To infinity (and beyond): The benefits of endless running videogames

Last week I was contacted by a journalist at the Red Bulletin Magazine who was “looking for an expert in gaming psychology to talk to for a piece on the mental benefits of endless running games, i.e.  ‘the gameplay building strong reward learning in players’. It should be a fun and practical guide…Just let me know if you’d be interested.” I was interested. I had been teaching in the morning so I didn’t get the email until a couple of hours after it had been sent. I scribbled down a few notes, got back in touch, but by the time I did, the journalist had already interviewed someone else for the feature. Since I’d already made a few bullet points, I thought I would use them for the basis of a blog. (I really don’t like things going to waste).

Although much of my research examines problematic gaming, I am not anti-gaming (and never have been), and I have published many papers on the benefits of gaming including therapeutic benefits, educational benefits, and psychological (cognitive) benefits (see ‘Further reading’ below). Some of you reading this may not know what endless running games are, so here is the Wikipedia definition from its entry on platform games:

“‘Endless running’ or ‘infinite running’ games are platform games in which the player character is continuously moving forward through a usually procedurally generated, theoretically endless game world. Game controls are limited to making the character jump, attack, or perform special actions. The object of these games is to get as far as possible before the character dies. Endless running games have found particular success on mobile platforms. They are well-suited to the small set of controls these games require, often limited to a single screen tap for jumping. Games with similar mechanics with automatic forward movement, but where levels have been pre-designed, or procedurally generated to have a set finish line, are often called “auto-runners” to distinguish them from endless runners”.

Endless running games are incredibly popular and played by millions of individuals around the world (including myself on occasions). One of the best things about endless running games is that because they can be played on smartphones and other small hand-held devices they can be played anywhere at any time. Like any good game, the rules are easy to understand, the gameplay is deceptively simple, but in the end, it takes skill to succeed. The simplicity of endless running games is one of the key reasons for their global success in terms player numbers. For successful games, the mechanics should be challenging but not impossible. Such games can lead to what has been described as a state of ‘flow’ (coined by Mihaly Csíkszentmihályi in his seminal books Flow: The Psychology of Optimal Experience [1990] and Flow: The Psychology of Happiness [1992]).

With the flow experience, a game player derives intense enjoyment by being immersed in the gaming experience, the challenges of the game are matched by the player’s skills, and the player’s sense of time is distorted so that time passes without it being noticed. For some video game players, this may then mean repeatedly seeking out similar experiences on a regular basis to the extent that they can escape from their concerns in the ‘real world’ by being continually engrossed in a flow-inducing world. However, something like flow – viewed largely as a positive psychological phenomenon – may be less positive in the long-term for some video game players if they are craving the same kind of emotional ‘high’ that they obtained the last time that they experienced flow when playing a video game.

Flow has been proposed (by Jackson and Eklund, 2006) as comprising nine elements that include: (i) striking a balance between the challenges of an activity and one’s abilities; (ii) a merging of performance of actions with one’s self-awareness; (iii) possessing clear goals; (iv) gaining unambiguous feedback on performance; (v) having full concentration on the task in hand; (vi) experiencing a sense of being in control; (vii) losing any form of self-consciousness; (viii) having a sense of time distorted so that time seems to speed up or slow down; and (ix) the undergoing of an auto-telic experience (e.g., the goals are generated by the person and not for some anticipated future benefit). Endless running games are one of many types of videogame that can result in ‘flow’ experiences (which for the vast majority of gamers is going to result in something more positive (psychologically) than negative.

There are many studies showing that playing video games can improve reaction times and hand-eye co-ordination. For example, research has shown that spatial visualisation ability, such as mentally rotating and manipulating two- and three-dimensional objects, improves with videogame playing. Again, endless running videogames rely very heavily on hand-eye co-ordination and fast reaction to on-screen events. In this specific area, I see endless running games as having nothing but positive benefits in terms of improving hand-eye co-ordination skills, reflexes, and attention spans.

Although I’m not a neuroscientist or a neuropsychologist, I know that on a neurobiological level, when we engage in pleasurable activity, our bodies produce its own opiate-like neurochemicals in the form of endorphins and dopamine. The novelty aspects of endless running games will for many players result in the production of neurochemical pleasure which is rewarding and reinforcing for the gamer.

I also believe that endless running games have an appeal that crosses many demographic boundaries, such as age, gender, ethnicity, or educational attainment. They can be used to help set goals and rehearse working towards them, provide feedback, reinforcement, self-esteem, and maintain a record of behavioural change in the form of personal scores. Beating one’s own personal high scores or having higher scores than our friends and fellow gamers can also be psychologically rewarding.

Because video games can be so engaging, they can also be used therapeutically. For instance, research has consistently shown that videogames are excellent cognitive distractors and can help reduce pain. Because I have a number of chronic and degenerative health conditions, I play a number of cognitively-engrossing casual games because when my mind is 100% engaged in an activity I don’t feel any pain whatsoever. Again, endless running games tick this particular box for me (and others). Also, on a personal level, I am time-poor because I work so hard in my job. Endless running games are ideal for individuals like myself who simply don’t have the time to engage in playing massively multiplayer online games that can take up hours every day but will quite happily keep myself amused and pain-free on my commute into work on the bus.

As I have pointed out in so many of my research papers and populist writings over the years, is that the negative consequences of playing almost always involve a minority of individuals that are excessive video game players. There is little evidence of serious acute adverse effects on health from moderate play, endless running games included.

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

Further reading

Csíkszentmihályi, M. (1990). Flow: The Psychology of Optimal Experience. New York: Harper and Row

Csíkszentmihályi, M. (1992). Flow: The psychology of happiness. London: Random House.

Griffiths, M.D. (2002).  The educational benefits of videogames Education and Health, 20, 47-51.

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

Griffiths, M.D. (2004). Can videogames be good for your health?  Journal of Health Psychology, 9, 339-344.

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

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

Griffiths, M.D. (2010). Adolescent video game playing: Issues for the classroom. Education Today: Quarterly Journal of the College of Teachers, 60(4), 31-34.

Griffiths, M.D. (2019). The therapeutic and health benefits of playing videogames. In: Attrill-Smith, A., Fullwood, C. Keep, M. & Kuss, D.J. (Eds.). The Oxford Handbook of Cyberpsychology. (pp. 485-505). Oxford: Oxford University Press.

Griffiths, M.D., Kuss, D.J., & Ortiz de Gortari, A. (2017). Videogames as therapy: An updated selective review of the medical and psychological literature. International Journal of Privacy and Health Information Management, 5(2), 71-96.

Jackson, S.A. & Eklund, R.C. (2006). The flow scale manual. Morgan Town, WV: Fitness Information Technology.

Nuyens, F., Kuss, D.J., Lopez-Fernandez, O., & Griffiths, M.D. (2019). The experimental analysis of non-problematic video gaming and cognitive skills: A systematic review. International Journal of Mental Health and Addiction, 17, 389-414.

Needers of the pack: A brief look at addiction to Solitaire

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

Further reading

Fatayer, J. (2008). Addiction types: A clinical sociology perspective. Journal of Applied Social Science, 2(1), 88-93.

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

Griffiths, M.D. (1999). Internet addiction: Internet fuels other addictions. Student British Medical Journal, 7, 428-429.

Griffiths, M.D. (2000). Internet addiction – Time to be taken seriously? Addiction Research, 8, 413-418.

Griffiths, M.D.  (2005). A ‘components’ model of addiction within a biopsychosocial framework. Journal of Substance Use, 10, 191-197.

Mitchell, P. (2000). Internet addiction: genuine diagnosis or not? The Lancet, 355(9204), 632.

National Day Calendar (2018). National Solitaire Day. Located at: https://nationaldaycalendar.com/national-solitaire-day-may-22/

Widyanto, L. & Griffiths, M.D. (2006). Internet addiction: A critical review. International Journal of Mental Health and Addiction, 4, 31-51.

Young K. (1999). Internet addiction: Evaluation and treatment. Student British Medical Journal, 7, 351-352.

(Loot) boxing clever? Has child and adolescent problem gambling really risen in the UK?

A couple of months ago, teenage gambling was grabbing the media headlines. The UK Gambling Commission published its annual statistics showing that based on a self-report survey of 2865 children and adolescents aged 11-16 year-olds, that the prevalence of problem gambling had risen to 1.7% (2% for boys and 1.3% for girls) compared to 0.4% in 2016 and 0.9% in 2017. This lead to predictable headlines such as “Number of child gamblers quadruples in just two years”.

I’ve been researching adolescent gambling for over three decades and was the topic for my first two books in 1995 and 2002. While the figures were concerning, the good news is that the prevalence of adolescent problem gambling has been on the decline in the UK over the past 20 years. For instance, the prevalence of adolescent problem gambling back in 2000 was approximately 5% but by 2016 was less than one-tenth of that. The rise over the past two years is a potential worry although the Gambling Commission’s ‘technical annex’ report about the methodology used to collect the data for the latest survey did suggest that one of the main reasons for the significant increase in problem gambling was likely due to a change in the way data were collected.

In short, the filtering questions in the latest study were changed (so that they more matched the adult gambling prevalence surveys that are carried out) which lead to a doubling of teenagers completing the problem gambling screen that was used to assess problem gambling (18% completing the problem gambling screen in 2017 compared to 34% in 2018). However, it is still worth noting that using the same methodology, there was more than a doubling of adolescent problem gambling from 2016 to 2017 (0.4% to 0.9%).

If there has been a genuine increase in adolescent problem gambling over the past couple of years, I think one of the main factors in this is the playing of simulated gambling games (or gambling-like activities such as the buying of loot boxes) in video games. The Gambling Commission’s report noted that 13% had played gambling-style games online, and that 31% had accessed loot boxes in a videogame or app, to try to acquire in-game items.

