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Nag, nag, nag: Another look at horse race betting and problem gambling

Literature reviews carried out by myself and others in the gambling studies field have concluded that electronic gaming machines (EGMs such as slot machines, pokie machines, video lottery terminals [VLTs], etc.) tend to have a higher association with problem gambling than other forms of gambling. Although any form of gambling can be potentially problematic, there is surprisingly little in the academically peer-reviewed gambling literature showing that horse race betting has a high association with problem gambling, particularly in comparison to activities such as EGM gambling.

Along with individual susceptibility and risk factors of the individual gambler, the most important determinants in the development and maintenance of problem gambling are structural characteristics, particularly those relating to the speed and frequency of the game (and more specifically event frequency, bet frequency, event duration and payout interval). More specifically, I have argued that researchers in the gambling studies field need to think about game parameters rather than specific game type when it comes to any association with problem and pathological gambling and that event frequency is the single most important determinant.

horse-racing

A study by Dr. Debi LaPlante and colleagues in the European Journal of Public Health examining types of gambling and level of gambling involvement (using data from the 2007 British Gambling Prevalence Survey of which I was one of the co-authors) indicated that when level of gambling is accounted, no specific type of gambling was associated anymore with disordered gambling, and that level of involvement in gambling better characterizes problem gambling than individual forms of gambling. In fact, this paper also concluded that:

“Two games, private betting and betting on horses, had a reversal of association. After controlling for involvement, individuals who engaged in private betting or betting on horses were significantly less likely to have gambling-related problems than people who did not…One interesting, and perhaps unanticipated, finding was that the nature of the relationships between private betting and betting on horses and gambling problems changed when we considered the influence of involvement: engaging in these types of gambling, but not other types, seemed to protect players against developing gambling problems. This finding suggests that the apparent risk between gambling activities and developing gambling-related problems resides, perhaps primarily or even entirely, among individuals who have high rates of involvement. For others who do not have high rates of involvement, playing these types of games might reflect social setting characteristics (e.g. norms) that encourage control and preclude excessive gambling”.

Similar results were also found in an Australian study by Dr. James Phillips and his colleagues in a 2013 issues of the Journal of Gambling Studies. A 2009 study by Dr. Thomas Holtgraves in the journal Psychology of Addictive Behaviors analysed all data from population-based surveys conducted in Canada between 2001 and 2005 comprising 21,374 participants (including 12,229 who had gambled in the past year). Using the Problem Gambling Severity Index to assess problem gambling, the study found that horse race gamblers had the lowest prevalence rates of problem gambling along with those that played bingo and bought raffle tickets (3%). Some types of gambling activity such as sports betting (25%) and playing video lottery terminals (18%) were much higher.

The most recent British Gambling Prevalence Survey [BGPS] published in 2011 reported that the most popular British gambling activity was playing the National Lottery (59%), a slight increase in participation from 2007 (57%). The prevalence of past-year betting on horse races was 16%. Among past year gamblers, problem gambling prevalence rates were highest among those who had played poker at a pub/club (12.8%), online slot machine games (9.1%) and fixed odds betting terminals (8.8%). The lowest problem gambling rates were among those that played the National Lottery (1.3%) and scratchcards (2.5%). Horse race gamblers also had one of the lower prevalence rates for problem gambling (2.7%). However, problem gamblers also gamble on many different activities and problem gambling prevalence was highest among those that gambled on nine or more different activities on a regular basis (28%).

More recently in 2014, Carla Seabury and Heather Wardle published an overview of gambling behaviour in England and Scotland by combining the data from the Health Survey for England and Scottish Health Survey (n=11,774 participants). It was reported that two-thirds of the sample (65%) had gambled in the past year, with men (68%) gambling more than women (62%). The findings were similar to the previous BGPS reports and showed that in terms of past-year gambling, the most popular forms of gambling were playing the National Lottery (52%; 56% males and 49% females) and scratchcards (19%; 19% males and 20% females). One in ten people (10%) had a engaged in horse race betting (12% males and 8% females).

Again, problem gambling rates were also examined by type of gambling activity. Results showed that among past year gamblers, problem gambling was highest among spread betting (20.9%), playing poker in pubs or clubs (13.2%), bet on events other than horse racing with a bookmaker (12.9%), gambling at a betting exchange (10.6%) and playing machines in bookmakers (7.2%). The activities with the lowest rates of problem gambling were playing the National Lottery (0.9%) and scratchcards (1.7%). Problem gambling among horse race gamblers were also among the lowest (2.3%). Problem gambling rates were highest among individuals that had participated in seven or more activities in the past year (8.6%) and lowest among those that had participated in a single activity (0.1%).

Along with Filipa Calado, I recently co-authored two reviews of problem gambling worldwide (one on adult gambling and one of adolescent gambling). None of the studies we reviewed highlighted horse racing to be of particular concern in relation to problem gambling and only two countries (France and Sweden) was horse race betting one of the most preferred and prevalent forms of gambling. Analysis of a 2011 French national prevalence survey by Dr. Jean-Michel Costes reported that horse race betting was fourth in a list of six gambling activities that were most associated with problem gambling (with Rapido [a high event frequency lottery game], sports betting, and poker being the most problematic gambling forms). There is also evidence from gambling treatment service providers that horse race betting is much less of an issue than other forms of gambling. In Finland, the national helpline for problem gamblers, [Peluuri] only 1% of the telephone calls received concern horse betting. In Germany, two studies surveying therapists that treat problem gambling found that the vast majority of treatment was for slot machine gamblers (approximately 75%-80% of clients) whereas treatment for horse race gamblers was 0.6%-1.7% of clients. Unfortunately, the UK problem gambling helpline run by GamCare does not separate horse race betting from any other sports betting in its’ annual helpline statistics. The most recent (2016) GamCare report noted that 11% of their callers concerned betting in a bookmaker’s but this figure included all betting not just horse race betting.

In 2008, I was invited to write a report for the Gambling Commission and reported that internationally, the vast majority of problem gamblers that contact helplines or seek treatment report machine gambling as their primary form of gambling. In Europe many countries report that it is problem EGM gamblers that are most likely to seek treatment and/or contact national gambling helplines (rather than other forms of gambling including horse race betting) including 60% of gamblers seeking help in Belgium, 72% in Denmark, 93% in Estonia, 66% in Finland, 49.5% in France, 83% in Germany, 75% in Spain, and 35% in Sweden.

All data collected in Great Britain and elsewhere in the world demonstrate that horse race betting has a relatively low past-year participation rate. All major literature reviews have concluded that electronic gaming machines tend to have a higher association with problem gambling than other forms of gambling including horse race betting. Although no form of gambling is immune from problem gambling, horse race betting has one of the lowest associations with problem gambling. Furthermore, some analysis of the most recent BGPS data has demonstrated that after controlling for gambling involvement, individuals who engage in horse race betting are significantly less likely to have gambling-related problems than people who did not.

For the vast majority of horse gamblers, the activity is a discontinuous form of gambling in that they make one or a few bets in a small time period but then not bet again for days or weeks. Therefore, the event frequencies for betting on horse racing are much lower than other gambling activities and helps explain why there is a low association with problem gambling compared to activities that have much higher event frequencies (e.g., slot machines, roulette, blackjack, etc.).

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

Further reading

Abbott, M.W.  (2007). Situational factors that affect gambling behavior. In G. Smith, D. Hodgins & R. Williams (Eds.), Research and Measurement Issues in Gambling Studies. pp.251-278. New York: Elsevier.

Calado, F., Alexandre, J. & Griffiths, M.D. (2016). Prevalence of adolescent problem gambling: A systematic review of recent research. Journal of Gambling Studies. doi: 10.1007/s10899-016-9627-5

Calado, F. & Griffiths, M.D. (2016). Problem gambling worldwide: An update of empirical research (2000-2015). Journal of Behavioral Addictions, 5, 592–613.

Costes, J. M., Pousset, M., Eroukmanoff, V., Le Nezet, O., Richard, J. B., Guignard, R., … & Arwidson, P. (2011). Les niveaux et pratiques des jeux de hasard et d’argent en 2010. Tendances, 77(1), 8

Costes, J. M, Eroukmanoff V., Richard, J.B, Tovar, M. L. (2015). Les jeux de hasard et d’argent en France en 2014. Les Notes de l’Observatoire des Jeux, 6, 1-9.

Delfabbro, P.H., King, D.L & Griffiths, M.D. (2012). Behavioural profiling of problem gamblers: A critical review. International Gambling Studies, 12, 349-366.

EMPA Pari Mutuel Europe (2012). Common Position On Responsible Gambling. Brussels: EMPA.

GamCare (2016). Annual Statistics 2015/2016. London: GamCare.

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

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

Griffiths, M.D. (2008). Impact of high stake, high prize gaming machines on problem gaming. Birmingham: Gambling Commission.

Griffiths, M.D. (2016). Problem gambling and gambling addiction are not the same. Journal of Addiction and Dependence, 2(1), 1-3.

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

Holtgraves, T. (2009). Gambling, gambling activities, and problem gambling. Psychology of Addictive Behaviors, 23(2), 295-302.

LaPlante, D.A., Nelson, S.E., LaBrie, R.A., & Shaffer, H.J. (2009). Disordered gambling, type of gambling and gambling involvement in the British Gambling Prevalence Survey 2007. The European Journal of Public Health, 21, 532–537

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

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

Phillips, J.G., Ogeil, R., Chow, Y.W., & Blaszczynski, A. (2013). Gambling involvement and increased risk of gambling problems. Journal of Gambling Studies, 29(4), 601-611.

Seabury, C. & Wardle, H. (2014). Gambling behaviour in England and Scotland. Birmingham: Gambling Commission.

Sussman, S., Lisha, N. & Griffiths, M.D. (2011). Prevalence of the addictions: A problem of the majority or the minority? Evaluation and the Health Professions, 34, 3-56.

