Category Archives: Cyberpsychology

If phonely: Are you addicted to your mobile phone?

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

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

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

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

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

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

smartphone-addiction

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Further reading

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

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

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

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

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

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

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

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

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

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

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

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

The construct of ‘selfitis’

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

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

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

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

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

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

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

The construct of ‘behavioural addiction’

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

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

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

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

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

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

 

References

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

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

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

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

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

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

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

Remote control: ‘Cashing out’ in sports betting

“Cash Out lets you take profit early if your bet is coming in, or get some of your stake back if your bet is going against you – all before the event you’re betting on is over. Cash Out offers are made in real time on your current bets, based on live market prices. Whenever you are ready to Cash Out, simply hit the yellow button. Cash out is available on singles and multiples, on a wide range of sports, including football, tennis, horse racing, and many more! You can Cash Out of bets pre-play, in-play, and between legs” (Definition of ‘cash out’ betting on Betfair website, 2017).

Most European sports betting operators now feature ‘cash out’ functionalities in their online platforms. This means that bettors can withdraw their bets before the event bet upon has concluded, obtaining a smaller but guaranteed return if the outcome of the bet is going their way, or, conversely, cutting down the monetary impact of a foreseeable loss. The ‘cash out’ functionality has rapidly become popular among sports bettors that bet in-play (i.e., during the game on things such as soccer matches and horse races) as a way of maximising value on the bets they have made.

Industry voices such as David O’Reilly, from Colossus Bets, have identified four major benefits of cash out features for bookmakers: (i) reducing the volatility of the operator’s revenue; (ii) increasing the recycling of player returns, with more players banking smaller amounts; (iii) enabling players to avoid their ‘near miss’ frustration; and (iv) improving the player engagement with the platform by introducing a mechanism that promotes constant checking. However, for sports bettors, cashing out strategies might typically involve cutting down the profit while being ahead but rarely reducing the loss when going behind. In this regard, cashing out does not appear to differ greatly from other new internet-based betting forms (e.g. so-called ‘exotic’ or multiple bets), which have been found to possess, in general, higher expected losses for gamblers and greater profit margins for operators.

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However, beyond the feature’s financial rationale, cash out affects the nature of sports betting in more meaningful ways. It is, arguably, a game-changer, that leads (along with other features such as ‘edit my acca’ features in which specific bets can be removed from ‘accumulator’ bets) to the transformation of sports betting from a discontinuous to a continuous form of gambling. Here, our contention is that cash out is a key component of the contemporary bettor-bookmaker interaction, and that the widespread adoption by devoted sports bettors merits a closer look into the implications of such an interaction from a problem gambling perspective. Such an examination also suggests that regulators and policymakers need to think about how to protect gambling consumers from the potential harm caused by this new type of betting.

Structural characteristics have been proposed as a determining factor that can influence problem gambling behaviour. Structural characteristics are those associated with the design of a gambling product that shape the way gamblers interact with it. Typical structural characteristics include, but are not limited to, bet frequency, bet duration, event frequency, near misses, stake size, jackpot size, probability of winning, and interface design (e.g., the use of music and colour stimuli in the design of slot machines).

The internet has altered significantly the structural characteristics of gambling and sports betting more specifically. For example, in a number of European countries, the football (soccer) pools used to comprise bets placed during a weekday on the outcome of a game played typically on a Saturday or Sunday (i.e., a once a week wager). This reward delay was a major protective factor against excessive gambling, which on a psychobiological level has been theorised as an imbalance in an individual’s dopamine receptors, and therefore, highly sensitive to shorter bet reward periods. Betting via the internet has reduced such delays in receiving rewards from gambling, thus modifying a major structural characteristic of betting from once a week to (in some instances) every few minutes.

In parallel to the increased uptake of Internet betting in many jurisdictions, a second dynamic, namely globalisation, has further widened the possibilities of betting across countries, sports, and time zones, ultimately transforming sports betting into a 24/7 activity where the bookmaker never closes the shop any day during the year. For the first time, if a gambler has a craving to bet, the market is able to respond to that demand anytime and anywhere via a range of Wi-Fi enabled portable devices (e.g., smartphone, tablets, laptops, etc.). Virtual sports have expanded the availability of betting options even more, eliminating the need to bet on real world sport events.

Although the time between bets (i.e., bet frequency) was effectively reduced to near zero, the time within bets (i.e., bet duration) changed little until cash out functionality was first introduced by the gaming operator William Hill in December 2012. With cash out features, sports betting has become a potentially continuous gambling activity, one that resembles the playing mechanics the stock market. As with investing in stocks, bet values in in-play sports betting are re-calculated seamlessly. The outcome of a sport event might not be as relevant for many bettors as the value their bet will acquire in the next few seconds, even if that bet turns out to be erroneous at the end of the game. As in stock market investing, betting becomes continuous because non-actions also qualify as actions in themselves. Every single second that a bettor decides not to cash out, a new bet takes place. Eventually, cash out features introduce the notion that it is the bet itself the commodity that is being traded in the sports betting market. This new continuous type of sports betting raises questions concerning the gambling-related harm that could be associated with it. It also suggests that the kinds of regulation found widely in the stock market investment sector might have some utility if applied to this new form of gambling.

From a marketing perspective, cash out functionality is often advertised as a control-enhancing mechanism for bettors. Given that cashing out is typically presented in television advertisements as a risk-free operation, the product is likely to be perceived as reimbursable if the client is not happy with it, arguably promoting less planned gambling behaviours. Some gaming operators use the alternative name of “edit my bet” to refer to cash out, focusing on the capacity of bettors to correct later possible errors of judgement. The problem is that (and as happens in stock market investing), cashing out is only possible at the current value of the stock (which may be inferior to the purchasing price). Additionally, and contrary to what happens in stock market investing, betting operators automatically devalue the bet price immediately after the purchase. For example, a bookmaker will typically offer to cash out for $0.95 or similar a $1 bet placed one second ago, a price devaluation unmotivated by any new information or event actually affecting the predicted value of such a bet.

Beyond its most apparent attributes, we have demonstrated that cash out within in-play gambling is a pivotal feature that has been introduced by the sports betting industry to transform sports betting from what was traditionally a discontinuous form of gambling into a continuous one. It is contended that, although cashing out presupposes more engaged gamblers that feel more in control of their bets, the emotionally charged context in which it is often used and the structural attributes of the product itself might actually make some bettors lose control over their gambling wagers. Consequently, gambling policymakers and regulators should be cognizant of the challenges of this transformation of sports betting and consider the implications for the protection of gambling consumers.

[Note: This article was co-written with Dr. Hibai Lopez-Gonzalez]

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

Further reading

Betfair (2017). Sportsbook: What is cash out and how does it work? Retrieved March 1, 2017, from: https://en-betfair.custhelp.com/app/answers/detail/a_id/4/~/sportsbook%3A-what-is-cash-out-and-how-does-it-work%3F

Gainsbury, S. M. (2015). Online gambling addiction: The relationship between internet gambling and disordered gambling. Current Addiction Reports, 2(2), 185-193.

Griffiths, M.D. (1993). Fruit machine gambling: The importance of structural characteristics. Journal of Gambling Studies, 9, 101-120.

Griffiths, M. D. (2005). A biopsychosocial approach to addiction. Psyke & Logos, 26(1), 9–26.

Griffiths, M.D. & Auer, M. (2013). The irrelevancy of game-type in the acquisition, development and maintenance of problem gambling. Frontiers in Psychology, 3, 621. doi: 10.3389/fpsyg.2012.00621.

Lopez-Gonzalez, H., & Griffiths, M. D. (2016). Understanding the convergence of online sports betting markets. International Review for the Sociology of Sport. http://doi.org/doi:10.1177/1012690216680602

Lopez-Gonzalez, H. & Griffiths, M.D. (2017). ‘Cashing out’ in sports betting: Implications for problem gambling and regulation. Gaming Law Review: Economics, Regulation, Compliance and Policy, 21(4), 323-326.

