Blog Archives

Story rebellion: A brief look at ‘news addiction’

Earlier this year, I was contacted by a BBC reporter asking me what the latest research on ‘news addiction’ was. I politely told him I was unaware of any such research and that if ‘news addiction’ existed, it would be more akin to ‘television addiction’ or ‘boxset bingeing’. About a month after that call, a paper on ‘news addiction’ was published in the Journal of the Dow University of Health Sciences Karachi by Pakistani psychologists Ghulam Ishaq, Rafia Rafique, and Muhammad Asif.

I have to admit that some might say I’m a bit of a ‘news junkie’. As soon as I get up in the morning or as soon as I come home from work I switch on the radio or television to listen to the news. However, I do not consider my love of listening to the news to be an addiction, and I suspect most people like me wouldn’t either. Of course, there are now other ways for individuals to get their ‘news fix’ including thousands of online news sites and via social media which is why Ishaq and his colleagues decided to look at the construct of ‘news addiction’. They claimed that:

“People are persuaded towards news. Similarly, engrossment of certain individuals in any domain from politics, sports, global issues, arson or terrorism can also promote news habituation or addiction and intensify inspection towards news. News addiction comes under the term behavioral-related behavior…When somebody interacts with news, this gives him/her satisfying feelings and sensations that he/she is not able to get in other ways. The reinforcement an individual gets from these feelings compels him to repeat their behavior to get these types of feelings and sensations repeatedly… eventually causing a disturbance in every sphere of life… individuals who are addicted to news feel themselves much obsessed to check the news in uncontrollable ways”.

Screen Shot 2017-12-04 at 16.42.08Theoretically there is no reason why individuals cannot be addicted to reading and/or listening to the news as long as they are being constantly rewarded for their behaviour. In fact, the authors used some of my papers on behavioural addiction more generally to argue for the construct of ‘news addiction’ as a construct to be empirically investigated. In their study, Ishaq and colleagues wanted to examine the relationship between (the personality construct of) conscientiousness, neuroticism, self-control, and news addiction. Conscientiousness is a personality trait and refers to individuals who are orderly, careful, and well organised. Neuroticism is another major personality trait and refers to individuals who have high mental instability such as depression and high anxiety. The researchers hypothesised that there would be negative correlation between conscientiousness and news addiction, and that neuroticism would be positively correlated with news addiction.

To test their hypotheses, a survey was completed by 300 participants (aged 18 to 60 years; average age 39 years) from major cities of the Punjab (Lahore, Multan, Bahawalpur, Faisalabad, Sargodha). The authors developed their own 19-item News Addiction Scale (NAS) although the paper didn’t give any examples of any of the items in the NAS. They also administered the ‘Big Five Inventory’ (which assesses five major personality traits – Openness, Conscientiousness, Extraversion, Agreeableness, and Neuroticism). The study found that the hypotheses were supported (i.e., news addiction was positively correlated with neuroticism and negatively correlated with conscientiousness. Previous literature has consistently shown that there is relationship between personality traits and behavioural addiction. The findings of this study are very similar to those more widely in the general literature for both substance and behavioural addictions (which also show most addictions have a low correlation with conscientiousness and a high correlation with neuroticism). The authors also argued that:

“(The findings show that) self-control plays an active role [in] refraining from the instant pleasure of impulse that would hinder with daily functioning and attainment goals…[The] current study findings demonstrated that self-control acts as a mediating variable between conscientiousness, neuroticism and news addiction”.

They also reported that females had higher scores on neuroticism and conscientiousness and that males had higher scores on the News Addiction Scale. The authors also claimed that there was much similarity between social media addiction (although provided no evidence for this except to say that they were both examples of behavioural addiction).

There was no mention at all in the paper about how their participants accessed their news. I access most (but certainly not all) of my news via television and therefore if I was watching an abnormal amount of news on the television, this would more likely be a sub-type of television addiction or a sub-type of television binge-watcher (both of which have been reported in the psychological literature). If someone addictively accessed all their news online or via social media, this could perhaps come under more general umbrella terms such as ‘internet addiction’ or ‘social media addiction’.

However, things are further complicated by the fact that ‘news’ can be defined in a number of ways. In the study by Ishaq and colleagues, news was defined as a statement of specific information and facts and figures on any substantial event” but such a definition doesn’t take into account such things as political opinions and nor does it define what a ‘substantial event’ is. Given that this is the only study on news addiction that I am aware of, I’ll need a lot more research evidence before I am convinced that it really exists.

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

Further reading

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

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

Ishaq, G., Rafique, R., & Asif, M. (2017). Personality traits and news addiction: Mediating role of self-control. Journal of Dow University of Health Sciences, 11(2), 31-53.

Orosz, G., Bőthe, B., & Tóth-Király, I. (2016). The development of the Problematic Series WatchingScale (PSWS). Journal of Behavioral Addictions, 5(1), 144-150.

Orosz, G., Vallerand, R. J., Bőthe, B., Tóth-Király, I., & Paskuj, B. (2016). On the correlates of passion for screen-based behaviors: The case of impulsivity and the problematic and non-problematic Facebook use and TV series watching. Personality and Individual Differences, 101, 167-176.

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

Walton-Pattison, E., Dombrowski, S.U. & Presseau, J. (2017). ‘Just one more episode’: Frequency and theoretical correlates of television binge watching. Journal of Health Psychology, doi:1359105316643379

Serial delights: Killing as an addiction

A couple of days ago I watched the 2007 US psychological thriller Mr. Brooks. The film is about a celebrated businessman (Mr. Earl Brooks played by Kevin Costner) who also happens to be serial killer (known as the ‘thumbprint killer’). The reason I mention all this is that the explanation given in the film by Earl for the serial killing is that it was an addiction. A number of times in the film he is seem attending Alcoholics Anonymous and quoting from the 12-step recovery program to help him ‘beat his addiction’. With the help of the AA Fellowship, he had managed not to kill anyone for two years but at the start of the film, Earl’s psychological alter-ego (‘Marshall’ played by William Hurt) manages to coerce Earl into killing once again. I won’t spoil the plot for people who have not seen the film but the underlying theme that serial killing is an addiction that Earl is constantly fighting against, is embedded in an implicit narrative that addiction somehow ‘explains’ his behaviour and that he is not really responsible for it. This is not a view I hold myself as all addicts have to take some responsibility for their behaviour.

serial-killers-serial-killers-5806919-532-459

The idea of serial killing being conceptualized as an addiction in popular culture is not new. For instance, Brian Masters book about British serial killer Dennis Nilsen (who killed at least 12 young men and was also a necrophile) was entitled Killing for Company: The Story of a Man Addicted to Murder, and Mikaela Sitford’s book about Harold Shipman, the British GP (aka ‘Dr. Death’) who killed over 200 people, was entitled Addicted to Murder: The True Story of Dr. Harold Shipman.

One of the things that I have always argued throughout my career, is that someone cannot become addicted to an activity or a substance unless they are constantly being rewarded (either by continual positive and/or negative reinforcement). Given that serial killing is a discontinuous activity (i.e., it happens relatively infrequently rather than every hour or day) how could killing be an addiction? One answer is that the act of killing is part of the wider behaviour in that the preoccupation with killing can also include the re-enacting of past kills and the keeping of ‘trophies’ from the victims (which I overviewed in a previous blog). As the author of the book Freud, Profiled: Serial Killer noted:

“The serial killer is most often described as a kind of addict. Murder is his addiction, the thrill achieved in murder his ‘kick.’ This addiction requires a maintenance ‘fix.’ At first, the experience is wonderfully exhilarating, later the fix is needed to just feel normal again. It is a hard habit to break, the hungering sensation to consume another life returns. Between murders, they often play back video or sound recordings or look at photos made of their previous murders. This voyeurism provides a surrogate death-meal until their next feeding”.

In Eric Hickey’s 2010 book Serial Murderers and Their Victims, Dr. Hickey makes reference to an unpublished 1990 monograph by Dr. Victor Cline who outlined a four-factor addiction syndrome in relation to sexual serial killers who (so-called ‘lust murderers’ that I also examined in a previous blog). More specifically:

“The offender first experiences ‘addiction’ similar to the physiological/psychological addiction to drugs, which then generates stress in his or her everyday activities. The person then enters a stage of ‘escalation’, in which the appetite for more deviant, bizarre, and explicit sexual material is fostered. Third, the person gradually becomes ‘desensitized’ to that which was once revolting and taboo-breaking. Finally, the person begins to ‘act out’ the things that he or she has seen”.

This four-stage model is arguably applicable to serial killing more generally. It also appears to be backed up by one of the most notorious serial killers, Ted Bundy. In an interview with psychologist Dr. James Dobson (found in Harold Schecter’s 2003 book The Serial Killer Files: The Who, What, Where, How, and Why of the World’s Most Terrifying Murderers), Bundy claimed:

“Once you become addicted to [pornography], and I look at this as a kind of addiction, you look for more potent, more explicit, more graphic kinds of material. Like an addiction, you keep craving something which is harder and gives you a greater sense of excitement, until you reach the point where the pornography only goes so far – that jumping-off point where you begin to think maybe actually doing it will give you that which is just beyond reading about it and looking at it”.

Dr. Hickey claims that such urges to kill are fuelled by fantasies that have become well-developed and killers to vicariously gain control of other individual. He also believes that fantasies for lust killers are far greater than an escape, and becomes the focal point of all behaviour. He concludes by saying that “even though the killer is able to maintain contact with reality, the world of fantasy becomes as addictive as an escape into drugs”. In the book The Serial Killer Files, Harold Schechter notes that:

“For homicidal psychopaths, lust-killing often becomes an addiction. Like heroin users, they not only become dependent on the thrilling sensation – the rush – of torture, rape, and murder; they come to require ever greater and more frequent fixes. After a while, merely stabbing a co-ed to death every few months isn’t enough. They have to kill every few weeks, then every few days. And to achieve the highest pitch of arousal, they have to torture the victim before putting her to death. This kind of escalation can easily lead to the killer’s own destruction. Like a junkie who ODs in his urgent quest to satisfy his cravings, serial killers are often undone by their increasingly unbridled sadism, which drives them to such reckless extremes that they are finally caught. Monsters tend to be sadists, deriving sexual gratification from imposing pain on others. Their secret perversions, at first sporadic, often trap them in a pattern as the intervals between indulgences become briefer: it is a pattern whose repetitions develop into a hysterical crescendo, as if from one outrage to another the monster were seeking as a climax his own annihilation”.

