Surprise, surprise: A brief overview of our recent papers on strange addictions and behaviours

Following my recent blogs where I outlined some of the papers that my colleagues and I have published on mindfulness, Internet addiction, gaming addiction, youth gambling, workaholism, exercise addiction, and sex addiction, here is a round-up of recent papers that my colleagues and I have published on strange and/or surprising addictions and behaviours.

Foster, A.C., Shorter, G.W. & Griffiths, M.D. (2015). Muscle Dysmorphia: Could it be classified as an Addiction to Body Image? Journal of Behavioral Addictions, 4, 1-5.

• Background: Muscle dysmorphia (MD) describes a condition characterised by a misconstrued body image in which individuals who interpret their body size as both small or weak even though they may look normal or highly muscular. MD has been conceptualized as a type of body dysmorphic disorder, an eating disorder, and obsessive–compulsive disorder symptomatology. Method and aim: Through a review of the most salient literature on MD, this paper proposes an alternative classification of MD – the ‘Addiction to Body Image’ (ABI) model – using Griffiths (2005) addiction components model as the framework in which to define MD as an addiction. Results: It is argued the addictive activity in MD is the maintaining of body image via a number of different activities such as bodybuilding, exercise, eating certain foods, taking specific drugs (e.g., anabolic steroids), shopping for certain foods, food supplements, and the use or purchase of physical exercise accessories). In the ABI model, the perception of the positive effects on the self-body image is accounted for as a critical aspect of the MD condition (rather than addiction to exercise or certain types of eating disorder). Conclusions: Based on empirical evidence to date, it is proposed that MD could be re-classified as an addiction due to the individual continuing to engage in maintenance behaviours that may cause long-term harm.

Griffiths, M.D., Foster, A.C. & Shorter, G.W. (2015). Muscle dysmorphia as an addiction: A response to Nieuwoudt (2015) and Grant (2015). Journal of Behavioral Addictions, 4, 11-13.

• Background: Following the publication of our paper ‘Muscle Dysmorphia: Could it be classified as an addiction to body image?’ in the Journal of Behavioral Addictions, two commentaries by Jon Grant and Johanna Nieuwoudt were published in response to our paper. Method: Using the ‘addiction components model’, our main contention is that muscle dysmorphia (MD) actually comprises a number of different actions and behaviors and that the actual addictive activity is the maintaining of body image via a number of different activities such as bodybuilding, exercise, eating certain foods, taking specific drugs (e.g., anabolic steroids), shopping for certain foods, food supplements, and purchase or use of physical exercise accessories. This paper briefly responds to these two commentaries. Results: While our hypothesized specifics relating to each addiction component sometimes lack empirical support (as noted explicitly by both Nieuwoudt and Grant), we still believe that our main thesis (that almost all the thoughts and behaviors of those with MD revolve around the maintenance of body image) is something that could be empirically tested in future research by those who already work in the area. Conclusions: We hope that the ‘Addiction to Body Image’ model we proposed provides a new framework for carrying out work in both empirical and clinical settings. The idea that MD could potentially be classed as an addiction cannot be negated on theoretical grounds as many people in the addiction field are turning their attention to research in new areas of behavioral addiction.

Maraz, A., Király, O., Urbán, R., Griffiths, M.D., Demetrovics, Z. (2015). Why do you dance? Development of the Dance Motivation Inventory (DMI). PLoS ONE, 10(3): e0122866. doi:10.1371/ journal.pone.0122866

• Dancing is a popular form of physical exercise and studies have show that dancing can decrease anxiety, increase self-esteem, and improve psychological wellbeing. The aim of the current study was to explore the motivational basis of recreational social dancing and develop a new psychometric instrument to assess dancing motivation. The sample comprised 447 salsa and/or ballroom dancers (68% female; mean age 32.8 years) who completed an online survey. Eight motivational factors were identified via exploratory factor analysis and comprise a new Dance Motivation Inventory: Fitness, Mood Enhancement, Intimacy, Socialising, Trance, Mastery, Self-confidence and Escapism. Mood Enhancement was the strongest motivational factor for both males and females, although motives differed according to gender. Dancing intensity was predicted by three motivational factors: Mood Enhancement, Socialising, and Escapism. The eight dimensions identified cover possible motives for social recreational dancing, and the DMI proved to be a suitable measurement tool to assess these motives. The explored motives such as Mood Enhancement, Socialising and Escapism appear to be similar to those identified in other forms of behaviour such as drinking alcohol, exercise, gambling, and gaming.

Maraz, A., Urbán, R., Griffiths, M.D. & Demetrovics Z. (2015). An empirical investigation of dance addiction. PloS ONE, 10(5): e0125988. doi:10.1371/journal.pone.0125988.

• Although recreational dancing is associated with increased physical and psychological well-being, little is known about the harmful effects of excessive dancing. The aim of the present study was to explore the psychopathological factors associated with dance addiction. The sample comprised 447 salsa and ballroom dancers (68% female, mean age: 32.8 years) who danced recreationally at least once a week. The Exercise Addiction Inventory (Terry, Szabo, & Griffiths, 2004) was adapted for dance (Dance Addiction Inventory, DAI). Motivation, general mental health (BSI-GSI, and Mental Health Continuum), borderline personality disorder, eating disorder symptoms, and dance motives were also assessed. Five latent classes were explored based on addiction symptoms with 11% of participants belonging to the most problematic class. DAI was positively associated with psychiatric distress, borderline personality and eating disorder symptoms. Hierarchical linear regression model indicated that Intensity (ß=0.22), borderline (ß=0.08), eating disorder (ß=0.11) symptoms, as well as Escapism (ß=0.47) and Mood Enhancement (ß=0.15) (as motivational factors) together explained 42% of DAI scores. Dance addiction as assessed with the Dance Addiction Inventory is associated with indicators of mild psychopathology and therefore warrants further research.

