Julie M. Hynes, MA, CPSNorthwest Institute on Addiction Studies Conference
July 22, 2015 | Portland, OR
the
blurring lines of games and
gambling
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Presenter
Presentation Notes
Workshop Description: In this presentation, we will examine the rapidly-shifting world of technology that has outpaced even many experts’ abilities to keep up. From video games to social network gaming, we will look into recent trends with regard to online and mobile technology and play, and how the lines have become blurred between traditional “games” and gambling. We will look into specifics such as development of games that are more attractive to younger populations laws (and how kids work around them), similarities and differences between various platforms and game play, different methods of incentives and forms of payment. We will examine the research on gaming disorders and gambling disorders—including similarities, differences and common risk factors and vulnerable populations (and discuss the DSM-5). And we won’t just stay stuck in the problem: you will be equipped with practical and evidence-based tips and tools that aim at protecting, and advocating for, vulnerable populations – with a special focus on youth and those in addictions recovery. Learning Objective 1: Identify several recent trends, technological issues and parallels related to gambling and social gaming. Learning Objective 2: Identify which populations present the greatest risk for harmful consequences related to excessive online behavior. Learning Objective 3: Name at least four tools that can be used to help reduce the risk of harmful consequences of electronic games/gambling. In this presentation, we will examine the rapidly-shifting world of technology that has outpaced even many experts’ abilities to keep up. From video games to social network gaming, we will look into recent trends with regard to online and mobile technology and play, and how the lines have become blurred between traditional “games” and gambling. We will look into specifics such as development of games that are more attractive to younger populations laws (and how kids work around them), similarities and differences between various platforms and game play, different methods of incentives and forms of payment. We will examine the research on gaming disorders and gambling disorders—including similarities, differences and common risk factors and vulnerable populations (and discuss the DSM-5). And we won’t just stay stuck in the problem: you will be equipped with practical and evidence-based tips and tools that aim at protecting, and advocating for, vulnerable populations – with a special focus on youth and those in addictions recovery.
The complete slide deck & print-friendly handouts are posted at:
www.preventionlane.org/nwias
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Northwest Institute on Addiction StudiesOregon Problem Gambling ServicesJeff Marotta
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More than ever, behavioral health specialists need to be aware of technology and the issues that face populations from youth to those in recovery for addictions.
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Is our definition of “gambling” blurring?
Are we prepared to deal with today’s changing world of potential addictions?
How do we work with those in recovery who play frequent, possibly excessive, online social games?
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Presenter
Presentation Notes
During this presentation, we will discuss these issues in an open, non-judgmental format, and provide participants with practical, evidence-based information and tools that are relevant to our everyday work.
• Identify several recent trends, technological issues and parallels related to gambling and social gaming.
• Identify which populations present the greatest risk for harmful consequences related to excessive online behavior.
• Name at least four tools that can be used to help reduce the risk of harmful consequences of electronic games/gambling.
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This is focused mainly on GAMING/GAMBLINGconnections, but parallels are likely to be seen with many other more general internet / tech-related disorders (i.e., shopping, etc.).
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Presenter
Presentation Notes
During this presentation, we will discuss these issues in an open, non-judgmental format, and provide participants with practical, evidence-based information and tools that are relevant to our everyday work.
Some content here could present as a “trigger.”If you feel yourself starting to be triggered, please feel free to do whatever you need to do to feel safe.
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Technology, Trends & Tie-in’s
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Presenter
Presentation Notes
Addiction to mobile text messaging applications is noting to “lol” about, September 2013, Abdullah J. Sultan Consumers in Kuwait (effects of CMC technology on consumers in the Middle East region) Blackberry Messenger (BBM), WhatsApp; allowed consumers to socialize and stay connected longer using their smart phones without having to pay for a networks operators short message service (SMS) charges Current stream of research that defines the personality characteristics of CMC users along the introversion/extroversion and social anxiety continuums Technology/internet addiction: behavioral addiction that involves human-machine interaction and that is non-chemical in nature Growing research suggests that Internet addiction involves tolerance, withdrawal symptoms, affective disturbances, and interruption of social relationships Weak sample given how they were recruited; business students enrolled in undergraduate course at large university in Kuwait sent BBM or WhatsApp messages with a survey link to all their contacts. 552 participants, 79.2% response rate 185 male students, 367 female students – did not report on age 237 were BBM users, 315 were WhatsApp users Hourly usage: 10.9%, 1-3 times, 21.9%, 4-6 times, 21.83%, 7-12 times, 32.25%, 12 times Reasons for using these apps: communicate with family and friends, news, entertainment, boredom, express themselves, meet new people In general, research does not suggest that these advanced communication applications are inherently harmful Problem gambling, gaming, and Internet use in adolescents: Relationships with emotional intelligence in clinical and special needs samples, February 2013, James D.A Parker, Laura J. Summerfeldt, Robyn N. Taylor, Patricia H. Kloosterman, Kateryna V. Keefer Adolescent involvement in gambling activities continues to increase in developed countries Adolescents are especially vulnerable to developing gambling problems, and the prevalence of disordered gambling has been reported to be higher in adolescents compared to adults, with boys being at greater risk than girls. There is empirical evidence indicating that addiction-related recreational behaviors, including Internet and video/computer game abuse, are an increasing problem among adolescents Excessive adolescent video/computer game playing (gaming) has been linked to a number of negative outcomes that match those linked with adolescent pathological/problem gambling, including antisocial behavior, poor academic achievement, and the deterioration of social relationships. Compared to non-problem and social gamblers, adolescent