Reward reactivity and dark flow in slot-machine gambling: “Light” and “dark” routes to enjoyment [open-access article].

Background and aims: Slot machines are a very popular form of gambling. In this study, we look at two different routes to enjoying slots play. One route involves the degree to which players react to rewards. The other route involves what we call dark flow – a pleasurable, but maladaptive state where players become completely engrossed in slots play, providing an escape from the depressing thoughts that characterize their everyday lives.

Methods: One hundred and twenty-nine high-frequency slots players were tested on slot-machine simulators set up in the lobby of a casino. We measured reward reactivity using post-reinforcement pauses (PRPs) and the force with which players pressed the spin button following different slot-machine outcomes. For each player, we calculated the slopes of PRPs and force as a function of credit gains. We also assessed players’ slots game enjoyment and their experience of dark flow, depression, and problem gambling.

Results: Both the PRP and the force measures of reward reactivity were significantly correlated with players’ enjoyment of the slots session, but neither measure was correlated with either problem gambling or depression. Ratings of dark flow were strongly correlated with slots enjoyment (which accounted for far more positive affect variance than the reward reactivity measures) and were correlated with both problem gambling scores and depression.

Discussion and conclusions: Our results suggest that of these two routes to enjoying slot-machine play, the dark flow route is especially problematic. We contend that the dark flow state may be enjoyable because it provides escape from the negative thoughts linked to depressionArticle available online

Citation: Dixon, M.J., Gutierrez, J., Larche, C.J., Stange, M., Graydon, C., Kruger, T.B., & Smith, S.D. (2019). Reward reactivity and dark flow in slot-machine gambling: “Light” and “dark” routes to enjoyment. Journal of Behavioral Addictions. doi: 10.1556/2006.8.2019.38


The interplay between chasing behavior, time perspective, and gambling severity: An experimental study [open-access article].

Background and aims: Chasing refers to continued gambling in an attempt to recoup previous losses and is one of the diagnostic criteria for gambling disorder. However, research on the topic is still in its infancy. This study investigated whether chasing behavior mediates the relationship between time perspective and gambling severity.
Methods: Nonproblem gamblers (N = 26) and problem gamblers (N = 66) with the same demographic features (age and gender) were compared on the Consideration of Future Consequences and a computerized task assessing chasing. The Italian South Oaks Gambling Screen was used to discriminate participants in terms of gambling severity.
Results: Significant correlations were found relating to gambling severity, chasing, and time perspective. More specifically, the results showed that problem gamblers reported more chasing and a foreshortened time horizon. Chasers, compared to nonchasers, were found to be more oriented to the present. Regression analysis showed that male gender, present-oriented time perspective, and chasing were good predictors of gambling severity. Finally, to clarify if present orientation was on the path from chasing to gambling severity or if chasing was the mediator of the impact of present orientation on gambling severity, a path analysis was performed. The results indicated that present orientation had a direct effect on gambling severity and mediated the relationship between chasing and gambling involvement.
Conclusion: The findings support the exacerbating role of chasing in gambling disorder and for the first time show the relationship of time perspective, chasing, and gambling severity among adults. Article available online

Reference: Ciccarelli, M., Cosenza, M., Griffiths, M.D., D’Olimpio. F., & Nigro, G. (2019). The interplay between chasing behavior, time perspective, and gambling severity: An experimental study. Journal of Behavioral Addictions. DOI: 10.1556/2006.8.2019.29

Giving room to subjectivity in understanding and assessing problem gambling: A patient-centered approach focused on quality of life [open access article]

Background and aims: Problem gambling is characterized by high stigma and self-stigma, making relevant measurement of the burden of the disorder complex. The aim of our qualitative study was to describe health related quality of life (HRQOL) impacted by problem gambling from the patients’ perspective.

Methods: We conducted 6 focus groups with 25 current or lifetime at-risk problem gamblers to identify key domains of quality of life impacted by problem gambling. A content analysis from the focus groups data was conducted using Alceste© software, using descendant hierarchical classification analysis, to obtain stable classes and the significant presences of reduced forms. The class of interest, detailing the core of impacted quality of life, was described using a cluster analysis.

Results: Thematic content analysis identified three stable classes. Class 1 contained the interviewers’ speech. Class 3 was composed of the vocabulary related to gambling practice, games and gambling venues (casino, horse betting, etc.). Class 2 described the core of impact of gambling on quality of life and corresponded to 43% of the analyzed elementary context units. This analysis revealed seven key domains of impact of problem gambling: loneliness, financial pressure, relationships deterioration, feeling of incomprehension, preoccupation with gambling, negative emotions, and avoidance of helping relationships.

Conclusions: We identified, beyond objective damage, the subjective distress felt by problem gamblers over the course of the disorder and in the helping process, marked in particular by stigma and self-stigma. Four impacted HRQOL areas were new and gambling-specific: loneliness, feeling of incomprehension, avoidance of helping relationships, and preoccupation with gambling. These results support the relevance of developing, in a next step, a specific HRQOL scale in the context of gambling. Access full article

Reference: VBonfils, N.A., Grall-Bronnec, M., Caillon, J., Limosin, F., Benyamina, A., Aubin, H., & Luquiens, A. (2018). Giving room to subjectivity in understanding and assessing problem gambling: A patient-centered approach focused on quality of life. Journal of Behavioral Addictions. DOI:10.1556/2006.7.2018.137

Excessive social media users demonstrate impaired decision making in the Iowa Gambling Task [open access article]

Background and aims: Online social networking sites (SNSs) like Facebook provide users with myriad social rewards. These social rewards bring users back to SNSs repeatedly, with some users displaying maladaptive, excessive SNS use. Symptoms of this excessive SNS use are similar to symptoms of substance use and behavioral addictive disorders. Importantly, individuals with substance use and behavioral addictive disorders have difficulty making value-based decisions, as demonstrated with paradigms like the Iowa Gambling Task (IGT); however, it is currently unknown if excessive SNS users display the same decision-making deficits. Therefore, in this study, we aimed to investigate the relationship between excessive SNS use and IGT performance.

