Dr. Alex Blaszczynski: Breaks in Play - An Irresponsible Strategy?

Horizons RG
Horizons RGResponsible Gambling Conference at BCLC
Dr. Alex Blaszczynski: Breaks in Play - An Irresponsible Strategy?
Dr. Alex Blaszczynski: Breaks in Play - An Irresponsible Strategy?
Dr. Alex Blaszczynski
Professor and Director, Gambling Treatment Clinic and Research
University of Sydney
Breaks in play: An irresponsible strategy?
Are imposed ‘breaks in play’ effective in
achieving their objectives?
Director, Gambling Treatment Clinic & School of Psychology
Alex Blaszczynski & Kate Hinsley
Funding Disclosures
› Research grants from direct & indirect gambling-related agencies:
- National & international state, provincial & federal governments
- Australian & international gambling industry operators
- Industry philanthropic grants
› Consultations to:
- Government & industry operators
- Senate submissions to State & Federal governments
› Will accept funding from any source for gambling research: all
donations gratefully accepted
5
Why the title of this presentation?
› Assumptions on which presentation is based:
- A proportion of the gambling public suffer significant gambling-
related harms
- All harms are caused by individuals gambling more money
&/or time than affordable
6
Why the title of this presentation?
- Responsible gambling policies & strategies are
therefore designed to assist individuals gamble within
affordable limits
- These policies & strategies are based on either
empirical data or opinions:
“Something needs to be done;
This is something;
Therefore, this should be done”
7
RG strategies directed to:
› Enhancing INTERNAL player control
- Education/awareness
- Correcting erroneous cognitions
- Stimulus control to avoid temptations
› Imposing EXTERNAL player control
- Mandatory limit & total loss limits
- Venue shutdown periods
- Removal of ATMs
- BREAKS IN PLAY
8
9
Why did we select ‘breaks in play’?
Acknowledgement: Study based on Kate Hinsely’s Honours research project
10
11
› It Makes You Wait
› “…The most genius element of Candy Crush is its ability to
make you long for it. You get five chances (lives).... Once you
run out of lives, you have to wait in 30-minute increments to
continue play. Or, if you’re impatient, you can pay to get back
in the game…”
› …It’s much better from an entertainment point of view to
create a more balanced experience where you have natural
breaks.”
Australian Hotels Association (SA) (undated):
Response to Code of Conduct Consultation
› …highly probable that gamblers might increase size or rate of gambling in
anticipation of pending break in play (similar to the “six o’clock” swill in hotels).
› Features: pop up reminders of time spent playing after 60, 90 and 120 minutes, 5-
minute cash out warning at 145 minutes, & mandatory cash out at 150 minutes.
Mandatory cash out is essentially an enforced break in play.
› Researchers from Dalhousie University and Focal Research Consultants, found that
on average:
- Gamblers reduced amount of time spent playing
BUT
- Increased their rate of expenditure such that overall expenditure remained the
same
12
13
Impetus for
reflections on the concept of
‘Break in Play’
If ‘breaks in play’ increase the urge to continue
play in gaming, why do they decrease the urge
in gambling?
14
Theoretical models: increased urges
Can breaks in play be counterproductive?
› McConaghy’s (1980) Behaviour Completion Mechanism Model
- Neuronal representation of habitual behaviour established
- Once triggered, drive to complete behaviour (urge/craving) persists until
behaviour is completed
- Reduction in urge/craving reinforces neuronal representation
› Tiffany’s (1990) model of drug craving: Arousal & heightened craving when
intention to use is thwarted.
- Results in increased focus on object of addiction & intensify craving
- Heightened focus may amplify dissociative experience on resumption & hence act
to reinforce behaviours
15
Break in play productive
› Narrowed focus of attention Anderson & Brown (1984)
› General Theory of Addictions
- Hyper- or hypo- arousal states
- Homeostatic equilibrium achieved
through dissociation & escape
from aversive arousal state
- Results in loss of awareness
16
(Jacobs,1986)
Theoretical models: Dissociation
Dissociative effects
- Trance-like states induced by immersive electronic gaming machine play
& gaming: Emotional escape
• Diskin & Hodgins (1999), Wood et al. (2007)
• Hussain & Griffiths (2009), Beranuy et al. (2013)
• “Internet gambling highly interactive, minimal distractions, involvement
encouraged through promotions (bonus offers, free credit), capacity to
play multiple games & use of multimedia to enhance entertainment
value”
Gainsbury (2014)
17
What is the implication of dissociation for
responsible gambling policies?