problem gamblers tend to report higher levels of stress, depression, and anxiety, and are also more likely to use avoidant and emotion-based coping strategies (including gambling and substances) to reduce stress and improve negative mood Participants and procedure: “The first sample consisted of 270 adolescent clinical outpatients (180 male, 90 female) 13–18 years of age recruited from a local pediatric clinic at the time of a regular clinic appointment. The majority (58%) had a primary diagnosis of ADHD, 34% learning disorder, 4% mood disorder, 2% anxiety disorder, and 2% had other diagnoses. The mean age in this sample was 15.22 years (SD = 1.63); 15.13 years (SD = 1.60) for boys and 15.39 years (SD = 1.69) for girls. Most participants (91.5%) identified themselves as White, 2.3% as Black, 3.1% as Asian, 1.5% as Hispanic, 1% as Native American, and 1.2% as other.” “The second sample consisted of 256 special needs students (160 male, 96 female) 14–18 years of age recruited from local schools via presentations to teachers, school staff members, parents, and students. Participants self-disclosed details about their Individual Education Plans (IEPs), which were later confirmed via school records. In this sample, 8.6% had IEPs for literacy-related learning problems (i.e., difficulties with listening, reading, spelling, or writing), 13.2% for numeracy-related learning problems (i.e., difficulties with mathematical operations and computations), 49.6% for both literacy and numeracy-related learning problems, and 28.6% for other behavioral and/or mental health issues. The mean age in this sample was 16.27 years (SD = 1.21); 16.29 years (SD = 1.19) for boys and 16.25 years (SD = 1.24) for girls. Most participants (79.0%) identified themselves as White, 4.6% as Black, 8.8% as Asian, 1.0% as Hispanic, 1.0% as Native American, and 5.9% as other. The special needs students were significantly older than the outpatient sample, t (524) = 8.40, p < .001, d = 0.73, although the proportions of males.” Measures: The self-report package included the youth version of the Emotional Quotient Inventory, the South Oaks Gambling Screen-Revised for Adolescents, the Internet Addiction Test, and the Problem Video Game Playing Scale. “This study sought to validate the dysfunctional preoccupation cluster of addiction-related behaviors and examine its association with affect-regulation vulnerabilities in two samples of adolescents with learning-related and externalizing/internalizing problems. Consistent with prior research with a community-based sample (Parker et al., 2008), the study found empirical evidence that the addiction-related behaviors of video/computer game use, Internet use, and gambling can be accounted for by a common dysfunctional preoccupation latent variable.” “Nevertheless, latent variable path analysis revealed that EI was a robust predictor of the dysfunctional preoccupation variable; accounting for 41% of the variance in the adolescent clinical outpatient sample and 25% in the adolescent special needs sample.” “The special needs sample scored significantly higher than the clinical outpatient sample on measures of problematic Internet behaviors and gambling and significantly lower on the interpersonal EQ-i:YV subscale.” Relationships between problematic Internet use and problem-gambling severity: Findings from a high-school survey, 2014, Yvonne H.C Yau, Corey E. Pilver, Marvin A. Steinberg, Loreen J. Rugle, Rani A. Hoff, Suchitra Krishnan-Sarin, Marc N. Potenza Problematic Internet use (PIU) has been associated with substance-use disorders, mood disorders, incarceration, legal troubles, and poor physical and mental health Internet addiction has been modeled after impulse control disorders PIU just like problem gambling (PG) has been proposed as a non-substance or “behavioral” addiction The behavioral-addiction perspective suggests that PIU and PG share characteristics of substance dependence such as tolerance, withdrawal, and cravings Parallels between Internet use and gambling have been proposed – personality traits that promote problematic engagement in Internet use might relate to gambling-related measures PG and PIU are related to similar psychological and neurobiological profiles. PG is associated with impaired impulse control, substance use, depression, anxiety, and aggressive behavior in adult and adolescent populations and similar factors appear associated with PIU. Study analyzed data from a survey of risk behaviors in high-school students in Connecticut All public 4 year, non-vocational, non-special education high schools in the state of Connecticut were invited to participate Not a random sample, but the final sample (N=4523) displayed demographics consistent with census data on Connecticut residents 14-18 years old 2039 students were excluded for non-completion of the gambling section and 326 students were exclude for non-completion of the Internet sections The final sample was 1884 students, 1050 males and 844 females 48.6% of the adolescents met criteria for at risk problematic internet use (ARPIU) The ARPIU group, in contrast to the non-ARPIU group, was more likely to report that their parents disapproved of gambling and that their family had expressed concerns regarding their gambling behavior Among ARPIU respondents, problem gambling severity was associated with participation in extracurricular actives, carry a weapon, engaging in a serious fight, lifetime tobacco smoking, lifetime marijuana use, lifetime other drug use, and caffeine use. Similar associations were observed among non-ARPIU respondents Association Between Internet Gambling and Problematic Internet Use Among Adolescents, October 2010, Artemis Tsitsika, Elena Critselis, Mari Janikian, George Kormas, Dimitrios A. Kafetzis Athens, Greece Cross sectional study design Study sample of 529 people, 9th and 10th grade at randomly selected public junior high and high schools 47.8% boys and 52.2% girls Anonymous self-completed questionnaires 15.1% internet gamblers Boys 2.86 times more likely to participate in internet gambling Adolescents who participated in internet gambling had higher mean Conduct Problems and Peer Problems scores than the control group One quarter of the adolescents who participated in internet gambling concomitantly reported problematic internet use, 1.81 times more likely to report problematic internet use as compared to the control group. It is noteworthy that neither the locations of internet access nor extended history of internet use were associated with problematic internet use among study population.
Graphic source: http://www.cyber-scholar.com/
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Evenat the HappiestPlace On Earth!
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______ something of valuein the _________________
something of greater value.hopes of obtaining
RISKING
Source: American Psychiatric Association - DSM-5 (2013).
Gambling.
Presenter
Presentation Notes
American Psychiatric Association (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, D.C.: Author.
Lottery.
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Prize: Anything of value the sponsor awards in a promotion. For example goods/services with a monetary value or items of intrinsic value.
Chance: A process beyond the participant's direct control determines the outcome. A few examples of chance are a random sweepstakes drawing or an instant win/collect and win game; ultimately luck is the deciding factor.
