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Dr. Luke Clark

  1. Deconstructing the Modern Slot Machine: Psychological Ingredients and Personal Vulnerabilities Dr Luke Clark New Horizons in Responsible Gambling 22 February 2017
  2. Disclosure Statement The Centre for Gambling Research at UBC is supported by the British Columbia Lottery Corporation (a Crown Corporation) and the Province of BC government. Honoraria: Svenska Spel (Sweden), Victorian Responsible Gambling Foundation (Australia), National Center for Responsible Gaming (US) Consultancy: Cambridge Cognition Ltd (UK)
  3. Objectives • Psychiatry and neuroscience has focussed on personal vulnerability factors to gambling addiction, neglecting the role of the gambling product. • Modern slot machines are among the most harmful gambling products. These games contain many psychological ingredients that may underlie their addictiveness. – Near Misses – Immersion (as a net result) – Cash vs credit-based payment • RG initiatives should respond to, and consider regulating, specific features.
  4. Who Develops Gambling Problems? • “Medical Model” (psychiatry & neuroscience) places Gambling Disorder alongside the substance addictions • “Addiction is a brain disease” (Leshner, 1997 Science) • Uneven playing field in who develops addictions
  5. Impulsivity: the Addictive Personality 0 5 10 15 20 25 30 35 40 Neg Urgency Pos Urgency Lack of Premed Lack of Persev Sens Seeking UPPS-PSubscaleScore PG Controls UPPS-P Scale Effect Size (d) Negative Urgency 1.8 Positive Urgency 1.5 Lack of Premeditation 0.8 Lack of Perseverance 0.6 Sensation Seeking 0.2 “mood-related impulsivity” “narrow” impulsivity ** ** Michalczuk et al (2011) * *
  6. Early Predictors
  7. 0 1 2 3 4 D2 in Overall Striatum Controls Gamblers Clark et al (2012 NeuroImage) Con Gam 1.5 2 2.5 3 10 20 30 40 50 BPNDLimbicStriatum Negative Urgency GD Controls 11C-raclopride PET of dopamine transmission in Gambling Disorder
  8. Individual Vulnerabilities 0.6 0.7 0.8 0.9 1 9 8 7 6 ProportionMajority Choice Majority Colour PG Controls Neuropsychological Markers 1.5 2 2.5 3 30 35 40 45 D2BPinOverall Striatum Negative Urgency Neurochemistry (PET) Personality Traits 0 10 20 30 40 Neg Urgency Pos Urgency Lack of Premed Lack of Persev Sens Seeking UPPS-PSubscaleScore PG Controls Brain Responses (fMRI)
  9. A Public Health Approach to Gambling Harm GAMBLERGAME GAMBLING ENVIRONMENT Impulsivity Dopamine Brain structure Near-misses Speed of play Jackpot size Korn & Shaffer 1999 Murch & Clark 2015 Venue size Age restrictions Opening hours
  10. Revenues & problems by different forms Maclaren 2015: revenue from different forms, across all provinces • BC: Most popular forms of gambling: lottery (44%), charity raffle (16%), casino (11%), private games (11%), sports betting (3%) • Forms most associated with PG: casino (42%), private games (39%), stocks & shares (27%), bingo (14%), internet gambling (13%) 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 0 100 200 300 400 500 600 Fiscal year RevenueperCanadianadult (CAD) VLTs Slots Lottery Horse All other
  11. Treatment Services • In treatment services, the most common preferred / problematic form of gambling are slot machines (25 of 51 in our Vancouver study; Dawn Kennedy’s poster) • (in UK, 40-50% at London clinic have electronic Roulette as preferred form) • More rapid progression from initial use to problematic gambling (Breen & Zimmerman 2002)
  12. Early Slot Machines 1895 Charles Fey invents the ‘Liberty Bell’ 1938 Bally’s ‘Double Bell’ 1973 Bally’s ‘Circus’
  13. The Modern EGM Ice Impress (WMS Games)
  14. Game Features Speed / Continuity Pay-out features: Jackpot Size, Max Bet, Return to Player Mode of Payment (bill acceptors) Sensory Feedback / ‘Losses Disguised as Wins’ Illusory Control (e.g. stopper buttons) Near-Misses
  15. Slot Machine Simulations Pick a shape Choice No win Full-miss outcome Anticipation Win outcome Win 5€ No win Near-miss outcome Rating Win 5€ How much do you want to continue gambling?
  16. Problem Gamblers show increased brain responses to near-misses CONTROLS GAMBLERS GAMBLERS > CONTROLS fMRI: near-miss > full-miss Sulpiride Percentsignalchange Near-miss Full-miss T 6.7 11 CONTROLS Sescousse et al, 2016 GAMBLERS
  17. The UBC ‘Casino Lab’ 0 1000 2000 3000 4000 5000 6000 5 10 15 20 25 30 Credits Minutes Slot-Tracker algorithm
  18. Lost in the Game • During play, some gamblers enter a ‘trance- like’ state (immersion, flow, dissociation) • This state may provide a means of escape from stress, low mood, boredom • Particularly common during slot machine gambling; slot machine design has served to “smooth the play experience” Spencer Murch
  19. Measuring Immersion 3X 0 5 10 15 20 0 3 6 9 12 15 18 21 24 27 DQScore Problem Gambling Symptoms Dissociation 0 3 6 9 12 15 0 3 6 9 12 15 18 21 24 27 Targets Problem Gambling Symptoms Targets Detected Murch et al, 2017
  20. Shattering the Zone: RG Implications 3X $17.50 GS-$2.50 3X GS $17.50
  21. Sensory Feedback in the Rat Casino stimulus lights on nosepoke in lit hole 5s time out (p = 0.1) P1: 1 pellet (p = 0.9) P4: 4 pellets (p = 0.4) P2: 2 pellets (p = 0.8) P3: 3 pellets (p = 0.5) 40s time out (p = 0.6) 10s time out (p = 0.2) 30s time out (p = 0.5) Trial rewarded Trial punished OR Cued rGT: Uncued rGT: Profitability 295 99 411 135 Barrus & Winstanley (2016)
  22. The Plastic Trap • In a ‘cashless’ society, should we be able to play slot machines using credit cards / app-based payment? • In consumer psychology, people make more risky & excessive purchases when paying on credit (the ‘pain of paying’ hypothesis) • Current practices are a hybrid: cash in, ticket out Chua et al, New Horizons poster
  23. Cash vs Credit 0 50 100 150 PERSISTENCE (MEAN # TRIALS) 0 100 200 300 400 500 BETTING (MEAN PER MINUTE) CASH CREDIT CASH CREDIT Chua et al, New Horizons poster
  24. Conclusions  Clinical emphasis on vulnerability to gambling addiction should not trivialize the impact of the gambling product.  Slot machines are psychologically complex games with many ingredients. Are the ingredients that make a game fun the same ingredients that make it addictive?  From an RG perspective, initiatives to encourage limit setting are important, but by themselves may be insufficient.  The next phase of research will describe how specific game features interact with personal vulnerability to shape gambling harms.
  25. CGR People Dr Luke Clark Director Dawn Kennedy Research Assistant Spencer Murch Dr Tilman Lesch Dr Eve Limbrick- Oldfield Graduate Students Mario Ferrari Ke ZhangGabriel Brooks Post-Doc Fellows Cindy Chang Candy Chua Undergrad RAs Keni Ng
  26. Email Web Twitter @LukeClark01 @CGR_UBC
  27. The Modern EGM 27
  28. Limbrick-Oldfield et al 2017: brain areas hyper-reactive to gambling cues and correlated with cravings in problem gamblers 2.3 4.5 Z = -4 X = -2
  29. -12 -10 -8 -6 -4 -2 0 2 4 6 Carfentanil Displacement by Amphetamine (Opioid Release) PG Con * * * ** Carfentanil PET imaging of mu-opioid receptors and opioid release in Gambling Disorder Oral amphetamine (0.5 mg/kg) releases endogenous opioids, displacing ligand from receptors (lower BP) Opioid release blunted in PGs (no diff in baseline receptors) BASELINE POST-AMPH Mick et al (2016 Neuropsychopharm)
  30. Genes or Environment? 31 Slutske et al 2000: 6744 Vietnam era twins. Rate of lifetime Path. Gambling: 1.4%, subclinical: 6.2% Rate of lifetime Alcohol Dependence: 35% PG genetics: 40-50% (from MZ-DZ disparity) Overlap between PG genes and AD genes: 12-20%
  31. Game category breakdown

