Category Archives: Psychology

Game on: A brief look at gambling on eSports

Like daily fantasy sports, betting on eSports (i.e., professional video gaming) has increased in popularity over the last few years and has given rise to allegations of unregulated and underage gambling. The eSports market is large. According to a 2016 report by Superdata, professional eSports is growing exponentially and is worth an estimated $612 (US) million a year. Furthermore, Eilers and Krejcik Gaming estimate that real money betting on eSports betting will reach $10 billion (US) by 2020. The professionalization and sportification of this entertainment form has brought sports-world elements to it: stadium-like facilities, cheering stands, sponsors, big rewards, and competition. Instant replays, jumbotrons (i.e., super-huge television screens), and referees add to the sport dramatisation. In some notorious cases, prizes have gone beyond the $10 million [US] threshold in a packed arena housing 73,000 fans. According to by John McMullan and Delthia Miller in a 2008 issue of the Journal of Gambling Issues, sportification is the process of incorporating the logics of sport to non-sporting contexts (e.g., poker, eSports. This can materialise in many ways but most commonly occurs when (i) other industries capitalise on the positive attributes of sport (e.g., popularity, engagement, or sanity and health inferences); and (ii) non-sport fields try to increase the entertainment and playability of their products and their association with joy and excitement.


Twitch, an online platform that streams live video gaming, informs its’ advertisers that it has 100 million monthly viewers, who watch for an average of 106 minutes a day. Betting on eSports presents new challenges. As a news report in Bloomberg news observed in relation to betting on the game Counterstrike: Global Offensive (CSGO):

“Gambling – licensed, regulated, and by adults – is generally accepted in eSports. There is growing concern, though, that teenagers are being attracted to different forms of betting facilitated by third-party providers. One such platform is CSGO Lounge (an independent site not affiliated with Valve Software, which develops the game itself). The site allows spectators to bet in-game add-ons known as skins – weapons, tools and the like – on the results of matches. Not all skins are created equal, and the rarity of some means they can cost hundreds of real dollars on marketplace sites like The temptation is too much for some”.

Put simply, skin gambling is the use of virtual goods and items (typically cosmetic elements that have no direct influence on gameplay) as virtual currency to bet on the outcome of professional matches. The Bloomberg article also claims on the basis of interviews with industry insiders that underage skin gambling is a “huge problem”. Justin Carlson (lead developer of SkinXchange) claims there are “countless” parents whose children have used their credit cards without their knowledge to buy skins and bet on gaming on other sites. Although anecdotal, Carlson claims that some minors have “racked up hundreds or thousands of dollars in skins on ‘SkinXchange’ just to lose them all on some betting or jackpot site”. It’s clear that people trading skins in eSports has grown over the last few years and various regulators around the world – such as the UK Gambling Commission (UKGC) – are considering regulation and says it is an “emerging product” and an “area for continuing future focus”. More specifically, the UKGC’s 2016 Annual Report notes:

 “The growing market in esports and computer gaming has scope to present issues for regulation and player protection – issues which are being examined by gambling regulators in other international markets…These issues range from the emergence of real money esports betting markets, to trading in-game items which blur the lines between gambling and social gaming. Our focus will be to understand developments, including engaging with key stakeholders, and we will work wherever we can to ensure the risks associated with these, particularly to children and young people, are minimised”.

One of the complicating factors for eSports gambling is that while cash is the currency for many gamblers, there is a growing trend towards the use of virtual currencies, or ‘in-game items’ which, according to the UKGC, can be “won, traded, sold or used as virtual currency to gamble with and converted into money or money’s worth”. These, according to the UKGC, “include digital commodities (such as ‘skins’) which can be won or purchased within the confines of computer games and can then be used as a form of virtual currency on a growing number of gambling websites”. No academic research has examined underage skin gambling but this is an issue that is unlikely to diminish over the coming years.

It is also worth noting that this massive interest in eSports followed by a massive audience has led most major betting operators to include eSports in their daily gambling offer. However, the singularities of eSports market pose new challenges that conventional online betting sites struggle to address. Suraj Gosai, co-founder of Blinkpool, an eSports dedicated betting platform, laid out two main problems: in-play betting limitations and odds algorithmic programming. For in-play betting to be viable, companies need to get access to reliable, instantaneous, and unambiguous data that can settle bets and separate winners from losers. Data companies like Perform do that in sport, and betting operators rely on their data to offer in-play action to gamblers. The problem in eSports is that actions are not as quantified and standardised as in real-life sports. To counteract that, Blinkpool created a computer vision technology that extracts data from real-time action and promotes hyper-contextual opportunities, that is, 10- to 45-second in-play betting mini-markets concerning very specific developments in the narrative of the games.

Odds programming in sports betting is fundamentally based on historical data from hundreds of thousands of games, from which each factor (home advantage, table position, head-to-head, etc.) is weighted in to determine the probability of an event occurring. In the fixed-odds betting market, the bookmaker makes available to bettors that probability plus a benefit margin. When placing a bet, an individual bets against the probability that the house has predicted. This is not yet feasible in eSports because the historical data are scarce and the modelling is complex. Companies are circumventing this problem by offering exchange betting rather than fixed-odds. This method comprises peer betting, that is, bettors do not bet against the house but between one another. This way, the house gets a commission from winning bets and operates a much less risky business.

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

Further reading

Bracken, G. (2016). We hope to be the home of eSports betting. Gambling Insider. Available from:

Gambling Commission (2015). Explaining our approach to social gaming. Located at:

Gambling Commission (2016). Annual Report 2015/16. Birmingham: Gambling Commission.

McMullan, J. L., & Miller, D. (2008). All in! The commercial advertising of offshore gambling on television. Journal of Gambling Issues, 22, 230-251.

Melbourne, K. & Campbell, M. (2015). Professional gaming may have an underage gambling problem. Bloomberg, September 7. Available at:

Superdata (2016). eSports Market Report. Available at:

Wingfield, N. (2014) In e-Sports, video gamers draw real crowds and big money. New York Times, August 30. Available from:

Wood, J. (2016). UK Gambling Commission: We’ll work to minimize risks from emerging esports betting markets. Esports Betting Report, July 19. Available at:

No laughing matter: A brief look at scary clowns and coulrophobia

A few days ago, the Nottingham Trent University Press Office asked if I would be interested in speaking to BBC Online News about coulrophobia (i.e., a fear of clowns). Obviously this is not my specialist area and the only article I’ve ever written about clown psychology was a previous blog on coulrophilia (i.e., sexual arousal from clowns) and an article on the psychology of fancy dress. It turned out that the BBC were writing a story about the British police being inundated with clowns scaring people by jumping out and chasing them. More specifically, the story claimed:

“Police across England have been called to dozens of incidents in which pranksters dress as ‘creepy clowns’ to deliberately scare people. The culprits are said to be following a trend that started in the US [and has spread to other countries, including Canada, Australia and France]. A 30-year-old man was arrested in Norwich after someone dressed as a clown jumped out from behind a tree and “terrified” a woman in a public park. On Sunday Thames Valley Police said it had been called to 14 incidents in 24 hours. In County Durham on Friday, four children were followed to school by a man in a clown outfit who was armed with what turned out to be a plastic machete. In a separate clowning caper in County Durham on Friday, police in Peterlee posted a photo on their Facebook page of items including two masks confiscated from two 12-year-olds who officers said had gone to a primary school to scare children. Meanwhile, in Kidlington, Oxfordshire, a man dressed as a clown and carrying a baseball bat was reported to have chased a 10-year-old child through a park. Gloucestershire Police said it had received six reports of ‘clowns’ behaving suspiciously or carrying knives. In one instance a child was followed. A cyclist in Eastbourne, Sussex, was left ‘shaken’ after someone dressed as a clown jumped out from a bush brandishing what he believed was an offensive weapon. And in Sudbury, Suffolk, a boy was chased by “several people dressed as clowns”.


