Category Archives: Psychological disorders

Bed-ly serious: A brief look at ‘sleeping addiction’

As a life-long insomniac, I’ve always been interest in sleep at a personal level. In 1984, when I was studying for my psychology degree, the first ever research seminar I attended was one on the psychology of sleep by Dr. Jim Horne (who was, and I think still is, at Loughborough University). I found the lecture really interesting and although I never pursued a career in sleep research it was at that point that I started to take an interest more professionally. In my blog I’ve written a number of articles on various aspects of sleep including sexsomnia (engaging in sexual acts while sleeping, for instance, while sleepwalking), somnophilia (engaging in sexual acts while individuals are sleeping), Sleeping Beauty paraphilia (a sub-type of somnophilia in which individuals are sexually aroused by watching other people sleep), and lucid dreaming (where individuals are aware they are dreaming and exert some kind of control over the content of the dream),

More recently, I’ve been a co-author on a number of research papers in journals such as Sleep Medicine Reviews, Journal of Sleep Research, and Sleep and Biological Rhythms (see ‘Further reading below) but these have all involved either the effects of internet addiction on sleep or the psychometric evaluation of insomnia screening instruments rather than being about the psychology of sleep.

In a previous A-Z article on “strange and bizarre addictions” I included ‘sleep addiction’ as one of the entries. Obviously I don’t believe that sleeping can be an addiction (at least not by my own criteria) but the term ‘sleep addiction’ is sometimes used to describe the behaviour of individuals who sleep too much. Conditions such as hypersomnia (the opposite of insomnia) has been referred to ‘sleeping addiction’ (in the populist literature at least). In a 2010 issue of the Rhode Island Medical Journal, Stanley Aronson wrote a short article entitled ‘Those esoteric, exoteric and fantabulous diagnoses’ and listed clinomania as the compulsion to stay in bed. Given the use of the word ‘compulsive’ in this definition, there is an argument to consider clinomania as an addiction or at least a behaviour with addictive type elements.

In an online article entitled ‘Sleep addiction’, Amber Merton also mentioned clinomania in relation to an addiction to sleep:

“If you are obsessed with sleeping or have an intense desire to stay in bed, you could be suffering from a condition called clinomania. That doesn’t mean that there aren’t people who can experience symptoms similar to addiction and even withdrawal in association with sleep, or lack thereof”.

The reference to ‘addiction-like’ symptoms appears to have some validity based on these self-report accounts I found online. All of these individuals mention various similarities between their constant need for sleep and addiction. I have highlighted these to emphasize my assertions that some of the consequences are at the very least addiction-like:

  • Extract 1: “I believe someone can become psychologically dependent on sleep. I am 47 and have used sleep for 40 years to escape from life…I typically sleep 4-6 hours too much each day. Sleep feels like an addiction to me because I crave it several times a day and am looking forward to how I can sneak it in. I don’t seem to be able to control it with will power for very long…I only have short periods when this isn’t a problem. When I am under stress it is at its worse. If I have any free or unstructured time, I can’t control how much I sleep excessively. When my time is heavily scheduled, I really struggle with keeping a full schedule and crave the time off when I can sleep for hours. If I know I’ll have a few hours in between activities free, I will find ways to sneak in some sleep. I am embarrassed about this, don’t tell the people around me the extent of the problems and devise ways to sneak in sleep without people knowing”.
  • Extract 2: “I love sleeping. It feels so good I think I could even become addicted if I didn’t HAVE to wake up. I sleep about 12 hours every day and could sleep more if I didn’t have to do daily necessities. I am aware of the fact that people who generally sleep more than they are supposed to, die sooner and have other various health problems. To be honest I would rather sleep than do most things. I even choose sleep over sex a lot”.
  • Extract 3: “I often sleep for 12-20 hours at a time. I have depression and am on anti-depressants. I just love sleeping. It’s so safe and comfy. I don’t know how else to explain it. It’s just amazing”.
  • Extract 4: “I sleep AT LEAST 12 hours a day. But on days off I’ve been known to sleep for about 15-20 hours. [I am] addicted to sleep. I’ve cancelled social outings with friends pretending to be sick when really I just wanted to sleep in. I love sleep and I can’t get enough of it. I’ve slept through the entire weekend multiple times before, only waking up Monday morning when my alarm rang. And even after that much wonderful sleep I was still tired. The second I come home from work every day I eat, shower, and then crawl into bed and sleep the entire evening and night away. My alarm’s the only thing that can wake me up anymore…As for why I love sleep so much, I see a lot of people saying it’s an escape for them. For me it’s more, I don’t like people or going out or socializing, so sleep is my drug of choice. Is it bad? Maybe. Do I care? Not really…I more than love it, and it’s not hurting anyone if we’re being honest”.
  • Extract 5: “I feel like I’m addicted to sleep. Here’s why I think though. I suffered for 13 years with depression and while I know I am still getting over it I don’t feel that’s the reason I’m addicted. During those 13 years I would have serious bouts of chronic insomnia. The doctors tried to many different sleeping medications, meditation, clinics to help me find a routine for natural sleep without meds. Nothing worked. Now I live in Thailand and my doctor here recommended melatonin tablets, all natural as your brain is supposed to produce it anyway to tell you when it’s dark it’s time to sleep and when it’s like light it’s time to wake up. She thinks my brain fails to produce certain chemicals as such with serotonin and now figured melatonin. Since I have been taking a melatonin supplement, I sleep so well, I fall asleep within 20 minutes and I sleep for AT LEAST 8 hours. When I wake up I just want to go back to sleep again because it feels amazing. I don’t feel like it’s part of my anxiety or my depression, I just think it’s because I had insomnia for so long its addictive!
  • Extract 6: “To be honest if I could I would sleep my life away. My so called normal sleeping pattern: I am awake all night. Fall asleep around 4am-8am. Sleep 12 hours. Repeat. My mind is a broken record, constantly repeating the trauma. I do suffer from depression and anxiety. Sleep is my addiction. When I sleep I feel SAFE regardless?”
  • Extract 7: “I’ve been addicted to sleep (the escape from an abusive childhood, depression, and PTSD) since I was ten years old! I want to change though because my body is a mess. I’ve slept for 4 days and sometimes more with short awake periods to eat a little and use the potty. Not enough though, because now my body doesn’t work properly…Oversleeping has its consequences”.
  • Extract 8: “I’m so pleased that I have found this site and other people who are addicted to sleep as this problem has plagued my adult life and I would like it to stop. Take today for instance, I woke at 5.30am and was quite awake feeling a little anxious but I could not wait to get to sleep again, so I did and stayed in bed till around 2.20 pm. I have many days like this and as the lady above the sleep state is quite lucid and I do seem to enjoy it rather than getting up and living life for real”.

Again, I reiterate that none of these individuals are addicted to sleep but in addition to the addiction-like descriptions, there is also crossover in the motivations for excessive sleep and motivations underlying addictions (most noticeably the association with depression, anxiety, psychological trauma, and using the activity as an escape). In relation to addiction, these extracts include references to salience (engaging in sleep to the neglect of everything else in their life), cravings (for sleep), the sleep being excessive, repetitive and habitual, sleep leading to negative consequences (conflict), and loss of control. The fact that many of these individuals describe their behaviour as an addiction or addictive doesn’t mean that it is.

While there is no academic paper that I know of that has ever claimed sleep can be a genuine addiction there are countless clinical and empirical papers examining excessive sleep (i.e., hypersomnia) and the different etiological pathways that can lead to hypersomnia. Although hypersomnia is not an addiction, those with the condition (like addicts) can suffer many negative side-effects from the relatively minor (e.g., low energy, fatigue, headaches, loss of appetite, restlessness, hallucinations) to the more severe (e.g., diabetes, obesity, heart disease, clinical depression, memory loss, suicidal ideation, and in extreme cases, death). In one online article I came across, the similarity between hypersomnia and addiction in relation to depression was evident:

It’s important to note that in some cases separating cause from effect here can be muddled. For instance, does over sleeping contribute to depression or does depression contribute to oversleeping? Or are both oversleeping and depression the effect of a larger underlying cause? Furthermore, once a person is experiencing both, could they act to reinforce the other as a feedback loop?”

This observation could just as easily be made about most addictions (substance or behavioural). Finally, it’s worth noting that there are many sub-types of hypersomnia and excessive sleep. In a good review of hypersomnia [HS] in Current Neurology and Neuroscience Reports, Dr. Yves Dauvilliers notes the following hypersomnia sub-types (including narcolepsy which can include excessive sleep but isn’t usually classed as a type of hypersomnia; also note that ‘idiopathic’ means of unknown cause) which I have paraphrased below:

  • Narcolepsy: This is a disabling neurologic disorder characterized by excessive daytime sleep (EDS) and cataplexy (i.e., a sudden loss of voluntary muscular tone without any alteration of consciousness in relation with strong emotive reactions such as laughter, joking).
  • Narcolepsy without cataplexy: This is simply a variant of narcolepsy with cataplexy (but without the cataplexy).
  • Idiopathic hypersomnia: Idiopathic HS is rare and remains a relatively poorly defined condition due to the absence of specific symptoms such as cataplexy or sleep apneas (i.e., loss of breathing while sleeping).
  • Recurrent hypersomnia: This HS is characterized by repeated episodes of excessive sleep (at least 16 hours a day) lasting from a few days up to several weeks. The most well-known recurrent HS is Kleine-Levin syndrome which comprises both cognitive disturbances (feelings of confusion and unreality) and behavioural disturbances (such as overeating and hypersexual behaviour during symptomatic episodes).
  • Hypersomnia associated with neurologic disorders: This type of HS causes EDS and can be a result of brain tumours, dysfunction in the thalamus, hypothalamus, or brainstem that may mimic idiopathic HS or narcolepsy.
  • Hypersomnia associated with infectious disorders: This type of HS can be a result of viral infection such as HIV pneumonia, Whipple’s disease (a systemic disease most likely caused by a gram-positive bacterium), or Guillain-Barré syndrome (a rapid-onset muscle weakness caused by the immune system damaging the peripheral nervous system).
  • Hypersomnia associated with metabolic or endocrine disorders: This type of HS can be a result of conditions such as hyperthyroidism, diabetes, hepatic encephalopathy (a liver dysfunction among individuals with cirrhosis), and acromegaly (a hormonal disorder that develops when the pituitary gland produces too much growth hormone).
  • Hypersomnia caused by drugs: This type of HS is secondary to many different types of drug medication including hypnotics, anxiolytics, antidepressants, neuroleptics, anti-histamines, and anti-epileptics.
  • Hypersomnia not caused by drugs or known physiologic conditions: This type of HS can be caused by a range of disorders such as depressive disorder, seasonal affective disorder, and abnormal personality traits.

None of these types of HS is an addiction but clearly the negative consequences can be just as serious for the individual.

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

Further reading

Alimoradi, Z., Lin, C-Y., Broström, A., Bülow, P.H., Bajalan, Z., Griffiths, M.D., Ohayon, M.M. & Pakpour, A.H. (2019). Internet addiction and sleep problems: A systematic review and meta-analysis. Sleep Medicine Review, 47, 51-61.

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

Bener, A., Yildirim, E., Torun, P., Çatan, F., Bolat, E., Alıç, S., Akyel, S., & Griffiths, M.D. (2019). Internet addiction, fatigue, and sleep problems among students: A largescale survey study. International Journal of Mental Health and Addiction. doi: 10.1007/s11469-018-9937-1

Billiard, M., & Dauvilliers, Y. (2001). Idiopathic hypersomnia. Sleep Medicine Reviews, 5(5), 349-358.

Dauvilliers, Y. (2006). Differential diagnosis in hypersomnia. Current Neurology and Neuroscience Reports, 6(2), 156-162.

