Category Archives: Psychiatry
In a previous blog I examined whether celebrities are more prone to addictions. In that article I argued that many high profile celebrities have the financial means to afford a drug habit like cocaine or heroin. For many in the entertainment business such as being the lead singer in a famous rock band, taking drugs may also be viewed as one of the defining behaviours of the stereotypical ‘rock ‘n’ roll’ lifestyle. In short, it’s almost expected. There is also another way of looking at the relationship between celebrities and drugs and this is in relation to creativity, particularly as to whether the use of drugs can inspire creative writing or music. For instance, did drugs like cannabis and LSD help The Beatles create some of the best music ever such as Revolver? Did the Beach Boys’ Brian Wilson’s use of drugs play a major role in why the album Pet Sounds is often voted the best album of all time? Did the use of opium by Edgar Allen Poe create great fiction? Did William S. Burroughs’ use of heroin enhance his novel writing?
To investigate the question of whether drug use enhances creativity, I and my research colleagues Fruzsina Iszáj and Zsolt Demetrovics have just published a review paper in the International Journal of Mental Health and Addiction examining this issue. We carried out a systematic review of the psychological literature and reviewed any study that provided empirical data on the relationship between psychoactive substance use and creativity/artistic creative process that had been published in English in peer-reviewed journals or scientific books. Following a rigorous filtering process, we were surprised to find only 19 studies that had empirically examined the relationship between drug use and creativity (14 empirical studies and five case studies).
Six of the 19 studies (four empirical papers and two case reports) were published during the 1960s and 1970s. However, following the peak of psychedelia, only three papers (all of them empirical) were published in the following 20 years. Since 2003, a further 10 studies were published (seven empirical papers and three case studies). The majority of the studies (58%) were published in the USA. This dominance is especially true for the early studies in which six of the seven empirical papers and both case studies that were published before mid-1990s were written by US researchers. However, over the past 14 years, this has changed. The seven empirical papers published post-2000 were shared between six different countries (USA, UK, Italy, Wales, Hungary, Austria), and the three case studies came from three countries (USA, UK, Germany).
Seven empirical papers and two case studies dealt with the relationship between various psychoactive substances and artistic creation/creativity. Among the studies that examined a specific substance, six (three empirical papers and three case studies) focused on the effects of either LSD or psilocybin. One empirical study focused on cannabis, and one concerned ayahuasca.
With the exception of one study where the sample focused on adolescents, all the studies comprised adults. More non-clinical samples (15 studies, including case studies) were found than clinical ones (four studies). Three different methodological approaches were identified. Among the empirical studies, seven used questionnaires comprising psychological assessment measures such as the Torrance Test of Creative Thinking (TTCT).
According to the types of psychoactive substance effect on creativity, we identified three groups. These were studies that examined the effect of psychedelic substances (n=5), the effect of cannabis (n=1), and those that did not make a distinction between substances used because of the diverse substances used by participants in the samples (n=7). In one study, the substances studied were not explicitly identified.
The most notable observation of our review was that the findings of these studies show only limited convergence. The main reason for this is likely to be found in the extreme heterogeneity concerning the objectives, methodology, samples, applied measures, and psychoactive substances examined among the small number of studies. Consequently, it is hard to draw a clear conclusion about the effect of psychoactive substance use on creativity based on the reviewed material.
Despite the limited agreement, most of the studies confirmed some sort of association between creativity and psychoactive substance use, but the nature of this relationship was not clearly established. The frequently discussed view that the use of psychoactive substances leads to enhanced creativity was by no means confirmed. What the review of relevant studies suggests is that: (i) substance use is more characteristic in those with higher creativity than in other populations, and (ii) it is probable that this association is based on the inter-relationship of these two phenomena. At the same time, it is probable that there is no evidence of a direct contribution of psychoactive substances to enhanced creativity of artists.
It is more likely that substances act indirectly by enhancing experiences and sensitivity, and loosening conscious processes that might have an influence on the creative process. This means the artist will not be more creative but the quality of the artistic product will be altered due to substance use. On the other hand, it appears that psychoactive substances may have another role concerning artists, namely that they stabilize and/or compensate a more unstable functioning.
Beyond the artistic product, we also noted that (iii) specific functions associated with creativity appear to be modified and enhanced in the case of ordinary individuals due to psychoactive substance use. However, it needs to be emphasized that these studies examined specific functions while creativity is a complex process. In light of these studies, it is clear that psychoactive substances might contribute to a change of aesthetic experience, or enhanced creative problem solving. One study (a case study of the cartoonist Robert Crumb) showed that LSD changed his cartoon illustrating style. Similarly, a case study of Brian Wilson argued that the modification of musical style was connected to substance use. However, these changes in themselves will not result in creative production (although they may contribute to the change of production style or to the modification of certain aspects of pieces of arts). What was also shown is that (iv) in certain cases, substances may strengthen already existing personality traits.
In connection with the findings reviewed, one should not overlook that studies focused on two basically different areas of creative processes. Some studies examined the actual effects of a psychoactive substance or substances in a controlled setting, while others examined the association between creativity and chronic substance users. These two facets differ fundamentally. While the former might explain the acute changes in specific functions, the latter may highlight the role of chronic substance use and artistic production.
It should also be noted that the studies we reviewed differed not only regarding their objectives and methodology, but also showed great heterogeneity in quality. Basic methodological problems were identified in many of these studies (small sample sizes, unrepresentative samples, reliance on self-report and/or non-standardized assessment methods, speculative research questions, etc.). Furthermore, the total number of empirical studies was very few. At the same time, the topic is highly relevant both in order to understand the high level of substance use in artists and in order to clarify the validity of the association present in public opinion. However, it is important that future studies put specific emphasis on adequate methodology and clear research questions.
Belli, S. (2009). A psychobiographical analysis of Brian Douglas Wilson: Creativity, drugs, and models of schizophrenic and affective disorders. Personality and Individual Differences, 46, 809-819.
Dobkin de Rios, M. & Janiger, O. (2003). LSD, spirituality, and the creative process. Rochester, VT: Park Street Press.
Edwards, J. (1993). Creative abilities of adolescent substance abusers. Journal of Group Psychotherapy, Psychodrama & Sociometry, 46, 52-60.
Fink, A., Slamar-Halbedl, M., Unterrainer, H.F. & Weiss, E.M. (2012). Creativity: Genius, madness, or a combination of both? Psychology of Aesthetics, Creativity, and the Arts, 6(1), 11–18.
Forgeard, M.J.C. & Elstein, J.G. (2014). Advancing the clinical science of creativity. Frontiers in Psychology, 5, 613.
Frecska, E., Móré Cs. E., Vargha, A. & Luna, L.E. (2012). Enhancement of creative expression and entoptic phenomena as after-effects of repeated ayahuasca ceremonies. Journal of Psychoactive Drugs, 44, 191-199
Holm-Hadulla, R.M. & Bertolino, A. (2014). Creativity, alcohol and drug abuse: The pop icon Jim Morrison. Psychopathology, 47,167-73
Iszáj, F. & Demetrovics, Z. (2011). Balancing between sensitization and repression: The role of opium in the life and art of Edgar Allan Poe and Samuel Taylor Coleridge. Substance Use and Misuse, 46, 1613-1618
Iszaj, F., Griffiths, M.D. & Demetrovics, Z. (2016). Creativity and psychoactive substance use: A systematic review. International Journal of Mental Health and Addiction. doi: 10.1007/s11469-016-9709-8
Jones, M.T. (2007). The creativity of crumb: Research on the effects of psychedelic drugs on the comic art of Robert Crumb. Journal of Psychoactive Drugs, 39, 283-291.
Jones, K.A., Blagrove, M. & Parrott, A.C. (2009). Cannabis and ecstasy/ MDMA: Empirical measures of creativity in recreational users. Journal of Psychoactive Drugs. 41(4), 323-329
Kerr, B. & Shaffer, J. & Chambers, C., & Hallowell, K. (1991). Substance use of creatively talented adults. Journal of Creative Behavior, 25(2), 145-153.
Knafo, D. (2008). The senses grow skilled in their craving: Thoughts on creativity and addiction. Psychoanalytic Review, 95, 571-595.
Lowe, G. (1995). Judgements of substance use and creativity in ’ordinary’ people’s everyday lifestyles. Psychological Reports. 76, 1147-1154.
Oleynick, V.C., Thrash, T. M., LeFew, M. C., Moldovan, E. G. & Kieffaber, P. D. (2014). The scientific study of inspiration in the creative process: challenges and opportunities. Frontiers in Human Neuroscience, 8, 436.
