so what? · personality traits • mental health history ... >80% play video games at ......
TRANSCRIPT
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SO WHAT?
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RELATIONSHIPS & RISKS
PART 2.
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“ADDICTION” is the desired industry term.
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ThePREFRONTAL CORTEX iLASTPART to develop.
25
The brain is still
developinguntil
MOST SENSITIVE TO DOPAMINE.
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Source: Brain Briefings (2007, October), Society for Neuroscience, Washington, DC
GAMING/GAMBLING & DOPAMINE
Dopamine not released when expecting a loss.Flooded with dopamine when expecting a win!
It’s NOT about the money!
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GAMING ADDICTION THE DSM…Not yet.
“INTERNET GAMING DISORDER” (IGD) is…
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders: DSM-5. Washington, D.C: Author.
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= Internet Gaming Disorder criteria checklist (Petry, et al., 2014)
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Much like the technologyitself, researchis new.
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CAVEAT before viewing researchLet’s be careful not to pathologize all gaming behavior. (Much as we would for alcohol use and non-problem gambling.)
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RECALLING PROBLEM GAMBLING AS ON A CONTINUUM.
No Gambling Experimentation
Recreational
At-RiskProblem Gambling (AKA “Gambling Disorder”)
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THE FREEMIUM ISSUE.
Adolescents playing simulated gambling games more likely to later move to real gambling…
…and are also more likely to have later gambling problemsGainsbury, Hing, Delfabbro, & King, 2014; Hollingshead, Kim, Wohl, & Derevensky, 2016
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MOTIVATIONS: FROM FREE TO PAYING
• Peer influence• Incentives
• Ads• Inflated payout rates
Kim, Wohl, Gupta & Derevensky, 2017
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MOTIVATIONS: WHY DO THEY KEEP PLAYING?
• Wealth – in-game rewards
• Achievement – pursuing goals
• Inadequacy – keeping up
King, Herd & Delfabbro, 2018
THE GAME NEVER ENDS...
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WHAT WE KNOW: 2018 WHO - ICD-11: Gaming Disorder
Source: World Health Organization. (2018). http://www.who.int/features/qa/gaming-disorder/en/
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Source: Petry, et al., 2014. An international consensus for assessing internet gaming disorder using the new DSM-5 approachhttp://dx.doi.org/10.1111/add.12457
CROSSWALKING GAMING & GAMBLING DISORDER CRITERIA
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SAME CRITERIA: GAMBLING DISORDER• Tolerance• Preoccupation• Use to escape• Inability to cut back/quit• Irritability when cutting
back/quitting• “Chasing” losses• Lying or concealing
• Risk/lose relationships
• Continue despite neg. consequences (gaming)
• Bailouts (gambling)
Source: Petry, et al., 2014. An international consensus for assessing internet gaming disorder using the new DSM-5 approach http://dx.doi.org/10.1111/add.12457
DIFFERENCES:
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RISK & PROTECTIVE FACTORS
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FAMILY COMMUNITY
Barnes et al.,1999; Hayatbakhsh et al., 2006; Johansson et al., 2009; King & Delfabbro, 2016; Raylu & Oei, 2002; Scholes-Balog et al., 2014; Shead et al., 2010; Volberg, 2008; Winters et al., 2002
SCHOOL INDIVIDUAL/PEER
- Family conflict- Family history antisocial
behavior- Parental gambling
- Academic failure & poor school performance
- Low school commitment
- Male- Early initiation - Early big wins- Rebelliousness- Delinquency- Impulsivity- Competitiveness - Interaction w/
antisocial peers
- Friends’ use/pressure
- ATOD use- Psychological
distress, mental health issues
RISK FACTORS APPEAR SIMILAR
- Exposure to gambling- Availability & accessibility- Media portrayal
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FAMILY COMMUNITY
Barnes et al.,1999; Hayatbakhsh et al., 2006; Johansson et al., 2009; King & Delfabbro, 2016; Raylu & Oei, 2002; Scholes-Balog et al., 2014; Shead et al., 2010; Volberg, 2008; Winters et al., 2002
SCHOOL INDIVIDUAL/PEER+ Female+ Prosocial involvement+ Early losses+ Boredom+ Awareness of risk
Sports?? Less screen time??Exposure to nature??
