NCRG Conference on Gambling and Addiction

NCRG Conference News and On-Site Reports Move to Gambling Disorders 360°

2010-06-13T09:15:00.001-07:00

Looking for the latest information about the NCRG's annual Conference on Gambling and Addiction? Visit our new blog - Gambling Disorders 360° - for updates about the conference, including registration information, conference program details, speaker information and more. Gambling Disorders 360° also will include on-site reports from the annual conference, such as interviews with speakers, session summaries and conference highlights.

Gambling Disorders 360° is housed on the the Institute for Research on Gambling Disorders' website - www.gamblingdisorders.org. You can also keep up-to-date on conference news and receive special registration discounts by following the NCRG on Facebook.

Save the Date for the 10th Annual NCRG Conference on Gambling and Addiction

2009-06-24T11:50:00.000-07:00

Mark your calendars for the 10th Annual NCRG Conference on Gambling and Addiction, themed Money, Money, Money: Current Issues Affecting Research, Recovery and Responsible Gaming. The conference will be held Nov. 15-17 at the Mandalay Bay Resort & Casino and Las Vegas Convention Center.

This year’s conference program will highlight the many ways that money and finances impact gambling disorders and treatment. Sessions will examine issues such as how financial risk affects a gambler’s decision making, integrating financial management into treatment for gambling disorders and the state of responsible gaming efforts during the recession. Join the world’s leading addiction scientists, clinicians, public health workers and industry representatives to discuss these and a host of other topics.

What: 10th Annual NCRG Conference on Gambling and Addiction, themed “Money, Money, Money: Current Issues Affecting Research, Recovery and Responsible Gaming”

Where: Mandalay Bay Resort & Casino and Las Vegas Convention Center in Las Vegas, Nevada

When: Nov.15-17, 2009

Looking for the latest news and issues in the gambling disorders research community between conferences? Check out Issues & Insights, a new, monthly online column published by the Institute for Research on Gambling Disorders.

Working Together: Responsible Gaming in Indian Country

2008-11-18T16:52:00.001-08:00

Jana McKeag, president of Lowry Strategies and a national expert in Indian gaming issues, began this afternoon’s NCRG at G2E session by discussing public misconceptions about problem gambling at tribal casinos. McKeag said that many people assume that few tribal casinos have robust responsible gaming initiatives, and, she explained, these incorrect assumption are often used by gambling opponents to undermine tribal casinos. That is why, she said, tribal casinos must “take the next step” and begin pursuing responsible gaming efforts more aggressively.

McKeag added that the NCRG’s PEER (Partnership for Excellence in Education and Responsible Gaming) program can help tribal casinos take that next step. PEER provides casinos – both large and small – with a blueprint to develop and implement world-class responsible gaming programs. PEER, she said, was a particularly important tool for tribal casinos for two reasons: First, it provides them with a report card that quantifies their responsible gaming efforts, and second, PEER can be customized to meet the distinct needs of tribal casinos.

McKeag turned the presentation over to Dr. Kate Spilde Contreras, chair of the Sycuan Institute on Tribal Gaming at San Diego University, who has conducted research on responsible gaming efforts at tribal casinos in California. In her research, she learned that many tribal casinos wanted to implement responsible gaming programs at their facilities, but that there was a dearth of information available on how to do so. After completing her research, Spilde Contreras joined forces with the NCRG to connect tribal and commercial casinos with practical, easy-to-use responsible gaming resources.

Spilde Contreras then provided audience members with background on the NCRG. She said that the number of responsible gaming resources has grown considerably in recent years, thanks in large part to the NCRG. She added that casinos should approach responsible gaming as a corporate social responsibility initiative. As McKeag said, “responsible gaming helps maximize the benefits of gaming, while minimizing the potential harms.”

Contreras then introduced Jacob Coin, director of the office of public affairs for the San Manuel Band of Mission Indians, and his colleague, Diana Scina. Jacob told a story about his father, who returned home from World War II with severe alcohol problems. He said that similar issues, such as gambling addiction, are plaguing Indian communities. He added that it is the responsibility of tribal leaders to preserve the cultural, spiritual and social health of their communities. He said, “We are in the entertainment business, but there is nothing entertaining about seeing people lose their jobs, homes, or families because of their addictions.”

Scina then discussed the responsible gaming efforts in place at the San Manuel Indian Bingo and Casino. There, she said, they have placed responsible gaming posters throughout the facility. Also, they have trained all front-line employees on how to identify gamblers who may have problems. All management staff is trained to reach out to potential problem gamblers, and management also is prohibited from gambling at the facility. In addition, the San Manuel Indian Bingo and Casino has implemented a self-exclusion program and strict age restrictions for the entire facility, not just the gaming floor.

The panel then accepted questions from audience members, who asked about the specifics of the San Manuel Indian Bingo and Casino self-exclusion programs and marketing materials. Spilde Contreras briefly reviewed the PEER program and encouraged audience members to participate in a demonstration of the program at the conclusion of the breakout session. McKeag concluded the session by reiterating how helpful the PEER program can be for tribal casinos, calling it the “next wave” in responsible gaming.

Interview with Kate Spilde Contreras of San Diego State University

2008-11-18T16:32:00.000-08:00

Click here for the NCRG Blog Team interview with Dr. Kate Spilde Contreras, chair of the Sycuan Institute on Tribal Gaming at San Diego State University, about her NCRG Conference experience. Spilde Contreras participated in this afternoon’s NCRG at G2E session, Working Together: Responsible Gaming in Indian Country.

Analyzing the Costs and Benefits of Gambling: Cultural, Historical and Economic Perspectives

2008-11-18T13:25:00.000-08:00

In a packed room at the Las Vegas Convention Center this morning, session moderator Alan Feldman, senior vice president of public affairs at MGM MIRAGE, kicked off a much-anticipated discussion about the costs and benefits of gambling by asking the panel why exactly it is so difficult to measure the social and economic impacts of gambling.

Dr. William Eadington, professor of economics and director of the Institute for the Study of Gambling and Commercial Gaming at the University of Nevada, Reno, first reminded the audience that gambling is an inherently political industry because it already is the largest industry in the world created by political processes, a fact that shades the research in this area. Eadington added that another challenge lies in the fact that there simply isn’t much research in this field because there are only a handful of researchers studying the issue.

Dr. Douglas Walker, associate professor in economics at the College of Charleston, built on Eadington’s point about the political nature of this issue, explaining that, in some ways, it makes it difficult to have good, quality research. According to Walker, politicians and policymakers have a low threshold for the quality of the research, and it seems that so long as they have some statistics to cite to show that gambling is either good or bad, they don’t have a strong interest in the quality of that information. Eadington added that this phenomenon extends to the media. He credited our “sound bite” culture and the desire to provide an easy explanation of what is an extremely complicated issue with giving a larger platform to a number of unscientific cost-benefit estimates.

Feldman asked the panelists to describe what the costs and benefits of gambling are. Walker began by explaining that there is some disagreement of what constitutes a social cost – most economists consider a social cost to be a cost which requires society to allocate resources for something when they otherwise would have been used elsewhere. In the case of gambling, this would include costs for treatment of problem and pathological gamblers, regulation and supervision. He mentioned that there is disagreement in the field about whether the transfer of wealth associated with gambling is a social cost. Walker doesn’t believe it should be considered a cost, adding that one problem with research on this topic is that people say, “this sounds like it should be a cost,” and so they decide to include it.

Regarding the costs of pathological gambling, Dr. David Schwartz, director of the Center for Gaming Research, at University of Nevada, Las Vegas, explained that while it is possible to track the life and habits of one pathological gambler, it is difficult to abstract this number out to society as a whole. He suggested instead of a cost-benefit ratio, policymakers need to view gambling though the lens of a series of tradeoffs. He said that this is a much more honest and neutral way than a lot of the numbers that are out there, but that, unfortunately, given the nature of the news cycle, people prefer to have a quick and easy number.

Eadington noted that pathological gambling is an individual cost of gambling, but that economic research tends to regard individuals as rational and self-interested. He said that future research on this issue needs to marry issues economists bring to the table with more sensitive issues from psychiatry and other social sciences.

Walker added that the benefits of gambling are easier to measure. He said they usually are measured in employment, tax revenues, and the development within complimentary industries. Ha also added that the major benefit of gambling is that consumers enjoy it and are willing to pay money for it, so why not let people spend their money the way they want to? Despite the fact that this is perhaps the largest benefit of gambling, Walker said it is largely ignored in public policy debate around gambling.

Feldman then asked the panelists what their views are of the statistics that are often used to describe costs and benefits and whether there is any veracity to them. Eadington quickly rattled off three commonly cited statistics about the costs of gambling and explained that there is no evidence to justify any of them, but they have been widely disseminated because of our sound bite culture. He added that once bad statistics are out there, they tend to take on a life of their own.

According to Walker, the fact that the cost ranges are so wide and varied indicates that there’s something wrong with research in this area. He noted that, as of yet, no one has developed a good way to measure the costs. He used the example of the losses of pathological gamblers, explaining that a lot of the existing numbers on this issue are based on self-reporting; however, several scientific studies have shown that many of these people are unable to accurately calculate how much money they lose, so the numbers are almost completely arbitrary.

Feldman then asked the panelists what advice they would give to policymakers who are seeking to understand this issue. Eadington said that pathological gambling has risen to top of public policy debate, and that he believes policy in this arena is moving toward a way to separate people who have gambling problems from those who don’t and finding a way to prevent those with gambling problems from using the product. He mentioned examples of this type of approach currently used in Australia, Singapore and China, in which governments seem to be attempting to keep gambling from “getting too big.”

Walker recommended policymakers not rely on dollar estimates because the ones that exist are unreliable. He instead suggested policymakers focus on the general issues of what the likely costs and benefits are, instead of specific dollar amounts, and more fundamental issues of what role the government has in determining how people spend their money.

Schwartz said he believes it is not the government’s responsibility to decide how much we gamble, that instead policymakers should let the market decide. He said that government has a responsibility to regulate the product and make sure the industry is fairly and honestly run, but that when government tries to regulate the supply, that’s problematic.

Interview with Doug Walker of the College of Charleston

2008-11-18T11:07:00.000-08:00

Click here for the NCRG Blog Team interview with Dr. Doug Walker, associate professor in economics at the College of Charleston. Walker participated in one of today’s NCRG at G2E sessions, Analyzing the Costs and Benefits of Gambling: Cultural, Historical and Economic Perspectives.

NCRG Conference: Day 3 At-a-Glance

2008-11-18T08:10:00.000-08:00

The 9th annual NCRG Conference on Gambling and Addiction wraps up today at the Las Vegas Convention Center with its special NCRG at G2E sessions, produced in conjunction with Global Gaming Expo. Here’s a quick look at today’s schedule.

8 - 9 a.m. – The Verdict’s Still Out: Updates on Problem Gambling Regulations and Litigation
Moderator:
David Stewart, Of Counsel, Ropes & Gray, LLP
Speakers:
Connie Jones, Director of Responsible Gaming, International Game Technology
Richard A. LaBrie, Ed.D., Instructor in Psychiatry, Harvard Medical
School
Location:
Room N107

9:15 - 10:15 a.m. – Analyzing the Costs and Benefits of Gambling: Cultural, Historical and Economic Perspectives
Moderator:
Alan Feldman, Senior Vice President of Public Affairs, MGM MIRAGE
Speakers:
William Eadington, Ph.D., Professor of Economics and Director, Institute for the Study of Gambling and Commercial Gaming, University of Nevada, Reno
David Schwartz, Ph.D., Director, Center for Gaming Research, University of Nevada, Las Vegas
Douglas M. Walker, Ph.D., Associate Professor in Economics, Georgia College and State University
Location:
Room N107

10:30 - 11:30 a.m. – G2E Opening Day Keynote Address featuring award-winning journalist Ron Insana
Location:
Room N250

11:45 a.m. - 12:45 p.m. – Common Cause: How HR Departments and EAPs Address Gambling Disorders in the Workforce
Moderator:
Sue Cox, Board Member, NCRG
Speakers:
Robert Boswell, Senior Vice President, Pioneer Behavioral Health
Carl G. Braunlich, D.B.A., Associate Professor, William F. Harrah College of Hotel Administration, University of Nevada, Las Vegas
Susan McDaniel, Director of Human Resources, The Mirage
Location:
Room N107

2 - 3 p.m. – Working Together: Responsible Gaming in Indian Country
Moderator:
Jana McKeag, President, Lowry Strategies
Speakers:
Kate Spilde Contreras, Ph.D., Chair, Sycuan Institute on Tribal Gaming, San Diego State University
Jacob Coin, Director, Office of Public Affairs, San Manuel Band of Mission Indians
Location:
Room N102

3 p.m. – G2E Show Floor Tour (Pre-registration Required)

Seeking a Treatment Standard for Gambling Disorders: Are We There Yet?

2008-11-17T18:40:00.000-08:00

According to Dr. Peter Nathan, professor emeritus of community and behavioral health at the University of Iowa, we’re getting there.

While no existing pharmacological (drug) or psychosocial (therapy) treatments for pathological gambling have yet met the usual standards that would establish them as empirically-supported, Nathan said there are treatments that show promise. Nathan asserted that, for empirically-supported treatments to be identified, the field must first complete well-designed, large-scale, multisite randomized-clinical-trial studies of treatments. But there are barriers. One particular that he noted was the fact that it is harder to get pathological gamblers to admit they have a problem, and therefore agree to participate in studies, than it is with other, similar groups, such as alcoholics – perhaps because of a lingering social stigma about gambling disorders.

In the last session of the day, which focused on evidence-based (i.e., empirically supported) treatments for pathological gambling, Nathan laid out several criteria for a treatment to be considered empirically-supported, including studies that have a randomized assignment of patients; compare the experimental treatment with an active comparison treatment, rather than a no-treatment control group; the use of multiple outcome measures; and appropriate treatment follow-up, so that the “staying power” of the experimental and comparison treatments can be evaluated. He also noted that the treatment itself must lead to significantly better outcomes for significantly more patients than comparison treatments, and that these findings must ultimately be replicated by more than a single team of investigators.

In his presentation, Nathan mentioned that “it is only human nature to assume that the treatments we have learned to deliver are the most useful,” and that “there is often a special place in our hearts for the treatments we learned in our early years in the field.” He encouraged his fellow clinicians, however, to familiarize themselves with and consider adopting treatments that have been systematically compared to others and shown their efficacy.

Nathan then led attendees through a detailed overview of the existing treatments used to treat pathological gambling, including psychosocial treatments – such as Cognitive Behavioral Therapy, Motivational Enhancement Therapy and Twelve-Step Facilitation Therapy – and pharmacological treatments – such as antidepressants, mood stabilizers and opioid antagonists. These forms of treatment have been the subjects of increasing study over the past several years, yet, Nathan explained that very few studies have examined the combination of drug and behavioral treatments. Similarly, there have been very few studies on the treatment of pathological gambling in conjunction with comorbid conditions, i.e., other disorders, such as drug- or alcohol-use disorders, that a pathological gambler also suffers from.

Following Nathan’s presentation, Dr. Lisa Najavits, professor of psychiatry at Boston University School of Medicine and president-elect of the American Psychological Association’s Division on Addictions, raised some broader themes that have arisen from psychotherapy research. One consistent finding, she noted, is that good manualized treatments (those administered based on a standard, written manual) will almost always be equal to each other, so she encouraged clinicians to find good treatments of this kind that fit them as clinicians while also fitting their clients’ needs.

Another consistent finding Najavits pointed out was that manual-based treatments almost always out-perform “treatment as usual” (i.e., when a clinician simply “makes it up on the spot”). She also mentioned that, while there has not been a considerable amount of literature on this point, existing research does seem to show that the assignment of a therapist is even more important than assignment to treatment type to patient success. Additionally, Najavits reminded the audience that the criteria for evidence-based treatments haven’t been standardized, which further complicates both identifying and implementing efficacious treatments.

In a question-and-answer session with the audience, the panel discussed the growing interest in the certification of therapists for pathological gambling. Nathan said that, in principle, certification makes a lot of sense. He noted that it has been helpful to the alcohol treatment industry because it sets a standard for people to aspire to. He also noted, however, that he did not think pathological gambling is in the same boat, citing the need for more data about empirically-supported treatments.

Najavits added that the problem with the vast majority of certification programs is that they measure knowledge, but they don’t measure the skills that are connected to outcomes. She recommended having a patient evaluation as part of a certification process, and to find other measures to evaluate – such as empathy and interaction with the client – until assessments that can actually measure the work clinicians do are developed.

Culture Counts: Designing Relevant Interventions and Responsible Gaming Strategies for Asians and Asian-Americans

2008-11-17T18:36:00.000-08:00

Dr. Nolan Zane, professor of psychology and Asian-American studies at the University of California, Davis, kicked off the session with a discussion about the importance of cultural competency when establishing treatment plans. He outlined three types of cultural competency: cognitive competency, which includes academic knowledge; affective competency, which is the ability to understand unique difficulties that different cultural groups may experience; and role competence, which is a basic understanding of the way roles and behavior influence relationships in a culture. Role competence, he said, is the most difficult to learn.