Plucker, J.A., McNeely, A. & Morgan, C. (2009). Controlled substance-related beliefs and use: Relationships to undergraduates’ creative personality traits. Journal of Creative Behavior, 43(2), 94-101
Preti, A. & Vellante, M. (2007). Creativity and psychopathology. Higher rates of psychosis proneness and nonright-handedness among creative artists compared to same age and gender peers. Journal of Nervous and Mental Disease, 195(10), 837-845.
Schafer, G. & Feilding, A. & Morgan, C. J. A. & Agathangelou, M. & Freeman, T. P. & Curran, H.V. (2012). Investigating the interaction between schizotypy, divergent thinking and cannabis use. Consciousness and Cognition, 21, 292–298
Thrash, T.M., Maruskin, L.A., Cassidy, S. E., Fryer, J.W. & Ryan, R.M. (2010). Mediating between the muse and the masses: inspiration and the actualization of creative ideas. Journal of Personality and Social Psychology, 98, 469–487.
Case 1: Autoerotic death by aerosol propellant
Source: Medicine, Science and the Law. Personal details: 32-year old white US man. Single. Computer programmer.
- Bizarre death event: Found dead in bed with cassette recorder next to him. He was wearing headphones which playing “snorting” horse sounds. There was also a can of aerosol propellant. At the end of the bed was a large painting of a male strapped to the hind legs of a horse who was being anally penetrating by the horse. The horse was ridden by a leather-clad woman. He was also wearing some kind if homemade masturbatory device. His death was recorded as cardio-respiratory failure consistent with aerosol propellant abuse (death by misadventure). Self-administration of the chemical agent to modify the sensations of masturbation. He was covered in dry semen stains.
Case 2: Autoerotic death by clothing
Source: Medicine, Science and the Law. Personal details: 25-year old Japanese male. Single.
- Bizarre death event: Man found dead in his bed one morning. naked except for clothing wrapping his head and underpants which were pulled down. He was covered in dry semen stains. He had put a black skirt on his face and then pulled a second skirt upside down over his head and turned down the bottom of it. He then put a plastic bag over these two garments followed by a pair of tights. The legs of the tights were used to tie a knot around the bottom of the skirts. He then wrapped a third skirt around all of this. Death was due to suffocation.
Case 3: Autoerotic death by hanging (female)
Source: Handbook of Forensic Pathology. Personal details: 19-year old white female. Single. College student.
- Bizarre death event: Woman was found dead in her bedroom hanging from the hinge of her closet door dressed as an Oriental “harem girl”. A window sash cord was tied around her body in a complicated fashion and she was also wearing a blindfold and mouth gag (made from the belt of her dressing gown). Next to her lay an underground magazine (this was folded out and showed a bizarre dance involving a clock – the minute hand being a nude male who would make love with the other figure on the hour), a paperback Hitchcock book which explained her fantasy. The paperback contained the story about an Oriental harem master. In this story the harem master provides girls to his lord who stored them by hanging them around his walls on hooks
Case 4: Autoerotic death by vacuum cleaner
Source: American Journal of Forensic Medicine and Pathology. Personal details: 57-year old white US male. Single. History of heart disease and chronic pancreatitis
- Bizarre death event: Man was found naked slumped over his vacuum cleaner after a neighbour wondered why the vacuum cleaner had been on continuously for a long time. The man was found leaning against the dining table with his testicles, buttocks and thighs tightly bound with women’s tights. Near the table was a jar of urine, jars of lubricant and a wooden table leg covered in fecal excrement. The man was covered in burns from the vacuum cleaner. No defect was found in the vacuum cleaner. The man basically had a heart attack while engaged in autoerotic activity. The wooden table leg had been used in an attempt to stimulate orgasm via anal penetration. His wife had caught him masturbating with the vacuum cleaner before (they hadn’t had sex for five years). The death was classed as natural rather than accidental.
Case 5: Autoerotic death by hydraulic tractor shovel
Source: Journal of Forensic Sciences. Personal details: 62 year-old US white male. Married. Farmer.
- Bizarre death event: Found dead in a barn lying on his front pinned under the hydraulic shovel of his tractor. His body was covered with semen stains and there was evidence of masochistic sexual bondage. His clothes were folded neatly away nearby. He was found naked except for a pair of women’s red shoes (with 8 inch heels), knee high stockings and tape duct wrapped around his ankles. Ropes led from his feet to the tractor which when raised would lift his inverted body causing complete suspension. It is not known exactly what happened but it is likely that the engine stalled and he was crushed underneath the tractor shovel. He died of positional asphyxiation by chest compression. This was an atypical autoerotic fatality because he did not purposely use asphyxiation but it did cause his death.
Aggrawal A. (2009). Forensic and Medico-legal Aspects of Sexual Crimes and Unusual Sexual Practices. Boca Raton: CRC Press.
Byard, R. W. (1994). Autoerotic death—characteristic features and diagnostic difficulties. Journal of Clinical Forensic Medicine, 1(2), 71-78
Cordner, S.M. (1983). An unusual case of sudden death associated with masturbation. Medicine, Science and the Law, 23(1), 54-56
Dietz, P. E., & O’Halloran, R.L. (1993). Autoerotic fatalities with power hydraulics. Journal of Forensic Science, 38(2), 359-364.
Ikeda, N., Harada, A., Umetsu, K., & Suzuki, T. (1988). A case of fatal suffocation during an unusual auto-erotic practice. Medicine, Science and the Law, 28(2), 131-134.
Imami, R. H., & Kemal, M. (1988). Vacuum cleaner use in autoerotic death. American Journal of Forensic Medicine and Pathology, 9(3), 246-248.
Love, B. (2001). Encyclopedia of Unusual Sex Practices. London: Greenwich Editions.
Sauvageau, A., & Racette, S. (2006). Autoerotic deaths in the literature from 1954 to 2004: A review. Journal of Forensic Sciences, 51(1), 140-146.
In previous blogs I have examined many different sexual paraphilias that have ended up in death for individuals engaged in such practices. Many of these are from autoerotic asphyxiation but also from other sexual practices such as electrophilia and anaesthesiophilia. Today’s blog takes a brief look at some of the most bizarre autoerotic deaths reported in the medical forensic literature.
Case 1: Autoerotic death by car
Source: Journal of Forensic Sciences. Personal details: 40-year old white US male airline pilot. Married and father of two children.
- Bizarre death event: A man left his home at 6am in the morning and told his wife that he was going shooting in the country. He was found naked except for a large-link 10-foot chain harness secured around his body. (The harness was tied around the man’s neck in a moderately tight loop and bolted. The chain then went down his chest and was tied into another loop around his waist. This was tied to the bumper of the car) at 7.30am in the morning in a remote area crushed against the left fender of his car (equivalent of a VW beetle). The engine was still running, ignition was on and the driver’s door was still open. The steering wheel was tied so that it would go round in anti-clockwise circles. His clothes were in the boot of the car. Reconstruction of the events leading to his death showed that he was either being dragged round by the car or following the car producing feelings of asphyxia. When he had finished his sexual turn-on he had tried to approach the car door but had forgotten to undo the chain from the bumper. The chain had got tangled up in the car’s axle and the man was found strangled to death by the chain.
Case 2: Autoerotic death by hanging (male)
Source: American Journal of Forensic Medicine and Pathology. Personal details: 57-year old white US male. Single.
- Bizarre death event: Early one winter’s morning, two joggers found a partially clothed man hanging from a tree five inches from the ground. He was hanging from a rope tied round his neck but also had two other loops of rope harness around his thighs which also encircled his chest. His neatly folded clothes lay two feet away along with lipstick and a jar of Vaseline. He was wearing a woman’s brown wig and a stuffed white bra. He also wore a pair of men’s red underpants, a pair of tights and a pair of high-heeled women’s shoes. He was also found to have a carrot protruding from his anus. Basically his seat harness slipped and he asphyxiated himself on the ropes.
Case 3: Autoerotic death by blankets
Source: American Journal of Forensic Medicine and Pathology. Personal details: 60-year old white US male. Single. Diagnosed schizophrenic and had various sexual compulsions. Well educated former teacher.