As there was little academic research in coulrophobia, I felt I was as qualified as anyone to speculate on the roots of coulrophobia. I told the BBC that clowns tend to be scary because of their exaggerated looks and evil representation in films. Obviously, the vast majority of individuals are not scared of clowns in a day-to-day context but a clown’s face has become part of a scare culture. I noted that there is a stereotype of the nasty, evil, eerie clown. If you look at clowns facially what you tend to find is part of their face or feet are exaggerated, they have huge noses, scary mouths, huge elongated shoes, and wildfire hair. I also made reference to the cinematic trope of the evil clown. If you look at everything from Heath Ledger as The Joker in Batman to the clown in Stephen King‘s It. These clowns or characters with clown faces are either killers or they are doing really nasty things. Even if you have not come into contact with clowns, you’re likely to be influenced by what you see in television and films. According to the Wikipedia entry on coulrophobia:

“Clown costumes tend to exaggerate the facial features and some body parts, such as hands and feet and noses. This can be read as monstrous or deformed as easily as it can be read as comical. The significant aberrations in a clown’s face may alter a person’s appearance so much that it enters the so-called ‘uncanny valley’ in which a figure is lifelike enough to be disturbing, but not realistic enough to be pleasant—and thus frightens a child so much that they carry this phobia throughout their adult life. According to psychology professor Joseph Durwin at California State University, Northridge, young children are ‘very reactive to a familiar body type with an unfamiliar face. Researchers who have studied the phobia believe there is some correlation to the uncanny valley effect. Additionally, the fact that much clown behavior is ‘transgressive’ (anti-social behavior) can create feelings of unease”.

A couple of weeks ago after the spate of US clown attacks, Professor Frank McAndrew wrote an article for The Conversation on the psychology of what creeps us out about clowns. He compared his own thinking to that of the Canadian psychologist Dr. Rami Nader. More specifically, Professor McAndrew noted:

“[Dr. Nader] believes that clown phobias are fueled by the fact that clowns wear makeup and disguises that hide their true identities and feelings. This is perfectly consistent with my hypothesis that it is the inherent ambiguity surrounding clowns that make them creepy. They seem to be happy, but are they really? And they’re mischievous, which puts people constantly on guard. People interacting with a clown during one of his routines never know if they are about to get a pie in the face or be the victim of some other humiliating prank. The highly unusual physical characteristics of the clown (the wig, the big red nose, the makeup, the odd clothing) only magnify the uncertainty of what the clown might do next”.

No-one knows why the spate of clown attacks have occurred in the UK (or elsewhere). My own take on it is that the flurry of media stories about the phenomenon has probably contributed to some copycat cases (which then led one news story to the headline based on my radio interview with Talk Radio: Killer clown attacks: Leading professor says sensationalist media has fuelled ‘Clownpocalypse’”) although there are likely to be other reasons (given that Halloween is coming up). As a psychologist I am far more interested in why someone would attack others dressed as a clown in the first place.

Here, I see a lot of similarities with online behaviour in that dressing up as a character is like the taking on of another persona when people are online carrying out anti-social acts such as trolling. While the psychological core and personality of an individual online or dressed up in an outfit with a mask (or thick hideous make-up) is still that same person, the anonymity provided by the nature of online interactions and the anonymity provided by wearing a different face or mask both lead to the person becoming more disinhibited and doing things that they would never do in a normal face-to-face situation. In essence, such people are taking on other identities – at least momentarily – and carrying out anti-social acts that they would normally not do. However, there will also be those who carry out such attacks because they get crazed and/or sadistic pleasure from doing so. Their motives may be as simple as boredom, revenge and/ or just wanting to ‘have a laugh’ – the main motives that have been found in my own research among people who troll online.

The current spate of clown attacks may well die down as quickly as they have come about and I’m sure as the media reporting decreases there will be less of such attacks (at least I am hoping so).

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

Further reading

BBC News (2016). ‘Creepy clown’ police warnings as craze spreads. October 10, Located at:

Dolan, L. (2016). Killer clown attacks: Leading professor says sensationalist media has fuelled ‘Clownpocalypse’. Talk Radio, October 11. Located at:

Griffiths, M.D. (2014). Adolescent trolling in online environments: A brief overview. Education and Health, 32, 85-87.

Hayden, D. (2016). ‘Creepy clowns’ craze: Professionals hit out at pranksters. BBC News, October 11. Located at:

McAndrew, F.T. (2016). The psychology behind why clowns creep us out. The Conversation, September 29. Located at:

Thacker, S. & Griffiths, M.D. (2012). An exploratory study of trolling in online video gaming. International Journal of Cyber Behavior, Psychology and Learning, 2(4), 17-33.

Wikipedia (2016). Coulrophobia. Located at:

Wikipedia (2016). Uncanny valley. Located at:

Zidbits (2011). Why are some people afraid of clowns? October 20. Located at:

Teaming with gain: Are daily fantasy sports a form of gambling?

Fantasy sports games have been popular for many years and involves individuals assuming the role of a professional sports team manager (typically football) and assembling a virtual team of sportsmen to compete against other players within a private or public league. For decades, the game was played out across the whole season with the winners being those that had accumulated the most points (with the points gained being based on the real-life statistics of individual sportsmen using a predetermined scoring system).

However, fantasy sports have changed dramatically over the last few years. Although the game can still be played over a whole season, the playing of daily fantasy sports (DFS) has become increasing popular (particularly in countries such as the USA, Canada, and Australia) and can operate over much shorter time periods. In DFS, players can pay to play and this has led to the blurring of lines of whether the activity is a game or whether it is gambling. As Dr. Dylan Pickering and his colleagues noted in a 2016 issue of Current Addiction Reports:

“Daily fantasy sports (DFS) is the most recent and controversial of FS games…It is an accelerated version of FS conducted over much shorter time periods: generally a single game (per day) or weekly round of competition. Users pay entry fees ranging from US 25 cents to US $5000 per league, which is deposited into a prize pool typically paid out to the highest ranked users in the contest. A portion of the entry fees also goes to the operator as commission. Accordingly, DFS, as such, is most associated with wagering. Currently, the US DFS market is dominated by ‘FanDuel’ and ‘DraftKings’ (combined with about 95 % of the market)”.


According to figures in the same paper, in the USA, the fantasy sports (FS) market is currently estimated to be between $3 billion and $4 billion. In 2015, approximately 57 million Americans played FS. Research suggests that the prevalence rates are higher in North America than elsewhere with 19% of Canadian adults and 16% of American adults engaging in FS compared to 10% of British adults and 6% of Australian adults (Pickering et al., 2016). However, these figures relate to FS rather than DFS and many FS players do not pay money to participate in the game and simply play for fun. Some research by Dr. Joris Drayer and colleagues in a 2013 issue of the European Sport Management Quarterly also suggests that those who engage in playing DFS do not typically engage in other forms of gambling. Furthermore, in a 2011 issue of Journal of Sport Management, Dr. Brendan Dwyer and Dr. Yongjae Kim reported that compared to more traditional forms of gambling, the elements of fun, excitement, competition play a bigger role than winning money in the playing of DFS games.

A study carried out by Dr. Ryan Martin and Dr. Sarah Nelson published in a 2014 issue of Addictive Behaviors found that college students who were FS users (free and fee-based) were five times more likely to incur gambling problems than non-FS users, and students who played FS for money had significantly higher rates of gambling problems than those who played in free leagues. A more recent 2016 study by Loredana Marchica and Dr. Jeff Derevensky in the International Journal of Mental Health and Addiction examined data from national surveys of collegiate athletes and reported a steady rise in FS participation among college students between 2004 and 2012. They reported that approximately half of the male and a quarter of the female college athletes who qualified as at-risk or problem gamblers also reported wagering on FS.

