Term warfare: Internet Gaming Disorder and Internet Addiction Disorder are not the same

Over the last 15 years, research into various online addictions has greatly increased. Alongside this, there have been scholarly debates about whether internet addiction really exists. Some may argue that because internet use does not involve the ingestion of a psychoactive substance, then it should not be considered a genuine addictive behaviour. However, the latest (fifth) edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) re-classified ‘Gambling Disorder’ as a behavioural addiction rather than as a disorder of impulse control. The implications of this reclassification are potentially far-reaching. The most significant implication is that if an activity that does not involve the consumption of drugs (i.e., gambling) can be a genuine addiction accepted by the psychiatric and medical community, there is no theoretical reason why other problematic and habitual behaviours (e.g., shopping, work, exercise, sex, video gaming, etc.) cannot be classed as a bone fide addiction.

There have also been debates among scholars that consider excessive problematic internet use to be a genuine addiction as to whether the those in the field should study generalized internet addiction (the totality of all online activities) and/or specific addictions on the internet such as internet gambling, internet gaming and internet sex. Since the late 1990s, I have constantly argued that there is a fundamental difference between addictions on the internet, and addictions to the internet. I argued that the overwhelming majority of individuals that were allegedly addicted to the internet were not internet addicts but were individuals that used the medium of the internet as a vehicle for other addictions. More specifically, I argued that internet gambling addicts and internet gaming addicts were not internet addicts but were gambling and gaming addicts using the convenience and ubiquity of the internet to gamble or play video games.

Prior to the publication of the latest DSM-5, there had also been debates as to whether ‘internet addiction’ should be introduced into the text as a separate disorder. Following these debates, the Substance Use Disorder Work Group (SUDWG) recommended that the DSM-5 include a sub-type of problematic internet use (i.e., internet gaming disorder [IGD]) in Section 3 (‘Emerging Measures and Models’) as an area that needed future research before being included in future editions of the DSM. However, far from clarifying the debates surrounding generalized versus specific internet use disorders, the section of the DSM-5 discussing IGD noted that:

“There are no well-researched subtypes for Internet gaming disorder to date. Internet gaming disorder most often involves specific Internet games, but it could involve non-Internet computerized games as well, although these have been less researched. It is likely that preferred games will vary over time as new games are developed and popularized, and it is unclear if behaviors and consequence associated with Internet gaming disorder vary by game type…Internet gaming disorder has significant public health importance, and additional research may eventually lead to evidence that Internet gaming disorder (also commonly referred to as Internet use disorder, Internet addiction, or gaming addiction) has merit as an independent disorder” (p.796).

In light of what has been already highlighted in previous research, two immediate problematic issues arise from these assertions. Firstly, IGD is clearly seen as synonymous with internet addiction as the text claims that internet addiction and internet use disorder are simply other names for IGD. Secondly – and somewhat confusingly – it is asserted that IGD (which is by definition internet-based) can also include offline gaming disorders.

With regards to the first assertion, internet addiction and online gaming addiction are not the same. A number of recent studies (including ones I’ve co-authored) clearly shows that to be the case. The second assertion that IGD can include offline video gaming is both baffling and confusing. Some researchers consider video games as the starting point for examining the characteristics of gaming disorder, while others consider the internet as the main platform that unites different addictive internet activities, including online games. For instance, I have argued that although all addictions have particular and idiosyncratic characteristics, they share more commonalities than differences (i.e., salience, mood modification, tolerance, withdrawal symptoms, conflict, and relapse), and likely reflects a common etiology of addictive behaviour. For me, IGD is clearly a sub-type of video game addiction. For people like Dr. Kimberley Young, ‘cyber-relationship addictions’, ‘cyber-sexual addictions’, ‘net compulsions’ (gambling, day trading) and ‘information overload’ are all internet addictions. However, many would argue that these – if they are addictions – are addictions on the internet, not to it. The internet is a medium and it is a situational characteristic. The fact that the medium might enhance addictiveness or problematic behaviour does not necessarily make it a sub-type of internet addiction.

However, recent studies have made an effort to integrate both approaches. For instance, some researchers claim that neither the first nor the second approach adequately captures the unique features of Massively Multiplayer Online Role-Playing Games (MMORPGs), and argue an integrated approach is a necessity. A common observation is that “Internet users are no more addicted to the Internet than alcoholics are addicted to bottles”. The internet is just a channel through which individuals may access whatever content they want (e.g., gambling, shopping, chatting, sex). On the other hand, online games differ from traditional standalone games, such as offline video games, in important aspects such as the social dimension or the role-playing dimension that allow interaction with other real players. Consequently, it could be argued that IGD can either be viewed as a specific type of video game addiction, or as a variant of internet addiction, or as an independent diagnosis. However, the idea that IGD can include offline gaming disorders does little for clarity or conceptualization.

Finally, it is also worth mentioning that there are some problematic online behaviours that could be called internet addictions as they can only take place online. The most obvious activity that fulfills this criterion is social networking as it is a ‘pure’ online activity and does not and cannot take place offline. Other activities such as gambling, gaming, and shopping can still be engaged in offline (as gamblers can go to a gambling venue, gamers can play a standalone console game, shoppers can go to a retail outlet). However, those engaged in social networking would not (if unable to access the internet) walk into a big room of people and start chatting to them all. However, even if social networking addiction is a genuine internet addiction, social networking itself is still a specific online application and could still be considered an addiction on the internet, rather than to it.

Based on recent empirical evidence, IGD (or any of the alternate names used to describe problematic gaming) is not the same as Internet Addiction Disorder. The gaming studies field needs conceptual clarity but as demonstrated, the DSM-5 itself is both misleading and misguided when it comes to the issue of IGD.

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

Further reading

Demetrovics, Z., Urbán, R., Nagygyörgy, K., Farkas, J., Griffiths, M. D., Pápay, O., . . . Oláh, A. (2012). The development of the Problematic Online Gaming Questionnaire (POGQ). PLoS ONE, 7(5), e36417.

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(4), 191-197.

Griffiths, M.D., King, D.L. & Demetrovics, Z. (2014). DSM-5 Internet Gaming Disorder needs a unified approach to assessment. Neuropsychiatry, under review.

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

Griffiths, M.D. & Pontes, H.M. (2014). Internet addiction disorder and internet gaming disorder are not the same. Journal of Addiction Research and Therapy, 5: e124. doi:10.4172/2155-6105.1000e124.

Kim, M. G., & Kim, J. (2010). Cross-validation of reliability, convergent and discriminant validity for the problematic online game use scale. Computers in Human Behavior, 26(3), 389-398.

King, D. L., Delfabbro, P. H., Griffiths, M. D., & Gradisar, M. (2011). Assessing clinical trials of Internet addiction treatment: A systematic review and CONSORT evaluation. Clinical Psychology Review, 31, 1110-1116.

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

King, D.L., Haagsma, M.C., Delfabbro, P.H., Gradisar, M.S.^, Griffiths, M.D. (2013). Toward a consensus definition of pathological video-gaming: A systematic review of psychometric assessment tools. Clinical Psychology Review, 33, 331-342.

Koronczai, B., Urban, R., Kokonyei, G., Paksi, B., Papp, K., Kun, B., . . . Demetrovics, Z. (2011). Confirmation of the three-factor model of problematic internet use on off-line adolescent and adult samples. Cyberpsychology, Behavior and Social Networking, 14, 657–664.

Kuss, D.J. & Griffiths, M.D. (2012). Internet and gaming addiction: A systematic literature review of neuroimaging studies. Brain Sciences, 2, 347-374.

Kuss, D.J., Griffiths, M.D., Karila, L. & Billieux, J. (2014).  Internet addiction: A systematic review of epidemiological research for the last decade. Current Pharmaceutical Design, 20, 4026-4052.

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

Petry, N.M., & O’Brien, C.P. (2013). Internet gaming disorder and the DSM-5. Addiction, 108, 1186–1187.

Pontes, H. & Griffiths, M.D. (2014). The assessment of internet gaming disorder in clinical research. Clinical Research and Regulatory Affairs, 31(2-4), 35-48.

Pontes, H. & Griffiths, M.D. (2015). Measuring DSM-5 Internet Gaming Disorder: Development and validation of a short psychometric scale. Computers in Human Behavior, 45, 137-143.

Pontes, H., Király, O. Demetrovics, Z. & Griffiths, M.D. (2014). The conceptualisation and measurement of DSM-5 Internet Gaming Disorder: The development of the IGD-20 Test. PLoS ONE, 9(10): e110137. doi:10.1371/journal.pone.0110137.

Pontes, H., Kuss, D. & Griffiths, M.D. (2015). The clinical psychology of Internet addiction: A review of its conceptualization, prevalence, neuronal processes, and implications for treatment. Neuroscience and Neuroeconomics, 4, 11-23.