- Bizarre death event: After being reported missing from work by his employer, a man was found dead rolled up in 14 different blankets which had been sewn together (the two outermost layers were found fixed with adhesive tape in various places which raised the possibility of murder). Inside the blankets he was dressed in two pairs of hotpants, a pair of long johns and a vest. The body was wet and his hands and arms were outstretched above his head. They found a plastic bag over his penis into which he had ejaculated. He was masturbating while inside the blankets but he had become too hypoxic and died. He was immobilized inside the blankets and was unable to free himself. Over the last few years he had bought an astonishing number of blankets by mail order (over 60 found in his apartment most of which seemed to have some ritual or obsessive meaning by the way were laid out. No pornography was found in the place.
Case 4: Autoerotic death by dental anaesthetic
Source: American Journal of Forensic Medicine and Pathology. Personal details: 59-year old white US male. Single. Antiques dealer
- Bizarre death event: Found dead in his locked apartment. He was seated in front of a dental anaesthetic machine with the anaesthetic face-mask over his face. He was sucking on a rubber teat similar (but much bigger) than a baby’s feeding bottle. There were other anaesthetic machines around the apartment as well as a lot of sexual literature (magazines, photographs, paintings, manuscripts all concerned with his elaborate fetish some of which included photographs of himself in these situations). He was wearing a rubber type apron, three woollen cardigans, a woman’s blouse and two pairs of women’s trousers and a pair of women’s bloomers.
Case 5: Autoerotic death by electrocution
Source: Medicine, Science and the Law. Personal details: 36-year old UK male. Gay (with partner). Unemployed ex-television engineer
- Bizarre death event: Man found dead with a wire cradle applied to his scrotum with another loop of wire (end folded over) inserted into his Vaseline-lubricated anus. The wires were connected to the two terminals that supplied the loudspeaker within the television. When switched on, these wires carried a current of 0.6 amps at 2.2 volts (a quarter of the current needed to light a small torch). The body had two significant injuries. One on the right side of his face (entrance mark of the current), and the other over the left side of his scrotum (where the loop of the wire had been). Unfortunately, one of the wires had broken off resulting in a cessation of the stimulating activity. The man looked inside the back of the open TV set and his face came into contact with an exposed metal cap which zapped 2500 volts through him. The metal cap was the only live part of the television set and it was this that killed him.
(Part 2 can be found here).
Aggrawal A. (2009). Forensic and Medico-legal Aspects of Sexual Crimes and Unusual Sexual Practices. Boca Raton: CRC Press.
Eriksson, A., Gezelius, C., & Bring, G. (1987). Rolled up to death: An unusual autoerotic fatality. American Journal of Forensic Medicine and Pathology, 8(3), 263-265.
Hazelwood, R. R., Burgess, A. W., & Groth, A. N. (1981). Death during dangerous autoerotic practice. Social Science & Medicine. Part E: Medical Psychology, 15(2), 129-133.
Hiss, J., Rosenberg, S. B., & Adelson, L. (1985). ” Swinging in the park”: An investigation of an autoerotic death. American Journal of Forensic Medicine and Pathology, 6(3), 250-255.
Klintschar, M., Grabuschnigg, P., & Beham, A. (1998). Death from electrocution during autoerotic practice: case report and review of the literature. American Journal of Forensic Medicine and Pathology, 19(2), 190-193.
Leadbeatter, S. (1988). Dental anesthetic death: An unusual autoerotic episode. American Journal of Forensic Medicine and Pathology, 9(1), 60-63.
Love, B. (2001). Encyclopedia of Unusual Sex Practices. London: Greenwich Editions.
Minyard, F. (1985). Wrapped to death. Unusual autoerotic death. The American Journal of Forensic Medicine and Pathology, 6(2), 151-152
Rupp, J. C. (1973). The love bug. Journal of Forensic Science, 18(3), 259-262.
Sauvageau, A., & Racette, S. (2006). Autoerotic deaths in the literature from 1954 to 2004: A review. Journal of Forensic Sciences, 51(1), 140-146.
In previous blogs I have looked at pica (i.e., the eating of non-nutritive items or substances) and subtypes of pica such as geophagia (eating of soil, mud, clay, etc.), pagophagia (eating of ice), acuphagia (eating of metal), and coprophagia (eating of faeces). It wasn’t until I started to research on specific sub-types of pica, that I discovered how many different types of non-food substances had been identified in the academic and clinical literature. For instance, Dr. V.J. Louw and colleagues provided a long list in a 2007 issue of the South African Medical Journal including cravings for the heads of burnt matches (cautopyreiophagia), cigarettes and cigarette ashes, paper, starch (amylophagia), crayons, cardboard, stones (lithophagia), mothballs, hair (trichophagia), egg shells, foam rubber, aspirin, coins, vinyl gloves, popcorn (arabositophagia), and baking powder. Most of these are generally thought to be harmless but as Louw and colleagues note, a wide range of medical problems have been documented:
“These include abdominal problems (sometimes necessitating surgery), hypokalaemia, hyperkalaemia, dental injury, napthalene poisoning (in pica for toilet air-freshener blocks), phosphorus poisoning (in pica for burnt matches), peritoneal mesothelioma (geophagia of asbestos-rich soil), mercury poisoning (in paper pica), lead poisoning (in dried paint pica and geophagia), and a pre-eclampsia-like syndrome (baking powder pica)”.
In the clinical literature, the eating of paper has been occasionally documented (although anecdotal evidence suggests this is fairly common and I remember doing it myself as a child). A review paper on pica by Dr. Silvestre Frenk and colleagues in the Mexican journal Boletín Médico del Hospital Infantil de México highlighted dozens of pica-subtypes and created many new names for various pica sub-types. They proposed that people who eat paper display ‘papirophagia’ (in fact if you type ‘papirphagia’ into Google, you only get one hit – the paper by Silvestre and colleagues – although this blog may make it two!). Eating paper is not thought to be particularly harmful although I did find a case of mercury poisoning because of ‘paper pica’ (as the authors – Dr. F. Olynk and Dr. D. Sharpe – called it) in a 1982 issue of the New England Journal of Medicine.
One sub-type of papirophagia is the eating of toilet paper. As far as I am aware, there is only one case study in the literature and this was published back in 1981, Dr. J. Chisholm Jr. and Dr. H. Martín in the Journal of the National Medical Association. They described the case of a 37-year old black woman with an “unusually bizarre craving” for toilet tissue paper. The authors reported that:
“[The] woman was referred for evaluation of disturbed smell and loss of taste for over one year. These were associated with chronic fatigue and listlessness. During this same period of time, she rather embarrassedly admitted to an overwhelming desire to eat toilet tissue. Frequently, she would awaken at night and dash to her bathroom to eat toilet tissue. No other type(s) of pica were admitted. In addition, she gave a long history of menorrhagia and frequently passed vaginal blood clots during her menses. Her libido was normal and there was no history of poor wound healing, skin or mucous membrane lesions, or intestinal symptoms. Her dietary history suggested a high carbohydrate diet, and due to a mild exogenous obesity she intermittently resorted to a vegan-like diet that included beans and various seeds”
A variety of medical tests were carried out and she was diagnosed with combined iron and zinc deficiency. She was treated with iron and zinc tablets and within a week, both her taste and smell had returned, and her energy levels greatly improved. Zinc deficiencies can lead to a wide variety of clinical disorders including loss of small and taste, anorexia, dwarfism (i.e., growth retardation), impaired wound healing, and geophagia. The woman’s (sometimes) vegan diet may have been to blame for her zinc deficiency as the authors noted that:
“Although vegetables contain zinc, vegans should be made aware that zinc from plant sources is not readily absorbed because naturally occurring phytates, particularly high in beans and seeds, reduce zinc gastrointestinal absorption. Carbohydrates are very poor sources of zinc. Chronic iron deficiency secondary to chronic menorrhagia accounts well for the anemia, fatigue, and unusual pica for toilet tissue noted in this patient”.
Paper pica has occasionally been mentioned in other academic papers although details have typically been limited. For instance, a 1995 paper in the journal Birth by Dr. N.R. Cooksey on three cases of pica in pregnancy reported that one of the women chewed non-perfumed blue toilet paper during the first trimester of her pregnancy (and was forced by her mother to stop). There was also a 2003 paper published by Dr. Dumaguing in the Journal of Geriatric Psychiatry and Neurology examining pica in mentally ill geriatrics. One of the cases mentioned was a 76-year old patient that not only ingested their medication (an emollient cream for arthritis) but was also recorded eating toilet paper, napkins, Styrofoam cups, crayons, and other patients’ medications.