Greenhill, R. & Griffiths, M.D. (2015). Compassion, dominance/submission, and curled lips: A thematic analysis of dacryphilic experience. International Journal of Sexual Health, 27, 337-350.

• Objectives: Dacryphilia is a non-normative sexual interest that involves enjoyment or arousal from tears and crying, and to date has never been researched empirically. The present study set out to discover the different interests within dacryphilia and explore the range of dacryphilic experience. Methods: A set of online interviews were carried out with individuals with dacryphilic preferences and interests (six females and two males) from four countries. The data were analyzed for semantic and latent themes using thematic analysis. Results: The respondents’ statements focused attention on three distinct areas that may be relevant to the experience of dacryphilia: (i) compassion; (ii) dominance/submission; and (iii) curled-lips. The data provided detailed descriptions of features within all three interests, which are discussed in relation to previous quantitative and qualitative research within emotional crying and tears, and the general area of non-normative sexual interests. Conclusions: The study suggests new directions for potential research both within dacryphilia and with regard to other non-normative sexual interests.

Atroszko, P.A., Andreassen, C.S., Griffiths, M.D. & Pallesen, S. (2015). Study addiction – A new area of psychological study: Conceptualization, assessment, and preliminary empirical findings. Journal of Behavioral Addictions, 4, 75–84.

• Aims: Recent research has suggested that for some individuals, educational studying may become compulsive and excessive and lead to ‘study addiction’. The present study conceptualized and assessed study addiction within the framework of workaholism, defining it as compulsive over-involvement in studying that interferes with functioning in other domains and that is detrimental for individuals and/or their environment. Methods: The Bergen Study Addiction Scale (BStAS) was tested — reflecting seven core addiction symptoms (salience, mood modification, tolerance, withdrawal, conflict, relapse, and problems) — related to studying. The scale was administered via a cross-sectional survey distributed to Norwegian (n = 218) and Polish (n = 993) students with additional questions concerning demographic variables, study-related variables, health, and personality. Results: A one-factor solution had acceptable fit with the data in both samples and the scale demonstrated good reliability. Scores on BStAS converged with scores on learning engagement. Study addiction (BStAS) was significantly related to specific aspects of studying (longer learning time, lower academic performance), personality traits (higher neuroticism and conscientiousness, lower extroversion), and negative health-related factors (impaired general health, decreased quality of life and sleep quality, higher perceived stress). Conclusions: It is concluded that BStAS has good psychometric properties, making it a promising tool in the assessment of study addiction. Study addiction is related in predictable ways to personality and health variables, as predicted from contemporary workaholism theory and research.

Atroszko, P.A., Andreassen, C.S., Griffiths, M.D. & Pallesen, S. (2016). Study addiction: A cross-cultural longitudinal study examining temporal stability and predictors of its changes. Journal of Behavioral Addictions, 5, 357–362.

• Background and aims: ‘Study addiction’ has recently been conceptualized as a behavioral addiction and defined within the framework of work addiction.  Using a newly developed measure to assess this construct, the Bergen Study Addiction Scale (BStAS), the present study examined the one-year stability of study addiction and factors related to changes in this construct over time, and is the first longitudinal investigation of study addiction thus far. Methods: The BStAS and the Ten Item Personality Inventory (TIPI) were administered online together with questions concerning demographics and study-related variables in two waves. In Wave 1, a total of 2,559 students in Norway and 2,177 students in Poland participated. A year later, in Wave 2, 1,133 Norwegians and 794 Polish who were still students completed the survey. Results: The test-retest reliability coefficients for the BStAS revealed that the scores were relatively stable over time. In Norway scores on the BStAS were higher in Wave 2 than in Wave 1, while in Poland the reverse pattern was observed. Learning time outside classes at Wave 1 was positively related to escalation of study addiction symptoms over time in both samples. Being female and scoring higher on neuroticism were related to an increase in study addiction in the Norwegian sample only. Conclusion: Study addiction appears to be temporally stable, and the amount of learning time spent outside classes predicts changes in study addiction one year later.

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

Further reading

Greenhill, R. & Griffiths, M.D. (2014). The use of online asynchronous interviews in the study of paraphilias. SAGE Research Methods Cases. Located at: http://dx.doi.org/10.4135/978144627305013508526

Greenhill, R. & Griffiths, M.D. (2016). Sexual interest as performance, intellect and pathological dilemma: A critical discursive case study of dacryphilia. Psychology and Sexuality, 7, 265-278.

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

Griffiths, M.D. (1999). Dying for it: Autoerotic deaths. Bizarre, 24, 62-65.

Griffiths, M.D. (2001). Stumped! Amputee fetishes. Bizarre, 44, 70-74.

Griffiths, M.D. (2001). Heaven can wait: The psychology of near death experiences. Bizarre, December, 63-66.

Griffiths, M.D. (2012). The use of online methodologies in studying paraphilia: A review. Journal of Behavioral Addictions, 1, 143-150.

Griffiths, M.D. (2013). Bizarre sex. New Turn Magazine, 3, 49-51.

Griffiths, M.D. (2013). Eproctophilia in a young adult male: A case study. Archives of Sexual Behavior, 42, 1383-1386.

Career to the ground: A brief overview of our recent papers on workaholism

Following my recent blogs where I outlined some of the papers that my colleagues and I have published on mindfulness, Internet addiction, gaming addiction, sex addiction, responsible gambling, shopping addiction, exercise addiction, and youth gambling, here is a round-up of papers that my colleagues and I have published on workaholism and work addiction over the last few years.

Andreassen, C.S., Griffiths, M.D., Hetland, J. & Pallesen, S. (2012). Development of a Work Addiction Scale. Scandinavian Journal of Psychology, 53, 265-272.

