Reliable statistics on the prevalence of individuals addicted to work on a country-by-country basis are almost non-existent. Only two countries (Norway and Hungary) has carried out nationally representative studies. Norwegian studies led by Dr. Cecilie Andreassen reported that approximately 7.3%-8.3% of Norwegians are addicted to work using the Bergen Work Addiction Scale. A Hungarian study led by Dr. Zsolt Demetrovics reported that 8.2% of the 18- to 64-year old population working at least 40 hours a week is at risk for work addiction using the Work Addiction Risk Test.
In a comprehensive literature review that I co-authored using US data, provided a tentative estimation of the prevalence of work addiction among Americans at 10%. Some estimates are as high as 15%-25% among employed individuals although some of these estimates appear to relate to excessive and committed working rather than a genuine addictive behaviour Others claim that the rates of work addiction are high amongst professionals (e.g., lawyers, medics, scientists). Such individuals may work very long hours, expend high effort in their job, delegate rarely, and may not necessarily be more productive. It also appears that those genuinely addicted to work appear to have a compulsive drive to gain approval and success but can result in impaired judgment, poor health, burnout, and breakdowns as opposed to what might be described ‘enthusiastic workaholism’ where few problems are associated with the behaviour.
Last month, I and two of my colleagues published a paper in the Journal of Behavioral Addictions examining various myths concerning work addiction. One of the myths we explored was that ‘work addiction is similar to other behavioural addictions’. While work addiction does indeed have many similarities to other behavioural addictions (e.g., gambling, gaming, shopping, sex, etc.), it fundamentally differs from them in a critical way because it is the only behaviour that individuals are typically required to do eight hours a day and is an activity that individuals receive gratification from the local environment and/or society more generally for engaging in the activity. There may also be some benefits from normal [and excessive] work (e.g., financial security through earning a good salary, financial bonuses based on productivity, international travel, free or reduced medical insurance, company car, etc.). Unlike other behavioural and substance addictions where one of the key criteria is typically a negative impact on occupational duties, work addicts cannot negatively impact on the activity they are already engaged in (except in the sense that their addiction to work may impacts on work productivity or work quality due to resulting psychological and/or physical illness).
In some respects, work addiction is similar to exercise addiction in that it is an activity that should be a part of people’s lives and often has some benefits even when engaged in excessively. Such activities have been described by Ian Brown as ‘mixed blessings’ addictions. For instance, in the case of exercise addiction, problematic exercise that interferes with both job and relationships can still have some positive consequences (such as being physically fit). However, it should be emphasized that such positive consequences are typically short lasting, and in the long run, addiction will take its toll on health (even exercise in excess is physiologically unhealthy in the long run in terms of immune function, cardiovascular health, bone health, and mental health). Furthermore, some research suggests that work and exercise addiction have also similar personality correlates different from other addictions, namely high conscientiousness. This might contribute to the fact that work addiction is so perplexing because this personality trait is consistently linked to better health.
Another myth we explored was ‘work addiction and workaholism are the same thing’. The issue of whether ‘workaholism’ and ‘work addiction’ are the same entity depends on how these constructs are defined. For instance, I have argued that any behaviour that fulfils six core components (i.e., salience, conflict, mood modification, tolerance, withdrawal symptoms, and relapse) should be operationalized as an addiction. These six components have also been the basis of many psychometric instruments for assessing potential addictions including work addiction (such as the Bergen Work Addiction Scale that I co-developed and was published in a 2012 issue of the Journal of Scandinavian Psychology). The empirical research carried out by myself and others over the last five years concerning ‘work addiction’ is theoretically rooted in the core addiction literature whereas ‘workaholism’ncludes a wider range of theoretical underpinnings and in some research is a construct seen as something positive rather than negative. Arguably, in popular press and in common everyday language ‘workaholism’ is often used as a positive notiono describe very engaged workers, which adds significantly to the confusion about the two terms.
‘Workaholism’ is arguably a generic term that throughout the literature (as well as by lay people and the popular press) appears to equate to excessive working irrespective of whether the consequences are advantageous or disadvantageous. There is clearly lack of precise dictionary definitions of ‘work addiction’ and ‘workaholism’, and there is no reason to assume they could not be used as synonyms. However, the common use of the term ‘workaholism’ to denote anything related to high involvement in work may suggest that for practical reasons in the professional literature on work addiction, understood within addiction framework, it would be advisable to limit usage of this term. While, it is almost impossible to control natural usage of terms, preference for ‘work addiction’ in addiction literature would be a way to emphasize the addiction framework in which the phenomenon is being conceptualized. In short, ‘work addiction’ is a psychological construct while ‘workaholism’ is arguably a more generic term.
