Inhibitory control in poker: Do experienced non-pathological poker gamblers exhibit better performance than healthy controls on motor, verbal and emotional expression inhibition?

BACKGROUND AND AIMS: Strategic games, such as poker, require gamblers to develop several skills to perform better than others and to expect a potential gain. Players must remain as unpredictable and unreadable as possible by inhibiting the expression of their emotions in response to both good and bad poker events. The aim of the present study was to compare several aspects of the inhibition process in experienced poker gamblers and controls to better understand how inhibitory control is involved in poker performance. METHODS: Thirty experienced non-pathological poker gamblers (EG) and thirty healthy controls with no or limited poker experience (HC) completed 3 cognitive tasks. Each task measured a specific type of inhibition: motor inhibition [Go/No-Go task], verbal inhibition [Hayling Sentence Completion Task] and expressive inhibition [expressive suppression task, which combines subjective, expressive (facial EMG) and physiological (skin conductance, heart interbeat interval, cardiovascular and respiratory activation) measures of emotional experience]. Linear mixed models with random effects were performed. RESULTS: Inhibitory control skills were similar between the two groups, regardless of the form of inhibition tested. The only difference observed in EG was a higher ability to partially suppress the physiological expression of emotion. However, this difference was only present for negative and positive emotional induction and was not maintained for emotional induction related to poker situations. DISCUSSION AND CONCLUSIONS: The development of specific inhibition skills in experienced poker gamblers was not supported and raises questions about the transferability of poker skills previously discussed in the literature.

Materialism, Financial Motives and Gambling: Examination of an Unexplored Relationship.

Gambling has an inherent structural monetary component, and financial motive is one of the main motivations for gambling. Despite this, and contrary to other addictive behaviours that involve money such as compulsive buying, gambling has never been studied from a materialism perspective. The objective of the present study was to explore the links between materialism and gambling disorder (GD) and whether this relationship is mediated by financial motives for gambling. We compared 65 pathological gamblers (PGs) seeking treatment to 65 matched non-problem gamblers. The data collection included socio-demographics, gambling characteristics, the Materialism Values Scale, the Gambling Motives Questionnaire-Financial, and the Rosenberg Self-Esteem Scale. The statistical analysis included linear mixed models and Structural Equation Modelling. The level of materialism was significantly higher for the PGs, except for the Centrality dimension. Only one mediated effect was significant, and it concerned an indirect path from Happiness through financial motives. Moreover, Happiness explained most of the variance of the probability of becoming a PG. Contrary to compulsive buying, the PGs seemed to display materialism in a more experiential way that was centred on what possessions can induce secondarily rather than on the possessions themselves. The belief that material possessions are essential to achieving happiness may encourage the PG to gamble, thus contributing to both the development and maintenance of GD. We provided evidence that materialism is a key concept in the comprehension of GD and should be further considered when adapting care strategies.

Effectiveness of At-Risk Gamblers' Temporary Self-Exclusion from Internet Gambling Sites.

To prevent risks associated with online gambling, many jurisdictions propose self-exclusion strategies as a part of a responsible gambling policy. To protect online gamblers, French law provides for a 7-day temporary non-reducible and voluntary self-exclusion measure that applies only to select websites. The objective of our study was to evaluate the effectiveness of this self-exclusion measure for at-risk online gamblers. It was an experimental randomized controlled trial targeted at risk prevention. The main outcomes were the money wagered and time spent gambling assessed 15 days (short-term) and 2 months (medium-term) after the implementation of the self-exclusion measure. The effectiveness of self-exclusion was also compared according to the gambling type (pure chance games, such as lottery or scratch tickets, skill and chance bank games such as sports betting or horserace betting, and skill and chance games such as poker). Sixty participants were randomly assigned to the experimental condition (n = 30; with the implementation of a self-exclusion measure) or control condition (n = 30). The randomization was stratified according to their favorite game [pure chance games (n = 20), skill and chance bank games (n = 20), and skill and chance social games (n = 20)]. The results revealed that self-exclusion had no short-term impact-but did have a medium-term impact-on gambling habits. After 2 months, the gambling-related cognitions ("illusion of control" and "the perceived inability to stop gambling") and the subscale "desire" of the Gambling Craving Scale (GACS) have decreased. Participants' opinions about the impact and effectiveness of self-exclusion were discussed. To conclude, it appeared that temporary self-exclusion is an interesting tool to protect online gamblers from excessive practices, but several modifications have to be made to improve its effectiveness and use.

Workaholism: are physicians at risk?