• Research into excessive work has gained increasing attention over the last 20 years. Terms such as “workaholism,””work addiction” and “excessive work” have been used interchangeably. Given the increase in empirical research, this study presents the development of the Bergen Work Addiction Scale (BWAS), a new psychometrically validated scale for the assessment of work addiction. A pool of 14 items, with two reflecting each of seven core elements of addiction (i.e., salience, mood modification, tolerance, withdrawal, conflict, relapse, and problems) was initially constructed. The items were then administered to two samples, one recruited by a web survey following a television broadcast about workaholism (n=11,769) and one comprising participants in the second wave of a longitudinal internet-based survey about working life (n=368). The items with the highest corrected item-total correlation from within each of the seven addiction elements were retained in the final scale. The assumed one-factor solution of the refined seven-item scale was acceptable (root mean square error of approximation=0.077, Comparative Fit Index=0.96, Tucker-Lewis Index=0.95) and the internal reliability of the two samples were 0.84 and 0.80, respectively. The scores of the BWAS converged with scores on other workaholism scales, except for a Work Enjoyment subscale. A suggested cut-off for categorization of workaholics showed good discriminative ability in terms of working hours, leadership position, and subjective health complaints. It is concluded that the BWAS has good psychometric properties.

Andreassen, C.S., Griffiths, M.D., Hetland, J., Kravina, L., Jensen, F., & Pallesen, S. (2014). The prevalence of workaholism: A survey study in a nationally representative sample of Norwegian employees. PLoS ONE, 9(8): e102446. doi:10.1371/journal.pone.0102446.

• Workaholism has become an increasingly popular area for empirical study. However, most studies examining the prevalence of workaholism have used non-representative samples and measures with poorly defined cut-off scores. To overcome these methodological limitations, a nationally representative survey among employees in Norway (N = 1,124) was conducted. Questions relating to gender, age, marital status, caretaker responsibility for children, percentage of full-time equivalent, and educational level were asked. Workaholism was assessed by the use of a psychometrically validated instrument (i.e., Bergen Work Addiction Scale). Personality was assessed using the Mini-International Personality Item Pool. Results showed that the prevalence of workaholism was 8.3% (95% CI= 6.7–9.9%). An adjusted logistic regression analysis showed that workaholism was negatively related to age and positively related to the personality dimensions agreeableness, neuroticism, and intellect/imagination. Implications for these findings are discussed.

Quinones, C. & Griffiths, M.D. (2015). Addiction to work: recommendations for assessment. Journal of Psychosocial Nursing and Mental Health Services, 10, 48-59.

• Workaholism was first conceptualized in the early 1970s as a behavioral addiction, featuring compulsive use and interpersonal conflict. The current article briefly examines the empirical and theoretical literature over the past four decades. In relation to conceptualization and measurement, how the concept of workaholism has worsened from using dimensions based on anecdotal evidence, ad-hoc measures with weak theoretical foundation, and poor factorial validity of multidimensional conceptualizations is highlighted. Benefits of building on the addiction literature to conceptualize workaholism are presented (including the only instrument that has used core addiction criteria: the Bergen Work Addiction Scale). Problems estimating accurate prevalence estimates of work addiction are also presented. Individual and sociocultural risk factors, and the negative consequences of workaholism from the addiction perspective (e.g., depression, burnout, poor health, life dissatisfaction, family/relationship problems) are discussed. The current article summarizes how current research can be used to evaluate workaholism by psychiatric–mental health nurses in clinical practice, including primary care and mental health settings.

Karanika-Murray, M., Pontes, H.M., Griffiths, M.D. & Biron, C. (2015). Sickness presenteeism determines job satisfaction via affective-motivational states. Social Science and Medicine, 139, 100-106.

• Introduction: Research on the consequences of sickness presenteeism, or the phenomenon of attending work whilst ill, has focused predominantly on identifying its economic, health, and absenteeism outcomes, in the process neglecting important attitudinal-motivational outcomes. Purpose: A mediation model of sickness presenteeism as a determinant of job satisfaction via affective-motivational states (specifically engagement with work and addiction to work) is proposed. This model adds to the current literature, by focussing on (i) job satisfaction as an outcome of presenteeism, and (ii) the psychological processes associated with this. It posits sickness presenteeism as psychological absence and work engagement and work addiction as motivational states that originate in that. Methods: An online survey on sickness presenteeism, work engagement, work addiction, and job satisfaction was completed by 158 office workers. Results: The results of bootstrapped mediation analysis with observable variables supported the model. Sickness presenteeism was negatively associated with job satisfaction. This relationship was fully mediated by both engagement with work and addiction to work, explaining a total of 48.07% of the variance in job satisfaction. Despite the small sample, the data provide preliminary support for the model. Conclusions: Given that there is currently no available research on the attitudinal consequences of sickness presenteeism, these findings offer promise for advancing theorising in this area.

Quinones, C., Griffiths, M.D. & Kakabadse, N. (2016). Compulsive Internet use and workaholism: An exploratory two-wave longitudinal study. Computers in Human Behavior, 60, 492-499.

• Workaholism refers to the uncontrollable need to work and comprises working compulsively (WC) and working excessively (WE). Compulsive Internet Use (CIU), involves a similar behavioural pattern although in specific relation to Internet use. Since many occupations rely upon use of the Internet, and the lines between home and the workplace have become increasingly blurred, a self-reinforcing pattern of workaholism and CIU could develop from those vulnerable to one or the other. The present study explored the relationship between these compulsive behaviours utilizing a two-wave longitudinal study over six months. A total of 244 participants who used the Internet as part of their occupational role and were in full-time employment completed the online survey at each wave. This survey contained previously validated measures of each variable. Data were analysed using cross-lagged analysis. Results indicated that Internet usage and CIU were reciprocally related, supporting the existence of tolerance in CIU. It was also found that CIU at Time 1 predicted WC at Time 2 and that WE was unrelated to CIU. It is concluded that a masking mechanism appears a sensible explanation for the findings. Although further studies are needed, these findings encourage a more holistic evaluation and treatment of compulsive behaviours.

Orosz, G., Dombi, E., Andreassen, C.S., Griffiths, M.D. & Demetrovics, Z. (2016). Analyzing models of work addiction: Single factor and bi-factor models of the Bergen Work Addiction Scale. International Journal of Mental Health and Addiction, in press.

