Aim: To explore the views of professionals working within health, care and other agencies about harmful gambling among adults with health and social care needs.
Background: Gambling is increasingly seen as a public health rather than an individual problem. Opportunities to gamble have grown in England in the last decade since the liberalisation of the gambling industry meaning that gambling is widely available, accessible and advertised within society. An estimated two million people in the UK are at risk of developing a gambling problem, some of whom may be adults with health and social care needs.
Methods: Twenty-three key informants from primary care, social care services and third sector organisations in England were interviewed about their understanding of the risks to adults with health and social care needs from gambling participation.
Findings: Thematic analysis revealed four themes: (1) gambling-related harm as a public health problem; (2) identification of groups of adults with health and social care needs who may be vulnerable to gambling-related harm; (3) factors potentially impeding the identification of gambling-related harm among adults with health and social care needs and subsequent helpseeking behaviour and (4) calls for professional development activities. Informants reported a perceived lack of awareness of gambling-related harm and a lack of a clear pathway or guidance which they could follow when supporting individuals experiencing gambling-related harm. Interviewees called for professional development activities to improve their knowledge and expertise in this area. Article available online
Reference: Bramley, S., Norrie, C., & Manthorpe, J. (2019) The nature of gambling related harm for adults with health and social care needs: an exploratory study of the views of key informants. Primary Health Care Research & Development 20(e115): 1–7. doi: 10.1017/ S1463423619000549
Though largely banned throughout the early 1900s, gambling experienced a rebirth in the second half of the twentieth century. Shortly after the 1988 Indian Gaming Regulatory Act, however, federal legislators were worried that gambling would extend beyond traditional casino gambling and into the realm of sports, a possibility legislators unanimously opposed. Sports gambling had long been opposed by many legislators fearing it would corrupt amateur and professional sports organizations.
Validating legislators’ opposition and fear, several sports gambling scandals in the 1900s utilized bribery and extortion to compromise athletes. For example, in 1919, eight Chicago White Sox players arranged with the nation’s leading gamblers to manipulate the outcome of the World Series of Major League Baseball (“MLB”) to guarantee and collect a lucrative payout—infamously becoming known as “The Black Sox.” Thus, in 1992, with the support of those opposing sports gambling, Congress passed the Professional and Amateur Sports Protection Act (“PASPA”), a statute that prohibited wagering on amateur and professional sports. Article available online
Reference: Haines, H.M. (2019). Passing the ball: The United States Supreme Court strikes down PASPA and throws sports gambling back to the state legislatures. Maryland Law Review, 78(3), 604-635.
Abstract: This brief report examines whether there are differences in aspects of different characteristics, including design/methodologies of responsible gambling (RG), between studies funded by industry as compared to other sources. To investigate this, the authors used those studies included in a recent meta-analysis focusing on the empirical basis of RG initiatives (Ladouceur et al. in Addict Res Theory 25:225–235, 2017). We examined eight associations between funding sources, and different design/methodological characteristics of these studies; type of strategy, inclusion of comparison groups, measurement scales and repeated measures, publication source, number of inclusion criteria met, secondary sources of funding, publication year. The results revealed no statistically significant difference between the funding source, and the index study characteristics. These results do not support claims that funding exerts influence on the design or methodologies of RG studies. However, the absence of statistically significant findings should not be used to assert the absence of a funding effect because there are many reasons for failing to find differences, or interpretation of findings. Unexpectedly, a third of the papers included in this study failed to disclose their funding sources. This finding highlights the need for more open and transparent disclosures. Article details and access conditions
Reference: Ladouceur, R., Shaffer, P., Blaszczynski, A. et al. (2019). Responsible gambling research and industry funding biases. Journal of Gambling Studies, 35(725). https://doi.org/10.1007/s10899-018-9792-9.