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

Newall, P. W. S. (2015). How bookies make your money. Judgment and Decision Making, 10(3), 225–231.

Newall, P. W. S. (2017). Behavioral complexity of British gambling advertising. Addiction Research & Theory. http://doi.org/10.1080/16066359.2017.1287901

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

Sports Trading Life. (2015). Is “cash out” actually BAD for betting punters? Retrieved March 1, 2017, from http://sportstradinglife.com/2015/03/is-cash-out-actually-bad-for-punters/

Every little ring: Another look at excessive smartphone use

Last week I did seven back-to-back BBC radio interviews concerning my thoughts on a new study on smartphone use carried out by Opinium Research for Virgin Mobile and reported in a number of papers including the Daily Mail. The company surveyed 2,004 British adults (aged 18 years and over) who own a smartphone as well 200 British teenagers and tweenagers aged between 10 and 17 years. The main findings were that:

  • British adults receive an average of 33,800 mobile phone messages and alerts annually
  • British adults spend the equivalent of 22 days a year checking messages on their smartphones (an average of 26 minutes a day)
  • An average smartphone user gets 93 buzzes a day
  • Those aged between 18 and 24 years have almost three times more messages receiving 239 messages and alerts a day on average (approximately 87,300 a year).
  • On average, Britons are members of six chat groups, although a small minority (2%) are members of 50 groups or more, rising to 7% among those aged 18 to 24 years.
  • One in four adults say they check a WhatsApp message instantly, with this increasing to almost one in three among 18 to 24-year-olds.
  • Smartphone users receive 427% more messages and notifications than they did a decade ago
  • Smartphone users sent 278% more messages than they did a decade ago

The survey found a contributing factor behind the surge in the number of messages received was the rise of group chats on platforms like WhatsApp and Facebook. In the press release, Dr Dimitrios Tsivrikos (consumer and business psychologist at University College London) said:

“The boom in smartphone use was a positive trend and allowed consumers greater control over their lives. In an age where we are constantly surrounded by endless tasks, always flooded with a sea of data, smartphones allow us to manage our lives in a way that suits us. From calendars and reminders, to emails and instantaneous access to an encyclopaedia of human knowledge, smartphones give us total control, right at our fingertips.”

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There was nothing in the study that I found particularly surprising but I was hoping to see what survey had found from those under 18 years of age (but nothing was reported in the national newspapers and I’ve been unable to track down anything beyond the press release).

In my radio interviews, most of the presenters wanted to know the extent to which individuals are now ‘addicted’ to their mobile phones. I then trotted out my usual response that ‘people are no more addicted to their smartphones than alcoholics are addicted to a bottle’ and said if there was anything addicting then it was the application (e.g., gaming, gambling, shopping, social networking, etc.) rather than the smartphone itself. I also went through the addiction components model and hypothesized what the behaviour of a smartphone addict would look like if they were genuinely addicted to their smartphone applications:

  • Salience – This occurs when using a smartphone becomes the single most important activity in the person’s life and dominates their thinking (preoccupations and cognitive distortions), feelings (cravings) and behaviour (deterioration of socialised behaviour). For instance, even if the person is not actually on their smartphone they will be constantly thinking about the next time that they will be (i.e., a total preoccupation with smartphone use).
  • Mood modification – This refers to the subjective experiences that people report as a consequence of using their smartphone and can be seen as a coping strategy (i.e., they experience an arousing ‘buzz’ or a ‘high’ or paradoxically a tranquilizing feel of ‘escape’ or ‘numbing’ whenever they use their smartphone).
  • Tolerance – This is the process whereby increasing amounts of time on a smartphone are required to achieve the former mood modifying effects. This basically means that for someone engaged on a smartphone, they gradually build up the amount of the time they spend using a smartphone every day.
  • Withdrawal symptoms – These are the unpleasant feeling states and/or physical effects (e.g., the shakes, moodiness, irritability, etc.), that occur when the person is unable to access their smartphone because they have mislaid or lost it, are too ill to use it, in a place with no reception, etc.
  • Conflict – This refers to the conflicts between the person and those around them (interpersonal conflict), conflicts with other activities (social life, hobbies and interests) or from within the individual themselves (intra-psychic conflict and/or subjective feelings of loss of control) that are concerned with spending too much time on a smartphone.
  • Relapse – This is the tendency for repeated reversions to earlier patterns of excessive smartphone use to recur and for even the most extreme patterns typical of the height of excessive smartphone use to be quickly restored after periods of control.

Using these criteria, I then went on to say that very few people would be classed as addicted to their smartphones. However, I did point out that such behaviour is on a continuum and that there may be a growing number of people that experience problematic smartphone use rather than being addicted. The examples I used included those individuals who would rather spend time on their smartphone than spending it with their partner and/or children, or individuals who spend so much time on their smartphone that it impacts on their job or their education (depending upon how old they are). Neither of these on their own (or together) necessarily indicate addictive use of smartphones but could be a sign that such individuals are at risk for developing an addiction to the applications on their smartphone. However, I would still argue that someone that spends all their time on social networking sites and social media (via their mobile phone) are a social media addict rather than a smartphone addict although others might see this as a semantic difference rather than a difference of substance. Whatever we call the behaviour, there does seem to be growing evidence that smartphones play a major role in people’s lives and that a small minority appear to have problematic use (as outlined in a number of studies that I have co-authored – see ‘Further reading’ below).

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

Further reading

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

Carbonell, X., Chamarro, A., Beranuy, M., Griffiths, M.D. Oberst, U., Cladellas, R. & Talarn, A. (2012). Problematic Internet and cell phone use in Spanish teenagers and young students. Anales de Psicologia, 28, 789-796.

Csibi, S., Griffiths, M.D., Cook, B., Demetrovics, Z., & Szabo, A. (2018). The psychometric properties of the Smartphone: Applications-Based Addiction Scale (SABAS). International Journal of Mental Health and Addiction. doi: 10.1007/s11469-017-9787-2

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

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

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

Lopez-Fernandez, O., Kuss, D.J., Romo, L. Morvan, Y., Kern, L., … Griffiths, M.D., … Billieux, J. (2017). Self-reported dependence on mobile phones in young adults: A European cross-cultural empirical survey. Journal of Behavioral Addictions, 6, 168-177.

Lopez-Fernandez, O., Männikkö, N., Kääriäinen, M., Griffiths, M.D., & Kuss, D.J. (2018). Mobile gaming does not predict smartphone dependence: A cross-cultural study between Belgium and Finland. Journal of Behavioral Addictions. doi: 10.1556/2006.6.2017.080

Richardson, M., Hussain, Z. & Griffiths, M.D. (2018). Problematic smartphone use, nature connectedness, and anxiety. Journal of Behavioral Addictions. doi: 10.1556/2006.7.2018.10

 

To see or not to see: A brief look at hallucinations in virtual reality applications

As a teenager I was fascinated with LSD purely as a consequence of my love of The Beatles and its alleged association with songs such as ‘Lucy in the Sky with Diamonds‘ (I say ‘alleged’ because all Beatle fanatics know that this song got its’ title from a drawing by John Lennon’s son Julian and that lyrically the song was inspired by the writings of Lewis Carroll, the creator of Alice in Wonderland [AIW], a book which gave its’ name to AIW Syndrome that I examined in a couple of previous blogs).

When I first started teaching my ‘Addictive Behaviours’ module back in 1990, almost all my lectures concentrated on drug addictions (as opposed to behavioural addictions which now take centre stage in my teaching), and it was my session on hallucinogenic drugs (also known as psychedelic drugs) that was always the most fun to teach and the topic that students appeared to be most engaged in. Like many of my students, I have always been interested in altered states of consciousness both in my own research into addiction and the topic more generally.

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The reason why I mention all these things as that I did a media interview on the hallucinogenic effects of virtual reality products. The interview was based on comments by Microsoft researcher Mar Gonzalez Franco, who said that virtual reality will soon replace the need for hallucinogenic drugs. More specifically, she was quoted as saying:

“By 2027 we will have ubiquitous virtual reality systems that will provide such rich multi-sensorial experiences that will be capable of producing hallucinations which blend or alter perceived reality. Using this technology, humans will retrain, recalibrate and improve their perceptual systems…In contrast to current virtual reality systems that only stimulate visual and auditory senses, in the future the experience will expand to other sensory modalities including tactile with haptic devices“.

