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Bridging the Gap between Research and Practice Mark R. Dixon & Alyssa Wilson Southern Illinois University

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Bridging the Gap between Research and Practice. Mark R. Dixon & Alyssa Wilson Southern Illinois University. The Road to Somewhere…. Problem gambling is not the problem. Problem gambling is the outcome of deeper rooted clinical problem. - PowerPoint PPT Presentation

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Page 1: Bridging the Gap between Research and Practice

Bridging the Gap between Research and Practice

Mark R. Dixon & Alyssa WilsonSouthern Illinois University

Page 2: Bridging the Gap between Research and Practice

The Road to Somewhere…..

• Casino laboratory• College students as

subjects in research• Computerized versions of

actual casino games

Bench

• Answering basic psychological processes with a clinical/sub-clinical sample

• In the field research or clients entered into lab

Translational • Real pathological gamblers• Real gambling problems• Real treatment that YOU

can take with you today

Bedside

Page 3: Bridging the Gap between Research and Practice

Problem gambling is not the problem.

• Problem gambling is the outcome of deeper rooted clinical problem.

• Treatment should be designed to treat what the “cause” of the gambling is, not just the gambling itself.

• Life is not just “fine” except for problems with gambling.

Page 4: Bridging the Gap between Research and Practice

Popular Treatment Approaches

• Gamblers Anonymous– Disease model– Client is a victim– You never “beat” the disease– No active treatment. Social support group.

• Self-Exclusion Programs– Self or court orders gambler to be banned from gaming establishments– No way to ban online or illegal local gambling

• Medication– Certain dopamine blockers can be effective at suppressing gambling for some people– Remove the medication, the problem returns

• Psycho-educational– Teach people about game odds– Teach about risk to self or others from repeated gambling

Page 5: Bridging the Gap between Research and Practice

Classic Behavioral Treatments

• Aversive Conditioning

• Thought suppression

• Self-monitoring/reinforcement

Page 6: Bridging the Gap between Research and Practice

Contemporary Behavioral Contributions

• Contingency-based Models

Page 7: Bridging the Gap between Research and Practice

Response Cost

Page 8: Bridging the Gap between Research and Practice
Page 9: Bridging the Gap between Research and Practice

Behavioral Contributions

• Contingency-based Models• Language-based Models– External rules

Page 10: Bridging the Gap between Research and Practice

Dixon (2000) – The Psychological Record

• Subjects: 5 Recreational roulette players• Baseline: Wagered on numbers they picked or the

experimenter picked.• Intervention: Provided rules to the subjects

– Roulette is easy to win; the more you play the more you win; the best way to win is to pick your own numbers

– Roulette is a losing game; the more you play the more you lose; the experimenter can not predict good/bad numbers

• Outcome: relative rise and decline in wagers while contingencies remained the same

• Conclusion: Rules matter – contingencies do not

Page 11: Bridging the Gap between Research and Practice

Dixon, Hayes, & Aban (2000) – The Psychological Record

• Subjects: 45 Recreational roulette players• Baseline: Wagered on numbers they picked or the experimenter

picked.• Intervention: Provided one set of rules to the subjects

– Roulette is easy to win; the more you play the more you win; the best way to win is to pick your own numbers

– OR---– Roulette is a losing game; the more you play the more you lose; the

experimenter can not predict good/bad numbers• Outcome: relative rise and decline in wagers while contingencies

remained the same• Conclusion: Rules matter – contingencies do not

Page 12: Bridging the Gap between Research and Practice

Behavioral Contributions

• Contingency-based Models• Language-based Models

• Delivered Rules• Self-Rules

Page 13: Bridging the Gap between Research and Practice

Recent Attention Paid to Near-Miss

Page 14: Bridging the Gap between Research and Practice
Page 15: Bridging the Gap between Research and Practice
Page 16: Bridging the Gap between Research and Practice

Procedure

• Participants – 18 recreational slot machine players• Setting - small room, computer, video camera,

observation mirror. Three computerized slot machines available concurrently.

• Method – – 100 trials w/ 20% chance of a win on every trial– 100 trials w/ 0% chance of a win on every trial

• Various densities of near-misses on each “slot machine”• Reinforcement densities were constant on each slot machine

Page 17: Bridging the Gap between Research and Practice
Page 18: Bridging the Gap between Research and Practice
Page 19: Bridging the Gap between Research and Practice

What we know:

• Subjects will rate near-miss displays as:– Closer to wins– More pleasurable / less aversive to look at

• Subjects will prefer near-misses in concurrent operant preparations– Density effect of NM– Extinction conditions alter preference

• Neurological traces of the near-miss– Near-misses produce different levels of dopamine in brain– Pathological gamblers react neurologically different than non-

pathological

Page 20: Bridging the Gap between Research and Practice

What we don’t know:

• What behavioral process produces a near-miss effect?

