Coining it in: Neologisms and ‘New Syndrome’ Syndrome

One of things I am very proud of in my academic career is the coining of the term ‘technological addiction’ back in 1995 (an umbrella term that I invented to describe a number of different person-machine addictions including slot machine addictions, video game addiction, television addiction, etc.). I’m also proud of coining the term ‘aca-media’ (relating to academics like myself that use the media to disseminate our research). A neologism (i.e., the name for a newly coined term) is often (according to Wikipedia) directly attributable to a specific event, person, publication, or period.

In the 1980s and early 1990s, there seemed to be a real upsurge is the naming of ‘new syndromes’ in the medical literature including many relating to excessive use of technology (such as ‘Space Invader’s Wrist’) and other leisure activities (such as ‘Cuber’s Thumb’ relating to excessive use of the Rubik’s Cube) – both of which made their appearance in 1981 issues of the New England Journal of Medicine. Other videogame medical complaints include ‘Pseudovideoma’ (in a 1984 issue of the Journal of Hand Surgery), ‘Pac-Man Phalanx’ (in a 1983 issue of Arthritis and Rheumatism) and ‘Joystick Digit’ (in a 1987 issue of the Journal of the American Medical Association). Another videogame-related medical complaint (in this case an infection), was reported in a 1987 issue of the Western Journal of Medicine by Dr. G.B. Soe and colleagues:

“We wish to focus WJM readers’ attention on another complication associated with video games-one that originally presented as an “infected spider bite. A 17-year-old right-handed boy noted progressive swelling and redness of his left hand seven days before admission. Two days before admission he was given penicillin intramuscularly and oral cephalexin to take at home. The swelling did not subside and the hand became very painful, so he came to the medical center for treatment. On admission his mother reported that she had seen many spiders around the house with a violin pattern on their backs, and that her son had probably been bitten by a spider…After seven days of parenteral antibiotic therapy, the edema, erythema and fever had disappeared and the patient was discharged home. Further questioning revealed that the young man was spending almost all of his time playing his favorite video game, which involved a fighting kung fu character. The patient used his left hand in manipulating a ball-shaped joystick to move the figure up, down, left and right, and his right in operating buttons to kick and jab. Extensive use of the joystick resulted in blisters on his left palm. He rubbed the blisters off, and an infection resulted that progressed to abscess formation. Neuromuscular complications of video games (‘pseudovideoma’, ‘Pac-Man phalanx’, ‘firing-finger syndrome’ and ‘Space Invaders wrist’) have been reported, as well as video game-induced seizures, but we have not come across any reports of an infectious complication of video games. Perhaps video game players should wear gloves to protect their palms, similar to ones worn by golfers and baseball players, who also need to get a firm grip on their respective sticks”.

Another one that I’d never heard of is ‘Nurd Knuckles’ coined by Dr. J.B. Martin in the Canadian Medical Association Journal in 1982:

“I wish to describe a case of painful knuckles associated with the use and manipulation of a new, allegedly therapeutic product, a Nurd. A Nurd is a head 10 cm across with a smiling face and large ears, reminiscent of the character Yoda of ‘Star Wars’. It is made of malleable material that can be stretched, twisted or deformed in any direction, yet with release of tension quickly resumes its original shape without a trace of distortion. A 32-year-old public school teacher presented with painful knuckles of his right hand. His students, perhaps feeling that their teacher was under increased stress during the marking of exams, had given him a Nurd for Christmas, and during a particularly trying day he had found occasion to use it. He repeatedly stretched its ears and twisted its neck without ill effect; however, on punching it he suffered sharp pain of his fourth and fifth metacarpophalangeal joints. On examination the joints were found to be reddened, with point tenderness over the fifth metacarpal head; there was no evidence of deformity. He was advised to stop beating his Nurd, and the pain subsided. While the Nurd is very plastic, yielding to the linear tension of stretching and twisting, it is very resistant to compression. Punching a Nurd does not cause the surface to give way, and, since the force of the blow is returned to the fist, it is conceivable that a fracture might result. Therefore, although stretching and twisting Nurds does not cause any harm, users should be cautioned against punching their Nurd. The Nurd is advertised as being a ‘punchable, stretchable, pushable and likeable alternative to tension, migraine headaches, drug abuse, alcoholism and manic depression’, but these claims are unsubstantiated. A MEDLINE search of the medical literature shows that no retrospective or prospective case control studies or controlled double blind crossover studies have been undertaken. Before the clinical efficacy of the Nurd can be taken seriously in the treatment of this broad spectrum of disease, full clinical trials must be completed. Subjects entering into trials must, however, be duly informed of the hazards of punching Nurds”.

