Relatively stressed: How to cope with family-related tensions this Christmas

As much as we all want Christmas to revolve around perfect presents, tasty food and drink, no work, and leisure time to be spent with close family and friends, it can be a psychologically tense and stressful time even among the most happy and well-adjusted families.

Not only is there the crowded shopping, the writing of copious Christmas cards, the wrapping of presents, and the travelling, but there is often the extra burden of obligatory extended family staying and/or visiting. Patience can be pushed to the outer limit throughout the festive period. Trying to satisfy multiple family members all of who have different needs is difficult at best.

Additionally, family reunions have the potential to bring about a range of deep- rooted emotions including jealousy, resentment, competitiveness, and (sibling) rivalry. Expectations may not be met. Instead of joy and happiness we may feel stressed, hurt and/or exhausted. So how do you cope with the family-related stresses and strains during the festive period? Here are my top ten tips.

• Keep expectations of time spent with family hopeful but realistic – You may not be able to change your family’s dynamics, but at least be aware of how your family can affect your psychological mood state. Some relatives may use the Christmas family reunion to play out family dynamics or re-enact old sibling rivalries. Knowing the problems you might expect from particular family members makes them easier to deal with should they arise. If possible, find ways to shorten or eliminate the family experiences that put you in a bad, anxious or depressed mood.

• Make your family time count – Instead of watching television or DVDs for hours on end, do something together as a family. Go for a walk after the Christmas dinner, play a karaoke video game, play a board game or a parlour game like charades. Basically, do anything where you have to interact with each other. Even making the Christmas dinner could be a communal activity where each adult and child has a specific job.

• Drink alcohol in moderation – Alcohol can be a double-edged sword so be mindful when drinking with family members. Alcohol’s disinhibiting effect can help facilitate friendly family interaction but drinking too much during family gatherings can sometimes lead to saying things that we later regret.

• Don’t take everything personally – The ability to step back from a stressful situation caused by a family member is a skill to be cultivated. Remember that any family member is an individual with moods and desires that are separate from their relationship with you. If something really irritates or stresses you, think about what triggered the feeling, then try to let it go and don’t take it personally.

• Take time out every day – Stress at Christmas time can sometimes arise just because there is a house full of people with little opportunity for “me” time. Try to find time in the day to do something on your own. Go for a brisk walk, pop to the newsagents, have a long bath, tidy up the kitchen while listening to a soccer match or the Ashes, or put your headphones on and listen to your favourite music. Do anything that gives you that much needed little ‘time out’ for the day.

• Be organized – Sounds easy but good organization can often be the key to a hassle-free day. Starting out each day with some kind of ‘game plan’ can help alleviate the typical stress that arises from the Christmas family politics.

• Be assertive – Again, easier said than done but learning the power of how to be politely assertive and just saying ‘no’ when faced with family obligations over Christmas can pay big stress-free dividends. Learn how to set boundaries with family so you can experience the true joy of the festive season.

• Beware the vicious circle – Children, as well as adults, can feel stressed during Christmas. Children often pick up on signs of your anxiety and they themselves can become stressed. This can lead to you feeling even more stressed. In short, a vicious circle where stress and anxiety feeds off each other. Try to hide the stress you feel, especially from children, as this may decrease the length of time you feel anxious.

• Be grateful for what you have in life – No matter how stressful your family may be over the festive period, it is always good to be grateful for the things you have in your life. As one psychologist noted in his blog: “If you are reading this online, then you are alive, have access to the internet, and have at least some free time to surf the net”.

• Remember that relationships are the most important thing we have – All of us need to remember that the Christmas feelings of joy and happiness come not from the gifts, decorations, food and drink, but from our relationships with other people. Christmas is about relationships – not only the relationship you have your family and friends, but also the relationship you have with yourself. If we make our close relationships the top priority, then the rest of the Christmas should fall naturally into place.

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

Blame it on the fame: The psychology of being ‘starstruck’

“We have an infatuation for famous. It’s gone global. It seems that, with the rise of fame generated through social media sites and TV, we all have this non-specific person, this idol, plonked on a pedestal, simply because they could be bothered to do something to get themselves out there…A lot of [celebrities are] known for their talent, work bloody hard for it, and that’s inspirational. That’s something to idolise – their drive and passion. But being starstruck because of somebody’s position or wealth or title – just think about it. Most of the people who would leave you starstruck will be everyday folk, just getting on with their thing, even if that’s earning £250,000 a week” (from ‘Starstruck, fame-obsessed and suckers for Hollywood culture’ by Bianca Chadda)

Regular readers of my blog will know that I have more than a passing interest in the psychology of fame. For instance, I have looked at many aspects of fame and celebrity including whether fame can be addictive, the role of celebrity endorsement in advertising, individuals that become sexually aroused by famous people (so-called celebriphilia), individuals that are obsessed with celebrity (i.e., celebrity worship syndrome), and whether celebrities are more prone to addictions than the general public, as well a speculative look at the psychology of various celebrities (including – amongst others – Iggy Pop, Lou Reed, Adam Ant, Roland Orzabal, Salvador Dali and Allen Jones).

The reason I mention this is because a few days ago (December 11), I was interviewed by Georgey Spanswick on BBC radio about the psychology of being ‘starstruck’. The first thing that occurred to me was what ‘starstruck’ actually means. I knew what my own perception of the term meant but when I began to look into it there are many different definitions of ‘starstruck’ (some of which hyphenate the word), many of which did not match my own definition. Here are a selection which highlight that some of those differences:

• “Star-struck – fascinated or greatly impressed by famous people, especially those connected with the cinema or the theatre” (Oxford Dictionary).
• “Star-struck – feeling great or too much respect for famous or important people, especially famous actors or performers” (Cambridge Dictionary).
• “Starstruck – particularly taken with celebrities (as movie stars)” (Merriam Webster Dictionary).
• Starstruck – Fascinated by or exhibiting a fascination with famous people” (Free Dictionary).
• “Star-struck – a star-struck person admires famous people very much, especially film stars and entertainers” (Macmillan Dictionary).
• “Starstruck – when you meet someone you are very fond of, like a celebrity, movie star, etc. and you get completely overwhelmed, paralyzed and/or speechless by the experience” (Urban Dictionary).

Of all the definitions listed above, it is actually the final one from the online Urban Dictionary that most matches my own conception. In fact, an article by Ainehi Edoro on the Brittle Paper website provides a lay person’s view on being starstruck and how it can leave an individual:

“What does it mean to be starstruck? You meet a celebrity and you are struck by a force that freezes you, holds you captive. You can’t think, your eyes are glazed over, your heart is beating really fast, open or closed, your mouth is useless – it’s either not making any sound or spewing out pure nonsense. In a flash, it’s all over. The celebrity disappears. And you’re left with a sense of loss that turns into regret and, perhaps, embarrassment”.

However, as there is no academic research on the topic of being starstruck (at least not to my knowledge), the rest of this article is pure speculation and uses non-academic sources. The most in-depth (and by that I simply mean longest) article that I came across on why people get starstruck (i.e., being completely overwhelmed and speechless when in the company of a celebrity) was by Lior on the Say Why I Do website. The article claimed there were five reasons that may contribute to being starstruck. These are being (i) excited from a feeling of anticipation of meeting a celebrity, (ii) pumped up from the effort of wanting to impress a celebrity, (iii) excited from receiving undeserved attention from a celebrity, (iv) starstruck because that is how other people act around a celebrity, and (v) excited from overwhelming sexual tension towards a celebrity. More specifically:

Excited from a feeling of anticipation of meeting a celebrity: This simply relates to the anticipation that is felt after taking an interest in someone that the individual has admired and revered for years (i.e., they have become “idealized” and “bigger than life”). What will the celebrity really be like to the individual? Will they meet the expectations of the individual?

Pumped up from the effort of wanting to impress a celebrity: This relates to the fact that when meeting someone an individual admires (in this case a celebrity), the individual is trying to make the best impression they can and to put forward a persona that the individual would like the celebrity to perceive them as. This can be a situation that brings about a lot of pressure resulting in being starstruck.

Excited from receiving undeserved attention from a celebrity: This relates to the idea that the individual perceives the celebrity as somehow better (i.e., more successful, attractive, and/or talented than themselves) and that to even acknowledge the individual’s existence is somehow undeserved. The lower the self-esteem of such individuals, the more undeserved they feel by attention from a celebrity.

Starstruck because that is how other people act around a celebrity: This simply relates to the idea that individuals feel starstruck because everyone around them does (or they perceive that everyone else does). Similar situations arise when a crowd goes wild, screams, cries and faints when watching their favourite pop bands. As Lior’s article notes:

“Before Frank Sinatra became a celebrity, it wasn’t common at all to see screaming fans. In 1942, a publicity stunt was done to promote the 25-year old Sinatra, where they planted a number of girls in the audience who were told to scream and swoon when he stepped on stage. What began as a publicity stunt spread through the whole theatre to become a mass hysteria of screaming and fainting. It’s in human nature to copy behaviour around us”.

