A few days ago I was interviewed by Business Insider about the addictiveness of the card game Solitaire (also known as Klondike and Patience). The ‘hook’ for the Business Insider article (no pun intended) was that May 22 is National Solitaire Day (NSD). A quick look on the online National Day Calendar confirmed that NSD does indeed exist (a celebration day that only began for the first time last year) and the website also pointed out that the game is over 200 years’ old and that Solitaire “truly went viral” in 1990 when Microsoft included the Microsoft Solitaire game in Windows 3.0 (as a way to teach people how to use the mouse on their computers). The NSD webpage notes that:
“Over the past 28 years, Microsoft Solitaire has been providing great entertainment to hundreds of millions of players in every corner of the world…In 2012, Microsoft evolved Solitaire into the Microsoft Solitaire Collection, which features five of the top Solitaire games in one app. Since then, the game has been played by over 242 million people and has become so popular that each year 33 billion games are played with over 3.2 trillion cards dealt!”
Back in 2000, a short article on internet addiction in The Lancet by Peter Mitchell noted that one of the pioneers in internet addiction research, the clinical psychologist Maressa Hecht Orzack claimed to have a problem (a “near addiction”) playing Solitaire. Orzack was quoted in Mitchell’s article as saying: “So now I don’t have a computer at work. [My playing Solitaire] was getting that serious”. Orzack was also quoted in the Business Insider article. Her Solitaire playing was a “growing obsession” and she neglected her work and lost sleep because of her Solitaire playing. She said: “I kept playing solitaire more and more – my late husband would find me asleep at the computer. I was missing deadlines. I knew something had to be done”.
As far as I am aware, there is no empirical research about addiction to Solitaire, and I’ve never come across a published case study. However, I have mentioned Solitaire in a number of my papers over the years but all of them were in my critique of Dr. Kimberley Young’s taxonomy of the different types of internet addiction. Young claimed there were five different types of internet addiction (‘cyber-sexual addiction’, cyber-relationship addiction, ‘net compulsions’, ‘information overload’ and ‘computer addiction’). In a number of my publications in journals such as the Student British Medical Journal (1999), Addiction Research (2000), and the International Journal of Mental Health and Addiction (2006), I argued that the typology was flawed and that most of the examples Young provided were addictions on the internet, not addictions to the internet (and echoing my assertion that individuals are no more addicted to the internet than alcoholics are addicted to bottles).
The reference to Solitaire was in relation to Young’s final type of internet addiction – ‘computer addiction’. One of her examples of ‘computer addiction’ as the playing of Solitaire on computers. (I found this strange particularly because the example didn’t even rely on being on the internet – it was merely about individuals being addicted to playing Solitaire on computers and laptops). Young never provided any empirical evidence that she had ever met or treated anyone with an addiction to Solitaire, just that being addicted to Solitaire would be classed as a ‘computer addiction’ in her typology.
Young is not the only social scientist to use Solitaire as an example in an addiction typology. In a 2008 paper published in the Journal of Applied Social Science, Jawad Fatayer outlined what he believes are the four types of addiction – alpha addictions (addictions that impact the body and physical health such as nicotine addiction and food addiction), beta addictions (addictions that impact the mind and the body such as alcohol and other drug addictions), gamma addictions (all behavioural addictions), and delta addictions (two or more addictions experiences simultaneously). Addiction to Solitaire was listed as a gamma addiction (but again, there was no empirical evidence to support the claim that Solitaire addiction actually exists).
Business Insider spoke to two other psychologists in addition to myself. Dr. Chris Ferguson (with whom I have co-authored a few papers) said:
“It’s important to recognize the difference between really liking something and having a clinical addiction. People (say) ‘I’m addicted to cupcakes’, ‘I’m addicted to chocolate’ meaning ‘This is a really fun thing that I like to do a lot’. There’s a huge debate that goes on in the field right now about whether video games can be compared to things like substance abuse, or if video games are more similar to hobby-like activities that many people enjoy — and some people might overdo…a fixation with Solitaire is more of a behavioral addiction – an obsessive behavioral pattern that can be a sign of underlying mental distress or illness. People who have mental health issues, or are simply under stress, tend to be drawn to things that are fun and distracting. And that’s mostly good, actually. It’s just that sometimes, for some individuals, they may begin to really overdo those activities as a form of escapism…It’s not about technology. It’s about mental health”.
