Net losses: Another look at problematic online gaming

I have examined problematic and/or addictive video gaming in a number of my previous blogs. Despite the increasing amount of empirical research into problematic online gaming, the phenomenon still sadly lacks a consensual definition. Some researchers (including myself, and others such as John Charlton and Ian Danforth) consider video games as the starting point for examining the characteristics of this specific pathology, while other researchers consider the internet as the main platform that unites different addictive internet activities including online games (such as my friends and colleagues Tony Van Rooij and Kimberley Young). There are also recent studies that have made an effort to integrate both approaches (such as some work I carried out with Zsolt Demetrovics and his team of Hungarian researchers in the journal PLoS ONE).

I have noted in a number of my papers on addiction (particularly in a paper I had published in a 2005 issue of the Journal of Substance Use) that although each addiction has several particular and idiosyncratic characteristics, they have more commonalities than differences that may reflect a common etiology of addictive behaviour. Using the ‘components’ model of addiction, within a biopsychosocial framework, I consider online game addiction a specific type of video game addiction that can be categorized as a nonfinancial type of pathological gambling. I developed the components of video game addiction theory by modifying Iain Brown’s earlier addiction criteria. These are:

(1) Salience: This is when video gaming becomes the most important activity in the person’s life and dominates his/her thinking (i.e., preoccupations and cognitive distortions), feelings (i.e., cravings) and behaviour (i.e., deterioration of socialized behaviour);

(2) Mood modification: This is the subjective experience that people report as a consequence of engaging in video game play (i.e. they experience an arousing ‘buzz’ or a ‘high’ or, paradoxically, a tranquillizing and/or distressing feel of ‘escape’ or ‘numbing’).

(3) Tolerance: This is the process whereby increasing amounts of video game play are required to achieve the former effects, meaning that for persons engaged in video game playing, they gradually build up the amount of the time they spend online engaged in the behaviour.

(4) Withdrawal symptoms: These are the unpleasant feeling states or physical effects that occur when video gaming is discontinued or suddenly reduced, for example, the shakes, moodiness, irritability, etc.

(5) Conflict: This refers to the conflicts between the video game player and those around them (i.e., interpersonal conflict), conflicts with other activities (e.g., job, schoolwork, social life, hobbies and interests) or from within the individual themselves (i.e., intrapsychic conflict and/or subjective feelings of loss of control) which are concerned with spending too much time engaged in video game play.

(6) Relapse: This is the tendency for repeated reversions to earlier patterns of video game play to recur and for even the most extreme patterns typical at the height of excessive video game play to be quickly restored after periods of abstinence or control.

John Charlton and Ian Danforth analyzed these six criteria and found that tolerance, mood modification and cognitive salience were indicators of high engagement, while the other components – withdrawal symptoms, conflict, relapse and behavioural salience – played a central role in the development of addiction.

Researchers such as Guy Porter and Vladan Starcevic don’t differentiate between problematic video game use and problematic online game use. They conceptualized problematic video game use as excessive use of one or more video games resulting in a preoccupation with and a loss of control over playing video games, and various negative psychosocial and/or physical consequences. Their criteria for problematic video game use didn’t include other features usually associated with dependence or addiction, such as tolerance and physical symptoms of withdrawal, because in their opinion there is no clear evidence that problem video game use is associated with these phenomena.

Arguably the most well known representative of the internet-based approach is Kimberley Young who developed her theoretical framework for problematic online gaming based on her internet addiction criteria which were based on the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders – (Fourth Edition, DSM-IV) criteria for pathological gambling. Her theory states that online game addicts gradually lose control over their game play, that is, they are unable to decrease the amount of time spent playing while immersing themselves increasingly in this particular recreational activity, and eventually develop problems in their real life. The idea that internet/online video game addiction can be assessed by the combination of an internet addiction score and the amount of time spent gaming are also reflective of the internet-based approach.

Integrative approaches try to take into consideration both aforementioned approaches. For instance, a 2010 paper by M.G. Kim and J. Kim in Computers in Human Behavior claimed that neither the first nor the second approach can adequately capture the unique features of online games such as Massively Multiplayer Online Role-Playing Games (MMORPGs), therefore it’s absolutely necessary to create an integrated approach. They argued that “internet users are no more addicted to the internet than alcoholics are addicted to bottles” which means that the internet is just one channel through which people may access whatever content they want (e.g., gambling, shopping, chatting, sex, etc.) and therefore users of the internet may be addicted to the particular content or services that the Internet provides, rather than the channel itself. On the other hand, online games differ from traditional stand-alone games, such as offline video games, in important aspects such as the social dimension or the role-playing dimension that allow interaction with other real players.

Their multidimensional Problematic Online Game Use (POGU) model reflects this integrated approach fairly well. It was theoretically developed on the basis of several studies and theories (such as those by Iain Brown, John Charlton, Ian Danforth, Kimberley Young and myself), and resulted in five underlying dimensions: euphoria, health problems, conflict, failure of self-control, and preference of virtual relationship. A 2012 study I carried out with Zsolt Demetrovics and his team also support the integrative approach and stresses the need to include all types of online games in addiction models in order to make comparisons between genres and gamer populations possible (such as those who play online Real-Time Strategy (RTS) games and online First Person Shooter (FPS) games in addition to the widely researched MMORPG players). According to this model, six dimensions cover the phenomenon of problematic online gaming – preoccupation, overuse, immersion, social isolation, interpersonal conflicts, and withdrawal. Personally, I believe that online game addiction can be defined as one type of behavioural addiction. In fact ‘internet gaming disorder’ has just been included in the appendices of the new DSM-5 in order to encourage research to determine whether this particular condition should be added to the manual as a disorder in the future.

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

Additional input: Orsolya Pápay, Katalin Nagygyörgy and Zsolt Demetrovics

Further reading

Charlton, J. P., & Danforth, I.D.W. (2007). Distinguishing addiction and high engagement in the context of online game playing. Computers in Human Behavior, 23(3), 1531-1548.

Demetrovics, Z., Urbán, R., Nagygyörgy, K., Farkas, J., Griffiths, M.D., Pápay, O. & Oláh, A. (2012). The development of the Problematic Online Gaming Questionnaire (POGQ). PLoS ONE, 7(5): e36417. doi:10.1371/journal.pone.0036417.

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

Han, D. H., Hwang, J. W., & Renshaw, P. F. (2010). Bupropion sustained release treatment decreases craving for video games and cue-induced brain activity in patients with Internet video game addiction. Experimental and Clinical Psychopharmacology, 18, 297-304.

Kim, M.G., & Kim, J. (2010). Cross-validation of reliability, convergent and discriminant validity for the problematic online game use scale. Computers in Human Behavior, 26(3), 389-398.

King, D.L., Haagsma, M.C.^, Delfabbro, P.H., Gradisar, M.S.^, Griffiths, M.D. (2013). Toward a consensus definition of pathological video-gaming: A systematic review of psychometric assessment tools. Clinical Psychology Review, 33, 331-342.

Peters, C. S., & Malesky, L. A. (2008). Problematic usage among highly-engaged players of massively multiplayer online role playing games. Cyberpsychology & Behavior, 11(4), 480-483.

Pontes, H. & Griffiths, M.D. (2014). The assessment of internet gaming disorder in clinical research. Clinical Research and Regulatory Affairs, 31(2-4), 35-48.

Pontes, H., Király, O. Demetrovics, Z. & Griffiths, M.D. (2014). The conceptualisation and measurement of DSM-5 Internet Gaming Disorder: The development of the IGD-20 Test. PLoS ONE, 9(10): e110137. doi:10.1371/journal.pone.0110137.

Pontes, H. & Griffiths, M.D. (2015). Measuring DSM-5 Internet Gaming Disorder: Development and validation of a short psychometric scale. Computers in Human Behavior, 45, 137-143.

Porter, G., Starcevic, V., Berle, D., & Fenech, P. (2010). Recognizing problem video game use. The Australian and New Zealand Journal of Psychiatry, 44, 120-128.

Van Rooij, A. J., Schoenmakers, T. M., Vermulst, A. A., Van den Eijnden, R. J., & Van de Mheen, D. (2011). Online video game addiction: identification of addicted adolescent gamers. Addiction, 106(1), 205-212.

Young, K. S. (1998a). Caught in the Net: How to recognize the signs of Internet addiction and a winning strategy for recovery. New York: Wiley.

Young, K. S. (1999). Internet addiction: Symptoms, evaluation, and treatment. In L. Vande Creek & T. Jackson (Eds.), Innovations in clinical practice: A source book (pp. 17, 19–31). Sarasota, FL: Professional Resource Press.

Net calls: Is online gambling regulation a help or hindrance?

Online gambling regulation is a hot topic and many online gambling operators are wondering what the effect of increased (and arguably stricter) legislative measures will have on the online gambling market. Based on the studies that our research unit has carried out, I would guess that overall it is good news for the industry as I believe this will lead to an increased uptake by those people who are somewhat sceptical or agnostic about online gaming. So why do I think this?

Despite the increase in online gambling research over the last ten years, there has been very little empirical research examining why people gamble online or – just as importantly – why they don’t gamble online. Because there is so little research in this area, Dr Abby McCormack and I published a study in the International Journal of Mental Health and Addiction with adult online and offline gamblers examining the motivating and inhibiting factors in online gambling.

Our findings on the inhibiting factors of online gambling identified one major overarching theme as to what people don’t like about gambling online. In a nutshell, gamblers said that the authenticity of gambling was reduced when gambling online. However, many online gaming operators have now introduced more ‘realistic’ live gaming experiences (e.g., via webcams) so this may diminish over time. However, we also identified other online gaming inhibitors (i.e., the asocial nature and characteristics of the internet, the reduced psychological value of gambling with virtual money, and concerns about the safety of online gambling websites and their trustworthiness). These factors all contributed to the reduced authenticity of the online gambling experience.

Issues around website security, safety and trust, were all major inhibitors that decreased the likelihood of punters gambling online. Predictably, we found that online gamblers were much more likely than the offline gamblers and non-gamblers to believe that the gambling websites were secure. However, there was a perception that some websites were considered more trustworthy than others, and consequently the gamblers generally played on well known sites (e.g., companies that were well established offline).