Excited from overwhelming sexual tension towards a celebrity: This relates to the idea that many celebrities are sexually attractive to individuals that admire and revere them. As Lior notes:

“When some people find someone good looking, they may start to behave in a way that’s quite similar to being star-struck. Star struckness from sexual tension may arise for several reasons. It may be a manifestation of embarrassment about having had fantasies about the person who is now standing in front of you. It may be that every time you look at that person, your thoughts go to places you can’t quite control and that makes you unable to think straight”.

If you are someone who thinks they might be starstruck if you met someone famous, there are various articles on the internet that provide tips on meeting famous people either out in public or within the confines of your job (see ‘Further reading’ below). I’ve been fortunate to meet many celebrities in my line of work with all the media work that I do but I always tell myself that celebrities are human beings just like you or I. I treat them as I would any other human being. No worse, no better. I’m friendly and I’m professional (at least I hope I am). I’ve yet to be starstruck although I’ve never met anyone famous that inspired me to get to where I wanted to get. There is a well known cliché that you should never meet your heroes but if David Bowie or Paul McCartney fancy coming round to my house for dinner I’m pretty sure I wouldn’t be lost for words.

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

Further reading

Chadda, B. (2013). Starstruck, fame-obsessed and suckers for Hollywood culture. Lots of Words, March 3. Located at: https://biancajchadda.wordpress.com/2013/03/06/starstruck-fame-obsessed-and-suckers-for-hollywood-culture/

Edora, A. (2012). Seven tips on how to avoid being starstruck. Brittle Paper. May 21. Located at: http://brittlepaper.com/2012/05/meet-celebrities-starstruck

Intern Like A Rock Star (2012). Starstruck: How to talk to celebrities you meet at work. January 2. Located at: http://www.internlikearockstar.com/2012/01/starstruck-how-to-talk-to-celebrities.html#sthash.JBtzCC9Y.dpbs

Lior (2011). Why do people get star struck? SayWhyIDo.com. February 7. Located at: http://www.saywhydoi.com/why-do-people-get-star-struck/

We can work it out: A brief look at ‘study addiction’

In today’s modern society, students face multiple academic pressures. The best colleges and universities require the best grades for entry and parents push and expect their children to succeed educationally. At school, pupils learn early on that success comes through dedication, discipline, and hard work. For some individuals, the act of educational study may become excessive and/or compulsive and lead to what has been termed ‘study addiction’.

Although there is little research and no generally accepted definition of study addiction to date, such behaviour (as a way of dealing with academic stress and pressure) has been conceptualized within contemporary research into workaholism. Consequently, from a ‘work addiction’ (i.e., workaholism) perspective, study addiction was defined by Dr. Cecilie Andreassen and her colleagues in a 2014 issue of the Journal of Managerial Psychology as: “Being overly concerned with studying, to be driven by an uncontrollable studying motivation, and to put so much energy and effort into studying that it impairs private relationships, spare-time activities, and/or health”.

The many similarities between studying and working lead to the notion that study addiction may be a precursor for or an early form of workaholism that might manifest itself in childhood or adolescence. Work appears to share many similarities to that of learning and studying, as both involve sustained effort in order to achieve success, often related to skills and knowledge, and both fulfill important social roles. In previous studies (including some of my own – see ‘Further reading’ below), workaholism has been shown to be a relatively stable entity over time. This suggests that the behavioural tendency to work excessively may be manifesting itself early in the development of an individual in relation to learning and associated academic behaviours. Given the similarities between excessive work and excessive study, there is no theoretical reason to believe that ‘study addiction’ (like work addiction) does not exist.

Given that most scales to assess workaholism have been developed without adequate consideration of all facets of addiction, my colleagues and I developed the Bergen Work Addiction Scale (BWAS). This was published in a 2012 issue of the Scandinavian Journal of Psychology and was developed to overcome the theoretical and conceptual weaknesses of previous instrumentation. This BWAS assesses core elements of addiction (salience, mood modification, tolerance, withdrawal, conflict, relapse, and problems). As no current measure of study addiction exists, we adapted the BWAS by replacing the words ‘work’ and ‘working’ with ‘study’ and ‘studying’ (creating the Bergen Study Addiction Scale) and carried out the first ever study on ‘study addiction’ and some of the results of this study that have just been published in the Journal of Behavioral Addictions are highlighted later in this article.

Unlike most other behavioural addictions (e.g., pathological gambling, video gaming addiction, shopping addiction, etc.), workaholism – like exercise addiction – has often been regarded as a positive and productive kind of addiction. Notably, workaholics typically score higher on personality traits such as conscientiousness and perfectionism compared to other addicts. As with the workaholic, the “perfect student” is hard working and involved, and it is likely that study addiction is also associated with conscientiousness. Along with the academic pressure derived from many differing sources (such as the fear of failure), it is also conceivable that such individuals – like workaholics – will score higher on neuroticism.

Although the societal notion of workaholism as a positive behaviour has received some support, most current scholars conceive it as a negative condition due to its association with impaired health, low perceived quality of life, diminished sleep quality, work-family conflicts, and lowered job performance. Given these well-established associations, we hypothesized in our study that extreme studying behaviour (i.e., study addiction) would be negatively related to psychological wellbeing, health, and academic performance, and positively related to stress.

On the basis of previous theoretical frameworks and empirical research into work addiction, we hypothesized that study addiction would be (i) positively and significantly associated with conscientiousness and neuroticism, (ii) positively and significantly associated with stress, and lower quality of life, health, and sleep, and (iii) negatively and significantly related to academic performance. Our study comprised two samples of students (n=1,211). The first sample comprised 218 first-year psychology undergraduate students at the University of Bergen in Norway. The second sample comprised 993 participants studying at three Polish universities.

We found there were positive associations between study addiction, neuroticism and conscientiousness, and lack of relationship with agreeableness (in both the Polish and Norwegian samples). In the Polish sample, extraversion was negatively related to study addiction. Our results also showed that study addiction was positively related to perceived stress and negatively associated with general quality of life, general health, and sleep quality above and beyond personality factors. These results parallel current knowledge about negative correlates of work addiction. When controlling for personality traits, study addiction was negatively associated with immediate academic performance (although not statistically significant in the Norwegian sample, probably due to the relatively small sample size in terms of exam results compared to the much bigger Polish sample).

As expected, study addiction was related to several negative consequences and problems. Although our results were interesting and (on the whole supported our hypotheses) the two groups of students comprised convenience samples, were predominantly female, and mainly comprised psychology and education students. Therefore, the results of our study cannot be generalized to other populations. However, our study is first ever study to conceptualize ‘study addiction’ and to test psychometric properties of a corresponding measurement tool (which for all you psychometricians out there had good reliability and validity). We also used several variables comprising possible antecedents and consequences of study addiction, including valid and reliable measures of personality, psychological wellbeing, health, stress, and academic performance. We believe that our study significantly adds to the existing literature on workaholism and behavioural addictions, and our initial findings appear to support the concept of study addiction and provide an empirical base for its further investigation.

If we had an unlimited research budget, we’d like to carry out longitudinal studies in younger samples (e.g., high school) as such data would likely provide useful information in terms of possible developmental risk factors, determinants, and correlates of study addiction. The relationship between study addiction and later work addiction should also be investigated longitudinally in order to investigate if these are aspects are part of the same phenomenon and/or pathological process.

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

Please note; This article was written in conjunction with Paweł Atroszko University of Gdańsk, Poland), Cecilie Schou Andreassen (University of Bergen, Norway), and Ståle Pallesen (University of Bergen, Norway).

Further reading

Andreassen, C. S. (2014). Workaholism: An overview and current status of the research. Journal of Behavioral Addictions, 3, 1-11.

Andreassen, C., Griffiths, M., Gjertsen, S., Krossbakken, E., Kvam, S., & Pallesen, S. (2013). The relationships between behavioral addictions and the five-factor model of personality. Journal of Behavioral Addictions, 2, 90-99.

Andreassen, C. S., Griffiths, M. D., Hetland, J., Kravina, L., Jensen, F., & Pallesen, S. (2014). The prevalence of workaholism: a survey study in a nationally representative sample of norwegian employees. PLoS One, 9, e102446. doi: 10.1371/journal.pone.0102446

Andreassen, C. S., Griffiths, M. D., Hetland, J., & Pallesen, S. (2012). Development of a work addiction scale. Scandinavian Journal of Psychology, 53, 265-272.