Another one that caught my attention was a new affliction (‘Breaker’s Neck’) caused by the craze of ‘break dancing’ reported by Dr. Bertha Ramirez and her colleagues in a 1984 issue of the Journal of the American Medical Association. (The reason why I say it caught my eye is that I am currently involved in some research on ‘dancing addiction’ with some of my Hungarian colleagues and we have just had a new paper accepted in the journal PLoS ONE concerning the development of our ‘Dancing Motives Inventory’ – see ‘Further Reading’ below).

“To be added to the rapidly growing list of socially acquired injuries, we report a case of traumatic cervical subluxation caused by a new dance technique. This technique, labeled ‘breaking’ by its devotees, involves a modified head stand, in which the dancer, using his arms and hands for balance, spins rapidly on his head, neck, or shoulders to the rhythm of disco music. He then lowers his body to the floor and performs a series of rotational motions using his arms as a fulcrum…A 15-year-old boy was seen in our pediatric emergency room complaining that, on awakening two days previously, he felt a ‘snap’ in his neck, followed by persistent neck stiffness. He reported having ‘danced on his head’ the night prior to this incident. On physical examination, his head was tilted to the left with an inability to flex”.

Engaging in excessive sporting activity has given rise to a number of medical syndromes. One such consequence is ‘Rower’s Rump’ reported by Drs. K Tomecki and J. Mikesell in a 1987 issue of the Journal of the American Academy of Dermatology. In a previous blog I examined addiction to cycling. In the 1980s there were many medical complaints reported as a result of excessive cycling. One such complaint (given the name of ‘Bicycling nipples’) was highlighted by Dr. B. Powell in a 1983 issue of the Journal of the American Medical Association:

“Bicyclists are likely to suffer from a number of maladies, including dysuria, numb penises, and more. During cool or cold weather, another problem, bicyclist’s nipples, may occur. This condition is similar to jogger’s nipples, but it is primarily a thermal injury instead of an irritation secondary to friction, as with the jogger’s complaint. Often the rider is out in the cold weather for some time, and his or her undershirt, jersey, and jacket can become moist from perspiration. Evaporation and the chill of the wind lower the temperature of the nipples. They get downright cold, and they hurt. The pain continues after the ride is over. Indeed, it can continue for several days. The nipples are sore, sensitive to both temperature change and touch”.

After reading this I found out that Dr. Fred Levit had reported a case of ‘Jogger’s Nipples’ in a 1977 issue of the New England Journal of Medicine. All of these related nipple conditions are all examples of fissure of the nipple as they are all caused by friction resulting in soreness, dryness or irritation to, or bleeding of, one or both nipples. The Wikipedia entry also notes that “the condition is also experienced by women who breastfeed, and by surfers who do not wear rash guards”. The article also noted that:

“Jogger’s nipple is caused by friction from the repeated rubbing of a t-shirt or other upper body clothing against the nipples during a prolonged period of exercise. The condition is suffered mainly by runners. Long-distance runners are especially prone, because they are exposed to the friction on the nipple for the greatest period of time. However, it is not only suffered by athletes; the inside of a badge, a logo on normal items of clothing, or breastfeeding can also cause the friction which results in this condition”.

Outside of the leisure sphere, there were two case study reports of ‘Diaper Doer’s Hand’ in a 1987 issue of the journal Clinical Rehabilitation by Dr. J.L. Cosgrove and colleagues:

“Three cases of stenosing tenosynovitis occurred three to six months postpartum. Childcare activities aggravated the symptoms of pain and swelling in both patients. In two cases, a specific method of carrying the child was implicated as the mechanism of injury. Although there was no evidence of generalized inflammatory arthritis, all patients had very low positive titres of anti-nuclear antibodies. While it is likely that tenosynovitis was caused by mechanical factors, the possibility of increased susceptibility to inflammatory disease in the postpartum period cannot be discounted. The patients were successfully treated with a low temperature plastic splint, superficial heat and gentle mobilization”.