Schecter uses the ‘addiction’ explanation for serial killing throughout his writings even for serial killers from the past including American nurse Jane Toppan (the ‘Angel of Death’) who confessed to 33 murders in 1901 and died in 1938 (“she became addicted to murder”), cannibalistic child serial killers Gilles Garnier (died in 1573) and Peter Stubbe (died 1589) (“both became addicted to murder and cannibalism, both preferred to prey upon children”), and Lydia Sherman (died 1878) who killed 8 children including six of her own (“confirmed predator, addicted to cruelty and death”).

In a recent 2012 paper on mental disorders in serial killers in the Iranian Journal of Medical Law, Dr. N. Mehra and A.S. Pirouz quoted the literary academic Akira Lippit who argued that in films, the “completion of each serial murder lays the foundation for the next act which in turn precipitates future acts, leaving the serial subject always wanting more, always hungry, addicted”. They then go on to conclude that:

“Once a killer has tasted the success of a kill, and is not apprehended, it will ultimately mean he will strike again. He put it simply, that once something good has happened, something that made the killer feel good, and powerful, and then they will not hesitate to try it again. The first attempt may leave them with a feeling of fear but at the same time, it is like an addictive drug. Some killers revisit the crime scene or take trophies, such as jewelry or body parts, or video tape the scenario so as to be able to re-live the actual feeling of power at a later date”.

Although I haven’t done an extensive review of the literature, I do think it’s possible – even on the slimmest of empirical bases presented here – to conceptualize serial killing as a potential behavioural addiction for some individuals. However, it will always depend upon how addiction is defined in the first place.

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

Further reading

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

Brophy, J. (1967). The Meaning of Murder. London: Crowell.

Hickey, E.W. (2010). Serial Murderers and Their Victims (Fifth Edition). Pacific Grove, CA: Brooks/Cole.

Lippit, A.M. (1996). The infinite series: Fathers, cannibals, chemists. Criticism, Summer, 1-18.

Masters, B. (1986). Killing for Company: The Story of a Man Addicted to Murder. New York: Stein and Day.

Mehra, N., & Pirouz, A. S. (2012). A study on mental disorder in serial killers. Iranian Journal of Medical Law, 1(1), 38-51.

Miller, E. (2014). Freud, Profiled: Serial Killer. San Diego: New Directions Publishing.

Schecter, H. (2003). The Serial Killer Files: The Who, What, Where, How, and Why of the World’s Most Terrifying Murderers. New York: Ballantine Books

Sitford, M. (2000). Addicted to Murder: The True Story of Dr. Harold Shipman. London: Virgin Publishing.

Taylor, T. (2014). Is serial killing an addiction? IOL, April 9. Located at: http://www.iol.co.za/news/crime-courts/is-serial-killing-an-addiction-1673542

Dream lovers: Can lucid dreaming be addictive?

Last week I watched the South Korean film Lucid Dream (a 2017 Netflix original that premiered on June 2), the directorial debut by Kim Joon-sung. For those who don’t know, lucid dreams are those in “which the dreamer is aware of dreaming. During lucid dreaming, the dreamer may be able to exert some degree of control over the dream characters, narrative, and environment” (Wikipedia). The reason I mention this is because one of the characters in the film claims he is ‘addicted’ to lucid dreams. Obviously the use of the word ‘addicted’ in this context piqued my interest (in what must be said was a mediocre film).

Unknown

I’ve been fascinated by lucid dreams even before I knew what they were. Although I’ve suffered from insomnia for most of my life, I’m also someone that has very vivid dreams when I sleep. I learned a lot more about lucid dreaming during my PhD at the University of Exeter because one of my best friends (Rob Rooksby) was carrying out research into the area. Over the course of a few years, I had many conversations with Rob about the topic (both professional and personal) because I had experienced lucid dreams myself (and still do).

One of the academics that Rob mentioned many times to me was the psychologist Dr. Jayne Gackenbach who at the time was editor of a journal called Lucidity Letter (and in which Rob had a couple of papers published in, see ‘Further reading’ below. By co-incidence, I came to know Dr. Gackenbach professionally in the 1990s and since then I have written three chapters in some of her edited books – two on internet addiction and one on Game Transfer Phenomena – also see ‘Further reading’ below). In a short 1987 paper in Lucidity Letter, Dr. Gackenbach claimed that lucid dreaming could be potentially addictive:

“I would caution against taking an attitude toward the lucid dream state of it being unrelated to waking life. This could result in undue absorption in lucid dreaming, leading potentially to addiction (see the letter by Barroso in [the December, 1987] issue of Lucidity Letter for an excellent example)…After hearing about Tholey’s training of an Olympic athlete with dream lucidity, a colleague spontaneously remarked, “Dream lucidity is really the ultimate drug!” Yes, the state has that potential. But so too comes the potentiality of abuse through ignorance of proper use and possibly addiction”.

Consequently, I managed to track down a copy of Mark Barroso’s 1987 published letter where he asserted that:

“I would like to comment on how lucid dreaming became counterproductive. Like most everything else I’ve enjoyed, too much of it could be very destructive. Living in the dream world became preferable to reality. I would lay in bed, miss work, and wrap myself in a catatonic state in which to spin dreams, dreams, dreams. I would sleep in public places to use various stimuli for my lucid dreams: a park, a downtown bench, the beach, park the car near a school yard of children playing. If you have mastered lucid dreaming, you should try this, it really is incredible. Real and random sounds factor in the dream. Basically, all I did was lucid dream and nothing else. With a life like that it could be hard to pay the rent. So I just stopped. Over time I lost the ability to lucid dream…Although I never regarded myself as having a special ability, it never occurred to me that others did this as well. I finally “O.D.’d” on lucid dreaming when I stayed in bed for 4 or 5 days, only rising to drink and use the bathroom. I was a hermit with no other ambition. I got a job where people were counting on me to show up and found within me the motivation to shake the cobwebs from my eyes”.

Although I am highly sceptical that lucid dreaming can be potentially addictive, Barroso’s letter does contain anecdotal evidence at least suggestive of addiction-like symptoms where lucid dreaming completely took over his life and impacted negatively on every area of his life. These aren’t the only references to ‘lucid dreaming addiction’ in the academic literature. In a 1990 book by Dr. Stephen LaBerge and Dr. Howard Rheingold entitled Exploring The World of Lucid Dreaming, one chapter (‘Preparing for learning lucid dreaming’) featured a ‘Q&A’ section including the following question and answer:

“Q. Lucid dreams are so exciting and feel so good that real life pales by comparison. Isn’t it possible to get addicted to them and not wish to do anything else? 

A. It may be possible for the die-hard escapist whose life is otherwise dull to become obsessed with lucid dreaming. Whether or not this deserves to be called addiction is another question. In any case, some advice for those who find the idea of “sleeping their life away” for the sake of lucid dreaming is to consider applying what they have learned in lucid dreams to their waking lives. If lucid dreams seem so much more real and exciting, then this should inspire you to make your life more like your dreams – more vivid, intense, pleasurable, and rewarding. In both worlds your behavior strongly influences your experience”.

Another similar Q&A featured on the World of Lucid Dreaming (WLD) website founded by Rebecca Turner. One of the WLD readers (‘Nikki’) asked Turner: Is lucid dreaming addictive? I really want to have lucid dreams but I read that lucid dreaming is really addictive and this worries me. Would you compare this need to taking drugs? How do you keep control over it?” Turner responded by saying: “I [too] have read in the media that “lucid dreaming is addictive” but this is a poor use of language. They are trying to say that it’s highly enjoyable and you’ll want to do it more”.

As far as I am aware, no empirical study has ever examined addiction to lucid dreaming although there are plenty of individuals on various lucid dreaming online forums who have claimed that such activity can be addictive from either their own experiences or by those known to them. Here are a few of the more detailed examples I have come across:

  • Extract 1: “I first lucid dreamed purposely about 5-6 years ago. For the past year and a half. I’ve lucid dreamed every single night, except when I’m really drunk, I don’t seem to dream then. I have a bit of an addictive personality, I smoke weed every day. I have a sex in my dreams very often, a few times a week, and they almost always end up with an orgasm and a wet awakening later. I always just have the greatest times and see the greatest things while I’m dreaming. But it is getting harder and harder to get up in the morning. I will sleep an extra 2-3 hours after I want to wake up because I don’t want to leave the dream world, and I find if I go to sleep while the dream is fresh in my mind still I can continue it with ease. I have lost many jobs, and fucked up many opportunities because I couldn’t get out of bed in the morning…Now I am on welfare, get money from the government every month, and I sleep all the time, I have no set sleep schedule, I sleep in the day, I sleep at night, I sleep whenever I feel like it. I feel like the second my head hits the pillow I’m sucked into another world in my head. I daydream whenever I’m not sleeping, I’ve lost track of time. My whole world feels like a lucid dream now” (Steezy 233).
  • Extract 2: I think I spend at least half of my nights lucid dreaming. I never get tired of it…I love the world my mind creates every night…I have a really long history with lucid dreaming and hallucinations, but if I were to go that in-depth this post would end up being a novel or something. Long story short, I used to have hypnagogic hallucinations and sleep paralysis every night when I was young (4-10, I think)…Then one night I had my first lucid dream, and did some investigating…I became better and better at lucid dreaming, and somehow parts of my dream world have become consistent (architecture, people, holidays even). I love living in the dream world. It’s fun, and horrifying at times, but either way it’s exciting. But in the day, everything is drab. Living feels so dull and dead and repetitive and stressful…I love dreaming. I’m depressed when I’m not dreaming. Sometimes I wish I could dream and never wake up. I’m not suicidal or anything dangerous like thatI don’t really want people I know to know I have this addiction to dreaming” (‘JDBar’).
  • Extract 3: “When I first learned how to induce lucid dreams as a teenager, and then program the dream I wanted to have, it was intoxicating! Every night before I went to sleep I would have to decide if I wanted to do something romantic with a hunky male movie star, or save the world as Storm from the X-Men, or work on astral projection, or try to contact my friends who were also lucid dreaming, etc. I was practically living a double life because my night life was vastly different than my waking life.  I was becoming addicted to the pleasures of lucid dreaming. That habit led to some unfortunate experiences, however.  The more I explored the dream world and different planes of existence, the less connected I was to my waking life.  This was not at all healthy. It would take too long to explain everything that happened…but suffice it to say, it nearly destroyed my sanity. I eventually decided I had to plug back into my “real” life and leave some of the other world behind.  It took a couple of years to reconnect with the living instead of the astral” (Erin).
  • Extract 4: Well, I’ll admit that I went through a bad stage last year. I had high levels of anxiety and depression and I saw lucid dreaming as a way to escape from everything that was going on at school and in my life. I would even fake sick just to stay home and sleep all day to lucid dream. But something just changed lately and I’m no longer depressed…I don’t rely on lucid dreaming like I used to, instead I just see it as some fun. I wouldn’t say there’s any real reason not to lucid dream, though. It’s a lot of fun and can help with night terrors and nightmares” (Daydreamer14).