So what are the implications of these findings for stricter online gaming regulation? From a psychological perspective, research on how and why people access commercial websites indicates that one of the most important factors is trust. If people know and trust the name, they are more likely to use that service. Reliability of the service provider is also a related key factor. Stricter regulation is likely to increase consumer confidence if they feel more protected when they perceive the service to be unfair and/or goes wrong. It is likely to change sceptical gamblers’ perceptions about the reliability and trustworthiness of online gaming operators for the better (no pun intended!).

Even with increased protective legislation, research shows that some punters will always have concerns about Internet security and may never be happy about putting their personal details online. But this mistrust will diminish over the long-term as the ‘screenagers’ of today (the so-called ‘digital natives’) are the potential gamblers of tomorrow. Digital natives generally have more positive attitudes towards online commercial operations. Today’s children and younger adolescents have never known a world without the Internet, mobile phones and interactive television, and are therefore tech-savvy, have no techno-phobia, and are very trusting of these new technologies. For many ‘screenagers’, their first gambling experiences may come not in a traditional offline environment but via the Internet, mobile phone or interactive television. Stricter regulation may not even be an issue for tomorrow’s gamblers as they are already accessing a myriad of online services and are highly trusting of such services.

Despite the lack of trust by some players, the online gaming industry shouldn’t be too worried about stricter regulation. The prevalence of online gambling is steadily increasing and there are lots of reasons why some punters prefer online to offline gambling. Our research findings indicate that those who prefer online (to offline) gambling like the increased convenience, the greater value for money, the greater variety of games, and the anonymity.

Furthermore, online gambling has many advantages for punters as it saves time because they don’t have to travel anywhere, they are not restricted by opening hours, and they can gamble from the comfort of their own home. The removal of unnecessary time consumption (e.g., travelling to a gambling venue) through online gambling is another barrier to gambling participation that had been removed. Increased regulation is highly unlikely to change any of these important motivating factors for gambling online.

Finally, compared to offline gamblers, our research also indicates that online gamblers are more likely to be male, young adults, single, have good qualifications, and in professional and managerial employment. Given this particular demographic profile, this group appears to be highly educated, and are likely to make well informed decisions to gamble online based on due consideration of the facts at hand. Again, stricter regulation is something that is likely to strengthen the decision to gamble rather than inhibit it.

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

Further reading

Griffiths, M.D., Wardle, J., Orford, J., Sproston, K. & Erens, B. (2009). Socio-demographic correlates of internet gambling: findings from the 2007 British Gambling Prevalence Survey. CyberPsychology and Behavior, 12, 199-202.

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

McCormack. A. & Griffiths, M.D. (2012). Motivating and inhibiting factors in online gambling behaviour: A grounded theory study. International Journal of Mental Health and Addiction, 10, 39-53.

McCormack. A. & Griffiths, M.D. (2012). What differentiates professional poker players from recreational poker players? A qualitative interview study. International Journal of Mental Health and Addiction, 10, 243-257.

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.

McCormack, A., Shorter, G. & Griffiths, M.D. (2013). An examination of participation in online gambling activities and the relationship with problem gambling. Journal of Behavioral Addictions, 2(1), 31-41.

McCormack, A., Shorter, G. & Griffiths, M.D. (2013). Characteristics and predictors of problem gambling on the internet. International Journal of Mental Health and Addiction, 11, 634-657.

Parke, A. & Griffiths, M.D. (2011). Poker gambling virtual communities: The use of Computer-Mediated Communication to develop cognitive poker gambling skills. International Journal of Cyber Behavior, Psychology and Learning, 1(2), 31-44.

Parke, A. & Griffiths, M.D. (2011). Effects on gambling behaviour of developments in information technology: A grounded theoretical framework. International Journal of Cyber Behaviour, Psychology and Learning, 1(4), 36-48.

Parke, A. & Griffiths, M.D. (2012). Beyond illusion of control: An interpretative phenomenological analysis of gambling in the context of information technology. Addiction Research and Theory, 20, 250-260.

Wardle, H., Moody, A., Griffiths, M.D., Orford, J. & and Volberg, R. (2011). Defining the online gambler and patterns of behaviour integration: Evidence from the British Gambling Prevalence Survey 2010. International Gambling Studies, 11, 339-356.

Distraction plans: Excessive smartphone use and pain perception

In a previous blog I outlined many physical syndromes that had been reported in the 1980s medical literature, a number of which related to excessive video game playing. This included ‘Space Invader’s Wrist’ (published in the New England Journal of Medicine), ‘Pseudovideoma’ (Journal of Hand Surgery), ‘Pac-Man Phalanx’ (Arthritis and Rheumatism) and ‘Joystick Digit’ (Journal of the American Medical Association). More recently, other new medical complaints have been reported related to excessive mobile phone use including a report of ‘Blackberry thumb’ in a 2013 issue of the Canadian Medical Association Journal. 

Earlier this month saw the publication of a case report involving a tendon rupture in a man excessively playing a video game on his smartphone. The report appeared in JAMA Internal Medicine by Dr. Andrew Doan and his colleagues (the same Dr. Doan that reported a case study of someone “addicted” to Google Glass that I examined in a previous blog). The authors of the latest report wrote:

“We describe a patient with rupture of the extensor pollicis longus tendon associated with excessive video game play on his smartphone. A 29-year-old, right hand–dominant man presented with chronic left thumb pain and loss of active motion. Before the onset of symptoms, he reported playing a video game on his smartphone all day for 6 to 8 weeks. He played with his left hand while using his right hand for other tasks, stating that ‘playing was a kind of secondary thing, but it was constantly on.’ When playing the video game, the patient reported that he felt no pain. He reported no injuries or prior operations to either hand. He denied a history of inflammatory arthritis, quinolone use, or other predisposing medical condition for ten-don rupture. On physical examination, the left extensor pollicis longus tendon was not palpable, and no tendon motion was noted with wrist tenodesis. The thumb metacarpophalangeal range of motion was 10° to 80°, and thumb interphalangeal range of motion was 30° to 70°. The findings on physical examination of the patient’s right hand were unremarkable. The clinical diagnosis was rupture of the left extensor pollicis longus tendon. A magnetic resonance imaging study of his left hand revealed tendon attenuation and rupture of the tendon. Radiographic studies of the wrist found no bone spurs or prior or current fractures. The patient subsequently underwent an extensor indicis proprius (1 of 2 tendons that extend the index finger) to extensor pollicis longus tendon transfer. During surgery, rupture of the extensor pollicis longus tendon was seen between the metacarpophalangeal and wrist joints”

One of the things that I found interesting was that despite the tendon rupture, when the man was actually playing the game, he felt no pain. This is something I know only too well from personal experience. Unfortunately, I have a chronic and degenerative spinal complaint (herniated discs in my neck) but I feel no pain whatsoever when I am cognitively distracted. I find that work is a much better analgesic than dihydrocodeine (i.e., when I am working I feel no pain whatsoever). However, playing video games come a close second as when I am engaged in video game playing (even on simple casual games), the fact that it takes up all my cognitive resources means that I don’t feel any pain. This is nothing new and many medics are aware of the therapeutic benefits of gaming. There are now many studies showing that children undergoing chemotherapy need much less pain relief if they play video games after their treatment compared to children that don’t play video games. (In fact I’ve written a number of papers and book chapters on ‘video game therapy’ – see ‘Further reading’ below). This case report then went on to say:

“Video games suppress pain perception in pediatric patients and during burn treatments. Visual distraction and neuroendocrine hypothalamic-pituitary-adrenal arousal provide a plausible explanation for why the patient did not feel pain from his injury. Without the expected physiologic negative pain feedback, excessive gaming may have led to tendon attenuation and subsequent attritional rupture of the tendon. Attritional rupture at the midtendon differs from high- energy ruptures that occur where the tendon is thinnest or be- tween tendon and bone. Although this is only a single case report, research might consider whether video games have a role in clinical pain management and as nonpharmacologic alternatives during uncomfortable or painful medical procedures. They may also have a role in reducing stress. It may be interesting to ascertain whether various games differ in their ability to reduce the perception of pain…Research might also consider whether pain reduction is a reason some individuals play video games excessively, manifest addiction, or sustain injuries associated with video gaming”.

This conclusion does appear to suggest that the authors are unaware of the many hundreds of studies that have examined the therapeutic benefits of gaming (in fact there’s even an academic journal dedicated to such studies appropriately called the Games For Health Journal). As I have noted in a number of my writings about video gaming as a medical intervention for children:

• Videogames are likely to engage much of a person’s individual active attention because of the cognitive and motor activity required.
• Videogames allow the possibility to achieve sustained achievement because of the level of difficulty (i.e., challenge) of most games during extended play.
• Videogames appear to appeal most to adolescents.

Consequently, videogames have also been used in a number of studies as ‘distractor tasks’. This latest case report highlights the simultaneous potential positive and negatives of gaming within a single individual but also highlights the fact that video gaming is both mobile and spreading to many more types of hardware. I’m now wondering which medical team will be the first to write about a new medical syndrome relating to the new Apple Watch.

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

Further reading

Behr, J.T. (1984). Pseudovideoma. Journal of Hand Surgery, 9(4), 613.

Gibofsky, A. (1983). Pac‐Man phalanx. Arthritis and Rheumatism, 26(1), 120.

Gilman, L., Cage, D.N., Horn, A. Bishop, F., Klam, W.P. & Doan, A.P. (2015). Tendon rupture associated with excessive smartphone gaming. JAMA Internal Medicine, doi:10.1001/jamainternmed.2015.0753

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

Griffiths, M.D. (2005). Video games and health. British Medical Journal, 331, 122-123.

Griffiths, M.D. (2005). The therapeutic value of videogames. In J. Goldstein & J. Raessens (Eds.), Handbook of Computer Game Studies (pp. 161-171). Boston: MIT Press.

Griffiths, M. D., Kuss, D.J., & Ortiz de Gortari, A. (2013). Videogames as therapy: A review of the medical and psychological literature. In I. M. Miranda & M. M. Cruz-Cunha (Eds.), Handbook of research on ICTs for healthcare and social services: Developments and applications (pp.43-68). Pennsylvania: IGI Global.

McCowan, T.C. (1981). Space Invader’s wrist. New England Journal of Medicine, 304,1368.

Osterman, A. L., Weinberg, P., & Miller, G. (1987). Joystick digit. Journal of the American Medical Association, 257(6), 782.