• Will the near-miss effect be demonstrated with other casino games?

• Can the near-miss effect be assessed independently of the by-chance reinforcers that occur during gambling

Page 21: Bridging the Gap between Research and Practice

What Actually is the Near-Miss Effect?

• Product of Stimulus Generalization– Current display looks structurally similar to a

reinforced display, and thus it serves reinforcing function

• A Discriminative Stimulus– Signals the availability of an upcoming reinforcer

• Product of Verbal ConstructionOr, an interaction of all the above?

Page 22: Bridging the Gap between Research and Practice

Almost winning…A verbal event

“Almost”

Page 23: Bridging the Gap between Research and Practice

“9 + 4 = 14”

“9 + 4 = 14”

Antecedent

“Almost” + GCR

“What is 9 + 4 ?”Speaker

Listener

Math Time

Behavior Consequence

“What is 9 + 4 ?”

Verbal Construction

Note: GCR might be < for “almost” than for “correct”

Page 24: Bridging the Gap between Research and Practice

Looking for House #34

See House #26 “Almost There” Arrive Soon at House #34

Antecedent Behavior Consequence

Page 25: Bridging the Gap between Research and Practice

Looking for House #34

See Gas Station “Almost There” Arrive Soon at House #34

Antecedent Behavior Consequence

See Sign for Off Ramp

See Sign for Sunset Blvd

See House

#26

Page 26: Bridging the Gap between Research and Practice

“Almost”

Desired OutcomeIn Close Proximity

Page 27: Bridging the Gap between Research and Practice
Page 28: Bridging the Gap between Research and Practice

Methods

• 16 participants with history of gambling• Rating of 100 various slot machine displays– Near miss - loss - win

HOW CLOSE IS THIS DISPLAY TO A WIN?

1 (not at all) 5 10 (very much like a win)

Page 29: Bridging the Gap between Research and Practice

Methods

• Phase 1:– Rate slot machine images

• Phase 2: – Develop 3 three member stimulus classes– Attempt to derive “almost” to non-near miss display

• Phase 3:– Repeat exposure to Phase 1 task

Page 30: Bridging the Gap between Research and Practice

Stimulus 1 Stimulus 2 Stimulus 3

A Stimuli

WIN Almost Lose

B Stimuli

C Stimuli

Stimulus 1 Stimulus 2 Stimulus 3

A Stimuli

WIN Almost Lose

B Stimuli

C Stimuli

Page 31: Bridging the Gap between Research and Practice

0

2

4

6

8

10

76 112 113 115 123 169 195 211 339 357 769 771 772 773 774 776

0

2

4

6

8

10

76 112 113 115 123 169 195 211 339 357 769 771 772 773 774 776

Participant Number

Lik

ert

Rat

ing

s (1

= l

oss

--

10 =

win

)

Pre-Test

Post-Test

Loss Near-Miss

Win

0

2

4

6

8

10

76 112 113 115 123 169 195 211 339 357 769 771 772 773 774 776

0

2

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76 112 113 115 123 169 195 211 339 357 769 771 772 773 774 776

Participant Number

Lik

ert

Rat

ing

s (1

= l

oss

--

10 =

win

)

Pre-Test

Post-Test

Loss Near-Miss

Win

Page 32: Bridging the Gap between Research and Practice

More than Slots

• Many more types of near misses occur while gambling:

– Blackjack

– Roulette

– Craps

Page 33: Bridging the Gap between Research and Practice

Blackjack

Page 34: Bridging the Gap between Research and Practice

Near Miss: Blackjack• Participants:

– 5 undergrads with history of playing cards for money

– Paid 50 dollars in lotto drawing based on # of chips left

• 50 trials (1o practice trials)

• Data Collection• Self-recorded data

• Experimenter IOR on 30% trials

• End of trial – circle number 1-9 on how close their hand was to a win – 1 = no chance ; moderate

chance; good chance (as anchors)

– Record their score, dealer’s score and if they won or not on that given hand

Page 35: Bridging the Gap between Research and Practice

Results• 2 factor Near-Miss Effect– Non-bust loss– Mathematical difference between dealer and

player

Minimal Difference between player and

dealer cards

Non-Bust (under 21)

NearMiss

Minimal Difference between player and

dealer cards

Bust(over 21)

No Near Miss

Page 36: Bridging the Gap between Research and Practice

Average Loss Trials

Page 37: Bridging the Gap between Research and Practice

All Loss Trials (all players combined)

Page 38: Bridging the Gap between Research and Practice

Roulette

Page 39: Bridging the Gap between Research and Practice
Page 40: Bridging the Gap between Research and Practice

Near Miss: Roulette

• Participants:– 28 College Undergraduates (run concurrently)

