with your loved one, etc.). Knowing what the triggers are can be a strategy for avoiding temptation (e.g., changing the routes on your way back home to avoid walking past your favourite pub, doing something else instead of watching television, etc.).

Get a new hobby: Changing one aspect of your routine life can also help change other aspects. Sometimes, changing one aspect of your life (such as introducing daily exercise) goes hand-in-hand with other areas of your life (drinking less alcohol, eating more healthily).

Think of the benefits of not drinking alcohol: Not drinking alcohol can bring lots of positives. In six months without alcohol I’ve lost about 6.35kg in weight because alcohol is high in calories (and that’s without exercise!). Other benefits include more money for other things, better quality sleep, less stress (because alcohol is a depressant), and better health.

Use alcohol tracking tools: Many apps are now available to help you keep track of your alcohol intake. For instance, the MyDrinkaware tool allows you to see how alcohol is affecting you on a number of different dimensions including your health (how many units you are consuming over time), weight (how many calories you are consuming over time), and finances (how much money you are spending on alcohol over time).

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

Further reading

Drinkaware (2015). Tips for cutting down when out. Located at: https://www.drinkaware.co.uk/make-a-change/how-to-cut-down/cutting-down-when-out-and-about/tips-for-cutting-down-when-out

Drinkaware (2015). Track your drinking. Located at: https://www.drinkaware.co.uk/unitcalculator#unitcalculator

Griffiths, M.D. (2014). I drink, therefore I am: The UK’s alcohol dependence. Intervene, April, 20-23.

Griffiths, M.D., Wardle, J., Orford, J., Sproston, K. & Erens, B. (2010). Gambling, alcohol consumption, cigarette smoking and health: Findings from the 2007 British Gambling Prevalence Survey. Addiction Research and Theory, 18, 208-223.

Griffiths, M.D., Wardle, J., Orford, J., Sproston, K. & Erens, B. (2011). Internet gambling, health. Smoking and alcohol use: Findings from the 2007 British Gambling Prevalence Survey. International Journal of Mental Health and Addiction, 9, 1-11.

Glynn, S. (2012). Living close to a bar increases chance of risky drinking. Medical News Today, November 7. Located at: http://www.medicalnewstoday.com/articles/252462.php

NHS Choices (2015). Tips on cutting down [alcohol]. Located at: http://www.nhs.uk/Livewell/alcohol/Pages/Tipsoncuttingdown.aspx

Resnick, S. & Griffiths, M.D. (2010). Service quality in alcohol treatment: A qualitative study. International Journal of Mental Health and Addiction, 8, 453-470.

Resnick, S. & Griffiths, M.D. (2011). Service quality in alcohol treatment: A research note. International Journal of Health Care Quality Assurance, 24, 149-163.

Resnick, S. & Griffiths, M.D. (2012). Alcohol treatment: A qualitative comparison of public and private treatment centres. International Journal of Mental Health and Addiction, 10, 185-196.

Confession session: The psychology of apology

(Please note: The following blog is an extended version of an article that was first published earlier this year in the Nottingham Post).

Back in March 2016, Nottingham Labour Councillor Alan Rhodes made a public apology after the former social worker Andris Logins was jailed for 20 years for rape and abuse of children at a Nottinghamshire care home. Mr Rhodes said: “It was our role to keep children safe and we clearly didn’t” and that “we failed in our duty of care”. Although most of us apologise for all sorts of things each day, it’s becoming increasingly common for a ‘non-celebrities’ to say sorry in a public way – particularly for historical events that the person giving the apology had no part in.

There are three main ways of saying sorry. The first is the apology with no excuse, when we don’t try to justify what we’ve done. We simply take full responsibility and promise it will never happen again. Secondly, there’s the excuse apology when we say we’re sorry but also add it wasn’t our fault. For instance, we might blame someone else, an accident, human error, or a lapse of judgement. With the third type of apology, we don’t feel we’ve done wrong, but offer some sort of justification. If we’ve wronged someone, we might say they deserved it. We might even feel what we’ve done is so trivial it’s not even worth bothering about. Dr. Aaron Lazare, author of the 2005 book On Apology, says that an apology is one of the most profound interactions that two human beings can have between one another

But why do we apologise? Psychologist Dr. Guy Winch views apologies as linguistic tools that help us acknowledge violations of social expectations and norms. He also says that apologies help us take direct responsibility for the impact of our actions on other individuals and provide a way of asking for forgiveness. Consequently, we are able to repair our relationships with those individuals, restore our own social standing, and help ease guilt and/or shame. Confessing and saying sorry is a simple way to get rid of all those negative feelings. The guilt created by transgressions, such as lying on a CV, or cheating in an exam, can eat away at some people for years.

There also appear to be gender differences. Research studies have tended to find that women appear to say sorry far more than men, because men feel they’re ‘one down’ to someone if they offer an apology. In contrast, women will say sorry for things they haven’t done because they prefer to smooth things over quickly and keep relationships going. However, the differences may be more nuanced. One study found no differences between men and women in the number of the proportion of offenses that prompted apologies but men apologized less frequently than women because they had a higher threshold for what constitutes offensive behaviour. Another study found that men apologized more frequently to women than they did to other men.

We also appear to have developed a ‘confessional culture’ over recent years in which celebrities and politicians are keener than ever to publicly admit to their private indiscretions. It could be that we’re more forgiving of public figures and that because we know more about the pressures of fame, we empathise with them. Another reason might be we no longer care because we don’t think what someone does in the private life affects their job. One thing we do expect from public figures is for their apologies to be sincere.