• Work addiction (‘workaholism’) has become an increasingly studied topic in the behavioral addictions literature and had led to the development of a number of instruments to assess it. One such instrument is the Bergen Work Addiction Scale (BWAS). However, the BWAS has never been investigated in Eastern-European countries. The goal of the present study was to examine the factor structure, the reliability and cut-off scores of the BWAS in a comprehensive Hungarian sample. This study is a direct extension of the original validation of BWAS by providing results on the basis of representative data and the development of appropriate cut-off scores. The study utilized an online questionnaire with a Hungarian representative sample including 500 respondents (F = 251; Mage = 35.05 years) who completed the BWAS. A series of confirmatory factor analyses were carried out leading to a short, 7-item first-order factor structure and a longer 14-item seven-factor nested structure. Despite the good validity of the longer version, its reliability was not as high as it could have been. One-fifth (20.6 %) of the Hungarians who used the internet at least weekly were categorized as work addicts using the BWAS. It is recommended that researchers use the original seven items from the Norwegian scale in order to facilitate and stimulate cross-national research on addiction to work.

Andreassen, C.S., Griffiths, M.D., Sinha, R., Hetland, J. & Pallesen, S. (2016). The relationships between workaholism and symptoms of psychiatric disorders: A large-scale cross-sectional study. PLoS ONE, 11(5): e0152978. doi:10.1371/journal. pone.0152978.

• Despite the many number of workaholism studies, large-scale studies have been lacking. The present study utilized an open web-based cross-sectional survey assessing symptoms of psychiatric disorders and workaholism among 16,426 workers (M_age=37.3 years, SD₌11.4, range=16-75 years). Participants were administered the Adult ADHD Self-Report Scale, the Obsession-Compulsive Inventory-Revised, the Hospital Anxiety and Depression Scale, and the Bergen Work Addiction Scale, along with additional questions examining demographic and work-related variables. Analyses of variance revealed significant workaholism group differences in terms of age, marital status, education, professional position, work sector, occupation, and annual income. No gender differences were found, except in a logistic regression analysis, indicating that women had a greater risk than men of being categorized as workaholics. Correlations between all psychiatric symptoms and workaholism were significant and positively correlated. Workaholism comprised the dependent variable in a four-step linear multiple hierarchical regression analysis as well as in a logistic regression analysis. In the linear regression analysis demographics (age, gender, and marital status) explained 0.8% of the variance in workaholism. The mental health variables (ADHD, OCD, anxiety, and depression) explained between 1.9% and 11.9% of the variance. In an adjusted logistic regression analysis, all psychiatric symptoms were positively associated with workaholism. Although most effect sizes were relatively small, the study’s findings expand our understanding of possible mental health predictors of workaholism, and sheds new light on the reality of adult ADHD in work life. The study’s implications, strengths, and shortcomings are also discussed.

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

Further reading

Griffiths, M.D. (2005). Workaholism is still a useful construct Addiction Research and Theory, 13, 97-100.

Griffiths, M.D. (2011). Workaholism: A 21^st century addiction. The Psychologist: Bulletin of the British Psychological Society, 24, 740-744.

Griffiths, M.D. & Karanika-Murray, M. (2012). Contextualising over-engagement in work: Towards a more global understanding of workaholism as an addiction. Journal of Behavioral Addictions, 1(3), 87-95.

Karanika-Murray, M., Duncan, N., Pontes, H. & Griffiths, M.D. (2015). Organizational identification, work engagement, and job satisfaction. Journal of Managerial Psychology, 30, 1019-1033.

Shonin, E., Van Gordon, W., & Griffiths M.D. (2014). The treatment of workaholism with Meditation Awareness Training: A case study. Explore: Journal of Science and Healing, 10, 193-195.

Occupational hazards: The relationship between workaholism, ADHD, and psychiatric disorders

A few weeks ago, my colleagues and I received a lot of media coverage around the world for our latest study on workaholism that was published in the journal PLoS ONE. The study involved researchers from the University of Bergen (Norway) and Yale University USA) and is probably the largest ever study done on the topic as it included 16,426 working Norwegian adults. Our study got a lot of press attention because we examined the associations between workaholism and a number of different psychiatric disorders.

We found that workaholics scored higher on all the psychiatric symptoms than non-workaholics. For instance we found that among those we classed as workaholics (using the Bergen Work Addiction Scale that we published in the Scandinavian Journal of Psychology four years ago and which I talked about in a previous blog), we found that:

• 32.7% met ADHD (attention-deficit/hyperactivity disorder) criteria (12.7 per cent among non-workaholics).
• 25.6% met OCD (obsessive-compulsive disorder) criteria (8.7 per cent among non-workaholics).
• 33.8% met anxiety criteria (11.9 per cent among non-workaholics).
• 8.9% met depression criteria (2.6 per cent among non-workaholics).

These were all statistically significant differences between workaholics and non-workaholics.

I think a lot of people wondered why we looked at the relationship between workaholism and ADHD to begin with. Firstly, research has consistently demonstrated that Attention-Deficit/Hyperactivity Disorder (ADHD) increases the risk of various chemical and non-chemical addictions. ADHD is prevalent in 2.5–5% of the adult population, and is typically manifested by inattentiveness and lack of focus, and/or impulsivity, and excessive physical activity. Individuals with ADHD may often stop working due to their disorder, and may have trouble in getting work health insurance as they are regarded as a risk group. For this reason, we thought that individuals with ADHD may compensate for this by over-working to meet the expectations required to hold down a job. Although this is a contentious issue, there are a number of reasons why ADHD may be relevant to workaholism.