The buying of loot boxes takes place within online videogames and are (in essence) virtual games of chance. Players use real money to buy virtual in-game items and can redeem such items by buying keys to open the boxes where they receive a chance selection of further virtual items. Other types of equivalent in-game virtual assets that can be bought include crates, cases, chests, bundles, and card packs. The virtual items that can be ‘won’ can comprise basic customization (i.e., cosmetic) options for a player’s in-game character (avatar) to in-game assets that can help players progress more effectively in the game (e.g., gameplay improvement items such as weapons, armour). All players hope that they can win ‘rare’ items and are often encouraged to spend more money to do so because the chances of winning such items are minimal. Many popular videogames now feature loot boxes and these require the paying of real money in exchange for a completely random in-game item.

At present, the UK Gambling Commission does not consider loot boxes as a form of gambling because (they claim) the in-game items have no real-life value outside of the game. However, this is not the case because there are many websites that allow players to trade in-game items and/or virtual currency for real money. The Gambling Commission appears to acknowledge this point and claim that the buying of in-game loot boxes (and their equivalents) are not gambling but, if third party sites become involved (by allowing the buying and selling of in-game items), the activity does become a form of gambling. Personally, I view the buying of loot boxes as a form of gambling, particularly because the ‘prizes’ won are (in financial terms) often a lot less than that of the price paid.

A study published in the journal PLoS ONE claimed they had evidence for a link between the amount that videogame players spent on loot boxes and problem gambling severity in a large survey of 7422 gamers. The paper concluded that:

“This link was stronger than a link between problem gambling and buying other in-game items with real-world money…suggesting that the gambling-like features of loot boxes are specifically responsible for the observed relationship between problem gambling and spending on loot boxes”

However, this evidence is correlational not causal. I’ve also cited empirical research in my academic papers that engaging in simulated gambling within videogames is a risk factor for both gambling with real money and problem gambling. In November 2018, the Mail on Sunday (MoS) published some of my concerns after they interviewed me about the issue of simulated gambling in online videogames. Although no real money is staked, I have argued that such activities normalize gambling for children and that such activities behaviourally condition children towards gambling.

The MoS claimed that I said that children should be banned from playing online games such as Candy Crush. What I actually said was that children should be prohibited from engaging in gambling simulations within videogames. Candy Crush now features a gambling-type element in the form of a ‘wheel of fortune’ type game (which has also been used in other videogames like Runescape and which I have also argued are gambling when players have to pay to spin the wheel) and that children should be prohibited from accessing such gambling-like features. There is no evidence that the playing of Candy Crush causes problematic behaviour but the playing of simulated gambling-type games has been shown to be a risk factor for problem gambling among adolescents.

The question as to whether there has been a genuine increase in problem gambling among children and adolescents cannot be answered from the Gambling Commission’s latest report but based on other pieces of research there does appear to have been a slight rise over the past couple of years.

(Please note that a different version of this article was first published in The Conversation).

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

Further reading

Calado, F., Alexandre, J. & Griffiths, M.D. (2017). Prevalence of adolescent problem gambling: A systematic review of recent research. Journal of Gambling Studies, 33, 397-424.

Calado, F. & Griffiths, M.D. (2016). Problem gambling worldwide: An update of empirical research (2000-2015). Journal of Behavioral Addictions, 5, 592–613.

Griffiths, M.D. (2002). Gambling and Gaming Addictions in Adolescence. Leicester: British Psychological Society/Blackwells.

Griffiths, M.D.  (2003). Adolescent gambling: Risk factors and implications for prevention, intervention, and treatment. In D. Romer (Ed.), Reducing Adolescent Risk: Toward An Integrated Approach (pp. 223-238). London: Sage.

Griffiths, M.D. (2008). Adolescent gambling in Great Britain. Education Today: Quarterly Journal of the College of Teachers. 58(1), 7-11.

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). Adolescent gambling via social networking sites: A brief overview. Education and Health, 31, 84-87.

Griffiths, M.D. (2018). Is the buying of loot boxes in videogames a form of gambling or gaming? Gaming Law Review, 22(1), 52-54.

Griffiths, M.D. & King, R. (2015). Are mini-games within RuneScape gambling or gaming? Gaming Law Review and Economics, 19, 64-643.

Griffiths, M.D. & Parke, J. (2010). Adolescent gambling on the Internet: A review. International Journal of Adolescent Medicine and Health, 22, 59-75.

 

Eyes on the prize: Is the buying of loot boxes in videogames a form of gambling?

The buying of loot boxes takes place within online videogames and are (in essence) virtual games of chance. Players use real money to buy virtual in-game items and can redeem such items by buying keys to open the boxes where they receive a chance selection of further virtual items. Other types of equivalent in-game virtual assets that can be bought include crates, cases, chests, bundles, and card packs. The virtual items that can be ‘won’ can comprise basic customization (i.e., cosmetic) options for a player’s in-game character (avatar) to in-game assets that can help players progress more effectively in the game (e.g., gameplay improvement items such as weapons, armor). All players hope that they can win ‘rare’ items and are often encouraged to spend more money to do so because the chances of winning such items are minimal. Many popular videogames now feature loot boxes (or equivalents) including Overwatch, Middle-earth: Shadow of War, Star Wars Battlefront 2, FIFA Ultimate Team, Mass Effect: Andromeda, Fortress 2, Injustice 2, Lawbreakers, Forza Motorsport 7, and For Honor. In short, all of these require the paying of real money in exchange for a completely random in-game item. In an interview with Eurogamer, psychologist Jamie Madigan said:

“Whenever you open [a loot box], you may get something awesome (or you may get trash). This randomness taps into some of the very fundamental ways our brains work when trying to predict whether or not a good thing will happen. We are particularly excited by unexpected pleasures like a patch of wild berries or an epic skin for our character. This is because our brains are trying to pay attention to and trying to figure out such awesome rewards. But unlike in the real world, these rewards can be completely random (or close enough not to matter) and we can’t predict randomness. But the reward system in your brain doesn’t know that. Buying [loot boxes] puts them into the same category of packs of Pokémon cards or baseball cards. Unlike gambling in a casino, you’re going to get something out of that pack. Maybe just not the thing you wanted”.

Although there are many definitions in many disciplines defining gambling, there are a number of common elements that occur in the majority of gambling instances that distinguish ‘true’ gambling from mere risk-taking. These include: (i) the exchange is determined by a future event, which at the time of staking money (or something of financial value) the outcome is unknown, (ii) the result is determined (at least partly or wholly) by chance, (iii) the re-allocation of wealth (i.e., the exchange of money [or something of financial value] usually without the introduction of productive work on either side, and (iv) losses incurred can be avoided by simply not taking part in the activity in the first place. Added to this it could be argued that the money or prize to be won should be of greater financial value than the money staked in the first place. Based on these elements, the buying of loot boxes (or equivalents) would be classed as a form of gambling, as would other activities such as the Treasure Hunter and Squeal of Fortune games within the Runescape videogame and online penny auctions (which I have argued in previous papers – see ‘Further reading’).

In the UK Gambling Commission’s most recent (March 2017) position paper on virtual currencies and social casino gambling noted:

“One commonly used method for players to acquire in-game items is through the purchase of keys from the games publisher to unlock ‘crates’, ‘cases’ or ‘bundles’ which contain an unknown quantity and value of in-game items as a prize. The payment of a stake (key) for the opportunity to win a prize (in-game items) determined (or presented as determined) at random bears a close resemblance, for instance, to the playing of a gaming machine. Where there are readily accessible opportunities to cash in or exchange those awarded in-game items for money or money’s worth those elements of the game are likely to be considered licensable gambling activities [Section 3.17]…Additional consumer protection in the form of gambling regulation, is required in circumstances where players are being incentivised to participate in gambling style activities through the provision of prizes of money or money’s worth. Where prizes are successfully restricted for use solely within the game, such in-game features would not be licensable gambling, notwithstanding the elements of expenditure and chance [Section 3.18]”.

Consequently, the UK Gambling Commission does not consider loot boxes as a form of gambling because (they claim) the in-game items have no real-life value outside of the game. However, this is not the case because there are many websites that allow players to trade in-game items and/or virtual currency for real money. The Gambling Commission appear to acknowledge this point and claim that the buying of in-game loot boxes (and their equivalents) are not gambling but if third party sites become involved (by allowing the buying and selling of in-game items), the activity does become a form of gambling. As Vic Hood (in a 2017 article in Eurogamer) rightly notes, this appears to be a case of the law struggling to keep pace with technology. There are also issues surrounding age limits and whether games that offer loot boxes (or equivalents) should be restricted to those over the age of 18 years.

Predictably, those in the videogame industry do not view the buying of loot boxes as gambling either. For instance, Dirk Bosmans (from PEGI [Pan European Game Information], the European-based videogame rating organization) stated in a recent interview with Eurogamer that:

“Loot crates are currently not considered gambling: you always get something when you purchase them, even if it’s not what you hoped for. For that reason, a loot crate system does not trigger the gambling content descriptor. If something is considered gambling, it needs to follow a very specific set of legislation, which has all kinds of practical consequences for the company that runs it. Therefore, the games that get a PEGI gambling content descriptor either contain content that simulates what is considered gambling or they contain actual gambling with cash payouts. If PEGI would label something as gambling while it is not considered as such from a legal point of view, it would mostly create confusion. We are always monitoring such developments and mapping consumer complaints. We see a growing need for information about specific features in games and apps (social interaction, data sharing, digital purchases), but the challenge is that such features are rapidly becoming ubiquitous in the market, yet they still come in very different shapes and sizes.”

This appears somewhat hardline given that PEGI’s descriptor of gambling content is used whenever any videogame “teaches or encourages” gambling. Such a descriptor would arguably cover gambling-like games or activities and the buying of loot boxes is ‘gambling-like’ at the very least. The same stance has been taken by the Entertainment Software Rating Board (ESRB) which rates videogames in Canada and the USA. A spokesman for the ESRB told Eurogamer that:

“ESRB does not consider [the buying of loot boxes] to be gambling because the player uses real money to pay for and obtain in-game content. The player is always guaranteed to receive something – even if the player doesn’t want what is received. Think of it like opening a pack of collectible cards: sometimes you’ll get a brand new, rare card, but other times you’ll get a pack full of cards you already have. That said, ESRB does disclose gambling content should it be present in a game via one of two content descriptors: Simulated Gambling (player can gamble without betting or wagering real cash or currency) and Real Gambling (player can gamble, including betting or wagering real cash or currency). Neither of these apply to loot boxes and similar mechanics.”