18
Breaks in Play: Responsible Gambling
19
Decision-making: Aim is to have player evaluate behaviour
Loss of
tracking of
money & time
Dissociation
Immersion
Absorption
(Jacobs, 1986)
Break in play
Appraisal of
behaviour
20
What constitutes a ‘break in play’?
Types of ‘breaks in play’
1. Suspension of play for unspecified time
- Voluntary
- Imposed
- Suspension play after period of continuous play (30 or 60 min or ‘x’
number of spins)
- Termination of play once precommitment threshold reached
Definition of break in play not clearly specified:
21
Play terminated: Pre-set limit reached
What is a ‘break in play’
22
2. Interference
- Play suspended briefly for pop-up
or scrolling message to appear on-screen
3. Distraction
- Player accessing player information display on screen
- In-venue announcements
Distractions & interference strategies
- Time-related announcements: ‘Courtesy bus will leave at 5:00pm’
Announce morning tea or other non-gambling event
- Require patron to obtain drinks from bar or self-service beverage
- Offer promotions which require patrons to leave their seat
23
Queensland Responsible Gambling Resource Manual (Clubs) (Department
of Justice &Attorney-General) &
Australian Hotels Association RG Code of Conduct
What is a ‘break in play’
24
2. Interference
- Play suspended briefly for pop-up
or scrolling message to appear on-screen
3. Distraction
- Player accessing player information display on screen
- In-venue announcements
4. Interruption
- Social or staff interactions while gambling
What is the evidence for optimal structure &
timing of ‘break in play’?
25
• Schellinck & Schrans (2002): Pop-up message froze play for 15
sec after 60, 90, 120 minutes continuous play
• 60 min – small reduction in session length & expenditure
• 50% of participants did not read message & continued play
• 25% suggested pop-reminder had positive effect
• Ladouceur & Sevigny (2003): message appeared 7 sec every 15
trials causing break in play
• Fewer games with break in play with and without message
26
Responsible Gaming Player Protection:
› 888: Global leaders of online gaming entertainment:
› If, at any stage, you become concerned about your gambling behavior, you
can request one of the following:
- “Take a Break” for one day
- “Take a Break” for seven days
- “Take a Break” for two weeks
- “Take a Break” for one month
- “Take a Break” for two months
- “Take a Break” for three months
- A six-month self-exclusion period
27http://www.888responsible.com/play-responsibly/player-protection.htm
› Monaghan (2008; 2009); Monaghan & Blaszczynski (2009;2010)
- 15 sec pop‐up during a forced break in play accurately recalled by
majority of participants
› Griffiths (2012): 5 minute forced breaks every 60 minutes
› Other studies included additional educational or other interventions
• Overall consensus is that messages & breaks in play are effective
in moderating gambling behaviour
28
29
What is the mechanism of action of ‘breaks in
play’?
Content, break in play or interaction?
Informed
choice
Personal
appraisal
Accurate & timely information:
correcting cognitive distortions
Break in play
Interrupt
dissociative
state
+/-
Current study: Candy Crush & break in play
Hypotheses tested:
1. That length of break is associated with intensity of cravings
2. That greater dissociation during initial play, the stronger the
craving at beginning of break
3. That increased cravings during break will result in greater
dissociation on resumption of play
31
Aim: To evaluate impact of break in play in absence of monetary
rewards or personal appraisal messaging
Study design
Three minute break
Six minute break
Nine minute break
Continued play
123 undergraduate
students
43%
Age = 19.5
Candy Crush
Random allocation
• 31% play video games daily
• 31% a few times per week
• 38% every few weeks
• 22% had not played Candy Crush
Q1
Dissociation
Craving
Q2
Arousal
Craving
6 min: Q1 4 min Q2
9 min: Q1 6 min Q2
15 minutes play
Baseline
demographics
15 minutes play
3 min: Q1+Q2
Q1
Dissociation
Study findings
› No between group differences on key variables (age, gaming
experience)
› Mean Problem Video Game Playing Score = 42.2: comparable to
King et al.’s (2011) sample of Australian undergraduates
› Mean playing time = 7.7 hrs. (SD= 10.4)
› Mean Dissociation score = 2.1 (SD=0.83)
34
Results
› Hypo 1: That length of break is associated with intensity of
cravings
- Partial support: Significant increase in cravings found at 9 but not 3 & 6
minute breaks
- Arousal & cravings:
- At low arousal, no change in craving
- Increased craving associated with moderate & high arousal
35
Cravings
Findings
36
-1
-0.5
0
0.5
1
1.5
2