Consideration: Anything that requires a participant to expend a monetary amount or significant effort to participate. For example the purchase of a product, multiple store or internet visits, correctly answering trivia questions, downloading a file, or attendance at sales presentations.
Gaming that doesn’t meet the legal definition of gambling.
Remove prize, chance or consideration “Freemium” model Sweepstakes
Social Gaming.
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Limited age verification. Video & social gaming correlated with gambling. Some social gaming features associated with addiction. Recreational gamblers may not converge, but what
about problem gamblers? Normal population prevalence of PG = 2-3 million
Unclear oversight & no standards. It’s moving very fast.
Presenter
Presentation Notes
Risky features include frequency of play, high speed of play, opaque odds & terms
Reasons for Play
Theme/Genre
Rewards & Reinforcements
Dopamine
Platforms
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Center photo: Daniel Berman.
Our Changing World
• Technology• Speed• Platform
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Presenter
Presentation Notes
Video poker and other computerized gambling develop gambling disorders “faster” – 15 months can be average to addictions – 4x as fast as horse/dog betting More problem gamblers with a preference for video lottery than any other form of gambling Provide a mechanism for escape, relieve boredom, promote fantasy, stimulate neurological systems Deceptively expensive to play You can bet $4.50 every five seconds on a five cent machine, $54 for each minute of play
As of January 2014* Ï 90% of American adults have a cell phoneÏ 58% of American adults have a smartphoneÏ 42% of American adults own a tablet
computer
Source: Pew Internet Project*Latest data available, as of 2/4/15
Data source: http://fortune.com/2015/01/15/mobile-console-game-revenues-2015/
Presenter
Presentation Notes
“Practically everyone in mature markets now has a smartphone and the majority has access to a tablet,” van Deelen says. “In emerging markets, the smartphone is often their first device that is connected to the Internet. With an installed base of billions, the audience is enormous on a global scale. A console is not a must-have device like smartphones, and in a growing number of cases, tablets are. Mobile devices, which aren’t purchased to play games on, introduce new consumers to games.”
Week of July 31, 2015; Source: appdata.com
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TECHNOLOGY
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* (WITH “IN-APP PURCHASES.”)
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Presenter
Presentation Notes
l
Ï Higher wagersÏ Inflated payoutsÏ Better odds
Ï Most popular choice for youth
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(By the way, this was a “pop-up” ad on a children’s game.)
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Pop-up on my own kid’s game, Feb 2015
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“ADDICTION” is the desired term…
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“Addiction is not about what you DO, but what you DON'T DO because of the replacement of the addictive behavior.”
– Erin Hoffman, Video Game Designer
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“”
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“Executives love to hear the phrase "addictive gameplay.“ Game designers, speaking for myself and those I know… find the concept intriguing but simultaneously dangerous.”
– Erin Hoffman, Video Game Designer
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Article source: Life, Addictive Game Mechanics, And The Truth Hiding In Bejeweled. Image source: ea.com
• Competition• Convenience• Speed & intensity• Discovery – new content• No real “Game Over” for many games• Perpetuity• “Relationships” and “FOMO”
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Discussion.
Gaming / Gambling. Risk Factors.
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Presenter
Presentation Notes
Addiction to mobile text messaging applications is noting to “lol” about, September 2013, Abdullah J. Sultan Consumers in Kuwait (effects of CMC technology on consumers in the Middle East region) Blackberry Messenger (BBM), WhatsApp; allowed consumers to socialize and stay connected longer using their smart phones without having to pay for a networks operators short message service (SMS) charges Current stream of research that defines the personality characteristics of CMC users along the introversion/extroversion and social anxiety continuums Technology/internet addiction: behavioral addiction that involves human-machine interaction and that is non-chemical in nature Growing research suggests that Internet addiction involves tolerance, withdrawal symptoms, affective disturbances, and interruption of social relationships Weak sample given how they were recruited; business students enrolled in undergraduate course at large university in Kuwait sent BBM or WhatsApp messages with a survey link to all their contacts. 552 participants, 79.2% response rate 185 male students, 367 female students – did not report on age 237 were BBM users, 315 were WhatsApp users Hourly usage: 10.9%, 1-3 times, 21.9%, 4-6 times, 21.83%, 7-12 times, 32.25%, 12 times Reasons for using these apps: communicate with family and friends, news, entertainment, boredom, express themselves, meet new people In general, research does not suggest that these advanced communication applications are inherently harmful Problem gambling, gaming, and Internet use in adolescents: Relationships with emotional intelligence in clinical and special needs samples, February 2013, James D.A Parker, Laura J. Summerfeldt, Robyn N. Taylor, Patricia H. Kloosterman, Kateryna V. Keefer Adolescent involvement in gambling activities continues to increase in developed countries Adolescents are especially vulnerable to developing gambling problems, and the prevalence of disordered gambling has been reported to be higher in adolescents compared to adults, with boys being at greater risk than girls. There is empirical evidence indicating that addiction-related recreational behaviors, including Internet and video/computer game abuse, are an increasing problem among adolescents Excessive adolescent video/computer game playing (gaming) has been linked to a number of negative outcomes that match those linked with adolescent pathological/problem gambling, including antisocial behavior, poor academic achievement, and the deterioration of social relationships. Compared to non-problem and social gamblers, adolescent problem gamblers tend to report higher levels of stress, depression, and anxiety, and are also more likely to use avoidant and emotion-based coping strategies (including gambling and substances) to reduce stress and improve negative mood Participants and procedure: “The first sample consisted of 270 adolescent clinical outpatients (180 male, 90 female) 13–18 years of age recruited from a local pediatric clinic at the time of a regular clinic appointment. The majority (58%) had a primary diagnosis of