Porter, G., Starcevic, V., Berle, D., & Fenech, P. (2010). Recognizing problem video game use. The Australian and New Zealand Journal of Psychiatry, 44, 120-128.

Young, K. S. (1998). Internet addiction: The emergence of a new clinical disorder. Cyberpsychology and Behavior, 1, 237-244.

Ringing the changes: Can disordered mobile phone use be considered a behavioural addiction?

Over the last decade, I have published various papers on excessive mobile phone use both in general and related to particular aspects of mobile phone use (such as gambling and gaming via mobile phones (see ‘Further reading’ below). Recently, some colleagues and I (and led by Dr. Joël Billieux) published a new review in the journal Current Addiction Reports examining disordered mobile phone use.

I don’t think many people would say that their lives are worse because of mobile phones as the positives appear to greatly outweigh the negatives. However, in the scientific literature, excessive mobile phone use has been linked with self-reported dependence and addiction-like symptoms, sleep interference, financial problems, dangerous use (phoning while driving), prohibited use (phoning in banned areas), and mobile phone-based aggressive behaviours (e.g., cyberbullying).

Despite accumulating evidence that mobile phone use can become problematic and lead to negative consequences, its incidence, prevalence, and symptomatology remain a matter of much debate. For instance, our recent review noted that prevalence studies conducted within the last decade have reported highly variable rates of problematic use ranging from just above 0% to more than 35%. This is mainly due to the fact most studies in the field have been conducted in the absence of a theoretical rationale.

Too often, excessive mobile phone use has simply been conceptualized as a behavioural addiction and subsequently develop screening tools using items adapted from the substance use and pathological gambling literature, without taking into account either the specificities of mobile phone “addiction” (e.g., dysfunctional mobile phone use may often be related to interpersonal processes) or the fact that the most recent generation of mobile phones (i.e., smartphones) are tools that – like the internet – allow the involvement in a wide range of activities going far beyond traditional oral and written (SMS) communication between individuals (e.g., gaming, gambling, social networking, shopping, etc.).

The first scientific studies examining problematic mobile phone use (PMPU) were published a decade ago. Since then, the number of published studies on the topic has grown substantially. At present, several terms are frequently used to describe the phenomenon, the more popular being ‘mobile phone (or smartphone) addiction’, ‘mobile phone (or smartphone) dependence’ or ‘nomophobia’ (that refers to the fear of not being able to use the mobile phone).

PMPU is generally conceptualized as a behavioural addiction including the core components of addictive behaviours, such as cognitive salience, loss of control, mood modification, tolerance, withdrawal, conflict and relapse. Accordingly, the criteria (and screening tools developed using such criteria) that have been proposed to diagnose an addiction to the mobile phone have been directly transposed from those classifying and diagnosing other addictive behaviours, i.e., the criteria for substance use and pathological gambling. For example, in a recent study published in the Journal of Behavioral Addictions, Dr. Peter Smetaniuk reported a prevalence of PMPU around 20% in U.S. undergraduate students using adapted survey items that were initially developed to diagnose disordered gambling.

Although many scholars believe that PMPU is a behavioural addiction, evidence is still lacking that either confirms or rejects such conceptualization. Indeed, the fact that this condition can be considered as an addiction is to date only supported by exploratory studies relying on self-report data collected via convenience samples. More specifically, there is a crucial lack of evidence that similar neurobiological and psychological mechanisms are involved in the aetiology of mobile phone addiction compared to other chemical and behavioural addictions. Such types of evidence played a major role in the recent recognition of Gambling Disorder and Internet Gaming Disorder as addictive disorders in the latest (fifth) addiction of the DSM (i.e., DSM-5) In particular, three key features of addictive behaviours, namely loss of control, tolerance and withdrawal, have – to date – received very limited empirical support in the field of mobile phone addiction research.

Given these concerns, it appears that the empirical evidence supporting the conceptualization of PMPU as a genuine addictive behaviour is currently scarce. However, this does not mean that PMPU is not a genuine addictive behaviour (at least for a subgroup of individuals displaying PMPU symptoms), but rather that the nature and amount of the available data at the present time are not sufficient to draw definitive and valid conclusions. Therefore, further studies are required. In particular, longitudinal and experimental research is needed to obtain behavioural and neurobiological correlates of PMPU. In the absence of such types of data, all attempts to consider PMPU within the framework of behavioural addictions will remain tentative. It is worth noting here that it took decades of empirical research before disordered gambling was officially recognized as an addiction (as opposed to a disorder of impulse control) in the DSM-5.

The current conceptual chaos surrounding PMPU research can also be related to the fact that while the number of empirical studies is growing quickly, these studies have (to date) primarily been based on concepts borrowed from other disorders (e.g., problematic Internet use, pathological gambling, substance abuse, etc.). This approach is atheoretical and lacks specificity with regard to the phenomenon under investigation. In fact, by adopting such a ‘confirmatory approach’ relying on deductive quantitative studies, important findings that are unique to the experience of PMPU have been neglected. As an illustration, no qualitative analyses of PMPU exist, and only a few models have been proposed. This implies that most studies have been conducted without a theoretical rationale that goes beyond transposing what is known about addictions in the analysis of PMPU.

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

Additional input: Joël Billieux, Pierre Maurage, Olatz Lopez-Fernandez and Daria J. Kuss

Further reading

Bianchi, A. & Phillips, J.G. (2005). Psychological predictors of problem mobile phone use. Cyberpsychology and Behavior, 8, 39–51.

Billieux, J. (2012). Problematic use of the mobile phone: A literature review and a pathways model. Current Psychiatry Reviews, 8, 299–307.

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. Obert, U., Cladellas, R. & Talarn, A. (2012). Problematic Internet and cell phone use in Spanish teenagers and young students. Anales de Psicologia, 28, 789-796.

Chóliz M. (2010). Mobile phone addiction: a point of issue. Addiction. 105, 373-374.

Griffiths, M.D. (2007). Mobile phone gambling. In D. Taniar (Ed.), Encyclopedia of Mobile Computing and Commerce (pp.553-556). Pennsylvania: Information Science Reference.

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

Lopez-Fernandez, O., Honrubia-Serrano, L., Freixa-Blanxart, M., & Gibson, W. (2014). Prevalence of problematic mobile phone use in British adolescents. Cyberpsychology, Behavior and Social Networking, 17, 91-98.

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.

Smetaniuk, P. (2014). A preliminary investigation into the prevalence and prediction of problematic cell phone use. Journal of Behavioral Addictions, 3(1), 41-53.

Sell division: Responsible marketing and advertising by the gambling industry

Over the last few years there has been a great deal of speculation over the role of advertising as a possible stimulus to increased gambling, and as a contributor to problem gambling (including underage gambling). Various lobby groups (e.g., anti-gambling coalitions, religious groups, etc.) claim advertising has played a role in the widespread cultural acceptance of gambling. These groups also claim casino advertising tends to use glamorous images and beautiful people to sell gambling, while other advertisements for lottery tickets and slot machines depict ordinary people winning loads of money or millions from a single coin in the slot.

Around the world, various lobby groups claim that advertisements used by the gambling industry often border on misrepresentations and distortion. There are further claims that adverts are seductive, appealing to people’s greed and desperation for money. Real examples include: ‘Winning is easy’, ‘Win a truckload of cash’, ‘Win a million, the fewer numbers you choose, the easier it is to win’, ‘It’s easy to win’ and ‘$600,000 giveaway simply by inserting card into the poker machine’. Lobby groups further claim that in amongst the thousands of words and images of encouragement, there is rarely anything about the odds of winning – let alone the odds of losing. It has also been claimed that many gambling adverts feature get-rich-quick slogans that sometimes denigrate the values of hard work, initiative, responsibility, perseverance, optimism, investing for the future, and even education.

Those promoting gambling products typically respond in a number of ways. The most popular arguments used to defend such marketing and advertising is that: (i) the gaming industry is in the business of selling fantasies and dreams, (ii) consumers knows the claims are excessive, (iii) big claims are made to catch people’s attention, (iv) people don’t really believe these advertisements, and (v) business advertising is not there to emphasise ‘negative’ aspects of products.   While some of these industry responses have some merit, a much fairer balance is needed.

Statements such as ‘winning is easy’ are most likely (in a legal sense) be considered to be ‘puffery’. Puffery involves making exaggerated statements of opinion (not fact) to attract attention. Various jurisdictions deem it is not misleading or deceptive to engage in puffery. Whether a statement is puffery will depend on the circumstances. A claim is less likely to be puffery if its accuracy can be assessed. The use of a claim such as ‘winning is easy’ is likely to be considered puffery because it is subjective and cannot be assessed for accuracy. However, a statement like ‘five chances to win a million’ may not be puffery as it likely to be measurable.