PROTECTIVE FACTORS BY DOMAIN
+ Encouragement of prosocial behavior
+ Connection+ Commitment to school
Less screen time??
+ Connection
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• Technology• Speed• Platforms
JUST THINK HOW QUICKLY OUR NORMS HAVE CHANGED.
Images: Top right, cbssports.com; middle right, www.csgolounge.com; left center, Daniel Berman; bottom left, Poker Deluxe app screen shot.
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Almost always a common denominator of risk:
TRAUMA.
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(Hodgins et al. 2010; Kraus et al. 2003; Najavits et al. 2010; Petry and Steinberg 2005; Taber et al. 1987)
Exposure to early childhood trauma has consistently been associated with
disordered gambling.
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GAMBLING & ADVERSE CHILDHOOD EXPERIENCEs
Associated w/ ADHD, personality disorders &…Disordered gambling
Source: Poole et al., 2017
Adverse Childhood
Experiences (ACEs)
Emotional dysregulation
Self-medicating w/substance use, eating, gambling,
etc.
Substance use disorders, eating
disorders, disordered gambling
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Right now, one can go to sporting venues and see the glow of cell phones throughout the crowd…Some, I would think, are also betting
on offshore sites. When legal and regulated betting opportunities gets loaded on that device…look for that glow of phones to grow
brighter throughout the venue. Now think of the example that all of the adults are providing to their own and other children within the
venue, if in fact they are even paying attention to them.
- Richard Schuetz, 4/20/19, https://ggbnews.com/article/phoning-it-in/
OUR VIEWS ON “NEGLECT” COULD BE CHANGING.
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KEY RISK GROUPS IN MA: Let’s Tease this Out for Youth.• Male• Black• HS education or less• Exposed to gambling• Starting early• Unemployed• Has disability• Low household income
• Excitement-seeking personality traits
• Mental health history• Parents who gamble• Childhood trauma history• College students• Those preferring electronic
gaming machines
Volberg et al., 2015 (baseline SEIGMA survey) light blue=let’s discuss this with attention on youth
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YOUTH “PATHOLOGICAL” VIDEO GAMERSn=3,034 – grades 3, 4, 7 & 8
9% pathological gaming
●Less empathy●More impulsivity
Source: Gentile, Choo, Liau, et al. (2011). Pathological video game use among youth: A two year longitudinal study. Pediatrics, 127, e319-29
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Gentile, D. (2009). Pathological video-game use among youth ages 8-18: A national study. Psychological Science, 20, 594-602.
• Sample of 1,178 youth in the U.S.: 8.5% of youth gamers were classified as “pathological gamers”
• >80% play video games at least occasionally
• “Pathological” gaming: (using 5 of 10 of DSM-IV; this was prior to DSM-5)
YOUTH “PATHOLOGICAL” VIDEO GAMERS
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Similarities between those with internet gaming disorder (IGD) & pathological gamblers:• Less sensitive to loss• More reactive
to gaming and gambling cues• More impulsive choices
Fauth-Büler, M., Mann, K. (2015, Nov.) Neurobiological correlates of internet gaming disorder: Similarities to pathological gambling. Journal of Addictive Behaviors doi: 10.1016/j.addbeh.2015.11.004
IGD & PATHOLOGICAL GAMBLING:
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LOOT BOX RESEARCH• Paying for loot boxes
linked to problem gambling (Zendle & Cairns, 2018)
• Over 90% of gamers had opened a loot box (Brooks & Clark, 2019 –caveat – adult gamers)
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THE GAMING CONNECTIONS MAKE SENSE.
“ALMOST WINNING”: dopamineis activated the same as ACTUALLY winning.
Problem gamblers are more likely to see their near misses as “NEAR WINS”
People play LONGER when machines give them NEAR MISSES.
