Making play while the sun shines: Online games can be a great environment for friendship and social support

A couple of weeks ago, I was commissioned by The Conversation to write an article on the social benefits of online gaming in times of lockdown due to coronavirus-19 (COVID-19). Today’s blog features the original article I write rather than the version that was eventually published. The published article can be read here).

As people all around the world begin to self-isolate and increasingly live life indoors as the spread of COVID-19 widens, there has been much discussion in the mass media about how individuals must use modern technologies to socialize and keep in touch with each other. While much of the conversation appears to focus on social media, Skype, and FaceTime, another popular way in which individuals can do this is through online gaming. Here, gamers can socialize with others online and create a sense of community and wellbeing. Most gamers value the socialization aspects very highly and are among the main motivations for playing, particularly when it comes to engaging in ‘massively multiplayer online games’.

I first became interested in the psychology of videogames while I was doing a PhD on slot machine addiction back in the late 1980s. I used to spend a lot of time doing observational research in amusement arcades up and down the country and I soon realized there was a lot of psychological, social, and behavioural overlap between arcade slot machine players and arcade videogame players and developed player typologies based on playing behaviour and socialization characteristics. I never could have imagined back when I started my gaming research over 30 years ago that gaming would evolve into what it has become today. Over the past three decades, gaming has become more and more social and many players develop good friendships with the people they meet with online.

In a previous article for The Conversation I wrote about many of the positive aspects of gaming. There is now lots of research showing the many benefits of gaming and I have written on most of these including educational benefits, therapeutic and medical benefits, cognitive benefits, and social benefits. While I have probably published more papers on gaming addiction than any other academic I am not at all anti-gaming and I have always advocated that the advantages of gaming far outweigh the disadvantages.

In 2003, I published the first empirical study concerning online gaming and debunked the stereotypical myth that online gamers were socially withdrawn teenagers. Among a sample of over 11,000 Everquest players, most were adults, and 23% said that their favourite aspect of playing the game was grouping and interacting with other people (23%), and a further 10% said it was chatting with friends and guild mates (10%). We followed up with a study a year later and found almost identical results.

In 2007, I carried out a study with Helena Cole that specifically examined social interactions in online gaming that received worldwide media attention (and has also become one of my most cited studies). We surveyed over 900 massively multiplayer online role-playing game (MMORPG) players from 45 different countries and found that MMORPGs were highly socially interactive environments providing the opportunity to create strong friendships and emotional relationships. The study showed MMORPGs can be extremely social games, with high percentages of gamers making life-long friends and partners.

Approximately three-quarters of both males and females said they had made good friends within the game (and the average number of ‘good friends’ in the game was seven). Many players went on to meet up in real life with others they had first ‘met’ in the game. One of the reasons we got so much press publicity about our study was that 10% of the participants reported having at least one romantic relationship with someone they had met in-game. We concluded that online gaming allowed players to express themselves in ways they may not feel comfortable doing in real life because of their appearance, gender, sexuality, and/or age. MMORPGs also offered a place where teamwork, encouragement, and fun could be experienced. A gamer in one of my later published case studies ended up marrying someone he met in the online game World of Warcraft.

According to the latest gaming industry statistics, 65% of adults play videogames across different types of hardware (60% on smartphones, 52% on a personal computer, and 49% on a dedicated console). What might be surprising is that among gamers, the gender split is narrowing – 46% are female (average age 34 years) and 54% are male (average age 32 years). One of the most significant findings is that 63% of gamers play with others and that many players get social support from the gaming communities that they are in. Other research has shown that there appears to be no difference in general friendships between gamers and non-gamers and that social online gaming time increases the probability of finding online friends.

Gaming often gets bad publicity because most media coverage tends to concentrate on the minority of gamers who play to such an extent that it compromises all other areas of their life (i.e., ‘gaming disorder’) but we have to remember that millions of gamers play every day and many do so for the many positives it brings. Friendship, social support, and being in a like-minded community are just some of the reasons that online gaming is going to be so popular at a time when we are being asked to stay indoors as much as possible.

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

Further reading

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

Griffiths, M.D. (1991). Amusement machine playing in childhood and adolescence: A comparative analysis of video games and fruit machines. Journal of Adolescence, 14, 53-73.

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

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

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

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

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

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

Griffiths, M.D. (2010). The role of context in online gaming excess and addiction: Some case study evidence. International Journal of Mental Health and Addiction, 8, 119-125.

Griffiths, M.D. (2019). The therapeutic and health benefits of playing videogames. In: Attrill-Smith, A., Fullwood, C. Keep, M. & Kuss, D.J. (Eds.). The Oxford Handbook of Cyberpsychology. (pp. 485-505). Oxford: Oxford University Press.

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).  Online computer gaming: A comparison of adolescent and adult gamers. Journal of Adolescence, 27, 87-96.

Griffiths, M.D., Kuss, D.J., & Ortiz de Gortari, A. (2017). Videogames as therapy: An updated selective review of the medical and psychological literature. International Journal of Privacy and Health Information Management, 5(2), 71-96.

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

Nuyens, F., Kuss, D.J., Lopez-Fernandez, O., & Griffiths, M.D. (2019). The experimental analysis of non-problematic video gaming and cognitive skills: A systematic review. International Journal of Mental Health and Addiction, 17, 389-414.

The sciences of reliances on appliances: Have we become reliant on digital technologies and what can we do about it?

Readers of my blog will know that I hate to waste anything that I have put time and effort into and today’s blog contain the written transcripts of partly unpublished interviews on smartphone and social media use that I did a number of months ago with the Daily Express and the Nottingham Post. I have no idea which parts of my responses were used or in what context, but here my complete responses to the questions I was asked.

Q: Are we too reliant on tech and gadgets when it comes to family life both in the home, and also social media?

Mark Griffiths: In most walks of life including work, education, and leisure, reliance on tech and gadgets has become the norm. It’s almost impossible to function without relying on tech. However, individuals often spend too much time on things that distract them from what they should be doing. I use social media every day but for no more than about 10-15 minutes so it doesn’t interfere with work productivity or time spent with my family. Most individuals are habitual smartphone and/or social media users. Even though very few people are genuinely addicted to the applications on their smartphones, a few hours use each day can reduce the amount of time they should be spending on their occupation or education (depending upon age) and can reduce the amount of quality time spent with family members. I have three screenagers all who spend a disproportionate amount of time in front of their smartphones. However, I have no problem if it doesn’t impact on their education, chores around the house, social friendships with their peers, or their physical education. However, some parents use tech heavily themselves (which is not good in terms of being a role model to their children) and others use tech as electronic ‘babysitters’ for their children.

Q: What problems can this cause?

MG: Thankfully, serious side effects and genuine addiction to smartphone applications is minimal. However, habitual smartphone use simply leads to less time spent on things that people should be doing including their (i) job or school/ college/ university work, (ii) physical exercise (because smartphone use tends to be a sedentary for most people), and (iii) quality time with friends and family (less face-to-face interaction). For those at risk of genuine addiction, excessive smartphone use leads to a complete deterioration and compromising of everything in that person’s life and can lead to mental health issues (e.g., depression, social anxiety, etc.) but as I said the number of individuals genuinely affected in this way is minimal.

Q: What are the benefits of a more simple life, less gadgets, less tech?

MG: I gave up using my smartphone a couple of years ago and am highly productive in my job. I still actively use social media and am online a lot of the time but doing it via my laptop or work computer means that I’m not constantly bombarded with notifications, pings by the minute, or constant phone vibrations. The benefits of technology far outweigh the negatives but that doesn’t mean that we should be living our whole lives online.

Q: What are your top tips for switching off as a family 

MG: I’ve written a lot about the benefits of digital detox and how to so it (see: https://drmarkgriffiths.wordpress.com/2016/04/26/tech-your-time-12-top-tips-for-a-digital-detox/ ). As a father of three screenagers we have some general rules:

• No smartphones at the dinner table.
• No smartphone use late at night (can’t do that now as my children are now al over 18 years of age) but parents have every right to control their younger children’s tech use.
• No smartphones for children under 11 years of age.
• Remember that what you do with tech will be mimicked by your children so set a good example of responsible tech use.
• Having family events where smartphone use is difficult (e.g., going swimming, going for outdoor walks where reception is poor, going on holiday in places where there is no Wi-Fi access). These types of event are more about showing children that life can still live life without being online 24/7. All my children are very sporty and play competitive sport so that’s great for restricting smartphone use.

Q: How young is too young to own a mobile phone?

MG: Making a decision on when is the right time depends on each child and their parents. It is about responsible parenting and limiting screen time. There is no scientific evidence about what the right age is to give a phone. I have three screenagers and none of them got a phone before the age of 11 years of age. We live in a very technologically advances society and there is no harm in letting children learn early on how to use an i-Pad or tablet. It stops them becoming technophobes when they grow older. The majority of children know more about it than adults now. Obviously you need to monitor what they are using the phone for. We wouldn’t want our children using gambling apps for instance but they mostly just want to keep in touch with their friends. However, parents know their children better than anyone else and there is a reason to give a child a phone when it concerns safety and knowing where your child is, especially if they are walking to and from school. One reason to give a child a phone at the start of secondary school is so that they don’t feel ostracized when they realise everyone else in their class has one. Ironically the majority of kids that have a phone rarely use it to make calls but knowing where they are and being able to talk to them almost instantly is a huge relief for parents.