Wardle, H., Moody. A., Spence, S., Orford, J., Volberg, R., Jotangia, D., Griffiths, M.D., Hussey, D. & Dobbie, F. (2011).  British Gambling Prevalence Survey 2010. London: The Stationery Office.

Wardle, H., Sproston, K., Orford, J., Erens, B., Griffiths, M. D., Constantine, R., & Pigott, S. (2007). The British Gambling Prevalence Survey 2007. London: National Centre for Social Research.

Feeling hot, hot, hot: A brief look at sex and the sun

Most people now accept that weather can affect mood state and for some people can lead to extreme depression in the form of Seasonal Affective Disorder. There also seems to be some evidence that weather can affect people’s sex lives. Being too hot or too cold is likely to lessen the desire to engage in sexual behaviour. Most academic research appears to indicate that sex drives are higher in spring and summer. One of the reasons given for this is that during spring and summer, there is more sun, and that a particular hormone – Melanocyte Stimulating Hormone (MSH) – stimulates sex, particularly in women.

Sex-and-the-sun-online-300x300@2x-300x195@2x

A number of studies have also indicated that during the spring and summer months, the body produces more seretonin (the so-called ‘feel good neurotransmitter’) because increased luminosity of sunlight. During the winter months as the amount of sunlight decreases, the body produces more melatonin, and this appears to inhibit sex drives. However, there is wide individual variation and the weather and subsequent hormone stimulation differs highly from one person to the next. As an online article by Shiv Joshi confirms:

“Sunlight has a direct effect on the brain’s serotonin production, according to researchers at the Human Neurotransmitter Laboratory and Alfred and Baker Medical Unit, Baker Heart Research Institute, Australia. Our serotonin levels increase with increase in luminosity. And how does that matter? Among other things, serotonin also regulates arousal, says Ray Sahelian, MD, author of Mind Boosters…Not just serotonin, but sunlight affects many other hormones in our body as well, some of which are associated with mood and pleasure feelings, according to professor Carmen Fusco, an instructor in pharmacology. It decreases melatonin, norepinephrine, and acetylcholine and increases cortisol, serotonin, GABA, and dopamine. The summer heat is good for your sex life too. It works on your muscles, by relaxing them and intensifies sensations of the skin. Further, the heat slows us down. This helps us get in touch with our more subdued sensual side, according to psychologist Stella Resnick, PhD, author of The Pleasure Zone”.

German researchers Winfried März and colleagues examined the relationship between vitamin D production (aided by sunny weather) and sex hormones (published a 2010 issue of the journal Clinical Endocrinology). In a study of 2,299 men, the researchers found that levels of Vitamin D were associated with androgen (i.e., testosterone) production with peak levels in August (the sunniest time of year in Germany). They concluded that testosterone and Vitamin D levels “are associated in men and reveal a concordant seasonal variation. Randomized controlled trials are warranted to evaluate the effect of vitamin D supplementation on androgen levels”. The study was replicated by Dr. Katharina Nimptsch and her colleagues among a sample of 1,362 men (also published in the same journal in 2012), and they found the same association between Vitamin D and testosterone production (although they found no seasonal effect). However, a more recent 2014 study published by Dr. Elizabeth Lerchbaim and her colleagues in the journal Andrology found no association (but it was on a much smaller sample of 225 men).

Although I have been unable to track down the academic source, an article by Sam Rider in Coach Magazine claimed that:

 “Exposing the skin to sunlight for just 15-20 minutes can raise your testosterone levels by 120%, says a report from Boston State Hospital in the US. The research also found that the hormone increased by a whopping 200% when genital skin was exposed to the sun. Stick to the privacy of your own garden though – we don’t want any arrests”.

In previous blogs I briefly reviewed some of the many studies into courtship requests by Dr. Nicolas Guéguen (which you can read here and here). In one of his studies (published in a 2013 issue of Social Influence), Guéguen examined the effect of sunshine on romantic relationships (reasoning that sunny weather puts people in a better mood than non-sunny weather). In this study, an attractive 20-year old man approached young women walking alone in the street and asked them for their telephone number in two conditions (sunny or cloudy days). The temperature was controlled for and all days of the experiment were dry. The results showed that more women gave the man their telephone numbers on the sunny days. Guéguen concluded that positive mood induction by the sun may explain the success in courtship solicitation.

Finally, in his 2009 book Forensic and Medico-legal Aspects of Sexual Crimes and Unusual Sexual Practices, Dr. Aggrawal was quoted as saying that “like allergies, sexual arousal may occur from anything under the sun including the sun”. In fact, Aggrawal’s book arguably contains the most references to fetishes that concern the weather. This includes fetishes and paraphilias in relation to sexual arousal to sunny weather (actirasty), sexual arousal from the cold or winter (cheimaphilia), sexual arousal from snow (chionophilia), sexual arousal from thunderstorms (brontophilia), sexual arousal from thunder and lightning (keraunophilia), sexual arousal from fog (nebulophilia), sexual arousal from rain and being rained upon (ombrophilia and pluviophilia), and love of thunder (tonitrophilia). However, as far as I am aware, no scientific research has ever investigated any of these alleged fetishes.

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

Further reading

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

Amanad, V. (2012). Does weather affect your sex drive? Only My Health, June 29. http://www.onlymyhealth.com/does-weather-affect-your-sex-drive-1340990772

Guéguen, N. (2013). Weather and courtship behavior: A quasi-experiment with the flirty sunshine. Social Influence, 8, 312-319.

Herbert, E. (2009). Sex: Weather-driven desire? Elle, July 28. Located at: http://www.elle.com/life-love/sex-relationships/sex-tips-women

Hurwood, B.J. (1965). The Golden Age of Erotica. Los Angeles, CA: Sherbourne Press.

Joshi, S. (2010). Summer and intimacy: Felling hot, hot, hot. Complete Wellbeing, May 11. Located at: http://completewellbeing.com/article/feeling-hot-hot-hot/

Lerchbaum, E., Pilz, S., Trummer, C., Rabe, T., Schenk, M., Heijboer, A. C., & Obermayer‐Pietsch, B. (2014). Serum vitamin D levels and hypogonadism in men. Andrology, 2(5), 748-754.

Nimptsch, K., Platz, E. A., Willett, W. C., & Giovannucci, E. (2012). Association between plasma 25‐OH vitamin D and testosterone levels in men. Clinical Endocrinology, 77(1), 106-112.

Rider, S. (2015). How to boost your testosterone levels (the natural way). Coach Magazine, October 5. Located at: http://www.coachmag.co.uk/lifestyle/1558/10-ways-boost-testosterone

Wehr, E., Pilz, S., Boehm, B. O., März, W., & Obermayer‐Pietsch, B. (2010). Association of vitamin D status with serum androgen levels in men. Clinical Endocrinology, 73(2), 243-248.

General selection: Is voluntary self-exclusion a good proxy measure for problem gambling?

A couple of months ago, Dr. Michael Auer and I published a short paper in the Journal of Addiction Medicine and Therapy (JAMT) critically addressing a recent approach by researchers that use voluntary self-exclusion (VSE) by gamblers as a proxy measure for problem gambling in their empirical studies. We argued that this approach is flawed and is unlikely to help in developing harm-minimization measures.

For those who don’t know, self-exclusion practices typically refer to the possibility for gamblers to voluntarily ban themselves from playing all (or a selection of) games over a predetermined period. The period of exclusion can typically be chosen by the gambler although some operators have non-negotiable self-exclusion periods. Self-exclusion in both online sites and offline venues has become an important responsible gambling practice that is widely used by socially responsible operators.

There are many reasons why players self-exclude. In a 2011 study in the Journal of Gambling Studies by Dr. Tobias Hayer and Dr. Gerhard Meyer, players frequently reported excluding as a preventive measure and annoyance with the gambling operator as reasons for VSE. Furthermore, only one-fifth of self-excluders reported to be problem gamblers (21.2%). A recent 2016 (conference) paper by Dr. Suzanne Lischer (2016) reported that in a study of three Swiss casinos, 29% of self-excluders were pathological gamblers, 33% were problem gamblers, and 38% were recreational gamblers. Given that many voluntary self-excluders do not exclude themselves for gambling-related problems, Dr. Lischer concluded that self-exclusion is not a good indicator of gambling-related problems. In line with these results, a 2015 study published in International Gambling Studies led by Simo Dragicevic compared self-excluders with other online players and reported no differences in the (i) mean number of gambling hours per month or (ii) minutes per gambling session. The study also reported that 25% of players self-excluded within one day of their registration with the online operator. This could also be due to the fact that online players can self-exclude with just a few mouse-clicks.

post-featured-image-glasgow

Most studies to date report that the majority of voluntary self-excluders tend to be non-problem gamblers. Additionally, in 2010, the Australian Productivity Commission reported 15,000 active voluntary self-exclusions from 2002 to 2009 and that this represented only 10-20% of the population of problem gamblers. This means that in addition to most self-excluders being non-problem gamblers, that most problem gamblers are not self-excluders. This leads to the conclusion that there is little overlap between problem gambling and self-excluding.

Over the decade, analytical approaches to harm minimization have become popular. This has led to the development of various tracking tools such as PlayScan (developed by Svenska Spel), Observer (developed by 888.com), and mentor (developed by neccton and myself). Furthermore, regulators are increasingly recognizing the importance of early risk detection via behavioural tracking systems. VSE also plays an important role in this context. However, some systems use VSE as a proxy of at-risk or problem gambling.

