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A laboratory-based investigation of relations among video lottery terminal (VLT) play, negative mood, and alcohol consumption in regular VLT players

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Abstract

Thirty regular video lottery terminal (VLT) players were randomly assigned to 90 min of VLT play or a control activity (viewing a movie) to examine the impact of VLT play on alcohol use. Ratings of dysphoric mood were taken at baseline, midactivity, and postactivity. Alcoholic and nonalcoholic control beverages were available throughout. As hypothesized, those in the VLT condition were more likely to consume alcoholic than nonalcoholic control beverages (i.e., 73% drank alcohol and 20% drank control beverages), whereas no such preference for alcohol was observed in the movie control condition (i.e., 40% drank alcohol and 47% drank control beverages). Consistentwith predictions derived from Steele and Josephs' [J. Abnorm. Psychol. 97 (1988) 196; Am. Psychol. 45 (1990) 921.] attention allocation model, VLT condition participants who drank alcohol showed increases in dysphoric effect over the course of testing. No such changes in negative mood were observed in VLT participants who did not consume alcohol or in movie control participants regardless of whether they drank alcohol. An observed temporal pattern of greater drinking during the early phase of VLT play indicated that the relation between alcohol use and dysphoric affect among VLT condition participants could not readily be explained by drinking to relieve dysphoria induced by VLT losses. Clinical and policy implications are discussed.

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... The influence of gambling on alcohol consumption has not been well established. Stewart et al. (2002) conducted a laboratory study of the effects of gambling on the desire to drink and mood state in 30 regular video lottery players. Participants were provided with money and randomly assigned to gamble on standard casino video lottery terminals for as long as they wished, or watch a nondysphoric movie. ...
... Gambling has been found to dramatically influence mood state in both positive and negative directions within a short time frame (Brown et al., 2004;Hills et al., 2001;Stewart et al., 2002). Gee et al. (2005) collected mood state ratings from regular gamblers before, during, and after gambling episodes using an interactive telephone system. ...
... Participants who gambled or watched exciting sports were more likely to report greater urges to drink compared with participants who watched a movie or a nondysphoric sporting event. This finding is consistent with research indicating gamblers often drink alcohol while gambling (Horn et al., 2023a(Horn et al., , 2023bLangham et al., 2015;Weinstock, et al., 2004), and with experimental results that have shown gambling related to increased alcohol consumption (Stewart et al., 2002). This finding is also consistent with findings that sports fans often drink alcohol while watching sports (Nelson & Wechsler, 2003). ...
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Several decades of research have experimentally investigated the influence of alcohol on gambling. However, there has been only minimal experimental exploration of how gambling influences alcohol use. The aim of the current project was to evaluate how gambling influenced mood state and alcohol cravings through randomized experimental design when analyzed with comparison conditions.College students (N = 76) who reported regular alcohol use, gambling within the past year, and being college basketball fans were randomly assigned to watch a video of an exciting basketball game, watch a nondysphoric basketball game, watch a movie, or engage in slot machine gambling. Participants who watched exciting sports or engaged in gambling to reported more energized mood states and higher urges to drink compared to those who watched nondysphoric sports or a movie. These results suggest that the context of gambling may prime individuals to want to consume alcohol.
... Only one experimental study has examined the reverse pathway, of how gambling influences alcohol consumption. Stewart et al. (2002) studied recreational gamblers who were able to purchase beverages during a session of play on an electronic gaming machine (EGM) in a bar laboratory for 90 min. Compared to a control group who could purchase beverages while watching an action movie, the gambling group purchased more alcoholic beverages and fewer non-alcoholic beverages. ...
... The present study sought to update and extend the findings by Stewart et al. (2002) in a number of ways. First, in Stewart et al. (2002), drinking took place concurrently with gambling, so that the temporal dynamics of the effect remain ambiguous; do the effects of gambling continue when the player steps away from the machine itself? ...
... The present study sought to update and extend the findings by Stewart et al. (2002) in a number of ways. First, in Stewart et al. (2002), drinking took place concurrently with gambling, so that the temporal dynamics of the effect remain ambiguous; do the effects of gambling continue when the player steps away from the machine itself? Second, slot machine design has advanced over the past decade (Schüll 2012), and we sought to corroborate the Stewart et al. (2002) findings using modern, fully electronic, multi-line slot machines. ...
Article
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Experimental studies examining the relationship between alcohol use and gambling have focused predominantly on alcohol's influence on gambling behavior. There has been little consideration of the reverse pathway: whether gambling influences subsequent alcohol use. Two experiments examined whether gambling and gambling outcomes (i.e. profits during a gambling session) influenced subsequent alcohol consumption. Experiment 1 (n = 53) used an ad libitum consumption test, in which participants could request beverages during a 30 min window. Experiment 2 (n = 29) used a beer taste test procedure, in which participants were asked to rate a series of beers. In both studies, male regular gamblers were assigned to watch a television show or play a modern slot machine for 30 min, before being provided with access to alcohol. On the ad libitum procedure, gambling significantly increased the number of alcoholic drinks ordered, the volume of alcohol consumed, the participants' speed of drinking, and their intention to drink alcohol. These effects were not corroborated using the taste test procedure. Across both studies, gambling outcomes were not associated with alcohol consumption. In conjunction with prior findings, the observation that gambling can promote alcohol consumption under certain conditions highlights a possible feedback loop whereby gambling and alcohol reinforce one another. However, the divergent results between the ad libitum and taste test experiments point to boundary conditions for the effect and raise methodological considerations for future work measuring alcohol consumption in gambling environments.
... A Canadian survey showed that 74% regular video lottery terminal players reported drinking alcohol while gambling (Focal Research, 1998). Similarly high rates of alcohol use during video lottery terminal play were more recently obtained in an observational study of regular gamblers (Stewart, McWilliams, Blackburn, & Klein, 2002). ...
... Clinicians should be made aware of these differences and of their implications for treatment (e.g., the importance of assessing for suicidal ideation among problem gamblers who present with co-morbid alcohol problems). Although prior research shows that most gamblers drink alcohol while gambling (e.g., Focal Research, 1998;Stewart et al., 2002), the functional relationship between particular gambling events (e.g., wins, losses) and alcohol use remains unknown. Dr. ...
... Thus, activation of an alcohol memory network by positive gambling outcomes (or the anticipation of these outcomes) may be one process that contributes to co-morbid problem gambling and alcohol misuse. Prior research shows that most gamblers drink alcohol while gambling (Focal Research, 1998;Stewart et al., 2002). Doctoral candidate Michael Ellery presented the results of a study that tested whether alcohol increases risk-taking during video lottery terminal (VLT) play and whether the hypothesized effect of alcohol on risk-taking is particularly strong among pathological gamblers. ...