ADHD, 34% learning disorder, 4% mood disorder, 2% anxiety disorder, and 2% had other diagnoses. The mean age in this sample was 15.22 years (SD = 1.63); 15.13 years (SD = 1.60) for boys and 15.39 years (SD = 1.69) for girls. Most participants (91.5%) identified themselves as White, 2.3% as Black, 3.1% as Asian, 1.5% as Hispanic, 1% as Native American, and 1.2% as other.” “The second sample consisted of 256 special needs students (160 male, 96 female) 14–18 years of age recruited from local schools via presentations to teachers, school staff members, parents, and students. Participants self-disclosed details about their Individual Education Plans (IEPs), which were later confirmed via school records. In this sample, 8.6% had IEPs for literacy-related learning problems (i.e., difficulties with listening, reading, spelling, or writing), 13.2% for numeracy-related learning problems (i.e., difficulties with mathematical operations and computations), 49.6% for both literacy and numeracy-related learning problems, and 28.6% for other behavioral and/or mental health issues. The mean age in this sample was 16.27 years (SD = 1.21); 16.29 years (SD = 1.19) for boys and 16.25 years (SD = 1.24) for girls. Most participants (79.0%) identified themselves as White, 4.6% as Black, 8.8% as Asian, 1.0% as Hispanic, 1.0% as Native American, and 5.9% as other. The special needs students were significantly older than the outpatient sample, t (524) = 8.40, p < .001, d = 0.73, although the proportions of males.” Measures: The self-report package included the youth version of the Emotional Quotient Inventory, the South Oaks Gambling Screen-Revised for Adolescents, the Internet Addiction Test, and the Problem Video Game Playing Scale. “This study sought to validate the dysfunctional preoccupation cluster of addiction-related behaviors and examine its association with affect-regulation vulnerabilities in two samples of adolescents with learning-related and externalizing/internalizing problems. Consistent with prior research with a community-based sample (Parker et al., 2008), the study found empirical evidence that the addiction-related behaviors of video/computer game use, Internet use, and gambling can be accounted for by a common dysfunctional preoccupation latent variable.” “Nevertheless, latent variable path analysis revealed that EI was a robust predictor of the dysfunctional preoccupation variable; accounting for 41% of the variance in the adolescent clinical outpatient sample and 25% in the adolescent special needs sample.” “The special needs sample scored significantly higher than the clinical outpatient sample on measures of problematic Internet behaviors and gambling and significantly lower on the interpersonal EQ-i:YV subscale.” Relationships between problematic Internet use and problem-gambling severity: Findings from a high-school survey, 2014, Yvonne H.C Yau, Corey E. Pilver, Marvin A. Steinberg, Loreen J. Rugle, Rani A. Hoff, Suchitra Krishnan-Sarin, Marc N. Potenza Problematic Internet use (PIU) has been associated with substance-use disorders, mood disorders, incarceration, legal troubles, and poor physical and mental health Internet addiction has been modeled after impulse control disorders PIU just like problem gambling (PG) has been proposed as a non-substance or “behavioral” addiction The behavioral-addiction perspective suggests that PIU and PG share characteristics of substance dependence such as tolerance, withdrawal, and cravings Parallels between Internet use and gambling have been proposed – personality traits that promote problematic engagement in Internet use might relate to gambling-related measures PG and PIU are related to similar psychological and neurobiological profiles. PG is associated with impaired impulse control, substance use, depression, anxiety, and aggressive behavior in adult and adolescent populations and similar factors appear associated with PIU. Study analyzed data from a survey of risk behaviors in high-school students in Connecticut All public 4 year, non-vocational, non-special education high schools in the state of Connecticut were invited to participate Not a random sample, but the final sample (N=4523) displayed demographics consistent with census data on Connecticut residents 14-18 years old 2039 students were excluded for non-completion of the gambling section and 326 students were exclude for non-completion of the Internet sections The final sample was 1884 students, 1050 males and 844 females 48.6% of the adolescents met criteria for at risk problematic internet use (ARPIU) The ARPIU group, in contrast to the non-ARPIU group, was more likely to report that their parents disapproved of gambling and that their family had expressed concerns regarding their gambling behavior Among ARPIU respondents, problem gambling severity was associated with participation in extracurricular actives, carry a weapon, engaging in a serious fight, lifetime tobacco smoking, lifetime marijuana use, lifetime other drug use, and caffeine use. Similar associations were observed among non-ARPIU respondents Association Between Internet Gambling and Problematic Internet Use Among Adolescents, October 2010, Artemis Tsitsika, Elena Critselis, Mari Janikian, George Kormas, Dimitrios A. Kafetzis Athens, Greece Cross sectional study design Study sample of 529 people, 9th and 10th grade at randomly selected public junior high and high schools 47.8% boys and 52.2% girls Anonymous self-completed questionnaires 15.1% internet gamblers Boys 2.86 times more likely to participate in internet gambling Adolescents who participated in internet gambling had higher mean Conduct Problems and Peer Problems scores than the control group One quarter of the adolescents who participated in internet gambling concomitantly reported problematic internet use, 1.81 times more likely to report problematic internet use as compared to the control group. It is noteworthy that neither the locations of internet access nor extended history of internet use were associated with problematic internet use among study population.
problem
No Gambling Experimentation
Recreational Problem Pathological
Sources: 1. Moore (2006). 2. Volberg, Hedberg, & Moore (2008). 3. Shaffer & Hall (2001). 4. Northwest Survey & Data Services (2007). 5. Moore (2001).
Between 2-3% adults 18+ problem gamblers Teens (13-17 y.o.): 6% at risk or problem gamblers 2
College age (18-24): 5.6% 3
At-Risk“GAMBLING DISORDER”
Presenter
Presentation Notes
DiClemente, 2003: Addiction & Change: Self-regulated engagement: Balanced view of pros and cons and acknowledgement of the potential for negative consequences Action stage abuse & dependence: decisions focus on the positive end of the behavior; support repeated engagement Normalize & minimize problems associated with it Relationships, beliefs, attitudes, social systems are modified to support repeated engagement Quantity and frequency Own definition or pattern of what they consider “out of control” (gambling only on weekends, certain types of gambling, etc.)
5.6% college age (18-24)
2½ % all adults (18+)
4% teens (13-17)
This is the first generation of widely available electronic gambling.
