Category Archives: Psychiatry

Imitate modern: Why do people commit copycat killings?

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)

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

Further reading

Barber, N. (2012). Copycat killings: Making sense of the senseless. Psychology Today, July 27. Located at:

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:

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:

More term warfare: Is the concept of ‘internet addiction’ a misnomer?

A recent study by Professor Phil Reed and his colleagues published in the Journal of Clinical Psychiatry provided some experimental evidence that internet addicts may be conditioned by what they view on the screen. Given that I was the first person in the world to publish an academic paper on internet addiction back in November 1996 it’s good to see that the number of studies into internet addiction has grown substantially over the last 20 years and that there are now hundreds of studies that have investigated the disorder worldwide in many different ways.

This newly published study is one of the few in the field that has investigated internet addiction from an experimental perspective (as opposed the majority that use self-report survey methods and the increasing number of neuroimaging studies examining what happens inside the brains of those who spend excessive amounts of time online).

Professor Reed’s study involved 100 adult volunteers who were deprived of internet access for four hours. The research team then asked the participants to name a colour (the first one that they could think of) and then gave them 15 minutes to access any websites that they wanted to on the internet. The research team monitored all the sites that the participants visited and after the 15-minute period they were again asked to think of the first colour that came to mind. The participants were also asked to complete various psychometric questionnaires including the Internet Addiction Test (IAT). The IAT is a 20-item test where each item is scored from 0 [not applicable] or 1 [rarely] up to 5 [always]. An example item is How often do you check your e-mail before something else that you need to do?” Those scoring 80 or above (out of 100) are typically defined as having a probable addiction to the internet by those who have used the IAT in previous studies.

Those classed as “high problem [internet] users” on the basis of IAT scores (and who were deprived internet access) were more likely to choose a colour that was prominent on the websites they visited during the 15-minute period after internet deprivation. This wasn’t found in those not classed as internet addicts. Professor Reed said:

“The internet addicts chose a colour associated with the websites they had just visited [and] suggests that aspects of the websites viewed after a period without the net became positively valued. Similar findings have been seen with people who misuse substances, with previous studies showing that a cue associated with any drug that relieves withdrawal becomes positively valued itself. This is the first time though that such an effect has been seen for a behavioural addiction like problematic internet usage”.

While this is an interesting finding there are some major shortcomings both from a methodological standpoint and from a more conceptual angle. Firstly, the number of high problem internet users that were deprived internet access for four hours comprised just 12 individuals so the sample size was incredibly low. Secondly, the individuals classed as high problem internet users had IAT scores ranging from 40 to 72. In short, it is highly unlikely that any of the participants were actually addicted to the internet. Thirdly, although the IAT is arguably the most used screen in the field, it has questionable reliability and validity and is now very out-dated (having been devised in 1998) and does not use the criteria suggested for Internet Disorder in the latest (fifth) edition of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Using more recently developed instruments such as our own Internet Disorder Scale would have perhaps overcome some of these problems.

There are also much wider problems with the use of the term ‘internet addiction’ as most studies in the field have really investigated addictions on the internet rather than to the internet. For instance, individuals addicted to online gaming, online gambling or online shopping are not internet addicts. They are gambling addicts, gaming addicts or shopping addicts that are using the medium of the internet to engage in their addictive behaviour. There are of course some activities – such as social networking – that could be argued to be a genuine type of internet addiction as such activities only take place online. However, the addiction is to an application rather than the internet itself and this should be termed social networking addiction rather than internet addiction. In short, the overwhelming majority of so-called internet addicts are no more addicted to the internet than alcoholics are addicted to the bottle.

A shorter version of this article was first published in The Conversation

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

Further reading

Griffiths, M.D. & Kuss, D.J. (2015). Online addictions: The case of gambling, video gaming, and social networking. In Sundar, S.S. (Ed.), Handbook of the Psychology of Communication Technology (pp.384-403). Chichester: Wiley-Blackwell.

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

Griffiths, M.D., 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.

Kuss, D.J. & Griffiths, M.D. (2015). Internet Addiction in Psychotherapy. Basingstoke: Palgrave Macmillan.

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.

Osborne, L. A., Romano, M., Re, F., Roaro, A., Truzoli, R., & Reed, P. (2016). Evidence for an internet addiction disorder: internet exposure reinforces color preference in withdrawn problem users. Journal of Clinical Psychiatry, 77(2), 269-274.

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.

Career to the ground: A brief overview of our recent papers on workaholism

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 addictionexercise 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.

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

Further reading

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.

The beast inside: The psychology of animal torture

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.

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

Further reading

Arluke, A., Levin, J., Luke, C., & Ascione, F. (1999). The relationship of animal abuse to violence and other forms of antisocial behavior. Journal of Interpersonal Violence, 14(9), 963-975.

Bartmann, C.P. & Wohlsein, P. (2002). Injuries caused by outside violence with forensic importance in horses. Dtsch Tierarztl Wochenschr, 109, 112-115.

Beetz, Andrea (2002). Love, Violence, and Sexuality in Relationships between Humans and Animals. Germany: Shaker Verlag.

Beirne, P. (1999). For a nonspeciesist criminology: Animal abuse as an object of study. Criminology, 37(1), 117-148.

Felthous, A.R. (1980). Aggression against cats, dogs, and people. Child Psychiatry and Human Development, 10, 169-177.

Furnham, A., Richards, S. C., & Paulhus, D. L. (2013). The Dark Triad of personality: A 10 year review. Social and Personality Psychology Compass, 7(3), 199-216.

Hickey, E. W. (2013). Serial murderers and their victims. Cengage Learning.

James, S., Kavanagh, P. S., Jonason, P. K., Chonody, J. M., & Scrutton, H. E. (2014). The Dark Triad, schadenfreude, and sensational interests: Dark personalities, dark emotions, and dark behaviors. Personality and Individual Differences, 68, 211-216.

Jonason, P. K., & Kavanagh, P. (2010). The dark side of love: Love styles and the Dark Triad. Personality and Individual Differences, 49(6), 606-610.

Kavanagh, P. S., Signal, T. D., & Taylor, N. (2013). The Dark Triad and animal cruelty: Dark personalities, dark attitudes, and dark behaviors. Personality and Individual Differences, 55(6), 666-670.

Macdonald, J.M. (1963). The threat to kill. American Journal of Psychiatry, 120, 125-130.

Patterson‐Kane, E. G., & Piper, H. (2009). Animal abuse as a sentinel for human violence: A critique. Journal of Social Issues, 65(3), 589-614.

Ressler, R., Burgess, A., & Douglas, J. (1988). Sexual homicide: Patterns and motives. Lanham, MD: Lexington Books.

Schedel-Stupperich, A. (2002). [Criminal acts against horses – phenomenology and psychosocial construct]. Dtsch Tierarztl Wochenschr, 109, 116-119.

Wochner, M. & Klosinski, G. (1988). Child and adolescent psychiatry aspects of animal abuse (a comparison with aggressive patients in child and adolescent psychiatry). Schweiz Arch Neurol Psychiatry, 139(3), 59-67.