Methods: We administered the Bergen Facebook Addiction Scale (BFAS) to 71 participants to assess their maladaptive use of the Facebook SNS. We next had them perform 100 trials of the IGT to assess their value-based decision making. Results: We found a negative correlation between BFAS score and performance in the IGT across participants, specifically over the last block of 20 trials. There were no correlations between BFAS score and IGT performance in earlier blocks of trials.

Discussion: Our results demonstrate that more severe, excessive SNS use is associated with more deficient value based decision making. In particular, our results indicate that excessive SNS users may make more risky decisions during the IGT task. Conclusion: This result further supports a parallel between individuals with problematic, excessive SNS use, and individuals with substance use and behavioral addictive disorders. Access full article

Citation: Meshi, D., Elizarova, A., Bender, A., & Verdejo-Garcia, A. (2018). Journal of Behavioral Addictions. DOI: 10.1556/2006.7.2018.138

Gambling disorder, increased mortality, suicidality, and associated comorbidity: A longitudinal nationwide register study [open access article]

Background and aims: Gambling disorder (GD) appears to be an independent risk factor for suicide, and all-cause mortality has been sparsely studied in patients with GD. This study aims to explore mortality and suicide rates in individuals with GD compared to the general population as well as explore risk factors associated with all-cause mortality and suicide mortality. Access full article

Anna Karlsson and Anders Håkansson; Faculty of Medicine, Department of Clinical Sciences Lund, Psychiatry, Lund University, Lund, Sweden; Clinical Research Unit, Malmö Addiction Center, Region Skåne, Sweden. Journal of Behavioral Addictions.
DOI: 10.1556/2006.7.2018.112

Relationship between attention-deficit hyperactivity disorder symptoms and problem gambling: A mediation analysis of influential factors among 7,403 individuals from the UK (open access article)

Jacob, L., Haro, J. M., & and Koyanagi, A. (2018). Journal of Behavioral Addictions, 7(3), 781–791. doi: 10.1556/2006.7.2018.72

Background and aims: Our goal was to examine the association between attention-deficit hyperactivity disorder (ADHD) symptoms and gambling problems, and to identify potential mediating factors of this association. Methods: This study used cross-sectional, community-based data from 7,403 people aged ≥16 years who participated in the Adult Psychiatric Morbidity Survey 2007. ADHD symptoms were assessed using the Adult DHD Self-Report Scale (ASRS) Screener. Problem gambling was assessed using a questionnaire based on the 10 DSM-IV diagnostic criteria for pathological gambling. Respondents were classified as having no problem, at-risk, or problem gambling. Logistic regression and mediation analyses were conducted to analyze the association between ADHD symptoms (i.e., ASRS score ≥14) and problem gambling and the role of several variables in this association. Results: The prevalence of at-risk (5.3% vs. 2.4%) and problem gambling (2.4% vs. 0.6%) was higher in individuals with ADHD symptoms than in those without ADHD symptoms. ADHD symptoms were significantly associated with both at-risk (OR = 2.15; 95% CI = 1.22–3.79) and problem gambling (OR = 3.57; 95% CI = 1.53–8.31) when adjusted for age, sex, and ethnicity. Common mental disorders (CMDs; i.e., depression and anxiety disorders) (mediated percentage = 22.4%), borderline personality disorder (BPD) traits (22.1%), stressful life events (13.2%), stress at work or home (12.6%), alcohol dependence (11.8%), and impulsivity (11.2%) were significant mediators in the ADHD–gambling association. Discussion and conclusions: Overall, ADHD symptoms were positively associated with problem gambling. CMDs, BPD traits, and stressful life events were important mediators in this relationship. Access full article


The crucial role of recovery capital in individuals with a gambling disorder (open access article)

Gavriel-Fried, B. (2018). Journal of Behavioral Addictions, 7(3), 792–799. doi: 10.1556/2006.7.2018.82

Background and aims: The concept of recovery capital (RC) describes the internal and external resources that individuals draw upon to initiate and sustain the processes of addiction recovery. This concept has been primarily applied to individuals recovering from substance addictions. In this study, the RC concept was applied to individuals
with a gambling disorder (GD) to test its associations with the diagnosis and severity of GD and with levels of psychopathology as manifested in depression and anxiety. Methods: A sample of 140 individuals who recovered or did not recover from a GD was drawn from lists of former and currently treated individuals in five gambling treatment centers in Israel. The DSM-5 diagnostic criteria for GD, Assessment of Recovery Capital and Brief Assessment of Recovery Capital Scales adapted to Gambling, Generalized Anxiety Disorder Scale, and the Patient Health Questionnaire 9 which measures depression were used. Results: RC clearly distinguishes between individuals who have recovered from GD and those who have not. A structural equation model showed significant negative associations between RC and GD severity, depression, and generalized anxiety. The associations between GD severity and depression and anxiety were not significant. However, when omitting the path between RC and depression/anxiety, the associations between GD and depression/anxiety became significant. Conclusions: RC plays an important role in GD severity and diagnosis, as well as in psychopathology. This study extends the concept of RC to the area of gambling and contributes to the growing body of studies that have found parallels and common denominators between substance addiction and behavioral addictions. Access full article. Access full article