Arguably one of the most high profile examples was former US president Bill Clinton and his sexual relationship with Monica Lewinsky. Although Clinton continually denied for seven months any such relationship, when he eventually said sorry in August 1998, it was seen as sincere and many people sympathised with him. By apologising sincerely, or appearing to, public figures demonstrate they’re human, with weaknesses just like the rest of us.

bill-clinton-monica-lewinsky

These days, celebrities are quick to admit to what they’ve done. Lots of actors, comedians, singers and sports people have confessed to their addictions to drugs, alcohol and gambling before checking into high profile clinics like The Priory. For some, it’s no doubt a cynical move to help their public image. By apologising promptly, they’re seen as being brave, and any bad publicity will die down more quickly. Those who offer belated, grudging apologies see their image suffer.

Apologies can also help those who receive them. Police forces up and down the country have piloted schemes where criminals are confronted by their victims and offered a chance to apologies (known as ‘restorative justice’). Many victims say the one thing they’d really appreciate is an apology, and they’re often grateful to receive on. As the saying goes, “sorry seems to be the hardest word” but it has the potential to mean so much to so many.

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

Further reading

Bachman, G. F., & Guerrero, L. K. (2006). Forgiveness, apology, and communicative responses to hurtful events. Communication Reports, 19(1), 45-56.

Griffiths, M.D. (2000). Saying sorry can make you feel so much better. The Sunday Post, January 23, p. 30-31.

Griffiths, M.D. (2016). Sorry may be the hardest word but more people than ever are saying it. Nottingham Post, April 11, p.14.

Fehr, R., & Gelfand, M.J. (2010). When apologies work: How matching apology components to victims’ self-construals facilitates forgiveness. Organizational Behavior and Human Decision Processes, 113(1), 37-50.

Frantz, C.M., & Bennigson, C. (2005). Better late than early: The influence of timing on apology effectiveness. Journal of Experimental Social Psychology, 41(2), 201-207.

Lazare, A. (2005). On Apology. Oxford: Oxford University Press.

Scher, S. J., & Darley, J. M. (1997). How effective are the things people say to apologize? Effects of the realization of the apology speech act. Journal of Psycholinguistic Research, 26(1), 127-140.

Struthers, C. W., Eaton, J., Santelli, A. G., Uchiyama, M., & Shirvani, N. (2008). The effects of attributions of intent and apology on forgiveness: When saying sorry may not help the story. Journal of Experimental Social Psychology, 44(4), 983-992.

Takaku, S. (2001). The effects of apology and perspective taking on interpersonal forgiveness: A dissonance-attribution model of interpersonal forgiveness. Journal of Social Psychology, 141(4), 494-508.

Takaku, S., Weiner, B., & Ohbuchi, K.I. (2001). A cross-cultural examination of the effects of apology and perspective taking on forgiveness. Journal of Language and Social Psychology, 20(1-2), 144-166.

Winch, G. (2013). Emotional First Aid: Healing Rejection, Guilt, Failure, and Other Everyday Hurts. London: Penguin.

Mack, the life: The psychology of Billy Mackenzie and The Associates

For the past month, the only music I have listened to on my iPod is all the albums by The Associates (along with the solo albums by their lead singer Billy Mackenzie), and have just finished reading Tom Doyle’s excellent biography of Mackenzie The Glamour Chasealso the title of their 1988 LP but remained unreleased until 2002). Mackenzie committed suicide in 1997, a few months before his 40th birthday. Following the death of his mother in the summer of 1996 (who he was very close to), Mackenzie became clinically depressed and took his on January 22nd, 1997 (following a previous suicide attempt on New Year’s Eve 1996).

I have loved The Associates since the early 1980s and became hooked on their music following the 1981 singles ‘White Car in Germany’ and ‘Message Oblique Speech’ (two of the great six singles they released that year and all available on their second LP, Fourth Drawer Down). Even if people don’t like Mackenzie’s recorded outputs, I doubt many people who have heard him sing would dispute how good his multi-octave voice was.

the-associates-billy-mackenzie-by-gilbert-blecken-1994-1images

Most people will know The Associates for their classic 1982 top ten album Sulk and the three British hit singles that year – ‘Party Fears Two’ (No.9), ‘Club Country’ (No.13), and ’18 Carat Love Affair’ (No. 21) but I’ve followed their whole career through thick and thin and have every one of their six albums (seven if you include the partial re-recording/remixing of their first album The Affectionate Punch) as well as the three BBC Radio 1 session LPs, the three compilation ‘greatest hits’ collections (Popera, Singles, and The Very Best of Associates), the rarities LP Double Hipness, and their only live album (Billy Mackenzie and The Associates In Concert).

Hailing from Dundee (Scotland), The Associates (Billy Mackenzie and Alan Rankine the two lynch-pin members) formed as punk exploded in 1976. Before changing their name to The Associates in 1979 they used the moniker Mental Torture (a name that biographer Doyle described as “biographically embarrassing”) but as a psychologist a choice of name that I find interesting. The ‘classic’ line-up of The Associates ended at the height of their commercial success in 1982 when Rankine left the band. Following that, many view the next three Associates’ LPs as Billy Mackenzie solo albums in all but name and that he never reached such critical acclaim ever again. That’s a viewpoint I share (despite there being many other great songs in his post-1982 catalogue). The creative and artistic chemistry he shared with Rankine was never bettered in the last 15 years of his life, and even the handful of demos he recorded with Rankine in a short-lived reunion in 1993 (available on the Double Hipness album and on the latest The Very Best of Associates compilation) clearly demonstrated Gestalt psychology’s underlying maxim that the whole was greater than the sum of its parts.