Andreassen, C. S., Hetland, J., & Pallesen, S. (2014). Psychometric assessment of workaholism measures. Journal of Managerial Psychology, 29, 7-24.

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.

Burke, R. J., Matthiesen, S. B., & Pallesen, S. (2006). Personality correlates of workaholism. Personality and Individual Differences, 40, 1223-1233.

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

Griffiths, M.D. (2005). Workaholism is still a useful construct Addiction Research and Theory, 13, 97-100.

Griffiths, M.D. (2011). Workaholism: A 21^st century addiction. The Psychologist: Bulletin of the British Psychological Society, 24, 740-744.

Griffiths, M.D. & Karanika-Murray, M. (2012). Contextualising over-engagement in work: Towards a more global understanding of workaholism as an addiction. Journal of Behavioral Addictions, 1(3), 87-95.

Quinones, C. & Mark D. Griffiths (2015). Addiction to work: recommendations for assessment. Journal of Psychosocial Nursing and Mental Health Services, 10, 48-59.

Spence, J. T., & Robbins, A. S. (1992). Workaholism – definition, measurement, and preliminary results. Journal of Personality Assessment, 58, 160-178.

van Beek, I., Taris, T. W., & Schaufeli, W. B. (2011). Workaholic and work engaged employees: dead ringers or worlds apart? Journal of Occupational Health Psychology, 16, 468-482.

Are you ‘intexticated’?: Another look at excessive smartphone use

Yesterday, I received a copy of a new book called Too Much Of A Good Thing: Are You Addicted To Your Smartphone? by Dr. James Roberts (a Professor of Marketing at Baylor University in Waco, Texas). It’s a populist and easy-to-read book that you can read from cover to cover inside two hours. It’s not an academic book but there’s lots of input from various academics around the world (including me – which is why I was sent a copy of the book). It’s a fun read and is written by someone (who like myself) loves technology and all the great benefits it brings us.

The main thrust of the book doesn’t concern addiction per se, but is more concerned with how smartphones take us away from or compromises other things in our lives like our friends, our loved ones, our hobbies and (in extreme cases) our jobs. Roberts describes this as ‘cellularitis’ – “a Socially Transmitted Disease (STD) that results in habitual use of one’s cell phone to the detriment of his or her psychological and physical health and well-being”. In the second chapter, Dr. Roberts uses my addiction components model to describe his ‘Six Signs of Cell Phone Addiction Scale’ (although uses an older version of the components model taken from a paper I published on internet addiction back in 1999 in The Psychologist).

One of the chapters on the phenomena of ‘phubbing’ (i.e., phone snubbing – where someone you are socially interacting with would rather be on their smartphone, rather than talking to you). One recent paper by Dr. Roberts published in the journal Computers in Human Behavior even had the title ‘My life has become a major distraction from my cell phone’. The chapter also contains a 9-item ‘Phubbing Scale’ that Roberts developed with his colleague Dr. Meredith David (and a later chapter also includes the ‘Partner Phubbing Scale’). Academic research into phubbing has already started (see ‘Further reading below) and I’ll hopefully write a blog on that in the future. I also liked the concept of being ‘intexticated’ defined as being “distracted by the act of texting to such a degree that one seems intoxicated”.

In previous blogs I have examined the concept of mobile phone addiction, the most recent of which argued that there was nowhere near enough empirical evidence to be able to confirm whether addiction to smartphones exists. Dr. Roberts asked me about the topic for his book and here are the answers to the questions he asked me.

Can someone be addicted to their cell phone? Why or why not?

That depends on how ‘addiction’ is defined. I believe that anything can be potentially addictive if constant rewards and reinforcement are present. Some people may confuse habitual use of such technology as an addictive behaviour (when in reality it may not be). For instance, some people may consider themselves cell phone addicts because they never go out of the house without their cell phone, do not turn their cell phone off at night, are always expecting calls from family members or friends, and/or over-utilise cell phones in their work and/or social life. There is also the importance of economic and/or life costs. The crucial difference between some forms of cell phone use and pathological cell phone use is that some applications involve a financial cost. If a person is using the application more and is spending more money, there may be negative consequences as a result of not being able to afford the activity (e.g., negative economic, job-related, and/or family consequences). High expenditure may also be indicative of cell phone addiction but the phone bills of adolescents are often paid for by parents, therefore the financial problems may not impact on the users themselves.

It is very difficult to determine at what point cell phone use becomes an addiction. The cautiousness of researchers suggests that we are not yet in a position to confirm the existence of a serious and persistent psychopathological addictive disorder related to cell phone addiction on the basis of population survey data alone. This cautiousness is aided and supported by other factors including: (a) the absence of any clinical demand in accordance with the percentages of problematic users identified by these investigations, (b) the fact that the psychometric instruments used could be measuring ‘concern’ or ‘preoccupation’ rather than ‘addiction, (c) the normalisation of behaviour and/or absence of any concern as users grow older; and (d) the importance of distinguishing between excessive use and addictive use.

What signs or symptoms would you look for when deciding if someone is addicted to their cell phone?

You could argue that a person is no more addicted to their phone than an alcoholic is addicted to the bottle. Individuals tend to have addictions on their mobile phone rather than to their phone. For me to class someone as addicted to their mobile phone they would have to fulfill the following six criteria:

• Salience – This occurs when the mobile phone use becomes the single most important activity in the person’s life and dominates their thinking (preoccupations and cognitive distortions), feelings (cravings) and behaviour (deterioration of socialised behaviour). For instance, even if the person is not actually on their phone they will be constantly thinking about the next time that they will be (i.e., a total preoccupation with their mobile phone).
• Mood modification – This refers to the subjective experiences that people report as a consequence of mobile phone use and can be seen as a coping strategy (i.e., they experience an arousing ‘buzz’ or a ‘high’ or paradoxically a tranquilizing feel of ‘escape’ or ‘numbing’) when on the phone.
• Tolerance – This is the process whereby increasing amounts of mobile phone use are mobile phone users gradually build up the amount of the time they spend on their phone every day.
• Withdrawal symptoms – These are the unpleasant feeling states and/or physical effects (e.g., the shakes, moodiness, irritability, etc.) that occur when the person is unable to use their phone because there is no signal, mislaid or broken phone, etc.
• Conflict – This refers to the conflicts between the person and those around them (interpersonal conflict), conflicts with other activities (social life, hobbies and interests) or from within the individual themselves (intra-psychic conflict and/or subjective feelings of loss of control) that are concerned with spending too much on their mobile phone.
• Relapse – This is the tendency for repeated reversions to earlier patterns of excessive mobile phone use to recur and for even the most extreme patterns typical of the height of excessive mobile phone use to be quickly restored after periods of control.

What is one suggestion you could offer to help someone better control their cell phone use?

I don’t have a single suggestion. If there was a single suggestion to overcome or better control problematic phone use then I could give up my whole research career. However, my tips on digital detox can be found here.

 

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

Further reading

Bianchi, A. & Phillips, J.G. (2005). Psychological predictors of problem mobile phone use. Cyberpsychology and Behavior, 8, 39–51.

Billieux, J. (2012). Problematic use of the mobile phone: A literature review and a pathways model. Current Psychiatry Reviews, 8, 299–307.

Billieux, J., Maurage, P., Lopez-Fernandez, O., Kuss, D.J. & Griffiths, M.D. (2015). Can disordered mobile phone use be considered a behavioural addiction? An update on current evidence and a comprehensive model for future research. Current Addiction Reports, DOI 10.1007/s40429-015-0054-y

Carbonell, X., Chamarro, A., Beranuy, M., Griffiths, M.D. Obert, U., Cladellas, R. & Talarn, A. (2012). Problematic Internet and cell phone use in Spanish teenagers and young students. Anales de Psicologia, 28, 789-796.

Chóliz M. (2010). Mobile phone addiction: a point of issue. Addiction. 105, 373-374.

Griffiths, M.D. (1999). Internet addiction: Fact or fiction? The Psychologist: Bulletin of the British Psychological Society, 12, 246-250.

Griffiths, M.D. (2007). Mobile phone gambling. In D. Taniar (Ed.), Encyclopedia of Mobile Computing and Commerce (pp.553-556). Pennsylvania: Information Science Reference.

Griffiths, M.D. (2013). Adolescent mobile phone addiction: A cause for concern? Education and Health, 31, 76-78.

Karadağ, E., Tosuntaş, Ş. B., Erzen, E., Duru, P., Bostan, N., Şahin, B. M., … & Babadağ, B. (2015). Determinants of phubbing, which is the sum of many virtual addictions: A structural equation model. Journal of Behavioral Addictions, 4, 60-74.

Lopez-Fernandez, O., Honrubia-Serrano, L., Freixa-Blanxart, M., & Gibson, W. (2014). Prevalence of problematic mobile phone use in British adolescents. Cyberpsychology, Behavior and Social Networking, 17, 91-98.