Dr. Mark Griffiths, Professor of Behavioural Addiction, International Gaming Research Unit, Nottingham Trent University, Nottingham, UK
Andreassen, C. S., Griffiths, M. D., Hetland, J., Kravina, L., Jensen, F., & Pallesen, S. (2014). The prevalence of workaholism: A survey study in a nationally representative sample of norwegian employees. PLoS ONE, 9, e102446. doi:10.1371/journal.pone.0102446
Andreassen, C. S., Griffiths, M. D., Hetland, J., & Pallesen, S. (2012). Development of a work addiction scale. Scandinavian Journal of Psychology, 53, 265–272. doi:10.1111/sjop.2012.53.issue-3
Andreassen, C. S., Griffiths, M. D., Sinha, R., Hetland, J., & Pallesen, S. (2016) The Relationships between workaholism and symptoms of psychiatric disorders: A large-scale cross-sectional study. PLoS ONE, 11: e0152978. doi:10.1371/journal.pone.0152978
Brown, R. I. F. (1993). Some contributions of the study of gambling to the study of other addictions. In W.R. Eadington & J. Cornelius (Eds.), Gambling Behavior and Problem Gambling (pp. 341-372). Reno, Nevada: University of Nevada Press.
Griffiths, M. D. (1996). Behavioural addictions: An issue for everybody? Journal of Workplace Learning, 8(3), 19-25.
Griffiths, M.D. (2005). Workaholism is still a useful construct. Addiction Research and Theory, 13, 97-100.
Griffiths, M. D. (2005b). A ‘components’ model of addiction within a biopsychosocial framework. Journal of Substance Use, 10, 191–197
Griffiths, M.D. (2011). Workaholism: A 21st century addiction. The Psychologist: Bulletin of the British Psychological Society, 24, 740-744.
Griffiths, M.D., Demetrovics, Z. & Atroszko, P.A. (2018). Ten myths about work addiction. Journal of Behavioral Addictions. Epu ahead of print. doi: 10.1556/2006.7.2018.05
Griffiths, M.D. & Karanika-Murray, M. (2012). Contextualising over-engagement in work: Towards a more global understanding of workaholism as an addiction. Journal of Behavioral Addictions, 1(3), 87-95.
Paksi, B., Rózsa, S., Kun, B., Arnold, P., Demetrovics, Z. (2009). Addictive behaviors in Hungary: The methodology and sample description of the National Survey on Addiction Problems in Hungary (NSAPH). [in Hungarian] Mentálhigiéné és Pszichoszomatika, 10(4), 273-300.
Quinones, C., & Griffiths, M. D. (2015). Addiction to work: A critical review of the workaholism construct and recommendations for assessment. Journal of Psychosocial Nursing and Mental Health Services, 10, 48–59.
Sussman, S., Lisha, N. & Griffiths, M.D. (2011). Prevalence of the addictions: A problem of the majority or the minority? Evaluation and the Health Professions, 34, 3-56.
In previous blogs I have looked at the alleged addictiveness of extreme sports including BASE jumping and bungee jumping as well as briefly overviewing so called ‘adrenaline junkies’. Over the last year, a couple of papers by Robert Heirene, David Shearer, and Gareth Roderique-Davies have looked at the addictive properties of rock climbing specifically concentrating on withdrawal symptoms and craving.
In the first paper on withdrawal symptoms published last year in the Journal of Behavioral Addictions, the authors highlighted some previous research suggesting that there are similarities in the phenomenology of substance-related addictions and extreme sports. For instance, they noted:
Extreme sports athletes commonly describe a “rush” or “high” when participating in their sport (Buckley, 2012; Price & Bundesen, 2005) and liken these experiences to those of drug users (Willig, 2008). For example, a participant in Willig’ s study described: “It’s like for a drug user, they will take cocaine to get high. For me it’s my addiction, I have to go to the mountains to get high.” Similarly, skydivers have described their sport as “like an addiction,” stating that they “can’t get enough,” and their “relationships suffer” as a result (Celsi, Rose, & Leigh, 1993).”