So what was it in Mackenzie’s psyche that killed the goose that laid the golden egg? Rankine didn’t leave the band because of clichéd “creative differences” but left after Mackenzie refused to go on a lucrative US tour (and Rankine knew that touring to promote their music was the only viable option to maintain a successful national and international profile). There appeared to be a combination of factors that led to Mackenzie’s decision including stage fright (i.e., performance anxiety which surfaced throughout his career) and the fact Mackenzie didn’t want to do the usual cycles of making an album, doing the obligatory media circuit, followed by the big tour. In short he didn’t want to play by the accepted rules and conventions – something the underpinned his whole persona. He wanted to be a ‘studio band’ – something that Rankine thought would never work.

My blog had always focused on life’s extremities and much of what Mackenzie did was about living life at the extreme. The liner notes of The Associates most recent CD compilation by Martin Aston neatly sums it up:

“In some ways, The Associates music mirrored their behavioural excess, pioneered by the naughty boy that was Billy Mackenzie, music both lush and visceral, abrasive and ravishing, pure pop and reckless adventurism, devoured and sprayed over an unsuspecting audience”.

(The “sprayed over an unsuspecting audience” was more in reference to the fact that Mackenzie had an unusual ‘gift’ of being able to projective vomit and something he demonstrated on fans in the front row in an early gig where The Associates supported Siouxsie and the Banshees). When it came to music, most of Mackenzie’s collaborators (musicians, singers, producers) describe him as obsessive and a perfectionist. Michael Dempsey, a founding member of The Cure and bass guitarist with The Associates in the early 1980s said: “He was obsessive, always on top of every detail. It was even down to whether you were wearing the right shoes because that was part of the composition and the production to him”. Tom Doyle’s biography is full of stories about Mackenzie taking hours in the studio to get the sound of one right or taking 40 takes to do one song (almost the opposite of David Bowie – one of Mackenzie’s musical heroes – who often recorded songs in one or two takes). Musical collaborators also talk about Mackenzie’s ability to “see” music in his head (which is perhaps not as strange as it sounds as there are countless reports in the psychological and neurological literature of synaesthesia (a neurological phenomenon in which stimulation of one sensory or cognitive pathway leads to automatic, involuntary experiences in a second sensory or cognitive pathway” – for example, some people can see specific colours when they hear a particular piece of music). His obsessiveness was not just restricted to music. His flatmates described his “mildly obsessive hygiene and beauty routines: using an entire tube of toothpaste in one single brushing, spending an eternity rubbing lotions into his skin before he would shave”.

Mackenzie arguably had only three passions in his life – his music, his family, and his love of dogs (and more specifically whippets). He never had any significant romantic relationship in his life (although had a very brief marriage in his teens to American Chloe Dummar when he briefly lived in California). Like Morrissey, Mackenzie was fiercely private about his sexuality and rarely talked about his personal life to the press. It was only in a 1994 interview in Time Out magazine that he first spoke publicly of his bisexuality. I mention Morrissey because it was rumoured that Mackenzie had a brief relationship with him and that Mackenzie was the subject of The Smiths‘ British (No.17) hit single ‘William, It Was Really Nothing’. This appeared to have some legitimacy when during the Associates brief 1993 re-union, Mackenzie wrote a song called ‘Stephen, You’re Really Something’ (Stephen, of course, being Morrissey’s first name).

In both Doyle’s biography (and in a profile piece on The Associates in the latest issue of Mojo magazine by Tom Sheehan), it is noted that Mackenzie had a “particular idea of his own sexuality” and that it was “beyond male and female, beyond sexuality”. Martha Ladly (of one-hit wonders Martha and the Muffins, and backing singer in The Associates in the 1980s) describes him as being “omnisexual…he didn’t see sexuality in people, he saw it in situations and in all things”. The online Urban Dictionary says that omnisexual is “generally interchangeable with pansexual, one whose romantic, emotional, or sexual attractions are geared towards others regardless of sex and/or gender expression” – check out my previous blog on pandrogyny in relation to Throbbing Gristle’s lead ‘singer’ Genesis P. Orridge). In the Mojo article, Rankine said Mackenzie was “very compartmentalised. All the way through [The Associates] it never occurred to me that Bill was having affairs. Everyone he came across he was shagging”. He was arguably a little vain (and overly conscious of his receding hairline in the last decade of his life) and always sought reassuring compliments from those around him about his looks. His obsessive grooming habits appear to provide a good indication of how important his look was to him but I’ve read nothing to suggest that he was narcissistic (although perfectionism is known to be a trait associated with narcissism).

The other personal characteristic that Mackenkie was infamous for was spending money and loved life’s luxuries. One of my research areas is shopping addiction and compulsive buying but on reading Doyle’s biography I don’t think Mackenzie would be classed as a shopaholic or compulsive spender by my own criteria (but did end up bankrupt so was a problematic spender at the very least). Like many people, Mackenzie believed that money was for spending and he spent loads of other people’s money (usually the record company’s) on everything from clothes and daily taxis (including many a black cab ride from London to Dundee), to the best hotel rooms. My view is that he was much more of an impulsive (rather than compulsive) spender.

