Blog Archives

Tales of the unexpected: 10 bad habits that sometimes do us good (Part 1)

All of us have bad habits, and all of us from time to time feel guilty about these habits. But there are some bad habits – at least when carried out in moderation – that might actually have benefits for psychological and/or physical wellbeing. Most bad habits help change our mood state and reduce stress (at least in the very short-term) but tend to become less helpful the more they are engaged in. Some of these bad habits turn into addictions where the short-term benefits are outweighed by the long-term costs. However, there are many activities that can sometimes have unexpected benefits and five of these are outlined in this blog. The next five bad habits will be in my next blog.

(1) Fidgeting helps burn calories

While fidgeting might be annoying for individuals and those around them, it is an activity that expends energy and burns calories. Fidgeting is one of a number of activities (along with walking, gardening, typing, tidying up, etc.) that are known as non-exercise activity thermogenesis (NEAT). In basic terms, NEAT is any activity that is not eating, sleeping, or sporting exercise. A number of studies carried out by obesity expert Dr. James Levine at the US Mayo Clinic (Arizona, US) have shown that individuals who fidget burn up about 350kcal a day. This is because fidgeting speeds up an individual’s metabolism by stimulating neurochemicals in the body thus increasing the ability to convert body fat into energy. So, if you are a compulsive foot tapper, an excessive thumb twiddler, or a restless doodler, just remember that all of these activities burn calories.

(2) Chewing gum helps boost thinking and alertness

Watching people chew gum is not a pretty site but if English football managers are anything to go by, chewing gum appears to be a stress relieving activity. In fact, there appear to appear to be many cognitive benefits of chewing gum. Dr. Kin-ya Kubo and colleagues in the book Senescence and Senescence-Related Disorders noted that chewing gum immediately before performing a cognitive task increases blood oxygen levels in the prefrontal cortex and hippocampus (important brain structures involved in learning and memory), thereby improving task performance. Dr. Kubo argues that chewing gum may therefore be a drug-free and simple method of helping those with senile dementia and stress-related disorders that are often associated with cognitive dysfunction. Another study by Dr. Yoshiyuki Hirano and colleagues showed that chewing gum boosts thinking and alertness, and that reaction times among chewers were 10% faster than non-chewers. The research team also reported that up to eight areas of the brain are affected by chewing (most notably the areas concerning attention and movement). As Professor Andy Smith (Cardiff University, UK) neatly summed up: “The effects of chewing on reaction time are profound. Perhaps football managers arrived at the idea of chewing gum by accident, but they seem to be on the right track”. 

(3) Playing video games helps relieve pain

Many individuals that do not play video games view the activity as a complete waste of time and potentially addictive. While excessive video game playing may cause problems in a minority of individuals, there is lots of scientific evidence that playing video games can have many beneficial effects. For instance, a number of studies have shown that children with cancer who play video games after chemotherapy take less pain killing medication. Video games have also been used as pain relieving therapy for other medical conditions such as burns victims and those with back pain. This is because playing video games is an engaging and engrossing activity that means the player cannot think about anything else but playing the game (and is what psychologists refer to as a ‘cognitive distractor task’). Pain has a large psychological component and individuals experience less pain if the person is engaged in an activity that takes up all their cognitive mind space. As well as being a pain reliever, there are also many studies showing that playing video games increase hand-eye co-ordination, increase reaction times, and have educational learning benefits.

(4) Eating snot helps strengthen the immune system (maybe)

How does it make you feel when you see someone picking their nose and then eating what they have found? Disgust? Contempt? Amused? In 2008, Dr Friedrich Bischinger, an Austrian lung specialist, claimed that picking your nose and eating it was good for you. He claimed that people who pick their noses with their fingers were healthy, happier and probably better in tune with their bodies than those who didn’t. Dr. Bischinger believes that eating the dry remains of what you pull out of your nose is a great way of strengthening the body’s immune system. He explained that in terms of the immune system, the nose is a filter in which a great deal of bacteria are collected, and when this mixture arrives in the intestines it works just like a medicine. He said that “people who pick their nose and eat it get a natural boost to their immune system for free. I would recommend a new approach where children are encouraged to pick their nose. It is a completely natural response and medically a good idea as well”. He went on to suggest that if anyone was worried about what other people think, they should pick their noses privately if they want to get the benefits.  This view is also shared by Dr. Scott Napper, a biochemist at the University of Saskatchewan. He theorises that hygiene improvement has led to the increase in allergies and auto-immune disorders and that eating snot may boost the immune system by ingesting small and harmless amounts of germs into the body. The same theory has also been applied to another bad habit – biting fingernails – because again, the act of biting nails introduces germs directly into a person’s orifices.