Q: Anything else you’d like to add?

MG: There’s no scientific evidence that moderate tech use has a negative impact (psychologically or physically on people’s lives). The old cliché is true – everything in moderation. Excessive use of almost anything even when it’s something socially approved and socially sanctioned (e.g., work, exercise, education, etc.) can be problematic if it’s done to the neglect of everything else.

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

Further reading

Balakrishnan, J. & Griffiths, M.D. (2017). Social media addiction: What is the role of content in YouTube? Journal of Behavioral Addictions, 6, 364-377.

Balakrishnan, J. & Griffiths, M.D. (2019). Perceived addictiveness of smartphone games: A content analysis of game reviews by players. International Journal of Mental Health and Addictions, 17, 922-934.

Balta, S., Jonason, P., Denes, A., Emirtekin, E., Tosuntaş, S.B., Kircaburun, K., Griffiths, M.D. (2019). Dark personality traits and problematic smartphone use: The mediating role of fearful attachment. Personality and Individual Differences, 149, 214-219.

Griffiths, M.D. (2013) Social networking addiction: Emerging themes and issues. Journal of Addiction Research and Therapy, 4: e118. doi: 10.4172/2155-6105.1000e118.

Griffiths, M.D. & Kuss, D.J. (2011). Adolescent social networking: Should parents and teachers be worried? Education and Health, 29, 23-25.

Griffiths, M.D., Kuss, D.J. & Demetrovics, Z. (2014). Social networking addiction: An overview of preliminary findings. In K. Rosenberg & L. Feder (Eds.), Behavioral Addictions: Criteria, Evidence and Treatment (pp.119-141). New York: Elsevier.

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.

Kırcaburun, K. & Griffiths, M.D. (2018). Instagram addiction and the big five of personality: The mediating role of self-liking. Journal of Behavioral Addictions, 7, 158-170.

Kuss, D.J. & Griffiths, M.D. (2011). Online social networking and addiction: A literature review of empirical research. International Journal of Environmental Research and Public Health, 8, 3528-3552.

Kuss, D.J. & Griffiths, M.D. (2017). Social networking sites and addiction: Ten lessons learned. International Journal of Environmental Research and Public Health, 14, 311; doi:10.3390/ijerph14030311

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

Yang, Z., Asbury, K., & Griffiths, M. D. (2019). Do Chinese and British university students use smartphones differently? A cross-cultural mixed methods study. International Journal of Mental Health and Addiction, 17(3), 644-657.

Risky business: Organisations should have a ‘gambling at work’ policy

Earlier this week, I was interviewed by the BBC about whether organisations should help individuals who have gambling problems and whether they should have a ‘gambling at work’ policy. Most of us work in organisations that have policies on behaviours such as drinking alcohol and cigarette smoking. However, very few companies have a ‘gambling at work’ policy. One problem gambler in a position of financial trust can bring down a whole organisation – Nick Leeson being a case in point when he single-handedly brought down Barings Bank). Leeson’s (albeit somewhat extreme) antics demonstrate that organisations need to acknowledge that gambling with company money can be disastrous for the company if things go horribly wrong. While no company expects an employee gambling to bring about their collapse, Leeson’s case does at least highlight gambling as an issue that companies ought to think about in terms of risk assessment.

Gambling is a popular leisure activity and national UK surveys into gambling participation show that around two-thirds of adults’ gamble annually and that problem gambling affects approximately 0.5% of the British population (although the prevalence rates for adolescents can be three to four rimes higher). There are a number of socio-demographic factors associated with problem gambling. These included being male, having a parent who was or who has been a problem gambler, being single, and having a low income. Other research shows that those who experience unemployment, poor health, housing, and low educational qualifications have significantly higher rates of problem gambling than the general population.

It is clear that the social and health costs of problem gambling can be large on both an individual and societal level. Personal costs can include irritability, extreme moodiness, problems with personal relationships (including divorce), absenteeism from work, family neglect, and bankruptcy. There can also be adverse health consequences for both the problem gambler and their partner including depression, insomnia, intestinal disorders, migraines, and other stress-related disorders.

For most people, gambling is not a serious problem and in some cases may even be of benefit in team building and/or creating a collegiate atmosphere in the workplace (e.g., National Lottery syndicates, office sweepstakes). However, for those whose gambling starts to become more of a problem, it can affect both the organisation and other work colleagues. Typically problem gambling at work can lead to many negative “warning signs” such as misuse of time, mysterious disappearances, long lunches, late to work, leaving early from work, unusual vacation patterns, unexplained sick leave, internet and telephone misuse, etc. However, new forms of gambling, such as gambling via the internet or smartphones at work, means that many of these warning signs are unlikely to be picked up. However, just because problem gambling is difficult to spot does not mean that managers should not include it in risk assessments and/or planning procedures. Listed below are some practical steps that can be taken to help minimise the potential problem.

• Take the issue of gambling seriously. Gambling (in all its many forms) has not been viewed as an occupational issue at any serious level. Managers, in conjunction with Human Resources Departments need to ensure they are aware of the issue and the potential risks it can bring to both their employees and the whole organisation. They also need to be aware that for employees who deal with finances, the consequences for the company should that person be a problem gambler can be very great.
• Raise awareness of gambling issues at work. This can be done through e-mail circulation, leaflets, and posters on general notice boards. Most countries (including the UK) have national and /or local gambling agencies that can supply useful educational literature (including posters). Telephone numbers for these organisations can usually be found in most telephone directories.
• Ask employees to be vigilant. Problem gambling at work can have serious repercussions not only for the individual but also for those employees who befriend a problem gambler, and the organisation itself. Fellow staff members need to know the signs and symptoms of problem gambling. Employee behaviours such as asking to borrow money all the time might be indicative of a gambling problem.
• Give employees access to diagnostic gambling checklists. Make sure that any literature or poster within the workplace includes a self-diagnostic checklist so that employees can check themselves to see if they might have (or be developing) a gambling problem.
• Check internet “bookmarks” of staff. In some jurisdictions across the world, employers can legally access the e-mails and internet content of their employees. One of the easiest checks is to simply look at an employee’s list of “bookmarked” websites. If they are gambling on the internet regularly, internet gambling sites are almost certainly likely to be bookmarked.
• Develop a “Gambling at Work” policy. As mentioned at the start of this blog, many organisations have policies for behaviours such as smoking or drinking alcohol in the workplace. Employers should develop their own gambling policies by liaison between Human Resource Services and local gambling agencies. A risk assessment policy in relation to gambling would also be helpful.
• Give support to identified problem gamblers.  Most large organisations have counselling services and other forms of support for employees who find themselves in difficulties. Problem gambling needs to be treated sympathetically (like other more bona fide addictions such as alcoholism). Employee support services must also be educated about the potential problems of workplace gambling.

Problem gambling can clearly be a hidden activity and the growing availability of internet gambling and gambling via smartphone or tablets is making it easier to gamble from the workplace. Thankfully, it would appear that for most people, gambling is not a serious problem. For those whose gambling starts to become more of a problem, it can affect both the organisation and other work colleagues (and in extreme cases cause major problems for the company as a whole). Managers clearly need to have their awareness of this issue raised, and once this has happened, they need to raise awareness of the issue among the work force. Gambling is a social issue, a health issue and an occupational issue. Although not high on the list for most employers, the issues highlighted here suggest that it should at least be on the list somewhere.

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

Further reading

Calado, F., Alexandre, J. & Griffiths, M.D. (2017). Prevalence of adolescent problem gambling: A systematic review of recent research. Journal of Gambling Studies, 33, 397-424.

Calado, F. & Griffiths, M.D. (2016). Problem gambling worldwide: An update of empirical research (2000-2015). Journal of Behavioral Addictions, 5, 592–613.

Griffiths, M.D. (2002). Internet gambling in the workplace. In M. Anandarajan & C. Simmers (Eds.). Managing Web Usage in the Workplace: A Social, Ethical and Legal Perspective. pp. 148-167. Hershey, Pennsylvania: Idea Publishing.

Griffiths, M.D.  (2002).  Occupational health issues concerning Internet use in the workplace. Work and Stress, 16, 283-287.

Griffiths, M.D. (2004). Betting your life on it: Problem gambling has clear health related consequences. British Medical Journal, 329, 1055-1056.

Griffiths, M.D. (2009). Internet gambling in the workplace. Journal of Workplace Learning, 21, 658-670.

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

Griffiths, M.D. (2010). The hidden addiction: Gambling in the workplace. Counselling at Work, 70, 20-23.

Needers of the pack: A brief look at addiction to Solitaire

A few days ago I was interviewed by Business Insider about the addictiveness of the card game Solitaire (also known as Klondike and Patience). The ‘hook’ for the Business Insider article (no pun intended) was that May 22 is National Solitaire Day (NSD). A quick look on the online National Day Calendar confirmed that NSD does indeed exist (a celebration day that only began for the first time last year) and the website also pointed out that the game is over 200 years’ old and that Solitaire “truly went viral” in 1990 when Microsoft included the Microsoft Solitaire game in Windows 3.0 (as a way to teach people how to use the mouse on their computers). The NSD webpage notes that:

“Over the past 28 years, Microsoft Solitaire has been providing great entertainment to hundreds of millions of players in every corner of the world…In 2012, Microsoft evolved Solitaire into the Microsoft Solitaire Collection, which features five of the top Solitaire games in one app. Since then, the game has been played by over 242 million people and has become so popular that each year 33 billion games are played with over 3.2 trillion cards dealt!”