Firstly, we argued that the inattentive nature of individuals with ADHD causes them to spend time beyond the typical working day (i.e., evenings and weekends) to accomplish what is done by their fellow employees within normal working hours (i.e., the compensation hypothesis). In addition, as they may have a hard time concentrating while at work due to environmental noise and distractions (especially office work in open landscape environments), they might find it easier to work after co-workers have left their working environment or work from home. Their attentive shortcomings may also cause them to overly check for errors on the tasks given, since they often experience careless mistakes due to their inattentiveness. This may cause a cycle of procrastination, work binges, exhaustion, and – in some cases – a fear of imperfection. Although ADHD is associated with lack of focus, such individuals often have the ability to hyper-focus once they find something interesting–often being unable to detach themselves from the task.

Secondly, we argued that the impulsive nature of individuals with ADHD causes them to say ‘yes’ and taking on many tasks without them thinking ahead, and taking on more work than they can realistically handle–eventually leading to workaholic levels of activity. Thirdly, we also argued that the hyperactive nature of individuals with ADHD and the need to be constantly active without being able to relax, causes such individuals to keep on working in an attempt to alleviate their restless thoughts and behaviors. Consequently, work stress might act as a stimulant, and they may choose active (and often multiple) jobs with high pressure, deadlines and activity (e.g., media, sales, restaurant work) – where they have the opportunity to multitask and constantly shift between tasks (e.g., Type-A personality behavior).

In line with this, Type-A personality has often been associated – and sometimes used inter-changeably – with workaholism in previous research. This line of reasoning also relates to the workaholic type portrayed by Dr. Bryan Robinson (in his 2014 book Chained to the desk: A guidebook for workaholics, their partners and children, and the clinicians who treat them), in which he actually denoted “attention-deficit workaholics” (who tend to start many projects but become bored easily and need to be stimulated at all times). His description of the “relentless” type also corresponds well with ADHD symptoms (i.e., unstoppable in working fast and meeting deadlines, often with many projects going on simultaneously). In other words, these types may utilize work pressure to obtain focus, constantly seeking stimulation, crisis, and excitement – and therefore like risky jobs.

Finally, people with ADHD are often mistaken as being lazy, irresponsible, or unintelligent because of their difficulties with planning, time management, organizing, and decision-making. Feeling misunderstood might cause individuals with ADHD to push themselves to prove these misconceptions as wrong – and resulting in an excessive and/or compulsive working pattern. Such individuals are often intelligent, but may feel forced or motivated to start up their own business (i.e., entrepreneurs), as they find it troubling to adjust to standard work schedules or organizational boundaries. Previous research has highlighted that workaholism is prevalent among entrepreneurs and the self-employed. Often failing in other aspects of life (e.g., family), work for such individuals may become even more important to them (e.g., self- efficacy). This is why we hypothesized that ADHD symptoms will be positively associated with workaholism in our study (and that is what we found).

Obsessive-Compulsive Disorder (OCD) is another underlying psychiatric disorder that increases the likelihood of developing an addiction. Full-blown OCD occurs in approximately 2-3% of children and adults, and is commonly manifested by intrusive thoughts and repetitive behaviors of checking, obsessing, ordering, hoarding, washing, and/or neutralizing. It has been suggested that addictive behaviors might represent a coping and/or escape mechanism of OCD symptoms, or as an OCD-behavior that eventually becomes an addiction in itself. Previous workaholic typologies such as those described by Dr. Kimberly Scotti and her colleagues in the journal Human Relations have incorporated the ‘compulsive-dependent’ and ‘perfectionistic’ workaholic types, and some empirical studies have demonstrated that obsessive-compulsive traits are present among workaholics. The OCD tendency of having the need to arrange things in a certain way (i.e., a strong need for control) and obsessing over details to the point of paralysis – may predispose workers with such traits to develop workaholic working patterns. Again we found in our study that OCD symptoms were positively related to workaholism.

It has also been reported that other psychiatric disorders such as anxiety and depression may also increase the risk of developing an addiction. Approximately 30% of people will suffer from an anxiety disorder in their lifetime, and 20% will have at least one episode of depression. These conditions often occur simultaneously, as most people who are depressed also experience acute anxiety. Consequently, anxiety and/or depression can lead to addiction, and vice versa. A number of studies have previously reported a link between anxiety, depression, and workaholism. Furthermore, we know that workaholism (in some instances) develops as an attempt to reduce uncomfortable feelings of anxiety and depression. Working hard is praised and honored in modern society, and thus serves as a legitimate behavior for individuals to combat or alleviate negative feelings – and to feel better about themselves and raise their self-esteem. This is why we hypothesized that there would be a positive association between anxiety, depression, and workaholism (and that is what we found). In relation to our study’s findings as a whole, the lead author of our study (Dr. Cecilie Andreassen) told the world’s media:

“Taking work to the extreme may be a sign of deeper psychological or emotional issues. Whether this reflects overlapping genetic vulnerabilities, disorders leading to workaholism or, conversely, workaholism causing such disorders, remain uncertain…Physicians should not take for granted that a seemingly successful workaholic does not have ADHD-related or other clinical features. Their considerations affect both the identification and treatment of these disorders”.

Our findings clearly highlighted the importance of further investigating neurobiological differences related to workaholic behaviour. Finally, in line with our previous research published two years ago (also in the PLoS ONE journal) using a nationally representative sample, 7.8% of the participants in our latest study were classed as workaholics compared to 8.3% in our previous study.

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

Further reading

Andreassen, C.S., Griffiths, M.D., Hetland, J., Kravina, L., Jensen, F., & Pallesen, S. (2014). The prevalence of workaholism: A survey study in a nationally representative sample of Norwegian employees. PLoS ONE, 9(8): e102446. doi:10.1371/journal.pone.0102446.

Andreassen, C.S., Griffiths, M.D., Hetland, J. & Pallesen, S. (2012). Development of a Work Addiction Scale. Scandinavian Journal of Psychology, 53, 265-272.

Andreassen, C.S., Griffiths, M.D., Sinha, R., Hetland, J. & Pallesen, S. (2016). The relationships between workaholism and symptoms of psychiatric disorders: A large-scale cross-sectional study. PLoS ONE, 11(5): e0152978. doi:10.1371/journal. pone.0152978.