At present, there are a number of countries (mainly in South East Asia such as China and Japan) who do view the buying of loot boxes as a form of gambling and have incorporated such activities into their gambling regulation. However, most countries have either not considered regulating the buying of loot boxes at all, or (like the UK) have ruled out that buying loot boxes does not currently meet their regulatory definition of gambling. Although there has been little published in academic journals on loot boxes, a number of articles in the trade press have claimed that the buying of loot boxes can be problematic and/or addictive because they are designed using highly similar reward schedules to those used in the design of slot machines. This is something that have also pointed out in relation to similar activities to the buying of loot boxes where individuals play for points rather than money. Personally, I view the buying of loot boxes as a form of gambling particularly because the ‘prizes’ won are (in financial terms) often a lot less than that of the price paid. Obviously I am out of step in relation to the regulators in my own country, but if third party websites continue to host services where in-game virtual items can be bought and sold, the activity definitely constitutes a form of gambling by almost any definition of gambling currently used in the field of social sciences.

(N.B. This article uses material from a paper I recently published in Gaming Law Review)

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

Further reading

Alexandra, H. (2017). Loot boxes are designed to exploit us. Kotaku, October 13. https://kotaku.com/loot-boxes-are-designed-to-exploit-us-1819457592

Avard, A (2017). Video games have a loot box fetish, and it’s starting to harm the way we play. Games Radar, October 10. Located at: http://www.gamesradar.com/loot-boxes-shadow-of-war/

Gambling Commission (2017). Virtual currencies, esports and social casino gaming – position paper. Birmingham: Gambling Commission.

Griffiths, M.D. (2015). Adolescent gambling and gambling-type games on social networking sites: Issues, concerns, and recommendations. Aloma: Revista de Psicologia, Ciències de l’Educació i de l’Esport, 33(2), 31-37.

Griffiths, M.D. (2017). Is the buying of loot boxes in videogames a form of gambling or gaming? Gaming Law Review, 22(1), 52-54.

Griffiths, M.D. & Carran, M. (2015). Are online penny auctions a form of gambling? Gaming Law Review and Economics, 19, 190-196.

Griffiths, M.D. & King, R. (2015). Are mini-games within RuneScape gambling or gaming? Gaming Law Review and Economics, 19, 64-643.

Hood, V. (2017). Are loot boxes gambling? Eurogamer, October 12. Located at: Located at: http://www.eurogamer.net/articles/2017-10-11-are-loot-boxes-gambling

Lawrence, N, (2017). The troubling psychology of pay-to-loot systems. IGN, April 23. Located at: http://uk.ign.com/articles/2017/04/24/the-troubling-psychology-of-pay-to-loot-systems

Perks, M. (2016). Limited edition loot boxes: Problematic gambling and monetization. Cube, October 11. Located at: https://medium.com/the-cube/limited-edition-loot-boxes-problematic-gambling-and-monetization-756819f2c54f

Wikipedia (2017). Loot box (2017). Located at: https://en.wikipedia.org/wiki/Loot_box

Wiltshire, W. (2017). Behind the addictive psychology and seductive art of loot boxes. PC Gamer, September 29. Located at: http://www.pcgamer.com/behind-the-addictive-psychology-and-seductive-art-of-loot-boxes/

To see or not to see: A brief look at hallucinations in virtual reality applications

As a teenager I was fascinated with LSD purely as a consequence of my love of The Beatles and its alleged association with songs such as ‘Lucy in the Sky with Diamonds‘ (I say ‘alleged’ because all Beatle fanatics know that this song got its’ title from a drawing by John Lennon’s son Julian and that lyrically the song was inspired by the writings of Lewis Carroll, the creator of Alice in Wonderland [AIW], a book which gave its’ name to AIW Syndrome that I examined in a couple of previous blogs).

When I first started teaching my ‘Addictive Behaviours’ module back in 1990, almost all my lectures concentrated on drug addictions (as opposed to behavioural addictions which now take centre stage in my teaching), and it was my session on hallucinogenic drugs (also known as psychedelic drugs) that was always the most fun to teach and the topic that students appeared to be most engaged in. Like many of my students, I have always been interested in altered states of consciousness both in my own research into addiction and the topic more generally.

The reason why I mention all these things as that I did a media interview on the hallucinogenic effects of virtual reality products. The interview was based on comments by Microsoft researcher Mar Gonzalez Franco, who said that virtual reality will soon replace the need for hallucinogenic drugs. More specifically, she was quoted as saying:

“By 2027 we will have ubiquitous virtual reality systems that will provide such rich multi-sensorial experiences that will be capable of producing hallucinations which blend or alter perceived reality. Using this technology, humans will retrain, recalibrate and improve their perceptual systems…In contrast to current virtual reality systems that only stimulate visual and auditory senses, in the future the experience will expand to other sensory modalities including tactile with haptic devices“.

Claims that VR products have the potential to induce hallucinogenic experiences have already started appearing in the media. A recent story in the Daily Mail reported that there was already a VR app (SelfSound) that claimed it can reproduce the effects of hallucinogenic drugs and “plays on the neurological phenomena known as synaesthesia” and that a “program is used to promote mediation through creating abstract reality [and] plays face-melting music with synesthetic DMT-style visualizations uniquely generated in response to [a person’s] voice”. (DMT is an abbreviation for dimethyltryptamine, a powerful hallucinogenic drug).

Over the last seven years, I have published a series of studies with Dr. Angelica Ortiz de Gotari (some of them listed in the ‘Further reading’ section below) showing that hallucinations are common among video gamers in our working examining Game Transfer Phenomena (GTP). Therefore, it’s no surprise that VR games can do the same thing. We have reported that visual and auditory hallucinations are commonly experiences by regular videogame players.

For instance, one of our studies published in the International Journal of Human-Computer Interaction found that some video gamers experience altered visual perceptions after playing (e.g., distorted versions of real world surroundings). Others saw video game images and misinterpreted real life objects after they had stopped playing. Gamers reported seeing video game menus popping up in front their eyes when they were in a conversation, or saw coloured images and ‘heads up’ displays when driving on the motorway. Our study analysed 656 experiences from 483 gamers collected in 54 online video game forums. Visual illusions can easily trick the brain, and staring at visual stimuli can cause ‘after-images’ or ‘ghost images’ among videogame players. We found that GTP were triggered by associations between video game experiences, and objects and activities in real life contexts. Our findings also raised questions about the effects of the exposure to specific visual effects used in video games.

We also reported that in some playing experiences, video game images appeared without awareness and control of the gamers, and in some cases, the images were uncomfortable, especially when gamers could not sleep or concentrate on something else. These experiences also resulted in irrational thoughts such as gamers questioning their own mental health, getting embarrassed or performing impulsive behaviours in social contexts. However, other gamers clearly thought that these experiences were fun and some even tried to induce them.

Visual experiences identified in GTP show us the interplay of physiological, perceptual and cognitive mechanisms and the potential of learning with video games even without awareness. It also invites us to reflect about the effects of prolonged exposure to synthetic stimuli and the challenges that the human mind affront due to the technological advances that are still to come. However, because we collected our data for most of our published studies from online video game forums, the psychological profile of the gamers in our studies are unknown. However, different gamers reported similar experiences in the same games. This highlights the relevance of the video games’ structural characteristics but gamers’ habits also appear to be crucial. Some gamers may be more susceptible than others to experience GTP. The effects of these experiences appear to be short-lived, but some gamers experience them recurrently. It goes without saying (but I’ll say it anyway) that more research is needed to understand the cognitive and psychological implications of GTP. Most of these GTP experiences are viewed positively but a small minority of players find them detrimental.

Whether such hallucinations – either in typical videogames or VR videogames – can be induced on demand is debatable. Very few players in our own research said they were able to induce hallucinations. At present, we simply don’t know what the long-term effects of VR gaming will be and that goes for VR-induced gaming hallucinations too. It may be the case that VR induced hallucinogenic states will be ‘safer’ than ones induced by psychedelic drugs as there is no ingestion of a psychoactive substance, but that’s just speculation on my part.

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

Further reading

Cawley, C. (2016). Virtual Reality could make you hallucinate; Don’t freak out. Tech Co, December 15. Located at: http://tech.co/virtual-reality-hallucinate-dont-freak-2016-12

Hamill, J. (2016). Windows of perception: Microsoft says virtual reality will soon have same mind-bending effects as LSD. The Sun, December 7. Located at: https://www.thesun.co.uk/news/2347705/microsoft-says-virtual-reality-will-soon-have-same-mind-bending-effects-as-lsd/

Liberatore, S. (2016). That’s trippy! Watch the VR app that claims to be able to reproduce the effects of a hallucinogenic drug. Daily Mail, May 4, Located at: http://www.dailymail.co.uk/sciencetech/article-3572184/That-s-trippy-Watch-VR-app-claims-able-reproduce-effects-hallucinogenic-drug.html

Ortiz de Gortari, A.B. & Griffiths, M.D. (2012). An introduction to Game Transfer Phenomena in video game playing. In J. Gackenbach (Ed.), Video Game Play and Consciousness (pp.223-250). Hauppauge, NY: Nova Science.

Ortiz de Gortari, A.B. & Griffiths, M.D. (2014). Altered visual perception in Game Transfer Phenomena: An empirical self-report study. International Journal of Human-Computer Interaction, 30, 95-105.

Ortiz de Gortari, A.B. & Griffiths, M.D. (2014). Auditory experiences in Game Transfer Phenomena: An empirical self-report study. International Journal of Cyber Behavior, Psychology and Learning, 4(1), 59-75.

Ortiz de Gortari, A.B. & Griffiths, M.D. (2014). Automatic mental processes, automatic actions and behaviours in Game Transfer Phenomena: An empirical self-report study using online forum data. International Journal of Mental Health and Addiction, 12, 432-452.

Ortiz de Gortari, A.B. & Griffiths, M.D. (2015). Game Transfer Phenomena and its associated factors: An exploratory empirical online survey study. Computers in Human Behavior, 51, 195-202.