Most of us who work in the field of responsible gambling agree that all relevant governmental gambling regulatory agencies should ban aggressive advertising strategies, especially those that target people in impoverished individuals or youth. It is also worth pointing out that there are many examples of good practice. Responsible marketing and advertising needs to think about the content and tone of gambling advertising, including the use of minors in ads, and the inclusion of game information. There has to be a strong commitment to socially responsible behaviour that applies across all product sectors, including sensitive areas like gambling. Socially responsible advertising should form one of the elements of protection afforded to ordinary customers and be reflected in the codes of practice. Children and problem gamblers deserve additional shielding from exposure to gambling products and premises, and their advertising. Many codes that regulate gambling marketing and advertising across the world now typically include special provisions on the protection of such groups.

Gambling advertising also plays an important role in ‘normalizing’ gambling. Content analyses of gambling adverts have reported that gambling is portrayed as a normal, enjoyable form of entertainment involving fun and excitement. Furthermore, they are often centred on friends and social events. The likelihood of large financial gain is often central theme, with gambling also viewed as a way to escape day-to-day pressures (one gaming company’s advertising even had the strapline “Bet to forget”). Research has found that there is a large public awareness of gambling advertising, and that problem gamblers often mention advertising as a trigger to gambling.

An example of good practice is that of Canadian gaming operator Loto-Quebec. They did a thorough review of its advertising code and some of the key aspects in terms of responsible marketing and advertising of gambling included:

• A marketing policy that (i) prohibits any advertising that is overly aggressive, (ii) rejects concepts liable to incite the interest of children, and (iii) prohibits the use of spokespeople who are popular among youth, and (iv) prohibits placement of advertisements within media programs viewed mainly by minors.
• The odds of winning are highlighted. This is being done in response to the suggestions expressed so frequently by various groups interested in knowing their chances of winning.
• Television commercials for new products devote 20% of their airtime to promoting the gambling help line and to presenting warnings about problem gambling.
• A policy that prohibits the targeting of any particular group or community for the purposes of promoting its products. For example, one of their instant lotteries used a Chinese theme to stimulate interest. However, the Chinese community did not agree with making references to its customs in order to promote the game. Out of respect for this community, the game was immediately suspended.

As various national and international advertising regulation bodies have advocated, socially responsible advertising should form one of the elements of protection afforded to ordinary customers and be reflected in the codes of practice. Personally, I believe that gambling advertising should focus on buying entertainment rather than winning money. Gambling problems often occur when an individual’s primary reason to gamble is to win money.

Many countries have strict codes for gambling advertisements, and good codes (like those in the UK) recommend that gambling advertisements must not: (i) exploit cultural beliefs or traditions about gambling or luck, (ii) condone or encourage criminal or anti-social behaviour, (iii) condone or feature gambling in a working environment (with the exception for licensed gambling premises), (iv) exploit the susceptibilities, aspirations, credulity, inexperience or lack of knowledge of under-18s or other vulnerable persons, (v) be likely to be of particular appeal to under-18s, especially by reflecting or being associated with youth culture, and (vi) feature anyone who is, or seems to be, under 25 years old gambling or playing a significant role.

Quite clearly it is appropriate and necessary for the gaming industry to advertise, market, and promote its facilities and products. However, I believe that all advertising and marketing should be carried out in a socially responsible manner as it is good for long-term repeat business.

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

Further reading

Adams, P. (2004). Minimising the impact of gambling in the subtle degradation of democratic systems, Journal of Gambling Issues, 11. Available at: http://www.camh.net/egambling/issue11/jgi_11_adams.html.

Binde, P. (2007). Selling dreams – causing nightmares? On gambling advertising and problem gambling. Journal of Gambling Issues, 20, 167-191.

Griffiths, M.D. (2005). Does advertising of gambling increase gambling addiction? International Journal of Mental Health and Addiction, 3(2), 15-25.

Griffiths, M.D. (2007). Brand psychology: Social acceptability and familiarity that breeds trust and loyalty. Casino and Gaming International, 3(3), 69-72.

Griffiths, M.D. (2010). Online ads and the promotion of responsible gambling. World Online Gambling Law Report, 9(6), 14.

Griffiths, M.D. & Wood, R.T.A. (2008). Responsible gaming and best practice: How can academics help? Casino and Gaming International, 4(1), 107-112.

Hanss, D., Mentzoni, R.A., Griffiths, M.D., & Pallesen, S. (2015). The impact of gambling advertising: Problem gamblers report stronger impacts on involvement, knowledge, and awareness than recreational gamblers. Psychology of Addictive Behaviors, in press.

Korn, D, Hurson, T. & Reynolds, J. (2004). Commercial Gambling Advertising: Possible Impact on Youth Knowledge, Attitudes, Beliefs and Behavioural Intentions. Report submitted to the Ontario Gambling Research Centre.

Cell growth: A brief look at mobile sports betting

It is often claimed by marketeers that remote gambling makes commercial sense (i.e., the combining of gambling and remote technologies such as the internet and mobile phones into one convenient package). Mobile phone betting and gambling not only provides convenience and flexibility, but perhaps more importantly from a gaming operator’s perspective, provides gambling on the move, whenever and wherever. Since it is somewhat unnatural to always be near a computer, it could be argued that mobile phones are an ideal medium for betting and gambling. Whenever gamblers have a few minutes to spare (at the airport, commuting to work, waiting in a queue, etc.), they can occupy themselves by gambling.

Conventional wisdom says that two things have the power to drive any new consumer technology – pornography and gambling. These activities helped satellite and cable television, video, and the Internet and provide adult entertainment in a convenient and guilt-free environment. Betting via mobile phone is no different. Along with pornography, gambling should have little trouble reaching profitability – especially if this is combined with sports events. Sports interest is huge. There are thousands of communities (including those online). The most successful of those communities will look to ‘mobilize’ and then ‘monetize’.

The mobile phone industry has grown rapidly in the last decade. Market research highlights that mobile phone revenues from mobile gambling and gaming is increasingly rapidly. Although mobile gaming revenues are increasing, it is estimated that less than 2% of mobile industry revenue is generated by gaming and gambling. It is generally thought that lottery gambling will make most money for mobile gambling operators because governments are generally less censorious about lotteries than other forms of gambling. They are also easy to play and relatively low cost compared to other types of gambling.

To some extent, the majority of gamblers are risk-takers to begin with. Therefore, they may be less cautious with new forms of technology. For every day gamblers, mobile phones are ideal for bet placing, and gamblers will be able to check on their bets, and place new ones. Furthermore, it is anonymous, and can provide immediate gratification, anytime, anywhere. Anonymity and secrecy may be potential benefits of mobile gambling as for a lot of people there is still stigma attached to gambling in places like betting shops and casinos. Mobile sports betting is also well suited to personal (i.e., one-to-one) gambling, where users bet against each other rather than bookies. Online betting exchanges demonstrate that people bet on anything and everything to do with sport (with each other).

Although mobile phone technology has improved exponentially over the last decade, it is unlikely that mobile phone graphics and technology will ever truly compete with Internet web browsers (although I am happy to be proved wrong). Intuitively, mobile phone gambling is best suited for sports and event betting. With mobile phone betting, all that is required is real-time access to data about the event to be bet on (e.g., a horse race, a football match), and the ability to make a bet in a timely fashion.

These basic requirements are, of course, easily be provided by the current generation of mobile phones, and the appropriate software. The placing of the bet is not the driving motivation in event wagering. Since being the spectator is what sports fans are really interested in, the sports gambler does not need fulfillment from the process of gambling. People betting on sports will use mobile phones because they are easy, convenient and take no time to boot up. Once they have their sports book registered as a bookmark on their phone, they can access it and place a bet within a very short space of time.

As I have noted in previous blogs, all forms of gambling lie on a chance-skill dimension. Neither games of pure skill nor games of pure chance are particularly attractive to sports bettors. Games of chance (like lotteries) offer no significant edge to sports bettors and are unlikely to be gambled upon. Serious punters gravitate towards types of gambling that provide an appropriate mix of chance and skill. This is one of the reasons why sports betting – and in particular activities like horse race betting – is so popular for gamblers. The edge available in horse race gambling can be sufficient to fully support professional gamblers as they bring their wide range of knowledge to the activity. There is the complex interplay of factors that contributes to the final outcome of the race. However, in the mobile sports betting market, it is likely to be football that will make the big money for sports betting agencies.

Consider the following scenario. A betting service that knows where you are and/or what you are doing has the capacity to suggest something context-related to the mobile user to bet on. For instance, if the mobile phone user bought a ticket for a soccer match using an electronic service, this service may share this information with a betting company. If in that match the referee gives a penalty for one team, a person’s mobile could ring and give the user an opportunity (on screen) to bet whether or not the penalty will be scored. On this type of service, the mobile phone user will only have to decide if they want to bet, and if they do, the amount of money. Two clicks and the bet will be placed. Context, timeliness, simplicity, and above all user involvement look like enough to convince also people that never entered a bet-shop.