Griffiths, M.D. (2005). Workaholism is still a useful construct. Addiction Research and Theory, 13, 97-100.

Griffiths, M.D. (2011). Workaholism: A 21st century addiction. The Psychologist: Bulletin of the British Psychological Society, 24, 740-744.

Griffiths, M.D. & Karanika-Murray, M. (2012). Contextualising over-engagement in work: Towards a more global understanding of workaholism as an addiction. Journal of Behavioral Addictions, 1(3), 87-95.

Karanika-Murray, M., Duncan, N., Pontes, H. & Griffiths, M.D. (2015). Organizational identification, work engagement, and job satisfaction. Journal of Managerial Psychology, 30, 1019-1033.

Karanika-Murray, M., Pontes, H.M., Griffiths, M.D. & Biron, C. (2015). Sickness presenteeism determines job satisfaction via affective-motivational states. Social Science and Medicine, 139, 100-106.

Orosz, G., Dombi, E., Andreassen, C.S., Griffiths, M.D. & Demetrovics, Z. (2016). Analyzing models of work addiction: Single factor and bi-factor models of the Bergen Work Addiction Scale. International Journal of Mental Health and Addiction, in press

Quinones, C. & Griffiths, M.D. (2015). Addiction to work: recommendations for assessment. Journal of Psychosocial Nursing and Mental Health Services, 10, 48-59.

Quinones, C., Griffiths, M.D. & Kakabadse, N. (2016). Compulsive Internet use and workaholism: An exploratory two-wave longitudinal study. Computers in Human Behavior, 60, 492-499.

Robinson, B.E. (2014). Chained to the desk: A guidebook for workaholics, their partners and children, and the clinicians who treat them. New York: New York University Press.

Scotti, K.A., Moore, K.S., & Miceli, M.P. (1997). An exploration of the meaning and consequences of workaholism. Human Relations, 50, 287–314.

Shonin, E., Van Gordon, W., & Griffiths M.D. (2014). The treatment of workaholism with Meditation Awareness Training: A case study. Explore: Journal of Science and Healing, 10, 193-195.

Sussman, S., Lisha, N. & Griffiths, M.D. (2011). Prevalence of the addictions: A problem of the majority or the minority? Evaluation and the Health Professions, 34, 3-56.

Career ache: Is workaholism a genuine addiction?

Please note: The following article is an extended version of an article that was recently published on Rehabs.com

The term ‘workaholism’ has been around over 40 years since the publication of Wayne Oates’ book Confessions of a Workaholic in 1971. Despite increasing research into workaholism, there is still no single definition or conceptualization of this phenomenon. In my own research into the topic, I claimed that the definitions used by other researchers didn’t really conceptualise workaholism as an addiction or if they did conceptualise it as an addiction, the criteria were different to those used when examining other behavioral addictions such as gambling addiction, Internet addiction, sex addiction, exercise addiction, and video game addiction.

Some people view workaholics as hyper-performers whereas others view workaholics as unhappy and obsessive individuals who do not perform well in their jobs. Others claim workaholism arises when a person prefers to work as a way of stopping the person thinking about their emotional and personal lives and/or are over concerned with their work and neglect other areas of their lives. Various researchers differentiate between positive and negative forms of workaholism. For instance, some view workaholism as both a negative and complex process that eventually affects the person’s ability to function properly. Others highlight the workaholics who are totally achievement oriented and have perfectionist and compulsive-dependent traits.

The most widely employed empirical approach to workaholism proposes three underlying dimensions: (i) work involvement, (ii) drive, and (iii) work enjoyment. Researchers have claimed that workaholism can be deadly and dangerous with an onset (e.g., busyness), a progression (e.g., loss of productivity, relationship breakdowns, etc.), and a conclusion (e.g., hospitalization or death from a heart attack). Psychological research has also shown links between workaholism and personality types including those with Type A Behavior Patterns (i.e., competitive, achievement-oriented individuals) and those with obsessive-compulsive traits. The condition is generally characterized by the number of hours spent on work, and the inability to detach psychologically from work.

Reliable statistics on the prevalence of workaholism are hard to come by although a review that I published with some colleagues in 2011 based on all published studies up to that point estimated a prevalence rate of about 10% in most countries that had carried out empirical studies. Whether or not workaholism is a bona fide addiction all depends on the operational definition that is used. In one of my papers, I argued the only way of determining whether non-chemical (i.e., behavioral) addictions (such as workaholism) are addictive in a non-metaphorical sense is to compare them against clinical criteria for other established drug-ingested addictions. However, most people researching in the field have failed to do this. I operationally define addictive behavior as any behavior that features what I believe are the six core components of addiction (i.e., salience, mood modification, tolerance, withdrawal symptoms, conflict and relapse). Any behavior (e.g., work) that fulfils these six criteria would be operationally defined as an addiction. In relation to workaholism, the six components would be:

• Salience – This occurs when work becomes the single most important activity in the person’s life and dominates their thinking (preoccupations and cognitive distortions), feelings (cravings) and behavior (deterioration of socialized behavior). For instance, even if the person is not actually working they will be constantly thinking about the next time that they will be (i.e., a total preoccupation with work).
• Mood modification – This refers to the subjective experiences that people report as a consequence of working 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 work are required to achieve the former mood modifying effects. This basically means that for someone engaged in work, they gradually build up the amount of the time they spend working 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 work because they are ill, on holiday, 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 working.
• Relapse – This is the tendency for repeated reversions to earlier patterns of excessive work to recur and for even the most extreme patterns typical of the height of excessive working to be quickly restored after periods of control.

Using these components, I and some of my Norwegian colleagues at the University of Bergen developed a new ‘work addiction scale’. We believe the scale may add value to work addiction research and practice, particularly when it comes to facilitating treatment and estimating prevalence of work addiction in the general population worldwide. The scale has been psychometrically validated and comprises seven simple questions (see end of article). We recently used this scale on a nationally representative Norwegian sample and found that 8% of our participants were addicted to work using this new instrument.