(5) Daydreaming helps problem solving

Daydreaming is something that can occupy up to one-third of our waking lives and is often viewed as a sign of laziness, inattentiveness and/or procrastination. However, scientific research has shown that the ‘executive network’ in our brain is highly active when we daydream. A study carried out by Professor Kalina Christoff and colleagues and published in the Proceedings of the National Academy of Sciences found activity in numerous brain regions while daydreaming including areas associated with complex problem solving. These brain regions were more active while daydreaming compared to routine tasks. It is believed that when an individual uses conscious thought they can become too rigid and limited in their thinking. The findings suggest that daydreaming is an important cognitive state where individuals turn their attention from immediate tasks to unconsciously think about problems in their lives. Christoff says that “when you daydream, you may not be achieving your immediate goal – say reading a book or paying attention in class – but your mind may be taking that time to address more important questions in your life, such as advancing your career or personal relationships”. In addition to this, Dr. Eric Klinger of the University of Minnesota has argued that daydreaming also serves an evolutionary purpose. When individuals are engaged on one task, daydreaming can trigger reminders of other, concurrent goals so that they do not lose sight of them.

Part 2 of this article will be in the next blog.

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

Further reading

Christoff, K., Gordon, A.M., Smallwood, J., Smith, R., & Schooler, J.W. (2009). Experience sampling during fMRI reveals default network and executive system contributions to mind wandering. Proceedings of the National Academy of Sciences, 106, 8719-872

Fox, K.C., Nijeboer, S., Solomonova, E., Domhoff, G.W., & Christoff, K. (2013). Dreaming as mind wandering: evidence from functional neuroimaging and first-person content reports. Frontiers in Human Neuroscience, 7, 42. doi: 10.3389/fnhum.2013.00412.

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

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

Hirano, Y., Obata, T., Takahashi, H., Tachibana, A., Kuroiwa, D., Takahashi, T., … & Onozuka, M. (2013). Effects of chewing on cognitive processing speed. Brain and Cognition, 81, 376-381.

Kato, P. M., Cole, S. W., Bradlyn, A. S., & Pollock, B. H. (2008). A video game improves behavioral outcomes in adolescents and young adults with cancer: A randomized trial. Pediatrics, 122, E305-E317.

Klinger, E. (2009). Daydreaming and fantasizing: Thought flow and motivation. In Markman, K. D., Klein, W.P., & Suhr, J.A. (Eds.), Handbook of Imagination and Mental Simulation (pp. 225-239). New York: Psychology Press.

Klinger, E., Henning, V. R., & Janssen, J. M. (2009). Fantasy-proneness dimensionalized: Dissociative component is related to psychopathology, daydreaming as such is not. Journal of Research in Personality, 43, 506-510.

Kubo, K. Y., Chen, H., & Onozuka, M. (2013). The relationship between mastication and cognition. In Wang, Z. & Inuzuka (Eds.), Senescence and Senescence-Related Disorders. InTech. Located at: http://www.intechopen.com/books/senescence-and-senescence-related-disorders

Levine, J.A. (2004). Nonexercise activity thermogenesis (NEAT): environment and biology. American Journal of Physiology-Endocrinology And Metabolism, 286, E675-E685.

Levine, J.A., Melanson, E. L., Westerterp, K. R., & Hill, J.O. (2001). Measurement of the components of nonexercise activity thermogenesis. American Journal of Physiology-Endocrinology and Metabolism, 281, E670-E675.

Levine, J.A., Schleusner, S. J., & Jensen, M.D. (2000). Energy expenditure of nonexercise activity. American Journal of Clinical Nutrition, 72, 1451-1454.

Redd, W.H., Jacobsen, P.B., DieTrill, M., Dermatis, H., McEvoy, M., & Holland, J.C. (1987). Cognitive-attentional distraction in the control of conditioned nausea in pediatric cancer patients receiving chemotherapy. Journal of Consulting and Clinical Psychology, 55, 391-395.

Reichlin, L., Mani, N., McArthur, K., Harris, A.M., Rajan, N., & Dacso, C.C. (2011). Assessing the acceptability and usability of an interactive serious game in aiding treatment decisions for patients with localized prostate cancer. Journal of Medical Internet Research, 13, 188-201.

Vasterling, J., Jenkins, R.A., Tope, D.M., & Burish, T.G. (1993). Cognitive distraction and relaxation training for the control of side effects due to cancer chemotherapy. Journal of Behavioral Medicine, 16, 65-80.

Wighton, K. (2013). From biting your nails to burping and even eating in bed: The bad habits that can be GOOD for you! Daily Mail, April 8. Located at: http://www.dailymail.co.uk/health/article-2305953/Bad-habits-From-biting-nails-burping-eating-bed-The-bad-habits-GOOD-you.html

Distraction plans: Excessive smartphone use and pain perception

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

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

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

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

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

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

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

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

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

Further reading

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

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

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

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

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

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

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

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

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

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

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

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