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

O presente estudo teve como objetivo caracterizar o comportamento de jogadores que frequentam casas de bingo, videopoker e Jockey Club. Foram pesquisados 171 sujeitos, sendo 63 no Jockey Club, 65 em casas de bingo e 43 em casas de videopoker. Em cada categoria de jogo obtiveram-se 25 questionários classificados como jogadores patológicos pela escala SOGS. A maioria dos entrevistados eram de sexo masculino, casados, de religião católica, tinham 2o. grau ou superior completo e trabalhava em período integral. A média de idade foi de 40 anos e a mediana da renda foi R$ 4.000,00. Em ordem decrescente, os jogos mais praticados pelo menos uma vez na vida pelos jogadores pesquisados foram: loteria, bingo, cartas e corridas de cavalo. Jogadores patológicos e jogadores não patológicos não se diferenciaram quanto a nenhuma das características socio-demográficas pesquisadas, mas se diferenciaram quanto à prática de alguns jogos. Na vida, mais jogadores patológicos jogaram carta, em corridas de cavalo, videopoker e dados do que os não patológicos. Nos últimos 12 meses e nos últimos 30 dias, jogadores patológicos se diferenciaram por jogar mais videopoker. Esses jogadores também utilizaram mais dinheiro para apostar em um só dia, além declararem ter ganho quantias maiores de dinheiro no jogo. Quanto ao estado emocional relativo ao jogo, jogadores patológicos tendem a ficar mais ficam tensos antes de jogar e relatam sentimentos negativos durante e depois do jogo. Não patológicos sentem-se bem e tranquilos antes, relatam sentimentos neutros durante e positivos depois de jogar. Quando pararam de jogar por um tempo, jogadores patológicos relataram sentimentos negativos enquanto que os não patológicos relataram sentimentos neutros. Jogadores patológicos sentem mais falta do jogo quando param de jogar, mas poucos procuraram ajuda devido a problemas associados ao jogo. Pais de jogadores patológicos não se diferenciaram quanto ao fato de jogarem ou beberem demais de pais de jogadores não patológicos . Quando se analisa o uso de álcool e outras drogas, a única diferença significativa encontrada foi maior uso de tabaco na vida pelos jogadores patológicos. Os jogadores patológicos pesquisados no bingo, videopoker e Jockey Club foram também comparados entre si. As únicas diferenças significativas encontradas foram: presença de mais jogadores casados no bingo e jovens no videopoker; no Jockey Club, maior frequência de apostas em esportes, de discussão familiar por causa do dinheiro gasto no jogo e de empréstimo por agiotas. / In this study sociodemographic variables and gambling behavior of videopoker, bingo and horse-race gamblers were examined. One hundred seventy one subjects, 63 from the Jockey-Club of São Paulo, 65 from bingo clubs and 43 from videopoker clubs were administered a questionnaire adapted from the South Oacks Gambling Screen - SOGS, and 25 individuals of each group were classified as pathological gamblers. The majority of subjects were married catholic males, who had at least a high school degree and full-time jobs. Mean age was 40 years and median income was U$ 4000.00. In descending order, lottery, bingo, card games, and horse-race were the most frequent types of games played at least once by the subjects. Comparisons between pathological and non-pathological gamblers revealed no significant difference in any sociodemographic variables, but the two groups differed in their gambling activities. Pathological gamblers had played significantly more cards, bet on horses, played videopoker and dice games in their lives than the other group. Pathological gamblers also played significantly more videopoker in the previous month and previous year than non-pathological gamblers. They also bet more money in one day of gambling and also reported making more money from this activity than non-pathological gamblers. With respect to gambling-related emotions, pathological gamblers reported feeling tense before gambling and negative affects during and after gambling. The non-pathological group reported a sense of well being before gambling and neutral affects during and after it. Pathological-gamblers reported negative affects during periods when they stopped gambling, while neutral feelings were reported by the non-pathological group. The former also missed this activity more than the non-pathological group, but few sought help for problems associated with gambling. Gambling habits and alcohol use between parents of pathological and non-pathological gamblers were not significantly different. The two groups also did not differ in their use of alcohol and other drugs but tobacco, which was significantly more consumed in a lifetime by the pathological gambling subjects. Comparisons between bingo, videopoker and horse-race subgroups evidenced few significant differences. There were more married subjects in the bingo group and younger individuals in the videopoker group. The pathological gamblers interviewed at the Jockey Club reported higher frequency of bets in sports, of family arguments between family members because of the amount of money spent on gambling and more credit lines with bookies.

