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The Development of the Problematic Series Watching Scale (PSWS)

Author(s): Gábor Orosz,Beáta Böthe / Language(s): English Issue: 1/2016

The goal of the present study was to create a short Problematic Series Watching Scale (PSWS). Methods: On the basis of the six components model of Griffiths (2005), six items were identified covering all components of problematic series watching. Confirmatory factor analyses were carried out on two independent samples (N1 = 366, N2 = 752). Results: The PSWS has appropriate factor structure and reliability. The amount of free time was not, but the series watching time was associated with PSWS scores. Women had higher scores than men. Discussion: Before PSWS, no prior scale has been created to measure problematic series watching. Further research is needed to properly assess its validity and reliability; and for examining whether extensive series watching can lead to health-related and psychosocial problems. Conclusions: In the increasingly digitalized world there are many motivational forces which encourage people watching online series. In the light of these changes, research on problematic series watching will be progressively relevant.

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Muscle Dysmorphia: Could it be Classified as an Addiction to Body Image?

Author(s): Andrew C. Foster,Gillian W. Shorter,Mark D. Griffiths / Language(s): English Issue: 1/2015

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.

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Commentary on: Muscle dysmorphia: Could it be classified as an addiction to body image?

Author(s): Johanna E. Nieuwoudt / Language(s): English Issue: 1/2015

The article titled ‘Muscle dysmorphia: Could it be classified as an addiction to body image?’ used Griffiths (2005) addiction components model as the framework in which to define muscle dysmorphia (MD) as an addiction. The authors (Foster, Shorter & Griffiths, 2014) proposed that MD could be re-classified as an addiction to body image. Method and aim: In response to the original article, the author of this commentary reflected on the ‘Addiction to body image’ model and the components of addiction as described in the context of MD. This invited commentary aimed to provide opposing viewpoints in order to give a balanced overview on the topic. Results: It appears as if the components of addictions can be used as a framework in which to define MD. However, systematic empirical evidence had not been provided for the withdrawal symptoms associated with this behavioral addiction. An opposing viewpoint is provided in response to Foster et al.’s (2014) statement that MD is different from other body dysmorphic disorders in regards to cognitive dysfunction, and therefore cannot be explained in the same way. Conclusions: Based on the little systematic empirical evidence to date, it may be a bit premature to re-classify MD as an addiction to body image.

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Commentary on muscle dysmorphia as an addiction: A response to Grant (2015) and Nieuwoudt (2015)

Author(s): Mark D. Griffiths,Andrew C. Foster,Gillian W. Shorter / Language(s): English Issue: 1/2015

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.

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Sexual compulsion – Relationship with sex, attachment and sexual orientation

Author(s): Aviv Weinstein,Lichen Katz,Hila Eberhardt,Koby Cohen,Michel Lejoyeux / Language(s): English Issue: 1/2015

Sexual addiction, also known as hypersexual disorder, is associated with serious psychosocial problems for many people. Methods: This study used questionnaires to investigate the effects of gender, sexual orientation and attachment (avoidance and anxiety) on sexual compulsion among 100 heterosexual and homosexual men and women. Results: Apositive correlation was found between anxious attachment and sexual compulsivity (r = 0.46; p < 0.01) and a positive correlation between avoidant attachment and sexual compulsivity (r = 0.39; p £ 0.01) in all participants. Secondly, an analysis of covariance showed a gender by sexual orientation interaction effect [F(1, 103) = 6.39, p < 0.01] but no attachment effect on sexual compulsivity. A follow-up comparison showed that lesbian women had higher rates of sexual compulsivity than heterosexual women [t(2, 50) = 5.08, p < 0.001] whereas there was non-significant difference in sexual compulsivity between homosexual and heterosexual men [t(2, 50) = 1.30, p = N.S.]. Discussion: The results provide preliminary evidence for an association between attachment and sexual compulsivity and the effects of gender and sexual orientation on sexual compulsivity.

