Category Archives: Psychological disorders

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.

Levy settle: A statutory gambling levy is needed to help treat gambling addicts

At the most recent Labour Party conference, the Party’s deputy leader Tom Watson said that if they formed the next Government they would introduce legislation to force gambling operators to pay a levy to fund research and NHS treatment to help problem gamblers deal with their addiction. This is something which I wholeheartedly support and is also something that I have been calling for myself for over a decade

The most recent statistics on gambling participation by the Gambling Commission in August 2017 reported that 63% of the British population had gambled in the last year and that the prevalence rate of problem gambling among those 16 years and over was 0.6%-0.7%. While this is relatively low, this still equates to approximately 360,000 adult problem gamblers and is of serious concern.

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At present the gambling industry voluntarily donates money to an independent charitable trust (GambleAware) and most of this money funds gambling treatment (with the remaining monies being used to fund education and research). In the 12 months prior to March 2017, the gambling industry had donated £8 million, an amount still 20% below the £10 million a year I recommended in a report I wrote for the British Medical Association a number of years ago.

A statutory levy of 1% on all gambling profits made by the British gambling industry would raise considerably more money for gambling education, treatment and research than the £8 million voluntarily donated last year and is the main reason why I am in favour of it. Gambling has not been traditionally viewed as a public health matter. However, I believe that gambling addiction is a health issue as much as a social issue because there are many health consequences for those addicted to gambling including depression, insomnia, intestinal disorders, migraine, and other stress related disorders. This is in addition to other personal issues such as problems with personal relationships (including divorce), absenteeism from work, neglect of family, and bankruptcy.

There are also many recommendations that I would make in addition to a statutory levy. These include:

  • Brief screening for gambling problems among participants in alcohol and drug treatment facilities, mental health centres and outpatient clinics, as well as probation services and prisons should be routine.
  • The need for education and training in the diagnosis and effective treatment of gambling problems must be addressed within GP training. Furthermore, GPs should screen for problem gambling in the same way that they do for other consumptive behaviours such as cigarette smoking and alcohol drinking. At the very least, GPs should know where they can refer their patients with gambling problems to.
  • Research into the efficacy of various approaches to the treatment of gambling addiction in the UK needs to be undertaken and should be funded by GambleAware.
  • Treatment for problem gambling should be provided under the NHS (either as standalone services or alongside drug and alcohol addiction services) and funded either by gambling-derived revenue (i.e., a ‘polluter pays’ model).
  • Given the associations between problem gambling, crime, and other psychological disorders (including other addictions), brief screening should be routine for gambling problems should be carried out in alcohol and drug treatment facilities, mental health centres and outpatient clinics, as well as probation services and prisons.
  • Education and prevention programmes should be targeted at adolescents along with other potentially addictive and harmful behaviours (e.g., smoking, drinking, and drug taking) within the school curriculum.

As I have tried to demonstrate, problem gambling is very much a health issue that needs to be taken seriously by all in the medical profession. General practitioners routinely ask patients about smoking and drinking, but gambling is something that is not generally discussed. Problem gambling may be perceived as a grey area in the field of health. If the main aim of practitioners is to ensure the health of their patients, then an awareness of gambling and the issues surrounding it should be an important part of basic knowledge in the training of those working in the health field.

Gambling is not an issue that will go away. Opportunities to gamble and access to gambling have increased due to the fact that anyone with Wi-Fi access and a smartphone or tablet can gamble from wherever they are. While problem gambling can never be totally eliminated, the Government must have robust gambling policies in place so that potential harm is minimized for the millions of people that gamble. For the small minority of individuals who develop gambling problems, there must be treatment resources in place that are affordable and easily accessible.

(N.B. This is a longer version of an article that was originally published in The Conversation)

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.

Griffiths, M.D. (2003). Problem gambling. The Psychologist: Bulletin of the British Psychological Society, 16, 582-584.

Griffiths, M.D. (2004). Betting your life on it: Problem gambling has clear health related consequences. British Medical Journal, 329, 1055-1056.

Griffiths, M.D. (2006). The lost gamblers: Problem gambling. Journal of the Royal Statistical Society, 3(1), 13-15.