2.5
3
3.5
3 6 9
ChangeinCraving
Breaks in Play (minutes)
Low Arousal (-1SD)
Moderate Arousal
High Arousal (+1SD)
Results
› Hypo 1:
- Supports theoretical models that externally imposed break is associated
with frustration & cravings
- ? Not clear if this applies to subjective &/or physiological arousal
- ? Negative valenced (frustration) or positive valenced (anticipation)
arousal states
› Consistent with Jacob’s (1986) theory that hyper-aroused individuals may
experience increased cravings in breaks triggered by desire to re-instate
homeostatic balance of arousal
37
Cravings
Results
› Hypo 2: Supports Jacob’s (1986) theory
› That greater dissociation during initial play, the stronger the craving at
beginning of break
- Level of dissociation at first session associated with stronger cravings
- Problem gaming scores better predictor of dissociation
- Findings for gaming similar to that postulated for gambling
38
Dissociation
Results
› Hypo 3:
› That increased cravings during break will result in greater
dissociation on resumption of play
- The larger the craving change scores the greater the dissociation at
second session
39
Dissociation
Blackjack
› Blackjack pilot study
› 141 university students (mean age 21 yrs; 45% males)
- Similar design & measures but used: no break, 3 & 8 minute breaks
- Highest score awarded $40 prize to enhance motivation
› Preliminary results
- Craving highest in long break condition
- Short break significantly higher craving scores than no break
- No support found for break in play to reduce feelings of dissociation
- Dissociation positively correlated with craving to continue play
40
Cowley, Anthony, Blaszczynski & Hinsley (2015)
Conclusions
› Externally imposed break in play may increase craving &
result in greater experience of dissociation in subsequent
session thereby reinforcing habitual behaviours
› Support for Jacob’s (1086) model that hyper-aroused
individual experience greater cravings when frustrated with
break in play
› Break in play per se may be effective if player initiated, i.e., in
setting voluntary limits (hypothesis to be tested)
41
Breaks in play: An irresponsible strategy?
Are imposed ‘breaks in play’ effective in
achieving their objectives?
Director, Gambling Treatment Clinic & School of Psychology
Alex Blaszczynski & Kate Hinsley
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Dr. Alex Blaszczynski: Breaks in Play - An Irresponsible Strategy?

  • 3. Dr. Alex Blaszczynski Professor and Director, Gambling Treatment Clinic and Research University of Sydney
  • 4. Breaks in play: An irresponsible strategy? Are imposed ‘breaks in play’ effective in achieving their objectives? Director, Gambling Treatment Clinic & School of Psychology Alex Blaszczynski & Kate Hinsley
  • 5. Funding Disclosures › Research grants from direct & indirect gambling-related agencies: - National & international state, provincial & federal governments - Australian & international gambling industry operators - Industry philanthropic grants › Consultations to: - Government & industry operators - Senate submissions to State & Federal governments › Will accept funding from any source for gambling research: all donations gratefully accepted 5
  • 6. Why the title of this presentation? › Assumptions on which presentation is based: - A proportion of the gambling public suffer significant gambling- related harms - All harms are caused by individuals gambling more money &/or time than affordable 6
  • 7. Why the title of this presentation? - Responsible gambling policies & strategies are therefore designed to assist individuals gamble within affordable limits - These policies & strategies are based on either empirical data or opinions: “Something needs to be done; This is something; Therefore, this should be done” 7
  • 8. RG strategies directed to: › Enhancing INTERNAL player control - Education/awareness - Correcting erroneous cognitions - Stimulus control to avoid temptations › Imposing EXTERNAL player control - Mandatory limit & total loss limits - Venue shutdown periods - Removal of ATMs - BREAKS IN PLAY 8
  • 9. 9 Why did we select ‘breaks in play’? Acknowledgement: Study based on Kate Hinsely’s Honours research project
  • 10. 10
  • 11. 11 › It Makes You Wait › “…The most genius element of Candy Crush is its ability to make you long for it. You get five chances (lives).... Once you run out of lives, you have to wait in 30-minute increments to continue play. Or, if you’re impatient, you can pay to get back in the game…” › …It’s much better from an entertainment point of view to create a more balanced experience where you have natural breaks.”