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Book Reviews

Author(s): Attila Körmendi,Csilla Ágoston / Language(s): English Issue: 1/2015

The reviews of: -“Mindfulness-based sobriety: A clinician’s treatment guide for addiction recovery using relapse prevention therapy, acceptance and commitment therapy, and motivational interviewing” by N. Turner, P. Welches and S. Conti; New Harbinger, Oakland, 2013, 256 pp. ISBN 978-1-60882-853-1 -“Internet Gambling: Current Research Findings and Implications” by S. Gainsbury; Springer, New York, 2012, 151 pp. ISBN 978-1-4614-3390-3

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Study Addiction – A New Area of Psychological Study: Conceptualization, Assessment, and Preliminary Empirical Findings

Author(s): Paweł Atroszko,Cecilie Schou Andreassen,Mark D. Griffiths,Ståle Pallesen / Language(s): English Issue: 2/2015

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.

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Relationship of Smartphone Use Severity with Sleep Quality, Depression, and Anxiety In University Students

Author(s): Kadír Demír,Mehmet Akgönül,Abdullah Akpinar / Language(s): English Issue: 2/2015

The usage of smartphones has increased rapidly in recent years, and this has brought about addiction. The aim of the current study was to investigate the relationship between smartphone use severity and sleep quality, depression, and anxiety in university students. Methods: In total, 319 university students (203 females and 116 males; mean age = 20.5 ± 2.45) were included in the study. Participants were divided into the following three groups: a smartphone non-user group (n = 71, 22.3%), a low smartphone use group (n = 121, 37.9%), and a high smartphone use group (n = 127, 39.8%). All participants were evaluated using the Pittsburgh Sleep Quality Index, Beck Depression Inventory, Beck Anxiety Inventory; moreover, participants other than those in the smartphone non-user group were also assessed with the Smartphone Addiction Scale. Results: The findings revealed that the Smartphone Addiction Scale scores of females were significantly higher than those of males. Depression, anxiety, and daytime dysfunction scores were higher in the high smartphone use group than in the low smartphone use group. Positive correlations were found between the Smartphone Addiction Scale scores and depression levels, anxiety levels, and some sleep quality scores. Conclusion: The results indicate that depression, anxiety, and sleep quality may be associated with smartphone overuse. Such overuse may lead to depression and/or anxiety, which can in turn result in sleep problems. University students with high depression and anxiety scores should be carefully monitored for smartphone addiction.

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Bipolar Spectrum Disorders in a Clinical Sample of Patients With Internet Addiction: Hidden Comorbidity or Differential Diagnosis?

Author(s): Klaus Wölfling,Manfred E. Beutel,Michael Dreier,Kai W. Müller / Language(s): English Issue: 2/2015

Behavioral addictions and bipolar disorders have a certain probability of co-occurrence. While the presence of a manic episode has been defined as an exclusion criterion for gambling disorder, no such exclusion has been formulated for Internet addiction. Methods: A clinical sample of 368 treatment seekers presenting with excessive to addictive Internet use was screened for bipolar spectrum disorders using the Mood Disorder Questionnaire. Psychopathology was assessed by the Symptom Checklist 90R and a clinical interview was administered to screen for comorbid disorders. Results: Comorbid bipolar disorders were more frequent in patients meeting criteria for Internet addiction (30.9%) than among the excessive users (5.6%). This subgroup showed heightened psychopathological symptoms, including substance use disorders, affective disorders and personality disorders. Further differences were found regarding frequency of Internet use regarding social networking sites and online-pornography. Discussion: Patients with Internet addiction have a heightened probability for meeting criteria of bipolar disorders. It is not possible to draw conclusions regarding the direction of this association but it is recommended to implement screening for bipolar disorders in patients presenting with Internet addiction. Conclusion: Similar to gambling disorder, it might prove necessary to subsume bipolar disorders as an exclusion criterion for the future criteria of Internet addiction.