O’Sullivan, B. (2013). Beyond BlackBerry thumb. CMAJ, 185, 185-186.

Soe, G.B., Gersten, L. M., Wilkins, J., Patzakis, M. J., & Harvey, J.P. (1987). Infection associated with joystick mimicking a spider bite. Western Journal of Medicine, 146(6), 748.

Yung, K., Eickhoff, E., Davis, D. L., Klam, W. P., & Doan, A. P. (2014). Internet Addiction Disorder and problematic use of Google Glass™ in patient treated at a residential substance abuse treatment program. Addictive Behaviors, http://dx.doi.org/10.1016/j.addbeh.2014.09.024.

Prophet share: A case study of ‘addiction to fortune telling’

In the latest issue of the Journal of Behavioral Addictions, there are two papers that I co-authored on muscle dysmorphia as an addiction (see ‘Further reading’ below). The reason I mention this is because in the same issue there was a case study report by Dr. Marie Grall-Bronnec and her colleagues of a woman (Helen) that was ‘addicted’ to fortune tellers. As noted in their paper:

“Clairvoyance consulting, also known as fortune teller consulting, is a behavior that may seem harmless, but can also become excessive. Fortune telling is defined as the practice of predicting information about a person’s life, using for example…astrology, cartomancy or crystallomancy”.

As I have noted in a number of my previous blogs, I subscribe to the view that if there are clinical criteria for addiction and a behaviour fulfils the criteria, it should be classed as an addiction (irrespective of the behaviour). This has led to accusations of me “watering down the concept of addiction” because such criteria have been applied to behaviours as diverse as gardening and chewing gum. According to the authors of the ‘fortune telling addiction’ paper:

“Helen is a 45-year-old woman who declares early on suffering from ‘a clairvoyance addiction’…She has no particular medical history, except for two major depression episodes after romantic breakups, and does not take any medication. She regularly sees a psychiatrist for support psychotherapy because of negative life events (sexual abuse and death in her family). She is divorced and does not have any children. Her career as a manager seems to fully satisfy her. She decides to seek treatment on account of her excessive financial expenditures due to the consultation of fortune tellers. Another motivation that explains her decision is her age. Indeed, she says she is entering a new phase in her life, after renouncing to the idea of becoming a mother one day”.

According to the paper, Helen had been consulting fortune tellers since she was 19 years old. She started using such people for educational and career advice as she claimed that she was poor at reaching important decisions herself and thought the life choices she made would be wrong. The authors noted that her first meeting with a clairvoyant was an event that gave her a feeling of reassurance. In her mid-twenties, her visits to clairvoyants escalated significantly and ended up “losing control of her use of fortune telling”. At that particular time, she was visiting clairvoyants to get relationship advice from them (e.g., “Does he really love me?” and “How long will our relationship last?”). Her current ‘addiction to clairvoyants’ dates back to her mid- to late-30s when she got divorced after the failure of her marriage:

“She repeatedly returned to fortune telling to reassure herself about the future of her relationship, and increasingly so as it deteriorated. The breakup worsened the disorder. Since her divorce, she consults fortune tellers – not always the same person – on the phone or online, in a compulsive way, more and more often (up to every day), for longer and longer periods of time (up to 8 hours a day) and spends each time more and more money (up to 200 euros per session). As she is never satisfied with the fortune tellers’ predictions, she will consult again very soon after the latest call or connection. Every choice she has to make, from the most trivial (going to the movies) to the most important (making relationship decisions), leads her to irrationally consult a fortune teller”

Before each consultation she said he got very excited at the prospect and that the experience relieved all of her psychological discomfort (at least in the short-term). However, not long after consultations she would feel incredibly guilty. The paper also reported that during consultations with the fortune tellers, she was totally convinced that they could see her future and that their predictions would come true. He authors went on to report:

“This excessive behavior gives her some kind of reassurance and allows her to make up for her lack of self-confidence. In that sense, the excessive behavior could be considered as an attempt at self-medication or as a way to cope with negative emotions. However, Helen knows that her belief in the fortune tellers’ ability to predict the future is completely irrational. This brings major adverse consequences, particularly in financial terms: despite a comfortable income, she is indebted. She also says having low self-esteem, due to her in- ability to resist her strong urge to consult fortune tellers, and due to her being isolated from the others because of the time spent consulting fortune tellers. Helen succeeds in limiting the consultation of fortune tellers during short periods of time, when her financial situation becomes too critical”.

The authors of the report also used different sets of addiction criteria to determine whether Helen was truly addicted to consulting clairvoyants. They also used my own six criteria (salience, mood modification, tolerance, withdrawal, conflict, and relapse). Here are the authors own description of the behaviour using my components model:

• Salience: “Consulting fortune tellers becomes the most important activity in Helen’s life and dominates her thinking (preoccupation and cognitive distortions), feelings (cravings) and behavior (she has progressively quit all her leisure activities, particularly going out with friends)”.
• Mood modification: “Helen says feeling excitement before each consultation, but also feels nervous tension and anxiety. This excessive behavior gives her some kind of reassurance and the excessive behavior could be considered as an attempt at self-medication or a way to cope with negative emotions”.
• Tolerance: “Over time, Helen has been feeling a growing need to consult fortune tellers, and the consultations have to last longer to obtain the same effect of relief”.
• Withdrawal: “When she attempts to resist the urge to consult or has to refrain from consulting fortune tellers (in the case of her financial situation being too critical, for example), she feels tense and nervous”.
• Conflict: “Helen knows that her use of fortune telling is problematic, and that it brings very negative consequences. However, she cannot refrain from consulting fortune tellers, leading to an intra-psychic conflict and guilt”.
• Relapse: “Over the years, Helen has made repeated efforts to reduce and stop this problematic behavior. Her clinical course is characterized by relapses and remissions”.

Based on the evidence presented, there is clear evidence that Helen’s behaviour was problematic. Whether it was genuinely addictive is debatable but the authors provided some evidence that (in this case at least) the behaviour appeared to include some addictive aspects. The authors conclude that in addition to individual risk factors, other situational and structural characteristics may have played a role in the development of problematic behaviour concerning Helen’s ‘addiction’:

“Regarding the risk factors related to the object of addiction (i.e. fortune telling use), one might mention, inter alia, the possibility to consult online, which guarantees anonymity. Furthermore, the Internet increases both accessibility and availability. Finally, the money spent during fortune telling sessions seems virtual, which makes it all the more easy to spend. Increased risks related to the Internet have already been described on gambling (Griffiths, Wardle, Orford, Sproston & Erens, 2009). Regarding socio-environmental risk factors, today’s society encourages the need for control and does not give way to uncertainty. In Helen’s case, all the conditions were met for the fortune telling use to become excessive, and we are tempted to conclude that it is an addictive-like phenomenon”.

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

Further reading

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

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

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

Griffiths, M. (2005). A “components” model of addiction within a biopsychosocial framework. Journal of Substance Use, 10, 191–197.

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

Griffiths, M., Wardle, H., Orford, J., Sproston, K. & Erens, B. (2009). Sociodemographic correlates of internet gambling: Findings from the 2007 British gambling prevalence survey. CyberPsychology and Behavior, 12, 199–202.

Hughes, M., Behanna, R. & Signorella, M. L. (2001). Perceived ac- curacy of fortune telling and belief in the paranormal. Journal of Social Psychology, 141(1), 159–160.

Shein, P. P., Li, Y. Y. & Huang, T. C. (2014). Relationship between scientific knowledge and fortune-telling. Public Understanding of Science, 23(7), 780–796.

Coining it in: Neologisms and ‘New Syndrome’ Syndrome

One of things I am very proud of in my academic career is the coining of the term ‘technological addiction’ back in 1995 (an umbrella term that I invented to describe a number of different person-machine addictions including slot machine addictions, video game addiction, television addiction, etc.). I’m also proud of coining the term ‘aca-media’ (relating to academics like myself that use the media to disseminate our research). A neologism (i.e., the name for a newly coined term) is often (according to Wikipedia) directly attributable to a specific event, person, publication, or period.

In the 1980s and early 1990s, there seemed to be a real upsurge is the naming of ‘new syndromes’ in the medical literature including many relating to excessive use of technology (such as ‘Space Invader’s Wrist’) and other leisure activities (such as ‘Cuber’s Thumb’ relating to excessive use of the Rubik’s Cube) – both of which made their appearance in 1981 issues of the New England Journal of Medicine. Other videogame medical complaints include ‘Pseudovideoma’ (in a 1984 issue of the Journal of Hand Surgery), ‘Pac-Man Phalanx’ (in a 1983 issue of Arthritis and Rheumatism) and ‘Joystick Digit’ (in a 1987 issue of the Journal of the American Medical Association). Another videogame-related medical complaint (in this case an infection), was reported in a 1987 issue of the Western Journal of Medicine by Dr. G.B. Soe and colleagues:

“We wish to focus WJM readers’ attention on another complication associated with video games-one that originally presented as an “infected spider bite. A 17-year-old right-handed boy noted progressive swelling and redness of his left hand seven days before admission. Two days before admission he was given penicillin intramuscularly and oral cephalexin to take at home. The swelling did not subside and the hand became very painful, so he came to the medical center for treatment. On admission his mother reported that she had seen many spiders around the house with a violin pattern on their backs, and that her son had probably been bitten by a spider…After seven days of parenteral antibiotic therapy, the edema, erythema and fever had disappeared and the patient was discharged home. Further questioning revealed that the young man was spending almost all of his time playing his favorite video game, which involved a fighting kung fu character. The patient used his left hand in manipulating a ball-shaped joystick to move the figure up, down, left and right, and his right in operating buttons to kick and jab. Extensive use of the joystick resulted in blisters on his left palm. He rubbed the blisters off, and an infection resulted that progressed to abscess formation. Neuromuscular complications of video games (‘pseudovideoma’, ‘Pac-Man phalanx’, ‘firing-finger syndrome’ and ‘Space Invaders wrist’) have been reported, as well as video game-induced seizures, but we have not come across any reports of an infectious complication of video games. Perhaps video game players should wear gloves to protect their palms, similar to ones worn by golfers and baseball players, who also need to get a firm grip on their respective sticks”.

