Impact of Wagering Inducements on the Gambling Behaviors, Cognitions, and Emotions of Online Gamblers: A Randomized Controlled Study.

Wagering inducements are part of loyalty/reward programs implemented by online gambling operators to retain or attract consumers. They constitute incentives to bet that are offered to gamblers provided that they perform certain betting-related activities. They are often considered risk factors for gambling problems, but studies exploring the actual impacts of such incentives are scarce. The objective of the present study was to assess the actual impact of wagering inducements on gambling behaviors, cognitions, and emotions of online gamblers. One hundred seventy-one adults (18-65 years old) who gamble on a regular basis on the Internet, including at-risk and recreational gamblers, were recruited through media announcements and in panels from survey institutes. Participants were randomly assigned to one of four experimental conditions, in which a defined amount of money was given to the gambler with a bank e-card system during an experimental gambling session to simulate a wagering inducement (€10, €50, €100, or €200), or the control condition, in which no incentive was given. The experimental gambling session was designed to be as natural as possible (participants gambled with their own gambling account and their own money). Participants completed a pretest interview, took part in the experimental gambling session, and then completed a post-test interview. The impact of wagering inducements was estimated on objective (money wagered and time spent gambling during the gambling session) and subjective (cognitive distortions, enjoyment of gambling, loss of control, and respect of usual gambling habits) gambling endpoints that were compared between conditions. Two-thirds of participants reported having already received wagering inducements at some point of their gambling course. Although no effect was demonstrated on time spent gambling, inducements increased money wagered, gambling-related expectancies and perceived loss of control. In particular, it seems that wagering inducements could lead to extreme expenses, especially for at-risk gamblers. This research suggests that regulating wagering inducements could be helpful for prevention and early intervention. Future research on the impacts of wagering inducements is still needed, especially more ecological studies based on behavioral tracking data and studies assessing the differential impacts of various incentive types. Clinical Trial Registration: NCT01789580 (ClinicalTrials.gov).

Modeling Early Gambling Behavior Using Indicators from Online Lottery Gambling Tracking Data: Longitudinal Analysis.

BACKGROUND: Individuals who gamble online may be at risk of gambling excessively, but internet gambling also provides a unique opportunity to monitor gambling behavior in real environments which may allow intervention for those who encounter difficulties. OBJECTIVE: The objective of this study was to model the early gambling trajectories of individuals who play online lottery. METHODS: Anonymized gambling-related records of the initial 6 months of 1152 clients of the French national lottery who created their internet gambling accounts between September 2015 and February 2016 were analyzed using a two-step approach that combined growth mixture modeling and latent class analysis. The analysis was based upon behavior indicators of gambling activity (money wagered and number of gambling days) and indicators of gambling problems (breadth of involvement and chasing). Profiles were described based upon the probabilities of following the trajectories that were identified for the four indicators, and upon several covariates (age, gender, deposits, type of play, net losses, voluntary self-exclusion, and Playscan classification-a responsible gambling tool that provides each player with a risk assessment: green for low risk, orange for medium risk and red for high risk). Net losses, voluntary self-exclusion, and Playscan classification were used as external verification of problem gambling. RESULTS: We identified 5 distinct profiles of online lottery gambling. Classes 1 (56.8%), 2 (14.8%) and 3 (13.9%) were characterized by low to medium gambling activity and low values for markers of problem gambling. They displayed low net losses, did not use the voluntary self-exclusion measure, and were classified predominantly with green Playscan tags (range 90%-98%). Class 4 (9.7%) was characterized by medium to high gambling activity, played a higher breadth of game types (range 1-6), and had zero to few chasing episodes. They had high net losses but were classified with green (66%) or orange (25%) Playscan tags and did not use the voluntary self-exclusion measure. Class 5 (4.8%) was characterized by medium to very high gambling activity, played a higher breadth of game types (range 1-17), and had a high number of chasing episodes (range 0-5). They experienced the highest net losses, the highest proportion of orange (32%) and red (39%) tags within the Playscan classification system and represented the only class in which voluntary self-exclusion was present. CONCLUSIONS: Classes 1, 2, 3 may be considered to represent recreational gambling. Class 4 had higher gambling activity and higher breadth of involvement and may be representative of players at risk for future gambling problems. Class 5 stood out in terms of much higher gambling activity and breadth of involvement, and the presence of chasing behavior. Individuals in classes 4 and 5 may benefit from early preventive measures.

Dopamine Agonists and Impulse Control Disorders: A Complex Association.

Impulse control disorders (ICDs) are a well-known adverse effect of dopamine agonists (DAAs). This critical review aims to summarize data on the prevalence and factors associated with the development of an ICD simultaneous to DAA use. A search of two electronic databases was completed from inception to July 2017. The search terms were medical subject headings (MeSH) terms including "dopamine agonists" AND "disruptive disorders", "impulse control disorders", or "conduct disorders". Articles had to fulfill the following criteria to be included: (i) the target problem was an ICD; (ii) the medication was a dopaminergic drug; and (iii) the article was an original article. Of the potential 584 articles, 90 met the criteria for inclusion. DAAs were used in Parkinson's disease (PD), restless legs syndrome (RLS) or prolactinoma. The prevalence of ICDs ranged from 2.6 to 34.8% in PD patients, reaching higher rates in specific PD populations; a lower prevalence was found in RLS patients. We found only two studies about prolactinoma. The most robust findings relative to the factors associated with the development of an ICD included the type of DAA, the dosage, male gender, a younger age, a history of psychiatric symptoms, an earlier onset of disease, a longer disease duration, and motor complications in PD. This review suggests that DAA use is associated with an increased risk in the occurrence of an ICD, under the combined influence of various factors. Guidelines to help prevent and to treat ICDs when required do exist, although further studies are required to better identify patients with a predisposition.