Zane focused his presentation on cultural values in Asian communities and how they can affect the client-therapist relationship. The first issue he examined was face, which is defined as a person’s set of socially-sanctioned claims concerning his/her social character and integrity. Zane’s research has shown that face can affect self-disclosure among problem gamblers. During treatment, people concerned about face will exhibit certain behaviors, such as careful monitoring of conversations, self-restraint in expression or the use of respect, politeness and courtesy as protective maneuvers. In these situations, a clinician must provide a patient with avenues to save face.

Also, Zane found that East Asian cultures socialize people to handle emotions differently. Western cultures view emotional suppression as negative, but Eastern cultures view emotional suppression more positively. Therefore, since psychotherapy is often centered on catharsis, this approach may be in direct conflict with what Eastern cultures teach.

Chien-Chi Huang, Asian community program specialist for the Massachusetts Council on Compulsive Gambling, discussed the translation of the gambling self-help tool Your First Step to Change into three Asian languages (Mandarin, Khmer and Vietnamese) and the challenges inherent in developing problem gambling resources targeted at Asian communities.

During the translation process, researchers took care to ensure that the tone was gentile and nonjudgmental. During the adaptation process, researchers added new information about family involvement and problem gambling prevalence. Design of the booklets also was important, as each version used a design that was most meaningful to each community’s culture. A natural motif was used in all three to convey health and healing.

During the question and answer portion of the session, the panel was asked how clinicians encourage members of Asian communities to see a value in treatment. Zane said that treatment rates in Asian communities are low and recommended developing ways to help those who need it without having to actually see them face-to-face. Huang added that many Asians see gambling problems as a moral issue. She said that treatment providers should respond by telling problem gamblers that it is a serious health issue that should be addressed.

High-Tech Solutions for Assessment and Counseling: Web-Based Intervention Programs

2008-11-17T15:50:00.000-08:00

Reid K. Hester, Ph.D., director of the research division at Behavior Therapy Associates, began his breakout session, High-Tech Solutions for Assessment and Counseling, by discussing the concept of self-motivation.

Hester said that a high percentage of people with impulse disorders – such as alcohol, drug or gambling addictions – will never seek professional treatment. He explained that many people, particularly those with less-severe impulse disorders, can recover from these conditions by self-correcting their behavior. Hester briefly reviewed research on the challenges and benefits of self-recovery for problem gamblers.

Through his work at Behavior Therapy Associates, Hester is finding ways to reach out to individuals working to recover naturally from alcohol-use disorders. He has developed several Web-based intervention programs for people trying to moderate their drinking. Hester focused today on Drinker’s Check-Up, a Web site that helps people with alcohol addiction understand their behaviors and decide whether to change them. The site provides users with confidential screenings, individualized feedback and motivational enhancement exercises. Since the psychology of pathological gambling and alcohol addiction are very similar, Hester explained, Drinker’s Check-Up can serve as a template for comparable programs for problem gamblers.

Hester recently conducted a clinical trial to determine the effectiveness of Drinker’s Check-Up, and he found that most users had positive experiences with the program. The average number of drinks consumed by Drinker’s Check-Up users decreased after they completed the program. Overall dependence on alcohol among users also decreased. Interestingly, Hester also found that drinkers who wish to change their behavior tended to do so immediately, rather than waiting to do so.

In testing the program, Hester learned several important lessons about creating Web-based intervention programs, which he shared during today’s session. First, he found that program participants were very nervous about enrolling; they tended to be afraid of what they might learn about themselves. He said it was important for an intervention Web site to have a nonjudgmental tone. He added that it was critical for a site to include simple, easy-to-understand language that would not intimidate users.

Hester also is involved with several other Web-based intervention programs, including College Drinker’s Check-Up Web site; SMART Recovery, a site that connects people to self-help programs; and Moderation Management, a site about the benefits and risks of drinking in moderation.

Inside the Virtual Casino: Betting Patterns of Online Gamblers

2008-11-17T14:27:00.000-08:00

Dr. Sarah Nelson, instructor in psychiatry at Harvard Medical School, opened this afternoon’s session on online gambling by pointing out that the research being discussed in the session was notable because it is based on actual behavioral gambling data, rather than self-report data.

Nelson introduced Dr. Richard LaBrie, instructor in psychiatry at Harvard Medical School, who outlined the results of a longitudinal study of actual Internet casino gambling that used data collected through a collaboration with bwin International, an Internet gambling company based in Austria. The study was a follow-up to previous research that focused on the habits of Internet sports bettors.

In the Internet casino study, researchers studied the gambling behavior of 4,222 gamblers from 46 countries. The sample was 93 percent male; however, results showed that women made more bets per day, played more quickly and with a greater intensity.

The study found discontinuities between the gambling behavior of top 5 percent of the most-involved casino bettors, those who lost the most money, and the gambling behavior of the rest of the sample. This subgroup would be most likely to contain individuals who have gambling problems as defined by large losses, but it also would contain individuals who have a lot of money available to lose.

When the extreme 5 percent of subjects were compared to the rest of the sample, they were found to gamble longer, place more bets per day and place larger bets than the other 95 percent of the sample. Correlations among Internet casino gambling show that gamblers tend to be consistent in their day-to-day betting and that gamblers exhibit rational decision-making because their wagering tended to decrease as losses increased.

Dr. Debi LaPlante, instructor in psychiatry at Harvard Medical School, followed LaBrie with descriptions of two studies of responsible gaming efforts in the virtual world. These studies also utilized data from bwin and examined the effects of corporate deposit limits and self-limitation of deposits on online gamblers.

LaPlante explained that bwin subscribers who try to deposit more than the allowed amount receive a notification message that they are about to exceed the deposit limit, and bwin then rejects the deposit. Only 0.3 percent of the overall sample received at least one notification (exceeders). Exceeders were found to have the same number of active betting days as other gamblers, but their bets per day and the size of bets were higher than others. They were more likely to be members of the most involved bettors group, and while they lost more money overall, exceeders lost a smaller percentage of what they gambled. It was found that once exceeders were notified, they made fewer, larger bets, meaning that notifications did not stop them from betting, they merely changed the way they bet. According to LaPlante, this information illustrates an apparent need to rethink the use of notification systems as harm reduction devices for those at risk for excessive patterns of betting.

A study of the “self-limitation of deposits” option that bwin gives its subscribers found that 1.2 percent of the overall sample were “limiters.” Compared to those who did not self-limit their deposits, limiters were found to play a greater diversity of games, bet on more days, place more bets per day and wager less money per bet. The study found that after self-limitation, limiters generally moved toward fewer active betting days, fewer bets per day and smaller amounts wagered. LaPlante pointed out that since limiters were more active bettors than the rest of the sample, if self-limitation is a sign of disordered gambling, involvement might be as important to indicating gambling-related problems as expenditures.

LaPlante concluded by noting that the Internet provides unique opportunities for harm-reduction devices that might be executed with some degree of success; however, limiting resources are only helpful if people can access them easily and interventions can only work if messages reach the intended target.

During the question and answer period, an audience member asked if self-limitation could be viewed as a marker of a gambler’s intention to modify behavior and practice a greater level of self-control. Nelson replied that many people stopped gambling altogether after imposing limits and 7 percent of people set self-limitation before they placed a bet.

Outstanding Poster Award Presentation

2008-11-17T13:39:00.000-08:00

Dr. Richard LaBrie of Harvard Medical School's Psychiatry Department presented this year's Outstanding Poster Award to a team from Jamaica including representatives from Hope Enterprises, Ltd. and RISE Life Management Services for their study entitled Jamaica Child and Adolescent Gambling Survey 2007. Team members included Deborah Bourne from Hope Enterprises Ltd. and Sonita Morin-Abrahams, Richard Henry, Fay Williams and Winston De La Haye from RISE Life Management Services.

Their study, which surveyed 2,299 Jamaican youth aged 10-19 years, found that 45 percent of youth had gambled at least once, and 30 percent had gambled within the last 12 months. It also found that male gender, age, the presence of a family member who gambles and an accepting attitude toward gambling were all significantly associated with gambling initiation.

This year 19 groups submitted posters with empirical research, 13 of which included members from countries outside the United States.

Grand Theft Childhood: Do Video Games Present Health Risks for Children?

2008-11-17T11:11:00.000-08:00

Day two of the NCRG Conference on Gambling and Addiction kicked-off with the much-anticipated plenary session, Grand Theft Childhood: What Are the Health Risks of Video Gaming? The session’s featured speaker was Lawrence Kutner, Ph.D., co-director of The Harvard Center for Mental Health and Media, whose groundbreaking research on the health effects of video and computer games on children is featured in a new book, Grand Theft Childhood: The Surprising Truth About Violent Video Games and What Parents Can Do.

Kutner explained that, although pundits and politicians often blame violent video games for increased aggression in children, it is very difficult to measure such a relationship. In fact, Kutner argued, regular video and computer game play can impact children in both positive and negative ways. In his evaluation of 1,300 middle-school gamers and their parents, Kutner identified some unexpected trends that can inform parents’ decisions about what games to allow in their homes.

Not surprisingly, an overwhelming majority of children play video or computers games; very few do not. Boys typically play games more frequently (often several times a week), and they are more likely to play violent (Mature, i.e., M-rated) games. Perhaps alarmingly, 20 percent of boys and 11 percent of girls report playing with strangers over the Internet regularly. Fun, excitement and competition were among the most prominent reasons cited for playing video and computer games. Children also consider gaming a very social activity, and some children use games to regulate their emotions.

The data from Kutner’s study identified, for the first time ever, a tentative relationship between violent video games and behavioral problems. Children who play M-rated games are more likely to get into fights, start trouble at school, damage property and get poor grades. Kutner noted, however, that violent crime among children is down nationwide, and he argues that the correlation between violent games and misbehavior may be indirect. He added that, “other factors are likely at play.”

Conversely, Kutner listed several benefits for children who play video and computer games. Gaming appears to improve selective attention span, help children cope with stress and inspire new interests. Interestingly, Kutner noted that children diagnosed with attention deficit disorder (commonly referred to as ADD) can play video games for hours without losing interest.

After his presentation, Kutner answered audience questions, discussing the effects of text messaging on children, the risks of gaming alone and the potential physical health problems as a result of gaming too frequently. Kutner closed the session by discussing what he called a “tradition of moral outrage” about new media in the U.S. He said that, years ago, people worried about the potentially negative social consequences of comic books, movies and even paperback novels. Kutner said, “I worry about worrying too much,” and added that he believes that video and computer games, too, will eventually prove to be less risky than initially feared.

NCRG Conference: Day 2 At-a-Glance

2008-11-17T08:51:00.000-08:00

The 9th annual NCRG Conference on Gambling and Addiction continues today with a full day of sessions. Here’s a quick look at today’s schedule.

Morning Plenary Sessions
8:15 - 9:30 a.m. – Grand Theft Childhood: What Are the Health Risks of Video Gaming?
Moderator:
Howard J. Shaffer, Ph.D. C.A.S., Associate Professor of Psychology in Psychiatry, Harvard Medical School
Speaker:
Lawrence Kutner, Ph.D., Co-Director, The Harvard Center for Mental Health and Media
Location:
South Seas Ballroom B

10 - 11:15 a.m. – Inside the Virtual Casino: The Betting Patterns of Online Gamblers
Moderator:
Sarah E. Nelson, Ph.D., Instructor in Psychiatry, Harvard Medical School
Speakers:
Richard A. LaBrie, Ed.D., Instructor in Psychiatry, Harvard Medical School
Debi A. LaPlante, Ph.D., Instructor in Psychiatry, Harvard Medical School
Location:
South Seas Ballroom B

Breakout Sessions – 11:30 a.m. - 12:30 p.m.
High-Tech Solutions for Assessment and Counseling
Moderator:
Lisa Najavits, Ph.D., Professor of Psychiatry, Boston University School of Medicine
Speaker:
Reid K. Hester, Ph.D., Director, Research Division, Behavior Therapy Associates
Location:
South Seas Ballroom B

Gambling Responsibly in Cyberspace
Moderator:
Glenn Christenson, Board Member, NCRG, and Managing Director, Velstand Investments, LLC
Speakers:
Bo Bernhard, Ph.D., Assistant Professor of Sociology, University of Nevada, Las Vegas
Sue Schneider, Founder, Interactive Gaming News
Location:
South Seas Ballroom H

Event
12:30 - 2 p.m. – Networking Luncheon and Poster Award Session
Location:
South Seas Ballroom E

Afternoon Plenary Sessions
2:15 - 3:45 p.m. – Culture Counts: Designing Relevant Interventions and Responsible Gaming Strategies for Asians and Asian-Americans
Moderator:
Kathy Scanlan, Executive Director, Massachusetts Council on Compulsive Gambling
Speakers:
Chien-Chi Huang, M.S., Asian Community Program Specialist, Massachusetts Council on Compulsive Gambling
Nolan Zane, Ph.D., Professor of Psychology and Asian-American Studies, University of California, Davis
Location:
South Seas Ballroom B

4 - 5:30 p.m. – Seeking a Treatment Standard for Gambling Disorders: Are We There Yet?
Moderator:
Harold Wynne, Ph.D., President, Wynne Resources
Speakers:
Lisa Najavits, Ph.D., Professor of Psychiatry, Boston University School of Medicine
Peter Nathan, Ph.D., Professor Emeritus of Community and Behavioral Health, University of Iowa
Location:
South Seas Ballroom B

Discussing the Benefits and Challenges of Gambling Self-Exclusion Programs

2008-11-16T19:33:00.000-08:00

Sarah E. Nelson, Ph.D., instructor in psychiatry at Harvard Medical School, kicked off an insightful breakout session about gambling self-exclusion programs with a whimsical story excerpted from “Frog and Toad Together,” a book she often reads to her daughter. Nelson told the tale of two friends who rely on their power of will – sometimes unsuccessfully – to stop eating cookies. Nelson said that the story illustrated how unique and challenging gambling self-exclusion programs can be.

Nelson then reviewed the findings from a recent study on the efficacy of the Missouri Voluntary Exclusion Program conducted by the Division on Addictions at the Cambridge Health Alliance. The study, she said, confirmed that the program was largely a success. It found that the majority of gamblers who recently joined the program reported gambling less now. However, this outcome, the study found, was not solely attributable to self-administered casino bans. Many self-excluders also reported enrolling in disordered gambling treatment programs and making other efforts to become healthy.

Nelson also noted that the study identified several vulnerabilities in the Missouri Voluntary Exclusion Program, which could potentially inform the development of similar state-administered programs. For example, she said, “if enforcement is a priority, more stringent measures need to be in place” to prevent self-excluders from entering casinos. Many program participants reported being able to enter a casino without penalty after signing the self-exclusion agreement. Nelson added that program administrators should keep better records of program participants to facilitate research and increase program enforcement.

Nelson then turned the session over to Richard A. LaBrie, Ed.D., instructor in psychiatry at Harvard Medical School, to discuss other key findings from the study. LaBrie discussed how the study identified what appeared to be a sort of adaptation effect. He said that program enrollment, like the illness, demonstrated rapid acceleration in its early stages, but that it leveled off with time. He also discussed how, using simple math, the number of self-excluders can roughly determine the number of pathological gamblers in a given location.

Nelson, LaBrie and Jennifer Shatley, vice president of responsible gaming programs and compliance at Harrah’s Entertainment, Inc., then took questions from the audience. An engaging dialogue about the challenges of implementing and measuring the success of gambling self-exclusion programs followed. LaBrie discussed the long-term efficacy of the programs, wondering, “if you shelter someone from gambling-related harms, do you give them strength to resist them long-term?” The panelists also discussed how difficult it is to ensure that self-exclusion programs are enforced in different states.

Scientific Achievement Award Presentation

2008-11-16T19:05:00.000-08:00

Dr. Marc Potenza, associate professor of psychiatry and director of the problem gambling clinic at Yale University, was named as the recipient of the 2008 NCRG Scientific Achievement Award today in the senior investigator category. Potenza is the first person to receive NCRG Scientific Achievement Awards in both the Young Investigator (2003) and Senior Investigator categories.

The award was presented by Dr. Peter Nathan, professor emeritus of community and behavioral health at the University of Iowa. The senior investigator award honors scientists whose career work has led to important advancements, discoveries or developments in the field of gambling-related research.

Potenza, who was selected by an independent awards committee, has made contributions to the study of gambling disorders in the areas of population studies, genetics, treatment outcome research and neuroscience. Among the many milestones of his career is his completion of the first two brain imaging studies conducted in this field.

Potenza’s initial groundbreaking brain imaging studies involving subjects with pathological gambling, published in 2003, showed differences in the brain activity of pathological gamblers compared with control subjects and laid the groundwork for future investigations of the neurobiological elements of pathological gambling. Potenza since has conducted research using brain imaging in clinical trials to help identify brain characteristics that may be able to predict whether or not a particular drug treatment will be successful for the patient. His current research also includes a brain-imaging study that has found similarities in the brain activity of pathological gamblers when they experience gambling urges to the brain activity of people with cocaine dependence when they experience cocaine cravings.