Based on the findings from empirical research, self-exclusion is a poor proxy measure for categorizing at-risk or problem gamblers and VSE should not be used in early problem gambling detection systems. The reasons for this are evident:

  • There is no evidence of a direct relationship between self-exclusion and problem gambling. As argued above, self-excluders are not necessarily problem gamblers and thus cannot be used for early risk detection.
  • There are various reasons for self-exclusion that have nothing to do with problem gambling. Players exclude for different reasons and one of the most salient appears to be annoyance and frustration with the operator (i.e., VSE is used as a way of venting their unhappiness with the operator). In this case, an early detection model based on self-exclusion would basically identify unhappy players and be more useful to the marketing department than to those interested in harm minimization
  • Problem gamblers who self-exclude are already actively changing their behaviour. The trans-theoretical ‘stages of change’ model (developed by Dr. Carlo DiClemente and Dr. James Prochaska) argues that behavioural change follows stages from pre-contemplation to action and maintenance. One could argue that the segment of players who self-exclude because they believe their gambling to be problematic are the ones who already past the stages where assistance is usually helpful in triggering action to cease gambling. These players are making use of a harm-minimization tool. The ones actually in need of detection and intervention are the ones who have not yet reached this stage of change yet and are not thinking about changing their behaviour at all. This is one more argument for the inappropriateness of self-exclusion as a proxy for problem gambling.

But what could be done to prevent the development of gambling-related problems in the first place? For the reasons outlined above, we would argue that the attempt to identify problem gambling via playing patterns that are derived from self-excluders does not assist harm minimization. Firstly, this approach does not target problem gamblers, and secondly it does not provide any insights into the prevention of such problems.

It is evident that any gambling environment should strive to minimize gambling-related harm and reduce the amount of gambling among vulnerable groups. It is also known that information that is given to individuals to enable behavioural change should encourage reflection because research has shown that self-monitoring can enable behavioural change in the desired direction. Dr. Jim Orford has also stated that attempts to explain such disparate gambling types from a single theoretical perspective are essentially a fool’s errand. This also complements the notion that problem gambling is not a homogenous phenomenon and there is not a single type of problem gambler (as I argued in my first book on gambling back in 1995). This also goes in line with the belief of Dr. Auer and myself that gambling sites have to personalize communication and offer the right player the right assistance based on their individual playing history. Recent research that Dr. Auer and I have carried out supports this line of thinking.

Studies have also shown that dynamic feedback in the form of pop-up messages has a positive effect on gambling behaviour and gambling-related thoughts. For instance, research from Dr. Michael Wohl’s team in Canada have found that animation-based information enhanced the effectiveness of a pop-up message related to gambling time limits. Our own research has found that an enhanced pop-up message (that included self-appraisal and normative feedback) led to significantly greater number of players ending their session than a simple pop-up message. In a real-world study of online gamblers, we also found that personalized feedback had a significant effect in reducing the time and money spent gambling.

Personalized feedback is a player-centric approach and in addition to gambling-specific research, there is evidence from many other areas that shows the beneficial effects on behavioural change. For instance, personalized messages have shown to enable behavioural change in areas such as smoking cessation, diabetes management, and fitness activity. Contrary to the self-exclusion oriented detection approach, we concluded in our recent JAMT paper that personalized feedback aims to prevent and minimize harm in the first place and is a much better approach to the prevention of problem gambling than using data from those that self-exclude from gambling.

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

 Further reading

Auer, M. & Griffiths, M. D. (2014). Personalised feedback in the promotion of responsible gambling: A brief overview. Responsible Gambling Review, 1, 27-36.

Auer, M. Griffiths, M.D. (2015). The use of personalized behavioral feedback for online gamblers: an empirical study. Frontiers in Psychology, 6, 1406.  doi:10.3389/fpsyg.2015.01406

Auer, M., Griffiths, M.D. (2015). Testing normative and self-appraisal feedback in an online slot-machine pop-up in a real-world setting. Frontiers in Psychology. 6, 339 doi: 10.3389/fpsyg.2015.00339

Auer, M., Littler, A., Griffiths, M. D. (2015). Legal Aspects of Responsible Gaming Pre-commitment and Personal Feedback Initiatives. Gaming Law Review and Economics. 19, 444-456.

DiClemente, C. C., Prochaska, J. O., Fairhurst, S. K., Velicer, W. F., Velasquez, M. M., & Rossi, J. S. (1991). The process of smoking cessation: an analysis of precontemplation, contemplation, and preparation stages of change. Journal of Consulting and Clinical Psychology, 59, 295-304.

Dragicevic, S., Percy, C., Kudic, A., Parke, J. (2015). A descriptive analysis of demographic and behavioral data from Internet gamblers and those who self-exclude from online gambling platforms. Journal of Gambling Studies. 31, 105-132.

Gainsbury, S. (2013). Review of self-exclusion from gambling venues as an intervention for problem gambling. Journal of Gambling Studies, 30, 229-251.

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

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

Hayer, T., & Meyer, G. (2011). Self-exclusion as a harm-minimization strategy: Evidence for the casino sector from selected European countries. Journal of Gambling Studies, 27, 685-700

Kim, H. S., Wohl, M. J., Stewart, M. K., Sztainert, T., Gainsbury, S. M. (2014). Limit your time, gamble responsibly: setting a time limit (via pop-up message) on an electronic gaming machine reduces time on device. International Gambling Studies, 14, 266-278.

Lischer, S. (2016, June). Gambling-related problems of self-excluders in Swiss casinos. Paper presented at the 16th International Conference on Gambling & Risk Taking, Las Vegas, USA.

Suurvali, H., Hodgins, D. C., Cunningham, J. A. (2010). Motivators for resolving or seeking help for gambling problems: A review of the empirical literature. Journal of Gambling Studies, 26, 1-33

Drowning gory: A brief look at quicksand fetishes

“[There] is a natural or unexpected form of bondage where girls step into cement, wander into spider webs or sink into quicksand. Often girls find themselves in perilous or humiliating situations like being in danger of sinking under quicksand or unable to stop the advances of a horny teenager after having stepped into superglue” (Weird and Sexy website).

I used the opening quote in a previous blog on ‘stuck fetishism’ but is just as appropriate in the context of this article on quicksand fetishes. Such fetishes appear to be a sub-type of taphephilia (that I also examined in a previous blog on claustrophilia [sexual arousal from being in confined spaces]). Dr. Anil Aggrawal in his book Forensic and Medico-legal Aspects of Sexual Crimes and Unusual Sexual Practices defines taphephilia as deriving sexual pleasure and arousal from being buried alive. I noted in my previous blog that when I first read about this paraphilia I had major doubts about it’s existence until I came across groups such as the Six Feet Under Club and the Buried Stories website. As the Buried Stories homepage asserts:

“Buried or burial whilst still alive is a nightmare to some but a joy or fetish to others. The desire to be boxed, bagged and buried is a great turn on for many. The feeling of utter helplessness as the sounds of the first shovel of dirt hits the top of their coffin. The fantasy may also involve being placed in a casket, bodybag, or other enclosure before being buried either on the beach, in dirt or even in quicksand. Encased or entombed, enclosed or just bagged. ‘Buried Stories’ contains stories of people being buried, sunk in quicksand or encased within an enclosure. Some may have acted out their desires whilst others have written about their fantasy to share with you”

07-1457352185-quicksand

An article about ‘stuck fetishism’ (on the now defunct Nation Master website) provided a typology of all the different types of stuck fetishes. There was no empirical evidence supporting the typology but has good face validity based on what I have read about the topic. The different type of stuck fetishism includes (i) sticky substance immobilization fetishes, (ii) non-sticky substance immobilization fetishes, (iii) situational immobilization fetishes, (iv) perceived situational immobilization fetish, (v) stuck clothing fetish, (vi) stuck transport fetish, (vii) stuck transformation fetish, (viii) stuck multi-person fetish, and (ix) stuck conjoinment fetish (for a detailed description of each of these fetishes, see my previous blog on stuck fetishism). These fetishes – while specific – may not be mutually exclusive, and some stuck fetishists may gain sexual arousal from more than one of these scenario. Quicksand fetishes are an example of ‘non-sticky substance immobilization fetishes’ (i.e., the individual is rendered immobile and derives sexual arousal from a substance that is not sticky but stops the individual from being able to move such as quicksand, mud or cement).

In an article on the Cracked.com website, ‘Girls stuck in quicksand’ was one of the six most bizarre safe for work fetishes they listed. The article noted:

“There’s no official name for this weird fetish – yet – but that doesn’t mean the Internet isn’t full of videos and photos depicting it. For some people, the idea of a person, especially a woman, nearly drowning in quicksand is quite the turn on. Perhaps these viewers imagine themselves as a hero who can swoop in and save the day. Or maybe these people are aroused by the woman’s fear. Either way, this is a fetish we hope you won’t experience any time soon. This is a perfect example of a nearly ‘safe for work’ fetish – it requires no nudity or sex, and it in fact involves a situation in which sex would be utterly impossible. It’s people who get aroused at the sight of fully clothed women sinking in quicksand”.

The article then went on to say things that I have confirmed for myself when visiting such sites as Quicksand Visuals and Quicksand Fans:

 

“A cursory search online would reveal tons of sites dedicated to compiling clips from various sources of girls drowning in quicksand, and then there are the niche video sites dedicated to providing original content (there probably is a booming industry in quicksand pit installation these days). On those sites, elaborate storylines are created to justify how these lovely ladies came to be trapped in the unforgiving, bottomless pit of certain-yet-sexy death. So … maybe the quicksand thing triggers some ‘damsel in distress’ response in the [brain’s cortex]? If there’s anything lonely Internet tough guys love, it’s sitting behind their keyboards visualizing all the many ways they would totally jump in and save the unfortunate lady fake drowning in a boggy marsh”.