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This article summarizes a symposium held at the 2002 Annual Meeting of the Research Society on Alcoholism in San Francisco, CA, and was prepared on behalf of the symposium participants by the symposium co-organizers/co-chairs. Prior research with both clinical and nonclinical populations indicates a high comorbidity between alcohol-use disorders and pathological gambling. This symposium involved a set of papers in which exciting new research on this form of comorbidity was presented. The studies spanned populations of problem-gambling helpline callers, problem gamblers attempting to recover, and community-recruited gambler research volunteers. The studies used methodologies ranging from questionnaire and interview to laboratory-based paradigms (i.e., cognitive and alcohol challenge). Study designs ranged from cross-sectional to longitudinal and from correlation to experiment. The symposium highlighted novel approaches that researchers are using to enhance understanding of functional relations that may underlie this common comorbidity.
... Laboratory studies have failed to establish consistent relationships between alcohol consumption and gambling duration or participation. While a relationship between gambling duration and alcohol consumption has previously been demonstrated in cohorts of university students [9] and problem gamblers [8], in similar laboratory studies both Cronce & Corbin [10] and Stewart et al. [11] found no evidence of a relationship. Recent laboratory-based studies have also uncovered little evidence of a relationship between willingness to participate in gambling activities and alcohol consumption [12,13], although previous research has demonstrated both positive and negative relationships, with outcome dependant on the quantity of alcohol consumed [14] and personality type [15]. ...
... Experimental studies in which behaviours (such as alcohol consumption) are assigned fail to capture the prevalence of those behaviours in naturalistic settings. Second, the small sample sizes of these studies (the laboratory studies cited above had a median sample size of 35) and sample bias towards university students [9,10,13,14] or non-problem drinkers or gamblers [8][9][10][11][12] limit their generalisability to the broader population of drinkers and gamblers. ...
... The finding that moderate alcohol consumption is associated with reduced gambling duration conflicts with the findings of previous laboratory studies which found either no relationship between gambling dura-tion and alcohol consumption [10,11] or a significantly increased duration [8,9]. We suggest that this is because, outside laboratory settings, the effects of context have a greater impact on gambling behaviour than the psychological effects of intoxication. ...
Article
Introduction and aims: Despite the well-documented comorbidity between disordered alcohol use and problem gambling, little is known about the co-occurrence of drinking and gambling in gambling venues. This paper appears to be the first to investigate the association between drinking and gambling behaviour among a large sample of gamblers during a specific, non-laboratory gambling episode. Design and methods: We conducted a mail survey of all available households in the Northern Territory of Australia, including questions on drinking and gambling behaviour on the last visit to a gambling venue. We estimate the effect of moderate (1-4 standard drinks) and risky (>4 standard drinks) alcohol consumption on gambling participation and gambling duration for both problem and non-problem gamblers using regression analysis of 7044 survey responses. Results: The probability of participating in electronic gaming machine (EGM) gambling decreased with alcohol consumption for non-problem gamblers, while the probability of participating in TAB (Totalisator Agency Board, off-course totalisator) gambling increased with risky alcohol consumption for all gamblers. Alcohol consumption was not associated with EGM gambling participation for problem gamblers. Moderate alcohol consumption was negatively associated with EGM gambling duration, with a stronger effect observed for problem gamblers. Discussion and conclusions: Moderate alcohol consumption is inversely correlated with both the duration of play and probability of participation for EGM gambling. Current laboratory studies do not predict the drinking-gambling behaviour of the general population in non-laboratory settings. Future research on alcohol and gambling co-occurrence must explicitly consider the drinking and gambling environment in order to produce policy-relevant findings.
... Win, Lose, and Booze: Implicit Gambling Outcome – Alcohol Associations in Problem Gamblers. Although prior research shows that most gamblers drink alcohol while gambling (e.g., Focal Research, 1998; Stewart et al., 2002), the functional relationship between particular gambling events (e.g., wins, losses) and alcohol use remains unknown. Dr. Martin Zack presented the results of a study which examined priming of alcohol cognition by gambling gain and loss events among gamblers with differing histories of drinking in response to these events. ...
... Prior research shows that most gamblers drink alcohol while gambling (Focal Research, 1998; Stewart et al., 2002). Doctoral candidate Michael Ellery presented the results of a study that tested whether alcohol increases risk-taking during video lottery terminal (VLT) play and whether the hypothesized effect of alcohol on risk-taking is particularly strong among pathological gamblers. ...
... Further, at the event-level (co-occurring behaviors) level of analysis, Potenza and colleagues found that that only a small percentage of those with current GD and past AUD reported usually drinking when they gamble. At least at first glance, these findings appear to contradict previous results from survey and observational studies showing high rates of drinking during gambling activity (e.g., Focal Research, 1998; Stewart et al., 2002). Reasons for this inconsistency need to be clarified and might pertain to sample differences or the manner in which drinking-gambling activity overlap was assessed across studies. ...
Article
This article summarizes a symposium held at the 2002 Annual Meeting of the Research Society on Alcoholism in San Francisco, CA, and was prepared on behalf of the symposium participants by the symposium co-organizers/co-chairs. Prior research with both clinical and nonclinical populations indicates a high comorbidity between alcohol-use disorders and pathological gambling. This symposium involved a set of papers in which exciting new research on this form of comorbidity was presented. The studies spanned populations of problem-gambling helpline callers, problem gamblers attempting to recover, and community-recruited gambler research volunteers. The studies used methodologies ranging from questionnaire and interview to laboratory-based paradigms (i.e., cognitive and alcohol challenge). Study designs ranged from cross-sectional to longitudinal and from correlation to experiment. The symposium highlighted novel approaches that researchers are using to enhance understanding of functional relations that may underlie this common comorbidity.
... Considering the potential effects that alcohol can have in overriding cues to quit by diminishing capacity for attentional inhibition, working memory (Dry et al., 2012), perception of time (Hernández-Collados et al., 1997;Ogden et al., 2011), behavioural flexibility and response inhibition (Robbins & Arnsten, 2009), the combined effect is likely to lead to increased length of play, compounded by a decrease in reaction time (Kerr & Hindmarch, 1998). In support of this hypothesis, several laboratory-based studies, using precisely administered doses of alcohol, have shown such a positive correlation with time spent on EGMs (Ellery et al., 2005;Giacopassi et al., 1998;Kyngdon & Dickerson, 1999), although in contrast, Stewart et al. (2002) found no correlation between play duration and alcohol consumption in their laboratory study. As useful as they are, laboratory studies may be sensitive to unintended participant strategies. ...
... From a physiological perspective, we know that alcohol binds to GABA-A neurotransmitter receptors, leading to a depressive effect on the central nervous system and subsequent slowing of reaction times. From this, we had hypothesised that we might find an increase in average length of play amongst those who usually consumed alcohol while gambling at a venue, though previous findings had been ambiguous, with some studies showing an effect (Baron & Dickerson, 1999;Ellery et al., 2005;Giacopassi et al., 1998;Kyngdon & Dickerson, 1999;Markham et al., 2012) and others, like ours, showing no effect on duration of play (Cronce & Corbin, 2010;Stewart et al., 2002). Together, these findings suggest that factors other than alcohol alone are determinants in the decision of a player to end a session, e.g. ...