Many people were surprised (including me) that he was clinically depressed during the last few months of his life because up to the point of his mother’s death, he appeared was always outgoing and extraverted. In his earlier life he was hedonistic and engaged in heavy alcohol drinking and recreational drug use but as he matured the use of psychoactive substances all but disappeared from his life. No-one around him thought he would be the type of person to commit suicide (although it’s worth noting there appears to be an association between perfectionism and depression, and depression is one of the major risk factors for suicide along with stress caused by severe financial difficulties).

One of Mackenzie’s best known songs in The Associates back catalogue is Rezső Seress’ Hungarian suicide song ‘Gloomy Sunday’ (from their 1982 masterpiece Sulk). The Wikipedia entry about the song has a dedicated sub-section on urban legends connected to the song and Doyle’s biography also discussed it:

“While Mackenzie had first encountered ‘Gloomy Sunday’ through the version recorded by Billie Holiday in 1941 that – along with ‘Strange Fruit‘ – remained one of the dark show-stoppers forming a significant element of her repertoire, the song has a morbid history that stretches back to pre-war Hungary. Rezro [sic] Seress composed the mournful song in 1933, the lyric expressing a feeling of futility and helplessness following the death of a loved one, unusual in that it is directed at the person, the narrator detailing numberless shadows and conveying thoughts of suicide”.

Doyle goes on to tell some of the stories that came to be associated with the song being cursed:

“The first reported death associated with ‘Gloomy Sunday’ was that of Joseph Keller, a Budapest shoemaker whose suicide note in 1936 quoted the lyric. In the Hungarian capital alone, seventeen other similar deaths apparently followed, bearing some connection with the song: a couple were said to have shot themselves while a gypsy band performed ‘Gloomy Sunday’; there was talk that a fourteen-year-old girl had thrown herself into a river clutching the sheet music. The song was eventually banned in Hungary, although even these days the occasional piano rendition is performed in the Kis Papa restaurant in Budapest where Seres first aired the song. The legend of ‘Gloomy Sunday’ grew as its apparent effects became further reaching. In New York in the [1940s], there were reports that a typist gassed herself, leaving instructions for the song to be played at her funeral. In London, a policeman was alerted to the fact that a recorded instrumental of the song was being repeatedly played by an unseen female neighbour who, when her flat was entered, was discovered to have overdosed on barbiturates while an automatic phonograph played the song over and over again. Doubtful these tales have been embellished over the years in an effort to emphasize the myth surrounding ‘Gloomy Sunday’, but certain facts remain: the BBC ban imposed on the song in the [1940s] has not been lifted to this day: Holiday suffered a tragic premature death at forty-three form heroin-related liver cirrhosis in 1959; Seress, the song’s composer, himself committed suicide in 1968”.

The Wikipedia entry on ‘Gloomy Sunday’ covers similar ground but is a bit more sceptical. It also references an article on the myth-busting website Snopes.com and notes the BBC ban on the song was lifted in 2002:

“Press reports in the 1930s associated at least nineteen suicides, both in Hungary and the United States, with ‘Gloomy Sunday’, but most of the deaths supposedly linked to it are difficult to verify. The urban legend appears to be, for the most part, simply an embellishment of the high number of Hungarian suicides that occurred in the decade when the song was composed due to other factors such as famine and poverty. No studies have drawn a clear link between the song and suicide. In January 1968, some thirty-five years after writing the song, its composer did commit suicide. The BBC banned Billie Holiday’s version of the song from being broadcast, as being detrimental to wartime morale, but allowed performances of instrumental versions. However, there is little evidence of any other radio bans; the BBC’s ban was lifted by 2002”.

Here is Doyle’s take in relation to Mackenzie in the months after Mackenzie’s mother had died where Mackenzie was having a ‘house leaving’ party:

“The personal grief at the time imbues the song’s lyrics an uneasy resonance that could not have escaped [Mackenzie]. As he lay there singing in the early hours of the Sunday morning following the party, Billy alternated the line ‘Let them not weep, let them know that I’m glad to go’ with his own lamenting alternative: ‘Let them not weep, let them know that I’m sad to go’”.

Arguably his life was a paradox personified. It took him years to get noticed but when he finally made the limelight, he appeared to shun the fame. He lived life his own way on his own terms. Thankfully, while Mackenzie is no longer with us, his music – and his legacy – lives on.

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

Further reading

Dalton, S. (2016). 18-carat love affair. Electronic Sound, 2.0, 70-75.

Doyle, T. (2011). The Glamour Chase: The Maverick Life of Billy Mackenzie (Revised Edition). Edinburgh: Bloomsbury Publishing.

Mikkelson, D. (2007). Gloomy Sunday: Was the song ‘Gloomy Sunday’ banned because it led to too many suicides? Snopes.com, May 23. Located at: http://www.snopes.com/music/songs/gloomy.asp

Reynolds, S. (2006). Rip It Up and Start Again: Postpunk, 1978–1984. New York: Penguin.

Sheehan, T. (2016). Beautiful dreamer. Mojo, 272, 50-55.

Vive Le Rock (2016). A rough guide to…The Associates, Vive Le Rock, 35, 84-85.

