Indiana University-Purdue University Indianapolis (IUPUI) / Deficits in impulse control and decision-making have been implicated in the development and maintenance of alcohol use disorders (AUDs). Individuals with AUD often make disadvantageous choices under conditions of probabilistic risk. The Iowa Gambling Task (IGT) is often used to measure risky decision-making, in which impaired individuals tend to favor large, infrequent rewards even when punished for these choices, rather than smaller, safer, and more advantageous rewards. It remains poorly understood if these deficits are behaviors under genetic control and if ethanol intoxication may alter decision-making. High and Low Alcohol Preferring (HAP3 and LAP3, respectively) mice were trained on a novel gambling task to investigate these possible influences. In Experiment 1, HAP3s and LAP3s responded for a 0.1% saccharin solution, choosing between a risky and a safe option. Importantly, choosing the risky option was meant to be ultimately disadvantageous. In Experiment 2, these same HAP3 mice responded for saccharin or saccharin plus 10% ethanol. Contrary to hypothesis, LAP3s preferred the risky option more than HAP3s. Alcohol increased preference for the risky lever, but only in male mice. HAP3 preference for the safe lever may be explained by higher motivation to obtain sweet rewards, or higher overall avidity for responding. Ethanol-induced changes in male risk behavior may be explained by higher androgen levels, but further investigation is required. Similarly, continued research is necessary to optimize a risky decision-making task for both lines, and thus investigate possible genetic differences in risk acceptance that correlate with differences in alcohol intake.

In the United States, at least 65% of adults have gambled and/or played a video game in the past year. An emerging form of entertainment combines gambling and video game play and has led to an approximately $30 billion per year industry. Despite an explosion in growth, this form of potentially high-risk behavior has received little research attention. This paper will present a systematic review of the available peer-reviewed and grey literature related to gambling on video games. Our review identifies three major methods of combining gambling and video games. First is betting directly on the outcomes of eSports, either with money or via skin gambling. Second is gambling within video games where players purchase a chance to win a valued prize or consumable virtual item (e.g., loot box, prize crate, gacha). Prizes change the within game experience, from superficial items that change an in-game character’s appearance to items that substantially improve a player’s chance of winning. Further, if desired, these items can be sold for actual money in secondary marketplaces. Third, there are gamified casino games with the sequential, skill-based feel of video games and real money at stake. Implications: This paper is the first comprehensive review of this nascent literature. Results will provide clinicians with important insights into the language and behaviors of clients who gamble on video games. Further, findings may have future policy implications as some gambling on video games is potentially accessible to underage gamblers.

京都大学 / 0048 / 新制・課程博士 / 博士(医学) / 甲第18876号 / 医博第3987号 / 新制||医||1008(附属図書館) / 31827 / 京都大学大学院医学研究科医学専攻 / (主査)教授 髙橋 良輔, 教授 小泉 昭夫, 教授 宮本 享 / 学位規則第4条第1項該当 / Doctor of Medical Science / Kyoto University / DFAM

京都大学 / 0048 / 新制・課程博士 / 博士(医学) / 甲第20567号 / 医博第4252号 / 新制||医||1022(附属図書館) / 京都大学大学院医学研究科医学専攻 / (主査)教授 古川 壽亮, 教授 髙橋 良輔, 教授 富樫 かおり / 学位規則第4条第1項該当 / Doctor of Medical Science / Kyoto University / DFAM

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Problem gambling is a growing social concern that results in debt, lost jobs, broken families, and at times, suicide. Slot machines are the most popular and most addictive form of gambling, generating nearly 70% of annual profits for the commercial casino industry in North America. Behavioral researchers have identified variables that establish and maintain problem gambling on slot machines, and the data reveal characteristics that influence preference for specific games, and subsequently, time spent engaged with specific machines. A degree of variability has been reported in the outcomes observed across participants and studies; such variability may be influenced by generic features of the games used by researchers utilizing a “one machine suits all” approach to slot research, i.e., within most studies a single machine is used for all participants rather than chosen according to participant preference for the machine or features therein. The following set of studies aimed to investigate variables related to slot machine selection, gambler preference for structural characteristics, and the reinforcing effectiveness of the machine on gambling behavior. The first of three experiments evaluated participant preference for functional and structural characteristics of popular three-, four- and five-reel electronic Vegas-style slot machines according to (a) a Likert rating scale of attitudes toward the machines, (b) forced ranking of most-preferred machines, and (c) a paired-stimulus preference assessment. Experiment II utilized a series of multiple schedules randomized across participants to examine differences in the rate of play when participants gambled on their most- and least-preferred machines. In Experiment III, the reinforcing effectiveness of the machines was evaluated. Participants engaged in an arbitrary task to gain access to their highest- and least-preferred machines as indicated in Experiment I. Response effort during the work task was evaluated under a progressive ratio schedule of reinforcement to determine the degree to which the individual would work to gain access to the machine. Participant break points were compared across the two conditions. Results of Experiment I yielded significant differences in the degree to which participants rated the machines: three-reel machines and those displaying a win were rated significantly higher in the attitude assessment when compared to four- or five-reel machines, and when compared to those with a loss, respectively. During the forced ranking procedure, participants again selected three-reel machines significantly more frequently in their “top five” favorite machines than four- or five-reel options. Last, when subjected to the paired stimulus preference assessment, participants selected three-reel machines on a significantly higher percentage of trials than five-reel alternatives. Results of Experiment II demonstrated that rate of play on high-preference machines is on average, faster than rate of play on lower-preference machines, and results from Experiment III yielded on average, higher break points in participant responding when offered the opportunity to gamble on high-preference slot machines following a response requirement than when offered a low-preference option; however, the average rate of response on the work task that led to machine access was lower during high-preference conditions than low-preference conditions. Implications of these findings for the gambling literature and for the effective prevention and treatment of disordered slot machine gambling are discussed.