Claims that VR products have the potential to induce hallucinogenic experiences have already started appearing in the media. A recent story in the Daily Mail reported that there was already a VR app (SelfSound) that claimed it can reproduce the effects of hallucinogenic drugs and plays on the neurological phenomena known as synaesthesia and that a “program is used to promote mediation through creating abstract reality [and] plays face-melting music with synesthetic DMT-style visualizations uniquely generated in response to [a person’s] voice”. (DMT is an abbreviation for dimethyltryptamine, a powerful hallucinogenic drug).

Over the last seven years, I have published a series of studies with Dr. Angelica Ortiz de Gotari (some of them listed in the ‘Further reading’ section below) showing that hallucinations are common among video gamers in our working examining Game Transfer Phenomena (GTP). Therefore, it’s no surprise that VR games can do the same thing. We have reported that visual and auditory hallucinations are commonly experiences by regular videogame players.

For instance, one of our studies published in the International Journal of Human-Computer Interaction found that some video gamers experience altered visual perceptions after playing (e.g., distorted versions of real world surroundings). Others saw video game images and misinterpreted real life objects after they had stopped playing. Gamers reported seeing video game menus popping up in front their eyes when they were in a conversation, or saw coloured images and ‘heads up’ displays when driving on the motorway. Our study analysed 656 experiences from 483 gamers collected in 54 online video game forums. Visual illusions can easily trick the brain, and staring at visual stimuli can cause ‘after-images’ or ‘ghost images’ among videogame players. We found that GTP were triggered by associations between video game experiences, and objects and activities in real life contexts. Our findings also raised questions about the effects of the exposure to specific visual effects used in video games.

We also reported that in some playing experiences, video game images appeared without awareness and control of the gamers, and in some cases, the images were uncomfortable, especially when gamers could not sleep or concentrate on something else. These experiences also resulted in irrational thoughts such as gamers questioning their own mental health, getting embarrassed or performing impulsive behaviours in social contexts. However, other gamers clearly thought that these experiences were fun and some even tried to induce them.

Visual experiences identified in GTP show us the interplay of physiological, perceptual and cognitive mechanisms and the potential of learning with video games even without awareness. It also invites us to reflect about the effects of prolonged exposure to synthetic stimuli and the challenges that the human mind affront due to the technological advances that are still to come. However, because we collected our data for most of our published studies from online video game forums, the psychological profile of the gamers in our studies are unknown. However, different gamers reported similar experiences in the same games. This highlights the relevance of the video games’ structural characteristics but gamers’ habits also appear to be crucial. Some gamers may be more susceptible than others to experience GTP. The effects of these experiences appear to be short-lived, but some gamers experience them recurrently. It goes without saying (but I’ll say it anyway) that more research is needed to understand the cognitive and psychological implications of GTP. Most of these GTP experiences are viewed positively but a small minority of players find them detrimental.

Whether such hallucinations – either in typical videogames or VR videogames – can be induced on demand is debatable. Very few players in our own research said they were able to induce hallucinations. At present, we simply don’t know what the long-term effects of VR gaming will be and that goes for VR-induced gaming hallucinations too. It may be the case that VR induced hallucinogenic states will be ‘safer’ than ones induced by psychedelic drugs as there is no ingestion of a psychoactive substance, but that’s just speculation on my part.

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

Further reading

Cawley, C. (2016). Virtual Reality could make you hallucinate; Don’t freak out. Tech Co, December 15. Located at: http://tech.co/virtual-reality-hallucinate-dont-freak-2016-12

Hamill, J. (2016). Windows of perception: Microsoft says virtual reality will soon have same mind-bending effects as LSD. The Sun, December 7. Located at: https://www.thesun.co.uk/news/2347705/microsoft-says-virtual-reality-will-soon-have-same-mind-bending-effects-as-lsd/

Liberatore, S. (2016). That’s trippy! Watch the VR app that claims to be able to reproduce the effects of a hallucinogenic drug. Daily Mail, May 4, Located at: http://www.dailymail.co.uk/sciencetech/article-3572184/That-s-trippy-Watch-VR-app-claims-able-reproduce-effects-hallucinogenic-drug.html

Ortiz de Gortari, A.B. & Griffiths, M.D. (2012). An introduction to Game Transfer Phenomena in video game playing. In J. Gackenbach (Ed.), Video Game Play and Consciousness (pp.223-250). Hauppauge, NY: Nova Science.

Ortiz de Gortari, A.B. & Griffiths, M.D. (2014). Altered visual perception in Game Transfer Phenomena: An empirical self-report study. International Journal of Human-Computer Interaction, 30, 95-105.

Ortiz de Gortari, A.B. & Griffiths, M.D. (2014). Auditory experiences in Game Transfer Phenomena: An empirical self-report study. International Journal of Cyber Behavior, Psychology and Learning, 4(1), 59-75.

Ortiz de Gortari, A.B. & Griffiths, M.D. (2014). Automatic mental processes, automatic actions and behaviours in Game Transfer Phenomena: An empirical self-report study using online forum data. International Journal of Mental Health and Addiction, 12, 432-452.

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

Ortiz de Gortari, A.B. & Griffiths, M.D. (2015). Auditory experiences in Game Transfer Phenomena: An empirical self-report study. In: Gamification: Concepts, Methodologies, Tools, and Applications (pp.1329-1345). Pennsylvania: IGI Global.

Ortiz de Gortari, A.B. & Griffiths, M.D. (2016). Prevalence and characteristics of Game Transfer Phenomena: A descriptive survey study. International Journal of Human-Computer Interaction, 32, 470-480.

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

Rothman, P. (2014). Virtual Reality and Drugs – Yes, you should get high before using VR. H Plus Magazine, July 31. Located at: http://hplusmagazine.com/2014/07/31/virtual-reality-and-drugs-yes-you-should-get-high-before-using-vr/

Screenage rampage: What should parents know about videogame playing for children?

Last month, the World Health Organisation (WHO) announced that it was planning to include ‘Gaming Disorder’ (GD) in the latest edition of the International Classification of Diseases. This followed the American Psychiatric Association’s decision to include ‘Internet Gaming Disorder’ in the latest edition of the Diagnostic and Statistical Manual of Mental Disorders in 2013. According to the WHO, an individual with GD is a person who lets playing video games “take precedence over other life interests and daily activities,” resulting in “negative consequences” such as “significant impairment in personal, family, social, educational, occupational or other important areas of functioning.”

I have been researching videogame addiction for nearly 30 years, and during that time I have received many letters, emails, and telephone calls from parents wanting advice concerning videogames. Typical examples include ‘Is my child playing too much?’, ‘Will playing videogames spoil my pupils’ education?’, ‘Are videogames bad for children’s health? and ‘How do I know if a child is spending too long playing videogames?’ To answer these and other questions in a simple and helpful way, I have written this article as a way of disseminating this information quickly and easily.

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To begin with parents should begin by finding out what videogames their children are actually playing! Parents might find that some of them contain material that they would prefer them not to be having exposure to. If they have objections to the content of the games they should facilitate discussion with children about this, and if appropriate, have a few rules. A few aims with children should be:

  • To help them choose suitable games which are still fun
  • To talk with them about the content of the games so that they understand the difference between make-believe and reality
  • To discourage solitary game playing
  • To guard against obsessive playing
  • To follow recommendations on the possible risks outlined by videogame manufacturers
  • To ensure that they have plenty of other activities to pursue in their free time besides the playing of videogames

Parents need to remember that in the right context videogames can be educational (helping children to think and learn more quickly), can help raise a child’s self-esteem, and can increase the speed of their reaction times. Parents can also use videogames as a starting point for other activities like painting, drawing, acting or storytelling. All of these things will help a child at school. It needs to be remembered that videogame playing is just one of many activities that a child can do alongside sporting activities, school clubs, reading and watching the television. These can all contribute to a balanced recreational diet.