Back in 2000, a short article on internet addiction in The Lancet by Peter Mitchell noted that one of the pioneers in internet addiction research, the clinical psychologist Maressa Hecht Orzack claimed to have a problem (a “near addiction”) playing Solitaire. Orzack was quoted in Mitchell’s article as saying: “So now I don’t have a computer at work. [My playing Solitaire] was getting that serious”. Orzack was also quoted in the Business Insider article. Her Solitaire playing was a “growing obsession” and she neglected her work and lost sleep because of her Solitaire playing. She said: “I kept playing solitaire more and more – my late husband would find me asleep at the computer. I was missing deadlines. I knew something had to be done”.

As far as I am aware, there is no empirical research about addiction to Solitaire, and I’ve never come across a published case study. However, I have mentioned Solitaire in a number of my papers over the years but all of them were in my critique of Dr. Kimberley Young’s taxonomy of the different types of internet addiction. Young claimed there were five different types of internet addiction (‘cyber-sexual addiction’, cyber-relationship addiction, ‘net compulsions’, ‘information overload’ and ‘computer addiction’). In a number of my publications in journals such as the Student British Medical Journal (1999), Addiction Research (2000), and the International Journal of Mental Health and Addiction (2006), I argued that the typology was flawed and that most of the examples Young provided were addictions on the internet, not addictions to the internet (and echoing my assertion that individuals are no more addicted to the internet than alcoholics are addicted to bottles).

The reference to Solitaire was in relation to Young’s final type of internet addiction – ‘computer addiction’. One of her examples of ‘computer addiction’ as the playing of Solitaire on computers. (I found this strange particularly because the example didn’t even rely on being on the internet – it was merely about individuals being addicted to playing Solitaire on computers and laptops). Young never provided any empirical evidence that she had ever met or treated anyone with an addiction to Solitaire, just that being addicted to Solitaire would be classed as a ‘computer addiction’ in her typology.

Young is not the only social scientist to use Solitaire as an example in an addiction typology. In a 2008 paper published in the Journal of Applied Social Science, Jawad Fatayer outlined what he believes are the four types of addiction – alpha addictions (addictions that impact the body and physical health such as nicotine addiction and food addiction), beta addictions (addictions that impact the mind and the body such as alcohol and other drug addictions), gamma addictions (all behavioural addictions), and delta addictions (two or more addictions experiences simultaneously). Addiction to Solitaire was listed as a gamma addiction (but again, there was no empirical evidence to support the claim that Solitaire addiction actually exists).

Business Insider spoke to two other psychologists in addition to myself. Dr. Chris Ferguson (with whom I have co-authored a few papers) said:

“It’s important to recognize the difference between really liking something and having a clinical addiction. People (say) ‘I’m addicted to cupcakes’, ‘I’m addicted to chocolate’ meaning ‘This is a really fun thing that I like to do a lot’. There’s a huge debate that goes on in the field right now about whether video games can be compared to things like substance abuse, or if video games are more similar to hobby-like activities that many people enjoy — and some people might overdo…a fixation with Solitaire is more of a behavioral addiction – an obsessive behavioral pattern that can be a sign of underlying mental distress or illness. People who have mental health issues, or are simply under stress, tend to be drawn to things that are fun and distracting. And that’s mostly good, actually. It’s just that sometimes, for some individuals, they may begin to really overdo those activities as a form of escapism…It’s not about technology. It’s about mental health”.

A clinical psychologist, Anthony Bean said:

“There are some clear signs that Solitaire might be playing too big a role in your life. (If you’re) noticing you’re putting more time than other areas into the game and, let’s say, not paying attention to your family, not paying attention to work, not paying attention to school”.

My contribution to the Business Insider was taken from an email I sent the journalist. Very little of what I sent was used. I was asked two specific questions: (i) what characteristics of the game Solitaire might make it addicting? and (ii) what should people be aware of as signs of a disruptive addiction to Solitaire (or gaming in general)?

In answer to the first question, I wrote that addictions rely on constant rewards (what psychologists refer to as reinforcement) and each game of Solitaire can be played quickly and individuals can be quickly rewarded if they win (positive reinforcement) but when they lose, the feeling of disappointment or cognitive regret can be eliminated by playing again straight away (negative reinforcement – playing as way to relive a dysphoric mood state). I also stated that addictions typically result as a coping mechanism to other things in a person’s life. They use such behaviours as a way of escape and the repetitive playing of games can help in such circumstances. For the overwhelming majority of people, such playing behaviour will be an adaptive coping mechanism but if the game takes over all other aspects of the person’s life and compromises their relationships and their education/occupation (depending upon their age), this becomes a poor coping strategy because the short-term benefits are heavily outweighed by the long-term costs.

In relation to the second question, I outlined what I believe to be the six core criteria of addictive behaviour and outlined them with what I believed a genuine Solitaire addiction would constitute. My response was purely hypothetical because I have never met or even heard of anyone being genuinely addicted to Solitaire. So, hypothetically, Solitaire addiction would comprise anyone that fulfilled all of the following six criteria:

• Salience –This occurs when Solitaire 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 playing Solitaire they will be constantly thinking about the next time that they will be (i.e., a total preoccupation with Solitaire).
• Mood modification –This refers to the subjective experiences that people report as a consequence of playing Solitaire 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’).
• Tolerance –This is the process whereby increasing amounts of time spent playing Solitaire are required to achieve the former mood modifying effects. This basically means that for someone engaged in Solitaire, they gradually build up the amount of the time they spend playing Solitaire 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 play Solitaire because they are ill, have no computer connection, 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 playing Solitaire
• Relapse– This is the tendency for repeated reversions to earlier patterns of excessive Solitaire playing to recur and for even the most extreme patterns typical at the height of excessive Solitaire playing to be quickly restored after periods of control.

Finally, I just want to reiterate that I know of no evidence to support the contention that there are individuals genuinely addicted to Solitaire. However, I do think it’s theoretically possible even though I’ve yet to meet or hear about such individuals.

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

Further reading

Fatayer, J. (2008). Addiction types: A clinical sociology perspective. Journal of Applied Social Science, 2(1), 88-93.

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

Griffiths, M.D. (1999). Internet addiction: Internet fuels other addictions. Student British Medical Journal, 7, 428-429.

Griffiths, M.D. (2000). Internet addiction – Time to be taken seriously? Addiction Research, 8, 413-418.

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

Mitchell, P. (2000). Internet addiction: genuine diagnosis or not? The Lancet, 355(9204), 632.

National Day Calendar (2018). National Solitaire Day. Located at: https://nationaldaycalendar.com/national-solitaire-day-may-22/

Widyanto, L. & Griffiths, M.D. (2006). Internet addiction: A critical review. International Journal of Mental Health and Addiction, 4, 31-51.

Young K. (1999). Internet addiction: Evaluation and treatment. Student British Medical Journal, 7, 351-352.

The (not so) beautiful game: A brief look at problematic videogame playing among professional football players

Today’s blog briefly looks at the issue of problematic gaming amongst footballers and whether it is an issue that professional football clubs must take seriously. In a previous article I wrote about gambling (and gambling addiction) among professional footballers which has become a well-known issue over the last couple of decades. The reasons for why professional footballers gamble have similarities to why they play videogames.

It is the night before a big match. Professional football players are confined to staying in a hotel. No sex. No alcohol. No junk food. Basically, no access to all the things they might love. To pass time, footballers may watch television, play cards for money, or play a video game believing these are ‘healthier’ for them. The difficulty in detecting problematic gaming is likely to be one factor in its growth over other forms of potential addiction – especially as many players are more health-conscious and the testing for alcohol and drugs is now more rigorous. However, any of these ‘healthier’ activities when taken to excess can cause problems. Many years ago, England goalkeeper David James once claimed his loss of form was because of his round-the-clock video game playing. In short, the top players are very well paid and inevitably have lots of time on their hands.

During my career, I have been asked a handful of times by the press to comment on why footballers play videogames. For instance, I was recently interviewed by The i newspaper about the medical consequences of excessive gaming after a story emerged that Arsenal’s Mesut Ozil frequent back problems may have been related to the excessive amount of time he spent playing Fortnite (at least according to Professor Ingo Frobose at the Sport University Cologne in Germany).

Although the English Football Association has strict rules on gambling by footballers, there are none (as far as I am aware) on the playing of videogames (and to be honest there is no real need to do so). There are many reasons why footballers may gamble or play videogames to excess compared to other less ‘healthy’ behaviours like excessive drinking or drug taking. It is a shame that addictions to drugs and alcohol tend to generate more sympathy among the general public as many people view gambling and gaming as self-inflicted vices. But gambling or gaming to excess can be just as destructive because of the huge consequences on time and/or money.