Domenighini, A. (2016). Can you be addicted to sleep? Vice, January 24. Located at: https://www.vice.com/en_us/article/mg7e33/can-you-be-addicted-to-sleep

Hawi, N.S., Samaha, M., & Griffiths, M.D. (2018). Internet gaming disorder in Lebanon: Relationships with age, sleep habits, and academic achievement. Journal of Behavioral Addiction, 7, 70-78.

Mamun, M.A. & Griffiths, M.D. (2019). Internet addiction and sleep quality: A response to Jahan et al. (2019). Sleep and Biological Rhythms. doi: 10.1007/s41105-019-00233-0

Merton, A. (2008). Sleep addiction. Located at: https://www.plushbeds.com/blog/sleep-disorders/sleep-addiction/

Mignot, E. J. (2012). A practical guide to the therapy of narcolepsy and hypersomnia syndromes. Neurotherapeutics, 9(4), 739-752.

Pakpour, A., Lin, C-Y., Cheng, A.S., Imani, V., Ulander, M., Browall, M. Griffiths, M.D., Broström, A. (2019). A thorough psychometric comparison between Athens Insomnia Scale and Insomnia Severity Index among patients with advanced cancer. Journal of Sleep Research. doi: 10.1111/jsr.12891.

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

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

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  • Argentine tango addiction: A French study published in a 2013 issue of the Journal of Behavioral Addictions by Remi Targhetta and colleagues argued that a minority of 1129 Argentine tango dancers they surveyed may be addicted to dancing. In 2015, I and some of my Hungarian colleagues developed the Dance Addiction Inventory (published in PLoS ONE) and also argued that a minority of dancers (more generally) might be addicted to dance and conceptualized the behaviour as a form of exercise addiction.
  • Badminton addiction: While there are many behaviours I could have chosen here including addictions to box set television watching (aka ‘box set bingeing), bargain hunting, bungee jumping, blogging, and bodybuilding, a recent 2018 paper published in NeuroQuantology by Minji Kwon and colleagues carried out a neuroimaging study on a sample 45 badminton players. Using the Korean Exercise Addiction Scale, 20% of the sample were defined as being addicted to badminton.
  • Carrot eating addiction: Again, there are many behaviours I could have chosen here including alleged addictions to crypto-trading, chaos, collecting, crosswords, and cycling, there are a number of published case studies in the psychological literature highlighting individuals addicted to eating carrots including papers by Ludek Černý and Karel Černý, K. (British Journal of Addiction, 1992), and Robert Kaplan (Australian and New Zealand Journal of Psychiatry, 1996).
  • Death addiction: A recent paper by Dr. Marc Reisinger entitled ‘Addiction to death’ in the journal CNS Spectrums attempted to argue that attraction to death be considered an addiction similar to gambling addiction. Reisinger related the concept to individuals who have left Europe to join the jihad in Syria, and outlined the case of 24-year-old French-Algerian Mohamed Merah who committed several attacks in Toulouse in 2012 and who ‘glorified’ death. Te paper claimed that this “addiction to death is taught by Salafist preachers, whose videos, readily accessible on the internet, are kind of advertisements for death, complete with depictions of soothing fountains and beautiful young girls”.
  • Entrepreneurship addiction: There are a couple of papers by April Spivack and Alexander McKelvie (a 2014 paper in the Journal of Business Venturing, and a 2018 paper Academy of Management) arguing that entrepreneurship can be addictive. They define ‘entrepreneurship addiction’ as “the excessive or compulsive engagement in entrepreneurial activities that results in a variety of social, emotional, and/or physiological problems and that despite the development of these problems, the entrepreneur is unable to resist the compulsion to engage in entrepreneurial activities”. They also make the case that that entrepreneurship addiction is different from workaholism.
  • Fortune telling addiction: Although I could have included addictions to financial trading or fame, a 2015 paper in the Journal of Behavioral Addictions by Marie Grall-Bronnec and her colleagues reported the case study of a woman (Helen) that was ‘addicted’ to fortune tellers. They used my addiction criteria to assess whether Helen was addicted to fortune telling, and argued that she was.
  • Google Glass addiction: In previous blogs I have written on addictions to gossip and gardening (although these were based more on non-academic literature). However, a 2015 paper published by Kathryn Yung and her colleagues in the journal Addictive Behaviors, published the first (and to my knowledge) only case of addiction to Google Glass (wearable computer-aided glasses with Bluetooth connectivity to internet-ready devices. The authors claimed that their paper, (i) showed that excessive and problematic uses of Google Glasscan be associated with involuntary movements to the temple area and short-term memory problems, and (ii) highlighted that the man in their case study displayed frustration and irritability that were related to withdrawal symptoms from excessive use of Google Glass.
  • Hacking addiction: Back in the late 1990s and early 2000s I wrote a number of papers on internet addiction and included ‘hacking addiction’ as a type of internet addiction. Given the criminal element of this type of internet addiction I wrote about it in criminological-based journals such as The Probation Journal (1997) and The Police Journal (2000). One of the most infamous cases that I have written about took place in London in 1993, where Paul Bedworth was accused of hacking-related crime causing over £500,000 worth of damage. On the basis of expert witness testimony, he was acquitted on the basis that he was addicted to hacking. Since then, various papers have been published arguing that hacking can be an addiction. For instance, in an in-depth interview study of 62 hackers, Siew Chan and Lee Yao used addiction as a framework to explain their participants’ behaviour (see their paper in the Review of Business Information Systems, 2005).
  • Internet search addiction: Although I was tempted to go for IVF addiction, I thought I would go for ‘internet search addiction’ which basically refers to constant ‘googling’ where individuals spend hours and hours every day using online databases to go searching for things. This behaviour was first alluded to by Kimberley Young in her 1999 classification of different types of internet addiction which she called ‘information overload’ and was defined as compulsive web surfing or database searches. More recently, Yifan Wang and her colleagues developed the Questionnaire on Internet Search Dependence (QISD) published in Frontiers in Public Health (FiPH). I criticized the QISD in a response paper published in FiPH, not because I didn’t think internet search addiction didn’t exist (because theoretically it might do, even though I’ve never come across a genuine case) but because the items in the instrument had very little to do with addiction.
  • Joyriding addiction: There have been a number of academic papers published on joyriding addiction. Arguably the most well-known study was published by Sue Kellett and Harriet Gross in a 2006 issue of Psychology, Crime and Law. The study comprised semi-structured interviews with 54 joyriders (aged 15 to 21 years of age) all of whom were convicted car thieves (“mainly in custodial care”). The results of the study indicated that all addiction criteria occurred within the joyriders’ accounts of their behaviour particularly ‘‘persistence despite knowledge and concern about the harmful consequences’’, ‘‘tolerance’’, ‘‘persistent desire and/or unsuccessful attempts to stop’’, “large amounts of time being spent thinking about and/or recovering from the behaviour’’ and “loss of control”. The paper also cited examples of ‘withdrawal’ symptoms when not joyriding, the giving up of other important activities so that they could go joyriding instead, and spending more time participating in joyriding than they had originally intended.
  • Killing addiction: The idea of serial killing being conceptualized as an addiction in popular culture is not new. For instance, Brian Masters book about British serial killer Dennis Nilsen (who killed at least 12 young men) was entitled Killing for Company: The Story of a Man Addicted to Murder, and Mikaela Sitford’s book about Harold Shipman, the British GP who killed over 200 people, was entitled Addicted to Murder: The True Story of Dr. Harold Shipman. In Eric Hickey’s 2010 book Serial Murderers and Their Victims, Hickey makes reference to an unpublished 1990 monograph by Dr. Victor Cline who outlined a four-factor addiction syndrome in relation to sexual serial killers who (so-called ‘lust murderers’ that I examined in a previous blog). One of the things that I have always argued throughout my career, is that someone cannot become addicted to an activity or a substance unless they are constantly being rewarded (either by continual positive and/or negative reinforcement). Given that serial killing is a discontinuous activity (i.e., it happens relatively infrequently rather than every hour or day) how could killing be an addiction? One answer is that the act of killing is part of the wider behaviour in that the preoccupation with killing can also include the re-enacting of past kills and the keeping of ‘trophies’ from the victims (which I overviewed in a previous blog).
  • Love addiction: In the psychological literature, the concept of love addiction has been around for some time dating back to works by Sigmund Freud. Arguably the most cited work in this area is the 1975 book Love and Addiction by Stanton Peele and Archie Brodsky. Their book suggested that some forms of love are actually forms of addiction, and tried to make the case that some forms of love addiction may be potentially more destructive and prevalent than widely recognized opiate drugs. There have also been a number of instruments developed assessing love addiction including the Love Addiction Scale (developed by Hunter, Nitschke, and Hogan, 1981), and the Passionate Love Scale (developed by Hatfield, and Sprecher, 1986).
  • Muscle dysmporphia as an addiction: In a paper I published with Andrew Foster and Gillian Shorter in a 2015 issue of the Journal of Behavioral Addictions, we argued that muscle dysmorphia (MD) could be classed as an addiction. MD is a condition characterised by a misconstrued body image in individuals who interpret their body size as both small or weak even though they may look normal or highly muscular. MD has been conceptualized as a body dysmorphic disorder, an eating disorder, and/or part of the obsessive-compulsive disorder symptomatology. Reviewing the most salient literature on MD, we proposed an alternative classification of MD that we termed the ‘Addiction to Body Image’ (ABI) model. We argued the addictive activity in MD is the maintaining of body image via a number of different activities such as bodybuilding, exercise, eating specific foods, taking specific drugs (e.g., anabolic steroids), shopping for specific foods, food supplements, and/or physical exercise accessories, etc.. In the ABI model, the perception of the positive effects on the self-body image is accounted for as a critical aspect of the MD condition (rather than addiction to exercise or certain types of eating disorder). Based on empirical evidence, we proposed that MD could be re-classed as an addiction due to the individual continuing to engage in maintenance behaviours that may cause long-term harm.
  • News addiction: Although I could have chosen nasal spray addiction or near death addiction, a recent 2017 paper on ‘news addiction’ was published in the Journal of the Dow University of Health Sciences Karachi by Ghulam Ishaq and colleagues. The authors used some of my papers on behavioural addiction to argue for the construct of ‘news addiction’ as a construct to be empirically investigated. The authors also developed their own 19-item News Addiction Scale (NAS) although the paper didn’t give any examples of any of the items in the NAS. In relation to personality types (and like other addictions), they found news addiction was positively correlated with neuroticism and negatively correlated with conscientiousness. Given that this is the only study on news addiction that I am aware of, I’ll need a lot more research evidence before I am convinced that it really exists.
  • Online auction addiction: A number of academics have made the claim that some individuals can become addicted to participating in online auctions. In a 2004 paper on internet addiction published in American Behavioral Scientist, Kimberley Young mentioned online auction [eBay] addiction in passing. The same observation was also made in a later 2009 paper by Tonino Cantelmi and Massimo Talls in the Journal of CyberTherapy and Rehabilitation. Other researchers have carried out empirical studies including a (i) 2007 paper by Cara Peters and Charles Bodkin in the Journal of Retailing and Consumer Services, (ii) 2008 paper by Chih-Chien Wang in the Proceedings of the Asia-Pacific Services Computing Conference, and (iii) 2011 study carried out by Dr. Ofir Turel and colleagues published in the MIS Quarerly. These papers indicated that those with problematic online auction use experienced (i) psychological distress, (ii) habitual usage, (iii) compulsive behaviour, (iv) negative consequences, and/or (v) dependence, withdrawal and self-regulation.
  • Pinball addiction: Although I could have listed alleged addictions to plastic surgery and poetry, as far as I am aware, I am the only academic to have published a paper on pinball addiction. Back in 1992, I published a case study in Psychological Reports. My paper featured the case of a young man (aged 25 years) who (based on classic addiction criteria) was totally hooked on pinball. It was the most important thing in his life, used the behaviour to modify his moods, got withdrawal symptoms if he was unable to play pinball, had engaged in repeated efforts to cut down or stop playing pinball, and compromised all other activities in his life (education, occupation and relationships). To me, this individual had a gaming addiction but it was pinball rather than videogame addiction.
  • Qat addiction: Qat (sometimes known as khat, kat, cat, and ghat) is a flowering plant traditionally used as a mild stimulant in African and Middle East countries (Somalia, Yemen, Ethiopia). Heavy qat users can experience many side effects including insomnia, anxiety, increased aggression, high blood pressure, and heart problems. There are numerous reports in the medical literature of qat addiction (see papers by Rita Manghi and colleagues in the Journal of Psychoactive Drugs, and Nezar Al-Hebshi and Nils Skuag in Addiction Biology).
  • Rock climbing addiction: Over the past two years, a couple of papers by Robert Heirene, David Shearer, and Gareth Roderique-Davies have looked at the addictive properties of rock climbing specifically concentrating on withdrawal symptoms and craving. In the first paper on withdrawal symptoms published in 2016 in the Journal of Behavioral Addictions, the authors highlighted some previous research suggesting that there are similarities in the phenomenology of substance-related addictions and extreme sports (in this case rock climbing). The study concluded that based on self-report, rock climbers experienced genuine withdrawal symptoms during abstinence from climbing and that these were comparable to individuals with substance and other behavioural addictions. In a second investigation just published in Frontiers in Psychology, the same team reported the development of the Rock Climbing Craving Questionnaire comprising three factors (‘positive reinforcement’, ‘negative reinforcement’ and ‘urge to climb’).
  • Study addiction: I was spoilt for choice on the letter ‘S’ and could have mentioned addictions to speeding, selfie-taking, shoplifting, Sudoko, and stock market speculation. However, there are now a number of published papers on ‘study addiction’ (individuals addicted to their academic study), three of which I have co-authored (all in the Journal of Behavioral Addictions and led by my colleague Pawel Atroszko). We have conceptualised study addiction as a type of work addiction (or a pre-cursor to work addiction) and in a series of studies (including longitudinal research) we have found empirical evidence of ‘study addiction’. Italian researchers (Yura Loscalzo and Marco Giannini) have also published research on ‘overstudying’ and ‘studyholism’ too (in the journals ARC Journal of Psychiatry, 2017; Social Indicators Research, 2018).
  • Tanning addiction: There is now lots of empirical research examining ‘tanorexia’ (individuals who crave tanning and spend every day on sunbeds). However, I along with my colleagues in Norway recently reconceptualised tanorexia as a ‘tanning addiction’ and developed a scale to assess it (which was recently published in a 2018 issue of the British Journal of Dermatology). Our study was the largest over study on tanning (over 23,000 participants) and our newly developed scale (the Bergen Tanning Addiction Scale) had good psychometric properties.
  • Upskirting addiction: Upskirting refers to taking a photograph (typically with a smartphone) up someone’s skirt without their permission. In the UK there have been a number of high profile court cases including Paul Appleby who managed to take 9000 upskirting photos in the space of just five weeks (suggesting that he was doing it all day every day to have taken so many photos), and Andrew MacRae who had amassed 49,000 upskirt photos and videos using hidden cameras at his workplace, on trains, and at the beach. Both men avoided a custodial sentence because their lawyers argued they were addicted and/or had a compulsion to upskirting. In a 2017 issue of the Law Gazette, forensic psychologist Julia Lam made countless references to upskirting in an overview of voyeuristic disorder. Dr. Lam also talked about her treatment of upskirting voyeurs and recounted one case which she claimed was a compulsion (and who was successfully treated). The case involved a male university student who was very sport active but who masturbated excessively whenever major sporting events or important exams were imminent as a coping strategy to relieve stress.
  • Virtual reality addiction: Back in 1995, in a paper I entitled ‘Technological addictions’ in the journal Clinical Psychology Forum, I asserted that addiction to virtual reality would be something that psychologists would be seeing more of in the future. Although I wrote the paper over 20 years ago, there is still little empirical evidence (as yet) that individuals have become addicted to virtual reality (VR). However, that is probably more to do with the fact that – until very recently – there had been little in the way of affordable VR headsets. (I ought to just add that when I use the term ‘VR addiction’ what I am really talking about is addiction to the applications that can be utilized via VR hardware rather than the VR hardware itself). Of all the behaviours on this list, this is the one where there is less good evidence for its existence. Perhaps of most psychological concern is the use of VR in video gaming. There is a small minority of players out there who are already experiencing genuine addictions to online gaming. VR takes immersive gaming to the next level, and for those that use games as a method of coping and escape from the problems they have in the real world it’s not hard to see how a minority of individuals will prefer to spend a significant amount of their waking time in VR environments rather than their real life.
  • Water addiction: In a blog I wrote back in 2015, I recounted some press stories on individuals who claimed they were ‘addicted’ to drinking water. My research into the topic led to a case study of ‘water dependence’ published a 1973 issue of the British Journal of Addiction by E.L. Edelstein. This paper reported that the excessive drinking of water can dilute electrolytes in an individual’s brain and cause intoxication. This led me to a condition called polydipsia (which in practical terms means drinking more than three litres of water a day) which often goes hand-in-hand with hyponatraemia (i.e., low sodium concentration in the blood) and in extreme cases can lead to excessive water drinkers slipping into a coma. There are also dozens and dozens of academic papers on psychogenic polydipsia (PPD). A paper by Dr. Brian Dundas and colleagues in a 2007 issue of Current Psychiatry Reports noted that PPD is a clinical syndrome characterized by polyuria (constantly going to the toilet) and polydipsia (constantly drinking too much water), and is common among individuals with psychiatric disorders. A 2000 study in European Psychiatry by E. Mercier-Guidez and G. Loas examined water intoxication in 353 French psychiatric inpatients. They reported that water intoxication can lead to irreversible brain damage and that around one-fifth of deaths among schizophrenics below the age of 53 years are caused this way. Whether ‘water intoxication’ is a symptom of being ‘addicted’ to water depends upon the definition of addiction being used.
  • X-ray addiction: OK, this one’s a little bit of a cheat but what I really wanted to concentrate on what has been unofficially termed factitious disorder (FD). According to Kamil Jaghab and colleagues in a 2006 issue of the Psychiatry journal FD is sometimes referred to as hospital addiction, pathomimia, or polysurgical addiction”. The primary characteristic of people suffering from FD is that they deliberately pretend to be ill in the absence of external incentives (such as criminal prosecution or financial gain). It is called a factitious because sufferers feign illness, pretend to have a disease, and/or fake psychological trauma typically to gain attention and/or sympathy from other people. Again, whether such behaviours can be viewed as an addiction depends upon the definition of addiction being used.
  • YouTube addiction: I unexpectedly found my research on internet addiction being cited in a news article by Paula Gaita on compulsive viewing of YouTube videos (‘Does compulsive YouTube viewing qualify as addiction?‘). The article was actually reporting a case study from a different news article published by PBS NewsHour by science correspondent Lesley McClurg (‘After compulsively watching YouTube, teenage girl lands in rehab for digital addiction’). The story profiled a student whose obsessive viewing of YouTube content led to extreme behaviour changes and eventually, depression and a suicide attempt. Not long after this, I and my colleague Janarthanan Balakrishnan published what we believe is the only ever study on YouTube addiction in the Journal of Behavioral Addictions. In a study of over 400 YouTube users we found that YouTube addiction was more associated with content creation than watching content
  • ‘Zedding’ addiction: OK, I’m using the Urban Dictionary’s synonym here as a way of including ‘sleep addiction’. The term ‘sleep addiction’ is sometimes used to describe the behavior of individuals who sleep too much. Conditions such as hypersomnia (the opposite of insomnia) has been referred to ‘sleeping addiction’ (in the populist literature at least). In a 2010 issue of the Rhode Island Medical Journal, Stanley Aronson wrote a short article entitled “Those esoteric, exoteric and fantabulous diagnoses” and listed clinomania as the compulsion to stay in bed. Given the use of the word ‘compulsive’ in this definition, there is an argument to consider clinomania as an addiction or at least a behaviour with addictive type elements.