There has been much debate (particularly by US legislators) as to whether playing DFS for money is classed as a legitimate form of gambling. If gambling is defined as “an agreement between two or more parties to deliberately stake something of value (typically money) with intent to profit on the outcome of an event that is determined wholly, or partially by chance” (by Pickering and colleagues), then DFS could well be a form of gambling as they argue:

“DFS can be construed as representing a form of gambling: (a) DFS includes an agreement between an individual and others, (b) money is staked on the relative performances of athletes across a certain number of sporting events with the outcome determined by both chance and skill, and (c) chance is involved given that multiple unknown factors can influence outcomes. In this regard, similarities are found in horse and sports wagering where some skill in selecting horse/sports outcomes is present, but unpredictable variables influence results (i.e., chance)…Literature from the legal field asserts that gambling must contain three elements: (a) consideration (staking something of value in order to participate), (b) chance (luck is a substantial factor in determining results), and (c) prizes (cash, merchandise, services, or points) are redeemable…While the first and third elements are clearly present in DFS, the second element, chance, is the source of current disagreement”.

The US legislation on gambling rests on whether an activity is more skill than chance determined. If DFS is predominantly a game of skill it is not deemed to be a form of gambling. The DFS operators claim that DFS games are not gambling because of the “substantial” amount of skill involved in the selection and management of FS teams. But is this any different for the professional gambler who bets on horse racing given the many factors that the person gambling has to take into account (the form of the horse, the skill of the jockey, the weather conditions, the state of the track, the number of other horses involved in the race, etc.). Similarly, poker and blackjack are both games that players can win big if they are skilful. Personally, I believe that playing DFS games for money is definitely a form of gambling, and even if it isn’t legally classed as a form of gambling, the games contain structural elements (including high event frequencies, low entry fee per game, lots of games, etc.) that can facilitate excessive use and expose vulnerable players to harm. DFS operators also allow team line-ups from a previous sporting event to populate other events which increases the speed of play, another factor that can facilitate habitual use. Furthermore, as Dr. Samantha Thomas and her colleagues argued in a recent 2015 report, the enhanced participatory role that fantasy games introduce could facilitate the illusion of control as they perform actions, making bettors overestimate the importance of skills and knowledge for the outcome of the competitions.

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

Further reading

Drayer, J., Dwyer, B., & Shapiro, S. L. (2013). Examining the impact of league entry fees on online fantasy sport participation and league consumption. European Sport Management Quarterly, 13(3), 339-335.

Dwyer, B., & Kim, Y. (2011). For love or money: Developing and validating a motivational scale for fantasy football participation. Journal of Sport Management, 25(1), 70-83.

Marchica, L., & Derevensky, J. (2016). Fantasy sports: A growing concern among college student-athletes. International Journal of Mental Health and Addiction, 1-15. Epub ahead of print.

Martin, R. J., & Nelson, S. (2014). Fantasy sports, real money: Exploration of the relationship between fantasy sports participation and gambling-related problems. Addictive Behaviors, 39(10), 1377-138.

Pickering, D., Blaszczynski, A., Hartmann, M., & Keen, B. (2016). Fantasy sports: Skill, gambling, or are these irrelevant issues? Current Addiction Reports, 3(3), 307-313.

Thomas, S., Bestman, A., Pitt, H., Deans, E., Randle, M., Stoneham, M., & Daube, M. (2015). The marketing of wagering on social media: An analysis of promotional content on YouTube, Twitter and Facebook. Victoria, Australia: Victorian Responsible Gambling Foundation.

No joking on smoking: My top ten tips for giving up smoking this Stoptober

Although most of my academic research is on behavioural addiction, I have published quite a few papers on more traditional addictions such as alcohol addiction and nicotine addiction (see ‘Further reading’ below). In 2012, I had to watch my mother fight a losing battle with smoking-related lung cancer and chronic obstructive pulmonary disease. She died in September 2012 aged 66 years, and had chain-smoked most of her adult life. This followed the death of my father who also died of smoking-related heart disease, aged just 54.

In my previous blog I looked at ways to reduce alcohol intake as part of the ‘Go Sober For October‘ campaign. In today’s blog I provide my advice for giving up smoking as part of the annual ‘Stoptober’ campaign. In the UK smoking accounts for approximately one in four cancer deaths, and as I said, it’s something I’ve witnessed first-hand. I’m sure most people reading this are aware of the addictive nature of nicotine. As soon as nicotine is ingested via cigarettes, it can pass from lungs to brain within ten seconds and stimulates the release of the neurotransmitter dopamine. The release of dopamine into the body provides reinforcing mood modifying effects. Despite nicotine being a stimulant, many people use cigarettes for both tranquillising and euphoric effects.


Most authorities accept that nicotine is one of the most addictive drugs on the planet and that smokers can become hooked quickly. One of the reasons my own parents were never able to give up was because of the prolonged withdrawal effects they experienced whenever they went more than a few hours without smoking. This would lead to intense cravings for a cigarette. Watching both my parents’ die of smoking-related diseases is enough incentive for me to never smoke a cigarette. Hopefully, others can find the incentives they need to help them give up permanently. Here are my top ten tips to help you (or someone you know and love) stop smoking:

  • (1) Develop the motivation to stop smoking: Many smokers say they would like to stop but don’t really want to. When you take stock, make sure you are clear as to why you want to give up. It may be to save money, to improve your health, to prevent yourself getting a smoking-related disease, or to protect your family from passive smoking. (It could of course be all of the above). Really wanting to give up is the best predictor of successful smoking cessation.
  • (2) Get all the emotional support you can: Another good predictor of whether someone will overcome their addiction to nicotine is having a good support network. You need people around you that will support your efforts to quit. Tell as many people that you know that you are trying to quit. It could be the difference between stopping and starting again.
  • (3) Avoid ‘cold turkey’: Although some people can stop through willpower alone, most people will need to reduce their nicotine intake slowly. The best way of doing this is to replace cigarettes with a safe form of nicotine such as those available from the pharmacy, or on prescription from the doctor.
  • (4) Get support from a professional: Even if you are using a safe form of nicotine from your pharmacist or doctor, cutting out cigarettes completely can be hard. Getting support from a trained NHS stop smoking adviser can double your chances of stopping smoking. To find your nearest free NHS stop smoking service (in the UK call 0300 123 1044) or visit the Smokefree website.
  • (5) Use non-nicotine cigarette shaped substitutes: Smoking is also a habitual behaviour where the feel of it in your hands may be as important as the nicotine it contains. The use of plastic cigarettes or e-cigarettes will help with the habitual behaviour associated with smoking but contain none of the addictive nicotine.
  • (6) Use relaxation techniques: When cravings strike, use relaxation exercises to help overcome the negative feelings. At the very least take deep breaths. There are dozens of relaxation exercises online. Practice makes perfect.
  • (7) Treat yourself: One of the immediate benefits of stopping smoking will be the amount of money you save. At the start of the cessation process, treat yourself to rewards with the money you save.
  • (8) Focus on the positive: Giving up smoking is one of the hardest things that anyone can do. Write down lists of all the positive things that will be gained by stopping smoking. Constantly remind yourself of what the long-term advantages will be that will outweigh the short-term benefits of smoking a cigarette. In short, focus on the gains of stopping rather than what you will miss about cigarettes.
  • (9) Know the triggers for your smoking: Knowing the situations in which you tend to smoke can help in overcoming the urges. Lighting up a cigarette can sometimes be the result of a classically-conditioned response (e.g. having a cigarette after every meal). These often occur unconsciously so you need to break the automatic response and de-condition the smoking. You need to replace the unhealthy activity with a more positive one and re-condition your behaviour.
  • (10) Fill the void: One of the most difficult things when cigarette craving and withdrawal symptoms strike is not having an activity to fill the void. Some things (like engaging in physical activity) may help you in forgetting about the urge to smoke. Plan out alternative activities and distraction tasks to help fill the hole when the urge to smoke strikes (e.g. chew gum, eat something healthy like a carrot stick, call a friend, occupy your hands, do a word puzzle, etc.). However, avoid filling the void with other potentially addictive substances (e.g. alcohol) or activities (e.g. gambling).

Dr Mark Griffiths, Professor of Gambling Studies, International Gaming Research Unit, Nottingham Trent University, Nottingham, UK

Further reading

Griffiths, M.D. (1994). An exploratory study of gambling cross addictions. Journal of Gambling Studies, 10, 371-384.

