key reviews Flashcards
Public health england 2023-
MIxed methods review!- HOWEVER on problem gambling
The UK has one of the biggest gambling markets in the world, generating a profit of £14.2 billion in 2020.
who-In 2018, 24.5 million people in England gambled (54% of the adult population, or 40% when you exclude the National Lottery). The National Lottery is the most common type of gambling across all age groups, except among younger people where scratch cards are more common. Football pools and electronic gaming machines are more common among people under 35 years of age compared with older age groups. Men are more likely to gamble than women, and this difference is most obvious for online gambling where 15% of men participate, compared to 4% of women.
at-risk and problem gambling, where there is a higher prevalence among people with poor health, low life satisfaction and wellbeing
RISKS-impulsivity (a cognitive trait)
substance use (alcohol, tobacco, cannabis and other illegal drugs)
being male
experiencing depression
harms- reviewed 53 studies- 34
showed finacnial problems-One high quality study reported that an increase in the number of electronic gaming venues in a local area increased the number of personal bankruptcies in that area. There was also considerable evidence from the qualitative studies that gambling directly causes financial harms to gamblers and their close associates, particularly intimate partners.
We identified gambling-related debt as a crucial harm that can lead to other harms such as relationship problems, physical and mental health problems, and crime.
Two quantitative studies (of moderate and high quality) reported that deaths from suicide were significantly higher among adults with gambling disorder or problems compared to the general adult population. One of these found that some participants, particularly women, had already experienced suicidal events before starting to gamble. This suggests that gambling may trigger suicidal events in some people already prone to suicidal ideation. The link between gambling and suicide and self-harm was supported by qualitative studies.
other harms included employment issues/ criminal activities
issues with studies (public health england)
but this proved difficult as the reviews were low quality and relied heavily on cross-sectional studies. The majority of the evidence focused on personal or individual level factors, with limited evidence on family, societal or environmental factors.
Most of the studies published on gambling and harm do not allow us to determine that gambling came before the harm. We intended to draw on previous reviews as well as primary studies, but we could not identify any reviews that focused on longitudinal studies. It’s possible that there are more longitudinal studies that we did not identify through this method.
We also found that the evidence of harms was limited. We were not able to cost any harms to affected others in the economic analysis. We have detailed the research gaps in each piece of work, but examples of further research needed are:
studies that quantify the types and extent of financial harm experienced by people engaging in harmful gambling
longitudinal studies on if or how community, societal and commercial factors can influence harmful gambling
longitudinal quantitative studies that quantify the impact of harmful gambling on affected others, including family members, friends and close associates
Fong et al., 2005
From a medical perspective, pathological gamblers are at increased risk to develop stress-related conditions, such as hypertension, sleep deprivation, cardiovascular disease, and peptic ulcer disease. Common psychiatric sequelae of pathological gambling include exacerbation and initiation of major depressive episodes, anxiety disorders, or substance use disorders. Unintended psychological consequences may also include intense levels of guilt and shame, deceptive practices, and heightened impulsivity/ impaired decision-making. Finally, the social consequences of pathological gambling can be enormous, often ranging from involvement with the legal system to lost productivity at work to strained interpersonal relationships
problem gambling can even lead to homelessness in extreme cases (Nower et al., 2015)
wardele et al., 2011- men more likley
critical points
Many policy decisions, public health interventions, and harm reduction strategies are based on problem gambling research—not necessarily gambling addiction research.
The fact that gambling addiction is in the DSM-5, yet many studies still refer to problem gambling, can be seen as a gap in research and clinical understanding.
This distinction might impact treatment approaches, as someone with a gambling disorder may require more intensive intervention than a person with problem gambling.
Banjeree et al., studies
This study focuses on loss-chasing, which is when gamblers keep gambling or gamble more intensely after experiencing losses. It’s a key sign of gambling disorder and is common in at-risk gamblers. The study reviews how loss-chasing has been defined and measured in past research, as it has been studied in different ways.
The study divides loss-chasing into two categories:
Between-session loss-chasing: This is when gamblers return to gamble later to try to recover their losses. It can also be measured by how much time passes between gambling sessions or whether the gambler increases their bets in the next session.
Within-session loss-chasing: This happens when gamblers keep gambling during the same session, either by taking bigger risks, increasing their stake, or speeding up their play to make up for losses.
The study also points out that the way loss-chasing is defined and measured varies a lot across different studies, including the gambling situations studied, how losses are defined, and whether the idea of win-chasing (chasing wins, instead of losses) is considered.
the variable ratio schedule
skinner 1997-
Banjeree et al. 2023-
The variable ratio schedule is a concept from behavioral psychology that refers to a pattern of reinforcement in which a reward (such as money or a prize) is given after an unpredictable number of responses or actions. This schedule is a key principle in understanding why gambling can be so addictive, and it’s a powerful tool used by gambling companies.
How the Variable Ratio Schedule Works in Gambling:
In the context of gambling, the “responses” are the bets or spins, and the “reinforcement” is the win. With a variable ratio schedule, the gambler doesn’t know how many bets they need to make before hitting a win, which can lead to the following psychological effects:
Uncertainty and Excitement: The unpredictability of when a win will come creates an element of suspense and excitement. The gambler is motivated to keep playing because they never know when the next win will occur, and that uncertainty drives them to continue making bets.
Persistent Behavior: Since the reinforcement (win) happens after a random number of bets, it creates a very strong response pattern where the gambler keeps playing for longer periods, even if they experience several losses. The occasional win serves to maintain the gambling behavior, even though it’s intermittent.
Gambler’s Fallacy: This schedule can also play into cognitive biases. Gamblers may believe that because they’ve lost several times in a row, they’re “due” for a win, which encourages them to keep betting in the hope that the next win is just around the corner.
Dopamine Release: Wins, even if infrequent, trigger dopamine release in the brain. This is a reward chemical that makes people feel good, reinforcing the gambling behavior and making the individual more likely to continue. The unpredictability of the wins creates a powerful cycle of anticipation and reward.
Do Gambling Companies Know This Psychology?
Yes, gambling companies are well aware of the psychology behind variable ratio reinforcement, and they use this knowledge to design their games and platforms. Here’s how they might leverage it:
Slot Machines: Many slot machines are designed with a variable ratio schedule of reinforcement. A player might win after a few spins, or it could take many more spins before the next payout, creating a situation where players keep trying, hoping for the next win.
Online Gambling: In online casinos and sports betting, algorithms are designed to create similar patterns of unpredictability in terms of wins and losses. This unpredictability is key to maintaining engagement, as users will often keep playing, thinking that their next bet might be the one that leads to a win.
Game Design and In-App Purchases: In mobile and online games (which often have gambling elements like loot boxes), variable rewards are often used to keep players engaged. The thrill of never knowing when the next reward will come keeps players playing longer and spending more money.
Bonus Systems: Many gambling platforms use bonuses and promotions that are structured around unpredictable rewards, reinforcing the same psychological principles. The “you never know when it will hit” effect keeps players coming back, hoping for that next bonus.
In short, the variable ratio schedule plays a central role in gambling addiction. Gambling companies intentionally design their games and systems around this principle, knowing that it can lead to sustained engagement and repeat gambling behavior. This psychological tactic, combined with the immediate rewards, creates a compelling reason for people to continue gambling, even in the face of repeated losses.