Article
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While comorbidity of problematic alcohol and gambling use is well established, much less is known about the way in which alcohol consumption while gambling interacts with problem-gambling severity and other individual differences. We hypothesised three factors that would interact with alcohol consumption while gambling on electronic gaming machines (EGMs) to influence four behavioural gambling measures: preferred number of lines bet, average duration of play, average spend per session and preferred electronic gaming machine denomination. The latter is a measure of gambler’s preference for the monetary denomination in which EGM bets are placed (e.g. 1 cent, 2 cents, 5 cents, 10 cents, 20 cents, $1), with higher denomination EGMs being higher risk since bets can be placed in larger amounts and money can be lost more rapidly. The three hypothesised interacting factors were problem-gambling severity, presence/absence of alcohol use disorder and biological gender. A total of 1557 male and female participants completed a questionnaire, measuring their problem-gambling status, problem alcohol status, consumption of alcohol at the gambling venue, preferred EGM denomination, preferred number of lines bet, average duration of play and average spend per session. We found the anticipated gender-differential spending effect with males spending more than females, but we also found a surprising reverse differential spending effect for problem gamblers such that females spent more than males. We also found that alcohol consumption while gambling was generally associated with a preference for higher denomination machines and that those players without alcohol problems who drank at the venue preferred to bet on more lines, suggesting a double-max strategy amongst gamblers who drank at the venue. Finally, for non-problem and low-risk gamblers, concurrent alcohol consumption was related to preference for higher denomination EGMs in female players, but not for male players. These findings are discussed in the context of the physiological and psychological effects of alcohol.
... Although viewed as desirable in many occupational and recreational contexts (1), immersion in gambling activities is a robust predictor of problem gambling risk (2)(3)(4)(5)(6)(7)(8)(9)(10). Slot machine gambling may be especially immersive: an Australian survey found that 79% of gambling-related immersion experiences involved slot machines (11). ...
... The slot machine session was carried out in our laboratory, which houses four genuine slot machines, balancing the ecological validity of real slot machines with the situational control afforded by a laboratory environment (11,12). Participants were endowed $40 to play "Buffalo Spirit" (Scientific Games Co., Las Vegas, NV). ...
Article
Background and aims: Immersion during slot machine gambling has been linked to disordered gambling. Current conceptualizations of immersion (namely dissociation, flow, and the machine zone) make contrasting predictions as to whether gamblers are captivated by the game per se ('zoned in') or motivated by the escape that immersion provides ('zoned out'). We examined whether selected eye movement metrics can distinguish between these predictions. Design and setting: Pre-registered, correlational analysis in a laboratory setting. Participants gambled on a genuine slot machine for 20 minutes while wearing eye tracking glasses. Participants: Fifty-three adult slot machine gamblers who were not high-risk problem gamblers. Measurements: We examined self-reported immersion during the gambling session and eye movements at different areas of the slot machine screen (the reels, the credit window, etc.). We further explored these variables' relationships with saccade count and amplitude. Findings: The ratio of dwell time on the game's credit window relative to the game's reels was positively associated with immersion (t(51) = 1.68, p = .049 one-tailed, R2 = .05). Follow-up analyses described event-related changes in these patterns following different spin outcomes. Conclusions: Immersion while gambling on a slot machine appears to be associated with active scanning of the game and a focus on the game's credit window. These results are more consistent with a 'zoned in' account of immersion aligned with flow theory than a 'zoned out' account based on escape.
... Studies looking at pathological gamblers' self-reported reasons for gambling have shown that a large group of gamblers report using gambling as a way of escaping problems or temporarily relieving depressive symptoms (Blaszczynski and McConaghy, 1989; Dickerson et al., 1996; Gupta and Derevensky, 1998; Beaudoin and Cox, 1999; Wood and Griffiths, 2007). Several studies have looked at mood in connection with gambling, either by looking at associations between depressive mood and starting or continuing gambling (Blaszczynski and McConaghy, 1989; Corless and Dickerson, 1989; Dickerson et al., 1991), or by examining possible mood changes from gambling (Griffiths, 1993; Griffiths, 1995; Hills et al., 2001; Stewart et al., 2002; Brown et al., 2004; Gee et al., 2005). Findings from these studies offer some support for an association between negative mood and gambling persistence, but less in terms of starting a session. ...
... Studies of pathological gamblers' self-reported reasons for gambling also seem to favor a self-medication hypothesis, by showing that a large group of pathological gamblers report using gambling as a way of escaping problems or temporarily relieving depressive symptoms (Blaszczynski and McConaghy, 1989; Dickerson et al., 1996; Gupta and Derevensky, 1998; Beaudoin and Cox, 1999; Wood and Griffiths, 2007). However, the mentioned studies of mood 'before', 'during', and 'after' gambling provide sparse support for a self-medication effect on depressed mood (Blaszczynski and McConaghy, 1989; Corless and Dickerson, 1989; Dickerson et al., 1991; Griffiths, 1993; Griffiths, 1995; Hills et al., 2001; Stewart et al., 2002; Brown et al., 2004; Hodgins and el-Guebaly, 2004; Gee et al., 2005). The distinction between wanting and liking, which was proposed by Robinson and Berridge (1993, 2008) to explain the phenomenon that drug addicts crave for the next shot without necessarily deriving pleasure from it, might help explain these seemingly contradictory findings. ...
Article
The objective of this study was to investigate the relationship between gambling severity and depressive symptoms in pathological gamblers addicted to slot machines, with the hypothesis that comorbid depressive symptoms are associated with exacerbated gambling symptoms and behavior. Twenty controls and 20 pathological gamblers with different levels of depressive symptoms were studied during slot machine gambling. We found exacerbated gambling behavior in gamblers with high compared to low levels of depressive symptoms in terms of self-reported gambling urge (P < 0.01) and excitement from gambling (P < 0.05), number of games played (P < 0.01), and duration of gambling (P < 0.05). A correlation between depressive and gambling symptoms was found (r = 0.602, P < 0.01), thereby questioning which symptoms contribute to the exacerbated gambling behavior. Regression analyses showed that the symptoms influenced gambling behavior albeit in different ways. Although gambling symptoms predicted the rate of games played (P < 0.001), depressive symptoms predicted gambling urge (P < 0.01) and duration of gambling (P < 0.05). We discuss whether gambling symptoms only co-occur with other disorders; the need to look beyond the classification of pathological gambling as an impulse control disorder; and the potential role of anhedonia in depressed gamblers.