Griffiths, M.D. (2007). Gambling Addiction and its Treatment Within the NHS. London: British Medical Association

Griffiths, M.D. (2017). Gambling regulation from a psychologist’s perspective: Thoughts and recommendations. In Gebhardt, I. (Ed.), Glücksspiel – Ökonomie, Recht, Sucht (Gambling – Economy, Law, Addiction) (Second Edition) (pp. 938-944). Berlin: De Gruyter.

Meyer, G., Hayer, T. & Griffiths, M.D. (2009). Problem Gambling in Europe: Challenges, Prevention, and Interventions. New York: Springer.

Stammer time: A brief look at psellismophilia

Over the Christmas holiday I received a notification from Google to say that my work on sexual paraphilias had been cited in an article entitled ‘Forget feet, meet the fetishists turned on by insects, stuttering and stairs’ on the Shoofee website. The article was a brief overview of seven paraphilias and fetishes, and many of those listed referred readers to articles on my personal blog. Of the seven listed, I had already written articles on six of them but I had never done one on the seventh – psellismophilia.

According to Dr. Anil Aggrawal in his 2009 book Forensic and Medico-legal Aspects of Sexual Crimes and Unusual Sexual Practices, psellismophilia is a paraphilia that involves becoming sexually aroused by stuttering. Psellismophilia is another paraphilia whose name has been derived as being the opposite of a specific phobia (i.e., psellismophobia, an irrational and persistent fear of stuttering). According to the Massive Phobia website, the root word ‘psellismo’ is the Greek word for ‘stammering’. The Phobia Source website notes stuttering as:

“A speech disorder wherein sounds, syllables or words are repeated or prolonged and this disrupts the normal flow of speech. This affects a person’s quality of life because people find it difficult to communicate with others and people might have also a hard time understanding people who stutter or might find it even annoying. Stuttering can be a source of ridicule and humiliation and this can lead to a full blown phobia called psellismophobia…We must remember that stuttering is not equivalent to lack of intelligence. In fact, most people who stutter are extremely intelligent and is said to be that their brains process their thoughts too fast and their speech can’t cope up with their thoughts”.

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As with any human behaviour that I know little about, I first did a search on Google Scholar and found that no article had ever been written on the topic. I then did a simple search on Google and again found that no articles had ever been done on the behaviour. However, there were plenty of articles that mentioned it in passing including articles in The Huffington Post (‘46 sexual fetishes you’ve never heard of’), Crave Online (‘15 bizarre sexual fetishes you’ve probably never heard of’), The Buzz (‘15 bizarre/disgusting sexual fetishes you’ve probably never heard of!’), The Thrillist (‘20 bizarre sexual fetishes you never knew existed’), The Sex Health Mag (‘The 10 strange sexual fetishes you’ve probably never heard of’), The Hook Mag (‘20 of the most f**ked up sexual fetishes you’d prefer not to know about’), and The Inked Mag (‘50 shades of weird. 49 of the most bizarre sex fetishes!’). Not one of these articles had anything more than a one-line definition (typically describing the condition as an abnormal affection and/or love for stuttering). The article in Shoofee, did offer a little more in the way of explanation:

“Stuttering affects one percent of the world’s population and many sufferers find themselves the butt of jokes. But if they were to come across a psellismophiliac they could find that their speech is an instant aphrodisiac, for this is a fetish which involves arousal to stuttering. Natalie, a 22-year-old psellismophiliac, explained her condition on an online psychology forum. ‘I feel like I can’t date regularly because I won’t be sexually interested in anyone who doesn’t have a stammer,’ she wrote. Natalie added that when she mentioned it to boyfriends they tried to pretend to stutter but she said it failed to arouse her like the real thing”.