Potenza has conducted significant investigations into a biological basis for pathological gambling. This research has included a study into the relationship between pathological gambling and major depression in men, which has helped the scientific community to better identify the genetic and environmental factors that contribute to pathological gambling. In his roles as director of the Women and Addictive Disorders Core, Women’s Health Research at Yale and director of neuroimaging at the Mental Illness Research, Education and Clinical Center (MIRECC) in West Haven, Conn., Potenza has conducted a substantial amount of research into the differences between men and women with pathological gambling, as well as pathological gambling in the context of co-occurring disorders.

Potenza is internationally recognized for his research into drug treatments for pathological gambling and has investigated a series of possible drug therapy treatments, a subject he addressed in today’s conference session, Working with Clients on Medication Management for Gambling and Alcohol Use Disorders.

In addition to his research, Potenza regularly treats individuals with gambling problems and serves as an editorial board member for a number of peer-reviewed scientific journals including the Journal of Addiction Medicine and The American Journal on Addictions. He has authored more than 100 research and theoretical articles and has contributed to more than 40 books. Potenza earned his M.D. at Yale University School of Medicine and his Ph.D. in cell biology at Yale University.

Government Support for Addressing Gambling Disorders: Practice and Pitfalls

2008-11-16T18:46:00.000-08:00

In this afternoon’s session on government support for addressing gambling disorders, attendees heard from representatives from Indiana, California and Nevada. While each state faces different challenges based on resources, and the geographic location and type of gaming facilities, there was unanimous consent among the panelists that perhaps the most significant challenge they face is a lack of properly trained and certified treatment providers.

Mike Smith, executive director of the Casino Association of Indiana, described how the state has recognized the clear need to build an infrastructure for treatment. According to Smith, this means both making sure there are treatment providers who have the proper training and certification, but also that these providers are located throughout the state so that individuals with gambling problems don’t have to travel a considerable distance to get help. Indiana also has used tax dollars collected from the state’s casinos to conduct research on disordered gambling, which is due out early next year. In addition, Smith mentioned that, due to the fact that Indiana’s casinos are located close to the state’s borders, the state is attempting to work with its neighboring states – Illinois and Kentucky – to find a way to help problem gamblers from these states who gamble in Indiana have access to the help they need.

Jodi Tyson, M.P.H., a social service program specialist in the Nevada Department of Health and Human Service’s Grants Management Unit, discussed Nevada’s Problem Gambling Revolving Account, which was established by state legislation in 2005. The Revolving Account, which is funded through a tax of approximately $2 on each slot machine in the state, is used to fund prevention, treatment, research and workforce development initiatives throughout the state. Tyson pointed out that treatment always was intended to be the primary focus of the Revolving Account’s funds, with 60 percent of the grant money distributed by the Revolving Account dedicated to treatment initiatives.

Alexandra Vuksich, commissioner of the California Gambling Control Commission, was the final panelist for the session. She explained how the complicated gambling landscape in California – which includes tribal gaming, horse-racing tracks, a lottery and card clubs – has led to unique challenges in addressing problem gambling issues. One example, said Vuksich, is tribal gaming compacts, which represent the state's only opportunity to negotiate regulatory matters with the tribes' sovreign governments. According to Vuksich, California's tribal gaming compacts, the first of which were signed in 1999, have gone from hardly mentioning problem gambling to having much more of a focus on the issue in more recent compacts. She also pointed to the economic challenges the state is facing; California is currently $11.2 billion in debt, which, she said, means the prospect for money coming out of the state’s general fund to support disordered gambling treatment is unlikely.

As a whole, the panel emphasized the fact that state support for addressing problem gambling is evolving. As the body of sound research on disordered gambling continues to grow, and more research is conducted at the state level, it continues to shape the way states address this issue.

Does the Diagnostic Definition of Pathological Gambling Need Revising? Debating DSM-V

2008-11-16T17:33:00.000-08:00

To kick-off the opening plenary session of the 2008 NCRG Conference on Gambling and Addiction, NCRG Board Director Glenn Christenson welcomed nearly 350 attendees from across the globe and introduced this year’s conference theme, The Changing Landscape of Treatment, Responsible Gaming and Public Policy. Christenson took a moment to report the news of the recent passing of Dr. Rena Nora, a leader in the field of pathological gambling research, and dedicated the session – titled Debating DSM-V: Will New Research Change the Diagnosis of Pathological Gambling? – to her memory.

Linda B. Cottler, Ph.D., professor of epidemiology in psychiatry at the Washington University School of Medicine, began the session with a presentation on the history of the DSM – the American Psychiatric Association’s (APA) Diagnostic and Statistical Manual of Mental Disorders – and its evolving definition of pathological gambling. She also discussed how new research developments could again reshape the definition of the disorder in the DSM-V, which will have profound implications for how pathological gambling is diagnosed and treated. The APA has assembled a Workgroup on Substance Use Disorders to prepare for the next installment of the manual, and Cottler encouraged conference attendees to contact the group to “let your voices be known and your concerns be heard.”

Dr. Thomas Widiger, Ph.D., professor of psychology at the University of Kentucky, discussed how the DSM-V would likely shift from the current categorical classifications of mental disorders toward dimensional classifications of mental disorders, which will better capture the range and intensity of problem behaviors attributed to different disorders. He added that there was no gold standard for diagnosing pathological gambling, explaining that DSM’s prototype of the disorder represents the most severe form of the condition. This, he said, can lead to a large number of sub-threshold cases and poor treatment options.

Dr. Howard J. Shaffer, Ph.D. C.A.S. associate professor of psychology in psychiatry at Harvard Medical School, said that one challenge facing clinicians and researchers was that few people understand the term “diagnosis” in the same way. Shaffer said that diagnosis means “understanding people through and through,” and said that the DSM was a tool for accomplishing that goal. He added that he felt “pathological gambling” was a pejorative term and should no longer be used.

A lively question and answer session with members of the audience followed, during which Cottler, Widiger and Shaffer offered their perspectives on dimensional classification, defining addiction, sharing information with others in the field and developing a flexible definition for pathological gambling that applies to a wide range of demographic groups. Shaffer closed the plenary session by saying that “pathological gambling research is still a young field. We have a long way to go, but we have already accomplished a great deal.”

Interview with Linda Cottler of the Washington University School of Medicine

2008-11-16T17:01:00.000-08:00

Click here for the NCRG Blog Team interview with Dr. Linda Cottler, professor of epidemiology in psychiatry at the Washington University School of Medicine, about her NCRG Conference experience. Cottler participated in today’s opening plenary session.

Interview with Howard Shaffer of Harvard Medical School and the Division on Addictions

2008-11-16T16:58:00.000-08:00

Click here for the NCRG Blog Team interview with Dr. Howard Shaffer, associate professor of psychology in the department of psychiatry at Harvard Medical School and director of the Division on Addictions at the Cambridge Health Alliance. Shaffer is one of the co-hosts of the 9th annual NCRG Conference on Gambling and Addiction and participated in today’s opening plenary session.

Interview with Glenn Christenson of the National Center for Responsible Gaming

2008-11-16T13:51:00.000-08:00

Click here for the NCRG Blog Team interview with Glenn Christenson, board member of the National Center for Responsible Gaming and managing director of Velstand Investments, LLC, about his NCRG Conference experience. Christenson gave the opening welcome address today, and tomorrow will be moderating the Gambling Responsibly in Cyberspace panel.

NCRG Conference: Day 1 At-a-Glance

2008-11-16T10:39:00.000-08:00

The 9th annual NCRG Conference on Gambling and Addiction kicks-off today at 1 p.m. Here’s a quick look at the sessions and special events taking place this afternoon.

1 - 1:15 p.m. – Welcome Address
Speaker:
Glenn C. Christenson, Board Member, National Center for Responsible Gaming, and Managing Director, Velstand Investments, LLC
Location:
South Seas Ballroom B

Plenary Session
1:15 - 3:15 p.m. – Debating DSM-V: Will New Research Change the Diagnosis of Pathological Gambling?
Moderator:
Brian McKay, Former Attorney General, State of Nevada
Speakers:
Linda B. Cottler, Ph.D., Professor of Epidemiology in Psychiatry, Washington University School of Medicine
Alan Feldman, Senior Vice President of Public Affairs, MGM MIRAGE
Howard J. Shaffer, Ph.D. C.A.S., Associate Professor of Psychology in Psychiatry, Harvard Medical School
Thomas Widiger, Ph.D., Professor of Psychology, University of Kentucky
Location:
South Seas Ballroom B

Breakout Sessions – 3:30 – 4:45 p.m.
How Addictions Develop and Addicted People Recover: Stages of Change and Addiction Revisited
Moderator:
Ken C. Winters, Ph.D., Professor of Psychiatry, University of Minnesota Medical School
Speaker:
Carlo C. DiClemente, Ph.D., A.B.P.P., Professor of Psychology, University of Maryland, Baltimore County
Location:
South Seas Ballroom B

Government Support for Addressing Gambling Disorders: Practice and Pitfalls
Moderator:
Gary Fisher, Ph.D., Professor, College of Health and Human Sciences, University of Nevada, Reno
Speakers:
Jodi Tyson, M.P.H., Social Services Program Specialist III, Grants Management Unit, Nevada Department of Health and Human Services
Mike Smith, Executive Director, Casino Association of Indiana
Alexandra Vuksich, Commissioner, California Gambling Control Commission
Location:
South Seas Ballroom H

Breakout Sessions – 5 – 6:15 p.m.
Working with Clients on Medication for Addictive and Psychiatric Disorders
Moderator:
Ken C. Winters, Ph.D., Professor of Psychiatry, University of Minnesota Medical School
Speaker:
Marc N. Potenza, M.D., Ph.D., Associate Professor of Psychiatry, Yale University School of Medicine
Location:
South Seas Ballroom B

Evaluating Self-Exclusion Programs: From Theory to Practice
Moderator:
Jennifer Shatley, Vice President, Responsible Gaming Programs and Compliance, Harrah’s Entertainment, Inc.
Speakers:
Richard A. LaBrie, Ed.D., Instructor in Psychiatry, Harvard Medical School
Sarah E. Nelson, Ph.D., Instructor in Psychiatry, Harvard Medical School
Location:
South Seas Ballroom H

6:15 - 7:30 p.m. – Poster Session and 2008 Scientific Achievement Award Presentation Reception
Location:
South Seas Ballroom E

Welcome from your Conference Hosts

2008-10-20T10:45:00.000-07:00

In approximately one month, representatives from the scientific community, health care sector, gaming industry and government will convene in Las Vegas for the 9th annual NCRG Conference on Gambling and Addiction. The theme of this year’s conference – The Changing Landscape of Treatment, Responsible Gaming and Public Policy – reflects the current scientific and societal trends that are influencing gambling research and responsible gaming initiatives.

As you will see from our conference topics, there are a number of important potential changes underway in the field of disordered gambling research. Perhaps nowhere is this more evident than in our opening session this year, which will explore whether new research suggests the need for a revised clinical definition of pathological gambling in the upcoming fifth edition of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM). Leading experts will offer their insights on this and other topics such as the health risks of Internet gambling and video gaming, how technology can improve assessment and counseling, the latest responsible gaming approaches for tribal casinos, and developing culturally relevant responsible gaming programs for Asian populations and Asian Americans. Read more about this year’s conference sessions in our online conference program.

The conference will take place Nov. 16-18 at the Mandalay Bay Hotel and Casino and the Las Vegas Convention Center. Considered the finest event of its kind by participants and observers alike, the conference is sponsored by the National Center for Responsible Gaming (NCRG) and the Institute for Research on Pathological Gambling and Related Disorders, a program of the Division on Addictions at Cambridge Health Alliance, a teaching affiliate of Harvard Medical School.

Leading up to the conference, right here on the NCRG conference blog, you will have the opportunity to read more about some of the research and topics that will be discussed at the event. While the conference is underway, on-site reports will bring you up-to-the-minute details of some of our most exciting sessions and special events. We encourage you to sign up for our RSS feed (select an icon in the Subscribe section of the sidebar) to have blog updates automatically delivered to you.

If you haven’t already done so, please be sure to register for the conference. We hope you can join us for what promises to be an engaging, informative and insightful event. If you are unable to join us in Las Vegas, we look forward to having you visit us here at the conference blog during the coming weeks.

Phil Satre
Chairman, National Center for Responsible Gaming

Howard J. Shaffer, Ph.D., C.A.S.
Associate Professor of Psychology in Psychiatry, Harvard Medical School
Director, Division on Addictions, The Cambridge Health Alliance

Save the Date

2008-03-27T09:33:00.000-07:00

Mark your calendars now for the 9th Annual National Center for Responsible Gaming (NCRG) Conference on Gambling and Addiction. The conference, themed “The Changing Landscape of Treatment, Responsible Gaming and Public Policy,” will be held Nov. 16-18 at the Mandalay Bay Resort & Casino and Las Vegas Convention Center.

The conference program will feature the latest scientific research into new drug treatments for disordered gambling, provide a forum to discuss how responsible gaming programs can be tailored for ethnic minorities, as well as examine how the Internet is changing the face of responsible gaming. The conference will also address the upcoming DSM-V and the possibility of a new clinical definition for pathological gambling. Regular updates on the conference program can be found by visiting www.ncrg.org

What: 9th Annual NCRG Conference, themed “The Changing Landscape of Treatment, Responsible Gaming and Public Policy”

Where: Mandalay Bay Resort & Casino and Las Vegas Convention Center in Las Vegas, Nevada

When: November 16-18, 2008

EMERGE: A New Standard for Responsible Gaming Education for Employees

2007-11-13T14:54:00.000-08:00

The last session of the NCRG conference introduced EMERGE, an interactive responsible gaming training program designed for gaming employees. Kevin Mullally, General Counsel and Director of Government Affairs, Gambling Laboratories Int., moderated the session and Christine Reilly, Executive Director, Institute for Research on Pathological Gambling and Related Disorders, presented the EMERGE program.

EMERGE, which stands for Executive Management and Employee Responsible Gaming Education, is the only employee training program developed by Harvard Medical School faculty and one of the first web-based programs.

Mullally pointed out that it wasn't so long ago when research on problem gambling was practically non-existent and people in the gaming industry knew very little about how to define or even talk about problem gambling. Reilly and Mullally both stressed that EMERGE is an important tool as casino employees and industry members strive to protect and promote the health and safety of their customers. Reilly explained that the American Gaming Association's (AGA) Code of Conduct requires member casinos to educate employees and make information available on problem gambling.

Reilly explained that through EMERGE, employees learn how and why people become addicted, the nature and prevalence of gambling disorders, what constitutes responsible gaming and how to respond to requests for information on these issues. She stressed that employees are not trained to approach customers and should not do so even if they think a customer has a problem. Even trained clinicians have difficulty identifying someone with a gambling problem.

The program can be customized for the participating company to ensure the training reflects their responsible gaming practices and policies. She explained that because EMERGE is interactive and web-based, employees can move at their own pace. The program is available online 24/7, so companies can train a large number of employees and it automatically tracks employee participation and quiz results, sending them back to company management.

Reilly gave a demonstration of the EMERGE program, which uses audio, video, photos and graphics to accompany the text. At the end of each "chapter", the employee takes a quiz on what he or she has just learned. Since casino employees may be at higher risk for gambling problems, EMERGE is also a way to educate the employee and let them know where to seek help if the program raises questions about their own behavior or that of a family or friend.

Words into Action: Responsible Gaming and its Impact on the Casino Floor

2007-11-13T10:44:00.000-08:00

Glenn Christenson, chairman of the Nevada Governor’s Problem Gambling Advisory Committee, opened today’s session by asserting that problem gambling is one of the most important issues facing the gaming entertainment industry, but that with that challenge comes the opportunity to be proactive in educating employees and patrons about responsible gaming.

Bill Bingham, vice president of table games at Bellagio Hotel and Casino, began the discussion with a brief overview of the evolution of the response to problem gambling in the state of Nevada. According the Bingham, As late as 1994, the industry in Nevada, with the exception of one or two forward-thinking companies, weren’t doing anything in the realm of responsible gaming. There was no signage or employee training, and at the same time, the issue wasn’t a big one in the public eye, so there was no media pressure to focus on the issue.

In 1995, with the formation of the Nevada Council on Problem Gambling, gaming companies began to post signage and provide collateral material to employees and patrons that included information on how to get help for a gambling problem. These actions were taken before there were specific regulatory requirements to do so. The American Gaming Association then created the AGA Code of Conduct, which pulled together national best practices for responsible gaming and other responsible operating practices. According to Bingham, the AGA Code of Conduct meets or exceeds all state regulatory requirements.

Michael Tunney, regional learning and development manager for Boyd Gaming Corporation, explained the practices Boyd Gaming Corporation has put in place. One of the important challenges Boyd faced, said Tunney, is the fact that the company operates properties in several states throughout the U.S. This means that the regulatory requirements for responsible gaming practices can differ greatly, making it hard to create a standard training program for employees.

