Category Archives: Problem gamblng
Tech’s appeal: Another look at Internet addiction
Generally speaking, Internet addiction (IA) has been characterized by excessive or poorly controlled preoccupation, urges, and/or behaviours regarding Internet use that lead to impairment or distress in several life domains. However, according to Dr. Kimberly Young, IA is a problematic behaviour akin to pathological gambling that can be operationally defined as an impulse-control disorder not involving the ingestion of psychoactive intoxicants.
Following the conceptual framework developed by Young and her colleagues to understand IA, five specific types of distinct online addictive behaviours were identified: (i) ‘cyber-sexual addiction’, (ii) ‘cyber-relationship addiction’, (iii) ‘net compulsions (i.e., obsessive online gambling, shopping, or trading), (iv) ‘information overload’, and (v) ‘computer addiction’ (i.e., obsessive computer game playing).
However, I have argued in many of my papers over the last 15 years that the Internet may simply be the means or ‘place’ where the most commonly reported addictive behaviours occur. In short, the Internet may be just a medium to fuel other addictions. Interestingly, new evidence pointing towards the need to make this distinction has been provided from the online gaming field where new studies (including some I have carried out with my Hungarian colleagues) have demonstrated that IA is not the same as other more specific addictive behaviours carried out online (i.e., gaming addiction), further magnifying the meaningfulness to differentiate between what may be called ‘generalized’ and ‘specific’ forms of online addictive behaviours, and also between IA and gaming addiction as these behaviours are conceptually different.
Additionally, the lack of formal diagnostic criteria to assess IA holds another methodological problem since researchers are systematically adopting modified criteria from other addictions to investigate IA. Although IA may share some commonalities with other substance-based addictions, it is unclear to what extent such criteria are useful and suitable to evaluate IA. Notwithstanding the existing difficulties in understanding and comparing IA with behaviours such as pathological gambling, recent research provided useful insights on this topic.
A recent study by Dr. Federico Tonioni (published in a 2014 issue of the journal Addictive Behaviors) involving two clinical (i.e., 31 IA patients and 11 pathological gamblers) and a control group (i.e., 38 healthy individuals) investigated whether IA patients presented different psychological symptoms, temperamental traits, coping strategies, and relational patterns in comparison to pathological gamblers, concluded that Internet-addicts presented higher mental and behavioural disengagement associated with significant more interpersonal impairment. Moreover, temperamental patterns, coping strategies, and social impairments appeared to be different across both disorders. Nonetheless, the similarities between IA and pathological gambling were essentially in terms of psychopathological symptoms such as depression, anxiety, and global functioning. Although, individuals with IA and pathological gambling appear to share similar psychological profiles, previous research has found little overlap between these two populations, therefore, both phenomena are separate disorders.
Despite the fact that initial conceptualizations of IA helped advance the current knowledge and understanding of IA in different aspects and contexts, it has become evident that the field has greatly evolved since then in several ways. As a result of these ongoing changes, behavioural addictions (more specifically Gambling Disorder and Internet Gaming Disorder) have now recently received official recognition in the latest (fifth) edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Moreover, IA can also be characterized as a form of technological addiction, which I have operationally defined as a non-chemical (behavioural) addiction involving excessive human-machine interaction. In this theoretical framework, technological addictions such as IA represent a subset of behavioural addictions featuring six core components: (i) salience, (ii) mood modification, (iii) tolerance, (iv) withdrawal, (v) conflict, and (vi) relapse. The components model of addiction appears to be a more updated framework for understanding IA as a behavioural addiction not only conceptually but also empirically. Moreover, this theoretical framework has recently received empirical support from several studies, further evidencing its suitability and applicability to the understanding of IA.
For many in the IA field, problematic Internet use is considered to be a serious issue – albeit not yet officially recognised as a disorder – and has been described across the literature as being associated with a wide range of co-occurring psychiatric comorbidities alongside an array of dysfunctional behavioural patterns. For instance, IA has been recently associated with low life satisfaction, low academic performance, less motivation to study, poorer physical health, social anxiety, attention deficit/hyperactivity disorder and depression, poorer emotional wellbeing and substance use, higher impulsivity, cognitive distortion, deficient self-regulation, poorer family environment, higher mental distress, loneliness, among other negative psychological, biological, and neuronal aspects.
