Blog Archives
Loud and proud: A psychological (and personal) look at the ‘Sin of Pride’
A number of years ago, I was asked to write an article on “The Sin of Pride” for the British Psychological Society. Before writing that article, I knew very little about the topic. To me it was the title of an record album by The Undertones that I bought in 1983 when I was 16 years old from Castle Records in Loughborough. I perhaps learned a bit more about it when I watched 1995 film ‘Seven’ directed by David Fincher and starring Brad Pitt (which coincidentally just happens to be one of my all-time favourite films).
After agreeing to write the article I did a bit of research on the subject (which admittedly meant I did a quick Google search followed by a more considered in-depth search on Google Scholar). While I’m no expert on the topic I can at least have a decent pub conversation about it if anyone is prepared to listen. Just to show my complete ignorance, I wasn’t even aware that the sin of pride was the sin of all sins (although I could in a pub quiz be relied upon to name the seven deadly sins).
I was asked to write on this topic because I was seen as someone who is very proud of the work that I do (and for the record, I am). However, I have often realized that just because I am proud of things that I have done in my academic career it doesn’t necessarily mean others think in the same way. In fact, on some occasions I have been quite taken aback by others’ reactions to things that I have done for which I feel justifiably proud (but more of that later).
At a very basic level, the sin of pride is rooted in a preoccupation with the self. However, in psychological terms, pride has been defined by Dr. Michael Lewis and colleagues in the International Journal of Behavioral Development as “a pleasant, sometimes exhilarating, emotion that results from a positive self-evaluation” and has been described by Dr. Jessica Tracy and her colleagues (in the journal Emotion) as one the three ‘self-conscious’ emotions known to have recognizable expressions (shame and embarrassment being the other two). From my reading of the psychological literature, it could perhaps be argued that pride has been regarded as having a more positive than negative quality, and (according to a paper in the Journal of Economic Psychology by my PhD supervisors – Professor Paul Webley and Professor Stephen Lea) is usually associated with achievement, high self-esteem and positive self-image – all of which are fundamental to my own thinking. My reading on the topic has also led to the conclusion that pride is sometimes viewed as an ‘intellectual’ or secondary emotion. In practical (and psychological) terms, sin is either a high sense of one’s personal status or ego, or the specific mostly positive emotion that is a product of praise or independent self-reflection.
One of the most useful distinctions can be made about sin (and is rooted in my own personal experience), is what Lea and Webley distinguish as ‘proper pride’ and ‘false pride’. They claim that:
“Proper pride is pride in genuine achievements (or genuine good qualities) that are genuinely one’s own. False pride is pride in what is not an achievement, or not admirable, or does not properly belong to oneself. Proper pride is associated with the desirable property of self-esteem; false pride with vanity or conceit. Proper pride is associated with persistence, endurance and doggedness; false pride with stubbornness, obstinacy and pig-headedness.”
As I noted above, there have been times when I have been immensely proud of doing something only for friends and colleagues to be appalled. ‘Proper pride’ as Lea and Webley would argue. One notable instance was when I wrote a full-page article for The Sun on ‘internet addiction’ published in August 1997. I originally wanted to be a journalist before I became a psychologist, and my journalist friends had always said that to get a full-page ‘by line’ in the biggest selling newspaper in the UK was a real achievement. I was immensely proud – apart from the headline that a sub-editor had dubbed my piece ‘The Internuts’ – and showed the article to whoever was around.
I had always passionately argued (and still do) that I want my research to be disseminated and read by as many people as possible. What was better than getting my work published in an outlet with (at the time) 10 million readers? My elation was short-lived. One close colleague and friend was very disparaging and asked how I could stoop so low as to “write for the bloody Sun?” Similar comments came from other colleagues and I have to admit that I was put off writing for the national tabloids for a number of years. (However, I am now back writing regularly for the national dailies and am strong enough to defend myself against the detractors).
In 2006, I was invited to the House of Commons by the ex-Leader of the Conservative Party, Iain Duncan-Smith and invited to Chair his Centre For Social Justice Working Party on Gambling and write a report as part of the Conservative Party’s ‘Breakdown Britain’ initiative. Anyone who knows me will attest that my political leanings are left of centre and that I working with the Conservatives on this issue was not something I did without a lot of consideration. I came to the conclusion that gambling was indeed a political issue (rather than a party political issue) and if the Conservative Party saw this as an important issue, I felt duty bound to help given my research experience in the area. I spent a number of months working closely with Iain Duncan-Smith’s office and when the report was published I was again very proud of my achievement.
However, as soon as the report came out I received disbelieving and/or snide emails asking how I could have “worked with the Conservatives”. I have spent years trying to put the psychosocial impact of gambling on the political agenda. If I am offered further opportunities by those with political clout, I won’t think twice about taking them. I am still immensely proud of such actions despite what others may think.
Pride is ultimately a subjective experience and the two personal experiences that I outlined above will not put me off doing what I want to do. I shall continue to engage in activities where I think my work can have an impact and shall work with (and write for) those that can help me disseminate my research findings to as many people as possible.
Dr Mark Griffiths, Professor of Behavioural Addiction, International Gaming Research Unit, Nottingham Trent University, Nottingham, UK
Further reading
Averill, J.R. (1991). Intellectual emotions. In: C.D. Spielberger, I.G. Sarason, Z. Kulesar & G.L. van Heck (Eds.), Stress and Emotion: Anger, Anxiety and Curiosity [Vol. 14] pp.3-16. New York: Hemisphere.
Griffiths, M.D. (1997). The internuts (internet addiction). The Sun, August 13, p.6.
Griffiths, M.D. (2007). Gambling addiction in the UK. In K. Gyngell (Ed.), Breakdown Britain: Ending the Costs of Social Breakdown (pp.393-426). London: Social Justice Policy Group.
Kemper, T.D. (1987). How many emotions are there? Wedding the social and autonomic components. American Journal of Sociology, 93, 263-289.
Lawler, E.J. (1992). Affective attachments to nested groups: A choice-process theory. American Sociological Review, 57, 327-339.
Lea, S.E.G. & Webley, P. (1997). Pride in economic psychology. Journal of Economic Psychology, 18, 323-340.
Lewis, M., Takai-Kawakami, K., Kawakami, K., & Sullivan, M. W. (2010). Cultural differences in emotional responses to success and failure. International Journal of Behavioral Development, 34, 53-61
Tracy, J.L., Robins, R.W. & Schriber, R.A. (2009). Development of a FACS-verified set of basic and self-conscious emotion expressions. Emotion, 9, 554-559.