Lopez-Fernandez, O., Kuss, D.J., Griffiths, M.D., & Billieux, J. (in press). The conceptualization and assessment of problematic mobile phone use. In Z. Yan (Ed.), Encyclopedia of Mobile Phone Behavior (Volumes 1, 2, & 3). Hershey, PA: IGI Global.

Roberts, J.A. (2016). Too Much Of A Good Thing: Are You Addicted To Your Smartphone? Austin: Sentia Publishing.

Roberts, J. A., & David, M. E. (2016). My life has become a major distraction from my cell phone: Partner phubbing and relationship satisfaction among romantic partners. Computers in Human Behavior, 54, 134-141

Smetaniuk, P. (2014). A preliminary investigation into the prevalence and prediction of problematic cell phone use. Journal of Behavioral Addictions, 3(1), 41-53.

Ugur, N. G., & Koc, T. (2015). Time for digital detox: Misuse of mobile technology and phubbing. Procedia-Social and Behavioral Sciences, 195, 1022-1031.

Naming desire: A personal look at my new job title

Back in 2002, I was incredibly proud when I became one of the youngest full Professors in the UK when I was bestowed the title of Professor of Gambling Studies based on my research contribitions to the gambling studies field. Anyone that has followed my career over the last decade (or this blog over the last four years) will no doubt have realised that my research interests and expertise include a lot more than gambling.

Although I still publish a lot of papers on gambling (12 to 17 papers per calendar year; see Appendix 1 below) I have carried out more and more research into non-gambling addictions and over the last six years (2010-2015) my refereed journal outputs on gambling have only constituted one-third of all my refereed journal outputs (32%) (see Appendix 1 and Figure 1).

The overwhelming majority of my published refereed papers since January 2010 (n=246; 88%) concern behavioural addictions (i.e., gambling addiction, videogame addiction, internet addiction, work addiction, sex addiction, exercise addiction, shopping addiction, dancing addiction, etc.). If gambling addiction is removed from these papers, this still leaves 56% of all my papers during the 2010-2015 period concerning other behavioural addictions (n=158). The remainder of my refereed journal papers (34 papers; 12%) mainly concern the topic of mindfulness carried out with my colleagues Edo Shonin and William Van Gordon. Even my three books in the 2010-2105 timeframe have been on three totally separate topics (i.e., problem gambling, internet addiction and mindfulness). Of my 71 book chapters in this 2010-2015 period, 22 have been on gambling addiction, 41 have been on other behavioural addictions, and 8 have concerned other topics (see Figure 2). In the ‘Further reading’ section below is some of the papers that I have published this year and even a quick glance will highlight that gambling papers are in the minority.

It is also worth noting that I am one of the most highly cited academics in the UK (soemthig else that I am very proud of) and a quick look at my Google Scholar citations profile (currently over 24,500 citations as of October 31, 2015) that of my top ten most highly cited papers, only one is on gambling adiction and the other nine concern my papers on videogame addiction and internet addiction.

Basically, my job title didn’t reflect what I was actually doing on the research front. And this is the very argument I put to my employer (Nottingham Trent University) a number of weeks ago. As far as I am aware, I am the first professor at NTU to ever ask for my title to be changed but last week I was informed by my line manager that the university was convinced by the case I put forward and from now on I will be Professor of Behavioural Addiction.

This new title change has pleased me greatly and of course subsumes the vast majority of the research that I am doing (including my research into gambling addiction). I don’t think I will ever stop carrying out research in the gambling field but my new job title will stop me feeling guilty about working in non-gambling areas. It may also stop some of few abusive emails I get regarding my blogs (saying in very colourful language that I should stop writing about other behavioural addictions and sexual paraphilias and “write about what I get paid to do”). Firstly, I would point out to these individuals that I don’t get paid to write my personal blog and even if I did, I write all my blogs in my spare time.

If you’ve read this far, then thank you. I promise normal service will be resumed in my next blog when it will be about something other than myself.

Appendix 1: Summary statistics of my refereed journal papers (January 1, 2010 to October 20, 2015)

• 2010: Gambling papers (n=17); Behavioural addiction papers (n=19); Other papers (n=1)
• 2011: Gambling papers (n=15); Behavioural addiction papers (n=15); Other papers (n=2)
• 2012: Gambling papers (n=10); Behavioural addiction papers (n=28); Other papers (n=3)
• 2013: Gambling papers (n=12); Behavioural addiction papers (n=23); Other papers (n=4)
• 2014: Gambling papers (n=13); Behavioural addiction papers (n=33); Other papers (n=13)
• 2015: Gambling papers (n=13); Behavioural addiction papers (n=27); Other papers (n=7)
• In press: Gambling papers (n=8); Behavioural addiction papers (n=13); Other papers (n=4)

 

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

Further reading (some recent papers)

Andreassen, C.S., Griffiths, M.D., Pallesen, S., Bilder, R.M., Torsheim, T. Aboujaoude, E.N. (2015). The Bergen Shopping Addiction Scale: Reliability and validity of a brief screening test. Frontiers in Psychology, 6:1374. doi: 10.3389/fpsyg.2015.01374.

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.

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

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

Billieux, J., Maurage, P., Lopez-Fernandez, O., Kuss, D.J. & Griffiths, M.D. (2015). Can disordered mobile phone use be considered a behavioral addiction? An update on current evidence and a comprehensive model for future research. Current Addiction Reports, 2, 154-162.

Canale, N. Santinello, M. & Griffiths, M.D. (2015). Validation of the Reasons for Gambling Questionnaire (RGQ) in a British population survey. Addictive Behaviors, 45, 276-280.

Canale, N., Vieno, A., Griffiths, M.D., Rubaltelli, E., Santinello, M. (2015). Trait urgency and gambling problems in young people: the role of decision-making processes. Addictive Behaviors, 46, 39-44.

Canale, N., Vieno, A., Griffiths, M.D., Rubaltelli, E., Santinello, M. (2015). How do impulsivity traits influence problem gambling through gambling motives? The role of perceived gambling risk/benefits. Psychology of Addictive Behaviors, 29, 813–823.

Cleghorn, J. & Griffiths, M.D. (2015). Why do gamers buy ‘virtual assets’? An insight in to the psychology behind purchase behaviour. Digital Education Review, 27, 98-117.

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.

Dhuffar, M. & Pontes, H.M. & Griffiths, M.D. (2015). Dysphoric mood states and consequences of sexual behaviours as predictors of hypersexual behaviours in university students: An exploratory study. Journal of Behavioural Addictions, 4, 181–188.

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.

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.

Griffiths, M.D. (2015). Problematic technology use during adolescence: Why don’t teenagers seek treatment? Education and Health, 33, 6-9.

Griffiths, M.D., Urbán, R., Demetrovics, Z., Lichtenstein, M.B., de la Vega, R., Kun, B., Ruiz-Barquín, R., Youngman, J. & Szabo, A. (2015). A cross-cultural re-evaluation of the Exercise Addiction Inventory (EAI) in five countries. Sports Medicine Open, 1:5.

Hanss, D., Mentzoni, R.A., Griffiths, M.D., & Pallesen, S. (2015). The impact of gambling advertising: Problem gamblers report stronger impacts on involvement, knowledge, and awareness than recreational gamblers. Psychology of Addictive Behaviors, 29, 483-491.

Hussain, Z., Williams, G. & Griffiths, M.D. (2015). An exploratory study of the association between online gaming addiction and enjoyment motivations for playing massively multiplayer online role-playing games. Computers in Human Behavior, 50, 221–230.

Karanika-Murray, M., Pontes, H.M., Griffiths, M.D. & Biron, C. (2015). Sickness presenteeism determines job satisfaction via affective-motivational states. Social Science and Medicine, 139, 100-106.

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

Király, O., Urbán, R., Griffiths, M.D., Ágoston, C., Nagygyörgy, K., Kökönyei, G. & Demetrovics, Z. (2015). Psychiatric symptoms and problematic online gaming: The mediating effect of gaming motivation. Journal of Medical Internet Research, 17(4) :e88.

Maraz, A., Eisinger, A., Hende, Urbán, R., Paksi, B., Kun, B., Kökönyei, G., Griffiths, M.D. & Demetrovics, Z. (2015). Measuring compulsive buying behaviour: Psychometric validity of three different scales and prevalence in the general population and in shopping centres. Psychiatry Research, 225, 326–334.

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

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.

Ortiz de Gortari, A.B. & Griffiths, M.D. (2015). Game Transfer Phenomena and its associated factors: An exploratory empirical online survey study. Computers in Human Behavior, 51, 195-202.

