Author: Christina Galanis
Galanis, Christina, 2025 Behavioural addictions and stigma: The nature and predictors of negative attitudes towards digital technology-related problems , Flinders University, College of Education, Psychology and Social Work
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Addictive disorders are among the most stigmatized health conditions, with as many as 71% of individuals with an addictive disorder reporting that they had received negative comments from others. Stigma can lead to prejudice, discrimination, and negatively impact on help and treatment-seeking behaviour. A growing focus of addiction research has been on the emerging class of behavioural addictions. This interest has been propelled by the World Health Organization’s recognition of gaming disorder in the International Classification of Diseases (ICD-11), along with clinical and public health concerns about the effects of continuously evolving and increasingly accessible digital technologies on users. Problem use of these devices has been the subject of two major areas of debate: (1) the need for policies regulating the use of digital technology in governments around the world, and (2) whether diagnostic categories may generate or exacerbate stigma for both problem and recreational engagement with these technologies.
As a new field of research, the academic literature on stigma related to problem use of digital technology is at an early stage of development. Key issues for research include the conceptualisation and measurement of stigma across different behavioural addictions. Therefore, this thesis sought to contribute to our understanding of stigma related to behavioural addictions, with a focus on digital technology-related problems. This project sought to (1) summarize what is known about addiction stigma and consider whether research on stigma related to substance-based addiction can be applied to behavioural addictions; (2) investigate the psychometric qualities and suitability of measures of stigma in behavioural addictions, and; (3) increase our understanding of the nature and origins of behavioural addiction stigma, including (a) how the introduction of gaming disorder in the ICD-11 and an addiction formulation for gaming behaviours might impact stigma towards gaming and problem gaming, and; (b) as a case example, the impact of government policy restricting mobile phone use in schools on stigma towards mobile phone use problems.
Study 1 in this project was a systematic review which identified 99 studies of addictions and stigma. This review indicated that neurobiological explanations (as opposed to non-addictive explanations) of behavioural addictions tended to reduce blame, and familiarity with behavioural addictions tended to reduce stigma. Of the 21 stigma measures reviewed, few measures were developed for behavioural addictions. Study 2 used a qualitative framework analysis to examine written responses from non-gaming adults and problem gaming. Most (82%) participants endorsed that problem gaming can be considered an addictive disorder and many thought that a diagnostic category would increase the availability of help. Gaming-related stigma was associated with negative stereotypes about gamers (e.g., ‘lazy’, ‘childish’, ‘toxic’) and gaming as an activity (e.g., ‘waste of time’, ‘dangerous for children’). Study 3 investigated the predictors of perceived mobile phone use stigma by recruiting adolescents from South Australian public schools for a survey involving a range of social and psychological factors. Lack of social capital (or, social support or resources) was the strongest predictor of stigma. Study 4 engaged high school students for a quasi-experiment involving two surveys administered as schools transitioned to a mobile phone ban. The no ban group reported significantly more stigma toward problem phone use than the ban group, however, there was no significant change in stigma over time. This thesis indicated that stigma towards digital technology-based problems may be influenced by social factors and personal experience with digital technology.
Stigma is a complex psychological phenomenon that intersects with social, clinical and political domains. This thesis informs current policy, debates, and research for examining stigma towards behavioural addictions. Study 1 suggests that predictors of stigma may apply differently to behavioural addictions than compared to substance-based addictions. Study 2 suggests that views of on problem gaming as a public health issue and mental disorder are linked to perceptions of the availability and accessibility of resources and interventions. Study 3 suggests that predictors of stigma and stereotypes may be important to address in anti-stigma programs, including, for example, the specific groups who may benefit from these measures. Study 4 suggests that policies relating to restricting digital technology, primarily mobile phones, are unlikely to influence students’ views of how mobile phone use problems are seen in society; for the majority, these views are shaped by broader factors, including the social context of the policy. Future research should examine how stigma can be addressed in practice, to ultimately help the populations who experience behavioural addictions to seek and receive help with respect, dignity, and self-worth.
Keywords: Stigma; Behavioural addiction; Gaming Disorder; Problem Phone Use
Subject: Psychology thesis
Thesis type: Doctor of Philosophy
Completed: 2025
School: College of Education, Psychology and Social Work
Supervisor: Daniel King