A clinical psychologist, Anthony Bean said:
“There are some clear signs that Solitaire might be playing too big a role in your life. (If you’re) noticing you’re putting more time than other areas into the game and, let’s say, not paying attention to your family, not paying attention to work, not paying attention to school”.
My contribution to the Business Insider was taken from an email I sent the journalist. Very little of what I sent was used. I was asked two specific questions: (i) what characteristics of the game Solitaire might make it addicting? and (ii) what should people be aware of as signs of a disruptive addiction to Solitaire (or gaming in general)?
In answer to the first question, I wrote that addictions rely on constant rewards (what psychologists refer to as reinforcement) and each game of Solitaire can be played quickly and individuals can be quickly rewarded if they win (positive reinforcement) but when they lose, the feeling of disappointment or cognitive regret can be eliminated by playing again straight away (negative reinforcement – playing as way to relive a dysphoric mood state). I also stated that addictions typically result as a coping mechanism to other things in a person’s life. They use such behaviours as a way of escape and the repetitive playing of games can help in such circumstances. For the overwhelming majority of people, such playing behaviour will be an adaptive coping mechanism but if the game takes over all other aspects of the person’s life and compromises their relationships and their education/occupation (depending upon their age), this becomes a poor coping strategy because the short-term benefits are heavily outweighed by the long-term costs.
In relation to the second question, I outlined what I believe to be the six core criteria of addictive behaviour and outlined them with what I believed a genuine Solitaire addiction would constitute. My response was purely hypothetical because I have never met or even heard of anyone being genuinely addicted to Solitaire. So, hypothetically, Solitaire addiction would comprise anyone that fulfilled all of the following six criteria:
- Salience –This occurs when Solitaire becomes the single most important activity in the person’s life and dominates their thinking (preoccupations and cognitive distortions), feelings (cravings) and behaviour (deterioration of socialised behaviour). For instance, even if the person is not actually playing Solitaire they will be constantly thinking about the next time that they will be (i.e., a total preoccupation with Solitaire).
- Mood modification –This refers to the subjective experiences that people report as a consequence of playing Solitaire and can be seen as a coping strategy (i.e., they experience an arousing ‘buzz’ or a ‘high’ or paradoxically a tranquilizing feel of ‘escape’ or ‘numbing’).
- Tolerance –This is the process whereby increasing amounts of time spent playing Solitaire are required to achieve the former mood modifying effects. This basically means that for someone engaged in Solitaire, they gradually build up the amount of the time they spend playing Solitaire every day.
- Withdrawal symptoms– These are the unpleasant feeling states and/or physical effects (e.g., the shakes, moodiness, irritability, etc.), that occur when the person is unable to play Solitaire because they are ill, have no computer connection, etc.
- Conflict – This refers to the conflicts between the person and those around them (interpersonal conflict), conflicts with other activities (social life, hobbies and interests) or from within the individual themselves (intra-psychic conflict and/or subjective feelings of loss of control) that are concerned with spending too much time playing Solitaire
- Relapse– This is the tendency for repeated reversions to earlier patterns of excessive Solitaire playing to recur and for even the most extreme patterns typical at the height of excessive Solitaire playing to be quickly restored after periods of control.
Finally, I just want to reiterate that I know of no evidence to support the contention that there are individuals genuinely addicted to Solitaire. However, I do think it’s theoretically possible even though I’ve yet to meet or hear about such individuals.
Dr Mark Griffiths, Distinguished Professor of Behavioural Addiction, International Gaming Research Unit, Nottingham Trent University, Nottingham, UK
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National Day Calendar (2018). National Solitaire Day. Located at: https://nationaldaycalendar.com/national-solitaire-day-may-22/
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The issue of sex addiction as a behavioural addiction has been hotly debated over the last decade. A recent contribution to this debate is a review by Shane Kraus and his colleagues in the latest issue of the journal Addiction that examined the empirical evidence base for classifying compulsive sexual behaviour (CSB) as a behavioural (i.e., non-substance) addiction. The review raised many important issues and highlighted many of the problems in the area including the problems in defining CSB, and the lack of robust data from many different perspectives (epidemiological, longitudinal, neuropsychological, neurobiological, genetic, etc.).