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

Further reading

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Ishaq, G., Rafique, R., & Asif, M. (2017). Personality traits and news addiction: Mediating role of self-control. Journal of Dow University of Health Sciences, 11(2), 31-53.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Walton-Pattison, E., Dombrowski, S.U. & Presseau, J. (2017). ‘Just one more episode’: Frequency and theoretical correlates of television binge watching. Journal of Health Psychology, doi:1359105316643379

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

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

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

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

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

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

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

Myth world: A brief look at some myths about Gaming Disorder

Earlier this year, the World Health Organisation announced that ‘Gaming Disorder’ (GD) was to be officially been included in the latest (eleventh) edition of the International Classification of Diseases (ICD-11). The announcement received worldwide media coverage alongside many debates as to whether its inclusion was justified based on the scientific evidence. The extensive media coverage raised many questions but also appeared to give rise to a number of myths. In this blog, I address these myths in the British context but some of these myths also have resonance outside the UK.

GamingDisorder-1

Myth 1 – Gaming Disorder equates to gaming addiction. Almost all of the worldwide press coverage for GD in June 2018 was equated with gaming addiction. However, the World Health Organization (WHO) does not describe GD as an addiction and the WHO criteria for GD do not include criteria that I believe are core to being genuine addictions (such as tolerance and withdrawal symptoms). Confusingly, the criteria for Internet Gaming Disorder (IGD) in the latest (fifth) edition of the Diagnostic Manual of Mental Disorders (DSM-5) does include all my core criteria of addiction. However, to be diagnosed with IGD, an individual does not necessarily have to endorse all the core addiction criteria. In short, all genuine gaming addicts are likely to be diagnosed as having GD and/or IGD but not all those with GD and/or IGD are necessarily gaming addicts.

Myth 2 – Gaming has many benefits so should not be classed as a disorder as it will create a ‘moral panic’: Predictably, the videogame industry has not welcomed the WHO’s decision to include GD in the ICD-11 and issued a statement to say gaming has many personal benefits and that GD will create moral panic and ‘abuse of diagnosis’. None of us in the field dispute the fact that gaming has many benefits but many other activities such as work, sex, and exercise can be disordered and addictive for a small minority, and is not a good basis for denying the existence of GD. The videogame industry also claims the empirical basis for GD is highly contested but then ironically uses non-empirical claims (i.e., that the introduction of GD will cause a moral panic and lead to diagnostic abuse by practitioners) as a core argument for why GD should not exist.

Myth 3 – Gaming Disorder is associated with other comorbidities so is not a separate disorder. In coverage concerning GD, those denying the existence of GD sometimes resort to the argument that problematic gaming is typically comorbid with other mental health conditions (e.g., depression, anxiety disorders, etc.) and therefore should not be classed as a separate disorder. However, such an argument is not applied (for instance) to those with alcohol use disorder or gambling disorder which are known to be associated with other comorbidities. In fact, we recently published some case studies in the International Journal of Mental Health and Addiction highlighting those attending treatment for GD included individuals both with and without underlying comorbidities. Consequently, diagnosis of disorders should be based on the external symptomatic behavior and consequences, not on the underlying causes and etiology.

Myth 4 – Gaming Disorder can now be treated for free by the National Health Service: Unlike many other countries, the UK has a National Health Service (NHS) whose treatment services can be accessed free of charge. A number of British newspapers reported that inclusion of GD in the ICD-11 meant that those with GD can now get free treatment. However, this claim is untenable and is unlikely to happen. All health trusts in the UK have a finite budget and allocate resources to those conditions considered a priority. Treating individuals with GD will rarely (if ever) be given priority over treatment for cancer, heart disease, schizophrenia, depression, etc. In countries where private health insurance is the norm, GD is likely to be a condition excluded for treatment on such policies even though it is now in the ICD-11. 