Ortiz de Gortari, A.B. & Griffiths, M.D. (2015). Auditory experiences in Game Transfer Phenomena: An empirical self-report study. In: Gamification: Concepts, Methodologies, Tools, and Applications (pp.1329-1345). Pennsylvania: IGI Global.

Ortiz de Gortari, A.B. & Griffiths, M.D. (2016). Prevalence and characteristics of Game Transfer Phenomena: A descriptive survey study. International Journal of Human-Computer Interaction, 32, 470-480.

Ortiz de Gortari, A.B., Pontes, H.M. & Griffiths, M.D. (2015). The Game Transfer Phenomena Scale: An instrument for investigating the non-volitional effects of video game playing. Cyberpsychology, Behavior and Social Networking, 18, 588-594.

Rothman, P. (2014). Virtual Reality and Drugs – Yes, you should get high before using VR. H Plus Magazine, July 31. Located at: http://hplusmagazine.com/2014/07/31/virtual-reality-and-drugs-yes-you-should-get-high-before-using-vr/

Screenage rampage: What should parents know about videogame playing for children?

Last month, the World Health Organisation (WHO) announced that it was planning to include ‘Gaming Disorder’ (GD) in the latest edition of the International Classification of Diseases. This followed the American Psychiatric Association’s decision to include ‘Internet Gaming Disorder’ in the latest edition of the Diagnostic and Statistical Manual of Mental Disorders in 2013. According to the WHO, an individual with GD is a person who lets playing video games “take precedence over other life interests and daily activities,” resulting in “negative consequences” such as “significant impairment in personal, family, social, educational, occupational or other important areas of functioning.”

I have been researching videogame addiction for nearly 30 years, and during that time I have received many letters, emails, and telephone calls from parents wanting advice concerning videogames. Typical examples include ‘Is my child playing too much?’, ‘Will playing videogames spoil my pupils’ education?’, ‘Are videogames bad for children’s health? and ‘How do I know if a child is spending too long playing videogames?’ To answer these and other questions in a simple and helpful way, I have written this article as a way of disseminating this information quickly and easily.

To begin with parents should begin by finding out what videogames their children are actually playing! Parents might find that some of them contain material that they would prefer them not to be having exposure to. If they have objections to the content of the games they should facilitate discussion with children about this, and if appropriate, have a few rules. A few aims with children should be:

• To help them choose suitable games which are still fun
• To talk with them about the content of the games so that they understand the difference between make-believe and reality
• To discourage solitary game playing
• To guard against obsessive playing
• To follow recommendations on the possible risks outlined by videogame manufacturers
• To ensure that they have plenty of other activities to pursue in their free time besides the playing of videogames

Parents need to remember that in the right context videogames can be educational (helping children to think and learn more quickly), can help raise a child’s self-esteem, and can increase the speed of their reaction times. Parents can also use videogames as a starting point for other activities like painting, drawing, acting or storytelling. All of these things will help a child at school. It needs to be remembered that videogame playing is just one of many activities that a child can do alongside sporting activities, school clubs, reading and watching the television. These can all contribute to a balanced recreational diet.

The most asked question a parent wants answering is ‘How much videogame playing is too much? To help answer this question I devised the following checklist. It is designed to check if a child’s videogame playing is getting out of hand. Ask these simple questions. Does your child:

• Play videogames every day?
• Often play videogames for long periods (e.g., 3 to 6 hours at a time)?
• Play videogames for excitement or ‘buzz’ or as a way of forgetting about other things in their life?
• Get restless, irritable, and moody if they can’t play videogames?
• Sacrifice social and sporting activities to play videogames?
• Play videogames instead of doing their homework?
• Try to cut down the amount of videogame playing but can’t?

If the answer is ‘yes’ to more than four of these questions, then your child may be playing too much. But what can you do if your child is playing videogames too much?

• First of all, check the content of the games. Try and give children games that are educational rather than the violent ones. Parents usually have control over what their child watches on television – videogames should not be any different.
• Secondly, try to encourage video game playing in groups rather than as a solitary activity. This will lead to children talking and working together.
• Thirdly, set time limits on children’s playing time. Tell them that they can play for a couple of hours after they have done their homework or their chores – not before.
• Fourthly, parents should always get their children to follow the recommendations by the videogame manufacturers (e.g., sit at least two feet from the screen, play in a well-lit room, never have the screen at maximum brightness, and never play videogames when feeling tired).

I have spent many years examining both the possible dangers and the potential benefits of videogame playing. Evidence suggests that in the right context videogames can have positive health and educational benefits to a large range of different sub-groups. What is also clear from the case studies displaying the more negative consequences of playing is that they all involved children who were excessive users of videogames. From prevalence studies in this area, there is little evidence of serious acute adverse effects on health from moderate play. In fact, in some of my studies, I found that moderate videogame players were more likely to have friends, do homework, and engage in sporting activities, than those who played no videogames at all.

For excessive videogame players, adverse effects are likely to be relatively minor, and temporary, resolving spontaneously with decreased frequency of play, or to affect only a small subgroup of players. Excessive players are the most at-risk from developing health problems although more research is needed. If care is taken in the design, and if they are put into the right context, videogames have the potential to be used as training aids in classrooms and therapeutic settings, and to provide skills in psychomotor coordination, and in simulations of real life events (e.g., training recruits for the armed forces).

Every week I receive emails from parents claiming that their sons are addicted to playing online games or that their daughters are addicted to social media. When I ask them why they think this is the case, they almost all reply “because they spend most of their leisure time in front of a screen.” This is simply a case of parents pathologising their children’s behaviour because they think what they are doing is “a waste of time.” I always ask parents the same three things in relation to their child’s screen use. Does it affect their schoolwork? Does it affect their physical education? Does it affect their peer development and interaction? Usually parents say that none of these things are affected so if that is the case, there is little to worry about when it comes to screen time. Parents also have to bear in mind that this is how today’s children live their lives. Parents need to realise that excessive screen time doesn’t always have negative consequences and that the content and context of their child’s screen use is more important than the amount of screen time.

(N.B. This article is an extended version of an article that was originally published by Parent Zone)

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

Further reading

Griffiths, M.D. (2003).  Videogames: Advice for teachers and parents. Education and Health, 21, 48-49.

Griffiths, M.D. (2009). Online computer gaming: Advice for parents and teachers. Education and Health, 27, 3-6.

Griffiths, M.D., Kuss, D.J. & King, D.L. (2012). Video game addiction: Past, present and future. Current Psychiatry Reviews, 8, 308-318.

Griffiths, M.D., Kuss, D.J. & Pontes, H. (2016). A brief overview of Internet Gaming Disorder and its treatment. Australian Clinical Psychologist, 2(1), 20108.

Griffiths, M.D. & Meredith, A. (2009). Videogame addiction and treatment. Journal of Contemporary Psychotherapy, 39(4), 47-53.

King, D.L., Delfabbro, P.H. & Griffiths, M.D. (2012). Clinical interventions for technology-based problems: Excessive Internet and video game use. Journal of Cognitive Psychotherapy: An International Quarterly, 26, 43-56.

King, D.L., Delfabbro, P.H., Griffiths, M.D. & Gradisar, M. (2012). Cognitive-behavioural approaches to outpatient treatment of Internet addiction in children and adolescents. Journal of Clinical Psychology, 68, 1185-1195.

Király, O., Nagygyörgy, K., Griffiths, M.D. & Demetrovics, Z. (2014). Problematic online gaming. In K. Rosenberg & L. Feder (Eds.), Behavioral Addictions: Criteria, Evidence and Treatment (pp.61-95). New York: Elsevier.

Kuss, D.J. & Griffiths, M.D. (2012). Online gaming addiction in adolescence: A literature review of empirical research. Journal of Behavioral Addictions, 1, 3-22.

Kuss, D.J. & Griffiths, M.D. (2012). Internet gaming addiction: A systematic review. International Journal of Mental Health and Addiction, 10, 278-296.

The born identity: Can online gaming help people with gender dysphoria?

About a year ago, my colleagues and I published what we believe is the very first study of the helping role that video gaming can play in the lives of transgender individuals. Before I get to that, it’s probably worth noting that there have been studies of how gamers and fans play with sexuality, gender, and the video game Minecraft on YouTube as well as papers discussing whether the gaming industry should cater for marginalized groups and develop games for groups where there is little representation within games (e.g., gay and transgendered characters). For instance, there is now a short autobiographical game by Auntie Pixellante called Dys4ia. This is a WarioWare-style game, played only with the arrow keys, chronicling the experiences of a trans woman rectifying her own gender dysphoria. Such videogames raise interesting questions about how those individuals with gender dysphoria utilize gaming as part of their identity.

In a previous blog I briefly looked at gender swapping in online video games including some of my own research. For instance, in 2003 I published a paper in the journal CyberPsychology and Behavior using secondary poll data from online gaming forums. The paper reported that of 10,350 players at the Everlore fan site, 15% had swapped the gender of their main in-game playing character. We also reported a similar finding among 8,694 players at the Allakhazam fan site with 15.5% reporting that they had gender swapped their main in-game character (and more specifically, 14.5% males and 1% were females who had changed the gender of their lead character). In a 2004 follow-up survey among 540 Everquest gamers (again in the journal CyberPsychology and Behavior) my colleagues and I reported that 60% had swapped their online in-game characters. The prevalence of gender swapping was probably much higher in this study because the question related to the gender swapping of any online game character not just their main playing character.

In a small exploratory study I published in 2008 with Dr. Zaheer Hussain in the International Journal of Mental Health and Addiction, we examined why people engaged in gender swapping in a self-selecting sample of 119 online gamers (mean age of 28.5 years). We reported that 57% of gamers had engaged in gender swapping (any character not just their main character), and that males adopting an online female persona believed there were a number of positive social attributes to becoming female characters in male-oriented gaming environments. The study also reported that significantly more females than males had gender swapped their character – mainly to prevent unsolicited male approaches on their female characters. Some females appeared to gender swap purely out of interest to see what would happen in the game (as a personal experiment), while others claimed that they were treated more favourably by male gamers when they played as a male character. Others reported that gender swapping enabled them to play around with aspects of their identity that would not be possible to explore in real life. Other reasons for gender swapping were that (i) female characters had better in-game statistics, (ii) some specific tools were only available with female characters, (iii) the class of character was sometimes only available in one gender, (iv) they played for fun, and/or (v) they did it to so something that they would not normally do in the game (i.e., they did it for a change in their usual playing behaviour).