Reference was made in the paragraph above to a “damsel in distress response”. In a previous blog I examined ‘damsel in distress’ (DiD) fetishes. I noted in thatblog that (like quicksand fetishes) it is mostly males who have DiD fetishes and that they can be very specific including (but not restricted to) such things as (i) ‘kidnap and rescue’ fetishes (sexual pleasure from watching or engaging in women being kidnapped and/or rescued from potentially life-threatening scenarios where they are cuffed, bound and/or controlled by another person or persons), (ii) tickle bondage fetishes (sexual pleasure from watching or tickling women while they are tied up), (iii) quicksand fetishes (sexual pleasure from watching women sink in quicksand), and (iv) ‘pedal pumping’ and ‘cranking’ fetishes (sexual pleasure from watching women stranded in their cars with repeated pressing of the gas pedal and revving up – which also has elements of foot fetishism – while turning the key in an attempt to get the engine to start).

Unsurprisingly, there are no academic papers on quicksand fetishes and very few articles of any description on the topic. One article by Jagger Gravning on the Motherboard news site wrote an interesting article on ‘The fetish for video game characters trapped in quicksand’ (and could arguably be classed as a sub-type of quicksand fetishism). This could also be classed as a type of toonophilia (sexual arousal from cartoon characters) that I also examined in a previous blog.

Gravning’s article concentrated on the ‘quicksand artists’ (and other types of fetish illustrations on the Deviant Art website) rather than the quicksand fetishists (such as A-020, an artist who draws women trapped in quicksand for the titillation of those with a predilection for such imagery”) as well as interviewing various academics about the fetishistic side of the practice. However, A-020 admitted he was also a quicksand fetishist. When asked about the origins of his fetish, which he claimed were integrated with other types of fetish behaviour: “I think it could be a distant cousin of fetishes like vore and bondage with a combination of muddy and stuck elements. Those similarities may be why I find it interesting mixed with an attractive female”.

Gravning wanted to know whether witnessing human beings stuck in quicksand in cartoons over and over as a child possibly lead to this unusual fetish. She asked Dr. Catherine Salmon, an evolutionary psychologist, who wrote the book Warrior Lovers: Erotic Fiction, Evolution and Female Sexuality:

“It could be something like that. Whether it’s quicksand or tar pits, there are things like that in children’s cartoons. It could be something as simple as that. Part of it is the damsel in distress kind of image. Watching ‘Wonder Woman’ caught in that kind of circumstance when people are younger—[it’s] an image that’s eroticized, a very sexually drawn, very feminine image. And they might enjoy watching that sort of thing or the struggle, as she’s trying to get out of whatever that circumstance is. There are a lot of unusual circumstances in cartoons and fantasy and you may get aroused while you’re watching it and then carry some of that too”.

Gravning also interviewed Dr. Elizabeth Larson, the Director of the Seattle Institute for Sex Therapy, Education and Research. Like me, Dr. Larson sees the development of such fetishes as most likely the consequence of associative pairing early in childhood or adolescence. More specifically she noted:

“These associations that come to be associated with an aroused state and are ‘accidents of learning’. These accidents of learning are most potent in the early sexual learning history, although it’s not impossible later. They don’t have to be exactly like the fantasy that comes. It just has to resemble it…[Quicksand fetishists] probably fantasized and got into the feeling that goes with that, not just watching. It could [also] be identifying with it. The kid imagining himself stuck in quicksand in the victim’s place, for example, could be part of its erotic appeal. You could either be observing it or experiencing it. You could be doing both at the same time in a fantasy. Some evidence certainly suggests that sexual patterns are already there, for sure in males, by the age of eight [years of age]. They may or may not have begun masturbating to fantasies until adolescence but something is going on internally at a very young age”.

 Gravning also spoke to the US computational neuroscientist Dr. Ogi Ogas who was quoted as saying: 

“While uncommon, the notion of being smothered or trapped is universal in the sense that it exists to greater and lesser degrees ‘all over’ [the world]. It’s not just one or two people that have it. It is found in a lot of places. Clearly our normal brain design is not that far removed from [wanting to be] enveloped. It’s probably something to do with our tactile system, our touch system of the brain, that’s quite naturally wired to our sexual arousal system. The tactile system is also interconnected with sensations like being smothered and being interred, being doused with water. Probably, somehow – and I’m speculating here – that’s what got crossed up for whatever reasons…A quirk in the brain, essentially…As we’re learning more about the genetics of brain construction, we’re coming to understand the genetic expression that leads to different neural wiring is highly variable and dependent on so many things [that] could happen in the womb, things that happen in early life, different environmental things. There’s just myriad, myriad factors that can cause unusual neural wiring to arise. Following this logic, some boy who just happens to have the notion of being smothered or trapped somehow interconnected to his arousal system becomes aroused when he sees an attractive woman struggling in quicksand, and that image burns into his mind”.

I have no idea how common quicksand fetishes are (but I would suspect it’s a very niche fetish), and I doubt whether the fetish is the only type of fetishistic behaviour among such people as there is so much crossover with many other different niche fetishes (stuck fetishism, buried fetishism, etc.). As with many other extreme sexual behaviours I have examined, I can’t see this becoming an area of serious academic study any time soon, but that doesn’t mean it’s not an interesting topic.

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

Further reading

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

Encyclopedia Dramatica (2016). Quicksand fetish. May 4. Located at:https://encyclopediadramatica.se/Quicksand_Fetish

Gravning, J. (2015). The fetish for video game characters trapped in quicksand. Motherboard, March 19. Located at: http://motherboard.vice.com/read/quicksand

Ntumy, E.K. (2013). The 6 most bizarre safe for work fetishes. Cracked.com. November 7. Located at: http://www.cracked.com/article_20691_the-6-most-bizarre-safe-work-fetishes.html

Pop Crunch (2010). Quicksand, pedal pumping, tickle bondage, women in distress in general. May 11. Located at: http://www.popcrunch.com/the-17-most-wtf-fetishes-imaginable/

Surprise, surprise: A brief overview of our recent papers on strange addictions and behaviours

Following my recent blogs where I outlined some of the papers that my colleagues and I have published on mindfulness, Internet addiction, gaming addiction, youth gambling, workaholism, exercise addiction, and sex addiction, here is a round-up of recent papers that my colleagues and I have published on strange and/or surprising addictions and behaviours.

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.

  • Background: Muscle dysmorphia (MD) describes a condition characterised by a misconstrued body image in which individuals who interpret their body size as both small or weak even though they may look normal or highly muscular. MD has been conceptualized as a type of body dysmorphic disorder, an eating disorder, and obsessive–compulsive disorder symptomatology. Method and aim: Through a review of the most salient literature on MD, this paper proposes an alternative classification of MD – the ‘Addiction to Body Image’ (ABI) model – using Griffiths (2005) addiction components model as the framework in which to define MD as an addiction. Results: It is argued the addictive activity in MD is the maintaining of body image via a number of different activities such as bodybuilding, exercise, eating certain foods, taking specific drugs (e.g., anabolic steroids), shopping for certain foods, food supplements, and the use or purchase of physical exercise accessories). In the ABI model, the perception of the positive effects on the self-body image is accounted for as a critical aspect of the MD condition (rather than addiction to exercise or certain types of eating disorder). Conclusions: Based on empirical evidence to date, it is proposed that MD could be re-classified as an addiction due to the individual continuing to engage in maintenance behaviours that may cause long-term harm.

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.

  • Background: Following the publication of our paper ‘Muscle Dysmorphia: Could it be classified as an addiction to body image?’ in the Journal of Behavioral Addictions, two commentaries by Jon Grant and Johanna Nieuwoudt were published in response to our paper. Method: Using the ‘addiction components model’, our main contention is that muscle dysmorphia (MD) actually comprises a number of different actions and behaviors and that the actual addictive activity is the maintaining of body image via a number of different activities such as bodybuilding, exercise, eating certain foods, taking specific drugs (e.g., anabolic steroids), shopping for certain foods, food supplements, and purchase or use of physical exercise accessories. This paper briefly responds to these two commentaries. Results: While our hypothesized specifics relating to each addiction component sometimes lack empirical support (as noted explicitly by both Nieuwoudt and Grant), we still believe that our main thesis (that almost all the thoughts and behaviors of those with MD revolve around the maintenance of body image) is something that could be empirically tested in future research by those who already work in the area. Conclusions: We hope that the ‘Addiction to Body Image’ model we proposed provides a new framework for carrying out work in both empirical and clinical settings. The idea that MD could potentially be classed as an addiction cannot be negated on theoretical grounds as many people in the addiction field are turning their attention to research in new areas of behavioral addiction.

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, 10(3): e0122866. doi:10.1371/ journal.pone.0122866

  • Dancing is a popular form of physical exercise and studies have show that dancing can decrease anxiety, increase self-esteem, and improve psychological wellbeing. The aim of the current study was to explore the motivational basis of recreational social dancing and develop a new psychometric instrument to assess dancing motivation. The sample comprised 447 salsa and/or ballroom dancers (68% female; mean age 32.8 years) who completed an online survey. Eight motivational factors were identified via exploratory factor analysis and comprise a new Dance Motivation Inventory: Fitness, Mood Enhancement, Intimacy, Socialising, Trance, Mastery, Self-confidence and Escapism. Mood Enhancement was the strongest motivational factor for both males and females, although motives differed according to gender. Dancing intensity was predicted by three motivational factors: Mood Enhancement, Socialising, and Escapism. The eight dimensions identified cover possible motives for social recreational dancing, and the DMI proved to be a suitable measurement tool to assess these motives. The explored motives such as Mood Enhancement, Socialising and Escapism appear to be similar to those identified in other forms of behaviour such as drinking alcohol, exercise, gambling, and gaming.