Back tracking: A brief look at using big data in gambling research

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

Further reading

Auer, M. & Griffiths, M.D. (2013). Behavioral tracking tools, regulation and corporate social responsibility in online gambling. Gaming Law Review and Economics, 17, 579-583.

Auer, M. & Griffiths, M.D. (2013). Voluntary limit setting and player choice in most intense online gamblers: An empirical study of gambling behaviour. Journal of Gambling Studies, 29, 647-660.

Auer, M. & Griffiths, M.D. (2014). Personalised feedback in the promotion of responsible gambling: A brief overview. Responsible Gambling Review, 1, 27-36.

Auer, M. & Griffiths, M.D. (2014). An empirical investigation of theoretical loss and gambling intensity. Journal of Gambling Studies, 30, 879-887.

Auer, M. & Griffiths, M.D. (2015). Testing normative and self-appraisal feedback in an online slot-machine pop-up message in a real-world setting. Frontiers in Psychology, 6, 339. doi: 10.3389/fpsyg.2015.00339.

Auer, M. & Griffiths, M.D. (2015). Theoretical loss and gambling intensity (revisited): A response to Braverman et al (2013). Journal of Gambling Studies, 31, 921-931.

Auer, M. & Griffiths, M.D. (2015). The use of personalized behavioral feedback for problematic online gamblers: An empirical study. Frontiers in Psychology, 6, 1406. doi: 10.3389/fpsyg.2015.01406.

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.

Auer, M., Malischnig, D. & Griffiths, M.D. (2014). Is ‘pop-up’ messaging in online slot machine gambling effective? An empirical research note. Journal of Gambling Issues, 29, 1-10.

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.

Griffiths, M.D. (1990). Addiction to fruit machines: A preliminary study among males. Journal of Gambling Studies, 6, 113-126.

Griffiths, M.D. & Auer, M. (2011). Approaches to understanding online versus offline gaming impacts. Casino and Gaming International, 7(3), 45-48.

Griffiths, M.D. & Auer, M. (2015). Research funding in gambling studies: Some further observations. International Gambling Studies, 15, 15-19.

Occupational hazards: The relationship between workaholism, ADHD, and psychiatric disorders

A few weeks ago, my colleagues and I received a lot of media coverage around the world for our latest study on workaholism that was published in the journal PLoS ONE. The study involved researchers from the University of Bergen (Norway) and Yale University USA) and is probably the largest ever study done on the topic as it included 16,426 working Norwegian adults. Our study got a lot of press attention because we examined the associations between workaholism and a number of different psychiatric disorders.

We found that workaholics scored higher on all the psychiatric symptoms than non-workaholics. For instance we found that among those we classed as workaholics (using the Bergen Work Addiction Scale that we published in the Scandinavian Journal of Psychology four years ago and which I talked about in a previous blog), we found that:

  • 32.7% met ADHD (attention-deficit/hyperactivity disorder) criteria (12.7 per cent among non-workaholics).
  • 25.6% met OCD (obsessive-compulsive disorder) criteria (8.7 per cent among non-workaholics).
  • 33.8% met anxiety criteria (11.9 per cent among non-workaholics).
  • 8.9% met depression criteria (2.6 per cent among non-workaholics).

These were all statistically significant differences between workaholics and non-workaholics.

I think a lot of people wondered why we looked at the relationship between workaholism and ADHD to begin with. Firstly, research has consistently demonstrated that Attention-Deficit/Hyperactivity Disorder (ADHD) increases the risk of various chemical and non-chemical addictions. ADHD is prevalent in 2.5–5% of the adult population, and is typically manifested by inattentiveness and lack of focus, and/or impulsivity, and excessive physical activity. Individuals with ADHD may often stop working due to their disorder, and may have trouble in getting work health insurance as they are regarded as a risk group. For this reason, we thought that individuals with ADHD may compensate for this by over-working to meet the expectations required to hold down a job. Although this is a contentious issue, there are a number of reasons why ADHD may be relevant to workaholism.

Firstly, we argued that the inattentive nature of individuals with ADHD causes them to spend time beyond the typical working day (i.e., evenings and weekends) to accomplish what is done by their fellow employees within normal working hours (i.e., the compensation hypothesis). In addition, as they may have a hard time concentrating while at work due to environmental noise and distractions (especially office work in open landscape environments), they might find it easier to work after co-workers have left their working environment or work from home. Their attentive shortcomings may also cause them to overly check for errors on the tasks given, since they often experience careless mistakes due to their inattentiveness. This may cause a cycle of procrastination, work binges, exhaustion, and – in some cases – a fear of imperfection. Although ADHD is associated with lack of focus, such individuals often have the ability to hyper-focus once they find something interesting–often being unable to detach themselves from the task.

Secondly, we argued that the impulsive nature of individuals with ADHD causes them to say ‘yes’ and taking on many tasks without them thinking ahead, and taking on more work than they can realistically handle–eventually leading to workaholic levels of activity. Thirdly, we also argued that the hyperactive nature of individuals with ADHD and the need to be constantly active without being able to relax, causes such individuals to keep on working in an attempt to alleviate their restless thoughts and behaviors. Consequently, work stress might act as a stimulant, and they may choose active (and often multiple) jobs with high pressure, deadlines and activity (e.g., media, sales, restaurant work) – where they have the opportunity to multitask and constantly shift between tasks (e.g., Type-A personality behavior).

In line with this, Type-A personality has often been associated – and sometimes used inter-changeably – with workaholism in previous research. This line of reasoning also relates to the workaholic type portrayed by Dr. Bryan Robinson (in his 2014 book Chained to the desk: A guidebook for workaholics, their partners and children, and the clinicians who treat them), in which he actually denoted “attention-deficit workaholics” (who tend to start many projects but become bored easily and need to be stimulated at all times). His description of the “relentless” type also corresponds well with ADHD symptoms (i.e., unstoppable in working fast and meeting deadlines, often with many projects going on simultaneously). In other words, these types may utilize work pressure to obtain focus, constantly seeking stimulation, crisis, and excitement – and therefore like risky jobs.

Finally, people with ADHD are often mistaken as being lazy, irresponsible, or unintelligent because of their difficulties with planning, time management, organizing, and decision-making. Feeling misunderstood might cause individuals with ADHD to push themselves to prove these misconceptions as wrong – and resulting in an excessive and/or compulsive working pattern. Such individuals are often intelligent, but may feel forced or motivated to start up their own business (i.e., entrepreneurs), as they find it troubling to adjust to standard work schedules or organizational boundaries. Previous research has highlighted that workaholism is prevalent among entrepreneurs and the self-employed. Often failing in other aspects of life (e.g., family), work for such individuals may become even more important to them (e.g., self- efficacy). This is why we hypothesized that ADHD symptoms will be positively associated with workaholism in our study (and that is what we found).