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“Skin in the Game: Counter-Strike has spawned a wild multibillion-dollar world of online casino gambling; it's barely regulated and open to any kid who wants in.” ESPN.com, 1/20/17http://www.espn.com/espn/feature/story/_/id/18510975/how-counter-strike-turned-teenager-compulsive-gambler
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Addressing the Issues
PART 3.
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LET’S BE REAL.
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THE BARRIERS IN GAMBLING PROFESSIONS ARE REAL.
Tobacco
Substance Abuse
Problem Gambling
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SUBSTANCE USE DISORDERS
U.S. Pop. With Past Year Problem 1
20.8 Million7.8% aged 12+
2016 Public Funds Invested into SUD Treatment3
GAMBLING DISORDERS
U.S. Pop. With Past Year Problem 2
5.45 Million(3.8 times smaller)
2016 Public Funds Invested into Problem Gambling Services4
$71.6 Million(341 times smaller)
2.2%
aged 18+
1 2015 National Survey on Drug Use and Health. 2 Williams, R.J., Volberg, R.A. & Stevens, R.M.G. (2012). 3SAMSHA Spending Estimates –Projections for 2010-2020 4 APGSA & NCPG National Survey (2016)
$24.4 Billion$14.7 B Federal
$9.7 B State
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Prevention: Active process of changing conditions & developing skills & intentions that support the well-being of people.
In Partnership with the MA Department of Public Health
Source: SAMHSAIn Partnership with the MA Department of Public Health
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5/2/19 | www.maccg.org/blurringlinesIn Partnership with the MA Department of Public Health
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PREVENTION AS PART OF THE CONTINUUM OF CARE
samsha.gov/prevention
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• Substance abuse• Violence • Delinquency• Teenage pregnancy• School dropout• Depression & Anxiety
RECOGNIZED PROBLEM BEHAVIORS
Problem gambling??
In Partnership with the MA Department of Public Health
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FAMILY COMMUNITY
Gupta & Derevensky, 2001; Gupta & Derevensky, 2000; Hayatbakhsh et al., 2006; Johansson et al., 2009; King & Delfabbro, 2016; Raylu & Oei, 2002; Scholes-Balog et al., 2014; Shead et al., 2010; Volberg, 2008; Winters et al., 2002
SCHOOL INDIVIDUAL/PEER
- Family conflict- Family history antisocial behavior- Parental gambling
- Academic failure & poor school performance
- Low school commitment
- Male- Early initiation - Early big wins- Rebelliousness- Delinquency- Impulsivity- Competitiveness - Interaction w/ antisocial peers- Friends’ use/pressure- Substance use, tobacco use, alcohol use- Psychological distress, mental health issues
+ Female+ Prosocial involvement+ Early losses+ Boredom+ Awareness of risk
YOUTH GAMBLING RISK & PROTECTIVE FACTORS BY DOMAIN
- Exposure to gambling- Availability & accessibility- Media portrayal
+ Encouragement of prosocial behavior
+ Connection
Clinical Training Series | Prevention | April 4, 2019 | [email protected]
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WE MUST APPROACH OUR TARGET GROUPS DIFFERENTLY.
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EVEN DIFFERENTLY THAN WE DID 2 YEARS AGO.
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YET USE THE SAME EFFECTIVE STRATEGIES.
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RESEARCHERS RECOMMEND OVERALL PREVENTION INITIATIVES AS
MOST EFFECTIVE.i.e., • Prevention efforts that address RISK FACTORS
common to other problem behaviors;• Prevention efforts that address PROTECTIVE
FACTORS (e.g., prosocial behaviors)
Examples: Alcohol & drug curricula, Life Skills programs, parenting programs, etc.
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a. Broad systems.
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NATL COUNCIL PROB GAMBLING
NCPG Prevention Committee: Has an“Emerging Trends” task group. Info:
www.ncpgprevention.org
POLICY, ADVOCACY & COALITION BUILDING.
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What if we were to advocate for “G-21”?