A more recent 2008 paper by Dr. Sera Young and her colleagues in the journal PLoS ONE, critically reviewed procedures and guidelines for interviews and sample collection in relation to pica substances. In describing the protocols involved, they referred to paper pica in the questions that should be asked:
“What is the local name, brand name, or type of pica substance desired or consumed? This will help others to know if this substance has already been studied and assist interested researchers in obtaining subsequent samples at a later date. Furthermore, different manufactured products may contain different materials, e.g. Crayola chalkboard chalk contains slightly different ingredients from other brands. Similarly, the consequences of toilet tissue paper consumption are different from those of eating pages of a novel; information would be lost if the substance was simply described as paper. For these reasons, the substance consumed should be described in as much detail and as accurately as possible”.
Personally (and based on anecdotal evidence), I think that papirophagia is not overly rare (especially among children – although I admit this may be more out of curiosity that craving) but the clinical literature suggests that it is a fairly rare disorder found amongst distinct sub-groups (pregnant women, the mentally ill). Given the fact that for most people eating paper would not cause any problems, this would provide the main reason why so few cases end up seeking medical, clinical, and/or psychological help.
Chisholm Jr, J. C., & Martín, H. I. (1981). Hypozincemia, ageusia, dysosmia, and toilet tissue pica. Journal of the National Medical Association, 73(2), 163-164.
Cooksey, N.R. (1995). Pica and olfactory craving of pregnancy: How deep are the secrets? Birth, 22, 129-137.
Dumaguing, N.I., Singh, I., Sethi, M., & Devanand, D.P. (2003). Pica in the geriatric mentally ill: unrelenting and potentially fatal. Journal of Geriatric Psychiatry and Neurology, 16, 189-191.
Frenk, S., Faure, M.A., Nieto, S. & Olivares, Z. (2013). Pica. Boletín Médico del Hospital Infantil de México, 70(1), 55-61
Louw, V.J., Du Preez, P., Malan, A., Van Deventer, L., Van Wyk, D., & Joubert, G. (2007). Pica and food craving in adults with iron deficiency in Bloemfontein, South Africa. South African Medical Journal, 97, 1069-1071.
Olynyk, F., & Sharpe, D. H. (1982). Mercury poisoning in paper pica. The New England Journal of Medicine, 306, 1056 -1057.
Young, S.L., Wilson, M.J., Miller, D., Hillier, S. (2008). Toward a comprehensive approach to the collection and analysis of pica substances, with emphasis on geophagic materials. PLoS ONE, 3(9), e3147. doi:10.1371/journal.pone.0003147
My favourite TV detective has always been Columbo (played by Peter Falk). I have watched every single one of the 69 episodes (as my family will attest) many times. While I am working, I will often have Columbo on in the background in the way that other people have music on in the background (although I do the latter as well). For those reading this that have not come across Columbo, here is a brief synopsis from Wikiquote:
“Columbo (1968, 1971-1978, 1989-2003) was an American crime fiction television show about Lieutenant Columbo, a homicide detective with the Los Angeles Police Department. He uses his deferential and absent-minded persona to lull criminal suspects into a false sense of security, by harassing and pestering suspects non-stop – without letting them know that they’re suspects – under the pretense that he’s simply being a pesky detective, in order to spy on them and agitate them into giving up clues”.
I have asked myself many times why I love the iconic show so much and it’s hard to put my finger on any single reason. One of the things I love about the show is that almost all the episodes are a ‘reverse whodunit’ (often referred to as an ‘open mystery’) in which the viewer knows the identity of the murderer(s) and we watch to see how Lt. Columbo uncovers who the killer or killers are. (I say “almost all” because there are actually a few episodes that are more typical ‘whodunits’ such as 1976’s ‘Last Salute To The Commodore’, 1992’s ‘No Time To Die’ [involving a kidnapping rather than a murder] and 1994’s ‘Undercover’). Another aspect I love is the inherent contradictions in Lt. Columbo’s day-to-day behaviour. His dishevelled clothing (the infamous beaten-up raincoat), his apparently bumbling absent-minded nature, and his habit of going off-topic in conversations, but knowing that he is actually one of the most astute and clever detectives that you are ever likely to meet (he would no-doubt fit the description of the stereotypical ‘absent-minded professor’). As a psychologist I find him fascinating. As an article about Columbo on the Cult TV Lounge rightly notes:
“The emphasis is on the psychological duel between detective and suspect, with (mercifully) no interest in social commentary and few concessions to the ‘realism’ that would become more and more of a fetish in TV cop shows during the course of the 70s. This is pure entertainment and it’s all the better for it”.
And finally, it is Lt. Columbo’s brilliant trademark ‘false exits’ that wrongfoot all the murderers. After most informal interrogations with the murderer, Columbo leaves the scene, only to return a few seconds later with the opening gambit of “there’s just one more thing” (or a variant of the phrase) only for it to be the most important question that he “forgot to ask”. As an obituary at the In The Dark website on Peter Falk noted:
“The more trivial the “thing” is, the more damning it proves. As an application of psychology, it’s a superb tactic and it slowly but surely grinds down the criminal’s resistance. Often the murderer’s exasperation at Columbo’s relentless badgering leads to rash actions and errors; the second murder, if there is one, is never as carefully planned as the first”.
As the selected (emboldened) quotes above show, psychology is an integral part of Columbo’s appeal. I was also surprised to find that clinical psychologists and forensic psychologists have used Lt. Columbo’s modus operandi in their day-to-day work. (In fact, even some writers claim that if you want to be a better writer you should watch Columbo according to an article by Shahan Mufti in the New York Times; also, a number of marketing gurus claim that Lt. Columbo can teach marketers a thing or two – check out ‘10 things marketeers can learn from Columbo’). For instance, in an article on motivational interviewing (MI) via the Australian Mental Health Academy describe the ‘Columbo approach’:
“Proponents of motivational interviewing owe a debt of gratitude to the 1970s television series Columbo…[Columbo] was a master of the skill of ‘deploying discrepancies’, and MI therapists/practitioners can use the same skill to get clients to help them make sense of their (the clients’) discrepancies. With the Columbo approach, an interviewer makes a curious enquiry about discrepant behaviours without being judgmental or blaming. In a non-confrontational manner, information that is contradictory is juxtaposed, allowing the therapist to address discrepancies between what clients say and their behaviour without evoking defensiveness or resistance. Wherever possible when deploying discrepancies, practitioners are encouraged to end the reflection on the side of change, as clients are more likely to elaborate on the last part of the statements”
The article then goes on to explicitly describe specific MI interventions using the ‘Columbo approach’. Another online article by Greg Lhamon (‘A simple trick to make a powerful last impression’) describes the ‘Columbo Technique’. Here is an abridged version:
“One way in which you can leave someone with a powerful last impression is to use…“the Columbo Technique”…named after the lovable yet shrewd TV detective from the 1970s…He was unassuming and appeared almost absent-minded as he questioned a murder suspect. Yet his seemingly random line of questioning was the process by which he built an airtight case against the suspect. At the conclusion of every interview, he did something unique: he’d thank the suspect profusely, step toward the door, stop, and then turn back, and say, “Oh, just one more thing.” Then he’d ask one last question, a particularly damning question that let the suspect know that Lieutenant Columbo was onto him. Like every form of good communication, sincerity is critical. It cannot be contrived. The goal is simply to make a strong, memorable point, not to manipulate someone. The process is simple: (1) hold back a critical piece of information and reserve it for the end of the meeting, (2) right before you part company, share the information or ask a question, and (3) enjoy the response you receive”.
A 2009 article in the American Bar Association Journal reported that the best way to interrogate a suspect is to ‘Think Columbo’. The advice given was that police should focus on what suspects say rather than their behaviour (such as fidgeting, sweating, and averting eyes during an interview). After reviewing interrogation tapes, Professor Ray Bull, a British forensic psychologist told the Times newspaper that British police use an investigative interviewing technique:
“These interviews sound much more like a chat in a bar. It’s a lot like the old Columbo show, you know, where he pretends to be an idiot but he’s gathered a lot of evidence.”
The ABA article also included comments from American psychologist Kevin Colwell, who said that suspects that lie in police interviews “often prepare a script that doesn’t have much detail”. Colwell recommended using interview techniques where the individual undergoing questioning should talk about the event in question more than once “adding details in retelling the event about things such as sounds and smells” and asking the person “to recall the event in reverse” and that:
“Those who tell the truth tend to add 20% to 30% more external detail than do those who are lying. Those who are adept at lying may start to feel more strain if the interviewer introduces evidence throughout the questioning that has been previously uncovered. Detective Columbo, it turns out, was not just made for TV”.