All of these new syndromes lead to why I put this article together in the first place. I found this letter in the British Medical Journal by Dr. E.P. Hoare entitled ‘New Syndrome Syndrome’ that I found both funny and poignant:

“Your readers will be familiar with tennis elbow, brazier’s ague, and soap packer’s jig not to mention Achilles’ heel. More recently we have heard of Space Invader’s wrist, jogger’s nipples, and the ultimate futility of Cuber’s thumb. May I point out another occupational disease which I have noticed among patrons of the reading room medical journal correspondence column reader’s neck or, more succinctly, the new syndrome syndrome. Symptoms usually begin with muscular contraction of the eyebrows, hyperventilation, and involuntary utterances, which in severe cases can lead to coprolalia. These may be followed by drowsiness, disorientation, hysterical amblyopia, and double vision (of the deja vu variety). If untreated the condition can result in a chronic pain in the neck. Treatment is 200 ml of gin and tonic stat by mouth and complete rest; music can also be helpful. The long-term prognosis is poor, however, unless journal editors can be persuaded to ban further reports of occupational afflictions or at least print a health warning at the head of their correspondence columns”.

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.

Cosgrove, J. L., Welch, D. A., Richardson, G. S., & Nicholas, J. J. (1987). Diaper doer’s hand: stenosing tenosynovitis in the postpartum period. Clinical Rehabilitation, 1(3), 219-223.

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

Griffiths, M.D. (1995). Technological addictions. Clinical Psychology Forum, 76, 14-19.

Griffiths, M.D. (1995). Pop psychology and “aca-media”: A reply to Mitchell. The Psychologist: Bulletin of the British Psychological Society, 8, 537-538.

Griffiths, M.D. (2001). A moral obligation in aca-media? The Psychologist: Bulletin of the British Psychological Society, 14, 460.

Hite, P. R., Greene, K. A., Levy, D. I., & Jackimczyk, K. (1993). Injuries resulting from bungee-cord jumping. Annals of emergency medicine, 22(6), 1060-1063.

Hoare, E.P. (1982). Points: New syndrome syndrome. British Medical Journal, 285(6352), 1429.

Levit, F. (1977). Jogger’s nipples. New England Journal of Medicine, 297(20), 1127.

Maraz, A., Király, O., Urbán, R., Griffiths, M.D., Demetrovics, Z. (2015). Why do you dance? Development of the Dance Motivation Inventory (DMI). PLoS ONE, in press.

Martyn, J. B. (1983). Nurd knuckles. Canadian Medical Association Journal, 129(3), 228.

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.

Powell, B. (1983). Bicyclist’s nipples. Journal of the American Medical Association, 249(18), 2457-2457.

Ramirez, B., Masella, P. A., Fiscina, B., Lala, V. R., & Edwards, M. D. (1984). Breaker’s neck. Journal of the American Medical Association, 252(24), 3366-3367.

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.

Tomecki, K. J., & Mikesell, J. F. (1987). Rower’s rump. Journal of the American Academy of Dermatology, 16(4), 890-891.

Torre, P. R., Williams, G. G., Blackwell, T., & Davis, C. P. (1993). Bungee jumper’s foot drop peroneal nerve palsy caused by bungee cord jumping. Annals of emergency medicine, 22(11), 1766-1767.

Waugh, D. (1981). Cuber’s thumb. New England Journal of Medicine, 305, 768.

Don’t be square (beware): A brief look at “Rubik’s Cube addiction”

“The speed world record for a single attempt [of solving the Rubik’s Cube] is 5.55 seconds, set by Dutchman Mats Valk last year. The world championship is determined by averaging three attempts. The current champion is 18-year-old Australian Feliks Zemdeg who averaged 8.18 seconds last year. To ensure fairness, a computer generates a randomised cube which all the competitors are given. The record for most Rubik’s cubes solved in 24 hours is 4,786, set by Milan Baticz of Hungary…There is a one-handed world record – held by Zemdegs – of 9.03 seconds. Fakhri Raihaan of Indonesia boasts the feet-only record of 27.93 seconds” (BBC Magazine, April 2014).