We really don’t know the effects yet.
Why? Is it the generation? Technology? Or what?
Presenter
Presentation Notes
Pathological gambling is characterized by a number of phenomenon, including: A preoccupation with gambling “Magical” thinking - control the uncontrollable Total loss of control Chasing losses Lying and cheating Illegal acts Family bailouts Family disruption Basically, there is a continuation of the behavior despite the adverse consequences Gambling is no longer a form of recreation - it evolves - into the center of the individual’s life. Flip the coin
The new DSM-5 (May 2013) definesA GAMBLING DISORDEr, A
“behavioral addiction”--the first of its kind.
Source: American Psychiatric Association, 2013. http://www.dsm5.org/Documents/changes%20from%20dsm-iv-tr%20to%20dsm-5.pdf
According to the American Psychiatric Association (APA), this change to an addiction:
Source: Brain Briefings (2007, October), Society for Neuroscience, Washington, DC
Dopamine
Dopamine not released when expecting a loss.Flooded with dopamine when expecting a win!
It’s not about the money – it’s about the action of the game and the hope of winning.
Presenter
Presentation Notes
http://www.youtube.com/watch?v=7A4Qxx7j63Y studies have found that when we anticipate financial gains - whether at the gaming tables or on the stock market - an area of our brain known as the ventral striatum becomes activated and flooded with dopamine, a brain chemical linked to pleasurable sensations. The release of this chemical also occurs during physically rewarding activities such as eating, sex and taking drugs, and is a key factor behind our desire to repeat these activities. When we start to consider the possibility of losing money, however, the same brain areas become less active. In fact, most people's brains show more negative sensitivity to losses than positive sensitivity to gains - neural evidence of our tendency toward risk aversion. Once considered a character defect, gambling is now known to be a highly addictive disorder with neurological causes. Thanks to new advances in brain imaging, scientists are beginning to identify the neural mechanisms that go awry in the brains of pathological and problem gamblers. What they're learning from such research is also shedding light on how these same mechanisms determine individual risk tolerance – and influence the financial choices we all make throughout our lives. You hold your breath as the wheel spins on the roulette table. You briefly close your eyes as the croupier deals you another card at the blackjack table. You stand frozen in place as the horse you bet on lunges toward the finish line. At such moments – when you're anticipating the possibility of a financial reward – certain areas of your brain jump into action. The particular pattern of that activity, neuroscientists are now discovering, helps identify how risk-averse you are – not only when you're at the gambling table or the racetrack – but when you ponder any decision that involves some financial risk. Should you take a new job? Should you invest in a new business? Should you put your savings in potentially volatile stocks or in the “sure thing” of a bank certificate of deposit? Those same neural patterns may also reveal whether you're at risk of becoming a pathological gambler, someone so addicted to gambling that you continue the activity even while mounting losses ruin your personal finances and relationships. Recent studies have found that when we anticipate financial gains – whether at the gaming tables or on the stock market – an area of our brain known as the ventral striatum becomes activated and flooded with dopamine, a brain chemical linked to pleasurable sensations. The release of this chemical also occurs during physically rewarding activities such as eating, sex and taking drugs, and is a key factor behind our desire to repeat these activities. When we start to consider the possibility of losing money, however, the same brain areas become less active. In fact, most people's brains show more negative sensitivity to losses than positive sensitivity to gains – neural evidence of our tendency toward risk aversion. In one study, researchers could predict how tolerant individuals were to risk by analyzing how their brains responded to potential gains versus potential losses. Those whose brains were less turned off by the possibility of increasing their losses tended to be more eager gamblers. In pathological gamblers, neural activity in the ventral striatum remains remarkably unreactive – even during winning streaks. Their brains also show decreased activation in the ventrolateral prefrontal cortex – the brain's “superego” – which, when functioning normally, keeps people from acting impulsively. This finding may explain why pathological gamblers keep betting despite the havoc it inflicts on their lives. To maintain even a normal level of dopamine in their brains, they must gamble with increasing frequency – and often for greater and greater stakes. And the impulse control in their brain is not functioning properly. Drug addicts show a similar brain pattern – and a similar need to keep feeding their addiction. Recently, pathological gambling has been found to be a rare side effect of specific types of dopamine agonists, drugs used to treat the tremors and balance problems associated with Parkinson's disease. The dopamine boost from these drugs appears to overload receptors in the ventral striatum, causing an irresistible urge to gamble. The effect does not occur in everybody who takes dopamine agonists and it dissipates once the medication is discontinued. Source: http://www.sfn. Good introductory video on dopamine & dopamine receptors: http://www.youtube.com/watch?v=7A4Qxx7j63Y
Neurotransmitter
Serotonin
Norepinephrine
Opioids
Dopamine
Role in Relation to Gambling
Behavior Initiation/Cessation
Arousal, Excitement
Pleasure, Urges
Reward, Reinforcement
Dopamine: most studied neurotransmitter in problem gambling
↓ Serotonin -- ↑ risk taking
Gambling - ↑ β-endorphin
PGs - ↑ NE levels
PGs - ↑ dopamine response
Neurotransmitter “PGs” = problem gamblers | Neurotransmitters are brain chemicals that transmit nerve impulses. Dopamine is known as the brain’s “reward system.”
Presenter
Presentation Notes
http://braininstitute.vanderbilt.edu/Vanderbilt_March07_PotenzaLecture.ppt Source: Grant, J. (2006, October.) Neurobiology and pharmacological treatment of pathological gambling. Presentation at Oregon Problem Gambling Services training, Bend, OR. Dopamine release associated with rewards and reinforcing Dopamine release - maximal when reward is most uncertain, suggesting it plays a central role in guiding behavior during risk-taking situations. Norepinephrine (NE) - an important component in the mediation of arousal, attention and sensation-seeking in PG PGs had higher urine levels of NE. Opioid system: The endogenous opioid system influences the experiencing of pleasure. Gambling or related behaviors have been associated with elevated blood levels of the endogenous opioid β-endorphin.