Ortiz de Gortari, A.B., Pontes, H.M. & Griffiths, M.D. (2015). The Game Transfer Phenomena Scale: An instrument for investigating the non-volitional effects of video game playing. Cyberpsychology, Behavior and Social Networking, 18, 588-594.

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

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

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

Quinones, C. & Mark D. Griffiths (2015). Addiction to work: recommendations for assessment. Journal of Psychosocial Nursing and Mental Health Services, 10, 48-59.

Shonin, E., Van Gordon W., Compare, A., Zangeneh, M. & Griffiths M.D. (2015). Buddhist-derived loving-kindness and compassion meditation for the treatment of psychopathology: A systematic review. Mindfulness, 6, 1161–1180.

Szabo, A., Griffiths, M.D., de La Vega Marcos, R., Mervo, B. & Demetrovics, Z. (2015). Methodological and conceptual limitations in exercise addiction research. Yale Journal of Biology and Medicine, 86, 303-308.

Van Gordon W., Shonin, E., Griffiths M.D. & Singh, N. (2015). There is only one mindfulness: Why science and Buddhism need to work together. Mindfulness, 6, 49-56.

Sound conclusions: The psychology of musical preferences

Last week I was invited to give a keynote talk at an Italian conference on community psychology in Padova. The reason I mention this is because it was at this conference I met another academic – Dr. Tom Ter Bogt – that has a job that I would love to have. Dr. Ter Bogt is a Professor in Popular Music and Youth Culture at the Department of Interdisciplinary Social Sciences of Utrecht University. Regular readers of my blog will know that I have an obsessive love of music and have written about the psychology many of my musical heroes in previous blogs.

It all started when Dr. Ter Bogt innocently asked me what I thought of Noel Gallagher’s latest album (Chasing Yesterday). When I told him that I thought it was great, it sparked a long conversation where we discussed our eclectic love of music taking in a shared appreciation of Oasis, The Beatles, Throbbing Gristle, The Velvet Underground, Lou Reed, Iggy Pop, David Bowie, Roxy Music, Brian Eno, Grace Jones, Johnny Cash, and Chic (to name but a few). I also learned that he used to be a club DJ and that he had authored a best selling book on the history of pop music in his home country. In further email conversations, he also shared with me that his most played artists were Television and the Comsat Angels (something I would never have predicted based on out initial conversation but something that I found endearing).

In the nicest way possible, I am envious of Dr. Ter Bogt’s job. He has managed to become a professor through his love of music, and now carries out scientific research on the topic. Our respective research backgrounds – while very different – occasionally intersect. For instance, Dr. Ter Bogt and his colleagues published a paper in a 2002 issue of Contemporary Drug Problems on ‘Dancestasy’ (dance and MDMA use) in Dutch youth culture and I have published papers on both dance as an addiction, and young people’s use of ecstasy as a ‘risky but rewarding behaviour’ (see ‘Further reading below).

As an avid music fan I was interested to read Dr. Ter Bogt’s typology of music listeners in a 2010 paper in the journal Psychology of Music. In this study, Dr. Ter Bogt and his colleagues constructed a typology of music listeners based on the of importance attributed to music and four types of music use (among a sample of nearly a thousand Dutch participants): (i) mood enhancement (e.g., “Music helps me to relax and stop thinking about things”), (ii) coping with problems (e.g., “I always play music when I feel sad”), (iii) defining personal identity (e.g., “Lyrics of my music often express how I feel”), and (iv) social identity (e.g., “I can’t be friends with someone who dislikes my music”).

Using latent class analysis, the study’s participants were classed into three listener groups – High-Involved Listeners (HILs; 19.7% of the sample), Medium-Involved Listeners (MILs; 74.2%), and Low-Involved Listeners (LILs; 6.1%). HILs listened to music most often for mood enhancement, coping with distress, identity construction and social identity formation. MILs and LILs formed predictably attached less importance to music in their lives. HILs liked a wide range of musical genres (e.g., pop, rock, urban, dance, etc.) and experienced the most positive affects when listening to music. Interestingly, both HILs and MILs (when compared to LILs) reported more negative affects (such as anger and sadness) when listening to music. The study also reported that even LILs listened to music frequently and used it as a mood enhancer.

In a 2010 study in the Journal of Adolescence, Dr. Ter Bogt and his colleagues examined the association between music preferences and adolescent substance use. In a nationally representative sample of 7324 Dutch adolescents (aged 12–16 years), the study collected data concerning music preferences, substance use behaviors, and the perceived number of peers using substances. Adolescent music preferences for eight different music genres clustered into four distinct styles labeled as pop (chart music, Dutch pop), adult (classical music, jazz), urban (rap/hip-hop, soul/R&B) and hard (punk/hardcore, techno/hard-house). Adolescent substance use among the participants comprised smoking, drinking, and cannabis use. The results showed that music preference and substance use was either wholly or partially mediated by perceived peer use.

Using the same dataset, a study published in a 2009 issue of Substance Use and Misuse reported that when all other factors were controlled for, higher levels of substance use was more likely among those who liked punk/hardcore, techno/hard-house, and reggae while lower levels of substance use was more likely among those who preferred pop and classical music. According to Ter Bogt and his colleagues, prior empirical research had demonstrated that liking heavy metal and rap predicted substance use. The Dutch data in this study found that “a preference for rap/hip-hop only indicated elevated smoking among girls, whereas heavy metal was associated with less smoking among boys and less drinking among girls”. Consequently, it was concluded that the music genres associated with increased substance use “may vary historically and cross-culturally, but, in general, preferences for nonmainstream music are associated positively with substance use, and preferences for mainstream pop and types of music preferred by adults (classical music) mark less substance use among adolescents”. The authors also noted that the data were correlational therefore the direction of causation of the music–substance use link cannot be drawn.

In a more recent (2013) study published in the journal Pediatrics, Dr. Ter Bogt and colleagues examined the relationship between early adolescents’ musical preferences and minor delinquency. Following 309 adolescents (149 boys, 160 girls) from the age of 12 years over a four-year period, the study found that that early fans of different types of rock (e.g., rock, heavy metal, gothic, punk), African American music (rhythm and blues, hip-hop), and electronic dance music (trance, techno/hard-house) showed elevated minor delinquency both concurrently and longitudinally. Conversely, preferring conventional pop (chart pop) or highbrow music (classic music, jazz) was negatively related to minor delinquency. The study concluded that “early music preferences emerged as more powerful indicators of later delinquency rather than early delinquency, indicating that music choice is a strong marker of later problem behavior”.

On a personal level, I know how important music is in my on life and as a source of my own identity. The many studies carried out by Dr. Ter Bogt and his research colleagues further our understanding of music across the lifespan (particularly its role in adolescence) and I look forward to reading their future work.

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

Further reading

Delsing, M. J., Ter Bogt, T. F., Engels, R. C., & Meeus, W. H. (2008). Adolescents’ music preferences and personality characteristics. European Journal of Personality, 22(2), 109-130.

Larkin, M. & Griffiths, M.D. (2004). Dangerous sports and recreational drug-use: Rationalising and contextualising risk. Journal of Community and Applied Social Psychology, 14, 215-232.

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

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.

Mulder, J., Ter Bogt, T. F., Raaijmakers, Q. A., Gabhainn, S. N., Monshouwer, K., & Vollebergh, W. A. (2009). The soundtrack of substance use: music preference and adolescent smoking and drinking. Substance Use and Misuse, 44(4), 514-531.

Mulder, J., Ter Bogt, T. F., Raaijmakers, Q. A., Gabhainn, S. N., Monshouwer, K., & Vollebergh, W. A. (2010). Is it the music? Peer substance use as a mediator of the link between music preferences and adolescent substance use. Journal of Adolescence, 33, 387-394.

Mulder, J., Ter Bogt, T., Raaijmakers, Q., & Vollebergh, W. (2007). Music taste groups and problem behavior. Journal of Youth and Adolescence, 36(3), 313-324.

Selfhout, M. H., Branje, S. J., ter Bogt, T. F., & Meeus, W. H. (2009). The role of music preferences in early adolescents’ friendship formation and stability. Journal of Adolescence, 32(1), 95-107.

Ter Bogt, T., Engels, R., Hibbel, B., Van Wel, F., & Verhagen, S. (2002). ‘Dancestasy’: Dance and MDMA use in Dutch youth culture. Contemporary Drug Problems, 29, 157–181.

Ter Bogt, T. F., Keijsers, L., & Meeus, W. H. (2013). Early adolescent music preferences and minor delinquency. Pediatrics, 131(2), e380-e389.

Ter Bogt, T.F., Mulder, J., Raaijmakers, Q.A., & Gabhainn, S.N. (2010). Moved by music: A typology of music listeners. Psychology of Music, 39, 147-163.