Outside of online gaming, a 2002 paper by Hegland and Nelson in the International Journal of Sexuality and Gender Studies noted that the Internet more generally can be used as a tool for expressing gender identity because it allows identities to cross cultural boundaries instantly and without regard for real physical space. They examined 30 cross-dressing websites and argued that for most cross-dressers that visited such websites, the online forum was their primary medium of expression. The users of the website used the Internet to nurture the ability to create a feminine identity, and helped them to pass as a woman in the offline public world. More generally, cross-dressers used the Internet to participate in the larger cultural dialogue of gender.

For an adult to meet current criteria for a diagnosis of transsexualism, the World Health Organisation’s International Classification of Diseases (ICD) reports they must express the desire to live and be accepted as a member of the opposite sex, usually accompanied by the wish to make his or her body as congruent as possible with the desired sex through surgery and cross-sex hormones. This transsexual identity must have been present persistently for a minimum of two years and not be a symptom of another mental disorder or a chromosomal abnormality. The latest (fifth) edition of Diagnostic and Statistical Manual of Mental Disorders (DSM-5) of the American Psychiatric Association uses the term gender dysphoria to describe people who are uncomfortable and/or distressed regarding their assigned gender, their physical sex characteristics and/or their associated social roles. Depending upon the intensity of this distress, some individuals may wish to transition from one point on a notional gender scale to another. The most common direction is from a man to a woman (individuals known as trans women), or from a woman to a man (individuals known as trans men). The distress intrinsic to gender dysphoria may be focused around anatomy, physiology, and/or being perceived and treated as someone of a gender with which the person does not identify. However, these diagnostic labels do not apply to all trans individuals for a multitude of reasons because some people will not identify themselves as a man or as a woman

The World Health Organisation working group has recommended that the latest ICD replace the term Transsexualism with Gender Incongruence) and remove it from the mental and behavioural disorders chapter. Gender incongruence denotes the incongruence between a person’s gender identity and their assigned sex and/or congenital primary and secondary sex characteristics. The terminology in this field has changed over the years and the terms ‘transgender’ and ‘trans’ have been used in the literature as umbrella terms to cover a wide variety of atypical gender experiences and expressions which may lead to permanent change of social gender role but does not necessarily involve treatment with cross-sex hormones or surgical intervention. A recent study has reported an prevalence for transsexualism of 4.6 in 100,000 individuals; 6.8 for trans women and 2.6 for trans men, which is primarily based on studies looking at individuals attending clinical services. (However, it should be noted that recent population studies have reported a significantly higher prevalence rate of atypical gender experiences and expressions).

The study we published in the journal Aloma originated from initial observations made by Dr. Jon Arcelus that a number of gender dysphoric clients presenting at the national (UK) gender dysphoria clinic admitted that they gender-swapped while playing online games. After I met with Dr. Arcelus I suggested he revisit his case files and and to write them up as case studies (as no study in the gaming field has ever examined online gaming among those with gender dysphoria). The main objectives of our study were to use exemplar case studies to highlight that gaming – in some circumstances – appears to be a functional way of dealing with gender identity issues, and that gender swapping in gaming may help such individuals to come to terms with their gender dysphoria.

Our paper featured four case studies who attended an assessment at the National Centre for Gender Dysphoria in Nottingham. All four individuals described in our paper were given pseudonyms and the content of their histories were anonymised (and included ‘Mary’ a 26-year old natal male who fully transitioned to the female social role six months prior to our study; ‘Mark’ a 20-year old natal female who first attended for an assessment in the female role; ‘Paul’ a 31-year old natal male who would like to be female, but still living full-time as a male; and ‘Harry’ a 23-year old natal male who presented for an assessment as a male). If you want to read about each case in detail, the paper can be downloaded for free from here).

The four case studies outlined in our paper are only a selected sample of the number of cases attending a national clinic for people with gender dysphoria. However, they were in no way unusual to the other clients that have sought help at the Centre. However, these individual accounts were specifically selected to demonstrate the different ways that video gaming may help people with gender dysphoria come to terms with their gender identity. For example, gaming can be used among trans people as a psychological tool to increase one’s awareness of gender identity and/or as part of the self. Gaming may therefore be a useful way to express one’s experienced gender identity in a safe, non-threatening, non-alienating, non-stigmatizing, and non-critical environment. This appears to mirror other the findings of other studies outside of the online gaming environment.

Articles published in the mass media have reported that online games such as World of Warcraft provide a creative space that allows gamers that might be questioning aspects of their identity to explore their lives as different individuals. Some have even gone as far as to argue that this could help gamers transform their ‘offline’ identity, as is the case with some trans gamers. This was also demonstrated in the case studies described in our study. Other authors have asserted that the online medium offers an infinite space for development and resistance to traditional gender roles, and that online interaction enables a transgression of the dichotomous categories of male and female, constructing trans (or even genderless) social identities and relationships. However, although such anonymous online communities may provide trans individuals with the power to subvert their physical sex.

Our case studies also demonstrated the different functions of gaming in trans people (e.g., the function of “testing out” their gender feelings). For instance, using gaming to ‘come out’ to other people, by initially coming out in the online community, which is perceived as a safe environment, and then gradually coming out in real life. Gaming, as for many non-trans individuals, can derive psychological benefits and a sense of escapism. This is even more relevant among trans people as it may be the only time that they feel they can be themselves, allowing them to feel happy, relaxed, and achieving a sense of completeness. This could develop into a powerful coping skill substituting unhealthy behaviours, such as self-harming behaviour. This is particularly important in this population as research shows a strong association between being trans and mental health problems, particularly depression and self-harm as a way to manage one’s trans feelings. This is not surprising as the discomfort and distress about assigned gender and body dissatisfaction may lead to a sense of hopelessness, which can bring low mood, self-injury and even suicide.

Although gaming appears (at least initially) to be a positive and beneficial activity for many trans people, there is also the risk that staying in the game becomes too much of a secure and safe environment. This can create a vicious circle where the trans person does not wish to move out of the secure online world, and back into reality. Spending an increasing amount of time in online gaming carries the risk of developing a gaming dependence or addiction. This may not only affect one’s personal relationships, work and/or study, but may also impair real life social gender role transition, as in many cases, the individual is expected to socially transition before they can be considered for treatment.

Obviously our paper only included four participants and may be perceived by some researchers as ‘anecdotal’ because the data were not collected for this specific study but were retrospectively collated. However, our findings showed that for a trans individual, the online gaming environment was perceived as “safe” but further research is needed to establish what the distinctive elements of online gaming are that help to raise gender awareness (or not as the case may be). With the rates of gender dysphoria attending clinical services increasing significantly, future research should investigate (i) the rates and severity of gaming among this population as well as its function, and (ii) the rates of gender dysphoria among game addiction as coming out may help their addiction. The game industry may also want to consider how they can use games as a way of helping trans people being more accepted within society by developing game industry may want to co-observe how their games can prepare and assist individuals to socially transition. Online games also provide a safe environment that provides people access to a platform where individuals can discuss and experiment with gender identity.

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

Further reading

Arcelus, J., Bouman, W. P., Witcomb, G. L., Van den Noortgate, W., Claes, L., & Fernandez-Aranda, F. (2015). Systematic review and meta-analysis of prevalence studies in transsexualism. European Psychiatry, 30, 807-815.

Arcelus, J., Jones, B., Richards, C., Jimenez-Murcia, S., Bouman, W.P. & Griffiths, M.D. (2017). Video gaming and gaming addiction in transgender people: An exploratory study. Journal of Behavioral Addictions, 6, 21–29.

Dale, L. K. (2014, January 23). How World of Warcraft helped me come out as transgender. The Guardian. Retrieved from http://www.theguardian.com/technology/gamesblog/2014/jan/23/how-world-of-warcraft-game-helped-me-come-out-transgender

Griffiths, M.D., Arcelus, J. & Bouman, W.P. (2016). Video gaming and gender dysphoria: Some case study evidence. Aloma: Revista de Psicologia, Ciències de l’Educació i de l’Esport, 34(2), 59-66.

Griffiths, M. D., Davies, M.N.O. & Chappell, D. (2003). Breaking the stereotype: The case of online gaming. CyberPsychology and Behavior, 6, 81-91.

Griffiths, M.D., Davies, M.N.O. & Chappell, D. (2004). Demographic factors and playing variables in online computer gaming. CyberPsychology and Behavior, 7, 479-487.

Griffiths, M. D., Kiraly, O., M. Pontes, H. M. & and Demetrovics, Z. (2015). An overview of problematic gaming. In Starcevic, V. & Aboujaoude, E. (Eds.), Mental Health in the Digital Age: Grave Dangers, Great Promise (pp.27-55). Oxford: Oxford University Press.

Fahs, B., & Gohr, M. (2012). Superpatriarchy meets cyberfeminism: Facebook, online gaming, and the new social genocide. MP: An Online Feminist Journal, 3(6), 1-40.

Hegland, J. E., & Nelson, N. J. (2002). Cross-dressers in cyber-space: Exploring the Internet as a tool for expressing gendered identity. International Journal of Sexuality and Gender Studies, 7(2-3), 139-161.

Huh, S., & Williams, D. (2010). Dude looks like a lady: Gender swapping in an online game. In Online worlds: Convergence of the real and the virtual (pp. 161-174). London: Springer.

Hussain, Z., & Griffiths, M. D. (2008). Gender swapping and socialising in cyberspace: An exploratory study. CyberPsychology and Behavior, 11, 47-53.

Lewis, A., & Griffiths, M. D. (2011). Confronting gender representation: A qualitative study of the experiences and motivations of female casual-gamers. Aloma: Revista de Psicologia, Ciencies de l’Educacio i de l’Esport, 28, 245-272.