According to a story earlier this week in The Sun newspaper, an “English football star” (who wanted to remain anonymous so as not to damage his reputation) had allegedly been playing the Fortnite videogame for up to 16 hours a day which he said was threatening his career (and his relationship) and causing him to miss training sessions. He also claimed “there are many more in the sport” just like him. By speaking out about the issue, his motive is to “raise awareness about an addiction which has been described as a ‘silent epidemic’ in football”. The Sun claimed that the footballer’s story was “likely to resonate with dozens of his fellow professionals, who also while away their free time on consoles”. Other footballers such as Mesut Ozil and Harry Kane have claimed to big fans of playing Fortnite. The Sun also claimed that the Professional Footballers’ Association had been contacted by football clubs concerned about the amount of gaming habits by players. In the footballer’s interview with The Sun, he said that:

 “[My] gaming has become a massive problem. When I get back from training, the first thing I do is turn the Xbox on to play Fortnite. I play for about eight to ten hours a day, but I once played 16 hours non-stop the day before a match. When we have away matches and we travel by coach, I am gaming from the moment we leave and then I carry on in my hotel room at night. It is quite normal for me to stay up playing until two o’clock or three o’clock in the morning. I get a lot of eye strain, I am tired the next day and I miss training sometimes. When I started missing training, that was when I knew I needed help as I was getting in trouble from my club. This has been going on for about a year now. If I get told to come off the game, I am sometimes quite aggressive. I have mood swings. If I keep gaming, I worry that it could potentially finish my career. It is also affecting my relationship with my girlfriend because I play on the Xbox instead of seeing her…I think some of my team-mates need help as well. About 50 per cent of our squad are into gaming. And I know they play for a lot of hours because I play Fortnite with them – as well as with players from other clubs.”

The Sun also spoke to the footballer’s psychotherapist Steve Pope. He is currently treating five professional footballers who have problematic gaming and he was quoted as saying:

“Over the last few years, we have probably treated more than 20 footballers for this problem alone. But that is just the tip of the iceberg. They are all at it. It is the biggest scourge of our times. It’s a silent epidemic because footballers can’t be tested for it. I don’t think clubs realise what a big problem this is and the debilitating effect excessive gaming has on a player’s psyche. They wouldn’t let a footballer have a bottle of vodka in their hotel room the night before a game, so why would they let him loose with an Xbox?…If it’s a national problem, which gaming is, then why shouldn’t it affect footballers who have hours and hours to kill on planes, trains and coaches, and then sit in hotel rooms by themselves? For footballers, the real appeal about computer games is that, unlike with other addictions, they can’t be tested for it. It is a problem that needs to be outed to save players’ careers”.

Pope then went on to say:

“Footballers have an addictive personality because that’s what makes them good at their job. From an early age at academies, they are conditioned to work for a high, whether that is making a great pass or scoring a great goal. That is the work-for high. The brain likes that feeling, likes that elation, likes that rush. But if they are not getting that high from football, they are getting it from something else – alcohol, drugs, gambling or gaming. That is the lazy high. Footballers are trained to be competitive and with the kind of games they are playing, Fortnite or Fifa, they are continually in a competition. It’s a follow on from playing football. The trouble is they are playing the games all night and use up all their happy chemicals so their brain is imbalanced. So come the match the following day, they are as flat as a pancake. They are a jangled wreck, trying to clear their head. When I worked in-house at Fleetwood, we banned game stations the night before matches. I would walk the hotel corridors at night time nicking PlayStations and Xboxes to stop them using them”.

Whilst I don’t subscribe to the idea of an addictive personality, much of what Pope says I agree with. It’s not hard to see how professional footballers can get hooked into gaming. Consequently, time rich and money rich young footballers need to be educated about the potential downsides of excessive videogame playing.

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

Further reading

Coverdale. D. (2019). Football’s silent addiction: Gaming makes me aggressive and I’m worried it’ll end my career. The Sun, march 28. Located at: https://www.thesun.co.uk/sport/football/8735239/football-silent-addiction-gaming-fortnight-addiction-career/

Griffiths, M.D. (2006). All in the game. Inside Edge: The Gambling Magazine, July (Issue 28), p. 67.

Griffiths, M.D. (2010). Gambling addiction among footballers: causes and consequences. World Sports Law Report, 8(3), 14-16.

Wigmore, T. (2018). If Mesut Ozil really is addicted to Fortnite then Arsenal have a problem. The i, December 14. Located at: https://inews.co.uk/sport/football/mesut-ozil-fortnite-addicted-gaming-arsenal-injury-news/

(Loot) boxing clever? Has child and adolescent problem gambling really risen in the UK?

A couple of months ago, teenage gambling was grabbing the media headlines. The UK Gambling Commission published its annual statistics showing that based on a self-report survey of 2865 children and adolescents aged 11-16 year-olds, that the prevalence of problem gambling had risen to 1.7% (2% for boys and 1.3% for girls) compared to 0.4% in 2016 and 0.9% in 2017. This lead to predictable headlines such as “Number of child gamblers quadruples in just two years”.

I’ve been researching adolescent gambling for over three decades and was the topic for my first two books in 1995 and 2002. While the figures were concerning, the good news is that the prevalence of adolescent problem gambling has been on the decline in the UK over the past 20 years. For instance, the prevalence of adolescent problem gambling back in 2000 was approximately 5% but by 2016 was less than one-tenth of that. The rise over the past two years is a potential worry although the Gambling Commission’s ‘technical annex’ report about the methodology used to collect the data for the latest survey did suggest that one of the main reasons for the significant increase in problem gambling was likely due to a change in the way data were collected.

In short, the filtering questions in the latest study were changed (so that they more matched the adult gambling prevalence surveys that are carried out) which lead to a doubling of teenagers completing the problem gambling screen that was used to assess problem gambling (18% completing the problem gambling screen in 2017 compared to 34% in 2018). However, it is still worth noting that using the same methodology, there was more than a doubling of adolescent problem gambling from 2016 to 2017 (0.4% to 0.9%).

If there has been a genuine increase in adolescent problem gambling over the past couple of years, I think one of the main factors in this is the playing of simulated gambling games (or gambling-like activities such as the buying of loot boxes) in video games. The Gambling Commission’s report noted that 13% had played gambling-style games online, and that 31% had accessed loot boxes in a videogame or app, to try to acquire in-game items.

The buying of loot boxes takes place within online videogames and are (in essence) virtual games of chance. Players use real money to buy virtual in-game items and can redeem such items by buying keys to open the boxes where they receive a chance selection of further virtual items. Other types of equivalent in-game virtual assets that can be bought include crates, cases, chests, bundles, and card packs. The virtual items that can be ‘won’ can comprise basic customization (i.e., cosmetic) options for a player’s in-game character (avatar) to in-game assets that can help players progress more effectively in the game (e.g., gameplay improvement items such as weapons, armour). All players hope that they can win ‘rare’ items and are often encouraged to spend more money to do so because the chances of winning such items are minimal. Many popular videogames now feature loot boxes and these require the paying of real money in exchange for a completely random in-game item.

At present, the UK Gambling Commission does not consider loot boxes as a form of gambling because (they claim) the in-game items have no real-life value outside of the game. However, this is not the case because there are many websites that allow players to trade in-game items and/or virtual currency for real money. The Gambling Commission appears to acknowledge this point and claim that the buying of in-game loot boxes (and their equivalents) are not gambling but, if third party sites become involved (by allowing the buying and selling of in-game items), the activity does become a form of gambling. Personally, I view the buying of loot boxes as a form of gambling, particularly because the ‘prizes’ won are (in financial terms) often a lot less than that of the price paid.

A study published in the journal PLoS ONE claimed they had evidence for a link between the amount that videogame players spent on loot boxes and problem gambling severity in a large survey of 7422 gamers. The paper concluded that:

“This link was stronger than a link between problem gambling and buying other in-game items with real-world money…suggesting that the gambling-like features of loot boxes are specifically responsible for the observed relationship between problem gambling and spending on loot boxes”

However, this evidence is correlational not causal. I’ve also cited empirical research in my academic papers that engaging in simulated gambling within videogames is a risk factor for both gambling with real money and problem gambling. In November 2018, the Mail on Sunday (MoS) published some of my concerns after they interviewed me about the issue of simulated gambling in online videogames. Although no real money is staked, I have argued that such activities normalize gambling for children and that such activities behaviourally condition children towards gambling.

The MoS claimed that I said that children should be banned from playing online games such as Candy Crush. What I actually said was that children should be prohibited from engaging in gambling simulations within videogames. Candy Crush now features a gambling-type element in the form of a ‘wheel of fortune’ type game (which has also been used in other videogames like Runescape and which I have also argued are gambling when players have to pay to spin the wheel) and that children should be prohibited from accessing such gambling-like features. There is no evidence that the playing of Candy Crush causes problematic behaviour but the playing of simulated gambling-type games has been shown to be a risk factor for problem gambling among adolescents.

The question as to whether there has been a genuine increase in problem gambling among children and adolescents cannot be answered from the Gambling Commission’s latest report but based on other pieces of research there does appear to have been a slight rise over the past couple of years.

(Please note that a different version of this article was first published in The Conversation).

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

Further reading

Calado, F., Alexandre, J. & Griffiths, M.D. (2017). Prevalence of adolescent problem gambling: A systematic review of recent research. Journal of Gambling Studies, 33, 397-424.

Calado, F. & Griffiths, M.D. (2016). Problem gambling worldwide: An update of empirical research (2000-2015). Journal of Behavioral Addictions, 5, 592–613.

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

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

Griffiths, M.D. (2008). Adolescent gambling in Great Britain. Education Today: Quarterly Journal of the College of Teachers. 58(1), 7-11.

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

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

Griffiths, M.D. (2018). Is the buying of loot boxes in videogames a form of gambling or gaming? Gaming Law Review, 22(1), 52-54.