The punch bunch: Aggressive behaviour in adult slot machine gamblers
I was idly looking through some of the academic papers I have published over the last 25 years and I was surprised by how a fair number of them examined aggressive behaviour in some way. Many of these concern the effect of video game violence on aggressive behaviour but I have also published papers examining sexual orientation and aggression, mindfulness and aggression, and gambling and aggression (see ‘Further Reading’ below for a selection of these).
Back when I was doing my PhD on slot machine addiction (1987-1990) I spent a lot of my time in amusement arcades watching fruit machine players. One thing that I noticed during my observational studies is how physically aggressive players could be when they lost (such as kicking or punching the machine if they lost a lot of money or being verbally aggressive towards staff and other players when things weren’t going the way they wanted). A number of studies have reported a link between gambling and aggressive behaviour although most of the research has concentrated on domestic violence between gamblers and their partners (i.e., problem gamblers taking out the frustration of losing lots of money on their partners).
In a paper in a 2005 issue of the Journal of Community and Applied Social Psychology, Dr. Adrian Parke and I speculated that there are two main types of aggressive act which are prevalent in slot machine gambling based on environmental and structural design factors – instrumental aggression and emotional aggression. Instrumental aggression differs from emotional aggression because there is an ulterior motive behind the act whereas emotional aggression is a result of being unpleasantly aroused. The Frustration-Aggression theory states that a barrier to expected goal attainment generates emotional aggression. Furthermore, the level of aggression is directly proportional to the (i) level of satisfaction they had expected, (ii) more they are prevented from achieving any of their goals and (iii) more often their attempts are resisted. Psychologists such as Dr. Leonard Berkowitz maintains that it is not the frustration that causes the aggressive urges, but the negative affect elicited by the frustration.
Dr. Parke and I also published some other papers on slot machine aggression during 2004 and 2005 in the International Journal of Mental Health and Addiction and Psychological Reports. We carried out a non-participant observation study and monitored the incidence of aggressive behaviour in 303 slot machine players over four 6-hour observation periods in a UK amusement arcade. We concluded that aggression was prevalent in the UK gambling arcade environment with an average of seven aggressive incidents per hour.
We also reported that the majority of aggressive incidents were verbal. Verbal aggression was directed towards members of staff, other gamblers and also the slot machines themselves. Verbal aggression towards members of staff, from an objective point of view, appeared to be caused by a misinterpretation of staff reactions towards incurred losses. With cues available to determine which slot machine will be profitable to play, selecting a machine with which the gambler incurs a loss can be interpreted as poor slot machine gambling skill. The psychologists Dr. Brad Bushman and Dr. Roy Baumeister argue that threatened egotism (an explicit dispute against one’s self value) is a strong risk factor for aggression reprisal. It is probable that in this situation the gamblers were motivated to rebuke such evaluations through an affrontive reprimand. For example:
“After losing all of the money he entered the premises with, participant 6 becomes verbally aggressive to an arcade staff member: ‘I should bring a bat into this place and break the fucking machine…What would you do? You wouldn’t have the balls to call the police.” (Parke & Griffiths, 2005; p. 53)
Given the apparent disproportionate aggressive reaction to minor provocation from staff members, there is scope to propose that rather than being a primary source of frustration and aggression, the phenomenon is evidence of Triggered Displaced Aggression. Displaced Aggression theory contends that individuals who are provoked but who are constrained against retaliating directly to the primary source may displace such anger onto unaccountable individuals. Triggered Displaced Aggression theory extends this position, by stating that after a preclusion of direct retaliation against the provocateur, minor triggers will produce an incommensurate level of aggression. Applying this theory to the phenomenon of verbal aggression towards staff members, it is probable that the gambler while frustrated and negatively aroused may be motivated to displace disproportionately high aggressive reactions onto staff members based on minor triggers such as amusement at incurred losses.
We also reported that verbal aggression directed towards other slot machine gamblers was probably a response to predatory play from opposing slot machine gamblers. With structural design factors enabling identification of slot machines that are profitable to play, naturally the environment becomes competitive. Gamblers become callous in their machine selection because the most effective way to make profits is to target machines that other gamblers have lost considerably on. Again, for the individual, self-esteem is likely to be diminished by permitting opponents to profit from experiencing loss. As a result it is probable that attempts are made to deflect such predatory behaviour with aggressive reprimands. For example:
“Participant 3 had gambled a considerable amount of money on one machine, and had no funds to continue playing. Participant 4 immediately began to play the same machine and win. Participant 3 retorted in an aggressive tone: ‘You watching me lose my money before. Wait till I lose everything and then play mate?’” (Parke & Griffiths, 2005; p.54)
Verbal aggression towards other slot machine gamblers could be understood from perspective of the Cognitive Neo-associationistic Model. (Fundamentally, this model suggests that aversive events produce negative affect, which transforms all associated stimuli into potential triggers of aggression). Applying this theory to the verbal aggression phenomenon, it is reasonable to propose that the experience of losing transforms environmental factors, such as opposing gamblers, into sources of aggression. Berkowitz has advocated two tiers of aggression activation. The first stage is simultaneous emotions of rudimentary fear and anger. The second stage is a second order evaluative phase where the individual considers the actual liability of environmental factors in anger creation. Naturally, as Berkowitz states, the individual’s attributional processes dictate whether they will actualise aggressive emotions. Put simply, an acknowledgement of the ability to isolate slot machines that are profitable to play based on identifying losing gamblers, is potentially a risk factor for acting aggressively towards other gamblers.
Finally, verbal aggression towards the slot machine is considered to be an emotionally aggressive act as a means to vent frustration rather than instrumentally preserve status as suggested above. Invariably, verbal emotional aggression was expressed through vilification and attribution of negative human characteristics to the machine such as sadism. Interestingly, such vilification was primarily sexually aggressive and constituted a feminisation of the slot machine. For example:
“This bitch is fucking me around…Are you going to fuck me around again this week?” (Parke & Griffiths, 2005; p.54)
We argued that the physical aggression towards the slot machine was believed to be an extension of tension release that was previously observed with verbal aggression towards the slot machine. For example:
“After considerable losses, Participant 8 began to slam the glass of the machine. After experiencing a near miss Participant 8 subsequently kicked the base of the machine.” (Parke & Griffiths, 2005; p.55)
Physical aggression was not directed towards opposing gamblers – perhaps identifying a boundary of conduct in order to remain within the gambling environment, as it was probable that such behaviour would result in getting thrown out of the premises. Essentially this does not equate to gamblers not be motivated to act physically aggressive to other slot machine gamblers, rather it only represents a reluctance to actualise such behaviour in the gambling environment.