... (VLT) gamblers in the Canadian province of Nova Scotia (where VLTs are located in bars) self-report drinking alcohol while they gamble. This figure has been confirmed in experimental, laboratory-based research (Stewart, McWilliams, Blackburn, & Klein, 2002). In this study, regular gamblers were given the opportunity to purchase alcoholic or non-alcoholic beverages, while they gambled or engaged in a control activity of movie watching. ...
... First, it could be that gambling disorders cause or exacerbate problems with alcohol use as is depicted in the top row of Figure 1. For example, an individual might begin to abuse alcohol (or escalate his or her abuse of alcohol) in an attempt to self-medicate for distress brought on by his or her problematic gambling (e.g., financial losses, relationship difficulties) (Stewart et al., 2002). Second, it could be that excessive drinking causes or exacerbates problems with gambling as is depicted in the middle row of Figure 1. ...
Article
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It has long been recognized that gambling is an activity that is often combined with alcohol intake. Not only do the behaviors of drinking and gambling frequently co-occur, alcohol use disorders and pathological gambling are also commonly co-morbid conditions in both clinical and non-clinical samples. This article introduces a special issue of the Journal of Gambling Studies focusing on cutting edge findings on the relations between gambling and alcohol use behaviors and their associated disorders. We set the stage for the following series of six novel empirical papers and integrative commentary by reviewing the theoretical pathways through which alcohol use and gambling disorders may be linked. We conclude by describing some of the novel contributions of each of the empirical studies from within the context of these theoretical models.
... As the gulf widens between the programming capacities of slot machine developers and gambling researchers, it is increasingly unfeasible to create convincing facsimiles of modern gambling products. As a result, gambling researchers are moving to more naturalistic designs that use genuine slot machines, housed in a laboratory environment (Murch et al., 2017;Stewart et al., 2002). Although this approach engenders a more convincing gambling experience to research participants, the use of real slot machines requires measuring and statistically controlling for variables that randomly vary between testing sessions, such as net profit or loss Limbrick-Oldfield et al., 2022; see the double-robust feature selection procedure described in Methods below). ...
Article
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The Post-Reinforcement Pause (PRP) is an operant effect in which response latencies increase on trials following the receipt and consumption of reward. Human studies demonstrate analogous effects in electronic gambling machines that utilise variable ratio reinforcement schedules. We sought to identify moderators of the human PRP effect, hypothesizing that the magnitude of gamblers’ PRPs is moderated by the type of reinforcing outcome (genuine wins vs. losses-disguised-as-wins vs. free-spin bonus features), and individuals’ level of gambling immersion, a cognitive state linked to problem gambling. Experienced slot machine users (N = 53) played a real slot machine for 20 minutes. The dependent variable was defined as the time delay in the initiation of each bet (‘Spin Initiation Latency’; SIL). Using 80% of trials, a linear model was fit regressing SIL on the independent variables (outcome type, immersion, and outcome-by-immersion interaction), and a larger group of covariates (participant ID, trial number, winnings, etc.) selected using double robust LASSO-regularized regression. The previously-unseen 20% of cases were used to validate the model. Positively-reinforcing outcome types showed significantly larger SILs than losses, indicating a PRP effect. Immersion did not predict response latencies, but win-by-immersion and LDW-by-immersion interactions indicated that pauses were greater among more immersed participants. The small number of free-spin bonus features showed similar trends that were not statistically significant. These results indicate that gamblers immersed in play remained sensitive to in-game reinforcement (contrary to prevailing accounts), and provide guidance for researchers bridging the gap between laboratory research and real-world behaviour.
... This study sought to develop a slot machine gambling procedure that is suitable for studying behavioral markers of habit formation and expression. For this goal, we required a higher degree of game-level control (over profits and losses) and behavioral surveillance than is viable using authentic EGMs in a lab environment (Ladouceur et al., 2003;Stewart et al., 2002). Using a highly realistic slot machine simulation, our aim was to assess how practice effects are expressed within and across three sessions of gambling, in novice participants without prior experience of playing slot machines. ...
Article
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Habit formation is a key process in contemporary models of addictive behaviors but has received limited attention in the context of gambling and problem gambling. Methods for examining habit formation and expression in relation to gambling are also lacking. In this study, 60 participants with no prior slot machine experience attended three sessions spaced 6–8 days apart, during which they played a short 200-spin session on a realistic simulation of a modern multi-line slot machine. Behavioral data were analyzed to characterize habit formation within and between sessions. Fixed-effects regressions, integrating trial- and session-level effects, assessed predictors of gambling speed (spin initiation latencies) and betting rigidity (the likelihood of switching the bet amount), as two putative markers of habit formation. Participants gambled faster and showed less variability in betting strategy as they accumulated experience in the number of trials and sessions gambled. Simultaneously, as the number of sessions gambled increased, participants showed a more pronounced tendency to slow their betting after larger wins (i.e. the post-reinforcement pause increased from session 1 to session 3). Our methods provide a basis for future research to examine habits in the context of slot machine gambling.
... Indeed, the makeup of our sample (younger adults, all male) does not match the demographic makeup of EGM patrons in most jurisdictions. The use of a hybrid casino laboratory allows us to study genuine EGMs in a highly-controlled environment, however some concern exists with respect to ecological validity (Anderson & Brown, 1984;Stewart, McWilliams, Blackburn, & Klein, 2002). It is notable, for example, that heart rate decreased during EGM play; a number of studies have reported HR increases during EGM use in naturalistic environments (Coventry & Constable, 1999;Coventry & Hudson, 2001;Diskin & Hodgins, 2003;Griffiths, 1993). ...
Article
Electronic Gaming Machines (EGMs) are regarded as a relatively harmful gambling product, and are associated with psychological immersion (the 'machine zone') and physiological arousal. Specifically, immersion is a phenomenon of attention manifesting as an intense focus on the game at the expense of peripheral stimuli and goals. Past research has indicated significant levels of immersion in response to modern multi-line EGMs when the overall bet is increased, which further scales with risk for problem gambling (Dixon et al., 2014). The present study sought to separate the effects of multi-line play and bet size, on measures of immersion and cardiac activity. Seventy-six male undergraduate students played an authentic EGM on each of 4 pre-defined play strategies while providing electrocardiogram data. The strategies varied the number of paylines and the bet multiplier. From the physiological data, we extracted Respiratory Sinus Arrhythmia (RSA), a marker of task attention derived from heart rate variability. We found that immersion ratings were significantly greater when both paylines and bet-size were high. Importantly, selectively increasing the paylines, but not bet multiplier, produced significant increases in immersion. RSA change indicated parasympathetic withdrawal, consistent with increases in attention during EGM use, but did not differentiate game settings. These results suggest that multi-line EGMs capture attention across a range of play-styles, and that immersion may be effectively amplified by multi-line play.
... realism of an actual gambling venue with the more rigorous control afforded by a lab (Stewart et al., 2002). ...
