Asymmetrical Attention to Gambling-related Stimuli and Pupillary Dilation in Response to Wins and Losses in Problem Gamblers

Gambling disorder and problem gambling are characterized by persistent and repetitive problematic gambling behavior. Attentional bias toward gambling-related stimuli such as casino chips, dice, roulette, etc. have been observed in problem gamblers (PGs), but it remains unclear whether stimuli in gambling tasks elicit greater attention and pupillary responses in PGs. To address this issue, we administrated PGs and non-problem gamblers (NPGs) a gambling task accompanied by eye-tracking measurements, in which the participants were required to choose one of the paired pictures to receive monetary rewards and avoid punishments. Concerning attentional allocation, PG showed a greater attentional preference for the right-hand pictures in the decision and feedback phases, and compared to NPGs, PGs’ attention was narrower and more focused on the left-hand pictures in the decision phase. Concerning pupillary dynamics indicative of noradrenergic locus coeruleus activity, pupillary dilation in response to rewards and punishments was observed only in PGs. Studies of unilateral spatial neglect have proposed that asymmetric attention is induced by hemispheric imbalance. Accordingly, asymmetrical allocation of attention by PGs may reflect hemispheric imbalance, and pupillary dynamics may reflect sensitivity to wins and losses.

Study protocol for an online randomised controlled trial among non-treatment seeking problem gamblers: training inhibition in online problem gambling (TRAIN-online) trial

IntroductionDevelopment of fully internet-based programs could provide a new avenue to improve access to healthcare for problem gamblers. In this project, we aim to assess the efficacy of a web-based cognitive intervention targeting inhibitory control among problem gamblers, using a randomised controlled design. As impaired inhibitory control is involved in self-regulation difficulties in behavioural addictions, it represents a particularly relevant cognitive process to target for an online psychological intervention.Methods and analysisThis will be a single-blinded, randomised, comparative therapeutic web-based, controlled trial. Up to 200 non-treatment seeking adult problem gamblers with a Problem Gambling Severity Index-recent (PGSI-recent) score ≥5 will be included. The intervention will be a computerised cognitive training program targeting inhibitory skills. The comparator, an active control, will be a computerised neutral sensorial program. Both programs will be carried out under similar conditions: biweekly online training for 6 weeks and optional telephone support will be offered to patients for debriefing. The main objective of the study is to assess the clinical efficacy of the online cognitive training program at 6 weeks, measured with the PGSI-recent. The secondary objectives are to assess the efficacy on the gambling behaviour assessed by the account-based gambling data, on the self-reported gambling practice, and on the inhibition performance at the neuropsychological level at 6, 14 and 52 weeks. We will also assess the acceptability of this program and the preferred level of guidance. Data analysis will be in intention-to-treat.Ethics and disseminationThis randomized controlled trial will be executed in compliance with the Helsinki Declaration, and was approved by the local ethics boards (Comité de Protection des Personnes) in October 2017. The findings will be published in peer-reviewed journals.Trial registration numberNCT03673800.

Applying the DSM-5 Criteria for Gambling Disorder to Online Gambling Account-Based Tracking Data: An Empirical Study Utilizing Cluster Analysis

The emergence of online gambling has raised concerns about potential gambling-related harm, and various measures have been implemented in order to minimise harm such as identifying and/or predicting potential markers of harm. The present study explored how the nine DSM-5 criteria for gambling disorder can be operationalised in terms of actual online gambling behaviour using account-based gambling tracking data. The authors were given access to an anonymised sample of 982 gamblers registered with an online gambling operator. The data collected for these gamblers consisted of their first three months’ gambling activity. The data points included customer service contacts, number of hours spent gambling, number of active days, deposit amounts and frequency, the number of times a responsible gambling tool (such as deposit limit) were removed by the gamblers themselves, number of cancelled withdrawals, number of third-party requests, number of registered credit cards, and frequency of requesting bonuses through customer service (i.e., the number of instances of ‘bonus begging’). Using these metrics, most of the DSM-5 criteria for gambling disorder can be operationalized (at least to some extent) using actual transaction data. These metrics were then applied to a sample of online gamblers, and through cluster analysis four types of online gambler based on these metrics (non-problem gamblers, at-risk gamblers, financially vulnerable gamblers, and emotionally vulnerable gamblers) were identified. The present study is the first to examine the application of the DSM-5 criteria of gambling disorder to actual gambling behaviour using online gambling transaction data and suggests ways that gambling operators could identify problem gamblers online without the need for self-report diagnostic screening instruments.

Effective and responsible marketing of online sports gambling to young adults in the UK

In an industry that has experienced rapid growth for a number of years, where product differentiation is minimal, the marketing tactics of online sports gambling (OSG) bookmakers are likely to push the boundaries of what can be considered responsible, as companies seek to stand out from competitors and take advantage of industry growth. This research aims to explore how the marketing tactics of OSG companies shape the gambling habits of young adult consumers, and whether this demographic considers these tactics responsible. Recommendations are made on how online bookmakers can remain responsible in their marketing to young adults. Findings revealed that the primary motivation behind young adults’ recreational gambling was the excitement induced through participation. Further, young adults’ OSG bookmaker preference is influenced by promotional offers for existing customers. Results from the study indicate that in general, young adults do not deem the varied marketing techniques employed by OSG companies as irresponsible practices. However there were concerns regarding the potential impact of the continued increase in OSG marketing on problem gamblers and children (under 18).