It is probable that aggressive behaviour observed in the slot machine gambling environment is not solely based on structural and environmental factors. Individual differences of the gamblers are likely to affect the prevalence of aggressive behaviour, based on propositions of the General Aggression Model that suggests that trait hostility can develop through life experiences. It is possible that the participants in our observational study held aggression-related biases. For example, Dr. Karen Dill and her colleagues argue that trait hostility precipitates a hostile expectation bias (the expectation that aggressive behaviour will be used by others instrumentally) and a hostile perception bias (the propensity of interpreting interpersonal interactions as aggressive). For gamblers, it is probable that trait hostility is exacerbating aggressive reactions towards provocation from environmental and structural game design factors. Overall, our research concluded that gambling-induced aggression is a manifestation of the underlying conflict of engaging in dysfunctional behaviour while consciously acknowledging its detrimental effects.
Dr Mark Griffiths, Professor of Gambling Studies, International Gaming Research Unit, Nottingham Trent University, Nottingham, UK
Additional input: Dr. Adrian Parke (University of Lincoln, UK)
Further reading
Anderson, C.A. & Bushman, B.J. (2002). Human Aggression. Annual Review of Psychology, 53, 27-51.
Berkowitz, L. (1993). Aggression: Its causes, consequences, and control. Philadelphia: Temple University Press.
Berkowitz, L. (1989). The frustration-aggression hypothesis: Examination and reformulation. Psychological Bulletin, 106, 59-73.
Berkowitz, L. (1990). On the formation and regulation of anger and aggression: A cognitive-neoassociationistic analysis. American Psychologist, 45, 494-505.
Bushman, B. J. & Baumeister, R. F. (1998). Threatened egotism, narcissism, self-esteem, and direct and displaced aggression: Does self-love or self-hate lead to violence. Journal of Personality and Social Psychology, 75, 219-229.
Dill, K.E., Anderson, C.A., Anderson, K.B. & Deuser, W.E. (1997). Effects of personality on social expectations and social perceptions. Journal of Research in Personality, 31, 272-292.
Dollard, J., Doob, L.W., Miller, N.E., Mowrer, O.H. & Sears, R.R. (1939). Frustration and Aggression. New Haven, Connecticut: Yale University Press.
Griffiths, M.D. (1997). Video games and aggression. The Psychologist: Bulletin of the British Psychological Society, 10, 397-401.
Griffiths, M.D. (1998). Video games and aggression: A review of the literature. Aggression and Violent Behavior, 4, 203-212.
Griffiths, M.D., Parke, A. & Parke, J. (2003). Violence in gambling environments: A cause for concern? Justice of the Peace, 167, 424-426.
Griffiths, M.D., Parke, A. & Parke, J. (2005). Gambling-related violence: An issue for the police? Police Journal, 78, 223-227.
Grüsser, S.M., Thalemann, R. & Griffiths, M.D. (2007). Excessive computer game playing: Evidence for addiction and aggression? CyberPsychology and Behavior, 10, 290-292.
Mehroof, M. & Griffiths, M.D. (2010). Online gaming addiction: The role of sensation seeking, self-control, neuroticism, aggression, state anxiety and trait anxiety. Cyberpsychology, Behavior, and Social Networking, 13, 313-316.
Miller, N. Pederson, W.C., Earleywine, M. & Pollock, V.E. (2003). A theoretical model of triggered displaced aggression, Personality and Social Psychology Review, 7, 75-97.
Miller, N.E. (1941). The frustration-aggression hypothesis. Psychological Review, 48, 337-342.
Parke, A. & Griffiths, M.D. (2004). Aggressive behavior in slot machine gamblers : A preliminary observational study. Psychological Reports, 95, 109-114.
Parke, A. & Griffiths, M.D. (2005). Aggressive behaviour in adult slot machine gamblers: A qualitative observational study. International Journal of Mental Health and Addiction, 2, 50-58.
Parke, A. & Griffiths, M.D. (2005). Aggressive behaviour in adult slot machine gamblers: An interpretative phenomenological analysis. Journal of Community and Applied Social Psychology, 15, 255-272.
Sergeant, M.J.T., Dickins, T.E., Davies, M.N.O., & Griffiths, M.D. (2006). Aggression, empathy and sexual orientation in males. Personality and Individual Differences, 40, 475-486.
Shonin, E.S., van Gordon, W., Slade, K. & Griffiths, M.D. (2013). Mindfulness and other Buddhist-derived interventions in correctional settings: A systematic review. Aggression and Violent Behavior, 18, 365-372.
Meditate to medicate: Mindfulness as a treatment for behavioural addiction
Please note: A version of the following article was first published on addiction.com and was co-written with my research colleagues Edo Shonin and William Van Gordon
Mindfulness is a form of meditation that derives from Buddhist practice and is one of the fastest growing areas of psychological research. We have defined mindfulness as the process of engaging a full, direct, and active awareness of experienced phenomena that is spiritual in aspect and that is maintained from one moment to the next. As part of the practice of mindfulness, a ‘meditative anchor’, such as observing the breath, is typically used to aid concentration and to help maintain an open-awareness of present moment sensory and cognitive-affective experience.
Throughout the last two decades, Buddhist principles have increasingly been employed in the treatment of a wide range of psychological disorders including mood and anxiety disorders, substance use disorders, bipolar disorder, and schizophrenia-spectrum disorders. The emerging role of Buddhism in clinical settings appears to mirror a growth in research examining the potential effects of Buddhist meditation on brain neurophysiology. Such research forms part of a wider dialogue concerned with the evidence-based applications of specific forms of spiritual practice for improved psychological health.
Within mental health and addiction treatment settings, mindfulness-based interventions (MBIs) are generally delivered in a secular eight-week format and often comprise the following: (i) weekly sessions of 90-180 minutes duration, (ii) a taught psycho-education component, (iii) guided mindfulness exercises, (iv) a CD of guided meditation to facilitate daily self-practice, and (v) varying degrees of one-to-one discussion-based therapy with the program instructor. Examples of MBIs used in behavioural addiction treatment studies include Mindfulness-Based Cognitive Therapy, Mindfulness-Enhanced Cognitive Behaviour Therapy, Mindfulness-Based Relapse Prevention, Mindfulness-Based Stress Reduction, and Meditation Awareness Training.