Back in 1981, I was one of the hundreds of thousands of teenagers that spent far too much time playing on a Rubik’s Cube (RC). Once I had mastered how to do it, all my friends and I would sit at the back of our classes having RC races. In fact, I and two of my friends were once given a detention by my mathematics teacher for continuing to race each other despite many warnings to stop. My typical time to complete the puzzle was around 90 seconds (although having done it recently in trying to teach my children, I took nearer five minutes). The reason I recount this story is that a few days ago, a report appeared in the BBC News Magazine headlined “The people who are still addicted to the Rubik’s Cube” followed by one in The Guardian (‘Beyond the Rubik’s Cube: Inside the competitive world of speedcubing’). The author of the BBC article (Tom de Castella) noted that:

“In the 1980s Rubik’s Cubes seemed to be everywhere, but there are still legions of people obsessed with the coloured puzzles. The record for a human is 5.55 seconds. A robot can do it in 3.253…The Magic Cube was invented in 1974 by Hungarian architecture professor Erno Rubik. After being relaunched in 1980 as the Rubik’s Cube, it sold an estimated 350 million around the world.As an object it has charm – its colours, the distinctive rattle as the pieces turn, a pleasing feel in the hand…The traditional cube has six faces each with three squares by three. Every face is a different colour – white, red, blue, orange, green and yellow. That is, until the cube has been thoroughly scrambled. The challenge then is to return it to its original state with each side a single colour. It all relies on impressive engineering – an internal pivot allowing both the rows and columns to turn.It is devilishly difficult. There are said to be 43 quintillion permutations – the number of possible positions the cube can hold…Some see it as a challenge – like swimming the Channel or climbing Everest – that must be overcome. There was a spike in sales in the US in 2006, attributed to Will Smith‘s movie The Pursuit of Happyness, in which Smith’s homeless character solves a Rubik’s Cube and impresses a businessman… Extreme devotees find completing it easy. Their focus is on speed, stamina or overcoming extra obstacles – such as being blindfolded”.

Thinking back to my own RC playing days (or should that be ‘playing daze’?), I started off with the aim of trying to complete one side of the same colour, then one row, then two rows, and then three rows (i.e., a completed cube). Once I had mastered how to do it, the aim was to do it as fast as I could. Over time, the motivations and reasons for doing the puzzle changed. I spent more an more time doing it and I suppose I would describe it as a kind of tolerance (i.e., needing to spend more and more time playing it to feel good in a good mood). The notion that trying to complete the RC is addictive is not new. In fact, back in 1996, I published a paper on behavioural addictions in the Journal of Workplace Learning. One of my introductory paragraphs in that paper noted:

“There is now a growing movement (e.g. Miller, 1980; Orford, 1985) which views a number of behaviours as potentially addictive, including many behaviours which do not involve the ingestion of a drug. These include behaviours diverse as gambling (Griffiths, 1995), overeating (Orford, 1985), sex (Carnes, 1983), exercise (Glasser, 1976), computer game playing (Griffiths, 1993a), pair bonding (Peele and Brodsky, 1975), wealth acquisition (Slater, 1980) and even Rubik’s Cube (Alexander, 1981)! Such diversity has led to new all encompassing definitions of what constitutes addictive behaviour”.

In the BBC article, Tom de Castella reported the case of Hampshire builder Graham Parker who after 26 years of trying, finally solved the RC in 2009. Parker allegedly wept when he finally solved it even though the activity “caused him backache and put a strain on his marriage”.In the same article, IT worker Billy Jeffs learned to solve the RC after making a bet and claimed that “When you learn to solve it the first time you either get the bug or not. It’s quite hard to leave the house without one. I have three in my bag”.

Despite the BBC article using the word ‘addicted’ in the title, no-one interviewed was anywhere near to being addicted based on the quotes that de Castella cited. I’m also unaware of any academic research that has examined the excessive playing of RCs (let alone research that has examined any potential addiction). The reference I cited in my own 1996 paper on behavioural addictions was actually from a story in the New York Times by Ron Alexander. However, although the RC is described by Alexander as an “addictive invention” there is again little evidence that any of the people interviewed in the article were actually addicted.