  • 12. Australian Hotels Association (SA) (undated): Response to Code of Conduct Consultation › …highly probable that gamblers might increase size or rate of gambling in anticipation of pending break in play (similar to the “six o’clock” swill in hotels). › Features: pop up reminders of time spent playing after 60, 90 and 120 minutes, 5- minute cash out warning at 145 minutes, & mandatory cash out at 150 minutes. Mandatory cash out is essentially an enforced break in play. › Researchers from Dalhousie University and Focal Research Consultants, found that on average: - Gamblers reduced amount of time spent playing BUT - Increased their rate of expenditure such that overall expenditure remained the same 12
  • 13. 13 Impetus for reflections on the concept of ‘Break in Play’
  • 14. If ‘breaks in play’ increase the urge to continue play in gaming, why do they decrease the urge in gambling? 14
  • 15. Theoretical models: increased urges Can breaks in play be counterproductive? › McConaghy’s (1980) Behaviour Completion Mechanism Model - Neuronal representation of habitual behaviour established - Once triggered, drive to complete behaviour (urge/craving) persists until behaviour is completed - Reduction in urge/craving reinforces neuronal representation › Tiffany’s (1990) model of drug craving: Arousal & heightened craving when intention to use is thwarted. - Results in increased focus on object of addiction & intensify craving - Heightened focus may amplify dissociative experience on resumption & hence act to reinforce behaviours 15
  • 16. Break in play productive › Narrowed focus of attention Anderson & Brown (1984) › General Theory of Addictions - Hyper- or hypo- arousal states - Homeostatic equilibrium achieved through dissociation & escape from aversive arousal state - Results in loss of awareness 16 (Jacobs,1986) Theoretical models: Dissociation
  • 17. Dissociative effects - Trance-like states induced by immersive electronic gaming machine play & gaming: Emotional escape • Diskin & Hodgins (1999), Wood et al. (2007) • Hussain & Griffiths (2009), Beranuy et al. (2013) • “Internet gambling highly interactive, minimal distractions, involvement encouraged through promotions (bonus offers, free credit), capacity to play multiple games & use of multimedia to enhance entertainment value” Gainsbury (2014) 17
  • 18. What is the implication of dissociation for responsible gambling policies? 18
  • 19. Breaks in Play: Responsible Gambling 19 Decision-making: Aim is to have player evaluate behaviour Loss of tracking of money & time Dissociation Immersion Absorption (Jacobs, 1986) Break in play Appraisal of behaviour
  • 20. 20 What constitutes a ‘break in play’?
  • 21. Types of ‘breaks in play’ 1. Suspension of play for unspecified time - Voluntary - Imposed - Suspension play after period of continuous play (30 or 60 min or ‘x’ number of spins) - Termination of play once precommitment threshold reached Definition of break in play not clearly specified: 21 Play terminated: Pre-set limit reached
  • 22. What is a ‘break in play’ 22 2. Interference - Play suspended briefly for pop-up or scrolling message to appear on-screen 3. Distraction - Player accessing player information display on screen - In-venue announcements
  • 23. Distractions & interference strategies - Time-related announcements: ‘Courtesy bus will leave at 5:00pm’ Announce morning tea or other non-gambling event - Require patron to obtain drinks from bar or self-service beverage - Offer promotions which require patrons to leave their seat 23 Queensland Responsible Gambling Resource Manual (Clubs) (Department of Justice &Attorney-General) & Australian Hotels Association RG Code of Conduct
  • 24. What is a ‘break in play’ 24 2. Interference - Play suspended briefly for pop-up or scrolling message to appear on-screen 3. Distraction - Player accessing player information display on screen - In-venue announcements 4. Interruption - Social or staff interactions while gambling
  • 25. What is the evidence for optimal structure & timing of ‘break in play’? 25
  • 26. • Schellinck & Schrans (2002): Pop-up message froze play for 15 sec after 60, 90, 120 minutes continuous play • 60 min – small reduction in session length & expenditure • 50% of participants did not read message & continued play • 25% suggested pop-reminder had positive effect • Ladouceur & Sevigny (2003): message appeared 7 sec every 15 trials causing break in play • Fewer games with break in play with and without message 26
  • 27. Responsible Gaming Player Protection: › 888: Global leaders of online gaming entertainment: › If, at any stage, you become concerned about your gambling behavior, you can request one of the following: - “Take a Break” for one day - “Take a Break” for seven days - “Take a Break” for two weeks - “Take a Break” for one month - “Take a Break” for two months - “Take a Break” for three months - A six-month self-exclusion period 27http://www.888responsible.com/play-responsibly/player-protection.htm
  • 28. › Monaghan (2008; 2009); Monaghan & Blaszczynski (2009;2010) - 15 sec pop‐up during a forced break in play accurately recalled by majority of participants › Griffiths (2012): 5 minute forced breaks every 60 minutes › Other studies included additional educational or other interventions • Overall consensus is that messages & breaks in play are effective in moderating gambling behaviour 28
  • 29. 29 What is the mechanism of action of ‘breaks in play’?