Given the complete lack of information on whether there are individuals who are sexually aroused by stuttering I began trawling various online forums and began to find individuals who confessed online that stuttering was something they found sexually arousing (or claim to know those who are). Obviously I have no way of knowing the veracity of the claims made, but most appeared to be genuine to me. Here are some extracts:

  • Extract 1: “I am a girl who finds listening to a guy stutter and struggle extremely sexy… no there is very little on the internet about it, guess there’s not many of us out there, but you’re not alone” (Lickerish, female, heterosexual).
  • Extract 2: “I’m a guy who gets turned on by listening to a girl stutter, and I’ve never been able to figure out why…There’s hardly anything on the internet about it, other than this thread and a few random ‘stuttering is sexy’ one-liners on other sites…But yeah, there are a few of us out there, and it’s interesting to know that it’s not limited to just one gender” (Wireless Mike, male, heterosexual).
  • Extract 3: “I’ve had this fetish for years (I’m 31 now), but it’s been getting stronger and stronger. I’m a gay guy attracted to other guys who stutter. I’ve met a couple of guys locally and a couple more over Skype. We are still friends with [three] of them – we just drifted apart with the other one since time zones don’t work to our advantage. But I find myself wishing I had more friends who stutter to talk to. It’s both a sexual thing and a non-sexual thing… in some ways I prefer chatting with guys who stutter than fluent guys…Does anyone else feel the same? It’s frustrating that I have to work so hard to convince others I’m not crazy” (Jay, male, gay).
  • Extract 4: “I had a chick ask me to stutter on her nether regions once. It’s about the closest I’ve seen of a “stuttering fetish” (Zachary, male, heterosexual).
  • Extract 5: “I have [a stutter fetish]. I’m female and I like men, but I have this fetish for males and females. I’ve never written this before. Certainly never said it” (Spector, female, bisexual).
  • Extract 6: “I don’t have personal experience with people fetishizing stuttering, but I’ve seen it, particularly in smutty fanfiction with ‘nervous’ submissive characters” (Croagunk, male, sexuality unknown).
  • Extract 7: “I once dated a girl who confessed during our brief relationship that she thought my stutter was ‘cute’. I’m pretty sure she was into ‘different’ kinds of guys. She would always bring it up and stare at my mouth. It was like a fetish. It was like she had a thing for disabled guys! I broke up with her not because I didn’t like her, just because it freaked me out. Made me feel really uncomfortable” (priateproducer, male, heterosexual).
  • Extract 8: The stutter can be sexy. The thing of gasping for air; moving tongues; flailing lips; breathing. These are sexual motions, these are movements of the mouth, the delicate lips, the waving of the soft tongue. To stutter is to wave the soft flesh of the face in rapid succession…Thinking about stuttering as an intimate act, akin to being naked, may change its constructed meaning and turn it into a moment of closeness with our community” (Zach, male, sexuality unknown)
  • Extract 9: “I am a guy who likes guys, and consider myself to have a stuttering fetish…It’s true that there isn’t much [online about] this, but I’ve spoken to 4 or 5 other guys (through the net and on the phone/skype occasionally) who also share this – so I’m not the only one!…I can’t quite explain it, but I really like guys who stutter. Let me say that it has to be more than just that to like a guy, but it helps!…For me, the more severe the stutter the more attractive it is. I’ve spoken to a quite a few guys who stutter and I’ve always been open about this. Some just find it strange or think I’m kidding, but most are really open and relieved to find someone who doesn’t have an issue with it. For me it’s not as simple as just a ‘fetish’, I’ve read a lot about it and can understand a lot about it. I’ve also talked to a couple of guys who like to pretend (even though they’re completely fluent otherwise) and I find that interesting too” (Jay, male, gay).
  • Extract 10: “I have a stuttering fetish…I look for videos of stuttering online to watch. The more severe the stutter, the more struggle and secondary characteristics, the better. I stuttered pretty badly as a child, and occasionally still do…It’s nice to know I’m not the only one” (eglorae, gender and sexuality unknown).
  • Extract 11: “I’m new on this forum so I was just only browsing and saw the stuttering topic and it immediately caught my attention so…yes I guess I have a soft spot for guys who stutter. It’s not quite a fetish, but I find it really cute and sexy. I used to [have] a crush on a guy when I was like 14 years old and he was a stutterer, oh his speaking was so hot!” (Alexandra, female, heterosexual).
  • Extract 12: “Wow, I thought I was the only one and that I was odd! I’m a guy who finds stuttering really sexy in women. No idea why…It’s just something I discovered that I like. I’d love to talk…with some girls who stutter but it seems very unlikely!” (emmanola, male, heterosexual).
  • Extract 13: “I have to tell you, that some of the guys I have met have found it an absolute turn on for them. During intimate moments my stuttering gets a lot worse which can send some guys crazy, although admittedly it is a very small number. I never thought it as being a fetish though, but maybe it is. I can’t say that anyone I have met has been actually looking for someone that stutters but rather looked at is a bonus when they found someone that did” (Kenny, male, gay).
  • Extract 14: “I stutter and it is a BIG turn-on for me. It’s nice to know that I’m not the only one. I would love to talk to another stutterer – especially one who thinks it’s a turn-on” (Stutteringdude, male, gay).