Tunney explained that Boyd met this challenge by taking the best practices from all its different jurisdictions and regulatory environments and combining them into one program that is used at all their properties throughout the country. The only exception, he said, is self-exclusion programs, which differ from state to state because they are very complicated to put into place, and in states where regulators are not involved in helping run the program, it is incredibly difficult for a company to run these types of programs on its own.

Tunney said that Boyd includes responsible gaming training as part of its orientation package, and now is examining the possibility of a staged training process, in which employees will receive additional training as they move up the ladder and take positions with greater responsibility within the company.

In his presentation, Dr. Robert Ladouceur, professor of psychology at Laval University in Quebec, asserted that interventions need to be focused on excessive gambling habits – spending too much time and money gambling – pointing out that what constitutes an excessive gambling habit will be different for different people. Ladouceur went on to recommend setting up policies and practices that will prevent problem gambling.

In creating these programs, said Ladouceur, it is important to keep in mind two basic principles: (1) the final decision to gamble belongs to the individual, and (2) the decision to gamble must be based on informed choice. He emphasized that the gaming industry’s role is to help inform the individual’s choice. He also stressed that casinos should avoid using intrusive or imposed measures because these approached may actually produce a negative effect, increasing the problem. He added, “These employees are not doctors or therapists,” saying they should be trained to educate patrons, but they are not trained to provide professional counseling. He said he sees future research exploring the line defining the casinos’ realm of responsibility.

Ladouceur went on to discuss findings from a few studies showing that employee training can help employees be more informed about responsible gaming, but suggesting that refresher courses may be needed at more frequent intervals to ensure long-term retention. In addition, he spoke to the attendees about the importance of evaluation, saying “Don’t spend any money on these programs if you don’t intend to evaluate, because if you can’t tell if it’s being effective, you’re part of the problem.”

For gaming companies looking for a scientific evaluation of their programs, Ladouceur recommended the following requirements: the scientist must be competent and have good credibility; the scientist also should be able to work well with various groups of people; the scientist should having different if not conflicting interests; the scientist must be objective; and the scientist must not have an anti-gambling bias.

From the scientist’s perspective, the company seeking an evaluation: must show a real commitment in responsible gaming; provide access to its data relevant to responsible gaming; be ready to modify some of its practices according to the results obtained by the study; and provide long-term funding support, meaning that research and evaluation take time and the company has to be willing to commit the resources to ensure a thorough and meaningful evaluation.

Interview with Glenn Christenson of the Nevada Governor’s Problem Gambling Advisory Committee

2007-11-13T09:28:00.000-08:00

Click here for the NCRG Blog Team interview with Glenn Christenson, chairman of the Nevada Governor’s Problem Gambling Advisory Committee and managing director of Velstand Investments, LLC, about his NCRG Conference experience. Christenson moderated one of today’s sessions, Words Into Action: Responsible Gaming and its Impact on the Casino Floor.

Reflections on 50 Years of Gamblers Anonymous

2007-11-12T19:06:00.000-08:00

In commemoration of the 50th anniversary of the founding of Gamblers Anonymous, a three-member plenary panel shared their personal experiences with the GA Twelve-Step Program and reflected on the place of GA in today’s efforts to promote recovery from gambling addiction.

One of the panelists, Ed Talbott, with Ad Care Hospital, recounted his story of how gambling slowly took control of his life. Now 30 years in recovery, he started gambling at age 17. He went to the racetrack and won. A seed was planted, he said. The gambling took off once he married and had a family. He began working at a Greyhound race track, and ended up losing everything, including, he said, his self respect, family relationships, job and thousands of dollars. When he finally went to his first GA meeting, he decided to keep attending and it helped transform his life.

Ed said he has seen some changes at GA over the years, for example, the types of gambling problems have expanded. In his day, the race track was popular. He sees people with problems now relating to the internet, lottery, casino and sports gambling. He said that GA has kept pace with these different types of gambling and also seems more open to recommending professional help for attendees if needed beyond GA.

Brenda Rose, another panelist, spoke about her multiple addictions over the years to drugs, alcohol and later gambling. After losing everything, the GA Twelve-Step Program helped her and “let her live again.” She said she still goes to the meetings and is learning to live one day at a time.

Dr. Rena Nora, who is the medical director of the Intensive Outpatient Program for Problem Gamblers at the VA Southern Nevada Healthcare System, has worked in this area for 28 years. She initially started a program in Atlantic City for compulsive gamblers and now is in Nevada. Dr. Nora said she never was trained formally in treating problem gamblers – her training was through attending meetings of GA over an intense three-month period. Her relationship with GA has been positive over the years. They work cooperatively, with GA even referring people to her for counseling and other needs. GA is also a good resource to find volunteer subjects for her research work. Dr. Nora concluded her presentation by saying that although there is no vaccine for problem gambling, they can find ways to manage the illness.

Founded in 1957, GA is based on the Twelve-Step Program of Alcoholics Anonymous.

Challenging One-Size Fits All: Traditional and Contemporary Medicine as Partners in Healing Addictions in Native Communities

2007-11-12T18:51:00.000-08:00

Dr. Dale Walker, a psychiatrist and member of the Cherokee tribe, spoke today about ways to prevent and treat addiction in native communities. Walker is the director of the One Sky Center, an organization focused on promoting effective and culturally appropriate prevention and treatment in American Indian and Native Alaskan communities.

Walker said the best practice for gambling prevention and treatment within native communities is to combine evidence-based knowledge with indigenous knowledge, through what he called integrative medicine. He explained that integrative medicine combines the best aspects of traditional and conventional medicine by focusing on patient-centered care that combines science and evidence-based medicine with cultural sensitivity and an understanding of wellness and the power of the mind. He went on to say that this model would be the best approach for any group bound by ethnic, religious or geographic similarities.

Walker said the principles of integrative medicine state that is better to prevent than to treat later. He explained that because people are unique, treatments must be customized. Walker pointed out that important tenets of integrated medicine include recognizing the interaction between the body, mind and spirit, and the belief in the innate healing power of the body.

Walker said native casinos are an important part of life on the reservation, regardless of whether they yield revenues, because it is the gathering place and a central part of community life, as well as a place for interaction with those living outside of the reservation.

He also pointed to a World Health Organization study that found that alcohol use was the fourth leading cause of disability around the world. Walker went on to say that the native population has six times the rate of alcoholism than the population at large. Walker explained that treatment of both addiction and other health problems faces difficulties in native communities due to lack of access to health care and information about health care. He further explained the health care system available to natives is highly fragmented, with coverage gaps, a lack of resources, and clashing ideologies about medical training and treatment between traditional and conventional medical practitioners.

Are Gambling Behaviors Stable or Shifting Over Time?

2007-11-12T18:40:00.000-08:00

According to DSM-IV, pathological gambling is defined as “persistent and recurring maladaptive gambling behavior,” and is widely considered to have a progressive course. Both Dr. LaPlante and Dr. Nelson presented recent empirical work that challengea this conventional wisdom.

Debi LaPlante, Ph.D., instructor of psychology in psychiatry at Harvard Medical School, addressed population-level stability, especially the effect of exposure, and individual-level stability in relation to persistence, selective-stability and progression.

With regard to population-level stability, the typical public health infection curve can be used as an analogy to understand the long-term consequences of exposure to gambling. The infection curve shows a high increase shortly after exposure, followed by a decline over time due to adaptation and resistance. This model receives general empirical support, and is supported by data from a recent study of online gambling behavior (bwin) showing that new subscribers show a rapid adaptation in their gambling activities. Data from bwin also suggests that a small segment of the new subscribers were heavily involved in gambling and adapted slower or not at all to the new exposure. The effects of exposure seem to differ in relation to individuals, regions, time points, and the initial effect of exposure declines over time.

With regard to individual-level stability, analyses on data from four former studies conducted by Winters et al., Abbott et al., Shaffer & Hall, and DeFuentes et al. indicate that the common wisdom that gambling is a persistent disorder is false – pathological gamblers do actually improve more than expected. The data show that high severity gamblers and low severity gamblers are equally likely to improve, and do not support the assumption about selective stability. Finally the data show that the progression or worsening of gambling symptoms is less common than expected.

LaPlante also emphasized the importance of recognizing the people who do not improve or recover from gambling symptoms, who do not adapt to new exposure, and who jump addictions. In addition, though people do not meet the diagnostic criteria for pathological gambling they can still experience problems.

Sarah Nelson, Ph.D., instructor of psychology in psychiatry at Harvard Medical School, presented data on individual stability across time, especially with focus on the fluctuations in the number of symptoms endorsed and the symptom profile.

According to DSM-IV a diagnosis of pathological gambling is given when a patient endorses five of the ten symptoms of pathological gambling. Even though the number of symptoms is crucial for a diagnosis, differences in symptom profile can make a huge clinical difference.

Research has found that the most reported symptoms are chasing, escape and preoccupation. Women are more likely than men to report “gambling to escape from problems.” “Risked relationships because of gambling” and “committing illegal acts to finance gambling” are the least reported symptoms, and are only reported by the most severe gamblers.

Analysis of the NESARC data – a national telephone survey – showed high fluctuations of the number of symptoms endorsed prior to the past year compared to the past year, high fluctuations in the specific symptoms endorsed prior to the past year compared to the past year, that stability decreases with the severity of gambling, that the most stable symptoms are escape and preoccupation, and that escape reported prior to past year is the best predictor of past year pathological gambling.

Nelson emphasized the importance of repeated assessment of gambling symptoms and the need for longitudinal studies of pathological gamblers. Though the overall gambling prevalence is relatively stable, this does not mean that individuals who meet the diagnosis are the same across time. According to Nelson, there seem to be great fluctuations in the number of symptoms and the specific symptoms over time.

CAUTION: Warning Messages Work – Don’t They?

2007-11-12T18:00:00.000-08:00

Today’s session on warning messages combined lessons learned from tobacco research with findings from preliminary gambling-focused studies. Douglas A. Luke, Ph.D., professor of community health at Saint Luis University School of Public Health, and director of the Center for Tobacco Policy Research, began the discussion by presenting a history of warning labels, which began in 1957 when the first legislation requiring cigarette packs to carry a warning label was introduced in the U.S. Congress.

Luke emphasized the fact that cigarette warning labels in the United States are hard to see – whether on cigarette packages or in advertisements. He contrasted U.S. labels against those from other countries, particularly Canada, where the labels are more dynamic, colorful and direct. He also referred to pending legislation expanding FDA regulation over warning labels that calls for warning messages that are more direct.

According to Luke, research shows that the warning labels that are most effective are prominent (in size, graphics/color and contrast), novel – using a new idea or message, “graphic” – using images to get the point across, comprehensive and relevant. Recent research also has documented that effective warning labels can lead to greater knowledge about the risks of smoking, greater negative affect towards smoking cues, reduced attractiveness of smoker images, reduced attractiveness of cigarette packaging, increased attention to quit and increased actual quit rates.

Luke pointed out that while the tobacco research can be informative for problem gambling stakeholders, the end goal of tobacco warning labels is much different from those that might be used in gambling. Since even one cigarette can have an adverse health consequence, the ultimate goal is to get people to quit smoking or never to start, said Luke. But with gambling, he said, it is an activity that can be enjoyed responsibly by the majority of the population, so the goal is safe use, not abstinence.

James Whelan, Ph.D., associate professor of psychology at The University of Memphis, gave attendees an overview of a few studies conducted with gambling warning labels. He began by pointing out characteristics that need to be in place to show that a warning label ahs had an effect. These characteristics include message integrity (i.e. is it a good, relevant message?), delivery (is the message delivered in a way that it can be acquired by the intended recipient?), and reception (has the message been actively received?).

According to Whelan, message integrity is important because people believe they have control over the situation and consider luck to be internal and/or predictable, a phenomenon he referred to as “magical thinking.” This “magical thinking” is important to understand and consider in the development of effective warning messages, said Whelan.

Overall, the research has shown that warning messages can be delivered with integrity and they can influence thoughts and behaviors. Whelan spoke about the fact that, with the video technology used on slot machines, warning messages for gambling have the ability to be more creative, more visually engaging and more interactive than the static tobacco warning labels are.

Through the research, said Whelan, investigators have determined that, to be effectively received, warning messages should be memorable, be short and worded for audience, be interactive (e.g. the gambler would have to touch the message on the screen to make it close), reduce the effort needed to comply, and embedded in an educational effort

To access Whelan’s 2006 study, Use of warning messages to modify gambling beliefs and behavior in a laboratory investigation, click here, or visit the Institute for Research on Pathological Gambling and Related Disorders’ NCRG Conference Resource Page. When prompted, please enter the case-sensitive password: institute.

Gambling and Co-occurring Disorders: Landmark Research from the National Comorbidity Survey

2007-11-12T16:51:00.001-08:00

The author of more than 500 journal articles, book chapters and other reports on mental health, Dr. Ronald Kessler today presented findings from the National Comorbidity Survey Replication (NCS-R), a landmark stud of mental health in the United States that included questions about gambling behaviors for the first time in the 2001-2003 version.

The NCS-R was designed to examine a nationally representative household sample of English-speaking adults (18-years-old and older). The data was collected from February 2001 through April 2003 from households in the continental United States. The survey also used a multistage cluster area probability sampling design, which means it didn’t take samples from places such as New York City, where it would be difficult to find a nationally representative sample.

The sampling design identified 10,843 pre-designated respondents from 177 counties in 34 states. Out of this group, Kessler and his colleagues running the survey were able to secure 9,282 completed interviews, which equates to a 70.9 percent “response” rate. The fieldwork for this survey included the work of more than 300 national, NCS-R certified interviewers from the Survey Research Center (SRC) University of Michigan and 18 SRC regional supervisors. Interviews were conducted face-to-face using a laptop computer-assisted technique, and the average interview lasted 2.5 hours. The data collected was weighted to mirror the U.S. population.

One of the interesting findings from the survey is that 46.4 percent of the respondents had a mental disorder at some point in their lives, as defined by the DSM-IV and WHO Composite International Diagnostic Interview. Kessler pointed out that while this finding may seem surprising, it makes sense given the fact that 99.9 percent of the population has experienced a physical disorder during their life, giving the example of a hangnail.

The survey findings also put the lifetime prevalence estimate of DSM-IV pathological gambling at 0.7 percent. Kessler pointed out that this number actually was lowered to 0.5 percent once respondents with bipolar I and bipolar II were excluded from the sample (according to the diagnostic code, people suffering from bipolar I and II cannot be diagnosed with pathological gambling as problem gambling behavior is considered a symptom of the bipolar disorder).

In addition, the survey was able to identify significant predictors of pathological gamblers. According to Kessler, pathological gamblers are more likely to be young (18-44), male, non-hispanic black, and have less than a college education.

Data from the survey shows several other patterns with relation to pathological gambling, including the prevalence of co-occuring disorders and how many pathological gamblers recover form the disorder. Kessler and his colleagues have made the data publicly available to encourage further, more detailed studies by researchers all over the world. The data can be found at www.hcp.harvard.edu/ncs.

Interview with Douglas Luke of the Saint Louis University School of Public Health

2007-11-12T16:06:00.000-08:00

Click here for the NCRG Blog Team interview with Douglas Luke, Ph.D., professor of community health at the Saint Louis University School of Public Health and director of the Center for Tobacco Policy Research, about his NCRG Conference experience. Luke presented in one of today’s sessions, CAUTION: Warning Messages Work – Don’t They?

Outstanding Poster Award Presentation

2007-11-12T14:55:00.000-08:00

Dr. Richard LaBrie of Harvard Medical School's Psychiatry Department presented this year's Outstanding Poster Award to the University of Sydney's Alex Blaszczynski and Sally Monaghan for their study entitled Pop-up Messages on Electronic Gaming Machines: Effect on Gambling-Related Thoughts and Behavior. Blaszczynski is a professor of Clinical Psychology and Monaghan is a DCP/Ph.D. student at the University of Sydney's School of Psychology. Their study found that pop-up messages on electronic gaming machines have more impact on thoughts and behaviors during play than more static messages that occurred after the session had ended.

This year 27 groups submitted posters with empirical research, 17 of which were from countries outside the United States.

Interview with Phil Satre of the National Center for Responsible Gaming

2007-11-12T13:09:00.000-08:00

Click here for the NCRG Blog Team interview with Phil Satre, chairman of the National Center for Responsible Gaming, and retired chairman and CEO of Harrah’s Entertainment, Inc. Satre is one of the co-hosts of the 8th annual NCRG Conference on Gambling and Addiction.

Interview with Rani Desai of the Yale School of Medicine

2007-11-12T12:56:00.000-08:00

Click here for the NCRG Blog Team interview with Rani Desai, Ph.D., associate professor of psychiatry and epidemiology at Yale School of Medicine, about her NCRG Conference experience. Desai presented in one of today’s sessions, Are Older Adults Who Gamble Really at a Higher Risk? Click here for our blog coverage of the session.

Are Older Adults Who Gamble Really at a Higher Risk?