Another reason I love Columbo because a number of episodes featured psychologists and/or psychiatrists as the killer, most of who used their psychological expertise to carry out an ingenious murder. This included the episodes ‘Prescription Murder’ (1968 – the first ever episode; Dr. Ray Flemming who uses his high intelligence rather than his psychiatric expertise to murder his wife), ‘Double Exposure’ (1973; Dr. Bart Kepple, a consumer psychologist who uses subliminal advertising to lure his victim to be killed), ‘A Deadly State Of Mind’ (1975; Dr. Marcus Collier, a psychiatrist who uses hypnosis to make his victim jump from a high rise apartment), ‘How To Dial A Murder’ (1978; Dr. Eric Mason, a behavioural psychologist who uses classical conditioning to train his dogs to kill his victim), and ‘Sex And The Married Detective’ (1998; Dr. Joan Allenby, a sex therapist who uses her knowledge of psychosexual roleplay to ensnare and kill her lover). In one episode (‘How To Dial A Murder’), Columbo and the psychologist Dr. Eric Mason have an interesting exchange:
Dr. Eric Mason: You’re a fascinating man, Lieutenant. Columbo: To a psychologist, sir? Dr. Eric Mason: You pass yourself off as a puppy in a raincoat happily running around the yard digging holes all up in the garden, only you’re laying a mine field and wagging your tail.
As an ex-Professor of Gambling Studies, another aspect that I have noticed is how many episodes of Columbo feature gamblers and gambling that are often integral to the storyline. Gambling is a key feature in the episodes ‘Double Shock’ (1973; the murderer Norman Paris, a banker, is featured at a Las Vegas casino running up gambling debts), ‘A Friend in Deed’ (1974; the murderer Mark Halperin, a deputy police commissioner, is shown in his opening scene to be a regular casino gambler), ‘Uneasy Lies The Crown’ (1990; the murderer, Dr. Wesley Corman is a dentist and a compulsive gambler), ‘Death Hits The Jackpot’ (1991; photographer and murder victim Freddy Brower wins a $30 million on the lottery and is killed by his uncle Leon Lamarr), ‘A Bird In The Hand’ (1992; would-be murderer Harold McCain, a compulsive gambler tries to murder his millionaire uncle, owner of a US football team), ‘All in The Game’ (1993; murder victim Nick Franco is a playboy and high stakes poker player killed by his lover Laura Staton), and ‘Strange Bedfellows’ (1995; Randy McVeigh the murder victim owes money for gambling debts to the Mafia and is killed by his brother Graham who has ‘inherited’ his brother’s debt).
In another episode (‘Troubled Waters’, 1975), it turns out that the killer (Hayden Danzinger, an autocar executive) is also a regular casino gambler but this only comes to light late in the episode when Lt. Columbo talks to his wife (Sylvia Danzinger). Here we learn that Lt. Columbo thinks about slot machines:
Columbo: You see that fellow over there playing the slot machines? Waste of money. I’ve played it 44 times. I won once right at the beginning and I never won again. Sylvia Danzinger: You can’t beat ‘em. I don’t even try. Columbo: You’re not a gambler? Sylvia Danzinger: No, I prefer more quiet activities. Columbo: That’s funny. I was under the impression you and your husband went to Las Vegas quite a few times. Sylvia Danzinger: Oh, no. Hayden goes often but without me. I wouldn’t be caught dead there.
I’ve often wondered if gambling was an important issue (positive or negative) for Peter Falk in his private life, because when he wasn’t playing Lt. Columbo, it wasn’t unusual for him to be in gambling-related acting roles. Most notably, he played an ageing bookmaker Vinnie in the 1988 film Money Kings (also known under the title Vig, a film about the illegal world of gambling), and the 1988 film Pronto he played Harry Arno, a sports bookmaker who stole money from the local mafia boss Jimmy Capatorto. He also played the poker player Waller in a 1960 episode of Have Gun – Will Travel (‘Poker Fiend‘), and in the 1970 film Husbands he played Archie Black, one of three men undergoing mid-life crises following the death of their friend who then who all go to Europe to gamble, drink, and womanise.
If you’ve got this far, I’ll just leave you with the answers to a couple of my favourite Columbo trivia questions. The most asked question concerning Lt. Columbo (like Inspector Morse) is what was his first name. (When asked the same question in the series itself, Columbo would answer ‘Lieutenant’!). Lt. Columbo never once revealed his first name verbally in the series but did once flash his police badge in an early episode (‘Dead Weight’; Episode 3, Series 1) and accidentally revealed his name was Frank. The second most asked question is how Peter Falk lost his eye. Falk had his eye removed at the age of three years (due to cancer) and had a glass eye for the rest of his life. Although Falk had a glass eye, fans debated for years whether Lt. Columbo had only one eye. The answer was revealed in the 25th anniversary episode (‘A Trace of Murder’) when Lt. Columbo asked the murderer (Patrick Kinsley, a forensic expert) to look at something with him because “three eyes are better than one”!
Burns, S. (2016). The Columbo Episode Guide. Located at: http://www.columbo-site.freeuk.com/episode.htm
Changing Minds (2013). The Columbo Technique. Located at: http://changingminds.org/techniques/questioning/columbo_technique.htm
Dawidziak, M. (1989). The Columbo Phile. Mysterious Press.
D For Doom (2015). Columbo, Season 1 (1971). Cult TV Lounge, July 3. Located at: http://cult-tv-lounge.blogspot.co.uk/2015/07/columbo-season-one-1971.html
Haynes, N. (2012). Guide to TV detectives: No.1. The Guardian, January 23. Located at: https://www.theguardian.com/tv-and-radio/tvandradioblog/2012/jan/23/natalie-haynes-detectives-columbo
Henley, J. (2013). 10 things marketeers can learn from Columbo – yes, Columbo. Rock The Deadline, November 24. Located at: http://rockthedeadline.com/blog/content-marketing/10-things-marketers-can-learn-from-columbo-yes-columbo/
Mental Health Academy (2015). Principles and techniques of motivational interviewing. January 12. Located at: http://www.aipc.net.au/articles/principles-and-techniques-of-motivational-interviewing/
Mufti, S. (2013). Want to write better? Watch Columbo. New York Times (The 6th Floor), September 25. Located at: http://6thfloor.blogs.nytimes.com/2013/09/25/want-to-write-better-watch-columbo/?_r=2
Telescoper (2011). In memorium: Peter Falk (1927-2011). In The Dark, https://telescoper.wordpress.com/2011/06/25/in-memoriam-peter-falk-1927-2011/
Weiss, D.C. (2009). The best way to interrogate: Think Columbo. American Bar Association, May 12. Located at: http://www.abajournal.com/news/article/the_best_way_to_interrogate_think_columbo/
Wikipedia (2016). Columbo. Located at: https://en.wikipedia.org/wiki/Columbo
Wikipedia (2016). List of Columbo episodes. Located at: https://en.wikipedia.org/wiki/List_of_Columbo_episodes
Wikipedia (2016). Peter Falk. Located at: https://en.wikipedia.org/wiki/Peter_Falk
Wikiquote (2016). Columbo. Located at: https://en.wikiquote.org/wiki/Columbo
The nine people murdered in Munich a couple of days ago by 18-year-old German-Iranian gunman David Ali Sonboly made headlines around the world. It has been claimed that Sonboly (who subsequently killed himself) was “obsessed with mass shootings” and that the police found lots of material in his room about mass killings including the massacre by Norway’s Anders Behring Breivik. Whether the murders by Sonboly are ‘copycat’ killings remains to be determined but there are dozens of other cases where copycat killings have been proven.
Back in 2014, the gruesome killing of two prostitutes in Hong King by British banking trader Rurik Jutting drew comparisons with the fictional character Patrick Bateman, the Wall Street investment banker and serial killer in the film American Psycho (based on the Bret Easton Ellis book of the same name).
As you might expect, a copycat murder is defined as a murder that has been modelled, motivated and/or inspired either by a real life murderer that has been reported by the print or broadcast media, or is based on a murderer portrayed in books, television or film. The term ‘copycat killer’ has been in use for almost 100 years and was first used in relation to murders that mimicked those of Jack the Ripper. Early research by criminologists began to speculate that the sensationalist publicity in the print media about the Ripper murders was the inspiration for Ripper-like copycat killings.
