Category Archives: Technology

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

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

GamingDisorder-1

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

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

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

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

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

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

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

Further reading

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Voyeurs and their lawyers: Can ‘upskirting’ be addictive?

Over the past few months, ‘upskirting’ has been in the British news, particularly in relation to making it a criminal offence. A campaign initiated by freelance writer Gina Martin was started after she became a victim of upskirting. For those who don’t know what I’m talking about, upskirting refers to taking a photograph (typically with a smartphone) up someone’s skirt without their permission. Martin published an account of her ordeal for the World Economic Forum in April 2018 and reported that:

“Last summer, I was standing in a crowd of 60,000, on a hot summer’s day in London, waiting for The Killers to come on stage, when a man – whose advances I’d rejected – took pictures of my crotch by putting his phone between my legs as I chatted to my sister blissfully unaware. A few minutes later, I saw one of his friends looking at an intrusive picture of a woman’s crotch covered by a thin strip of fabric. I knew it was me. I grabbed the phone off him and checked. Tears filled my eyes and I began drawing attention to him: ‘You guys have been taking pictures of my vagina! What is wrong with you!?’ He grabbed me and pushed his face in front of mine, bellowing that I give him his phone back. I didn’t…The police arrived and were lovely. I was, understandably, a mess and they patiently calmed me down. What the police then did was ask him to delete the images – my evidence – and then, they told me they couldn’t do anything. ‘We had to look at the image, and although it showed far more than you’d want anyone to see, it’s not technically a graphic image. There’s not much we can do. If you weren’t wearing knickers it would be a different story.’ I was completely humiliated and devastated”.

Following this incident, and because upskirting wasn’t an offence, Martin began a campaign to get the act criminalized. Upskirting is currently an offence in Scotland but not in England and Wales. Upskirting is one of many sexual acts that are present among those individuals that have a voyeuristic disorder. In an article for the Law Gazette in July 2017 (‘Fifty shades of sexual offending’), forensic psychologist Dr. Julia Lam made countless references to upskirting in an overview of voyeuristic disorder. She noted that:

“Voyeuristic Disorder is a paraphilic/psychosexual disorder in which an individual derives sexual pleasure and gratification from looking at naked bodies and genital organs, observing the disrobing or sexual acts of others…Instead of peeping in situ using high-powered binoculars, with advances in technology such as camera phones and pin-hole cameras, voyeurs can now record the private moments with their devices: taking upskirt photos of unsuspecting individuals on escalators, or filming women in various states of undress in toilets and changing rooms. Voyeuristic behaviour is on the rise…Learning theory suggests that an initially random or accidental observation of an unsuspecting person who is naked, in the process of disrobing, or engaging in sexual activity, may lead to sexual interest and arousal; with each successive repetition of the peeping act reinforcing and perpetuating the voyeuristic behaviour”.

She reported that voyeurism is the most common type of sexual offence and that voyeurs can be men or women but that “men are commonly the perpetrators in the peeping acts/upskirt, with women being the victims”. She noted that the lifetime prevalence of voyeuristic disorder is around 12% among men and 4% in women, and that the causes of voyeurism are unknown. She then went onto say:

“The new vocabulary ‘upskirt’ is both a verb (the practise of capturing an image/video of an unsuspecting and non-consenting person in a private moment) and a noun (i.e. the actual voyeuristic photos or videos made; referred as “voyeur photography”)…While most voyeurs film for self-gratification (i.e. using upskirt materials for fantasy and masturbation), there are offenders who make upskirt photos and videos specifically for uploading onto the internet (e.g. fetish and pornographic websites and video-sharing sites like YouTube) for monetary profit…Upskirt is considered a ‘serious’ crime in Singapore as it intrudes upon the privacy of unsuspecting and non-consenting individuals. Offences typically take place on escalators, in fitting rooms, public toilets or shower rooms; with the offenders trying to capture what is underneath the ‘skirts’ or private moments of the victims with a recording device which may or may not be disguise”.

Screen Shot 2018-08-20 at 17.10.18

She also said that in recent years in Singapore, she had assessed “a considerable number” of voyeurs that had engaged in upskirting and who were arrested, prosecuted, and incarcerated for their actions. Most of these criminal voyeurs were ‘first-timers’ (i.e., arrested and charged with upskirting for the first time), had a long history of engaging in excessive masturbation and pornography use, and that the offences were non-violent. However, she did note that although they may have been arrested for the first time, their interest in peeping and upskirting usually stemmed from adolescence. Dr. Lam also claimed that:

“Getting apprehended for [upskirting] is more a norm than an exception in this group, as it is just a matter of time that the offender would be careless or daring enough to invite apprehension. Police arrest usually serves as a final ‘wake-up call’ that breaks the offending pattern, accompanied with a great sense of shame and embarrassment. Many of these voyeurs are amenable to treatment…Most of the sufferers of Voyeuristic Disorder who came for my assessment reported their urges to upskirt and use the materials to masturbate as overwhelming, to the extent that they gave in to temptation without considering the grave consequences of their acts”.