In a recent systematic literature review conducted by Dr. Wen Li and colleagues (and published in the journal Computers and Human Behavior), the authors reviewed a total of 42 empirical studies that assessed the family correlates of IA in adolescents and young adults. According to the authors, virtually all studies reported greater family dysfunction amongst IA families in comparison to non-IA families. More specifically, individuals with IA exhibited more often (i) greater global dissatisfaction with their families, (ii) less organized, cohesive, and adaptable families, (iii) greater inter-parental and parent-child conflict, and (iv) perceptions of their parents as more punitive, less supportive, warm, and involved. Furthermore, families were significantly more likely to have divorced parents or to be a single parent family.
Another recent systematic literature review conducted by Dr. Lawrence Lam published in the journal Current Psychiatry Reports examined the possible links between IA and sleep problems. After reviewing seven studies (that met strict inclusion criteria), it was concluded that on the whole, IA was associated with sleep problems that encompassed subjective insomnia, short sleep duration, and poor sleep quality. The findings also suggested that participants with insomnia were 1.5 times more likely to be addicted to the Internet in comparison to those without sleep problems. Despite the strong evidence found supporting the links between IA and sleep problems, the author noted that due to the cross-sectional nature of most studies reviewed, the generalizability of the findings was somewhat limited.
IA is a relatively recent phenomenon that clearly warrants further investigation, and empirical studies suggest it needs to be taken seriously by psychologists, psychiatrists, and neuroscientists. Although uncertainties still remain regarding its diagnostic and clinical characterization, it is likely that these extant difficulties will eventually be tackled and the field will evolve to a point where IA may merit full recognition as a behavioural addiction from official medical bodies (ie, American Psychiatric Association) similar to other more established behavioural addictions such as ‘Gambling Disorder’ and ‘Internet Gaming Disorder’. However, in order to achieve official status, researchers will have to adopt a more commonly agreed upon definition as to what IA is, and how it can be conceptualized and operationalized both qualitatively and quantitatively (as well as in clinically diagnostic terms).
Dr. Mark Griffiths, Professor of Gambling Studies, International Gaming Research Unit, Nottingham Trent University, Nottingham, UK
Please note: This article was co-written with Halley Pontes and Daria Kuss.
Further reading
Griffiths, M.D. (2000). Internet addiction – Time to be taken seriously? Addiction Research, 8, 413-418.
Griffiths, M.D. (2010). Internet abuse and internet addiction in the workplace. Journal of Workplace Learning, 7, 463-472.
Griffiths, M.D., Kuss, D.J., Billieux J. & Pontes, H.M. (2016). The evolution of internet addiction: A global perspective. Addictive Behaviors, 53, 193–195.
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.
Király, O., Griffiths, M.D., Urbán, R., Farkas, J., Kökönyei, G. Elekes, Z., Domokos Tamás, D. & Demetrovics, Z. (2014). Problematic internet use and problematic online gaming are not the same: Findings from a large nationally representative adolescent sample. Cyberpsychology, Behavior and Social Networking, 17, 749-754.
Kuss, D.J. & Griffiths, M.D. (2015). Internet Addiction in Psychotherapy. Basingstoke: Palgrave Macmillan.
Kuss, D.J., Griffiths, M.D. & Binder, J. (2013). Internet addiction in students: Prevalence and risk factors. Computers in Human Behavior, 29, 959-966.
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.
Kuss, D.J., Shorter, G.W., van Rooij, A.J., Griffiths, M.D., & Schoenmakers, T.M. (2014). Assessing Internet addiction using the parsimonious Internet addiction components model – A preliminary study. International Journal of Mental Health and Addiction, 12, 351-366.
Kuss, D.J., van Rooij, A.J., Shorter, G.W., Griffiths, M.D. & van de Mheen, D. (2013). Internet addiction in adolescents: Prevalence and risk factors. Computers in Human Behavior, 29, 1987-1996.