  • 30. Content, break in play or interaction? Informed choice Personal appraisal Accurate & timely information: correcting cognitive distortions Break in play Interrupt dissociative state +/-
  • 31. Current study: Candy Crush & break in play Hypotheses tested: 1. That length of break is associated with intensity of cravings 2. That greater dissociation during initial play, the stronger the craving at beginning of break 3. That increased cravings during break will result in greater dissociation on resumption of play 31 Aim: To evaluate impact of break in play in absence of monetary rewards or personal appraisal messaging
  • 32. Study design Three minute break Six minute break Nine minute break Continued play 123 undergraduate students 43% Age = 19.5 Candy Crush Random allocation • 31% play video games daily • 31% a few times per week • 38% every few weeks • 22% had not played Candy Crush
  • 33. Q1 Dissociation Craving Q2 Arousal Craving 6 min: Q1 4 min Q2 9 min: Q1 6 min Q2 15 minutes play Baseline demographics 15 minutes play 3 min: Q1+Q2 Q1 Dissociation
  • 34. Study findings › No between group differences on key variables (age, gaming experience) › Mean Problem Video Game Playing Score = 42.2: comparable to King et al.’s (2011) sample of Australian undergraduates › Mean playing time = 7.7 hrs. (SD= 10.4) › Mean Dissociation score = 2.1 (SD=0.83) 34
  • 35. Results › Hypo 1: That length of break is associated with intensity of cravings - Partial support: Significant increase in cravings found at 9 but not 3 & 6 minute breaks - Arousal & cravings: - At low arousal, no change in craving - Increased craving associated with moderate & high arousal 35 Cravings
  • 36. Findings 36 -1 -0.5 0 0.5 1 1.5 2 2.5 3 3.5 3 6 9 ChangeinCraving Breaks in Play (minutes) Low Arousal (-1SD) Moderate Arousal High Arousal (+1SD)
  • 37. Results › Hypo 1: - Supports theoretical models that externally imposed break is associated with frustration & cravings - ? Not clear if this applies to subjective &/or physiological arousal - ? Negative valenced (frustration) or positive valenced (anticipation) arousal states › Consistent with Jacob’s (1986) theory that hyper-aroused individuals may experience increased cravings in breaks triggered by desire to re-instate homeostatic balance of arousal 37 Cravings
  • 38. Results › Hypo 2: Supports Jacob’s (1986) theory › That greater dissociation during initial play, the stronger the craving at beginning of break - Level of dissociation at first session associated with stronger cravings - Problem gaming scores better predictor of dissociation - Findings for gaming similar to that postulated for gambling 38 Dissociation
  • 39. Results › Hypo 3: › That increased cravings during break will result in greater dissociation on resumption of play - The larger the craving change scores the greater the dissociation at second session 39 Dissociation
  • 40. Blackjack › Blackjack pilot study › 141 university students (mean age 21 yrs; 45% males) - Similar design & measures but used: no break, 3 & 8 minute breaks - Highest score awarded $40 prize to enhance motivation › Preliminary results - Craving highest in long break condition - Short break significantly higher craving scores than no break - No support found for break in play to reduce feelings of dissociation - Dissociation positively correlated with craving to continue play 40 Cowley, Anthony, Blaszczynski & Hinsley (2015)
  • 41. Conclusions › Externally imposed break in play may increase craving & result in greater experience of dissociation in subsequent session thereby reinforcing habitual behaviours › Support for Jacob’s (1086) model that hyper-aroused individual experience greater cravings when frustrated with break in play › Break in play per se may be effective if player initiated, i.e., in setting voluntary limits (hypothesis to be tested) 41
  • 42. Breaks in play: An irresponsible strategy? Are imposed ‘breaks in play’ effective in achieving their objectives? Director, Gambling Treatment Clinic & School of Psychology Alex Blaszczynski & Kate Hinsley
  • 43. To provide session feedback: • Open New Horizons app • Select Agenda tile • Select this session • Select Take Survey at bottom of screen If you are unable to download app, please raise your hand for a paper version