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

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

 

World of the Weird: The A-Z of strange and bizarre addictions

Today’s blog takes a brief look at some of the stranger addictions that have been written about in the academic literature (or academics that have tried to argue these behaviours can be addictive). Some of these ‘addictions’ listed are not addictions by my own criteria but others have argued they are. The papers or books that have argued the case for the cited behaviour being a type of addiction are found in the ‘Further reading’ section.

• Argentine tango addiction: A French study published in a 2013 issue of the Journal of Behavioral Addictions by Remi Targhetta and colleagues argued that a minority of 1129 Argentine tango dancers they surveyed may be addicted to dancing. In 2015, I and some of my Hungarian colleagues developed the Dance Addiction Inventory (published in PLoS ONE) and also argued that a minority of dancers (more generally) might be addicted to dance and conceptualized the behaviour as a form of exercise addiction.
• Badminton addiction: While there are many behaviours I could have chosen here including addictions to box set television watching (aka ‘box set bingeing), bargain hunting, bungee jumping, blogging, and bodybuilding, a recent 2018 paper published in NeuroQuantology by Minji Kwon and colleagues carried out a neuroimaging study on a sample 45 badminton players. Using the Korean Exercise Addiction Scale, 20% of the sample were defined as being addicted to badminton.
• Carrot eating addiction: Again, there are many behaviours I could have chosen here including alleged addictions to crypto-trading, chaos, collecting, crosswords, and cycling, there are a number of published case studies in the psychological literature highlighting individuals addicted to eating carrots including papers by Ludek Černý and Karel Černý, K. (British Journal of Addiction, 1992), and Robert Kaplan (Australian and New Zealand Journal of Psychiatry, 1996).
• Death addiction: A recent paper by Dr. Marc Reisinger entitled ‘Addiction to death’ in the journal CNS Spectrums attempted to argue that attraction to death be considered an addiction similar to gambling addiction. Reisinger related the concept to individuals who have left Europe to join the jihad in Syria, and outlined the case of 24-year-old French-Algerian Mohamed Merah who committed several attacks in Toulouse in 2012 and who ‘glorified’ death. Te paper claimed that this “addiction to death is taught by Salafist preachers, whose videos, readily accessible on the internet, are kind of advertisements for death, complete with depictions of soothing fountains and beautiful young girls”.
• Entrepreneurship addiction: There are a couple of papers by April Spivack and Alexander McKelvie (a 2014 paper in the Journal of Business Venturing, and a 2018 paper Academy of Management) arguing that entrepreneurship can be addictive. They define ‘entrepreneurship addiction’ as “the excessive or compulsive engagement in entrepreneurial activities that results in a variety of social, emotional, and/or physiological problems and that despite the development of these problems, the entrepreneur is unable to resist the compulsion to engage in entrepreneurial activities”. They also make the case that that entrepreneurship addiction is different from workaholism.
• Fortune telling addiction: Although I could have included addictions to financial trading or fame, a 2015 paper in the Journal of Behavioral Addictions by Marie Grall-Bronnec and her colleagues reported the case study of a woman (Helen) that was ‘addicted’ to fortune tellers. They used my addiction criteria to assess whether Helen was addicted to fortune telling, and argued that she was.
• Google Glass addiction: In previous blogs I have written on addictions to gossip and gardening (although these were based more on non-academic literature). However, a 2015 paper published by Kathryn Yung and her colleagues in the journal Addictive Behaviors, published the first (and to my knowledge) only case of addiction to Google Glass (wearable computer-aided glasses with Bluetooth connectivity to internet-ready devices. The authors claimed that their paper, (i) showed that excessive and problematic uses of Google Glasscan be associated with involuntary movements to the temple area and short-term memory problems, and (ii) highlighted that the man in their case study displayed frustration and irritability that were related to withdrawal symptoms from excessive use of Google Glass.
• Hacking addiction: Back in the late 1990s and early 2000s I wrote a number of papers on internet addiction and included ‘hacking addiction’ as a type of internet addiction. Given the criminal element of this type of internet addiction I wrote about it in criminological-based journals such as The Probation Journal (1997) and The Police Journal (2000). One of the most infamous cases that I have written about took place in London in 1993, where Paul Bedworth was accused of hacking-related crime causing over £500,000 worth of damage. On the basis of expert witness testimony, he was acquitted on the basis that he was addicted to hacking. Since then, various papers have been published arguing that hacking can be an addiction. For instance, in an in-depth interview study of 62 hackers, Siew Chan and Lee Yao used addiction as a framework to explain their participants’ behaviour (see their paper in the Review of Business Information Systems, 2005).
• Internet search addiction: Although I was tempted to go for IVF addiction, I thought I would go for ‘internet search addiction’ which basically refers to constant ‘googling’ where individuals spend hours and hours every day using online databases to go searching for things. This behaviour was first alluded to by Kimberley Young in her 1999 classification of different types of internet addiction which she called ‘information overload’ and was defined as compulsive web surfing or database searches. More recently, Yifan Wang and her colleagues developed the Questionnaire on Internet Search Dependence (QISD) published in Frontiers in Public Health (FiPH). I criticized the QISD in a response paper published in FiPH, not because I didn’t think internet search addiction didn’t exist (because theoretically it might do, even though I’ve never come across a genuine case) but because the items in the instrument had very little to do with addiction.
• Joyriding addiction: There have been a number of academic papers published on joyriding addiction. Arguably the most well-known study was published by Sue Kellett and Harriet Gross in a 2006 issue of Psychology, Crime and Law. The study comprised semi-structured interviews with 54 joyriders (aged 15 to 21 years of age) all of whom were convicted car thieves (“mainly in custodial care”). The results of the study indicated that all addiction criteria occurred within the joyriders’ accounts of their behaviour particularly ‘‘persistence despite knowledge and concern about the harmful consequences’’, ‘‘tolerance’’, ‘‘persistent desire and/or unsuccessful attempts to stop’’, “large amounts of time being spent thinking about and/or recovering from the behaviour’’ and “loss of control”. The paper also cited examples of ‘withdrawal’ symptoms when not joyriding, the giving up of other important activities so that they could go joyriding instead, and spending more time participating in joyriding than they had originally intended.
• Killing addiction: The idea of serial killing being conceptualized as an addiction in popular culture is not new. For instance, Brian Masters book about British serial killer Dennis Nilsen (who killed at least 12 young men) was entitled Killing for Company: The Story of a Man Addicted to Murder, and Mikaela Sitford’s book about Harold Shipman, the British GP who killed over 200 people, was entitled Addicted to Murder: The True Story of Dr. Harold Shipman. In Eric Hickey’s 2010 book Serial Murderers and Their Victims, Hickey makes reference to an unpublished 1990 monograph by Dr. Victor Cline who outlined a four-factor addiction syndrome in relation to sexual serial killers who (so-called ‘lust murderers’ that I examined in a previous blog). One of the things that I have always argued throughout my career, is that someone cannot become addicted to an activity or a substance unless they are constantly being rewarded (either by continual positive and/or negative reinforcement). Given that serial killing is a discontinuous activity (i.e., it happens relatively infrequently rather than every hour or day) how could killing be an addiction? One answer is that the act of killing is part of the wider behaviour in that the preoccupation with killing can also include the re-enacting of past kills and the keeping of ‘trophies’ from the victims (which I overviewed in a previous blog).
• Love addiction: In the psychological literature, the concept of love addiction has been around for some time dating back to works by Sigmund Freud. Arguably the most cited work in this area is the 1975 book Love and Addiction by Stanton Peele and Archie Brodsky. Their book suggested that some forms of love are actually forms of addiction, and tried to make the case that some forms of love addiction may be potentially more destructive and prevalent than widely recognized opiate drugs. There have also been a number of instruments developed assessing love addiction including the Love Addiction Scale (developed by Hunter, Nitschke, and Hogan, 1981), and the Passionate Love Scale (developed by Hatfield, and Sprecher, 1986).
• Muscle dysmporphia as an addiction: In a paper I published with Andrew Foster and Gillian Shorter in a 2015 issue of the Journal of Behavioral Addictions, we argued that muscle dysmorphia (MD) could be classed as an addiction. MD is a condition characterised by a misconstrued body image in individuals who interpret their body size as both small or weak even though they may look normal or highly muscular. MD has been conceptualized as a body dysmorphic disorder, an eating disorder, and/or part of the obsessive-compulsive disorder symptomatology. Reviewing the most salient literature on MD, we proposed an alternative classification of MD that we termed the ‘Addiction to Body Image’ (ABI) model. We argued the addictive activity in MD is the maintaining of body image via a number of different activities such as bodybuilding, exercise, eating specific foods, taking specific drugs (e.g., anabolic steroids), shopping for specific foods, food supplements, and/or physical exercise accessories, etc.. In the ABI model, the perception of the positive effects on the self-body image is accounted for as a critical aspect of the MD condition (rather than addiction to exercise or certain types of eating disorder). Based on empirical evidence, we proposed that MD could be re-classed as an addiction due to the individual continuing to engage in maintenance behaviours that may cause long-term harm.
• News addiction: Although I could have chosen nasal spray addiction or near death addiction, a recent 2017 paper on ‘news addiction’ was published in the Journal of the Dow University of Health Sciences Karachi by Ghulam Ishaq and colleagues. The authors used some of my papers on behavioural addiction to argue for the construct of ‘news addiction’ as a construct to be empirically investigated. The authors also 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. In relation to personality types (and like other addictions), they found news addiction was positively correlated with neuroticism and negatively correlated with conscientiousness. 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.