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Book Reviews

Author(s): Kata Mónok,Borbála Hende / Language(s): English Issue: 2/2015

The reviews of: -„Data analysis with Mplus“ by Christian Geiser; The Guilford Press, 2013, 305 pp. Paperback ISBN 9781462502455, Hardcover ISBN 9781462507825 -„Trichotillomania, skin picking, and other body-focused repetitive behaviours“ by J. E. Grant, D. J. Stein, D. W. Woods and N. J. Keuthen; American Psychiatric Publishing, Arlington, 2011, 268 pp. ISBN: 1585623989

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Commentary on: Are we overpathologizing everyday life? A tenable blueprint for behavioral addiction research. On the slippery slopes: The case of gambling addiction

Author(s): Luke Clark / Language(s): English Issue: 3/2015

Billieux et al. (2015) propose that the recent proliferation of behavioral addictions has been driven by deficiencies in the underlying research strategy. This commentary considers how pathological gambling (now termed gambling disorder) traversed these challenges to become the first recognized behavioral addiction in the DSM-5. Ironically, many similar issues continue to exist in research on gambling disorder, including question-marks over the validity of tolerance, heterogeneity in gambling motives, and the under-specification of neuroimaging biomarkers. Nevertheless, I contend that the case for gambling disorder as a behavioral addiction has been bolstered by the existence of clear and consistent functional impairment (primarily in the form of debt), coupled with the development of a public health approach that has given emphasis to product features (i.e. the structural characteristics of gambling forms) as much as individual dispositions (the ‘addictive personality’).

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Commentary on: Are we overpathologizing everyday life? A tenable blueprint for behavioral addiction research. Addictions as a psychosocial and cultural construction

Author(s): Martial van der Linden / Language(s): English Issue: 3/2015

This commentary proposes a complementary perspective to that developed by Billieux, Schimmenti, Khazaal, Maurage and Heeren (2015). The addiction-as-disease approach tends to sideline explanatory factors of a psychosocial, cultural, political, or historical nature. I therefore suggest taking into account not only the personal characteristics (loss of self-control, impulsivity) related to the disease model, but also the social determinants of addictive behaviors (weak social ties, social exclusion, hyperindividualism, poverty, unemployment, etc.). Moreover, the disease model of addiction removes addictive behaviors from the cultural and historical contexts that shape them. I argue that the cultural and historical reasons for which certain factors (such as loss of self-control) became so important in the explanation of addictive behaviors should be more thoroughly considered.

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Commentary on: Are we overpathologizing everyday life? A tenable blueprint for behavioral addiction research. The diagnostic pitfalls of surveys: If you score positive on a test of addiction, you still have a good chance not to be addicted

Author(s): Anikó Maráz,Orsolya Király,Zsolt Demetrovics / Language(s): English Issue: 3/2015

Survey-based studies often fail to take into account the predictive value of a test, in other words, the probability of a person having (or not having) the disease when scoring positive (or negative) on the given screening test. Methods: We re-visited the theory and basic calculations of diagnostic accuracy. Results: In general, the lower the prevalence the worse the predictive value is. When the disorder is relatively rare, a positive test finding is typically not useful in confirming its presence given the high proportion of false positive cases. For example, using the Compulsive Buying Scale (Faber & O’Guinn, 1992) three in four people classified as having compulsive buying disorder will in fact not have the disorder. Conclusions: Screening tests are limited to serve as an early detection “gate” and only clinical (interview-based) studies are suitable to claim that a certain behaviour is truly “pathological”.

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The influence of exercise identity and social physique anxiety on exercise dependence

Author(s): Brian Cook,Trisha M. Karr,Christie Zunker,James E. Mitchell,Ron Thompson,Roberta Sherman,Ann Erickson,Li Cao,Ross D. Crosby / Language(s): English Issue: 3/2015