Meditate to medicate: Mindfulness as a treatment for behavioural addiction

Please note: A version of the following article was first published on addiction.com and was co-written with my research colleagues Edo Shonin and William Van Gordon

Mindfulness is a form of meditation that derives from Buddhist practice and is one of the fastest growing areas of psychological research. We have defined mindfulness as the process of engaging a full, direct, and active awareness of experienced phenomena that is spiritual in aspect and that is maintained from one moment to the next. As part of the practice of mindfulness, a ‘meditative anchor’, such as observing the breath, is typically used to aid concentration and to help maintain an open-awareness of present moment sensory and cognitive-affective experience.

Throughout the last two decades, Buddhist principles have increasingly been employed in the treatment of a wide range of psychological disorders including mood and anxiety disorders, substance use disorders, bipolar disorder, and schizophrenia-spectrum disorders. The emerging role of Buddhism in clinical settings appears to mirror a growth in research examining the potential effects of Buddhist meditation on brain neurophysiology. Such research forms part of a wider dialogue concerned with the evidence-based applications of specific forms of spiritual practice for improved psychological health.

Within mental health and addiction treatment settings, mindfulness-based interventions (MBIs) are generally delivered in a secular eight-week format and often comprise the following: (i) weekly sessions of 90-180 minutes duration, (ii) a taught psycho-education component, (iii) guided mindfulness exercises, (iv) a CD of guided meditation to facilitate daily self-practice, and (v) varying degrees of one-to-one discussion-based therapy with the program instructor. Examples of MBIs used in behavioural addiction treatment studies include Mindfulness-Based Cognitive Therapy, Mindfulness-Enhanced Cognitive Behaviour Therapy, Mindfulness-Based Relapse Prevention, Mindfulness-Based Stress Reduction, and Meditation Awareness Training.

Studies investigating the role of mindfulness in the treatment of behavioural addictions have – to date – primarily focused on problem and/or pathological gambling. These studies have shown that levels of dispositional mindfulness in problem gamblers are inversely associated with gambling severity, thought suppression, and psychological distress. Recent clinical case studies have demonstrated that weekly mindfulness therapy sessions can lead to clinically significant change in problem gambling individuals. Published case studies include: (i) a male in his sixties addicted to offline roulette playing, (ii) a 61-year old female (with comorbid anxiety and depression) addicted to slot machine gambling (treated with a modified version of Mindfulness-Based Cognitive Therapy), and (iii) a 32-year old female (with co-occurring schizophrenia) addicted to online slot-machine playing (treated with a modified version of Meditation Awareness Training). Also, a recent study showed that problem gamblers that received Mindfulness-Enhanced Cognitive Behaviour Therapy demonstrated significant improvements compared to a control group in levels of gambling severity, gambling urges, and emotional distress.

Outside of gambling addiction, case studies have investigated the applications of mindfulness for treating addiction to work (i.e., workaholism) and sex. In the case of the workaholic, a director of a blue-chip technology company in his late thirties was successfully treated for his workaholism utilizing Meditation Awareness Training. Significant pre-post improvements were also observed for sleep quality, psychological distress, work duration, work involvement during non-work hours, and employer-rated job performance. However, as with any case study, the single-participant nature of the study significantly restricts the generalizability of such findings.

Key treatment mechanisms that have been identified and/or proposed in this respect (several of which overlap with mechanisms identified as part of the mindfulness-based treatment of chemical addictions) include:

• A perceptual shift in the mode of responding and relating to sensory and cognitive-affective stimuli that permits individuals to objectify their cognitive processes and to apprehend them as passing phenomena.
• Reductions in relapse and withdrawal symptoms via substituting maladaptive addictive behaviours with a ‘positive addiction’ to mindfulness/meditation (particularly the ‘blissful’ and/or tranquil states associated with certain meditative practices).
• Transferring the locus of control for stress from external conditions to internal metacognitive and attentional resources.
• The modulation of dysphoric mood states and addiction-related shameful and self-disparaging schemas via the cultivation of compassion and self-compassion.
• Reductions in salience and myopic focus on reward (i.e., by undermining the intrinsic value and ‘authenticity’ that individuals assign to the object of addiction) due to a better understanding of the ‘impermanent’ nature of existence (e.g., all that is won must ultimately be lost, an attractive body will age and wither, a senior/lucrative occupational role must one day be relinquished, etc.).
• Growth in spiritual awareness that broadens perspective and induces a re-evaluation of life priorities.
• ‘Urge surfing’ (the meditative process of adopting an observatory, non-judgemental, and non-reactive attentional-set towards mental urges) that aids in the regulation of habitual compulsive responses.
• Reduced autonomic and psychological arousal via conscious-breathing-induced increases in prefrontal functioning and vagal nerve output (breath awareness is a central feature of mindfulness practice).
• Increased capacity to defer gratitude due to improvements in levels of patience.
• A greater ability to label and therefore modulate mental urges and faulty thinking patterns.

Although preliminary findings indicate that there are applications for MBIs in the treatment of behavioural addictions, further empirical and clinical research utilizing larger-sample controlled study designs is clearly needed. Despite this, both the classical Buddhist meditation literature and recent scientific findings appear to agree that when correctly practised and administered, mindfulness meditation is a safe, non-invasive, and cost-effective tool for treating behavioural addictions and for improving psychological health more generally.

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

Further reading

Griffiths, M.D., Shonin, E.S., & Van Gordon, W. (2015). Mindfulness as a treatment for gambling disorder. Journal of Gambling and Commercial Gaming Research, in press.

Shonin, E.S., Van Gordon, W. & Griffiths, M.D. (2013). Mindfulness-based interventions: Towards mindful clinical integration. Frontiers in Psychology, 4, 194, doi: 10.3389/fpsyg.2013.00194.

Shonin, E.S., Van Gordon, W. & Griffiths, M.D. (2013). Buddhist philosophy for the treatment of problem gambling. Journal of Behavioral Addictions, 2, 63-71.

Shonin, E., Van Gordon W., & Griffiths, M.D. (2014). Mindfulness as a treatment for behavioural addiction. Journal of Addiction Research and Therapy, 5: e122. doi: 10.4172/2155-6105.1000e122.

Shonin, E., Van Gordon W., & Griffiths, M.D. (2014). Current trends in mindfulness and mental health. International Journal of Mental Health and Addiction, 12, 113-115.

Shonin, E., Van Gordon, W., & Griffiths M.D. (2014). Cognitive Behavioral Therapy (CBT) and Meditation Awareness Training (MAT) for the treatment of co-occurring schizophrenia with pathological gambling: A case study. International Journal of Mental Health and Addiction, 12, 181-196.

Shonin, E., Van Gordon W., & Griffiths M.D. (2014). The emerging role of Buddhism in clinical psychology: Towards effective integration. Psychology of Religion and Spirituality, 6, 123-137.

Shonin, E., Van Gordon, W., & Griffiths M.D. (2014). The treatment of workaholism with Meditation Awareness Training: A case study. Explore: Journal of Science and Healing, 10, 193-195.

Shonin, E.S., Van Gordon, W. & Griffiths, M.D. (2014). Practical tips for using mindfulness in general practice. British Journal of General Practice, 624 368-369.

Shonin, E.S., Van Gordon, W. & Griffiths, M.D. (2015). Mindfulness in psychology: A breath of fresh air? The Psychologist: Bulletin of the British Psychological Society, 28, 28-31.

Shonin, E., Van Gordon W., Griffiths M.D. & Singh, N. (2015). There is only one mindfulness: Why science and Buddhism need to work together. Mindfulness, 6, 49-56.

Unfruitful approaches: Why are slot machine players so hard to study?

Anyone that researches in the area of slot machine gambling will know how difficult to can be to collect data from this group of gamblers. Over a decade ago, Dr. Jonathan Parke and I published a paper in the Journal of Gambling Issues on why slot machine players are so hard to study. Almost all of the things we wrote in that paper are still highly relevant today, so this blog briefly examines some of the issues we raised. The following explanations represented our experiences of several research efforts in attempting to examine the psychology of slot machine gamblers in the UK, Canada and the United States. Our explanations are roughly divided into three categories. More specifically, these relate to what we called (i) player-specific factors, (ii) researcher-specific factors, and (iii) miscellaneous external factors.