Dr. Lam also talked about her treating upskirting voyeurs and recounted one case which she claimed was a compulsion. The case involved a male university student who was very sport active but who masturbated excessively whenever major sporting events or important exams were imminent as a coping strategy to relieve stress. Upskirting was another one of his coping strategies and he was eventually arrested for his behaviour. Dr. Lam then went on to report” 

“Every morning after he woke up, he would feel the urge to go out to find his ‘targets’. Although he knew it was very risky to take upskirt [photos] on MRT escalators, he felt compelled to satiate his urges and gratification, and was oblivious to his surroundings (e.g. passers-by security staff and CCTV) and the risk of being arrested. He could still feel the thrill and excitement, but he no longer enjoyed the act. It had become more like a compulsion…He was prescribed medication to manage his mood and urges to act out, and attended psychotherapy to work on his voyeuristic behaviour and learn more effective coping skills. He has since graduated from university, and has not breached the law with [upskirting] behaviour again”.

Dr. Lam, like other practitioners who treat sex offenders, often view extreme cases of voyeurism as a compulsion, obsession and/or an addiction. If extreme voyeurism (in general) can be seen as an addiction, there is no theoretical reason why upskirting couldn’t be viewed similarly. As far as I am aware, the case described by Dr. Lam is the only one in the academic literature of outlining and treating an individual with an upskirting disorder. As with other sexually non-normative behaviours I went online to see if there were any anecdotal accounts of addiction to upskirting and came across a few self-confessed accounts (particularly on The Candid Forum website):

  • Extract 1: “I’m not sure if you could help me. I suppose it’s an addiction. I am obsessed with women’s knickers and constantly try to look up women’s skirts, even schoolgirls. I know it’s wrong but I love to see the secrets. One day I will be caught and arrested. Am I a pervert?” (‘Andy’).
  • Extract 2: “I’m really starting to feel overwhelmed by this ‘addiction’ I have to upskirt videos…I just can’t seem to get enough, even when in the big picture, most of them are all the same. I have well over 3000 videos on my computer of just upskirts (not including other types of videos)…It’s also stressful to know that I may very well not get through them all, at least for a very long time (I still have yet to watch 1800 of them). There’s a lot of time involved in downloading them (waiting due to file hosting sites telling you [that] you have reached your daily limit etc., entering captcha codes). But all these videos actually amaze me at the same time, due to just how many times guys have gotten away with it…There’s a certain ‘wow’ factor I guess, but that also derives from the entire voyeur aspect of it to begin with, where a guy is able to creep up on a woman and she doesn’t even realize it…Do any of you share the same addiction as me, and do you want to get rid of it? (‘GD102’).
  • Extract 3: I used to be really addicted [to upskirting] until I made myself understand something you already know – once you’ve seen 200 asses, you’ve pretty much seen them all. There’s no point in wasting your time overindulging in the same thrill over and over again. Yeah, the excitement of seeing something you’re not supposed to see is hot as hell, but you have to set limits for yourself, and not try to fantasize too much about the upskirts you haven’t seen, and spend more time enjoying, and maybe sorting, the upskirts you already have. That’s what I’ve been doing lately” (‘Agent Ika’).
  • Extract 4: “[Upskirting] really does get repetitive. For me the thrill now comes from pretending I’m a director of a film – getting new angles, upskirts from the front, whole body shots with the upskirt still showing, and always including faceshots” (‘Stimulus’).

Obviously I have no way of knowing whether these online forum confessions are true (but they seem to be). Based on these extracts, there is certainly the possibility raised that upskirting may be addictive to a very small minority of individuals. Extract 2 was particularly interesting in that the individual had never engaged in upskirting himself but his ‘addiction’ to watching upskirting videos takes up so much time in his life.

Another source suggesting that upskirting may be an addictive activity comes from the details of those arrested and prosecuted. For instance, one infamous example in the UK (in 2015) was the case of Paul Appleby who managed to take 9000 upskirting photos in the space of just five weeks (suggesting that he was doing it all day every day to have taken so many photos). Appleby was finally caught when he was caught bending over to take a photo up a woman’s skirt in a Poundland shop. The Daily Mirror reported that:

“The tubby pervert, who was ‘addicted’ to snapping upskirts, fled the store after he was spotted…when [police] officers found his camera and iPhone a staggering 9,000 ‘upskirt’ images were discovered. The photos had been taken between November 1 and December 4 last year. [Appleby] admitted two counts of committing an act of outraging public decency…and was given a three-year community order…[Appleby] had been prosecuted for a ‘similar matter’ of outraging public decency in London in 2010. Alistair Evans, defending claimed Appleby had committed the crime for ‘sexual gratification’ and his behaviour was a ‘compulsion and an addiction’ he needed treatment for”.