Another one that I’d never heard of is ‘Nurd Knuckles’ coined by Dr. J.B. Martin in the Canadian Medical Association Journal in 1982:

“I wish to describe a case of painful knuckles associated with the use and manipulation of a new, allegedly therapeutic product, a Nurd. A Nurd is a head 10 cm across with a smiling face and large ears, reminiscent of the character Yoda of ‘Star Wars’. It is made of malleable material that can be stretched, twisted or deformed in any direction, yet with release of tension quickly resumes its original shape without a trace of distortion. A 32-year-old public school teacher presented with painful knuckles of his right hand. His students, perhaps feeling that their teacher was under increased stress during the marking of exams, had given him a Nurd for Christmas, and during a particularly trying day he had found occasion to use it. He repeatedly stretched its ears and twisted its neck without ill effect; however, on punching it he suffered sharp pain of his fourth and fifth metacarpophalangeal joints. On examination the joints were found to be reddened, with point tenderness over the fifth metacarpal head; there was no evidence of deformity. He was advised to stop beating his Nurd, and the pain subsided. While the Nurd is very plastic, yielding to the linear tension of stretching and twisting, it is very resistant to compression. Punching a Nurd does not cause the surface to give way, and, since the force of the blow is returned to the fist, it is conceivable that a fracture might result. Therefore, although stretching and twisting Nurds does not cause any harm, users should be cautioned against punching their Nurd. The Nurd is advertised as being a ‘punchable, stretchable, pushable and likeable alternative to tension, migraine headaches, drug abuse, alcoholism and manic depression’, but these claims are unsubstantiated. A MEDLINE search of the medical literature shows that no retrospective or prospective case control studies or controlled double blind crossover studies have been undertaken. Before the clinical efficacy of the Nurd can be taken seriously in the treatment of this broad spectrum of disease, full clinical trials must be completed. Subjects entering into trials must, however, be duly informed of the hazards of punching Nurds”.

Another one that caught my attention was a new affliction (‘Breaker’s Neck’) caused by the craze of ‘break dancing’ reported by Dr. Bertha Ramirez and her colleagues in a 1984 issue of the Journal of the American Medical Association. (The reason why I say it caught my eye is that I am currently involved in some research on ‘dancing addiction’ with some of my Hungarian colleagues and we have just had a new paper accepted in the journal PLoS ONE concerning the development of our ‘Dancing Motives Inventory’ – see ‘Further Reading’ below).

“To be added to the rapidly growing list of socially acquired injuries, we report a case of traumatic cervical subluxation caused by a new dance technique. This technique, labeled ‘breaking’ by its devotees, involves a modified head stand, in which the dancer, using his arms and hands for balance, spins rapidly on his head, neck, or shoulders to the rhythm of disco music. He then lowers his body to the floor and performs a series of rotational motions using his arms as a fulcrum…A 15-year-old boy was seen in our pediatric emergency room complaining that, on awakening two days previously, he felt a ‘snap’ in his neck, followed by persistent neck stiffness. He reported having ‘danced on his head’ the night prior to this incident. On physical examination, his head was tilted to the left with an inability to flex”.

Engaging in excessive sporting activity has given rise to a number of medical syndromes. One such consequence is ‘Rower’s Rump’ reported by Drs. K Tomecki and J. Mikesell in a 1987 issue of the Journal of the American Academy of Dermatology. In a previous blog I examined addiction to cycling. In the 1980s there were many medical complaints reported as a result of excessive cycling. One such complaint (given the name of ‘Bicycling nipples’) was highlighted by Dr. B. Powell in a 1983 issue of the Journal of the American Medical Association:

“Bicyclists are likely to suffer from a number of maladies, including dysuria, numb penises, and more. During cool or cold weather, another problem, bicyclist’s nipples, may occur. This condition is similar to jogger’s nipples, but it is primarily a thermal injury instead of an irritation secondary to friction, as with the jogger’s complaint. Often the rider is out in the cold weather for some time, and his or her undershirt, jersey, and jacket can become moist from perspiration. Evaporation and the chill of the wind lower the temperature of the nipples. They get downright cold, and they hurt. The pain continues after the ride is over. Indeed, it can continue for several days. The nipples are sore, sensitive to both temperature change and touch”.

After reading this I found out that Dr. Fred Levit had reported a case of ‘Jogger’s Nipples’ in a 1977 issue of the New England Journal of Medicine. All of these related nipple conditions are all examples of fissure of the nipple as they are all caused by friction resulting in soreness, dryness or irritation to, or bleeding of, one or both nipples. The Wikipedia entry also notes that “the condition is also experienced by women who breastfeed, and by surfers who do not wear rash guards”. The article also noted that:

“Jogger’s nipple is caused by friction from the repeated rubbing of a t-shirt or other upper body clothing against the nipples during a prolonged period of exercise. The condition is suffered mainly by runners. Long-distance runners are especially prone, because they are exposed to the friction on the nipple for the greatest period of time. However, it is not only suffered by athletes; the inside of a badge, a logo on normal items of clothing, or breastfeeding can also cause the friction which results in this condition”.

Outside of the leisure sphere, there were two case study reports of ‘Diaper Doer’s Hand’ in a 1987 issue of the journal Clinical Rehabilitation by Dr. J.L. Cosgrove and colleagues:

“Three cases of stenosing tenosynovitis occurred three to six months postpartum. Childcare activities aggravated the symptoms of pain and swelling in both patients. In two cases, a specific method of carrying the child was implicated as the mechanism of injury. Although there was no evidence of generalized inflammatory arthritis, all patients had very low positive titres of anti-nuclear antibodies. While it is likely that tenosynovitis was caused by mechanical factors, the possibility of increased susceptibility to inflammatory disease in the postpartum period cannot be discounted. The patients were successfully treated with a low temperature plastic splint, superficial heat and gentle mobilization”.

All of these new syndromes lead to why I put this article together in the first place. I found this letter in the British Medical Journal by Dr. E.P. Hoare entitled ‘New Syndrome Syndrome’ that I found both funny and poignant:

“Your readers will be familiar with tennis elbow, brazier’s ague, and soap packer’s jig not to mention Achilles’ heel. More recently we have heard of Space Invader’s wrist, jogger’s nipples, and the ultimate futility of Cuber’s thumb. May I point out another occupational disease which I have noticed among patrons of the reading room medical journal correspondence column reader’s neck or, more succinctly, the new syndrome syndrome. Symptoms usually begin with muscular contraction of the eyebrows, hyperventilation, and involuntary utterances, which in severe cases can lead to coprolalia. These may be followed by drowsiness, disorientation, hysterical amblyopia, and double vision (of the deja vu variety). If untreated the condition can result in a chronic pain in the neck. Treatment is 200 ml of gin and tonic stat by mouth and complete rest; music can also be helpful. The long-term prognosis is poor, however, unless journal editors can be persuaded to ban further reports of occupational afflictions or at least print a health warning at the head of their correspondence columns”.

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

Further reading

Behr, J.T. (1984). Pseudovideoma. Journal of Hand Surgery, 9(4), 613.

Cosgrove, J. L., Welch, D. A., Richardson, G. S., & Nicholas, J. J. (1987). Diaper doer’s hand: stenosing tenosynovitis in the postpartum period. Clinical Rehabilitation, 1(3), 219-223.

Gibofsky, A. (1983). Pac‐Man phalanx. Arthritis and Rheumatism, 26(1), 120.

Griffiths, M.D. (1995). Technological addictions. Clinical Psychology Forum, 76, 14-19.

Griffiths, M.D. (1995). Pop psychology and “aca-media”: A reply to Mitchell. The Psychologist: Bulletin of the British Psychological Society, 8, 537-538.

Griffiths, M.D. (2001). A moral obligation in aca-media? The Psychologist: Bulletin of the British Psychological Society, 14, 460.

Hite, P. R., Greene, K. A., Levy, D. I., & Jackimczyk, K. (1993). Injuries resulting from bungee-cord jumping. Annals of emergency medicine, 22(6), 1060-1063.

Hoare, E.P. (1982). Points: New syndrome syndrome. British Medical Journal, 285(6352), 1429.

Levit, F. (1977). Jogger’s nipples. New England Journal of Medicine, 297(20), 1127.

Maraz, A., Király, O., Urbán, R., Griffiths, M.D., Demetrovics, Z. (2015). Why do you dance? Development of the Dance Motivation Inventory (DMI). PLoS ONE, in press.

Martyn, J. B. (1983). Nurd knuckles. Canadian Medical Association Journal, 129(3), 228.

McCowan, T.C. (1981). Space Invader’s wrist. New England Journal of Medicine, 304,1368.

Osterman, A. L., Weinberg, P., & Miller, G. (1987). Joystick digit. Journal of the American Medical Association, 257(6), 782.

Powell, B. (1983). Bicyclist’s nipples. Journal of the American Medical Association, 249(18), 2457-2457.

Ramirez, B., Masella, P. A., Fiscina, B., Lala, V. R., & Edwards, M. D. (1984). Breaker’s neck. Journal of the American Medical Association, 252(24), 3366-3367.

Soe, G.B., Gersten, L. M., Wilkins, J., Patzakis, M. J., & Harvey, J.P. (1987). Infection associated with joystick mimicking a spider bite. Western Journal of Medicine, 146(6), 748.

Tomecki, K. J., & Mikesell, J. F. (1987). Rower’s rump. Journal of the American Academy of Dermatology, 16(4), 890-891.

Torre, P. R., Williams, G. G., Blackwell, T., & Davis, C. P. (1993). Bungee jumper’s foot drop peroneal nerve palsy caused by bungee cord jumping. Annals of emergency medicine, 22(11), 1766-1767.

Waugh, D. (1981). Cuber’s thumb. New England Journal of Medicine, 305, 768.