Image source: tobacco21.org
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(BTW…this is what came up when I googled “T-21”… )
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INDUSTRY AIMS AT FAIRNESS
Julie Hynes, MA, CPS | 3/29/17 | www.preventionlane.org/indiana
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5/2/19 | maccg.org/blurringlinesSource: https://www.draftkings.com/help/responsible-gaming
“RESPONSIBLE PLAY”
Julie Hynes, MA, CPS | 3/29/17 | www.preventionlane.org/indiana
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Some progress: “responsible play”“RESPONSIBLE PLAY”
Julie Hynes, MA, CPS | 3/29/17 | www.preventionlane.org/indiana
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SELF-EXCLUSION.
Julie Hynes, MA, CPS | 3/29/17 | www.preventionlane.org/indiana
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a. Systems/policy level.
61
b. Local systems level.
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TREATMENT, PREVENTION
Using same strategies effective already in your work (i.e., you don’t have to know all of the details of the new tech!)
PROVIDING SERVICES.
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AWARENESS/EDUCATION
Capturing those who may not “think” they are gamblers.
INCLUDING NEW LANGUAGE
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AWARENESS/EDUCATION
Include gambling in conversationsabout alcohol & other drugs, ANDtechnology.
PARENTS, EDUCATORS, KIDS.
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FOR THOSE WHO CAN:
Engaging community members & partners to advocate on any laws involving online gambling / fantasy sports, loot boxes, etc. (can use NCPG guidelines as a tool).
POLICY & ADVOCACY.
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a. Systems level.b. Local systems level.
c. Ground level.
Protections:
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WHO SCREEN TIME GUIDELINES 4/24/19• Under 2: no screens• 2-4: one hour or less of screen time/day
“Replacing prolonged restrained or sedentary screen time with more active play, while making sure young children get enough good-quality sleep. Quality sedentary time spent in interactive non-screen-based activities with a caregiver, such as reading, storytelling, singing and puzzles, is very important for child development.”
https://www.who.int/news-room/detail/24-04-2019-to-grow-up-healthy-children-need-to-sit-less-and-play-more
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HELP FOR GAMERS:
GAME QUITTERS:www.gamequitters.com
Ridiculously helpful resource!
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TOMORROW! 4:30-7:30pm Hartford, CT
RSVP to Donna 959.230.4030
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COMMUNICATEexpectations.
USE TECHto your advantage.
Remember about when you need to shut the game off.
☺ love u
Jordan. Off. Now.
It’s LoL, mom.
K
Mom9:46PM
9:31PM
9:13 PM
9:45 PM
9:45 PM
9:46 PM
+ |
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APPS CAN WORK FOR YOUTH, TOO• Mindfulness apps – those that
encourage breathing, meditating, etc.• Exercise apps – physical activity to
encourage natural dopamine release and reduce stress.
• Recovery apps if needed (SoberTool, etc.)
• Use caution if concerned about screen addiction.
• Moderation is key!!
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• Rating• In-app purchases• Loot boxes• Watching games• Playing with them
74
MONITORING
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DEVICES & PARENTAL CONTROLS● Un-link credit card info from devices!!● Major mobile services (e.g., AT&T, T-Mobile, Verizon) offer
family protection plans● Features include: GPS, purchase blocking, turning off
browsing/data/texting, time of day, etc.● See www.preventionlane.org/online-safety for a list of helpful
links to these servicesPracticality alert: Some features CANNOT be blocked when user has access to WiFi (so…you may need to change your WiFi password often!)
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Listen to your gut!
J. Hynes | 6/22/17 | www.preventionlane.org/pa
LAST, BUT NOT LEAST:
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facebook.com/MAcouncil@MassCouncilCG@julhynes
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REFERENCESBányai, F., Griffiths, M., Király, O., Demetrovics, Z. (2018). The psychology of esports: A systematic literature review. Journal of Gambling Studies. https://doi.org/10.1007/s10899-018-9763-1
Brooks, G.A., & Clark, L. (2019). Associations between loot box use, problematic gaming and gambling, and gambling-related cognitions. Addictive Behaviors, 96, 26-34. https://doi.org/10.1016/j.addbeh.2019.04.009
Carey, B. (2018, July.) Endless gaming may be a bad habit. that doesn’t make it a mental illness. New York Times. Retrieved from https://www.nytimes.com/2018/07/02/health/internet-gaming-addiction.html
Fauth-Büler, M., Mann, K. (2015, Nov.) Neurobiological correlates of internet gaming disorder: Similarities to pathological gambling. Journal of Addictive Behaviors doi: 10.1016/j.addbeh.2015.11.004
Frieden, T. (2010). A framework for public heath action: The health impact pyramid. American Journal of Public Health, 100, 590–595.
