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Deconstructing the Modern Slot Machine: Psychological
Ingredients and Personal Vulnerabilities
Dr Luke Clark
New Horizons ...
Disclosure Statement
The Centre for Gambling Research at UBC is
supported by the British Columbia Lottery
Corporation (a C...
Objectives
• Psychiatry and neuroscience has focussed on personal vulnerability
factors to gambling addiction, neglecting ...
Who Develops Gambling Problems?
• “Medical Model” (psychiatry &
neuroscience) places Gambling
Disorder alongside the subst...
Impulsivity: the Addictive Personality
0
5
10
15
20
25
30
35
40
Neg
Urgency
Pos
Urgency
Lack of
Premed
Lack of
Persev
Sens...
Early Predictors
0
1
2
3
4
D2 in Overall Striatum
Controls Gamblers Clark et al (2012 NeuroImage)
Con Gam
1.5
2
2.5
3
10 20 30 40 50
BPNDLi...
Individual Vulnerabilities
0.6
0.7
0.8
0.9
1
9 8 7 6
ProportionMajority
Choice
Majority Colour
PG
Controls
Neuropsychologi...
A Public Health Approach to
Gambling Harm
GAMBLERGAME
GAMBLING
ENVIRONMENT
Impulsivity
Dopamine
Brain structure
Near-misse...
Revenues & problems by different forms
Maclaren 2015: revenue
from different forms,
across all provinces
• BC: Most popula...
Treatment Services
• In treatment services, the most common preferred /
problematic form of gambling are slot machines (25...
Early Slot Machines
1895 Charles Fey invents
the ‘Liberty Bell’
1938 Bally’s
‘Double Bell’
1973 Bally’s
‘Circus’
The Modern EGM
Ice Impress (WMS Games)
Game Features
Speed / Continuity
Pay-out features: Jackpot Size, Max
Bet, Return to Player
Mode of Payment (bill acceptors...
Slot Machine
Simulations
Pick a shape
Choice
No win
Full-miss outcome
Anticipation
Win outcome
Win 5€
No win
Near-miss out...
Problem Gamblers show increased
brain responses to near-misses
CONTROLS GAMBLERS
GAMBLERS > CONTROLS
fMRI:
near-miss >
ful...
The UBC ‘Casino Lab’
0
1000
2000
3000
4000
5000
6000
5 10 15 20 25 30
Credits
Minutes
Slot-Tracker algorithm
Lost in the Game
• During play, some gamblers enter a ‘trance-
like’ state (immersion, flow, dissociation)
• This state ma...
Measuring Immersion
3X 0
5
10
15
20
0 3 6 9 12 15 18 21 24 27
DQScore
Problem Gambling Symptoms
Dissociation
0
3
6
9
12
15...
Shattering the Zone: RG Implications
3X
$17.50
GS-$2.50
3X
GS
$17.50
Sensory Feedback in the Rat Casino
https://www.youtube.com/watch?v=0Mw50JsaESY
stimulus
lights on
nosepoke in lit
hole
5s ...
The Plastic Trap
• In a ‘cashless’ society, should
we be able to play slot machines
using credit cards / app-based
payment...
Cash vs Credit
0
50
100
150
PERSISTENCE (MEAN # TRIALS)
0
100
200
300
400
500
BETTING (MEAN PER MINUTE)
CASH CREDIT CASH C...
Conclusions
 Clinical emphasis on vulnerability to gambling addiction should not
trivialize the impact of the gambling pr...
CGR People
Dr Luke Clark
Director
Dawn Kennedy
Research
Assistant
Spencer Murch
Dr Tilman
Lesch
Dr Eve Limbrick-
Oldfield
...
Email luke.clark@psych.ubc.ca
Web www.cgr.psych.ubc.ca
Twitter @LukeClark01 @CGR_UBC
The Modern EGM
27
Limbrick-Oldfield et al 2017: brain areas hyper-reactive to gambling cues and
correlated with cravings in problem gamblers...
-12
-10
-8
-6
-4
-2
0
2
4
6
Carfentanil Displacement by Amphetamine
(Opioid Release)
PG Con
* * * **
Carfentanil PET imagi...
Genes or Environment?
31
Slutske et al 2000: 6744 Vietnam era twins.
Rate of lifetime Path. Gambling: 1.4%, subclinical: 6...
