Session Title

Session 3-1-E: Disordered Gambling Development and Impacts

Presentation Type

Event

Location

Caesars Palace, Las Vegas, Nevada

Start Date

30-5-2019 9:00 AM

End Date

30-5-2019 10:25 AM

Disciplines

Clinical Psychology | Cognitive Psychology | Community Psychology | Health Psychology

Abstract

Aims: (1) To introduce the concept of individual vulnerability for developing a gambling disorder (GD), (2) to question gambling supply reduction and access limitations as effective GD prevention strategies and (3) to derive short- and long-term implications for research, gambling regulation and consumer protection of vulnerable gamblers. Background: Gambling regulation is currently based on the assumption that participants have similar risks for the development of GD based on individual, social and predominantly gambling-related risk factors. Consequently, GD prevention mainly relies on supply and access limitations and “rational” consumer information and warnings within the Responsible Gambling concept. However, it remains an open research and policy question whether this “one-size-fits-all” approach really provides effective GD prevention. Method: Recent findings on characteristics and risk factors for GD from clinical and epidemiological studies as well as from basic experimental research and cohort studies are summarized. Results: Current evidence underpins a theoretical model that integrates a set of putative individual vulnerability factors for GD: Impaired cognitive control, increased reward and lower punishment sensitivity, higher attentional bias and cue reactivity, higher risk taking and steeper delay discounting, accompanied by a high rate of comorbid mental disorders. There is also increasing evidence that these intra-individual factors constitute antecedent vulnerability factors increasing the risk of individuals for GD. These findings would explain the relatively low prevalence rates of GD in different countries (0.5 to 2%) despite similar high availability and popularity of gambling in the adult population (around 40% to 80% lifetime gambling). Given this vulnerability concept, current gambling supply reduction policies are regarded as insufficient to protect vulnerable gamblers and as unnecessarily strict for the majority of resilient gamblers. Conclusions: Implications for short-term improved public health concepts and a two-step strategy will be presented: (1) general consumer protection activities for the majority of resilient gamblers (e.g. information, self-limitation strategies, feedback and warning systems) and (2) improved activities for early detection and support of vulnerable gamblers with a variety of interventions like personalized warnings, provider-suggested and initiated temporary responsible gambling limits or time-outs, voluntary self-exclusion, and forced exclusion as ultima ratio. These activities require strong public regulation and control agencies. To support and refine the presented vulnerability concept as long-term aim, more experimental and prospective cohort studies are essential to better define and to early detect vulnerability factors in active gamblers. A better understanding of possible interactions between individual vulnerability and gambling related features is also needed. Furthermore, the effectiveness of intervention methods specifically targeting vulnerable gamblers has to be tested. Finally, ethical aspects of gambling regulation options like gambling bans will be discussed.

Keywords

gambling disorder, consumer protection, vulnerable gamblers, resilient gamblers, individual vulnerability

Author Bios

Gerhard Bühringer (PhD) is senior professor at the University of Dresden and Director of the Work Group Addictive Behaviors, Risk Analysis and Risk Management (Institute of Clinical Psychology and Psychotherapy). His research interests cover epidemiology, etiology, and treatment of substance use and gambling disorders as well as public health and regulation concepts to minimize individual and social harm. To see his work: https://orcid.org/0000-0002-5568-1435 as well as https://www.psychauthors.de/psychauthors/index.php?wahl=forschung&uwahl=psychauthors&uuwahl=p00017GB_pub

Roxana Kotter (PhD) is a postdoctoral researcher and psychotherapist at the University of Würzburg. Her research interests focused on gambling and anxiety disorders (prevention and treatment) as well as social cognitive neuroscience (in particular, the psychological and psychopathological processes of social gaze). Her PhD thesis (University of Dresden) focused on the impact of casino exclusion. To see her work: https://orcid.org/0000-0001-8545-8632

Robert Czernecka is a PhD student at the University of Dresden. His research focus are risk factors for the development of substance-related and addictive disorders, especially for gambling disorder, and their implication for consumer protection.

