Exploring social gambling: scoping, classification and evidence review

The aim of this report is to speculate on the level of concern we might have regarding consumer risk in relation to ‘social gambling.’ In doing so, this report is intended to help form the basis to initiate debate around a new and under-researched social issue; assist in setting a scientific research agenda; and, where appropriate, highlight concerns about any potential areas that need to be considered in terms of precautionary regulation. This report does not present a set of empirical research findings regarding ‘social gambling’ but rather gathers information to improve stakeholder understanding

Virtual Reality as a Chance to Reconcile Ecological Validity and Experimental Control in Cue-Reactivity Research

High-performance virtual reality (VR) technology has opened new possibilities for the examination of the reactivity towards addiction-related cues (cue-reactivity) in addiction. We conducted two studies employing a virtual reality cue-reactivity design for participants suffering from gambling disorder (GD), that combined the assessment of subjective, physiological, and behavioral cue-reactivity. The first study aimed to examine the reliability of temporal discounting measures in VR and standard lab environments in a group of non-gambling control participants. Additionally, we aimed to explore the feasibility of applying sequential sampling models to temporal discounting data obtained in VR. The second study employed the VR design validated in the first study to investigate the subjective, behavioral, and physiological effects of VR gambling environment exposure in a group of regular gamblers (GD group) and matched non-gambling controls. Overall, the results obtained by both studies presented in this dissertation project revealed further evidence for the validity of temporal discounting and the two-step task as possible diagnostic markers of GD. We demonstrated high reliability of the temporal discounting task and reproduced established group differences in decision-making between participants suffering from GD and non-gambling controls in both behavioral tasks. Additionally, we showed that behavioral data obtained by both tasks in VR can be meaningfully interpreted with comprehensive computational modelling, especially with models including RTs such as the drift-diffusion model. In the context of cue-reactivity we found mixed results. While our design was effective in eliciting subjective craving in participants suffering from GD, we observed little evidence for behavioral or sympathetic physiological cue-reactivity

Operator-based approaches to harm minimisation in gambling: summary, review and future directions

In this report we give critical consideration to the nature and effectiveness of harm minimisation in gambling. We identify gambling-related harm as both personal (e.g., health, wellbeing, relationships) and economic (e.g., financial) harm that occurs from exceeding one’s disposable income or disposable leisure time. We have elected to use the term ‘harm minimisation’ as the most appropriate term for reducing the impact of problem gambling, given its breadth in regard to the range of goals it seeks to achieve, and the range of means by which they may be achieved. The extent to which an employee can proactively identify a problem gambler in a gambling venue is uncertain. Research suggests that indicators do exist, such as sessional information (e.g., duration or frequency of play) and negative emotional responses to gambling losses. However, the practical implications of requiring employees to identify and interact with customers suspected of experiencing harm are questionable, particularly as the employees may not possess the clinical intervention skills which may be necessary. Based on emerging evidence, behavioural indicators identifiable in industryheld data, could be used to identify customers experiencing harm. A programme of research is underway in Great Britain and in other jurisdiction