Background: 'Neuromarketing' is a term that has often been used in the media in recent years. These public discussions have generally centered around potential ethical aspects and the public fear of negative consequences for society in general, and consumers in particular. However, positive contributions to the scientific discourse from developing a biological model that tries to explain context-situated human behavior such as consumption have often been neglected. We argue for a differentiated terminology, naming commercial applications of neuroscientific methods 'neuromarketing' and scientific ones 'consumer neuroscience'. While marketing scholars have eagerly integrated neuroscientific evidence into their theoretical framework, neurology has only recently started to draw its attention to the results of consumer neuroscience. Discussion: In this paper we address key research topics of consumer neuroscience that we think are of interest for neurologists; namely the reward system, trust and ethical issues. We argue that there are overlapping research topics in neurology and consumer neuroscience where both sides can profit from collaboration. Further, neurologists joining the public discussion of ethical issues surrounding neuromarketing and consumer neuroscience could contribute standards and experience gained in clinical research. Summary: We identify the following areas where consumer neuroscience could contribute to the field of neurology: First, studies using game paradigms could help to gain further insights into the underlying pathophysiology of pathological gambling in Parkinson's disease, frontotemporal dementia, epilepsy, and Huntington's disease. Second, we identify compulsive buying as a common interest in neurology and consumer neuroscience. Paradigms commonly used in consumer neuroscience could be applied to patients suffering from Parkinson's disease and frontotemporal dementia to advance knowledge of this important behavioral symptom. Third, trust research in the medical context lacks empirical behavioral and neuroscientific evidence. Neurologists entering this field of research could profit from the extensive knowledge of the biological foundation of trust that scientists in economically-orientated neurosciences have gained. Fourth, neurologists could contribute significantly to the ethical debate about invasive methods in neuromarketing and consumer neuroscience. Further, neurologists should investigate biological and behavioral reactions of neurological patients to marketing and advertising measures, as they could show special consumer vulnerability and be subject to target marketing. (authors' abstract)

Pathological gambling is a maladaptive behaviour associated with diminished self-control over persistent compulsive gambling behaviour despite negative consequences. A significant revision to the clinical perspective of pathological gambling is underway, and the disorder will likely be recognized as a behavioural addiction in the fifth edition of Diagnostic and Statistical Manual of Mental Disorders. However, the neurobiological, cognitive and behavioural processes that drive a ‘behavioural addiction’ are unclear. A series of five studies were conducted to investigate cognitive mechanisms associated with neural and behavioural substrates of addictive processes in disordered gambling. Studies 1 through 3 investigated neurobiological correlates of addiction in individuals with pathological gambling as compared to individuals with cocaine dependence, and as compared to non-addicted healthy controls. Study 1 investigated brain activity associated with anticipatory and consummatory reward processing during slot-machine gambling. Study 2 investigated executive control processes by examining functional brain networks associated with loss-chasing behaviour. Study 3 employed voxel-based morphometry (VBM) to explore alterations in grey-matter volumes in individuals with addictive disorders. Studies 4 and 5 investigated the behavioural substrates of addiction in regular gamblers utilizing emerging and novel research techniques. Study 4 examined continuous hand motion trajectories to explore approach biases and implicit processing. Study 5 employed an adaptive testing methodology to explore the influence of gaming machine preferences on cognitive processes and gambling behaviour. Research identified neurobiological and behavioural substrates of gambling-related beliefs and biases that indicate significant contributions of cognitive mechanisms to the development and persistence of a behavioural addiction. Results suggest addictive disorders may share some common features of anticipatory reward processing and brain structure (Studies 1 and 3), while neural signals associated losing outcomes and decision-making during gambling may be specific to disordered gambling (Studies 1 and 2). Furthermore, cognitive distortions in regular gamblers may influence reinforcement and executive control processes (Study 4), and individual preferences for gaming speed may influence cognitions and behaviour during machine gambling. As additional psychological disorders are being considered for classification as behavioural addictions, and clinicians will be faced with the challenges of treating individuals with these non-substance-related addictive disorders, a better understanding of behavioural addictions, through the study of disordered gambling, will be essential under the new diagnostic framework.

Thesis "Gambling and its consequences - qualitative research of pathological gamblers" is discussing gambling as a present phenomenon and about the effects of gambling on gamblers and his environment in different aspects of his life. Theoretical part provides the introduction to this problem, specification of definitions and also particular impact of gambling on itself, namely health, social, criminal law and last but not least, financial consequences. The practical part deals with stories of abstaining gamblers and their subjectively perceived impacts of gambling on their lives, hindering factors in the development of addiction and factors facilitating entering to the treatment.