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

Griffiths, M.D. (2012). First person: Highly-addictive drug killed both of my parents. Nottingham Post, October 1, p.13.

Griffiths, M.D., Parke, J. & Wood, R.T.A. (2002). Excessive gambling and substance abuse: Is there a relationship? Journal of Substance Use, 7, 187-190.

Griffiths, M.D., Wardle, J., Orford, J., Sproston, K. & Erens, B. (2010). Gambling, alcohol consumption, cigarette smoking and health: findings from the 2007 British Gambling Prevalence Survey. Addiction Research and Theory, 18, 208-223.

Griffiths, M.D., Wardle, J., Orford, J., Sproston, K. & Erens, B. (2011). Internet gambling, health. Smoking and alcohol use: Findings from the 2007 British Gambling Prevalence Survey. International Journal of Mental Health and Addiction, 9, 1-11.

Resnick, S. & Griffiths, M.D. (2010). Service quality in alcohol treatment: A qualitative study. International Journal of Mental Health and Addiction, 8, 453-470.

Resnick, S. & Griffiths, M.D. (2011). Service quality in alcohol treatment: A research note. International Journal of Health Care Quality Assurance, 24, 149-163.

Resnick, S. & Griffiths, M.D. (2012). Alcohol treatment: A qualitative comparison of public and private treatment centres. International Journal of Mental Health and Addiction, 10, 185-196.

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.

Umeh, K. & Griffiths, M.D. (2001). Adolescent smoking: Behavioural risk factors and health beliefs. Education and Health, 19, 69-71.

Go sober this October: How to lower your alcohol intake this month

Last week I was interviewed by the Daily Telegraph about this year’s  ‘Go Sober For October‘ (“Octsober”) campaign. In addition to wanting some tips on how to cut down alcohol intake (see below), they wanted to know why people are so reliant on alcohol to relieve stress, socialise and escape. On a very simple level, alcohol is a pharmacological depressant that enhances disinhibition (i.e., a disregard for social conventions) and which is both physiologically and psychologically rewarding. Like most addictive behaviours it is a mood modifier that can either get individuals high, excited, buzzed up and aroused or (somewhat paradoxically) do the exact opposite and help them escape, numb, relax and de-stress. The fact that it’s socially condoned and widely available make it a perfect substance for individuals to use and misuse.


The remainder of today’s blog provides some tips on the simplest ways to cut down on alcohol intake. They are not aimed at problem drinkers as they require extra external support and interventions from family, friends, doctors and/or therapists. The tips below come from a variety of sources (listed in ‘Further reading’). I don’t claim to be an expert on alcohol addiction (although I have published more than a few papers on alcohol problems over the years – again, see some of these in ‘Further reading’ below) but most of these tips are practical and common sense:

Don’t go it alone: If you really want to cut down your alcohol intake, try do it with your friends and family together. Doing it with others rather than on your own means you will have others around you going through the same thing as yourself as well as having a ready made support group.

Don’t buy rounds of drinks in pubs and clubs: If you’ve ever been out on a pub crawl with friends, you will know that you tend to drink at the pace of the quickest drinker in the group (and this may be at a quicker rate than you would ideally prefer). If you do want to drink in rounds, then try opting out every other round and/or try to drink with a smaller group of friends (as larger groups typically lead to more alcohol being drunk over the course of an evening).

Spread out your drinking and drink more slowly: Sounds obvious but it’s true. (As I noted above, in places where alcohol is very expensive this becomes a natural option). A related option is to have one alcoholic drink followed by one non-alcoholic drink throughout the evening.

Don’t buy pints, doubles or large glass drinks: When you do drink in pubs and clubs, order smaller measures (wine in a small glass rather than a large one, halves instead of pints, a bottle of lager rather than a pint of lager). All of these smaller options mean a reduced ‘alcohol by volume’ ratio (i.e., less alcohol actually consumed). If you are the kind of person who says to yourself ‘I never have more than two glasses of wine a night’, then changing to a smaller glass will have an immediate and appreciable effect in lowering overall alcohol intake.

Where possible choose non–alcoholic drinks: When you eat out or dine at home, have a soft drink, juice or water rather than wine or beer with your meal.

Dilute alcoholic drinks: If the option of a non-alcoholic drink isn’t always possible or simple doesn’t appeal, then dilute your drinks. Have a lager shandy or a white wine spritzer.

Have ‘alcohol-free’ days: If you drink every day, start by trying to drink alcohol every other day. If you drink alcohol a few times a week, try to drink just once a week. Just cutting down on your normal weekly pattern will help you to realise that you can go without alcohol.

Avoid cocktails: Cocktails often contains a lot more alcohol than people think.

Drink alcohol free beers and lagers: If you love the taste of lager or beer, there are alcohol free options. There are also an increasing number of fake cocktails (‘mocktails’).

Reward yourself for not drinking alcohol: Many people drink as a way to alleviate the stresses and strains of every day life (or to do the exact opposite – to celebrate the fact that you’ve done something well or because it is a special occasion). The money not spent on alcohol could go towards giving yourself another kind of treat or reward (a massage, the new CD you wanted, watching a film at the cinema, etc.).

Tell everyone in your social circle you’re cutting down alcohol intake: By telling everyone you know including family, friends and work colleagues, you will be more committed to not drinking alcohol than if you told no-one.

Avoid temptation: One of the key factors in any potentially addictive activity is knowing what the ‘triggers’ are (e.g., walking past a pub, watching television, having an argument with your loved one, etc.). Knowing what the triggers are can be a strategy for avoiding temptation (e.g., changing the routes on your way back home to avoid walking past your favourite pub, doing something else instead of watching television, etc.).

Get a new hobby: Changing one aspect of your routine life can also help change other aspects. Sometimes, changing one aspect of your life (such as introducing daily exercise) goes hand-in-hand with other areas of your life (drinking less alcohol, eating more healthily).

Think of the benefits of not drinking alcohol: Not drinking alcohol can bring lots of positives. In six months without alcohol I’ve lost about 6.35kg in weight because alcohol is high in calories (and that’s without exercise!). Other benefits include more money for other things, better quality sleep, less stress (because alcohol is a depressant), and better health.

Use alcohol tracking tools: Many apps are now available to help you keep track of your alcohol intake. For instance, the MyDrinkaware tool allows you to see how alcohol is affecting you on a number of different dimensions including your health (how many units you are consuming over time), weight (how many calories you are consuming over time), and finances (how much money you are spending on alcohol over time).

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

Further reading

Drinkaware (2015). Tips for cutting down when out. Located at:

Drinkaware (2015). Track your drinking. Located at:

Griffiths, M.D. (2014). I drink, therefore I am: The UK’s alcohol dependence. Intervene, April, 20-23.

Griffiths, M.D., Wardle, J., Orford, J., Sproston, K. & Erens, B. (2010). Gambling, alcohol consumption, cigarette smoking and health: Findings from the 2007 British Gambling Prevalence Survey. Addiction Research and Theory, 18, 208-223.

Griffiths, M.D., Wardle, J., Orford, J., Sproston, K. & Erens, B. (2011). Internet gambling, health. Smoking and alcohol use: Findings from the 2007 British Gambling Prevalence Survey. International Journal of Mental Health and Addiction, 9, 1-11.

Glynn, S. (2012). Living close to a bar increases chance of risky drinking. Medical News Today, November 7. Located at:

NHS Choices (2015). Tips on cutting down [alcohol]. Located at:

Resnick, S. & Griffiths, M.D. (2010). Service quality in alcohol treatment: A qualitative study. International Journal of Mental Health and Addiction, 8, 453-470.

Resnick, S. & Griffiths, M.D. (2011). Service quality in alcohol treatment: A research note. International Journal of Health Care Quality Assurance, 24, 149-163.

Resnick, S. & Griffiths, M.D. (2012). Alcohol treatment: A qualitative comparison of public and private treatment centres. International Journal of Mental Health and Addiction, 10, 185-196.

