Expansion of gambling in Canada: implications for health and social policy

Canada experienced a dramatic increase in legalized gambling in the 1990s, primarily because of governments'' need to increase revenue without additional taxation. This article examines gambling from a public health perspective. The major public health issues include gambling addiction, family dysfunction and gambling by youth. Debates have emerged about the health, social and economic costs and benefits of gambling. Stakeholder and social policy groups have expressed concern about the impact of expanded gambling on the quality of life of individuals, families and communities. Epidemiological studies show that the prevalence of gambling in the general adult population is low but increasing. Of particular concern is the high though steady prevalence of gambling among youth. New technologies have been linked to gambling-related problems such as addiction to gambling by video lottery terminals. Gambling by means of the Internet represents another emerging issue. The article concludes with recommendations for health and social policy related to gambling. These recommendations incorporate a broad public health approach to create a strong research program and to balance risks and benefits.     

Horse versus machine: battles in the betting shop

Changes in regulation and taxation during the past decade have had a profound effect on the experience of betting in dedicated shops in the United Kingdom. This article explores how betting shop customers and staff in London have responded to the introduction of gambling machines depicting roulette and other casino‐type games in an environment that was traditionally dedicated to betting on horse and dog racing. The rise of machine gambling has been presented as a transition from ‘social’ to ‘asocial’ forms of gambling by researchers working in the UK, Las Vegas, and Australia. Traditional bettors and betting shop staff also present betting and machine play as discrete and value them differently. I show that while some of the experiential qualities of machine play observed elsewhere have been replicated in shops, the differences between traditional betting and machine play are overstated, for structural reasons. Traditional bettors and staff are interested in distinguishing their activities from those of newcomers. Responses to new gambling media in betting shops are socially, as well as experientially, mediated, a crucial insight for the wider study of gambling and gambling regulation.

Résumé

L'évolution de la réglementation et de la taxation des paris a eu depuis une dizaine d'année de profonds effets sur l'expérience des parieurs dans les officines du Royaume‐Uni. Le présent article étudie la réaction des clients et du personnel de bureaux de paris londoniens à l'apparition des machines proposant des jeux de roulette et autres jeux de casino dans un environnement traditionnellement dévolu aux paris sur les courses de chevaux et de chiens. Au Royaume‐Uni, à Las Vegas et en Australie, des chercheurs ont présenté l'essor des machines de jeux comme le passage de formes de jeu « sociales »à d'autres « asociales ». Les parieurs traditionnels et les employés des bureaux de paris considèrent eux aussi les paris et les jeux sur machines comme deux activités distinctes et de valeur différente. L'auteure montre ici qu'une partie des qualités de l'expérience du jeu sur machines observées ailleurs se retrouvent dans les bureaux de paris, mais que les auteurs ont exagéré les différences entre paris traditionnels et jeux sur machines, pour des raisons structurelles. Les parieurs traditionnels et les employés ont intérêt à distinguer leurs activités de celles des nouveaux venus. La réponse aux nouveaux modes de jeu dans les bureaux de paris, médiée socialement mais aussi par l'expérience, est très instructive pour l'étude plus large des jeux de paris et de leur réglementation.     

Big Losses Lead to Irrational Decision-Making in Gambling Situations: Relationship between Deliberation and Impulsivity

In gambling situations, we found a paradoxical reinforcing effect of high-risk decision-making after repeated big monetary losses. The computerized version of the Iowa Gambling Task (Bechara et al., 2000), which contained six big loss cards in deck B'', was conducted on normal healthy college students. The results indicated that the total number of selections from deck A'' and deck B'' decreased across trials. However, there was no decrease in selections from deck B''. Detailed analysis of the card selections revealed that some people persisted in selecting from the “risky” deck B'' as the number of big losses increased. This tendency was prominent in self-rated deliberative people. However, they were implicitly impulsive, as revealed by the matching familiar figure test. These results suggest that the gap between explicit deliberation and implicit impulsivity drew them into pathological gambling.     