Studies investigating the role of mindfulness in the treatment of behavioural addictions have – to date – primarily focused on problem and/or pathological gambling. These studies have shown that levels of dispositional mindfulness in problem gamblers are inversely associated with gambling severity, thought suppression, and psychological distress. Recent clinical case studies have demonstrated that weekly mindfulness therapy sessions can lead to clinically significant change in problem gambling individuals. Published case studies include: (i) a male in his sixties addicted to offline roulette playing, (ii) a 61-year old female (with comorbid anxiety and depression) addicted to slot machine gambling (treated with a modified version of Mindfulness-Based Cognitive Therapy), and (iii) a 32-year old female (with co-occurring schizophrenia) addicted to online slot-machine playing (treated with a modified version of Meditation Awareness Training). Also, a recent study showed that problem gamblers that received Mindfulness-Enhanced Cognitive Behaviour Therapy demonstrated significant improvements compared to a control group in levels of gambling severity, gambling urges, and emotional distress.
Outside of gambling addiction, case studies have investigated the applications of mindfulness for treating addiction to work (i.e., workaholism) and sex. In the case of the workaholic, a director of a blue-chip technology company in his late thirties was successfully treated for his workaholism utilizing Meditation Awareness Training. Significant pre-post improvements were also observed for sleep quality, psychological distress, work duration, work involvement during non-work hours, and employer-rated job performance. However, as with any case study, the single-participant nature of the study significantly restricts the generalizability of such findings.
Key treatment mechanisms that have been identified and/or proposed in this respect (several of which overlap with mechanisms identified as part of the mindfulness-based treatment of chemical addictions) include:
- A perceptual shift in the mode of responding and relating to sensory and cognitive-affective stimuli that permits individuals to objectify their cognitive processes and to apprehend them as passing phenomena.
- Reductions in relapse and withdrawal symptoms via substituting maladaptive addictive behaviours with a ‘positive addiction’ to mindfulness/meditation (particularly the ‘blissful’ and/or tranquil states associated with certain meditative practices).
- Transferring the locus of control for stress from external conditions to internal metacognitive and attentional resources.
- The modulation of dysphoric mood states and addiction-related shameful and self-disparaging schemas via the cultivation of compassion and self-compassion.
- Reductions in salience and myopic focus on reward (i.e., by undermining the intrinsic value and ‘authenticity’ that individuals assign to the object of addiction) due to a better understanding of the ‘impermanent’ nature of existence (e.g., all that is won must ultimately be lost, an attractive body will age and wither, a senior/lucrative occupational role must one day be relinquished, etc.).
- Growth in spiritual awareness that broadens perspective and induces a re-evaluation of life priorities.
- ‘Urge surfing’ (the meditative process of adopting an observatory, non-judgemental, and non-reactive attentional-set towards mental urges) that aids in the regulation of habitual compulsive responses.
- Reduced autonomic and psychological arousal via conscious-breathing-induced increases in prefrontal functioning and vagal nerve output (breath awareness is a central feature of mindfulness practice).
- Increased capacity to defer gratitude due to improvements in levels of patience.
- A greater ability to label and therefore modulate mental urges and faulty thinking patterns.
Although preliminary findings indicate that there are applications for MBIs in the treatment of behavioural addictions, further empirical and clinical research utilizing larger-sample controlled study designs is clearly needed. Despite this, both the classical Buddhist meditation literature and recent scientific findings appear to agree that when correctly practised and administered, mindfulness meditation is a safe, non-invasive, and cost-effective tool for treating behavioural addictions and for improving psychological health more generally.
Dr Mark Griffiths, Professor of Gambling Studies, International Gaming Research Unit, Nottingham Trent University, Nottingham, UK
Further reading
Griffiths, M.D., Shonin, E.S., & Van Gordon, W. (2015). Mindfulness as a treatment for gambling disorder. Journal of Gambling and Commercial Gaming Research, in press.
Shonin, E.S., Van Gordon, W. & Griffiths, M.D. (2013). Mindfulness-based interventions: Towards mindful clinical integration. Frontiers in Psychology, 4, 194, doi: 10.3389/fpsyg.2013.00194.
Shonin, E.S., Van Gordon, W. & Griffiths, M.D. (2013). Buddhist philosophy for the treatment of problem gambling. Journal of Behavioral Addictions, 2, 63-71.
Shonin, E., Van Gordon W., & Griffiths, M.D. (2014). Mindfulness as a treatment for behavioural addiction. Journal of Addiction Research and Therapy, 5: e122. doi: 10.4172/2155-6105.1000e122.
Shonin, E., Van Gordon W., & Griffiths, M.D. (2014). Current trends in mindfulness and mental health. International Journal of Mental Health and Addiction, 12, 113-115.
Shonin, E., Van Gordon, W., & Griffiths M.D. (2014). Cognitive Behavioral Therapy (CBT) and Meditation Awareness Training (MAT) for the treatment of co-occurring schizophrenia with pathological gambling: A case study. International Journal of Mental Health and Addiction, 12, 181-196.
Shonin, E., Van Gordon W., & Griffiths M.D. (2014). The emerging role of Buddhism in clinical psychology: Towards effective integration. Psychology of Religion and Spirituality, 6, 123-137.
Shonin, E., Van Gordon, W., & Griffiths M.D. (2014). The treatment of workaholism with Meditation Awareness Training: A case study. Explore: Journal of Science and Healing, 10, 193-195.
Shonin, E.S., Van Gordon, W. & Griffiths, M.D. (2014). Practical tips for using mindfulness in general practice. British Journal of General Practice, 624 368-369.
Shonin, E.S., Van Gordon, W. & Griffiths, M.D. (2015). Mindfulness in psychology: A breath of fresh air? The Psychologist: Bulletin of the British Psychological Society, 28, 28-31.
Shonin, E., Van Gordon W., Griffiths M.D. & Singh, N. (2015). There is only one mindfulness: Why science and Buddhism need to work together. Mindfulness, 6, 49-56.
Place your bets: Has problem gambling in Great Britain decreased?