BACKGROUND: Work addiction (WA), often called 'workaholism', is a relatively recent concept that has not yet been clearly defined. Ongoing studies have found prevalence rates that are highly variable due to the diversity of the models used and the populations studied. AIMS: To assess the characteristics of WA among hospital medical staff. METHODS: All physicians practising at a French university hospital were invited to participate in a survey based on two questionnaires: the Work Addiction Risk Test (WART) for WA and the Job Contents Questionnaire (JCQ) to assess psychosocial constraints at work. RESULTS: There were 444 responding physicians. The response rate was 45%. Thirteen per cent of respondents were considered to be highly work addicted and a further 35% were considered mildly work addicted. Professors had the highest average WART score, but neither age nor sex was associated with WA. Furthermore, all 3D scores obtained using the JCQ correlated with the WART score; the highest correlation coefficient being obtained between the WART score and the job demands score, indicating that workaholics experienced high job demands. CONCLUSIONS: WA especially affects professors, who have the highest status amongst doctors in the hospital hierarchy. This study highlights the importance of constraints and workload, which are consistent with individual vulnerability factors. These factors may help identify ways of preventing and managing this type of addiction, through improvement of working conditions and organizational structures.

[Video games: are the motivations and intensity of use changing with age? Comparison between a population of adolescent and adult gamers]. / Jeux vidéo : les motivations et l'intensité de la pratique évoluent-elles avec l'âge ? Comparaison entre une population de joueurs adolescents et adultes.

Despite the popularity of video games, few studies have been conducted in France on their use. The objective of this study was to gather data from a sample of French video game players to learn more about this population. This approach also aimed to examine whether differences exist between adolescent and adult gamers in terms of their motivations to play and whether this practice met the criteria for problem video game playing. A questionnaire collecting sociodemographic data and assessing the problems associated with the use of video games, as well as motivations to play, was distributed during a video game festival and on the Internet. A total of 778 people responded to the questionnaire. The results showed that there were few differences between adolescent and adult gamers. Both groups had an intense video game habit. The majority of them sometimes had the feeling of losing control of their use and sacrificed other activities to play video games. This last dimension was most frequently cited by adults. The feeling of spending more time playing was most frequently cited by adolescents. Concerning motivations to play, the two groups differed only on the score of the "social" dimension, significantly higher among adolescents.

[Pathological gambling in adolescence]. / Le jeu pathologique à l'adolescence.

Today's juveniles are the first generation to be raised in an environment where gambling is very accessible and socially acceptable. The recent legalization of Internet gambling has increased this accessibility. With 28,8 millions of gamblers in France in 2010, many believe that gambling is an innocent leisure activity. The first results of the national survey on the prevalence of gambling practices conducted in France show that in 2010, 1.3% of the population had a gambling problem. Also, despite the prohibition of gambling to minors, the mean age of onset of gambling behavior in the world is 11.5 years. Gambling (even non-problematic) in adolescence is associated with poor school performance, criminal behavior and family conflict. Recreational gambling shares with pathological gambling high rates of psychiatric comorbidities in adults, and risk behaviors among adolescents. Similarly, international studies show prevalence of problem gambling 2 to 4 times higher among adolescents than among adult, 3.5% to 8% of adolescents between 12 and 17 are pathological gamblers. The validity of the screening instruments and the frequency of spontaneous recovery in adulthood are discussed to explain the high prevalence in adolescence. This article proposes a focus on the practice of gambling in adolescence and its characteristics when the practice becomes pathological. We discuss the epidemiological, diagnostic, etiologic and therapeutic aspects of this problem. Three major types of risk factors implicated in gambling problems are identified: some of them are related to the subject (individual factors), others are related to the object of the addiction, here the gambling activity by itself (structural factors) like Internet with the recent legalization of gambling online, and the last are related to environment (contextual or situational factors). Thus, the development and maintenance of pathological gambling in youth seems to be conditioned by the interaction of a person and a gambling activity, in a particular context. This conceptual model is based on the well-known theory of Olivenstein on toxicomania, which was proposed in the seventies. In France, very few is known about problem gambling in this age and its implications in terms of treatment, prevention and research. There is little in the way of specific treatments for adolescent pathological gamblers so we briefly reviewed possibilities and limits. We discuss the importance to develop prevention, in particular to delay the initiation, and the necessity of research to develop screening instruments and news studies to have a better knowledge of this population.

[Pathological gambling: risk factors]. / Jeu pathologique : facteurs impliqués.