2007-11-12T12:07:00.000-08:00

Dr. Rani Desai of Yale's School of Medicine presented a study today that examined older adults and gambling. Given that older adults are one of the fastest growing demographic segments of the population, she said it is important to understand the risk factors and health correlates for recreational gamblers.

Desai explained that gambling has both positive and negative effects for older adults. She pointed out that some gambling provides opportunities for socialization, and sensory and cognitive stimulation. In her study she found residential and assisted-care facilities use gambling activities as part of their programming and report that bingo and other gambling activities are the biggest social activities at the homes.

Desai pointed out that older adults do have some unique risk factors related to their age. She found they have a preference for slot machines, which she notes may be more addictive than other kinds of casino games. She also pointed out that older adults are vulnerable because they cannot recoup losses as they are no longer working and because they are more at-risk for decreased cognitive function and dementia that could lead to poor decision making.

But overall, Desai said she found that older gamblers were, in fact, healthier. They rate their own physical health as significantly better than older non-gamblers and do not have the increased risk of drug and alcohol abuse that younger gamblers do. In light of these findings, Desai posed the question: Does this mean gambling is good for you? She said, Maybe. She explains that healthy aging literature has shown that older adults who remain socially and physically active do live longer and gambling activities can provide an opportunity for these kinds of activities. She goes on to note that as a scientist, she must also consider that older adults who gamble may already be healthier than their non-gambling counterparts, as they are well enough to go out and participate in gambling activities.

Joni Vander Bilt of the University of Pittsburgh also presented a study on older adults and gambling with similarly interesting findings. She said that the older gamblers tended to be male and less educated than non-gamblers, but she said they also have greater social support systems, tend to be less depressed, and have better health and higher cognitive function than their non-gambling counterparts.

To access Desai's full study, click here. For more information, visit the NCRG Conference Resource Page.

Where is Public Health Policy on Gambling Headed?

2007-11-12T11:23:00.000-08:00

This question drew a large crowd to this morning’s first plenary, where moderator Don Feeney, research and planning director of the Minnesota State Lottery, kicked off the discussion by saying that historically, public health policy tends to treat problem gambling as “someone else’s problem.” And as “someone else’s problem,” the issue becomes conveniently invisible.

Feeney, with more than 20 years of experience working with public and elected officials at the state level, went on to say that, to the extent problem gambling hasn’t been invisible in state-level public policy, the policy isn’t based on science – it is based on guilt. To these states, he said, the important matter is that something has been done, but what that something is doesn’t necessarily matter.

According to Feeney, elected officials are very good barometers of their constituencies and, therefore, one of the challenges problem gambling policy faces is that the conventional wisdom that exists within the public is also evident in the officials. To the public, a problem gambler is “that guy next door” who visits the casino frequently and is irresponsible with his money. People still view problem gambling as a moral problem and consider it to be different from chemical addictions. This conventional wisdom trivializes the issue, said Feeney, and therefore diminishes the need for a public response in the eyes of the public and elected officials.

“There is a lot of work to be done to overcome conventional wisdom,” said Feeney, “Which is a tremendous barrier to effective public policy.”

Feeney went on to say that stakeholders in the prevention and treatment of problem gambling need to make elected officials understand what it is. He emphasized the need for those who work in the field of problem gambling to develop advocacy skills, saying “We need to know how to effectively work with our elected officials. These are not skills you are born knowing, they can be learned. Knowing who to talk to, what their key issues are, and finding a champion.”

Feeney pointed out that one champion in a legislature of a few hundred can be a powerful tool. “We need to find those champions and advocates, work with them, and try our best to educate the others.”

With that, Feeney introduced Dr. Westley Clark, director of the Center for Substance Abuse Treatment at the Substance Abuse and Mental Health Services Administration (SAMHSA). Dr. Clark presented on the federal government’s response to problem gambling, which has been minimal because it was determined in 1999 by the congressional National Gambling Impact Study Commission that problem gambling is a state responsibility. Clark said SAMHSA has almost exclusively deferred to states and nonprofit organizations when it comes to problem gambling.

Forty-eight of the 50 states in the U.S. receive proceeds from some type of gambling. Clark pointed out this conflict of interest a one challenge facing the development of effective public health policy on pathological gambling. He also pointed to the “perceived need for treatment by those who are affected by the condition” as a major problem for those concerned about problem or pathological gambling.

Clark cited research showing that problem gambling is more common among people with alcohol use disorders than it is among those without such disorders. Due to this and the high rate of other co-occurring disorders, Clark pointed out that SAMHSA is faced with a dilemma about whether or not to get involved as the organization currently does not address gambling problems.

In addition, he emphasized that there currently is no public health paradigm for problem gambling, and encouraged those in the audience interested in the issue to pursue and encourage that goal. He concluded his presentation by providing recommendations for the development of state-level public health policy, which are: assume a neutral stance, recognize the state’s ethical responsibility, work with the gaming industry, learn from other states and be flexible in the planning.

To open his presentation, Gary Fisher, professor in the College of Health and Human Services at the University of Nevada, Reno, reminded the audience that there will be natural conflicts between industries that produce products that can cause harm and the people who are seeking to prevent or treat that harm.

He pointed out a disconnect in the substance abuse field with regard to the size of the problem and the size of the solution. For example, though alcohol abuse results in double the economic costs of drug abuse, said Fisher, government funding doesn’t reflect this as the National Institute for Alcohol Abuse receives less than half the funding of the National Institute for Drug Abuse.

He also pointed to the stigma surrounding addiction – addicts are perceived as weak-willed, and the public perceives that treatment doesn’t work because they see movie stars, athletes, politicians, and their friends and family continually bouncing in and out of treatment programs.

Fisher said alcohol policy is the best place for guidance because it is very comparable to gambling due to the fact that it is legal and can be used safely. Alcohol policies include environmental strategies, such as limiting the locations where it can be sold and the days on which it can be sold. According to Fisher, these types of strategies might also work for casinos.

He emphasized the need for a commitment to treatment, competing marketing campaigns and the need to find common ground where industry, government, nonprofit and all other stakeholders can come together. In addition, he stressed the importance of states taking action, saying that “you can’t count on the federal government” to take the lead.

Interview with Howard Shaffer of Harvard Medical School and the Division on Addictions

2007-11-12T10:07:00.000-08:00

Click here for the NCRG Blog Team interview with Howard Shaffer, associate professor of psychology in the department of psychiatry at Harvard Medical School and director of the Division on Addictions at the Cambridge Health Alliance. Shaffer is one of the co-hosts of the 8th annual NCRG Conference on Gambling and Addiction, and on Sunday was presented with the NCRG Scientific Achievement Award in the category of senior investigator.

NCRG Conference: Day 2 At-a-Glance

2007-11-12T08:21:00.000-08:00

The 8th annual NCRG Conference on Gambling and Addiction continues today with a full day of sessions. Here’s a quick look at the sessions and special events taking place today.

Plenary Sessions:
8:30 – 9:45 a.m. – Where is Public Health Policy on Gambling Headed?
Moderator:
Don Feeney, Research and Planning Director, Minnesota State Lottery
Presenters:
H. Westley Clark, Ph.D., J.D., M.P.H., C.A.S., F.A.S.A.M., Director, Center for Substance Abuse Treatment, Substance Abuse and Mental Health Services Administration
Alexandra Vuksich, Commissioner, California Gambling Control Commission
Gary L. Fisher, Ph.D., Professor, College of Health and Human Sciences, University of Nevada, Reno
Location:
Champagne 1/2

9:45 – 11 a.m. – Are Older Adults Who Gamble Really at a Higher Risk?
Moderator:
Sarah E. Nelson, Ph.D., Instructor of Psychology in Psychiatry, Harvard Medical School
Presenters:
Joni Vander Bilt, M.P.H., Senior Researcher, University of Pittsburgh and Western Psychiatric Institute & Clinic
Rani Desai, Ph.D., Associate Professor of Psychiatry and Epidemiology, Yale School of Medicine
Location:
Champagne 1/2

11:30 a.m. – 12:30 p.m. – Gambling and Co-occurring Disorders: Landmark Research from the National Comorbidity Survey
Moderator:
Howard J. Shaffer, Ph.D., C.A.S., Associate Professor of Psychology in the Department of Psychiatry, Harvard Medical School, and Director, Division on Addictions, Cambridge Health Alliance
Presenter:
Ronald Kessler, Ph.D., Professor of Health Care Policy, Harvard Medical School
Location:
Champagne 1/2

4:45 – 5:45 p.m. – Reflections on 50 Years of Gamblers Anonymous
Moderator:
Kathy Scanlan, Executive Director, Massachusetts Council on Compulsive Gambling
Presenters:
Rena Nora, M.D., Medical Director, Intensive Outpatient Program for Problem Gamblers, VA Southern Nevada Healthcare System
Ed Talbott, Community Service Representative, Ad Care Hospital
Location:
Champagne 1/2

Track A: Scientific and Clinical
2 – 3:15 p.m. – Are Gambling Behaviors Stable or Shifting Over Time?
Moderator:
Richard LaBrie, Ed.D., Instructor in the Department of Psychiatry, Harvard Medical School, and Associate Director for Research and Data Analysis, Division on Addictions, Cambridge Health Alliance
Presenters:
Debi A. LaPlante, Instructor of Psychology in Psychiatry, Harvard Medical School
Sarah E. Nelson, Ph.D., Instructor of Psychology in Psychiatry, Harvard Medical School
Location:
Champagne 1/2

3:45 – 4:45 p.m. – Challenging One-Size Fits All: Traditional and Contemporary Medicine as Partners in Healing Addiction in Native Communities
Moderator:
Peter Nathan, Ph.D., University of Iowa Foundation Professor Emeritus of Psychology and Public Health
Presenter:
R. Dale Walker, M.D., Professor of Psychiatry and Public Health and Preventative Medicine, Oregon Health and Science University, and Director, One Sky National Resource Center for American Indian/Alaska Native Substance Abuse Services
Location:
Champagne 1/2

Track B: Government and Industry
2 – 3:15 p.m. – CAUTION: Warning Messages Work – Don’t They?
Moderator:
Connie Jones, Director of Responsible Gaming, International Game Technology
Presenters:
Douglas A. Luke, Ph.D., Associate Professor of Community Health, Saint Louis University School of Public Health, and Director, Center for Tobacco Policy Research
James P. Whelan, Ph.D., Associate Professor of Psychology, The University of Memphis
Location:
Champagne 3/4

3:45 – 4:45 p.m. – On-site Resources in Casinos: Do They Improve the Odds of Safer Gaming?
Moderator:
Jennifer Shatley, Program Vice President of the Code of Conduct, Harrah’s Entertainment, Inc.
Presenters:
Laurie Bell, Director of Prevention Programs, Responsible Gaming Council (Ontario)
Chris Downy, Executive Director, Australian Casino Association
Bev Mehmel, Director of Responsible Gaming, Manitoba Lotteries Corporation
Location:
Champagne 3/4

Special Events
12:30 – 2 p.m. – Poster Award Presentation and Networking Luncheon
Location:
Versailles

Scientific Achievement Award Presentation

2007-11-11T20:26:00.000-08:00

Dr. Howard Shaffer, an early pioneer in the field of addictions and gambling disorders research, was named as the recipient of the 2007 NCRG Scientific Achievement Award today in the senior investigator category.

The award was presented by Dr. Peter Nathan, the University of Iowa Foundation Professor Emeritus of Psychology and Public Health, who called Shaffer a "towering figure in gambling research."

The senior investigator award honors scientists whose career work has led to important advancements, discoveries or developments in the field of gambling-related research. Shaffer, associate professor of psychology in psychiatry at Harvard Medical School and the director of the Division on Addictions, Cambridge Health Alliance, was selected by an independent awards committee in recognition of his groundbreaking research on gambling and for the profound impact it has had on the way that scientists understand and study addiction.

Shaffer’s distinguished career in research has yielded a number of “firsts” that have significantly advanced understanding of disordered gambling behavior. His 1997 meta-analysis of the prevalence rates of gambling disorders in the United States and Canada have been widely recognized as the first reliable estimates of the prevalence rate of the disorder (1 to 1.5 percent).

He also led the first longitudinal study of the health risks of casino employees, the first national survey of gambling behaviors and policies on U.S. college and university campuses, the first study of Internet sports gambling using actual monetary transaction data, and the first model for understanding addiction as a syndrome.

Beyond his many contributions as a scientist, Shaffer has helped create and strengthen the necessary infrastructure for the growing field of gambling research through his work as editor of the Journal of Gambling Studies and Psychology of Addictive Behaviors and his founding of the Institute for Research on Pathological Gambling and Related Disorders, supported by the NCRG. He has written more than 250 chapters, journal articles, and reviews, and published more than 120 newspaper articles and 10 books or monographs.

To see the tribute video for Dr. Shaffer that was shown at the awards presentation, click here.

Innovations in Public Policy: Gambling Court and the Iowa Gambling Treatment Program

2007-11-11T20:01:00.000-08:00

Judge Mark Farrell presented findings and observations today from the Amherst Gambling Treatment Court, which he created in 2001. The court was modeled after drug courts to provide treatment and rehabilitation as an alternative to traditional court systems. Farrell pointed out that most problem gamblers who run afoul of the law tend to commit non-violent crimes, especially identity theft, forged checks, theft from family and employers, and shoplifting to resell the stolen items. Much like the defendants in drug courts, the crimes were committed with the intention of acquiring more money with which to fund their habits.

Farrell said, however, that he has seen an increase in more serious crimes in the last few years, including burglary, felony-level street crime and drug-related crime, which he believes represent an even stronger case for the treatment and rehabilitation of individuals who have or could become a danger to the community if their addiction is left untreated.

Farrell explained that the therapeutic court system, like traditional courts, first arraigns the defendant on formal charges. If the judge refers the defendant for assessment, the defendant is back before the court within one week for an initial assessment. Following that, the defendant undergoes a full screening for pathological gambling within two weeks. Farrell pointed out that in traditional court systems, months pass before the defendant appears in court again. In the therapeutic system, the defendant is immediately evaluated, and enters into a treatment program and starts probation.

Farrell further explained that the most difficult aspect of the gambling court is identifying who is a problem gambler. He explained that the medical field has not yet created a test to prove whether someone has been gambling. He said that in lieu of a definitive test, pathological gambling is diagnosed by meeting several predetermined criteria.

Farrell went on to say that defendants who are non-compliant in the program can face sanctions from a judge, ranging from warnings in open court all the way to termination from the treatment from the program and jail time.

Mark Vander Linden from the Iowa Health Department's Gambling Treatment Center showed how they have also adopted policies that require gaming revenues fund services to treat gambling. He explains that the Health Department's goal is to ensure that the public health community is well-versed in and focused on strategies for treating problem gambling. In Iowa, said Vander Linden, the Health Department is committed to raising public awareness of problem gambling and have set up a help line, 1-800-BETS-OFF. He said that a range of prevention, education and treatment options, as well as a stronger community-based initiative is helping them reach out to at-risk communities.

Find a Responsible Gaming Quarterly article with more information on the Amherst Gambling Treatment Court here.

Can Medication Manage Disordered Gambling Behavior? Newest Trends in Research.

2007-11-11T19:05:00.000-08:00

According to Dr. Jon Grant, associate professor of psychiatry at the University of Minnesota Medical Center, medication can help manage disordered gambling, but there isn’t a “magic pill” that can cure gambling disorders.

Grant pointed out that drug companies haven’t been all that interested in the medication and treatment of gambling addiction – even those companies who are very interested in creating medication to treat substance addiction. His experience has shown that these companies don’t see pathological gambling as a real problem. Grant implied a link between this disinterest and the fact that all medication being tested for use in the treatment of gambling addiction is “off label” as the FDA has not approved any drugs for gambling addiction. The medication used, said Grant, is largely borrowed from what’s already being used for drug addiction.

One overarching theme Grant revisited throughout the session is that not all pathological gamblers are created equal – meaning that people categorized as pathological gamblers are driven by different motivators to participate in gambling behavior, and that there are different types of biology for different types of gamblers. In early pharmacological research on addicted gamblers, Grant explained, all addicted gamblers tended to be lumped into one category. This meant that the effectiveness of medications could be “watered down” simply because the medication being tested may not be treating the right biological factors for everyone in the group.

Grant pointed out that by understanding what goes on in brain, we can understand better how to target it. Over the years, Grant and his colleagues have found that the practice of subtyping pathological gamblers – dividing them into categories based on what drives them to gamble – helps to target medications in a way that can show improved responses to medication. Since it is incredibly difficult and expensive to do genetic testing on every single patient, Grant explained that subtyping can be a “stand in” for biology.

Subtyping looks at a pathological gambler’s family history and comorbitites (i.e. other disorders they may have). Grant presented four subtypes: anxiety-driven gamblers, affective/mood-driven gamblers, impulse-driven gamblers and urges/cravings-driven gamblers.

Particular progress has been made in the area of treating pathological gamblers driven by cravings. Grant and his colleagues recently completed the first study to replicate the results of successful medication treatment for gambling addiction in craving gamblers. The drug they studied was naltrexone, an opiod antagonist that has been approved for more than 20 years for treating alcoholism. Interestingly, Grant pointed to research which shows that pathological gamblers are much more likely to report cravings (60 to 70 percent) than are alcoholics (20 to 30 percent).