In the summer of 2014 I was commissioned to review problem gambling in Great Britain (the fall out of which I wrote about in detail in a previous blog). Earlier last year, a detailed report by Heather Wardle and her colleagues examined gambling behaviour in England and Scotland by combining the 2012 data from the Health Survey for England (HSE; n=8,291 aged 16 years and over) and the 2012 Scottish Health Survey (SHeS; n=4,815). To be included in the final data analysis, participants had to have completed at least one of the gambling participation questions. This resulted in a total sample of 11,774 participants. So what did the research find? Here is a brief summary of the main results:
- Two-thirds of the sample (65%) had gambled in the past year, with men (68%) gambling more than women (62%). As with the British Gambling Prevalence Survey (BGPS), past year participation was greatly influenced by the playing of the bi-weekly National Lottery (lotto) game. Removal of those individuals that only played the National Lottery meant that 43% had gambled during the past year (46% males and 40% females).
- Gambling was more likely to be carried out by younger people (50% among those aged 16-24 years and 52% among those aged 25-34 years).
- The findings were similar to the previous BGPS reports and showed that the most popular forms of gambling were playing the National Lottery (52%; 56% males and 49% females), scratchcards (19%; 19% males and 20% females), other lottery games (14%; 14% both males and females), horse race betting (10%; 12% males and 8% females), machines in a bookmaker (3%; 5% males and 1% females), slot machines (7%; 10% males and 4% females), online betting with a bookmaker (5%; 8% males and 2% females), offline sports betting (5%; 8% males and 1% females), private betting (5%; 8% males and 2% females), casino table games (3%; 5% males and 1% females), offline dog race betting (3%; 4% males and 2% females), online casino, slots and/or bing (3%; 4% males and 2% females), betting exchanges (1%; males 2% and females 0%), poker in pubs and clubs (1%; 2% males and 0% females), spread betting (1%; 1% males and 0% females).
- The only form of gambling (excluding lottery games) where females were more likely to gamble was playing bingo (5%; 7% females and 3% males).
- Most participants gambled on one or two different activities a year (1.7 mean average across the total sample).
- Problem gambling assessed using the Problem Gambling Severity (PGSI) criteria was reported to be 0.4%, with males (0.7%) being significantly more likely to be problem gamblers than females (0.1%). This equates to approximately 180,200 British adults aged 16 years and over.
- Problem gambling assessed using the criteria of the fourth Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) was reported to be 0.5%, with males (0.8%) being significantly more likely to be problem gamblers than females (0.1%). This equates to approximately 224,100 British adults aged 16 years and over.
- Using the PGSI screen, problem gambling rates were highest among young men aged 16-24 years (1.7%) and lowest among men aged 65-74 years (0.4%). Using the DSM-IV screen, problem gambling rates were highest among young men aged 16-24 years (2.1%) and lowest among men aged over 74 years (0.4%).
- Problem gambling rates were also examined by type of gambling activity. Results showed that among past year gamblers, problem gambling was highest among spread betting (20.9%), played poker in pubs or clubs (13.2%), bet on other events with a bookmaker (12.9%), bet with a betting exchange (10.6%) and played machines in bookmakers (7.2%).
- The activities with the lowest rates of problem gambling were playing the National Lottery (0.9%) and scratchcards (1.7%).
- Problem gambling rates were highest among individuals that had participated in seven or more activities in the past year (8.6%) and lowest among those that had participated in a single activity (0.1%).
The authors also carried out a latent class analysis and identified seven different types of gambler among both males and females. The male groups comprised:
- Cluster A: non-gamblers (33%)
- Cluster B: National Lottery only gamblers (22%)
- Cluster C: National Lottery and scratchcard gamblers only (20%)
- Cluster D: Minimal, no National Lottery [gambling on 1-2 activities] (9%)
- Cluster E: Moderate [gambling on 3-6 activities] (12%)
- Cluster F: Multiple [gambling on 6-10 activities] (3%)
- Cluster G: multiple, high [gambling on at least 11 activities] (1%).
The female groups comprised:
- Cluster A: non-gamblers (40%)
- Cluster B: National Lottery only gamblers (21%)
- Cluster C: National Lottery and scratchcard gamblers only (7%)
- Cluster D: Minimal, no National Lottery (8%)
- Cluster E: moderate, less varied [2-3 gambling activities, mainly lottery-related] (8%)
- Cluster F: moderate, more varied [2-3 gambling activities but wider range of activities] (6%)
- Cluster G: multiple [gambling on at least four activities] (6%)
Using these groupings, the prevalence of male problem gambling was highest among those in Cluster G: multiple high group (25.0%) followed by Cluster F: multiple group (3.3%) and Cluster E: moderate group (2.6%). The prevalence of problem gambling was lowest among those in the Cluster B; National Lottery Draw only group (0.1%) followed by Cluster C: minimal – lotteries and scratchcards group (0.7%). The prevalence of female problem gambling was highest among those in the Cluster G: multiple group (1.8%) followed by those in Cluster F: moderate – more varied group (0.6%). The number of female gamblers was too low to carry out any further analysis. The report also examined problem gambling (either DSM-IV or PGSI) by gambling activity type.
- The prevalence of problem gambling was highest among spread-bettors (20.9%), poker players in pubs or clubs (13.2%), bettors on events other than sports or horse/dog races (12.9%), betting exchange users (10.6%) and those that played machines in bookmakers (7.2%).
- The lowest problem gambling prevalence rates were among those that played the National Lottery (0.9%) and scratchcards (1.7%).
- These figures are very similar to those found in the 2010 BGPS study although problem gambling among those that played machines in bookmakers was lower (7.2%) than in the 2010 BGPS study (8.8%).
- As with the BGPS 2010 study, the prevalence of problem gambling was highest among those who had participated in seven or more activities in the past year (8.6%) and lowest among those who had taken part in just one activity (0.1%). Furthermore, problem gamblers participated in an average 6.6 activities in the past year.
Given that the same instruments were used to assess problem gambling, the results of the most recent surveys using data combined from the Health Survey for England (HSE) and Scottish Health Survey (SHeS) compared with the most recent British Gambling Prevalence Survey (BGPS) do seem to suggest that problem gambling in Great Britain has decreased over the last few years (from 0.9% to 0.5%). However, Seabury and Wardle again urged caution and noted:
“Comparisons of the combined HSE/SHeS data with the BGPS estimates should be made with caution. While the methods and questions used in each survey were the same, the survey vehicle was not. HSE and SHeS are general population health surveys, whereas the BGPS series was specifically designed to understand gambling behaviour and attitudes to gambling in greater detail. It is widely acknowledged that different survey vehicles can generate different estimates using the same measures because they can appeal to different types of people, with varying patterns of behaviour…Overall, problem gambling rates in Britain appear to be relatively stable, though we caution readers against viewing the combined health survey results as a continuation of the BGPS time series”.