This is the first generation of widely available electronic gaming & gambling. We really don’t know the effects yet.
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Much like the
technology
itself,
the research is
new.
Background
Suggested link between adolescent video game playing and adoption of gambling in later life.
Brown, 1989; Griffiths, 1999.
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Mark Griffiths, 2015 - http://www.cnn.com/2015/01/21/opinion/gaming-addiction-risks/
Backgroundhighly frequent and problem players of both gambling machines and video games report entering dissociative-like states when playing.
(Jacobs 1988; Wood et al. 2007).
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“Internet Gaming Disorder” A condition warranting more clinical research and experience before it might be considered for inclusion in the main book as a formal disorder.
Source: Brain Briefings (2007, October), Society for Neuroscience, Washington, DC
Dopamine not released when expecting a loss.Flooded with dopamine when expecting a win!
It’s NOT about the money!
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Presenter
Presentation Notes
http://www.youtube.com/watch?v=7A4Qxx7j63Y studies have found that when we anticipate financial gains - whether at the gaming tables or on the stock market - an area of our brain known as the ventral striatum becomes activated and flooded with dopamine, a brain chemical linked to pleasurable sensations. The release of this chemical also occurs during physically rewarding activities such as eating, sex and taking drugs, and is a key factor behind our desire to repeat these activities. When we start to consider the possibility of losing money, however, the same brain areas become less active. In fact, most people's brains show more negative sensitivity to losses than positive sensitivity to gains - neural evidence of our tendency toward risk aversion. Once considered a character defect, gambling is now known to be a highly addictive disorder with neurological causes. Thanks to new advances in brain imaging, scientists are beginning to identify the neural mechanisms that go awry in the brains of pathological and problem gamblers. What they're learning from such research is also shedding light on how these same mechanisms determine individual risk tolerance – and influence the financial choices we all make throughout our lives. You hold your breath as the wheel spins on the roulette table. You briefly close your eyes as the croupier deals you another card at the blackjack table. You stand frozen in place as the horse you bet on lunges toward the finish line. At such moments – when you're anticipating the possibility of a financial reward – certain areas of your brain jump into action. The particular pattern of that activity, neuroscientists are now discovering, helps identify how risk-averse you are – not only when you're at the gambling table or the racetrack – but when you ponder any decision that involves some financial risk. Should you take a new job? Should you invest in a new business? Should you put your savings in potentially volatile stocks or in the “sure thing” of a bank certificate of deposit? Those same neural patterns may also reveal whether you're at risk of becoming a pathological gambler, someone so addicted to gambling that you continue the activity even while mounting losses ruin your personal finances and relationships. Recent studies have found that when we anticipate financial gains – whether at the gaming tables or on the stock market – an area of our brain known as the ventral striatum becomes activated and flooded with dopamine, a brain chemical linked to pleasurable sensations. The release of this chemical also occurs during physically rewarding activities such as eating, sex and taking drugs, and is a key factor behind our desire to repeat these activities. When we start to consider the possibility of losing money, however, the same brain areas become less active. In fact, most people's brains show more negative sensitivity to losses than positive sensitivity to gains – neural evidence of our tendency toward risk aversion. In one study, researchers could predict how tolerant individuals were to risk by analyzing how their brains responded to potential gains versus potential losses. Those whose brains were less turned off by the possibility of increasing their losses tended to be more eager gamblers. In pathological gamblers, neural activity in the ventral striatum remains remarkably unreactive – even during winning streaks. Their brains also show decreased activation in the ventrolateral prefrontal cortex – the brain's “superego” – which, when functioning normally, keeps people from acting impulsively. This finding may explain why pathological gamblers keep betting despite the havoc it inflicts on their lives. To maintain even a normal level of dopamine in their brains, they must gamble with increasing frequency – and often for greater and greater stakes. And the impulse control in their brain is not functioning properly. Drug addicts show a similar brain pattern – and a similar need to keep feeding their addiction. Recently, pathological gambling has been found to be a rare side effect of specific types of dopamine agonists, drugs used to treat the tremors and balance problems associated with Parkinson's disease. The dopamine boost from these drugs appears to overload receptors in the ventral striatum, causing an irresistible urge to gamble. The effect does not occur in everybody who takes dopamine agonists and it dissipates once the medication is discontinued. Source: http://www.sfn. Good introductory video on dopamine & dopamine receptors: http://www.youtube.com/watch?v=7A4Qxx7j63Y
Electronics: about the action. Sound familiar?
“ALMOST WINNING”: dopamine is activated the same as ACTUALLY winning.
Problem gamblers are more likely to see their near misses as “NEAR WINS”
People play LONGER when machines give them NEAR MISSES.
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Major risk factor is TRAUMA -- about
90% of problem gamblers have experienced some kind of trauma.
Want to know more about trauma? Check out the Adverse Childhood Experiences (ACE) study. (http://www.cdc.gov/ace/)
• Older adults• College students• People of color• Incarcerated persons• Military & veterans• Women
• Substance abuse history
• Mental health history• Youth
These groups are at higher risk , and tend to have higher rates of problem gambling than other population groups.
Prone to abuse and/or neglect Child endangerment may increase Higher levels of tobacco,
alcohol, drug use, and overeating than peers Higher risk of pathological gambling Suffer effects from lack of financial stability
Being male, older teen Single-parent household Gambling on cards/sports Lower household income Competitive Having lost more than
$50 in a single monthStarted gambling before
8th grade (early
initiation)Parents who are
alcohol/substance abusers
Parents who gamble*
Source: Volberg, et al (2008; bid).
Key risk factors for YOUTH:
*this is the single biggest factor.
Youth are TWICE as likely to be at-risk gamblers & FOUR
TIMES as likely to be PROBLEM GAMBLERS.
Youth gambling is still under-studied & under the radar
Research shows a bunch of factors. I call these the “A’s.”