Obsessive-Compulsive Disorder (OCD) is another underlying psychiatric disorder that increases the likelihood of developing an addiction. Full-blown OCD occurs in approximately 2-3% of children and adults, and is commonly manifested by intrusive thoughts and repetitive behaviors of checking, obsessing, ordering, hoarding, washing, and/or neutralizing. It has been suggested that addictive behaviors might represent a coping and/or escape mechanism of OCD symptoms, or as an OCD-behavior that eventually becomes an addiction in itself. Previous workaholic typologies such as those described by Dr. Kimberly Scotti and her colleagues in the journal Human Relations have incorporated the ‘compulsive-dependent’ and ‘perfectionistic’ workaholic types, and some empirical studies have demonstrated that obsessive-compulsive traits are present among workaholics. The OCD tendency of having the need to arrange things in a certain way (i.e., a strong need for control) and obsessing over details to the point of paralysis – may predispose workers with such traits to develop workaholic working patterns. Again we found in our study that OCD symptoms were positively related to workaholism.

It has also been reported that other psychiatric disorders such as anxiety and depression may also increase the risk of developing an addiction. Approximately 30% of people will suffer from an anxiety disorder in their lifetime, and 20% will have at least one episode of depression. These conditions often occur simultaneously, as most people who are depressed also experience acute anxiety. Consequently, anxiety and/or depression can lead to addiction, and vice versa. A number of studies have previously reported a link between anxiety, depression, and workaholism. Furthermore, we know that workaholism (in some instances) develops as an attempt to reduce uncomfortable feelings of anxiety and depression. Working hard is praised and honored in modern society, and thus serves as a legitimate behavior for individuals to combat or alleviate negative feelings – and to feel better about themselves and raise their self-esteem. This is why we hypothesized that there would be a positive association between anxiety, depression, and workaholism (and that is what we found). In relation to our study’s findings as a whole, the lead author of our study (Dr. Cecilie Andreassen) told the world’s media:

“Taking work to the extreme may be a sign of deeper psychological or emotional issues. Whether this reflects overlapping genetic vulnerabilities, disorders leading to workaholism or, conversely, workaholism causing such disorders, remain uncertain…Physicians should not take for granted that a seemingly successful workaholic does not have ADHD-related or other clinical features. Their considerations affect both the identification and treatment of these disorders”.

Our findings clearly highlighted the importance of further investigating neurobiological differences related to workaholic behaviour. Finally, in line with our previous research published two years ago (also in the PLoS ONE journal) using a nationally representative sample, 7.8% of the participants in our latest study were classed as workaholics compared to 8.3% in our previous study.

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

Further reading

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.

Andreassen, C.S., Griffiths, M.D., Hetland, J. & Pallesen, S. (2012). Development of a Work Addiction Scale. Scandinavian Journal of Psychology, 53, 265-272.

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.

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.

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.

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

Quinones, C. & Griffiths, M.D. (2015). Addiction to work: recommendations for assessment. Journal of Psychosocial Nursing and Mental Health Services, 10, 48-59.

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.

Robinson, B.E. (2014). Chained to the desk: A guidebook for workaholics, their partners and children, and the clinicians who treat them. New York: New York University Press.

Scotti, K.A., Moore, K.S., & Miceli, M.P. (1997). An exploration of the meaning and consequences of workaholism. Human Relations, 50, 287–314.

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.

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

Lust discussed: A brief overview of our recent papers on sex addiction

Following my recent blogs where I outlined some of the papers that my colleagues and I have published on mindfulness, Internet addiction, gaming addiction, youth gambling, exercise addiction, and shopping addiction, here is a round-up of recent papers that my colleagues and I have published on sex addiction.

Griffiths, M.D. & Dhuffar, M. (2014). Treatment of sexual addiction within the British National Health Service. International Journal of Mental Health and Addiction, 12, 561-571.

  • At present, the prevalence of rates of sexual addiction in the UK is unknown. This study investigated what treatment services were available within British Mental Health Trusts (MHTs) that are currently provided for those who experience compulsive and/or addictive sexual behaviours within the National Health Service (NHS) system. In March and April 2013, a total of 58 letters were sent by email to all Mental Health Trusts in the UK requesting information about (i) sexual addiction services and (ii) past 5-year treatment of sexual addiction. The request for information was sent to all MHTs under the Freedom of Information Act (2001). Results showed that 53 of the 58 MHTs (91 %) did not provide any service (specialist or otherwise) for treating those with problematic sexual behaviours. Based on the responses provided, only five MHTs reported having had treated sexual addiction as a disorder that took primacy over the past 5 years. There was also some evidence to suggest that the NHS may potentially treat sexual addiction as a secondary disorder that is intrinsic and/or co-morbid to the initial referral made by the GP. In light of these findings, implications for the treatment of sex addiction in a British context are discussed.

Dhuffar, M. & Griffiths, M.D. (2014). Understanding the role of shame and its consequences in female hypersexual behaviours: A pilot study. Journal of Behavioural Addictions, 3, 231–237.

  • Background and aims: Hypersexuality and sexual addiction among females is a little understudied phenomenon. Shame is thought to be intrinsic to hypersexual behaviours, especially in women. Therefore, the aim of this study was to understand both hypersexual behaviours and consequences of hypersexual behaviours and their respective contributions to shame in a British sample of females (n = 102). Methods: Data were collected online via Survey Monkey. Results: Results showed the Sexual Behaviour History (SBH) and the Hypersexual Disorder Questionnaire (HDQ) had significant positive correlation with scores on the Shame Inventory. The results indicated that hypersexual behaviours were able to predict a small percentage of the variability in shame once sexual orientation (heterosexual vs. non-heterosexual) and religious beliefs (belief vs. no belief) were controlled for. Results also showed there was no evidence that religious affiliation and/or religious beliefs had an influence on the levels of hypersexuality and consequences of sexual behaviours as predictors of shame. Conclusions: While women in the UK are rapidly shifting to a feminist way of thinking with or without technology, hypersexual disorder may often be misdiagnosed and misunderstood because of the lack of understanding and how it is conceptualised. The implications of these findings are discussed.

Dhuffar, M. & Griffiths, M.D. (2015). A systematic review of online sex addiction and clinical treatments using CONSORT evaluation. Current Addiction Reports, 2, 163-174.

  • Researchers have suggested that the advances of the Internet over the past two decades have gradually eliminated traditional offline methods of obtaining sexual material. Additionally, research on cybersex and/or online sex addictions has increased alongside the development of online technology. The present study extended the findings from Griffiths’ (2012) systematic empirical review of online sex addiction by additionally investigating empirical studies that implemented and/or documented clinical treatments for online sex addiction in adults. A total of nine studies were identified and then each underwent a CONSORT evaluation. The main findings of the present review provide some evidence to suggest that some treatments (both psychological and/or pharmacological) provide positive outcomes among those experiencing difficulties with online sex addiction. Similar to Griffiths’ original review, this study recommends that further research is warranted to establish the efficacy of empirically driven treatments for online sex addiction.

Dhuffar, M. & Griffiths, M.D. (2015). Understanding conceptualisations of female sex addiction and recovery using Interpretative Phenomenological Analysis. Psychology Research, 5, 585-603.

  • Relatively little research has been carried out into female sex addiction. There is even less regarding understandings of lived experiences of sex addiction among females. Consequently, the purpose of the present study was to examine the experiences of female sex addiction (from onset to recovery). This was done by investigating the experiences and conceptualisations of three women who self-reported as having had a historical problem with sex addiction. An interpretative phenomenological analysis (IPA) methodology was applied in the current research process in which three female participants shared their journey through the onset, progression, and recovery of sex addiction. The IPA produced five superordinate themes that accounted for the varying degrees of sexual addiction among a British sample of females: (1) “Focus on self as a sex addict”; (2) “Uncontrollable desire”; (3) “Undesirable feelings”; (4) “Derision”; and (5) “Self help, treatment and recovery”. The implications of these findings towards the understanding and the need for the implementation of treatment are discussed.