There are other important caveats to take into account including the differences between the two screen tools used in the BGPS, HSE and SHeS studies. Although highly correlated, evidence from all the British surveys suggests that the PGSI and DSM-IV screens capture slightly different groups of problem gamblers. For instance, a 2010 study that I co-authored with Jim Orford, Heather Wardle, and others (in the journal International Gambling Studies) using data from the 2007 BGPS showed that the PGSI may under-estimate certain forms of gambling-related harm (particularly by women) that are more likely to be picked up by some of the DSM-IV items. Our analysis also suggested that the DSM-IV appears to measure two different factors (i.e., gambling-related harm and gambling dependence) rather than a single one. Another important distinction is that the two screens were developed for very different purposes (even though they are attempting to assess the same construct). The PGSI was specifically developed for use in population surveys whereas the DSM-IV was developed with clinical populations in mind. Given these differences, it is therefore unsurprising that national surveys that utilize the screens end up with slightly different results comprising slightly different groups of people.
It also needs stressing (as noted by the authors of most of the national gambling surveys in Great Britain) that the absolute number of problem gamblers identified in any of the surveys published to date has equated to approximately 60 people. To detect any significant differences statistically between any of the studies carried out to date requires very large sample sizes. Given the very low numbers of problem gamblers and the tiny number of pathological gamblers, it is hard to assess with complete accuracy whether there have been any significant changes in problem and pathological gambling between all the published studies over time. Wardle and her colleagues concluded that:
“Overall, based on this evidence, it appears that problem gambling rates in England and Scotland are broadly stable. Whilst problem gambling rates according to either the DSM-IV or the PGSI were higher in 2010, the estimate between 2007 and the health surveys data were similar. Likewise, problem gambling rates according to the DSM-IV and the PGSI individually did not vary statistically between surveys, meaning that they were relatively similar” (p.130).
Dr. Mark Griffiths, Professor of Gambling Studies, International Gaming Research Unit, Nottingham Trent University, Nottingham, UK
Further reading
Griffiths, M.D. (2014). Problem gambling in Great Britain: A brief review. London: Association of British Bookmakers.
Orford, J., Wardle, H., Griffiths, M.D., Sproston, K. & Erens, B. (2010). PGSI and DSM-IV in the 2007 British Gambling Prevalence Survey: Reliability, item response, factor structure and inter-scale agreement. International Gambling Studies, 10, 31-44.
Seabury, C. & Wardle, H. (2014). Gambling behaviour in England and Scotland. Birmingham: Gambling Commission.
Wardle, H. (2013). Gambling Behaviour. In Rutherford, L., Hinchliffe S., Sharp, C. (Eds.), The Scottish Health Survey: Vol 1: Main report. Edinburgh.
Wardle, H., Moody. A., Spence, S., Orford, J., Volberg, R., Jotangia, D., Griffiths, M.D., Hussey, D. & Dobbie, F. (2011). British Gambling Prevalence Survey 2010. London: The Stationery Office.
Wardle, H., & Seabury, C. (2013). Gambling Behaviour. In Craig, R., Mindell, J. (Eds.) Health Survey for England 2012 [Vol 1]. Health, social care and lifestyles. Leeds: Health and Social Care Information Centre.
Wardle, H., Seabury, C., Ahmed, H., Payne, C., Byron, C., Corbett, J. & Sutton, R. (2014). Gambling behaviour in England and Scotland: Findings from the Health Survey for England 2012 and Scottish Health Survey 2012. London: NatCen.
Wardle, H., Sproston, K., Orford, J., Erens, B., Griffiths, M. D., Constantine, R., & Pigott, S. (2007). The British Gambling Prevalence Survey 2007. London: National Centre for Social Research.
Wardle, H., Sutton, R., Philo, D., Hussey, D. & Nass, L. (2013). Examining Machine Gambling in the British Gambling Prevalence Survey. Report by NatCen to the Gambling Commission, Birmingham.
Gamblers anonymous: The psychology of live online casino gambling
Over the last decade, my research unit has carried out an increasing amount of research into the psychology of online gambling. In some of our recent research interviewing online gamblers, offline gamblers and non-gamblers, we found that people who gambled online did so because of its (i) convenience, (ii) greater value for money, (iii) the greater variety of games, and (iv) anonymity. Perhaps more interestingly, were the inhibiting reasons that stopped people from wanting to gamble online in the first place. The main inhibiting reason that stopped people gambling online was that offline gamblers and non-gamblers said the authenticity of gambling was significantly reduced when gambling online. We also found a number of other inhibitors of online gambling including (i) the reduced realism, (ii) the asocial nature of the internet, (iii) the use of electronic money, and (iv) concerns about the safety of online gambling websites. The reduced authenticity and realism may help to explain why online live action casino games are seen as increasingly popular among some types of gamblers.
This empirical research also chimes with my own personal psychology of online gambling. One of the main reasons I don’t like gambling at Internet casinos is that I believe the majority of game outcome are likely to be pre-programmed and/or predetermined. To me, this is somewhat akin to playing with imaginary dice! Our empirical research findings also help explain the rise of live online casino gambling. Players not only want increased realism and authenticity, but still have the added advantages of online anonymity while playing.
In online live casino gaming, the anonymity of the Internet allows players to privately engage in gambling without the fear of stigma. This anonymity may also provide the gambler with a greater sense of perceived control over the content, tone, and nature of the online experience. Anonymity may also increase feelings of comfort since there is a decreased ability to look for, and thus detect, signs of insincerity, disapproval, or judgment in facial expression, as would be typical in face-to-face interactions. For activities such as gambling, this may be a positive benefit particularly when losing as no-one will actually see the face of the loser. Anonymity may reduce social barriers to engaging in gambling, particularly those activities thought to be more skill-based gambling activities (such as poker or blackjack) that are relatively complex and often possess tacit social etiquette. The potential discomfort of committing a structural or social faux-pas in the gambling environment because of inexperience is minimized because the player’s identity remains concealed.
Furthermore, one of the main reasons why behaviour online is very different from offline is because it provides a ‘disinhibiting’ experience. One of the main consequences of disinhibition is that on the internet people lower their emotional guard and become much less restricted and inhibited in their actions.
The increase in online live casino gambling has happened alongside the rise of online betting exchanges – the type of online gambling where it could be argued that skill can – to some extent – be exercised. For gamblers, having a punt on live sporting events via betting exchanges is a psychologically safer option because punters know (or can check) who won a particular football or horse race. The playing of live action casino games via the Internet shares some of the psychological similarities of online betting exchanges.