Gambling harms caused by electronic gambling machines should be prevented with state control

Unlike in other Nordic countries, most of the electronic gambling machines (EGMs) are placed outside the Casino Helsinki and the gambling arcades in Finland. The placement of EGMs in non-casino locations, such as supermarkets, kiosks, and petrol stations, is matter of serious concern. We argue that availability and accessibility of EGMs has led to normalisation and banalisation of gambling in Finland. Exposure to EGMs also put at risk vulnerable populations and problem gamblers, who already suffer from the negative consequences of gambling harms. Gambling companies’ self-regulation initiatives and corporate social responsibility programmes are not enough to prevent and limit EGM related gambling harms. We suggest that Finland should follow Norway’s example and limit the availability of EGMs and transfer them from non-casino locations to gambling arcades. Finnish EGM policy should be a question of public policy guided by public health concerns.

Distinct motivations to seek out information in healthy individuals and problem gamblers

As massive amounts of information are becoming available to people, understanding the mechanisms underlying information-seeking is more pertinent today than ever. In this study, we investigate the underlying motivations to seek out information in healthy and addicted individuals. We developed a novel decision-making task and a novel computational model which allows dissociating the relative contribution of two motivating factors to seek out information: a desire for novelty and a general desire for knowledge. To investigate whether/how the motivations to seek out information vary between healthy and addicted individuals, in addition to healthy controls we included a sample of individuals with gambling disorder—a form of addiction without the confound of substance consumption and characterized by compulsive gambling. Our results indicate that healthy subjects and problem gamblers adopt distinct information-seeking “modes”. Healthy information-seeking behavior was mostly motivated by a desire for novelty. Problem gamblers, on the contrary, displayed reduced novelty-seeking and an increased desire for accumulating knowledge compared to healthy controls. Our findings not only shed new light on the motivations driving healthy and addicted individuals to seek out information, but they also have important implications for the treatment and diagnosis of behavioral addiction.

On being loyal to a casino: The interactive influence of tier status and disordered gambling symptomatology on attitudinal and behavioral loyalty

Background and AimsCasino loyalty programs are marketing strategies designed to foster attitudinal (i.e., identification and satisfaction) and behavioral (i.e., spending) loyalty among gamblers by offering rewards to members. Casino loyalty programs use a tier-based structure to segment members who spend more money into higher tiers, where they receive better rewards (compared to lower tiered members). Tier-based structures may encourage increased expenditure among patrons, especially among players living with a gambling disorder. The current work aimed to examine whether tier status and disordered gambling symptomatology interact to predict attitudinal and behavioral loyalty.MethodsStudy 1 used a cross-sectional design to examine whether tier status and disordered gambling symptomatology interact to predict self-reported loyalty among a sample of American casino loyalty program members (N = 396). In Study 2, archival player account data from Canadian casino loyalty program members (N = 649) were analyzed to examine whether tier status and disordered gambling symptomatology interact to predict objective measures of behavioral loyalty.ResultsThe greatest effect of tier status on attitudinal and behavioral loyalty was observed among non-problem gamblers in the highest tiers. Tier status, however, did not influence loyalty among members high in disordered gambling symptomatology.DiscussionResults suggest that once gambling has become problematic, loyalty programs may not influence player attitudes and behaviors. Non-problem gamblers may be particularly susceptible to the tiered structure of the programs.ConclusionNon-problem gamblers may benefit from casino loyalty programs in the short-term but longitudinal research is needed to understand the long-term influence of membership.

Discounting Behavior in Problem Gambling

Problem gamblers discount delayed rewards more rapidly than do non-gambling controls. Understanding this impulsivity is important for developing treatment options. In this article, we seek to make two contributions: First, we ask which of the currently debated economic models of intertemporal choice (exponential versus hyperbolic versus quasi-hyperbolic) provides the best description of gamblers’ discounting behavior. Second, we ask how problem gamblers differ from habitual gamblers and non-gambling controls within the most favored parametrization. Our analysis reveals that the quasi-hyperbolic discounting model is strongly favored over the other two parametrizations. Within the quasi-hyperbolic discounting model, problem gamblers have both a significantly stronger present bias and a smaller long-run discount factor, which suggests that gamblers’ impulsivity has two distinct sources.

Co-morbid gambling disorder in a local drug and alcohol service: an audit to determine prevalence

AimsNational surveys show that over 56% of adults in England gamble annually, and of those surveyed, 0.5% were problem gamblers, equating to 300,000 problem gamblers at any point. The prevalence of problem gambling in patients with a substance misuse disorder ranges from 20.5% to 55%.The audit aims to improve the care of patients with comorbid substance misuse and gambling disorder by assessing the extent to which the service currently enquires about and records problem gambling in its patient cohort.It is hypothesised that as no formal recording process is in place locally, this information will not be recorded systematically and in a way that is easily retrievable by the service.The audit will allow the service to assess whether changes need to be made to the initial assessment pathways into treatment for substance-related disorders to adequately record this information so that further assessment and onward referral can take place.MethodAll active patients (n = 2824) within the service had both their electronic initial assessments and their entire electronic notes screened for terms such as ‘betting’ and ‘gambling’ and this was recorded using an Excel spreadsheet. Prevalence rates across the teams (opiates, non-opiates and alcohol) were then calculated.ResultThe results showed that 0% of patients had any entries in their initial screening noting any gambling activity. Further scrutiny of the records revealed that only 3.5% (n-99) had ever discussed gambling with a worker in any of the services.ConclusionThe majority (n = 52) of patients who had discussed gambling only had one positive search result, suggesting this was not followed-up in a systematic fashion. Recommendations are to revise the common assessment pro-forma to include a validated brief screening tool (lie/bet), where one positive answer triggers a further assessment with an appropriate clinician for consideration of referral to the local NHS gambling service.