Week 8 Flashcards
What is the study of non substance-based addiction? (3)
Excessive and problematic consumption of psychoactive substances is a major focus of addiction theory and research
People can engage excessively in problematic behaviors as well (gambling, gaming, sex, shopping)
Can we use an addiction lens to understand these behaviors?
Who is Stanton Peele? (2) What are his 6 conditions of addictive behavior? (IAGPSI)
Leader in this area of addiction
States that all addictions are behavioral as treatment is addressing behavior not the substance
Says that any activity that can detract from the ability to carry through other involvements, eradicates a person’s awareness, provides predictive gratification, avoids pain and unpleasantness, damages self-esteem and destroys other involvement can take over someone’s life
What are the differences between gambling and substance addictions? (6) HOFWTI
Gambling is a hidden addiction that doesn’t visibly show its impacts as drug use does
Can’t overdose as there is no saturation point
Huge financial problems result at another level entirely
Can function at work
Can’t be tested in concrete ways like you can test for drugs
Doesn’t require ingestion
What are the similarities between gambling and substance addictions? (5)
Preoccupation (always on the mind)
Negative impact on major life areas
Tolerance (could be argued there is no research based evidence for this however)
Immediate gratification
Loss of control
What is a broader concept of addiction? (4)
States that non substance-based addiction resembles substance based addiction
Sees addiction as about enacting or performing a behavior, whether that is the behavioral aspect of substance addiction (taking the drugs) or the behavior itself that is addictive
All addiction is behavioral as addiction results from being absorbed by and dependent on a behavior to the extent of crowding out other involvements
This is why treatment usually involves stopping or changing behavior with alternative behaviors as replacement
How was disordered gambling classified in the DSM IV? How is it classified in the DSM V? (2)
DSM IV: under impulse control disorder section with other disorders like kleptomania, pyromania, etc.
DSM V: under Substance-Related and Addictive Disorders as a Non-Substance Related Disorder
This is the first formal recognition of a behavioral addiction resulting from increased research after mass legalization of gambling (sports, online, etc.)
What are the 9 DSM V criteria (and the 1 left out)?
Tolerance (needing to gamble with more money to achieve the desired excitement)
Restless or irritable when trying to stop or cut down
Repeated unsuccessful attempts to stop or control gambling
Preoccupation with gambling
Gambling when feeling distressed
Chasing (gambling more to get even after losing a lot of money)
Lying to conceal the extent of gambling
Jeopardized or lost a significant relationship, job or educational/career opportunity because of gambling
Reliance on others to provide money to relieve desperate financial situations caused by gambling
Left out illegal activities as it didn’t have a discriminating effect
What is the question of tolerance regarding gambling? (3)
Some research shows that people reported increased bet sizes to increase their chance of winning, not because of tolerance
Tolerance is seldom a characteristic of non-substance gambling
Take gaming by for example which does not have people needing to play more and more
What is the prevalence of disordered gambling? (5)
A lot of world developments has increased the accessibility of gambling (casino in your pocket with your phone, sports betting legalized, COVID closing the in person casinos down)
Prevalence rate around the world is usually low, from 1-2%
In Canada, it is a bit higher at 2.6%
In Ontario, a CAMH report found that 68.1% of adults gamble and 1.7% are disordered, showing that many people are gambling but not everyone becomes addicted due to risk/protective factors
For youths in Ontario, 31.8% of youths gamble and 1.1% have a problem (which is hard since it’s illegal to gamble underage)
What is the course of disordered gambling regarding exposure vs. adaptation? (2)
There are several different paths to harmful gambling and the relationship between exposure and harm is not a straight one
Not everyone who is exposed develops a harmful addiction
Does the “total consumption/single distribution” model apply to disordered gambling? (4)
There is mixed evidence for a single linear distribution where as consumption goes up, harm goes up at the same rate
Some people can increasingly gamble or game without any harm until a breaking point much later
Others, because of risk factors, experience immediate harm from initial consumption of the addictive behavior
The consumption/harm distribution is all dependent on risk factors, kind of gambling, amount of games, etc.
What is the epidemic curve? (6)
An exposure event creates rapid infection and increases exposure/illness among the most vulnerable
This leads to infection among the resistant and a rising number of cases
After the curve of number of cases peaks, there is population evidence for recovery
The whole point is to control the spread at the initial event and get ahead of the curve
This curve has been seen in COVID, obesity and can be seen in gambling like in the 1980s
Exposure events could be increase in casinos opened (which is what happened in the 80s), legalization of sports betting, etc.
What is the influence of consumption regarding gambling? (3)
As exposure to a stimulus (gambling apps, casinos, etc.) increases, the most vulnerable are the first to be “infected” (people who need to cope, who need money, with addictive personalities, etc.)
We may see increases in gambling participation near epicenters of gambling
Then there is a period of adaptation and resistance where society tries to intervene and address the problem
How did COVID impact gambling? (4)
Government closed the casinos, resulting in people with gambling problems who couldn’t go to the casino
People turned to online gambling, which had a drastic increase in Ontario after 2020
People were calling CAMH more with online gambling problems as it was so accessible
Online gambling became a big main problem
What is the problem with online sports betting? (6)
Became legalized in Ontario and has become very popular since
Very accessible as you only need a credit card and a phone (which most people have or can get)
Many incentives to get people in the door (free bet credits for signing up)
Changed how people consumed and watched sports
Heightened exposure with so many ads for sports betting everywhere you turn with celebrities and role models
These high rates of exposure and access are creating a curve (can be seen from increase in CAMH calls) and effect that we should be talking about and addressing
How does biology and dopamine impact disordered gambling? (4)
fMRI imaging has shown that change monetary rewards activate the brain’s dopamine reward system
Since the reward is never predictable, it gives a burst of dopamine into the brain every time you play
This is reinforced by social environmental cues resulting in the development and maintenance of a strong response that is very resistant to change
Not about how much money you make or spend but the chance factor and anticipation of reward when dopamine fires
How is gambling related to genetics? (3)
A meta analysis of 18 twin studies found that gambling behavior is moderately heritable as one identical twin who was a gambler was more likely to have a twin who is also a gambler than non-identical twins
Also found it is moderately influenced by non-shared environmental factors unique to each twin
Unique life experiences are important for understanding gambling