The most asked question a parent wants answering is ‘How much videogame playing is too much? To help answer this question I devised the following checklist. It is designed to check if a child’s videogame playing is getting out of hand. Ask these simple questions. Does your child:

  • Play videogames every day?
  • Often play videogames for long periods (e.g., 3 to 6 hours at a time)?
  • Play videogames for excitement or ‘buzz’ or as a way of forgetting about other things in their life?
  • Get restless, irritable, and moody if they can’t play videogames?
  • Sacrifice social and sporting activities to play videogames?
  • Play videogames instead of doing their homework?
  • Try to cut down the amount of videogame playing but can’t?

If the answer is ‘yes’ to more than four of these questions, then your child may be playing too much. But what can you do if your child is playing videogames too much?

  • First of all, check the content of the games. Try and give children games that are educational rather than the violent ones. Parents usually have control over what their child watches on television – videogames should not be any different.
  • Secondly, try to encourage video game playing in groups rather than as a solitary activity. This will lead to children talking and working together.
  • Thirdly, set time limits on children’s playing time. Tell them that they can play for a couple of hours after they have done their homework or their chores – not before.
  • Fourthly, parents should always get their children to follow the recommendations by the videogame manufacturers (e.g., sit at least two feet from the screen, play in a well-lit room, never have the screen at maximum brightness, and never play videogames when feeling tired).

I have spent many years examining both the possible dangers and the potential benefits of videogame playing. Evidence suggests that in the right context videogames can have positive health and educational benefits to a large range of different sub-groups. What is also clear from the case studies displaying the more negative consequences of playing is that they all involved children who were excessive users of videogames. From prevalence studies in this area, there is little evidence of serious acute adverse effects on health from moderate play. In fact, in some of my studies, I found that moderate videogame players were more likely to have friends, do homework, and engage in sporting activities, than those who played no videogames at all.

For excessive videogame players, adverse effects are likely to be relatively minor, and temporary, resolving spontaneously with decreased frequency of play, or to affect only a small subgroup of players. Excessive players are the most at-risk from developing health problems although more research is needed. If care is taken in the design, and if they are put into the right context, videogames have the potential to be used as training aids in classrooms and therapeutic settings, and to provide skills in psychomotor coordination, and in simulations of real life events (e.g., training recruits for the armed forces).

Every week I receive emails from parents claiming that their sons are addicted to playing online games or that their daughters are addicted to social media. When I ask them why they think this is the case, they almost all reply “because they spend most of their leisure time in front of a screen.” This is simply a case of parents pathologising their children’s behaviour because they think what they are doing is “a waste of time.” I always ask parents the same three things in relation to their child’s screen use. Does it affect their schoolwork? Does it affect their physical education? Does it affect their peer development and interaction? Usually parents say that none of these things are affected so if that is the case, there is little to worry about when it comes to screen time. Parents also have to bear in mind that this is how today’s children live their lives. Parents need to realise that excessive screen time doesn’t always have negative consequences and that the content and context of their child’s screen use is more important than the amount of screen time.

(N.B. This article is an extended version of an article that was originally published by Parent Zone)

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

Further reading

Griffiths, M.D. (2003).  Videogames: Advice for teachers and parents. Education and Health, 21, 48-49.

Griffiths, M.D. (2009). Online computer gaming: Advice for parents and teachers. Education and Health, 27, 3-6.

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

Griffiths, M.D., Kuss, D.J. & Pontes, H. (2016). A brief overview of Internet Gaming Disorder and its treatment. Australian Clinical Psychologist, 2(1), 20108.

Griffiths, M.D. & Meredith, A. (2009). Videogame addiction and treatment. Journal of Contemporary Psychotherapy, 39(4), 47-53.

King, D.L., Delfabbro, P.H. & Griffiths, M.D. (2012). Clinical interventions for technology-based problems: Excessive Internet and video game use. Journal of Cognitive Psychotherapy: An International Quarterly, 26, 43-56.

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.

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

Kuss, D.J. & Griffiths, M.D. (2012). Online gaming addiction in adolescence: A literature review of empirical research. Journal of Behavioral Addictions, 1, 3-22.

Kuss, D.J. & Griffiths, M.D. (2012). Internet gaming addiction: A systematic review. International Journal of Mental Health and Addiction, 10, 278-296.

The born identity: Can online gaming help people with gender dysphoria?

About a year ago, my colleagues and I published what we believe is the very first study of the helping role that video gaming can play in the lives of transgender individuals. Before I get to that, it’s probably worth noting that there have been studies of how gamers and fans play with sexuality, gender, and the video game Minecraft on YouTube as well as papers discussing whether the gaming industry should cater for marginalized groups and develop games for groups where there is little representation within games (e.g., gay and transgendered characters). For instance, there is now a short autobiographical game by Auntie Pixellante called Dys4ia. This is a WarioWare-style game, played only with the arrow keys, chronicling the experiences of a trans woman rectifying her own gender dysphoria. Such videogames raise interesting questions about how those individuals with gender dysphoria utilize gaming as part of their identity.

In a previous blog I briefly looked at gender swapping in online video games including some of my own research. For instance, in 2003 I published a paper in the journal CyberPsychology and Behavior using secondary poll data from online gaming forums. The paper reported that of 10,350 players at the Everlore fan site, 15% had swapped the gender of their main in-game playing character. We also reported a similar finding among 8,694 players at the Allakhazam fan site with 15.5% reporting that they had gender swapped their main in-game character (and more specifically, 14.5% males and 1% were females who had changed the gender of their lead character). In a 2004 follow-up survey among 540 Everquest gamers (again in the journal CyberPsychology and Behavior) my colleagues and I reported that 60% had swapped their online in-game characters. The prevalence of gender swapping was probably much higher in this study because the question related to the gender swapping of any online game character not just their main playing character.

In a small exploratory study I published in 2008 with Dr. Zaheer Hussain in the International Journal of Mental Health and Addiction, we examined why people engaged in gender swapping in a self-selecting sample of 119 online gamers (mean age of 28.5 years). We reported that 57% of gamers had engaged in gender swapping (any character not just their main character), and that males adopting an online female persona believed there were a number of positive social attributes to becoming female characters in male-oriented gaming environments. The study also reported that significantly more females than males had gender swapped their character – mainly to prevent unsolicited male approaches on their female characters. Some females appeared to gender swap purely out of interest to see what would happen in the game (as a personal experiment), while others claimed that they were treated more favourably by male gamers when they played as a male character. Others reported that gender swapping enabled them to play around with aspects of their identity that would not be possible to explore in real life. Other reasons for gender swapping were that (i) female characters had better in-game statistics, (ii) some specific tools were only available with female characters, (iii) the class of character was sometimes only available in one gender, (iv) they played for fun, and/or (v) they did it to so something that they would not normally do in the game (i.e., they did it for a change in their usual playing behaviour).

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Outside of online gaming, a 2002 paper by Hegland and Nelson in the International Journal of Sexuality and Gender Studies noted that the Internet more generally can be used as a tool for expressing gender identity because it allows identities to cross cultural boundaries instantly and without regard for real physical space. They examined 30 cross-dressing websites and argued that for most cross-dressers that visited such websites, the online forum was their primary medium of expression. The users of the website used the Internet to nurture the ability to create a feminine identity, and helped them to pass as a woman in the offline public world. More generally, cross-dressers used the Internet to participate in the larger cultural dialogue of gender.