As there appeared to be little evidence either in academic or journalistic articles, in the name of research I went searching on the internet for anecdotal evidence of RC addiction. There were the usual types of humour (such as ’50 reasons you know you’re addicted to speed solving [the Rubik’s Cube]’) and ‘Signs of Rubik’s Cube addiction’) but I did come across what appear to be some people that might be having problems with their RC use and/or urges to solve the puzzle. For instance:

• Extract 1: “I Have recently been diagnosed with Rubik’s Cube Addiction Syndrome and it is getting out of control. Every time I try to stop, I cant put it down for five minutes! I just have to solve it! Everyone says it’s just a phase but I really don’t think it is”.
• Extract 2: “I was once [a Rubik’s Cube] addict as well. And I decided since everyone thought it was dumb that I was obsessed with thing I would teach them how to solve a Rubik’s cube so they too saw the magic and became obsessed…I taught someone who got really good and caught on fast then challenged me to a showdown. Luckily I won …but unluckily I was so happy that I won I threw the cube on the ground like a touchdown in football and it burst into a million pieces all over the school till I lost some and had to buy a new one but never got around to it resulting in me becoming unobsessed with the thing”.
• Extract 3: “I have been cubing for like 3 years now…maybe a little more. I don’t have the urge to solve a cube more than once, but if I see a cube that is unsolved, in a friend’s room, or anywhere that is unsolved, I want to pick it up and solve it. After I do that I usually just put it back down and forget about it though”.
• Extract 4: “Many cubers have been accused of addiction to the Rubik’s Cube at least once. What is it about a 3x3x3 cube that turns someone into a crazed speedsolver? It all seems to start the same way, an innocent mission to find the ‘how to’ and ‘why’ behind Rubik’s design. I had two friends in high school that knew how to solve the cube…I just needed to prove to myself that I could do it… There I was, completing a task that boggled most challengers. The first few days just the completion was enough for that warm and fuzzy feeling. Diminishing returns is a pain though, and the satisfaction wore off because the challenge of it wore off. My first recorded time for the 3x3x3 was over 5 minutes. Nervous fingers, shaking hands, and fuming inner dialogue…ahhh, yes, the good stuff. The second solve was sub-5 (under 5 minutes), and I got that warm fuzzy feeling again! Within a few days I was consistently under 2 minutes. ‘What if I can go a little faster?’ It was the question that drove me personally in my journey, and ultimately it is what grabs everyone”.
• Extract 5: “Rubik’s Cube is played very frequently because it is very addicting. Many people ‘infected’ by Rubik cube only because they see their friend or seller play the cube. Once somebody addicted by the cube, it will be very difficult to escape from the addiction. Rubik’s Cube is often played during the lessons and many of the players often ignore their teacher or their friends who ask something. They don’t respond quickly to their surroundings. They may become antisocial. They play alone and only focus to the cube. Rubik’s Cube also may cause mental and physical disorder. People who play Rubik’s Cube usually play it for many hours non-stop. It is dangerous for eyes. It makes the eyes focuses and work hard. Many of them sleep below 8 hours only to solve puzzle that not yet solved. It disturbs human metabolism activity that only can be happen while sleeping”.

Another article entitled ‘Rubik’s Cube 3×3 – Psychological Barriers and Addiction?!’ claimed that “is rumored there was a divorce filed in the United States, with the basis for its request being a spouse obsessed with the Rubik’s Cube. I’m not sure if this is true and would love to find confirmation”.

Whether anyone has ever been genuinely addicted to the RC is highly debatable but there have been a few alleged medical conditions associated with excessive Rubik’s Cube use including ‘Rubik’s Wrist’ (“a reflex sympathetic dystrophy syndrome caused by hours of ‘speedcubing’ a Rubik’s Cube, which entails repeated rotation of the wrist”) and ‘Cuber’s Thumb’ (pretty much the same thing but applied to the thumb rather than the wrist and referred to in letters published in the early 1980s in both the Canadian Medical Association Journal and the New England Journal of Medicine). Although I have always claimed that almost any activity can become potentially addictive if the reward mechanisms are in place, I have yet to be convinced that there are any real RC addicts out there.

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

Further reading

Alexander, R. (1981). A cube popular in all circles. New York Times, 21 July, p. C6.

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

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

Orford, J. (1985). Excessive Appetites: A Psychological View of the Addictions. Wiley: Chichester.

Scheffler, I. (2014). Beyond the Rubik’s Cube: Inside the competitive world of speedcubing. The Guardian, May 2. Located at: http://www.theguardian.com/technology/2014/may/02/rubiks-cube-competitive-world-speedcubing

Thompson, J. M. (1982). Cuber’s thumb. Canadian Medical Association Journal, 126(7), 773.

Waugh, D. (1981). Cuber’s thumb. New England Journal of Medicine, 305(13), 768

Wikipedia (2014). Rubik’s Cube. Located at: http://en.wikipedia.org/wiki/Rubik’s_Cube