Lam, L.T. (2014). Internet Gaming Addiction, Problematic use of the Internet, and sleep problems: A systematic review. Current Psychiatry Reports, 16(4), 1-9.
Li, W., Garland, E.L., & Howard, M.O. (2014). Family factors in Internet addiction among Chinese youth: A review of English-and Chinese-language studies. Computers in Human. Behavior, 31, 393-411.
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.M., Kuss, D.J. & 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.
Pontes, H.M., Szabo, A. & Griffiths, M.D. (2015). The impact of Internet-based specific activities on the perceptions of Internet Addiction, Quality of Life, and excessive usage: A cross-sectional study. Addictive Behaviors Reports, 1, 19-25.
Tonioni, F., Mazza, M., Autullo, G., Cappelluti, R., Catalano, V., Marano, G., … & Lai, C. (2014). Is Internet addiction a psychopathological condition distinct from pathological gambling?. Addictive Behaviors, 39(6), 1052-1056.
Widyanto, L. & Griffiths, M.D. (2006). Internet addiction: A critical review. International Journal of Mental Health and Addiction, 4, 31-51.
Young, K. (1998). Caught in the net. New York: John Wiley
Young K. (1999). Internet addiction: Evaluation and treatment. Student British Medical Journal, 7, 351-352.
The punch bunch: Aggressive behaviour in adult slot machine gamblers
I was idly looking through some of the academic papers I have published over the last 25 years and I was surprised by how a fair number of them examined aggressive behaviour in some way. Many of these concern the effect of video game violence on aggressive behaviour but I have also published papers examining sexual orientation and aggression, mindfulness and aggression, and gambling and aggression (see ‘Further Reading’ below for a selection of these).
Back when I was doing my PhD on slot machine addiction (1987-1990) I spent a lot of my time in amusement arcades watching fruit machine players. One thing that I noticed during my observational studies is how physically aggressive players could be when they lost (such as kicking or punching the machine if they lost a lot of money or being verbally aggressive towards staff and other players when things weren’t going the way they wanted). A number of studies have reported a link between gambling and aggressive behaviour although most of the research has concentrated on domestic violence between gamblers and their partners (i.e., problem gamblers taking out the frustration of losing lots of money on their partners).
In a paper in a 2005 issue of the Journal of Community and Applied Social Psychology, Dr. Adrian Parke and I speculated that there are two main types of aggressive act which are prevalent in slot machine gambling based on environmental and structural design factors – instrumental aggression and emotional aggression. Instrumental aggression differs from emotional aggression because there is an ulterior motive behind the act whereas emotional aggression is a result of being unpleasantly aroused. The Frustration-Aggression theory states that a barrier to expected goal attainment generates emotional aggression. Furthermore, the level of aggression is directly proportional to the (i) level of satisfaction they had expected, (ii) more they are prevented from achieving any of their goals and (iii) more often their attempts are resisted. Psychologists such as Dr. Leonard Berkowitz maintains that it is not the frustration that causes the aggressive urges, but the negative affect elicited by the frustration.
Dr. Parke and I also published some other papers on slot machine aggression during 2004 and 2005 in the International Journal of Mental Health and Addiction and Psychological Reports. We carried out a non-participant observation study and monitored the incidence of aggressive behaviour in 303 slot machine players over four 6-hour observation periods in a UK amusement arcade. We concluded that aggression was prevalent in the UK gambling arcade environment with an average of seven aggressive incidents per hour.