Here, the mitigating factor for Appleby’s behaviour was that he was addicted to upskirting. The fact that Appleby did not receive a custodial sentence suggests the excuse of being ‘addicted’ to the behaviour led to the judge being more lenient. Another individual who avoided a custodial sentence for upskirting offences was Andrew MacRae who claimed he was addicted to sex. MacRae had amassed 49,000 upskirt photos and videos using hidden cameras at his workplace, on trains, and at the beach. He pled guilty to three counts of outraging public decency and seven counts of voyeurism. The judge said he would spare him jail if he was treated for his “compulsive voyeurism”. A report in the Daily Mail recounted what that Judge Jeremy Donne said:

“This was undoubtedly a sophisticated, organised, planned and long-running campaign of voyeurism – again with a significant degree of planning – and members of the general public, female commuters in the main, were caught by your voyeuristic activities. Your activities were undoubtedly despicable and will cause deep revulsion in all who hear them.  Women will undoubtedly feel a need to be protected from such behaviour by the knowledge that the courts will deal with offenders severely, and men will thereby be deterred from committing such offences. On the other hand, you suffer from an illness that can be treated and you have submitted to that treatment. You have features of sexual addiction disorder with disorders of sexual preference, namely voyeurism and fetishistic transvestism – all defined in the international classification of diseases. You continue to receive treatment from psychiatrists who consider you to be at low risk of re-offending”.

Another recent British case highlighted the ingenious methods used to aid upskirting. Here, Stafford Cant used spy cameras hidden inside one of his trainers, his key fob, and his wrist watch to engage in upskirting women (as well as filming the backs of their legs) who were shopping in a Cheshire village. Acting on a tip-off, his house was raided and the police found 222,000 videos and pictures dating back seven years. ‘Addiction’ was again used as a mitigating factor in the crimes (along with depression and anxiety disorders) but this time it was not addiction to voyeurism but an addiction to collecting things. However, unlike the two cases above, Cant was jailed for three years after pleading guilty to outraging public decency, voyeurism and possessing and distributing indecent images.

Although there is little psychological literature on upskirting, there appears to be anecdotal evidence that the behaviour (in the extreme) could perhaps be conceptualized as an addiction and/or compulsion among a minority of individuals. The cases of those that have been arrested and prosecuted demonstrate that upskirting behaviour was time-consuming given the sheer number of photos and videos amassed, and that the behaviour was ultimately problem-inducing and undesirable. Given that the relatively recent rise of upskirting appears to mirror the rise in the use of smartphones and spy equipment available at affordable prices, I expect to see more such cases to be written about in psychological and criminological journals in the years to come.

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

Further reading

Fight The New Drug (2018). What’s “upskirting”, and how does porn culture feed this twisted trend? July 5. Located at: https://fightthenewdrug.org/whats-upskirting-and-how-does-porn-culture-feed-this-twisted-trend/

Jolly, B. (2015). Upskirt pervert who took 9,000 secret photos in just five weeks avoids jail. Daily Mirror, January 28. Located at: https://www.mirror.co.uk/news/uk-news/upskirt-pervert-who-took-9000-5058048

Keay, L. (2018). Live Nation executive who built-up sordid library of 49,000 upskirt pictures by filming women on trains, the beach and at work is spared jail as his wife stands by him. Daily Mail, January 5. Located at: http://www.dailymail.co.uk/news/article-5239815/LiveNation-executive-Andrew-MacRae-avoids-jail-upskirt.html

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

Martin, G. (2018). What happened to me was wrong. Time to make it illegal, too. World Economic Forum, April 9. Located at: https://www.weforum.org/agenda/2018/04/what-happened-to-me-was-wrong-time-to-make-it-illegal-too/

Petter, O. (2018). Upskirting: What is it and why are people trying to make it illegal” The Independent, June 18. Located at: https://www.independent.co.uk/life-style/upskirting-explained-law-rules-criminal-offence-photos-skirt-consent-women-gina-martin-a8401011.html

Shepherd, R. & Smithers, D. (2018). The public school pervert who spent years secretly filming up women’s skirts in one of Britain’s wealthiest villages. Manchester Evening News, March 29. Located at: https://www.manchestereveningnews.co.uk/news/greater-manchester-news/alderley-edge-upskirt-film-pervert-14470375

The Strait Times (2016). Taking upskirt photos may be symptomatic of voyeuristic disorder. July 30. Located at: https://adelphipsych.sg/straits-times-taking-upskirt-photos-may-be-symptomatic-of-voyeuristic-disorder/

Wilson, H. (2004). Peeping Tom’s secret weapon. The Independent, July 8. Located at: https://www.independent.co.uk/news/science/peeping-toms-secret-weapon-552402.html

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.

Term warfare: Another look at ‘behavioural addiction’ and ‘selfitis’ as constructs

I recently published a response to a debate article by Dr. Vladan Starcevic and his colleagues in the Australian & New Zealand Journal of Psychiatry. Unfortunately, my response was restricted to a stringent word limit so I am using my personal blog to provide the original version of my response before it was edited. My published version can be found here. Below is the original version:

The article by Starcevic, Billieux and Schimmenti (2018) made a number of assertions concerning my research with various co-authors. While I am always grateful that my work is being read and cited, some of the assertions made were arguably unfair, misguided and/or not stated in context (and could therefore be construed as untrue). In this short article, I first address some of the claims made about our research into the construct of ‘selfitis’. I then address a few of the wider issues made by Starcevic et al. in relation to behavioural addictions more generally because they used some of my other research into various behavioural addictions to make their arguments.