A cite for more I’s? A brief personal look at obsessive self-citation

All of us who are involved in any kind of academic writing have to conform to minimum standards such as the meticulous recording of source material in the form of cited references. Griffiths (2005) noted that there are three main reasons why people use references. These being (i) the expression of an idea has been put forward more clearly elsewhere by someone else, (ii) to make specific reference to relevant past literature, and (iii) to provide suggestions for further background reading.

These reasons can also be applied to self-citation. However, self-citation has additional advantages. Griffiths (2005) also notes that self-citation references can also be used to (i) let journal reviewers and referees know who has written the paper (which may not always be a good thing!), (ii) to establish to readers your reputation in a given area and/or (iii) satisfy cravings to see your name in print! In today’s blog I aim to examine the art of obsessive self-citation in academic writing and give some effortless hints and tips.

It has previously been asserted that self-citation is academia’s way of expressing one’s ego although this was based on anecdotal evidence rather than any kind of empirical investigation (Griffiths, 2016a). After an exhaustive literature search it perhaps came as no surprise that I found absolutely nothing on the subject of self-citation except an unpublished paper by myself (Griffiths, 2013) which has been described as “the best article in this area” (Griffiths, 2016b).

So what can the experienced and obsessive self-citation expert get up to in the course of a single article? Self-citation aficionados are known to use such tricks as referring to themselves in less conventional formats such as letters to national newspaper (e.g. Griffiths, 1998), articles in international newspapers (Griffiths, 2014), articles in national newspapers (e.g. Griffiths, 2016c), articles in local newspapers (Griffiths, 2016d), educational leaflets (e.g. Griffiths, 1993a), consultancy reports (e.g. Griffiths, 2002a) or blogs (Griffiths, 2016e).


However, these work most effectively if they are buried away amongst more conventional references such as books and refereed journal articles. Those experienced in obsessive self-citation will often sink to even murkier depths. For instance, self-citation is an excellent way of introducing something that seems implausible into your argument. Two common ways to disguise implausibility is the liberal use of such phrases as “paper forthcoming”, “manuscript submitted for publication”, “internal report” or “personal communication” (however, the latter should be used very sparingly as it suggests that the author is someone who talks about things more than writing them). If you sprinkle these into an article and intersperse them with a few very genuine citations such as books you wrote which received very good reviews (Griffiths, 1995; 2002b) or some of your good and/or highly cited refereed journal papers spread across a number of years (Auer & Griffiths, 2015; Cole & Griffiths, 2007; Griffiths, 1991a; 1993b; 1994; 1996; 1997; 1999; 2000; 2001; 2003; 2004; 2008; 2010; Griffiths, Kuss, Billieux & Pontes, 2016; Kuss, Griffiths & Binder, 2013) it can look very professional and in some cases impressive (or just show you to be the egomaniac that you are).

For the really experienced, secondary self-citation or embedded self-citations can often be useful. This is a technique where you can use quotes attributed to you in a newspaper or magazine article written by someone else (e.g. Griffiths, 1991b) although it looks as though it is one of the author’s bona fide references.

However, as my last word on the subject, I will leave you with one practice you should definitely avoid. I am referring to the inclusion of self-citation by pseudonym that has been described by Mithgriffs (2015) as “a despicable habit that should be stamped out”.

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


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.

Cole, H. & Griffiths, M.D. (2007). Social interactions in Massively Multiplayer Online Role-Playing gamers. CyberPsychology and Behavior, 10, 575-583.

Griffiths, M.D. (1991a). The observational study of adolescent gambling in UK amusement arcades. Journal of Community and Applied Social Psychology, 1, 309-320.

Griffiths, M.D. (1991b). Cited in Neustatter, A. “Keyboard junkies”. The Independent on Sunday Review, November 17, p.64.

Griffiths, M.D. (1993a). Your child and video games: Advice for parents. Coventry: National Council for Educational Technology (leaflet).

Griffiths, M.D. (1993b). Tolerance in gambling: An objective measure using the psychophysiological analysis of male fruit machine gamblers. Addictive Behaviors, 18, 365-372.

Griffiths, M.D. (1994). The role of cognitive bias and skill in fruit machine gambling. British Journal of Psychology, 85, 351-369.

Griffiths, M. (1995). Adolescent Gambling. London: Routledge.

Griffiths, M.D. (1996). Pathological gambling and its treatment. British Journal of Clinical Psychology, 35, 477-479.

Griffiths, M.D. (1997). Video games and clinical practice: Issues, uses and treatments. British Journal of Clinical Psychology, 36, 639- 641.

Griffiths, M.D. (1998). Unlucky number for under-16s. The Guardian, February 25, p.15.

Griffiths, M.D. (1999). Counselling in the treatment of pathological gambling: An overview. British Journal of Guidance and Counselling, 27, 179-190.

Griffiths, M.D. (2000). Internet addiction – Time to be taken seriously? Addiction Research, 8, 413-418.

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

Griffiths, M.D. (2002a). The Social Impact of Casinos. Nottingham: Browne-Jackson.

Griffiths, M.D. (2002b). Gambling and Gaming Addictions in Adolescence. Leicester: British Psychological Society/Blackwells.

Griffiths, M.D. (2003). The therapeutic use of videogames in childhood and adolescence. Clinical Child Psychology and Psychiatry, 8, 547-554.

Griffiths, M.D. (2004a). Odds and sods: You (nearly) win again. The Guardian, April 20, p. 6.

Griffiths, M.D. (2004b). Can videogames be good for your health? Journal of Health Psychology, 9, 339-344.

Griffiths, M.D. (2005). Self-citation: A practical guide. Null Hypothesis: The Journal of Unlikely Science (‘Best of’ issue), 15-16.

Griffiths, M.D. (2008). The biopsychosocial and “complex” systems approach as a unified framework for addiction. Behavioral and Brain Sciences, 31, 446-447.

Griffiths, M.D. (2010). The role of context in online gaming excess and addiction: Some case study evidence. International Journal of Mental Health and Addiction, 8, 119-125.

Griffiths, M. (2013). The art of self-citation. Article submitted for publication.

Griffiths, M.D. (2014). Sunshine: As addictive as heroin? Washington Post. June 24. Located at

Griffiths, M. (2016a). Personal communication with myself. September 29, 2016.

Griffiths, M.D. (2016b). Personal communication with myself. September 29, 2016.

Griffiths, M.D. (2016c). It will rule your life but addicts can be helped. Sunday Mirror, May 1, p.5.

Griffiths, M.D. (2016d). Sorry may be the hardest word but more people than ever are saying it. Nottingham Post, April 11, p.14.

Griffiths, M.D. (2016e). Market forces: Does gambling advertising increase problem gambling? August 22. Located at:

Griffiths, M.D., Kuss, D.J., Billieux J. & Pontes, H.M. (2016). The evolution of internet addiction: A global perspective. Addictive Behaviors, 53, 193–195.

Kuss, D.J., Griffiths, M.D. & Binder, J. (2013). Internet addiction in students: Prevalence and risk factors. Computers in Human Behavior, 29, 959-966.

Mithgriffs, G. (2015). Whose self-citation is it anyway? Occasional Made-Up Paper (No.3).

Net bets: What makes betting online attractive to gamblers?

Over the past two decades I have carried out a lot of research on what factors are important in attracting people to engaging in online activities such as online video gaming, online gambling, online shopping, and online sex. Research has shown that virtual environments have the potential to provide short-term comfort, excitement and/or distraction – all of which can be highly reinforcing to internet users. My research has consistently shown that there are many generic factors that facilitate online use including accessibility, anonymity, affordability, convenience, escape, immersion, interactivity, disinhibition, and simulation. Today’s blog briefly examines these factors.


Accessibility Access to the Internet is now commonplace and widespread, and can be done easily from the home, the workplace and (via mobile gambling) on the move. Given that the uptake of consumptive behaviours is strongly correlated with increased access to the activity, it is not surprising that the incidence of activities like online gambling and online gaming is slowly increasing across different populations across the world. Fundamentally, increased accessibility of these activities enables the individual to rationalize involvement by removing previously restrictive barriers such as time constraints emanating from occupational and social commitments.