Most accounts I have come across online see the benefits of lucid dreaming as far outweighing any negatives. In fact, I came across a few websites claiming that lucid dreaming can be used as a method of overcoming more traditional addictions (similar to the idea of Dr. Bill Glasser’s positive addictions that I examined in a previous blog). For instance, at the Lucid Dream Leaf website it was claimed that:

“Lucid dreaming has a seemingly endless list of benefits attached to it. It can help people who are struggling with emotional pain, end recurring dreams and nightmares, expand consciousness, and so on. In addition to all of this, regular lucid dreaming practice can also be a useful tool to those in recovery (or moving toward recovery) from addictions”.

Other websites (such as the Remedy Free website) provide advice on how to overcome addiction to lucid dreaming or how to overcome problems with lucid dreaming (‘7 nasty side effects of lucid dreaming and how to fix them’ and ‘Lucid dreaming dangers – Obsession [Addiction]’). Although I’ve argued that any activity can be potentially addictive as long as there are constant rewards from the activity, lucid dreaming can only occur when an individual is asleep, so unless someone is constantly sleeping, it doesn’t appear it could be an addiction by my own criteria – but as ever, I am happy to be proved wrong. I ought to add that some online articles (such as one on the Dreaming Life blogsite) claim that lucid dreaming can be a consequence of ‘sleeping addiction’ (but I’ll leave that for another blog).

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

Further reading

Barroso, M., (1987). Letter to the Editor. Lucidity Letter, 6(2). Retrieved from https://journals.macewan.ca/lucidity/article/view/763/704

Gackenbach, J. (1987). Clinical and transpersonal concerns with lucid dreaming voiced. Lucidity Letter, 6(2), 1-4.

Glasser, W. (1976), Positive Addictions. Harper & Row, New York, NY.

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

LaBerge, S., & Rheingold, H. (1990). Exploring The World of Lucid Dreaming. New York: Ballantine Books.

Ortiz de Gortari, A.B. & Griffiths, M.D. (2012). An introduction to Game Transfer Phenomena in video game playing. In J. Gackenbach (Ed.), Video Game Play and Consciousness (pp.223-250). Hauppauge, NY: Nova Science.

Rooksby, R. (1989). Problems in the historical research of lucid dreaming. Lucidity Letter, 8(2), 75-80.

Rooksby, B., & Terwee, S. (1990). Freud, van Eeden and lucid dreaming. Lucidity Letter, 9(2), 1-10.

Widyanto, L. & Griffiths, M.D. (2006). Internet addiction: Does it really exist? (Revisited). In J. Gackenbach (Ed.), Psychology and the Internet: Intrapersonal, Interpersonal and Transpersonal Applications (2nd Edition), (pp.141-163). New York: Academic Press.

Wikipedia (2017). Lucid dream. Located at: https://en.wikipedia.org/wiki/Lucid_dream

Tubular hells: A brief look at ‘addiction’ to watching YouTube videos

 

A few days ago, I unexpectedly found my research on internet addiction being cited in a news article by Paula Gaita on compulsive viewing of YouTube videos (‘Does compulsive YouTube viewing qualify as addiction?‘). The article was actually reporting a case study from a different news article published by PBS NewsHour by science correspondent Lesley McClurg (‘After compulsively watching YouTube, teenage girl lands in rehab for digital addiction’). As Gaita reported:

“The story profiles a middle school student whose obsessive viewing of YouTube content led to extreme behavior changes and eventually, depression and a suicide attempt. The student finds support through therapy at an addiction recovery center…The student in question is a young girl named Olivia who felt at odds with the ‘popular’ kids at her Oakland area school. She began watching YouTube videos after hearing that it was a socially acceptable thing to do… Her viewing habits soon took the place of sleep, which impacted her energy and mood. Her grades began to falter, and external problems within her house – arguments between her parents and the death of her grandmother – led to depression and an admission of wanting to hang herself. Her parents took her to a psychiatric hospital, where she stayed for a week under suicide watch, but her self-harming compulsion continued after her release. She began viewing videos about how to commit suicide, which led to an attempt to overdose on Tylenol[Note: The name of the woman – Olivia – was a pseudonym].

McClurg interviewed Olivia’s mother for the PBS article and it was reported that Olivia went from being a “bubbly daughter…hanging out with a few close friends after school” to “isolating in her room for hours at a time”. Olivia’s mother also claimed that her daughter had always been kind of a nerd, a straight. A student who sang in a competitive choir. But she desperately wanted to be popular, and the cool kids talked a lot about their latest YouTube favorites”. According to news reports, all Olivia would do was to watch video after video for hours and hours on end and developed sleeping problems. Over time, the videos being watched focused on fighting girls and other videos featuring violence.

maxresdefault

The news story claimed that Olivia was “diagnosed with depression that led to compulsive internet use”. When Olivia went back home she was still feeling suicidal and then spent hours watching YouTube videos on how to commit suicide (and it’s where she got the idea for overdosing on Tylenol tablets).

After a couple of spells in hospital, Olivia’s parents took her to a Californian centre specialising in addiction recovery (called ‘Paradigm’ in San Rafael). The psychologist running the Paradigm clinic (Jeff Nalin) claimed Olivia’s problem was “not uncommon” among clients attending the clinic. Nalin believes (as I do and have pointed out in my own writings) that treating online addictions is not about abstinence but about getting the behaviour under control but developing skills to deal with the problematic behaviour. He was quoted as saying:

“I describe a lot of the kids that we see as having just stuck a cork in the volcano. Underneath there’s this rumbling going on, but it just rumbles and rumbles until it blows. And it blows with the emergence of a depression or it emerges with a suicide attempt…The best analogy is when you have something like an eating disorder. You cannot be clean and sober from food. So, you have to learn the skills to deal with it”.

The story by Gaita asked the question of whether compulsive use of watching YouTube could be called a genuine addiction (and that’s where my views based on my own research were used). I noted that addiction to the internet may be a symptom of another addiction, rather than an addiction unto itself. For instance, people addicted to online gambling are gambling addicts, not internet addicts. An individual addicted to online gaming or online shopping are addicted to gaming or shopping not to the internet.

An individual may be addicted to the activities one can do online and is not unlike saying that an alcoholic is not addicted to a bottle, but to what’s in it. I have gone on record many times saying that I believe anything can be addictive as long there are continuous rewards in place (i.e., constant reinforcement). Therefore, it’s not impossible for someone to become addicted to watching YouTube videos but the number of genuine cases of addiction are likely to be few and far between. Watching video after video is conceptually no different from binge watching specific television series or television addiction itself (topics that I have examined in previous blogs).

I ought to end by saying that some of my own research studies on internet addiction (particularly those co-written with Dr. Attila Szabo and Dr. Halley Pontes and published in the Journal of Behavioral Addictions and Addictive Behaviors Reports – see ‘Further reading’ below) have examined the preferred applications by those addicted to the internet, and that the watching of videos online is one of the activities that has a high association with internet addiction (along with such activities such as social networking and online gaming). Although we never asked participants to specify which channel they watched the videos, it’s fair to assume that many of our participants will have watched them on YouTube), and (as the Camelot lottery advert once said) maybe, just maybe, a few of those participants may have had an addiction to watching YouTube videos.

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

Further reading

Gaita, P. (2017). Does compulsive YouTube viewing qualify as addiction? The Fix, May 19. Located at: https://www.thefix.com/does-compulsive-youtube-viewing-qualify-addiction

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

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

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

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

Kuss, D.J. & Griffiths, M.D. (2015). Internet Addiction in Psychotherapy. Basingstoke: Palgrave Macmillan.

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

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

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

McClurg, L. (2017). After compulsively watching YouTube, teenage girl lands in rehab for ‘digital addiction’. PBS Newshour, May 16. Located at: http://www.pbs.org/newshour/rundown/compulsively-watching-youtube-teenage-girl-lands-rehab-digital-addiction/

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.

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

Fun in the sun? Does ‘tanorexia’ (addiction to sunshine) really exist?

If the many media reports are to be believed, a 2014 study published in the journal Cell claimed that “sunshine can be addictive like heroin”. In an experiment carried out on mice, a research team led by Dr. Gillian Fell at the Harvard Medical School in Boston (US) reported that ultraviolet exposure leads to elevated endorphin levels (endorphins being the body’s own ‘feel good’ endogenous morphine), that mice experience withdrawal effects after exposure to ultraviolet light, and that chronic ultraviolet causes dependency and ‘addiction-like’ behaviour.

Although the study was carried out on animals, the authors speculated that their findings may help to explain why we love lying in the sun and that in addition to topping up our tans, sunbathing may be the most natural way to satisfy our cravings for a ‘sunshine fix’ in the same way that drug addicts yearn for their drug of choice.

Reading the findings of this study took me back to 1998 when I appeared as a ‘behavioural addiction expert’ on Esther Rantzen’s daytime BBC television show that featured people who claimed they were addicted to tanning (and was dubbed by the researchers on the programme as ‘tanorexia’). I have to admit that none of the case studies on the show appeared to be addicted to tanning at least based on my own behavioural addiction criteria (i.e., salience, mood modification, tolerance, withdrawal, conflict, and relapse) but it did at least alert me to the fact that some people thought sunbathing and tanning was addictive (in fact, the people on the show said their excessive tanning was akin to nicotine addiction).