The construct of ‘selfitis’

Starcevic et al. noted that there has been a trend “to medicalize problematic behaviours” (p.1) and used the example of ‘selfitis’ to make their point. The way the article was written it would appear to the naïve reader that I and my co-author (Janarthan Balakrishnan) had coined the term ‘selfitis’. For instance, the article by Starcevic et al. cites our paper in specific reference to the following assertion:

“Instead of labelling an excessive and sometimes dangerous practice of taking selfies a ‘selfie addiction’, this behaviour was conceptualised as an inflammation-like selfitis (Balakrishnan and Griffiths, in press)”.

This sentence clearly gives the impression that it was Dr. Balakrishnan and I who conceptualised ‘selfitis’ and that our conceptualisation was that it was “inflammation-like”. However, we made it very clear to readers in the very first paragraph of our paper that the concept of ‘selfitis’ originally started a hoax claiming that the ‘disorder’ was to be included in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders. The original hoax report 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” which we again made clear in the second sentence of our paper. The two studies in our paper were exploratory and merely set out to examine whether there were individuals who were ‘obsessive selfie-takers’. In many parts of their article, Starcevic et al. appear to insinuate that our paper equates ‘selfitis’ with ‘selfie addiction’. For instance, they wrote:

“Interestingly, the components of selfitis that were identified (environmental enhancement, social competition, attention seeking, mood modification, self-confidence and subjective conformity) have practically nothing in common with behavioural addiction…Therefore, selfitis appears to be a construct that is very different from ‘selfie addiction’, and its purported link with compulsivity also seems tenuous” (p.1).

Screen Shot 2018-06-13 at 18.12.52The six components comprising selfitis in our new psychometric tool (the Selfitis Behavior Scale [SBS]) were correctly reported but at no point in our paper did we ever say that ‘selfitis’ was a behavioural addiction. What we did write was that (a) “selfitis is a new construct in which future researchers may investigate further in relation to selfitis addiction and/or compulsion” (p.8), and (ii) “the qualitative focus group data from participants strongly implied the presence of ‘selfie addiction’ although the SBS does not specifically assess selfie addiction” (p.11). They also noted that our published paper on selfitis:

“…did not go unnoticed by the media, always ready to exploit everything that is ‘novel’ and sensational. Thus, one newspaper reported that selfitis, ‘the obsessive need to post selfies’, was a ‘genuine mental disorder’ and quoted one of the authors of the aforementioned article that the existence of selfitis appeared to be confirmed (www.telegraph.co.uk/science/2017/12/15/selfitis-obsessiveneed-post-selfies-genuine-mental-disorder/)…The word has thus become enriched by one more ‘condition’, complete with an assessment tool to establish its severity and a suggestion that people with selfitis may need professional help” (p.2).

While it is true that our study did not go unnoticed by the media (and was reported in hundreds of news stories around the world), only one newspaper journalist ever interviewed me about the study and at no point either in our published paper or in any conversations with the broadcast media did we ever say that ‘selfitis’ was a mental disorder. Our paper simply concluded that obsessive selfie-taking was a condition that appears to exist and made the observation that selfitis has “psychological consequences (which may be both positive and negative)” (p.12). In fact, we talked about the positive aspects of selfitis throughout the discussion section of our paper. In short, I would like it to be made clear that (i) we did not coin the term ‘selfitis’, (ii) we have never anywhere in published print (academic papers or the print media) claimed selfitis is a mental disorder, (iii) we have never claimed selfitis is a behavioural addiction, and (iv) we have never equated ‘selfitis’ with ‘selfie addiction’ (although we have just published another paper briefly reviewing the studies that have examined the concept of ‘selfie addiction’ [i.e., Griffiths & Balakrishnan, 2018]).

The construct of ‘behavioural addiction’

Starcevic et al. also claimed in their article that the term ‘behavioural addiction’ is “vague, misused and applied to an exceptionally wide variety of activities” (p.1). I would argue that the far from being ‘vague’, behavioural addiction has clearly been defined as any addiction that does not involve the ingestion of a psychoactive substance (Griffiths, 1996, 2005). I agree that it is sometimes misused and I have written dozens of populist articles on my personal blog pointing this out. However, I totally disagree that behavioural addiction has been applied to an ‘exceptionally wide variety of activities’. As I noted in a recent paper: Very few of the thousands of leisure activities that individuals engage in have ever been written about in terms of addiction in peer-reviewed scientific papers” (Griffiths, 2017; p.1719). Starcevic et al. would be hard pushed to name more than about 20 leisure activities that have ever been empirically examined as a possible behavioural addiction. Of the five activities named by Starcevic in an attempt to show the behavioural addiction is being misused three of them were actually just sub-types of more widely researched behavioural addictions (i.e., stock market addiction is a sub-type of gambling addiction, study addiction is a sub-type of work addiction, and dance addiction is a sub-type of exercise addiction) as made clear in my papers on these topics.