They also noted prior research suggesting that athletes may experience withdrawal states during periods of abstinence that are also characteristic of those with an addiction. Heirene and his colleagues claimed that this their study was the first to explore withdrawal experiences of individuals engaged in extreme sports. They carried out a study very similar to one of my own where Michael Smeaton and I published a study where gamblers were specifically interviewed about their experiences of withdrawal (in a 2002 issue of Social Psychological Review).
Heirene’s team used semi-structured interviews to explore withdrawal experiences of what they defined as ‘high ability’ and ‘average-ability’ male rock climbers during periods of abstinence (four climbers in each of the two groups). They then investigated the behavioural and psychological and aspects of withdrawal (including craving, anhedonia [i.e., the inability to feel pleasure in normally pleasurable activities], and negative affect) and examined the differences in the frequency and intensity of these states between the two rock climbing groups. Based on an analysis of the interview transcripts, they found support for the existence of anhedonia, craving, and negative affect among rock climbers. They also reported that the effects were more pronounced and intense among the high ability rock climbers (apart from anhedonic symptoms). The authors also noted:
“All participants reported negative affective experiences during abstinence, including states of “restlessness” and being “miserable,” “agitated,” or “frustrated.” Similar dysphoric states have been identified in drug users, exercise addicts, and extreme sports athletes during abstinence…In the present study, both groups reported using climbing to alleviate negative affective states, particularly stress. This finding supports previous research that has reported skydivers use their sport in a self-medicating manner (Price & Bundesen, 2005). Similarly, psychopharmacology literature has found individuals engage in substance abuse as a means of coping with stress…suggesting similar participation motives in both drug use and extreme sports”.
The study concluded that based on self-report, rock climbers experienced genuine withdrawal symptoms during abstinence from climbing and that these were comparable to individuals with substance and other behavioral addictions. In a second investigation just published in Frontiers in Psychology, the same team (this time led by Gareth Roderique-Davies) reported the development of the Rock Climbing Craving Questionnaire (RCCQ). The development of this new psychometric instrument directly followed on from the previous study which had found evidence of craving amongst the rock climbers that had been interviewed.
In the second paper, the research team attempted to “quantitatively measure the craving experienced by participants of any extreme sports”. They claimed that the RCCQ could allow “a greater understanding of the craving experienced by extreme sports athletes and a comparison of these across sports (e.g., surfing) and activities (e.g., drug-use)”. To develop the RCCQ, they utilized previously validated craving measures as a template for the new instrument to assess craving in the sports of rock-climbing and mountaineering.
The second paper comprised two studies. The first study investigated the factor structure of the craving measure among 407 climbers who completed the RCCQ. (One of the limitations of the study was that the participant sample was heterogeneous and included climbers and mountaineers from multiple primary climbing disciplines, including indoor climbing, outdoor traditional climbing, alpine climbing, and ice climbing). Despite the heterogeneity of the sample, the results demonstrated that a three-factor model explained just over half the total variance in item scores. The three factors (‘positive reinforcement’, ‘negative reinforcement’ and ‘urge to climb’) each comprised five items. The second study validated the 15-item RCCQ on 254 climbers using confirmatory factor analysis across two conditions (a ‘climbing-related cue’ condition or a ‘cue-neutral’ condition). The authors concluded that:
“[The first study supported] the multi-dimensional nature of rock climbing craving and shows parallels with substance-related craving in reflecting intention and positive (desire) and negative (withdrawal) reinforcement. [The second study confirmed] this factor structure and gives initial validation to the measure with evidence that these factors are sensitive to cue exposure…if as shown here, craving for climbing (and potentially other extreme sports) is similar to that experienced by drug-users and addicts, there is the potential that climbing and other extreme sports could be used as a replacement therapy for drug users”.
This latter suggestion has been made in the literature dating back to the 1970s and the work of Dr. Bill Glasser on ‘positive addictions’ as well as by psychologists such as Iain Brown who suggested in the early 1990s that gambling addicts should replace their addictions with sensation-seeking activities such as sky-diving and parachuting. Critics will claim that these papers are another example of ‘over-pathologizing’ everyday behaviours, but as I have always argued, if any behaviour fulfils all the core criteria for addiction, they should be operationalised as such.