It’s also worth noting that some academics view workaholism as much a ‘system addiction’ as an individual one. Although the manifestations of workaholism are at the level of the individual, workaholic behavior is socially acceptable and even encouraged by major organizations. For employees, an organization can provide the structure and/or the mechanisms and dynamics for both the addictive substance (e.g., adrenalin) and/or the process (i.e., work itself).

Addictions always result from an interaction and interplay between many factors including the person’s biological and/or genetic predisposition, their psychological constitution (e.g. personality factors, unconscious motivations, attitudes, expectations, beliefs, etc.), their social environment (i.e. situational characteristics) and the nature of the activity itself (i.e. structural characteristics). This could be described as a ‘global model’ of addiction that goes beyond an individual biopsychosocial approach. Each of these three general sets of influences (i.e. individual, structural and situational) can be subdivided much further depending on the type of addiction, and can also be applied to workaholism.

For instance, the structural characteristics of work can include such things as the type of work (e.g., manual or non-manual; proactive or reactive; stimulating or non-stimulating), the familiarity of the work (e.g., novel or repetitive), number of hours per day or week spent doing the work, the flexibility of how the work fits into the daily and/or weekly routine of the worker, and direct and/or indirect financial rewards (e.g., amount of salary, medical insurance, pension, bonus payments, etc.). There are also the individual and idiosyncratic rewards of the job. The situational characteristics of work can include the organization’s work ethos and policies, the relationship dynamics between co-workers (e.g., the amount of collegiality between the workers and their line managers and/or fellow colleagues), social facilitation effects (i.e., working alone or working with others), the esthetics of the work environment (e.g., lighting, décor, colour in workspace), and the physical comfort and surroundings of workspaces (e.g., ‘heating, seating and eating’ facilities). The situational and cultural infrastructure of the workplace setting may therefore contribute and facilitate excessive working that in some individuals may lead to a genuine addiction.

It would appear that the integration of the three sets of characteristics (individual, situational and structural) combine to produce a variety of reinforcers such as financial rewards, social rewards, physiological rewards, and psychological rewards. One or more of these has the potential to induce addictive behavior as the basis of all addictive behavior is habitual reward and reinforcement. It is very clear that many contemporary research paradigms are insular and inadequate in explaining addiction to work.

Workaholism is a multifaceted behavior that is strongly influenced by contextual and structural factors that cannot be encompassed by any single theoretical perspective. These factors include variations in behavioral work involvement and motivation across different demographic groups, structural characteristics of work activities, and the developmental or temporal nature of addictive work behavior. Therefore, research into, and clinical interventions for workaholism, are best served by a biopsychosocial approach. More specifically, addictions (including workaholism) do not occur in a vacuum and successful interventions for workaholics have to take into account not just biological and/or genetic predispostions, psychological constitution (including attitudes, expectations and personality factors), and psychosocial factors, but also the social environment of where the work takes place, and the inherent structurally rewarding properties of work itself.

The Bergen Work Addiction Scale (BWAS)

The BWAS uses just seven basic criteria to identify work addiction, where all items are scored on the following scale: (1)=Never, (2)=Rarely, (3)=Sometimes, (4)=Often, and (5)=Always. The seven items are:

– You think of how you can free up more time to work
– You spend much more time working than initially intended
– You work in order to reduce feelings of guilt, anxiety, helplessness and depression
– You have been told by others to cut down on work without listening to them
– You become stressed if you are prohibited from working
– You deprioritise hobbies, leisure activities, and exercise because of your work
– You work so much that it has negatively influenced your health

If you respond ‘often’ or ‘always’ on at least four of the seven items it may be indicative of being a workaholic. Although there are other ‘workaholism’ scales that have been developed, this is the first scale to use core concepts of addiction found in other more traditional addictions.

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

Further reading

Andreassen, C.S., Griffiths, M.D., Hetland, J. & Pallesen, S. (2012). Development of a Work Addiction Scale. Scandinavian Journal of Psychology, 53, 265-272.

Griffiths, M.D. (2005). Workaholism is still a useful construct. Addiction Research and Theory, 13, 97-100.

Griffiths, M.D. (2011). Workaholism: A 21^st century addiction. The Psychologist: Bulletin of the British Psychological Society, 24, 740-744.

Matuska, K.M. (2010). Workaholism, life balance, and well-being: A comparative analysis. Journal of Occupational Science, 17, 104-111.

Schaufeli, W.B., Taris, T.W., & Bakker, A.B. (2006). Doctor Jekyll or Mr Hyde? On the differences between work engagement and workaholism. In R. Burke (Ed.), Workaholism and long working hours (pp. 193-217). Cheltenham: Edward Elgar.

Sussman, S., Lisha, N. & Griffiths, M.D. (2011). Prevalence of the addictions: A problem of the majority or the minority? Evaluation and the Health Professions, 34, 3-56.

van Beek, I., T.W., Taris, & Schaufeli, W.B. (2011). Workaholic and work engaged employees: Dead ringers or worlds apart? Journal of Occupational Health Psychology, 16, 468-482.

Job rule: The development of a new scale for workaholism

In a previous blog, I examined the concept of workaholism. Yesterday, a paper that I co-wrote with some of my research colleagues from the University of Bergen (Norway) – and led by Dr. Cecilie Andreasson –  featured in a lot of the national newspapers including the Daily Telegraph, Daily Mail, The Guardian, China Daily and USA Today.

In a nutshell, our new paper presents a new instrument to assess ‘work addiction’ and is based on core elements of addiction outlined in my very first blog and which are recognised as key diagnostic criteria for addictions. In the press release of our study, Dr Andreassen noted in the wake of globalisation, new technology and blurred boundaries between work and private life, we are witnessing an increase in work addiction. A number of studies show that work addiction has been associated with insomnia, health problems, burnout and stress, as well as creating conflict between work and family life.