Some progress also has been made in other categories. While the studies have been sparse, there has been some evidence showing that gamblers who are anxiety driven may benefit from medication that helps to alleviate that anxiety. For impulse-driven gamblers – those Grant described as people who regularly decide to engage in gambling behavior despite the potential negative consequences – Grant suggested that there may be an underlying attention deficit issue, and that it may be helpful to test and, if appropriate, treat gamblers in this group for these types of disorders.

Grant noted that medication is studied on its own – not in conjunction with other therapies – because researchers have to be able to determine if the medication actually works. Yet, in clinical settings, Grant explained that medication usually is used in combination with other methods such as Gamblers Anonymous, self-exclusion programs and other individual therapeutic treatment options. In response to a question at the end of the session about the long-term effects of medication, Grant said that not much is known, but that the target treatment time for medication in his clinical work is one year, with other therapies used in conjunction and continuing to be used afterward.

To access Grant’s 2006 study, Medication Management of Pathological Gambling, click here, or visit the Institute for Research on Pathological Gambling and Related Disorders’ NCRG Conference Resource Page. When prompted, please enter the case-sensitive password: institute.

Does Exposure to New Gambling Lead to Gambling Problems? A Case Study from Canada

2007-11-11T16:22:00.002-08:00

As legalized gambling and new casinos are introduced to communities around the world, researchers are reexamining whether exposure to gambling increases gambling problems in those areas.

Robert Ladouceur, professor of psychology at Laval University in Quebec, Canada, presented his recent study today during the afternoon plenary session, Does Exposure to New Gambling Lead to Problem Gambling? A Case Study from Canada, evaluating the impact of a new casino in Hull, Quebec. Ladouceur and co-author Christian Jacques' study weighed the results of Hull residents to the comparison group of residents in Quebec City. He explained that participants in the study answered gambling-related questions one month before the casino opening, one year after the casino opening, and again at the 2- and 4- year marks. Participants were evaluated on how frequently they participated in casino games and gambling activities and the amount of money lost in one day's gambling. They were also questioned on whether they had a pathological gambler in their household.

During the session, Ladouceur reiterated that 70-80% of adults who reside in areas where gambling is available have gambled in the last year. He also noted that less than 1% of the adult population was found to have a gambling problem.

Ladouceur stated that the conventional wisdom is that exposure to gambling leads to problem gambling. At the outset of the study, Ladouceur said he believed that this conventional wisdom held some truth and expected that the study would show that the longer at-risk individuals were exposed to gambling, the higher the rates of problem gambling would be. But he pointed out that this was shown not to be the case. While the study showed a significant increase in gambling activities at the one year mark, the trend did not continue at the 2- and 4- year marks. Ladouceur went on to say the data showed that after an initial increase in gambling in the community when a new casino opens, the frequency in gambling activities decreases over time. He explained this pattern has been exemplified in other studies and is known as the "social adaptation" model. The study points out that this may be because the novelty of casino games wears off and individuals move onto new activities.

When participants were asked at the 4-year mark if a member of their household had a gambling problem, Ladouceur said Hull residents reported more gambling problems than Quebec City. But he pointed out that it was impossible to determine how accurately the participants perceived the problem.

Ladouceur cited other studies that point out that participation in gambling activities is a prerequisite condition for developing gambling problems, in the same way that alcohol consumption is a prerequisite to developing a drinking problem. But he went on say, "In the case of gambling, the exposure to gambling is not sufficient to create a problem." While Ladouceur explained that he originally believed that the hypotheses were logical and made sense in the "conventional wisdom" framework, he concluded that the empirical data did not support it.

To access Ladouceur’s full study click here, or visit the Institute for Research on Pathological Gambling and Related Disorders’ NCRG Conference Resource Page. When prompted, please enter the case-sensitive password: institute.

Opening Plenary: Welcome and Town Hall

2007-11-11T15:08:00.000-08:00

Opening the first session of the 2007 NCRG Conference on Gambling and Addiction, NCRG Chairman Phil Satre welcomed nearly 400 attendees from 14 countries around the world and introduced attendees to this year’s conference theme, Responsible Gaming, Regulation and Recovery: Testing Conventional Wisdom. Satre also emphasized that today’s opening session was about hearing attendees voices and opinions.

Dr. Howard Shaffer, director of the Division on Addictions, echoed that message as he told the crowd that today’s opening session would be the first instant response session the NCRG Conference has ever featured. “This is a risky session,” said Shaffer, “It’s unscripted, which means it will require your participation. We are interested in your ideas.”

Before beginning the instant response portion of the session, Shaffer first spoke about the definition of conventional wisdom. Broadly, conventional wisdom in any belief that is widely held and considered unchallengeable, he said. Conventional wisdom has at times kept people from thinking of or considering new and alternative views.

Shaffer pointed out that in youthful fields such as the addictions, “we have to make time to identify our underlying assumptions and test them.” He likened this process to a cold shower – “it can be uncomfortable, but it’s necessary.” According to Shaffer, this conference is organized to provide attendees with a “cold shower” by challenging their own beliefs, beginning with their participation in this town hall session.

Armed with individual keypads, session attendees first answered questions about their occupations and home countries. Based on the responses, 24 percent are in the health care industry, 24 percent are in academic research, 27 percent are in the gaming industry, 14 percent are in government and 12 percent are in other fields. Shaffer called this an interesting and important distribution of participants because it is essential for all stakeholder parties to come to the table to reduce gambling-related harms, and the responses show this conference is providing a forum for these parties to meet. Attendees hailed from the United States (69 percent), Canada (15 percent), Europe (7 percent), Asia (2 percent), Australia (2 percent) and other countries (5 percent).

Shaffer then proceeded with asking attendees to answer several questions about addiction and gambling disorders, emphasizing that these questions, and the conventional truths surrounding them, will be examined in several of the conference sessions occurring over the next few days. These questions – and the attendees’ responses (shown as percentages at the left of the answer selection)– are detailed below:

1. Between 50 and 85 percent of people with an addictive disorder eventually seek formal treatment. What is the main reason that people avoid seeking addiction treatment?
- 5% - Stigma
- 3% - Lack of medical insurance, money
- 6% - Perception of addictive treatment as ineffective
- 26% - Denial
- 58% - All of the above
- 2% - Other

2. About 80 to 90 percent of individuals entering recovery from addiction will relapse during the first year after treatment. What does the high rate of relapse among disordered gamblers tell us about the disorder?
- 5% - It shows that once an addict, always and addict
- 47% - It shows how difficult it is to recover
- 9% - It shows that people with a gambling problem need to be in treatment
- 33% - It shows that addiction runs a chronic course
- 6% - Other

3. Does the introduction of new gambling opportunities lead to more gambling problems in a community?
- 42% - Yes
- 8% - No
- 14% - Yes, but only at first
- 13% - Yes, but only gradually
- 23% - Sometimes
***Shaffer pointed out that the idea that new gambling opportunities lead to more gambling problems is considered conventional wisdom, but that there isn’t always science to back up this belief. This question will be examined more closely in the session following the opening plenary, titled Does Exposure to New Gambling Lead to Gambling Problems: A Case Study from Canada.

4. Does your state/provincial or regional government have an initiative to reduce gambling-related harms
- 78% - Yes
- 22% - No
***Shaffer noted that 10 years ago, never would have seen a response like this one, and said he would argue that it has to do with the science that has been published in this time.

5. For those who said yes, how would you rate those efforts?
- 5% - Excellent
- 37% - Good
- 35% - Fair
- 23% - Poor

6. Are older adults who gamble more vulnerable to developing a gambling problem than the general adult population?
- 29% - Yes
- 32% - No
- 40% - Sometimes

7. How many people in the U.S adult population had a severe past-year gambling problem in 1977?
- 27% - Zero to one percent
- 42% - One to two percent
- 20% - Three to five percent
- 4% - Six to eight percent
- 6% - Much higher
***Shaffer pointed out that research on the prevalence of a severe past-year gambling problem in 1977, before gaming proliferated into several new jurisdictions – shows the prevalence was 0.77 percent.

8. How many people in the U.S adult population had a severe past-year gambling problem between 2001 and 2003?
- 11% - Zero to one percent
- 35% - One to two percent
- 33% - Three to five percent
- 14% - Six to eight percent
- 7% - Much higher
***According to Shaffer, research shows that the prevalence rate for a severe past-year gambling problem during this time was actually 0.6 percent.

9. The rate of pathological gambling in the United States is closest to the rate of the following disorder?
- 25% - Schizophrenia (Prevalence rate: 1.1 percent)
- 26% - Excessive shopping (Prevalence rate: 1.0 percent)
- 17% - Kleptomania (Prevalence rate: 1.1 percent)
- 24% - Obsessive Compulsive Disorder (Prevalence rate: 1.0 percent)
- 7% - Marijuana use disorder (Prevalence rate: 1.45 percent)
***The prevalence rates to the right of the disorders were revealed to the participants after their answers were recorded. Shaffer pointed out that the prevalence rates for all of these disorders are all close to 1 percent, but that while the U.S. government provides significant funding and resources in all these areas (except for, perhaps, excessive shopping), the same resources are not afforded pathological gambling research and treatment.

Several of these questions will be examined throughout the conference. Be sure to check out our ongoing conference blog coverage to see how conventional wisdom is tested and what the latest research reveals.

Interview with Kathy Scanlan of the Massachusetts Council on Compulsive Gambling

2007-11-11T11:22:00.000-08:00

Click here for the NCRG Blog Team interview with Kathy Scanlan, executive director of the Massachusetts Council on Compulsive Gambling, about her NCRG Conference experience. Scanlan also is moderating Reflection on 50 Years of Gamblers Anonymous, scheduled for tomorrow, Monday, Nov. 12, at 4:45 p.m.

NCRG Conference: Day 1 At-a-Glance

2007-11-11T10:42:00.000-08:00

The 8th annual NCRG Conference on Gambling and Addiction kicks-off today at 1 p.m. Here’s a quick look at the sessions and special events taking place this afternoon.

Plenary Sessions:
1 – 2 p.m. – Welcome and Town Hall Meeting
Moderator:
Phil Satre, Chairman, National Center for Responsible Gaming, and Retired Chairman and CEO, Harrah’s Entertainment, Inc.
Presenter:
Howard J. Shaffer, Ph.D., C.A.S., Associate Professor of Psychology in the Department of Psychiatry, Harvard Medical School, and Director, Division on Addictions, Cambridge Health Alliance
Location:
Champagne 1/2

2 – 3 p.m. – Does Exposure to New Gambling Lead to Gambling Problems? A Case Study from Canada
Moderator:
Debi A. LaPlante, Ph.D., Instructor of Psychology in Psychiatry, Harvard Medical School
Presenter:
Robert Ladouceur, Ph.D., Professor of Psychology, Laval University
Location:
Champagne 1/2

3:30 – 4:30 p.m. – The Reality of Relapse and Recovery Among Disordered Gamblers
Moderator:
Ken C. Winters, Ph.D., Professor of Psychiatry and Director of the Center for Adolescent Substance Abuse Research, University of Minnesota
Presenter:
David C. Hodgins, Ph.D., Professor of Psychology, University of Calgary
Location:
Champagne 1/2

Track A: Scientific and Clinical
4:30 – 5:45 p.m. – Can Medication Manage Disordered Gambling Behavior? Newest Trends in Research
Moderator:
Ken C. Winters, Ph.D., Professor of Psychiatry and Director of the Center for Adolescent Substance Abuse Research, University of Minnesota
Presenter:
Jon E. Grant, M.D., J.D., M.P.H., Associate Professor of Psychiatry, University of Minnesota Medical Center
Location:
Champagne 1/2

Track B: Government and Industry
4:30 – 5:45 p.m. – Innovations in Public Policy: Gambling Court and the Iowa Gambling Treatment Program
Moderator:
Alan Feldman, Senior Vice President of Public Affairs, MGM MIRAGE
Presenters:
Judge Mark G. Farrell, Senior Justice, Amherst Town Court
Mark Vander Linden, M.S.W., Director of Iowa Gambling Treatment Program, Iowa Department of Public Health
Location:
Champagne 3/4

Special Events
6 – 7:30 p.m. – Poster Session and Scientific Achievement Award Presentation Reception
Location:
Concorde A

Spotlight on Research: Can Medication Manage Disordered Gambling Behavior? Newest Trends in Research

2007-11-02T08:17:00.000-07:00

Research indicates a clear relationship between biological vulnerabilities and the development of a gambling disorder. For example, a vulnerability might be insufficient levels of chemicals – or neurotransmitters – in the brain that regulate mood and judgment. If the low mood is elevated by an activity like gambling, the person could develop a gambling problem. Furthermore, the simultaneous occurrence of depression and other psychiatric problems with a gambling disorder underlines the importance of exploring drug treatments for pathological gambling.

However, currently there is no treatment standard for disordered gambling and no medication has been approved by the FDA for treating the disorder.

Dr. Jon Grant, associate professor of psychiatry and co-director of the Impulse Control Disorders Clinic at the University of Minnesota Medical School, has done extensive research in this area. A review essay published in 2006 and co-authored by Dr. S.W. Kim examined the results of studies looking at three types of drugs used to treat pathological gambling – antidepressants, mood stabilizers, and opioid antagonists. Results from some of these controlled clinical trials are promising and could eventually lead to significant improvement in the lives of people struggling with a gambling disorder.

Grant will discuss this research and its important implications for treatment during the conference session Can Medication Manage Disordered Gambling Behavior? Newest Trends in Research, scheduled for 4:30 p.m. on Sunday, Nov. 11. To access Grant’s full study click here, or visit the Institute for Research on Pathological Gambling and Related Disorders’ NCRG Conference Resource Page. When prompted, please enter the case-sensitive password: institute.

Spotlight on Research: Does Exposure to New Gambling Lead to Gambling Problems?

2007-10-24T13:08:00.000-07:00

When states, provinces and local communities are considering introducing new forms of gambling, the “exposure” issue usually arises in public debates about the pros and cons of gambling. The conventional wisdom assumes that increased exposure to gambling opportunities will lead to an increase in the number of people with gambling-related problems. The validity of this assumption is usually unquestioned.

Alternatively, the “social adaption” model proposes that people exposed to new gambling opportunities may initially increase their gambling activities – whether with or without adverse consequences – but, eventually the population will adapt its behavior, leading to lower levels of gambling.

Until now, there have been few empirical studies to test this hypothesis. Dr. Robert Ladouceur, a professor of psychology at Laval University in Quebec, Canada, evaluated the impact of a new casino in Canada’s Hull, Quebec region. Ladouceur and co-author Christian Jacques, conducted a multi-year study on the gambling habits of individuals in that area. They surveyed participants one month before the casino opened, one year after its opening, and then again at the 2-year and 4-year mark. They found the results were surprising.

Ladouceur will discuss his research and its important implications for public health policy during the conference session Does Exposure to New Gambling Lead to Gambling Problems? A Case Study from Canada, scheduled for 3:30 p.m. on Sunday, Nov. 11. To access Ladouceur’s full study click here, or visit the Institute for Research on Pathological Gambling and Related Disorders’ NCRG Conference Resource Page. When prompted, please enter the case-sensitive password: institute.

Welcome from your Conference Hosts

2007-10-17T08:36:00.000-07:00

In less than one month’s time, more than 300 researchers, clinicians, regulators, policymakers and gaming industry representatives from all around the world will gather in Las Vegas at the 8th annual NCRG Conference on Gambling and Addiction. Together at this conference, these diverse groups will discuss the latest research about gambling and addiction, and consider how these findings can be adapted into real-world applications for prevention, treatment, education and responsible gaming.

We welcome you to this site and invite you to join us at the international conference, the only gathering of its kind in the U.S. that allows gaming industry and government representatives to engage in dialogue with the world’s leading scientific and clinical professionals.

The 2007 NCRG Conference on Gambling and Addiction will take place Nov. 11-13, at Paris Las Vegas. This event is sponsored by the National Center for Responsible Gaming (NCRG) and the Institute for Research on Pathological Gambling and Related Disorders, a program of the Division on Addictions at Cambridge Health Alliance, a teaching affiliate of Harvard Medical School.

The theme of this year’s conference, Responsible Gaming, Regulation and Recovery: Testing Conventional Wisdom, calls on attendees to test the “conventional wisdom” about gambling addiction and recovery using the most up-to-date science. Through such dialogue, we can develop more effective policies, regulations, responsible gaming programs and treatment for gambling addiction.

Over the coming weeks, the NCRG conference blog will preview of some of the research and trends that will be covered at the conference. While the conference is in progress, on-site reports will bring you up-to-the-minute details on some of our most compelling sessions and special events. Make sure you receive these updates by signing up for our RSS feed (select an icon in the Subscribe section of the sidebar) to have blog updates automatically delivered to you.

It’s not too late to register for this important event, so please be sure to join us. And if you can’t make it to Las Vegas, we look forward to having you visit us here on the conference blog in the coming weeks.