We also reported that the majority of aggressive incidents were verbal. Verbal aggression was directed towards members of staff, other gamblers and also the slot machines themselves. Verbal aggression towards members of staff, from an objective point of view, appeared to be caused by a misinterpretation of staff reactions towards incurred losses. With cues available to determine which slot machine will be profitable to play, selecting a machine with which the gambler incurs a loss can be interpreted as poor slot machine gambling skill. The psychologists Dr. Brad Bushman and Dr. Roy Baumeister argue that threatened egotism (an explicit dispute against one’s self value) is a strong risk factor for aggression reprisal. It is probable that in this situation the gamblers were motivated to rebuke such evaluations through an affrontive reprimand. For example:
“After losing all of the money he entered the premises with, participant 6 becomes verbally aggressive to an arcade staff member: ‘I should bring a bat into this place and break the fucking machine…What would you do? You wouldn’t have the balls to call the police.” (Parke & Griffiths, 2005; p. 53)
Given the apparent disproportionate aggressive reaction to minor provocation from staff members, there is scope to propose that rather than being a primary source of frustration and aggression, the phenomenon is evidence of Triggered Displaced Aggression. Displaced Aggression theory contends that individuals who are provoked but who are constrained against retaliating directly to the primary source may displace such anger onto unaccountable individuals. Triggered Displaced Aggression theory extends this position, by stating that after a preclusion of direct retaliation against the provocateur, minor triggers will produce an incommensurate level of aggression. Applying this theory to the phenomenon of verbal aggression towards staff members, it is probable that the gambler while frustrated and negatively aroused may be motivated to displace disproportionately high aggressive reactions onto staff members based on minor triggers such as amusement at incurred losses.
We also reported that verbal aggression directed towards other slot machine gamblers was probably a response to predatory play from opposing slot machine gamblers. With structural design factors enabling identification of slot machines that are profitable to play, naturally the environment becomes competitive. Gamblers become callous in their machine selection because the most effective way to make profits is to target machines that other gamblers have lost considerably on. Again, for the individual, self-esteem is likely to be diminished by permitting opponents to profit from experiencing loss. As a result it is probable that attempts are made to deflect such predatory behaviour with aggressive reprimands. For example:
“Participant 3 had gambled a considerable amount of money on one machine, and had no funds to continue playing. Participant 4 immediately began to play the same machine and win. Participant 3 retorted in an aggressive tone: ‘You watching me lose my money before. Wait till I lose everything and then play mate?’” (Parke & Griffiths, 2005; p.54)
Verbal aggression towards other slot machine gamblers could be understood from perspective of the Cognitive Neo-associationistic Model. (Fundamentally, this model suggests that aversive events produce negative affect, which transforms all associated stimuli into potential triggers of aggression). Applying this theory to the verbal aggression phenomenon, it is reasonable to propose that the experience of losing transforms environmental factors, such as opposing gamblers, into sources of aggression. Berkowitz has advocated two tiers of aggression activation. The first stage is simultaneous emotions of rudimentary fear and anger. The second stage is a second order evaluative phase where the individual considers the actual liability of environmental factors in anger creation. Naturally, as Berkowitz states, the individual’s attributional processes dictate whether they will actualise aggressive emotions. Put simply, an acknowledgement of the ability to isolate slot machines that are profitable to play based on identifying losing gamblers, is potentially a risk factor for acting aggressively towards other gamblers.
Finally, verbal aggression towards the slot machine is considered to be an emotionally aggressive act as a means to vent frustration rather than instrumentally preserve status as suggested above. Invariably, verbal emotional aggression was expressed through vilification and attribution of negative human characteristics to the machine such as sadism. Interestingly, such vilification was primarily sexually aggressive and constituted a feminisation of the slot machine. For example:
“This bitch is fucking me around…Are you going to fuck me around again this week?” (Parke & Griffiths, 2005; p.54)
We argued that the physical aggression towards the slot machine was believed to be an extension of tension release that was previously observed with verbal aggression towards the slot machine. For example:
“After considerable losses, Participant 8 began to slam the glass of the machine. After experiencing a near miss Participant 8 subsequently kicked the base of the machine.” (Parke & Griffiths, 2005; p.55)
Physical aggression was not directed towards opposing gamblers – perhaps identifying a boundary of conduct in order to remain within the gambling environment, as it was probable that such behaviour would result in getting thrown out of the premises. Essentially this does not equate to gamblers not be motivated to act physically aggressive to other slot machine gamblers, rather it only represents a reluctance to actualise such behaviour in the gambling environment.