• Online auction addiction: A number of academics have made the claim that some individuals can become addicted to participating in online auctions. In a 2004 paper on internet addiction published in American Behavioral Scientist, Kimberley Young mentioned online auction [eBay] addiction in passing. The same observation was also made in a later 2009 paper by Tonino Cantelmi and Massimo Talls in the Journal of CyberTherapy and Rehabilitation. Other researchers have carried out empirical studies including a (i) 2007 paper by Cara Peters and Charles Bodkin in the Journal of Retailing and Consumer Services, (ii) 2008 paper by Chih-Chien Wang in the Proceedings of the Asia-Pacific Services Computing Conference, and (iii) 2011 study carried out by Dr. Ofir Turel and colleagues published in the MIS Quarerly. These papers indicated that those with problematic online auction use experienced (i) psychological distress, (ii) habitual usage, (iii) compulsive behaviour, (iv) negative consequences, and/or (v) dependence, withdrawal and self-regulation.
• Pinball addiction: Although I could have listed alleged addictions to plastic surgery and poetry, as far as I am aware, I am the only academic to have published a paper on pinball addiction. Back in 1992, I published a case study in Psychological Reports. My paper featured the case of a young man (aged 25 years) who (based on classic addiction criteria) was totally hooked on pinball. It was the most important thing in his life, used the behaviour to modify his moods, got withdrawal symptoms if he was unable to play pinball, had engaged in repeated efforts to cut down or stop playing pinball, and compromised all other activities in his life (education, occupation and relationships). To me, this individual had a gaming addiction but it was pinball rather than videogame addiction.
• Qat addiction: Qat (sometimes known as khat, kat, cat, and ghat) is a flowering plant traditionally used as a mild stimulant in African and Middle East countries (Somalia, Yemen, Ethiopia). Heavy qat users can experience many side effects including insomnia, anxiety, increased aggression, high blood pressure, and heart problems. There are numerous reports in the medical literature of qat addiction (see papers by Rita Manghi and colleagues in the Journal of Psychoactive Drugs, and Nezar Al-Hebshi and Nils Skuag in Addiction Biology).
• Rock climbing addiction: Over the past two years, a couple of papers by Robert Heirene, David Shearer, and Gareth Roderique-Davies have looked at the addictive properties of rock climbing specifically concentrating on withdrawal symptoms and craving. In the first paper on withdrawal symptoms published in 2016 in the Journal of Behavioral Addictions, the authors highlighted some previous research suggesting that there are similarities in the phenomenology of substance-related addictions and extreme sports (in this case rock climbing). The study concluded that based on self-report, rock climbers experienced genuine withdrawal symptoms during abstinence from climbing and that these were comparable to individuals with substance and other behavioural addictions. In a second investigation just published in Frontiers in Psychology, the same team reported the development of the Rock Climbing Craving Questionnaire comprising three factors (‘positive reinforcement’, ‘negative reinforcement’ and ‘urge to climb’).
• Study addiction: I was spoilt for choice on the letter ‘S’ and could have mentioned addictions to speeding, selfie-taking, shoplifting, Sudoko, and stock market speculation. However, there are now a number of published papers on ‘study addiction’ (individuals addicted to their academic study), three of which I have co-authored (all in the Journal of Behavioral Addictions and led by my colleague Pawel Atroszko). We have conceptualised study addiction as a type of work addiction (or a pre-cursor to work addiction) and in a series of studies (including longitudinal research) we have found empirical evidence of ‘study addiction’. Italian researchers (Yura Loscalzo and Marco Giannini) have also published research on ‘overstudying’ and ‘studyholism’ too (in the journals ARC Journal of Psychiatry, 2017; Social Indicators Research, 2018).
• Tanning addiction: There is now lots of empirical research examining ‘tanorexia’ (individuals who crave tanning and spend every day on sunbeds). However, I along with my colleagues in Norway recently reconceptualised tanorexia as a ‘tanning addiction’ and developed a scale to assess it (which was recently published in a 2018 issue of the British Journal of Dermatology). Our study was the largest over study on tanning (over 23,000 participants) and our newly developed scale (the Bergen Tanning Addiction Scale) had good psychometric properties.
• Upskirting addiction: Upskirting refers to taking a photograph (typically with a smartphone) up someone’s skirt without their permission. In the UK there have been a number of high profile court cases including Paul Appleby who managed to take 9000 upskirting photos in the space of just five weeks (suggesting that he was doing it all day every day to have taken so many photos), and Andrew MacRae who had amassed 49,000 upskirt photos and videos using hidden cameras at his workplace, on trains, and at the beach. Both men avoided a custodial sentence because their lawyers argued they were addicted and/or had a compulsion to upskirting. In a 2017 issue of the Law Gazette, forensic psychologist Julia Lam made countless references to upskirting in an overview of voyeuristic disorder. Dr. Lam also talked about her treatment of upskirting voyeurs and recounted one case which she claimed was a compulsion (and who was successfully treated). The case involved a male university student who was very sport active but who masturbated excessively whenever major sporting events or important exams were imminent as a coping strategy to relieve stress.
• Virtual reality addiction: Back in 1995, in a paper I entitled ‘Technological addictions’ in the journal Clinical Psychology Forum, I asserted that addiction to virtual reality would be something that psychologists would be seeing more of in the future. Although I wrote the paper over 20 years ago, there is still little empirical evidence (as yet) that individuals have become addicted to virtual reality (VR). However, that is probably more to do with the fact that – until very recently – there had been little in the way of affordable VR headsets. (I ought to just add that when I use the term ‘VR addiction’ what I am really talking about is addiction to the applications that can be utilized via VR hardware rather than the VR hardware itself). Of all the behaviours on this list, this is the one where there is less good evidence for its existence. Perhaps of most psychological concern is the use of VR in video gaming. There is a small minority of players out there who are already experiencing genuine addictions to online gaming. VR takes immersive gaming to the next level, and for those that use games as a method of coping and escape from the problems they have in the real world it’s not hard to see how a minority of individuals will prefer to spend a significant amount of their waking time in VR environments rather than their real life.
• Water addiction: In a blog I wrote back in 2015, I recounted some press stories on individuals who claimed they were ‘addicted’ to drinking water. My research into the topic led to a case study of ‘water dependence’ published a 1973 issue of the British Journal of Addiction by E.L. Edelstein. This paper reported that the excessive drinking of water can dilute electrolytes in an individual’s brain and cause intoxication. This led me to a condition called polydipsia (which in practical terms means drinking more than three litres of water a day) which often goes hand-in-hand with hyponatraemia (i.e., low sodium concentration in the blood) and in extreme cases can lead to excessive water drinkers slipping into a coma. There are also dozens and dozens of academic papers on psychogenic polydipsia (PPD). A paper by Dr. Brian Dundas and colleagues in a 2007 issue of Current Psychiatry Reports noted that PPD is a clinical syndrome characterized by polyuria (constantly going to the toilet) and polydipsia (constantly drinking too much water), and is common among individuals with psychiatric disorders. A 2000 study in European Psychiatry by E. Mercier-Guidez and G. Loas examined water intoxication in 353 French psychiatric inpatients. They reported that water intoxication can lead to irreversible brain damage and that around one-fifth of deaths among schizophrenics below the age of 53 years are caused this way. Whether ‘water intoxication’ is a symptom of being ‘addicted’ to water depends upon the definition of addiction being used.
• X-ray addiction: OK, this one’s a little bit of a cheat but what I really wanted to concentrate on what has been unofficially termed factitious disorder (FD). According to Kamil Jaghab and colleagues in a 2006 issue of the Psychiatry journal “FD is sometimes referred to as hospital addiction, pathomimia, or polysurgical addiction”. The primary characteristic of people suffering from FD is that they deliberately pretend to be ill in the absence of external incentives (such as criminal prosecution or financial gain). It is called a factitious because sufferers feign illness, pretend to have a disease, and/or fake psychological trauma typically to gain attention and/or sympathy from other people. Again, whether such behaviours can be viewed as an addiction depends upon the definition of addiction being used.
• YouTube addiction: I unexpectedly found my research on internet addiction being cited in a news article by Paula Gaita on compulsive viewing of YouTube videos (‘Does compulsive YouTube viewing qualify as addiction?‘). The article was actually reporting a case study from a different news article published by PBS NewsHour by science correspondent Lesley McClurg (‘After compulsively watching YouTube, teenage girl lands in rehab for digital addiction’). The story profiled a student whose obsessive viewing of YouTube content led to extreme behaviour changes and eventually, depression and a suicide attempt. Not long after this, I and my colleague Janarthanan Balakrishnan published what we believe is the only ever study on YouTube addiction in the Journal of Behavioral Addictions. In a study of over 400 YouTube users we found that YouTube addiction was more associated with content creation than watching content
• ‘Zedding’ addiction: OK, I’m using the Urban Dictionary’s synonym here as a way of including ‘sleep addiction’. The term ‘sleep addiction’ is sometimes used to describe the behavior of individuals who sleep too much. Conditions such as hypersomnia (the opposite of insomnia) has been referred to ‘sleeping addiction’ (in the populist literature at least). In a 2010 issue of the Rhode Island Medical Journal, Stanley Aronson wrote a short article entitled “Those esoteric, exoteric and fantabulous diagnoses” and listed clinomania as the compulsion to stay in bed. Given the use of the word ‘compulsive’ in this definition, there is an argument to consider clinomania as an addiction or at least a behaviour with addictive type elements.