Dhuffar, M., Pontes, H.M. & Griffiths, M.D. (2015). The role of negative mood states and consequences of hypersexual behaviours in predicting hypersexuality among university students. Journal of Behavioural Addictions, 4, 181–188.

  • The issue of whether hypersexual behaviours exist among university students is controversial because many of these individuals engage in sexual exploration during their time at university. To date, little is known about the correlates of hypersexual behaviours among university students in the UK. Therefore, the aims of this exploratory study were two-fold. Firstly, to explore and establish the correlates of hypersexual behaviours, and secondly, to investigate whether hypersexuality among university students can be predicted by variables relating to negative mood states (i.e., emotional dysregulation, loneliness, shame, and life satisfaction) and consequences of hypersexual behaviour.

Van Gordon, W., Shonin, E., & Griffiths, M.D. (2016). Meditation Awareness Training for the treatment of sex addiction: A case study. Journal of Behavioral Addictions, in press.

  • Sex addiction is a disorder that can have serious adverse functional consequences. Treatment effectiveness research for sex addiction is currently underdeveloped, and interventions are generally based on guidelines for treating other behavioural (as well as chemical) addictions. Consequently, there is a need to clinically evaluate tailored treatments that target the specific symptoms of sex addiction. It has been proposed that second-generation mindfulness-based interventions (SG-MBIs) may be an appropriate treatment for sex addiction because in addition to helping individuals increase perceptual distance from craving for desired objects and experiences, some SG-MBIs specifically contain meditations intended to undermine attachment to sex and/or the human body. To date, no study exploring the utility of mindfulness for treating sex addiction has been conducted. This paper presents an in-depth clinical case study of a male individual suffering from sex addiction that underwent treatment utilising an SG-MBI known as Meditation Awareness Training (MAT). Following completion of MAT, the participant demonstrated clinically significant improvements regarding the addictive sexual behaviour, as well less depression and psychological distress. The MAT intervention also led to improvements in sleep quality, job satisfaction, and non-attachment to self and experiences. Salutary outcomes were maintained at six-month follow-up. The current study extends the literature exploring the applications of mindfulness for treating behavioural addiction, and findings of this case study indicate that further clinical investigation into the role of mindfulness for treating sex addiction is warranted.

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

Further reading

Griffiths, M.D. (2000). Excessive internet use: Implications for sexual behavior. CyberPsychology and Behavior, 3, 537-552.

Griffiths, M.D. (2001). Addicted to love: The psychology of sex addiction. Psychology Review, 8, 20-23.

Griffiths, M.D. (2001). Sex on the internet: Observations and implications for sex addiction. Journal of Sex Research, 38, 333-342.

Griffiths, M.D. (2004). Sex addiction on the Internet. Janus Head: Journal of Interdisciplinary Studies in Literature, Continental Philosophy, Phenomenological Psychology and the Arts, 7(2), 188-217.

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

Griffiths, M.D. (2012). Internet sex addiction: A review of empirical research. Addiction Research and Theory, 20, 111-124.

Griffiths, M.D. (2012). The use of online methodologies in studying paraphilia: A review. Journal of Behavioral Addictions, 1, 143-150.

Griffiths, M.D. & Dhuffar, M. (2014). Collecting behavioural addiction treatment data using Freedom of Information requests. SAGE Research Methods Cases. Located at: DOI:

Running up debt: A brief overview of our recent papers on exercise and shopping addictions

Following my recent blogs where I outlined some of the papers that my colleagues and I have published on mindfulness, Internet addiction, gaming addiction, youth gambling and other addictive behaviours, here is a round-up of recent papers that my colleagues and I have published on exercise addiction and shopping addictions (i.e., compulsive buying).

Griffiths, M.D., Urbán, R., Demetrovics, Z., Lichtenstein, M.B., de la Vega, R., Kun, B., Ruiz-Barquín, R., Youngman, J. & Szabo, A. (2015). A cross-cultural re-evaluation of the Exercise Addiction Inventory (EAI) in five countries. Sports Medicine Open, 1:5.

  • Research into the detrimental effects of excessive exercise has been conceptualized in a number of similar ways, including ‘exercise addiction’, ‘exercise dependence’, ‘obligatory exercising’, ‘exercise abuse’, and ‘compulsive exercise’. Among the most currently used (and psychometrically valid and reliable) instruments is the Exercise Addiction Inventory (EAI). The present study aimed to further explore the psychometric properties of the EAI by combining the datasets of a number of surveys carried out in five different countries (Denmark, Hungary, Spain, UK, and US) that have used the EAI with a total sample size of 6,031 participants. A series of multigroup confirmatory factor analyses (CFAs) were carried out examining configural invariance, metric invariance, and scalar invariance. The CFAs using the combined dataset supported the configural invariance and metric invariance but not scalar invariance. Therefore, EAI factor scores from five countries are not comparable because the use or interpretation of the scale was different in the five nations. However, the covariates of exercise addiction can be studied from a cross-cultural perspective because of the metric invariance of the scale. Gender differences among exercisers in the interpretation of the scale also emerged. The implications of the results are discussed, and it is concluded that the study’s findings will facilitate a more robust and reliable use of the EAI in future research.

Mónok, K., Berczik, K., Urbán, R., Szabó, A., Griffiths, M.D., Farkas, J., Magi, A., Eisinger, A., Kurimay, T., Kökönyei, G., Kun, B., Paksi, B. & Demetrovics, Z. (2012). Psychometric properties and concurrent validity of two exercise addiction measures: A population wide study in Hungary. Psychology of Sport and Exercise, 13, 739-746.

  • Objectives: The existence of exercise addiction has been examined in numerous studies. However, none of the measures developed for exercise addiction assessment have been validated on representative samples. Furthermore, estimates of exercise addiction prevalence in the general population are not available. The objective of the present study was to validate the Exercise Addiction Inventory (EAI; Terry, Szabo, & Griffiths, 2004), and the Exercise Dependence Scale (EDS; Hausenblas & Downs, 2002b), and to estimate the prevalence of exercise addiction in general population. Design: Exercise addiction was assessed within the framework of the National Survey on Addiction Problems in Hungary (NSAPH), a national representative study for the population aged 18–64 years (N = 2710). Method: 474 people in the sample (57% males; mean age 33.2 years) who reported to exercise at least once a week were asked to complete the two questionnaires (EAI, EDS). Results: Confirmatory Factor Analysis (CFA) indicated good fit both in the case of EAI (CFI = 0.971; TLI = 0.952; RMSEA = 0.052) and EDS (CFI = 0.938; TLI = 0.922; RMSEA = 0.049); and confirmed the factor structure of the two scales. The correlation between the two measures was high (r = 0.79). Results showed that 6.2% (EDS) and 10.1% (EAI) of the population were characterized as nondependent-symptomatic exercisers, while the proportion of the at-risk exercisers were 0.3% and 0.5%, respectively. Conclusions: Both EAI and EDS proved to be a reliable assessment tool for exercise addiction, a phenomenon that is present in the 0.3–0.5% of the adult general population.