Starcevic et al. also noted that a group of scholars (Kardefelt-Winther et al., 2017) “recently made an effort to reach a consensus, promote conceptual rigour and avoid misuse by proposing an open (modifiable) definition of behavioural addiction” (p.1). More specifically, Kardefelt‐Winther et al. provided four exclusion criteria and argued that behaviours should not be classed as a behavioural addiction if:

  1. “The behaviour is better explained by an underlying disorder (e.g. a depressive disorder or impulse-control disorder).
  2. The functional impairment results from an activity that, although potentially harmful, is the consequence of a willful choice (e.g. high-level sports).
  3. The behaviour can be characterized as a period of prolonged intensive involvement that detracts time and focus from other aspects of life, but does not lead to significant functional impairment or distress for the individual.
  4. The behaviour is the result of a coping strategy” (p.1710)

I doubt anyone researching in the behavioural addiction would disagree with the third exclusion criterion because to have a genuine behavioural addiction, the behaviour has to comprise significant functional impairment or distress for the individual. However, I would point out that if these criteria were applied to substance abuse, very few substance users would ever be classed as addicted (Griffiths, 2017). More specifically, I have written elsewhere that three of the four exclusion criteria proposed by Kardefelt‐Winther et al. (2017) are simply untenable:

“For instance, it is proposed that any behaviour in which functional impairment results from an activity that is a consequence of wilful choice should not be considered an addiction. I cannot think of a single addictive behaviour that when the person first started engaging in the behaviour (e.g., drinking alcohol, illicit drug-taking, gambling) was not engaged in wilfully…Also, not being classed as an addiction if the behaviour is secondary to another comorbid behaviour (e.g., a depressive disorder) or is used as a coping strategy again means that some other substance addictions (e.g., alcoholism) would not be classed as genuine addictive behaviours using such exclusion criteria because many substance-based addictions are used as coping strategies and/or are symptomatic of other underlying pathologies” (Griffiths, 2017; pp.1718-1719).

Throughout my 30 years of research into behavioural addiction, I have never simply looked at a behaviour and claimed that it cannot be potentially addictive. Using my own operational criteria for what I believe constitutes a genuine addiction (i.e., salience, conflict, tolerance, withdrawal, mood modification, and relapse; Griffiths, 1966, 2005) very few individuals would be classed as being addicted to activities such as sex, work, exercise, or gaming. However, if there is evidence of what I consider to be the core components of addiction in activities that others believe should not be pathologised (e.g., dancing or academic study), I would not choose to ignore such evidence if such activities caused significant functional impairment and distress for the individuals concerned.

References

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. Epub ahead of print. https://doi.org/10.1007/s11469-017-9844-x

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

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

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

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

Kardefelt-Winther D, Heeren A, Schimmenti A, et al. (2017) How can we conceptualize behavioural addiction without pathologizing common behaviours? Addiction 112: 1709–1715.

Starcevic, V., Billieux, J., & Schimmenti, A. (2018). Selfitis, selfie addiction, Twitteritis: Irresistible appeal of medical terminology for problematic behaviours in the digital age. Australian & New Zealand Journal of Psychiatry, Epub ahead of print. https://doi.org/10.1177/0004867418763532

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”).

Screen Shot 2018-06-13 at 18.12.52

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

Remote control: ‘Cashing out’ in sports betting

“Cash Out lets you take profit early if your bet is coming in, or get some of your stake back if your bet is going against you – all before the event you’re betting on is over. Cash Out offers are made in real time on your current bets, based on live market prices. Whenever you are ready to Cash Out, simply hit the yellow button. Cash out is available on singles and multiples, on a wide range of sports, including football, tennis, horse racing, and many more! You can Cash Out of bets pre-play, in-play, and between legs” (Definition of ‘cash out’ betting on Betfair website, 2017).

Most European sports betting operators now feature ‘cash out’ functionalities in their online platforms. This means that bettors can withdraw their bets before the event bet upon has concluded, obtaining a smaller but guaranteed return if the outcome of the bet is going their way, or, conversely, cutting down the monetary impact of a foreseeable loss. The ‘cash out’ functionality has rapidly become popular among sports bettors that bet in-play (i.e., during the game on things such as soccer matches and horse races) as a way of maximising value on the bets they have made.

Industry voices such as David O’Reilly, from Colossus Bets, have identified four major benefits of cash out features for bookmakers: (i) reducing the volatility of the operator’s revenue; (ii) increasing the recycling of player returns, with more players banking smaller amounts; (iii) enabling players to avoid their ‘near miss’ frustration; and (iv) improving the player engagement with the platform by introducing a mechanism that promotes constant checking. However, for sports bettors, cashing out strategies might typically involve cutting down the profit while being ahead but rarely reducing the loss when going behind. In this regard, cashing out does not appear to differ greatly from other new internet-based betting forms (e.g. so-called ‘exotic’ or multiple bets), which have been found to possess, in general, higher expected losses for gamblers and greater profit margins for operators.

images

However, beyond the feature’s financial rationale, cash out affects the nature of sports betting in more meaningful ways. It is, arguably, a game-changer, that leads (along with other features such as ‘edit my acca’ features in which specific bets can be removed from ‘accumulator’ bets) to the transformation of sports betting from a discontinuous to a continuous form of gambling. Here, our contention is that cash out is a key component of the contemporary bettor-bookmaker interaction, and that the widespread adoption by devoted sports bettors merits a closer look into the implications of such an interaction from a problem gambling perspective. Such an examination also suggests that regulators and policymakers need to think about how to protect gambling consumers from the potential harm caused by this new type of betting.