Anonymity – The anonymity of the Internet allows users to privately engage in such activities as sex and gambling without the fear of stigma. This anonymity can also provide the user with a greater sense of perceived control over the content, tone, and nature of the online experience. Anonymity also has the capacity to increase feelings of comfort since there is a decreased ability to look for, and thus detect, signs of insincerity, disapproval, or judgment in facial expression, as would be typical in face-to-face interactions. For activities such as gambling, this may be a positive benefit – particularly when losing – as no-one will actually see the face of the loser. Anonymity, like increased accessibility, may reduce social barriers to engaging in gambling, particularly skill-based gambling activities such as poker that are relatively complex and often possess tacit social etiquette. The potential discomfort of committing a structural or social faux-pas in the gambling environment because of inexperience is minimized because the individual’s identity remains concealed.

Affordability – Given the wide accessibility of the Internet, it is now relatively inexpensive to use online services on offer. Furthermore, the overall cost of has been reduced significantly through technological developments, again, rendering affordability less of a restrictive force when it comes to rationalizing involvement in the behaviour. For example, the saturation of online gambling industry has lead to increased competition, and the consumer is benefiting from the ensuing promotional offers and discounts available on gambling outlay. Regarding interactive wagering, the emergence of peer-to-peer gambling through the introduction of betting exchanges has provided punters with commission free sporting gambling odds, which in effect means the player needs to risk less money to obtain potential revenue. Finally, ancillary costs of face-to-face gambling, such as parking, tipping and purchasing refreshments, is removed when gambling within the home and therefore the overall cost of gambling is reduced making it more affordable.

Convenience – Online behaviours usually occur in the familiar and comfortable environment of home or workplace thus reducing the feeling of risk and allowing even more adventurous behaviours. For the internet user, not having to move from their home or their workplace is of great positive benefit and increases the attractiveness of online activities compared to offline activities.

Escape – For some internet users, the primary reinforcement to engage in an online behaviour is the gratification they experience online. However, the experience of activities like online gambling, online gaming and/or online sex may be reinforced through a subjectively and/or objectively experienced ‘high’ or positive change in mood state. The mood-modifying experience has the potential to provide an emotional or mental escape and further serves to reinforce the behaviour. In short, online activities can provide a potent escape from the stresses and strains of real life.

Immersion – The medium of the Internet can provide feelings of dissociation and immersion and may facilitate feelings of escape (see above). Immersion can produce lots of different types of feelings that may be reinforcing for the internet user such as losing track of time, feeling like you’re someone else, and being in a trance like state.

Interactivity – The interactivity component of the Internet can also be psychologically rewarding and different from other more passive forms of entertainment (e.g., television). The interactive nature of the Internet can therefore provide a convenient way of increasing such personal involvement that can – in online situations – lead to increased online use. Furthermore, the alternative methods of peer interaction are available within interactive online activities that retain the socially reinforcing aspects of the behaviour. Individuals can communicate via computer-mediated communication in most online activities (including gambling and gaming).

Disinhibition – The feeling of disinhibition is one of the Internet’s key appeals as there is little doubt that the Internet makes people less inhibited when they are online. Online users appear to open up more quickly online compared to offline situations and reveal themselves emotionally much faster than in the offline world. This has been referred to by Dr. John Suler as ‘hyperpersonal communication’. According to Dr. Suler, this occurs because of four features of online communication: 

  • The communicators usually share social categories so will perceive each other as similar (e.g., all online poker players)
  • The message sender can present themselves in a positive light, and so may be more confident
  • The format of online interaction (e.g., there are no other distractions, users can spend time composing messages, mix social and task messages, users don’t waste cognitive resources by answering immediately)
  • The communication medium provides a feedback loop whereby initial impressions are built upon and strengthened.

Simulation – Finally, simulations provide an ideal way in which to learn about something and which tends not to have any of the possible negative consequences. For instance, most online gambling sites have a practice mode format, where potential gamblers can place a non-monetary bet in order to see and practice the procedure of gambling on that site. Furthermore, gambling in practice modes can build self-efficacy and potentially increase perceptions of control in determining gambling outcomes motivating participation in their ‘real cash’ counterparts within the site.

Dr Mark Griffiths, Professor of Gambling Studies, International Gaming Research Unit, Nottingham Trent University, Nottingham, UK

Further reading

Griffiths, M.D. (1998). Internet addiction: Does it really exist? In J. Gackenbach (Ed.), Psychology and the Internet: Intrapersonal, Interpersonal and Transpersonal Applications. pp. 61-75. New York: Academic Press.

Griffiths, M.D. (2003). Internet gambling: Issues, concerns and recommendations. CyberPsychology and Behavior, 6, 557-568.

Griffiths, M.D. (2009). Internet gambling in the workplace. Journal of Workplace Learning, 21, 658-670.

Griffiths, M.D. (2010). Gambling addiction on the Internet. In K. Young & C. Nabuco de Abreu (Eds.), Internet Addiction: A Handbook for Evaluation and Treatment (pp. 91-111). New York: Wiley.

Griffiths, M.D. (2010). Internet abuse and internet addiction in the workplace. Journal of Worplace Learning, 7, 463-472.

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

Griffiths, M.D., Kuss, D.J., Billieux J. & Pontes, H.M. (2016). The evolution of internet addiction: A global perspective. Addictive Behaviors, 53, 193–195.

Griffiths, M.D. & Parke, J. (2002). The social impact of internet gambling. Social Science Computer Review, 20, 312-320.

Griffiths M.D. & Szabo, A. (2014). Is excessive online usage a function of medium or activity? An empirical pilot study. Journal of Behavioral Addictions, 3, 74–77.

Kuss, D.J. & Griffiths, M.D. (2011). Online social networking and addiction: A literature review of empirical research. International Journal of Environmental and Public Health, 8, 3528-3552.

Kuss, D. & Griffiths, M.D. (2012).  Internet gambling behavior. In Z. Yan (Ed.), Encyclopedia of Cyber Behavior (pp.735-753. Pennsylvania: IGI Global

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 and gaming addiction: A systematic literature review of neuroimaging studies. Brain Sciences, 2, 347-374.

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

Kuss, D.J., Griffiths, M.D., Karila, L. & Billieux, J. (2014). Internet addiction: A systematic review of epidemiological research for the last decade. Current Pharmaceutical Design, 20, 4026-4052.

Pontes, H.M., Kuss, D.J. & Griffiths, M.D. (2015). The clinical psychology of Internet addiction: A review of its conceptualization, prevalence, neuronal processes, and implications for treatment. Neuroscience and Neuroeconomics, 4, 11-23.

Pontes, H.M., Szabo, A. & Griffiths, M.D. (2015). The impact of Internet-based specific activities on the perceptions of Internet Addiction, Quality of Life, and excessive usage: A cross-sectional study. Addictive Behaviors Reports, 1, 19-25.

Suler, J. (2004). The online disinhibition effect. CyberPsychology & Behavior, 7, 321-326.

Widyanto, L. & Griffiths, M.D. (2006). Internet addiction: A critical review. International Journal of Mental Health and Addiction, 4, 31-51.

Widyanto, L. & Griffiths, M.D. (2009). Unravelling the Web: Adolescents and Internet Addiction. In R. Zheng, J. Burrow-Sanchez & C. Drew (Eds.), Adolescent Online Social Communication and Behavior: Relationship Formation on the Internet. pp. 29-49. Hershey, Pennsylvania: Idea Publishing.

Dying for it: Bizarre autoerotic deaths (Part 2)

In my previous blog I examined some of the most bizarre autoerotic deaths reported in the medical forensic literature. Here are another five.

Case 1: Autoerotic death by aerosol propellant

Source: Medicine, Science and the Law. Personal details:  32-year old white US man. Single. Computer programmer.