Brain humour: The Ig Nobels are coming to Nottingham Trent (again)

I apologise in advance, but today’s blog is (i) a not-so thinly disguised plug (well, a blatant plug) for a national event that is being hosted by my university on Wednesday 18th March (2015) and (ii) a just a slight updating of a blog I published a couple of years ago when the Ig Nobels last came to NTU. The new blurb I was sent by our local organizer Phil Banyard proclaims:

“The Ig Nobel Prizes honour achievements that first make people laugh, and then make them think. The prizes are intended to celebrate the unusual, honour the imaginative — and spur people’s interest in science, medicine, and technology. The awards are held each year at Harvard University and each award is presented by a Nobel laureate such is the esteem of this event. Over the past few years Marc Abrahams has brought an Ig Nobels tour to the UK in the spring. The tours highlights some of the key awards from the Ig Nobels’ back catalogue and provides a great opportunity to promote science to a wider audience. This year’s programme will feature Marc Abrahams, organiser of the Ig Nobel Prizes, editor of the Annals of Improbable Research, and Guardian columnist, together with a gaggle of Ig Nobel Prize winners and other improbable researchers. The programme will include: Chris McManus (Ig Nobel winner, Scrotal asymmetry in ancient Sculpture and man); Richard Stephens (Ig Nobel winner, The effect of swearing on pain); Richard Webb (Tribute to John Hoyland, the father of Nominative Determinism)”.

If that’s not enough to get you going, I would also like to add that science’s top journal Nature says: “The Ig Nobel awards are arguably the highlight of the scientific calendar” (and who am I to argue?). For those of you who know nothing about the Ig Nobels, they were initiated by one of my favourite journalists, Guardian columnist Marc Abrams. Abrams writes a weekly column for the Guardian called Improbable Research and he is also the editor of the Annals of Improbable Research.

Back in February 2010, I was delighted when Abrams did a whole column on my research into gambling entitled ‘Slot-machine gamblers are hard to pin down: Why are gamblers such a difficult subject for academic study?’ Secretly, I’m very proud that he dedicated a whole column to my research. (In fact, I found out while I was researching the original blog on this topic, is that my research also features in his 2012 book This is Improbable: Cheese String Theory, Magnetic Chickens, and Other WTF Research. Here are some of the things he wrote about my research into gambling:

“It’s hard to get good payoffs from slot machines, yes. But it’s also hard to get good information from slot machine gamblers, and that made things awkward for psychologists Mark Griffiths, of Nottingham Trent University, and Jonathan Parke, of Salford University. They explained how, in a monograph called Slot Machine Gamblers – Why Are They So Hard to Study? Griffiths and Parke published it a few years ago in the Journal of Gambling Issues. ‘We have both spent over 10 years playing in and researching this area,’ they wrote, ‘and we can offer some explanations on why it is so hard to gather reliable and valid data. Here are three from their long list.

• First, gamblers become engrossed in gambling. ‘We have observed that many gamblers will often miss meals and even utilise devices (such as catheters) so that they do not have to take toilet breaks. Given these observations, there is sometimes little chance that we as researchers can persuade them to participate in research’ 
• Second, gamblers like their privacy. They ‘may be dishonest about the extent of their gambling activities to researchers as well as to those close to them. This obviously has implications for the reliability and validity of any data collected.’
• Third, gamblers sometimes notice when a person is spying on them. “The most important aspect of non-participant observation research while monitoring fruit-machine players is the art of being inconspicuous. If the researcher fails to blend in, then slot-machine gamblers soon realise they are being watched and are therefore highly likely to change their behaviour.’

The gambling machines go by many names, ‘fruit machine’ and ‘one-armed bandit’ also being popular. But Griffiths and Parke don’t obsess about nomenclature. The two are giants in their chosen profession. The International Journal of Mental Health and Addiction ran a paean from a researcher who said: ‘In the problem gambling field we don’t exhibit the same adulation as music fans for their idols, but we have our superstars and, for me, Mark Griffiths is one.’

Professor Griffiths is one of the world’s most published scholars on matters relating to the psychology of fruit-machine gamblers, with at least 27 published studies that mention fruit machines in their title. These range from 1994’s appreciative Beating the Fruit Machine: Systems and Ploys Both Legal And Illegal to 1998’s admonitory Fruit Machine Gambling and Criminal Behaviour: Issues for the Judiciary*. Women get special attention (Fruit Machine Addiction in Females: a Case Study), as do youths (Adolescent Gambling on Fruit Machines and several other monographs). There is the humanist perspective (Observing the Social World of Fruit-Machine Playing) as well as that of the biomedical specialist (The Psychobiology of the Near Miss in Fruit Machine Gambling). Griffiths and Parke collaborate often. Strangers to their work might wish to begin by reading the classic The Psychology of the Fruit Machine. Their fruitful publication record reminds every scholar that, even when a subject is difficult to study, persistence and determination can yield a rewarding payoff”.

All I can say is that after re-reading this, I wonder how I can still get my head through the door.

More recently, one of my papers was actually reported by Marc Abrams on his Improbable Research website. More specifically, my case study published in the Archives of Sexual Behavior about eproctophilia (i.e., sexual arousal from flatulence), was given press coverage in over 100 newspaper and magazine stories around the world including those in the UK, Ireland, US, Greece, Italy, Holland, China, and Ghana (e.g., New York Daily News, Huffington Post, Daily Telegraph, Daily Mirror, The Sun, Metro, Times of Malta, Irish Examiner, Asian Image, and Cosmopolitan). However, it was actually Abrams who first reported the story under the headline “Academic Study of a Young Man’s Sexual Attraction to Human Gas”. For those who don’t know, the underlying philosophy of the IR website is to feature “research that makes people laugh and then think”. More specifically, Abrams wrote:

“Professor Mark D Griffiths of Nottingham Trent University has published a remarkable new study. Here’s how we know this study is remarkable:  The university’s press office sent copies of it to many prominent science journalists, remarking that (1) ‘It’s the world’s first paper on eproctophilia – sexual arousal from flatulence’ and (2) ‘Professor Griffiths would be more than happy to talk to you in more detail’. A remarkable number of those journalists immediately sent it on to us at the Annals of Improbable Research. We are, in this blog entry you are reading right now, remarking upon that study. There is more. Lots more. In other respects, too, Professor Griffiths is an expert. So renowned is he that Wikipedia devoted an entire web page to him. One of the many things on which he is an expert is the academic study of gamblers. We have celebrated some of his abundant work on that subject. (We express our thanks, and other emotions, to the many journalists who instinctively decided that they should alert us to the existence of Professor Griffiths’s new line of research.) BONUS (unrelated): The 1998 Ig Nobel Prize for literature was awarded to Dr. Mara Sidoli of Washington, DC, for her illuminating report, ‘Farting as a Defence Against Unspeakable Dread’ [Journal of Analytical Psychology, vol. 41, no. 2, 1996, pp. 165-78.]”

Anyway, if you’d like to go see Marc Abrams in person, here are the further details:

Event: The Ig Nobels: A celebration of Science

Time and date: 6.30 pm, Wednesday 18th March

Location: The Newton Building on the City Campus of the University.

Booking details: The event is free but booking is essential.

Book at: www.ntu.ac.uk/ignobles2015 (direct link here)

Details of their UK events and more information about the Ig Nobels can be found on their website: http://www.improbable.com/improbable-research-shows/complete-schedule/

* I’ve never actually written a paper with this title but I think it’s an inadvertent mix of two or three papers I’ve written with similar titles

 

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

Further reading (i.e., the papers cited by Marc Abrams above)

Griffiths, M.D. (1991). The psychobiology of the near miss in fruit machine gambling. Journal of Psychology, 125, 347-357.

Griffiths, M.D. (1994). Beating the fruit machine: Systems and ploys both legal and illegal. Journal of Gambling Studies, 10, 287-292.

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

Griffiths, M.D. (1996). Observing the social world of fruit-machine playing. Sociology Review, 6(1), 17-18.

Griffiths, M.D. (2003). Fruit machine addiction in females: A case study. Journal of Gambling Issues, 8. Located at: http://www.camh.net/egambling/issue8/clinic/griffiths/index.html.

Griffiths, M.D. (2013). Eproctophilia in a young adult male: A case study. Archives of Sexual Behavior, 42, 1383-1386.

Parke, J. & Griffiths, M.D. (2002). Slot machine gamblers – Why are they so hard to study? Journal of Gambling Issues, 6. Located at: http://jgi.camh.net/doi/full/10.4309/jgi.2002.6.7

Parke, J. & Griffiths, M.D. (2006). The psychology of the fruit machine: The role of structural characteristics (revisited). International Journal of Mental Health and Addiction, 4, 151-179.

Yeoman, T. & Griffiths, M.D. (1996). Adolescent machine gambling and crime (I). Journal of Adolescence, 19, 99-104.

Griffiths, M.D. & Sparrow, P. (1998). Fruit machine addiction and crime. Police Journal, 71, 327-334.

Griffiths, M.D. (2001). Cybercrime: Areas of concern for the judiciary. Justice of the Peace, 165, 296-298.

Flying ‘high’: A brief look at ‘binge flying’ and ‘flying addiction’

As part of my job I do a lot of travel. It’s an occupational necessity. Last year alone I did over 20 work trips abroad that comprised over 50 flights (such as the six flights that I had to take to get to a conference in Uruguay and then back to the UK). One of my research colleagues at a conference in Taiwan jokingly accused me of being ‘addicted’ to flying. Nothing could be further from the truth. For me, flying is little more than a way to get from A to B. However, I have tried to turn my experiences into something more positive and have written a number of short articles providing tips about flying and travelling abroad for outlets such as the British Medical Journal and the PsyPAG Quarterly (see ‘Further Reading’ below).

However, there are a few papers in the academic literature that have proposed the idea of ‘binge flying’ and ‘flying addiction’ in the Annals of Tourism Research. One British research team (Drs. Scott Cohen, James Higham and Christina Cavaliere) have written various papers on flying, particularly the dilemma that many business travellers face in wanting to be ‘green’ and ‘eco-friendly’ but knowing that the amount of flying they are doing is contributing to climate change and leaving a ‘carbon footprint’.

One of the papers published by Cohen and his colleagues was entitled ‘Binge flying: Behavioural addiction and climate change’. In their introduction to the topic, the authors referenced my 1996 paper in the Journal of Workplace Learning on behavioural addictions to argue there was now evidence that many behaviours could be potentially addictive even without the ingestion of a psychoactive substance. They then went on to say:

“[Two] articles in the popular press have further implicated frequent tourist air travel as a practice that may constitute behavioural addiction (Hill, 2007; Rosenthal, 2010). In stark contrast to most behavioural addictions, which are characterised by severe negative consequences for individuals directly, the destructive outcome attributable to excessive flying is premised upon air travel’s growing contribution to global climate change. Both Burns and Bibbings (2009) and Randles and Mander (2009) cite Hill’s (2007) interview in ‘The Observer’ with ‘Rough Guides’ founder Mark Ellingham, who coins the term ‘binge flying’ in critiquing the public’s growing appetite for holidays accessed through air travel”.