Many football clubs are turning themselves into powerful media companies. They have their own digital TV channel and signed up a host of big-name technology partners. Such companies will get the chance to develop co-branded mobile services with the club. This offers users access to content similar to their website (receiving real-time scores and team news via SMS). While watching matches, users will be able to view statistics, player biographies, and order merchandise. Such mobility will facilitate an increase in ‘personalized’ gambling where bettors gamble against each other, rather than the house.

Gambling will (if it is not already) become part of the match day experience. A typical scenario might involve a £10 bet with a friend on a weekend football match. The gambler can text their friend via SMS and log on to the betting service to make their gamble. If the friend accepts, the gambler has got the chance to win (or lose). Football clubs will get a share of the profits from the service. Clubs are keen to get fans using branded mobile devices where they can simply hit a ‘bet’ button and place a wager with the club’s mobile phone partner.

As with all new forms of technological gambling, ease of use is paramount to success. Mobile phones have become more user-friendly. Pricing structures are also important. Internet access and mobile phone use that is paid for by the minute produces very different customer behavior to those that have one off payment fees (e.g., unlimited use and access for a monthly rental fee). The latter payment structure facilitates leisure use, as punters would not be worried that for every extra minute they are online, they are increasing the size of their phone bills. For me, mobile sports betting is where the future of mobile gambling is likely to be.

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

Further reading

Griffiths, M.D. (2004). Mobile phone gambling: preparing for take off. World Online Gambling Law Report, 8(3), 6-7.

Griffiths, M.D. (2005). The psychosocial impact of mobile phone gambling. World Online Gambling Law Report, 4 (10), 14-15.

Griffiths, M.D. (2010). The psychology of sports betting: What should affiliates know? i-Gaming Business Affiliate, August/September, 46-47.

Griffiths, M.D. (2011). Mobile sportsbetting: A view from the social sciences. i-Gaming Business, 69, 64-65.

Griffiths, M.D. (2011). Technological trends remote gambling: A psychological perspective. i-Gaming Business, 71, 39-40.

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

Griffiths, M.D. (2007). Mobile phone gambling. In D. Taniar (Ed.), Encyclopedia of Mobile Computing and Commerce (pp.553-556). Pennsylvania: Information Science Reference.

Place your bets: Has problem gambling in Great Britain decreased?

In the summer of 2014 I was commissioned to review problem gambling in Great Britain (the fall out of which I wrote about in detail in a previous blog). Earlier last year, a detailed report by Heather Wardle and her colleagues examined gambling behaviour in England and Scotland by combining the 2012 data from the Health Survey for England (HSE; n=8,291 aged 16 years and over) and the 2012 Scottish Health Survey (SHeS; n=4,815). To be included in the final data analysis, participants had to have completed at least one of the gambling participation questions. This resulted in a total sample of 11,774 participants. So what did the research find? Here is a brief summary of the main results:

• Two-thirds of the sample (65%) had gambled in the past year, with men (68%) gambling more than women (62%). As with the British Gambling Prevalence Survey (BGPS), past year participation was greatly influenced by the playing of the bi-weekly National Lottery (lotto) game. Removal of those individuals that only played the National Lottery meant that 43% had gambled during the past year (46% males and 40% females).

• Gambling was more likely to be carried out by younger people (50% among those aged 16-24 years and 52% among those aged 25-34 years).

• The findings were similar to the previous BGPS reports and showed that the most popular forms of gambling were playing the National Lottery (52%; 56% males and 49% females), scratchcards (19%; 19% males and 20% females), other lottery games (14%; 14% both males and females), horse race betting (10%; 12% males and 8% females), machines in a bookmaker (3%; 5% males and 1% females), slot machines (7%; 10% males and 4% females), online betting with a bookmaker (5%; 8% males and 2% females), offline sports betting (5%; 8% males and 1% females), private betting (5%; 8% males and 2% females), casino table games (3%; 5% males and 1% females), offline dog race betting (3%; 4% males and 2% females), online casino, slots and/or bing (3%; 4% males and 2% females), betting exchanges (1%; males 2% and females 0%), poker in pubs and clubs (1%; 2% males and 0% females), spread betting (1%; 1% males and 0% females).

• The only form of gambling (excluding lottery games) where females were more likely to gamble was playing bingo (5%; 7% females and 3% males).

• Most participants gambled on one or two different activities a year (1.7 mean average across the total sample).

• Problem gambling assessed using the Problem Gambling Severity (PGSI) criteria was reported to be 0.4%, with males (0.7%) being significantly more likely to be problem gamblers than females (0.1%). This equates to approximately 180,200 British adults aged 16 years and over.

• Problem gambling assessed using the criteria of the fourth Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) was reported to be 0.5%, with males (0.8%) being significantly more likely to be problem gamblers than females (0.1%). This equates to approximately 224,100 British adults aged 16 years and over.

• Using the PGSI screen, problem gambling rates were highest among young men aged 16-24 years (1.7%) and lowest among men aged 65-74 years (0.4%). Using the DSM-IV screen, problem gambling rates were highest among young men aged 16-24 years (2.1%) and lowest among men aged over 74 years (0.4%).

• Problem gambling rates were also examined by type of gambling activity. Results showed that among past year gamblers, problem gambling was highest among spread betting (20.9%), played poker in pubs or clubs (13.2%), bet on other events with a bookmaker (12.9%), bet with a betting exchange (10.6%) and played machines in bookmakers (7.2%).

• The activities with the lowest rates of problem gambling were playing the National Lottery (0.9%) and scratchcards (1.7%).

• Problem gambling rates were highest among individuals that had participated in seven or more activities in the past year (8.6%) and lowest among those that had participated in a single activity (0.1%).

The authors also carried out a latent class analysis and identified seven different types of gambler among both males and females. The male groups comprised:

• Cluster A: non-gamblers (33%)
• Cluster B: National Lottery only gamblers (22%)
• Cluster C: National Lottery and scratchcard gamblers only (20%)
• Cluster D: Minimal, no National Lottery [gambling on 1-2 activities] (9%)
• Cluster E: Moderate [gambling on 3-6 activities] (12%)
• Cluster F: Multiple [gambling on 6-10 activities] (3%)
• Cluster G: multiple, high [gambling on at least 11 activities] (1%).

The female groups comprised:

• Cluster A: non-gamblers (40%)
• Cluster B: National Lottery only gamblers (21%)
• Cluster C: National Lottery and scratchcard gamblers only (7%)
• Cluster D: Minimal, no National Lottery (8%)
• Cluster E: moderate, less varied [2-3 gambling activities, mainly lottery-related] (8%)
• Cluster F: moderate, more varied [2-3 gambling activities but wider range of activities] (6%)
• Cluster G: multiple [gambling on at least four activities] (6%)

Using these groupings, the prevalence of male problem gambling was highest among those in Cluster G: multiple high group (25.0%) followed by Cluster F: multiple group (3.3%) and Cluster E: moderate group (2.6%). The prevalence of problem gambling was lowest among those in the Cluster B; National Lottery Draw only group (0.1%) followed by Cluster C: minimal – lotteries and scratchcards group (0.7%). The prevalence of female problem gambling was highest among those in the Cluster G: multiple group (1.8%) followed by those in Cluster F: moderate – more varied group (0.6%). The number of female gamblers was too low to carry out any further analysis. The report also examined problem gambling (either DSM-IV or PGSI) by gambling activity type.

• The prevalence of problem gambling was highest among spread-bettors (20.9%), poker players in pubs or clubs (13.2%), bettors on events other than sports or horse/dog races (12.9%), betting exchange users (10.6%) and those that played machines in bookmakers (7.2%).

• The lowest problem gambling prevalence rates were among those that played the National Lottery (0.9%) and scratchcards (1.7%).

• These figures are very similar to those found in the 2010 BGPS study although problem gambling among those that played machines in bookmakers was lower (7.2%) than in the 2010 BGPS study (8.8%).

• As with the BGPS 2010 study, the prevalence of problem gambling was highest among those who had participated in seven or more activities in the past year (8.6%) and lowest among those who had taken part in just one activity (0.1%). Furthermore, problem gamblers participated in an average 6.6 activities in the past year.

Given that the same instruments were used to assess problem gambling, the results of the most recent surveys using data combined from the Health Survey for England (HSE) and Scottish Health Survey (SHeS) compared with the most recent British Gambling Prevalence Survey (BGPS) do seem to suggest that problem gambling in Great Britain has decreased over the last few years (from 0.9% to 0.5%). However, Seabury and Wardle again urged caution and noted:

“Comparisons of the combined HSE/SHeS data with the BGPS estimates should be made with caution. While the methods and questions used in each survey were the same, the survey vehicle was not. HSE and SHeS are general population health surveys, whereas the BGPS series was specifically designed to understand gambling behaviour and attitudes to gambling in greater detail. It is widely acknowledged that different survey vehicles can generate different estimates using the same measures because they can appeal to different types of people, with varying patterns of behaviour…Overall, problem gambling rates in Britain appear to be relatively stable, though we caution readers against viewing the combined health survey results as a continuation of the BGPS time series”.