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

  • Although recreational dancing is associated with increased physical and psychological well-being, little is known about the harmful effects of excessive dancing. The aim of the present study was to explore the psychopathological factors associated with dance addiction. The sample comprised 447 salsa and ballroom dancers (68% female, mean age: 32.8 years) who danced recreationally at least once a week. The Exercise Addiction Inventory (Terry, Szabo, & Griffiths, 2004) was adapted for dance (Dance Addiction Inventory, DAI). Motivation, general mental health (BSI-GSI, and Mental Health Continuum), borderline personality disorder, eating disorder symptoms, and dance motives were also assessed. Five latent classes were explored based on addiction symptoms with 11% of participants belonging to the most problematic class. DAI was positively associated with psychiatric distress, borderline personality and eating disorder symptoms. Hierarchical linear regression model indicated that Intensity (ß=0.22), borderline (ß=0.08), eating disorder (ß=0.11) symptoms, as well as Escapism (ß=0.47) and Mood Enhancement (ß=0.15) (as motivational factors) together explained 42% of DAI scores. Dance addiction as assessed with the Dance Addiction Inventory is associated with indicators of mild psychopathology and therefore warrants further research.

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Greenhill, R. & Griffiths, M.D. (2015). Compassion, dominance/submission, and curled lips: A thematic analysis of dacryphilic experience. International Journal of Sexual Health, 27, 337-350.

  • Objectives: Dacryphilia is a non-normative sexual interest that involves enjoyment or arousal from tears and crying, and to date has never been researched empirically. The present study set out to discover the different interests within dacryphilia and explore the range of dacryphilic experience. Methods: A set of online interviews were carried out with individuals with dacryphilic preferences and interests (six females and two males) from four countries. The data were analyzed for semantic and latent themes using thematic analysis. Results: The respondents’ statements focused attention on three distinct areas that may be relevant to the experience of dacryphilia: (i) compassion; (ii) dominance/submission; and (iii) curled-lips. The data provided detailed descriptions of features within all three interests, which are discussed in relation to previous quantitative and qualitative research within emotional crying and tears, and the general area of non-normative sexual interests. Conclusions: The study suggests new directions for potential research both within dacryphilia and with regard to other non-normative sexual interests.

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

  • Aims: Recent research has suggested that for some individuals, educational studying may become compulsive and excessive and lead to ‘study addiction’. The present study conceptualized and assessed study addiction within the framework of workaholism, defining it as compulsive over-involvement in studying that interferes with functioning in other domains and that is detrimental for individuals and/or their environment. Methods: The Bergen Study Addiction Scale (BStAS) was tested — reflecting seven core addiction symptoms (salience, mood modification, tolerance, withdrawal, conflict, relapse, and problems) — related to studying. The scale was administered via a cross-sectional survey distributed to Norwegian (n = 218) and Polish (n = 993) students with additional questions concerning demographic variables, study-related variables, health, and personality. Results: A one-factor solution had acceptable fit with the data in both samples and the scale demonstrated good reliability. Scores on BStAS converged with scores on learning engagement. Study addiction (BStAS) was significantly related to specific aspects of studying (longer learning time, lower academic performance), personality traits (higher neuroticism and conscientiousness, lower extroversion), and negative health-related factors (impaired general health, decreased quality of life and sleep quality, higher perceived stress). Conclusions: It is concluded that BStAS has good psychometric properties, making it a promising tool in the assessment of study addiction. Study addiction is related in predictable ways to personality and health variables, as predicted from contemporary workaholism theory and research.

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

  • Background and aims: ‘Study addiction’ has recently been conceptualized as a behavioral addiction and defined within the framework of work addiction.  Using a newly developed measure to assess this construct, the Bergen Study Addiction Scale (BStAS), the present study examined the one-year stability of study addiction and factors related to changes in this construct over time, and is the first longitudinal investigation of study addiction thus far. Methods: The BStAS and the Ten Item Personality Inventory (TIPI) were administered online together with questions concerning demographics and study-related variables in two waves. In Wave 1, a total of 2,559 students in Norway and 2,177 students in Poland participated. A year later, in Wave 2, 1,133 Norwegians and 794 Polish who were still students completed the survey. Results: The test-retest reliability coefficients for the BStAS revealed that the scores were relatively stable over time. In Norway scores on the BStAS were higher in Wave 2 than in Wave 1, while in Poland the reverse pattern was observed. Learning time outside classes at Wave 1 was positively related to escalation of study addiction symptoms over time in both samples. Being female and scoring higher on neuroticism were related to an increase in study addiction in the Norwegian sample only. Conclusion: Study addiction appears to be temporally stable, and the amount of learning time spent outside classes predicts changes in study addiction one year later.

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

Further reading

Greenhill, R. & Griffiths, M.D. (2014). The use of online asynchronous interviews in the study of paraphilias. SAGE Research Methods Cases. Located at: http://dx.doi.org/10.4135/978144627305013508526

Greenhill, R. & Griffiths, M.D. (2016). Sexual interest as performance, intellect and pathological dilemma: A critical discursive case study of dacryphilia. Psychology and Sexuality, 7, 265-278.

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

Griffiths, M.D. (1999). Dying for it: Autoerotic deaths. Bizarre, 24, 62-65.

Griffiths, M.D. (2001). Stumped! Amputee fetishes. Bizarre, 44, 70-74.

Griffiths, M.D. (2001). Heaven can wait: The psychology of near death experiences. Bizarre, December, 63-66.

Griffiths, M.D. (2012). The use of online methodologies in studying paraphilia: A review. Journal of Behavioral Addictions, 1, 143-150.

Griffiths, M.D. (2013). Bizarre sex. New Turn Magazine, 3, 49-51.

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

Under the influence: Ten things I’ve learned from David Bowie

It’s now been a year since the tragic death of David Bowie and this is my fourth blog on him in that period (my others being my personal reflections on the psychology of Bowie, Bowie and the Beatles, and Bowie and the occult). Outside of my own friends and family, it’s still Bowie’s death that has affected me the most psychologically but at least I still have his music to listen to. Bowie inspired millions of people in many different ways. This blog looks at the things that I have learned from Bowie and how he influenced my career.

Persevere with your life goals – Most people are aware that it took years for Bowie to have has first hit single (‘Space Oddity’, 1969), five years after his first single (‘Liza Jane’, 1964). Even after the success of ‘Space Oddity’, it took another three years before he had his second hit single (‘Starman’, 1972) and in the early 1970s there were many who thought he would be a ‘one-hit wonder’ and a small footnote in music history. Bowie never gave up his quest for musical stardom and is arguably one of the best examples of the proverb If at first you don’t succeed, try, try again. I’ve often told others that they key to success is being able to learn from your mistakes and being able to handle rejection (which for academics is having papers rejected, grant bids rejected, and attempts at promotion rejected, etc.). Bowie personified perseverance and for this quality alone I am very grateful as it has been the bedrock of my career to date.

Encourage teamwork and collaboration – Despite being a solo artist for the vast majority of his post-1969 career (Tin Machine being the most high-profile notable exception), Bowie was (like me) a ‘promiscuous collaborator’ and much of his success would not have been possible without a gifted team around him whether it be his inner circle of musicians (Mick Ronson, Carlos Alomar, Robert Fripp, Mike Garson, etc.), his producers (Tony Visconti, Nile Rogers, Ken Scott, etc.), co-writers and inspirators (Iggy Pop, Lou Reed, Brian Eno, John Lennon, etc.), or those he jointly released music with (Mott The Hoople, Queen, Arcade Fire, Pet Shop Boys, Placebo, to name just a few). I have carried out and published research with hundreds of people during my 30-year academic career, and like Bowie, some are one-off collaborations and others are lifelong collaborations. Bowie taught me that although I can do some things by myself, it is the working with others that brings out the best in me.

Experiment to the end – Bowie was never afraid to experiment and try new things whether it was musical, pharmacological, spiritual, or sexual. Mistakes were part of the learning process and he pursued this – especially musically – until the very end of his life (for instance, on his ★ [Blackstar] album where he employed a local New York jazz combo led by saxophonist Donny McCaslin). Failure is success if we learn from it and this is one of the maxims that I live my life by. Bowie taught me that you can have lots of other interests that can be rewarding even if you are not as successful as your day job. Bowie liked to act (and obviously had some success in this area) and also liked to paint (but had much less success here than his other artistic endeavours). By any set of criteria, I am a successful academic but I also like to write journalistically and engage in a wide variety of consultancy (areas that I have had some success) and I like writing poetry (something that I have not been successful financially – although I did win a national Poetry Today competition back in 1997 and have published a number of my poems). Bowie taught me that success in one area of your life can lead to doing other more experimental and rewarding activities even if they are not as financially lucrative.

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Push yourself (even in the bad times) – One of the things I love about Bowie was his ability to carry on working and being productive even when he was not at his physical best. Nowhere is this more exemplified than working on the ★ LP while undergoing chemotherapy for his liver cancer. There are also other times in his life such as when he was at the height of his cocaine addiction in 1975 where he produced some of the best music of his career (most notably the Young Americans and Station to Station LPs, the latter of which is one of my all-time favourite records). I have had a few low periods in my life due to various health, relationship and/or personal issues but I have learned through experience that work is a great analgesic and that even when you are at your lowest ebb you can still be highly productive.

Have a Protestant work ethic – Bowie was arguably one of the most hard-working musicians of all time and had what can only be described as a Protestant work ethic from the early 1960s right up until his heart attack in 2004. I am a great believer in the philosophy that “you get out what you put in” and Bowie exemplified this. Andy Warhol told Lou Reed while he was in the Velvet Underground that he should work hard, because work is all that really matters (and was the subject of the song ‘Work’ on the seminal Songs For Drella LP by Reed and John Cale). Bowie also appeared to live by this mantra and is something that I adhere to myself (and is why I am often described as being a workaholic). While Bowie isn’t my only role model in this regard, he’s certainly the most high-profile.

Lead by example but acknowledge your influences – Bowie had a unique gift in being able to borrow from his own heroes but turn it into something of his own (without ever forgetting his own heroes and influences – his Pin Ups LP probably being the best example of this). One of my favourite phrases is Don’t jump on the bandwagon, create it”, and this has as underpinned a lot of the research areas that I have initiated and is something that I learned from Bowie. Maybe Bowie is a case of the quote often attributed to Oscar Wilde that “talent borrows, genius steals”.