They also used my 1996 paper to make a number of points to support their premise that excessive flying can be conceptualized as an addiction. More specifically, they noted:

“Griffiths (1996) notes that behavioural addictions may have ‘normative ambiguity’, in that moderate use is accepted but stigma can result from over-enactment of the behaviour, or compulsive consumption (Hirschman, 1992)…Even though addictions are typically conceptualised as purely negative, Griffiths (1996) distinguishes a number of possible addiction benefits that individuals may perceive, such as changes of mood and feelings of escape, positive experiences of pleasure, excitement, relaxation, disinhibition of behaviour and the activity as a source of identity and/or meaning in life…Not only does excessive tourist air travel meet this basic criterion of behavioural addiction where longer-term outlooks are sacrificed for immediate gratification, but tourist experiences also supply many of the psychological benefits that Griffiths (1996) uses to characterise sites of potential behavioural addiction. These include feelings of escape, heightened experiences of pleasure and excitement (a ‘buzz’ or ‘rush’), relaxation, disinhibition of behaviour and the activity as an arena for identity work and searching for meaning in life”.

To support their argument that flying can be an addiction, they assert there are three key characteristics that can be found in addictive behavior that can be applied to flying: (i) a drive or urge to engage in the behaviour, (ii) a denial of the harmful consequences of the behaviour, and (iii) a failure in attempts to modify the behaviour. As regular readers of my blog will know, I operationally define addictive behaviour as comprising six components (salience, mood modification, tolerance, withdrawal, conflict and relapse), and as such, flying would be unlikely to be classed as an addiction by my own criteria. The authors interviewed 30 participants as part of their research but little of the qualitative data presented made any reference to addiction or elements of addictive behaviour. They somehow concluded that:

“Continued movement in consumer discourses towards a mainstream negative perception of the practice of holiday frequent flying may eventually find tourism consumption the further subject of query as an addictive phenomenon. Frequent air travel may then join gambling, smoking, shopping, video games and Internet use, (Clark & Calleja, 2008), amongst others, as ‘pathologised’ sites of behavioural addiction that reflect society’s (re)positioning of certain types of behaviour as socially dysfunctional”.

The concept of ‘binge flying’ and ‘flying addiction’ were more recently critiqued by Dr. Martin Young and colleagues in a 2014 issue of the Annals of Tourism Research. Their view closely matches my own view (and they also cite my 1996 paper on behavioural addictions) when they asserted:

“We take issue with the application of a behavioural addiction framework in the context of consumption generally, and frequent flying specifically. We argue that while the conceptual lens of behavioural addiction may be seductive to some (cf. Hill, 2007), it is, in contrast to the position of Cohen et al. (2011), ultimately counterproductive to the development of a meaningful critical response to the question of frequent flying and environmental damage… There is, of course, a deep irony in even trying to view frequent flying through the lens of addiction. Tourism, traditionally the realm of freedom, unconstraint and abandon (Crompton, 1979; Sharpley, 2003) is now recast as a pathology, associated with the pernicious tendencies of the human psyche.

Dr. Young and colleagues’ paper asserts that the idea that flying in extreme cases could be classed as a behavioural addiction is “unconvincing” (and again is something that I agree with). The paper also adapts the 2013 DSM-5 criteria for gambling disorder (substituting the word ‘gambling’ with ‘flying’) to highlight that while it is theoretically possible for someone to have an addiction to flying, it is highly unlikely even amongst the most frequent of flyers. As they note:

“A diagnosed flying addict (and some may exist) would appear to differ from the frequent flyer who is feeling guilty about the environmental consequences of flying. Indeed, the latter would appear to be entirely rational. Flying may be associated with feelings of guilt and suppression, but so are many other activities, like driving to work, using plastic bags, and using electricity from coal-powered generators. This does not make flying an addiction as defined by the DSM-5. In addition, a flying addict would be addicted to the act of flying when, in reality, people fly as part of a broader tourism or business journey or experience. Flying may be incidental to the motivations for travel, merely an unavoidable part of attaining a particular experience. In other words, the focus of flying addiction is likely to be complicated and shifting, unlike, for instance, gambling addiction, that is more clear-cut”.

Pathologizing a behaviour like flying may be stretching the addiction analogy a little too far, but I don’t see a theoretical reason why someone could not become addicted. However, it’s unknown as to what the actual object of flying addiction might be. Is it the actual flying and being in the air? The thrill of take-offs and landings? Is it the feeling of being attended and catered for (especially when flying business class) by the airline staff? Is it the anticipation associated of visiting somewhere new? All of these suggestions could be empirically tested but probably from a purely motivational view rather than from an addiction perspective.

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

Further reading

Burns, P., & Bibbings, L. (2009). The end of tourism? Climate change and societal challenges. 21st Century Society, 4(1), 31-51.

Clark, M., & Calleja, K. (2008). Shopping addiction: A preliminary investigation among Maltese university students. Addiction Research and Theory, 16(6), 633-649.

Cohen, S. A., Higham, J. E., & Cavaliere, C. T. (2011). Binge flying: Behavioural addiction and climate change. Annals of Tourism Research, 38(3), 1070-1089.

Crompton, J. (1979). Motivations for pleasure vacation. Annals of Tourism Research, 6(4), 408–424.

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

Griffiths, M.D. (2003). Tips on…Business travel abroad, British Medical Journal, 327, S38.

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

Griffiths, M.D. (2012). Tips on…Conference travel abroad. Psy-PAG Quarterly, 83, 4-6.

Higham, J. Cohen, S. & Cavaliere, C. (2013). ‘Climate breakdown’ and the ‘flyer’s dilemma’: Insights from three European societies. In: Fountain, J. & Moore, K. (Eds.). CAUTHE 2013: Tourism and Global Change: On the Edge of Something Big (pp. 321-324). Christchurch, N.Z.: Lincoln University.

Hill, A. (2007). Travel: The new tobacco. The Observer, May 6. Located at: http://www.guardian.co.uk/travel/2007/may/06/travelnews.climatechange

Hirschman, E. C. (1992). The consciousness of addiction: Toward a general theory of compulsive consumption. Journal of Consumer Research, 19(2), 155-179.

Randles, S., & Mander, S. (2009a). Practice(s) and ratchet(s): A sociological examination of frequent flying. In S. Gössling & P. Upham (Eds.), Climate change and aviation: Issues, challenges and solutions (pp. 245-271). London: Earthscan.

Rosenthal, E. (2010, 24 May). Can we kick our addiction to flying? Guardian, May 24. Located at: http://www.guardian.co.uk/environment/2010/may/24/kick- addiction-flying

Sharpley, R. (2003). Tourism, tourists and society. Huntingdon: Elm Publications.

Young, M., Higham, J.E.S. & Reis, A.C. (2014). ‘Up in the air’: A conceptual critique of flying addiction. Annals of Tourism Research, 49, 51-64.

Boxing clever? Another look at television binge watching

Last Thursday (January 29), I was watching the newspaper review on Sky News when one of the reviewers referred to a story in the Daily Mail about the negative effects of box-set bingeing (‘Watching TV box-set marathons is warning sign you’re lonely and depressed – and will also make you fat’). Having examined the psychology of box-set bingeing in a previous blog, the story instantly grabbed my attention (and also because I love box-set bingeing when I get the time). (I also discovered in researching this article that in November 2013, the Oxford Dictionary announced that the word ‘binge-watch’ [defined as “to watch multiple episodes of a television programme in rapid succession” was a contender for its word of the year but was eventually beaten by the word ‘selfie’).

The Daily Mail story was based on some research led by doctoral researcher Ms. Yoon Hi Sung (at the University of Texas). Unfortunately, the research is not publicly available as it hasn’t actually been published yet. In fact, the study is from a conference paper that will be presented in May 2015 (at the Conference of the International Communication Association in Puerto Rico in May). Ms. Sung said that his findings “should be a wake-up call”. In typical Daily Mail style, a number of claims were made (which are listed below verbatim):

• “Watching TV box-set marathons is warning sign you’re lonely and depressed – and will also make you fat
• Watching TV for long periods of time can lead to obesity and exhaustion.
• ‘Binge-watchers’ are more likely to lack self-control and have addictions.
• University of Texas researchers said it’s no longer a ‘harmless addiction’.
• They said people will watch TV as a distraction when they are feeling low”.

Unfortunately there was little detail of the method used or much about 316 participants aged 18 to 29 years (e.g., how the participants were recruited, how representative the sample was of all those who engage in box-set bingeing, etc.) but the Daily Mail was adamant that box-set bingeing is bad for your health. More specifically, the journalist Daniel Bates wrote:

“People who suffer from low moods are more likely to spend hours or days viewing multiple episodes of their favourite programme online or on DVD box set. But by doing so they could neglect work, relationships and even their family. The researchers from the University of Texas at Austin said that binge-watching should no longer be considered a ‘harmless addiction’ and that people should think twice before settling in for a long session in front of the TV…The findings showed a direct link. The worse somebody felt, the more likely they were to watch a lot of TV in an apparent attempt to avoid their low mood”.

Ms. Sung was quoted as saying:

“Even though some people argue that binge-watching is a harmless addiction, findings from our study suggest that binge-watching should no longer be viewed this way. Physical fatigue and problems such as obesity and other health problems are related to binge-watching and they are a cause for concern. When binge-watching becomes rampant, viewers may start to neglect their work and their relationships with others. Even though people know they should not, they have difficulty resisting the desire to watch episodes continuously”.

Not having access to the details of the study make it difficult to make methodological criticism but as a Professor of Gambling Studies I would bet my bottom dollar that the claims go beyond the data. As far as I am aware there has never been any academic study of box set viewing behaviour (either watching ‘on demand’ via interactive television or DVD box-sets) but I did come across some commercial research carried out by the company MarketCast in 2013 (and reported in a Variety magazine article entitled ’10 insights from studies of binge watchers’ by Marc Fraser). In the study, over 1000 US television viewers, the report claimed that there were “elevated binge levels” when watching box-set television series on demand such as House of Cards, Breaking Bad, Dexter, The Walking Dead, True Blood, and Sons of Anarchy. As Fraser reported:

“As networks grapple with the potential effect of binge-viewing to their bottom line, what they’re starting to learn is less threatening than some early analysts have suggested. The good news for broadcasters is that bingeing actually creates more viewers for TV shows, MarketCast found, which should broaden the audience for advertisers and their commercials when new episodes air. That’s primarily because most binge viewers are just trying to catch up on a series they may have missed, and tend to tune into a series during its regular airings. For example, 65% of those surveyed said they would watch new episodes of ‘Breaking Bad’ without bingeing when the series returned, while another 58% said they would tune into ‘The Walking Dead’ in similar fashion. At the same time, despite the large amount of time required for bingeing, other forms of entertainment aren’t seeing a large decrease as a result of binge-viewing, the study [found]”.