There are other important caveats to take into account including the differences between the two screen tools used in the BGPS, HSE and SHeS studies. Although highly correlated, evidence from all the British surveys suggests that the PGSI and DSM-IV screens capture slightly different groups of problem gamblers. For instance, a 2010 study that I co-authored with Jim Orford, Heather Wardle, and others (in the journal International Gambling Studies) using data from the 2007 BGPS showed that the PGSI may under-estimate certain forms of gambling-related harm (particularly by women) that are more likely to be picked up by some of the DSM-IV items. Our analysis also suggested that the DSM-IV appears to measure two different factors (i.e., gambling-related harm and gambling dependence) rather than a single one. Another important distinction is that the two screens were developed for very different purposes (even though they are attempting to assess the same construct). The PGSI was specifically developed for use in population surveys whereas the DSM-IV was developed with clinical populations in mind. Given these differences, it is therefore unsurprising that national surveys that utilize the screens end up with slightly different results comprising slightly different groups of people.

It also needs stressing (as noted by the authors of most of the national gambling surveys in Great Britain) that the absolute number of problem gamblers identified in any of the surveys published to date has equated to approximately 60 people. To detect any significant differences statistically between any of the studies carried out to date requires very large sample sizes. Given the very low numbers of problem gamblers and the tiny number of pathological gamblers, it is hard to assess with complete accuracy whether there have been any significant changes in problem and pathological gambling between all the published studies over time. Wardle and her colleagues concluded that:

“Overall, based on this evidence, it appears that problem gambling rates in England and Scotland are broadly stable. Whilst problem gambling rates according to either the DSM-IV or the PGSI were higher in 2010, the estimate between 2007 and the health surveys data were similar. Likewise, problem gambling rates according to the DSM-IV and the PGSI individually did not vary statistically between surveys, meaning that they were relatively similar” (p.130).

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

Further reading

Griffiths, M.D. (2014). Problem gambling in Great Britain: A brief review. London: Association of British Bookmakers.

Orford, J., Wardle, H., Griffiths, M.D., Sproston, K. & Erens, B. (2010). PGSI and DSM-IV in the 2007 British Gambling Prevalence Survey: Reliability, item response, factor structure and inter-scale agreement. International Gambling Studies, 10, 31-44.

Seabury, C. & Wardle, H. (2014). Gambling behaviour in England and Scotland. Birmingham: Gambling Commission.

Wardle, H. (2013). Gambling Behaviour. In Rutherford, L., Hinchliffe S., Sharp, C. (Eds.), The Scottish Health Survey: Vol 1: Main report. Edinburgh.

Wardle, H., Moody. A., Spence, S., Orford, J., Volberg, R., Jotangia, D., Griffiths, M.D., Hussey, D. & Dobbie, F. (2011). British Gambling Prevalence Survey 2010. London: The Stationery Office.

Wardle, H., & Seabury, C. (2013). Gambling Behaviour. In Craig, R., Mindell, J. (Eds.) Health Survey for England 2012 [Vol 1]. Health, social care and lifestyles. Leeds: Health and Social Care Information Centre.

Wardle, H., Seabury, C., Ahmed, H., Payne, C., Byron, C., Corbett, J. & Sutton, R. (2014). Gambling behaviour in England and Scotland: Findings from the Health Survey for England 2012 and Scottish Health Survey 2012. London: NatCen.

Wardle, H., Sproston, K., Orford, J., Erens, B., Griffiths, M. D., Constantine, R., & Pigott, S. (2007). The British Gambling Prevalence Survey 2007. London: National Centre for Social Research.

Wardle, H., Sutton, R., Philo, D., Hussey, D. & Nass, L. (2013). Examining Machine Gambling in the British Gambling Prevalence Survey. Report by NatCen to the Gambling Commission, Birmingham.

Net calls: Is online gambling regulation a help or hindrance?

Online gambling regulation is a hot topic and many online gambling operators are wondering what the effect of increased (and arguably stricter) legislative measures will have on the online gambling market. Based on the studies that our research unit has carried out, I would guess that overall it is good news for the industry as I believe this will lead to an increased uptake by those people who are somewhat sceptical or agnostic about online gaming. So why do I think this?

Despite the increase in online gambling research over the last ten years, there has been very little empirical research examining why people gamble online or – just as importantly – why they don’t gamble online. Because there is so little research in this area, Dr Abby McCormack and I published a study in the International Journal of Mental Health and Addiction with adult online and offline gamblers examining the motivating and inhibiting factors in online gambling.

Our findings on the inhibiting factors of online gambling identified one major overarching theme as to what people don’t like about gambling online. In a nutshell, gamblers said that the authenticity of gambling was reduced when gambling online. However, many online gaming operators have now introduced more ‘realistic’ live gaming experiences (e.g., via webcams) so this may diminish over time. However, we also identified other online gaming inhibitors (i.e., the asocial nature and characteristics of the internet, the reduced psychological value of gambling with virtual money, and concerns about the safety of online gambling websites and their trustworthiness). These factors all contributed to the reduced authenticity of the online gambling experience.

Issues around website security, safety and trust, were all major inhibitors that decreased the likelihood of punters gambling online. Predictably, we found that online gamblers were much more likely than the offline gamblers and non-gamblers to believe that the gambling websites were secure. However, there was a perception that some websites were considered more trustworthy than others, and consequently the gamblers generally played on well known sites (e.g., companies that were well established offline).

So what are the implications of these findings for stricter online gaming regulation? From a psychological perspective, research on how and why people access commercial websites indicates that one of the most important factors is trust. If people know and trust the name, they are more likely to use that service. Reliability of the service provider is also a related key factor. Stricter regulation is likely to increase consumer confidence if they feel more protected when they perceive the service to be unfair and/or goes wrong. It is likely to change sceptical gamblers’ perceptions about the reliability and trustworthiness of online gaming operators for the better (no pun intended!).

Even with increased protective legislation, research shows that some punters will always have concerns about Internet security and may never be happy about putting their personal details online. But this mistrust will diminish over the long-term as the ‘screenagers’ of today (the so-called ‘digital natives’) are the potential gamblers of tomorrow. Digital natives generally have more positive attitudes towards online commercial operations. Today’s children and younger adolescents have never known a world without the Internet, mobile phones and interactive television, and are therefore tech-savvy, have no techno-phobia, and are very trusting of these new technologies. For many ‘screenagers’, their first gambling experiences may come not in a traditional offline environment but via the Internet, mobile phone or interactive television. Stricter regulation may not even be an issue for tomorrow’s gamblers as they are already accessing a myriad of online services and are highly trusting of such services.

Despite the lack of trust by some players, the online gaming industry shouldn’t be too worried about stricter regulation. The prevalence of online gambling is steadily increasing and there are lots of reasons why some punters prefer online to offline gambling. Our research findings indicate that those who prefer online (to offline) gambling like the increased convenience, the greater value for money, the greater variety of games, and the anonymity.

Furthermore, online gambling has many advantages for punters as it saves time because they don’t have to travel anywhere, they are not restricted by opening hours, and they can gamble from the comfort of their own home. The removal of unnecessary time consumption (e.g., travelling to a gambling venue) through online gambling is another barrier to gambling participation that had been removed. Increased regulation is highly unlikely to change any of these important motivating factors for gambling online.

Finally, compared to offline gamblers, our research also indicates that online gamblers are more likely to be male, young adults, single, have good qualifications, and in professional and managerial employment. Given this particular demographic profile, this group appears to be highly educated, and are likely to make well informed decisions to gamble online based on due consideration of the facts at hand. Again, stricter regulation is something that is likely to strengthen the decision to gamble rather than inhibit it.

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

Further reading

Griffiths, M.D., Wardle, J., Orford, J., Sproston, K. & Erens, B. (2009). Socio-demographic correlates of internet gambling: findings from the 2007 British Gambling Prevalence Survey. CyberPsychology and Behavior, 12, 199-202.

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

McCormack. A. & Griffiths, M.D. (2012). Motivating and inhibiting factors in online gambling behaviour: A grounded theory study. International Journal of Mental Health and Addiction, 10, 39-53.

McCormack. A. & Griffiths, M.D. (2012). What differentiates professional poker players from recreational poker players? A qualitative interview study. International Journal of Mental Health and Addiction, 10, 243-257.