Fung, B. (2018, November). U.S. consumer watchdog to investigate video games loot boxes. Washington Post. Retrieved from https://www.washingtonpost.com/technology/2018/11/28/us-consumer-watchdog-investigate-video-game-loot-boxes/?utm_term=.23f7f1e1c00e
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REFERENCESGainsbury, S., Abarbanel, B., & Blaszczynski, A. (2017). Intensity and gambling harms: Exploring breadth of gambling involvement among esports bettors. Gaming Law Review, 21(8), 610-615. https://doi.org/10.1089/glr2.2017.21813
Gainsbury, S., Russell, A., King, D., Delfabbro, P., & Hing, N. (2016). Migration from social casino games to gambling: Motivations and characteristics of gamers who gamble. Computers in Human Behavior, 63, 59-67.
Gainsbury, S. Russell, A., & Hing, N. (2014). an investigation of social casino gaming among land-based and internet gamblers: A comparison of socio-demographic characteristics, gambling and co-morbidities. Computers in Human Behavior, 33, 126–35. doi:10.1016/j.chb.2014.01.031.
Gainsbury, S. M., Hing, N., Delfabbro, P. H., & King, D. L. (2014). A taxonomy of gambling and casino games via social media and online technologies. International Gambling Studies,14, 196–213. https://doi.org/10.1080/14459795.2014.890634
Jacques, C., Fortin-Guichard, D., Bergeron, P., Boudreault, C., Levesque, D., Giroux, I. (2016). Gambling content in Facebook games: A common phenomenon? Computers in Human Behavior, 57, 48-53.
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REFERENCESKing, D., Delfabbro, P., & Griffiths, M. (2010). The role of structural characteristics in problem video game playing: A review. Cyberpsychology: Journal of Psychosocial Research on Cyberspace, 4, 1. Retrieved from https://cyberpsychology.eu/article/view/4229/3272
Kuss, D.J. & Griffiths, M.D. (2012). Online gaming addiction in children and adolescents: A review of empirical research. Journal of Behavioral Addictions, 1, 3-22. Retrieved from https://doi.org/10.1556/JBA.1.2012.1.1
Petry, N., Rebhein, F., Gentile, D.A. Lemmins, J.S., Rumpf, H.J. (2014). An international consensus for assessing internet gaming disorder using the new DSM-5 approach. http://dx.doi.org/10.1111/add.12457
Rose, I.N. (2006). Gambling and the law: An introduction to the law of internet gambling. UNLV Gaming Research & Review Journal, 10, 1-14.
Throuvala, M., Janikian, M., Griffiths, M., Rennoldson, M., & Kuss, D.(2019, in press). The role of family and personality traits in Internet gaming disorder: A mediation model combining cognitive and attachment perspectives. Journal of Behavioral Addictions. https://doi.org/10.1556/2006.8.2019.05
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REFERENCESWohl, M. J. A., Salmon, M. M., Hollingshead, S. J., & Kim, H. S. (2017). An examination of the relationship between social casino gaming and gambling: The bad, the ugly, and the good. Journal of Gambling Issues, 35, 1–23. https://doi.org/10.4309/jgi.2017.35.11
World Health Organization. (2018). International Classification of Diseases 11th edition (ICD-11). http://www.who.int/features/qa/gaming-disorder/en/
Zendle D, Cairns P (2018) Video game loot boxes are linked to problem gambling: Results of a large-scale survey. PLoS ONE 13(11): e0206767. https://doi.org/10.1371/journal.pone.0206767