Ecological energy accounting for the gambling sector: A case study in Macao

Macao is a population-dense society that depends heavily on exogenous natural resources. In parallel with an expanding gambling sector, tourism became the most important driving force in Macao's economy. Economic growth in Macao has now benefited from the gambling boom and associated tourism for more than two decades. Although traditional economic theory has been used to deal with the economics of the gambling sector, the materials and energy foundation for this sector has not been previously analyzed. This is an important omission from the literature, since the gambling sector provides gamblers with food, tickets, services, water, electricity, equipment, labor, and other services that consume large quantities of materials and energy. In this paper, emergy synthesis is introduced to analyze Macao's gambling sector in 2004. Macao's casinos provide a dense flow of services that favor gambling tourists, since the emergy/$ ratio (1.42 × 10¹² sej/$) for the sector is much lower than that for Macao as a whole (2.38 × 10¹² sej/$). The emergy imports by this sector totaled 78.1 × 10²⁰ sej, and its exports were 77.1 × 10²⁰ sej. The emergy of services therefore plays an important role in Macao's gambling sector, and the transformity of an employee in this sector (11.2 × 10¹⁶ sej/person) was much higher than that of a typical person in Macao (5.27 × 10¹⁶ sej/person).     

A quantum probability explanation for violations of ‘rational’ decision theory

Two experimental tasks in psychology, the two-stage gambling game and the Prisoner''s Dilemma game, show that people violate the sure thing principle of decision theory. These paradoxical findings have resisted explanation by classical decision theory for over a decade. A quantum probability model, based on a Hilbert space representation and Schrödinger''s equation, provides a simple and elegant explanation for this behaviour. The quantum model is compared with an equivalent Markov model and it is shown that the latter is unable to account for violations of the sure thing principle. Accordingly, it is argued that quantum probability provides a better framework for modelling human decision-making.     

Like or Dislike? Affective Preference Modulates Neural Response to Others' Gains and Losses

Previous studies have demonstrated that the brain responds differentially to others'' gains and losses relative to one''s own, moderated by social context factors such as competition and interpersonal relationships. In the current study, we tested the hypothesis that the neural response to others'' outcomes could be modulated by a short-term induced affective preference. We engaged 17 men and 18 women in a social-exchange game, in which two confederates played fairly or unfairly. Both men and women rated the fair player as likable and the unfair players as unlikable. Afterwards, ERPs were recorded while participants observed each confederates playing a gambling game individually. This study examines feedback related negativity (FRN), an ERP component sensitive to negative feedback. ANOVA showed a significant interaction in which females but not males displayed stronger FRNs when observing likable players'' outcomes compared to unlikable ones''. However, males did not respond differently under either circumstance. These findings suggest that, at least in females, the neural response is influenced by a short-term induced affective preference.     

Impulsive Action but Not Impulsive Choice Determines Problem Gambling Severity

Background

Impulsivity is a hallmark of problem gambling. However, impulsivity is not a unitary construct and this study investigated the relationship between problem gambling severity and two facets of impulsivity: impulsive action (impaired ability to withhold a motor response) and impulsive choice (abnormal aversion for the delay of reward).

Methods

The recruitment includes 65 problem gamblers and 35 normal control participants. On the basis of DSM-IV-TR criteria, two groups of gamblers were distinguished: problem gamblers (n = 38) and pathological gamblers (n = 27) with similar durations of gambling practice. Impulsive action was assessed using a response inhibition task (the stop-signal task). Impulsive choice was estimated with the delay-discounting task. Possible confounds (e.g., IQ, mood, ADHD symptoms) were recorded.

Results

Both problem and pathological gamblers discounted reward at a higher rate than their controls, but only pathological gamblers showed abnormally low performance on the most demanding condition of the stop-signal task. None of the potential confounds covaried with these results.

Conclusions

These results suggest that, whereas abnormal impulsive choice characterizes all problem gamblers, pathological gamblers'' impairments in impulsive action may represent an important developmental pathway of pathological gambling.     