Structural characteristics have been proposed as a determining factor that can influence problem gambling behaviour. Structural characteristics are those associated with the design of a gambling product that shape the way gamblers interact with it. Typical structural characteristics include, but are not limited to, bet frequency, bet duration, event frequency, near misses, stake size, jackpot size, probability of winning, and interface design (e.g., the use of music and colour stimuli in the design of slot machines).

The internet has altered significantly the structural characteristics of gambling and sports betting more specifically. For example, in a number of European countries, the football (soccer) pools used to comprise bets placed during a weekday on the outcome of a game played typically on a Saturday or Sunday (i.e., a once a week wager). This reward delay was a major protective factor against excessive gambling, which on a psychobiological level has been theorised as an imbalance in an individual’s dopamine receptors, and therefore, highly sensitive to shorter bet reward periods. Betting via the internet has reduced such delays in receiving rewards from gambling, thus modifying a major structural characteristic of betting from once a week to (in some instances) every few minutes.

In parallel to the increased uptake of Internet betting in many jurisdictions, a second dynamic, namely globalisation, has further widened the possibilities of betting across countries, sports, and time zones, ultimately transforming sports betting into a 24/7 activity where the bookmaker never closes the shop any day during the year. For the first time, if a gambler has a craving to bet, the market is able to respond to that demand anytime and anywhere via a range of Wi-Fi enabled portable devices (e.g., smartphone, tablets, laptops, etc.). Virtual sports have expanded the availability of betting options even more, eliminating the need to bet on real world sport events.

Although the time between bets (i.e., bet frequency) was effectively reduced to near zero, the time within bets (i.e., bet duration) changed little until cash out functionality was first introduced by the gaming operator William Hill in December 2012. With cash out features, sports betting has become a potentially continuous gambling activity, one that resembles the playing mechanics the stock market. As with investing in stocks, bet values in in-play sports betting are re-calculated seamlessly. The outcome of a sport event might not be as relevant for many bettors as the value their bet will acquire in the next few seconds, even if that bet turns out to be erroneous at the end of the game. As in stock market investing, betting becomes continuous because non-actions also qualify as actions in themselves. Every single second that a bettor decides not to cash out, a new bet takes place. Eventually, cash out features introduce the notion that it is the bet itself the commodity that is being traded in the sports betting market. This new continuous type of sports betting raises questions concerning the gambling-related harm that could be associated with it. It also suggests that the kinds of regulation found widely in the stock market investment sector might have some utility if applied to this new form of gambling.

From a marketing perspective, cash out functionality is often advertised as a control-enhancing mechanism for bettors. Given that cashing out is typically presented in television advertisements as a risk-free operation, the product is likely to be perceived as reimbursable if the client is not happy with it, arguably promoting less planned gambling behaviours. Some gaming operators use the alternative name of “edit my bet” to refer to cash out, focusing on the capacity of bettors to correct later possible errors of judgement. The problem is that (and as happens in stock market investing), cashing out is only possible at the current value of the stock (which may be inferior to the purchasing price). Additionally, and contrary to what happens in stock market investing, betting operators automatically devalue the bet price immediately after the purchase. For example, a bookmaker will typically offer to cash out for $0.95 or similar a $1 bet placed one second ago, a price devaluation unmotivated by any new information or event actually affecting the predicted value of such a bet.

Beyond its most apparent attributes, we have demonstrated that cash out within in-play gambling is a pivotal feature that has been introduced by the sports betting industry to transform sports betting from what was traditionally a discontinuous form of gambling into a continuous one. It is contended that, although cashing out presupposes more engaged gamblers that feel more in control of their bets, the emotionally charged context in which it is often used and the structural attributes of the product itself might actually make some bettors lose control over their gambling wagers. Consequently, gambling policymakers and regulators should be cognizant of the challenges of this transformation of sports betting and consider the implications for the protection of gambling consumers.

[Note: This article was co-written with Dr. Hibai Lopez-Gonzalez]

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

Further reading

Betfair (2017). Sportsbook: What is cash out and how does it work? Retrieved March 1, 2017, from: https://en-betfair.custhelp.com/app/answers/detail/a_id/4/~/sportsbook%3A-what-is-cash-out-and-how-does-it-work%3F

Gainsbury, S. M. (2015). Online gambling addiction: The relationship between internet gambling and disordered gambling. Current Addiction Reports, 2(2), 185-193.

Griffiths, M.D. (1993). Fruit machine gambling: The importance of structural characteristics. Journal of Gambling Studies, 9, 101-120.