Player-specific factors: There are a number of player-specific factors that can impede the collection of reliable and valid data. These include factors such as activity engrossment, dishonesty/social desirability, motivational distortion, fear of ignorance, guilt/embarrassment, infringement of player anonymity, unconscious motivation/lack of self-understanding, chasing, and lack of incentive. These are explained in more detail below:

• Activity engrossment – Slot machine gamblers can become fixated on their playing almost to the point where they ‘tune out’ to everything else around them. We have observed that many gamblers will often miss meals and/or utilise devices (such as catheters) so that they do not have to take toilet breaks. Given these observations, there is sometimes little chance that we as researchers can persuade them to participate in research studies – especially when they are gambling on the machine when approached.
• Dishonesty/Social desirability – It is well known that some gamblers will lie and be dishonest about their gambling behaviour. Social and problem gamblers alike are subject to social desirability factors and will be dishonest about the extent of their gambling activities to researchers (in addition to those close to them). This obviously has implications for the reliability and validity of any data collected.
• Motivational distortion – Many slot machine gamblers experience low self-esteem and when participating in research may provide ego-boosting responses that lead to motivational distortion. For this reason, many report that they win more (or lose less) than they actually do. Again, this self-report data has implications for reliability and validity of the data.
• Fear of ignorance – We have observed that many slot machine gamblers report to understand how the slot machine works when in fact they know very little. This appears to be a ‘face-saving’ mechanism so that they do not appear to be stupid and/or ignorant to the researchers.
• Guilt/embarrassment – Slot machine gamblers can often be guilty and/or embarrassed to be in the gambling environment in the first place. They like to convince themselves that they are not ‘gamblers’ but simply ‘social players’ who visit gambling environments infrequently. We have found that gamblers will often cite their infrequency of gambling as a reason or excuse not participate in an interview or fill out a questionnaire. Connected with this, some gamblers just simply do not want to face up to the fact that they gamble.
• Infringement of player anonymity – Some slot machine gamblers clearly play on machines as a means of escape. Many gamblers will perceive the gaming establishment in which they are gambling as a ‘private’ (rather than public) arena. As such, researchers who approach them may be viewed as people who are infringing on their anonymity.
• Unconscious motivation and lack of self-understanding – Unfortunately, many slot machine gamblers do not understand why they gamble themselves. Therefore, articulating this accurately to researchers can be very difficult. Furthermore, many gamblers experience the ‘pull’ of the slot machine where they feel compelled to play despite their better judgment but cannot articulate why.
• Chasing – When trying to carry out research in the playing environments (e.g., arcades, casinos, bingo halls, etc.), many regular gamblers do not want to leave ‘their’ slot machine in case someone “snipes” their machine while they are elsewhere. Understandably, gamblers are more concerned with chasing losses than participating in an interview or filling out a questionnaire for a researcher.
• Lack of incentive – Some slot machine gamblers simply refuse to take part in research because they feel that there is “nothing in it for them” (i.e., a lack of incentive). Furthermore, very few gamblers take the view that their gambling habits and experiences can be helpful to others.

Researcher-specific factors: In addition to player-specific factors, there are also some researcher-specific factors that can impede the collection of data from slot machine gamblers. Most of these factors concern research issues relating to participant and non-participant observational techniques (i.e., blending in, subjective sampling and interpretation, and lack of gambling knowledge). These are expanded on further below:

• Blending in – The most important aspect of non-participant observation work while monitoring fruit machine players is the art of being inconspicuous. If the researcher fails to ‘blend in’, slot machine gamblers soon realise they are being watched. As a result, they are increasingly likely to change their behaviour in some way. For instance, some players will get nervous and/or agitated and stop playing immediately whereas others will do the exact opposite and try to show off by exaggerating their playing ritual. Furthermore, these gamblers will discourage spectators as they are often considered to be “skimmers” (individuals trying to make profits by playing “other peoples machines”). Blending into the setting depends upon a number of factors. If the gambling establishment is crowded, it is very easy to just wander around without looking too suspicious. The researcher’s experience, age and sex can also affect the situation. In the UK, amusement arcades are generally frequented by young men and elderly women. The general rule is that the older the researcher gets, the harder it will be for them to mingle in successfully. If the arcade is not too crowded then there is little choice but to be one of the ‘punters’. The researcher will probably need to stay in the arcade for lengthy periods of time, therefore spending money is unavoidable unless the researcher has a job there – an approach that Dr. Parke took to collect data.
• Subjective sampling and interpretation – When the researcher is in the gambling environment, they cannot possibly study everyone at all times, in all places. Therefore it is a matter of personal choice as to what data are recorded, collected and observed. This obviously impacts on the reliability and validity of the findings. Furthermore, many of the data collected during observation will be qualitative in nature and therefore will not lend themselves to quantitative data analysis.
• Lack of gambling knowledge – Lack of ‘street knowledge’ about slot machine gamblers and the environments they frequent (e.g., terminology that players use, knowledge of the machine features, gambling etiquette, etc.) can lead to misguided assumptions. For instance, non-participant observation may lead to the recording of irrelevant data and/or an idiosyncratic interpretation of something that is widely known amongst gamblers. As above, this can lead to subjective interpretation issues.

External factors: In addition to player-specific and researcher-specific factors, there are also some external factors that can impede the collection of data from slot machine gamblers. Most of these factors concern the gaming industry’s reactions to researchers being in their establishments although there are other factors too. These are briefly outlined below:

• Gaming establishment design – It is clear from many of the arcades and casinos that we have done research in over the years that many are not ideally designed for doing covert research in. Non-participant observation is often very difficult in small establishments or in places where the clientele numbers are low.
• “Gatekeeper” issues and beaurocratic obstacles – The questions of ‘how?’ and ‘where?’ to access to the research situation can be gained raise ethical questions. Access is often determined by “informants” (quite often an acquaintance of the researcher) or “gatekeepers” (usually the manager of the organisation etc.). Getting permission to carry out research in a gambling establishment can be very difficult and is often the hardest obstacle that a researcher has to overcome to collect the data required. Many establishments do not have the power to make devolved decisions and have to seek the permission of their head office. The prevention of access by the industry can be for many reasons but the main ones are highlighted next.
• Management concerns – From the perspective of arcade or casino managers, the last thing they want are researchers that disturb their clientele (i.e., their players), by taking them away from their gambling and/or out of the establishment. Furthermore, they do not want us to give their customers any chance to make gamblers feel guilty about their gambling. In our experience, this is something that researchers are perceived by management to do. This obviously impacts on whether permission to carry out research is given in the first place.
• Industry perceptions – From the many years we have spent researching (and gambling on) slot machines, it has become evident that there are some people in the gaming industry that view researchers such as ourselves as ‘anti-gambling’ and/or that any research will report negatively about their clientele or establishment/organization. As with management concerns, this again impacts on whether permission to carry out research is given in the first place.

Dr. Parke and I envisaged that our explanations might enhance future research in this area by providing researchers with an understanding of some of the difficulties with data collection. Unfortunately, identification of slot machine gamblers is often limited to a “search and seek” method of trawling local gambling establishments (e.g., amusement arcades, casinos etc.). Therefore, researchers are often limited to collecting data during play rather than outside of it. Obviously data facilitation would be better if gamblers were not occupied by their machine gambling.

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

Further reading

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

Griffiths, M.D. (1994). The observational analysis of marketing methods in UK amusement arcades. Society for the Study of Gambling Newsletter, 24, 17-24.

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

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

Parke, A., & Griffiths, M.D. (2004). Aggressive behavior in slot machine gamblers: A preliminary observational study. Psychological Reports, 95, 109-114.

Parke, A. & Griffiths, M.D. (2005). Aggressive behaviour in adult slot machine gamblers: A qualitative observational study. International Journal of Mental Health and Addiction, 2, 50-58.

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

Parke, J. & Griffiths. M.D. (2008). Participant and non-participant observation in gambling environments. ENQUIRE, 1, 1-18.

Griffiths, M.D. (2011). A typology of UK slot machine gamblers: A longitudinal observational and interview study. International Journal of Mental Health and Addiction, 9, 606-626.

It’s no fabrication: A brief look at ‘quilting addiction’

“I am addicted to quilting enjoying the color, texture and patterns. This [Pinterest] board inspires me in color, quilts, designs and quilting!” (Kim Hazlett)

“My name is Laura and I’m addicted to quilting. I know there could be worse addictions, so all things considered, quilting is a harmless addiction. Unless that is, you are running out of time to do it all!. I did 4 [square blocks] over the past week and a half. I jumped ahead. I couldn’t help it. The more I make, the more I want to keep on making them! At this rate I’ll surely have all 111 blocks finished by 2012. Not that there’s a deadline)” (Laura)

“Addiction to quilting? Are you being serious?” I hear you say. Obviously there is no scientific research on ‘quilting addiction’ (although there is academic research on quilting that I’ll talk about later in this article) but a quick Google search shows there are numerous websites devoted to the topic (for example, Addicted to Quilts, My Quilting Addiction, Sew Addicted To Quilting, My Quilt Place, Quilt Addicts Anonymous, Addicted to Fabric, etc.). None of these sites are really about addiction but more about people’s overwhelming love of quilting (either professionally or personally). There are even books on the topic such as Get Addicted To Free-Motion Quilting (by Sheila Sinclair Snyder) and dedicated webpages such as ‘Addicted To Scraps’ on the Quiltmaker website or ’15 reasons to get addicted to Kantha quilts’ on the Houzz website.