The rise of live online gambling has been coupled with increasingly sophisticated gaming software, integrated e-cash systems, and increased realism (in the shape of “real” gambling via webcams, live remote wagering, and/or player and dealer avatars). These are all inter-linked facilitating factors. Another factor that I feel is really important in the rise of online gambling (including online live action casino games) is the inter-gambler competition. Obviously there is an overlap between competitiveness and skill but they are certainly not the same. What’s more recent research has suggested that being highly competitive may not necessarily be good for the gambler. For instance, Professor Howard Shaffer, a psychologist at Harvard University, claims that men are more likely to develop problematic gambling behaviour because of their conventionally high levels of aggression, impulsivity and competitiveness. Clearly, the idea of the competitiveness of the activity being one of the primary motivations to gamble is well supported.
Based on the fact that so little research has systematically examined the links between gambling and competitiveness, our research unit did some research into this area. We speculated that a gambler who is highly competitive will experience more arousal and stimulation, and be drawn to gambling as an outlet to release competitive instincts and drives. This is likely to occur more in activities like online poker and online live action casino games. Our research did indeed show that problem gamblers were significantly more likely than non-problem gamblers to be competitive.
Being highly competitive may help in explaining why in the face of sometimes negative and damaging financial consequences, gamblers persist in their habit. Psychological research in other areas has consistently shown that highly competitive individuals are more sensitive to social comparison with peers regarding their task performance. Applying this to a gambling situation, it is reasonable to suggest that competitive gamblers may be reluctant to stop gambling until they are in a positive state in relation to opposing gamblers, perhaps explaining why excessive gambling can sometimes occur.
Sociologists have speculated that factors of the human instinctual expressive needs, such as competition, can be temporarily satisfied when engaging in gambling activities. Evidence exists supporting gambling as an instrumental outlet for expressing competitive instinctual urges. The US sociologist Erving Goffman developed what he called the ‘deprivation-compensation’ theory to explain the relationship between gambling and competitiveness. He suggested that the stability of modern society no longer creates situations where competitive instincts are tested. Therefore, gambling is an artificial, self-imposed situation of instability that can be instrumental in creating an opportunity to test competitive capabilities. Again, online live action casino gambling is another gambling form that can facilitate such instinctive needs.
Dr Mark Griffiths, Professor of Gambling Studies, International Gaming Research Unit, Nottingham Trent University, Nottingham, UK
Further reading
Goffman, I. (1972). Where the action is. In: Interaction Ritual (pp. 149–270). Allen Lane, London.
Griffiths, M.D. (2010). Gambling addiction on the Internet. In K. Young & C. Nabuco de Abreu (Eds.), Internet Addiction: A Handbook for Evaluation and Treatment. pp. 91-111. New York: Wiley.
Griffiths, M.D. & Parke, J. (2003). The environmental psychology of gambling. In G. Reith (Ed.), Gambling: Who wins? Who Loses? pp. 277-292. New York: Prometheus Books.
Griffiths, M.D., Wardle, J., Orford, J., Sproston, K. & Erens, B. (2009). Socio-demographic correlates of internet gambling: findings from the 2007 British Gambling Prevalence Survey. CyberPsychology and Behavior, 12, 199-202.
Griffiths, M.D., Wardle, J., Orford, J., Sproston, K. & Erens, B. (2011). Internet gambling, health. Smoking and alcohol use: Findings from the 2007 British Gambling Prevalence Survey. International Journal of Mental Health and Addiction, 9, 1-11.
Kuss, D. & Griffiths, M.D. (2012). Internet gambling behavior. In Z. Yan (Ed.), Encyclopedia of Cyber Behavior (pp.735-753). Pennsylvania: IGI Global.
McCormack. A. & Griffiths, M.D. (2012). Motivating and inhibiting factors in online gambling behaviour: A grounded theory study. International Journal of Mental Health and Addiction, 10, 39-53.
McCormack, A. & Griffiths, M.D. (2013). A scoping study of the structural and situational characteristics of internet gambling. International Journal of Cyber Behavior, Psychology and Learning, 3(1), 29-49.
McCormack, A., Shorter, G. & Griffiths, M.D. (2013). An examination of participation in online gambling activities and the relationship with problem gambling. Journal of Behavioral Addictions, 2(1), 31-41.
McCormack, A., Shorter, G. & Griffiths, M.D. (2013). Characteristics and predictors of problem gambling on the internet. International Journal of Mental Health and Addiction, 11, 634-657.
Wardle, H. & Griffiths, M.D. (2011). Defining the ‘online gambler’: The British perspective. World Online Gambling Law Report, 10(2), 12-13.
Wardle, H., Moody, A., Griffiths, M.D., Orford, J. & and Volberg, R. (2011). Defining the online gambler and patterns of behaviour integration: Evidence from the British Gambling Prevalence Survey 2010. International Gambling Studies, 11, 339-356.
The highs of the prize: Are instant-win products a form of gambling?
A nine-year old boy walks into a shop and buys a packet of potato chips. An eight-year old girl walks into the same shop and buys a chocolate bar. Nothing particularly unusual except this particular packet of potato chips poses the question “Is there a spicy £100,000 inside?” in big letters on the front of the packet with the added rider “1000’s of real £5 notes to be won!” The bar of chocolate offers “£1 million in cash prizes – win instantly. Look inside to see if your a winner!!”. The boy opens up the bag of crisps but it contains nothing but crisps. He is very disappointed. The little girl opens up the chocolate bar and sees the all to familiar phrase “Sorry. You haven’t won this time but keep trying. Remember there’s £1 million in cash prizes to be won”. She too is very disappointed. Both of them decide to buy the product again to see if their luck will change. It doesn’t. This time a different chocolate bar says “Sorry this is not a winning bar. Better luck next time!” The most they are likely to win is another packet of crisps or some more chocolates.
This scenario describes a typical instant win product (whereby a consumer buys a particular product with the chance of instantly winning something else of financial value). This type of instant-win marketing has been around for some time and is not particularly new but it is the younger generation that is being targeted. In a different environment, it could be argued that these two children are “chasing” their losses in the same way a gambler chases theirs. All over the world, this type of marketing is becoming more prevalent with big multi-national companies also employing its use to increase sales (e.g., MacDonalds).