Wikipedia (2016). Alan Rankine. Located at: https://en.wikipedia.org/wiki/Alan_Rankine

Wikipedia (2016). Billy Mackenzie. Located at: https://en.wikipedia.org/wiki/Billy_Mackenzie

Wikipedia (2016). Gloomy Sunday. Located at: https://en.wikipedia.org/wiki/Gloomy_Sunday

Wikipedia (2016). Martha Ladly. Located at: https://en.wikipedia.org/wiki/Martha_Ladly

Wikipedia (2016). Michael Dempsey. Located at: https://en.wikipedia.org/wiki/Michael_Dempsey

Wikipedia (2016). The Associates (band). Located at: https://en.wikipedia.org/wiki/The_Associates_(band)

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Further reading

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

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

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

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

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

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

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

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

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

Musical flares: Bowie, The Beatles, psychology, songs, and addiction

It’s been only two weeks since David Bowie’s untimely death and the Bowie obsessive in me is still finding it difficult to accept. I have never been more upset by the death of someone that I didn’t know personally. The only other celebrity death that left me with such an empty feeling was that of John Lennon back in December 1980. I was only 14 years old but I remember waking up to the news on that Tuesday morning (December 9, the morning after he had been shot in New York by Mark David Chapman). I went to school that day with a feeling I had never experienced before and I got it again two weeks ago when Bowie (co-incidentally) died in New York.

Bowie and The Beatles (and Lennon in particular) are arguably the two biggest musical influences on my life. With my interest in addictive behaviours, Bowie and Lennon are just two of the many celebrities that have succumbed to substance abuse and addiction over the years (and was a topic I covered in a previous blog – ‘Excess in success: Are celebrities more prone to addiction?’). Thankfully, neither of their addictions was that long-lasting, and neither of them wrote that many songs about their drug-fuelled experiences (although Lennon’s ‘Cold Turkey’ about his heroin addiction is a notable exception).

Lennon was arguably one of Bowie’s musical heroes although Bowie’s 1973 covers LP Pin-Ups was notable for the absence of Beatle covers. By 1973, Bowie had covered songs by The Rolling Stones, The Kinks, Pink Floyd, The Pretty Things, and The Who on vinyl but never The Beatles. Having said that, two Beatle songs did play a small part in his concerts between 1972 and 1974. Most notably, The Beatles very first British single ‘Love Me Do’ was often played as a medley with ‘The Jean Genie’. (On the 1990 Sound and Vision Tour, a snippet of ‘A Hard Day’s Night‘ was also sometimes incorporated into ‘The Jean Genie’. He also sang a snippet of ‘With A Little Help From My Friends‘ in the encore of his final concert in 1978). Bowie also occasionally covered ‘This Boy’ (the b-side of ‘I Want To Hold Your Hand’, their fifth British hit single in his concerts) as part of the early ‘Ziggy Stardust’ shows. (I’m probably one of the few people in the world that has this song on bootleg). Speaking of bootlegs, the Chameleon Chronicles CD featured a cover of the 1967 single ‘Penny Lane‘ allegedly by Bowie along with The Monkees song ‘A Little Bit Me, A Little Bit You’ (written by Neil Diamond). Although these songs sound like 1960s Bowie, they were actually from a 1967 LP (Hits ’67) and sung by session singer (Tony Steven). Nicholas Pegg (in his great book The Complete David Bowie) also noted that Bowie’s late 1960s group Feathers included ‘Strawberry Fields Forever‘ in their live set and that Bowie performed ‘When I’m Sixty-Four‘ in his 1968 live cabaret show after his own song ‘When I’m Five‘).

It was in 1975 that Bowie worked with Lennon musically, and Lennon appeared on two songs of Bowie’s 1975 LP Young Americans (although Bowie gave Lennon a name check in his 1971 song ‘Life On Mars‘ – “Now the workers have struck for fame/’Cause Lennon’s on sale again”). The most well-known was ‘Fame’ (one of my own personal favoutrites) which went to No.1 in the US chart (but only No.17 here in the UK) and had a Bowie co-writing credit with Lennon (along with Bowie’s guitarist Carlos Alomar). Lennon was apparently reluctant to be acknowledged as co-writer but Bowie insisted (probably just to say he had a ‘Bowie/Lennon’ song in his canon and maybe because he was a little starstruck). The song should arguably include other co-writers as the riff was based on the song ‘Foot Stompin’’ (also covered by Bowie) by the doo-wop band The Flares (sometime referred to as The Flairs). Lennon also played on a version of The Beatles’ song ‘Across The Universe’ but was arguably the weakest song on the LP. It’s also worth mentioning that the title track also included a line – and tune –  from The Beatles ‘A Day In The Life‘ (“I heard the news today, oh boy”). Bowie and Lennon were also photographed together at the 1975 US Grammy Awards (where Bowie presented the award for the best ‘rhythm and blues’ performance by a female vocalist Aretha Franklin). This was around the height of Bowie’s cocaine addiction and he subsequently went in to say that he has no recollection of being there at all. In the same year, Bowie also appeared on singer Cher‘s US television show and sang a medley of songs that included ‘Young Americans‘ and The Beatles ‘Day Tripper‘.

Like millions of people around the world (including myself), Lennon’s death in 1980 hit Bowie hard. Not only had he lost a good friend, but he began to think of his own mortality and how easy it would be for a crazed fan to kill him in some kind of copycat assassination. At the time, Bowie was receiving rave reviews for his portrayal of Joseph Merrick in The Elephant Man on Broadway. (I’ve always been interested in The Elephant Man as I may even be a distant relation as my grandmother was a Merrick). He soon stepped down from the role and went into ‘semi-retirement’ before re-emerging in 1983 with his biggest selling single and album Let’s Dance.