  • Bizarre death event: Found dead in bed with cassette recorder next to him. He was wearing headphones which playing “snorting” horse sounds. There was also a can of aerosol propellant. At the end of the bed was a large painting of a male strapped to the hind legs of a horse who was being anally penetrating by the horse. The horse was ridden by a leather-clad woman. He was also wearing some kind if homemade masturbatory device. His death was recorded as cardio-respiratory failure consistent with aerosol propellant abuse (death by misadventure). Self-administration of the chemical agent to modify the sensations of masturbation. He was covered in dry semen stains.

Case 2: Autoerotic death by clothing

Source: Medicine, Science and the Law. Personal details:  25-year old Japanese male. Single.

  • Bizarre death event: Man found dead in his bed one morning. naked except for clothing wrapping his head and underpants which were pulled down. He was covered in dry semen stains. He had put a black skirt on his face and then pulled a second skirt upside down over his head and turned down the bottom of it. He then put a plastic bag over these two garments followed by a pair of tights. The legs of the tights were used to tie a knot around the bottom of the skirts. He then wrapped a third skirt around all of this. Death was due to suffocation.

Case 3: Autoerotic death by hanging (female)

Source: Handbook of Forensic Pathology. Personal details:  19-year old white female. Single. College student.

  • Bizarre death event: Woman was found dead in her bedroom hanging from the hinge of her closet door dressed as an Oriental “harem girl”. A window sash cord was tied around her body in a complicated fashion and she was also wearing a blindfold and mouth gag (made from the belt of her dressing gown). Next to her lay an underground magazine (this was folded out and showed a bizarre dance involving a clock – the minute hand being a nude male who would make love with the other figure on the hour), a paperback Hitchcock book which explained her fantasy. The paperback contained the story about an Oriental harem master. In this story the harem master provides girls to his lord who stored them by hanging them around his walls on hooks


Case 4: Autoerotic death by vacuum cleaner

Source: American Journal of Forensic Medicine and Pathology. Personal details: 57-year old white US male. Single. History of heart disease and chronic pancreatitis

  • Bizarre death event: Man was found naked slumped over his vacuum cleaner after a neighbour wondered why the vacuum cleaner had been on continuously for a long time. The man was found leaning against the dining table with his testicles, buttocks and thighs tightly bound with women’s tights. Near the table was a jar of urine, jars of lubricant and a wooden table leg covered in fecal excrement. The man was covered in burns from the vacuum cleaner. No defect was found in the vacuum cleaner. The man basically had a heart attack while engaged in autoerotic activity. The wooden table leg had been used in an attempt to stimulate orgasm via anal penetration. His wife had caught him masturbating with the vacuum cleaner before (they hadn’t had sex for five years). The death was classed as natural rather than accidental.

Case 5: Autoerotic death by hydraulic tractor shovel

Source: Journal of Forensic Sciences. Personal details:  62 year-old US white male. Married. Farmer.

  • Bizarre death event: Found dead in a barn lying on his front pinned under the hydraulic shovel of his tractor. His body was covered with semen stains and there was evidence of masochistic sexual bondage. His clothes were folded neatly away nearby. He was found naked except for a pair of women’s red shoes (with 8 inch heels), knee high stockings and tape duct wrapped around his ankles. Ropes led from his feet to the tractor which when raised would lift his inverted body causing complete suspension. It is not known exactly what happened but it is likely that the engine stalled and he was crushed underneath the tractor shovel. He died of positional asphyxiation by chest compression. This was an atypical autoerotic fatality because he did not purposely use asphyxiation but it did cause his death.

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.

Byard, R. W. (1994). Autoerotic death—characteristic features and diagnostic difficulties. Journal of Clinical Forensic Medicine, 1(2), 71-78

Cordner, S.M. (1983). An unusual case of sudden death associated with masturbation. Medicine, Science and the Law, 23(1), 54-56

Dietz, P. E., & O’Halloran, R.L. (1993). Autoerotic fatalities with power hydraulics. Journal of Forensic Science, 38(2), 359-364.

Ikeda, N., Harada, A., Umetsu, K., & Suzuki, T. (1988). A case of fatal suffocation during an unusual auto-erotic practice. Medicine, Science and the Law, 28(2), 131-134.

Imami, R. H., & Kemal, M. (1988). Vacuum cleaner use in autoerotic death. American Journal of Forensic Medicine and Pathology, 9(3), 246-248.

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

Sauvageau, A., & Racette, S. (2006). Autoerotic deaths in the literature from 1954 to 2004: A review. Journal of Forensic Sciences, 51(1), 140-146.

Dying for it: Bizarre autoerotic deaths (Part 1)

In previous blogs I have examined many different sexual paraphilias that have ended up in death for individuals engaged in such practices. Many of these are from autoerotic asphyxiation but also from other sexual practices such as electrophilia and anaesthesiophilia. Today’s blog takes a brief look at some of the most bizarre autoerotic deaths reported in the medical forensic literature.

Case 1: Autoerotic death by car

Source: Journal of Forensic Sciences. Personal details: 40-year old white US male airline pilot. Married and father of two children.

  • Bizarre death event: A man left his home at 6am in the morning and told his wife that he was going shooting in the country. He was found naked except for a large-link 10-foot chain harness secured around his body. (The harness was tied around the man’s neck in a moderately tight loop and bolted. The chain then went down his chest and was tied into another loop around his waist. This was tied to the bumper of the car) at 7.30am in the morning in a remote area crushed against the left fender of his car (equivalent of a VW beetle). The engine was still running, ignition was on and the driver’s door was still open. The steering wheel was tied so that it would go round in anti-clockwise circles. His clothes were in the boot of the car. Reconstruction of the events leading to his death showed that he was either being dragged round by the car or following the car producing feelings of asphyxia. When he had finished his sexual turn-on he had tried to approach the car door but had forgotten to undo the chain from the bumper. The chain had got tangled up in the car’s axle and the man was found strangled to death by the chain.

Case 2: Autoerotic death by hanging (male)

Source: American Journal of Forensic Medicine and Pathology. Personal details: 57-year old white US male. Single.

  • Bizarre death event: Early one winter’s morning, two joggers found a partially clothed man hanging from a tree five inches from the ground. He was hanging from a rope tied round his neck but also had two other loops of rope harness around his thighs which also encircled his chest. His neatly folded clothes lay two feet away along with lipstick and a jar of Vaseline. He was wearing a woman’s brown wig and a stuffed white bra. He also wore a pair of men’s red underpants, a pair of tights and a pair of high-heeled women’s shoes. He was also found to have a carrot protruding from his anus. Basically his seat harness slipped and he asphyxiated himself on the ropes.


Case 3: Autoerotic death by blankets

Source: American Journal of Forensic Medicine and Pathology. Personal details: 60-year old white US male. Single. Diagnosed schizophrenic and had various sexual compulsions. Well educated former teacher.

  • Bizarre death event: After being reported missing from work by his employer, a man was found dead rolled up in 14 different blankets which had been sewn together (the two outermost layers were found fixed with adhesive tape in various places which raised the possibility of murder). Inside the blankets he was dressed in two pairs of hotpants, a pair of long johns and a vest. The body was wet and his hands and arms were outstretched above his head. They found a plastic bag over his penis into which he had ejaculated. He was masturbating while inside the blankets but he had become too hypoxic and died. He was immobilized inside the blankets and was unable to free himself. Over the last few years he had bought an astonishing number of blankets by mail order (over 60 found in his apartment most of which seemed to have some ritual or obsessive meaning by the way were laid out. No pornography was found in the place.

Case 4: Autoerotic death by dental anaesthetic

Source: American Journal of Forensic Medicine and Pathology. Personal details: 59-year old white US male. Single. Antiques dealer

  • Bizarre death event: Found dead in his locked apartment. He was seated in front of a dental anaesthetic machine with the anaesthetic face-mask over his face. He was sucking on a rubber teat similar (but much bigger) than a baby’s feeding bottle. There were other anaesthetic machines around the apartment as well as a lot of sexual literature (magazines, photographs, paintings, manuscripts all concerned with his elaborate fetish some of which included photographs of himself in these situations). He was wearing a rubber type apron, three woollen cardigans, a woman’s blouse and two pairs of women’s trousers and a pair of women’s bloomers.

