For Better and For Worse: Frequent Gamblers Use Dual Counterfactuals to Justify Continued Gambling.

How might frequent gamblers convince themselves to keep playing despite persistent losses or after a win that should be savored? The purpose of this research is to examine the unexplored question of how frequent gamblers' use counterfactual thinking to motivate their desire to continue gambling. Using a sample of n = 69 high and n = 69 low frequency gamblers in a field setting, we found that infrequent gamblers tended to consider how the perceived outcome of losing "could have been better" (i.e., upward counterfactual thinking), and how a winning outcome "could have been worse" (i.e., downward counterfactual thinking). This pattern of counterfactual thinking is considered typical in many settings and may, in a gambling context, support a potentially more responsible approach by helping infrequent gamblers to learn from past mistakes to avoid significant future losses and to savor wins to protect returns gained. Alternatively, we found that frequent gamblers were more likely to generate 'dual counterfactuals' which include both upward and downward counterfactuals in response to losses and wins. We argue that this dual pattern of counterfactual thinking may allow frequent gamblers to more easily justify their desire to continue gambling. Findings suggest that challenging gamblers counterfactual thinking patterns could assist clinicians in moderating the potential for high-risk behaviors.

Breaks in Play: Do They Achieve Intended Aims?

Breaks in play represent a responsible gambling strategy designed to disrupt states of dissociation and enhance the likelihood of drawing attention to a player's session behaviour and expenditure with respect to time and money. The aim of the break in play is to motivate the player to modify or cease gambling so the activity remains within affordable levels. The aim of this study was to investigate whether imposed breaks in play in the absence of accompanying warning messages were effective in reducing cravings. Participants (141 university students) were randomly allocated to one of three conditions: 15 min computer simulated Black Jack play followed by no break, a 3 or 8 min break in play. Participants were administered a battery of measures to assess problem gambling card play, cravings, and dissociation to assess the effects of length of break on cravings. Results indicated that cravings increased rather than decreased with imposed breaks in play, and that the strength of cravings were higher following the eight- compared to 3-min break. It was concluded that breaks in play in isolation might produce counterproductive, unintended, and even perverse effects. The policy implications for responsible gambling strategies is that breaks in play ought to be accompanied with warning and/or personal appraisal messages if optimal effects in reducing within session gambling expenditure are to be achieved.

Understanding, benefits and difficulties of home medicines review - patients' perspectives.

BACKGROUND: The home medicines review (HMR) is an important tool for promoting a model of patient-centred care. This article seeks pa-tients' perspectives on understanding, and perceived benefits and difficulties of HMRs. METHODS: A qualitative study based on semi-structured interviews of adult participants who completed an HMR was undertaken in Black-town, a growing, multicultural suburb in Western Sydney. The medical centre is a large general practice offering comprehensive, integrated care. Fifteen participants consented to be interviewed. There was even representation of men and women, and the majority had completed high school. RESULTS: Three major areas were explored: understanding and expectation of an HMR, perceived patient benefits and difficulties. DISCUSSION: The HMR has the potential to be a useful tool in patients' management of their medications. There are clear benefits when per-formed well. However, we have identified areas of limitations in effectiveness, which present opportunities for strengthening the HMR process. Training of doctors and pharmacists may be needed to ensure better patient outcomes.