Évaluation et traitement des pensées dysfonctionnelles des joueurs pathologiques

Les pensées dysfonctionnelles contribuent largement au développement et au maintien du jeu d’argent pathologique. Le traitement spécifique des pensées dysfonctionnelles, la restructuration cognitive, consiste à corriger les pensées dysfonctionnelles après les avoir identifiées. Peu d’information concernant la façon d’effectuer la restructuration cognitive, spécifiquement auprès des joueurs, est disponible si bien qu’il s’avère difficile pour certains cliniciens de l’exécuter. Le but de cette thèse est de documenter l’évaluation et le traitement des pensées dysfonctionnelles des joueurs pathologiques. Cette thèse se divise en deux articles. Le premier article est une recension systématique de 39 études de traitement comprenant une restructuration cognitive qui documente : (1) les modalités d’intervention de la restructuration cognitive ; (2) ses cibles d’interventions ainsi que les mesures d’efficacité rapportées ; (3) les techniques/outils utilisées ; (4) l’adaptation aux jeux comprenant une part d’habileté ; et (5) les terminologies référant aux pensées dysfonctionnelles. Les résultats montrent que la restructuration cognitive est principalement effectuée en face à face, en individuel, pendant cinq à 20 séances. Peu d’études rapportent évaluer les pensées dysfonctionnelles pour juger de l’efficacité du traitement. L’exposition à une séance de jeu en imagination se retrouve la plus citée comme outil de restructuration cognitive. Aucune étude incluant des joueurs de jeux comprenant une part d’habileté (p.ex., poker) n’a rapporté une adaptation à la restructuration cognitive, malgré les études qui ont démontré que les joueurs de poker endossent à tort certaines pensées jugées comme étant erronées pour les joueurs de jeux de hasard purs. Finalement, les résultats montrent que les termes référant aux pensées des joueurs sont utilisés de manière interchangeable alors que certains pourraient ne pas convenir. De qualifier une pensée plus ou moins vraie dans son contenu (p.ex., le jeu m’aide à oublier mes problèmes) comme étant erronée ne serait pas juste. Il semble également que des pensées documentées dans le domaine des autres dépendances (p.ex., pensées soulageantes), ne sont pas considérées dans la restructuration cognitive. Des recommandations cliniques et de recherches futures sont émises, notamment en lien avec les différentes pensées dysfonctionnelles entretenues par les joueurs en situation de jeu, ainsi que l’exposition comme technique pour faciliter la restructuration cognitive. Le deuxième article de cette thèse a pour but d’identifier les différentes pensées dysfonctionnelles verbalisées par 29 joueurs en contexte d’exposition au jeu (16 en réalité virtuelle et 13 en imagination). Il vise également à comparer l’exposition en imagination avec l’exposition en réalité virtuelle quant au nombre de pensées spécifiques au jeu (celles étant erronées selon les principes du hasard) et de pensées liées aux dépendances (non liées au hasard). Il vise aussi à comparer ces deux types d’expositions quant à la diversité de pensées spécifiques au jeu verbalisées par les joueurs. Les résultats mettent en évidence que les joueurs exposés en réalité virtuelle ont verbalisé un plus grand nombre et une plus grande diversité de pensées spécifiques au jeu que ceux exposés en imagination. La réalité virtuelle, qui induit émotivité et un sentiment d’être réellement dans un environnement de jeu, ne permet toutefois pas d’identifier un plus grand nombre de pensées liées aux dépendances. Les pensées liées aux dépendances pourraient être plus automatiques (liées à des attentes du jeu ainsi qu’à la gestion des habitudes de jeu). L’environnement virtuel utilisé n’a également pas été développé pour susciter des pensées non liées au hasard. En somme, la réalité virtuelle est un outil permettant de faciliter l’identification des pensées spécifiques au jeu. L’exposition à des stimuli de jeu et l’émotivité qu’engendrerait une telle séance d’exposition pourraient accentuer l’efficacité de la restructuration cognitive considérant le fait qu’un contexte d’émotivité intense favorise les gains thérapeutiques. En conclusion, cette thèse s’intéresse à une technique de la restructuration cognitive, soit l’exposition, qui est documentée dans les études de traitement du jeu d’argent pathologique, mais peu décrite et peu évaluée. Cette thèse soulève également des questionnements concernant l’étude des pensées non liées au hasard dans le domaine du jeu d’argent pathologique, qui ne semblent pas considérées dans son traitement.Dysfunctional thoughts figure among the factors that contribute to the development and maintenance of gambling disorder. Cognitive restructuring, a treatment that targets dysfunctional thoughts, aims to identify and correct these thoughts. However, little information is available regarding the application of cognitive restructuring with gamblers, which makes it difficult for some counselors to apply it. Comprised of two articles, this thesis aims to document the evaluation and treatment of dysfunctional thoughts in individuals with gambling disorder. The first article is a systematic review of 39 treatment studies that applied cognitive restructuring. It documents: (1) cognitive restructuring intervention modalities; (2) objectives and outcome measures; (3) techniques/instruments/tools used; (4) the ways that cognitive restructuring is adapted for gamblers who play games that include a skill component and (5) terminology employed in studies to refer to gamblers’ thoughts. Results show that cognitive restructuring is mainly carried out face-to-face in an individual setting within five to 20 sessions. Few studies report a post-treatment measure of dysfunctional thoughts. Imaginal exposure is the most cited technique to facilitate cognitive restructuring. None of the studies that included skill games gamblers (e.g., poker) reported an adaptation of cognitive restructuring despite the fact that these gamblers endorse dysfunctional thoughts that are different from those of pure chance games gamblers. Results also show that the terms employed to refer to gamblers dysfunctional thoughts are used interchangeably while this may not be appropriate. To designate a thought that is somewhat false (e.g., “gambling helps me forget about my problems”) as erroneous would not be accurate. It also seems that thoughts documented in the field of addiction (e.g. relief-oriented thoughts) are not considered when applying cognitive restructuring with gamblers. Clinical and research recommendations are formulated regarding types of dysfunctional thoughts endorsed by gamblers during a gambling session and exposure as a technique to facilitate cognitive restructuring. The second article identifies dysfunctional thoughts verbalized by 29 individuals with gambling disorder during a session of gambling exposure (16 in virtual reality and 13 in imagination). It also compares imaginal exposure with virtual reality regarding quantity of gambling-specific thoughts (those that are erroneous based on the notion of chance) and the number of addiction-related thoughts (non-related to chance). It also compares the two exposure conditions on diversity of gambling-specific thoughts verbalized by gamblers. Results show that gamblers exposed in virtual reality verbalized a greater number and diversity of gambling-specific thoughts compared to gamblers in the imaginal exposure condition. Though apt to induce cravings and a feeling of being in a real gambling environment, virtual reality does not allow greater access to addiction-related thoughts compared to imaginal exposure. Addiction-related thoughts may be more automatic in gamblers (related to emotional expectations and management of gambling habits) and thus may not require an emotional context as induced by virtual reality to access them. However, exposure to gambling cues that induce cravings could bonify cognitive restructuring since it is known that such a context can increase therapeutic gains. In conclusion, this thesis focuses on exposure, a technique that is widely used to facilitate cognitive restructuring with gamblers, yet has seldom been described and evaluated for its efficacy. It also raises questions for the study of dysfunctional thoughts that are not related to the notion of chance in the gambling domain. Finally, it addresses the fact that addiction-related thoughts do not seem to be considered in cognitive restructuring with gamblers.Résumé en espagno