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

McCormack, A., Shorter, G. & Griffiths, M.D. (2013). An examination of participation in online gambling activities and the relationship with problem gambling. Journal of Behavioral Addictions, 2(1), 31-41.

McCormack, A., Shorter, G. & Griffiths, M.D. (2013). Characteristics and predictors of problem gambling on the internet. International Journal of Mental Health and Addiction, 11, 634-657.

Parke, A. & Griffiths, M.D. (2011). Poker gambling virtual communities: The use of Computer-Mediated Communication to develop cognitive poker gambling skills. International Journal of Cyber Behavior, Psychology and Learning, 1(2), 31-44.

Parke, A. & Griffiths, M.D. (2011). Effects on gambling behaviour of developments in information technology: A grounded theoretical framework. International Journal of Cyber Behaviour, Psychology and Learning, 1(4), 36-48.

Parke, A. & Griffiths, M.D. (2012). Beyond illusion of control: An interpretative phenomenological analysis of gambling in the context of information technology. Addiction Research and Theory, 20, 250-260.

Wardle, H., Moody, A., Griffiths, M.D., Orford, J. & and Volberg, R. (2011). Defining the online gambler and patterns of behaviour integration: Evidence from the British Gambling Prevalence Survey 2010. International Gambling Studies, 11, 339-356.

Net advantage: Another brief look at the psychology of online poker

From everything that I’ve observed over the last decade in the gambling world, the one thing that has caught my eye more than anything else is the number of online gambling stories – particularly about the rise of online poker. Clearly, online poker and traditional poker are not synonymous. As I outlined in one of my previous blogs, a very useful psychological tool in poker is to ‘read’ a player through their body language and their verbalisations. When playing online poker, a gambler is denied this advantage. Poker players must therefore seek to manipulate their poker-playing opponents by using the psychological tools at their disposal. One of my colleagues who has researched this area (Dr. Adrian Parke), believes that in a ‘SunTzu’-type way, an online poker player must take their weakness (in this case, not being able to physically see other players) and turn it into a positive strength. Put simply, a player must use the non-transparency inherent in the situation to their advantage.

Online poker permits players to create a false identity. As a player you could portray the façade of being a young attractive novice female player when in fact you are actually a very experienced recognised pro. On a psychological level, the key to a ‘hustle’ or manipulating other players in poker is by projecting a character and hiding your identity. Essentially it is about representing a façade, whether it is for one hand or the whole of the game. While playing poker online, a player can adapt any ‘character’ they wish to suit any game in which they engage in. For instance, if you are playing with novices it may be profitable to portray an experienced professional in order to intimidate players into submission.

Using the messaging systems provided, it is easier for online poker players to develop their persona(s). The tone and pitch of what a player “says” is not revealed in the text on the screen. At a fundamental level all players are acting with their most unemotional ‘poker face’. In these situations, players can exude confidence as they go all in on a psychological bluff, when in reality they may have shaking hands and be sweating like a pig. The key to winning on a psychological level is by inducing emotional reactions from other players, so with knowledge of the opponent, it is possible to ‘tailor’ interactions to induce the desired response.

Social interaction at the online poker table is not confined to adversarial chastising. It is also possible to develop amiable relationships between players. Online poker – particularly at low stakes tables – is often more about entertainment than making profits. In poker it is not necessary to reveal your hand if nobody calls (i.e., pays to see it). Without seeing cards it is more difficult to understand player behaviour. However, at more sociable tables, players will reveal what they had to opposing players, if nothing else but to indulge the observers. Creating false ‘alliances’ is a way of ascertaining more information about your opponents and improving your ability to ‘read’ them.

From a psychological perspective, there are also some things to be aware of in the online gambling world. At a basic level, what separates professional gamblers and novice (or problem) gamblers is the factor of self-control. The rule of thumb is to avoid becoming emotionally involved in the game. Inducing emotional rather than logical reactions from gamblers is what makes the gambling industry so profitable. By remaining unemotional gamblers can protect themselves from recklessly chasing losses and avoid going on ‘tilt’. People gambling online are particularly at risk from engaging in chasing losses for the simple reason that they have 24-hour convenient access from their home or workplace and have the potential to be constantly subjected to temptation. What’s more, in this asocial world, they often lack friends acting as a “social safety net” to give objective appraisals of the player’s behaviour.

The best ways of avoiding becoming emotionally engaged online is to have (i) reflective time outs and (ii) an objective attribution of outcomes. Having reflective time-outs simply refers to playing slowly, making gambling decisions with accrued knowledge (for example, knowledge of probability and of opponents). It is advisable after a ‘bad beat’ to be disciplined enough sit out one or two hands to regain composure before playing again. Determining objective attributions of outcomes occurs at a psychological level and concerns the gambler’s locus of control. For the gambler, this means having an external locus of control when assessing the cards they have and an internal locus of control regarding what they do with the cards available.

The mantra of poker players is that ‘You can only play the hand you were dealt’. All players will experience streaks of both desirable and poor hands, and it is how a player responds to these streaks that will determine their success. It is very easy to become frustrated while in a negative streak. Likewise, it is easy in a positive streak to become narcissistic and complacent. It is the knowledgeable player that understands probability and who realises that over a continuous playing period, positive and negative streaks are inevitable and transient.

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

Further reading

Biolcati, R., Passini, S. & Griffiths, M.D. (2015). All-in and bad beat: Professional poker players and pathological gambling. International Journal of Mental Health and Addiction, in press.

Griffiths, M.D., Parke, J., Wood, R.T.A. & Rigbye, J. (2010). Online poker gambling in university students: Further findings from an online survey. International Journal of Mental Health and Addiction, 8, 82-89.

McCormack. A. & Griffiths, M.D. (2012). What differentiates professional poker players from recreational poker players? A qualitative interview study. International Journal of Mental Health and Addiction, 10, 243-257.

Parke, A. & Griffiths, M.D. (2011). Poker gambling virtual communities: The use of Computer-Mediated Communication to develop cognitive poker gambling skills. International Journal of Cyber Behavior, Psychology and Learning, 1(2), 31-44.

Parke, A., Griffiths, M., & Parke, J. (2005) Can playing poker be good for you? Poker as a transferable skill. Journal of Gambling Issues, 14.

Recher, J. & Griffiths, M.D. (2012). An exploratory qualitative study of online poker professional players. Social Psychological Review, 14(2), 13-25.

Wood, R.T.A., Griffiths, M.D. & Parke, J. (2007). The acquisition, development, and maintenance of online poker playing in a student sample. CyberPsychology and Behavior, 10, 354-361.

Wood, R.T.A. & Griffiths. M.D. (2008). Why Swedish people play online poker and factors that can increase or decrease trust in poker websites: A qualitative investigation. Journal of Gambling Issues, 21, 80-97.

In dependence days: A brief overview of behavioural addictions

Please note: A version of this blog first appeared on addiction.com

Conceptualizing addiction has been a matter of great debate for decades. For many people the concept of addiction involves the taking of drugs. Therefore it is perhaps unsurprising that most official definitions concentrate on drug ingestion. Despite such definitions, there is now a growing movement that views a number of behaviours as potentially addictive including those that do not involve the ingestion of a drug. These include behaviours diverse as gambling, eating, sex, exercise, videogame playing, love, shopping, Internet use, social networking, and work. I have argued in many of my papers that all addictions – irrespective of whether they are chemical or behavioural – comprise six components (i.e., salience, mood modification, tolerance, withdrawal, conflict and relapse). More specifically:

• Salience – This occurs when the activity 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 socialized behaviour). For instance, even if the person is not actually engaged in the activity they will be constantly thinking about the next time that they will be (i.e., a total preoccupation with the activity).
• Mood modification – This refers to the subjective experiences that people report as a consequence of engaging in the activity 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 the activity are required to achieve the former mood modifying effects. This basically means that for someone engaged in the activity, they gradually build up the amount of the time they spend engaging in the activity 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 engage in the activity.
• Conflict – This refers to the conflicts between the person and those around them (interpersonal conflict), conflicts with other activities (e.g., work, social life, hobbies and interests) or from within the individual (e.g., intra-psychic conflict and/or subjective feelings of loss of control) that are concerned with spending too much time engaging in the activity.
• Relapse – This is the tendency for repeated reversions to earlier patterns of excessive engagement in the activity to recur, and for even the most extreme patterns typical of the height of excessive engagement in the activity to be quickly restored after periods of control.

In May 2013, the new criteria for problem gambling (now called ‘Gambling Disorder’) were published in the fifth edition of the Diagnostic and Statistical Manual for Mental Disorders (DSM-5), and for the very first time, problem gambling was included in the section ‘Substance-related and Addiction Disorders’ (rather than in the section on impulse control disorders as had been the case since 1980 when it was first included in the DSM-III). Although most of us in the field had been conceptualizing extreme problem gambling as an addiction for many years, this was arguably the first time that an established medical body had described it as such.