For an adult to meet current criteria for a diagnosis of transsexualism, the World Health Organisation’s International Classification of Diseases (ICD) reports they must express the desire to live and be accepted as a member of the opposite sex, usually accompanied by the wish to make his or her body as congruent as possible with the desired sex through surgery and cross-sex hormones. This transsexual identity must have been present persistently for a minimum of two years and not be a symptom of another mental disorder or a chromosomal abnormality. The latest (fifth) edition of Diagnostic and Statistical Manual of Mental Disorders (DSM-5) of the American Psychiatric Association uses the term gender dysphoria to describe people who are uncomfortable and/or distressed regarding their assigned gender, their physical sex characteristics and/or their associated social roles. Depending upon the intensity of this distress, some individuals may wish to transition from one point on a notional gender scale to another. The most common direction is from a man to a woman (individuals known as trans women), or from a woman to a man (individuals known as trans men). The distress intrinsic to gender dysphoria may be focused around anatomy, physiology, and/or being perceived and treated as someone of a gender with which the person does not identify. However, these diagnostic labels do not apply to all trans individuals for a multitude of reasons because some people will not identify themselves as a man or as a woman

The World Health Organisation working group has recommended that the latest ICD replace the term Transsexualism with Gender Incongruence) and remove it from the mental and behavioural disorders chapter. Gender incongruence denotes the incongruence between a person’s gender identity and their assigned sex and/or congenital primary and secondary sex characteristics. The terminology in this field has changed over the years and the terms ‘transgender’ and ‘trans’ have been used in the literature as umbrella terms to cover a wide variety of atypical gender experiences and expressions which may lead to permanent change of social gender role but does not necessarily involve treatment with cross-sex hormones or surgical intervention. A recent study has reported an prevalence for transsexualism of 4.6 in 100,000 individuals; 6.8 for trans women and 2.6 for trans men, which is primarily based on studies looking at individuals attending clinical services. (However, it should be noted that recent population studies have reported a significantly higher prevalence rate of atypical gender experiences and expressions).

The study we published in the journal Aloma originated from initial observations made by Dr. Jon Arcelus that a number of gender dysphoric clients presenting at the national (UK) gender dysphoria clinic admitted that they gender-swapped while playing online games. After I met with Dr. Arcelus I suggested he revisit his case files and and to write them up as case studies (as no study in the gaming field has ever examined online gaming among those with gender dysphoria). The main objectives of our study were to use exemplar case studies to highlight that gaming – in some circumstances – appears to be a functional way of dealing with gender identity issues, and that gender swapping in gaming may help such individuals to come to terms with their gender dysphoria.

Our paper featured four case studies who attended an assessment at the National Centre for Gender Dysphoria in Nottingham. All four individuals described in our paper were given pseudonyms and the content of their histories were anonymised (and included ‘Mary’ a 26-year old natal male who fully transitioned to the female social role six months prior to our study; ‘Mark’ a 20-year old natal female who first attended for an assessment in the female role; ‘Paul’ a 31-year old natal male who would like to be female, but still living full-time as a male; and ‘Harry’ a 23-year old natal male who presented for an assessment as a male). If you want to read about each case in detail, the paper can be downloaded for free from here).

The four case studies outlined in our paper are only a selected sample of the number of cases attending a national clinic for people with gender dysphoria. However, they were in no way unusual to the other clients that have sought help at the Centre. However, these individual accounts were specifically selected to demonstrate the different ways that video gaming may help people with gender dysphoria come to terms with their gender identity. For example, gaming can be used among trans people as a psychological tool to increase one’s awareness of gender identity and/or as part of the self. Gaming may therefore be a useful way to express one’s experienced gender identity in a safe, non-threatening, non-alienating, non-stigmatizing, and non-critical environment. This appears to mirror other the findings of other studies outside of the online gaming environment.

Articles published in the mass media have reported that online games such as World of Warcraft provide a creative space that allows gamers that might be questioning aspects of their identity to explore their lives as different individuals. Some have even gone as far as to argue that this could help gamers transform their ‘offline’ identity, as is the case with some trans gamers. This was also demonstrated in the case studies described in our study. Other authors have asserted that the online medium offers an infinite space for development and resistance to traditional gender roles, and that online interaction enables a transgression of the dichotomous categories of male and female, constructing trans (or even genderless) social identities and relationships. However, although such anonymous online communities may provide trans individuals with the power to subvert their physical sex.

Our case studies also demonstrated the different functions of gaming in trans people (e.g., the function of “testing out” their gender feelings). For instance, using gaming to ‘come out’ to other people, by initially coming out in the online community, which is perceived as a safe environment, and then gradually coming out in real life. Gaming, as for many non-trans individuals, can derive psychological benefits and a sense of escapism. This is even more relevant among trans people as it may be the only time that they feel they can be themselves, allowing them to feel happy, relaxed, and achieving a sense of completeness. This could develop into a powerful coping skill substituting unhealthy behaviours, such as self-harming behaviour. This is particularly important in this population as research shows a strong association between being trans and mental health problems, particularly depression and self-harm as a way to manage one’s trans feelings. This is not surprising as the discomfort and distress about assigned gender and body dissatisfaction may lead to a sense of hopelessness, which can bring low mood, self-injury and even suicide.

Although gaming appears (at least initially) to be a positive and beneficial activity for many trans people, there is also the risk that staying in the game becomes too much of a secure and safe environment. This can create a vicious circle where the trans person does not wish to move out of the secure online world, and back into reality. Spending an increasing amount of time in online gaming carries the risk of developing a gaming dependence or addiction. This may not only affect one’s personal relationships, work and/or study, but may also impair real life social gender role transition, as in many cases, the individual is expected to socially transition before they can be considered for treatment.

Obviously our paper only included four participants and may be perceived by some researchers as ‘anecdotal’ because the data were not collected for this specific study but were retrospectively collated. However, our findings showed that for a trans individual, the online gaming environment was perceived as “safe” but further research is needed to establish what the distinctive elements of online gaming are that help to raise gender awareness (or not as the case may be). With the rates of gender dysphoria attending clinical services increasing significantly, future research should investigate (i) the rates and severity of gaming among this population as well as its function, and (ii) the rates of gender dysphoria among game addiction as coming out may help their addiction. The game industry may also want to consider how they can use games as a way of helping trans people being more accepted within society by developing game industry may want to co-observe how their games can prepare and assist individuals to socially transition. Online games also provide a safe environment that provides people access to a platform where individuals can discuss and experiment with gender identity.

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

Further reading

Arcelus, J., Bouman, W. P., Witcomb, G. L., Van den Noortgate, W., Claes, L., & Fernandez-Aranda, F. (2015). Systematic review and meta-analysis of prevalence studies in transsexualism. European Psychiatry, 30, 807-815.

Arcelus, J., Jones, B., Richards, C., Jimenez-Murcia, S., Bouman, W.P. & Griffiths, M.D. (2017). Video gaming and gaming addiction in transgender people: An exploratory study. Journal of Behavioral Addictions, 6, 21–29.

Dale, L. K. (2014, January 23). How World of Warcraft helped me come out as transgender. The Guardian. Retrieved from http://www.theguardian.com/technology/gamesblog/2014/jan/23/how-world-of-warcraft-game-helped-me-come-out-transgender

Griffiths, M.D., Arcelus, J. & Bouman, W.P. (2016). Video gaming and gender dysphoria: Some case study evidence. Aloma: Revista de Psicologia, Ciències de l’Educació i de l’Esport, 34(2), 59-66.

Griffiths, M. D., Davies, M.N.O. & Chappell, D. (2003). Breaking the stereotype: The case of online gaming. CyberPsychology and Behavior, 6, 81-91.

Griffiths, M.D., Davies, M.N.O. & Chappell, D. (2004). Demographic factors and playing variables in online computer gaming. CyberPsychology and Behavior, 7, 479-487.

Griffiths, M. D., Kiraly, O., M. Pontes, H. M. & and Demetrovics, Z. (2015). An overview of problematic gaming. In Starcevic, V. & Aboujaoude, E. (Eds.), Mental Health in the Digital Age: Grave Dangers, Great Promise (pp.27-55). Oxford: Oxford University Press.

Fahs, B., & Gohr, M. (2012). Superpatriarchy meets cyberfeminism: Facebook, online gaming, and the new social genocide. MP: An Online Feminist Journal, 3(6), 1-40.

Hegland, J. E., & Nelson, N. J. (2002). Cross-dressers in cyber-space: Exploring the Internet as a tool for expressing gendered identity. International Journal of Sexuality and Gender Studies, 7(2-3), 139-161.