Szabo, A., Griffiths, M.D., de La Vega Marcos, R., Mervo, B. & Demetrovics, Z. (2015). Methodological and conceptual limitations in exercise addiction research. Yale Journal of Biology and Medicine, 86, 303-308.

  • The aim of this brief analytical review is to highlight and disentangle research dilemmas in the field of exercise addiction. Research examining exercise addiction is primarily based on self-reports, obtained by questionnaires (incorporating psychometrically validated instruments), and interviews, which provide a range of risk scores rather than diagnosis. Survey methodology indicates that the prevalence of risk for exercise addiction is approximately 3 percent among the exercising population. Several studies have reported a substantially greater prevalence of risk for exercise addiction in elite athletes compared to those who exercise for leisure. However, elite athletes may assign a different interpretation to the assessment tools than leisure exercisers. The present paper examines the: 1) discrepancies in the classification of exercise addiction; 2) inconsistent reporting of exercise addiction prevalence; and 3) varied interpretation of exercise addiction diagnostic tools. It is concluded that there is the need for consistent terminology, to follow-up results derived from exercise addiction instruments with interviews, and to follow a theory-driven rationale in this area of research.

Andreassen, C.S., Griffiths, M.D., Pallesen, S., Bilder, R.M., Torsheim, T. Aboujaoude, E.N. (2015). The Bergen Shopping Addiction Scale: Reliability and validity of a brief screening test. Frontiers in Psychology, 6:1374. doi: 10.3389/fpsyg.2015.01374.

  • Although excessive and compulsive shopping has been increasingly placed within the behavioral addiction paradigm in recent years, items in existing screens arguably do not assess the core criteria and components of addiction. To date, assessment screens for shopping disorders have primarily been rooted within the impulse-control or obsessive-compulsive disorder paradigms. Furthermore, existing screens use the terms ‘shopping,’ ‘buying,’ and ‘spending’ interchangeably, and do not necessarily reflect contemporary shopping habits. Consequently, a new screening tool for assessing shopping addiction was developed. Initially, 28 items, four for each of seven addiction criteria (salience, mood modification, conflict, tolerance, withdrawal, relapse, and problems), were constructed. These items and validated scales (i.e., Compulsive Buying Measurement Scale, Mini-International Personality Item Pool, Hospital Anxiety and Depression Scale, Rosenberg Self-Esteem Scale) were then administered to 23,537 participants (Mage = 35.8 years, SDage = 13.3). The highest loading item from each set of four pooled items reflecting the seven addiction criteria were retained in the final scale, The Bergen Shopping Addiction Scale (BSAS). The factor structure of the BSAS was good (RMSEA=0.064, CFI=0.983, TLI=0.973) and coefficient alpha was 0.87. The scores on the BSAS converged with scores on the Compulsive Buying Measurement Scale (CBMS; 0.80), and were positively correlated with extroversion and neuroticism, and negatively with conscientiousness, agreeableness, and intellect/imagination. The scores of the BSAS were positively associated with anxiety, depression, and low self-esteem and inversely related to age. Females scored higher than males on the BSAS. The BSAS is the first scale to fully embed shopping addiction within an addiction paradigm. A recommended cutoff score for the new scale and future research directions are discussed.

Davenport, K., Houston, J. & Griffiths, M.D. (2012). Excessive eating and compulsive buying behaviours in women: An empirical pilot study examining reward sensitivity, anxiety, impulsivity, self-esteem and social desirability. International Journal of Mental Health and Addiction, 10, 474-489.

  • ‘Mall disorders’ such as excessive eating and compulsive buying appear to be increasing, particularly among women. A battery of questionnaires was used in an attempt to determine this association between specific personality traits (i.e., reward sensitivity, impulsivity, cognitive and somatic anxiety, self-esteem, and social desirability) and excessive eating and compulsive buying in 134 women. Reward sensitivity and cognitive anxiety were positively related to excessive eating and compulsive buying, as was impulsivity to compulsive buying. Somatic anxiety and social desirability were negatively related to compulsive buying. These preliminary findings indicate that excessive behaviours are not necessarily interrelated. The behaviours examined in this study appear to act as an outlet for anxiety via the behaviours’ reinforcing properties (e.g., pleasure, attention, praise, etc.). As a consequence, this may boost self-esteem. The findings also appear to indicate a number of risk factors that could be used as ‘warning signs’ that the behaviour may develop into an addiction.

Maraz, A., Eisinger, A., Hende, Urbán, R., Paksi, B., Kun, B., Kökönyei, G., Griffiths, M.D. & Demetrovics, Z. (2015). Measuring compulsive buying behaviour: Psychometric validity of three different scales and prevalence in the general population and in shopping centres. Psychiatry Research, 225, 326–334.

  • Due to the problems of measurement and the lack of nationally representative data, the extent of compulsive buying behaviour (CBB) is relatively unknown. The validity of three different instruments was tested: Edwards Compulsive Buying Scale, Questionnaire About Buying Behavior and Richmond Compulsive Buying Scale using two independent samples. One was nationally representative of the Hungarian population (N=2710) while the other comprised shopping mall customers (N=1447). As a result, a new, four-factor solution for the ECBS was developed (Edwards Compulsive Buying Scale Revised (ECBS-R)), and confirmed the other two measures. Additionally, cut-off scores were defined for all measures. Results showed that the prevalence of CBB is 1.85% (with QABB) in the general population but significantly higher in shopping mall customers (8.7% with ECBS-R, 13.3% with QABB and 2.5% with RCBS-R). Conclusively, due to the diversity of content, each measure identifies a somewhat different CBB group.

Maraz, A., Griffiths, M.D., & Demetrovics, Z. (2016). The prevalence of compulsive buying in non-clinical populations: A systematic review and meta-analysis. Addiction, 111, 408-419.

  • Aims: To estimate the pooled prevalence of compulsive buying behaviour (CBB) in different populations and to determine the effect of age, gender, location and screening instrument on the reported heterogeneity in estimates of CBB and whether publication bias could be identified. Methods: Three databases were searched (Medline, PsychInfo, Web of Science) using the terms ‘compulsive buying’, ‘pathological buying’ and ‘compulsive shopping’ to estimate the pooled prevalence of CBB in different populations. Forty studies reporting 49 prevalence estimates from 16 countries were located (n = 32 000). To conduct the meta-analysis, data from non-clinical studies regarding mean age and gender proportion, geographical study location and screening instrument used to assess CBB were extracted by multiple independent observers and evaluated using a random-effects model. Four a priori subgroups were analysed using pooled estimation (Cohen’s Q) and covariate testing (moderator and meta-regression analysis). Results: The CBB pooled prevalence of adult representative studies was 4.9% (3.4–6.9%, eight estimates, 10 102 participants), although estimates were higher among university students: 8.3% (5.9–11.5%, 19 estimates, 14 947 participants) in adult non-representative samples: 12.3% (7.6–19.1%, 11 estimates, 3929 participants) and in shopping-specific samples: 16.2% (8.8–27.8%, 11 estimates, 4686 participants). Being young and female were associated with increased tendency, but not location (United States versus non-United States). Meta-regression revealed large heterogeneity within subgroups, due mainly to diverse measures and time-frames (current versus life-time) used to assess CBB. Conclusions: A pooled estimate of compulsive buying behaviour in the populations studied is approximately 5%, but there is large variation between samples accounted for largely by use of different time-frames and measures.