The MarketCast study also reported that 5% of their study participants said bingeing was the only way that they watched their favourite TV shows, and just under one-third of the sample planned to use the bingeing method of viewing their favourite TV series in the future. Here are some of the other key findings listed in the report:

• There are four types of binge-viewers. Those who binge (i) because they don’t like to wait a week to find out what happens next, (ii) because friends tell them they’re missing out; (iii) to watch TV shows they’ve seen before, and (iv) when they are ill or housebound because of injury,
• The main reasons for box-set bingeing are to (i) catch up on TV series that were missed when they first aired, (ii) avoid having to watch adverts (and save time), and (iii) avoid waiting to see what happens next.
• Two-thirds of the sample (67%) claimed to have had at least one binge-watching experience.
• Those who binge watch only are typically males under the age of 30 years (although there is no overall difference between males and females in binge watching behaviour). (Another piece of market research by Magid Generational Strategies in early 2013 reported tat 70% of binge viewers are aged 16 to 35 years).
• More binge watching is done alone (56%) and at home (98%). Binge watching is also done while travelling (13%) and/or while on holiday (16%).
• Box-set bingeing occurs online (e.g., via on-demand services) more than offline (e.g., DVD box-sets).
• Drama is most watched genre for bingeing (60%), followed by comedy (45%), and reality shows (26%).

Fraser also made reference to another piece of market research by Solutions Research Group that examined 1,200 Canadian subscribers of Netflix and their viewing habits related to the television series House of Cards (that puts all 13 episodes online simultaneously). The study found that one in three viewers watched all 13 episodes within four weeks of first airing).

Another news story I came across (in Australia’s Herald Sun) provided a more positive spin and claimed in the headline ‘Binge-viewing box sets on the couch now the best way to build romance’. The article by journalist Megan Miller reported:

“For more and more couples, churning through a lazy 12-episode series is a romance rekindler that takes less effort than a meal somewhere nice and is cheaper than a beach holiday. It can be done without leaving the comfort of one’s home (or even one’s flannie pyjamas) and provides valuable couple time as well as down time from the rigours of work and family. Everyone’s on board. Barack and Michelle Obama are said to be hooked on spy drama ‘Homeland’ and our own PM Tony Abbott loves sitting down with wife Margie to an [episode] (or three) of ‘Downton Abbey’”.

It appears that the inspiration for the herald Sun story may have been the “couple Phoebe and Mike, both 31 [years of age], were so addicted to cult hit Breaking Bad they took discs with the latest series on their Fijian honeymoon earlier this year, desperate to race back to their villa each night to keep up with the escapades of meth-maker Walter White”. Miller then interviewed Melbourne-based psychologist Sally-Anne McCormack who commented that:

“Doing something you both enjoy is at the heart of engaging in a binge session in front of the box. Shared interests create a bond and connection that’s great for relationships. Cuddling up on the couch and snuggling while watching a show that you both get enjoyment from gives a common interest and some relaxed time together…New partners may watch shows together for the sake of the other, not because they hold a great interest in it. An established relationship is one where the two people have a greater level of comfort together, and don’t depend on the environment to help impress the other. At a later point in a relationship the two are relaxed with one another and can negotiate each other’s interests and needs, and find a mutually interesting series that is exciting for both of them”.

All of the articles I have read on the topic describe binge-watching as an ‘addiction’ (at least in passing). Although there is a small literature on ‘television addiction’ (for a recent review in the Journal of Behavioral Addictions by my colleague Dr. Steve Sussman – see ‘Further reading’ below) I know of no empirical research on the topic of ‘binge-viewing addiction’. However, I did come across an arguably tongue-in-cheek list of signs in an article in the Daily Edge:

• The thought of a day doing nothing except watching a box set makes you genuinely excited.
• You have avoided a social engagement to stay in and watch something.
• At least once, you have woken up early specifically to watch the latest episode.
• You’ve had this thought – ‘Just one more episode’ or ‘Not sure if an actual memory or something I saw on TV’.
• You have accidentally drooled on at least one sofa cushion during a binge.
• You have cheated on your loved one with a box set. By which we mean, watching ahead while they’re out/on the phone to their mam/have gone to bed. AKA ‘Netflix Adultery’.
• You have had that moment where you get up from the couch, and have to shake food out of the folds of your clothes.
• You tell yourself you could stop at any time.
• When it’s all over, you feel confusion, shame and regret.

Even though these signs were probably written in jest, they would probably have good face validity should anyone decide to construct a new instrument to assess binge-watching addiction. However, even with the new study by the researchers at the University of Texas, I’m still to be convinced that box-set bingeing is a serious health concern – at least based on the scientific evidence.

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

Further reading

Bates, D. (2015). Watching TV box-set marathons is warning sign you’re lonely and depressed – and will also make you fat. Daily Mail, January 29. Located at: http://www.dailymail.co.uk/health/article-2931572/Love-marathon-TV-session-warning-sign-lonely-depressed.html

Daily Edge (2014). 11 signs of you’re suffering from a binge-watching problem. Located at: http://www.dailyedge.ie/binge-watching-problem-signs-1391910-Apr2014/

Graser, M. (2013). Marathon TV viewers tend to be millenials playing catch up on shows; say they’ll watch new seasons as they air. Variety, March 7. Located at: http://variety.com/2013/digital/news/10-insights-from-studies-of-binge-watchers-1200004807/

Koepsell, D. (2013). In defence of the box set binge: a global shared culture. New Statesman, December 29. Located at: http://www.newstatesman.com/culture/2013/12/defence-box-set-binge-global-shared-culture

Kompare, D. (2006). Publishing flow DVD Box Sets and the reconception of television. Television & New Media, 7(4), 335-360.

Miller, M. (2014). Binge-viewing box sets on the couch now the best way to build romance. Herald Sun, December 13. Located at: http://www.heraldsun.com.au/news/victoria/bingeviewing-box-sets-on-the-couch-now-the-best-way-to-build-romance/story-fni0fit3-1226782514245?nk=0ed250e88a2970045f6fc84123b03f10

Spangler, T. (2013). Poll of online TV watchers finds 61% watch 2-3 episodes in one sitting at least every few weeks. Variety, December 13. Located at: http://variety.com/2013/digital/news/netflix-survey-binge-watching-is-not-weird-or-unusual-1200952292/

Sussman, S., & Moran, M.B. (2013). Hidden addiction: Television. Journal of Behavioral Addictions, 2(3), 125-132.

Gamblers anonymous: The psychology of live online casino gambling

Over the last decade, my research unit has carried out an increasing amount of research into the psychology of online gambling. In some of our recent research interviewing online gamblers, offline gamblers and non-gamblers, we found that people who gambled online did so because of its (i) convenience, (ii) greater value for money, (iii) the greater variety of games, and (iv) anonymity. Perhaps more interestingly, were the inhibiting reasons that stopped people from wanting to gamble online in the first place. The main inhibiting reason that stopped people gambling online was that offline gamblers and non-gamblers said the authenticity of gambling was significantly reduced when gambling online. We also found a number of other inhibitors of online gambling including (i) the reduced realism, (ii) the asocial nature of the internet, (iii) the use of electronic money, and (iv) concerns about the safety of online gambling websites. The reduced authenticity and realism may help to explain why online live action casino games are seen as increasingly popular among some types of gamblers.

This empirical research also chimes with my own personal psychology of online gambling. One of the main reasons I don’t like gambling at Internet casinos is that I believe the majority of game outcome are likely to be pre-programmed and/or predetermined. To me, this is somewhat akin to playing with imaginary dice! Our empirical research findings also help explain the rise of live online casino gambling. Players not only want increased realism and authenticity, but still have the added advantages of online anonymity while playing.

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

Furthermore, one of the main reasons why behaviour online is very different from offline is because it provides a ‘disinhibiting’ experience. One of the main consequences of disinhibition is that on the internet people lower their emotional guard and become much less restricted and inhibited in their actions.

The increase in online live casino gambling has happened alongside the rise of online betting exchanges – the type of online gambling where it could be argued that skill can – to some extent – be exercised. For gamblers, having a punt on live sporting events via betting exchanges is a psychologically safer option because punters know (or can check) who won a particular football or horse race. The playing of live action casino games via the Internet shares some of the psychological similarities of online betting exchanges.

The rise of live online gambling has been coupled with increasingly sophisticated gaming software, integrated e-cash systems, and increased realism (in the shape of “real” gambling via webcams, live remote wagering, and/or player and dealer avatars). These are all inter-linked facilitating factors. Another factor that I feel is really important in the rise of online gambling (including online live action casino games) is the inter-gambler competition. Obviously there is an overlap between competitiveness and skill but they are certainly not the same. What’s more recent research has suggested that being highly competitive may not necessarily be good for the gambler. For instance, Professor Howard Shaffer, a psychologist at Harvard University, claims that men are more likely to develop problematic gambling behaviour because of their conventionally high levels of aggression, impulsivity and competitiveness. Clearly, the idea of the competitiveness of the activity being one of the primary motivations to gamble is well supported.

Based on the fact that so little research has systematically examined the links between gambling and competitiveness, our research unit did some research into this area. We speculated that a gambler who is highly competitive will experience more arousal and stimulation, and be drawn to gambling as an outlet to release competitive instincts and drives. This is likely to occur more in activities like online poker and online live action casino games. Our research did indeed show that problem gamblers were significantly more likely than non-problem gamblers to be competitive.

Being highly competitive may help in explaining why in the face of sometimes negative and damaging financial consequences, gamblers persist in their habit. Psychological research in other areas has consistently shown that highly competitive individuals are more sensitive to social comparison with peers regarding their task performance. Applying this to a gambling situation, it is reasonable to suggest that competitive gamblers may be reluctant to stop gambling until they are in a positive state in relation to opposing gamblers, perhaps explaining why excessive gambling can sometimes occur.