McLean, L., & Griffiths, M. D. (2013). Female gamers: A thematic analysis of their gaming experience. International Journal of Games-Based Learning, 3(3), 54-71.

Osborne, H. (2012). Performing self, performing character: Exploring gender performativity in online role-playing games. Transformative Works and Cultures, 11. doi:10.3983/twc.2012.0411.

Potts, A. (2015). ‘LOVE YOU GUYS (NO HOMO)’ How gamers and fans play with sexuality, gender, and Minecraft on YouTube. Critical Discourse Studies, 12(2), 163-186.

Shaw, A. (2012). Do you identify as a gamer? Gender, race, sexuality, and gamer identity. New Media and Society, 14(1), 28-44

Taylor, T. L. (2003). Multiple pleasures women and online gaming. Convergence: The International Journal of Research into New Media Technologies, 9(1), 21-46.

Todd, C. (2012). ‘Troubling’ gender in virtual gaming spaces. New Zealand Geographer, 68(2), 101-110.

Blocking out the pain: Tetris, trauma, and Game Transfer Phenomena

Unwanted visual intrusions are characteristic of Post-Traumatic Stress Disorder (PTSD). According to Dr. Emily Holmes and her colleagues in a 2009 paper in the journal PLoS ONE, one innovative intervention for inhibiting unwanted intrusions is playing the Tetris videogame, described as a ‘cognitive vaccine’ in preventing intrusions after traumatic events. Playing Tetris consumes heavy visuospatial working memory resources that potentially compete with cognitive resources required for elaboration of visual imagery. Since Holmes and colleagues’ study, other studies have used Tetris to inhibit intrusive imagery including more studies by Holmes and her colleagues and others by Ella James’ research group, as well as some innovative studies using Tetris to reduce drug cravings by Jessica Storka-Brown and her colleagues (see ‘Further reading’ below). However, none of these studies assessed the role of videogame content after playing in relation to Game Transfer Phenomena (GTP), an area that we have carried out a lot of research into (see ‘Further reading’ below).

GTP research has investigated non-volitional experiences (e.g., altered sensorial perceptions and automatic mental processes/behaviours) mostly experienced after gaming. Gamers often report sensorial (visual/auditory) intrusions after playing (e.g., visual and auditory imagery, hallucinations). In a survey of 2,362 gamers that we published in a 2016 issue of the International Journal of Human-Computer Interaction, most (77%) had visualized images from a variety of videogames (including tile-puzzle games) with closed-eyes, and one-third (31%) had visualized images with open-eyes. Other studies have experimentally induced videogame-related visualizations at sleep onset (including studies by Stickgold and colleagues [2000], Wamsley and colleagues [2010], Kusse and colleagues [2012] – see ‘Further reading’).

James and colleagues’ 2015 study in the journal Psychological Science was the first to make explicit reference to GTP (referred to as the ‘Tetris effect’ [TE]). In 2012, we argued the TE term is misleading as it suggests repetition is the core of transfer effects. However, other factors are involved. Research concerning GTP makes the distinction between sensorial modalities facilitating non-volitional phenomena with videogame content that occur along the continuum from mild to severe. Moreover, the descriptive constructs of GTP are empirically based on our analysis of 3,500+ gamers and have been examined via confirmatory factor analysis demonstrating good reliability and validity.

James and her colleagues tested if playing Tetris offered a protective mechanism against re-experiencing traumatic events. Healthy participants (n=56) were randomly assigned to either playing Tetris for 11 minutes, or doing nothing before exposure to a 12-minute traumatic film. Image-base memories about the film were then registered in a one-week dairy. However, playing Tetris as a proactive interference task before watching the film did not show significant results. James and colleagues offered different explanations including: (i) duration of the task in relation to film length, (ii) temporal contingencies between the tasks, (iii) differences between the task types, (iv) videogame types used, and (v) reactivation of gameplay during the film for aided interference. In a commentary paper published in a 2016 issue of Frontiers in Psychology, we discussed these findings and some of its shortcomings in relation to GTP literature.

• Duration of task in relation to film length: Playing Tetris for 11 minutes may not have been long enough to compete with the consolidation of memory of the 12-minute film. GTP are significantly more likely to occur when playing 3-6 hours. Our research reported only 4% of gamers reported GTP when playing sessions shorter than one-hour. Laboratory experiments have taken days of playing to induce game-related visualizations at sleep onset.
• Temporal contingencies between gaming and film watching: The tasks were performed minutes apart from each other. GTP mostly occur soon after stopping playing but our research has found that gamers have also reported GTP days after playing. In most cases, duration of experience is very short (seconds/minutes) but in some cases hours or longer.
• Differences between the tasks: Previous studies have demonstrated that similar tasks aid interference. However, watching a film is a passive activity while gaming is interactive requiring additional perceptual/motor skills. Therefore, it may be expected that gaming is more potent as interference task, particularly because inducing the subjective sense of presence in the virtual world may strengthen the interference.
• Type of videogame used as interference task and emotional content of film: The unrealistic (geometric) Tetris content may have been overwritten by the film’s traumatic images. Visualization of stereotypical games induced at sleep onset are characterized by lack of emotion, assuming that the amygdala and the reward system are not involved. In GTP research, emotions in tile-matching puzzle-games are incomparable to emotions in realistic videogames.
• Reactivation of gameplay during the film for aided interference: The use of cue reminders may have potential in reviving videogame content. In many cases, thoughts and altered perceptions are triggered by game-related cues. Selective attention toward game-related cues has been demonstrated in experiments. GTP have been reported in variety of videogame genres particularly those that have very realistic graphics and settings. Therefore, more realistic games may aid associations between real life stimuli and videogame content, and may be more effective in competing with memories of traumatic events.

In our Frontiers paper, we noted that playing Tetris is not only an effective visuospatial task (overloading working memory resources needed for imagery-formation while playing), but as demonstrated in our GTP studies, videogame content stays active after playing (e.g., mental imagery, sensory perceptions), and may offer additional benefits for managing unwanted intrusions. GTP may potentially strengthen effects of interference tasks but should be used cautiously, because videogame content not only targets unwanted intrusions, but also influences individual cognitions, perceptions, and behaviours in day-to-day contexts (e.g., attention bias, lack of task awareness, control inhibition failures). Moreover, our studies have shown distress and dysfunction have been reported with GTP.

Consequently, further research needs conducting to identify: (i) videogames that are most effective, (ii) playing duration, (iii) factors that reduce intervention efficacy and strategies to control them, and (iv) individuals that may benefit the most from such intervention. While using videogames as intervention tools for preventing unwanted imagery from traumatic experiences has potential, therapeutically it is still at an early stage.

• (Please note: This blog was co-written with Dr. Angelica Ortiz de Gortari and is based on an article we published in Frontiers in Psychology: Ortiz de Gortari, A.B. & Griffiths, M.D. (2016). Playing the computer game Tetris prior to viewing traumatic film material and subsequent intrusive memories: Examining proactive interference. Frontiers in Psychology, 7, 260. doi: 10.3389/fpsyg.2016.00260)

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

Further reading

Holmes, E. A., James, E. L., Kilford, E. J., & Deeprose, C. (2010). Key steps in developing a cognitive vaccine against traumatic flashbacks: Visuospatial Tetris versus Verbal Pub Quiz. PloS ONE, 5(11), e13706.

James, E. L., Bonsall, M. B., Hoppitt, L., Tunbridge, E. M., Geddes, J. R., Milton, A. L., & Holmes, E. A. (2015a). Computer game play reduces intrusive memories of experimental trauma via reconsolidation-update mechanisms. Psychological Science. doi: 10.1177/0956797615583071

James, E. L., Zhu, A. L., Tickle, H., Horsch, A., & Holmes, E. A. (2015b). Playing the computer game Tetris prior to viewing traumatic film material and subsequent intrusive memories: Examining proactive interference. Journal of Behavior Therapy and Experimental Psychiatry. doi: 10.1016/j.jbtep.2015.11.004

Kusse, C., Shaffii-Le Bourdiec, A., Schrouff, J., Matarazzo, L., & Maquet, P. (2012). Experience-dependent induction of hypnagogic images during daytime naps: A combined behavioural and EEG study. Journal of Sleep Research, 21(1), 10-20.

Ortiz de Gortari, A. B., Aronsson, K., & Griffiths, M. D. (2011). Game Transfer Phenomena in video game playing: A qualitative interview study. International Journal of Cyber Behavior, Psychology and Learning 1(3), 15-33.

Ortiz de Gortari, A. B., & Griffiths, M. D. (2012). An introduction to Game Transfer Phenomena in video game playing. In J. I. Gackenbach (Ed.), Video Game Play and Consciousness (pp. 223-250). Hauppauge, NY: Nova Publisher.

Ortiz de Gortari, A. B., & Griffiths, M. D. (2014a). Altered visual perception in Game Transfer Phenomena: An empirical self-report study. International Journal of Human-Computer Interaction, 30(2), 95-105.

Ortiz de Gortari, A. B., & Griffiths, M. D. (2014b). Auditory experiences in Game Transfer Phenomena: An empirical self-report study. International Journal of Cyber Behavior, Psychology and Learning 4(1), 59-75.

Ortiz de Gortari, A. B., & Griffiths, M. D. (2014c). Automatic mental processes, automatic actions and behaviours in Game Transfer Phenomena: An empirical self-report study using online forum data. International Journal of Mental Health and Addiction, 12(4), 1-21.

Ortiz de Gortari, A. B., & Griffiths, M. D. (2015a). Game Transfer Phenomena and its associated factors: An exploratory empirical online survey study. Computers in Human Behavior, 51, 195-202.

Ortiz de Gortari, A.B. & Griffiths, M.D. (2016). Prevalence and characteristics of Game Transfer Phenomena: A descriptive survey study. International Journal of Human-Computer Interaction, 32, 470-480.

Ortiz de Gortari, A.B., Oldfield, B. & Griffiths, M.D. (2016). An empirical examination of factors associated with Game Transfer Phenomena severity. Computers in Human Behavior, 64, 274-284.