Anja Kräplin (PhD) is postdoctoral researcher at the Collaborative Research Centre (CRC940) ‘Volition and Cognitive Control’ of the University of Dresden. Her research focus is on experimental studies investigating the role of impaired cognitive control and decision-making in the onset and course of substance-related and addictive disorders. To see her work: https://orcid.org/0000-0002-1612-3932

Funding Sources

For all authors: The presentation was partly funded by several sources mentioned in the competing interests section. These funding sources had no involvement in any aspect of the presentation and the underlying research, including research questions, methodology, research conduct, data analyses and publication of results.

Competing Interests

Gerhard Bühringer received unrestricted grants for gambling research activities from: Bavarian State Ministry of Finance (regulatory authority for and operator of the State Gambling Monopoly) via the Bavarian State Ministry of the Environment and Public Health; Deutsche Forschungsgemeinschaft (DFG, German Research Foundation); European Commission (ALICE-RAP); German Federal Ministry of Economics and Technology (regulatory authority for the commercial gaming industry); German Federal Ministry of Health; Public and commercial gambling providers. He is also a member of the ‘Düsseldorfer Kreis’ (a group of key stakeholders from public and private gambling providers, research and the support system). Robert Czernecka is partly funded by an unrestricted research donation of members of the ‘Düsseldorfer Kreis’ to the University of Dresden. Roxana Kotter was funded in part by an unrestricted research donation by the Federal Association of German Casinos (BupriS) to the University of Dresden. She currently works as a postdoctoral researcher and psychotherapist at the University of Würzburg. Anja Kräplin is supported by the German Research Foundation (DFG) within the Collaborative Research Centre “Volition and Cognitive Control” (SFB 940/1 2016 and SFB 940/2 2017).

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May 30th, 9:00 AM May 30th, 10:25 AM

The risk for developing disordered gambling: Equal for every player? Implications for research, policy and consumer protection

Caesars Palace, Las Vegas, Nevada

Aims: (1) To introduce the concept of individual vulnerability for developing a gambling disorder (GD), (2) to question gambling supply reduction and access limitations as effective GD prevention strategies and (3) to derive short- and long-term implications for research, gambling regulation and consumer protection of vulnerable gamblers. Background: Gambling regulation is currently based on the assumption that participants have similar risks for the development of GD based on individual, social and predominantly gambling-related risk factors. Consequently, GD prevention mainly relies on supply and access limitations and “rational” consumer information and warnings within the Responsible Gambling concept. However, it remains an open research and policy question whether this “one-size-fits-all” approach really provides effective GD prevention. Method: Recent findings on characteristics and risk factors for GD from clinical and epidemiological studies as well as from basic experimental research and cohort studies are summarized. Results: Current evidence underpins a theoretical model that integrates a set of putative individual vulnerability factors for GD: Impaired cognitive control, increased reward and lower punishment sensitivity, higher attentional bias and cue reactivity, higher risk taking and steeper delay discounting, accompanied by a high rate of comorbid mental disorders. There is also increasing evidence that these intra-individual factors constitute antecedent vulnerability factors increasing the risk of individuals for GD. These findings would explain the relatively low prevalence rates of GD in different countries (0.5 to 2%) despite similar high availability and popularity of gambling in the adult population (around 40% to 80% lifetime gambling). Given this vulnerability concept, current gambling supply reduction policies are regarded as insufficient to protect vulnerable gamblers and as unnecessarily strict for the majority of resilient gamblers. Conclusions: Implications for short-term improved public health concepts and a two-step strategy will be presented: (1) general consumer protection activities for the majority of resilient gamblers (e.g. information, self-limitation strategies, feedback and warning systems) and (2) improved activities for early detection and support of vulnerable gamblers with a variety of interventions like personalized warnings, provider-suggested and initiated temporary responsible gambling limits or time-outs, voluntary self-exclusion, and forced exclusion as ultima ratio. These activities require strong public regulation and control agencies. To support and refine the presented vulnerability concept as long-term aim, more experimental and prospective cohort studies are essential to better define and to early detect vulnerability factors in active gamblers. A better understanding of possible interactions between individual vulnerability and gambling related features is also needed. Furthermore, the effectiveness of intervention methods specifically targeting vulnerable gamblers has to be tested. Finally, ethical aspects of gambling regulation options like gambling bans will be discussed.