Myth 5 – The inclusion of Gaming Disorder as a mental disorder will lead to ‘millions’ of children being stigmatized for their videogame playing: This myth has been propagated by a group of scholars (mainly researchers working in the media studies field) but is completely unsubstantiated. The number of children who would ever be officially be diagnosed as having GD is extremely low and – as noted above – millions of children play videogames for enjoyment without any problems or stigma.

(Please note: This article is based on an editorial that I first published earlier this year: Griffiths, M.D. (2018). Five myths about gaming disorder. Social Health and Behavior Journal, 1, 2-3)

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

Further reading

Aarseth, E., Bean, A. M., Boonen, H., Colder Carras, M., Coulson, M., Das, D., … & Haagsma, M. C. (2017). Scholars’ open debate paper on the World Health Organization ICD-11 Gaming Disorder proposal. Journal of Behavioral Addictions, 6(3), 267-270.

Gentile, D.A., Bailey, K., Bavelier, D., Funk Brockmeyer, J., … & Young, K. (2017). The state of the science about Internet Gaming Disorder as defined by DSM-5: Implications and perspectives, Pediatrics, 140, S81-S85. doi: 10.1542/peds.2016-1758H

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

Griffiths, M.D. (2017). Behavioural addiction and substance addiction should be defined by their similarities not their dissimilarities. Addiction, 112, 1718-1720.

Griffiths, M.D. (2018). Conceptual issues concerning internet addiction and internet gaming disorder. International Journal of Mental Health and Addiction, 16, 233-239.

Griffiths, M.D., Kuss, D.J., Lopez-Fernandez, O., & Pontes, H.M. (2017). Problematic gaming exists and is an example of disordered gaming. Journal of Behavioral Addictions, 6, 296-301.

European Games Developer Foundation. Statement on WHO ICD-11 list and the inclusion of gaming. 2018 June 15. Available from: http://www.egdf.eu/wp-content/uploads/2018/06/Industry-Statement-on-18-June-WHO-ICD-11.pdf

Király, O., Griffiths, M.D. & Demetrovics Z. (2015). Internet gaming disorder and the DSM-5: Conceptualization, debates, and controversies, Current Addiction Reports, 2, 254–262.

Király, O., Griffiths, M.D., King, D., Lee, H-K., Lee, S-Y., Bányai, F., Zsila, A. Demetrovics, Z. (2018). An overview of policy responses to problematic videogame use. Journal of Behavioral Addictions, 7, 503-517.

Kuss, D.J., Griffiths, M.D. & Pontes, H.M. (2017). Chaos and confusion in DSM-5 diagnosis of Internet Gaming Disorder: Issues, concerns, and recommendations for clarity in the field. Journal of Behavioral Addictions, 6, 103-109.

Kuss, D.J., Pontes, H.M. & Griffiths, M.D. (2018). Neurobiological correlates in Internet Gaming Disorder: A systematic review. Frontiers in Psychiatry, 9, 166. doi: 10.3389/fpsyt.2018.00166

Griffiths, M.D., Van Rooij, A., Kardefelt-Winther, D., Starcevic, V., Király, O…Demetrovics, Z. (2016). Working towards an international consensus on criteria for assessing Internet Gaming Disorder: A critical commentary on Petry et al (2014). Addiction, 111, 167-175.

Rumpf, H. J., Achab, S., Billieux, J., Bowden-Jones, H., Carragher, N., Demetrovics, Z., … & Saunders, J. B. (2018). Including gaming disorder in the ICD-11: The need to do so from a clinical and public health perspective: Commentary on: A weak scientific basis for gaming disorder: Let us err on the side of caution (van Rooij et al., 2018). Journal of Behavioral Addictions, 7(3), 556-561.

Torres-Rodriguez, A., Griffiths, M.D., Carbonell, X. Farriols-Hernando, N. & Torres-Jimenez, E. (2018). Internet gaming disorder treatment: A case study evaluation of four adolescent problematic gamers. International Journal of Mental Health and Addiction, https://doi.org/10.1007/s11469-017-9845-9.

Teenage pics: A brief look at ‘selfie addiction’

In March 2014, the Daily Mirror published the story of Danny Bowman, a teenage ‘selfie addict’ who allegedly took up to 10 hours a day taking 200 selfies, dropped out of school, and tried to kill himself when he was unable take the perfect photo of himself. Taking selfies has become a very popular activity, particularly amongst teenagers and young adults. However, selfie-taking is more than just the taking of a photograph and can include the editing of the colour and contrast, changing backgrounds, and adding other effects, before uploading the picture onto a social media platform. These added options and the use of integrative editing has further popularized selfie-taking behaviour. From a psychological perspective, the taking of selfies is a self-oriented action which allows users to establish their individuality and self-importance and is also associated with personality traits such as narcissism. In an interview for the Daily Mirror, Bowman said that:

“I was constantly in search of taking the perfect selfie and when I realised I couldn’t I wanted to die. I lost my friends, my education, my health and almost my life. The only thing I cared about was having my phone with me so I could satisfy the urge to capture a picture of myself at any time of the day. “I finally realised I was never going to take a picture that made the craving go away and that was when I hit rock bottom. People don’t realise when they post a picture of themselves on Facebook or Twitter it can so quickly spiral out of control. It becomes a mission to get approval and it can destroy anyone. It’s a real problem like drugs, alcohol or gambling. I don’t want anyone to go through what I’ve been through. People would comment on [my selfies], but children can be cruel. One told me my nose was too big for my face and another picked on my skin. I started taking more and more to try to get the approval of my friends. I would be so high when someone wrote something nice but gutted when they wrote something unkind. [Taking lots of selfies sounds trivial and harmless but that’s the very thing that makes it so dangerous. It almost took my life, but I survived and I am determined never to get into that position again.”

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While Bowman’s case is extreme, it doesn’t mean that obsessive selfie-taking is a trivial condition. Bowman was diagnosed as having (and eventually treated for) body dysmorphic disorder (BDD) which at its simplest level, is a distressing, handicapping, and/or impairing preoccupation with an imagined or slight defect in body appearance that the sufferer perceives to be ugly, unattractive, and/or deformed. Bowman’s psychiatrist, Dr. David Veale (one of the world’s most foreknown experts on BDD) said that: “Danny’s case is particularly extreme. But this is a serious problem. It’s not a vanity issue. It’s a mental health one which has an extremely high suicide rate.”

To date, there has been very little research on ‘selfie addiction’ and most of what has been academically published (both theorizing and empirical research studies) has tended to come from psychiatrists and psychologists in India. The main reasons for this are that (i) no other country has more Facebook users than India, and (ii) India accounts for more selfie deaths in the world compared to any other country with 76 deaths reported from a total of 127 worldwide. For instance, the death on February 1, 2016, of the 16-year old Dinesh Kumar killed by a train in Chennai while taking a selfie was reported widely in the media.

In 2014, there were a handful of separate media reports all reporting that ‘selfie addiction’ had been recognized by psychologists and psychiatrists as a genuine mental disorder. On March 31, 2014, a news story appeared in the Adobo Chronicles website that the American Psychiatric Association (APA) had classed ‘selfitis’ (i.e., the obsessive taking of selfies) as a new mental disorder.

The article claimed that selfitis was “the obsessive compulsive desire to take photos of one’s self and post them on social media as a way to make up for the lack of self-esteem and to fill a gap in intimacy”. The same article also claimed there three levels of the disorder – borderline (“taking photos of one’s self at least three times a day but not posting them on social media”), acute (“taking photos of one’s self at least three times a day and posting each of the photos on social media”), and chronic (“uncontrollable urge to take photos of one’s self round the clock and posting the photos on social media more than six times a day”). The story was republished on numerous news sites around the world but it soon became clear the story was a hoax. However, many of the academic papers exploring the concept of ‘selfie addiction’ have reported the story as genuine.

Other academics claim in a rather uncritical way that ‘selfie addiction’ exists. For instance, in 2015, in an article in theInternational Journal of Emergency Mental Health and Human Resilience, Shah claimed that selfie-taking behaviour “classically fits” the criteria of addiction but then fails to say what these criteria are. He then goes on to argue that anyone taking more than 3-5 selfies a day “may be considered as a disease” and that spending more than 5 minutes taking a single selfie or more than 30 minutes per day may also be “considered as disease”. Such proposals add little to the credence of excessive selfie-taking being potentially addictive.

In a 2017 editorial entitled ‘Selfie addiction’ (in the journal Internet and Psychiatry), Singh and Lippmann asserted that knowing about the psychology of selfies and their consequences is important for both individuals and the communities in which they live. They claim that the taking of selfies can sometimes be “inconsiderate of other people, especially when ‘getting the perfect shot’ becomes an obsession”. They claim that excessive selfie clicking can become “a troublesome obsession and may be related to different personality traits” such as psychopathy, narcissism, and Machiavellianism. More specifically, the argue that:

“Narcissistic people exhibit feelings of superiority and perfection, but also often harbor self-doubt. Those with psychopathy have little compassion about harming others. Persons with Machiavellian traits fulfill their wishes with diminished ethics. All three utilize social websites that allow posting and amending pictures. Individuals with low self-esteem, obsession, and/or hyperactivity also sometimes exhibit high rates of “snapping” selfies”.

In a very brief review of the literature on selfie-taking and mental health in a 2016 issue of the Indian Journal of Health and Wellbeing, Kaur and Vig concluded that selfie addiction was most associated with low self-esteem, narcissism, loneliness and depression. Also in 2016, Sunitha and colleagues also reported similar findings based on their review of selfie-taking in theInternational Journal of Advances in Nursing Management. In an online populist article in 2017 on the rise of the ‘selfie generation’, Tolete and Salarda interviewed a teen development specialist, Dr. Robyn Silverman about how and why adolescents might get hooked on selfie-taking. He said that teens “crave positive feedback to help them see how their see how their identity fits into their world. Social media offers an opportunity to garner immediate information…the selfie generation ends up agonizing over very few likes or one or two negative comments, as if these are the only metrics that will prove they matter. One can only imagine the vulnerability of their still fragile self-esteem in such an environment”.

Other academics have claimed that while the evidence for ‘selfie addiction’ being a social problem is lacking, it does not mean that it could not be a ‘primary pathology’ in times to come. However, there has been very few empirical studies that have examined ‘selfie addiction, and those that have been published suffer from many methodological weaknesses.

For instance, in a 2017 issue of the Journal of Contemporary Medicine and Dentistry, Gaddala and colleagues examined the association between Internet addiction and ‘selfie addiction’ among 402 Indian medical students (262 females). They reported a significant association between selfie dependence and internet dependence. However, they used Shah’s operationalization of ‘selfie addiction’ (the taking of three or more selfies a day; 4% of the total sample), therefore it is unlikely that very few of the participants would have been genuinely addicted to taking selfies.

Singh and Tripathi carried out a very small study on 50 Indian adolescents aged 12-18 years of age (28 females; average age 14.6 years) in 2017 (in the journal SSRN). They found that narcissism and hyperactivity were positively correlated with ‘selfie addiction’ whereas self-image was negatively correlated with ‘selfie addiction’. However, in addition to the very small sample size, the instrument used to assess selfie tendencies had little to do with addiction and simply asked questions about typical selfie behaviour (e.g., how many selfies a day/week are taken, how much time a day is spent taking selfies, are the selfies posted onto social media, etc.)

Finally, a 2017 study in the Journal of Medical Science and Clinical Research by Kela and colleagues examined the more medical effects of excessive selfie-taking. In a survey of 250 Indian students aged 18-25 years (56% females), it was reported that 30% reported lower back ache, 15% suffered stress, 20%, suffered from cervical spondylitis, 25% suffered from headache, and 10% suffered from ‘selfie elbow’ (a tendonitis condition). However, it was unclear from the methodology described to what extent these effects were specifically attributable to selfie-taking.