4fa262e602de9.image

There certainly appeared to be some similarities between the people interviewed and nicotine addiction in the sense that the ‘tanorexics’ knew they were significantly increasing their chances of getting skin cancer as a direct result of their risky behaviour but felt they were unable to stop doing it (similar to nicotine addicts who know they are increasing the probability of various cancers but also feel unable to stop despite knowing the health risks).

Since then, tanorexia has become a topic for scientific investigation (and I looked at the topic in a previous blog). For instance, in a 2006 study published in the Journal of the American Academy of Dermatology by Dr. Mandeep Kaur and colleagues reported that frequent tanners (those who tanned 8-15 times a month) that took an endorphin blocker normally used to treat drug addictions (i.e., naltrexone) significantly reduced the amount of tanning compared to a control group of light tanners.

A 2005 study published in the Archives of Dermatology by Dr. Molly Warthan and colleagues claimed that a quarter of the sample of 145 “sun worshippers” would qualify as having a substance-related disorder if ultraviolet light was classed as the substance they crave. Their paper also reported that frequent tanners experienced a “loss of control” over their tanning schedule, and displayed a pattern of addiction similar to smokers and alcoholics.

A 2008 study published in the American Journal of Health Behavior by Dr. Carolyn Heckman and colleagues reported that 27% of 400 students they surveyed were classified as “tanning dependent”. The authors claimed that those classed as being tanning dependent had a number of similarities to substance use, including (i) higher prevalence among youth, (ii) an initial perception that the behaviour is image enhancing, (iii) high health risks and disregard for warnings about those risks, and (iv) the activity being mood enhancing.

Another study by Dr. Heckman and her colleagues in the American Journal of Health Promotion surveyed 306 female students and classed 25% of the respondents as ‘tanning dependent’ based upon a self-devised tanning dependence questionnaire. The problem with this and most of the psychological research on tanorexia to date is that almost all of the research is carried out on relatively small convenience samples using self-report and non-psychometrically validated ‘tanning addiction’ instruments.

Based on my own six criteria of behavioural addiction although some studies suggest some of these criteria appear to have been met, I have yet to be convinced that any of the published studies to date show genuine addiction to tanning (i.e., that there is evidence of all my criteria being endorsed) but that doesn’t mean it’s not theoretically possible. However, I’ve just done a study on tanorexia with my research colleagues at the University of Bergen and when we publish our findings I’ll be sure to let my blog readers know about it.

(Please note: A version of this article first appeared in The Conversation and The Washington Post)

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

Further reading

Fell, G.L., Robinson, K.C., Mao, J., Woolf, C.J., & Fisher, D.E. (2014). Skin β-endorphin mediates addiction to UV light. Cell, 157(7), 1527-1534.

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

Griffiths, M.D. (2014). Sunshine addiction is a hot topic – but does ‘tanorexia’ really exist? The Conversation. June 20. Located at: https://theconversation.com/sunshine-addiction-is-a-hot-topic-but-does-tanorexia-really-exist-28283

Griffiths, M.D. (2014). Sunshine: As addictive as heroin? Washington Post. June 24. Located at http://www.washingtonpost.com/posteverything/wp/2014/06/24/sunshine-as-addictive-as-heroin/

Heckman, C.J., Cohen-Filipic, J., Darlow, S., Kloss, J.D., Manne, S.L., & Munshi, T. (2014). Psychiatric and addictive symptoms of young adult female indoor tanners. American Journal of Health Promotion, 28(3), 168-174.

Heckman, C.J., Darlow, S., Kloss, J.D., Cohen‐Filipic, J., Manne, S.L., Munshi, T., … & Perlis, C. (2014). Measurement of tanning dependence. Journal of the European Academy of Dermatology and Venereology, 28(9), 1179-1185 .

Heckman, C.J., Egleston, B.L., Wilson, D.B., & Ingersoll, K.S. (2008). A preliminary investigation of the predictors of tanning dependence. American Journal of Health Behavior, 32(5), 451-464.

Kaur, M., Liguori, A., Lang, W., Rapp, S.R., Fleischer, A.B., & Feldman, S.R. (2006). Induction of withdrawal-like symptoms in a small randomized, controlled trial of opioid blockade in frequent tanners. Journal of the American Academy of Dermatology, 54(4), 709-711.

Warthan, M.M., Uchida, T., & Wagner, R.F. (2005). UV light tanning as a type of substance-related disorder. Archives of Dermatology, 141(8), 963-966.

A diction for addiction: A brief overview of our papers at the 2017 International Conference on Behavioral Addictions

This week I attended (and gave one of the keynote papers at) the fourth International Conference on Behavioral Addictions in Haifa (Israel). It was a great conference and I was accompanied by five of my colleagues from Nottingham Trent University all of who were also giving papers. All of the conference abstracts have just been published in the latest issue of the Journal of Behavioral Addictions (reprinted below in today’s blog) and if you would like copies of the presentations then do get in touch with me.

mark-haifa-keynote-2017

Griffiths, M.D. (2017). Behavioural tracking in gambling: Implications for responsible gambling, player protection, and harm minimization. Journal of Behavioral Addictions, 6 (Supplement 1), 2.

  • Social responsibility, responsible gambling, player protection, and harm minimization in gambling have become major issues for both researchers in the gambling studies field and the gaming industry. This has been coupled with the rise of behavioural tracking technologies that allow companies to track every behavioural decision and action made by gamblers on online gambling sites, slot machines, and/or any type of gambling that utilizes player cards. This paper has a number of distinct but related aims including: (i) a brief overview of behavioural tracking technologies accompanied by a critique of both advantages and disadvantages of such technologies for both the gaming industry and researchers; (ii) results from a series of studies carried out using behavioural tracking (particularly in relation to data concerning the use of social responsibility initiatives such as limit setting, pop-up messaging, and behavioural feedback); and (c) a brief overview of the behavioural tracking tool mentor that provides detailed help and feedback to players based on their actual gambling behaviour.

Calado, F., Alexandre, J. & Griffiths, M.D. (2017). Youth problem gambling: A cross-cultural study between Portuguese and English youth. Journal of Behavioral Addictions, 6 (Supplement 1), 7.

  • Background and aims: In spite of age prohibitions, most re- search suggests that a large proportion of adolescents engage in gambling, with a rate of problem gambling significantly higher than adults. There is some evidence suggesting that there are some cultural variables that might explain the development of gambling behaviours among this age group. However, cross­cultural studies on this field are generally lacking. This study aimed to test a model in which individual and family variables are integrated into a single perspective as predictors of youth gambling behaviour, in two different contexts (i.e., Portugal and England). Methods: A total of 1,137 adolescents and young adults (552 Portuguese and 585 English) were surveyed on the measures of problem gambling, gambling frequency, sensation seeking, parental attachment, and cognitive distortions. Results: The results of this study revealed that in both Portuguese and English youth, the most played gambling activities were scratch cards, sports betting, and lotteries. With regard to problem gambling prevalence, English youth showed a higher prevalence of problem gambling. The findings of this study also revealed that sensation seeking was a common predictor in both samples. However, there were some differences on the other predictors be- tween the two samples. Conclusions: The findings of this study suggest that youth problem gambling and its risk factors appear to be influenced by the cultural context and highlights the need to conduct more cross-cultural studies on this field.

Demetrovics, Z., Richman, M., Hende, B., Blum, K., Griffiths,
M.D, Magi, A., Király, O., Barta, C. & Urbán, R. (2017). Reward Deficiency Syndrome Questionnaire (RDSQ):
A new tool to assess the psychological features of reward deficiency. Journal of Behavioral Addictions, 6 (Supplement 1), 11.

  • ‘Reward Deficiency Syndrome’ (RDS) is a theory assuming that specific individuals do not reach a satisfactory state of reward due to the functioning of their hypodopaminergic reward system. For this reason, these people search for further rewarding stimuli in order to stimulate their central reward system (i.e., extreme sports, hypersexuality, substance use and/or other addictive behaviors such as gambling, gaming, etc.). Beside the growing genetic and neurobiological evidence regarding the existence of RDS little re- search has been done over the past two decades on the psychological processes behind this phenomenon. The aim of the present paper is to provide a psychological description of RDS as well as to present the development of the Reward Deficiency Syndrome Questionnaire (developed using a sample of 1,726 participants), a new four-factor instrument assessing the different aspects of reward deficiency. The results indicate that four specific factors contribute to RDS comprise “lack of satisfaction”, “risk seeking behaviors”, “need for being in action”, and “search for overstimulation”. The paper also provides psychological evidence of the association between reward deficiency and addictive disorders. The findings demonstrate that the concept of RDS provides a meaningful and theoretical useful context to the understanding of behavioral addictions.

Demetrovics, Z., Bothe, B., Diaz, J.R., Rahimi­Movaghar, A., Lukavska, K., Hrabec, O., Miovsky, M., Billieux, J., Deleuze,
J., Nuyens, P. Karila, L., Nagygyörgy, K., Griffiths, M.D. & Király, O. (2017). Ten-Item Internet Gaming Disorder Test (IGDT-10): Psychometric properties across seven language-based samples. Journal of Behavioral Addictions, 6 (Supplement 1), 11.

  • Background and aims: The Ten-Item Internet Gaming Disorder Test (IGDT-10) is a brief instrument developed to assess Internet Gaming Disorder as proposed in the DSM­5. The first psychometric analyses carried out among a large sample of Hungarian online gamers demonstrated that the IGDT-10 is a valid and reliable instrument. The present study aimed to test the psychometric properties in a large cross-cultural sample. Methods: Data were collected among Hungarian (n = 5222), Iranian (n = 791), Norwegian (n = 195), Czech (n = 503), Peruvian (n = 804), French­speaking (n = 425) and English­ speaking (n = 769) online gamers through gaming­related websites and gaming-related social networking site groups. Results: Confirmatory factor analysis was applied to test the dimensionality of the IGDT-10. Results showed that the theoretically chosen one-factor structure yielded appropriate to the data in all language­based subsamples. In addition, results indicated measurement invariance across all language-based subgroups and across gen- der in the total sample. Reliability indicators (i.e., Cronbach’s alpha, Guttman’s Lambda-2, and composite reliability) were acceptable in all subgroups. The IGDT- 10 had a strong positive association with the Problematic Online Gaming Questionnaire and was positively and moderately related to psychopathological symptoms, impulsivity and weekly game time supporting the construct validity of the instrument. Conclusions: Due to its satisfactory psychometric characteristics, the IGDT-10 appears to be an adequate tool for the assessment of internet gam- ing disorder as proposed in the DSM-5.