Phil Satre
Chairman, National Center for Responsible Gaming

Howard J. Shaffer, Ph.D., C.A.S.
Associate Professor of Psychology in Psychiatry, Harvard Medical School
Director, Division on Addictions, The Cambridge Health Alliance

Conference dates announced for 8th Annual NCRG Conference on Gambling and Addiction

2007-03-27T09:01:00.000-07:00

Save the date for the 8th Annual NCRG Conference on Gambling and Addiction, themed Responsible Gaming, Regulation and Recovery: Testing Conventional Wisdom.

Join researchers, clinicians, regulators, policy makers and industry representatives from around the world for meaningful dialogue on the latest developments in pathological gambling research and responsible gaming programming. Sessions will examine current research in addiction treatment, gambling’s impact on older adults, the effectiveness of public policy interventions, the impact of warning messages on gaming machines and more.

The conference is co-sponsored by the Institute for Research on Pathological Gambling and Related Disorders and held in conjunction with Global Gaming Expo (G2E), the gaming industry's largest international trade show and conference event.

When: Nov. 11-13, 2007. And stay for Global Gaming Expo (G2E), taking place Nov. 13-15 at the Las Vegas Convention Center.

Where: Paris Las Vegas Resort and Casino

Why Join Us: Exploring the latest research, treatment and policy advancements related to gambling disorders can help us determine the best way to adapt these findings into practical, real-world applications. This year’s conference will specifically examine how science can illuminate the practical issues facing gaming industry personnel, regulators and elected public officials, and perhaps offer new hope for better treatment and programs.

Learn more: To learn more about this year’s conference, visit the NCRG’s website at www.ncrg.org. We'll also be providing conference updates here on the blog in the coming months, so be sure to check back with us, or sign up for our RSS feed.

Reflecting on Recovery with Christopher Kennedy Lawford

2006-11-14T12:24:00.000-08:00

In the closing session of the 7th annual NCRG Conference on Gambling and Addiction, Christopher Kennedy Lawford admitted that, in writing his memoirs, Symptoms of Withdrawal: A Memoir of Snapshots and Redemption, his primary goal was to kick-start a writing career. What he didn’t anticipate was that the book would become a pathway to advocacy, a course he says he now embraces in a pursuit to help people like him who have struggled and continue to struggle with addiction.

Speaking to a room packed with conference attendees, Lawford shared his experiences both as a member of a famous family and as a person addicted to and in recovery from addictions to drugs and alcohol.

“Addicts are not bad people doing bad things who need to be handled in the criminal justice system,” Lawford said, reminding the audience that addiction is a chronic illness that needs to be treated.

While Lawford never suffered from gambling addiction, he made the connection between his experiences and those of gambling addicts by explaining that “addicts and alcoholics are all running away from something, we just choose different colored sneakers.”

To describe how important it is for addicts to seek outside help to turn their lives around, Lawford quoted Albert Einstein who said, “We cannot solve the problems we’ve created with the same type of thinking that created them.”

In addition to being a powerful message for those suffering from addiction, the quote also reminds researchers, clinicians, treatment providers, policy-makers and other stakeholders to be open and engaged in the development of new solutions to help people suffering from addiction. Lawford further emphasized that point by reminding he audience that getting someone sober is only the first step; recovery is contingent on a daily commitment to recovery. For all the stakeholders involved in problem gambling issues, Lawford’s comment can be translated into a daily commitment to reduce gambling-related harms.

Dr. Howard Shaffer closed the keynote session by noting that Lawford’s story is proof that science still has a long way to go in order to understand addiction, but that his story also serves as a powerful reminder that the ultimate purpose of the work of all stakeholders in problem gambling issues is to help people suffering from addiction.

Women and Gambling: Does Gender Make a Difference?

2006-11-14T11:44:00.000-08:00

While conventional wisdom often implies that gender does make a difference when it comes to gambling behavior, Debi LaPlante, Ph.D., an instructor of psychology in psychiatry at Harvard Medical School, reminded participants in today’s opening session that it’s important to examine what we think we know to be true to ensure it actually is.

With that tenet in mind, LaPlante and her colleagues from the Division on Addictions sought to explore gender’s role in gambling addiction with their research of individuals participating in the Iowa Gambling Treatment Program. The research team chose to focus specifically on gender’s role in the progression of a gambling disorders and choice of games.

In the case of disorder progression, LaPlante and her colleagues discovered that gender is an important predictor of disorder progression in treatment-seekers, but that the effect of gender on gambling problem trajectory is only a small part of the whole picture. In fact, their findings suggest that other psychosocial characteristics contribute as much or more than gender in the progression of the disorder within individuals. LaPlante emphasized that these other factors deserve at least as much weight as gender in prevention and treatment efforts.

With regard to game choice, the researchers found that gender doesn’t hold as much unique discriminatory power for distinguishing gambling preferences as many have thought. LaPlante pointed out that the factors providing essential distinguishing information for gamblers who prefer specific games were personal demographic, economic and health-related profiles.

LaPlante, and her fellow panelist, seminal women and alcohol researcher Dr. Sharon Wilsnack, maintained that there are definitely differences between men and women when it comes to gambling disorders and alcohol abuse. However, LaPlante emphasized that it’s imperative for treatment providers and others to avoid the tendency to over-generalize the importance of any one specific demographic characteristic, such as gender. Over-generalization, LaPlante said, values simplicity at the cost of precision in the identification of individual preferences, risk factors and tendencies related to gambling.

NCRG Conference: Day 3 At-A-Glance

2006-11-14T09:02:00.000-08:00

The 7th annual NCRG Conference on Gambling and Addiction concludes today, but be sure to join us for today’s sessions and special events.

Plenary Session:
8:30 – 9:30 a.m. – Women and Gambling: Does Gender Make a Difference?
Moderator:
Christine Reilly, Executive Director, Institute for Research on Pathological Gambling and Related Disorders
Presenters:
Debi LaPlante, Ph.D., Instructor of Psychology in Psychiatry, Harvard Medical School
Sharon Wilsnack, Ph.D., Chester Fritz Distinguished Professor, Department of Clinical Neuroscience, University of North Dakota School of Medicine and Health Sciences
Location:
Tropical Room

Keynote Address:
9:30 – 10:30 a.m. - Symptoms of Withdrawal: Reflections on Addiction and Recovery
Introduction:
Howard J. Shaffer, Ph.D., C.A.S., Associate Professor of Psychology in Psychiatry, Harvard Medical School and Director, Division on Addictions, Cambridge Health Alliance
Speaker:
Christopher Kennedy Lawford
Location:
Tropical Room

Insights from NCRG conference session moderator: Ken Winters, Ph.D.

2006-11-14T08:34:00.000-08:00

Here is what has impressed me about this year's gambling conference: Our scientific understanding of disordered gambling has come a long way, yet we still have such a long way to go.

The conference is now in the third quarter of a 4-quarter event. I have now listened to several talks, been involved in several informal, small discussions with colleagues, and had time to consider the eminence of the conference presenters in light of previous conferences.

The problem gambling field has matured to a most impressive level. We know so much more than just a few years ago -- such as the course of gambling behaviors, the role of natural recovery, what treatment models work, the possible role of genetics, and how to and how not to measure gambling's social impacts. More gambling researchers are scoring scientific touchdowns than ever before.

But an annoying issue remains. This growing collective knowledge is not yet significantly impacting clinical work. Clinicians are not maximally benefiting from the fruits of the research. More knowledge is great, but how can it be applied?

The substance abuse field has suffered this annoyance. They responded by getting their institute, NIDA, to create and fund the Clinical Trials Network, a concerted effort to get researchers to work with and help treatment providers.

Soon, we will deserve our own version of a Clinical Trials Network initiative.

Internet Accountability: Responsible Gaming in Cyberspace

2006-11-13T17:44:00.000-08:00

As the moderator for this afternoon’s panel on responsible gaming in cyberspace, Alan Feldman, senior vice president of public affairs for MGM MIRAGE, gave attendees a brief overview of the Unlawful Internet Gambling Enforcement Act of 2006 signed into law last month by President Bush. Among an assortment of reasons for the creation of the new law, Feldman pointed to the commonly held belief that problems that affect gambling are even worse on the Internet as one of the primary factors, but then posed the question, “Is this assumption true?”

Wolfgang Schwens, Mag. theol., M.B.A., corporate social responsibility manager at the Vienna, Austria-based Internet gaming company bwin Interactive Entertainment AG, discussed the responsible gaming practices bwin has undertaken as well as a relatively new research project his company is participating in that they hope will shed light Feldman’s question.

In 2004, bwin began a joint research project with Harvard Medical School to investigate addiction to online gambling. Currently, there is no other project like it in the field. According to Schwens, the cooperation between bwin and Harvard Medical School allows for a unique combination of theory and real-life situations that benefits scientific research and bwin’s online customers. Schwens says bwin will make the project results a “role model” for the industry, providing the early identification of addicted gamblers and state-of-the-art intervention strategies.

In the long-term, says Schwen, bwin hopes the research project will result in both partners (bwin and Harvard) to respond to questions regarding public order policy in the context of gambling addiction, research to support bwin’s notion that online gambling is a customer friendly and safe form of entertainment, the development of tested scientific models allowing bwin to observe and analyze gambling behavior, and research results that will put in place systematic measures for the protections of online gamblers who are at risk for addiction.

The company already has adopted a number of policies to minimize gambling-related harm, including self-exclusion tools, immediate account closures for customers saying they have a gambling problem, intervention strategies, company and customer determined betting limits (including a 72-hour waiting period for raising limits), internal monitoring systems to track conspicuous gambling activity, employee training programs, self-help kits and more.

“We have to walk the fine line between the customers’ responsibility and the company’s responsibility to reduce harm,” Schwens said. “We don’t think these programs are in the final stages, but they’re on their way.”

Presenting findings from a pilot section of the longitudinal study of bwin customers being conducted by Harvard Medical School, Richard LaBrie, Ed.D., put the study into context by explaining that there currently isn’t any information about online ambling and its relation to addiction. LaBrie, instructor in psychiatry at Harvard Medical School (HMS) and the associate director for research and data analysis of the Division on Addictions at the Cambridge Health Alliance, is leading the research team conducting the study.

According to LaBrie, the current body of knowledge on Internet gambling consists of small surveys of special populations, and relies largely on self-reporting and anecdotes. The new information they’re collecting in this study will begin to fill the information void by describing the actual gambling behavior over a long period of time of a large sample of European sports gamblers.

In the pilot group, the research revealed that the large majority of sports bettors wager moderately, incurring a “cost” of between two to three U.S. dollars per day they gambled. The data also showed that the “high rollers” didn’t lose as much money (8 percent stakes lost) as those betting smaller amounts (13 percent stakes lost).

LaBrie offered the following examples for future research: seek patterns of betting that are predictive of the progression to more disordered behavior; investigate the utility of company- and self-determined limits on promoting responsible gaming; study interventions that can remediate problem gambling behavior; and, identify risk factors general to disordered gambling in general and specific to the Internet environment.

LaBrie and his team currently are in the process of analyzing the data from the larger, 18-month longitudinal study of bwin’s customers, but their findings have not yet been published.

Is Pathological Gambling Hereditary?

2006-11-13T16:38:00.000-08:00

Not exactly, says Dr. Donald Black, professor of psychiatry at the University of Iowa Carver College of Medicine, citing the fact that pathological gambling is a social construct rather than an inheritable trait. During the first Track A: Scientific and Clinical session today, Black explained that what are hereditary are certain traits, such as impulsivity and reward dependence, that may predispose an individual to pathological gambling. But, he points out, environmental triggers must be present as well in order for an individual to develop of pathological gambling, meaning that without an available way or means to gamble, a person can’t be a pathological gambler.

In his presentation, Black focused on two family studies he’s conducted that look at the occurrence of pathological gambling among family members. According to Black, a family study can tell us whether a disorder is familial; can demonstrate patterns of familial aggregation of illness, meaning it can uncover what other disorders run in the family, which therefore might tell us what a disorder might be related to, in turn giving treatment providers other specific factors and illnesses to look for in addition to problem gambling indicators. Additionally, family studies can suggest proper classification of the disorder, allowing researchers and treatment providers to better define the disorder and leading to treatment approaches focused on genetics.

Black’s research revealed that disordered gambling runs in families. Additionally, he found that substance misuse and anti-social personality disorders also tend to run in these pathological gambling families. And, in an interesting finding, Black’s research showed that the families in which pathological gambling runs are large and chaotic, a fact which Black says complicates research efforts.

Perhaps the most important reason to study the genetics of pathological gambling is that it can lead to the development of new treatments for the disorder. Contributing further to the body of knowledge on the genetics of pathological gambling, Black will build on one of his small family studies, which was funded by the NCRG, to conduct a larger study of approximately 200 families which will be funded by the National Institute on Drug Abuse.

Please visit the Institute for Research on Pathological Gambling and Related Disorders’ NCRG Conference Resource Page to view Black’s family interview study and an article from The WAGER on his research. Enter the case sensitive password: institute when prompted. You can also read the Responsible Gaming Quarterly article on Black’s research by clicking on the linked publication title.

Scientific Achievement and Outstanding Poster Awards Presentation and Luncheon

2006-11-13T15:38:00.000-08:00

The awards luncheon began this afternoon with the presentation of the NCRG’s 2006 poster award winner. Richard LaBrie, Ed.D., an instructor of psychology in psychiatry at Harvard Medical School, bestowed this year’s honor to a team of researchers from the University of Missouri (Anna E. Goudriaan, Kenneth J. Sher and Wendy S. Slutske) for their collective work on Longitudinal patterns of gambling activities: Preliminary findings. The 16 teams of nominees in competition for the award showcased their work at last night’s welcome reception, discussing their empirical findings and research methodologies with conference attendees.

After the poster award was announced, Dr. Peter Nathan, the University of Iowa Foundation Distinguished Professor of Psychology, took the stage to award the NCRG’s Scientific Achievement Awards, now in their fifth year. Dr. Suck Won Kim, professor of psychiatry and director of the Impulse Control Disorders Clinic at the University of Minnesota Medical School, was awarded with the 2006 Senior Investigator Award. Kim is well-known throughout the research community as a pioneer in the pharmacological treatment of gambling disorders. His study of naltrexone, an anti-opioid drug typically used to dull cravings for alcohol, has shown the promise of such drugs for treating gambling disorders. The original study, funded by the NCRG in 1998, has been expanded with a grant of $464, 463 from the National Institute on Drug Abuse.

“Some years ago I received a grant from the NCRG for my naltrexone research thanks to Christine Reilly and Dr. Howard Shaffer,” said Kim. “At the time I was struggling and the seed money I received from the NCRG helped me to conduct all of my research. Without them and the organization, none of this would have been possible.”

Dr. Rina Gupta, unable to attend the awards luncheon, accepted honors for the 2006 Young Investigator Award via video. Gupta, co-director of the International Centre for Youth Gambling Problems and High-Risk Behaviors and assistant professor of school/applied child psychology at McGill University, is an accomplished scientist who has advanced the understanding of gambling disorders among children, adolescents and college-aged populations. Her research has led to important implications for intervention, prevention and social policy, and she has received international recognition for her expertise, sitting on the board for the South African Responsible Gambling Trust and consulting with the government of Singapore on the establishment of gambling prevention programs.

Recipients of the awards were selected by an independent committee of distinguished leaders in the in the field of addictions and gambling research, chaired by Joseph Coyle, the Eben S. Draper professor of psychiatry at Harvard Medical School.

Coverage of Morning Plenary Sessions: Helplines, Natural Recovery

2006-11-13T13:36:00.000-08:00

Making the Call: How Can Helplines be More Helpful?

Christine Reilly, executive director of the Institute for Research on Pathological Gambling and Related Disorders, kicked off this morning opening plenary session, Making the Call: How Can Helplines be More Helpful?, with a quick overview of the helplines that currently exist in the U.S., including what they cover, what kind of services they offer and how they offer those services.

Peter Bensinger, president & CEO of Bensinger, DuPont & Associates, a company that operates a number of helplines throughout the country, and J. Michael Ryan, executive director of the Missouri Gaming Association, whose organization funds the Missouri problem gambling helpline, followed Reilly's overview with specific examples from the helplines they're involved with.

According to Bensinger, the most important factor in the success of a helpline is making sure it's not a secret. In addition to ensuring a high level of availability and awareness (through publicizing it in a variety of ways), the helpline's services have to be able to accommodate both a large number of callers and callers who speak a variety of languages with live counselors, Bensinger says. He also strongly encourages referring callers to Gamblers Anonymous (GA), as data collected by his company indicates attendance at GA meetings was a common factor among callers who stopped gambling.

To be truly effective, Bensinger believes helplines need to provide immediate, live response (no answering machines); a deep staff of qualified, masters degree level counselors so that no one is put on hold; the ability to handle calls in multiple languages; accurate, in-depth data collection and reporting; extensive knowledge of available treatment resources near the caller; a solid relationship with the local GA chapters; familiarity with state and federal legislative and executive processes so the helpline can better understand and encourage government funding; briefings to the gaming board, industry and the public; the ability to conduct training and research, including providing information to researchers; and, financial stability and credibility.