Based on these online self-confessions, a few things can be concluded. Obviously I have no idea about whether these are in any way representative of those individuals who like those that stutter, but if it is a genuine fetish or paraphilia (and some of these individuals claim it is something they like strongly or have a preference for rather than it being a fetish as such), the behaviour appears to prevalent in both men and women and not be associated with one particular sexual orientation as it was described by those both gay and straight. Very few appear to know where their fetish for stuttering originates although some describe memories from adolescence and being sexually aroused in the formative stages of sexual development. Most see the fetish as something that they have kept to themselves without ever having talked to others about it. Some appear to be glad that they ‘are not alone’ in having the fetish and find comfort in hearing others’ stories. Some individuals went as far to offer explanations for the fetish or what it’s not about.

  • Extract 15: ‪I think I know what attracts [people] to the stutter. I think it’s most likely the tonality of a stutter. They raise in pitch, repeat syllables that sometimes mirror those of an orgasm or basic sexual moaning. I honestly do think you might find something a bit erotic about how similarly a stutter can mimic that of sexual moan…even the facial expressions made” (aimoo182, gender and sexuality unknown).
  • Extract 16: “I’ve also read a bit about stuttering and can understand a lot more than your average guy. I’ve been asked if it’s a [domination] thing…it’s not. I’d happily dom or be dommed by a guy who stutters. Or just hold a nice conversation. It doesn’t matter” (Jay, male, gay).

My own view is that most fetishes and paraphilias appear to begin developing in early adolescence and that classical conditioning (i.e., associative pairing between sexual arousal and the non-sexual stimulus, in this case the stuttering) is an important part of the acquisition process. Little of what I found fits my opinion on this but that’s more because the individuals themselves have little insight to their own behaviour and how the fetish manifested itself. Whether psellismophilia ever becomes the focus of serious academic study remains to be seen but I doubt that it will unless any negative consequences arise from the behaviour (and I have come across nothing suggesting that the condition – if it genuinely exists – is any way detrimental).

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

Further reading

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

Gates, K. (2000). Deviant Desires: Incredibly Strange Sex. New York: RE/Search Publications.

Love, B. (1992). Encyclopedia of Unusual Sex Practices. Fort Lee, NJ: Barricade Books.

Blocking out the pain: Tetris, trauma, and Game Transfer Phenomena

Unwanted visual intrusions are characteristic of Post-Traumatic Stress Disorder (PTSD). According to Dr. Emily Holmes and her colleagues in a 2009 paper in the journal PLoS ONE, one innovative intervention for inhibiting unwanted intrusions is playing the Tetris videogame, described as a ‘cognitive vaccine’ in preventing intrusions after traumatic events. Playing Tetris consumes heavy visuospatial working memory resources that potentially compete with cognitive resources required for elaboration of visual imagery. Since Holmes and colleagues’ study, other studies have used Tetris to inhibit intrusive imagery including more studies by Holmes and her colleagues and others by Ella James’ research group, as well as some innovative studies using Tetris to reduce drug cravings by Jessica Storka-Brown and her colleagues (see ‘Further reading’ below). However, none of these studies assessed the role of videogame content after playing in relation to Game Transfer Phenomena (GTP), an area that we have carried out a lot of research into (see ‘Further reading’ below).