As my regular blog readers will know, I have carried out empirical research into a wide variety of different behavioural addictions (gambling, video gaming, internet use, exercise, sex, work, etc.) and have argued that some types of problematic sexual behaviour can be classed as sex addiction depending upon the definition of addiction used. I was invited by the editors of Addiction to write a commentary on the review and this has just been published in the same issue as the paper by Kraus and colleagues. This blog briefly looks at the issues in that review that I highlighted in my commentary.
For instance, there are a number of areas in Kraus et al.’s paper that were briefly mentioned without any critical evaluation. For instance, in the short section on co-occurring psychopathology and CSB, reference was made to studies claiming that 4%-20% of those with CSB also display disordered gambling behaviour. I pointed out that a very comprehensive review that I published with Dr. Steve Sussman and Nadra Lisha (in the journal Evaluation and the Health Professions) examining 11 different potentially addictive behaviours also highlighted studies claiming that sex addiction could co-occur with exercise addiction (8%-12%), work addiction (28%-34%), and shopping addiction (5%-31%). While it is entirely possible for an individual to be addicted to (say) cocaine and sex concurrently (because both behaviours can be carried out simultaneously), there is little face validity that an individual could have two or more co-occurring behavioural addictions because genuine behavioural addictions consume large amounts of time every single day. My own view is that it is almost impossible for someone to be genuinely addicted to (for example) both work and sex (unless the person’s work was as an actor/actress in the pornographic film industry).
The paper by Kraus et al also made a number of references to “excessive/problematic sexual behavior” and appeared to make the assumption that ‘excessive’ behaviour is bad (i.e., problematic). While I agree that CSB is typically excessive, excessive sex in itself is not necessarily problematic. Preoccupation with any behaviour in relation to addiction obviously needs to take into account the context of the behaviour, as the context is far more important in defining addictive behaviour than the amount of the activity undertaken. As I have constantly argued, the fundamental difference between a healthy excessive enthusiasms and addictions is that healthy excessive enthusiasms add to life whereas addictions take away from them.
The paper also appeared to have an underlying assumption that empirical research from a neurobiological and genetic perspective should be treated more seriously than that from a psychological perspective. Whether problematic sexual behaviour is described as CSB, sex addiction and/or hypersexual disorder, there are thousands of psychological therapists around the world that treat such disorders. Consequently, clinical evidence from those that help and treat such individuals should be given greater credence by the psychiatric community.
Arguably the most important development in the field of CSB and sex addiction is how the internet is changing and facilitating CSB. This was not even mentioned until the concluding paragraph yet research into online sex addiction (while comprising a small empirical base) has existed since the late 1990s including sample sizes of up to almost 10,000 individuals. In fact, there have been a number of recent reviews of the empirical data concerning online sex addiction including its treatment including ones by myself in journals such as Addiction Research and Theory (in 2012) and Current Addiction Reports (in 2015). My review papers specifically outlined the many specific features of the Internet that may facilitate and stimulate addictive tendencies in relation to sexual behaviour (accessibility, affordability, anonymity, convenience, escape, disinhibition, etc.). The internet may also be facilitating behaviours that an individual would never imagine doing offline such as cybersexual stalking.
Finally, there is also the issue of why Internet Gaming Disorder was included in the DSM-5 (in Section 3 – ‘Emerging measures and models’) but sex addiction/hypersexual disorder was not, even though the empirical base for sex addiction is arguably on a par with IGD. One of the reasons might be that the term ‘sex addiction’ is often used (and arguably misused) by high profile celebrities as an excuse to justify their infidelity (e.g., Tiger Woods, Michael Douglas, David Duchovny, Russell Brand), and is little more than a ‘functional attribution’. For instance, the golfer Tiger Woods claimed an addiction to sex after his wife found out that he had many sexual relationships during their marriage. If his wife had never found out, I doubt whether Woods would have claimed he was addicted to sex. I would argue that many celebrities are in a position where they are bombarded with sexual advances from other individuals and have succumbed. But how many people would not do the same thing if they had the opportunity? Sex only becomes a problem (and is pathologised) when the person is found to have been unfaithful. Such examples arguably give sex addiction a ‘bad name’, and provides a good reason for those not wanting to include such behaviour in diagnostic psychiatry texts.
Dr. Mark Griffiths, Professor of Behavioural Addiction, International Gaming Research Unit, Nottingham Trent University, Nottingham, UK
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Van Gordon, W., Shonin, E., & Griffiths, M.D. (2016). Meditation Awareness Training for the treatment of sex addiction: A case study. Journal of Behavioral Addictions, 5, 363–372.