Promote yourself – If there is one thing that Bowie was gifted in as much as his songwriting, it was his own art of self-promotion. Bowie always had the knack to generate news stories about himself and his work without seemingly trying. By the end of his career, it was the act of not saying anything or doing any personal publicity that was just as newsworthy. Bowie intuitively knew how to garner media publicity on his own terms in a way that very few others can. (I also argued that another one of my heroes – Salvador Dali – did the same thing in one of my articles on him in The Psychologist back in 1994). I’d like to think I am good at promoting my work and Bowie is one of my role models in this regard.

Be opportunistic and flexible – If there is one thing besides working hard that sums up my career to date, it is being opportunistic and flexible. As a voracious reader of all things Bowie since my early teens, I always loved Bowie’s sense of adventure and just following paths because they might lead you to something unexpected. Whether it was his use of the ‘cut up’ technique for writing lyrics (developed by Brion Gysin and William S. Burroughs), his use of Brian Eno’s ‘oblique strategy’ cards, or his love of studio improvisation (such as on the Berlin trilogy albums and the Outside LP), Bowie showed that inspiration for his musical and lyrical ideas could come from anywhere – from a person, from a fleeting observation, from something he read, from something he heard or saw in film or TV programme, and from his own life experiences. I too have taken this approach to my work and believe I am a much better person for it.

Be a mentor to others – Whatever career path you follow, mentors are key in developing talent and Bowie was a mentor to many people that he personally worked with (including many of the artists I named in the section on encouraging teamwork and collaboration above) as well as being an inspirational influence to those he never met (including myself).

Learn from those younger and less experienced than yourself – Paradoxically, despite being an influence on millions of people across many walks of life, Bowie was never afraid to learn from those much younger than himself and exemplified the maxim that you’re never too old to learn new things. He loved innovation and ideas and would soak it up from whoever was around him. As I have got older, this is something that I value more and am never afraid to learn from those much younger or seemingly less experienced than myself – particularly my PhD students.

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

Further reading

Buckley, D. (2005). Strange Fascination: David Bowie – The Definitive Story. London: Virgin Books.

Cann, K. (2010). Any Day Now: David Bowie The London Years (1947-1974). Adelita.

Goddard, S. (2015). Ziggyology. London: Ebury Press.

Griffiths, M.D. (1994). Heroes: Salvador Dali. The Psychologist: Bulletin of the British Psychological Society, 7, 240.

Hewitt, P. (2013). David Bowie Album By Album. London: Carlton Books Ltd.

Leigh, W. (2014). Bowie: The Biography. London: Gallery.

Pegg, N. (2011). The Complete David Bowie. London: Titan Books.

Seabrook, T.J. (2008). Bowie In Berlin: A New Career In A New Town. London: Jawbone.

Spitz, M. (2009). Bowie: A Biography. Crown Archetype.

Trynka, P. (2011). Starman: David Bowie – The Definitive Biography. London: Little Brown & Company.

Betting kicks in flicks: A brief look at gambling on film

As a researcher in the gambling studies field and an avid watcher of films, it comes as little surprise that I love watching films where gambling is key to the plot. Occasionally, I write academic papers about gambling portrayals in film (most notably an in-depth look at my favourite gambling film, The Gambler – the original 1974 film starring James Caan in the title role and not the more recent 2014 remake starring Mark Wahlberg – which I published in a 2004 issue of the International Journal of Mental Health and Addiction). I wrote about this paper in a previous blog and I have also written a few blogs where gambling films are central to the articles such as my blog on Philip Seymour Hoffman and his film Owning Mahowny, my blog on the psychology of Columbo (where I argued that gambling and gamblers are central to many of the plot lines), and my blog on the psychopathology of Star Wars (where problem gambling is one of the many disorders that features in the film’s franchise).

casino-movie

The world of gambling and gamblers has been portrayed in many films and in many different ways throughout the years (e.g., The Sting, The Cincinnati Kid, Casino, Owning Mahoney, Rain Man). However, I argued (way back) in a 1989 issue of the Journal of Gambling Behavior that many of these film representations tend to cast gambling in an innocuous light, and often portray gamblers, largely male, as hero figures. I made this observation without doing any systematic review of films containing gambling and my thoughts were purely impressionistic.

A decade ago, Dr. Nigel Turner and his colleagues published a lovely study in the Journal of Gambling Issues examining ‘images of gambling’ in films. They built on Jeffrey Dement’s 1999 book Going for broke: The depiction of compulsive gambling in film. They noted that:

“Dement’s (1999) book, Going for Broke is a thorough examination of movies that depict pathological gambling. He examined a number of films in terms of the extent to which the portrayals delivered accurate and appropriate messages about problem gambling. Although some movies accurately portray the nature of pathological gambling at least during some segments, Dement found that many movies about pathological gambling had irresponsibly happy endings. Film images in some cases reflected societal views on gambling. However, images in films may also alter societal views of gambling (Dement, 1999)…Dement focused only on movies that were about problem and pathological gambling. Many films that depict gambling or have images of gambling that are not about pathological gambling per se. In [our] article we will extend Dement’s work by looking more broadly at films about gambling”.

In their study, Turner and colleagues content analysed 65 films (from an initial list of “several hundred films”) mainly from the two decades prior to the publication of the study. The authors recounted that:

Many of the films we discuss are personal favourites that we have watched several times (e.g., Rounders, The Hustler, Vegas Vacation, The Godfather). Some of the films reviewed in this article have been also discussed by [other scholars]. Some films were included because they were found listed as gambling films in film catalogues or by Web searches for ‘gambling movies’ (e.g., Get Shorty). Other films were suggested to us by recovering pathological gamblers, counsellors specializing in problem gambling, recreational gamblers, video rental store employees, and postings to the bulletin board of Gambling Issues International (a listserve for gambling treatment professionals). Our examination of movies was restricted to movies released in cinemas (i.e., not television), and filmed in English (with one exception, Pig’s Law)…In all cases, either the first or second author viewed each film. In some cases both authors viewed the same film separately. The authors then discussed the themes that they thought were depicted in the film. The authors then collected the descriptions of movies and organized them into general themes”. 

After viewing (and re-viewing) the films, the authors found eight themes (often overlapping) represented in the movies watched. More specifically these were the themes of: (1) pathological gambling (films such as Fever Pitch, The Gambler, Owning Mahowny, Pig’s Law, etc.), (2) the magical skill of the professional gambler (Rain Man, Two For The Money, The Cincinatti Kid, Maverick, etc.), (3) miraculous wins as happy endings (The Cooler, The Good Thief, Two For The Money, etc.), (4) gamblers are suckers (Casino, Croupier, Two For The Money, etc., (5) gamblers cheat (Rounders, The Sting, House of Games, The Grifters, etc.), (6) gambling is run by organized crime (The Godfather, Casino, Get Shorty, etc.), (7) the casino heist (Ocean’s Eleven, The Good Thief, Croupier, etc.), and (8) gambling as a symbolic backdrop to the story (Leaving Las Vegas, Pay It Forward, Fear and Loathing in Las Vegas, etc.).

After this initial content analysis, Dr. Turner and his colleagues organized these eight themes into a general taxonomy of films. They reported that:

“First these films can be divided into two categories: films in which gambling is a central focus of the film, and others where gambling is a relatively minor topic but serves a symbolic role in the film. The films that are about gambling can be further divided into those that present generally negative views of gambling (e.g., pathology, crime, cheating) and those that present a generally positive image of gambling (e.g., magical skills and miraculous wins). The positive image is mainly related to the ability of the player to win (by skill or by miracle), but some of these films also add additional positive images by hinting at a glamorous and exciting lifestyle (The Good Thief, James Bond films, Rounders). Negative images of gambling are more common than positive images of gambling. Negative images were further divided into pathological gambling, suckers, cheaters, organized crime, and robbing casinos”.

They also go on to note that: very few films show ordinary people gambling non-problematically:

“Throughout the history of movies, gambling-related stories have been present. Movies about gambling are most often inhabited by problem gamblers (e.g., The Gambler), cheats (e.g., Shade), criminals (e.g., The Godfather, Ocean’s Eleven), spies (e.g., Diamonds are Forever), people with incredible luck (e.g., Stealing Harvard), and professional gamblers (e.g., Rounders, The Hustler). With the exception of The Odd Couple (1968), we have come across few movies that show ordinary people gambling in a non-problematic manner”.

With regards to problem and pathological gambling they conclude that:

“Some movies provide important insights into the nature of pathological gambling (e.g., The Gambler, Owning Mahowny, The Hustler). However, others make light of the disorder or indulge in the wishful thinking common with pathological gamblers (e.g., Let It Ride, The Cooler, Fever Pitch, The Good Thief). In some movies people develop a problem too quickly (Viva Rock Vegas, Lost in America). Some films take the view that all gamblers are addicted (Croupier, Two for the Money)…Most films about pathological gambling depict a narrow segment of the problem gambling population focusing on the male “action” gambler (see also Griffiths, 2004). Most pathological gamblers simply do not embezzle millions of dollars as in Owning Mahowny or take stupid risks just for the thrill of it as in The Gambler. Films rarely show gamblers hooked on slot machines or other electronic gambling machines even though such machines, where they are available, now account for a majority of problem gamblers in treatment”.

Obviously the sample of films chosen was selective and there were over a hundred films that weren’t analysed. However, even though the study was published ten years ago I don’t think the results (if repeated on more contemporary films) would be particularly different.

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

Further reading

Dement, J.W. (1999) Going for broke: The depiction of compulsive gambling in film. Lanham, MD: The Scarecrow Press, Inc.

Griffiths, M.D. (1989). Gambling in children and adolescents. Journal of Gambling Behavior, 5, 66-83.