Illusionary pattern detection in habitual gamblers

Does problem gambling arise from an illusion that patterns exist where there are none? Our prior research suggested that “hot hand,” a tendency to perceive illusory streaks in sequences, may be a human universal, tied to an evolutionary history of foraging for clumpy resources. Like other evolved propensities, this tendency might be expressed more stongly in some people than others, leading them to see luck where others see only chance. If the desire to gamble is enhanced by illusory pattern detection, such individual differences could be predictive of gambling risk. While previous research has suggested a potential link between cognitive strategies and propensity to gamble, no prior study has directly measured gamblers' cognitive strategies using behavioral choice tasks, and linked them to risk taking or gambling propensities. Using a computerized sequential decision-making paradigm that directly measured subjects' predictions of sequences, we found evidence that subjects who have a greater tendency to gamble also have a higher tendency to perceive illusionary patterns, as measured by their preferences for a random slot machine over a negatively autocorrelated one. Casino gamblers played the random slot machine significantly more often even though a training phase and a history of outcomes were provided. Additionally, we found a marginally significant group difference between gamblers and matched community members in their slot-machine choice proportions. Performance on our behavioral choice task correlated with subjects' risk attitudes toward gambling and their frequency of play, as well as the selection of choice strategies in gambling activities.     

A randomized controlled trial of a personalized feedback intervention for problem gamblers

Background

Personalized feedback is a promising self-help for problem gamblers. Such interventions have shown consistently positive results with other addictive behaviours, and our own pilot test of personalized normative feedback materials for gamblers yielded positive findings. The current randomized controlled trial evaluated the effectiveness, and the sustained efficacy, of the personalized feedback intervention materials for problem gamblers.

Methodology/Principal Findings

Respondents recruited by a general population telephone screener of Ontario adults included gamblers with moderate and severe gambling problems. Those who agreed to participate were randomly assigned to receive: 1) the full personalized normative feedback intervention; 2) a partial feedback that contained all the feedback information provided to those in condition 1 but without the normative feedback content (i.e., no comparisons provided to general population gambling norms); or 3) a waiting list control condition. The primary hypothesis was that problem gamblers who received the personalized normative feedback intervention would reduce their gambling more than problem gamblers who did not receive any intervention (waiting list control condition) by the six-month follow-up.

Conclusions/Significance

The study found no evidence for the impact of normative personalized feedback. However, participants who received, the partial feedback (without norms) reduced the number of days they gambled compared to participants who did not receive the intervention. We concluded that personalized feedback interventions were well received and the materials may be helpful at reducing gambling. Realistically, it can be expected that the personalized feedback intervention may have a limited, short term impact on the severity of participants'' problem gambling because the intervention is just a brief screener. An Internet-based version of the personalized feedback intervention tool, however, may offer an easy to access and non-threatening portal that can be used to motivate participants to seek further help online or in person.

Trial Registration

ClinicalTrials.gov {"type":"clinical-trial","attrs":{"text":"NCT00578357","term_id":"NCT00578357"}}NCT00578357     

Neurological Soft Signs in Individuals with Pathological Gambling

Increased neurological soft signs (NSSs) have been found in a number of neuropsychiatric syndromes, including chemical addiction. The present study examined NSSs related to perceptual-motor and visuospatial processing in a behavioral addiction viz., pathological gambling (PG). As compared to mentally healthy individuals, pathological gamblers displayed significantly poorer ability to copy two- and three-dimensional figures, to recognize objects against a background noise, and to orient in space on a road-map test. Results indicated that PG is associated with subtle cerebral cortical abnormalities. Further prospective clinical research is needed to address the NSSs'' origin and chronology (e.g., predate or follow the development of PG) as well as their response to therapeutic interventions and/or their ability to predict such a response.     

Understanding Others' Regret: A fMRI Study

Previous studies showed that the understanding of others'' basic emotional experiences is based on a “resonant” mechanism, i.e., on the reactivation, in the observer''s brain, of the cerebral areas associated with those experiences. The present study aimed to investigate whether the same neural mechanism is activated both when experiencing and attending complex, cognitively-generated, emotions. A gambling task and functional-Magnetic-Resonance-Imaging (fMRI) were used to test this hypothesis using regret, the negative cognitively-based emotion resulting from an unfavorable counterfactual comparison between the outcomes of chosen and discarded options. Do the same brain structures that mediate the experience of regret become active in the observation of situations eliciting regret in another individual? Here we show that observing the regretful outcomes of someone else''s choices activates the same regions that are activated during a first-person experience of regret, i.e. the ventromedial prefrontal cortex, anterior cingulate cortex and hippocampus. These results extend the possible role of a mirror-like mechanism beyond basic emotions.     