Dr. Mark Griffiths, Professor of behavioural Addiction, International Gaming Research Unit, Nottingham Trent University, Nottingham, UK
Brymer, E., & Schweitzer, R. (2013). Extreme sports are good for your health: a phenomenological understanding of fear and anxiety in extreme sport. Journal of health psychology, 18(4), 477-487.
Buckley, R. (2012). Rush as a key motivation in skilled adventure tourism: Resolving the risk recreation paradox. Tourism Management, 33, 961–970.
Castanier, C., Le Scanff, C., & Woodman, T. (2010). Who takes risks in high-risk sports? A typological personality approach. Research Quarterly for Exercise and Sport, 81, 478–484.
Celsi, R. L., Rose, R. L., & Leigh, T. W. (1993). An exploration of high risk leisure consumption through skydiving. Journal of Consumer Research, 20(1), 1–23.
Glasser, W. (1976). Positive Addictions. New York: Harper & Row.
Griffiths, M.D. (2005). A ‘components’ model of addiction within a biopsychosocial framework. Journal of Substance Use, 10, 191-197.
Griffiths, M.D. & Smeaton, M. (2002). Withdrawal in pathological gamblers: A small qualitative study. Social Psychology Review, 4, 4-13.
Heirene, R. M., Shearer, D., Roderique-Davies, G., & Mellalieu, S. D. (2016). Addiction in extreme sports: An exploration of withdrawal states in rock climbers. Journal of Behavioral Addictions, 5(2), 332-341.
Larkin, M. & Griffiths, M.D. (2004). Dangerous sports and recreational drug-use: Rationalising and contextualising risk. Journal of Community and Applied Social Psychology, 14, 215-232.
Monasterio, E., & Mei-Dan, O. (2008). Risk and severity of injury in a population of BASE jumpers. New Zealand Medical Journal, 121, 70–75.
Monasterio, E., Mulder, R., Frampton, C., & Mei-Dan, O. (2012). Personality characteristics of BASE jumpers. Journal of Applied Sport Psychology, 24, 391-400.
Price, I. R., & Bundesen, C. (2005). Emotional changes in skydivers in relation to experience. Personality and Individual Differences, 38, 1203–1211.
Roderique-Davies, G. R. D., Heirene, R. M., Mellalieu, S., & Shearer, D. A. (2018). Development and initial validation of a rock climbing craving questionnaire (RCCQ). Frontiers in Psychology, 9, 204. doi: 10.3389/fpsyg.2018.00204
Willig, C. (2008). A phenomenological investigation of the experience of taking part in extreme sports. Journal of Health Psychology, 13(5), 690-702.
As a teenager I was fascinated with LSD purely as a consequence of my love of The Beatles and its alleged association with songs such as ‘Lucy in the Sky with Diamonds‘ (I say ‘alleged’ because all Beatle fanatics know that this song got its’ title from a drawing by John Lennon’s son Julian and that lyrically the song was inspired by the writings of Lewis Carroll, the creator of Alice in Wonderland [AIW], a book which gave its’ name to AIW Syndrome that I examined in a couple of previous blogs).
When I first started teaching my ‘Addictive Behaviours’ module back in 1990, almost all my lectures concentrated on drug addictions (as opposed to behavioural addictions which now take centre stage in my teaching), and it was my session on hallucinogenic drugs (also known as psychedelic drugs) that was always the most fun to teach and the topic that students appeared to be most engaged in. Like many of my students, I have always been interested in altered states of consciousness both in my own research into addiction and the topic more generally.
The reason why I mention all these things as that I did a media interview on the hallucinogenic effects of virtual reality products. The interview was based on comments by Microsoft researcher Mar Gonzalez Franco, who said that virtual reality will soon replace the need for hallucinogenic drugs. More specifically, she was quoted as saying:
“By 2027 we will have ubiquitous virtual reality systems that will provide such rich multi-sensorial experiences that will be capable of producing hallucinations which blend or alter perceived reality. Using this technology, humans will retrain, recalibrate and improve their perceptual systems…In contrast to current virtual reality systems that only stimulate visual and auditory senses, in the future the experience will expand to other sensory modalities including tactile with haptic devices“.
Claims that VR products have the potential to induce hallucinogenic experiences have already started appearing in the media. A recent story in the Daily Mail reported that there was already a VR app (SelfSound) that claimed it can reproduce the effects of hallucinogenic drugs and “plays on the neurological phenomena known as synaesthesia” and that a “program is used to promote mediation through creating abstract reality [and] plays face-melting music with synesthetic DMT-style visualizations uniquely generated in response to [a person’s] voice”. (DMT is an abbreviation for dimethyltryptamine, a powerful hallucinogenic drug).