Article
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Recent accounts of problematic electronic gaming machine (EGM) gambling have suggested attentional pathology among at-risk players. A putative slot machine zone is characterized by an intense immersion during game play, causing a neglect of outside events and competing goals. Prior studies of EGM immersion have relied heavily upon retrospective self-report scales. Here, the authors attempt to identify behavioral and psychophysiological correlates of the immersion experience. In samples of undergraduate students and experienced EGM users from the community, they tested 2 potential behavioral measures of immersion during EGM use: peripheral target detection and probe-caught mind wandering. During the EGM play sessions, electrocardiogram data were collected for analysis of respiratory sinus arrhythmia (RSA), a measure of calming self-regulation governed by the parasympathetic nervous system. Subjective measures of immersion during the EGM play session were consistently related to risk of problem gambling. Problem gambling score, in turn, significantly predicted decrements in peripheral target detection among experienced EGM users. Both samples showed robust RSA decreases during EGM play, indicating parasympathetic withdrawal, but neither immersion nor gambling risk were related to this change. This study identifies peripheral attention as a candidate for quantifying game immersion and its links with risk of problem gambling, with implications for responsible gambling interventions at both the game and venue levels.
... Moreover, surveys show that the majority of VLT players report drinking alcohol while playing. A recent laboratory study (Stewart, McWilliams, Blackburn & Klein, 2002) examined the impact of VLT play on alcohol use and whether combining VLT play and alcohol intake contributes to a negative mood state. As hypothesized, the authors found that VLT players, as opposed to a control group of movie viewers, were more likely to consume alcoholic beverages and, the imbibing VLT players, were more likely than control group and non-alcohol consuming VLT playing subjects to experience dysphoric moods. ...
... It is possible that binge drinking increases an individual's susceptibility to engage in gambling, regardless of their sensation seeking status, by decreasing inhibition and increasing risk taking behaviors. It is also possible, as was found in an experiment conducted by Stewart, McWilliams, Blackburn, and Klein (2002), that gaming promotes alcohol consumption. The crosssectional nature of this study prevents determining the directionality of the relationships. ...
... [8]). The majority of regular electronic gaming machine (EGM) players, including those classified as non-problem gamblers, report that they also smoke while gambling [9]. In a study of EGM players, it was found that problem gamblers were significantly more likely to also be smokers than non-problem gamblers (82.8% vs. 46.2%) ...
Article
Evidence suggests that tobacco smoking and gambling frequently co-occur. Although high rates of comorbid smoking and gambling have been documented in studies with clinical populations of pathological gamblers in treatment, in studies using samples drawn from the community, and in large-epidemiological surveys, little empirical attention has been directed towards investigating the exact nature of this relationship. In this review, we stress the literature that has examined the epidemiology, aetiology and environmental factors implicated in comorbid smoking and gambling. Publications included in the review were identified through PsycInfo, PubMed and Medline searches. Although conclusive evidence is lacking, a growing body of literature suggests that smoking and gambling might share similar neurobiological, genetic and/or common environmental influences. Comorbid tobacco smoking and gambling are highly prevalent at the event and syndrome levels. However, research investigating how smoking might affect gambling or vice versa is currently lacking. More studies that examine the impact of this comorbidity on rates of tobacco dependence and problem gambling, as well as implications for treatment outcomes, are needed.
... In addition, experimental studies have demonstrated that the influence of alcohol use on gambling behavior is more pronounced among individuals with a history of DG (Ellery et al., 2005). Conversely, experimental studies have also shown that individuals assigned to participate in a gambling task are more likely to drink an alcoholic beverage than individuals assigned to an alternate task (Stewart et al., 2002). These findings indicate that the genetic correlation between DG and AUD is likely due to both reciprocal causal effects between drinking and gambling behaviors and common genetic underpinnings for the two disorders. ...
Article
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Disordered gambling (DG) will soon be included along with the substance use disorders in a revised diagnostic category of the Diagnostic and Statistical Manual of Mental Disorders DSM-5 called 'Substance Use and Addictive Disorders'. This was premised in part on the common etiologies of DG and the substance use disorders. Using data from the national community-based Australian Twin Registry, we used biometric model fitting to examine the extent to which the genetic liabilities for DG and alcohol use disorder (AUD) were shared, and whether this differed for men and women. The effect of using categorical versus dimensional DG and AUD phenotypes was explored, as was the effect of using diagnoses based on the DSM-IV and the proposed DSM-5 diagnostic criteria. The genetic correlations between DG and AUD ranged from 0.29 to 0.44. There was a significantly larger genetic correlation between DG and AUD among men than women when using dimensional phenotypes. Overall, about one-half to two-thirds of the association between DG and AUD was due to a shared genetic vulnerability. This study represents one of the few empirical demonstrations of an overlap in the genetic risk for DG and another substance-related addictive disorder. More research is needed on the genetic overlap between DG and other substance use disorders, as well as the genetic overlap between DG and other (non-substance-related) psychiatric disorders.
... A community survey study found that 74% of regular video lottery terminal (VLT) players reported drinking alcohol while playing VLTs (Focal Research, 1998). Similarly high rates of alcohol use during VLT play were obtained in an observational study (Stewart, McWilliams, Blackburn, & Klein, 2002). Consistent with the third-variable explanation of comorbidity, evidence suggests a common genetic vulnerability for alcoholism and pathological gambling (see Slutske et al., 2000). ...
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The authors examined heart rate responses to video lottery terminal (VLT) play and alcohol intake. Forty-four VLT players were randomized to an alcohol (mean blood alcohol concentration=0.06%) or a control beverage condition. Heart rate was recorded at pre- and postdrinking baseline and during VLT play. Alcohol participants displayed elevated heart rates relative to controls at postdrinking and VLT play. Controls displayed elevated heart rates during VLT play relative to both pre- and postdrinking baselines, whereas alcohol participants displayed elevations at post- relative to predrinking and at VLT play relative to postdrinking. Heart rate increases from predrinking to VLT play were greater among alcohol participants relative to controls. Results provide novel information that the combination of VLT play and alcohol further intensifies heart rate increase relative to either alone. Implications for pathological gambling and alcohol use disorder comorbidity are discussed.
... As hypothesized, and consistent with our earlier study (Stewart et al., 2005), we did see that the degree of increase from predrinking to VLT play was greater for those in the alcohol condition. Thus, the combination of VLT play and alcohol consumption does appear to be linked to an additional heart-rate increase, compared with the heart rate increase associated with engaging in either addictive behavior alone, which may help explain the frequent pairing of these two activities in both clinical and nonclinical populations (Focal Research, 1998; Stewart & Kushner, 2003; Stewart et al., 2002). Although most aspects of our original study (Stewart et al., 2005) were replicated, there were some important differences as well. ...