– Extra credit value based on winnings• First 5 students to hit a number = 10 x points• Next 5 = 5 x points• Remainder of students = 1 x point

• Played 60 trials of roulette– 1 single bet on a single number (1:38 odds of winning)

– Rating of outcome• “How close to a win was this outcome for you?”• Scale 1 to 10

Page 41: Bridging the Gap between Research and Practice

1 3 5 7 9 11 13 15 17 19 21 23 25 27 29 310

1

2

3

4

5

6

7

8

9

10

- numerical value of bet and win

Avg

Sub

jecti

ve R

ating

Page 42: Bridging the Gap between Research and Practice

1 2 3 4 5 6 7 8 9 100123456789

10

- between Location of Bet and Win on Board

Avg

Sub

jecti

ve R

ating

Page 43: Bridging the Gap between Research and Practice

Alternative Methods

• Self-reports of:– How close to win– How much do you like

• Preference for near-misses during gambling– Interaction between display and superstitious

reinforcement

• Can we show a “preference” for near-misses absent of the reinforcement interaction?

Page 44: Bridging the Gap between Research and Practice

Paired-Choice Near- Miss

• Participants– 34 College

Undergraduates– Awarded course extra

credit– Randomly assigned to 2

groups of 17– Instructed to choose

between two slot images.• “Which one would you

rather see if you were playing a slot machine?”

• Procedures– Exposure to 120 trials of 3

trial types• Win vs Loss• Win vs Near Miss• Near Miss vs Loss

– Experimental Group• 5 min intervention

– Control Group• 5 min break in hallway

Page 45: Bridging the Gap between Research and Practice

Intervention Details

• Prior research suggests that rules are effective ways of altering gambling behavior– Dixon (2000); Dixon, Aban, & Hayes (2000)– Dixon & Delaney (2006)

• Prior research also suggests that the deliteralization of language can alter the current functions of a specific verbal stimulus– Aka: defusion in therapy contexts

Page 46: Bridging the Gap between Research and Practice

Experimental Intervention: (one slide)

• Almost winning is not winning at all

• Almost winning is a trick played on you by the slot machine

• Almost winning makes you feel good, but it is false feeling

• Losing is losing is losing is losing is losing is losing– Repeat for 2 minutes

Page 47: Bridging the Gap between Research and Practice

Which One??

A B

Page 48: Bridging the Gap between Research and Practice

Which One??

A B

Page 49: Bridging the Gap between Research and Practice

Which One??

A B

Page 50: Bridging the Gap between Research and Practice

Pre Post0

20

40

60

80

100

ExpControl

% C

hoic

es fo

r Win

Page 51: Bridging the Gap between Research and Practice

Pre Post0

20

40

60

80

100

ExpControl

% C

hoic

es fo

r N.M

.

Page 52: Bridging the Gap between Research and Practice

Pre Post0

20

40

60

80

100

ExpControl

% C

hoic

es fo

r Los

s

Page 53: Bridging the Gap between Research and Practice

Variations of Effect

• The Near-Miss effect varies• Not based exclusively on physical characteristics of the

stimulus

• Core behavioral process rests on altering of psychological function of the stimulus (stimuli)

• Altering psychological function will alter the type of stimulus that is considered a near-miss

Page 54: Bridging the Gap between Research and Practice

Variations of Assessment

• The Near-Miss Effect can be assessed with novel methods and produce similar effects

•Verbally based interventions for gamblers who are under control of near-misses appear promising

Page 55: Bridging the Gap between Research and Practice

Nastally and Dixon (2011): The Psychological Record

• N=3 Pathological gamblers • MBL across participants• Baseline Computerized slot machine play– 50, 70, 90 trials at baseline– Report out loud how close each outcome was to a

win– 1 (very far from a win) to 10 (very close to a win)

Page 56: Bridging the Gap between Research and Practice

SIMULATION

Page 57: Bridging the Gap between Research and Practice

SIMULATIONVisible Symbols

on Wheel

Page 58: Bridging the Gap between Research and Practice

Treatment

• Intervention– ACT intervention targeted each of the 6 components– Intervention delivered via PowerPoint presentation

each 5 min in length– Slides consisted of words/pictures in form of

directions + experiential exercises– Each component was delivered at equal length of

time

• Return to computerized slot machine play

Page 59: Bridging the Gap between Research and Practice

Self asContext

Contact with the Present Moment

Defusion

Acceptance

Committed Action

Values

Psychological

Flexibility

Page 60: Bridging the Gap between Research and Practice

Baseline Play and Self-Ratings

Baseline Play and Self-Ratings

Baseline Play and Self-Ratings

30 min ACT

30 min ACT

30 min ACT

Post-Treatment Play and Self Ratings

Post-Treatment Play and Self Ratings

Post-Treatment Play and Self Ratings

Time

Client 1

Client 2

Client 3