Development of an effective virtual environment in eliciting craving in adolescents and young adults with internet gaming disorder

Internet gaming disorder (IGD) is a new disorder that warrants further investigation, as recently noted in the research criteria of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Offering controlled environments that increase cue-induced craving, virtual reality cue-exposure therapy has been shown to be effective for some addiction disorders. To assess the feasibility of virtual reality for patients with IGD, this study aimed to develop virtual environments that represent risk situations for inducing craving, and assess the effect of virtual reality in cue reactivity. A total of 64 male adolescents and young adults (34 with IGD and 30 without) were recruited for participation. We developed a virtual internet cafe environment and the participants were exposed to four different tasks. As the primary feasibility outcome, cravings were measured with a visual analogue scale measuring current urge to play a game after exposure to each task. The virtual internet cafe induced significantly greater cravings in patients with IGD compared to controls. Additionally, patients exhibited a significantly higher acceptance rate of an avatar's invitation to play a game together than that of controls. In IGD, craving response to the tasks was positively associated with the symptom severity score as measured by Young's Internet Addiction Test. These findings reveal that virtual reality laden with complex game-related cues could evoke game craving in patients with IGD and could be used in the treatment of IGD as a cue-exposure therapy tool for eliciting craving.ope

Psychosociology of Addiction and Rehabilitation: Construction of a Psychometric Instrument for screening problem and pathological gambling

Gambling and gambling disorders have received solicitous attention by clinicians and researchers during the past three decades. The majority of existing psychometric instruments relevant to problem gambling are based on the clinical evaluation of symptomatology. The aim of this study was the development and evaluation of a self report instrument that comprehends elements based on three main factors: a. psychological, b. biological, c. sociological. In the first phase of this research, structured and semi-structured interview was conducted in 16 individuals. In the second phase, a pilot inventory that consisted of 227 items, was administered in 91 individuals of general population. In the last phase of this study participated 200 individuals from the community and completed the short form of the inventory that included 148 items. Factor analysis was conducted in all items and 115 statistically significant questions were derived which comprise the final form. The present instrument, which has demonstrated satisfactory psychometric properties, provides a first step in self evaluation of problem and pathological gambling in Greece and aims at effective counseling in order to reduce or even prevent addictive gambling behaviors

Virtual reality as a platform for research in gambling behaviour

Research into gambling behaviour is an important aspect of mitigating the effects of problem gambling. However, the majority of existing studies are conducted in the laboratory, rather than in vivo, raising questions over the generalisability of results. Virtual reality (VR) is well established as an effective tool for exposure therapy, and has also been used in other experimental contexts: such work is often motivated by the ability of the platform to create ecologically valid conditions, and simulations that would be hard to create in real life. Whilst a small number of studies have used VR to evoke the urge to gamble, and also to conduct behavioural studies, no work has yet considered the differences in experience between laboratory and VR conditions. We approach this from the perspective of immersion, arousal and user experience, and conduct a within-subjects study (N = 48) in which participants play a gambling game both on a laptop in a laboratory, and on a virtual gaming machine located in a VR simulation of a betting shop. Our results show that participants reported higher levels of arousal, as well as higher levels of immersion in the game when playing in VR. There was also a significant difference in self-reported physical task workload in VR. Based on our results, we argue for further use of VR in experimental research related to gambling, as well as further study of the experience and responses of problem gamblers to VR simulations of real-world gambling