Presenter
Presentation Notes
Problem is rising Youth are gambling more First generation of youth exposed to ready access & ways to gamble Rapid movement from social to pathological gambler Long-term costs unknown COMMUNITY: AVAILABILITY--Accessibility: greater access more gambling, greater $ spent, increased # PG’s LAWS & NORMS-- lack of awareness, social acceptance, media FAMILY: FAMILY CONFLICT--Competitive home environment, “must win” attitude PARENTAL ATTITUDES--Pathological gamblers and youth in general report early gambling in the home and with family members; siblings appear to be the predominant influence. Youth are significantly more likely to gamble, and gamble more often, if one or both of their parents gamble. Lack of parental objection STABILITY, LACK OF DISCIPLINE SCHOOL: ANTI-SOCIAL BEHAVIOR: impulse control INDIVIDUAL/PEERS: Gambling considered a rite of passage High imitation – 44% youth imitated because friends were involved FAVORABLE ATTITUDES: not afraid of getting caught as adolescents get older EARLY INITIATION: high correlation of age of onset to problem; many PG’s report starting at 10-11 y.o., age getting younger Purpose of our program to delay onset CONSTITUTIONAL: Biochemical factors, gender (males greater risk takers), much greater risk for depression/suicide Emotional distress Inability to delay gratification Aggressiveness/competitiveness Sensation seeking Lower self-esteem
(& Skirting Them)
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Presenter
Presentation Notes
Addiction to mobile text messaging applications is noting to “lol” about, September 2013, Abdullah J. Sultan Consumers in Kuwait (effects of CMC technology on consumers in the Middle East region) Blackberry Messenger (BBM), WhatsApp; allowed consumers to socialize and stay connected longer using their smart phones without having to pay for a networks operators short message service (SMS) charges Current stream of research that defines the personality characteristics of CMC users along the introversion/extroversion and social anxiety continuums Technology/internet addiction: behavioral addiction that involves human-machine interaction and that is non-chemical in nature Growing research suggests that Internet addiction involves tolerance, withdrawal symptoms, affective disturbances, and interruption of social relationships Weak sample given how they were recruited; business students enrolled in undergraduate course at large university in Kuwait sent BBM or WhatsApp messages with a survey link to all their contacts. 552 participants, 79.2% response rate 185 male students, 367 female students – did not report on age 237 were BBM users, 315 were WhatsApp users Hourly usage: 10.9%, 1-3 times, 21.9%, 4-6 times, 21.83%, 7-12 times, 32.25%, 12 times Reasons for using these apps: communicate with family and friends, news, entertainment, boredom, express themselves, meet new people In general, research does not suggest that these advanced communication applications are inherently harmful Problem gambling, gaming, and Internet use in adolescents: Relationships with emotional intelligence in clinical and special needs samples, February 2013, James D.A Parker, Laura J. Summerfeldt, Robyn N. Taylor, Patricia H. Kloosterman, Kateryna V. Keefer Adolescent involvement in gambling activities continues to increase in developed countries Adolescents are especially vulnerable to developing gambling problems, and the prevalence of disordered gambling has been reported to be higher in adolescents compared to adults, with boys being at greater risk than girls. There is empirical evidence indicating that addiction-related recreational behaviors, including Internet and video/computer game abuse, are an increasing problem among adolescents Excessive adolescent video/computer game playing (gaming) has been linked to a number of negative outcomes that match those linked with adolescent pathological/problem gambling, including antisocial behavior, poor academic achievement, and the deterioration of social relationships. Compared to non-problem and social gamblers, adolescent problem gamblers tend to report higher levels of stress, depression, and anxiety, and are also more likely to use avoidant and emotion-based coping strategies (including gambling and substances) to reduce stress and improve negative mood Participants and procedure: “The first sample consisted of 270 adolescent clinical outpatients (180 male, 90 female) 13–18 years of age recruited from a local pediatric clinic at the time of a regular clinic appointment. The majority (58%) had a primary diagnosis of ADHD, 34% learning disorder, 4% mood disorder, 2% anxiety disorder, and 2% had other diagnoses. The mean age in this sample was 15.22 years (SD = 1.63); 15.13 years (SD = 1.60) for boys and 15.39 years (SD = 1.69) for girls. Most participants (91.5%) identified themselves as White, 2.3% as Black, 3.1% as Asian, 1.5% as Hispanic, 1% as Native American, and 1.2% as other.” “The second sample consisted of 256 special needs students (160 male, 96 female) 14–18 years of age recruited from local schools via presentations to teachers, school staff members, parents, and students. Participants self-disclosed details about their Individual Education Plans (IEPs), which were later confirmed via school records. In this sample, 8.6% had IEPs for literacy-related learning problems (i.e., difficulties with listening, reading, spelling, or writing), 13.2% for numeracy-related learning problems (i.e., difficulties with mathematical operations and computations), 49.6% for both literacy and numeracy-related learning problems, and 28.6% for other behavioral and/or mental health issues. The mean age in this sample was 16.27 years (SD = 1.21); 16.29 years (SD = 1.19) for boys and 16.25 years (SD = 1.24) for girls. Most participants (79.0%) identified themselves as White, 4.6% as Black, 8.8% as Asian, 1.0% as Hispanic, 1.0% as Native American, and 5.9% as other. The special needs students were significantly older than the outpatient sample, t (524) = 8.40, p < .001, d = 0.73, although the proportions of males.” Measures: The self-report package included the youth version of the Emotional Quotient Inventory, the South Oaks Gambling Screen-Revised for Adolescents, the Internet Addiction Test, and the Problem Video Game Playing Scale. “This study sought to validate the dysfunctional preoccupation cluster of addiction-related behaviors and examine its association with affect-regulation vulnerabilities in two samples of adolescents with learning-related and externalizing/internalizing problems. Consistent with prior research with a community-based sample (Parker et al., 2008), the study found empirical evidence that the addiction-related behaviors of video/computer game use, Internet use, and gambling can be accounted for by a common dysfunctional preoccupation latent variable.” “Nevertheless, latent variable path analysis revealed that EI was a robust predictor of the dysfunctional preoccupation variable; accounting