Case 5: Autoerotic death by electrocution

Source: Medicine, Science and the Law. Personal details: 36-year old UK male. Gay (with partner). Unemployed ex-television engineer

  • Bizarre death event: Man found dead with a wire cradle applied to his scrotum with another loop of wire (end folded over) inserted into his Vaseline-lubricated anus. The wires were connected to the two terminals that supplied the loudspeaker within the television. When switched on, these wires carried a current of 0.6 amps at 2.2 volts (a quarter of the current needed to light a small torch). The body had two significant injuries. One on the right side of his face (entrance mark of the current), and the other over the left side of his scrotum (where the loop of the wire had been). Unfortunately, one of the wires had broken off resulting in a cessation of the stimulating activity. The man looked inside the back of the open TV set and his face came into contact with an exposed metal cap which zapped 2500 volts through him. The metal cap was the only live part of the television set and it was this that killed him.

(Part 2 can be found here).

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.

Eriksson, A., Gezelius, C., & Bring, G. (1987). Rolled up to death: An unusual autoerotic fatality. American Journal of Forensic Medicine and Pathology, 8(3), 263-265.

Hazelwood, R. R., Burgess, A. W., & Groth, A. N. (1981). Death during dangerous autoerotic practice. Social Science & Medicine. Part E: Medical Psychology, 15(2), 129-133.

Hiss, J., Rosenberg, S. B., & Adelson, L. (1985). ” Swinging in the park”: An investigation of an autoerotic death. American Journal of Forensic Medicine and Pathology, 6(3), 250-255.

Klintschar, M., Grabuschnigg, P., & Beham, A. (1998). Death from electrocution during autoerotic practice: case report and review of the literature. American Journal of Forensic Medicine and Pathology, 19(2), 190-193.

Leadbeatter, S. (1988). Dental anesthetic death: An unusual autoerotic episode. American Journal of Forensic Medicine and Pathology, 9(1), 60-63.

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

Minyard, F. (1985). Wrapped to death. Unusual autoerotic death. The American Journal of Forensic Medicine and Pathology, 6(2), 151-152

Rupp, J. C. (1973). The love bug. Journal of Forensic Science, 18(3), 259-262.

Sauvageau, A., & Racette, S. (2006). Autoerotic deaths in the literature from 1954 to 2004: A review. Journal of Forensic Sciences, 51(1), 140-146.

Confession session: The psychology of apology

(Please note: The following blog is an extended version of an article that was first published earlier this year in the Nottingham Post).

Back in March 2016, Nottingham Labour Councillor Alan Rhodes made a public apology after the former social worker Andris Logins was jailed for 20 years for rape and abuse of children at a Nottinghamshire care home. Mr Rhodes said: “It was our role to keep children safe and we clearly didn’t” and that “we failed in our duty of care”. Although most of us apologise for all sorts of things each day, it’s becoming increasingly common for a ‘non-celebrities’ to say sorry in a public way – particularly for historical events that the person giving the apology had no part in.

There are three main ways of saying sorry. The first is the apology with no excuse, when we don’t try to justify what we’ve done. We simply take full responsibility and promise it will never happen again. Secondly, there’s the excuse apology when we say we’re sorry but also add it wasn’t our fault. For instance, we might blame someone else, an accident, human error, or a lapse of judgement. With the third type of apology, we don’t feel we’ve done wrong, but offer some sort of justification. If we’ve wronged someone, we might say they deserved it. We might even feel what we’ve done is so trivial it’s not even worth bothering about. Dr. Aaron Lazare, author of the 2005 book On Apology, says that an apology is one of the most profound interactions that two human beings can have between one another

But why do we apologise? Psychologist Dr. Guy Winch views apologies as linguistic tools that help us acknowledge violations of social expectations and norms. He also says that apologies help us take direct responsibility for the impact of our actions on other individuals and provide a way of asking for forgiveness. Consequently, we are able to repair our relationships with those individuals, restore our own social standing, and help ease guilt and/or shame. Confessing and saying sorry is a simple way to get rid of all those negative feelings. The guilt created by transgressions, such as lying on a CV, or cheating in an exam, can eat away at some people for years.

There also appear to be gender differences. Research studies have tended to find that women appear to say sorry far more than men, because men feel they’re ‘one down’ to someone if they offer an apology. In contrast, women will say sorry for things they haven’t done because they prefer to smooth things over quickly and keep relationships going. However, the differences may be more nuanced. One study found no differences between men and women in the number of the proportion of offenses that prompted apologies but men apologized less frequently than women because they had a higher threshold for what constitutes offensive behaviour. Another study found that men apologized more frequently to women than they did to other men.

We also appear to have developed a ‘confessional culture’ over recent years in which celebrities and politicians are keener than ever to publicly admit to their private indiscretions. It could be that we’re more forgiving of public figures and that because we know more about the pressures of fame, we empathise with them. Another reason might be we no longer care because we don’t think what someone does in the private life affects their job. One thing we do expect from public figures is for their apologies to be sincere.

Arguably one of the most high profile examples was former US president Bill Clinton and his sexual relationship with Monica Lewinsky. Although Clinton continually denied for seven months any such relationship, when he eventually said sorry in August 1998, it was seen as sincere and many people sympathised with him. By apologising sincerely, or appearing to, public figures demonstrate they’re human, with weaknesses just like the rest of us.


These days, celebrities are quick to admit to what they’ve done. Lots of actors, comedians, singers and sports people have confessed to their addictions to drugs, alcohol and gambling before checking into high profile clinics like The Priory. For some, it’s no doubt a cynical move to help their public image. By apologising promptly, they’re seen as being brave, and any bad publicity will die down more quickly. Those who offer belated, grudging apologies see their image suffer.

Apologies can also help those who receive them. Police forces up and down the country have piloted schemes where criminals are confronted by their victims and offered a chance to apologies (known as ‘restorative justice’). Many victims say the one thing they’d really appreciate is an apology, and they’re often grateful to receive on. As the saying goes, “sorry seems to be the hardest word” but it has the potential to mean so much to so many.

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

Further reading

Bachman, G. F., & Guerrero, L. K. (2006). Forgiveness, apology, and communicative responses to hurtful events. Communication Reports, 19(1), 45-56.

Griffiths, M.D. (2000). Saying sorry can make you feel so much better. The Sunday Post, January 23, p. 30-31.

Griffiths, M.D. (2016). Sorry may be the hardest word but more people than ever are saying it. Nottingham Post, April 11, p.14.

Fehr, R., & Gelfand, M.J. (2010). When apologies work: How matching apology components to victims’ self-construals facilitates forgiveness. Organizational Behavior and Human Decision Processes, 113(1), 37-50.

Frantz, C.M., & Bennigson, C. (2005). Better late than early: The influence of timing on apology effectiveness. Journal of Experimental Social Psychology, 41(2), 201-207.

Lazare, A. (2005). On Apology. Oxford: Oxford University Press.

Scher, S. J., & Darley, J. M. (1997). How effective are the things people say to apologize? Effects of the realization of the apology speech act. Journal of Psycholinguistic Research, 26(1), 127-140.

Struthers, C. W., Eaton, J., Santelli, A. G., Uchiyama, M., & Shirvani, N. (2008). The effects of attributions of intent and apology on forgiveness: When saying sorry may not help the story. Journal of Experimental Social Psychology, 44(4), 983-992.

Takaku, S. (2001). The effects of apology and perspective taking on interpersonal forgiveness: A dissonance-attribution model of interpersonal forgiveness. Journal of Social Psychology, 141(4), 494-508.

Takaku, S., Weiner, B., & Ohbuchi, K.I. (2001). A cross-cultural examination of the effects of apology and perspective taking on forgiveness. Journal of Language and Social Psychology, 20(1-2), 144-166.

Winch, G. (2013). Emotional First Aid: Healing Rejection, Guilt, Failure, and Other Everyday Hurts. London: Penguin.