CONTEXT AND OBJECTIVE: In France, consumption of gambling games increased by 148% between 1960 and 2005. In 2004, gamblers lost approximately 0.9% of household income, compared to 0.4% in 1960. This represents approximately 134 Euros per year and per head. In spite of this important increase, the level remains lower than the European average (1%). However, gambling practices may continue to escalate in France in the next few years, particularly with the recent announce of the legalisation of online games and sports betting. With the spread of legalised gambling, pathological gambling rates may increase in France in the next years, in response to more widely available and more attractive gambling opportunities. In this context, there is a need for better understanding of the risk factors that are implicated in the development and maintenance of pathological gambling. METHODS: This paper briefly describes the major risk factors for pathological gambling by examining the recent published literature available during the first quarter of 2008. This documentary basis was collected by Inserm for the collective expert report procedure on Gambling (contexts and addictions). Seventy-two articles focusing on risk factors for pathological gambling were considered in this review. Only 47 of them were taken into account for analysis. The selection of these 47 publications was based on the guide on literature analysis established by the French National Agency for Accreditation and Assessment in Health (ANAES, 2000). Some publications from more recent literature have also been added, mostly about Internet gambling. RESULTS: We identify three major types of risk factors implicated in gambling problems: some of them are related to the subject (individual factors), others are related to the object of the addiction, here the gambling activity by itself (structural factors), and the last are related to environment (contextual or situational factors). Thus, the development and maintenance of pathological gambling seems to be conditioned by the interaction of a person and a gambling activity, in a particular context. This conceptual model is based on the well-known theory of Olivenstein on toxicomania, which was proposed in the seventies. The structural factors that appeared to be highly related to pathological gambling development and maintenance are payment modality, entertaining dimension, temporality, reward level, educational messages, gambling ambiance, gambling medium and part of hazard. Among contextual factors, availability and accessibility of gambling opportunities are well known. However, social and economic factors (e.g. culture, ethnicity, religion, education) are also important. Lastly, among individual factors, psychosocial factors are gender, age, familial and personal antecedents and psychiatric comorbidities. Neurobiological factors are not discussed here. CONCLUSIONS: This paper briefly summarises risk factors for development and maintenance of pathological gambling. It highlights that these factors are very similar to those that are implicated in substance use disorders, except for the gambling activity and context. Prevention regarding behavioural addictions should, in the future, take advantage of the findings on substance use disorder, since behavioural addictions are less known. Conversely, it seems obvious that findings on pathological gambling, and more widely behavioural addictions, could highlight all types of addiction. It appears that this fact is especially valid with regards to the evolution and stability of addictive status, which must be taken into account for treatment proposals.

[Socio-demographic and clinical assessment, and trajectory of a sample of French pathological gamblers]. / Évaluation sociodémographique, clinique et du parcours de jeu d'un échantillon de joueurs pathologiques français.

INTRODUCTION: International studies estimate the incidence of pathological gambling among adults at 0.2-3%. Following the lead of Anglo-Saxon countries, France has only just begun to consider this "new" addiction in studying its own population of pathological gamblers, attempting to understand the causes of the illness, and proposing specific treatments. OBJECTIVE: The purpose of this study was to carry out a multiaxial assessment of French pathological gamblers, current or former outpatients of the addiction ambulatory care center of the University Hospital of Nantes, in order to compare our findings with those of the international literature. METHOD: During a single personal interview, the participants filled in a set of questionnaires including a description of gambling characteristics (pathological gambling section in the DSM-IV, South Oaks Gambling Screen, gambling history), a screening for axis I (Mini International Neuropsychiatric Interview) and II (structured clinical interview for DSM-IV Axis II Personality Disorders), comorbidities and personality tests using a dimensional approach (Minnesota Multiphasic Personality Inventory, Sensation Seeking Scale, Barratt Impulsiveness Scale, Toronto Alexithymia Scale). The number of subjects to include was not previously calculated, since the size of the sample depended upon each subject's availability and on the inclusion time period limited to 4 months. Continuous variables were described in terms of means and standard deviations, while categorical variables were described in terms of percentages. The protocol was accepted by the Advisory Committee for the Protection of Biomedical Research Subjects. RESULTS: Analysis of the findings was based on a sample of 24 subjects. Half of the subjects fell into severe pathological gambling. Gambling had started at an average age of 24.9 years (S.D.=12.3). The gambling problem appeared on average 9.4 years later (S.D.=8.1). Casinos (41.7%) and sports pools (45.8%) were the most commonly reported types of games. Seventy-five percent of the sample suffered from at least one axis I psychiatric comorbidity. Most common among these were current (20.9%) and past (37.5%) episodes of major depression. Risk of suicide was observed in 36% of subjects, and nearly half of them were not currently suffering from an episode of major depression. The second most common psychiatric comorbidity was substance abuse (including alcohol) (54.2%). Personality disorders were common (54.2%) and mainly cluster B disorders (29.2%). Impulsiveness and alexithymia scores were above average, unlike sensation seeking scores. CONCLUSIONS: The results go along the same lines as those mentioned in the international literature and show how important it is to carry out multidimensional assessments within the context of pathological gambling, since comorbidities are such a burden. This study brings to light several perspectives. It would be interesting to repeat the assessment using a much larger sample. We plan to study those factors that influence the emergence of pathological gambling, and the initiation of specific treatments for pathological gamblers. Upon completion, the study would allow us to propose the treatment that is best suited to each gambler's profile.