There had also been debates about whether or not ‘Internet Addiction Disorder’ should have been included in the DSM-5. As a result of these debates, the Substance Use Disorder Work Group recommended that the DSM-5 include ‘Internet Gaming Disorder’ [IGD] in Section III (“Emerging Measures and Models”) as an area that required further research before possible inclusion in future editions of the DSM. To be included in its own right in the next edition, research will have to establish the defining features of IGD, obtain cross-cultural data on reliability and validity of specific diagnostic criteria, determine prevalence rates in representative epidemiological samples in countries around the world, and examine its associated biological features. Other than gambling and gaming, no other behaviour (e.g., sex, work, exercise, etc.) has yet to be classified as a genuine addiction by established medical and/or psychiatric organizations.

In one of the most comprehensive reviews of chemical and behavioural addictions, Dr. Steve Sussman, Nadra Lisha and myself examined all the prevalence literature relating to 11 different potentially addictive behaviours. We reported overall prevalence rates of addictions to cigarette smoking (15%), drinking alcohol (10%), illicit drug taking (5%), eating (2%), gambling (2%), internet use (2%), love (3%), sex (3%), exercise (3%), work (10%), and shopping (6%). However, most of the prevalence data relating to behavioural addictions (with the exception of gambling) did not have prevalence data from nationally representative samples and therefore relied on small and/or self-selected samples.

Addiction is an incredibly complex behaviour and always result from an interaction and interplay between many factors including the person’s biological and/or genetic predisposition, their psychological constitution (personality factors, unconscious motivations, attitudes, expectations, beliefs, etc.), their social environment (i.e. situational characteristics such as accessibility and availability of the activity, the advertising of the activity) and the nature of the activity itself (i.e. structural characteristics such as the size of the stake or jackpot in gambling). This ‘global’ view of addiction highlights the interconnected processes and integration between individual differences (i.e. personal vulnerability factors), situational characteristics, structural characteristics, and the resulting addictive behaviour.

There are many individual (personal vulnerability) factors that may be involved in the acquisition, development and maintenance of behavioural addictions (e.g. personality traits, biological and genetic predispositions, unconscious motivations, learning and conditioning effects, thoughts, beliefs, and attitudes), although some factors are more personal (e.g. financial motivation and economic pressures in the case of gambling addiction). However, there are also some key risk factors that are highly associated with developing almost any (chemical or behavioural) addiction such as having a family history of addiction, having co-morbid psychological problems, and having a lack of family involvement and supervision. Psychosocial factors such as low self-esteem, loneliness, depression, high anxiety, and stress all appear to be common among those with behavioural addictions.

This article briefly demonstrates that behavioural addictions are a part of a biopsychosocial process and not just restricted to drug-ingested (chemical) behaviours. Evidence is growing that excessive behaviours of all types do seem to have many commonalities and this may reflect a common etiology of addictive behaviour. Such commonalities may have implications not only for treatment of such behaviours but also for how the general public perceive such behaviours.

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

Further reading

Berczik, K., Griffiths, M.D., Szabó, A., Kurimay, T., Urban, R. & Demetrovics, Z. (2014). Exercise addiction. In K. Rosenberg & L. Feder (Eds.), Behavioral Addictions: Criteria, Evidence and Treatment (pp.317-342). New York: Elsevier.

Demetrovics, Z. & Griffiths, M.D. (2012). Behavioral addictions: Past, present and future. Journal of Behavioral Addictions, 1, 1-2.

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

Griffiths, M.D. (2009). Gambling addictions. In A. Browne-Miller (Ed.), The Praeger International Collection on Addictions: Behavioral Addictions from Concept to Compulsion (pp. 235-257). Westport, CT: Praeger.

Griffiths, M.D. (2010). Addicted to sex? Psychology Review, 16(1), 27-29

Griffiths, M.D. (2011). Behavioural addiction: The case for a biopsychosocial approach. Transgressive Culture, 1(1), 7-28.

Griffiths, M.D. (2011). Workaholism: A 21^st century addiction. The Psychologist: Bulletin of the British Psychological Society, 24, 740-744.

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.

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

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

Kuss, D.J., Griffiths, M.D., Karila, L. & Billieux, J. (2014).  Internet addiction: A systematic review of epidemiological research for the last decade. Current Pharmaceutical Design, 20, 4026-4052.

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

Gamblers anonymous: The psychology of live online casino gambling

Over the last decade, my research unit has carried out an increasing amount of research into the psychology of online gambling. In some of our recent research interviewing online gamblers, offline gamblers and non-gamblers, we found that people who gambled online did so because of its (i) convenience, (ii) greater value for money, (iii) the greater variety of games, and (iv) anonymity. Perhaps more interestingly, were the inhibiting reasons that stopped people from wanting to gamble online in the first place. The main inhibiting reason that stopped people gambling online was that offline gamblers and non-gamblers said the authenticity of gambling was significantly reduced when gambling online. We also found a number of other inhibitors of online gambling including (i) the reduced realism, (ii) the asocial nature of the internet, (iii) the use of electronic money, and (iv) concerns about the safety of online gambling websites. The reduced authenticity and realism may help to explain why online live action casino games are seen as increasingly popular among some types of gamblers.

This empirical research also chimes with my own personal psychology of online gambling. One of the main reasons I don’t like gambling at Internet casinos is that I believe the majority of game outcome are likely to be pre-programmed and/or predetermined. To me, this is somewhat akin to playing with imaginary dice! Our empirical research findings also help explain the rise of live online casino gambling. Players not only want increased realism and authenticity, but still have the added advantages of online anonymity while playing.

In online live casino gaming, the anonymity of the Internet allows players to privately engage in gambling without the fear of stigma. This anonymity may also provide the gambler with a greater sense of perceived control over the content, tone, and nature of the online experience. Anonymity may also increase feelings of comfort since there is a decreased ability to look for, and thus detect, signs of insincerity, disapproval, or judgment in facial expression, as would be typical in face-to-face interactions. For activities such as gambling, this may be a positive benefit particularly when losing as no-one will actually see the face of the loser. Anonymity may reduce social barriers to engaging in gambling, particularly those activities thought to be more skill-based gambling activities (such as poker or blackjack) that are relatively complex and often possess tacit social etiquette. The potential discomfort of committing a structural or social faux-pas in the gambling environment because of inexperience is minimized because the player’s identity remains concealed.

Furthermore, one of the main reasons why behaviour online is very different from offline is because it provides a ‘disinhibiting’ experience. One of the main consequences of disinhibition is that on the internet people lower their emotional guard and become much less restricted and inhibited in their actions.

The increase in online live casino gambling has happened alongside the rise of online betting exchanges – the type of online gambling where it could be argued that skill can – to some extent – be exercised. For gamblers, having a punt on live sporting events via betting exchanges is a psychologically safer option because punters know (or can check) who won a particular football or horse race. The playing of live action casino games via the Internet shares some of the psychological similarities of online betting exchanges.

The rise of live online gambling has been coupled with increasingly sophisticated gaming software, integrated e-cash systems, and increased realism (in the shape of “real” gambling via webcams, live remote wagering, and/or player and dealer avatars). These are all inter-linked facilitating factors. Another factor that I feel is really important in the rise of online gambling (including online live action casino games) is the inter-gambler competition. Obviously there is an overlap between competitiveness and skill but they are certainly not the same. What’s more recent research has suggested that being highly competitive may not necessarily be good for the gambler. For instance, Professor Howard Shaffer, a psychologist at Harvard University, claims that men are more likely to develop problematic gambling behaviour because of their conventionally high levels of aggression, impulsivity and competitiveness. Clearly, the idea of the competitiveness of the activity being one of the primary motivations to gamble is well supported.

Based on the fact that so little research has systematically examined the links between gambling and competitiveness, our research unit did some research into this area. We speculated that a gambler who is highly competitive will experience more arousal and stimulation, and be drawn to gambling as an outlet to release competitive instincts and drives. This is likely to occur more in activities like online poker and online live action casino games. Our research did indeed show that problem gamblers were significantly more likely than non-problem gamblers to be competitive.

Being highly competitive may help in explaining why in the face of sometimes negative and damaging financial consequences, gamblers persist in their habit. Psychological research in other areas has consistently shown that highly competitive individuals are more sensitive to social comparison with peers regarding their task performance. Applying this to a gambling situation, it is reasonable to suggest that competitive gamblers may be reluctant to stop gambling until they are in a positive state in relation to opposing gamblers, perhaps explaining why excessive gambling can sometimes occur.