Griffiths, M. D. (2005). A biopsychosocial approach to addiction. Psyke & Logos, 26(1), 9–26.

Griffiths, M.D. & Auer, M. (2013). The irrelevancy of game-type in the acquisition, development and maintenance of problem gambling. Frontiers in Psychology, 3, 621. doi: 10.3389/fpsyg.2012.00621.

Lopez-Gonzalez, H., & Griffiths, M. D. (2016). Understanding the convergence of online sports betting markets. International Review for the Sociology of Sport. http://doi.org/doi:10.1177/1012690216680602

Lopez-Gonzalez, H. & Griffiths, M.D. (2017). ‘Cashing out’ in sports betting: Implications for problem gambling and regulation. Gaming Law Review: Economics, Regulation, Compliance and Policy, 21(4), 323-326.

McCormack, A., & Griffiths, M. D. (2013). A scoping study of the structural and situational characteristics of internet gambling. International Journal of Cyber Behavior, Psychology and Learning, 3(1), 29–49.

Newall, P. W. S. (2015). How bookies make your money. Judgment and Decision Making, 10(3), 225–231.

Newall, P. W. S. (2017). Behavioral complexity of British gambling advertising. Addiction Research & Theory. http://doi.org/10.1080/16066359.2017.1287901

Parke, J., & Griffiths, M. D. (2007). The role of structural characteristics in gambling. In G. Smith, D. Hodgins, & R. Williams (Eds.), Research and Measurement Issues in Gambling Studies (pp. 211–243). New York: Elsevier.

Sports Trading Life. (2015). Is “cash out” actually BAD for betting punters? Retrieved March 1, 2017, from http://sportstradinglife.com/2015/03/is-cash-out-actually-bad-for-punters/

Gripped by ‘crypt’: A brief look at ‘crypto-trading addiction’

Last week I was approached by Rupert Wolfe-Murray, a PR representative of a well-known addiction treatment clinic (Castle Craig) asking what my views were on Bitcoin and cryptocurrency trading (colloquially known as ‘crypto trading’) and whether the activity could be addictive. More specifically he wrote:

“I write to you about the research we’re doing into addiction to Bitcoin and cryptocurrency trading. We’ve had an enquiry about this at Castle Craig and they would treat it as a gambling addiction. We think it’s a new type of behavioural addiction and we plan to publish a web page (and FAQ) with the intention of alerting people that the online trading of cryptocurrencies may be addictive. It would be very helpful if we could get a quote from you, putting it into perspective. Do you think it’s a growing problem? There’s very little information about this issue online but there is an active forum of ‘crypto addicts’ on Reddit, where I got some friendly feedback…The therapist I often turn to when writing about gambling and the behavioural addictions told me that it sounds like addiction to day trading. Would you agree?”

In short, I couldn’t agree more although my own view is that this is not a ‘new’ addiction but a sub-type of online day-trading addiction (on which I first published an article about back in 2000 for GamCare, the gambling charity I co-founded with Paul Bellringer in 1997) and/or stock market trading addiction (which I’ve written a couple of previous blogs about, here and here, and an article in iGaming Business Affiliate magazine). However, I decided to do a bit of research into the issue.

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A recent January 2018 article in the Jakarta Post by Ario Tamat examined this issue which was a personal account of his own experiences (‘Bitcoin trading: Addictive ‘hobby’ that could break my bank’). He wrote:

“I was always interested in Bitcoin, not that I really understand the technology, but first impressions were appealing: a decentralized currency, mined by solving mathematical equations and potentially accessible to anyone…Fast forward to 2017. Discussions on cryptocurrencies had entered the public consciousness, Bitcoin prices were sky high… A few friends introduced me to a local site on cryptocurrency trading – the most suitable term for the entire affair, actually – bitcoin.co.id. Taking the leap, I took some money out of my measly savings and bought myself some Bitcoin…In three days, I had made 6 percent. I was hooked… I’ve noticed that the whole cryptocurrency trading trend is like placing bets on a never-ending horse race, where new horses are introduced to the race almost daily”.

Another article by Douglas Lampi on the Steemit website noted that “the elements of addiction and gambling are a consistent risk that traders must always be on the guard against” and provided some signs to readers that they may be trading impulsively. These included (i) feeling muscle tension, (ii) feeling background anxiety, (iii) checking the price of Bitcoin and alt coins several times through the day, and (iv) thinking about trading while engaged in other activities. While these ‘symptoms’ and behaviours might be found among those addicted to crypto day trading, on their own they are arguably little more than mildly problematic. These signs applied to gambling or social media use would be unlikely to raise many worries among addiction treatment practitioners.

I also visited the online Bitcoin Forum where one of the topics was ‘Is crypto trading an addiction’ prompted by a Russian who allegedly committed suicide after losing all his money crypto trading. Most of the people on the forum didn’t think it was an addiction and claimed the suicide was reminiscent of the suicides that occurred at the time of the 2009 stock market crash (although a couple of individuals believed that crypto trading was a potentially ‘addicting’ activity). One participant in the discussion noted:

“Yes [crypto trading is] highly addictive, specially formulated if you start to notice that need, urge in side you, to check the price even in the middle of the night. Find yourself skipping your daily routines it is and can be addictive if you don’t know how to control you and your emotions. I have found somewhere that some say that it is like being in casino, betting, playing rules etc. because like every coin was made mostly for pure profit and it’s all speculation rather than to have their own sole purpose which when I think of it can make sense to even why it can be addictive”.