Since Lennon’s death, Bowie has covered three Lennon solo tracks (‘Imagine’, ‘Mother’, and ‘Working Class Hero’). He sang ‘Imagine’ at a concert in Hong Kong (December 8, 1983) three years to the day since Lennon had been shot (a soundboard recording of which appears on a number of different Bowie bootlegs). In 1989, Bowie recorded the first of two Lennon songs taken from Lennon’s most psychologically inspired album, John Lennon/Plastic Ono Band (1970) written while undergoing primal therapy (see my previous blog for an overview on primal therapy in music). The first was ‘Working Class Hero’ for the 1989 ill-fated album Tin Machine (often voted one of Bowie’s worst cover versions by fans). The second track he recorded was ‘Mother’ (in 1998) for a John Lennon tribute album that Lennon’s widow (Yoko Ono) was putting together. Unfortunately, the album was never released but in 2006 it was leaked on the internet and has now appeared on many Bowie bootlegs. Although Bowie and Lennon never collaborated musically again, they remained close friends until Lennon’s death.

As far as I am aware, the only other Beatle-related song that Bowie has ever recorded was ‘Try Some, Buy Some’ that appeared on George Harrison’s 1973 LP Living In The Material World. Bowie covered the song for his 2003 album Reality, and although this was recorded not long after Harrison’s death from throat cancer, Bowie claimed that he thought it was Ronnie Spector’s song (ex-lead singer of The Ronettes), as she was the first artist to record in 1971. It was also claimed by German newspaper Frankfurter Allgemeine Zeitung (26 January 2013) that Bowie’s 2001 song from Heathen, ‘Everyone Says ‘Hi’’ was a tribute to Harrison but I have yet to see this conformed by anyone within the Bowie camp. Harrison met Bowie in Memphis during his 1974 Dark Horse tour. In a 1974 interview to a New York radio station, Harrison said:

“I just met David Bowie [during the Dark Horse Tour]…David Bowie, these were my very words, and I hope he wasn’t offended by it because all I really meant was what I said. I pulled his hat up from over his eyes and said: ‘Hi, man, how are you, nice to meet you,’ pulled his hat up and said, you know, ‘Do you mind if I have a look at you, to see what you are because I’ve only ever seen those dopey pictures of you.’ I mean, every picture I’ve ever seen of David Bowie, or Elton John, they just look stupid to me…I want to see, you know, who the person is”.

It wasn’t until 1974 that Bowie and Lennon first met each other at a Hollywood party hosted by actress Elizabeth Taylor. Lennon was with his girlfriend May Pang at the time (during his 18-month separation from Yoko). According to Pang, Bowie and Lennon “hit it off instantly” and kept in touch. When John went back to Yoko, Pang remained friends with Bowie and eventually married Tony Visconti, Bowie’s long-time record producer.

One of the more interesting articles on the relationship between Bowie and The Beatles was by Peter Doggett – author of books on both artists. In a 2011 blog he noted:

“I was struck during the research of [my book ‘The Man Who Sold The World’] by the influence that the Beatles had on Bowie’s work in the 70s. Some of that influence is obvious – the McCartney-inspired piano styling of ‘Oh! You Pretty Things‘, for example. As early as 1965, in an obscure song entitled ‘That’s Where My Heart Is’, Bowie sounded as if he was learning how to write songs by listening to [The Beatles second 1963 album] ‘With The Beatles’…in the book I talk about the apparent Fab Four influence on ‘Blackout‘ from the ‘Heroes‘ LP. But the single most dramatic role played by the Beatles in Bowie’s 70s work was exerted by John Lennon’s ‘Plastic Ono Band’ album. You can hear a touch of Lennon in the way Bowie sings ‘Space Oddity’ in 1969; some Beatles-inspired backing vocals on ‘Star’ from the Ziggy Stardust album; and, of course, yer actual Lennon voice and guitar on Bowie’s cover of ‘Across The Universe’ and his hit single ‘Fame’. All of which made me wish that Bowie had made a whole album (1980’s Scary Monsters, perhaps) in similar vein. So I was intrigued to learn from Bowie fan Martyn Mitchell that guitarist Adrian Belew recalled working on a whole set of Plastic Ono Band-inspired tracks with Bowie around this period, but that Bowie never completed or issued them. Perhaps he was hoping that he might persuade Lennon himself to join him in the studio – until fate, and a madman, intervened”.

Following Bowie’s death, the remaining Beatles (Paul McCartney and Ringo Starr) both played tribute to Bowie’s genius. Ringo (who appeared in the Ziggy Stardust and the Spiders From Mars movie filmed in 1973 and released 1983) tweeted a short message, while McCartney’s message was a little more heartfelt:

“Very sad news to wake up to on this raining morning. David was a great star and I treasure the moments we had together. His music played a very strong part in British musical history and I’m proud to think of the huge influence he has had on people all around the world. I send my deepest sympathies to his family and will always remember the great laughs we had through the years. His star will shine in the sky forever”.

As far as I am aware, Bowie only met McCartney a few times in his life most notably at the July 1973 premiere of the James Bond film Live and Let Die (with McCartney writing the theme song), and at the Live Aid concert in 1985 (where Bowie was on of the backing singers as McCartney performed ‘Let It Be’). Yoko movingly described Bowie as a “father figure” to their son Sean Lennon following Lennon’s death:

“John and David respected each other. They were well matched in intellect and talent. As John and I had very few friends, we felt David was as close as family. After John died, David was always there for Sean and me. When Sean was at boarding school in Switzerland, David would pick him up and take him on trips to museums and let Sean hang out at his recording studio in Geneva. For Sean, this is losing another father figure. It will be hard for him, I know. But we have some sweet memories which will stay with us forever”.