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GTP research has investigated non-volitional experiences (e.g., altered sensorial perceptions and automatic mental processes/behaviours) mostly experienced after gaming. Gamers often report sensorial (visual/auditory) intrusions after playing (e.g., visual and auditory imagery, hallucinations). In a survey of 2,362 gamers that we published in a 2016 issue of the International Journal of Human-Computer Interaction, most (77%) had visualized images from a variety of videogames (including tile-puzzle games) with closed-eyes, and one-third (31%) had visualized images with open-eyes. Other studies have experimentally induced videogame-related visualizations at sleep onset (including studies by Stickgold and colleagues [2000], Wamsley and colleagues [2010], Kusse and colleagues [2012] – see ‘Further reading’).

James and colleagues’ 2015 study in the journal Psychological Science was the first to make explicit reference to GTP (referred to as the ‘Tetris effect’ [TE]). In 2012, we argued the TE term is misleading as it suggests repetition is the core of transfer effects. However, other factors are involved. Research concerning GTP makes the distinction between sensorial modalities facilitating non-volitional phenomena with videogame content that occur along the continuum from mild to severe. Moreover, the descriptive constructs of GTP are empirically based on our analysis of 3,500+ gamers and have been examined via confirmatory factor analysis demonstrating good reliability and validity.

James and her colleagues tested if playing Tetris offered a protective mechanism against re-experiencing traumatic events. Healthy participants (n=56) were randomly assigned to either playing Tetris for 11 minutes, or doing nothing before exposure to a 12-minute traumatic film. Image-base memories about the film were then registered in a one-week dairy. However, playing Tetris as a proactive interference task before watching the film did not show significant results. James and colleagues offered different explanations including: (i) duration of the task in relation to film length, (ii) temporal contingencies between the tasks, (iii) differences between the task types, (iv) videogame types used, and (v) reactivation of gameplay during the film for aided interference. In a commentary paper published in a 2016 issue of Frontiers in Psychology, we discussed these findings and some of its shortcomings in relation to GTP literature.

  • Duration of task in relation to film length: Playing Tetris for 11 minutes may not have been long enough to compete with the consolidation of memory of the 12-minute film. GTP are significantly more likely to occur when playing 3-6 hours. Our research reported only 4% of gamers reported GTP when playing sessions shorter than one-hour. Laboratory experiments have taken days of playing to induce game-related visualizations at sleep onset.
  • Temporal contingencies between gaming and film watching: The tasks were performed minutes apart from each other. GTP mostly occur soon after stopping playing but our research has found that gamers have also reported GTP days after playing. In most cases, duration of experience is very short (seconds/minutes) but in some cases hours or longer.
  • Differences between the tasks: Previous studies have demonstrated that similar tasks aid interference. However, watching a film is a passive activity while gaming is interactive requiring additional perceptual/motor skills. Therefore, it may be expected that gaming is more potent as interference task, particularly because inducing the subjective sense of presence in the virtual world may strengthen the interference.
  • Type of videogame used as interference task and emotional content of film: The unrealistic (geometric) Tetris content may have been overwritten by the film’s traumatic images. Visualization of stereotypical games induced at sleep onset are characterized by lack of emotion, assuming that the amygdala and the reward system are not involved. In GTP research, emotions in tile-matching puzzle-games are incomparable to emotions in realistic videogames.
  • Reactivation of gameplay during the film for aided interference: The use of cue reminders may have potential in reviving videogame content. In many cases, thoughts and altered perceptions are triggered by game-related cues. Selective attention toward game-related cues has been demonstrated in experiments. GTP have been reported in variety of videogame genres particularly those that have very realistic graphics and settings. Therefore, more realistic games may aid associations between real life stimuli and videogame content, and may be more effective in competing with memories of traumatic events.

In our Frontiers paper, we noted that playing Tetris is not only an effective visuospatial task (overloading working memory resources needed for imagery-formation while playing), but as demonstrated in our GTP studies, videogame content stays active after playing (e.g., mental imagery, sensory perceptions), and may offer additional benefits for managing unwanted intrusions. GTP may potentially strengthen effects of interference tasks but should be used cautiously, because videogame content not only targets unwanted intrusions, but also influences individual cognitions, perceptions, and behaviours in day-to-day contexts (e.g., attention bias, lack of task awareness, control inhibition failures). Moreover, our studies have shown distress and dysfunction have been reported with GTP.