In addition to murder, copycat crimes have been shown to occur in many other equally destructive acts including suicides, murder-suicides, familicides, and rampage killings. Arguably the most well known writing on the topic was Loren Coleman’s 2004 book The Copycat Effect. Coleman believes that because shocking crimes receive widespread media publicity it makes the perpetrators infamous. He argues that the notoriety and ‘fame’ that serial killers receive is one of the main reasons why copycats commit similar crimes. Put more simply, copycats may believe that by committing heinous crimes, they may end up being the subject of a book or film themselves. The Copycat Effect is so well known that it was even the subject of a Hollywood film – the 1995 psychological thriller Copycat starring Sigourney Weaver as a criminal psychologist involved in a case where each murder in the film is made by a serial killer meticulously copying previous high profile murderers such as Ted Bundy, Jeffrey Dahmer (the ‘Milwaukie Cannibal’), David Berkowitz (the ‘Son of Sam’), and the Hillside Strangler (actually two men, Kenneth Bianchi and Angelo Buono).
But is the media to blame for copycat murders? Well, partly – but not totally. Research has shown that although most people convicted of copycat murders admit to being motivated by something they had seen on the news or in a film, they already had a criminal record (often violent crime) and/or were mentally ill before they began killing. What this suggests is that media coverage and fictionalized accounts of serial killers tend to affect those that already have a criminal predisposition and/or mental health issues rather than have a more widespread effect on people more generally. In such extreme and minority cases, it does appear that watching or reading about high profile murderers (e.g., Jeffrey Dahmer, Ed Gein) or infamous fictionalised killers (e.g., Dexter Morgan in Dexter or Patrick Batemen in American Psycho) does at the very least give emotionally undeveloped people ideas on how they could kill someone.
Copycat murderers do appear to realise that the more shocking and heinous the killing, the more newsworthy it will be. This also appears to have had an impact on films too. It appears some cinema-going audience want to see more depraved, deranged and twisted ways in which people can be killed (as evidenced by the so-called ‘torture porn’ franchises of Saw and Hostel). The more blood and pain, the better. Methods to kill in such films may be the inspiration of copycat killers to come.
Although there is a relationship between copycat killers and what they have seen or read about in the media, there are many other risk factors that have been associated with (and have an interplay with) copycat killings. Men are more likely to be copycat killers than females, and many copycat killers are young adults (below the age of 30 years). Copycat killers are more likely to suffer from personality (and other mental health) disorders, come from socially dysfunctional and alienating family backgrounds, be emotionally vulnerable, be trusting of the media, and – as noted above – a previous criminal history (as well as self-identifying with criminals they have watched or seen in fact and/or fiction).
Psychologists have also noted there appears to be a natural human inhibition against killing (even in acts of lawful killing such as fighting in a war). However, if individuals adopt some kind of a persona, such inhibitions can be reduced (often referred to by psychologists as ‘depersonalization’). If copycat killers temporarily take on the persona of the person they are copying in addition to the act of killing, this may also play a contributory role in some of their actions. American evolutionary psychologist Dr.Nigel Barber has also noted in relation to rampage killing that: “Most copycats have their private agenda in a rampage killing but seek to tie it in to other events that received a lot of publicity. In this way, they bask in the reflected publicity, so to speak. In many cases, the rampage killer wants to commit suicide but opts to take others with him”.
Although there are many reasons as to how and why an individual becomes a copycat killer, the evidence does seem to suggest that the media perhaps need to take a more cautionary approach when reporting the details of murders, and also suggests that the police and other criminal agencies should not go into every detail about how the murders were committed. Such actions alone will not stop copycat killings, but it may help reduce the overall number occurring in the first place.
(Material in this blog first appeared in an article I wrote for The Independent in November 2014 – see ‘Further reading’ below)
Barber, N. (2012). Copycat killings: Making sense of the senseless. Psychology Today, July 27. Located at: https://www.psychologytoday.com/blog/the-human-beast/201207/copycat-killings
Boyle, K. (2001). What’s natural about killing? Gender, copycat violence and Natural Born Killers. Journal of Gender Studies, 10(3), 311-321.
Coleman, L. (2004). The copycat effect: How the media and popular culture trigger the mayhem in tomorrow’s headlines. New York: Simon and Schuster.
Fox, J.A., & Levin, J. (2014). Extreme killing: Understanding serial and mass murder. London: Sage.
Griffiths, M.D. (2014). Hong Kong murder: Why do people commit copycat killings? The Independent, November 4. Located at: http://www.independent.co.uk/life-style/health-and-families/features/hong-kong-murder-why-do-people-commit-copycat-killings-9838892.html
Kunich, J.C. (2000). Natural born copycat killers and the law of shock torts. Washington University Law Quarterly, 78(4), 1157-1270.
Surette, R. (2002). Self-reported copycat crime among a population of serious and violent juvenile offenders. Crime and Delinquency, 48(1), 46-69.
Wikipedia (2016). Copycat crime. Located at: https://en.wikipedia.org/wiki/Copycat_crime
Following my recent blogs where I outlined some of the papers that my colleagues and I have published on mindfulness, Internet addiction, gaming addiction, sex addiction, responsible gambling, shopping addiction, exercise addiction, and youth gambling, here is a round-up of papers that my colleagues and I have published on workaholism and work addiction over the last few years.
Andreassen, C.S., Griffiths, M.D., Hetland, J. & Pallesen, S. (2012). Development of a Work Addiction Scale. Scandinavian Journal of Psychology, 53, 265-272.
- Research into excessive work has gained increasing attention over the last 20 years. Terms such as “workaholism,””work addiction” and “excessive work” have been used interchangeably. Given the increase in empirical research, this study presents the development of the Bergen Work Addiction Scale (BWAS), a new psychometrically validated scale for the assessment of work addiction. A pool of 14 items, with two reflecting each of seven core elements of addiction (i.e., salience, mood modification, tolerance, withdrawal, conflict, relapse, and problems) was initially constructed. The items were then administered to two samples, one recruited by a web survey following a television broadcast about workaholism (n=11,769) and one comprising participants in the second wave of a longitudinal internet-based survey about working life (n=368). The items with the highest corrected item-total correlation from within each of the seven addiction elements were retained in the final scale. The assumed one-factor solution of the refined seven-item scale was acceptable (root mean square error of approximation=0.077, Comparative Fit Index=0.96, Tucker-Lewis Index=0.95) and the internal reliability of the two samples were 0.84 and 0.80, respectively. The scores of the BWAS converged with scores on other workaholism scales, except for a Work Enjoyment subscale. A suggested cut-off for categorization of workaholics showed good discriminative ability in terms of working hours, leadership position, and subjective health complaints. It is concluded that the BWAS has good psychometric properties.
Andreassen, C.S., Griffiths, M.D., Hetland, J., Kravina, L., Jensen, F., & Pallesen, S. (2014). The prevalence of workaholism: A survey study in a nationally representative sample of Norwegian employees. PLoS ONE, 9(8): e102446. doi:10.1371/journal.pone.0102446.
- Workaholism has become an increasingly popular area for empirical study. However, most studies examining the prevalence of workaholism have used non-representative samples and measures with poorly defined cut-off scores. To overcome these methodological limitations, a nationally representative survey among employees in Norway (N = 1,124) was conducted. Questions relating to gender, age, marital status, caretaker responsibility for children, percentage of full-time equivalent, and educational level were asked. Workaholism was assessed by the use of a psychometrically validated instrument (i.e., Bergen Work Addiction Scale). Personality was assessed using the Mini-International Personality Item Pool. Results showed that the prevalence of workaholism was 8.3% (95% CI= 6.7–9.9%). An adjusted logistic regression analysis showed that workaholism was negatively related to age and positively related to the personality dimensions agreeableness, neuroticism, and intellect/imagination. Implications for these findings are discussed.
Quinones, C. & Griffiths, M.D. (2015). Addiction to work: recommendations for assessment. Journal of Psychosocial Nursing and Mental Health Services, 10, 48-59.
- Workaholism was first conceptualized in the early 1970s as a behavioral addiction, featuring compulsive use and interpersonal conflict. The current article briefly examines the empirical and theoretical literature over the past four decades. In relation to conceptualization and measurement, how the concept of workaholism has worsened from using dimensions based on anecdotal evidence, ad-hoc measures with weak theoretical foundation, and poor factorial validity of multidimensional conceptualizations is highlighted. Benefits of building on the addiction literature to conceptualize workaholism are presented (including the only instrument that has used core addiction criteria: the Bergen Work Addiction Scale). Problems estimating accurate prevalence estimates of work addiction are also presented. Individual and sociocultural risk factors, and the negative consequences of workaholism from the addiction perspective (e.g., depression, burnout, poor health, life dissatisfaction, family/relationship problems) are discussed. The current article summarizes how current research can be used to evaluate workaholism by psychiatric–mental health nurses in clinical practice, including primary care and mental health settings.