Throuvala, M.A., Kuss, D.J., Rennoldson, M. & Griffiths, M.D. (2017). Delivering school-based prevention regarding digital use for adolescents: A systematic review in the UK. Journal of Behavioral Addictions, 6 (Supplement 1), 54.

  • Background: To date, the evidence base for school-delivered prevention programs for positive digital citizenship for adolescents is limited to internet safety programs. Despite the inclusion of Internet Gaming Disorder (IGD) as a pro- visional disorder in the DSM-5, with arguable worrying prevalence rates for problematic gaming across countries, and a growing societal concern over adolescents’ digital use, no scientifically designed digital citizenship programs have been delivered yet, addressing positive internet use among adolescents. Methods: A systematic database search of quantitative and qualitative research evidence followed by a search for governmental initiatives and policies, as well as, non­profit organizations’ websites and reports was conducted to evaluate if any systematic needs assessment and/or evidence-based, school delivered prevention or intervention programs have been conducted in the UK, targeting positive internet use in adolescent populations. Results: Limited evidence was found for school-based digital citizenship awareness programs and those that were identified mainly focused on the areas of internet safety and cyber bullying. To the authors’ knowledge, no systematic needs assessment has been conducted to assess the needs of relevant stakeholders (e.g., students, parents, schools), and no prevention program has taken place within UK school context to address mindful and positive digital consumption, with the exception of few nascent efforts by non­profit organizations that require systematic evaluation. Conclusions: There is a lack of systematic research in the design and delivery of school-delivered, evidence-based prevention and intervention programs in the UK that endorse more mindful, reflective attitudes that will aid adolescents in adopting healthier internet use habits across their lifetime. Research suggests that adolescence is the highest risk group for the development of internet addictions, with the highest internet usage rates of all age groups. Additionally, the inclusion of IGD in the DSM-5 as provisional disorder, the debatable alarming prevalence rates for problematic gaming and the growing societal focus on adolescents’ internet misuse, renders the review of relevant grey and published research timely, contributing to the development of digital citizenship programs that might effectively promote healthy internet use amongst adolescents.

Bányai, F., Zsila, A., Király, O., Maraz, A., Elekes, Z., Griffiths, M.D., Andreassen, C.S. & Demetrovics, Z. (2017). Problematic social networking sites use among adolescents: A national representative study. Journal of Behavioral Addictions, 6 (Supplement 1), 62.

  • Despite being one of the most popular activities among adolescents nowadays, robust measures of Social Media use and representative prevalence estimates are lacking in the field. N = 5961 adolescents (49.2% male; mean age 16.6 years) completed our survey. Results showed that the one-factor Bergen Social Media Addiction Scale (BSMAS) has appropriate psychometric properties. Based on latent pro le analysis, 4.5% of the adolescents belonged to the at-risk group, who reported low self-esteem, high level of depression and the elevated social media use (34+ hours a week). Conclusively, BSMAS is an adequate measure to identify those adolescents who are at risk of problematic Social Media use and should therefore be targeted by school-based prevention and intervention programs.

Bothe, B., Toth-Király, I. Zsila, A., Griffiths, M.D., Demetrovics, Z. & Orosz, G. (2017). The six-component problematic pornography consumption scale. Journal of Behavioral Addictions, 6 (Supplement 1), 62.

  • Background and aims: To our best knowledge, no scale ex- ists with strong psychometric properties assessing problematic pornography consumption which is based on an over- arching theoretical background. The goal of the present study was to develop a short scale (Problematic Pornography Consumption Scale; PPCS) on the basis of Griffiths` (2005) six-component addiction model that can assess problematic pornography consumption. Methods: The sample comprised 772 respondents (390 females; Mage = 22.56, SD = 4.98 years). Items creation was based on the definitions of the components of Griffiths’ model. Results: A confirmatory factor analysis was carried out leading to an 18­item second­order factor structure. The reliability of the PPCS was good and measurement invariance was established. Considering the sensitivity and specificity values, we identified an optimal cut­off to distinguish between problematic and non-problematic pornography users. In the present sample, 3.6% of the pornography consumers be- longed to the at-risk group. Discussion and Conclusion: The PPCS is a multidimensional scale of problematic pornography consumption with strong theoretical background that also has strong psychometric properties.

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

The words and the we’s: When is a new addiction scale not a new addiction scale?

“The words you use should be your own/Don’t plagiarize or take on loans/There’s always someone, somewhere/With a big nose, who knows” (Lyrics written by Morrissey from ‘Cemetry Gates’ (sic) by The Smiths)

Over the last few decades, research into ‘shopping addiction’ and ‘compulsive buying’ has greatly increased. In 2015, I along with my colleagues, developed and subsequently published (in the journal Frontiers in Psychology) a new scale to assess shopping addiction – the 7-item Bergen Shopping Addiction Scale (BSAS) which I wrote about in one of my previous blogs.

We noted in our Frontiers in Psychology paper that two scales had already been developed in the 2000s (i.e., one by Dr. George Christo and colleagues in 2003, and one by Dr. Nancy Ridgway and colleagues in 2008 – see ‘Further reading’ below), but that neither of these two instruments approached problematic shopping behaviour as an addiction in terms of core addiction criteria that are often used in the behavioural addiction field including salience, mood modification, tolerance, withdrawal, conflict, relapse, and problems. We also made the point that new Internet-related technologies have now greatly facilitated the emergence of problematic shopping behaviour because of factors such as accessibility, affordability, anonymity, convenience, and disinhibition, and that there was a need for a psychometrically robust instrument that assessed problematic shopping across all platforms (i.e., both online and offline). We concluded that the BSAS has good psychometrics, structure, content, convergent validity, and discriminative validity, and that researchers should consider using it in epidemiological studies and treatment settings concerning shopping addiction.

images

More recently, Srikant Amrut Manchiraju, Sadachar and Jessica Ridgway developed something they called the Compulsive Online Shopping Scale (COSS) in the International Journal of Mental Health and Addiction (IJMHA). Given that we had just developed a new shopping addiction scale that covered shopping across all media, we were interested to read about the new scale. The scale was a 28-item scale and was based on the 28 items included in the first step of BSAS development (i.e., initial 28-item pool). As the authors noted:

“First, to measure compulsive online shopping, we adopted the Bergen Shopping Addiction Scale (BSAS; Andreassen, 2015). The BSAS developed by Andreassen et al. (2015), was adapted for this study because it meets the addiction criteria (e.g., salience, mood modification, etc.) established in the DSM-5. In total, 28 items from the BSAS were modified to reflect compulsive online shopping. For example, the original item – ‘Shopping/buying is the most important thing in my life’ was modified as ‘Online shopping/buying is the most important thing in my life’… It is important to note that we are proposing a new behavioral addiction scale, specifically compulsive online shopping … In conclusion, the scale developed in this study demonstrated strong psychometric, structure, convergent, and discriminant validity, which is consistent with Andreassen et al.’s (2015) findings”.

Apart from the addition of the word ‘online’ to every item, all initial 28 items of the BSAS were used identically in the COSS. Therefore, I sought the opinion of several research colleagues about the ‘new’ scale. Nearly all were very surprised that an almost identical scale had been published. Some even questioned whether such wholescale use might constitute plagiarism (particularly as none of the developers of the COSS sought permission to adapt our scale).

According to the plagiarism.org website, several forms of plagiarism have been described including: “Copying so many words or ideas from a source that it makes up the majority of your work, whether you give credit or not” (p.1). Given the word-for-word reproduction of the 28 item–pool, an argument could be made that the COSS plagiarizes the BSAS, even though the authors acknowledge the source of their scale items. According to Katrina Korb’s 2012 article on adopting or adapting psychometric instruments:

“Adapting an instrument requires more substantial changes than adopting an instrument. In this situation, the researcher follows the general design of another instrument but adds items, removes items, and/or substantially changes the content of each item. Because adapting an instrument is similar to developing a new instrument, it is important that a researcher understands the key principles of developing an instrument…When adapting an instrument, the researcher should report the same information in the Instruments section as when adopting the instrument, but should also include what changes were made to the instrument and why” (p.1).

Dr. Manchiraju and his colleagues didn’t add or remove any of the original seven items, and did not substantially change the content of any of the 28 items on which the BSAS was based. They simply added the word ‘online’ to each existing item. Given that the BSAS was specifically developed to take into account the different ways in which people now shop and to include both online and offline shopping, there doesn’t seem to be a good rationale for developing an online version of the BSAS. Even if there was a good rationale, the scale could have made reference to the Bergen Shopping Addiction Scale in the name of the ‘new’ instrument. In a 2005 book chapter ‘Selected Ethical Issues Relevant to Test Adaptations’ by Dr. Thomas Oakland (2005), he noted the following in relation to plagiarism and psychometric test development:

Psychologists do not present portions of another’s work or data as their own, even if the other work or data source is cited … Plagiarism occurs commonly in test adaptation work (Oakland & Hu, 1991), especially when a test is adapted without the approval of its authors and publisher. Those who adapt a test by utilizing items from other tests without the approval of authors and publishers are likely to be violating ethical standards. This practice should not be condoned. Furthermore, this practice may violate laws in those countries that provide copyright protection to intellectual property. In terms of scale development, a measure that has the same original items with only one word added to each item (which only adds information on the context but does not change the meaning of the item) does not really constitute a new scale. They would find it really hard to demonstrate discriminant validity between the two measures”.