Introduction: Based on the results from numerous studies and discussions by expert groups organised by the WHO, gaming disorder is recognised as a mental disorder and is listed in the chapter of mental, behavioural and neurodevelopmental disorders in the recently released International Classification of Diseases, 11th Version (ICD-11). Gaming disorder, gambling disorder and substance use disorder belong to the same category of mental disorder. This change will help improve the public’s awareness and understanding of gaming disorder. Meanwhile, it will encourage related research and develop scientific and effective interventions for the purpose of negative consequences reduction. Short article available online
Reference: Zhao, M., & Hao., W. (2019). Challenges of gaming disorder: Suggestions from a public health perspective. General Psychiatry, 32(e100086). doi: 10.1136/gpsych-2019-100086
Abstract: The Iowa Gambling Task (IGT) provides a framework to evaluate an individual decision-making process through a simulated card game where the risks and rewards vary by the decks chosen. Participants are expected to understand the logic behind the allocation of gains and losses over the course of the test and adapt their pattern of choices accordingly. This review explores the scientific work on studying problem gambling via the IGT while employing neuroimaging techniques. We first concentrate on the historical evolution of the IGT as a mechanism for studying gamblers’ behavioral patterns. Our research will also discuss the prefrontal cortex as this region of the brain is most affected by changes in behavioral patterns. In this review, we describe a number of features that may be useful in investigating decision-making patterns that lead to gambling addiction. We discuss the evidence base to date including experiments involving gambling behavior in different groups of participants (e.g., males and females, adults and minors, patients and controls) and alterations to experiment conditions that provide more thorough understanding of thought patterns in potential gamblers. We conclude that psychological testing combined with functional imaging provide powerful tools to further examine the relationships between functional impairment of the brain and a person’s ability to objectively anticipate the end results of their decisions. Article available online
Reference: Aram, S., Levy, L., Patel, J.B., Anderson, A.A., Zaragoza, R., Dashtestani, H., Chowdhry, F.A., Gandjbakhche, A., & Tracy, J. K. (2019). The Iowa Gambling Task: A review of the historical evolution, scientific basis, and use in functional neuroimaging. SAGE Open. https://doi.org/10.1177/2158244019856911
Abstract: In the last years, the debate on the use of psychedelics in psychotherapeutic settings has intensified, attracting a lot of interest and attention from the scholarly community as well as from clinicians and paving the way for new therapeutic paradigms. Besides classical addictions and addictive behaviors, there exist forms of addictions, the so-called new addictions or behavioral addictions, whose characterization is not linked so much to substances but to widespread and socially accepted activities such as games, shopping, internet use, sex, love relationships, work and exercises, physical activities or sports.
Among the various addictions, the gambling disorder is the first form of behavioral addictions officially recognized by the DSM-V, in accordance with a wealth of neurobiological and clinical data showing the activation in patients of the gratification systems (especially dopamine).
Orthos, as intensive residential intervention program envisaging a non-moralistic approach to gambling, can be combined with the administration of psilocybin, a substance characterized by a very low potential for abuse, modulating brain areas and networks affected by addictive behaviors. Therefore, our proposal would be to start treating behavioral addictions combining psilocybin administration with existential-humanistic psychotherapy, like Orthos. Article available online
Reference: Raymondo, S., & Firenzuoli, F. (2019). Integrating psilocybin and existential-humanistic psychotherapy for pathological gambling treatment: a new perspective. Cosmos and History: The Journal of Natural and Social Philosophy, 15(1), 228–236.
Abstract: Although problem gambling and mental illnesses are highly comorbid, there are few examples of integrated problem gambling and mental illness services. This has meant that it is unclear whether such services are needed, why they may be used, and how they operate to support clients who are affected by the comorbidity and the clinicians who are providing care. This study reports on data collected via telephone questionnaire-assisted interviews of 20 clients and 19 referrers who had accessed one such Australian integrated problem gambling and mental illness program between July 2014 and June 2016.
Data revealed that clients were often referred in the context of psychiatric or psychosocial crisis, or when clinicians encountered clients who were not making progress and wanted a second opinion about diagnosis and treatment. Improved management of illness symptoms or gambling behaviour was a commonly reported benefit, and a number of clients reported gaining a feeling of reassurance and hope following assessment as a result of a deeper understanding of their issues and available treatment options. Access to dual-specialist expertise on problem gambling and mental illness may therefore enhance treatment planning, management during crises, and cross-sector collaboration to improve access to care and its impact on people who are experiencing comorbidity. Article available online
Reference: McCartney, L.E., Northe, V., Gordon, S., Symons, E., Shields, R., Kennedy, A., & Lee, S.J. (2019). Promoting cross-sector collaboration and input into care planning via an integrated problem gambling and mental health service. Journal of Gambling Issues, 42.