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The authors examined heart-rate responses to alcohol consumption and video lottery terminal (VLT) play. Regular VLT players (30 probable pathological gamblers [PPGs]; 30 nonpathological gamblers [NPGs]) were randomized to an alcohol (mean postdrinking blood alcohol concentration = 0.056%) or placebo condition. Heart rate was recorded at pre- and postdrinking baselines and during VLT play. Consistent with an earlier study, alcohol-condition participants displayed elevated heart rates relative to placebo-condition participants only at postdrinking and VLT play. Moreover, alcohol-condition participants showed a greater heart rate increase to VLT play than did placebo-condition participants. However, PPGs were not more susceptible to alcohol- and/or VLT play-induced heart rate accelerations than were NPGs. Implications for gambling/alcohol-disorder comorbidity are discussed.
... And do those who gamble primarily to enhance positive affect also use alcohol for similar reasons? We chose pathological gamblers who usually drink when gambling because of the high co-occurrence of these activities (Focal Research, 1998; Stewart et al., 2002) as well as to ensure against marked differences in their relative frequency, in order to test the second set of hypotheses regarding the withinperson overlap in specific motives for gambling and drinking. ...
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Cognitive measurement techniques, such as self-reports of behavior and reaction time measures, largely dominate the field of psychological research. It is uncommon for researchers to examine a phenomenon of interest by observing actual behavior within natural settings. To illustrate the existence of this methodological trend for gambling research, this article reviews systematically selected samples of the peer-reviewed literature related to lottery gambling in general and the literature related to pathological gambling and lottery more specifically. The results indicate that self-report surveys dominate the extant lottery literature, and experimental investigations of video lottery terminal gambling supplement those papers. This landscape encourages researchers to expand their methodological approaches to the study of lottery gambling. Currently, we know more about what research participants tell us they do with respect to lottery gambling than we do about their real-life lottery gambling behavior.
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This study explored the validity of classifying a community-recruited sample of substance-abusing women (N = 293) according to 4 personality risk factors for substance abuse (anxiety sensitivity, introversion–hopelessness, sensation seeking, and impulsivity). Cluster analyses reliably identified 5 subtypes of women who demonstrated differential lifetime risk for various addictive and nonaddictive disorders. An anxiety-sensitive subtype demonstrated greater lifetime risk for anxiolytic dependence, somatization disorder, and simple phobia, whereas an introverted–hopeless subtype evidenced a greater lifetime risk for opioid dependence, social phobia, and panic and depressive disorders. Sensation seeking was associated with exclusive alcohol dependence, and impulsivity was associated with higher rates of antisocial personality disorder and cocaine and alcohol dependence. Finally, a low personality risk subtype demonstrated lower lifetime rates of substance dependence and psychopathology.
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Individuals scoring high (HAS, n = 28) and low (LAS, n = 28) on the Anxiety Sensitivity Index (R. A. Peterson & S. Reiss, 1992) were exposed to a stress induction manipulation followed by a beverage taste-rating task in a study of coping-related alcohol consumption. Anticipation of an anxiety-relevant (AR) interview about their anxiety experiences did not result in greater alcohol consumption by HAS individuals as hypothesized. However, HAS individuals consumed significantly more alcohol than LAS individuals when anticipating an anxiety-irrelevant (AI) interview about their food preferences. The following explanations are explored: (a) Social-evaluative concerns may have suppressed alcoholic beverage consumption by HAS-AR individuals, and (b) enhanced interoceptive acuity and discomfort because of prior food deprivation may have increased alcoholic beverage consumption among HAS-AI individuals. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
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Investigated whether a similar neuropsychological deficit pattern underlies prefrontal lobe syndrome and alcohol intoxication and whether alcohol expectancy detrimentally affects neuropsychological performance. 72 male university students were administered a battery of neuropsychological tests, including the Porteus Maze Test and the Wisconsin Card Sorting Test, after receiving 1 of 3 different doses of alcohol. A high dose of alcohol detrimentally affected many functions associated with the prefrontal and temporal lobes, including planning, verbal fluency, memory, and complex motor control. Expectancy did not appear to play a significant role in determining this effect. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
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Animal studies suggest that drug effects can act as conditioned stimuli for various unconditioned stimuli including the effects of other drugs. The current study investigated drug-drug conditioning in human subjects. Sixteen subjects were given subcutaneous injections of either nicotine or saline before consumption of an alcoholic or soft drink in each of eight sessions. Across sessions the content of the injections was established as a reliable predictor of the alcoholic content of the drink. Physiological, subjective, and behavioural responses to the injections were used as indices of conditioning.Skin conductance measures obtained following the injections changed across trials in a way consistent with a conditioned response though patterns of change on cardiac inter-beat interval were less clear. However, neither behavioural nor subjective measures showed conditioning effects. In view of the number of variables studied the evidence for the development of conditioned responding on physiological measures must be suspected of being a type I error and is in need of replication. Subjects' reports revealed that nicotine and saline injections were difficult to discriminate. This would have weakened conditioning effects. Suggestions are made for improvements in the design of future studies of drug-drug conditioning in human subjects.
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This article explains how alcohol makes social responses more extreme, enhances important self-evaluations, and relieves anxiety and depression, effects that underlie both the social destructiveness of alcohol and the reinforcing effects that make it an addictive substance. The theories are based on alcohol's impairment of perception and thought--the myopia it causes--rather than on the ability of alcohol's pharmacology to directly cause specific reactions or on expectations associated with alcohol's use. Three conclusions are offered (a) Alcohol makes social behaviors more extreme by blocking a form of response conflict. (b) The same process can inflate self-evaluations. (c) Alcohol myopia, in combination with distracting activity, can reliably reduce anxiety and depression in all drinkers by making it difficult to allocate attention to the thoughts that provoke these states. These theories are discussed in terms of their significance for the prevention and treatment of alcohol abuse.
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Acute alcohol intoxication produces changes in the cognitive functioning of normal individuals. These changes appear similar prima facie to those exhibited by individuals who sustain prefrontal lobe damage during adulthood. In order to test the validity of this observation, and to control for the confounding effects of expectancy, 72 male subjects were administered a battery of neuropsychological tests, within the context of a balanced-placebo design. Each subject received one of three widely different doses of alcohol. Analysis of the results of the cognitive test battery demonstrated that a high dose of alcohol detrimentally affects a number of functions associated with the prefrontal and temporal lobes, including planning, verbal fluency, memory and complex motor control. Expectancy does not appear to play a significant role in determining this effect. The implications of this pattern of impairment are analyzed and discussed.
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Properties of a widely used measure of analogue alcohol consumption, the taste-rating task, were investigated. It was predicted and found that the taste-rating task led to more frequent sipping, smaller sip volume and a steeper decline in sipping across the 15 min drinking period than a procedurally similar tavern-evaluation task. These data demonstrate that the taste-rating task conveys implicit "how to drink" demands that seem to alter natural drinking topography. Examination of the correspondence between self-report and analogue consumption revealed that preexperimental estimates of typical drinking were significant yet modest predictors of analogue consumption. Moreover, postexperimental estimates of analogue consumption revealed that subjects accurately self-reported laboratory drinking, with taste-rating subjects showing more accuracy. Limitations of taste-rating methodology and directions for further investigation of analogue consumption measures are discussed.