Charles University of Prague Faculty of Pharmacy in Hradec Králové Department of Biological and Medicinal Sciences Student: Bc. Veronika Hončová Supervisor: Doc. MUDr. Josef Herink, DrSc. Consultant: MUDr. Jela Hrnčiarová Title: Signs of the temporolimbic dysfunction in gamblers Background: The aim of this thesis was to determine whether pathological gamblers exhibit symptoms related to epileptic spectrum disorder. Methods: To investigate, symptoms of the temporolimbic dysfunction were examined by means of the structured questionnaires CPSI (Complex Partial Symptoms Inventory) and LSCL-33 (Limbic System Checklist-33). Mann-Whitney U test and Spearman's correlation coefficient were used for statistical evaluation. Results: The mean score in the questionnaire CPSI of gamblers was 38,9 points, which is an abnormal score. With the questionnaire LSCL-33, the mean score of 21,5 points, corresponds to suspected findings. From the mean results it can be concluded that pathological gamblers may have a higher incidence of the symptoms of the temporolimbic dysfunction. When comparing the groups of gamblers with smokers, it was evaluated that in the questionnaire CPSI was a statistically significant difference between the appearances of symptoms of epileptic spectrum disorder, while it was not in the...

O objetivo deste estudo foi avaliar o perfil sócio-demográfico, comportamento de jogo e variáveis associadas nos jogadores patológicos idosos. Realizou-se uma entrevista semi-estruturada com 586 pacientes que procuraram tratamento específico para jogo. Jogadores idosos (51) comparados com os adultos (535) apresentam características sociais típicas da idade que podem deixá-los vulneráveis ao jogo. Idosos começam a jogar mais tarde, desenvolvem mais lentamente a doença e apresentam menor gravidade do quadro clínico o que sugere um melhor prognóstico. Nos jogadores idosos existem dois subgrupos: os de início de jogo precoce ou início tardio. Os de início precoce começaram a jogar no início da vida adulta e são em sua maioria homens. Jogadores patológicos idosos necessitam de abordagens específicas de ajuda / The objective of this study was evaluate the social-demographic profile, gambling behavior and associated variables of elderly pathological gamblers. A half-structuralized interview with 586 patients, who had sought specific treatment for gambling, was done. Aged gamblers (51) compared with adults (53) present typical social characteristics of ageing that may make them vulnerable to gamble. They start to gamble later, develop the disease much more slowly and present lower severity of clinical features suggesting a better prognosis. There are two groups concerning aged gamblers: early or later onset of gambling. Early onset start gamble at the beginning of adult life and they are most likely to be male. The elderly pathological gamblers need specific boarding of aid and suggest one better prognostic

This thesis deals with the definition of the concept of pathological gambling, diagnosis, prevalence and a description of vulnerable groups. It also discusses the creation, development and various stages of pathological gambling. Theoretical knowledge is enhanced by our own research, carried out a questionnaire, which has pointed out that the profession can be a risk factor for developing an illness / addiction. The research objective is to describe the rate and quality of risk-taking behavior in gambling on sports editor, and identify any related pathological gambling with their selected characteristics. The paper looks at what it looks like gambling and betting on sports editors in terms of rates, forms and circumstances. Whether the people in this group of pathological gambling occurs and, if so, to what extent and with what consequences. They try to answer it then also, what is the relationship between work characteristics and playing sports editor of gambling or betting. How this relationship sports editors perceive themselves and how to understand. Keywords: Pathological gambling, pathological player, gambling, gambling