Huh, S., & Williams, D. (2010). Dude looks like a lady: Gender swapping in an online game. In Online worlds: Convergence of the real and the virtual (pp. 161-174). London: Springer.

Hussain, Z., & Griffiths, M. D. (2008). Gender swapping and socialising in cyberspace: An exploratory study. CyberPsychology and Behavior, 11, 47-53.

Lewis, A., & Griffiths, M. D. (2011). Confronting gender representation: A qualitative study of the experiences and motivations of female casual-gamers. Aloma: Revista de Psicologia, Ciencies de l’Educacio i de l’Esport, 28, 245-272.

McLean, L., & Griffiths, M. D. (2013). Female gamers: A thematic analysis of their gaming experience. International Journal of Games-Based Learning, 3(3), 54-71.

Osborne, H. (2012). Performing self, performing character: Exploring gender performativity in online role-playing games. Transformative Works and Cultures, 11. doi:10.3983/twc.2012.0411.

Potts, A. (2015). ‘LOVE YOU GUYS (NO HOMO)’ How gamers and fans play with sexuality, gender, and Minecraft on YouTube. Critical Discourse Studies, 12(2), 163-186.

Shaw, A. (2012). Do you identify as a gamer? Gender, race, sexuality, and gamer identity. New Media and Society, 14(1), 28-44

Taylor, T. L. (2003). Multiple pleasures women and online gaming. Convergence: The International Journal of Research into New Media Technologies, 9(1), 21-46.

Todd, C. (2012). ‘Troubling’ gender in virtual gaming spaces. New Zealand Geographer, 68(2), 101-110.

Story rebellion: A brief look at ‘news addiction’

Earlier this year, I was contacted by a BBC reporter asking me what the latest research on ‘news addiction’ was. I politely told him I was unaware of any such research and that if ‘news addiction’ existed, it would be more akin to ‘television addiction’ or ‘boxset bingeing’. About a month after that call, a paper on ‘news addiction’ was published in the Journal of the Dow University of Health Sciences Karachi by Pakistani psychologists Ghulam Ishaq, Rafia Rafique, and Muhammad Asif.

I have to admit that some might say I’m a bit of a ‘news junkie’. As soon as I get up in the morning or as soon as I come home from work I switch on the radio or television to listen to the news. However, I do not consider my love of listening to the news to be an addiction, and I suspect most people like me wouldn’t either. Of course, there are now other ways for individuals to get their ‘news fix’ including thousands of online news sites and via social media which is why Ishaq and his colleagues decided to look at the construct of ‘news addiction’. They claimed that:

“People are persuaded towards news. Similarly, engrossment of certain individuals in any domain from politics, sports, global issues, arson or terrorism can also promote news habituation or addiction and intensify inspection towards news. News addiction comes under the term behavioral-related behavior…When somebody interacts with news, this gives him/her satisfying feelings and sensations that he/she is not able to get in other ways. The reinforcement an individual gets from these feelings compels him to repeat their behavior to get these types of feelings and sensations repeatedly… eventually causing a disturbance in every sphere of life… individuals who are addicted to news feel themselves much obsessed to check the news in uncontrollable ways”.

Screen Shot 2017-12-04 at 16.42.08Theoretically there is no reason why individuals cannot be addicted to reading and/or listening to the news as long as they are being constantly rewarded for their behaviour. In fact, the authors used some of my papers on behavioural addiction more generally to argue for the construct of ‘news addiction’ as a construct to be empirically investigated. In their study, Ishaq and colleagues wanted to examine the relationship between (the personality construct of) conscientiousness, neuroticism, self-control, and news addiction. Conscientiousness is a personality trait and refers to individuals who are orderly, careful, and well organised. Neuroticism is another major personality trait and refers to individuals who have high mental instability such as depression and high anxiety. The researchers hypothesised that there would be negative correlation between conscientiousness and news addiction, and that neuroticism would be positively correlated with news addiction.

To test their hypotheses, a survey was completed by 300 participants (aged 18 to 60 years; average age 39 years) from major cities of the Punjab (Lahore, Multan, Bahawalpur, Faisalabad, Sargodha). The authors developed their own 19-item News Addiction Scale (NAS) although the paper didn’t give any examples of any of the items in the NAS. They also administered the ‘Big Five Inventory’ (which assesses five major personality traits – Openness, Conscientiousness, Extraversion, Agreeableness, and Neuroticism). The study found that the hypotheses were supported (i.e., news addiction was positively correlated with neuroticism and negatively correlated with conscientiousness. Previous literature has consistently shown that there is relationship between personality traits and behavioural addiction. The findings of this study are very similar to those more widely in the general literature for both substance and behavioural addictions (which also show most addictions have a low correlation with conscientiousness and a high correlation with neuroticism). The authors also argued that:

“(The findings show that) self-control plays an active role [in] refraining from the instant pleasure of impulse that would hinder with daily functioning and attainment goals…[The] current study findings demonstrated that self-control acts as a mediating variable between conscientiousness, neuroticism and news addiction”.

They also reported that females had higher scores on neuroticism and conscientiousness and that males had higher scores on the News Addiction Scale. The authors also claimed that there was much similarity between social media addiction (although provided no evidence for this except to say that they were both examples of behavioural addiction).

There was no mention at all in the paper about how their participants accessed their news. I access most (but certainly not all) of my news via television and therefore if I was watching an abnormal amount of news on the television, this would more likely be a sub-type of television addiction or a sub-type of television binge-watcher (both of which have been reported in the psychological literature). If someone addictively accessed all their news online or via social media, this could perhaps come under more general umbrella terms such as ‘internet addiction’ or ‘social media addiction’.

However, things are further complicated by the fact that ‘news’ can be defined in a number of ways. In the study by Ishaq and colleagues, news was defined as a statement of specific information and facts and figures on any substantial event” but such a definition doesn’t take into account such things as political opinions and nor does it define what a ‘substantial event’ is. Given that this is the only study on news addiction that I am aware of, I’ll need a lot more research evidence before I am convinced that it really exists.

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

Further reading

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

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

Ishaq, G., Rafique, R., & Asif, M. (2017). Personality traits and news addiction: Mediating role of self-control. Journal of Dow University of Health Sciences, 11(2), 31-53.

Orosz, G., Bőthe, B., & Tóth-Király, I. (2016). The development of the Problematic Series WatchingScale (PSWS). Journal of Behavioral Addictions, 5(1), 144-150.

Orosz, G., Vallerand, R. J., Bőthe, B., Tóth-Király, I., & Paskuj, B. (2016). On the correlates of passion for screen-based behaviors: The case of impulsivity and the problematic and non-problematic Facebook use and TV series watching. Personality and Individual Differences, 101, 167-176.

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

Walton-Pattison, E., Dombrowski, S.U. & Presseau, J. (2017). ‘Just one more episode’: Frequency and theoretical correlates of television binge watching. Journal of Health Psychology, doi:1359105316643379

Out of sports: The influence of structural and situational characteristics in online sports betting

In a paper that I recently co-wrote in the Journal of Sport and Social Issues with Hibai Lopez-Gonzalez and Ana Estevez, we argued that the growing conversion of sports betting into an online activity has prompted two types of transformations in the way companies market their betting products. Firstly, the Internet has not only extended the opportunities to bet but has also changed the characteristics of the betting practice itself. Such product characteristics can be divided into two categories, namely situational and structural characteristics, that appear to be associated with factors influencing the onset and maintaining of betting as well as the difficulty of discontinuing it (the focus of this blog). Secondly, the online dimension has also enabled the proliferation of cross-marketing strategies leading to a convergence between previously independent markets or the tightening of the relationship between those with already established synergies (which I will examine in a future blog).

