Reward-related stimuli can potently influence behavior; for example, exposure to drug-paired cues can trigger drug use and relapse in people with addictions. Psychological mechanisms that generate such outcomes likely include cue-induced cravings and attentional biases. Recent animal data suggest another candidate mechanism: reward-paired cues can enhance risky decision making, yet whether this translates to humans is unknown. Here, we examined whether sensory reward-paired cues alter decision making under uncertainty and risk, as measured respectively by the Iowa Gambling Task and a two-choice lottery task. In the cued versions of both tasks, gain feedback was augmented with reward-concurrent audiovisual stimuli. Healthy human volunteers (53 males, 78 females) performed each task once, one with and the other without cues (cued Iowa Gambling Task/uncued Vancouver Gambling Task: n 63; uncued Iowa Gambling Task/cued Vancouver Gambling Task: n 68), with concurrent eye-tracking. Reward-paired cues did not affect choice on the Iowa Gambling Task. On the two-choice lottery task, the cued group displayed riskier choice and reduced sensitivity to probability information. The cued condition was associated with reduced eye fixations on probability information shown on the screen and greater pupil dilation related to decision and reward anticipation. This pupil effect was unrelated to the risk-promoting effects of cues: the degree of pupil dilation for risky versus risk-averse choices did not differ as a function of cues. Together, our data show that sensory reward cues can promote riskier decisions and have additional and distinct effects on arousal. Article available online
Citation: Cherkasova, M.V., Clark, L., Barton, J.S., Schulzer, M., Shafiee, M., Kingstone, A., Stoessl, A.J., & Winstanley, C.A. (2018). Win-concurrent sensory cues can promote riskier choice. Journal of Neuroscience, 38(48), 10362-10370. DOI:10.1523/JNEUROSCI.1171-18.2018
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
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.
Abstract: This study investigates mental health and substance use problems associated with gambling among Canadian emerging adults (ages 18–20 years). Drawing on a cross-sectional wave of 624 (47.8% male) participants from the Manitoba Longitudinal Study of Young Adults, our findings suggest that among emerging adults, problem gambling should be understood as part of a wider syndrome. The profile of syndromic associations varies with both problem gambling risk level and gender. With respect to risk level, regression models indicate that, relative to no-risk gamblers, lower risk gamblers are more likely to use drugs and alcohol, whereas higher risk gamblers report greater symptoms of depression and anxiety. Males and females present different barriers to recovery: High-risk female gamblers are more likely to rely on escape-avoidance coping mechanisms, whereas their male counterparts tend to lack perceived social support. Given the centrality of these two variables and the lack of literature addressing how they interact, we conclude that further research is needed to understand how gender and gambling severity interact to simultaneously influence gambling-related behaviours among emerging adults. Access online article
Reference: Sanscartier, M.D., Shen, J., & Edgerton, J.D. (2019). Gambling among emerging adults: How gender and risk level influence associated problem behaviours. Journal of Gambling Issues, 41(April), 101-123. Retrieved from http://jgi.camh.net/index.php/jgi/article/view/4043
Abstract: The Problem Gambling Severity Index (PGSI) is a screening instrument frequently used to identify risk and problem gambling. Even though the PGSI has good psychometric properties, it still produces a large proportion of misclassifications. Aims: To explore possible reasons for misclassifications in problem gambling level by analysing previously classified moderate-risk gamblers’ answers to the PGSI items, in relation to their own current and past gambling behaviours.
Methods: Semi-structured telephone interviews were conducted with 19 participants reporting no negative consequences from gambling. They were asked the PGSI questions within an eight-year time frame (2008 to 2016). Ambiguous answers to PGSI items were subject to content analysis.
Results: Several answers to the PGSI items contained ambiguities and misinterpretations, making it difficult to assess to what extent their answers actually indicated any problematic gambling over time. The item about feelings of guilt generated accounts rather reflecting self-recrimination over wasting money or regretting gambling as a meaningless or immoral activity. The item concerning critique involved mild interpretations such as being ridiculed for buying lottery tickets or getting comments for being boring. Similar accounts were given by the participants irrespective of initial
endorsement of the items. Other possible reasons for misclassifications were related to recall bias, language difficulties, selective memory, and a tendency to answer one part of the question without taking the whole question into account.
Conclusions: Answers to the PGSI can contain a variety of meanings based on the respondents’ subjective interpretations. Reports of lower levels of harm in the population should thus be interpreted with caution. In clinical settings it is important to combine use of screening instruments with interviews, to be able to better understand gamblers’ perceptions of the gambling behaviour and its negative consequences.
Article available online
Reference: Samuelsson, E., Wennberg, P., & Sundqvist, K. (2019). Gamblers’ (mis-)interpretations of Problem Gambling Severity Index items: Ambiguities in qualitative accounts from the Swedish longitudinal gambling study. Nordic Studies on Alcohol and Drugs, 36(2), 140–160. DOI: 10.1177/1455072519829407
Dowling, N., Ewin, C., Youssef, G., Merkouris, S., Suomi, A., Thomas, S., & Jackson, A. (2018). Journal of Behavioral Addictions. doi: 10.1556/2006.7.2018.74
Background and aims: Few studies have investigated the association between problem gambling (PG) and violence extending into the family beyond intimate partners. This study aimed to explore the association between PG and family violence (FV) in a population-representative sample. It was hypothesized that: (a) PG would be positively associated with FV, even after adjusting for sociodemographic variables and comorbidities and (b) these relationships would be significantly exacerbated by substance use and psychological distress. A secondary aim was to explore whether gender moderated these relationships. Methods: Computer-assisted telephone interviews were conducted with a population-representative sample of 4,153 Australian adults.
Results: Moderate-risk (MR)/problem gamblers had a 2.73-fold increase in the odds of experiencing FV victimization (21.3%; 95% CI: 13.1–29.4) relative to nonproblem gamblers (9.4%; 95% CI: 8.5–10.4). They also had a 2.56-fold increase in the odds of experiencing FV perpetration (19.7%; 95% CI: 11.8–27.7) relative to non-problem gamblers (9.0%; 95% CI: 8.0–10.0). Low-risk gamblers also had over a twofold increase in the odds of experiencing FV victimization (20.0%; 95% CI: 14.0–26.0) and perpetration (19.3%; 95% CI: 13.5–25.1). These relationships remained robust for low-risk gamblers, but were attenuated for MR/problem gamblers, after adjustment for substance use and psychological distress. MR/problem gamblers had a greater probability of FV victimization, if they reported hazardous alcohol use; and low-risk gamblers had a greater probability of FV perpetration if they were female. Discussion and conclusion: These findings provide further support for routine screening, highlight the need for prevention and intervention programs, and suggest that reducing alcohol use may be important in these efforts. Access full article