O presente estudo teve como objetivo caracterizar o comportamento de jogadores que frequentam casas de bingo, videopoker e Jockey Club. Foram pesquisados 171 sujeitos, sendo 63 no Jockey Club, 65 em casas de bingo e 43 em casas de videopoker. Em cada categoria de jogo obtiveram-se 25 questionários classificados como jogadores patológicos pela escala SOGS. A maioria dos entrevistados eram de sexo masculino, casados, de religião católica, tinham 2o. grau ou superior completo e trabalhava em período integral. A média de idade foi de 40 anos e a mediana da renda foi R$ 4.000,00. Em ordem decrescente, os jogos mais praticados pelo menos uma vez na vida pelos jogadores pesquisados foram: loteria, bingo, cartas e corridas de cavalo. Jogadores patológicos e jogadores não patológicos não se diferenciaram quanto a nenhuma das características socio-demográficas pesquisadas, mas se diferenciaram quanto à prática de alguns jogos. Na vida, mais jogadores patológicos jogaram carta, em corridas de cavalo, videopoker e dados do que os não patológicos. Nos últimos 12 meses e nos últimos 30 dias, jogadores patológicos se diferenciaram por jogar mais videopoker. Esses jogadores também utilizaram mais dinheiro para apostar em um só dia, além declararem ter ganho quantias maiores de dinheiro no jogo. Quanto ao estado emocional relativo ao jogo, jogadores patológicos tendem a ficar mais ficam tensos antes de jogar e relatam sentimentos negativos durante e depois do jogo. Não patológicos sentem-se bem e tranquilos antes, relatam sentimentos neutros durante e positivos depois de jogar. Quando pararam de jogar por um tempo, jogadores patológicos relataram sentimentos negativos enquanto que os não patológicos relataram sentimentos neutros. Jogadores patológicos sentem mais falta do jogo quando param de jogar, mas poucos procuraram ajuda devido a problemas associados ao jogo. Pais de jogadores patológicos não se diferenciaram quanto ao fato de jogarem ou beberem demais de pais de jogadores não patológicos . Quando se analisa o uso de álcool e outras drogas, a única diferença significativa encontrada foi maior uso de tabaco na vida pelos jogadores patológicos. Os jogadores patológicos pesquisados no bingo, videopoker e Jockey Club foram também comparados entre si. As únicas diferenças significativas encontradas foram: presença de mais jogadores casados no bingo e jovens no videopoker; no Jockey Club, maior frequência de apostas em esportes, de discussão familiar por causa do dinheiro gasto no jogo e de empréstimo por agiotas. / In this study sociodemographic variables and gambling behavior of videopoker, bingo and horse-race gamblers were examined. One hundred seventy one subjects, 63 from the Jockey-Club of São Paulo, 65 from bingo clubs and 43 from videopoker clubs were administered a questionnaire adapted from the South Oacks Gambling Screen - SOGS, and 25 individuals of each group were classified as pathological gamblers. The majority of subjects were married catholic males, who had at least a high school degree and full-time jobs. Mean age was 40 years and median income was U$ 4000.00. In descending order, lottery, bingo, card games, and horse-race were the most frequent types of games played at least once by the subjects. Comparisons between pathological and non-pathological gamblers revealed no significant difference in any sociodemographic variables, but the two groups differed in their gambling activities. Pathological gamblers had played significantly more cards, bet on horses, played videopoker and dice games in their lives than the other group. Pathological gamblers also played significantly more videopoker in the previous month and previous year than non-pathological gamblers. They also bet more money in one day of gambling and also reported making more money from this activity than non-pathological gamblers. With respect to gambling-related emotions, pathological gamblers reported feeling tense before gambling and negative affects during and after gambling. The non-pathological group reported a sense of well being before gambling and neutral affects during and after it. Pathological-gamblers reported negative affects during periods when they stopped gambling, while neutral feelings were reported by the non-pathological group. The former also missed this activity more than the non-pathological group, but few sought help for problems associated with gambling. Gambling habits and alcohol use between parents of pathological and non-pathological gamblers were not significantly different. The two groups also did not differ in their use of alcohol and other drugs but tobacco, which was significantly more consumed in a lifetime by the pathological gambling subjects. Comparisons between bingo, videopoker and horse-race subgroups evidenced few significant differences. There were more married subjects in the bingo group and younger individuals in the videopoker group. The pathological gamblers interviewed at the Jockey Club reported higher frequency of bets in sports, of family arguments between family members because of the amount of money spent on gambling and more credit lines with bookies.

This study used the D2-preferring dopamine antagonist, haloperidol (3mg) and D1-D2 antagonist, fluphenazine (3mg) to investigate the roles of D1 and D2 receptors in d-amphetamine (20-mg) reinforcement in humans with (9 M; 7 F) and without (12 M; 4 F) an addictive disorder, in a placebo-controlled, between-within counterbalanced design. To preclude neurotoxicity, pathological gamblers served to evaluate effects of addiction status. Incentive motivation (e.g., Desire to Gamble), hedonic impact (e.g., Liking) and risky decision-making were assessed. Haloperidol reduced Desire to Gamble in controls, whereas fluphenazine reduced Desire in gamblers. Both antagonists reduced hedonic impact in both groups, with fluphenazine exhibiting stronger effects in gamblers. Both antagonists decreased risky decisions in controls but increased risky decisions in gamblers. Results suggest that D1 mediates amphetamine-induced motivation to gamble; D2 mediates amphetamine’s hedonic effects; D1 function is deficient in gamblers; and D2 blockade may reverse a restorative effect of amphetamine in addicted individuals.