It is probable that aggressive behaviour observed in the slot machine gambling environment is not solely based on structural and environmental factors. Individual differences of the gamblers are likely to affect the prevalence of aggressive behaviour, based on propositions of the General Aggression Model that suggests that trait hostility can develop through life experiences. It is possible that the participants in our observational study held aggression-related biases. For example, Dr. Karen Dill and her colleagues argue that trait hostility precipitates a hostile expectation bias (the expectation that aggressive behaviour will be used by others instrumentally) and a hostile perception bias (the propensity of interpreting interpersonal interactions as aggressive). For gamblers, it is probable that trait hostility is exacerbating aggressive reactions towards provocation from environmental and structural game design factors. Overall, our research concluded that gambling-induced aggression is a manifestation of the underlying conflict of engaging in dysfunctional behaviour while consciously acknowledging its detrimental effects.
Dr Mark Griffiths, Professor of Gambling Studies, International Gaming Research Unit, Nottingham Trent University, Nottingham, UK
Additional input: Dr. Adrian Parke (University of Lincoln, UK)
Further reading
Anderson, C.A. & Bushman, B.J. (2002). Human Aggression. Annual Review of Psychology, 53, 27-51.
Berkowitz, L. (1993). Aggression: Its causes, consequences, and control. Philadelphia: Temple University Press.
Berkowitz, L. (1989). The frustration-aggression hypothesis: Examination and reformulation. Psychological Bulletin, 106, 59-73.
Berkowitz, L. (1990). On the formation and regulation of anger and aggression: A cognitive-neoassociationistic analysis. American Psychologist, 45, 494-505.
Bushman, B. J. & Baumeister, R. F. (1998). Threatened egotism, narcissism, self-esteem, and direct and displaced aggression: Does self-love or self-hate lead to violence. Journal of Personality and Social Psychology, 75, 219-229.
Dill, K.E., Anderson, C.A., Anderson, K.B. & Deuser, W.E. (1997). Effects of personality on social expectations and social perceptions. Journal of Research in Personality, 31, 272-292.
Dollard, J., Doob, L.W., Miller, N.E., Mowrer, O.H. & Sears, R.R. (1939). Frustration and Aggression. New Haven, Connecticut: Yale University Press.
Griffiths, M.D. (1997). Video games and aggression. The Psychologist: Bulletin of the British Psychological Society, 10, 397-401.
Griffiths, M.D. (1998). Video games and aggression: A review of the literature. Aggression and Violent Behavior, 4, 203-212.
Griffiths, M.D., Parke, A. & Parke, J. (2003). Violence in gambling environments: A cause for concern? Justice of the Peace, 167, 424-426.
Griffiths, M.D., Parke, A. & Parke, J. (2005). Gambling-related violence: An issue for the police? Police Journal, 78, 223-227.
Grüsser, S.M., Thalemann, R. & Griffiths, M.D. (2007). Excessive computer game playing: Evidence for addiction and aggression? CyberPsychology and Behavior, 10, 290-292.
Mehroof, M. & Griffiths, M.D. (2010). Online gaming addiction: The role of sensation seeking, self-control, neuroticism, aggression, state anxiety and trait anxiety. Cyberpsychology, Behavior, and Social Networking, 13, 313-316.
Miller, N. Pederson, W.C., Earleywine, M. & Pollock, V.E. (2003). A theoretical model of triggered displaced aggression, Personality and Social Psychology Review, 7, 75-97.
Miller, N.E. (1941). The frustration-aggression hypothesis. Psychological Review, 48, 337-342.
Parke, A. & Griffiths, M.D. (2004). Aggressive behavior in slot machine gamblers : A preliminary observational study. Psychological Reports, 95, 109-114.
Parke, A. & Griffiths, M.D. (2005). Aggressive behaviour in adult slot machine gamblers: A qualitative observational study. International Journal of Mental Health and Addiction, 2, 50-58.
Parke, A. & Griffiths, M.D. (2005). Aggressive behaviour in adult slot machine gamblers: An interpretative phenomenological analysis. Journal of Community and Applied Social Psychology, 15, 255-272.
Sergeant, M.J.T., Dickins, T.E., Davies, M.N.O., & Griffiths, M.D. (2006). Aggression, empathy and sexual orientation in males. Personality and Individual Differences, 40, 475-486.