Sociologists have speculated that factors of the human instinctual expressive needs, such as competition, can be temporarily satisfied when engaging in gambling activities. Evidence exists supporting gambling as an instrumental outlet for expressing competitive instinctual urges. The US sociologist Erving Goffman developed what he called the ‘deprivation-compensation’ theory to explain the relationship between gambling and competitiveness. He suggested that the stability of modern society no longer creates situations where competitive instincts are tested. Therefore, gambling is an artificial, self-imposed situation of instability that can be instrumental in creating an opportunity to test competitive capabilities. Again, online live action casino gambling is another gambling form that can facilitate such instinctive needs.

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

Further reading

Goffman, I. (1972). Where the action is. In: Interaction Ritual (pp. 149–270). Allen Lane, London.

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

Griffiths, M.D. & Parke, J. (2003). The environmental psychology of gambling. In G. Reith (Ed.), Gambling: Who wins? Who Loses? pp. 277-292. New York: Prometheus Books.

Griffiths, M.D., Wardle, J., Orford, J., Sproston, K. & Erens, B. (2009). Socio-demographic correlates of internet gambling: findings from the 2007 British Gambling Prevalence Survey. CyberPsychology and Behavior, 12, 199-202.

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

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

McCormack. A. & Griffiths, M.D. (2012). Motivating and inhibiting factors in online gambling behaviour: A grounded theory study. International Journal of Mental Health and Addiction, 10, 39-53.

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.

McCormack, A., Shorter, G. & Griffiths, M.D. (2013). An examination of participation in online gambling activities and the relationship with problem gambling. Journal of Behavioral Addictions, 2(1), 31-41.

McCormack, A., Shorter, G. & Griffiths, M.D. (2013). Characteristics and predictors of problem gambling on the internet. International Journal of Mental Health and Addiction, 11, 634-657.

Wardle, H. & Griffiths, M.D. (2011). Defining the ‘online gambler’: The British perspective. World Online Gambling Law Report, 10(2), 12-13.

Wardle, H., Moody, A., Griffiths, M.D., Orford, J. & and Volberg, R. (2011). Defining the online gambler and patterns of behaviour integration: Evidence from the British Gambling Prevalence Survey 2010. International Gambling Studies, 11, 339-356.

The junkie generation? Teenage “addiction” to social media

Earlier today I appeared live on my local radio station (BBC Radio Nottingham) commenting on a study released by the Allen Carr Addiction Clinics (ACAC) concerning teenage addiction (and more specifically addiction to social media). The study was a survey of 1,000 British teenagers aged 12 to 18 years old and the press release went with the heading “INFO UK BREEDING A GENERATION OF TEENAGE ADDICTS SAYS NEW STUDY” (their capital letters, not mine) with the sub-headline that “83% of UK teenagers would struggle to go ‘cold turkey’ from social media and their other vices for a month”.

As someone that has spent almost 30 years studying ‘technological addictions’ I was interested in the survey’s findings. I tried to get hold of the actual report by contacting the ACAC Press Office. They were very helpful and sent me a copy of the Excel file containing the raw data (entitled ‘Addicted Britain’). They also informed me that the data were collected for ACAC by the market research company OnePoll, and that the teenagers filled out the survey online (with parents’ permission). However, there is no actual published report with the findings (and more importantly, no methodological details). I asked ACAC if they knew the response rate (for instance, was the online survey sent to 10,000 teenagers to get their 1,000 responses that would give a response rate of 10%), and how were the teenagers recruited in the first place. Also, as the survey was carried out online, those teenagers who are the most tech-savvy and feel confident online, would be more likely to participate than those who don’t like (or rarely use) online applications. Before I comment on the survey itself, I would just like to provide some excerpts from the press release that was sent out:

“The explosion of social media, selfies and mobile devices is priming a generation of UK teenagers for a lifelong struggle with addiction…83% of UK teenagers admit they would struggle to give up their vices for a whole month. [The study] unveiled a worrying trend of growing numbers of young people constantly striving to find the next thrill, mostly via technology and social media. When asked which behaviours they could abstain from, UK teens said they would most struggle living without texting (66%), followed by social networking (58%), junk food (28%) and alcohol (6%). The report found that the average teen checks social media 11 times a days, sends 17 text messages and takes a ‘selfie’ picture every four days. This constant pursuit of stimulation, peer approval, instant gratification, and elements of narcissism are all potential indicators of addictive behaviour. The study highlights that parents across the UK are inadvertently becoming ‘co-dependents’ enabling their child’s addictions by providing them with cash albeit with the best of intentions”.

The first thing that struck me reading this text was the use of the word “vice”. Most dictionary definitions of a vice is “immoral or wicked behaviour” or “criminal activities involving prostitution, pornography, or drugs”. As far as I am concerned, social networking, junk food, and alcohol are not vices (especially social networking). The whole wording of the press release is written in a way to pathologise normal behaviours such as engaging in social media use. Also, asking teenagers about which behaviours they could not abstain from for a month tells us almost nothing about addiction. All it tells us is that the activities that teenagers most engage in are the ones they would find hardest not to do. This is just common sense. My main hobbies are listening to music on my i-Pod and reading. I would really have difficulty in not listening to my favourite music or reading for a whole month but I’m not addicted to music or reading.

The ACAC kindly sent me all the questions that were asked in the survey and there was no kind of addiction scale embedded in any of the questions asked. Basically, the survey does not investigate teenagers’ potential addictions, as no screening instrument for any behaviour asked about was included in the survey. There were some attitude questions asking whether activities like social networking could be addictive, but as I have argued in previous blogs, almost any activity that is constantly rewarding can be potentially addictive.

That’s not so say we shouldn’t be concerned about teenagers’ excessive use of technology as my own research has shown that a small minority of teenagers do appear to have problems and/or be addicted to various online activities. However, as my research has shown, doing something excessively doesn’t mean that it is addictive. As I have noted in a number of my academic papers, the difference between a healthy enthusiasm and an addiction is that healthy enthusiasm add to life and addictions take away from it. The perceived overuse of technology by the vast majority of teenagers is quite clearly something that is life-enhancing and positive with no detrimental effects whatsover.

Given that the vast majority of teenagers use the social media to communicate and interact with friends, I was surprised that ACAC’s findings were not closer to 100% saying that they couldn’t abstain for one month. Which teenagers would find it easy not to use social media for a month given how important it is in their day-to-day social lives? The findings in the press release also quote John Dicey (Global Managing Director and Senior Therapist of ACAC) who said:

“The findings of this report are cause for concern and highlight a generation of young people exhibiting many of the hallmarks of addictive behaviour. The explosion of technology we have seen since the late 90’s offers incredible opportunities to our youth – the constant stimulation provided by access to the internet for example can be a good or a bad thing. There’s a price to pay. This study indicates that huge numbers of young people are developing compulsions and behaviours that they’re not entirely in control of and cannot financially support. Unless we educate our young people as to the dangers of constant stimulation and consumption, we are sleepwalking towards an epidemic of adulthood addiction in the future”.

While my own research shows that a small minority of teenagers experience problems concerning various online activities, there was almost nothing in the ACAC report “huge numbers of young people are developing compulsions and behaviours that they’re not entirely in control of”. The use of the word “huge” is what we psychologists call a ‘fuzzy quantifier’ (as what is ‘huge’ to one person may not be ‘huge’ to another). Mr. Dicey’s conclusions simply cannot be made from the data collected. He says that the report shows that many teenagers are displaying the “hallmarks of addictive behaviour” but given no addiction screening instruments were used, the data do not show this. The press release uses the following findings to make the claim that “the abundance of technology that UK teens can access seems to be creating a generation of ‘tech addicts’!”

“One-third of UK teens (32%) admit they check social media more than 10 times a day. The report also found that the average teen checks social media 11 times day, which equals once every 1.5 hours they are awake. UK teens are also avid takers of ‘selfies’, with over a quarter taking more than 10 a month. The average teen takes 7.4 selfies a month, equalling one every four days on average…The plethora of technology available to teens is also having a worrying impact on their attention spans. 1 in 4 teens have over 20 apps on their smartphones, with the average teen having 13 apps on their device. The constant search for the ‘next thing’ is evidenced in how they use apps – 46% admitted that they stop using or delete an app less than a week after using it, freeing up storage space for a new app”.

Anyone that has teenagers (I have three screenagers myself) will tell you that the above statistics indicate adolescent normality not addiction. Checking social media 10 times a day does not indicate addiction in the slightest. Although I have never taken a selfie, I check my social media far more than 10 times a day. Deleting apps to make way for other apps is no different from me removing songs on my i-Pod every week to make way for other songs I want to listen to. Again, there is absolutely nothing in these statistics that provides evidence of adolescent addiction.

Anyone that is aware of my work will know that I take the issue of teenage technology use seriously and that I firmly believe that a small minority of adolescents experience addiction to various online applications. However, studies like the one done for ACAC do little for the area as the rhetoric of the claims are unsupported by their data.

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

Further reading

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

Griffiths, M.D., King, D.L. & Delfabbro, P.H. (2014). The technological convergence of gambling and gaming practices. In Richard, D.C.S., Blaszczynski, A. & Nower, L. (Eds.). The Wiley-Blackwell Handbook of Disordered Gambling (pp. 327-346). Chichester: Wiley.

Griffiths, M.D., King, D.L. & Demetrovics, Z. (2014). DSM-5 Internet Gaming Disorder needs a unified approach to assessment. Neuropsychiatry, 4(1), 1-4.

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

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

Griffiths, M.D. & Pontes, H.M. (2014). Internet addiction disorder and internet gaming disorder are not the same. Journal of Addiction Research and Therapy, 5: e124. doi:10.4172/2155-6105.1000e124.

Kuss, D.J. & Griffiths, M.D. (2011). Addiction to social networks on the internet: A literature review of empirical research. International Journal of Environmental and Public Health, 8, 3528-3552.

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

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

Kuss, D.J., van Rooij, A.J., Shorter, G.W., Griffiths, M.D. & van de Mheen, D. (2013). Internet addiction in adolescents: Prevalence and risk factors. Computers in Human Behavior, 29, 1987-1996.