Sociologists have speculated that factors of the human instinctual expressive needs, such as competition, can be temporarily satisfied when engaging in gambling activities. Evidence exists supporting gambling as an instrumental outlet for expressing competitive instinctual urges. The US sociologist Erving Goffman developed what he called the ‘deprivation-compensation’ theory to explain the relationship between gambling and competitiveness. He suggested that the stability of modern society no longer creates situations where competitive instincts are tested. Therefore, gambling is an artificial, self-imposed situation of instability that can be instrumental in creating an opportunity to test competitive capabilities. Again, online live action casino gambling is another gambling form that can facilitate such instinctive needs.

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

Further reading

Goffman, I. (1972). Where the action is. In: Interaction Ritual (pp. 149–270). Allen Lane, London.

Griffiths, M.D. (2010). Gambling addiction on the Internet. In K. Young & C. Nabuco de Abreu (Eds.), Internet Addiction: A Handbook for Evaluation and Treatment. pp. 91-111. New York: Wiley.

Griffiths, M.D. & Parke, J. (2003). The environmental psychology of gambling. In G. Reith (Ed.), Gambling: Who wins? Who Loses? pp. 277-292. New York: Prometheus Books.

Griffiths, M.D., Wardle, J., Orford, J., Sproston, K. & Erens, B. (2009). Socio-demographic correlates of internet gambling: findings from the 2007 British Gambling Prevalence Survey. CyberPsychology and Behavior, 12, 199-202.

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

Kuss, D. & Griffiths, M.D. (2012).  Internet gambling behavior. In Z. Yan (Ed.), Encyclopedia of Cyber Behavior (pp.735-753). Pennsylvania: IGI Global.

McCormack. A. & Griffiths, M.D. (2012). Motivating and inhibiting factors in online gambling behaviour: A grounded theory study. International Journal of Mental Health and Addiction, 10, 39-53.

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

McCormack, A., Shorter, G. & Griffiths, M.D. (2013). An examination of participation in online gambling activities and the relationship with problem gambling. Journal of Behavioral Addictions, 2(1), 31-41.

McCormack, A., Shorter, G. & Griffiths, M.D. (2013). Characteristics and predictors of problem gambling on the internet. International Journal of Mental Health and Addiction, 11, 634-657.

Wardle, H. & Griffiths, M.D. (2011). Defining the ‘online gambler’: The British perspective. World Online Gambling Law Report, 10(2), 12-13.

Wardle, H., Moody, A., Griffiths, M.D., Orford, J. & and Volberg, R. (2011). Defining the online gambler and patterns of behaviour integration: Evidence from the British Gambling Prevalence Survey 2010. International Gambling Studies, 11, 339-356.

Back to the ‘why’ fronts: A brief look at gambling motivation

In the three decades that I have been studying gambling, the question that I am most asked is ‘Why do people gamble?’ and variations on it, such as ‘Why do people gamble when most people consistently lose?’ All surveys of gambling have shown that there are a broad range motivational factors that are central to gambling, and that attitudes towards gambling are positively related to availability and cultural acceptability. However, this perspective fails to take into account many key findings and observations in gambling research. Surveys have also shown that not everyone gambles and some people gamble more than others (e.g., professional gamblers, problem gamblers). Research has consistently shown that people often gamble for reasons other than broad social and economic reasons. These other motivations may vary according to personal characteristics of the gambler and the type of gambling activity. Additionally, broad social and economic theories fail to explain why certain gambling activities are more popular or ‘addictive’ than others.

Variations in gambling preferences are thought to result from both differences in accessibility and motivation. Older people tend to choose activities that minimise the need for complex decision-making or concentration (e.g., bingo, slot machines), whereas gender differences have been attributed to a number of factors, including variations in sex-role socialisation, cultural differences and theories of motivation. Stereotypically, women tend to prefer chance-based games and men tend to prefer skill-based games. Even some games that are predominantly chance-based, men attempt to impose some level of skill. For instance, poker – which people regard as skill-based – has a massive amount of chance involved. Similarly, men often, in their own minds, change playing a slot machine from a chance-based event into a more skill-based activity via cognitive processes such as the illusion of control. The other factor to consider is that (in general) women don’t like it when other people see them losing. On a slot machine, no-one sees the player is losing so it’s very often a very guilt-free, private experience. Men, on the other hand, even when they lose big, there’s a machismo attached to it that says: “Yes, I’ve lost £500 but I can afford it.”

Variations in motivation are also frequently observed among people who participate in the same gambling activity. For example, slot machine players may gamble to win money, for enjoyment and excitement, to socialise and to escape negative feelings. Some people gamble for one reason only, whereas others gamble for a variety of reasons. A further complexity is that people’s motivations for gambling have a strong temporal dimension; that is, they do not remain stable over time. As people progress from social to regular and finally to excessive gambling, there are often significant changes in their reasons for gambling. Whereas a person might have initially gambled to obtain enjoyment, excitement and socialisation, the progression to problem gambling is almost always accompanied by an increased preoccupation with winning money and chasing losses.

Gambling is clearly a multifaceted rather than unitary phenomenon. Consequently, many factors may come into play in various ways and at different levels of analysis (e.g., biological, social, or psychological). Theories may be complementary rather than mutually exclusive, which suggests that limitations of individual theories might be overcome through the combination of ideas from different perspectives. This has often been discussed before in terms of recommendations for an ‘eclectic’ approach to gambling or a distinction between proximal and distal influences upon gambling. However, for the most part, such discussions have been descriptive rather than analytical, and so far, few attempts have been made to explain why an adherence to singular perspectives is untenable.

Gambling is one of those activities where people effectively can get something for nothing, which is why some people will take risks. The attraction of a lotter for example is that, for a very small stake, the individual can have a life-changing experience (and things are further complicated by the fact that most lottery players don’t see the activity as gambling). People who enjoy playing roulette or betting on a football match enjoy the betting or gaming experience itself. In short, each gambling activity has its own unique psychology (although there are undoubted overlaps).

Most economists claim that gamblers are primarily driven by the profit motive. However, the psychological evidence is overwhelming that other desires affect gambling actions. Put simply, for most gamblers, our actions contradict the desire to maximize profits. Whilst I am no Freudian, there appear to be a whole range of unconscious factors at play in gambling. For instance, if players make a successful bluff during a card game, it’s human nature to want to let people to know how smart they are. The golden rule in poker is never to give anything away but the human psyche works in such a way that we usually want to show off once in a while. Our psychological make-up also means that we let pride get in the way of minimizing losses. There are always games that should have been avoided but players end up staying in them long after they knew it was a mistake. None of us like to lose to who we think are weaker players, or admit that the game was too hard. How many times does a player continue playing because they want to try and get the better of a great player or show off because there is someone they are trying to impress? Although it’s a cliché, pride before a fall is commonplace. These short-term psychological satisfactions will almost always have a negative impact on long-term profits.

Because there are many non-financial types of rewards from many different sources while gambling, some people view losses as the price of entry. To these players (and I include myself as one of them), winning may be a bonus. However, most of us don’t like losing – and we especially don’t like persistent losing, regardless of whether there are other types of reinforcement. In the cold light of day, we are all rational human beings. In the height of action, rationality often goes out the window. I’ve done it myself at the roulette table and standing in front of a slot machine. While gambling I have felt omnipotent. It is only after I walk away penniless that the non-financial rewards are short-term and not worth it.

Understanding our own psychological motives is clearly important while gambling. Most players know the strategies they should be adopting but fail to apply them in real gambling situations. Players do not lack the information. It is far more profitable to learn why we don’t apply the lessons we have already learned, then ensure that we apply them. Until we understand and control our own motives — including the unconscious ones — we cannot possibly play to our best ability.

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

Further reading

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

Griffiths, M.D. (1990). The dangers of social psychology research. BPS Social Psychology Newsletter, 23, 20-23.

Griffiths, M.D. (1999). The psychology of the near miss (revisited). British Journal of Psychology, 90, 441-445.

Griffiths, M.D. (2006). An overview of pathological gambling. In T. Plante (Ed.), Mental Disorders of the New Millennium. Vol. I: Behavioral Issues. pp. 73-98. New York: Greenwood.

Griffiths, M.D. (2007). Gambling psychology: Motivation, emotion and control, Casino and Gaming International, (3)4 (November), 71-76.

Griffiths, M.D. & Wood, R.T.A. (2001). The psychology of lottery gambling. International Gambling Studies, 1, 27-44.

McCormack. A. & Griffiths, M.D. (2012). What differentiates professional poker players from recreational poker players? A qualitative interview study. International Journal of Mental Health and Addiction, 10, 243-257.

Parke, A. & Griffiths, M.D. (2011). Poker gambling virtual communities: The use of Computer-Mediated Communication to develop cognitive poker gambling skills. International Journal of Cyber Behavior, Psychology and Learning, 1(2), 31-44.

Parke, A. & Griffiths, M.D. (2012). Beyond illusion of control: An interpretative phenomenological analysis of gambling in the context of information technology. Addiction Research and Theory, 20, 250-260.