Over the last seven years, I have published a series of studies with Dr. Angelica Ortiz de Gotari (some of them listed in the ‘Further reading’ section below) showing that hallucinations are common among video gamers in our working examining Game Transfer Phenomena (GTP). Therefore, it’s no surprise that VR games can do the same thing. We have reported that visual and auditory hallucinations are commonly experiences by regular videogame players.
For instance, one of our studies published in the International Journal of Human-Computer Interaction found that some video gamers experience altered visual perceptions after playing (e.g., distorted versions of real world surroundings). Others saw video game images and misinterpreted real life objects after they had stopped playing. Gamers reported seeing video game menus popping up in front their eyes when they were in a conversation, or saw coloured images and ‘heads up’ displays when driving on the motorway. Our study analysed 656 experiences from 483 gamers collected in 54 online video game forums. Visual illusions can easily trick the brain, and staring at visual stimuli can cause ‘after-images’ or ‘ghost images’ among videogame players. We found that GTP were triggered by associations between video game experiences, and objects and activities in real life contexts. Our findings also raised questions about the effects of the exposure to specific visual effects used in video games.
We also reported that in some playing experiences, video game images appeared without awareness and control of the gamers, and in some cases, the images were uncomfortable, especially when gamers could not sleep or concentrate on something else. These experiences also resulted in irrational thoughts such as gamers questioning their own mental health, getting embarrassed or performing impulsive behaviours in social contexts. However, other gamers clearly thought that these experiences were fun and some even tried to induce them.
Visual experiences identified in GTP show us the interplay of physiological, perceptual and cognitive mechanisms and the potential of learning with video games even without awareness. It also invites us to reflect about the effects of prolonged exposure to synthetic stimuli and the challenges that the human mind affront due to the technological advances that are still to come. However, because we collected our data for most of our published studies from online video game forums, the psychological profile of the gamers in our studies are unknown. However, different gamers reported similar experiences in the same games. This highlights the relevance of the video games’ structural characteristics but gamers’ habits also appear to be crucial. Some gamers may be more susceptible than others to experience GTP. The effects of these experiences appear to be short-lived, but some gamers experience them recurrently. It goes without saying (but I’ll say it anyway) that more research is needed to understand the cognitive and psychological implications of GTP. Most of these GTP experiences are viewed positively but a small minority of players find them detrimental.
Whether such hallucinations – either in typical videogames or VR videogames – can be induced on demand is debatable. Very few players in our own research said they were able to induce hallucinations. At present, we simply don’t know what the long-term effects of VR gaming will be and that goes for VR-induced gaming hallucinations too. It may be the case that VR induced hallucinogenic states will be ‘safer’ than ones induced by psychedelic drugs as there is no ingestion of a psychoactive substance, but that’s just speculation on my part.
Dr. Mark Griffiths, Professor of Behavioural Addiction, International Gaming Research Unit, Nottingham Trent University, Nottingham, UK
Cawley, C. (2016). Virtual Reality could make you hallucinate; Don’t freak out. Tech Co, December 15. Located at: http://tech.co/virtual-reality-hallucinate-dont-freak-2016-12
Hamill, J. (2016). Windows of perception: Microsoft says virtual reality will soon have same mind-bending effects as LSD. The Sun, December 7. Located at: https://www.thesun.co.uk/news/2347705/microsoft-says-virtual-reality-will-soon-have-same-mind-bending-effects-as-lsd/
Liberatore, S. (2016). That’s trippy! Watch the VR app that claims to be able to reproduce the effects of a hallucinogenic drug. Daily Mail, May 4, Located at: http://www.dailymail.co.uk/sciencetech/article-3572184/That-s-trippy-Watch-VR-app-claims-able-reproduce-effects-hallucinogenic-drug.html
Ortiz de Gortari, A.B. & Griffiths, M.D. (2012). An introduction to Game Transfer Phenomena in video game playing. In J. Gackenbach (Ed.), Video Game Play and Consciousness (pp.223-250). Hauppauge, NY: Nova Science.