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

Further reading

Allegre, B., Souville, M., Therme, P. & Griffiths, M.D. (2006). Definitions and measures of exercise dependence, Addiction Research and Theory, 14, 631-646.

Allegre, B., Therme, P. & Griffiths, M.D. (2007). Individual factors and the context of physical activity in exercise dependence: A prospective study of ‘ultra-marathoners’. International Journal of Mental Health and Addiction, 5, 233-243.

Berczik, K., Szabó, A., Griffiths, M.D., Kurimay, T., Kun, B. & Demetrovics, Z. (2012). Exercise addiction: symptoms, diagnosis, epidemiology, and etiology. Substance Use and Misuse, 47, 403-417.

Berczik, K., Griffiths, M.D., Szabó, A., Kurimay, T., Kökönyei, G., Urbán, R. and Demetrovics, Z. (2014). Exercise addiction – the emergence of a new disorder. Australasian Epidemiologist, 21(2), 36-40.

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

Griffiths, M.D. (1997). Exercise addiction: A case study. Addiction Research, 5, 161-168.

Griffiths, M.D., Szabo, A. & Terry, A. (2005). The Exercise Addiction Inventory: A quick and easy screening tool for health practitioners. British Journal of Sports Medicine, 39, 30-31.

Kurimay, T., Griffiths, M.D., Berczik, K., & Demetrovics, Z. (2013). Exercise addiction: The dark side of sports and exercise. In Baron, D., Reardon, C. & Baron, S.H., Contemporary Issues in Sports Psychiatry: A Global Perspective (pp.33-43). Chichester: Wiley.

Szabo, A. & Griffiths, M.D. (2007). Exercise addiction in British sport science students. International Journal of Mental Health and Addiction, 5, 25-28.

Terry, A., Szabo, A. & Griffiths, M.D. (2004). The Exercise Addiction Inventory: A new brief screening tool, Addiction Research and Theory, 12, 489-499.

Warner, R. & Griffiths, M.D. (2006). A qualitative thematic analysis of exercise addiction: An exploratory study. International Journal of Mental Health and Addiction, 4, 13-26.

The eat is on: Cannibalism and sexual cannibalism (revisited)

Recently, I was approached by Ben Biggs, the editor of the Real Crime magazine, who was running an article on the practicalities and psychology of cannibalism, with expert commentary running through it (and with me as the “expert”). The article has just been published in the May 2016 issue and I was assured that the feature would “highlight how nasty cannibalism is, not glorify it”. I responded to the questions as part of an email interview and today’s blog contains the unedited responses to the questions that I was asked.

What are the main reasons a human might eat another human being?

There are a number of possible reasons including:

Out of necessity – For instance, in 1972, a rugby team from Uruguay was in a plane crash in the Andes. Fifteen people died and the only way they prevented themselves starving to death was to eat the flesh of the deceased (which given the fact it took 72 days for them to be rescued, was one of the few viable options to prevent starvation).

As a way of controlling population size – The Aztecs were said to have eaten no less than 15,000 victims a year as – some have argued – a form of population control).

As part of a religious belief – There are some religious beliefs involving the need to eat human flesh as a way of sustaining the universe or as part of magical and ritualistic ceremonies.

As part of the grieving process – Some acts of cannibalism are where dead people’s body parts are eaten as either part of the grieving process, as a way of guiding the souls of the dead into the bodies of the living, and/or as a way of imbibing the dead person’s ‘life force’ or more specific individual characteristics.

As part of tribal warfare – Cannibalistic acts were most often carried out as part of a celebration victory after battles with rival tribes.

For sexual gratification – Some individuals have claimed to get sexually aroused from eating (or thinking about eating) the flesh of others. When it comes to sexual cannibalism in humans, there are arguably different subtypes (although this is based on my own personal opinion and not on something I’ve read in a book or research paper). Most of these behaviours I have examined in previous blogs:

  • Vorarephilia is a sexual paraphilia in which individuals are sexually aroused by (i) the idea of being eaten, (ii) eating another person, and/or (iii) observing this process for sexual gratification. However, most vorarephiles’ behaviour is fantasy-based, although there have been real cases such as Armin Meiwes, the so-called ‘Rotenburg Cannibal’.
  • Erotophonophilia is a sexual paraphilia in which individuals have extreme violent fantasies and typically kill their victims during sex and/or mutilate their victims’ sexual organs (the latter of which is usually post-mortem). In some cases, the erotophonophiles will eat some of their victim’s body parts (usually post-mortem). Many lust murderers – including Jack the Ripper – are suspected of engaging in cannibalistic and/or gynophagic acts, taking away part of the female to eat later. Other examples of murderers who have eaten their victims (or parts of them) for sexual pleasure include Albert Fish, Issei Sagawa, Andrei Chikatilo, Ed Gein, and Jeffrey Dahmer.
  • Sexual necrophagy refers to the cannibalizing of a corpse for sexual pleasure. This may be associated with lust murder but Brenda Love in her Encyclopedia of Unusual Sex Practices says that such cases usually involve “one whose death the molester did not cause. Many cases of reported necrophilia include cannibalism or other forms of sadism and it is believed that many others fantasize about doing it”.
  • Vampirism as a sexual paraphilia in which an individual derives sexual arousal from the ingestion of blood from a living person.
  • Menophilia is a sexual paraphilia in which an individual (almost always male) derives sexual arousal from drinking the blood of menstruating females.
  • Gynophagia is a sexual fetish that involves fantasies of cooking and consumption of human females (gynophagia literally means “woman eating”). There is also a sub-type of gynophagia called pathenophagia. This is the practice of eating young girls or virgins. Several lust murderers were known to consume the flesh of young virgins, most notably Albert Fish).
  • ‘Sexual autophagy’ refers to the eating of one’s own flesh for sexual pleasure (and would be a sub-type of autosarcophagy).

A recent 2014 paper by Dr. Amy Lykins and Dr. James Cantor in the Archives of Sexual Behavior entitled ‘Vorarephilia: A case study in masochism and erotic consumption’ referred to the work of Dr Friedemann Pfafflin (a forensic psychotherapist at Ulm University, Germany): 

“Pfafflin (2008) commented on the many phrases that exist in the English language to relate sex/love and consumption, including referring to someone as ‘looking good enough to eat’, ’that ‘the way to a man’s heart is through his stomach’, and describing a sexually appealing person as ‘sweet’, ‘juicy’, ‘appetizing’, or ‘tasty’. Christian religions even sanction metaphorical cannibalism through their sacrament rituals, during which participants consume bread or wafers meant to represent the ‘body of Christ’ and wine intended to represent the ‘blood of Christ’ – a show of Jesus’s love of his people and, in turn, their love for him, by sharing in his ‘blood’ and ‘flesh’. This act was intended to ‘merge as one’ the divine and the mortal”.