PlayNow.com: Game category breakdown
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Deconstructing the Modern Slot Machine: Psychological Ingredients and Personal Vulnerabilities

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Dr. Luke Clark

  1. 1. Deconstructing the Modern Slot Machine: Psychological Ingredients and Personal Vulnerabilities Dr Luke Clark New Horizons in Responsible Gambling 22 February 2017
  2. 2. Disclosure Statement The Centre for Gambling Research at UBC is supported by the British Columbia Lottery Corporation (a Crown Corporation) and the Province of BC government. Honoraria: Svenska Spel (Sweden), Victorian Responsible Gambling Foundation (Australia), National Center for Responsible Gaming (US) Consultancy: Cambridge Cognition Ltd (UK)
  3. 3. Objectives • Psychiatry and neuroscience has focussed on personal vulnerability factors to gambling addiction, neglecting the role of the gambling product. • Modern slot machines are among the most harmful gambling products. These games contain many psychological ingredients that may underlie their addictiveness. – Near Misses – Immersion (as a net result) – Cash vs credit-based payment • RG initiatives should respond to, and consider regulating, specific features.
  4. 4. Who Develops Gambling Problems? • “Medical Model” (psychiatry & neuroscience) places Gambling Disorder alongside the substance addictions • “Addiction is a brain disease” (Leshner, 1997 Science) • Uneven playing field in who develops addictions
  5. 5. Impulsivity: the Addictive Personality 0 5 10 15 20 25 30 35 40 Neg Urgency Pos Urgency Lack of Premed Lack of Persev Sens Seeking UPPS-PSubscaleScore PG Controls UPPS-P Scale Effect Size (d) Negative Urgency 1.8 Positive Urgency 1.5 Lack of Premeditation 0.8 Lack of Perseverance 0.6 Sensation Seeking 0.2 “mood-related impulsivity” “narrow” impulsivity ** ** Michalczuk et al (2011) * *
  6. 6. Early Predictors
  7. 7. 0 1 2 3 4 D2 in Overall Striatum Controls Gamblers Clark et al (2012 NeuroImage) Con Gam 1.5 2 2.5 3 10 20 30 40 50 BPNDLimbicStriatum Negative Urgency GD Controls 11C-raclopride PET of dopamine transmission in Gambling Disorder
  8. 8. Individual Vulnerabilities 0.6 0.7 0.8 0.9 1 9 8 7 6 ProportionMajority Choice Majority Colour PG Controls Neuropsychological Markers 1.5 2 2.5 3 30 35 40 45 D2BPinOverall Striatum Negative Urgency Neurochemistry (PET) Personality Traits 0 10 20 30 40 Neg Urgency Pos Urgency Lack of Premed Lack of Persev Sens Seeking UPPS-PSubscaleScore PG Controls Brain Responses (fMRI)
  9. 9. A Public Health Approach to Gambling Harm GAMBLERGAME GAMBLING ENVIRONMENT Impulsivity Dopamine Brain structure Near-misses Speed of play Jackpot size Korn & Shaffer 1999 Murch & Clark 2015 Venue size Age restrictions Opening hours
  10. 10. Revenues & problems by different forms Maclaren 2015: revenue from different forms, across all provinces • BC: Most popular forms of gambling: lottery (44%), charity raffle (16%), casino (11%), private games (11%), sports betting (3%) • Forms most associated with PG: casino (42%), private games (39%), stocks & shares (27%), bingo (14%), internet gambling (13%) 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 0 100 200 300 400 500 600 Fiscal year RevenueperCanadianadult (CAD) VLTs Slots Lottery Horse All other
  11. 11. Treatment Services • In treatment services, the most common preferred / problematic form of gambling are slot machines (25 of 51 in our Vancouver study; Dawn Kennedy’s poster) • (in UK, 40-50% at London clinic have electronic Roulette as preferred form) • More rapid progression from initial use to problematic gambling (Breen & Zimmerman 2002)
  12. 12. Early Slot Machines 1895 Charles Fey invents the ‘Liberty Bell’ 1938 Bally’s ‘Double Bell’ 1973 Bally’s ‘Circus’
  13. 13. The Modern EGM Ice Impress (WMS Games)
  14. 14. Game Features Speed / Continuity Pay-out features: Jackpot Size, Max Bet, Return to Player Mode of Payment (bill acceptors) Sensory Feedback / ‘Losses Disguised as Wins’ Illusory Control (e.g. stopper buttons) Near-Misses
  15. 15. Slot Machine Simulations Pick a shape Choice No win Full-miss outcome Anticipation Win outcome Win 5€ No win Near-miss outcome Rating Win 5€ How much do you want to continue gambling?