It could perhaps be argued that Bowie and Lennon were cut from the same psychosocial cloth. They both had middle class backgrounds and had many of the same musical heroes (Little Richard, Chuck Berry, and Elvis Presley being the most salient – Bowie sharing Presley’s birthday on January 8). They were both interested in the arts more generally and they were both singers, songwriters, artists, and writers (to a greater or lesser extent). Although Lennon rarely engaged in acting, he always appeared at ease in front of the camera. They both knew how to use the media for their own artistic advantage. In short, there’s a lot that psychologists can learn from both of them.

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.

Doggett, P. (2009). The Art and Music of John Lennon. London: Omnibus Press.

Doggett, P. (2012). The Man Who Sold The World: David Bowie and the 1970s. London: Vintage.

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

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.

Target practice: The psychology of New Year’s resolutions and how to keep them

(Please note: This blog is a slightly extended and fully referenced version of an article that was first published in The Conversation).

Academic research by Dr. John Norcross and his colleagues has shown that up to 50% of adults make New Year’s resolutions (NYRs) and the most common resolutions are wanting to lose weight, doing more exercise, quitting smoking, and saving money. It’s a time that individuals want to re-invent themselves but less than 10% actually manage to keep the NYRs after a few months.

We’ve all made NYRs that we begin with the best of intentions but within a few weeks are back to our old ways. As a Professor of Behavioural Addiction I know how easy people can fall into bad habits, and why on trying to give up those habits is easy to relapse. NYRs usually come in the form of lifestyle changes and changing behaviour that has become routine and habitual (even if they are not problematic) can be very hard to break.

The main reason that people don’t stick to their NYRs is that they set too many and/or they are unrealistic to achieve. There has also been some research by Dr. Janet Polivy and Dr. Peter Herman into ‘false hope syndrome’ (FHS) that is applicable to NYRs. FHS is characterized by an individual’s unrealistic expectations about the likely speed, amount, ease, and consequences of changing their behaviour.

For some people, it takes something radical for them to change their ways. It took a medical diagnosis to make me give up alcohol and caffeine, and it took pregnancy for my partner to give up cigarette smoking. To change your day-to-day behaviour you also have to change your thinking. But there are tried and tested ways that can help individuals stick to their NYRs and here are my personal favourites:

Be realistic You need to begin by making NYRs that you can keep and that are practical. If you want to reduce your alcohol intake because you tend to drink alcohol every day, don’t immediately go teetotal. Try to cut out alcohol every other day or have a drink once every three days. Also, breaking up the longer-term goal into more manageable short-term goals can also be beneficial and more rewarding. The same principle can be applied to exercise or eating more healthily.

Do one thing at a time One of the easiest ways routes to failure is to have too many NYRs. If you want to be fitter and healthier, do just one thing at a time. Give up drinking. Give up smoking. Join a gym. Eat more healthily. But don’t do them all at once. Chose just one and do your best to stick to it. Once you have got one thing under your control, you can begin a second resolution.

Be SMART Anyone working in a jobs that includes objective-setting will know that any goal should be SMART (i.e., specific, measurable, achievable, realist and time-bound). NYRs should be no different. Cutting down alcohol drinking is an admirable goal but it’s not SMART. Drinking no more than two units of alcohol every other day for one month is a SMART resolution. Connecting the NYR to a specific aspirational goal can also be motivating (e.g., dropping a dress size or losing two inches off your waistline in time for the next summer holiday).

Tell someone your resolution(s) Letting family and friends around you know that you have a NYR that you really want to keep will act as both a safety barrier and a face-saver. If you really want to cut down smoking or drinking, real friends will not put temptation in your way and can help you in monitoring your day-to-day behaviour. Never be afraid to ask for help and support from those around you.

Change your behaviour with others – Trying to change habitual behaviour on your own can be difficult. For instance, if you and your partner both smoke, drink and/or eat unhealthily, it is really hard for one partner to change their behaviour if the other is still engaged in the same old bad habits. By having the same NYR (e.g., going on a diet), the chances of success will improve if you are both in it together.

Behavioural change isn’t limited to the New Year Changing your behaviour (or some aspect of it) doesn’t have to be restricted to the start of the New Year. It can be anytime.

Accept lapses as part of the process – It is inevitable that when trying to give up something (alcohol, cigarettes, junk food) that there will be lapses. You shouldn’t feel guilty about giving in to your cravings but accept that it is part of the learning process in enabling behavioural change. Bad habits can take years to become engrained and there are no quick fixes in making major lifestyle changes. These may be clichés but we learn by our mistakes and every day is a new day and you can start each day afresh. Right here. Right now.

Finally, some of you reading this might think all of this sounds like too much hard work and that it’s not worth making NYRs to begin with. However, research by John Norcross and colleagues has also shown that individuals who make NYRs are ten times more likely to achieve their goals than those that don’t make explicit NYRs. Food for thought (rather than thought for food)!

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

Further reading

Koestner, R. (2008). Reaching one’s personal goals: A motivational perspective focused on autonomy. Canadian Psychology/Psychologie Canadienne, 49(1), 60-67.