The internet has substantially transformed the situational and structural characteristics of sports betting. Situational factors comprise all environmental features that might make gamblers feel comfortable (both psychologically and physically) while gambling including sensory factors like colour, music, and smell in the environment, novelty of the activity, accessibility or proximity to a gambling venue, social facilitation and intrinsic association, which is defined as ‘the degree to which gambling is associated with other interests and attractions’.

images

New situational factors in online sports betting include: (i) easier and faster accessibility to betting opportunities; (ii) ubiquity of bettable competitions around the globe and seamless availability of those competitions around the clock; (iii) anonymity (in terms of social stigma traditionally attached to gambling) and comfortable betting from home or elsewhere via mobile devices; (iv) greater social facilitation via online communities of bettors or betting leagues organized between groups of friends; and (v) an enhanced intrinsic association of sports betting with sporting values such as health, competition, team identification and loyalty, further facilitated by the proliferation of live sport content on television and social media.

Structural factors refer to the specific characteristics or design of the gambling activity such as win probability, sound and lighting effects of the game, bet frequency (how many bets a person can place in a given period of time), loss chasing facilitation (gambling to recover lost money), jackpot size, price structure, near-miss opportunities (the psychological bias of interpreting losses as nearly wins or anticipatory of a winning streak).

New structural factors in online betting include: (i) a greater frequency of bets, with shorter intervals between bets, and shorter event durations (e.g., virtual sports), meaning faster reward mechanisms; (ii) in-play betting, which encompasses a closer connection between watching sport and betting; (iii) contextual betting, with live markets that open after specific actions (e.g. betting on the outcome of a penalty kick seconds after being awarded by the referee); (iv) greater illusion of control over the bets with new functionalities that emphasize the skills involved and diminish the role of luck, such as cash out (the person can withdraw the bet before the end of the event at the price stipulated by the betting site), accumulators (a person can aggregate multiple events in a single bet, increasing the potential return), exchange (betting against other people instead of the bookmaker); and (v) a greater integration in the betting process of the knowledge about the sport (e.g., daily fantasy sports), resulting in the gamification of the betting experience.

In a 2013 scoping study that I published with Dr. Abby McCormack in the International Journal of Cyber Behavior, Psychology and Learning, we noted that new situational and structural factors associated with Internet gambling could influence the onset of problem gambling in non-sporting gambling contexts. The relative novelty of these situational and structural characteristics affecting the wagering on sports is reflected in the scarcity of research devoted to understanding them. However, there are a few studies.

An analysis of 47,603 Bwin betting website subscribers (by Dr. Debi LaPLante and colleagues in the journal Computers in Human Behaviors) showed some interesting results in the direction of the importance of structural factors determining excessive gambling. The most involved bettors (those comprising the most active 1% of the user sample) who gambled on final outcomes did not escalate their gambling behaviour over time whereas those who gambled in-play did so. In a 2014 follow-up study in the journal Psychology of Addictive Behaviors, LaPlante and her colleagues examined the effect of in-play betting in the development of problem gambling. The researchers expanded the sample to other forms of gambling and compared the role of breadth (i.e., many different gambling forms) and depth involvement (i.e., more frequent betting) in problem gambling onset. They hypothesised that more involved users would be more likely to become problem gamblers (which was shown to be the case). For every form and gambling, when controlling for depth and breadth involvement, the model was not able to predict gambling-related problems, with one exception: in-play betting. The study suggested that a structural characteristic of a game, the live betting action, could be a precipitant, in conjunction with other determinants, of gambling disorders.

Another study by Dr. Richard LaBrie and Dr. Howard Shaffer (in a 2011 issue of Addiction Research and Theory) found that self-limiting features – in which the bettor determines a maximum amount of money to be bet – made problem gamblers bet less frequently but, in turn, increased the stakes of the bets placed. Bettors who scored high on problem gambling scales chased their losses by implementing a risk aversion strategy, placing high bets conservatively on short odds events (i.e., events with unbalanced contenders in which the outcome can more likely be determined beforehand but with a lower monetary return).

While there has been an increasing amount of research that has examined the influence of situational and structural characteristics in gambling (particularly in relation to slot machine gambling), the impact of such characteristics on online sports betting (at present) remains largely unknown.

(Please not that this article was co-written with Dr. Hibai Lopez-Gonzalez and Dr. Ana Estevez).

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

Further reading

Griffiths, M.D. (1993). Fruit machine gambling: The importance of structural characteristics. Journal of Gambling Studies, 9, 101-120.

Griffiths, M.D. (1999). Gambling technologies: Prospects for problem gambling. Journal of Gambling Studies, 15(3), 265–283.

Griffiths, M.D. (2005). A biopsychosocial approach to addiction. Psyke & Logos, 26(1), 9–26.

Griffiths, M.D. & Auer, M. (2013) The irrelevancy of game-type in the acquisition, development and maintenance of problem gambling. Frontiers in Psychology, 3, (621). doi: 10.3389/fpsyg.2012.00621.

LaBrie, R. & Shaffer, H.J. (2011). Identifying behavioral markers of disordered Internet sports gambling. Addiction Research & Theory, 19(1), 56–65.

LaPlante, D., Nelson, S.E. & Gray, H.M. (2014). Breadth and depth involvement: Understanding Internet gambling involvement and its relationship to gambling problems. Psychology of Addictive Behaviors, 28(2), 396-403.

LaPlante, D.A., Schumann, A., LaBrie, R.A., et al. (2008). Population trends in Internet sports gambling. Computers in Human Behavior, 24(5), 2399–2414.

Leino, T., Torsheim, T., Blaszczynski, A., Griffiths, M.D., Mentzoni, R., Pallesen, S. & Molde, H. (2015). The relationship between structural characteristics and gambling behavior: A population based study. Journal of Gambling Studies, 31, 1297-1315.

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

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

Lopez-Gonzalez, H. & Griffiths, M.D. (2017). Understanding the convergence of online sports betting markets. International Review for the Sociology of Sport, in press.

Lopez-Gonzalez, H. & Griffiths, M.D. (2017). ‘Cashing out’ in sports betting: Implications for problem gambling and regulation. Gaming Law Review and Economics, in press.

McCormack, A. & Griffiths, M.D. (2013). A scoping study of the structural and situational characteristics of internet gambling., 3(1), 29–49.

Parke, J. & Griffiths, M.D. (2006). The psychology of the fruit machine: The role of structural characteristics (revisited). International Journal of Mental Health and Addiction, 4, 151-179.

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

Blocking out the pain: Tetris, trauma, and Game Transfer Phenomena

Unwanted visual intrusions are characteristic of Post-Traumatic Stress Disorder (PTSD). According to Dr. Emily Holmes and her colleagues in a 2009 paper in the journal PLoS ONE, one innovative intervention for inhibiting unwanted intrusions is playing the Tetris videogame, described as a ‘cognitive vaccine’ in preventing intrusions after traumatic events. Playing Tetris consumes heavy visuospatial working memory resources that potentially compete with cognitive resources required for elaboration of visual imagery. Since Holmes and colleagues’ study, other studies have used Tetris to inhibit intrusive imagery including more studies by Holmes and her colleagues and others by Ella James’ research group, as well as some innovative studies using Tetris to reduce drug cravings by Jessica Storka-Brown and her colleagues (see ‘Further reading’ below). However, none of these studies assessed the role of videogame content after playing in relation to Game Transfer Phenomena (GTP), an area that we have carried out a lot of research into (see ‘Further reading’ below).

tetris_2933521b

GTP research has investigated non-volitional experiences (e.g., altered sensorial perceptions and automatic mental processes/behaviours) mostly experienced after gaming. Gamers often report sensorial (visual/auditory) intrusions after playing (e.g., visual and auditory imagery, hallucinations). In a survey of 2,362 gamers that we published in a 2016 issue of the International Journal of Human-Computer Interaction, most (77%) had visualized images from a variety of videogames (including tile-puzzle games) with closed-eyes, and one-third (31%) had visualized images with open-eyes. Other studies have experimentally induced videogame-related visualizations at sleep onset (including studies by Stickgold and colleagues [2000], Wamsley and colleagues [2010], Kusse and colleagues [2012] – see ‘Further reading’).