Taking the academic literature as a whole, there is little evidence – as yet – that ‘selfie addiction’ exists although if stories like Danny Bowman are to be believed, it does appear at least theoretically possible for an individual to become addicted to such an activity.

(Note: some of this material first appeared in the following paper: Griffiths, M.D. & Balakrishnan, J. (2018). The psychosocial impact of excessive selfie-taking in youth: A brief overview. Education and Health, 36(1), 3-5).

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

Further reading

Balakrishnan, J. & Griffiths, M.D. (2018). An exploratory study of ‘selfitis’ and the development of the Selfitis Behavior Scale. International Journal of Mental Health and Addiction, https://doi.org/10.1007/s11469-017-9844-x.

Barakat, C. (2014). Science links selfies to narcissism, addiction, and low self esteem. Adweek, April 16. Located at: www.adweek.com/socialtimes/selfies-narcissism-addiction-low-self-esteem/147769

Bhattacharyya, R. (2017). Addiction to modern gadgets and technologies across generations. Eastern Journal of Psychiatry, 18(2), 27-37.

Gaddala, A., Hari Kumar, K. J., & Pusphalatha, C. (2017). A study on various effects of internet and selfie dependence among undergraduate medical students. Journal of Contemporary Medicine and Dentistry, 5(2), 29-32.

Grossman, S. (2014). Teenager reportedly tried to kill himself because he wasn’t satisfied with the quality of his selfies. Time, March 24. Located at: http://time.com/35701/selfie-addict-attempts-suicide/

Gupta, R. & Pooja, M. (2016). Selfie an infectious gift of IT to modern society. Global Journal for Research Analysis, 5(1), 278-280.

Kaur, S., & Vig, D. (2016). Selfie and mental health issues: An overview. Indian Journal of Health and Wellbeing, 7(12), 1149-1152.

Kela, R., Khan, N., Saraswat, R., & Amin, B. (2017). Selfie: Enjoyment or addiction? Journal of Medical Science and Clinical Research, 5, 15836-15840.

Lee, R. L. (2016). Diagnosing the selfie: Pathology or parody? Networking the spectacle in late capitalism. Third Text, 30(3-4), 264-27

Senft, T. M., & Baym, N. K. (2015). Selfies introduction – What does the selfie say? Investigating a global phenomenon. International Journal of Communication, 9, 19.

Shah, P.M. (2015). Selfie – a new generation addiction disorder – Literature review and updates. International Journal of Emergency Mental Health and Human Resilience, 17, 602.

Singh, D., & Lippmann, S. (2017). Selfie addiction. Internet and Psychiatry, April 2. Located at: https://www.internetandpsychiatry.com/wp/editorials/selfie-addiction/

Singh, S. & Tripathi, K.M. (2017). Selfie: A new obsession. SSRN, 1-3. Located at: https://papers.ssrn.com/sol3/papers.cfm?abstract_id=2920945

Sunitha, P. S., Vidya, M., Rashmi, P., & Mamatha, M. (2016). Selfy [sic] as a mental disorder – A review. International Journal of Advances in Nursing Management, 4(2), 169-172.

Me, myself-itis: A brief overview of obsessive selfie-taking

According to the Oxford English Dictionary, a selfie is a “photograph that one has taken of oneself, typically one taken with a smartphone or webcam and shared via social media”. From a psychological perspective, the taking of selfies is a self-oriented action that allows users to establish their individuality and self-importance; it is also associated with personality traits such as narcissism.

However, selfie-taking is more than just the taking of a photograph. It can include the editing of the color and contrast, the changing of backgrounds, and the addition of other effects before uploading. These added options and the use of integrative editing have further popularized selfie-taking behavior, particularly amongst teenagers and young adults.

On March 31, 2014, a story appeared on a website called the Adobo Chronicles that claimed that the American Psychiatric Association (APA) had classed “selfitis” as a new mental disorder. According to the author, the organization had defined selfitis as “the obsessive compulsive desire to take photos of one’s self and post them on social media as a way to make up for the lack of self-esteem and to fill a gap in intimacy”. The same article also claimed there three levels of the disorder: borderline (“taking photos of one’s self at least three times a day but not posting them on social media”), acute (“taking photos of one’s self at least three times a day and posting each of the photos on social media”), and chronic (“uncontrollable urge to take photos of one’s self round the clock and posting the photos on social media more than six times a day”).

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The story was republished on numerous news sites around the world, but it soon became clear the story was a hoax. However, one of the reasons that so many news outlets republished the story – other than that it seemingly fit certain preexisting stereotypes in people’s minds – was that the criteria used to delineate the three levels of selfitis (i.e., borderline, acute, and chronic) seemed believable.

Therefore, we thought it would be interesting to examine whether there was any substance to the claims that taking selfies can be a time-consuming and potentially obsessive behavior – the stereotype underlying many people’s credulity about the fake story. We empirically explored the concept of selfitis across two studies and collected data on the existence of selfitis with respect to the three alleged levels (borderline, acute, and chronic), ultimately developed our own psychometric scale to assess the sub-components of selfitis (the Selfitis Behaviour Scale).

We used Indian students as participants in our research because India has the largest total number of users on Facebook by country. We also knew India accounts for more selfie-related deaths in the world compared to any other country. with a reported 76 deaths reported out of a total of 127 worldwide since 2014. (Those deaths usually occur when people attempt to take selfies in dangerous contexts, such as in water, from heights, in the proximity of moving vehicles, like trains, or while posing with weapons).

Our study began by using focus group interviews with 225 young adults with an average age of 21 years old to gather an initial set of criteria that underlie selfitis. Example questions used during the focus group interviews included ‘What compels you to take selfies?’, ‘Do you feel addicted to taking selfies?’ and ‘Do you think that someone can become addicted to taking selfies?’ It was during these interviews that participants confirmed there appeared to be individuals who obsessively take selfies — or, in other words, that selfitis does at least exist. But, since we did not collect any data on the negative psychosocial impacts, we cannot yet claim that the behavior is a mental disorder; negative consequences of the behavior is a key part of that determination.

The six components of selfitis, tested on the further participants, were: environmental enhancement (e.g., taking selfies in specific locations to feel good and show off to others); social competition (e.g., taking selfies to get more ‘likes’ on social media); attention-seeking (e.g., taking selfies to gain attention from others); mood modification (e.g., taking selfies to feel better); self-confidence (e.g., taking selfies to feel more positive about oneself); and subjective conformity (e.g., taking selfies to fit in with one’s social group and peers).

Our findings showed that those with chronic selfitis were more likely to be motivated to take selfies due to attention-seeking, environmental enhancement and social competition. The results suggest that people with chronic levels of selfitis are seeking to fit in with those around them, and may display symptoms similar to other potentially addictive behaviours. Other studies have also suggested that a minority of individuals might have a ‘selfie addiction’ (see ‘References and further reading’ below).

With the existence of the condition apparently confirmed, we hope that further research will be carried out to understand more about how and why people develop this potentially obsessive behaviour, and what can be done to help people who are the most affected. However, the findings of our research do not indicate that selfitis is a mental disorder based on the findings of this study – a claim made in many of the news reports about our study, possibly demonstrating how deep the stereotypes about selfie-takes run – only that selfitis appears to be a condition that requires further research to fully assess the psychosocial impacts that the behaviour might have on the individual.

If you are interested in assessing your own behavior, click here to download where you can complete the self-assessment test in the Appendix of our paper.

Please note: This article was co-written with Dr. Janarthanan Balakrishnan (Thiagarajar School of Management, India)

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

Further reading

Balakrishnan, J. & Griffiths, M.D. (2018). An exploratory study of ‘selfitis’ and the development of the Selfitis Behavior Scale. International Journal of Mental Health and Addiction, https://doi.org/10.1007/s11469-017-9844-x.

Gaddala, A., Hari Kumar, K. J., & Pusphalatha, C. (2017). A study on various effects of internet and selfie dependence among undergraduate medical students. Journal of Contemporary Medicine and Dentistry, 5(2), 29-32.

Griffiths, M.D. & Balakrishnan, J. (2018). The psychosocial impact of excessive selfie-taking in youth: A brief overview. Education and Health, 36(1), 3-5.

Kaur, S., & Vig, D. (2016). Selfie and mental health issues: An overview. Indian Journal of Health and Wellbeing, 7(12), 1149

Khan, N., Saraswat, R., & Amin, B. (2017). Selfie: Enjoyment or addiction? Journal of Medical Science and Clinical Research, 5, 15836-15840.

Lee, R. L. (2016). Diagnosing the selfie: Pathology or parody? Networking the spectacle in late capitalism. Third Text, 30(3-4), 264-27

Senft, T. M., & Baym, N. K. (2015). Selfies introduction – What does the selfie say? Investigating a global phenomenon. International Journal of Communication, 9, 19

Singh, D., & Lippmann, S. (2017). Selfie addiction. Internet and Psychiatry, April 2. Located at: https://www.internetandpsychiatry.com/wp/editorials/selfie-addiction/

Singh, S. & Tripathi, K.M. (2017). Selfie: A new obsession. SSRN, Located at: http://dx.doi.org/10.2139/ssrn.2920945

Painless steal? Another look at shoplifting as an addiction

In a previous 2014 blog, I looked at the psychology of shoplifting (which I called ‘Men of Steal’) based on the work of American psychologist John C. Brady (who’s upcoming book is also entitled ‘Men of Steal’). Brady is a really engaging writer and he recently published an article in Counsellor magazine on celebrity theft and why for some people it should be classed as an addiction.

Brady briefly recounted the cases of three celebrities who had been caught shoplifting (Lindsay Lohan, Kim Richards, and Winona Ryder – click on the links to get the stories of each of these celebrity shoplifting stories). Other famous celebrity shoplifters include Britney Spears, Megan Fox, Kristin Cavallari, Farrah Fawcett, and WWE Diva Emma (if you’re really interested in these and other celebrity shoplifters, then check out this story in Rebel Circus). According to Dr. Brady “psychological analysis reveals they are not greedy, rather they are addicted to the ‘rush’ associated with theft” and that there is an ‘addictive criminal syndrome’.

Brady’s article used the ‘celebrity’ angle as the ‘hook’ to write more generally about ‘shoplifting addictions’ and briefly outlined the cases of three high profile ‘theft addicts’:

“The first man is Bruce McNall, former LA Kings owner, Hollywood film producer, and a convicted felon. He received five years in Lompoc Federal Prison for stealing $238 million. The second man, John Spano, former owner of the New York Islanders, went off to two terms in federal prisons for stealing $80 million. He is currently an inmate in an Ohio prison doing ten more years for a crime he did not originate. Finally, William “Boots” Del Biaggio III, former Silicon Valley venture capitalist operator and founder of Heritage Bank in San Jose, graduated in 2016 from eight years at Lompoc for fraud. He stole $110 million to buy the Nashville Predators hockey team. He later expressed regret—maybe too little too late”.

Brady believes that these individuals had a behavioural addiction to stealing. The cases he outlined were all true and were examples of what Brady described as “elite offenders who became addicted to the rush connected to stealing”. Some commonalities between the three individuals was noted: they were charming, deceptive, had personalities that were outgoing, never used violence or aggression in the carrying out of their thefts, and (in Brady’s view) were addicted to crime. Like many addicts, they harmed themselves, their families, and their communities as a consequence of their behaviour.