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Two experiments examined an attention-allocation model of alcohol’s effect on psychological stress (Steele, Southwick, & Pagano, 1986). On the basis of this model, it was hypothesized that alcohol’s impairment of information processing, coupled with the demands of distracting activity, would reduce anxiety over an upcoming stressful event by making it harder to allocate attention to thoughts about the event. Alcohol intoxication without a distracting activity was not expected to have an anxiety-reducing effect but possibly to increase anxiety by narrowing and constraining attention to the imminent stressor. Finally, the distracting activity in this experiment, without intoxication, was not expected to reduce anxiety. The present experiments tested this reasoning by crossing whether or not subjects had received alcohol (dose of 1 ml/kg) with whether they rated art slides or did nothing during the period prior to an expected stressful speech. As predicted, being intoxicated and rating slides reduced subjects’ anxiety over the speech significantly more than any other condition in both experiments; being intoxicated and doing nothing significantly increased subjects’ anxiety compared with the other conditions, but only when the data from both experiments were combined. Activity alone had no anxiety-reducing effect. These results are discussed as (a) supporting the role of cognitive impairment and attention allocation in mediating alcohol’s anxiety-reducing effects, (b) clarifying conditions under which alcohol can increase anxiety, and (c) demonstrating the importance of activity in mediating the variability of alcohol’s tension-reducing effects.
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Patients in an alcoholism and drug dependency treatment facility were questioned about their gambling behavior in order to find out what percentage of them were abusing alcohol and/or drugs and gambling. In order to do this, a pathological gambling signs index was constructed according to a modification of DSM III criteria and validated using independent procedures. Out of 458 patients interviewed, 40 (9%) were diagnosed as pathological gamblers and an additional 47 (10%) showed signs of problematic gambling. These patients showed clear signs of emotional, financial, family and occupational disruption, and illegal behavior in connection with their gambling which compound the disruption induced by alcohol and/or drugs. Five per cent of the patients abusing only alcohol, 12% of those with alcohol and another drug in combination, and 18% of those with other drug abuse problems without an alcohol component showed clear signs of pathological gambling; 11 1/2% of males and 2% of females were classified as pathological gamblers. The index was also significantly associated with parental gambling (38% of the children of pathological gamblers were pathological gamblers themselves). Gambling by siblings, alcoholism in the father (but not in the mother), gambling prior to age 20, greater amounts of gambling for more money, and "chasing losses in order to get even" were also positively correlated with the index. The implications for study and treatment of these individuals are discussed in terms of the study of addictions.
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The South Oaks Gambling Screen is a 20-item questionnaire based on DSM-III criteria for pathological gambling. It may be self-administered or administered by nonprofessional or professional interviewers. A total of 1,616 subjects were involved in its development: 867 patients with diagnoses of substance abuse and pathological gambling, 213 members of Gamblers Anonymous, 384 university students, and 152 hospital employees. Independent validation by family members and counselors was obtained for the calibration sample, and internal consistency and test-retest reliability were established. The instrument correlates well with the criteria of the revised version of DSM-III (DSM-III-R). It offers a convenient means to screen clinical populations of alcoholics and drug abusers, as well as general populations, for pathological gambling.
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This study explored the validity of classifying a community-recruited sample of substance-abusing women (N = 293) according to 4 personality risk factors for substance abuse (anxiety sensitivity, introversion-hopelessness, sensation seeking, and impulsivity). Cluster analyses reliably identified 5 subtypes of women who demonstrated differential lifetime risk for various addictive and nonaddictive disorders. An anxiety-sensitive subtype demonstrated greater lifetime risk for anxiolytic dependence, somatization disorder, and simple phobia, whereas an introverted-hopeless subtype evidenced a greater lifetime risk for opioid dependence, social phobia, and panic and depressive disorders. Sensation seeking was associated with exclusive alcohol dependence, and impulsivity was associated with higher rates of antisocial personality disorder and cocaine and alcohol dependence. Finally, a low personality risk subtype demonstrated lower lifetime rates of substance dependence and psychopathology.
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The phenomena of attention and dissociation were investigated in pathological and occasional video lottery (VLT) gamblers. Twelve problem VLT gamblers [mean age 41.3; 6 male, 6 female; South Oaks Gambling Screen (SOGS; Lesieur & Blume, 1987) scores >/= 5] were compared to a group of 11 occasional VLT gamblers, (mean age 31.9; 4 male, 7 female; SOGS scores < 5). Pathological gamblers were slower than occasional gamblers in reacting to irrelevant external light stimuli while playing on a demonstration video lottery terminal. They were significantly more likely to report more symptoms of general dissociation as measured by the Dissociative Experiences Scale (Bernstein & Putnam, 1986). The results suggest that pathological gamblers may experience a greater narrowing of attention than occasional gamblers when engaged in VLT play.
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Until recently the study of adolescent gambling has received little academic attention. There is however an emerging literature which not only reveals that adolescents gamble but that some display pathological tendencies. To date in the U.K., most studies of adolescent gambling have focussed on the incidence of fruit machine gambling and its negative effects. This paper reports data obtained from a postal study of former adolescent fruit machine addicts. In addition to demographic data, other information (e.g. reasons for playing, gambling pathology, skill factors (if any) during playing, and mood variables before, during and after play) was collected. Self written personal histories of gambling experiences revealed descriptive insights into their fruit machine addiction and how some of them had managed to overcome their problems without professional help.
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Thesis- Includes bibliographies and index. Microfilm. Ann Arbor, Mich. : Xerox University Microfilms International, 1974.--1 reel ; 35 mm.--(Publication: Current periodical series; no. 8271).
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To compare the effects of pleasant and aversive arousal on alcohol consumption, 18 male undergraduates had three weekly sessions to separately view erotic, mutilation or neutral slides in a simulated memory experiment. Following exposure to the slides, they received access to alcoholic and nonalcoholic beverages, which were presented to half the subjects in a taste rating task, and to half as the result of engaging in an operant lever-press task. Subjects believed these tasks to be distractors during a purported retention interval. Self-report instruments and basal skin conductance confirmed the success of the affective manipulations. However, only the subjects using the taste task after viewing erotic slides significantly increased alcohol consumption. These results question a tension reduction model of drinking and qualify the contribution of autonomic arousal to motivation for drinking.