Bakgrund: Personer med spelproblem har betydligt oftare suicidtankar, suicidplaner och suicidförsök än den allmänna befolkningen. Spelproblem är ett folkhälsoproblem då det kan ge allvarliga sociala, hälsomässiga och ekonomiska konsekvenser för individen, för närstående och för samhället i stort. Syftet med den kvalitativa studien är att öka kunskapen om spelberoende samt få fördjupad förståelse för de spelfria spelberoendes upplevelser om deras väg till tillfrisknande. Metoden jag har använt mig av är kvalitativt inriktad forskning till följd av att jag vill förstå problemspelares upplevelser och syn på deras livsvärld och på så sätt få detaljrika berättelser. Resultatet av studien är att åtta kvalitativa forskningsintervjuer har genomförts med åtta spelfria spelberoende från tre ideella föreningar i tre olika städer i landet. Intervjumaterialet har därefter analyserats utifrån två teoretiska verktyg; Känsla av sammanhang (KASAM) och stigma. Slutsatsen av studien är att intervjupersonerna hade upplevt personlighetsförändringar där lögn, manipulationer och stjäla pengar blev deras vardag. De levde i sin bubbla för att de kände skam och skuld över att berätta för sina närstående om spelberoendet som orsakade förödande negativa konsekvenser för deras psykiska hälsa, sociala relationer och ekonomi. Vägen mot tillfrisknandet har varit i samband med kapitulationen och stödet från anhöriga men framförallt från självhjälpsgrupperna som har varit avgörande för upprätthållandet av återhållsamheten. / Background: People with gambling problems have significantly more frequent suicidal thoughts, plans and suicide attempts than the general population. Gambling problems are a public health problem as it can have serious social, health and economic consequences for the individual, for relatives and for society as a whole. The purpose of the qualitative study is to increase knowledge about gambling addiction and gain an in-depth understanding of the former gambling addicts´ perceptions and experiences about their path to recovery. The method I have used is qualitative research as a result of the fact that I want to understand problem players' experiences and views of their world of life and thus get detailed stories. The result of the study is that eight qualitative research interviews were conducted with eight former gambling addicts from three non-profit support groups in three different cities in the country. The interview material was then analyzed based on two theoretical tools; Sense of coherence (SOC) and stigma. The conclusion of the study is that the interviewees had experienced personality changes where lying, manipulation and stealing money became their everyday life. They lived in their bubble because they felt ashamed and guilty about telling their loved ones about gambling addiction that caused devastating negative consequences for their mental health, social relationships and finances. The path to recovery has been in connection with the capitulation and support from relatives, but above all from the self-help groups that have been crucial for maintaining restraint.

Gambling disorder is today a common disorder causing lives to shatter. As this disorder activates the reward system and increases the need of dopamine, recovering from gamling disorder can be hard. Research has shown that gambling addiction appears to have similarities to substance abuse, but no substance has been named. Therefore, this systematic review discusses similarities and differences between gambling and opioid addiction. The aim is to compare behavior and neurological correlates of gambling and opioid addiction tocreate a better understanding of the relationship between these addictions and hopefully help improve treatments. My expectation was that I would find behavioral and neurological similarities between opioid and gambling addicts. To investigate this, I conducted a systematic search across databases. I compared six studies which all used a task to investigate decision-making ability and brain-scanning to investigate neural correlates. Both gambling and opioid addicts show decreased activation in the orbitofrontal cortex, which plays a central role in decision-making. Regarding task performance, some studies showed addicts to perform worse than controls, suggesting that addicts show an impaired decision-making ability compared to controls. This systematic review contributes to the literature within addiction, but to draw a conclusion that gambling and opioid addicts suffer from similar decision-making impairment further research is needed.

The somatic marker hypothesis posits that physiological arousal is partially responsible for decision-making behavior. Arousal, measured by skin conductance responses (SCR), increases before deck choice in the Iowa Gambling Task (IGT). These markers co-vary with performance -- pathological gamblers lack these markers and perform poorly. Personality also modulates IGT behavior – high-novelty-seeking (NS) individuals tend to perform worse. In the IGT, participants decide which deck to select, creating a potential confound between personality, performance, and arousal. For example, high-NS individuals select the bad decks more often, potentially causing habituation and a muted SCR. The first goal of this research was to replicate the finding that personality modulates arousal in a task which removes these confounds. Participants selected a series of cards from two decks. Each card was either a win or loss. Real money was used. To remove the potential confound between choice and outcome, all participants experienced the same outcomes regardless of choice. SCR was measured during the task. Personality characteristics previously shown to modulate gambling behavior, such as sensation seeking (SS), were measured. Arousal may also occur during other phases of gambling, for example, before or after the outcome is revealed. To date, few studies have examined the relationship between arousal in these different phases. The second goal was to determine this relationship. The phases of gambling (pre-choice, anticipation, and outcome) were temporally separated to allow for precise SCR measurement in each phase. The final goal was to determine the relationship between perceived control and physiological arousal. An 'illusion of control', e.g., pulling the lever on a slot machine, promotes gambling, especially in pathological gamblers. Little work has addressed the relationship between personality, control, and arousal. In different sessions, participants either selected the next card or the next card was selected for them. SS decreased arousal during all three gambling phases. The perception of control decreased arousal during the pre-choice phase only. This latter effect was strongest for low-SS individuals. The ramifications of this study are clear: identifying how physiological responses vary with personality opens up avenues for potential treatment of problem gambling.