Hinweis der Redaktion

  1. .
  2. One of the other unique aspects of the research environment at UBC is the opportunity to collaborate with Catharine Winstanley’s lab at the Centre for Brain Health, who are the leading group anywhere in the world on animal models of gambling behaviour. In this rat gambling task, the animal can choose on each trial between 4 holes in the wall of the cage, by poking its nose into the hole. The outcomes of these choices can be good or bad. The rat might win some food pellets, between 1 and 4 pellets across the different options. But there’s a chance that the rat might suffer a time-out, which is like a rat equivalent of being sent to the naughty step, when the rat can’t earn any more food pellets for a short time. So P2 here is quite a good gamble; there’s a high chance of etting 2 pellets, and a low chance of a short timeout. P3 on the other hand offers 3 pellets but the probability is much lower, and the timeout is both longer and more likely. So the return to player on these 2 options is very different: P2 is a much better bet in the long run. Now Catharine’s task has been refining this procedure for coming up to a decade now, and in their latest version, they manipulate the bells and whistles. The uncued group play the game with the sound turned off, but for another group of animals, whenever they win the food pellets, they receive additional feedback in the form of flashing lights and a chiming flourish, and the intensity of that feedback scales with the number of pellets: P3 gives more intense feedback than P2. So the food is the money here; you should be making choices based on food profitability, but the rats are skewed by the bells and whistles. This group make fewer choices to P2, and more choices to the riskier option P3. This was also a variable effect; some rats are much more sensitive to the cues that others, and in Mike Barrus’ paper this was further linked to a specific kind of dopamine receptor. One way that we’re currently taking this forward is to see if we can use this model of sensory feedback to emulate a loss disguised as a win in the rats.