Shonin, E.S., van Gordon, W., Slade, K. & Griffiths, M.D. (2013). Mindfulness and other Buddhist-derived interventions in correctional settings: A systematic review. Aggression and Violent Behavior, 18, 365-372.
Meditate to medicate: Mindfulness as a treatment for behavioural addiction
Please note: A version of the following article was first published on addiction.com and was co-written with my research colleagues Edo Shonin and William Van Gordon
Mindfulness is a form of meditation that derives from Buddhist practice and is one of the fastest growing areas of psychological research. We have defined mindfulness as the process of engaging a full, direct, and active awareness of experienced phenomena that is spiritual in aspect and that is maintained from one moment to the next. As part of the practice of mindfulness, a ‘meditative anchor’, such as observing the breath, is typically used to aid concentration and to help maintain an open-awareness of present moment sensory and cognitive-affective experience.
Throughout the last two decades, Buddhist principles have increasingly been employed in the treatment of a wide range of psychological disorders including mood and anxiety disorders, substance use disorders, bipolar disorder, and schizophrenia-spectrum disorders. The emerging role of Buddhism in clinical settings appears to mirror a growth in research examining the potential effects of Buddhist meditation on brain neurophysiology. Such research forms part of a wider dialogue concerned with the evidence-based applications of specific forms of spiritual practice for improved psychological health.
Within mental health and addiction treatment settings, mindfulness-based interventions (MBIs) are generally delivered in a secular eight-week format and often comprise the following: (i) weekly sessions of 90-180 minutes duration, (ii) a taught psycho-education component, (iii) guided mindfulness exercises, (iv) a CD of guided meditation to facilitate daily self-practice, and (v) varying degrees of one-to-one discussion-based therapy with the program instructor. Examples of MBIs used in behavioural addiction treatment studies include Mindfulness-Based Cognitive Therapy, Mindfulness-Enhanced Cognitive Behaviour Therapy, Mindfulness-Based Relapse Prevention, Mindfulness-Based Stress Reduction, and Meditation Awareness Training.
Studies investigating the role of mindfulness in the treatment of behavioural addictions have – to date – primarily focused on problem and/or pathological gambling. These studies have shown that levels of dispositional mindfulness in problem gamblers are inversely associated with gambling severity, thought suppression, and psychological distress. Recent clinical case studies have demonstrated that weekly mindfulness therapy sessions can lead to clinically significant change in problem gambling individuals. Published case studies include: (i) a male in his sixties addicted to offline roulette playing, (ii) a 61-year old female (with comorbid anxiety and depression) addicted to slot machine gambling (treated with a modified version of Mindfulness-Based Cognitive Therapy), and (iii) a 32-year old female (with co-occurring schizophrenia) addicted to online slot-machine playing (treated with a modified version of Meditation Awareness Training). Also, a recent study showed that problem gamblers that received Mindfulness-Enhanced Cognitive Behaviour Therapy demonstrated significant improvements compared to a control group in levels of gambling severity, gambling urges, and emotional distress.
Outside of gambling addiction, case studies have investigated the applications of mindfulness for treating addiction to work (i.e., workaholism) and sex. In the case of the workaholic, a director of a blue-chip technology company in his late thirties was successfully treated for his workaholism utilizing Meditation Awareness Training. Significant pre-post improvements were also observed for sleep quality, psychological distress, work duration, work involvement during non-work hours, and employer-rated job performance. However, as with any case study, the single-participant nature of the study significantly restricts the generalizability of such findings.
Key treatment mechanisms that have been identified and/or proposed in this respect (several of which overlap with mechanisms identified as part of the mindfulness-based treatment of chemical addictions) include:
- A perceptual shift in the mode of responding and relating to sensory and cognitive-affective stimuli that permits individuals to objectify their cognitive processes and to apprehend them as passing phenomena.
- Reductions in relapse and withdrawal symptoms via substituting maladaptive addictive behaviours with a ‘positive addiction’ to mindfulness/meditation (particularly the ‘blissful’ and/or tranquil states associated with certain meditative practices).