Another individual on the Bitcoin Pub website wrote:

“I think I might actually have an unhealthy addiction to [crypto trading]. I’d say 3/4 times when I unlock my phone I’m checking Blockfolio, when I’m at work, at home, with my girlfriend, or even between sets at the gym. I’m starting to think I need to discipline myself to NOT check it or limit it to maybe 1-2 times a day as its noticeably impacting my passions and in turn my mental state. I’m not a day trader, I hold all my coins in cold storage. So there’s really no reason for me to be checking that frequently, or watching crypto analysis YouTube videos, or reading articles about it several times a day”.

The issue was also discussed in a recent February 2018 article in the Irish Times by Fiona Reddan (‘It’s addictive’: Why investors are still flocking to bitcoin and crypto’). Interviewing Nicholas Charalambous (Managing Director of Alpha Wealth) was quoted as saying: “Previously, I would have described cryptos as ‘shares on steroids’; now I would say they’re shares with jetpacks and boosters and then some”. While Bitcoin shares have fallen, there are plenty of new cryptocurrencies that individuals can dabble buying shares in (ethereum, litecoin, ripple, putincoin and dogecoin) and all can be akin to gambling. Reddan also interviewed Jonathan Sheehan (Managing Director, Compass Private Wealth) who said:

“It has the exact same risk and return characteristics as a naive gambler, who has opened their first online betting account. There is absolutely no valuation metric for these currencies and allocating capital to them is an extreme and unnecessary risk”.

One country that has taken crypto trading addiction seriously is South Korea. Their government’s Office for Government Policy Coordination has introduced new rules to inhibit the speculation on cryptocurrencies. According to a Market Watch article:

“The proposed measures…range from levying capital-gain taxes on trading cryptocurrencies, to restricting financial firms from holding, acquiring and investing in them…The new regulations come amid mounting concern within South Korea about the potential for people to become addicted to bitcoin trading”.

The country’s prime minister Lee Nak-yon went as far as to say that the increasing interest in cryptocurrencies could “lead to some serious distorted or pathological phenomenon”.

I did quickly check what had been written about academically. I came across a couple of papers on Google Scholar that mentioned possible addiction to crypto trading. Justine Brecese (in a 2013 ‘research note’ on the socioeconomic implications of cyber‐currencies for ASA Risk Consultants) asserted that risks with virtual currency include the potential for addiction and resultant over-spending” (but providing little in the way of empirical evidence for the claim). In a paper by Haraši Namztohoto on ‘cryptocoin avarice’, he noted:

“Reason often discretely quits the cognitive battlefield whenever hoarding tendencies of human beings are coupled with addictive behaviour which financial derivate trading surely is, thus leaving humans prone to caprices of mass psychology”.

Given that addictions rely on constant rewards and reinforcement, there is no theoretical reason why crypto trading cannot be addictive. However, there is only anecdotal evidence of addicted individuals and if they are addicted a case could be made that this is a type of gambling addiction.

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

Further reading

Brecese, J. (2013). Research note – Money from nothing: The socioeconomic implications of “cyber-currencies”. Seattle, WA: ASA Institute for Risk & Innovation

Griffiths, M.D. (2000). Day trading: Another possible gambling addiction? GamCare News, 8, 13-14.

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

Griffiths, M.D. (2013). Financial trading as a form of gambling. i-Gaming Business Affiliate, April/May, 40.

Namztohoto, H. (2013). Myth, machinery and cryptocoin avarice. Wizzion.com. Located at: http://wizzion.com/papers/2013/cryptocoin-avarice.pdf

Jeong, E-Y. & Russolillo, S. (2017). South Korea mulls taxing cryptocurrency trade as fears mount about bitcoin addiction, speculation. Market Watch, December 13. Located at: https://www.marketwatch.com/story/south-korea-mulls-taxing-cryptocurrency-trade-as-fears-mount-about-bitcoin-addiction-speculation-2017-12-13

Lampi, D. (2018). Two sure signs YOU are a crypto trading addict. Steemit.com. February. Located: https://steemit.com/cryptocurrency/@ipmal/two-sure-signs-you-are-a-crypto-trading-addict

Reddan, F. (2018). ‘It’s addictive’: Why investors are still flocking to bitcoin and crypto. Irish Times, February 13. Located at: https://www.irishtimes.com/business/financial-services/it-s-addictive-why-investors-are-still-flocking-to-bitcoin-and-crypto-1.3388392

Tamat, A. (2018). Bitcoin trading: Addictive ‘hobby’ that could break my bank. The Jakarta Post, January 8. Located at: http://www.thejakartapost.com/life/2018/01/08/bitcoin-trading-addictive-hobby-that-could-break-my-bank.html

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.