  16. 16. Problem Gamblers show increased brain responses to near-misses CONTROLS GAMBLERS GAMBLERS > CONTROLS fMRI: near-miss > full-miss Sulpiride Percentsignalchange Near-miss Full-miss T 6.7 11 CONTROLS Sescousse et al, 2016 GAMBLERS
  17. 17. The UBC ‘Casino Lab’ 0 1000 2000 3000 4000 5000 6000 5 10 15 20 25 30 Credits Minutes Slot-Tracker algorithm
  18. 18. Lost in the Game • During play, some gamblers enter a ‘trance- like’ state (immersion, flow, dissociation) • This state may provide a means of escape from stress, low mood, boredom • Particularly common during slot machine gambling; slot machine design has served to “smooth the play experience” Spencer Murch
  19. 19. Measuring Immersion 3X 0 5 10 15 20 0 3 6 9 12 15 18 21 24 27 DQScore Problem Gambling Symptoms Dissociation 0 3 6 9 12 15 0 3 6 9 12 15 18 21 24 27 Targets Problem Gambling Symptoms Targets Detected Murch et al, 2017
  20. 20. Shattering the Zone: RG Implications 3X $17.50 GS-$2.50 3X GS $17.50
  21. 21. Sensory Feedback in the Rat Casino https://www.youtube.com/watch?v=0Mw50JsaESY stimulus lights on nosepoke in lit hole 5s time out (p = 0.1) P1: 1 pellet (p = 0.9) P4: 4 pellets (p = 0.4) P2: 2 pellets (p = 0.8) P3: 3 pellets (p = 0.5) 40s time out (p = 0.6) 10s time out (p = 0.2) 30s time out (p = 0.5) Trial rewarded Trial punished OR Cued rGT: Uncued rGT: Profitability 295 99 411 135 Barrus & Winstanley (2016)
  22. 22. The Plastic Trap • In a ‘cashless’ society, should we be able to play slot machines using credit cards / app-based payment? • In consumer psychology, people make more risky & excessive purchases when paying on credit (the ‘pain of paying’ hypothesis) • Current practices are a hybrid: cash in, ticket out Chua et al, New Horizons poster
  23. 23. Cash vs Credit 0 50 100 150 PERSISTENCE (MEAN # TRIALS) 0 100 200 300 400 500 BETTING (MEAN PER MINUTE) CASH CREDIT CASH CREDIT Chua et al, New Horizons poster
  24. 24. Conclusions  Clinical emphasis on vulnerability to gambling addiction should not trivialize the impact of the gambling product.  Slot machines are psychologically complex games with many ingredients. Are the ingredients that make a game fun the same ingredients that make it addictive?  From an RG perspective, initiatives to encourage limit setting are important, but by themselves may be insufficient.  The next phase of research will describe how specific game features interact with personal vulnerability to shape gambling harms.
  25. 25. CGR People Dr Luke Clark Director Dawn Kennedy Research Assistant Spencer Murch Dr Tilman Lesch Dr Eve Limbrick- Oldfield Graduate Students Mario Ferrari Ke ZhangGabriel Brooks Post-Doc Fellows Cindy Chang Candy Chua Undergrad RAs Keni Ng
  26. 26. Email luke.clark@psych.ubc.ca Web www.cgr.psych.ubc.ca Twitter @LukeClark01 @CGR_UBC
  27. 27. The Modern EGM 27
  28. 28. Limbrick-Oldfield et al 2017: brain areas hyper-reactive to gambling cues and correlated with cravings in problem gamblers 2.3 4.5 Z = -4 X = -2
  29. 29. -12 -10 -8 -6 -4 -2 0 2 4 6 Carfentanil Displacement by Amphetamine (Opioid Release) PG Con * * * ** Carfentanil PET imaging of mu-opioid receptors and opioid release in Gambling Disorder Oral amphetamine (0.5 mg/kg) releases endogenous opioids, displacing ligand from receptors (lower BP) Opioid release blunted in PGs (no diff in baseline receptors) BASELINE POST-AMPH Mick et al (2016 Neuropsychopharm)
  30. 30. Genes or Environment? 31 Slutske et al 2000: 6744 Vietnam era twins. Rate of lifetime Path. Gambling: 1.4%, subclinical: 6.2% Rate of lifetime Alcohol Dependence: 35% PG genetics: 40-50% (from MZ-DZ disparity) Overlap between PG genes and AD genes: 12-20%
  31. 31. PlayNow.com: Game category breakdown

Deconstructing the Modern Slot Machine: Psychological Ingredients and Personal Vulnerabilities

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