James and colleagues’ 2015 study in the journal Psychological Science was the first to make explicit reference to GTP (referred to as the ‘Tetris effect’ [TE]). In 2012, we argued the TE term is misleading as it suggests repetition is the core of transfer effects. However, other factors are involved. Research concerning GTP makes the distinction between sensorial modalities facilitating non-volitional phenomena with videogame content that occur along the continuum from mild to severe. Moreover, the descriptive constructs of GTP are empirically based on our analysis of 3,500+ gamers and have been examined via confirmatory factor analysis demonstrating good reliability and validity.

James and her colleagues tested if playing Tetris offered a protective mechanism against re-experiencing traumatic events. Healthy participants (n=56) were randomly assigned to either playing Tetris for 11 minutes, or doing nothing before exposure to a 12-minute traumatic film. Image-base memories about the film were then registered in a one-week dairy. However, playing Tetris as a proactive interference task before watching the film did not show significant results. James and colleagues offered different explanations including: (i) duration of the task in relation to film length, (ii) temporal contingencies between the tasks, (iii) differences between the task types, (iv) videogame types used, and (v) reactivation of gameplay during the film for aided interference. In a commentary paper published in a 2016 issue of Frontiers in Psychology, we discussed these findings and some of its shortcomings in relation to GTP literature.

  • Duration of task in relation to film length: Playing Tetris for 11 minutes may not have been long enough to compete with the consolidation of memory of the 12-minute film. GTP are significantly more likely to occur when playing 3-6 hours. Our research reported only 4% of gamers reported GTP when playing sessions shorter than one-hour. Laboratory experiments have taken days of playing to induce game-related visualizations at sleep onset.
  • Temporal contingencies between gaming and film watching: The tasks were performed minutes apart from each other. GTP mostly occur soon after stopping playing but our research has found that gamers have also reported GTP days after playing. In most cases, duration of experience is very short (seconds/minutes) but in some cases hours or longer.
  • Differences between the tasks: Previous studies have demonstrated that similar tasks aid interference. However, watching a film is a passive activity while gaming is interactive requiring additional perceptual/motor skills. Therefore, it may be expected that gaming is more potent as interference task, particularly because inducing the subjective sense of presence in the virtual world may strengthen the interference.
  • Type of videogame used as interference task and emotional content of film: The unrealistic (geometric) Tetris content may have been overwritten by the film’s traumatic images. Visualization of stereotypical games induced at sleep onset are characterized by lack of emotion, assuming that the amygdala and the reward system are not involved. In GTP research, emotions in tile-matching puzzle-games are incomparable to emotions in realistic videogames.
  • Reactivation of gameplay during the film for aided interference: The use of cue reminders may have potential in reviving videogame content. In many cases, thoughts and altered perceptions are triggered by game-related cues. Selective attention toward game-related cues has been demonstrated in experiments. GTP have been reported in variety of videogame genres particularly those that have very realistic graphics and settings. Therefore, more realistic games may aid associations between real life stimuli and videogame content, and may be more effective in competing with memories of traumatic events.

In our Frontiers paper, we noted that playing Tetris is not only an effective visuospatial task (overloading working memory resources needed for imagery-formation while playing), but as demonstrated in our GTP studies, videogame content stays active after playing (e.g., mental imagery, sensory perceptions), and may offer additional benefits for managing unwanted intrusions. GTP may potentially strengthen effects of interference tasks but should be used cautiously, because videogame content not only targets unwanted intrusions, but also influences individual cognitions, perceptions, and behaviours in day-to-day contexts (e.g., attention bias, lack of task awareness, control inhibition failures). Moreover, our studies have shown distress and dysfunction have been reported with GTP.

Consequently, further research needs conducting to identify: (i) videogames that are most effective, (ii) playing duration, (iii) factors that reduce intervention efficacy and strategies to control them, and (iv) individuals that may benefit the most from such intervention. While using videogames as intervention tools for preventing unwanted imagery from traumatic experiences has potential, therapeutically it is still at an early stage.

  • (Please note: This blog was co-written with Dr. Angelica Ortiz de Gortari and is based on an article we published in Frontiers in Psychology: Ortiz de Gortari, A.B. & Griffiths, M.D. (2016). Playing the computer game Tetris prior to viewing traumatic film material and subsequent intrusive memories: Examining proactive interference. Frontiers in Psychology, 7, 260. doi: 10.3389/fpsyg.2016.00260)

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

Further reading

Holmes, E. A., James, E. L., Kilford, E. J., & Deeprose, C. (2010). Key steps in developing a cognitive vaccine against traumatic flashbacks: Visuospatial Tetris versus Verbal Pub Quiz. PloS ONE, 5(11), e13706.

James, E. L., Bonsall, M. B., Hoppitt, L., Tunbridge, E. M., Geddes, J. R., Milton, A. L., & Holmes, E. A. (2015a). Computer game play reduces intrusive memories of experimental trauma via reconsolidation-update mechanisms. Psychological Science. doi: 10.1177/0956797615583071

James, E. L., Zhu, A. L., Tickle, H., Horsch, A., & Holmes, E. A. (2015b). Playing the computer game Tetris prior to viewing traumatic film material and subsequent intrusive memories: Examining proactive interference. Journal of Behavior Therapy and Experimental Psychiatry. doi: 10.1016/j.jbtep.2015.11.004

Kusse, C., Shaffii-Le Bourdiec, A., Schrouff, J., Matarazzo, L., & Maquet, P. (2012). Experience-dependent induction of hypnagogic images during daytime naps: A combined behavioural and EEG study. Journal of Sleep Research, 21(1), 10-20.

Ortiz de Gortari, A. B., Aronsson, K., & Griffiths, M. D. (2011). Game Transfer Phenomena in video game playing: A qualitative interview study. International Journal of Cyber Behavior, Psychology and Learning 1(3), 15-33.

Ortiz de Gortari, A. B., & Griffiths, M. D. (2012). An introduction to Game Transfer Phenomena in video game playing. In J. I. Gackenbach (Ed.), Video Game Play and Consciousness (pp. 223-250). Hauppauge, NY: Nova Publisher.

Ortiz de Gortari, A. B., & Griffiths, M. D. (2014a). Altered visual perception in Game Transfer Phenomena: An empirical self-report study. International Journal of Human-Computer Interaction, 30(2), 95-105.

Ortiz de Gortari, A. B., & Griffiths, M. D. (2014b). Auditory experiences in Game Transfer Phenomena: An empirical self-report study. International Journal of Cyber Behavior, Psychology and Learning 4(1), 59-75.

Ortiz de Gortari, A. B., & Griffiths, M. D. (2014c). Automatic mental processes, automatic actions and behaviours in Game Transfer Phenomena: An empirical self-report study using online forum data. International Journal of Mental Health and Addiction, 12(4), 1-21.

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

Ortiz de Gortari, A.B. & Griffiths, M.D. (2016). Prevalence and characteristics of Game Transfer Phenomena: A descriptive survey study. International Journal of Human-Computer Interaction, 32, 470-480.

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

Ortiz de Gortari, A. B., Pontes, H. M. & Griffiths, M. D.  (2015). The Game Transfer Phenomena Scale: An instrument for investigating the nonvolitional effects of video game playing. Cyberpsychology, Behavior, and Social Networking 10, 588-594

Skorka-Brown, J., Andrade, J., & May, J. (2014). Playing ‘Tetris’ reduces the strength, frequency and vividness of naturally occurring cravings. Appetite, 76 , 161-165.

Skorka-Brown, J., Andrade, J., Whalley, B., & May, J. (2015). Playing Tetris decreases drug and other cravings in real world settings. Addictive Behaviors, 51, 165-170.

Stickgold, R., Malia, A., Maguire, D., Roddenberry, D., & O’Connor, M. (2000). Replaying the Game: Hypnagogic images in normals and amnesics. Science, 290(5490), 350-353.

Wamsley, E. J., Perry, K., Djonlagic, I., Reaven, L. B., & Stickgold, R. (2010). Cognitive replay of visuomotor learning at sleep onset: Temporal dynamics and relationship to task performance. Sleep, 1(33), 59-68.