Ortiz de Gortari, A. B., Pontes, H. M. & Griffiths, M. D.  (2015). The Game Transfer Phenomena Scale: An instrument for investigating the nonvolitional effects of video game playing. Cyberpsychology, Behavior, and Social Networking 10, 588-594

Skorka-Brown, J., Andrade, J., & May, J. (2014). Playing ‘Tetris’ reduces the strength, frequency and vividness of naturally occurring cravings. Appetite, 76 , 161-165.

Skorka-Brown, J., Andrade, J., Whalley, B., & May, J. (2015). Playing Tetris decreases drug and other cravings in real world settings. Addictive Behaviors, 51, 165-170.

Stickgold, R., Malia, A., Maguire, D., Roddenberry, D., & O’Connor, M. (2000). Replaying the Game: Hypnagogic images in normals and amnesics. Science, 290(5490), 350-353.

Wamsley, E. J., Perry, K., Djonlagic, I., Reaven, L. B., & Stickgold, R. (2010). Cognitive replay of visuomotor learning at sleep onset: Temporal dynamics and relationship to task performance. Sleep, 1(33), 59-68.

 

Gaming desires: A brief look at ‘venatophilia’

In a previous blog on sexual paraphilias that have yet to be studied empirically, I briefly mentioned ‘venatophilia’.  In an online article about cartoon quicksand fetishes (which I discuss below), there was mention of a fetish group called ‘Giant Video Game Girls’ and they appear to have coined the term ‘venatophilia’ from the Latin venatus, meaning ‘game’ and describes sexual attraction to or fascination with video game characters. Venatophilia also gets a mention on the Wiktionary protologism page (a page that lists prototype neologisms) where it listed alongside venatology (“the study of games, the act of playing them, and the players and cultures surrounding them”), venatomania (an obsession with games), and venatophobia (a fear of games). Personally I find this somewhat strange as most paraphilias derive from Greek (rather than Latin) names. If this paraphilia exists I would argue that it is a sub-type of toonophilia (sexual attraction to cartoon characters) that I examined in a previous blog.

Cartoon quicksand fetishes are an integration of quicksand fetishes (itself a form of ‘stuck fetishism‘ that I examined in a previous blog) and (as mentioned above) cartoon fetishism (‘toonophilia‘). The Motherboard article by Jagger Gravning featured an interview with ‘quicksand artist’ A-020 who draws fictional damsels, women that are stuck in quicksand typically wearing a “tight miniskirt, pantyhose, heels, and boots”. (If you are interested, there is lots of art featuring women stuck in quicksand on the Deviant Art webpage). A-020 said:

 “I’m open with [my quicksand cartoon fetish] online because I’m comfortable under a screenname…Though when it comes to knowing me in person, it’s pretty much a secret! I haven’t been in a situation where I had to reveal this fetish…I was pretty young, maybe 7 or 8, when I started seeing quicksand scenes in a movie or a TV show. Some of those films I recall seeing were Beastmaster, Neverending Story, A Nightmare on Elm Street 4 and Ursus in the Valley of the Lions…Once in a while, I’d fantasize about it”.

Gravning makes the point that there are other fetishes that cartoonists incorporate into their videogame graphics. Some of these are strange behaviors that I outlined in a previous blog – ‘unbirthing’ (i.e., returning to the womb) such as that featuring ‘Princess Peach’ and Pokemon characters (such as those here and here) and vore (vorarephilia). In fact, Zeus Tipado wrote an online article for The Stoned Gamer about the “vore fetish of game characters swallowing each other whole”. There are also online articles that examine the best sexual moments in videogame history. In an online article entitled ‘Gamers as fetishists‘  by Gus Mastrapa on the Joystick Division website notes:

“Nowadays we equate fetishism with perversity, but the roots of the word are about perceiving power in objects or things. A religious idol is a fetish object. In the days when more and more parts of our lives are digital it is easy to fetishize the physical. Gamers, I think, have a bit of a head start. Because the videogames we play have long been about making our imaginations physical – by embodying and creating the ideals and fantasies we carry around with us. I mean just look at the characters in a Final Fantasy game and tell me that gamers aren’t serious fetishists…There’s a huge swath of the gaming community who love JRPGs [Japanese role playing games] like Final Fantasy and Persona – where characters are defined more by what they wear than their facial features. Costumes are a huge concern for these fans…It is easy to pick on anime nerds and their weird fixation with trench coats, boots and nerdy glasses. But this exercise would be pointless without self-examination…Gamer fetishism goes beyond the aesthetic…Games encourage obsession. They draw it out of us or provide a vessel for us to pour it into. And so it makes sense that they’d also be filled with objects of our obsession. Weapons, riches, vehicles, clothing, other people – they’re all things we want because we fill them with our dreams and desires”

Earlier this year, the makers of World of Warcraft launched a new videogame, Overwatch which according to an article in Maxim magazine by Zeynep Yenisey is “an over-sexualized first-person shooter featuring tons of big-breasted anime chicks”. Yenisey reported that after the game was released, there had been an 817% increase on Pornhub for Overwatch-related searches particularly for the buxom character Tracer.

So what is the psychology behind fetishes and sexual attraction to videogame characters? Gravning interviewed the evolutionary psychologist Dr. Catherine Salmon

“If somebody has attached to a character because they play a game a lot and fantasize about that character, it wouldn’t be surprising that they take that character and stick it somewhere else. It’s not surprising that some of the female characters in video games who are heroines and are portrayed as very sexual characters in terms of the way that they’re drawn might end up as the stars of gamers’ sexual fantasies. The social aspect of using familiar characters is another reason for using them in quicksand imagery and other fetishes. If you use a known character for a fetish, it gives your work some degree of a built-in audience, a device often used for fanfiction…There is a community of men who are creating and sharing these stories or these images. If they share an interest in the original material as well, then using that original material creates an additional commonality of interest. It’s one thing to have your sexual fantasies and it’s another thing to share your sexual fantasies. If you’re creating art or fiction and you’re putting it on the web, you’re not just doing it for yourself, it’s not just your fantasy that you’re jerking off to, you’re giving that to other people as well. To do that, you find a built-in community if you’re using a shared character”.

Gravning notes some of the “shared characters” find themselves in “exactly the same situations that these artists fetishize” and asked Dr. Salmon whether witnessing individuals repeatedly stuck in quicksand when a child could possibly lead to such unusual fetishes:

“It could be something like that. Whether it’s quicksand or tar pits, there’s things like that in children’s cartoons. It could be something as simple as that. Part of it is the damsel in distress kind of image. Watching ‘Wonder Woman’ caught in that kind of circumstance when people are younger – [it’s] an image that’s eroticized, a very sexually drawn, very feminine image. And they might enjoy watching that sort of thing or the struggle, as she’s trying to get out of whatever that circumstance is. There are a lot of unusual circumstances in cartoons and fantasy and you may get aroused while you’re watching it and then carry some of that too”.

Gravning also interviewed the sex therapist Dr. Elizabeth Lars (who shares my own view on this by alluding to classical conditioning). Dr. Lars calls such associations “accidents of learning” in which the associations “don’t have to be exactly like the fantasy that comes, it just has to resemble it”. Furthermore, she went on to speculate:

[Quicksand fetishists] probably fantasized and got into the feeling that goes with that, not just watching. It could [also] be identifying with it. The kid imagining himself stuck in quicksand in the victim’s place, for example, could be part of its erotic appeal. You could either be observing it or experiencing it. You could be doing both at the same time in a fantasy. Some evidence certainly suggests that sexual patterns are already there, for sure in males, by the age of eight. They may or may not have begun masturbating to fantasies until adolescence, but something is going on internally at a very young age. This highly influential period of age eight through adolescence is also probably for many a prime time for the ingestion of the bizarre imagery and situations contained in video games and cartoons, which often also incorporate sexualized heroines. It looks like what we call fetishes are remarkably easy to install in the early learning experiences. Same thing about fears too.”

Back in the late 1990s, I had a regular column with the now defunct magazine Arcade. My very first column (which you can download here) was on the psychology of Tomb Raider and the sexualization of lead character Lara Croft and the influence it might have on young boys and emerging adolescents. This is echoed by the neuroscientist Dr. Ogi Ogas who when interviewed by Gravning said that pubertal males probably spending a lot of time with sexualized videogame characters like Lara Croft.

“They are seeing these characters during their formative time. They are kind of perfect and ideal – and you don’t have to actually interact with them. Psychologically, it’s truly like a stripped-down, pure erotic stimuli. So it’s much easier to imprint on that, to fetishize that. Part of the fascination is simply being culturally exposed to characters like Lara Croft…[In relation to quicksand fetishes], the notion of being smothered or trapped is universal in the sense that it exists to greater and lesser degrees all over. It’s not just one or two people that have it. It is found in a lot of places. Clearly our normal brain design is not that far removed from [wanting to be] enveloped. It’s probably something to do with our tactile system, our touch system of the brain, that’s quite naturally wired to our sexual arousal system. The tactile system is also interconnected with sensations like being smothered and being interred, being doused with water. Probably, somehow – and I’m speculating here – that’s what got crossed up for whatever reasons. How someone’s brain entangles sexual arousal with the notion of being trapped or smothered might simply be a perturbation of the neural system. A quirk in the brain, essentially. It could be some randomness in the seemingly infinite complexity of your DNA. So, from a perspective rooted in computational neuroscience, niche sexual desires needn’t be wholly, or at all, explained as the result of social construction or evolutionary adaptation. As we’re learning more about the genetics of brain construction, “we’re coming to understand the genetic expression that leads to different neural wiring is highly variable and dependent on so many things [that] could happen in the womb, things that happen in early life, different environmental things. There’s just myriad, myriad factors that can cause unusual neural wiring to arise.”

Dr. Ogas also claimed are fundamental to the human condition and that one in particular (domination/submission) seems to underlie many fetishes:

“The most important, underappreciated sexual interest in our species is an interest in domination and submission. This interest in manifestations of domination and submission applies to people worldwide. To men, women, whether they be gay, lesbian, straight, or anything else. Everybody. Whether your mindset is to be dominant or submissive sexually is fundamental to your sexual identity even though this interest is thought of culturally as an atypical fetish. The concept that one person has power, one person doesn’t, runs through all forms of erotica across the world”.