Again, according to Oakland’s description of plagiarism specifically in relation to the development of psychometric tests (rather than plagiarism more generally), the COSS appears to have plagiarized the BSAS particularly as Oakland makes specific reference to the adding of one word to each item (“In terms of scale development, a measure that has the same original items with only one word added to each item … does not really constitute a new scale”).

Still, it is important to point that I have no reason to think that this use of the BSAS was carried out maliciously. Indeed, it may well be that the only wrongdoing was lack of familiarity with the conventions of psychometric scale development. It may be that the authors took one line in our original Frontiers in Psychology paper too literally (the BSAS may be freely used by researchers in their future studies in this field”). However, the purpose of this sentence was to give fellow researchers permission to use the validated scale in their own studies and to avoid the inconvenience of having to request permission to use the BSAS and then waiting for an answer. Another important aspect here is that the BSAS (which may be freely used) consists of seven items only, not 28. The seven BSAS items were extracted from an initial item pool in accordance with our intent to create a brief shopping addiction scale. Consequently, there exists only one version of BSAS, the 7-item version. Here, Dr. Manchiraju and his colleagues seem to have misinterpreted this when referring to a 28-item BSAS.

(Please note: This blog is adapted using material from the following paper: Griffiths, M.D., Andreassen, C.S., Pallesen, S., Bilder, R.M., Torsheim, T. Aboujaoude, E.N. (2016). When is a new scale not a new scale? The case of the Bergen Shopping Addiction Scale and the Compulsive Online Shopping Scale. International Journal of Mental Health and Addiction, 14, 1107-1110).

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

Further reading

Aboujaoude, E. (2014). Compulsive buying disorder: a review and update. Current Pharmaceutical Design, 20, 4021–4025.

Andreassen, C. S., Griffiths, M. D., Pallesen, S., Bilder, R. M., Torsheim, T., & Aboujaoude, E. (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

Christo, G., Jones, S., Haylett, S., Stephenson, G., Lefever, R. M., & Lefever, R. (2003). The shorter PROMIS questionnaire: further validation of a tool for simultaneous assessment of multiple addictive behaviors. Addictive Behaviors, 28, 225–248.

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

Griffiths, M.D., Andreassen, C.S., Pallesen, S., Bilder, R.M., Torsheim, T. Aboujaoude, E.N. (2016). When is a new scale not a new scale? The case of the Bergen Shopping Addiction Scale and the Compulsive Online Shopping Scale. International Journal of Mental Health and Addiction, 14, 1107-1110.

Korb, K. (2012). Adopting or adapting an instrument. Retrieved September 12, 2016, from: http://korbedpsych.com/R09aAdopt.html

Manchiraju, S., Sadachar, A., & Ridgway, J. L. (2016). The Compulsive Online Shopping Scale (COSS): Development and Validation Using Panel Data. International Journal of Mental Health and Addiction, 1-15. doi: 10.1007/s11469-016-9662-6.

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., Griffiths, M. D., & Demetrovics, Z. (2016). The prevalence of compulsive buying in non-clinical populations: A systematic review and meta-analysis. Addiction, 111, 408-419.

Oakland, T. (2005). Selected ethical issues relevant to test adaptations. In Hambleton, R., Spielberger, C. & Meranda, P. (Eds.). Adapting educational and psychological tests for cross-cultural assessment (pp. 65-92). Mahwah, NY: Erlbaum Press.

Oakland, T., & Hu, S. (1991). Professionals who administer tests with children and youth: An international survey. Journal of Psychoeducational Assessment, 9(2), 108-120.

Plagiarism.org (2016). What is plagiarism? Retrieved September 12, 2016, from: http://www.plagiarism.org/plagiarism-101/what-is-plagiarism

Ridgway, N., Kukar-Kinney, M., & Monroe, K. (2008). An expanded conceptualization and a new measure of compulsive buying. Journal of Consumer Research, 35, 622–639.

Weinstein, A., Maraz, A., Griffiths, M.D., Lejoyeux, M. & Demetrovics, Z. (2016). Shopping addiction and compulsive buying: Features and characteristics of addiction. In V. Preedy (Ed.), The Neuropathology Of Drug Addictions And Substance Misuse (Vol. 3). (pp. 993-1008). London: Academic Press.

Meditation as self-medication: Can mindfulness be addictive?

(Please note, the following blog is an extended version of an article by my research colleagues Dr. Edo Shonin and William Van Gordon (that was first published hereand to which I have added some further text. If citing this article, we recommend: Shonin, E., Van Gordon, W. & Griffiths, M.D. (2016). Meditation as self-medication: Can mindfulness be addictive? Located at: https://drmarkgriffiths.wordpress.com/2016/10/24/meditation-as-self-medication-can-mindfulness-be-addictive/).

Mindfulness is growing in popularity and is increasingly being used by healthcare professionals for treating mental health problems. There has also been a gradual uptake of mindfulness by a range of organisations including schools, universities, large corporations, and the armed forces. However, the rate at which mindfulness has been assimilated by Western society has – in our opinion – meant that there has been a lack of research exploring the circumstances where mindfulness may actually cause a person harm. An example of a potentially harmful consequence of mindfulness that we have identified in our own research is that of a person developing an addiction to mindfulness.

screen-shot-2016-10-23-at-18-05-00

In a previous blog, the issue of whether meditation more generally can be addictive was examined. In a 2010 article by Michael Sigman in the Huffington Post entitled “Meditation and Addiction: A Two-Way Street?”, Sigman recounted the story about how one of his friends spent over two hours every day engaging in meditation while sat in the lotus position. He then claimed:

“There are those few for whom meditation can become compulsive, even addictive. The irony here is that an increasing body of research shows that meditation – in particular Buddhist Vipassana meditation – is an effective tool in treating addiction. One category of meditation addiction is related to the so-called ‘spiritual bypass’. Those who experience bliss when they meditate may practice relentlessly to recreate that experience, at the expense of authentic self-awareness. A close friend who’s done Transcendental Meditation for decades feels so addicted to it, she has a hard time functioning when she hasn’t ‘transcended’”.

Obviously, this is purely anecdotal but at least raises the issue that maybe for a very small minority, meditation might be addictive. In addition, empirical studies have shown that meditation can increase pain tolerance, and that the body produces its own morphine-like substances (i.e., endorphins). Therefore, the addictive qualities of meditation may be due to increased endorphin production that creates a semi-dissociative blissful state.

Being addicted to meditation – and more specifically mindfulness – would constitute a form of behavioural addiction (i.e., as opposed to chemical addiction). Examples of better known forms of behavioural addiction are gambling disorder, internet gaming disorder, problematic internet use, sex addiction, and workaholism. According to the components model of addiction, a person would suffer from an addiction to mindfulness if they satisfied the following six criteria:

  • Salience: Mindfulness has become the single most important activity in their life.
  • Mood modification: Mindfulness is used in order to alleviate emotional stress (i.e., escape) or to experience euphoria (i.e., a ‘high’).
  • Tolerance: Practising mindfulness for longer durations in order to derive the same mood-modifying effects.
  • Withdrawal: Experiencing emotional and physical distress (e.g., painful bodily sensations) when not practising mindfulness.
  • Conflict: The individual’s routine of mindfulness practice causes (i) interpersonal conflict with family members and friends, (ii) conflict with activities such as work, socialising, and exercising, and (iii) psychological and emotional conflict (also known as intra-psychic conflict).
  • Relapse: Reverting to earlier patterns of excessive mindfulness practice following periods of control or abstinence.

In modern society, the word ‘addiction’ has negative connotations but it should be remembered that addictions have been described by some as both positive and negative (for instance, Dr. Bill Glasser has spent his whole career talking about ‘positive’ addictions). For example, in separate clinical case studies that we conducted with individuals suffering from pathological gambling, sex addiction, and workaholism, it was observed that the participants substituted their addiction to gambling, work, or sex with mindfulness (and maybe even developed an addiction to it, depending upon the definition of addiction). In the beginning phases of psychotherapy, this process of addiction substitution represented a move forward in terms of the individual’s therapeutic recovery. However, as the therapy progressed and the individual’s dependency on gambling, work, or sex began to weaken, their “addiction” to mindfulness was restricting their personal and spiritual growth, and was starting to cause conflict in other areas of their life. Therefore, it became necessary to help them change the way they practiced and related to mindfulness.

Mindfulness is a technique or behaviour that an individual can choose to practice. However, the idea is that the individual doesn’t separate mindfulness from the rest of their lives. If an individual sees mindfulness as a practice or something that they need to do in order to find calm and escape from their problems, there is a risk that they will become addicted to it. It is for this reason that we always exercise caution before recommending that people follow a strict daily routine of mindfulness practice. In fact, in the mindfulness intervention that we (Shonin and Van Gordon) developed called Meditation Awareness Training, we don’t encourage participants to practice at set times of day or to adhere to a rigid routine. Rather, we guide participants to follow a dynamic routine of mindfulness practice that is flexible and that can be adapted according to the demands of daily living. For example, if a baby decides to wake up earlier than usual one morning, the mother can’t tell it to wait and be quite because it’s interfering with her time for practising mindfulness meditation. Rather, she has to tend to the baby and find another time to sit in meditation. Or better still, she can tend to the baby with love and awareness, and turn the encounter with her child into a form of mindfulness practice. We live in a very uncertain world and so it is valuable if we can learn to be accommodating and work mindfully with situations as they unfold around us.

One of the components in the components model of addiction is ‘salience’ (put more simply, importance). In general, if an individual prioritises a behaviour (such as gambling) or a substance (such as cannabis) above all other aspects of their life, then it’s probably fair to say that their perspective on life is misguided and that they are in need of help and support. However, as far as mindfulness is concerned, we would argue that it’s good if it becomes the most important thing in a person’s life. Human beings don’t live very long and there can be no guarantee that a person will survive the next week, let alone the next year. Therefore, it’s our view that it is a wise move to dedicate oneself to some form of authentic spiritual practice. However, there is a big difference between understanding the importance of mindfulness and correctly assimilating it into one’s life, and becoming dependent upon it.

If a person becomes dependent upon mindfulness, it means that it has remained external to their being. It means that they don’t live and breathe mindfulness, and that they see it as a method of coping with (or even avoiding) the rest of their life. Under these circumstances, it’s easy to see how a person can develop an addiction to mindfulness, and how they can become irritable with both themselves and others when they don’t receive their normal ‘fix’ of mindfulness on a given day.