Griffiths, M. (2004). An empirical analysis of the film ‘The Gambler’. International Journal of Mental Health and Addiction, 1(2), 39-43.

Gluss, H.M. & Smith, S.E., (2002). Reel people: Finding ourselves in the movies. Keylight: Los Angeles.

Turner, N. E., Fritz, B., & Zangeneh, M. (2007). Images of gambling in film. Journal of Gambling Issues, 20, 117-143.

Come undone: The strange case of the ‘ejaculate fetishist’

In a previous blog I briefly examined semen fetishes and the acts of ‘bukkake’ (most commonly seen in hard core pornographic films where a group of men all simultaneously ejaculate over a women or man), and ‘gokkun’ (where a man or woman consumes the semen of one or more men from a drinking receptacle, e.g., cups, glasses, beakers, etc.). In that article I noted that while there is a fair amount of (non-academic) literature about bukkake, references to semen fetishes appear to be rare with nothing published in academic journals.

However, since writing that article, a case study of a 39-year old man with an ‘ejaculate fetish’ was published in the Journal of Psychiatry by three Turkish medics (Dr. Safak Taktak, Dr. Mustafa Karakus and Dr. Salih Murat Eke) –  ‘The Man Whose Fetish Object is Ejaculate: A Case Report’. (In fact, Dr. Taktak has published a number of interesting case studies of paraphilic behaviour including shoe fetishism and paraphilias more generally [see ‘Further reading’ below]). Following a crime of molestation, the man had been arrested by Turkish police. (In fact, it turned out the man had already spent 10 years in prison for armed robbery when he was in his twenties and was released from jail when he was 31 years old).

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The judicial authorities demanded that the man had to undergo a psychiatric assessment because one of his behaviours was the buying of ejaculate from young men that he would then smear on his genitals for sexual satisfaction. The act of smearing semen on his body had begun in prison when he would smear semen on bodily wounds and provided (presumably therapeutic) relief (as the prison did not provide medicine or cream for bodily injuries). The paper also claimed that the act of taking semen from each other and applying it to wounds and sores was commonplace in the prison he was at. Following his release from prison, he continued the habit and “became obsessed with it and he bought semen from different people on a monthly basis and spread it on the genital area”. Fifteen days prior to his psychiatric assessment, he was accused of molesting a 16-year old adolescent while trying to buy semen from him. The adolescent was reported as saying:

“A man held my arm and said that he had a job for me and he would give money if I do that job. I told him if I can do, I would do. He said he would be there [an hour and a half] later, and told me to find him. After he came, he told me that he buys human sperm, and asked me if I give him sperm, which surprised me a lot. Then he took three or four plastic bags out of the pocket of his jacket full of white things. He said these bags are the sperms that he bought from three or four kids. In exchange of sperm, he gave things like money, stereos and televisions”.

The adolescent’s father found out what had happened to his son and caught the man who had wanted his son’s semen. The man told the father that he wanted the semen to alleviate itchiness. During the psychiatric examination by the authors, the man was described as having mildly depressive emotions, natural psychomotor activity, sufficient cognitive function, and no delusions and/or hallucinations. He also had a history of alcohol and marijuana abuse (but since leaving prison he had stopped abusing these substances). Using the Minnesota Multiphasic Personality Inventory (MMPI) the authors said he had inconsistent behaviour, difficulty in controlling his impulses, was angry and short tempered, displayed antisocial behaviour, was sexually deviant, had obsessive sexual thoughts, was socially isolated, and had a negative self-perception. They also wrote that his psychological profile suggested an antisocial or schizoid personality disorder.

The paper also noted that his father has also been in prison on a number of occasions, and that his mother and her relatives looked after him and his younger brother, and that they had “a hard life” while growing up. From the age of 11-12 years old, he started masturbating regularly (sometimes a few times a day). During early adolescence he began engaging in frotteurism (rubbing his genitals up against other people) particularly on bus journeys. Now, as a man, he claimed he could not masturbate without the use of other people’s semen. He began buying other individuals’ semen when he got out of prison (“from 30 young men in exchanges for money”) and always carried semen with him wherever he went.

The authors noted that unlike most other fetishes, the sexualisation of semen as a fetish did not occur until he was in prison (i.e., adulthood rather than childhood or adolescence). I’m not sure why (based on the evidence in the paper) but they also speculated that the man’s semen fetish was used to overcome low self-esteem and a sense of failure” and that the fetish behaviour “occurred from a trauma caused by the bad attitude of [his] parents at an early age, and [that] such negative experiences contributed to the emergence of fetish behavior”. The paper also claimed that: “He discovered the fetish object to deal with the anger for the negative events he faced when he was in prison for ten years for armed robbery. Impulse control is likely to be impaired because of the adverse conditions created by the prison”.

They also described the man’s semen fetish as a “mental illness” (in fact, the paper seemed to imply that all fetishes are mental illnesses which is clearly not the case as most non-normative sex is non-problematic for those engaging in such behaviour). However, by diagnosing the man has having a mental illness, it meant that he was not mentally competent enough to stand trial. The paper concluded that:

“In our case, the number of [victims] is few, but [our patient is] respectively harmless to the victims and not dangerous. He cannot control his urges and behaviors. For [these] kind of cases, generally, diminished criminal responsibility is decided but for this case, it was decided that he has no criminal responsibility”.

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

Further reading

BBC News (2010). Israel jails man for ‘holy semen’ sex abuse. April 26. Located at: http://news.bbc.co.uk/1/hi/world/middle_east/8644637.stm

Kuro5hin (2002). A modern craving. August 5. Located at: http://www.kuro5hin.org/story/2002/8/5/71044/01543

Taktak, S., Karakus, M., & Eke, S. M. (2015). The man whose fetish object is ejaculate: A case report. Journal of Psychiatry, 18(3), 276.

Taktak, S., Karakus, M., Kaplan, A., & Eke, S.M. (2015) Shoe fetishism and kleptomania comorbidity: A case report. European Journal of Pharmaceutical and Medical Research, 2, 14-19.

Taktak, S., Yılmaz, E., Karamustafalıoglu, O., & Unsal, A. (2016). Characteristics of paraphilics in Turkey: A retrospective study – 20 years. International Journal of Law and Psychiatry, in press.

Wikipedia (2012). Bukkake. Located at: http://en.wikipedia.org/wiki/Bukkake

Wikipedia (2012). Gokkun. Located at: http://en.wikipedia.org/wiki/Gokkun

Ga(y)ming studies: The importance of sexuality in video gaming

Back in May 2014, hundreds of news outlets reported on Nintendo’s decision not to allow gamers to play as gay characters and form same-sex relationships in the life-simulation game Tomodachi Life. Understandably, there was disquiet and outrage from a number of quarters despite Nintendo’s statement that “Tomodachi Life was intended to be a whimsical and quirky game [and] not trying to provide social commentary”. Their statement at the time appeared to fan the flames rather than silence the critics.

I have been researching video game play for almost three decades and I’ve always found issues surrounding character formation, sexuality, and gender in gaming of great psychological interest. In one of our studies we found that a majority of gamers (57%) had gender-swapped their game character with female gamers (68%) being more likely to gender swap than male gamers (54%). We argued that gender swapping enabled gamers to play around and experiment with various aspects of their in-game character that are not so easy to do in real life. For others it was just fun to see if they felt any different playing a different gendered character. What makes our findings interesting is that in most instances, the gamers had the opportunity to choose the gender of their character and to develop other aspects of their character before they began to play. Choosing to gender swap may have had an effect on the gamers’ styles of play and interaction with other gamers. Whatever the reasons, it was clear from our research that the development of gamers’ online characters and avatars was important to them.

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One of the reasons for the importance of online gaming identities may be because it subverts traditional parasocial interaction (PI). PI is a concept used by psychologists that has traditionally described one-sided, parasocial interpersonal relationships in situations where one individual knows a great deal about someone else, but where the other person knows little about the other (the most common being the relationship between celebrities and their fans).

A study led by Nicholas Bowman (and published in a 2012 issue of the journal Cyberpsychology, Behavior and Social Networking [CPBSN]) argued that the playing of video games challenges this concept “as the distance between game players and characters is greatly reduced, if not completely removed, in virtual environments.” The study claimed that online gaming encourages the “psychological merging of a player’s and a character’s mind” and is critical in the development of character attachment. In this context, the sexuality of a character for a player may be of fundamental psychological importance.

This appears to be confirmed in a paper by Melissa Lewis and colleagues (also published in CPBSN) who developed a scale to assess ‘character attachment’ (the connection felt by a video game player toward a video game character”). They found that character attachment had a significant relationship with self-esteem, addiction, game enjoyment, and time spent playing games.

American researcher Dr. Adrienne Shaw has carried out a number of studies into lesbian, gay, bisexual, and transgender (LGBT) representation in video games from a cultural production perspective. She was one of the first academics in the gaming studies field to note that there was a relative lack of LGBT representation in video games. Other areas of the entertainment media (e.g., music, film, and television) appear to have much greater LGBT representation than in video games so it does beg the question of why the gaming industry appears to be behind in this respect. I recall writing a paper back in 1993 (in The Psychologist) where I argued that most video games at the time were designed by males for other males. This arguably alienated female gamers but eventually led to developers introducing strong female characters into video games (the most notable being Lara Croft in Tomb Raider). Maybe the appearance of LGBT characters and role models within games will increase over time but I’m not holding my breath.

In a more recent paper in a 2012 paper in the journal New Media and Society, Dr. Shaw claimed that the demand for minority representation in video games “often focuses on proving that members of marginalized groups are gamers” and that the gaming industry should focus on appealing to such players via targeted content. However, she argues that an individual’s identity as a gamer will intersect with “other identities like gender, race, and sexuality.” She then goes on to say that the negative connotations about being an online gamer may lead to such marginalized groups not wanting to engage in gaming. She concluded that “those invested in diversity in video games must focus their attention on the construction of the medium, and not the construction of the audience…[This] is necessary to develop arguments for representation in games that do not rely on marking groups as specific kinds of gaming markets via identifiers like gender, race, and sexuality.”