Previous research has identified exercise identity and social physique anxiety as two independent factors that are associated with exercise dependence. Aims: The purpose of our study was to investigate the unique and interactive effect of these two known correlates of exercise dependence in a sample of 1,766 female runners. Methods: Regression analyses tested the main effects of exercise identity and social physique anxiety on exercise dependence. An interaction term was calculated to examine the potential moderating effect of social physique anxiety on the exercise identity and exercise dependence relationship. Results: Results indicate a main effect for exercise identity and social physique anxiety on exercise dependence; and the interaction of these factors explained exercise dependence scores beyond the independent effects. Thus, social physique anxiety acted as a moderator in the exercise identity and exercise dependence relationship. Discussion: Our results indicate that individuals who strongly identify themselves as an exerciser and also endorse a high degree of social physique anxiety may be at risk for developing exercise dependence. Conclusions: Our study supports previous research which has examined factors that may contribute to the development of exercise dependence and also suggests a previously unknown moderating relationship for social physique anxiety on exercise dependence.

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Eating disorder risk, exercise dependence, and body weight dissatisfaction among female nutrition and exercise science university majors

Author(s): Natalie Harris,David Gee,Dana Ogan,Kelly Pritchett / Language(s): English Issue: 3/2015

Past research has examined eating disorder risk among college students majoring in Nutrition and has suggested an increased risk, while other studies contradict these results. Exercise Science majors, however, have yet to be fully examined regarding their risk for eating disorders and exercise dependence. Based on pressures to fit the image associated with careers related to these two disciplines, research is warranted to examine the potential risk for both eating disorder and exercise dependence. The purpose of this study is to compare eating disorder risk, exercise dependence, and body weight dissatisfaction (BWD) between Nutrition and Exercise Science majors, compared to students outside of these career pathways. Methods: Participants (n = 89) were divided into three groups based on major; Nutrition majors (NUTR; n = 31), Exercise Science majors (EXSC; n = 30), and other majors (CON; n = 28). Participants were given the EAT-26 questionnaire and the Exercise Dependence Scale. BWD was calculated as the discrepancy between actual BMI and ideal BMI. Results: The majority of participants expressed a desire to weigh less (83%) and EXSC had significantly (p = .03) greater BWD than NUTR. However, there were no significant differences in eating disorder risk or exercise dependence among majors. Discussion and Conclusions: This study suggested there was no significant difference in eating disorder risk or exercise dependence between the three groups (NUTR, EXSC, and CON).

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Book Reviews

Author(s): Gyöngyi Kökönyei,Renáta Cserjési / Language(s): English Issue: 3/2015

The reviews of: -“Handbook of emotion regulation (second edition)” by James J. Gross (Editor); The Guilford Press, New York, London, 2014, 669 pp. ISBN 978-1-4625-0350-6 -“The behavioral addictions” by Michael S. Ascher (Author, Editor) and Petros Levounis (Editor); American Psychiatric Publishing, Arlington, 2014, 235 pp. ISBN: 1585624853

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‘Wanting’ and ‘liking’ skin picking: A validation of the Skin Picking Reward Scale

Author(s): Ivar Snorrason,Ragnar P. Olafsson,David C. Houghton,Douglas W. Woods,Han-Joo Lee / Language(s): English Issue: 4/2015

Excoriation (skin-picking) disorder (SPD) is often conceptualized as a behavioral addiction in which aberrant reward processing may play an important role. The current study sought to develop a self-report instrument – the Skin Picking Reward Scale (SPRS) – that measures how strongly skin picking is ‘liked’ (i.e., the degree of pleasurable feelings while receiving the reward) and ‘wanted’ (i.e., the degree of the motivation to seek the reward). Methods: We administered the SPRS to individuals who endorsed excessive skin picking in online surveys and examined the scale’s factor structure (Studies 1 and 2). We then asked individuals with documented pathological skin picking to complete the SPRS and other relevant questionnaires on two occasions one week apart (Study 3). Results: Exploratory (Study 1; n = 330) and confirmatory (Study 2; n = 144) factor analyses consistently supported a two-factor structure reflecting the ‘liking’ and ‘wanting’ constructs. Results from Study 3 (N = 36) indicated that the Wanting and the Liking scales had adequate internal consistency and test–retest reliability. Additionally, consistent with predictions, the Wanting scale, but not the Liking scale, was associated with picking urges the following week, greater cue-reactivity, and more picking-related routines/habits. Discussion: These initial findings suggest that SPRS is a psychometrically sound measure of ‘wanting’ and ‘liking’ in pathological skin picking. The SPRS may facilitate research on reward processing anomalies in SPD and serve as a useful clinical instrument (e.g., to identify those at risk for cue-induced relapse).