Marlatt, G. A., & Kaplan, B. E. (1972). Self-initiated attempts to change behavior: A study of New Year’s resolutions. Psychological Reports, 30(1), 123-131.

Norcross, J. C. (2006). Integrating self-help into psychotherapy: 16 practical suggestions. Professional Psychology: Research and Practice, 37(6), 683-693.

Norcross, J. C., & Mrykalo, M. S. (2002). Auld Lang Syne: Success predictors, change Processes, and self-reported outcomes of New Year’s resolvers and nonresolvers. Journal of Clinical Psychology, 58, 397-405.

Norcross, J. C., Ratzin, A. C., & Payne, D. (1989). Ringing in the New Year: The change processes and reported outcomes of resolutions. Addictive Behaviors, 14(2), 205-212.

Norcross, J. C., & Vangarelli, D. J. (1989). The resolution solution: longitudinal examination of New Year’s change attempts. Journal of Substance Abuse, 1(2), 127-134.

Polivy, J. (2001). The false hope syndrome: Unrealistic expectations of self-change. International Journal of Obesity and Related Metabolic Disorders, 25, S80-84.

Polivy, J., & Herman, C. P. (2000). The False-Hope Syndrome Unfulfilled Expectations of Self-Change. Current Directions in Psychological Science, 9(4), 128-131.

Polivy, J., & Herman, C. P. (2002). If at first you don’t succeed: False hopes of self-change. American Psychologist, 57(9), 677-689.

Relatively stressed: How to cope with family-related tensions this Christmas

As much as we all want Christmas to revolve around perfect presents, tasty food and drink, no work, and leisure time to be spent with close family and friends, it can be a psychologically tense and stressful time even among the most happy and well-adjusted families.

Not only is there the crowded shopping, the writing of copious Christmas cards, the wrapping of presents, and the travelling, but there is often the extra burden of obligatory extended family staying and/or visiting. Patience can be pushed to the outer limit throughout the festive period. Trying to satisfy multiple family members all of who have different needs is difficult at best.

Additionally, family reunions have the potential to bring about a range of deep- rooted emotions including jealousy, resentment, competitiveness, and (sibling) rivalry. Expectations may not be met. Instead of joy and happiness we may feel stressed, hurt and/or exhausted. So how do you cope with the family-related stresses and strains during the festive period? Here are my top ten tips.

  • Keep expectations of time spent with family hopeful but realistic – You may not be able to change your family’s dynamics, but at least be aware of how your family can affect your psychological mood state. Some relatives may use the Christmas family reunion to play out family dynamics or re-enact old sibling rivalries. Knowing the problems you might expect from particular family members makes them easier to deal with should they arise. If possible, find ways to shorten or eliminate the family experiences that put you in a bad, anxious or depressed mood.
  • Make your family time count – Instead of watching television or DVDs for hours on end, do something together as a family. Go for a walk after the Christmas dinner, play a karaoke video game, play a board game or a parlour game like charades. Basically, do anything where you have to interact with each other. Even making the Christmas dinner could be a communal activity where each adult and child has a specific job.
  • Drink alcohol in moderationAlcohol can be a double-edged sword so be mindful when drinking with family members. Alcohol’s disinhibiting effect can help facilitate friendly family interaction but drinking too much during family gatherings can sometimes lead to saying things that we later regret.
  • Don’t take everything personally – The ability to step back from a stressful situation caused by a family member is a skill to be cultivated. Remember that any family member is an individual with moods and desires that are separate from their relationship with you. If something really irritates or stresses you, think about what triggered the feeling, then try to let it go and don’t take it personally.
  • Take time out every day – Stress at Christmas time can sometimes arise just because there is a house full of people with little opportunity for “me” time. Try to find time in the day to do something on your own. Go for a brisk walk, pop to the newsagents, have a long bath, tidy up the kitchen while listening to a soccer match or the Ashes, or put your headphones on and listen to your favourite music. Do anything that gives you that much needed little ‘time out’ for the day.
  • Be organized – Sounds easy but good organization can often be the key to a hassle-free day. Starting out each day with some kind of ‘game plan’ can help alleviate the typical stress that arises from the Christmas family politics.
  • Be assertive – Again, easier said than done but learning the power of how to be politely assertive and just saying ‘no’ when faced with family obligations over Christmas can pay big stress-free dividends. Learn how to set boundaries with family so you can experience the true joy of the festive season.
  • Beware the vicious circle – Children, as well as adults, can feel stressed during Christmas. Children often pick up on signs of your anxiety and they themselves can become stressed. This can lead to you feeling even more stressed. In short, a vicious circle where stress and anxiety feeds off each other. Try to hide the stress you feel, especially from children, as this may decrease the length of time you feel anxious.
  • Be grateful for what you have in life – No matter how stressful your family may be over the festive period, it is always good to be grateful for the things you have in your life. As one psychologist noted in his blog: “If you are reading this online, then you are alive, have access to the internet, and have at least some free time to surf the net”.
  • Remember that relationships are the most important thing we have – All of us need to remember that the Christmas feelings of joy and happiness come not from the gifts, decorations, food and drink, but from our relationships with other people. Christmas is about relationships – not only the relationship you have your family and friends, but also the relationship you have with yourself. If we make our close relationships the top priority, then the rest of the Christmas should fall naturally into place.

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

Cured meets: Treating addictive behaviours

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

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

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

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

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

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

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

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

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

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

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

Further reading

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

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

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

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

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

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

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

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

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

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