In gambling situations after losing money, gamblers often gamble again straight away or return another day in order to get even. This is commonly referred to as “chasing” losses. Chasing is symptomatic of problem gambling and is often characterized by unrealistic optimism on the gambler’s part. All bets are made in an effort to recoup their losses. The result is that instead of “cutting their losses” gamblers get deeper into debt pre-occupying themselves with gambling, determined that a big win will repay their loans and solve all their problems. Although not on this scale, the scenario outlined above appears to be a chasing-like experience akin to that found in gambling. To children, this type of behaviour appears to be a gambling-type experience and is similar to other gambling pre-cursors that I have highlighted in some of my papers such as the playing of marbles, card flipping, and sports card playing. For instance, in sports card playing, it is not uncommon for adolescents to keep buying packs of cards to get their favorite baseball or football star. Products like crisps and chocolate are popular and appeal not only to the young but to adults too. However, the fact that such promotions are often coupled with the appearance of teenage idols (e.g., famous pop groups or top soccer sporting heroes) suggests that it is younger people that are being aimed for.
Manufacturers of instant-win products claim that people buy their products because customers want them. They further claim that the appeal of a promotion is secondary to the appeal of the product. This may well be true with most people but instant-win promotions obviously increase sales otherwise so many companies would not resort to it in the first place. It would appear that most people have no problem on moral (or other) grounds with companies who use this type of promotion. However, there are those (such as those who work in the area of youth gambling) who wonder whether this type of promotion exploits the vulnerable in some way (i.e., children and adolescents). The question to ask is whether young children and adolescents are actually engaging in a form of gambling by buying these types of products.
Gambling is normally defined as the staking of money (or something of financial value) on the uncertain outcome of a future event. Technically, instant-win promotions are not a form of gambling. This is because (by law) manufacturers are required to state that “no purchase is necessary”. This whole practice it is little more than a lottery except that in very small letters at the bottom of the packet there is the added phrase “No purchase necessary – see back for details”. However, very few people would know this unless they bought the product in the first place, and secondly, the likelihood is that a vast majority will not do this anyway – particularly children and adolescents.
The small print usually reads “No purchase necessary. Should you wish to enter this promotion without purchasing a promotional pack, please send your name and address clearly printed on a plain piece of paper. If you are under 18, please ask a parent or guardian to sign your entry. An independently supervised draw will be made on your behalf, and should you be a winner, a prize will be sent to you within 28 days”. I have tried writing to companies to ascertain how many people utilize this route but (to date) I have been unsuccessful in gaining any further information. It is highly likely that very few people write to the companies concerned. There is a high likelihood that the companies in question have the empirical evidence but unfortunately it is not in the public domain. If it is assumed that the number of people who actually write to the companies for their names to be put into an independently supervised draw is very low, it can be argued that to all intents and purposes that people who buy such products are engaged in a form of gambling.
Since the introduction of the UK National Lottery and instant scratchcards in the mid-1990s, a “something-for-nothing” culture appears to have developed where people want to win big prizes on lots of different things. Children themselves are growing up in an environment where gambling is endemic. Having examined a variety of instant-win promotions, I am in little doubt that they should be viewed as gambling pre-cursors in that they are gambling-like experiences without being a form of gambling with which anyone can identify. It is unlikely that great numbers of children will develop a problem with this activity, but there is the potential concern that a small minority will. Research has consistently shown that the earlier that a child starts to gamble the more likely they are to develop a gambling problem.
Evidence that instant-win products are problematic to young children is mostly anecdotal. For instance, a number of years ago, I appeared on a UK daytime television programme with a mother and her two children (aged nine and ten years of age) who literally spent all their disposable income on instant-win promotions. These two children had spent hundreds of pounds of their pocket money in the hope of winning the elusive prizes offered but never won more than another bag of potato chips. The mother claimed they had “the gambling bug” and was “terrified they will have problems when they grow up”. She claimed she had done her utmost to stop them using their pocket money in this way but as soon as her back was turned they were off to the local corner shop to buy instant-win products. This wasn’t just restricted to products they enjoyed anyway. For instance, when they went to the supermarket to shop the children just fill up the shopping trolley with anything that has an instant-win promotion including tins of cat food – even though they didn’t have a cat!
Harsh critics of instant-win promotions might advocate a complete banning of these types of marketing endeavors. However, this is impractical if not somewhat over the top. What is more, there is no empirical evidence (to date) that there is a problem. However, this does not mean that such practices should not be monitored. Instant-win marketing appears to be on the increase and it may be that young children are particularly vulnerable to this type of promotion if anecdotal case study accounts are anything to go by.
Dr Mark Griffiths, Professor of Gambling Studies, International Gaming Research Unit, Nottingham Trent University, Nottingham, UK
Further reading
Griffiths, M.D. (1989). Gambling in children and adolescents. Journal of Gambling Behavior, 5, 66-83.
Griffiths, M.D. (1995). Adolescent Gambling. London : Routledge.
Griffiths, M.D. (1997). Instant-win promotions: Part of the gambling environment? Education and Health, 15, 62-63.
Griffiths, M.D. (2002). Gambling and Gaming Addictions in Adolescence. Leicester: British Psychological Society/Blackwells.
Griffiths, M.D. (2003). Instant-win products and prize draws: Are these forms of gambling? Journal of Gambling Issues, 9. Located at: http://jgi.camh.net/doi/full/10.4309/jgi.2003.9.5
Griffiths, M.D. (2005). Does advertising of gambling increase gambling addiction? International Journal of Mental Health and Addiction, 3(2), 15-25.
Griffiths, M.D. (2011). Adolescent gambling. In B. Bradford Brown & Mitch Prinstein (Eds.), Encyclopedia of Adolescence (Volume 3) (pp.11-20). San Diego: Academic Press.
Griffiths, M.D. (2013). Responsible marketing and advertising of gambling. i-Gaming Business Affiliate, August/September, 50.
Griffiths, M.D., King, D.L. & Delfabbro, P.H. (2009). Adolescent gambling-like experiences: Are they a cause for concern? Education and Health, 27, 27-30.
Hayer, T. & Griffiths, M.D. (2015). The prevention and treatment of problem gambling in adolescence. In T.P. Gullotta & G. Adams (Eds). Handbook of Adolescent Behavioral Problems: Evidence-based Approaches to Prevention and Treatment (Second Edition) (pp. 539-558). New York: Kluwer.
Zangeneh, M., Griffiths, M.D. & Parke, J. (2008). The marketing of gambling. In Zangeneh, M., Blaszczynski, A., and Turner, N. (Eds.), In The Pursuit Of Winning (pp. 135-153). New York: Springer.