Consequently, further research needs conducting to identify: (i) videogames that are most effective, (ii) playing duration, (iii) factors that reduce intervention efficacy and strategies to control them, and (iv) individuals that may benefit the most from such intervention. While using videogames as intervention tools for preventing unwanted imagery from traumatic experiences has potential, therapeutically it is still at an early stage.

  • (Please note: This blog was co-written with Dr. Angelica Ortiz de Gortari and is based on an article we published in Frontiers in Psychology: Ortiz de Gortari, A.B. & Griffiths, M.D. (2016). Playing the computer game Tetris prior to viewing traumatic film material and subsequent intrusive memories: Examining proactive interference. Frontiers in Psychology, 7, 260. doi: 10.3389/fpsyg.2016.00260)

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

Further reading

Holmes, E. A., James, E. L., Kilford, E. J., & Deeprose, C. (2010). Key steps in developing a cognitive vaccine against traumatic flashbacks: Visuospatial Tetris versus Verbal Pub Quiz. PloS ONE, 5(11), e13706.

James, E. L., Bonsall, M. B., Hoppitt, L., Tunbridge, E. M., Geddes, J. R., Milton, A. L., & Holmes, E. A. (2015a). Computer game play reduces intrusive memories of experimental trauma via reconsolidation-update mechanisms. Psychological Science. doi: 10.1177/0956797615583071

James, E. L., Zhu, A. L., Tickle, H., Horsch, A., & Holmes, E. A. (2015b). Playing the computer game Tetris prior to viewing traumatic film material and subsequent intrusive memories: Examining proactive interference. Journal of Behavior Therapy and Experimental Psychiatry. doi: 10.1016/j.jbtep.2015.11.004

Kusse, C., Shaffii-Le Bourdiec, A., Schrouff, J., Matarazzo, L., & Maquet, P. (2012). Experience-dependent induction of hypnagogic images during daytime naps: A combined behavioural and EEG study. Journal of Sleep Research, 21(1), 10-20.

Ortiz de Gortari, A. B., Aronsson, K., & Griffiths, M. D. (2011). Game Transfer Phenomena in video game playing: A qualitative interview study. International Journal of Cyber Behavior, Psychology and Learning 1(3), 15-33.

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

Ortiz de Gortari, A. B., & Griffiths, M. D. (2014a). Altered visual perception in Game Transfer Phenomena: An empirical self-report study. International Journal of Human-Computer Interaction, 30(2), 95-105.

Ortiz de Gortari, A. B., & Griffiths, M. D. (2014b). 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. (2014c). 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(4), 1-21.

Ortiz de Gortari, A. B., & Griffiths, M. D. (2015a). 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. (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., Oldfield, B. & Griffiths, M.D. (2016). An empirical examination of factors associated with Game Transfer Phenomena severity. Computers in Human Behavior, 64, 274-284.

Ortiz de Gortari, A. B., Pontes, H. M. & Griffiths, M. D.  (2015). The Game Transfer Phenomena Scale: An instrument for investigating the nonvolitional effects of video game playing. Cyberpsychology, Behavior, and Social Networking 10, 588-594

Skorka-Brown, J., Andrade, J., & May, J. (2014). Playing ‘Tetris’ reduces the strength, frequency and vividness of naturally occurring cravings. Appetite, 76 , 161-165.

Skorka-Brown, J., Andrade, J., Whalley, B., & May, J. (2015). Playing Tetris decreases drug and other cravings in real world settings. Addictive Behaviors, 51, 165-170.

Stickgold, R., Malia, A., Maguire, D., Roddenberry, D., & O’Connor, M. (2000). Replaying the Game: Hypnagogic images in normals and amnesics. Science, 290(5490), 350-353.

Wamsley, E. J., Perry, K., Djonlagic, I., Reaven, L. B., & Stickgold, R. (2010). Cognitive replay of visuomotor learning at sleep onset: Temporal dynamics and relationship to task performance. Sleep, 1(33), 59-68.