for 41% of the variance in the adolescent clinical outpatient sample and 25% in the adolescent special needs sample.” “The special needs sample scored significantly higher than the clinical outpatient sample on measures of problematic Internet behaviors and gambling and significantly lower on the interpersonal EQ-i:YV subscale.” Relationships between problematic Internet use and problem-gambling severity: Findings from a high-school survey, 2014, Yvonne H.C Yau, Corey E. Pilver, Marvin A. Steinberg, Loreen J. Rugle, Rani A. Hoff, Suchitra Krishnan-Sarin, Marc N. Potenza Problematic Internet use (PIU) has been associated with substance-use disorders, mood disorders, incarceration, legal troubles, and poor physical and mental health Internet addiction has been modeled after impulse control disorders PIU just like problem gambling (PG) has been proposed as a non-substance or “behavioral” addiction The behavioral-addiction perspective suggests that PIU and PG share characteristics of substance dependence such as tolerance, withdrawal, and cravings Parallels between Internet use and gambling have been proposed – personality traits that promote problematic engagement in Internet use might relate to gambling-related measures PG and PIU are related to similar psychological and neurobiological profiles. PG is associated with impaired impulse control, substance use, depression, anxiety, and aggressive behavior in adult and adolescent populations and similar factors appear associated with PIU. Study analyzed data from a survey of risk behaviors in high-school students in Connecticut All public 4 year, non-vocational, non-special education high schools in the state of Connecticut were invited to participate Not a random sample, but the final sample (N=4523) displayed demographics consistent with census data on Connecticut residents 14-18 years old 2039 students were excluded for non-completion of the gambling section and 326 students were exclude for non-completion of the Internet sections The final sample was 1884 students, 1050 males and 844 females 48.6% of the adolescents met criteria for at risk problematic internet use (ARPIU) The ARPIU group, in contrast to the non-ARPIU group, was more likely to report that their parents disapproved of gambling and that their family had expressed concerns regarding their gambling behavior Among ARPIU respondents, problem gambling severity was associated with participation in extracurricular actives, carry a weapon, engaging in a serious fight, lifetime tobacco smoking, lifetime marijuana use, lifetime other drug use, and caffeine use. Similar associations were observed among non-ARPIU respondents Association Between Internet Gambling and Problematic Internet Use Among Adolescents, October 2010, Artemis Tsitsika, Elena Critselis, Mari Janikian, George Kormas, Dimitrios A. Kafetzis Athens, Greece Cross sectional study design Study sample of 529 people, 9th and 10th grade at randomly selected public junior high and high schools 47.8% boys and 52.2% girls Anonymous self-completed questionnaires 15.1% internet gamblers Boys 2.86 times more likely to participate in internet gambling Adolescents who participated in internet gambling had higher mean Conduct Problems and Peer Problems scores than the control group One quarter of the adolescents who participated in internet gambling concomitantly reported problematic internet use, 1.81 times more likely to report problematic internet use as compared to the control group. It is noteworthy that neither the locations of internet access nor extended history of internet use were associated with problematic internet use among study population.
• Made it illegal to make interstate SPORTS bets
• While this is technically legal today at licensed racetracks, the government has cited the act to prevent ONLINE sports betting.
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• Made it illegal for banks and credit card companies to allow money to be transferred to online casinos or gambling websites
• Fostered growth in third party (PayPal-esque) accounts for money transfers
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• Switched gears
• Gambling technically not ILLEGAL
• Up to the states to decide
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Individual states sometimes have very specific, restrictive laws about online gambling. Some states expressly prohibit online gambling by residents while others have no clear laws.
States currently with legalized online gambling: NV
NJ
DE
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Source: betclic.com93
Ï Completely digital $Ï Peer to peer (doesn’t go through a bank)Ï Can be used in
any countryÏ ANONYMOUS
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Policy Recommendations & Practical Tools
Recommendations:
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Regulation will “kill” social gaming. Has greatly benefited many industries, especially
gaming. Monetary prizes are an essential component of
gambling addiction. For addicts, its not about the money.
SG operators are not obligated or required to be responsible. Responsible gambling is good customer service,
builds public support, mitigates individual harms and ensures sustainability.
Source: Keith Whyte, Executive Director, National Council on Problem Gambling
Presenter
Presentation Notes
If model can only thrive unregulated, invites scrutiny.
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Ï Gambling-Like Monetized GamesÏ Responsible Gaming FeaturesÏ Age ControlsÏ Data Driven ResearchÏ Education Of Players
From: Social Games Consumer Protection Guidelines, National Council on Problem Gambling (2013, Draft, v. 3)
Remember about when you need to shut the game off.
☺ love u
Jordan. phone goes off. Now.
Minecraft, mom.
K
Mom9:46PM
9:31PM
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9:13 PM
9:45 PM
9:45 PM
9:46 PM
My 80’s Frogger game
Image source: eBay user duramax1989
CONSEQUENCES
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Ï Check out the games/apps WITH your kidsÏ Play with your kids or sit with them while they play.
You will have fun and learn about their gaming, too. Ï Check the ratings of the games your kids want to
play. Most games at retail stores are described and rated by the Entertainment Software Rating Board(ESRB). Use these ratings as you discuss the most appropriate games with your child or teen. Note that many of these ratings list “E” for everyone!
Ï Pay attention to clues: restless, withdrawal, lack of interest, different friends, signs you know from problem gambling
Ï INTERVENE if you see warning signs. (Get intervention tips: www.drugfree.org/intervene)
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Presenter
Presentation Notes
Closing Although can’t teen-proof your teen… Be authoritative not authoritarian; set clear limits/communicate expectations i.e., youth who know their parents disapprove of underage drinking are less likely to drink alcohol. Keep communicating with your teen; staying engaged