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The idea of being addicted to crime is not new, and the addiction components model that I have developed over the last couple of decades was based on that of one of my mentors – Iain Brown – who used such a model to explain addictive criminal offending in a really good book chapter published back in 1997 (in the book Addicted to Crime? edited by the psychologists John Hodge, Mary McMurran and Clive Hollin – see ‘Further reading’ below). Like me, Brady also read Addicted to Crime? in which it was posited that some criminals appear to become addicted to stealing (and that the act of theft made them feel good psychologically by providing a ‘high’ or a ‘rush’ similar to the feelings individuals experience when they ingest psychoactive substances). Brady argues that an addiction to stealing is a behavioural addiction and that it is “functionally equivalent” to substance-based addictions for two main reasons: that theft addicts (i) “generally derive the same initial uplifting, euphoric, and subjective sensations similar to substance abusers”, and (ii) “are almost blindly driven toward their goal and they cannot stop their self-defeating behaviors”.   

Brady contends that there are five addictive criminal stages of what he terms “the zone”: (i) criminal triggers, (ii) moral neutralisation, (iii) commission of the criminal act, (iv) post-criminal-act exhilaration, and (v) post-criminal-act confusion. Brady asserts:

“The five addictive stages comprising the criminal addictive zone helps explain why certain offenders arrived at such low points in their lives and progressively became drawn deeper into the addictive zone. Because these three men became frozen into one or more of these stages, they simply could not easily find an exit sign. I have applied this criminal zonal theory to a variety of deviant groups, including white-collar deviants and now to these three elite, nonviolent bank robbers. An analysis of the criminal addictive personality forms the foundation of the addictive zone. This zone is marked with multiple, negative psychological forces evidenced during each of the five stages…The movement through these overlapping stages results in a negative, criminological, transformative process during which theft addicts surrender their prior noncriminal status (positive), thereby adopting a new deviant one (negative)…After entering into this enigmatic zone, offenders often become locked into one or more of these overlapping stages. The one factor that remains constant is that the progression through these five stages dramatically and unalterably changed these men’s lives, their victims’ lives, and the lives of people around them”.

Brady’s five addictive criminal stages are:

  • Criminal triggers – In the first stage. these internal triggers revolve around salience and low self-esteem and comprise “confusing and mostly illogical thoughts” that criminals acquire. These negative thoughts are “reflective of peoples’ compromised self-concepts coupled with the desire to overcompensate for perceived personal shortcomings” and primarily originate from feelings of loneliness, emptiness, and inadequacy.
  • Moral neutralisation – In the second stage, Brady claims that this stage is the most complex and essential of all the stages and is rooted in conflict. The destructive and self-defeating behaviour that criminals experience is not driven by material (economic) motives but is simply individuals “trying to enrich their empty shell identities” and fuelled by irrational thoughts of wanting to prove to significant others that they are really important. These motives may be completely unconscious
  • Commission of the criminal act – In the third stage, the actual carrying out of the criminal acts demands that criminals “neutralize the unsavory aspects of their offenses…and lend meaning to inexplicable behaviors”. The more a criminal engages in the activity the more criminals become “skilled practitioners in the art of self-deception”. Here, the criminal behaviour is paired with “exciting sensations” associated with the risk of engaging in criminal activity (“an anticipated visceral feeling or mental excitement and stimulation, if not an elation, a thrill, a rush, and even a sense of euphoria”). In short, the euphoric sensations experienced reinforce the criminal behaviour.
  • Post-criminal-act exhilaration – In the fourth stage, Brady claims there is typically a “flooding of mood-elevating feelings similar to an adrenaline rush, accompanied with thoughts that synthetically increase their sense of well-being” and what my mentor Iain Brown refers to as “hedonic mood management”. In short, the criminal act can help individuals feel like “bigshots” and criminals may justify doing something bad because it makes them feel so good. Brady also claims that many of these exhilarating feelings “manifest themselves on an unconscious level that is easily experienced, yet not easily comprehended by a theft addict”
  • Post-criminal-act confusion – In the fifth stage, Brady claims that the mood modifying experiences in the third and fourth stages are “replaced with new, dramatic, and unexpected changes in the offenders’ emotional awareness”. Here, criminals become confused, depressed and socially withdrawn, as well as experiencing withdrawal-like reactions (e.g., sweating, headaches, anxiety, nausea, heart arrhythmia, etc.). Brady says that on a psychological level, the fifth stage five is characterized by “confusion, guilt, afterthoughts, misgivings, anxiety, depression, and dramatic mood shifts ranging from feelings of sadness to hopelessness”. It is also during this stage that criminals might start to show signs of remorse.

Brady concludes that for the criminals he has known and treated “used the stolen money to boost their status and enhance their enormous egos so they could attain ‘big shot’ fame”. I find this last observation interesting given a previous blog that I wrote on fame being addictive. I’ve also written other blogs on addictive criminal behaviour (such as joy-riding).

I am of the opinion that specific types of crime can be classed as an addictive behaviour because addictions rely on constant rewards (i.e., reinforcement) and crime can provide many rewarding experiences (both financially and psychologically), at least in the short-term. I’m not for one-minute condoning such behaviour, just simply stating my opinion that I believe it’s theoretically possible to become addicted to activities such as stealing.

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

Further reading

Brady, J.C. (2013). Why Rich Women Shoplift – When They Have It All. San Jose, CA: Western Psych Press.

Brady, J.C. (2017) Celebrity theft: Unmasking addictive criminal intent. Counselor, July/August. Located at: http://www.counselormagazine.com/detailpageoverride.aspx?pageid=1729&id=15032386763

Brown, I. (1997). A theoretical model of the behavioral addictions: Applied to offending. In J.E. Hodge, M. McMurran, & C.R. Hollin (Eds.), Addicted to crime? (pp. 15–63). Chichester: Wiley.

Hodge, J.E., McMurran, M., & Hollin, C.R. (1997). Addicted to crime? Chichester: Wiley.

Shulman, T.D. (2011). Cluttered Lives, Empty Souls – Compulsive Stealing, Spending and Hoarding. West Conshohocken, PA: Infinity Publishing.

Soriano, M. (2015). 15 celebrities who were caught shoplifting. Rebel Circus, May 13. Located at: http://www.rebelcircus.com/blog/celebrities-caught-shoplifting/

We can work it out: A brief look at ‘entrepreneurship addiction’

Last month, a paper appeared online in the journal Academy of Management (AJM). I’d never heard of the journal before but its remit is publish empirical research that tests, extends, or builds management theory and contributes to management practice”. The paper I came across was entitled ‘Entrepreneurship addiction: Shedding light on the manifestation of the ‘dark side’ in work behavior patterns’ – and is an addiction that I’d never heard of before. The authors of the paper – April Spivack and Alexander McKelvie – define ‘entrepreneurship addiction’ as the excessive or compulsive engagement in entrepreneurial activities that results in a variety of social, emotional, and/or physiological problems and that despite the development of these problems, the entrepreneur is unable to resist the compulsion to engage in entrepreneurial activities”. Going by the title of the paper alone, I assumed ‘entrepreneurship addiction’ was another name for ‘work addiction’ or ‘workaholism’ but the authors state:

“We address what is unique about this type of behavioral addiction compared to related work pattern concepts of workaholism, entrepreneurial passion, and work engagement. We identify new and promising areas to expand understanding of what factors lead to entrepreneurship addiction, what entrepreneurship addiction leads to, how to effectively study entrepreneurship addiction, and other applications where entrepreneurship addiction might be relevant to study. These help to set a research agenda that more fully addresses a potential ‘dark side’ psychological factor among some entrepreneurs”.

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The paper is a theoretical paper and doesn’t include any primary data collection. The authors had published a previous 2014 paper in the Journal of Business Venturing, on the same topic (‘Habitual entrepreneurs: Possible cases of entrepreneurship addiction?’) based on case study interviews with two habitual entrepreneurs. In that paper the authors argued that addiction symptoms can manifest in the entrepreneurial context. Much of the two papers uses the ‘workaholism’ literature to ground the term but the authors do view ‘entrepreneurship addiction’ and ‘work addiction’ as two separate entities (although my own view is that entrepreneurship addiction’ is a sub-type of ‘work addiction’ based on what I’ve read – in fact I would argue that all ‘entrepreneurship addicts’ are work addicts but not all work addicts are ‘entrepreneurship addicts’). Spivak and McKelvie are right to assert that entrepreneurship addiction is a relatively new term and represents an emerging area of inquiry” and that “reliable prevalence rates are currently unknown”.

The aim of the AJM paper is to “situate entrepreneurship addiction as a distinct concept” and to examine entrepreneurship addiction in relation to other similar work patterns (i.e., workaholism, work engagement, and entrepreneurial passion). Like my own six component model of addiction, Spivak and McKelvie also have six components (and are similar to my own) which are presented below verbatim from their AJM paper:

  • Obsessive thoughts – constantly thinking about the behavior and continually searching for novelties within the behavior;
  • Withdrawal/engagement cycles – feeling anticipation and undertaking ritualized behavior, experiencing anxiety or tension when away, and giving into a compulsion to engage in the behavior whenever possible;
  • Self-worth – viewing the behavior as the main source of self-worth;
  • Tolerance – making increasing resource (e.g., time and money) investments;
  • Neglect – disregarding or abandoning previously important friends and activities;
  • Negative outcomes – experiencing negative emotional outcomes (e.g., guilt, lying, and withholding information about the behavior from others), increased or high levels of strain, and negative physiological/health outcomes.

As in my own writings on work addiction (see ‘Further reading’ below), Spivak and McKelvie also note that even when addicted, there may still be some positive outcomes and/or benefits from such behaviour (as can be found in other behavioural addictions such as exercise addiction). As noted in the AJM paper:

“Some of these positive outcomes may include benefits to the business venture including quick responsiveness to competitive pressures or customer demands and high levels of innovation, while benefits to the individual may include high levels of autonomy, financial security, and job satisfaction. It is the complexity of these relationships, or the combined positive and negative outcomes, that may obscure the dysfunctional dark side elements of entrepreneurship addiction”.

Spivak and McKelvie also go to great lengths to differentiate entrepreneurship addiction from workaholism (although I ought to point out, I have recently argued in a paper in the Journal of Behavioral Addictions [‘Ten myths about work addiction’] that ‘workaholism’ and ‘work addiction’ are not the same thing, and outlined in a previous blog). Spivak and McKelvie concede that entrepreneurship addiction is a “sister construct” to ‘workaholism’ because of the core elements they have in common. More specifically, in relation to similarities, they assert:

“Workaholism, like entrepreneurship addiction, emphasizes the compulsion to work, working long hours, obsessive thoughts that extend beyond the domain of work, and results in some of the negative outcomes that have been linked to entrepreneurship addiction, including difficulties in social relationships and diminished physical health (Spivack et al., 2014). Some of the conceptualizations of workaholism draw from the literature on psychological disorders. Similarly, we recognize and propose that there may be significant overlap with various psychological conditions among those that develop entrepreneurship addiction, including, but not limited to, obsessive compulsive disorder, bipolar disorder, and ADD/ADHD”.

However, they then do on to describe what they feel are the practical and conceptual distinctions between entrepreneurship addiction and workaholism. More specifically, they argue that:

“(M)ost workaholics are embedded within existing firms and are delegated tasks and resources in line with the organization’s mission, often in a team-based structure. Most workaholics work on these assigned projects with intensity and some will do so with high levels of engagement, as specified in previous literature. But, in reward for their efforts, many employed workaholics may be limited to receiving recognition and performance bonuses. As a team member employed within the structures of an existing organization, the individual’s contribution to organizational outcomes may be obfuscated just as the reciprocal impact of organizational performance (whether negative or positive) on the individual may be buffered (i.e., there is little chance an employee will lose their home if the business doesn’t perform well). In contrast, entrepreneurs, by definition, are proactive creators of their work context. They are responsible for a myriad of decisions and actions both within and outside of the scope of their initial expertise, and are challenged to situate their work within a dynamic business environment. Entrepreneurs are more clearly linked with their work, as they are responsible for acquiring the resources and implementing them in unique business strategies to create a new entity”.