Based on what I’ve seen and read online, venatophilia appears to exist although it could be argued that videogame fetishes are just sub-classes of other types of fetishes and paraphilias such as vorarephilia, unbirthing, and stuck fetishism.

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

Further reading

Aggrawal A. (2009). Forensic and Medico-legal Aspects of Sexual Crimes and Unusual Sexual Practices. Boca Raton: CRC Press.

Gravning, J. (2016). The fetish for video game characters trapped in quicksand. Motherboard, March 19. Located at: http://motherboard.vice.com/read/quicksand

Griffiths, M.D. (1998). Shrink rap: The Croft Report. Arcade, 1 (November), p. 49.

Love, B. (2001). Encyclopedia of Unusual Sex Practices. London: Greenwich Editions.

Mastrapa, G. (2011). Gamers are fetishists. Joystick Division, March 9. Located at: http://www.joystickdivision.com/2011/09/gamers_are_fetishists.php

McCombs, E. (2008). Toonophilia: Is it porn? Huffington Post, October 1^st. Located at: http://www.asylum.com/2008/10/01/toonophilia-is-it-porn/

Monroe, W. (2012). Fetish of the week: Schediaphilia (toonophilia). ZZ Insider, March 12. Located at: http://www.zzinsider.com/blogs/view/fetish_of_the_week_schediaphilia_toonophilia

Tipado, Z. (2015). Exploring the vore fetish of game characters eating each other whole. The Stoned Gamer, October 25. Located at: http://thestonedgamer.com/features/item/351-exploring-the-vore-fetish-of-game-characters-swallowing-each-other-whole

Yenisey, Z. (2016). How the bizarre ‘overwatch’ fetish is getting gamers hot and bothered. Maxim, May 11. Located at: http://www.maxim.com/entertainment/overwatch-pornhub-2016-5

Play a way: A brief overview of our recent papers on Game Transfer Phenomena

Following my recent blogs where I outlined some of the papers that my colleagues and I have published on mindfulness, Internet addiction, gaming addiction, workaholism, and youth gambling, here is a round-up of recent papers that Dr. Angelica Ortiz de Gortari and I have published on Game Transfer Phenomena.

Ortiz de Gortari, A.B., Oldfield, B. & Griffiths, M.D. (2016). An empirical examination of factors associated with Game Transfer Phenomena severity. Computers in Human Behavior, 64, 274-284.

• Game Transfer Phenomena (GTP) (i.e. altered perceptions, spontaneous thoughts and behaviors with game content) occur on a continuum from mild to severe. This study examined the differences between mild, moderate and severe levels of GTP. A total of 2281 gamers’ participated in an online survey. The majority of gamers experienced a mild level of GTP. The factors significantly associated with the severe level of GTP were: (i) being students, (ii) being aged 18 to 22 years, (iii) being professional gamers, (iv) playing videogames every day in sessions of 6 h or more, (iv) playing to escape from the real world, (v) having a sleep disorder, mental disorder or reported dysfunctional gaming, and (vi) having experienced distress or dysfunction due to GTP. In addition, having used drugs and experiencing flashbacks as side- effects of drug use were significantly less likely to be reported by those with mild level of GTP. In a regression analysis, predictors of severe GTP included positive appraisals of GTP, distress or dysfunction due to GTP, and tendency to recall dreams. In general, the findings suggest that those with severe level of GTP share characteristics with profiles of gamers with dysfunctional gaming (e.g., problematic and/or addictive gaming).

Ortiz de Gortari, A.B. & Griffiths, M.D. (2015). Game Transfer Phenomena and its associated factors: An exploratory empirical online survey study. Computers in Human Behavior, 51, 195-202.

• Previous qualitative and quantitative studies examining Game Transfer Phenomena (GTP) have demonstrated that GTP experiences are common. These studies have shown that many gamers report altered perceptions, involuntary thoughts and behaviors after playing video games (e.g., pseudo-hallucinatory experiences, automatic motor activations, etc.). However, the factors associated with GTP are unknown. In the present study, a total of 2362 gamers were surveyed using an online questionnaire to examine the relationship between GTP and socio-demographic factors, gaming habits, individual characteristics, and motivations for playing. Results showed that having a pre-existing medical condition, playing for 3–6 h, and playing for immersion, exploration, customization, mechanics and escape from the real world were significantly associated with having experienced GTP. Those who were 33–38 years old, playing sessions for less than one hour, being a professional player, being self-employed, and never recalling dreams, were significantly more likely to have not experienced GTP. The findings suggest that attention should be paid to young adults and the length of gaming sessions, as well as taking into consideration underlying factors such as medical conditions that may make gamers more prone to GTP.

Ortiz de Gortari, A.B., Pontes, H.M. & Griffiths, M.D. (2015). The Game Transfer Phenomena Scale: An instrument for investigating the non-volitional effects of video game playing. Cyberpsychology, Behavior and Social Networking, 18, 588-594.

• A variety of instruments have been developed to assess different dimensions of playing video games and its effects on cognitions, affect, and behaviors. The present study examined the psychometric properties of the Game Transfer Phenomena Scale (GTPS) that assesses nonvolitional phenomena experienced after playing video games (i.e., altered perceptions, automatic mental processes, and involuntary behaviors). A total of 1,736 gamers participated in an online survey used as the basis for the analysis. Confirmatory factor analysis (CFA) was performed to confirm the factorial structure of the GTPS. The five-factor structure using the 20 indicators based on the analysis of gamers’ self-reports fitted the data well. Population cross-validity was also achieved, and the positive associations between the session length and overall scores indicate the GTPS warranted criterion-related validity. Although the understanding of Game Transfer Phenomena is still in its infancy, the GTPS appears to be a valid and reliable instrument for assessing nonvolitional gaming-related phenomena. The GTPS can be used for understanding the phenomenology of post-effects of playing video games.

Ortiz de Gortari, A.B. & Griffiths, M.D. (2015). Auditory experiences in Game Transfer Phenomena: An empirical self-report study. In: Gamification: Concepts, Methodologies, Tools, and Applications (pp.1329-1345). Pennsylvania: IGI Global.

• This study investigated gamers’ auditory experiences as after effects of playing. This was done by classifying, quantifying, and analysing 192 experiences from 155 gamers collected from online videogame forums. The gamers’ experiences were classified as: (i) involuntary auditory imagery (e.g., hearing the music, sounds or voices from the game), (ii) inner speech (e.g., completing phrases in the mind), (iii) auditory misperceptions (e.g., confusing real life sounds with videogame sounds), and (iv) multisensorial auditory experiences (e.g., hearing music while involuntary moving the fingers). Gamers heard auditory cues from the game in their heads, in their ears, but also coming from external sources. Occasionally, the vividness of the sound evoked thoughts and emotions that resulted in behaviours and copying strategies. The psychosocial implications of the gamers’ auditory experiences are discussed. This study contributes to the understanding of the effects of auditory features in videogames, and to the phenomenology of non-volitional auditory experiences.

Ortiz de Gortari, A.B. & Griffiths, M.D. (2016). Prevalence and characteristics of Game Transfer Phenomena: A descriptive survey study. International Journal of Human-Computer Interaction, 32, 470-480.

• Previous qualitative studies suggest that gamers experience Game Transfer Phenomena (GTP), a variety of non-volitional phenomena related to playing videogames including thoughts, urges, images, and sounds when not playing. To investigate (i) which types of GTP were more common and (ii) their general characteristics, the present study surveyed a total of 2362 gamers via an online survey. The majority of the participants were male, students, aged between 18 and 27 years, and “hard-core” gamers. Most participants reported having experienced at least one type of GTP at some point (96.6%), the majority having experienced GTP more than once, with many reporting 6 to 10 different types of GTP. Results demonstrated that videogame players experienced (i) altered visual perceptions, (ii) altered auditory perceptions, (iii) altered body perceptions, (iv) automated mental processes, and (v) behaviors. In most cases, GTP could not be explained by being under the influence of a psychoactive substance. The GTP experiences were usually short-lived, tended to occur after videogame playing rather than during play, occurred recurrently, and usually occurred while doing day-to-day activities. One in five gamers had experienced some type of distress or dysfunction due to GTP. Many experienced GTP as pleasant and some wanted GTP to happen again.

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

Further reading

Griffiths, M.D. & Ortiz de Gortari, A.B. (2015). Musical hallucinations: Review of treatment effects. Frontiers in Psychology, 6, 1885. doi: 10.3389/fpsyg.2015.01885

Ortiz de Gotari, A., Aronsson, K. & Griffiths, M.D. (2011). Game Transfer Phenomena in video game playing: A qualitative interview study. International Journal of Cyber Behavior, Psychology and Learning, 1(3), 15-33.

Ortiz de Gortari, A.B. & Griffiths, M.D. (2012). An introduction to Game Transfer Phenomena in video game playing. In J. Gackenbach (Ed.), Video Game Play and Consciousness (pp.223-250). Hauppauge, NY: Nova Science.

Ortiz de Gortari, A.B. & Griffiths, M.D. (2014). Altered visual perception in Game Transfer Phenomena: An empirical self-report study. International Journal of Human-Computer Interaction, 30, 95-105.

Ortiz de Gortari, A.B. & Griffiths, M.D. (2014). Auditory experiences in Game Transfer Phenomena: An empirical self-report study. International Journal of Cyber Behavior, Psychology and Learning, 4(1), 59-75.

Ortiz de Gortari, A.B. & Griffiths, M.D. (2014). Automatic mental processes, automatic actions and behaviours in Game Transfer Phenomena: An empirical self-report study using online forum data. International Journal of Mental Health and Addiction, 12, 432-452.

Ortiz de Gortari, A.B. & Griffiths, M.D. (2016). Playing the computer game Tetris prior to viewing traumatic film material and subsequent intrusive memories: Examining proactive interference. Frontiers in Psychology, 7, 260. doi: 10.3389/fpsyg.2016.00260