New national and regional bryophyte records, 28

Abstract

We are grateful to all those who have sent references for inclusion in this list and will be pleased to learn of any publications we have failed to note. Electronic access to all citations in 'Recent Bryological Literature' from RBL 112, and all citations in 'Recent Literature on Bryophytes' from The Bryologist, are available via W3MOST on the TROPICOS website (http://mobot.mobot.org/W3T/Search/mbib.html).     

The XXXXY Chromosome Anomaly: Report of Three New Cases and Review of 30 Cases from the Literature

The majority of abnormal sex chromosome complexes in the male have been considered to be variants of Klinefelter''s syndrome but an exception should probably be made in the case of the XXXXY individual who has distinctive phenotypic features. Clinical, radiological and cytological data on three new cases of XXXXY syndrome are presented and 30 cases from the literature are reviewed. In many cases the published clinical and radiological data were supplemented and re-evaluated. Mental retardation, usually severe, was present in all cases. Typical facies was observed in many; clinodactyly of the fifth finger was seen in nearly all.Radiological examination revealed abnormalities in the elbows and wrists in all the 19 personally evaluated cases, and other skeletal anomalies were very frequent. Cryptorchism is very common and absence of Leydig''s cells may differentiate the XXXXY chromosome anomaly from polysomic variants of Klinefelter''s syndrome. The relationship of this syndrome to Klinefelter''s syndrome and to Down''s syndrome is discussed.     

External irradiation of the hypophysis for Cushing's disease

During the past 12 years 17 patients with Cushing''s disease (bilateral adrenal hyperplasia secondary to excessive pituitary adrenocorticotrophic hormone) have been treated initially with external pituitary irradiation. Of the 15 patients who have had adequate follow-up, nine showed complete biochemical remission, and one showed biochemical improvement. There were no complications. It is therefore recommended that the first mode of therapy for all patients with Cushing''s disease should be pituitary irradiation if the patient''s clinical condition permits.     

The Social Bayesian Brain: Does Mentalizing Make a Difference When We Learn?

When it comes to interpreting others'' behaviour, we almost irrepressibly engage in the attribution of mental states (beliefs, emotions…). Such "mentalizing" can become very sophisticated, eventually endowing us with highly adaptive skills such as convincing, teaching or deceiving. Here, sophistication can be captured in terms of the depth of our recursive beliefs, as in "I think that you think that I think…" In this work, we test whether such sophisticated recursive beliefs subtend learning in the context of social interaction. We asked participants to play repeated games against artificial (Bayesian) mentalizing agents, which differ in their sophistication. Critically, we made people believe either that they were playing against each other, or that they were gambling like in a casino. Although both framings are similarly deceiving, participants win against the artificial (sophisticated) mentalizing agents in the social framing of the task, and lose in the non-social framing. Moreover, we find that participants'' choice sequences are best explained by sophisticated mentalizing Bayesian learning models only in the social framing. This study is the first demonstration of the added-value of mentalizing on learning in the context of repeated social interactions. Importantly, our results show that we would not be able to decipher intentional behaviour without a priori attributing mental states to others.     

Serum screening for Down's syndrome: experiences of obstetricians in England and Wales.

OBJECTIVES--To assess the experiences of obstetricians in England and Wales of serum screening for Down''s syndrome. DESIGN--Postal questionnaire survey. SUBJECTS--Questionnaires were sent to all practising obstetricians in England and Wales with nonacademic appointments who had not participated in an earlier (randomly sampled) survey of obstetricians'' attitudes (n = 555). Responses were received from 393 (71%), of which 351 were analysed. The data represent about one third of obstetric consultants in England and Wales. MAIN OUTCOME MEASURES--The extent of use of serum screening for Down''s syndrome, and the problems encountered. RESULTS--Serum screening for Down''s syndrome was being offered on some basis by virtually all obstetricians in the survey. Nearly half the sample said that they did not have adequate resources for counselling all the women to whom screening was offered. Many problems were reported, which in all cases were more common than equivalent problems encountered with serum screening for neural tube defects. Over 80% (289) said that women not understanding the test was a problem. CONCLUSIONS--There is considerable confusion associated with serum screening for Down''s syndrome. The precedent of serum screening for neural tube defects does not seem to have lessened the problems experienced, rather the contrary. Many obstetricians report inadequate resources for counselling, which is consistent with the high prevalence of problems associated with women not understanding the test. There is an urgent need to consider what counselling should consist of and who should undertake it and to ensure that necessary resources are available.