To date, a few measures of workaholism have been developed. The first quantitative measure of work addiction or workaholism was the Work Addiction Risk Test (WART), developed in 1989 by Dr. Bryan Robinson. Items were based on symptoms reported by clinicians working with both clients and families experiencing work addiction problems. Several studies by Robinson and his colleagues have attested to the psychometric properties of the WART. The total composite scores of the WART have been shown to be positively associated with scores on measures of anxiety and Type A behaviour.

The WART comprises 25 items, all rated on a 4-point scale ranging from 1 (never true) to 4 (always true). Initially, the 25 items appeared to be distributed between five factors/subscales: (i) compulsive tendencies; (ii) control; (iii) impaired communication/self-absorption; (iv) inability to delegate; and (v) self-worth. However, further investigation revealed that only 15 items, distributed across the three initial factors, were useful for correctly discriminating between workaholics and a control group. The authors concluded that the Compulsive Tendencies subscale was the most important in making this distinction, and suggested using the revised scale in future studies. However, the WART has been criticized for overlapping little with more contemporary and widely accepted views on workaholism.

In 1992, Dr. Janet Spence developed the most frequently used measure of workaholism (i.e., the Workaholism Battery; Work-BAT). They argued that the typical workaholic is heavily involved in work, feels motivated to work by an inner drive, and has low enjoyment of work. In line with these ideas, they created three self-report scales assessing (i) work involvement; (ii) drive; and (iii) enjoyment of work. Potential items were first administered to students. Items showing poor psychometric properties were dropped or rewritten before the scale was administered to an adult sample. The WorkBAT comprises 25 items answered on a 5-point scale ranging from ‘‘strongly disagree’’ to ‘‘strongly agree’’. Although the WorkBAT is currently the most used measure of Workaholism, the Work Involvement subscale has in several studies failed to display appropriate psychometric properties. The concept of the ‘Enjoyment of Work’ subscale has been criticized by many researchers because it is not regarded as defining the characteristics of workaholism.

In 2009, Dr. Wilmar Schaufeli and colleagues developed a new workaholism scale. From a theoretical perspective, they argued that workaholics typically spend a great deal of time on work activities, and that additionally they are obsessed with their work. On this basis, they constructed the Dutch Workaholism Scale (DUWAS). The scale reflected these two dimensions, using five items from the Compulsive Tendencies Scale of the WART that they renamed Working Excessively, and five items from the Drive scale of the WorkBAT, which were denoted as Working Compulsively. The DUWAS has shown good psychometric properties in several studies

However, we argued that because the concept of workaholism stems from the field of addiction, measures of workaholism or work addiction should be expected to be closely linked to the core elements of addictions. When reviewing the construction processes of the three workaholism instruments outlined above, few of them have specifically been developed with the addiction perspective in mind and could be argued to lack face validity.

Our new scale – The Bergen Work Addiction Scale (BWAS) – was published this week in the Scandinavian Journal of Psychology. By using our scale, anyone can find out their degree of work addiction: non-addicted, mildly addicted or workaholic. More than 12,000 Norwegian employees from 25 different industries participated in the development of the scale. The scale was administrated to two cross-occupational samples and reflects the seven core elements of addiction: salience, mood modification, tolerance, withdrawal, conflict, relapse, and problems. The results of our study showed that the scale as reliably differentiating between workaholics and non-workaholics.

We believe the scale may add value to work addiction research and practice, particularly when it comes to facilitating treatment and estimating prevalence of work addiction in the general population worldwide. It uses just seven basic criteria to identify work addiction, where all items are scored on the following scale: (1)=Never, (2)=Rarely, (3)=Sometimes, (4)=Often, and (5)=Always. The seven items are:

• You think of how you can free up more time to work
• You spend much more time working than initially intended
• You work in order to reduce feelings of guilt, anxiety, helplessness and depression
• You have been told by others to cut down on work without listening to them
• You become stressed if you are prohibited from working
• You deprioritise hobbies, leisure activities, and exercise because of your work
• You work so much that it has negatively influenced your health

If you respond ‘often’ or ‘always’ on at least four of the seven items it may be indicative of being a workaholic. Although there are other ‘workaholism’ scales that have been developed, this is the first scale to use core concepts of addiction found in other more traditional addictions.

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

Further reading

Andreassen, C.S., Griffiths, M.D., Hetland, J. & Pallesen, S. (2012). Development of a Work Addiction Scale. Scandinavian Journal of Psychology, DOI: 10.1111/j.1467-9450.2012.00947.x.

Griffiths, M.D. (2005). Workaholism is still a useful construct. Addiction Research and Theory, 13, 97-100.

Griffiths, M.D. (2011). Workaholism: A 21^st century addiction. The Psychologist: Bulletin of the British Psychological Society, 24, 740-744.

Matuska, K.M. (2010). Workaholism, life balance, and well-being: A comparative analysis. Journal of Occupational Science, 17, 104-111.

Schaufeli, W.B., Shimazu, A. & Taris, T. W. (2009). Being driven to work excessively hard. The evaluation of a two-factor measure of workaholism in the Netherlands and Japan. Cross-Cultural Research, 43, 320–348

Schaufeli, W.B., Taris, T.W., & Bakker, A.B. (2006). Doctor Jekyll or Mr Hyde? On the differences between work engagement and workaholism. In R. Burke (Ed.), Workaholism and long working hours (pp. 193-217). Cheltenham: Edward Elgar.

Spence, J. T. & Robbins, A. S. (1992). Workaholism – definition, mea- surement, and preliminary results. Journal of Personality Assessment, 58, 160-178.

Sussman, S., Lisha, N. & Griffiths, M.D. (2011). Prevalence of the addictions: A problem of the majority or the minority? Evaluation and the Health Professions, 34, 3-56.

van Beek, I., T.W., Taris, & Schaufeli, W.B. (2011). Workaholic and work engaged employees: Dead ringers or worlds apart? Journal of Occupational Health Psychology, 16, 468-482.