Mindfulness is a relatively simple practice but it’s also very subtle. It takes a highly skilled and experienced meditation teacher to correctly and safely instruct people in how to practise mindfulness. It’s our view that because the rate of uptake of mindfulness in the West has been relatively fast, in the future there will be more and more people who experience problems – including mental health problems such as being addicted to mindfulness – as a result of practising mindfulness. Of course, it’s not mindfulness itself that will cause their problems to arise. Rather, problems will arise because people have been taught how to practice mindfulness by instructors who are not teaching from an experiential perspective and who don’t really know what they are talking about. From personal experience, we know that mindfulness works and that it is good for a person’s physical, mental, and spiritual health. However, we also know that teaching mindfulness and meditation incorrectly can give rise to harmful consequences, including developing an addiction to mindfulness.

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

Further Reading

Glasser, W. (1976). Positive addictions. Harper & Row, New York, NY.

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

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

Griffiths, M.D. (2011). Behavioural addiction: The case for a biopsychosocial approach. Trangressive Culture, 1, 7-28.

Larkin, M., Wood, R.T.A. & Griffiths, M.D. (2006). Towards addiction as relationship. Addiction Research and Theory, 14, 207-215.

Shonin, E., 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). The treatment of workaholism with Meditation Awareness Training: A case study. Explore: The Journal of Science and Healing, 10, 193-195.

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

Shonin, E., Van Gordon W., & Griffiths, M.D. (2015). Are there risks associated with using mindfulness for the treatment of psychopathology? Clinical Practice, 11, 389-382.

Shonin, E., Van Gordon, W., & Griffiths, M.D. (2016). Mindfulness and Buddhist-derived Approaches in Mental Health and Addiction. New York: Springer.

Sigman, M. (2010). Meditation and addiction: A two-way street? Huffington Post, November 15. Located at: http://www.huffingtonpost.com/michael-sigman/meditation-and-addiction_b_783552.htm

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

Van Gordon, W., Shonin, E., & Griffiths, M.D. (2015). Mindfulness in mental health: A critical reflection. Journal of Psychology, Neuropsychiatric Disorders and Brain Stimulation, 1(1), 102.

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

Van Gordon, W., Shonin, E., & Griffiths, M.D. (2016). Ontological addiction: Classification, etiology, and treatment. Mindfulness, 7, 660-671.

Ride on high: Another look at the psychology (and cycleology) of ‘cycling addiction’

Back in 2012, I wrote an article on cycling addiction for my blog and classed the behaviour as a sub-type of exercise addiction. Recently (June 2016), I was interviewed by Cycling Weekly magazine for an article on addiction to cycling, so I thought it opportune to look at the issue again. Over the last five years or so there has been an increase in the amount of research into exercise addiction (as I have outlined in a number of papers with my Hungarian colleagues Attila Szabo and Zsolt Demetrovics – see ‘Further reading’ below). However, there has still been no empirical research specifically into cycling addiction. In his 1997 book Motivation and Emotion in Sport, Dr. John Kerr speculated that endurance type exercise activities (e.g. running, cycling, swimming, aerobics and weight training) were most often associated with exercise addiction and dependence but this was based more on anecdotal as opposed to scientific evidence.

For the Cycling Weekly article, I was interviewed by Dr. Josephine Perry (who just happed to be both a psychologist and a cyclist). She noted in her article that:

“As a regular cyclist, it’s very likely you take a close interest in performance and have a strong drive to improve coupled with a willingness to push yourself hard in training and racing. Sometimes you probably feel under attack from family or colleagues who question or tease you about your ‘obsessive’ cycling habit. You no doubt retaliate by citing the many benefits of cycling: the brilliant friendships, massive health improvements, toned body and all the places you get to explore on your bike. But do your critics occasionally have a point? Does your relentless drive to improve sometimes go too far and place you in danger of crossing the thin line from dedication into addiction? Addiction to cycling is defined by an incessant internal need to train hard every day without taking the time off that you need to rest and recover — not to mention attend to other commitments in your life. In other words, addiction is defined by harm. You ignore the pleas from family or friends to cut back. Your priorities get rearranged, and nothing is allowed to come between you and your bike. Once this line is crossed, the benefits of cycling begin to diminish. The addicted cyclist feels more aches and pains, becomes prone to physical injuries, regular colds and hidden illnesses”.

In a recent (2016) book chapter, my colleagues and I noted that exercise addiction (irrespective of the sub-type) is a condition in which a regularly exercising person loses control over her or his exercise behaviour, while acting compulsively and exhibiting dependence, resulting in negative consequences in their day-to-day health and/or life. This maladaptive exercise behaviour is characterized by severe withdrawal symptoms when exercise is not possible, similar to both chemical addictions (e.g., alcohol addiction) and other behavioural addictions (e.g., gambling addiction). Based on the scientific evidence, exercise addiction is relatively rare, ranging from 0.3% to 0.5% as noted in the only study published using a representative national sample of the general population that we carried out in Hungary back in 2012 (published in the journal Psychology of Sport and Exercise). Given that exercise addiction (in general) is rare, the prevalence of cycling addiction would therefore be even lower. However, that doesn’t mean it doesn’t exist.

A recent study carried out by Dr. Bernd Zeulner and his colleagues among 1,031 endurance athletes (that included an unspecified number of cyclists) assessed the prevalence of exercise addiction using the Exercise Addiction Inventory (EAI; a scale that I co-developed with my colleagues Attila Szabo and Annabel Terry). The study (published in the journal Advances in Physical Education) found that 2.7% had the potential to develop an exercise addiction and that is higher than the prevalence among the general population.

Another study published in the Journal of Clinical Sport Psychology by Dr. Jason Youngman and Dr. Duncan Simpson examined exercise addiction among 1,285 triathletes (cycling, swimming and running) also using the EAI. The study found that approximately 20% of triathletes were at risk for exercise addiction, and that training for longer distance races puts triathletes at greater risk for exercise addiction than training for shorter races. They also found that as the number of weekly training hours increased, so did a triathlete’s risk for exercise addiction. Despite the lack of empirical evidence specifically on cycling addiction, Dr. Perry also noted in her article that:

“[Addicted cyclists] can also become susceptible to burnout and all that comes with it: decreased performance, low mood, changes in appetite, difficulty sleeping and generally a feeling that the outcomes are not matching the intensity of the effort being put in. For a cycling addict, this loss of form and the feelings of difficulty can be devastating…Other research has found the risks are highest in those exercising over five times a week. With the average amount of training for serious amateur cyclists being around 10 hours a week, they are certainly in the higher-risk category”.

I am not sure which study Dr. Perry is referring to in this quote, but in my interview with her, I noted that from my perspective, any behaviour can be potentially addictive if the reward mechanisms are in place but that we should be cautious about imposing the ‘addiction’ label. I told her that we can’t define whether someone is addicted just by the behaviour that they display. It is all to do with the context of that behaviour in their life. More importantly, it’s is not about the amount of time spent engaging in the behaviour but what impact the behaviour has on them. As I explained:

“A healthy enthusiasm adds to their life. An addiction takes away from it. If you have no dependants and both you and your partner enjoy the sport and there is no conflict, it would not be classed as an addiction. If family conflict becomes a factor, the exercise habit becomes fraught with complications.”

I noted in my previous blog on cycling addiction that one of the traits that appears to be associated with exercise addiction is perfectionism according to a 1990 paper by Dr. Caroline Davis that appeared in the journal Personality and Individual Differences. Research (by Dr. Heather Hasenblaus among others) has also found that extraversion, neuroticism, and agreeableness predict exercise addiction symptoms. I also noted in my interview with Dr. Perry that some people (such as those with Type A personalities) appear to have their risk for exercise addiction built into them. Some cyclists will be those Type-A achievers who are reward-orientated to do the best they can, in whatever they do. If they take up a sport, those personality traits previously used to be successful and focused in other areas such as work go into the new area.

I also noted in my Cycling Weekly interview that there are a number of signs that can help you spot if your attitude towards cycling is unhealthy. The most obvious one is when cycling becomes the most important activity in your life, dominating thinking, feelings and behaviour. If you need to cycle more to get the same mood benefit that you used to, your mood changes significantly and/or you feel physical effects when you can’t cycle, you may also be at risk. If you start to resent your family, job, social life, hobbies or other interests getting in the way of you cycling, you need to consider if you have crossed the line. Those addicted to cycling are more likely to get into debt to fund their habit, become excessively controlling over their eating to regulate weight and competitiveness, and find it hard to balance work, social and family commitments with training.

I was also asked for my views on the treatment of cycling addiction and said that cognitive-behavioural therapy would likely be the most effective (as the addict would be guided to identify goals that motivate them and be helped to find safe and reasonable ways to reach those goals) but that the type of treatment depends on whether the addiction to cycling was primary or secondary. Primary addicts, who are actually addicted because they love their sport, will find it is very hard to give up. Telling them they can’t continue will be stressful in itself. Secondary addicts may be trying to lose weight or to escape negative, unpleasant feelings or difficulties in their lives, using cycling to control their thoughts. These cyclists are using exercise as a coping mechanism. The key here is finding out why they are doing it to such an extent in the first place. Most will find their addiction is symptomatic of something else.

After interviewing me about whether cycling can be potentially addictive, Dr. Perry summed up my own views arguably better than I could have done it myself:

“[Cycling addiction] is not just about how many hours you are doing on the bike, how much you love your riding, or how many bikes you have; what matters is the impact on your life. If your work and family life allows it without conflict, and you’re not feeling over-stressed or over-tired, then your commitment to cycling is just that – a commitment. If you are suffering from continual injuries and not recovering fully, have found yourself feeling burnt out, dips in mood, feel obliged to miss family or social events for training, resulting in arguments, then you need to ask yourself seriously: am I addicted?”

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

Further reading

Allegre, B., Souville, M., Therme, P. & Griffiths, M.D. (2006). Definitions and measures of exercise dependence, Addiction Research and Theory, 14, 631-646.