Article
This study examines NEO-FFI correlates of risk for alcoholism, alcohol use disorders and alcoholism subtyping dimensions in a mixed-gender sample of 468 young adults (mean age = 21.3) presumed to be at high risk (n = 239) or low risk (n = 229) for alcoholism on the basis of a family history of paternal alcoholism. The NEO-FFI is a brief personality inventory measuring each of the key dimensions of the five-factor model of personality (FFMP), a comprehensive, empirically-derived model of personality structure. Familial risk for alcoholism was positively associated with openness and negatively associated with agreeableness and conscientiousness. Alcohol use disorders were positively associated with neuroticism and negatively associated with aggreeableness and conscientiousness. With the exceptions of alcoholism subtyped by comorbid antisocial personality disorder and by familial alcoholism, all of the alcoholic subtypes examined were related to at least one of the five dimensions. We conclude that the FFMP holds promise for studying personality traits in alcohol use disorders and in bringing a unifying perspective to research and clinical work in this area.
Article
The literature including a number of review articles was examined for answers to the questions, have distinctive personality test profiles of pathological gamblers been identified, do pathological gamblers have control over their behavior, have studies of alcoholism and addiction increased understanding of compulsive gambling, and has psychotherapy or Gamblers Anonymous been successful for them? Much more information is needed to build on what research on these questions has yielded.
Article
Thirty lifetime pathological gamblers (DSM-III, no exclusion criteria) were identified when 7,214 randomly selected household residents of Edmonton were interviewed by trained lay interviewers using the Diagnostic Interview Schedule. The lifelong prevalence of pathological gambling was 0.42% (ratio of males to females 3:1). The peak age of onset was 25 to 29 years. Gamblers had high rates of comorbidity with other psychiatric disorders. They were likely to have made suicide attempts (13.3%), to have been convicted of offences (26.7%), to be spouse and child abusers (23.3% and 16.7% respectively) and to have spent long periods unemployed (40%). In addition, 80% had trouble at home or work because of gambling, and 60% borrowed or stole to gamble.
Article
The prevalence rate of potential and pathological gambling was examined among Native American and Caucasian patients (n = 85) being treated for alcohol dependence. Previous studies with alcohol-dependent (mainly Caucasian) populations revealed 10-15% to have gambling problems. This study, the first to measure pathological gambling among a Native American population, utilized the South Oaks Gambling Screen and was administered in a group setting, between 1/91 and 4/91 on the alcohol treatment ward of the Ft. Meade Veterans Administration Hospital. Results showed that 22% of the Native Americans studied (compared to 7.3% Caucasian), scored in a range indicating a probable pathological gambling addiction. Furthermore, 41% of the Native Americans studied (compared to 21.3% Caucasian) admitted to some difficulty with gambling. Education and treatment is encouraged to help stem projected radical increases in pathological gambling and related problems among this cultural group as Native American gambling becomes widespread.
Article
Previous studies have suggested that pathological gambling and substance abuse may be more likely to occur together than expected by chance. We examined this possibility as well as explored psychosocial and diagnostic variables that may be associated with this coincidence. Of 276 patients who were administered the South Oaks Gambling Screen, 134 subjects were interviewed using a semistructured comprehensive psychiatric questionnaire. Data analysis utilized Student t tests or analysis of variance routines. The rate of comorbid pathological gambling in the sample was 33% (92 of 276). A high rate of comorbid substance abuse and pathological gambling was associated with a positive history of childhood experiences of gambling in the family group (p = .001) and with larger family size (p = .001). In addition, current alcohol consumption was significantly higher (p = .007) in the pathological gambling group. Comorbidity of substance abuse and pathological gambling is common in substance abuse patients in a VA hospital. Substance abuse treatment programs should identify patients with pathological gambling and include treatment interventions that address both problems.
Article
To demonstrate the link between gambling, alcohol and drug problems among Ontario adults and to present information on the relationship between expenditures on gambling and type of gambling with gambling problems. Using data collected in a 1994 telephone survey of 2,016 randomly chosen Ontario adults, gambling problems are related to the CAGE scale of alcohol problems and the ICD-10 measure of alcohol dependence, as well as smoking, other drug use, and demographic variables. Descriptive tables based on crosstabulations and means are provided, as well as a series of 9 logistic regression models. The most significant predictor of gambling problems was the amount spent on gambling in the preceding 30 days, with alcohol dependence on the ICD-10 scale and age also important predictors. Lottery players, compared to other gamblers, are more likely to be male, relatively less affluent, older on average, more likely to report alcohol problems (but not dependence) and be currently smoking. The results make clear that heavy drinking and drinking problems are associated with higher levels of spending on gambling and reports of gambling problems. This leads to the suggestion that treatment programs for those with gambling, alcohol or other drug problems should assess that possibility of comorbidity, since the presence of more than one of these problems can significantly affect the success of treatment and contribute to relapse.
Article
To critically review the current literature on pathological gambling as regards the significant psychiatric comorbidities associated with it. The authors synthesized information found via electronic searches (MEDLINE) and bibliographic-directed searches in over 60 publications. Pathological gamblers frequently have comorbid substance use disorders. In addition, a subset appear to have comorbid antisocial personality disorder, but they represent a minority when compared with those people who have acquired their antisocial traits as a consequence of their gambling behaviour. A comorbidity with the mood disorders is probable, but methodological concerns and inconsistencies with the data prevent further delineation of this. Emerging research for other disorders possibly associated with pathological gambling is also reviewed. Pathological gambling is associated with significant psychiatric comorbidity. Recommendations for future research are described.
Article
To develop a self-report instrument to assess diagnostic criteria and associated features of pathological gambling in order to learn more about the characteristics of individuals who seek treatment for gambling problems in a Canadian setting. Fifty-seven adults seeking treatment for gambling problems at the Addictions Foundation of Manitoba were assessed. There was substantial variation in the endorsement of Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) symptoms. Lying to family members or friends and "chasing" previous gambling losses were frequently reported, while more serious consequences (for example, relationship breakup, job losses) were less frequent. DSM-IV ratings were correlated (r = 0.59) with the South Oaks Gambling Screen. Many individuals reported gambling as a way to alleviate dysphoric mood, and 30% reported receiving mental health services in the past. Approximately 50% reported suicidal ideation, although recent suicide attempts were not common. These preliminary results of Canadian adults seeking treatment for gambling problems suggest a somewhat different profile from many United States studies, which often rely on older male pathological gamblers. More systematic investigation of the presence of major depression and other psychiatric disorders is warranted. Consistent with demographic data collected at the Addictions Foundation of Manitoba, it appears that video lottery terminals play a major role in the type of problem gambling experience seen in Canadian settings.
Article
In 1968 an editorial in the British Medical Journal rejected the view that compulsive or pathological gambling should be included under the rubric of illness. Exactly 20 years later an invited paper to the same journal noted that the problem was an addictive behaviour or dependency disorder and listed the American Psychiatric Association's diagnostic criteria. The following review critically evaluates some of the key conceptual and research developments during the intervening period. 1990 Australasian Professional Society on Alcohol and other Drugs
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