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

Further reading

Al‐Hebshi, N., & Skaug, N. (2005). Khat (Catha edulis) – An updated review. Addiction Biology, 10(4), 299-307.

Andreassen, C.S., Pallesen, S. Torsheim, T., Demetrovics, Z. & Griffiths, M.D. (2018). Tanning addiction: Conceptualization, assessment, and correlates. British Journal of Dermatology. doi: 10.1111/bjd.16480

Aronson, S. M. (2010). Those esoteric, exoteric and fantabulous diagnoses. Rhode Island Medical Journal, 93(5), 163.

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

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

Atroszko, P.A., Andreassen, C.S., Griffiths, M.D., Pallesen, S. (2016). The relationship between study addiction and work addiction: A cross-cultural longitudinal study. Journal of Behavioral Addiction, 5, 708–714.

Balakrishnan, J. & Griffiths, M.D. (2017). Social media addiction: What is the role of content in YouTube? Journal of Behavioral Addictions, 6, 364-377.

Black, D., Belsare, G., & Schlosser, S. (1999). Clinical features, psychiatric comorbidity, and health-related quality of life in persons reporting compulsive computer use behavior. Journal of Clinical Psychiatry, 60, 839-843.

Burn, C. (2016). Poesegraphilia – Addiction to the act of writing poetry. Poetry Changes Lives, May 27. Located at: http://www.poetrychangeslives.com/addiction-to-the-act-of-writing-poetry/

Cantelmi, T & Talls, M. (2009). Trapped in the web: The psychopathology of cyberspace. Journal of CyberTherapy and Rehabilitation, 2, 337-350.

Černý, L. & Černý, K. (1992). Can carrots be addictive? An extraordinary form of drug dependence. British Journal of Addiction, 87, 1195-1197.

Chan, S. H., & Yao, L. J. (2005). An empirical investigation of hacking behavior. The Review of Business Information Systems, 9(4), 42-58.

Daily Mail (2005). Aquaholics: Addicted to drinking water. May 16. Located at: http://www.dailymail.co.uk/health/article-348917/Aquaholics-Addicted-drinking-water.html

de Leon, J., Verghese, C., Tracy, J. I., Josiassen, R. C., & Simpson, G. M. (1994). Polydipsia and water intoxication in psychiatric patients: A review of the epidemiological literature. Biological Psychiatry, 35(6), 408-419.

Dundas, B., Harris, M., & Narasimhan, M. (2007). Psychogenic polydipsia review: etiology, differential, and treatment. Current Psychiatry Reports, 9(3), 236-241.

Edelstein, E.L. (1973). A case of water dependence. British Journal of Addiction to Alcohol and Other Drugs, 68, 365–367.

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

Gaita, P. (2017). Does compulsive YouTube viewing qualify as addiction? The Fix, May 19. Located at: https://www.thefix.com/does-compulsive-youtube-viewing-qualify-addiction

Grall-Bronnec, M. Bulteau, S., Victorri-Vigneau, C., Bouju, G. & Sauvaget, A. (2015). Fortune telling addiction: Unfortunately a serious topic about a case report. Journal of Behavioral Addiction, 4, 27-31.

Griffiths, M.D. (1992). Pinball wizard: A case study of a pinball addict. Psychological Reports, 71, 160-162.

Griffiths, M.D. (2000). Computer crime and hacking: A serious issue for the police. Police Journal, 73, 18-24.

Griffiths, M.D. (2017). Commentary: Development and validation of a self-reported Questionnaire for Measuring Internet Search Dependence. Frontiers in Public Health, 5, 95. doi: 10.3389/fpubh.2017.00095

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

Hatfield, E., & Sprecher, S. (1998). The passionate love scale. In Fisher, T.D., Davis, C.M., Yarber, W.L. & Davis, S. (Eds.). Handbook of sexuality-related measures (pp. 449-451). London: Sage.

Heirene, R. M., Shearer, D., Roderique-Davies, G., & Mellalieu, S. D. (2016). Addiction in extreme sports: An exploration of withdrawal states in rock climbers. Journal of Behavioral Addictions, 5(2), 332-341.

Hickey, E.W. (2010). Serial Murderers and Their Victims (Fifth Edition). Pacific Grove, CA: Brooks/Cole.

Hunter, M. S., Nitschke, C., & Hogan, L. 1981. A scale to measure love addiction. Psychological Reports, 48, 582-582.

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.

Jaghab, K., Skodnek, K. B., & Padder, T. A. (2006). Munchausen’s syndrome and other factitious disorders in children: Case series and literature review. Psychiatry (Edgmont), 3(3), 46-55.

Kaplan, R. (1996), Carrot addiction. Australian and New Zealand Journal of Psychiatry, 30, 698-700.

Kellett, S.  & Gross, H. (2006). Addicted to joyriding? An exploration of young offenders’ accounts of their car crime. Psychology, Crime & Law, 12, 39-59.

Kennedy, J. G., Teague, J., & Fairbanks, L. (1980). Qat use in North Yemen and the problem of addiction: a study in medical anthropology. Culture, medicine and psychiatry, 4(4), 311-344.

Kwon, M., Kim, Y., Kim, H., & Kim, J. (2018). Does sport addiction enhance frontal executive function? The case of badminton. NeuroQuantology, 16(6), 13-21.

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

Loscalzo, Y, & Giannini, M. (2017).  Evaluating the overstudy climate at school and in the family: The Overstudy Climate Scale (OCS). ARC Journal of Psychiatry, 2(3), 5-10.

Loscalzo, Y., & Giannini, M. (2018). Study engagement in Italian university students: A Confirmatory Factor Analysis of the Utrecht Work Engagement Scale—Student Version. Social Indicators Research, Epub ahead of print. https://doi.org/10.1007/s11205-018-1943-y

Manghi, R. A., Broers, B., Khan, R., Benguettat, D., Khazaal, Y., & Zullino, D. F. (2009). Khat use: lifestyle or addiction? Journal of Psychoactive Drugs, 41(1), 1-10.

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

Masters, B. (1986). Killing for Company: The Story of a Man Addicted to Murder. New York: Stein and Day.

McClurg, L. (2017). After compulsively watching YouTube, teenage girl lands in rehab for ‘digital addiction’. PBS Newshour, May 16. Located at: http://www.pbs.org/newshour/rundown/compulsively-watching-youtube-teenage-girl-lands-rehab-digital-addiction/

Menninger, K. A. (1934). Polysurgery and polysurgical addiction. The Psychoanalytic Quarterly, 3(2), 173-199.

Mercier-Guidez, E., & Loas, G. (2000). Polydipsia and water intoxication in 353 psychiatric inpatients: an epidemiological and psychopathological study. European Psychiatry, 15(5), 306-311.

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

Peele, S. & Brodsky, A. (1975), Love and addiction. New York: Taplinger.

Peters, C.  & Bodkin, C.D. (2007). An exploratory investigation of problematic online auction behaviors: Experiences of eBay users. Journal of Retailing and Consumer Services, 14(1), 1-16.

Reisinger, M. (2018). Addiction to death. CNS Spectrums, 23(2), 166-169.

Relangi, K. (2012). Gossip, the ugly addiction. Purple Room Healing, June 12. Located at: https://deadmanswill.wordpress.com/2012/06/02/gossip-the-ugly-addiction/

Roderique-Davies, G. R. D., Heirene, R. M., Mellalieu, S., & Shearer, D. A. (2018). Development and initial validation of a rock climbing craving questionnaire (RCCQ). Frontiers in Psychology, 9, 204. doi: 10.3389/fpsyg.2018.00204

Sitford, M. (2000). Addicted to Murder: The True Story of Dr. Harold Shipman. London: Virgin Publishing.

Sparrow, P. & Griffiths, M.D. (1997). Crime and IT: Hacking and pornography on the internet. Probation Journal, 44, 144-147.

Spivack, A., & McKelvie, A. (2018). Entrepreneurship addiction: Shedding light on the manifestation of the ‘dark side’ in work behavior patterns. The Academy of Management Perspectives. https://doi.org/10.5465/amp.2016.0185

Spivack, A. J., McKelvie, A., & Haynie, J. M. (2014). Habitual entrepreneurs: Possible cases of entrepreneurship addiction? Journal of Business Venturing, 29(5), 651-667.

Targhetta, R., Nalpas, B. & Perney, P. (2013). Argentine tango: Another behavioral addiction? Journal of Behavioral Addictions, 2, 179-186.

Turel, O., Serenko, A. & Giles, P. (2011). Integrating technology addiction and use: An empirical investigation of online auction users. MIS Quarterly, 35, 1043-1061.

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

Wang, C-C. (2008). The influence of passion and compulsive buying on online auction addiction. Proceedings of the Asia-Pacific Services Computing Conference (pp. 1187 – 1192). IEEE.

Wang, Y., Wu, L., Zhou, H., Xu, J. & Dong, G. (2016). Development and validation of a self-reported Questionnaire for Measuring Internet Search Dependence. Frontiers in Public Health, 4, 274. doi: 10.3389/fpubh.2016.00274

Wright, M. R. (1986). Surgical addiction: A complication of modern surgery? Archives of Otolaryngology–Head & Neck Surgery, 112(8), 870-872.