Berczik, K., Griffiths, M.D., Szabó, A., Kurimay, T., Kökönyei, G., Urbán, R. and Demetrovics, Z. (2014). Exercise addiction – the emergence of a new disorder. Australasian Epidemiologist, 21(2), 36-40.

Berczik, K., Griffiths, M.D., Szabó, A., Kurimay, T., Urban, R. & Demetrovics, Z. (2014). Exercise addiction. In K. Rosenberg & L. Feder (Eds.), Behavioral Addictions: Criteria, Evidence and Treatment (pp.317-342). New York: Elsevier.

Berczik, K., Szabó, A., Griffiths, M.D., Kurimay, T., Kun, B. & Demetrovics, Z. (2011). Exercise addiction: Symptoms, diagnosis, epidemiology, and etiology. Substance Use and Misuse, 47, 403-417.

Davis, C. (1990). Weight and diet preoccupation and addictiveness: The role of exercise. Personality and Individual Differences, 11, 823-827.

Freimuth, M., Moniz, S., & Kim, S.R. (2011). Clarifying exercise addiction: differential diagnosis, co-occurring disorders, and phases of addiction. International Journal of Environmental Research and Public Health, 8(10), 4069-4081.

Griffiths, M. D. (1997). Exercise addiction: A case study. Addiction Research, 5, 161-168.

Griffiths, M. D., Szabo, A., & Terry, A. (2005). The exercise addiction inventory: a quick and easy screening tool for health practitioners. British Journal of Sports Medicine, 39(6), e30-31.

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.

Hausenblas, H.A., & Giacobbi, P.R. (2004). Relationship between exercise dependence symptoms and personality. Personality and Individual differences, 36(6), 1265-1273.

Kerr, J. H. (1997) Motivation and Emotion in Sport: Reversal Theory. Hove: Psychology Press.

Kerr, J.H., Lindner, K.J. & Blaydon, M. (2007). Exercise Dependence. Oxford: Rutledge.

Kurimay, T., Griffiths, M.D., Berczik, K., & Demetrovics, Z. (2013). Exercise addiction: The dark side of sports and exercise. In Baron, D., Reardon, C. & Baron, S.H., Contemporary Issues in Sports Psychiatry: A Global Perspective (pp.33-43). Chichester: Wiley.

Mónok, K., Berczik, K., Urbán, R., Szabó, A., Griffiths, M.D., Farkas, J., Magi, A., Eisinger, A., Kurimay, T., Kökönyei, G., Kun, B., Paksi, B. & Demetrovics, Z. (2012). Psychometric properties and concurrent validity of two exercise addiction measures: A population wide study in Hungary. Psychology of Sport and Exercise, 13, 739-746.

Perry, J. (2016). Are you addicted to cycling? Cycling Weekly, July 21. Located at: http://www.cyclingweekly.co.uk/fitness/training/are-you-addicted-to-cycling-261852

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.

Szabo, A., Griffiths, M.D. & Demetrovics, Z. (2016). Exercise addiction. In V. Preedy (Ed.), The Neuropathology Of Drug Addictions And Substance Misuse (Vol. 3) (pp. 984-992). London: Academic Press.

Terry, A., Szabo, A., & Griffiths, M. D. (2004). The exercise addiction inventory: A new brief screening tool. Addiction Research and Theory, 12, 489-499.

Youngman, J., & Simpson, D. (2014). Risk for exercise addiction: A comparison of triathletes training for sprint-, Olympic-, half-Ironman-, and Ironman-distance triathlons. Journal of Clinical Sport Psychology, 8, 19-37.

Zeulner, B., Ziemainz, H., Beyer, C., Hammon, M., & Janka, R. (2016). Disordered Eating and Exercise Dependence in Endurance Athletes. Advances in Physical Education, 6(2), 76.

Lust discussed: A brief overview of our recent papers on sex addiction

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

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

  • At present, the prevalence of rates of sexual addiction in the UK is unknown. This study investigated what treatment services were available within British Mental Health Trusts (MHTs) that are currently provided for those who experience compulsive and/or addictive sexual behaviours within the National Health Service (NHS) system. In March and April 2013, a total of 58 letters were sent by email to all Mental Health Trusts in the UK requesting information about (i) sexual addiction services and (ii) past 5-year treatment of sexual addiction. The request for information was sent to all MHTs under the Freedom of Information Act (2001). Results showed that 53 of the 58 MHTs (91 %) did not provide any service (specialist or otherwise) for treating those with problematic sexual behaviours. Based on the responses provided, only five MHTs reported having had treated sexual addiction as a disorder that took primacy over the past 5 years. There was also some evidence to suggest that the NHS may potentially treat sexual addiction as a secondary disorder that is intrinsic and/or co-morbid to the initial referral made by the GP. In light of these findings, implications for the treatment of sex addiction in a British context are discussed.

Dhuffar, M. & Griffiths, M.D. (2014). Understanding the role of shame and its consequences in female hypersexual behaviours: A pilot study. Journal of Behavioural Addictions, 3, 231–237.

  • Background and aims: Hypersexuality and sexual addiction among females is a little understudied phenomenon. Shame is thought to be intrinsic to hypersexual behaviours, especially in women. Therefore, the aim of this study was to understand both hypersexual behaviours and consequences of hypersexual behaviours and their respective contributions to shame in a British sample of females (n = 102). Methods: Data were collected online via Survey Monkey. Results: Results showed the Sexual Behaviour History (SBH) and the Hypersexual Disorder Questionnaire (HDQ) had significant positive correlation with scores on the Shame Inventory. The results indicated that hypersexual behaviours were able to predict a small percentage of the variability in shame once sexual orientation (heterosexual vs. non-heterosexual) and religious beliefs (belief vs. no belief) were controlled for. Results also showed there was no evidence that religious affiliation and/or religious beliefs had an influence on the levels of hypersexuality and consequences of sexual behaviours as predictors of shame. Conclusions: While women in the UK are rapidly shifting to a feminist way of thinking with or without technology, hypersexual disorder may often be misdiagnosed and misunderstood because of the lack of understanding and how it is conceptualised. The implications of these findings are discussed.

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.

  • Researchers have suggested that the advances of the Internet over the past two decades have gradually eliminated traditional offline methods of obtaining sexual material. Additionally, research on cybersex and/or online sex addictions has increased alongside the development of online technology. The present study extended the findings from Griffiths’ (2012) systematic empirical review of online sex addiction by additionally investigating empirical studies that implemented and/or documented clinical treatments for online sex addiction in adults. A total of nine studies were identified and then each underwent a CONSORT evaluation. The main findings of the present review provide some evidence to suggest that some treatments (both psychological and/or pharmacological) provide positive outcomes among those experiencing difficulties with online sex addiction. Similar to Griffiths’ original review, this study recommends that further research is warranted to establish the efficacy of empirically driven treatments for online sex addiction.

Dhuffar, M. & Griffiths, M.D. (2015). Understanding conceptualisations of female sex addiction and recovery using Interpretative Phenomenological Analysis. Psychology Research, 5, 585-603.

  • Relatively little research has been carried out into female sex addiction. There is even less regarding understandings of lived experiences of sex addiction among females. Consequently, the purpose of the present study was to examine the experiences of female sex addiction (from onset to recovery). This was done by investigating the experiences and conceptualisations of three women who self-reported as having had a historical problem with sex addiction. An interpretative phenomenological analysis (IPA) methodology was applied in the current research process in which three female participants shared their journey through the onset, progression, and recovery of sex addiction. The IPA produced five superordinate themes that accounted for the varying degrees of sexual addiction among a British sample of females: (1) “Focus on self as a sex addict”; (2) “Uncontrollable desire”; (3) “Undesirable feelings”; (4) “Derision”; and (5) “Self help, treatment and recovery”. The implications of these findings towards the understanding and the need for the implementation of treatment are discussed.

Dhuffar, M., Pontes, H.M. & Griffiths, M.D. (2015). The role of negative mood states and consequences of hypersexual behaviours in predicting hypersexuality among university students. Journal of Behavioural Addictions, 4, 181–188.

  • The issue of whether hypersexual behaviours exist among university students is controversial because many of these individuals engage in sexual exploration during their time at university. To date, little is known about the correlates of hypersexual behaviours among university students in the UK. Therefore, the aims of this exploratory study were two-fold. Firstly, to explore and establish the correlates of hypersexual behaviours, and secondly, to investigate whether hypersexuality among university students can be predicted by variables relating to negative mood states (i.e., emotional dysregulation, loneliness, shame, and life satisfaction) and consequences of hypersexual behaviour.

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

  • Sex addiction is a disorder that can have serious adverse functional consequences. Treatment effectiveness research for sex addiction is currently underdeveloped, and interventions are generally based on guidelines for treating other behavioural (as well as chemical) addictions. Consequently, there is a need to clinically evaluate tailored treatments that target the specific symptoms of sex addiction. It has been proposed that second-generation mindfulness-based interventions (SG-MBIs) may be an appropriate treatment for sex addiction because in addition to helping individuals increase perceptual distance from craving for desired objects and experiences, some SG-MBIs specifically contain meditations intended to undermine attachment to sex and/or the human body. To date, no study exploring the utility of mindfulness for treating sex addiction has been conducted. This paper presents an in-depth clinical case study of a male individual suffering from sex addiction that underwent treatment utilising an SG-MBI known as Meditation Awareness Training (MAT). Following completion of MAT, the participant demonstrated clinically significant improvements regarding the addictive sexual behaviour, as well less depression and psychological distress. The MAT intervention also led to improvements in sleep quality, job satisfaction, and non-attachment to self and experiences. Salutary outcomes were maintained at six-month follow-up. The current study extends the literature exploring the applications of mindfulness for treating behavioural addiction, and findings of this case study indicate that further clinical investigation into the role of mindfulness for treating sex addiction is warranted.

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

Further reading

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

Griffiths, M.D. (2001). Addicted to love: The psychology of sex addiction. Psychology Review, 8, 20-23.

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

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

Griffiths, M.D. (2010). Addicted to sex? Psychology Review, 16(1), 27-29.

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

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

Griffiths, M.D. & Dhuffar, M. (2014). Collecting behavioural addiction treatment data using Freedom of Information requests. SAGE Research Methods Cases. Located at: DOI: http://dx.doi.org/10.4135/978144627305014533925