- Transferring the locus of control for stress from external conditions to internal metacognitive and attentional resources.
- The modulation of dysphoric mood states and addiction-related shameful and self-disparaging schemas via the cultivation of compassion and self-compassion.
- Reductions in salience and myopic focus on reward (i.e., by undermining the intrinsic value and ‘authenticity’ that individuals assign to the object of addiction) due to a better understanding of the ‘impermanent’ nature of existence (e.g., all that is won must ultimately be lost, an attractive body will age and wither, a senior/lucrative occupational role must one day be relinquished, etc.).
- Growth in spiritual awareness that broadens perspective and induces a re-evaluation of life priorities.
- ‘Urge surfing’ (the meditative process of adopting an observatory, non-judgemental, and non-reactive attentional-set towards mental urges) that aids in the regulation of habitual compulsive responses.
- Reduced autonomic and psychological arousal via conscious-breathing-induced increases in prefrontal functioning and vagal nerve output (breath awareness is a central feature of mindfulness practice).
- Increased capacity to defer gratitude due to improvements in levels of patience.
- A greater ability to label and therefore modulate mental urges and faulty thinking patterns.
Although preliminary findings indicate that there are applications for MBIs in the treatment of behavioural addictions, further empirical and clinical research utilizing larger-sample controlled study designs is clearly needed. Despite this, both the classical Buddhist meditation literature and recent scientific findings appear to agree that when correctly practised and administered, mindfulness meditation is a safe, non-invasive, and cost-effective tool for treating behavioural addictions and for improving psychological health more generally.
Dr Mark Griffiths, Professor of Gambling Studies, International Gaming Research Unit, Nottingham Trent University, Nottingham, UK
Further reading
Griffiths, M.D., Shonin, E.S., & Van Gordon, W. (2015). Mindfulness as a treatment for gambling disorder. Journal of Gambling and Commercial Gaming Research, in press.
Shonin, E.S., Van Gordon, W. & Griffiths, M.D. (2013). Mindfulness-based interventions: Towards mindful clinical integration. Frontiers in Psychology, 4, 194, doi: 10.3389/fpsyg.2013.00194.
Shonin, E.S., Van Gordon, W. & Griffiths, M.D. (2013). Buddhist philosophy for the treatment of problem gambling. Journal of Behavioral Addictions, 2, 63-71.
Shonin, E., Van Gordon W., & Griffiths, M.D. (2014). Mindfulness as a treatment for behavioural addiction. Journal of Addiction Research and Therapy, 5: e122. doi: 10.4172/2155-6105.1000e122.
Shonin, E., Van Gordon W., & Griffiths, M.D. (2014). Current trends in mindfulness and mental health. International Journal of Mental Health and Addiction, 12, 113-115.
Shonin, E., Van Gordon, W., & Griffiths M.D. (2014). Cognitive Behavioral Therapy (CBT) and Meditation Awareness Training (MAT) for the treatment of co-occurring schizophrenia with pathological gambling: A case study. International Journal of Mental Health and Addiction, 12, 181-196.
Shonin, E., Van Gordon W., & Griffiths M.D. (2014). The emerging role of Buddhism in clinical psychology: Towards effective integration. Psychology of Religion and Spirituality, 6, 123-137.
Shonin, E., Van Gordon, W., & Griffiths M.D. (2014). The treatment of workaholism with Meditation Awareness Training: A case study. Explore: Journal of Science and Healing, 10, 193-195.
Shonin, E.S., Van Gordon, W. & Griffiths, M.D. (2014). Practical tips for using mindfulness in general practice. British Journal of General Practice, 624 368-369.
Shonin, E.S., Van Gordon, W. & Griffiths, M.D. (2015). Mindfulness in psychology: A breath of fresh air? The Psychologist: Bulletin of the British Psychological Society, 28, 28-31.
Shonin, E., Van Gordon W., Griffiths M.D. & Singh, N. (2015). There is only one mindfulness: Why science and Buddhism need to work together. Mindfulness, 6, 49-56.
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.