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Risk for exercise dependence, eating disorder pathology, alcohol use disorder and addictive behaviors among clients of fitness centers

Author(s): Astrid Müller,Sabine Loeber,Johanna Söchtig,Bert Theodor Te Wildt,Martina De Zwaan / Language(s): English Issue: 4/2015

Exercise dependence (EXD) is considered a behavioral addiction that is often associated with eating disorders. To date, only few studies examined the potential overlap between EXD and other addictive behaviors. Therefore, the present study aimed at investigating the relationship of EXD with pathological buying, pathological video gaming (offline and online), hypersexual behavior, and alcohol use disorder in a sample of clients of fitness centers. Methods: The following questionnaires were answered by 128 individuals (age M = 26.5, SD = 6.7 years; 71.7% men, 74.2% university students): Exercise Dependence Scale, Eating Disorder Examination-Questionnaire, Compulsive Buying Scale, Pathological Computer-Gaming Scale, Hypersexual Behavior Inventory, and Alcohol Use Disorders Identification Test (AUDIT). Results: 7.8% of the sample were at-risk for EXD, 10.9% reported eating disorder pathology, 2.3% pathological buying, 3.1% hypersexual behavior, and none of the participants suffered from pathological video gaming. The criteria for severe alcohol disorder pathology (AUDIT ≥ 16) were fulfilled by 10.2%. With regard to continuous symptom scores, EXD symptoms were positively correlated with both eating disorder pathology and pathological buying but not with pathological video gaming, hypersexuality or alcohol use disorder. It is noteworthy that more symptoms of pathological buying corresponded with more symptoms of hypersexual behavior. The correlation pattern did not differ by gender. Discussion: The co-occurrence of EXD, pathological buying and hypersexual behavior on a subclinical level or in the early stage of the disorders should be taken into account when assessing and treating patients. More research is warranted in order to investigate possible interactions between these conditions.

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Problematic digital gaming behavior and its relation to the psychological, social and physical health of Finnish adolescents and young adults

Author(s): Niko Männikkö,Joël Billieux,Maria Kääriäinen / Language(s): English Issue: 4/2015

The aim of this study was to identify problematic gaming behavior among Finnish adolescents and young adults, and evaluate its connection to a variety of psychological, social, and physical health symptoms. Methods: This cross-sectional study was conducted with a random sample of 293 respondents aged from 13 to 24 years. Participants completed an online survey. Problematic gaming behavior was measured with the Game Addiction Scale (GAS). Self-reports covered health measures such as psychological health (psychopathological symptoms, satisfaction with life), social health (preferences for social interaction), and physical health (general health, Body Mass Index [BMI], body discomfort, physical activity). Results: Problematic gaming behavior was found to relate to psychological and health problems, namely fatigue, sleep interference, depression and anxiety symptoms. Multiple linear regression indicated that the amount of weekly gaming, depression and a preference for online social interaction predicted increased problematic gaming symptoms. Conclusions: This research emphasized that problematic gaming behavior had a strong negative correlation to a variety of subjective health outcomes.

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Book Reviews

Author(s): Attila Szabó,Edina Szabó / Language(s): English Issue: 4/2015

The reviews of: -“Handbook on psychopathy and law” by Kent A. Kiehl and Walter P. Sinnott-Armstrong (Eds.); New York, NY: Oxford University Press, 2013, 395 pp. ISBN: 978-0-1998-4138-7 -“The truth about exercise addiction–Understanding the dark side of thinspiration” by Katherine Schreiber and Heather A. Hausenblas; Rowman & Littlefield Publishing Group Inc., Lanham, Maryland, 2015, 239 pp. ISBN: 978-1-4422-3329-4

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