Karanika-Murray, M., Pontes, H.M., Griffiths, M.D. & Biron, C. (2015). Sickness presenteeism determines job satisfaction via affective-motivational states. Social Science and Medicine, 139, 100-106.
- Introduction: Research on the consequences of sickness presenteeism, or the phenomenon of attending work whilst ill, has focused predominantly on identifying its economic, health, and absenteeism outcomes, in the process neglecting important attitudinal-motivational outcomes. Purpose: A mediation model of sickness presenteeism as a determinant of job satisfaction via affective-motivational states (specifically engagement with work and addiction to work) is proposed. This model adds to the current literature, by focussing on (i) job satisfaction as an outcome of presenteeism, and (ii) the psychological processes associated with this. It posits sickness presenteeism as psychological absence and work engagement and work addiction as motivational states that originate in that. Methods: An online survey on sickness presenteeism, work engagement, work addiction, and job satisfaction was completed by 158 office workers. Results: The results of bootstrapped mediation analysis with observable variables supported the model. Sickness presenteeism was negatively associated with job satisfaction. This relationship was fully mediated by both engagement with work and addiction to work, explaining a total of 48.07% of the variance in job satisfaction. Despite the small sample, the data provide preliminary support for the model. Conclusions: Given that there is currently no available research on the attitudinal consequences of sickness presenteeism, these findings offer promise for advancing theorising in this area.
Quinones, C., Griffiths, M.D. & Kakabadse, N. (2016). Compulsive Internet use and workaholism: An exploratory two-wave longitudinal study. Computers in Human Behavior, 60, 492-499.
- Workaholism refers to the uncontrollable need to work and comprises working compulsively (WC) and working excessively (WE). Compulsive Internet Use (CIU), involves a similar behavioural pattern although in specific relation to Internet use. Since many occupations rely upon use of the Internet, and the lines between home and the workplace have become increasingly blurred, a self-reinforcing pattern of workaholism and CIU could develop from those vulnerable to one or the other. The present study explored the relationship between these compulsive behaviours utilizing a two-wave longitudinal study over six months. A total of 244 participants who used the Internet as part of their occupational role and were in full-time employment completed the online survey at each wave. This survey contained previously validated measures of each variable. Data were analysed using cross-lagged analysis. Results indicated that Internet usage and CIU were reciprocally related, supporting the existence of tolerance in CIU. It was also found that CIU at Time 1 predicted WC at Time 2 and that WE was unrelated to CIU. It is concluded that a masking mechanism appears a sensible explanation for the findings. Although further studies are needed, these findings encourage a more holistic evaluation and treatment of compulsive behaviours.
Orosz, G., Dombi, E., Andreassen, C.S., Griffiths, M.D. & Demetrovics, Z. (2016). Analyzing models of work addiction: Single factor and bi-factor models of the Bergen Work Addiction Scale. International Journal of Mental Health and Addiction, in press.
- Work addiction (‘workaholism’) has become an increasingly studied topic in the behavioral addictions literature and had led to the development of a number of instruments to assess it. One such instrument is the Bergen Work Addiction Scale (BWAS). However, the BWAS has never been investigated in Eastern-European countries. The goal of the present study was to examine the factor structure, the reliability and cut-off scores of the BWAS in a comprehensive Hungarian sample. This study is a direct extension of the original validation of BWAS by providing results on the basis of representative data and the development of appropriate cut-off scores. The study utilized an online questionnaire with a Hungarian representative sample including 500 respondents (F = 251; Mage = 35.05 years) who completed the BWAS. A series of confirmatory factor analyses were carried out leading to a short, 7-item first-order factor structure and a longer 14-item seven-factor nested structure. Despite the good validity of the longer version, its reliability was not as high as it could have been. One-fifth (20.6 %) of the Hungarians who used the internet at least weekly were categorized as work addicts using the BWAS. It is recommended that researchers use the original seven items from the Norwegian scale in order to facilitate and stimulate cross-national research on addiction to work.
Andreassen, C.S., Griffiths, M.D., Sinha, R., Hetland, J. & Pallesen, S. (2016). The relationships between workaholism and symptoms of psychiatric disorders: A large-scale cross-sectional study. PLoS ONE, 11(5): e0152978. doi:10.1371/journal. pone.0152978.
- Despite the many number of workaholism studies, large-scale studies have been lacking. The present study utilized an open web-based cross-sectional survey assessing symptoms of psychiatric disorders and workaholism among 16,426 workers (Mage=37.3 years, SD=11.4, range=16-75 years). Participants were administered the Adult ADHD Self-Report Scale, the Obsession-Compulsive Inventory-Revised, the Hospital Anxiety and Depression Scale, and the Bergen Work Addiction Scale, along with additional questions examining demographic and work-related variables. Analyses of variance revealed significant workaholism group differences in terms of age, marital status, education, professional position, work sector, occupation, and annual income. No gender differences were found, except in a logistic regression analysis, indicating that women had a greater risk than men of being categorized as workaholics. Correlations between all psychiatric symptoms and workaholism were significant and positively correlated. Workaholism comprised the dependent variable in a four-step linear multiple hierarchical regression analysis as well as in a logistic regression analysis. In the linear regression analysis demographics (age, gender, and marital status) explained 0.8% of the variance in workaholism. The mental health variables (ADHD, OCD, anxiety, and depression) explained between 1.9% and 11.9% of the variance. In an adjusted logistic regression analysis, all psychiatric symptoms were positively associated with workaholism. Although most effect sizes were relatively small, the study’s findings expand our understanding of possible mental health predictors of workaholism, and sheds new light on the reality of adult ADHD in work life. The study’s implications, strengths, and shortcomings are also discussed.
Griffiths, M.D. (2005). Workaholism is still a useful construct Addiction Research and Theory, 13, 97-100.
Griffiths, M.D. (2011). Workaholism: A 21st century addiction. The Psychologist: Bulletin of the British Psychological Society, 24, 740-744.
Griffiths, M.D. & Karanika-Murray, M. (2012). Contextualising over-engagement in work: Towards a more global understanding of workaholism as an addiction. Journal of Behavioral Addictions, 1(3), 87-95.
Karanika-Murray, M., Duncan, N., Pontes, H. & Griffiths, M.D. (2015). Organizational identification, work engagement, and job satisfaction. Journal of Managerial Psychology, 30, 1019-1033.
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.
A few days ago, I was interviewed by the Irish newspaper The Journal about someone deliberately trying to poison a dog by throwing three rat poison-stuffed chorizo sausages into Linda O’Byrne’s garden. But what typically possesses anyone to inflict such acts of intentional animal torture and cruelty (IATC)? In this particular case it may have been done as an act of revenge or as a way to shock O’Byrne to the amusement of the person who did it.
In addition to these reasons, rhere are many types of IATC including individuals that do it (i) as a religious ritual sacrifice, (ii) as an ‘artistic’ sacrifice (e.g., killing animals in films such as the controversial Cannibal Holocaust), (iii) because they have psychological disorders (such as anti-social/psychopathic personality disorders and engage in deliberate acts of zoosadism), and/or (iv) because they have sexually paraphilic disorders (such as crush fetishism in which small animals are crushed for sexual pleasure). Additionally, there is some research showing that in some circumstances, IATC is sometimes used to coerce, control and intimidate women and/or children to be silent about domestic abuse within the home. Although any animal torture is shocking, arguably the most disturbing type of IATC is that which occurs amongst those with anti-social personality disorders.
When the science of behavioural profiling began to emerge in the 1970s, one of the most consistent findings reported by the FBI profiling unit was that childhood IATC appeared to be a common behaviour among serial murderers and rapists (i.e., those with psychopathic traits characterized by impulsivity, selfishness, and lack of remorse). Many notorious serial killers – such as Jeffrey Dahmer – began by torturing and killing animals in their childhood. Dahmer also collected animal roadkill, dissected the remains, and masturbated over the animals he had cut up. Other killers known to have engaged in childhood IATC include child murderer Mary Bell (who throttled pigeons), Jamie Bulger’s murderer Robert Thompson who (who was cruel to household pets), and Moors murderer Ian Brady (who abused animals).