Ortiz de Gortari, A.B. & Griffiths, M.D. (2014). Altered visual perception in Game Transfer Phenomena: An empirical self-report study. International Journal of Human-Computer Interaction, 30, 95-105.
Ortiz de Gortari, A.B. & Griffiths, M.D. (2014). Auditory experiences in Game Transfer Phenomena: An empirical self-report study. International Journal of Cyber Behavior, Psychology and Learning, 4(1), 59-75.
Ortiz de Gortari, A.B. & Griffiths, M.D. (2014). Automatic mental processes, automatic actions and behaviours in Game Transfer Phenomena: An empirical self-report study using online forum data. International Journal of Mental Health and Addiction, 12, 432-452.
Ortiz de Gortari, A.B. & Griffiths, M.D. (2015). Auditory experiences in Game Transfer Phenomena: An empirical self-report study. In: Gamification: Concepts, Methodologies, Tools, and Applications (pp.1329-1345). Pennsylvania: IGI Global.
Ortiz de Gortari, A.B. & Griffiths, M.D. (2016). Prevalence and characteristics of Game Transfer Phenomena: A descriptive survey study. International Journal of Human-Computer Interaction, 32, 470-480.
Ortiz de Gortari, A.B., Pontes, H.M. & Griffiths, M.D. (2015). The Game Transfer Phenomena Scale: An instrument for investigating the non-volitional effects of video game playing. Cyberpsychology, Behavior and Social Networking, 18, 588-594.
Rothman, P. (2014). Virtual Reality and Drugs – Yes, you should get high before using VR. H Plus Magazine, July 31. Located at: http://hplusmagazine.com/2014/07/31/virtual-reality-and-drugs-yes-you-should-get-high-before-using-vr/
Last month, the World Health Organisation (WHO) announced that it was planning to include ‘Gaming Disorder’ (GD) in the latest edition of the International Classification of Diseases. This followed the American Psychiatric Association’s decision to include ‘Internet Gaming Disorder’ in the latest edition of the Diagnostic and Statistical Manual of Mental Disorders in 2013. According to the WHO, an individual with GD is a person who lets playing video games “take precedence over other life interests and daily activities,” resulting in “negative consequences” such as “significant impairment in personal, family, social, educational, occupational or other important areas of functioning.”
I have been researching videogame addiction for nearly 30 years, and during that time I have received many letters, emails, and telephone calls from parents wanting advice concerning videogames. Typical examples include ‘Is my child playing too much?’, ‘Will playing videogames spoil my pupils’ education?’, ‘Are videogames bad for children’s health? and ‘How do I know if a child is spending too long playing videogames?’ To answer these and other questions in a simple and helpful way, I have written this article as a way of disseminating this information quickly and easily.
To begin with parents should begin by finding out what videogames their children are actually playing! Parents might find that some of them contain material that they would prefer them not to be having exposure to. If they have objections to the content of the games they should facilitate discussion with children about this, and if appropriate, have a few rules. A few aims with children should be:
- To help them choose suitable games which are still fun
- To talk with them about the content of the games so that they understand the difference between make-believe and reality
- To discourage solitary game playing
- To guard against obsessive playing
- To follow recommendations on the possible risks outlined by videogame manufacturers
- To ensure that they have plenty of other activities to pursue in their free time besides the playing of videogames
Parents need to remember that in the right context videogames can be educational (helping children to think and learn more quickly), can help raise a child’s self-esteem, and can increase the speed of their reaction times. Parents can also use videogames as a starting point for other activities like painting, drawing, acting or storytelling. All of these things will help a child at school. It needs to be remembered that videogame playing is just one of many activities that a child can do alongside sporting activities, school clubs, reading and watching the television. These can all contribute to a balanced recreational diet.
The most asked question a parent wants answering is ‘How much videogame playing is too much? To help answer this question I devised the following checklist. It is designed to check if a child’s videogame playing is getting out of hand. Ask these simple questions. Does your child:
- Play videogames every day?
- Often play videogames for long periods (e.g., 3 to 6 hours at a time)?
- Play videogames for excitement or ‘buzz’ or as a way of forgetting about other things in their life?
- Get restless, irritable, and moody if they can’t play videogames?
- Sacrifice social and sporting activities to play videogames?
- Play videogames instead of doing their homework?
- Try to cut down the amount of videogame playing but can’t?
If the answer is ‘yes’ to more than four of these questions, then your child may be playing too much. But what can you do if your child is playing videogames too much?