I would argue that many of the things listed here are not unique to entrepreneurs as I could argue that in my own job as a researcher that I also have many of the benefits outlined above (because within flexible parameters I have a job that I can do what I want, when I want, how I want, and with who I want – there are so many possible rewards in the job I do that it isn’t that far removed from entrepreneurial activity – in fact some of my job now actually includes entrepreneurial activity). As Spivak and McKelvie then go on to say:

“As a result of the intense qualities of the entrepreneurial experience, there are also more intense potential outcomes, whether rewards or punishments in financial, social, and psychological domains. For example, potential rewards for entrepreneurs extend far beyond supervisor recognition and pay bonuses, into the realm of public awareness of accomplishments (or failures), media heralding, and life-changing financial gains or losses. Entrepreneurship addiction thereby moves beyond workaholism into similarities with gambling because of the intensity of the experience and personal risk tied to outcomes”.

I’m not sure I would agree with the gambling analogy, but I agree with the broad thrust of what is being argued (but would still say that entrepreneurship addiction is a sub-type of work addiction). I ought to add that there has also been discussion about the risk of overabundance of unsubstantiated addictive disorders. For instance, in a 2015 paper in the Journal of Behavioral Addiction, Joel Billieux and his colleagues described a hypothetical case of someone they deem fitting into the criteria of the concept of “research addiction” (maybe they had someone like myself in mind?), invented for the purpose of the argument. However, it is worthwhile noting that if their hypothetical example of ‘research addiction’ already fits well into the persisting compulsive over-involvement in job/study to the exclusion of other spheres of life, and if it leads to serious harm (and conflict symptoms suggest that it may) then it could be argued that the person is addicted to work. What we could perhaps agree on, is that for the example of ‘research addiction’ we do not have to invent a new addiction, (just as we do not distinguish between vodka addicts, gin addicts or whisky addicts as there is the overarching construct of alcoholism). Maybe the same argument can be made for entrepreneurship addiction in relation to work addiction.

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, 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. doi:10.1111/sjop.2012.53.issue-3

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: e0152978. doi:10.1371/journal.pone.0152978

Billieux, J., Schimmenti, A., Khazaal, Y., Maurage, P., & Heeren, A. (2015). Are we overpathologizing everyday life? A tenable blueprint for behavioral addiction research. Journal of Behavioral Addictions, 4, 142–144.

Brown, R. I. F. (1993). Some contributions of the study of gambling to the study of other addictions. In W.R. Eadington & J. Cornelius (Eds.), Gambling Behavior and Problem Gambling (pp. 341-372). Reno, Nevada: University of Nevada Press.

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

Griffiths, M.D. (2005). Workaholism is still a useful construct. Addiction Research and Theory, 13, 97-100.

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

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

Griffiths, M.D., Demetrovics, Z. & Atroszko, P.A. (2018). Ten myths about work addiction. Journal of Behavioral Addictions. Epu ahead of print. doi: 10.1556/2006.7.2018.05

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.

Paksi, B., Rózsa, S., Kun, B., Arnold, P., Demetrovics, Z. (2009). Addictive behaviors in Hungary: The methodology and sample description of the National Survey on Addiction Problems in Hungary (NSAPH). [in Hungarian] Mentálhigiéné és Pszichoszomatika, 10(4), 273-300.

Quinones, C., & Griffiths, M. D. (2015). Addiction to work: A critical review of the workaholism construct and recommendations for assessment. Journal of Psychosocial Nursing and Mental Health Services, 10, 48–59.

Spivack, A., & McKelvie, A. (2017). Entrepreneurship addiction: Shedding light on the manifestation of the ‘dark side’ in work behavior patterns. The Academy of Management Perspectives. https://doi.org/10.5465/amp.2016.0185

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

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.

Odds on: Ten ways to help prevent problem gambling

[Please note: The following article was written with Dr. Michael Auer]

Problem gambling has become a major issue in many countries worldwide. In this short article we provide ten ways to help prevent problem gambling.

Raise the minimum age of all forms of commercial gambling to 18 years – Research has consistently shown that the younger a person starts to gamble, the more likely they are to develop gambling problems. Stopping problem gambling in adolescence is a key step in preventing problem gambling in the first place. Any venue or website that hosts gambling games should have effective age verification procedures.

Restrict the most harmful types of gambling – Most research shows that gambling activities which can be gambled on continuously such as slot machines tend to be far more problematic than discontinuous games such as weekly lotteries. More harmful forms of gambling should be restricted to dedicated gambling venues rather than housed in non-dedicated gambling premises (such as supermarkets, cafes, and restaurants).

Educate players to pre-commit when engaging in the most harmful types of gambling – Ideally, the most harmful forms of gambling should have mandatory limit-setting options for players to set their own voluntary time and money limits when playing the games. Gambling operators can also use mandatory loss limits to keep gambling expenditure to a minimum.

Take responsibility for where problem gambling lies – While all individuals are ultimately responsible for their own gambling behaviour, other stakeholders – including the gambling industry – have control over the structural and situational characteristics of gambling products. Government policymakers and legislators have a responsibility to ensure that gambling products are tightly regulated and to ensure that any given jurisdiction has the infrastructure to keep gambling problems to a minimum. Gambling operators are responsible for all advertising and marketing and need to ensure that the content is socially responsible and promotes responsible gambling. Within gambling venues, all practices and procedures should be socially responsible (such as not giving free alcohol while gambling, and no ATM machines on the gaming floor).

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Put social responsibility at the heart of gambling operating practice – The most socially responsible gambling operators always puts player protection and harm minimisation at the heart of their business. They need to provide all information about their products so that individuals can make an informed choice about whether to gamble in the first place. They should advertise their products responsibly and provide their clientele with tools to aid responsible gambling, and provide help and guidance for those who think they are developing a gambling problem or have one.

Raise awareness about gambling among health practitioners and the general public – Problem gambling may be perceived as a somewhat ‘grey’ area in the field of health. However, there is an urgent need to enhance awareness about gambling-related problems within the general public and the medical and health professions.

Identify at-risk players Big Data and Artificial Intelligence are common approaches applied in behavioural analysis across many industries. Online gambling and personalized land-based gambling operators can detect harmful behavioural patterns such as chasing losses or binge gambling. Such players can be excluded from direct marketing, specific types of games, and/or contacted to prevent the development of problem gambling.

Use personalized feedbackResearch across many areas such as sports, health behaviour, as well as gambling has shown that personalized feedback can effectively change behaviour. Using behavioural data available in online gambling and personalized land-based venues, gamblers can be informed in real-time about behavioural changes in order to make them more aware and use pre-commitment tools such as limit-setting and/or self-exclusion.   

Set up both general and targeted gambling prevention initiatives The goals of gambling intervention are to (i) prevent gambling-related problems, (ii) promote informed, balanced attitudes, and choices, and (iii) protect vulnerable groups. The guiding principles for action on gambling are therefore prevention, health promotion, harm reduction, and personal and social responsibility. This includes:

  • General awareness raising (e.g. public education campaigns through advertisements on television, radio, newspapers).
  • Targeted prevention (e.g. education programs and campaigns for particularly vulnerable populations such as senior citizens, adolescents, ethnic minorities).
  • Awareness raising within gambling establishments (e.g. brochures and leaflets describing problem gambling, indicative warning signs, where help for problems can be sought such as problem gambling helplines, referral service, telephone counselling web-based chatrooms for problem gamblers, and outpatient treatment).
  • Training materials (e.g. training videos about problem gambling shown in schools, job centres).

Educate and training those working in the gambling industry about problem gambling – All gaming personnel in any gambling establishments from shop retailers to croupiers should receive ongoing training regarding responsible gambling and problem gambling.

Dr. Mark Griffiths, Professor of Behavioural Addiction, 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., 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. & 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). 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. & Griffiths, M.D. (2016). Personalized behavioral feedback for online gamblers: A real world empirical study. Frontiers in Psychology, 7, 1875. doi: 10.3389/fpsyg.2016.01875.

Griffiths, M.D. (2017). Evaluating responsible gambling tools using behavioural tracking data. Casino and Gaming International, 31, 41-45.

Griffiths, M.D. (2016). Gambling advertising, responsible gambling, and problem gambling: A brief overview. Casino and Gaming International, 27, 57-60.

Griffiths, M.D. & Auer, M. (2016). Should voluntary self-exclusion by gamblers be used as a proxy measure for problem gambling? Journal of Addiction Medicine and Therapy, 2(2), 00019.

Griffiths, M.D., Harris, A. & Auer, M. (2016). A brief overview of behavioural feedback in promoting responsible gambling. Casino and Gaming International, 26, 65-70.

Harris, A. & Griffiths, M.D. (2017). A critical review of the harm-minimisation tools available for electronic gambling. Journal of Gambling Studies, 33, 187–221.

Oehler, S., Banzer, R., Gruenerbl, A., Malischnig, D., Griffiths, M.D. & Haring, C. (2017). Principles for developing benchmark criteria for staff training in responsible gambling. Journal of Gambling Studies, 33, 167-186.

Wood, R.T.A. & Griffiths, M.D. (2015). Understanding positive play: An exploration of playing experiences and responsible gambling practices. Journal of Gambling Studies, 31, 1715-1734.

Wood, R.T.A., Shorter, G.W. & Griffiths, M.D. (2014). Rating the suitability of responsible gambling features for specific game types: A resource for optimizing responsible gambling strategy. International Journal of Mental Health and Addiction, 12, 94–112.

To see or not to see: A brief look at hallucinations in virtual reality applications

As a teenager I was fascinated with LSD purely as a consequence of my love of The Beatles and its alleged association with songs such as ‘Lucy in the Sky with Diamonds‘ (I say ‘alleged’ because all Beatle fanatics know that this song got its’ title from a drawing by John Lennon’s son Julian and that lyrically the song was inspired by the writings of Lewis Carroll, the creator of Alice in Wonderland [AIW], a book which gave its’ name to AIW Syndrome that I examined in a couple of previous blogs).

When I first started teaching my ‘Addictive Behaviours’ module back in 1990, almost all my lectures concentrated on drug addictions (as opposed to behavioural addictions which now take centre stage in my teaching), and it was my session on hallucinogenic drugs (also known as psychedelic drugs) that was always the most fun to teach and the topic that students appeared to be most engaged in. Like many of my students, I have always been interested in altered states of consciousness both in my own research into addiction and the topic more generally.

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The reason why I mention all these things as that I did a media interview on the hallucinogenic effects of virtual reality products. The interview was based on comments by Microsoft researcher Mar Gonzalez Franco, who said that virtual reality will soon replace the need for hallucinogenic drugs. More specifically, she was quoted as saying:

“By 2027 we will have ubiquitous virtual reality systems that will provide such rich multi-sensorial experiences that will be capable of producing hallucinations which blend or alter perceived reality. Using this technology, humans will retrain, recalibrate and improve their perceptual systems…In contrast to current virtual reality systems that only stimulate visual and auditory senses, in the future the experience will expand to other sensory modalities including tactile with haptic devices“.

Claims that VR products have the potential to induce hallucinogenic experiences have already started appearing in the media. A recent story in the Daily Mail reported that there was already a VR app (SelfSound) that claimed it can reproduce the effects of hallucinogenic drugs and plays on the neurological phenomena known as synaesthesia and that a “program is used to promote mediation through creating abstract reality [and] plays face-melting music with synesthetic DMT-style visualizations uniquely generated in response to [a person’s] voice”. (DMT is an abbreviation for dimethyltryptamine, a powerful hallucinogenic drug).