Nintendo’s decision not to allow gay relationships to form within Tomodachi Life was ill-judged, ill-informed, and outdated. Games in which identity content can be generated by its users needs to reflect the world in which the gamers’ live. In short, there should be no compromise when it comes to allowing gamers to choose their sexuality within the game.

(N.B. A version of this article first appeared in The Conversation)

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

Further reading

Bowman, N. D., Schultheiss, D., & Schumann, C. (2012). “I’m attached, and I’m a good guy/gal!”: how character attachment influences pro-and anti-social motivations to play massively multiplayer online role-playing games. Cyberpsychology, Behavior, and Social Networking, 15(3), 169-174

Griffiths, M.D. (1993). Are computer games bad for children? The Psychologist: Bulletin of the British Psychological Society, 6, 401-407.

Griffiths, M.D., Arcelus, J. & Bouman, W.P. (2016). Video gaming and gender dysphoria: Some case study evidence. Aloma: Revista de Psicologia, Ciències de l’Educació i de l’Esport, 34(2), 59-66.

Hussain, Z., & Griffiths, M. D. (2008). Gender swapping and socializing in cyberspace: An exploratory study. CyberPsychology and Behavior, 11(1), 47-53.

Lewis, A. & Griffiths, M.D. (2011). Confronting gender representation: A qualitative study of the experiences and motivations of female casual-gamers. Aloma: Revista de Psicologia, Ciències de l’Educació i de l’Esport, 28, 245-272.

Lewis, M. L., Weber, R., & Bowman, N. D. (2008). “They may be pixels, but they’re MY pixels:” Developing a metric of character attachment in role-playing video games. CyberPsychology and Behavior, 11(4), 515-518.

McLean, L. & Griffiths, M.D. (2013). Female gamers: A thematic analysis of their gaming experience. International Journal of Games-Based Learning, 3(3), 54-71.

Shaw, A. (2009). Putting the gay in games cultural production and GLBT content in video games. Games and Culture, 4(3), 228-253.

Shaw, A. (2012). Do you identify as a gamer? Gender, race, sexuality, and gamer identity. New Media and Society, 14(1), 28-44.

Shaw, A. (2015). Gaming at the edge: Sexuality and gender at the margins of gamer culture. Minnesota: University of Minnesota Press.

More mass debating: Compulsive sexual behaviour and the internet

The issue of sex addiction as a behavioural addiction has been hotly debated over the last decade. A recent contribution to this debate is a review by Shane Kraus and his colleagues in the latest issue of the journal Addiction that examined the empirical evidence base for classifying compulsive sexual behaviour (CSB) as a behavioural (i.e., non-substance) addiction. The review raised many important issues and highlighted many of the problems in the area including the problems in defining CSB, and the lack of robust data from many different perspectives (epidemiological, longitudinal, neuropsychological, neurobiological, genetic, etc.).

As my regular blog readers will know, I have carried out empirical research into a wide variety of different behavioural addictions (gambling, video gaming, internet use, exercise, sex, work, etc.) and have argued that some types of problematic sexual behaviour can be classed as sex addiction depending upon the definition of addiction used. I was invited by the editors of Addiction to write a commentary on the review and this has just been published in the same issue as the paper by Kraus and colleagues. This blog briefly looks at the issues in that review that I highlighted in my commentary.

For instance, there are a number of areas in Kraus et al.’s paper that were briefly mentioned without any critical evaluation. For instance, in the short section on co-occurring psychopathology and CSB, reference was made to studies claiming that 4%-20% of those with CSB also display disordered gambling behaviour. I pointed out that a very comprehensive review that I published with Dr. Steve Sussman and Nadra Lisha (in the journal Evaluation and the Health Professions) examining 11 different potentially addictive behaviours also highlighted studies claiming that sex addiction could co-occur with exercise addiction (8%-12%), work addiction (28%-34%), and shopping addiction (5%-31%). While it is entirely possible for an individual to be addicted to (say) cocaine and sex concurrently (because both behaviours can be carried out simultaneously), there is little face validity that an individual could have two or more co-occurring behavioural addictions because genuine behavioural addictions consume large amounts of time every single day. My own view is that it is almost impossible for someone to be genuinely addicted to (for example) both work and sex (unless the person’s work was as an actor/actress in the pornographic film industry).

The paper by Kraus et al also made a number of references to “excessive/problematic sexual behavior” and appeared to make the assumption that ‘excessive’ behaviour is bad (i.e., problematic).  While I agree that CSB is typically excessive, excessive sex in itself is not necessarily problematic. Preoccupation with any behaviour in relation to addiction obviously needs to take into account the context of the behaviour, as the context is far more important in defining addictive behaviour than the amount of the activity undertaken. As I have constantly argued, the fundamental difference between a healthy excessive enthusiasms and addictions is that healthy excessive enthusiasms add to life whereas addictions take away from them.

The paper also appeared to have an underlying assumption that empirical research from a neurobiological and genetic perspective should be treated more seriously than that from a psychological perspective. Whether problematic sexual behaviour is described as CSB, sex addiction and/or hypersexual disorder, there are thousands of psychological therapists around the world that treat such disorders. Consequently, clinical evidence from those that help and treat such individuals should be given greater credence by the psychiatric community.

shutterstock_cybersex

Arguably the most important development in the field of CSB and sex addiction is how the internet is changing and facilitating CSB. This was not even mentioned until the concluding paragraph yet research into online sex addiction (while comprising a small empirical base) has existed since the late 1990s including sample sizes of up to almost 10,000 individuals. In fact, there have been a number of recent reviews of the empirical data concerning online sex addiction including its treatment including ones by myself in journals such as Addiction Research and Theory (in 2012) and Current Addiction Reports (in 2015). My review papers specifically outlined the many specific features of the Internet that may facilitate and stimulate addictive tendencies in relation to sexual behaviour (accessibility, affordability, anonymity, convenience, escape, disinhibition, etc.). The internet may also be facilitating behaviours that an individual would never imagine doing offline such as cybersexual stalking.

Finally, there is also the issue of why Internet Gaming Disorder was included in the DSM-5 (in Section 3 – ‘Emerging measures and models’) but sex addiction/hypersexual disorder was not, even though the empirical base for sex addiction is arguably on a par with IGD. One of the reasons might be that the term ‘sex addiction’ is often used (and arguably misused) by high profile celebrities as an excuse to justify their infidelity (e.g., Tiger Woods, Michael Douglas, David Duchovny, Russell Brand), and is little more than a ‘functional attribution’. For instance, the golfer Tiger Woods claimed an addiction to sex after his wife found out that he had many sexual relationships during their marriage. If his wife had never found out, I doubt whether Woods would have claimed he was addicted to sex. I would argue that many celebrities are in a position where they are bombarded with sexual advances from other individuals and have succumbed. But how many people would not do the same thing if they had the opportunity? Sex only becomes a problem (and is pathologised) when the person is found to have been unfaithful. Such examples arguably give sex addiction a ‘bad name’, and provides a good reason for those not wanting to include such behaviour in diagnostic psychiatry texts.

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

Further reading

Bocij, P., Griffiths, M.D., McFarlane, L. (2002). Cyberstalking: A new challenge for criminal law. Criminal Lawyer, 122, 3-5.

Cooper, A., Delmonico, D.L., & Burg, R. (2000). Cybersex users, abusers, and compulsives: New findings and implications. Sexual Addiction and Compulsivity, 6, 79-104.

Cooper, A., Delmonico, D.L., Griffin-Shelley, E., & Mathy, R.M. (2004). Online sexual activity: An examination of potentially problematic behaviors. Sexual Addiction and Compulsivity, 11, 129-143.

Cooper, A., Galbreath, N., Becker, M.A. (2004). Sex on the Internet: Furthering our understanding of men with online sexual problems. Psychology of Addictive Behaviors, 18, 223-230.

Cooper, A., Griffin-Shelley, E., Delmonico, D.L., Mathy, R.M. (2001). Online sexual problems: Assessment and predictive variables. Sexual Addiction and Compulsivity, 8, 267-285.

Dhuffar, M. & Griffiths, M.D. (2015). A systematic review of online sex addiction and clinical treatments using CONSORT evaluation. Current Addiction Reports, 2, 163-174.

Griffiths, M.D. (2000).  Excessive internet use: Implications for sexual behavior. CyberPsychology and Behavior, 3, 537-552.

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

Griffiths, M.D. (2004). Sex addiction on the Internet. Janus Head: Journal of Interdisciplinary Studies in Literature, Continental Philosophy, Phenomenological Psychology and the Arts, 7(2), 188-217.

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

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

Griffiths, M.D. (2016). Compulsive sexual behaviour as a behavioural addiction: The impact of the Internet and other issues. Addiction, 111, 2107-2109.

Griffiths, M.D. & Dhuffar, M. (2014). Treatment of sexual addiction within the British National Health Service. International Journal of Mental Health and Addiction, 12, 561-571.

Kraus, S., Voon, V., & Potenza, M. (2016). Should compulsive sexual behavior be considered an addiction? Addiction 111, 2097-2106.

Orzack M.H., & Ross C.J. (2000). Should virtual sex be treated like other sex addictions? Sexual Addiction and Compulsivity, 7, 113-125.

Sussman, S., Lisha, N. & Griffiths, M.D. (2011). Prevalence of the addictions: A problem of the majority or the minority? Evaluation and the Health Professions, 34, 3-56.

Van Gordon, W., Shonin, E., & Griffiths, M.D. (2016). Meditation Awareness Training for the treatment of sex addiction: A case study. Journal of Behavioral Addictions, 5, 363–372.