- First of all, check the content of the games. Try and give children games that are educational rather than the violent ones. Parents usually have control over what their child watches on television – videogames should not be any different.
- Secondly, try to encourage video game playing in groups rather than as a solitary activity. This will lead to children talking and working together.
- Thirdly, set time limits on children’s playing time. Tell them that they can play for a couple of hours after they have done their homework or their chores – not before.
- Fourthly, parents should always get their children to follow the recommendations by the videogame manufacturers (e.g., sit at least two feet from the screen, play in a well-lit room, never have the screen at maximum brightness, and never play videogames when feeling tired).
I have spent many years examining both the possible dangers and the potential benefits of videogame playing. Evidence suggests that in the right context videogames can have positive health and educational benefits to a large range of different sub-groups. What is also clear from the case studies displaying the more negative consequences of playing is that they all involved children who were excessive users of videogames. From prevalence studies in this area, there is little evidence of serious acute adverse effects on health from moderate play. In fact, in some of my studies, I found that moderate videogame players were more likely to have friends, do homework, and engage in sporting activities, than those who played no videogames at all.
For excessive videogame players, adverse effects are likely to be relatively minor, and temporary, resolving spontaneously with decreased frequency of play, or to affect only a small subgroup of players. Excessive players are the most at-risk from developing health problems although more research is needed. If care is taken in the design, and if they are put into the right context, videogames have the potential to be used as training aids in classrooms and therapeutic settings, and to provide skills in psychomotor coordination, and in simulations of real life events (e.g., training recruits for the armed forces).
Every week I receive emails from parents claiming that their sons are addicted to playing online games or that their daughters are addicted to social media. When I ask them why they think this is the case, they almost all reply “because they spend most of their leisure time in front of a screen.” This is simply a case of parents pathologising their children’s behaviour because they think what they are doing is “a waste of time.” I always ask parents the same three things in relation to their child’s screen use. Does it affect their schoolwork? Does it affect their physical education? Does it affect their peer development and interaction? Usually parents say that none of these things are affected so if that is the case, there is little to worry about when it comes to screen time. Parents also have to bear in mind that this is how today’s children live their lives. Parents need to realise that excessive screen time doesn’t always have negative consequences and that the content and context of their child’s screen use is more important than the amount of screen time.
(N.B. This article is an extended version of an article that was originally published by Parent Zone)
Dr. Mark Griffiths, Professor of Behavioural Addiction, International Gaming Research Unit, Nottingham Trent University, Nottingham, UK
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Griffiths, M.D. (2009). Online computer gaming: Advice for parents and teachers. Education and Health, 27, 3-6.
Griffiths, M.D., Kuss, D.J. & King, D.L. (2012). Video game addiction: Past, present and future. Current Psychiatry Reviews, 8, 308-318.
Griffiths, M.D., Kuss, D.J. & Pontes, H. (2016). A brief overview of Internet Gaming Disorder and its treatment. Australian Clinical Psychologist, 2(1), 20108.
Griffiths, M.D. & Meredith, A. (2009). Videogame addiction and treatment. Journal of Contemporary Psychotherapy, 39(4), 47-53.
King, D.L., Delfabbro, P.H. & Griffiths, M.D. (2012). Clinical interventions for technology-based problems: Excessive Internet and video game use. Journal of Cognitive Psychotherapy: An International Quarterly, 26, 43-56.
King, D.L., Delfabbro, P.H., Griffiths, M.D. & Gradisar, M. (2012). Cognitive-behavioural approaches to outpatient treatment of Internet addiction in children and adolescents. Journal of Clinical Psychology, 68, 1185-1195.
Király, O., Nagygyörgy, K., Griffiths, M.D. & Demetrovics, Z. (2014). Problematic online gaming. In K. Rosenberg & L. Feder (Eds.), Behavioral Addictions: Criteria, Evidence and Treatment (pp.61-95). New York: Elsevier.
Kuss, D.J. & Griffiths, M.D. (2012). Online gaming addiction in adolescence: A literature review of empirical research. Journal of Behavioral Addictions, 1, 3-22.
Kuss, D.J. & Griffiths, M.D. (2012). Internet gaming addiction: A systematic review. International Journal of Mental Health and Addiction, 10, 278-296.
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.
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.
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
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).
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 that…I 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).
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
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).
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)
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.