Over the last seven years, I have published a series of studies with Dr. Angelica Ortiz de Gotari (some of them listed in the ‘Further reading’ section below) showing that hallucinations are common among video gamers in our working examining Game Transfer Phenomena (GTP). Therefore, it’s no surprise that VR games can do the same thing. We have reported that visual and auditory hallucinations are commonly experiences by regular videogame players.

For instance, one of our studies published in the International Journal of Human-Computer Interaction found that some video gamers experience altered visual perceptions after playing (e.g., distorted versions of real world surroundings). Others saw video game images and misinterpreted real life objects after they had stopped playing. Gamers reported seeing video game menus popping up in front their eyes when they were in a conversation, or saw coloured images and ‘heads up’ displays when driving on the motorway. Our study analysed 656 experiences from 483 gamers collected in 54 online video game forums. Visual illusions can easily trick the brain, and staring at visual stimuli can cause ‘after-images’ or ‘ghost images’ among videogame players. We found that GTP were triggered by associations between video game experiences, and objects and activities in real life contexts. Our findings also raised questions about the effects of the exposure to specific visual effects used in video games.

We also reported that in some playing experiences, video game images appeared without awareness and control of the gamers, and in some cases, the images were uncomfortable, especially when gamers could not sleep or concentrate on something else. These experiences also resulted in irrational thoughts such as gamers questioning their own mental health, getting embarrassed or performing impulsive behaviours in social contexts. However, other gamers clearly thought that these experiences were fun and some even tried to induce them.

Visual experiences identified in GTP show us the interplay of physiological, perceptual and cognitive mechanisms and the potential of learning with video games even without awareness. It also invites us to reflect about the effects of prolonged exposure to synthetic stimuli and the challenges that the human mind affront due to the technological advances that are still to come. However, because we collected our data for most of our published studies from online video game forums, the psychological profile of the gamers in our studies are unknown. However, different gamers reported similar experiences in the same games. This highlights the relevance of the video games’ structural characteristics but gamers’ habits also appear to be crucial. Some gamers may be more susceptible than others to experience GTP. The effects of these experiences appear to be short-lived, but some gamers experience them recurrently. It goes without saying (but I’ll say it anyway) that more research is needed to understand the cognitive and psychological implications of GTP. Most of these GTP experiences are viewed positively but a small minority of players find them detrimental.

Whether such hallucinations – either in typical videogames or VR videogames – can be induced on demand is debatable. Very few players in our own research said they were able to induce hallucinations. At present, we simply don’t know what the long-term effects of VR gaming will be and that goes for VR-induced gaming hallucinations too. It may be the case that VR induced hallucinogenic states will be ‘safer’ than ones induced by psychedelic drugs as there is no ingestion of a psychoactive substance, but that’s just speculation on my part.

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

Further reading

Cawley, C. (2016). Virtual Reality could make you hallucinate; Don’t freak out. Tech Co, December 15. Located at: http://tech.co/virtual-reality-hallucinate-dont-freak-2016-12

Hamill, J. (2016). Windows of perception: Microsoft says virtual reality will soon have same mind-bending effects as LSD. The Sun, December 7. Located at: https://www.thesun.co.uk/news/2347705/microsoft-says-virtual-reality-will-soon-have-same-mind-bending-effects-as-lsd/

Liberatore, S. (2016). That’s trippy! Watch the VR app that claims to be able to reproduce the effects of a hallucinogenic drug. Daily Mail, May 4, Located at: http://www.dailymail.co.uk/sciencetech/article-3572184/That-s-trippy-Watch-VR-app-claims-able-reproduce-effects-hallucinogenic-drug.html

Ortiz de Gortari, A.B. & Griffiths, M.D. (2012). An introduction to Game Transfer Phenomena in video game playing. In J. Gackenbach (Ed.), Video Game Play and Consciousness (pp.223-250). Hauppauge, NY: Nova Science.

Ortiz de Gortari, A.B. & Griffiths, M.D. (2014). Altered visual perception in Game Transfer Phenomena: An empirical self-report study. International Journal of Human-Computer Interaction, 30, 95-105.

Ortiz de Gortari, A.B. & Griffiths, M.D. (2014). Auditory experiences in Game Transfer Phenomena: An empirical self-report study. International Journal of Cyber Behavior, Psychology and Learning, 4(1), 59-75.

Ortiz de Gortari, A.B. & Griffiths, M.D. (2014). Automatic mental processes, automatic actions and behaviours in Game Transfer Phenomena: An empirical self-report study using online forum data. International Journal of Mental Health and Addiction, 12, 432-452.

Ortiz de Gortari, A.B. & Griffiths, M.D. (2015). Game Transfer Phenomena and its associated factors: An exploratory empirical online survey study. Computers in Human Behavior, 51, 195-202.

Ortiz de Gortari, A.B. & Griffiths, M.D. (2015). Auditory experiences in Game Transfer Phenomena: An empirical self-report study. In: Gamification: Concepts, Methodologies, Tools, and Applications (pp.1329-1345). Pennsylvania: IGI Global.

Ortiz de Gortari, A.B. & Griffiths, M.D. (2016). Prevalence and characteristics of Game Transfer Phenomena: A descriptive survey study. International Journal of Human-Computer Interaction, 32, 470-480.

Ortiz de Gortari, A.B., Pontes, H.M. & Griffiths, M.D. (2015). The Game Transfer Phenomena Scale: An instrument for investigating the non-volitional effects of video game playing. Cyberpsychology, Behavior and Social Networking, 18, 588-594.

Rothman, P. (2014). Virtual Reality and Drugs – Yes, you should get high before using VR. H Plus Magazine, July 31. Located at: http://hplusmagazine.com/2014/07/31/virtual-reality-and-drugs-yes-you-should-get-high-before-using-vr/

Screenage rampage: What should parents know about videogame playing for children?

Last month, the World Health Organisation (WHO) announced that it was planning to include ‘Gaming Disorder’ (GD) in the latest edition of the International Classification of Diseases. This followed the American Psychiatric Association’s decision to include ‘Internet Gaming Disorder’ in the latest edition of the Diagnostic and Statistical Manual of Mental Disorders in 2013. According to the WHO, an individual with GD is a person who lets playing video games “take precedence over other life interests and daily activities,” resulting in “negative consequences” such as “significant impairment in personal, family, social, educational, occupational or other important areas of functioning.”

I have been researching videogame addiction for nearly 30 years, and during that time I have received many letters, emails, and telephone calls from parents wanting advice concerning videogames. Typical examples include ‘Is my child playing too much?’, ‘Will playing videogames spoil my pupils’ education?’, ‘Are videogames bad for children’s health? and ‘How do I know if a child is spending too long playing videogames?’ To answer these and other questions in a simple and helpful way, I have written this article as a way of disseminating this information quickly and easily.

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To begin with parents should begin by finding out what videogames their children are actually playing! Parents might find that some of them contain material that they would prefer them not to be having exposure to. If they have objections to the content of the games they should facilitate discussion with children about this, and if appropriate, have a few rules. A few aims with children should be:

  • To help them choose suitable games which are still fun
  • To talk with them about the content of the games so that they understand the difference between make-believe and reality
  • To discourage solitary game playing
  • To guard against obsessive playing
  • To follow recommendations on the possible risks outlined by videogame manufacturers
  • To ensure that they have plenty of other activities to pursue in their free time besides the playing of videogames

Parents need to remember that in the right context videogames can be educational (helping children to think and learn more quickly), can help raise a child’s self-esteem, and can increase the speed of their reaction times. Parents can also use videogames as a starting point for other activities like painting, drawing, acting or storytelling. All of these things will help a child at school. It needs to be remembered that videogame playing is just one of many activities that a child can do alongside sporting activities, school clubs, reading and watching the television. These can all contribute to a balanced recreational diet.

The most asked question a parent wants answering is ‘How much videogame playing is too much? To help answer this question I devised the following checklist. It is designed to check if a child’s videogame playing is getting out of hand. Ask these simple questions. Does your child:

  • Play videogames every day?
  • Often play videogames for long periods (e.g., 3 to 6 hours at a time)?
  • Play videogames for excitement or ‘buzz’ or as a way of forgetting about other things in their life?
  • Get restless, irritable, and moody if they can’t play videogames?
  • Sacrifice social and sporting activities to play videogames?
  • Play videogames instead of doing their homework?
  • Try to cut down the amount of videogame playing but can’t?

If the answer is ‘yes’ to more than four of these questions, then your child may be playing too much. But what can you do if your child is playing videogames too much?

  • First of all, check the content of the games. Try and give children games that are educational rather than the violent ones. Parents usually have control over what their child watches on television – videogames should not be any different.
  • Secondly, try to encourage video game playing in groups rather than as a solitary activity. This will lead to children talking and working together.
  • Thirdly, set time limits on children’s playing time. Tell them that they can play for a couple of hours after they have done their homework or their chores – not before.
  • Fourthly, parents should always get their children to follow the recommendations by the videogame manufacturers (e.g., sit at least two feet from the screen, play in a well-lit room, never have the screen at maximum brightness, and never play videogames when feeling tired).

I have spent many years examining both the possible dangers and the potential benefits of videogame playing. Evidence suggests that in the right context videogames can have positive health and educational benefits to a large range of different sub-groups. What is also clear from the case studies displaying the more negative consequences of playing is that they all involved children who were excessive users of videogames. From prevalence studies in this area, there is little evidence of serious acute adverse effects on health from moderate play. In fact, in some of my studies, I found that moderate videogame players were more likely to have friends, do homework, and engage in sporting activities, than those who played no videogames at all.

For excessive videogame players, adverse effects are likely to be relatively minor, and temporary, resolving spontaneously with decreased frequency of play, or to affect only a small subgroup of players. Excessive players are the most at-risk from developing health problems although more research is needed. If care is taken in the design, and if they are put into the right context, videogames have the potential to be used as training aids in classrooms and therapeutic settings, and to provide skills in psychomotor coordination, and in simulations of real life events (e.g., training recruits for the armed forces).

Every week I receive emails from parents claiming that their sons are addicted to playing online games or that their daughters are addicted to social media. When I ask them why they think this is the case, they almost all reply “because they spend most of their leisure time in front of a screen.” This is simply a case of parents pathologising their children’s behaviour because they think what they are doing is “a waste of time.” I always ask parents the same three things in relation to their child’s screen use. Does it affect their schoolwork? Does it affect their physical education? Does it affect their peer development and interaction? Usually parents say that none of these things are affected so if that is the case, there is little to worry about when it comes to screen time. Parents also have to bear in mind that this is how today’s children live their lives. Parents need to realise that excessive screen time doesn’t always have negative consequences and that the content and context of their child’s screen use is more important than the amount of screen time.

(N.B. This article is an extended version of an article that was originally published by Parent Zone)

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

Further reading

Griffiths, M.D. (2003).  Videogames: Advice for teachers and parents. Education and Health, 21, 48-49.

Griffiths, M.D. (2009). Online computer gaming: Advice for parents and teachers. Education and Health, 27, 3-6.

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

Griffiths, M.D., Kuss, D.J. & Pontes, H. (2016). A brief overview of Internet Gaming Disorder and its treatment. Australian Clinical Psychologist, 2(1), 20108.

Griffiths, M.D. & Meredith, A. (2009). Videogame addiction and treatment. Journal of Contemporary Psychotherapy, 39(4), 47-53.

King, D.L., Delfabbro, P.H. & Griffiths, M.D. (2012). Clinical interventions for technology-based problems: Excessive Internet and video game use. Journal of Cognitive Psychotherapy: An International Quarterly, 26, 43-56.

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

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

Kuss, D.J. & Griffiths, M.D. (2012). Online gaming addiction in adolescence: A literature review of empirical research. Journal of Behavioral Addictions, 1, 3-22.

Kuss, D.J. & Griffiths, M.D. (2012). Internet gaming addiction: A systematic review. International Journal of Mental Health and Addiction, 10, 278-296.