Renelda Peldunas-Harter (RPH), author of From Ensign’s Bars to Colonel’s Stars: Making Quilts to Honor Those Who Serve and author of the online article ‘Are you addicted to quilting?’ asserted:

“Quilting is habit-forming and I’m going to try and break down certain aspects of the addiction. I’m going to throw a disclaimer in right here – I am not trained to diagnose or explain anything, I am merely an observer and chronicler of the quilting animal and want to share my observations. Quilters can display many ‘habit-forming’ behaviors”.

RPH breaks quilting into three categories – the fabrics, the tools used, and stash building (more of which later in the blog). More specifically, quilting addiction depends upon the type of fabrics chosen to make quilts, the number of different tools the quilter owns to make quilts, and (probably the most obvious indicators of an addiction) the accumulating of quilting paraphernalia. For RPH, stash building encompasses many things:

“It can mean an obsession to make quilt related gifts, compulsion to collect quilt magazines, quilt gadgets, quilt patterns, fabric/items with a certain theme, machines, patterns, or buying large/medium/small amounts of fabric in general with no earthly idea of what to do with it – otherwise known as stash building!”

With tongue firmly in cheek, the article outlines ‘The Quilting Commandments, which if adhered to could certainly indicative of addiction: “(1) Always buy new fabric no matter how much you already have; (2) Sew all day and night – absolutely no cooking permitted; (3) Always start a new quilt before the last one is finished; (4) Repeat Step 1”.

While researching this article, I was surprised to find that there had been quite a bit of research on quilting. In a 2001 paper in the World Leisure Journal, Dr. Faye King examined the social dynamics of quilting (based on her own 1997 PhD thesis). Based on her research, Faye reached three main conclusions: (i) quilting expresses powerful rhetorical statements about the maker’s values and social concerns (in which Faye provides a number of examples of where quilts were created to make political statements); (ii) quilting can have a social impact on society as well as their individual maker (those donated to charities and hospitals for sick children); and (iii) quilting provides meaning for the maker and as a leisure activity can help help reduce stress in one’s life (which indirectly provides a reason as to why some people might theoretically develop an ‘addiction’).

A qualitative study by Dr. Rhiannon Gainor of 25 quilters that run their own quilting websites and/or blogs examined motivations for quilting and their expressions of personal creativity. One of the salient themes that emerged was ‘quilting as passion’ and described by some as an addiction. More specifically, Gainor noted that:

“Quilters also wrote about quilting being a passion, an addiction, and a lifelong interest. These kinds of comments on the sites made it clear that quilting for many is more avocation than pastime, supporting Stebbins’ (2004) definition of the serious leisure enthusiast as one finding gratification and fulfillment, rather than mere fun, in their chosen activity”.

Dr. Marybeth Stalp has written a few papers on quilting. In one of them published in a 2008 issue of the journal Home Cultures, she examined the “stash” of those that engaged in domestic handicraft (including quilters). She makes a reference to addiction:

“Those who create domestic arts and handcrafts are quite familiar with the term ‘stash’ and may even have one (or more). While it is not a reference to addictive drugs (or is it?), questions regarding the stash illuminate the themes that exist within the stash and the ‘lifeworlds’ of the collectors of the stash”.

Via participant observation and interviews, the paper examined the meaning and role of the stash in the lives of knitters, quilters, and crocheters. Arguably, the findings use the language of addictions in various places:

“Handcrafters collectively refer to their collections as ‘stash,’ hoard whatever they collect over time, find un/official support groups to support their habits, and together strategize hiding places and storage. Collecting, hoarding, and hiding stash is quite normal for crafters, yet such acts are often deviant to others, particularly those who share their living space. Often the stash is portrayed negatively by non-crafting family members and friends, as well as the popular media, and sometimes even by handcrafters themselves…The handcrafter continues to acquire and stash fabric, yarn, floss, etc. despite how much space the stash demands, or how the stash influences relationships with others. The larger social structures of family, work and friends shape how we think about our stashes”.

In an earlier paper published in a 2006 issue of the journal Textile: The Journal of Cloth and Culture, Stalp presented her results of a four-year ethnographic study of 70 US amateur quilters. She examined the “guilty pleasures surrounding quilting practices, including the deviant acts of hiding both identity and fabric from family members and friends”. The paper describes how quilters slowly build up their stash of fabric, purchasing more fabric than they need than necessary, and both hoarding and strategically hiding it from their families. She then goes on to say that:

“Women’s anxieties surrounding acquiring, hoarding, and hiding their fabric stashes highlight their diminished ability, relative to their spouses and their children, to pursue leisure activities without a stigma. Collecting and hiding the fabric stash become symbolic of women’s attempts to carve out time and space for themselves amid the multiple demands placed on them by such greedy institutions such as family and the workplace”. 

Another academic who has written a few papers on quilting is Dr. Rosemary Wilkinson. Her first paper on the topic in the International Journal of the Humanities examined the rhetoric of obsession, addiction, guilt, and subterfuge in two Australian quilters’ magazines (Down Under Quilts and Quilters Companion) over a five-year period. She reported that while some of the quilting publications describe the benefits of quilting to individuals and communities, she also noted the ways in which the magazines integrate the “rhetotic of addiction” in constructing of the identity of quilters. She concludes that:

“[This] ploy seemingly at odds with the overall positive and promotional tone of the magazines…[the findings] demonstrate that the concept of addiction is exploited within the magazines to reinforce the quilter’s creative drive, her communal belonging and her vocation”.

In a more recent 2014 paper in the journal TEXT, Dr. Williamson reprised the same findings:

“Both the turning towards and the intensity of commitment to quilts may be expressed through metaphors of addiction, illness or affliction. The rhetoric of addiction is well established among quilters generally, and has occurred in [Australian quilting magazines] since their inception…Profiles from 2010 to 2013 contain references to, for example, catching ‘the quilting bug’…or other phrases that translate commitment into popular clichés of addiction (‘Jenny began a creative journey that soon became an addiction, as is so often the case’)…Frequent references in profiles to quilters’ passion for what they do, even if expressed in clichés of addiction, connote personal commitment and satisfaction as driving forces for career development that is organic and responsive to, and accommodating of, personal circumstances”.

In reading the academic papers on quilting, I got the sense that the word ‘addiction’ was being used in a non-clinical sense and as a metaphor for justifying the amount of time that quilters engaged in their passion and pastime. There was little evidence of negative detriment although some quilters clearly feel they need to lie about or hide away aspects of their hobby.

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

Further reading

Bratich, J. Z., & Brush, H. M. (2011). Fabricating activism: Craft-work, popular culture, gender. Utopian Studies, 22(2), 233-260.

Gainor, R. (2011). Hobby quilting websites and voluntary provision of information. New Directions in Folklore, 9(1/2), 41-67.

King, F.L. (2001). Social dynamics of quilting. World Leisure Journal, 43(2), 26-29.

Peldunas-Harter, R. (2014). Are you addicted to quilting? Take the quiz. Schiffer Publishing, December 15. Located at: http://schifferpublishing.tumblr.com/post/105289542106/are-you-addicted-to-quilting-take-the-quiz

Sayasane, J.H. (2011). My quilting addiction explained. Quilters Newsletter, March 2. Located at: http://www.quiltersnewsletter.com/blogs/insideqn/2011/03/02/my-quilting-addiction-explained/

Stalp, M. C. (2006). Hiding the (fabric) stash: Collecting, hoarding, and hiding strategies of contemporary US quilters. Textile: The Journal of Cloth and Culture, 4(1), 104-124.

Stalp, M. C., & Winge, T. M. (2008). My collection is bigger than yours: Tales from the handcrafter’s stash. Home Cultures, 5(2), 197-218.

Stebbins, R. (2007). Serious Leisure: A Perspective for Our Time. New Brunswick, NJ: Transaction Publishers.

Williamson, R. (2008). Obsession, guilt, subterfuge and penury: The rhetoric of addiction and the construction of creative identity in Australian quilters’ magazines. The International Journal of the Humanities, 5(11), 163-70.

Williamson, R. (2014). Modelling the creative and professional self: The magazine profile as narrative of transition and transformation. TEXT, Special Issue 25. Australasian magazines: new perspectives on writing and publishing. http://www.textjournal.com.au/speciss/issue25/Williamson.pdf

Distraction plans: Excessive smartphone use and pain perception

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

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

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

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

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

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

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

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

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

Further reading

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

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

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

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

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

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

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

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

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

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

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

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