Wulfsohn, I. (2013). A dangerous addiction: Qat and its draining of Yemen’s water, economy, and people. Middle East Economy, 3(10), 1-5.

Young, K. S. (1999). Internet addiction: Evaluation and treatment. Student British Medical Journal, 7, 351-352.

Young, K. S. (2004). Internet addiction: A new clinical phenomenon and its consequences. American Behavioral Scientist, 48, 402–415.

Yung, K., Eickhoff, E., Davis, D. L., Klam, W. P., & Doan, A. P. (2014). Internet Addiction Disorder and problematic use of Google Glass™ in patient treated at a residential substance abuse treatment program. Addictive Behaviors, 41, 58-60.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Further reading

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Gripped by ‘crypt’: A brief look at ‘crypto-trading addiction’

Last week I was approached by Rupert Wolfe-Murray, a PR representative of a well-known addiction treatment clinic (Castle Craig) asking what my views were on Bitcoin and cryptocurrency trading (colloquially known as ‘crypto trading’) and whether the activity could be addictive. More specifically he wrote:

“I write to you about the research we’re doing into addiction to Bitcoin and cryptocurrency trading. We’ve had an enquiry about this at Castle Craig and they would treat it as a gambling addiction. We think it’s a new type of behavioural addiction and we plan to publish a web page (and FAQ) with the intention of alerting people that the online trading of cryptocurrencies may be addictive. It would be very helpful if we could get a quote from you, putting it into perspective. Do you think it’s a growing problem? There’s very little information about this issue online but there is an active forum of ‘crypto addicts’ on Reddit, where I got some friendly feedback…The therapist I often turn to when writing about gambling and the behavioural addictions told me that it sounds like addiction to day trading. Would you agree?”

In short, I couldn’t agree more although my own view is that this is not a ‘new’ addiction but a sub-type of online day-trading addiction (on which I first published an article about back in 2000 for GamCare, the gambling charity I co-founded with Paul Bellringer in 1997) and/or stock market trading addiction (which I’ve written a couple of previous blogs about, here and here, and an article in iGaming Business Affiliate magazine). However, I decided to do a bit of research into the issue.

A recent January 2018 article in the Jakarta Post by Ario Tamat examined this issue which was a personal account of his own experiences (‘Bitcoin trading: Addictive ‘hobby’ that could break my bank’). He wrote:

“I was always interested in Bitcoin, not that I really understand the technology, but first impressions were appealing: a decentralized currency, mined by solving mathematical equations and potentially accessible to anyone…Fast forward to 2017. Discussions on cryptocurrencies had entered the public consciousness, Bitcoin prices were sky high… A few friends introduced me to a local site on cryptocurrency trading – the most suitable term for the entire affair, actually – bitcoin.co.id. Taking the leap, I took some money out of my measly savings and bought myself some Bitcoin…In three days, I had made 6 percent. I was hooked… I’ve noticed that the whole cryptocurrency trading trend is like placing bets on a never-ending horse race, where new horses are introduced to the race almost daily”.

Another article by Douglas Lampi on the Steemit website noted that “the elements of addiction and gambling are a consistent risk that traders must always be on the guard against” and provided some signs to readers that they may be trading impulsively. These included (i) feeling muscle tension, (ii) feeling background anxiety, (iii) checking the price of Bitcoin and alt coins several times through the day, and (iv) thinking about trading while engaged in other activities. While these ‘symptoms’ and behaviours might be found among those addicted to crypto day trading, on their own they are arguably little more than mildly problematic. These signs applied to gambling or social media use would be unlikely to raise many worries among addiction treatment practitioners.

I also visited the online Bitcoin Forum where one of the topics was ‘Is crypto trading an addiction’ prompted by a Russian who allegedly committed suicide after losing all his money crypto trading. Most of the people on the forum didn’t think it was an addiction and claimed the suicide was reminiscent of the suicides that occurred at the time of the 2009 stock market crash (although a couple of individuals believed that crypto trading was a potentially ‘addicting’ activity). One participant in the discussion noted:

“Yes [crypto trading is] highly addictive, specially formulated if you start to notice that need, urge in side you, to check the price even in the middle of the night. Find yourself skipping your daily routines it is and can be addictive if you don’t know how to control you and your emotions. I have found somewhere that some say that it is like being in casino, betting, playing rules etc. because like every coin was made mostly for pure profit and it’s all speculation rather than to have their own sole purpose which when I think of it can make sense to even why it can be addictive”.

Another individual on the Bitcoin Pub website wrote:

“I think I might actually have an unhealthy addiction to [crypto trading]. I’d say 3/4 times when I unlock my phone I’m checking Blockfolio, when I’m at work, at home, with my girlfriend, or even between sets at the gym. I’m starting to think I need to discipline myself to NOT check it or limit it to maybe 1-2 times a day as its noticeably impacting my passions and in turn my mental state. I’m not a day trader, I hold all my coins in cold storage. So there’s really no reason for me to be checking that frequently, or watching crypto analysis YouTube videos, or reading articles about it several times a day”.

The issue was also discussed in a recent February 2018 article in the Irish Times by Fiona Reddan (‘It’s addictive’: Why investors are still flocking to bitcoin and crypto’). Interviewing Nicholas Charalambous (Managing Director of Alpha Wealth) was quoted as saying: “Previously, I would have described cryptos as ‘shares on steroids’; now I would say they’re shares with jetpacks and boosters and then some”. While Bitcoin shares have fallen, there are plenty of new cryptocurrencies that individuals can dabble buying shares in (ethereum, litecoin, ripple, putincoin and dogecoin) and all can be akin to gambling. Reddan also interviewed Jonathan Sheehan (Managing Director, Compass Private Wealth) who said:

“It has the exact same risk and return characteristics as a naive gambler, who has opened their first online betting account. There is absolutely no valuation metric for these currencies and allocating capital to them is an extreme and unnecessary risk”.

One country that has taken crypto trading addiction seriously is South Korea. Their government’s Office for Government Policy Coordination has introduced new rules to inhibit the speculation on cryptocurrencies. According to a Market Watch article:

“The proposed measures…range from levying capital-gain taxes on trading cryptocurrencies, to restricting financial firms from holding, acquiring and investing in them…The new regulations come amid mounting concern within South Korea about the potential for people to become addicted to bitcoin trading”.

The country’s prime minister Lee Nak-yon went as far as to say that the increasing interest in cryptocurrencies could “lead to some serious distorted or pathological phenomenon”.

I did quickly check what had been written about academically. I came across a couple of papers on Google Scholar that mentioned possible addiction to crypto trading. Justine Brecese (in a 2013 ‘research note’ on the socioeconomic implications of cyber‐currencies for ASA Risk Consultants) asserted that “risks with virtual currency include the potential for addiction and resultant over-spending” (but providing little in the way of empirical evidence for the claim). In a paper by Haraši Namztohoto on ‘cryptocoin avarice’, he noted:

“Reason often discretely quits the cognitive battlefield whenever hoarding tendencies of human beings are coupled with addictive behaviour which financial derivate trading surely is, thus leaving humans prone to caprices of mass psychology”.

Given that addictions rely on constant rewards and reinforcement, there is no theoretical reason why crypto trading cannot be addictive. However, there is only anecdotal evidence of addicted individuals and if they are addicted a case could be made that this is a type of gambling addiction.

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

Further reading

Brecese, J. (2013). Research note – Money from nothing: The socioeconomic implications of “cyber-currencies”. Seattle, WA: ASA Institute for Risk & Innovation

Griffiths, M.D. (2000). Day trading: Another possible gambling addiction? GamCare News, 8, 13-14.

Griffiths, M.D. (2009). Internet gambling in the workplace. Journal of Workplace Learning, 21, 658-670.

Griffiths, M.D. (2013). Financial trading as a form of gambling. i-Gaming Business Affiliate, April/May, 40.

Namztohoto, H. (2013). Myth, machinery and cryptocoin avarice. Wizzion.com. Located at: http://wizzion.com/papers/2013/cryptocoin-avarice.pdf

Jeong, E-Y. & Russolillo, S. (2017). South Korea mulls taxing cryptocurrency trade as fears mount about bitcoin addiction, speculation. Market Watch, December 13. Located at: https://www.marketwatch.com/story/south-korea-mulls-taxing-cryptocurrency-trade-as-fears-mount-about-bitcoin-addiction-speculation-2017-12-13

Lampi, D. (2018). Two sure signs YOU are a crypto trading addict. Steemit.com. February. Located: https://steemit.com/cryptocurrency/@ipmal/two-sure-signs-you-are-a-crypto-trading-addict

Reddan, F. (2018). ‘It’s addictive’: Why investors are still flocking to bitcoin and crypto. Irish Times, February 13. Located at: https://www.irishtimes.com/business/financial-services/it-s-addictive-why-investors-are-still-flocking-to-bitcoin-and-crypto-1.3388392

Tamat, A. (2018). Bitcoin trading: Addictive ‘hobby’ that could break my bank. The Jakarta Post, January 8. Located at: http://www.thejakartapost.com/life/2018/01/08/bitcoin-trading-addictive-hobby-that-could-break-my-bank.html

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.”

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