IATC is one of the three adolescent behaviours in what is often referred to the ‘Homicidal Triad’ (the other two being persistent bedwetting and obsessive fire-setting). Some criminologists and psychologists believe that the combination of two or more of these three behaviours increases the risk of homicidal behaviour in adult life. However, scientific evidence for this has been mixed. There has also been research into some of the contributory factors as to why a minority of children engage in IATC. Research has shown that the behaviours in the ‘Homicidal Triad’ (including IATC) are often associated with parental abuse, parental brutality (and witnessing domestic violence), and/or parental neglect.
A number of criminological studies have shown that around a third to a half of all sexual murderers have abused animals during childhood and/or adolescence (although I ought to add that sample sizes in most of these published studies are usually relatively small). However, most research has reported that one of the most important ‘warning signs’ and risk factors (specifically relating to the propensity for sex offending), is animal cruelty if accompanied by a sexual interest in animals. Other researchers have speculated that the zoosadistic acts among male adolescents may be connected to problems of puberty and proving virility.
Another ‘triad’ of psychological factors that have been associated with IATC are three specific characteristics of personality – Machiavellianism, narcissism, and psychopathy (the so-called ‘Dark Triad’). Studies carried out by Dr. Phillip Kavanagh and his colleagues have examined the relationship between the three Dark Triad personality traits and attitudes towards animal abuse and self-reported acts of animal cruelty. They found that the psychopathy trait is related to intentionally hurting or torturing animals, and was also a composite measure of all three Dark Triad traits.
In Germany, there have been an increasing number of violent crimes against horses. This offence of ‘horse ripping’ (i.e., violently cutting, slashing and/or stabbing of horses) has been accepted as a criminal phenomenon in Germany and has led to a number of studies on the topic. Horse ripping has been defined as a destructive act “with the aim to harm a horse or the acceptance of a possible injury of a horse, especially killing, maltreatment, mutilation and sexual abuse in sadomasochistic context”. In 2002, German researchers Dr, Claus Bartmann and Dr. Peter Wohlsein reported a study examining 193 traumatic horse injuries over a four-year period. They reported that at least ten of the injuries (including wounds from knives, spears, and guns) were acts of zoosadism.
There is no easy solution to childhood IATC. Given that most children learn anti-social behaviour from those around them, the best way to prevent it is teaching by example. Here, parents are the key. Pro-social behaviour by parents and other role models towards animals (such as rescuing spiders in the bath, feeding birds, treating pets as a member of the family) has the potential to make a positive lasting impression on children.
Note: A version of this article was first published in The Independent.
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I’ve been working in the area of gambling for nearly 30 years and over the past 15 years I have carrying out research into both online gambling and responsible gambling. As I have outlined in previous blogs, one of the new methods I have been using in my published papers is online behavioural tracking. The chance to carry out innovative research in both areas using a new methodology was highly appealing – especially as I have used so many other methods in my gambling research (including online and offline surveys, experiments in laboratories and ecologically valid settings, offline focus groups, online and offline case study interviews, participant and non-participation observation, secondary analysis of survey data, and analysis of various forms of online data such as those found in online forums and online diary blogs).
Over the last decade there has been a big push by gambling regulators for gambling operators to be more socially responsible towards its clientele and this has led to the use of many different responsible gambling (RG) tools and initiatives such as voluntary self-exclusion schemes (where gamblers can ban themselves from gambling), limit setting (where gamblers can choose how much time and/or money they want to lose while gambling), personalized feedback (where gamblers can get personal feedback and advice based on their actual gambling behaviour) and pop-up messages (where gamblers receive a pop-up message during play that informs them how long they have been playing or how much money that have spent during the session).
However, very little is known about whether these RG tools and initiatives actually work, and most of the research that has been published relies on laboratory methods and self-reports – both of which have problems as reliable methods when it comes to evaluating whether RG tools work. Laboratory experiments typically contain very few participants and are carried out in non-ecologically valid settings, and self-reports are prone to many biases (including social desirability and recall biases). Additionally, the sample sizes are also relatively small (although bigger than experiments).
The datasets to analyse player behaviour are huge and can include hundreds of thousands of online gamblers. Given that my first empirical paper on gambling published in the Journal of Gambling Studies in 1990 was a participant observational analysis of eight slot machine gamblers at one British amusement arcade, it is extraordinary to think that decades later I have access to datasets beyond anything I could have imagined back in the 1980s when I began my research career. The data analysis is carried with my research colleague Michael Auer who has a specific expertise in data mining and we use traditional statistical tests to analyse the data. However, the hardest part is always trying to work out which parameters to use in assessing whether the RG tool worked or not. The kind of data we have includes how much time and money that players are spending on the gambling website, and using that data we can assess to what extent the amount of time and money decreases as a result of using limit setting measures, or receiving personalized feedback or a pop-up message.
One of the biggest problems in doing this type of research in the gambling studies field is getting access to the data in the first place and the associated issue of whether academics should be working with the gambling industry in the first place. The bottom line is that we would never have been able to undertake this kind of innovative research with participant sizes of hundreds of thousands of real gamblers without working in co-operation with the gambling industry. (It should also be noted that the gambling companies in question did not fund the research but provided simply provided access to their databases and customers). In fact, I would go as far as to say the research would have been impossible without gambling industry co-operation. Data access provided by the gambling industry has to be one of the key ways forward if the field is to progress.
Unlike other consumptive and potentially addictive behaviours (smoking cigarettes, drinking alcohol, etc.), researchers can study real-time gambling (and other potentially addictive behaviours like video gaming and social networking) in a way that just cannot be done in other chemical and behavioural addictions (e.g., sex, exercise, work, etc.) because of online and/or card-based technologies (such as loyalty cards and player cards). There is no equivalent of this is the tobacco or alcohol industry, and is one of the reasons why researchers in the gambling field are beginning to liaise and/or collaborate with gambling operators. As researchers, we should always strive to improve our theories and models and it appears strange to neglect this purely objective information simply because it involves working together with the gambling industry. This is especially important given the recent research by Dr. Julia Braverman and colleagues published in the journal Psychological Assessment using data from gamblers on the bwin website showing that self-recollected information does not match with objective behavioural tracking data.
The great thing about online behavioural tracking data collected from gamblers is that it is totally objective (as it provides a true record of what every gambler does click-by-click), is collected from real world gambling websites (so is ecologically valid), and has large sample sizes (typically tens of thousands of online gamblers). There of course some disadvantages, the main ones being that the sample is unrepresentative of all online gamblers (as the data only comes from gamblers at one website) and nothing is known about the person’s gambling activity at other websites (research has shown that online gamblers typically gamble at a number of different websites and not just one). Despite these limitations, the analysis of behavioural tracking data (so-called ‘big data’) is a reliable and cutting-edge way to assess and evaluate online gambling behaviour and to assess whether RG tools actually work in real world gambling settings with real online gamblers in real time.
To get access to such data you have to cultivate a trusting relationship with the data providers. It took me years to build up trust with the gambling industry because researchers who study problem gambling are often perceived by the gambling industry to be ‘anti-gambling’ but in my case this wasn’t true. I am ‘pro-responsible gambling’ and gamble myself so it would be hypocritical to be anti-gambling. My main aim in my gambling research is to protect players and minimise harm. Problem gambling will never be totally eliminated but it can be minimised. If gambling companies share the same aim and philosophy of not wanting to make money from problem gamblers but to make money from non-problem gamblers, then I would be prepared to help and collaborate.
You also need to be thick-skinned. If you are analysing any behavioural tracking data provided by the gambling industry, then you need to be prepared for others in the field criticizing you for working in collaboration with the industry. Although none of this research is funded by the industry, the fact that you are collaborating is enough for some people to accuse you of not being independent and/or being in the pockets of the gambling industry. Neither of these are true but it won’t stop the criticism. Nor will it stop me from carrying on researching in this area using datasets provided by the gambling industry.
Dr. Mark Griffiths, Professor of Gambling Studies, International Gaming Research Unit, Nottingham Trent University, Nottingham, UK
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Auer, M., Littler, A. & Griffiths, M.D. (2015). Legal aspects of responsible gaming pre-commitment and personal feedback initiatives. Gaming Law Review and Economics, 6, 444-456.
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Auer, M., Schneeberger, A. & Griffiths, M.D. (2012). Theoretical loss and gambling intensity: A simulation study. Gaming Law Review and Economics, 16, 269-273.
Braverman, J., Tom, M., & Shaffer, H. J. (2014). Accuracy of self-reported versus actual online gambling wins and losses. Psychological Assessment, 26, 865-877.
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Griffiths, M.D. & Auer, M. (2015). Research funding in gambling studies: Some further observations. International Gambling Studies, 15, 15-19.