It’s not unusual for a serial killer to cannibalise parts of their victims. Why is this, and what can cause that behaviour? 

I think it’s a rare behaviour, even among serial killers. As noted above, in these instances the eating (or the thought of eating) others is sexually arousing. It has also been claimed that the sexual cannibal may also release sexual frustration or pent up anger when eating human flesh. Some consider sexual cannibalism to be a form of sexual sadism and is often associated with the act of necrophilia (sex with corpses). Others have claimed that cannibals feel a sense of euphoria and/or intense sexual stimulation when consuming human flesh. All of these online accounts cite the same article by Clara Bruce (‘Chew On This: You’re What’s for Dinner’) that I have been unable to track down (so I can’t vouch for the veracity of the claims made). Bruce’s article claimed that cannibals had compared eating human flesh with having an orgasm, and that flesh eating caused an out-of-body-experience experience with effects comparable to taking the drug mescaline.

In the case of Japanese cannibal Issei Sagawa, he said that he might have been satisfied with consuming some, non-vital part of his victim Renee Hartevelt, such as her pubic hair, but he couldn’t bring himself to ask her for it. Does the murder and the consumption of flesh stem from the same mental disorder, or is murder just a necessary evil? 

I have not seen these claims. I have only read that his desire to eat women was to “absorb their energy”.

Do you think Issei Sagawa would have been satisfied with eating her hair?

Again, I have never read about this. He seems to have claimed that he had cannibalistic desires since his youth and that his murder of women was for this reason and no other.

Serial Killer Jeffrey Dahmer said he liked to eat mens’ biceps, because he was a ‘bicep guy’. Does the body part consumed necessarily bear a direct relation to the part of the victim’s anatomy the cannibal has a sexual preference for?

Not that I am aware of. Most people that are partialists (i.e., derive sexual arousal from particular body parts such has hands, feet, buttocks, etc.) would be unlikely to get aroused if the body part was not attached to something living.

There are rarer cases where, rather than having a fantasy of eating a sexual partner, the ‘victim’ consents to being eaten by the killer. Does this stem from the same psycho-sexual disorder that leads to a cannibal killing?

This is something entirely different and is part of vorarephilia (highlighted earlier). My understanding is that the flesh eating would only occur consensually (as in the case of Armin Meiwes and Bernd Jürgen Brand).

What reason would there be for someone to eat their own body parts? 

The practice is very rare and has only been documented a number of times in the psychological and psychiatric literature (and all are individual case studies). It has sometimes been labeled as a type of pica (on the basis that the person is eating something non-nutritive) although personally I think this is misguided as it could be argued that human flesh may be nutritious (even if most people find the whole concept morally repugnant). However, there are documented cases of autosarcophagy where people have eaten their own skin as an extreme form of body modification. Some authors argue that auto-vampirism (i.e., the practice of people drinking their own blood) should also be classed as a form of autosarcophagy (although again, I think this is stretching the point a little).

The practice has certainly come to the fore in some high profile examples in the fictional literature. Arguably the most infamous example, was in Thomas Harris’ novel Hannibal (and also in the film adaptation directed by Ridley Scott), where Hannibal ‘the Cannibal’ Lecter psychologically manipulates the paedophile Mason Verger into eating his own nose, and then gets Verger to slice off pieces of his own face off and feed them to his dog. In what many people see as an even more gruesome autosarcophagic scene, Lecter manages to feed FBI agent Paul Krendler slices of his own brain. In real life (rather than fiction), autosarcophagy is typically a lot less stomach churning but in extreme examples can still be something that makes people wince.

Depending on the definition of autosarcophagy used, the spectrum of self-cannibalism could potentially range from behaviours such as eating a bit of your own skin right through eating your own limbs. There are many reasons including for art, for the taste, for body modification, for protest (associated to mental illness), because they had taken mind-altering drugs, and for sexual pleasure. Here are four autosarcophagic examples that have been widely reported in the media but are very different in scope and the public’s reaction to them.

  • Example 1: Following a liposuction operation in 1996, the Chilean-born artist Marco Evaristti held a dinner party for close friends and served up a pasta dish with meatballs made from beef and the fatty liposuction remains. The meal was claimed by Evaristti to be an artistic statement but was highly criticized as being “disgusting, publicity-seeking and immoral”.
  • Example 2: On a February 1998 episode of the Channel 4 British cookery programme TV Dinners, a mother was shown engaging in placentophagy when she cooked her own placenta (with fried garlic and shallots), made into a pate and served on foccacia bread. The programme received a lot of complaints that were upheld by the British Broadcasting Standards Commission who concluded that the act of eating placenta pate on a highly watched TV programme had  “breached convention”.
  • Example 3: In 2009, Andre Thomas, a 25-year old murderer on Texas death row (and with a history of mental problems) pulled out his eye in prison and ate it.
  • Example 4: The German man Bernd Jürgen Brande who engaged in self-cannibalism (cutting off and then eating his own cooked penis) before being killed and eaten by Armin Meiwes, the ‘Rotenburg Cannibal’ (who also shared in the eating of Brande’s cooked penis).

Dr Friedemann Pfafflin (a forensic psychotherapist at Ulm University, Germany) and who has written about Armin Meiwes, the ‘Rotenburg Cannibal’ asserts that “apart from acts of cannibalism arising from situations of extreme necessity…the cannibalistic deeds of individuals are always an expression of severe psychopathology”.

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

Further reading

Aggrawal A. (2009). Forensic and Medico-legal Aspects of Sexual Crimes and Unusual Sexual Practices. Boca Raton: CRC Press.

Ahuja, N. & Lloyd, A.J. (2007). Self-cannibalism: an unusual case of self-mutilation. Australian and New Journal of Psychiatry, 41, 294-5.

Arens, William (1979). The Man-Eating Myth: Anthropology and Anthropophagy. Oxford: Oxford University Press.

Beier, K. (2008). Comment on Pfafflin’s (2008) “Good enough to eat”. Archives of Sexual Behavior, 38, 164-165.

Beneke M. (1999). First report of nonpsychotic self-cannibalism (autophagy), tongue splitting, and scar patterns (scarification) as an extreme form of cultural body modification in a western civilization. American Journal of Forensic Medicine and Pathology, 20, 281-285.

Benezech, M., Bourgeois, M., Boukhabza, D. & Yesavage, J. (1981). Cannibalism and vampirism in paranoid schizophrenia. Journal of Clinical Psychiatry, 42(7), 290.

Beier, K. (2008). Comment on Pfafflin’s (2008) “Good enough to eat”. Archives of Sexual Behavior, 38, 164-165.

Betts, W.C. (1964). Autocannibalism: an additional observation. American Journal of Psychiatry 121, 402-403.

Cannon, J. (2002). Fascination with cannibalism has sexual roots. Indiana Statesman, November 22. Located at:

de Moore, G.M. & Clement, M. (2006). Self-cannibalism: an unusual case of self-mutilation. Australian and New Zealand Journal of Psychiatry, 40, 937.

Gates, K. (2000). Deviant desires: Incredibly strange sex. New York: Juno Books.

Huffington Post (2009). Andre Thomas, Texas Death Row inmate, pulls out eye, eats it. TheHuffington Post, September 9. Located at:

Krafft-Ebing, R. von (1886). Psychopathia sexualis (C.G. Chaddock, Trans.). Philadelphia: F.A. Davis.

Love, B. (2001). Encyclopedia of Unusual Sex Practices. London: Greenwich Editions.

Lykins, A.D., & Cantor, J.M. (2014). Vorarephilia: A case study in masochism and erotic consumption. Archives of Sexual Behavior, 43, 181-186.

Mikellides, A.P. (1950). Two cases of self-cannibalism (autosarcophagy). Cyprus Medical Journal, 3, 498-500.

Mintz, I.L. (1964). Autocannibalism: a case study. American Journal of Psychiatry, 120, 1017.

Monasterio, E. & Prince, C. (2011). Self-cannibalism in the absence of psychosis and substance use. Australasian Psychiatry, 19, 170-172.

Pfafflin, F. (2008). Good enough to eat. Archives of Sexual Behavior, 37, 286-293.

Pfafflin, F. (2009). Reply to Beier (2009). Archives of Sexual Behavior, 38, 166-167.

Prins, H. (1985). Vampirism: A clinical condition. British Journal of Psychiatry, 146, 666-668.

Reuters (1997). Meatballs made from fat, anyone? May 18. Located at:

Sunay, O. & Menderes, A. (2011). Self cannibalism of fingers in an alzheimer patient. Balkan Medical Journal, 28, 214-215.

Unlimited Blog (2007). Sexual cannibalism and Nithari murders. November. Located at:

Wikipdia (2012). Cannibalism. Located at:

Wikipedia (2012). Sexual cannibalism. Located at:

Loud and proud: A psychological (and personal) look at the ‘Sin of Pride’

A number of years ago, I was asked to write an article on “The Sin of Pride” for the British Psychological Society. Before writing that article, I knew very little about the topic. To me it was the title of an record album by The Undertones that I bought in 1983 when I was 16 years old from Castle Records in Loughborough. I perhaps learned a bit more about it when I watched 1995 film Sevendirected by David Fincher and starring Brad Pitt (which coincidentally just happens to be one of my all-time favourite films).

After agreeing to write the article I did a bit of research on the subject (which admittedly meant I did a quick Google search followed by a more considered in-depth search on Google Scholar). While I’m no expert on the topic I can at least have a decent pub conversation about it if anyone is prepared to listen. Just to show my complete ignorance, I wasn’t even aware that the sin of pride was the sin of all sins (although I could in a pub quiz be relied upon to name the seven deadly sins).

I was asked to write on this topic because I was seen as someone who is very proud of the work that I do (and for the record, I am). However, I have often realized that just because I am proud of things that I have done in my academic career it doesn’t necessarily mean others think in the same way. In fact, on some occasions I have been quite taken aback by others’ reactions to things that I have done for which I feel justifiably proud (but more of that later).

At a very basic level, the sin of pride is rooted in a preoccupation with the self. However, in psychological terms, pride has been defined by Dr. Michael Lewis and colleagues in the International Journal of Behavioral Development as “a pleasant, sometimes exhilarating, emotion that results from a positive self-evaluation” and has been described by Dr. Jessica Tracy and her colleagues (in the journal Emotion) as one the three ‘self-conscious’ emotions known to have recognizable expressions (shame and embarrassment being the other two). From my reading of the psychological literature, it could perhaps be argued that pride has been regarded as having a more positive than negative quality, and (according to a paper in the Journal of Economic Psychology by my PhD supervisors – Professor Paul Webley and Professor Stephen Lea) is usually associated with achievement, high self-esteem and positive self-image – all of which are fundamental to my own thinking. My reading on the topic has also led to the conclusion that pride is sometimes viewed as an ‘intellectual’ or secondary emotion. In practical (and psychological) terms, sin is either a high sense of one’s personal status or ego, or the specific mostly positive emotion that is a product of praise or independent self-reflection.

One of the most useful distinctions can be made about sin (and is rooted in my own personal experience), is what Lea and Webley distinguish as ‘proper pride’ and ‘false pride’. They claim that:

“Proper pride is pride in genuine achievements (or genuine good qualities) that are genuinely one’s own. False pride is pride in what is not an achievement, or not admirable, or does not properly belong to oneself. Proper pride is associated with the desirable property of self-esteem; false pride with vanity or conceit. Proper pride is associated with persistence, endurance and doggedness; false pride with stubbornness, obstinacy and pig-headedness.”

As I noted above, there have been times when I have been immensely proud of doing something only for friends and colleagues to be appalled. ‘Proper pride’ as Lea and Webley would argue. One notable instance was when I wrote a full-page article for The Sun on ‘internet addiction’ published in August 1997. I originally wanted to be a journalist before I became a psychologist, and my journalist friends had always said that to get a full-page ‘by line’ in the biggest selling newspaper in the UK was a real achievement. I was immensely proud – apart from the headline that a sub-editor had dubbed my piece ‘The Internuts’ – and showed the article to whoever was around.

Screen Shot 2016-05-09 at 15.27.58Screen Shot 2016-05-09 at 15.37.07

I had always passionately argued (and still do) that I want my research to be disseminated and read by as many people as possible. What was better than getting my work published in an outlet with (at the time) 10 million readers? My elation was short-lived. One close colleague and friend was very disparaging and asked how I could stoop so low as to “write for the bloody Sun?” Similar comments came from other colleagues and I have to admit that I was put off writing for the national tabloids for a number of years. (However, I am now back writing regularly for the national dailies and am strong enough to defend myself against the detractors).

In 2006, I was invited to the House of Commons by the ex-Leader of the Conservative Party, Iain Duncan-Smith and invited to Chair his Centre For Social Justice Working Party on Gambling and write a report as part of the Conservative Party’s ‘Breakdown Britain’ initiative. Anyone who knows me will attest that my political leanings are left of centre and that I working with the Conservatives on this issue was not something I did without a lot of consideration. I came to the conclusion that gambling was indeed a political issue (rather than a party political issue) and if the Conservative Party saw this as an important issue, I felt duty bound to help given my research experience in the area. I spent a number of months working closely with Iain Duncan-Smith’s office and when the report was published I was again very proud of my achievement.

However, as soon as the report came out I received disbelieving and/or snide emails asking how I could have “worked with the Conservatives”. I have spent years trying to put the psychosocial impact of gambling on the political agenda. If I am offered further opportunities by those with political clout, I won’t think twice about taking them. I am still immensely proud of such actions despite what others may think.

Pride is ultimately a subjective experience and the two personal experiences that I outlined above will not put me off doing what I want to do. I shall continue to engage in activities where I think my work can have an impact and shall work with (and write for) those that can help me disseminate my research findings to as many people as possible.

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

Further reading

Averill, J.R. (1991). Intellectual emotions. In: C.D. Spielberger, I.G. Sarason, Z. Kulesar & G.L. van Heck (Eds.), Stress and Emotion: Anger, Anxiety and Curiosity [Vol. 14] pp.3-16. New York: Hemisphere.

Griffiths, M.D. (1997). The internuts (internet addiction). The Sun, August 13, p.6.

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