Ryan echoed Bensinger's emphasis on the importance of a well- and diversely-publicized helpline, citing statistics from the Missouri helpline in which 67 percent of callers found the helpline number on their players cards, a wallet-sized card required by the state of Missouri for patrons to enter a casino gaming facility. Ryan also pointed out that the helpline is the gateway to other programs run by the Missouri Alliance to Curb Problem Gambling, a partnership of state and private agencies that includes the Missouri Gaming Commission.

All the panelists acknowledged there is a lack of research on how effective helplines are, in part, perhaps, because there are no national standards for helplines and the goals of some helplines are different, with certain helpline focusing on providing information and other going a step further and providing treatment.

"If all we're doing when people call is telling them where the GA meeting is or referring them to a care provider, we're missing an important opportunity to help," Bensinger said.

Additionally, all agreed that facilitating and promoting more research on helpline outcomes will be important to defining future improvements helplines can make to ensure their effectiveness.

Getting Well on Your Own: New Research on Natural Recovery Among Disordered Gamblers

Immediately following the opening plenary, Dr. Wendy Slutske, associate professor of psychology at the University of Missouri-Columbia, shared with a diverse audience her research on natural recovery among pathological gamblers. As reported in the pre-conference post on this session, Slutske found that approximately one third of pathological gamblers recover without seeking or accepting formal treatment. Slutske further clarified her definition of natural recovery by explaining that the pathological gamblers she characterized as experiencing natural recovery may have calsubstantialbstantialbstansial support from family and friends, but they didn't attend GA meetings or meet with a mental health or counseling professional about their problems

Among the most interesting outcomes of Slutske's research is that that pathological gambling does not always follow the chronic and persisting course the disorder is assigned under the DSM IV, the "diagnostic bible" for psychiatric disorders.

Slutske laid out five insights about natural recovery for the audience: first, that reducing gambling may not always be a deliberate choice; the fact that someone recognizes he or she has a gambling problem is not the same as that person having a clinically diagnosable pathological gambling disorder; recovery does not require abstinence; intentional natural recovery involves many of the same strategies used in formal treatments; and lastly, that there are individual differences that can determine who can achieve natural recovery, but there isn't yet enough data to know what makes someone a good candidate.

Slutske also offered some ways natural recovery can be incorporated or addressed in practical applications. She said that just being told that there are people who do get better can help people currently struggling with disordered gambling. She also encouraged the use of treatment strategies that promote moderate solution, for example controlled gambling outcomes and exclusion programs that last for perhaps a one year period rather than a blanket, lifetime exclusion.

These moderate solutions are particularly important for people who don't identify with the stereotyped picture of a problem gambler. Slutske stressed it is important that counselor and helplines don't just offer referrals, but that they also promote self-recovery. She also encouraged stakeholders to create a different public picture of problem gamblers, not the dark pictures currently promoted, to help raise public awareness and help people with gambling problems to be more comfortable in identifying with and recognizing themselves as problem gamblers.

Please visit the Institute for Research on Pathological Gambling and Related Disorders' NCRG Conference Resource Page for Slutske's full study and articles on her research from The WAGER. Enter the case sensitive password: institute when prompted. You can also read the Responsible Gaming Quarterly article on Slutske’s research by clicking on the linked publication title.

NCRG Conference: Day 2 At-A-Glance

2006-11-13T09:12:00.000-08:00

The 7th annual NCRG Conference on Gambling and Addiction continues today with a full schedule. Here’s a quick look at the sessions and special events happening today.

Plenary Sessions:
9 – 10 a.m. - Making the Call: How Can Helplines Be More Helpful?
Moderator:
Kathy Scanlan, Executive Director, Massachusetts Council on Compulsive Gambling
Presenters:
Peter Bensinger, President & CEO, Bensinger, DuPont & Associates
Christine Reilly, Executive Director, Institute for Research on Pathological Gambling and Related Disorders
J. Michael Ryan, Executive Director, Missouri Gaming Association
Location:
Penn & Teller Theater

10 – 11 a.m. - Getting Well on Your Own: New Research on Natural Recovery Among Disordered Gamblers
Moderator:
Ken Winters, Ph.D., Professor of Psychiatry and Director, Center for Adolescent Substance Abuse Research, University of Minnesota Medical School
Presenter:
Wendy Slutske, Ph.D., Associate Professor of Psychology, University of Missouri-Columbia
Location:
Penn & Teller Theater

4:30 – 5:30 p.m. - Dealing with Disordered Gamblers: What are the Boundaries of Responsible Gaming?
Moderator:
Phil Satre, Chairman, National Center for Responsible Gaming
Presenters:
Pieter Remmers, Managing Director, Jellinek Consultancy
David Stewart, Partner, Ropes & Gray
James Whelan, Ph.D., Associate Professor of Psychology, Director of the Psychology Training Clinic and Co-Director of the Gambling Clinic, University of Memphis
Location:
Penn & Teller Theater

Track A: Scientific and Clinical
11:30 a.m. – 12:30 p.m. - Runs in the Family: New Research on Genetic Links of Disordered Gambling
Moderator:
Ken Winters, Ph.D., Professor of Psychiatry and Director, Center for Adolescent Substance Abuse Research, University of Minnesota Medical School
Presenter:
Donald Black, M.D., Professor of Psychiatry, Carver College of Medicine, University of Iowa
Location:
Tropical Room

2 – 3 p.m. - How Research Informs Clinical Practice: New Research on Gamblers Anonymous and Cognitive Behavioral Therapy for Gambling Disorders
Moderator:
Lisa Najavits, Ph.D., A.B.P.P., Professor of Psychiatry, Boston University School of Medicine; Adjunct Faculty Member, Harvard Medical School; Director, Trauma Research Program, McLean Hospital
Presenter:
Nancy Petry, Ph.D., Professor of Psychiatry, University of Connecticut Health Center
Location:
Tropical Room

3 – 4 p.m. - The Heart of Addiction: A New Approach to Disordered Gambling Behavior
Moderator:
Lisa Najavits, Ph.D., A.B.P.P., Professor of Psychiatry, Boston University School of Medicine; Adjunct Faculty Member, Harvard Medical School; Director, Trauma Research Program, McLean Hospital
Presenter:
Lance Dodes, M.D., Practicing Psychiatrist and Psychoanalyst, and Assistant Clinical Professor of Psychiatry, Harvard Medical School
Location:
Tropical Room

Track B: Government and Industry
11:30 a.m. – 12:30 p.m. - Global Gaming, Part 2: Three Continents’ Approaches to Responsible Gaming
Moderator:
Jennifer Shatley, Program Vice President, Code of Commitment, Harrah’s Entertainment, Inc.
Presenters:
Peter Dean, Chairman, U.K. Gambling Commission
Clive Keegan, Research Manager, South African Responsible Gaming Programme
Pieter Remmers, Managing Director, Jellinek Consultancy
Location:
Palma Room

2 – 3 p.m. - Internet Accountability: Responsible Gaming in Cyberspace
Moderator:
Alan Feldman, Senior Vice President, Public Affairs, MGM MIRAGE
Presenters:
Richard LaBrie, Instructor in Psychiatry, Harvard Medical School and Associate Director for Research and Data Analysis, Division on Addictions, Cambridge Health Alliance
Wolfgang Schwens, Mag. theol., M.B.A., Corporate Social Responsibility Manager, bwin Interactive Entertainment AG
Location:
Palma Room

3 – 4 p.m. - The Real Costs: How to Effectively Measure Social and Economic Impacts
Moderator:
Alan Feldman, Senior Vice President, Public Affairs, MGM MIRAGE
Presenters:
Kate Spilde Contreras, Ph.D., Visiting Scholar and Managing Director, Center for California Native Nations, University of California, Riverside
William Eadington, Ph.D., Professor of Economics and Director, Institute for the Study of Gambling and Commercial Gaming, University of Nevada, Reno
Douglas Walker, Ph.D., Associate Professor of Economics, Georgia College and State University
Location:
Palma Room

Special Events
12:30 – 2 p.m. - NCRG Scientific Achievement and Outstanding Poster Awards Presentation and Luncheon
Sponsored by International Game Technology
Location:
Brasilia Ballroom

Global Gaming, Part 1: Asian and Australian Approaches to Responsible Gaming

2006-11-12T18:26:00.000-08:00

The recent rapid growth of the gaming industry in Asia has been accompanied by increased interest in responsible gaming practices and policies targeting Asian populations. This afternoon’s session, Global Gaming, Part 1: Asian and Australian Approaches to Responsible Gaming, sought to shed light on the existing responsible gaming practices in Asia as well as those being implemented in Australia.

In his presentation, Ivan YIU, head of the Youth and Family section and Coordinator of Addiction Counseling Services at the Tung Wah Group of Hospitals in Hong Kong, examined the meaning of gambling in Chinese culture and the implications it has for prevention and treatment. YIU pointed out that Asian people generally are regarded as liking gambling more than people from Western cultures, and that research shows countries with primarily Chinese populations have a higher prevalence rate of pathological gamblers than other places in the world.

YIU identified some of the cultural characteristics of Chinese gamblers, which included the knowledge that gambling is a socially recognized way of making money in Chinese culture, a strong belief that intuition and inspirations will help winning and a strong illusion of control in gambling, which is aggravated by cultural beliefs of supernatural factors like “Fate,” “Luck” and “Feng Shui.” YIU also pointed to the fact that Asian families often are more willing to pay off debts of gambling family members.

These characteristics have an important influence on the types of responsible gaming programs that are created and implemented in Asian populations, YIU said. To best fit the needs presented by these cultural characteristics, Asian community prevention efforts include education about the probability of winning in different forms of gambling activities, education about alternative ways to relax and cope with stress, education on assertive skills relating to dealing with peer pressure and more. Similarly, Asian treatment efforts include the development of culturally sensitive screening tools, such as the newly created Chinese G-MAP, which differs from Western tools in that it puts more focus on the family environment rather than just on the individual; relapse prevention by paying attention to high-risk occasions such as Chinese New Year, and cognitive therapy that takes into account cultural and supernatural beliefs.

The need to adjust responsible gaming education tools for Asian population was echoed by Scott Ross, director of government relations for the Las Vegas Sands Corporation. Las Vegas Sands opened the first U.S.-owned casino in Asia, the Sands Macao, in May 2004 and will be opening the Venetian Macao next year. In some of its recent responsible gaming education efforts, Ross explained that the company has had to adjust its programs to ensure they are tailored to the cultural needs of their Asian employees and customers. These adjustments range from translating acronyms so they make sense in the new language to adjusting the premises and values upon which the education efforts are based.

Ross stressed that the key to any good responsible gaming program is partnerships with the health sector, the government and other key stakeholders. Las Vegas Sands’ Asian responsible gaming program will include a responsible gaming policy and mission statement, the implementation of a responsible gaming committee, a self-exclusion program, staff training and education sessions conducted by fellow staff members and partnerships with health and government groups.

In addition, Vicki Flannery, a gaming industry consultant and the first CEO of the Australian Gaming Council, offered some history and insights on responsible gaming strategies in Australia, including the emerging trends in current strategies. These trends include a continued call for tough measures with regard to the advertising and restrictions surrounding gaming, loss limit and pre-commitment measures, community awareness and education, school programs, financial literacy counseling and the continued measurement of treatment effectiveness. She pointed out that policy issues surrounding responsible gaming remain a “hot issue,” but that there has been some trend to a public health model, which focuses on the collaboration of myriad stakeholders and helping consumers make an informed choice, in some Australian states. Additionally, Flannery said the industry really has improved its performance in the realm of responsible gaming over the past five to six years.

Opening Plenary: Gambling Research: What We Know and What We Need to Know for "Best Practices"

2006-11-12T16:28:00.000-08:00

In today’s opening plenary session, Gambling Research: What We Know and What We Need to Know for "Best Practices," Dr. Howard Shaffer set the tone for the 7th annual NCRG Conference on Gambling and Addiction by identifying some of the obstacles that exist in the process of taking solid scientific research and turning it into best practices for the treatment and prevention of gambling addictions, as well as discussing the trends in disordered gambling research over the past 100 years.

According to Shaffer, the process of translating research to practice is very complex, involving a number of steps in which clinicians, researchers, industry advocates and patients can “get lost” (i.e. drop out) of the process. With this in mind, Shaffer stressed how important it is for all those involved in the prevention and treatment of gambling disorders to focus on the ultimate goal of research and practice: to prevent, reduce and ameliorate addiction-related suffering. During this session, Shaffer used treatment to cover a broad range of generic treatment activities, ranging from clinical and counselor facilitated programs to responsible gaming practices and public policy.

Shaffer identified a number of obstacles to achieving the ultimate objective including the willful disregard for the ultimate objective by research proponents and critics alike, the natural debates among researchers and clinicians that are corollary to the translation process, and the fact that some treatment providers already think they know the best practices despite having little or no evidence. In a youthful field like disordered gambling research, each of these obstacles is dangerous for the development of best practices, Shaffer said.

In the study Trends in Gambling Research: Quantifying, Categorizing, and Describing Citations, Shaffer and his colleagues examined the growth of knowledge in the field of gambling studies by examining the literature published between 1903 and 2003. Their study found that the growth of gambling studies has been exponential, with 97 percent of gambling-related articles having been published since 1963, and 33 percent of all gambling-related citations being published between 1999 and 2003. The most popular topics explored in gambling studies citations have been pathology, risk-taking, decision-making and addiction. Additionally, between 1999 and 2003, studies addressing epidemiology, drug abuse, comorbidity and neuroscience have become increasingly prevalent. According to Shaffer, these findings imply there is a trend toward placing gambling in a larger context to understand not only the behavior, but also the behaviors and factors that surround it.

Before closing, Shaffer encouraged treatment providers to not let patients get lost in translation. He stressed that patients must be treated with compassion, empathy and respect as part of the treatment process. To illustrate his meaning, Shaffer offered case studies from his Expressions of Addictions project, which is a collection of photographs and mini biographies of people who have suffered from addiction at any time in their lives.

To access Dr. Shaffer’s study on trends in gambling research, click here, or visit the Institute for Research on Pathological Gambling and Related Disorders’ NCRG Conference Resource Page. When prompted, please enter the case-sensitive password: institute.

NCRG Conference: Day 1 At-a-Glance

2006-11-12T11:10:00.000-08:00

The 7th annual NCRG Conference on Gambling and Addiction kicks-off today at 2 p.m. Here’s a quick look at the sessions and special events taking place this afternoon.

Plenary Sessions:
2 – 3 p.m. - Gambling Research: What We Know and What We Need to Know for “Best Practices”
Moderator:
Phil Satre, Chairman, National Center for Responsible Gaming
Presenter:
Howard J. Shaffer, Ph.D., C.A.S., Associate Professor of Psychology in Psychiatry, Harvard Medical School and Director, Division on Addictions, Cambridge Health Alliance
Location:
Penn & Teller Theater

3 – 4 p.m. - What Happens When We Ignore Science? Risks to Public Policy and Public Health
Moderator:
Linda Cottler, Ph.D., Professor of Epidemiology, Department of Psychiatry and Director of the Epidemiology and Prevention Research Group, Washington University School of Medicine in St. Louis
Presenters:
Bo Bernhard, Ph.D., Assistant Professor in the Departments of Sociology and Hotel Management, University of Nevada, Las Vegas
Peter Nathan, Ph.D., University of Iowa Foundation Distinguished Professor of Psychology
Douglas Walker, Ph.D., Associate Professor of Economics, Georgia College and State University
Location:
Penn & Teller Theater

Track A: Scientific and Clinical
4:30 – 5:30 p.m. - Speaking the Language: Cross-Cultural Issues in Treating Pathological Gambling and Related Disorders
Moderator:
Linda Cottler, Ph.D., Professor of Epidemiology, Department of Psychiatry and Director of the Epidemiology and Prevention Research Group, Washington University School of Medicine
Presenter:
Nolan Zane, Ph.D., Professor of Psychology and Asian American Studies, University of California, Davis
Location:
Tropical Room

Track B: Government and Industry
4:30 – 5:30 p.m. - Global Gaming, Part 1: Asian and Australian Approaches to Responsible Gaming
Moderator:
Bo Bernhard, Ph.D., Assistant Professor in the Departments of Sociology and Hotel Management, University of Nevada, Las Vegas
Presenters:
Andy Abboud, Director of Government Relations for the Venetian, Las Vegas
Vicki Flannery, Gambling Industry Consultant, First CEO of the Australian Gaming Council
Ivan YIU, M.Soc.Sc., P.C.Ed., C.G.C., R.S.W., Head of the Youth and Family Section and Coordinator of Addiction Counselling Services, Tung Wah Group of Hospitals
Location:
Palma Room

Special Events
5:30 – 7 p.m. – Poster Session and Reception
Location:
Brasilia Ballroom

Women and Gambling: Does Gender Make a Difference?

2006-11-09T15:34:00.000-08:00

Past gambling research suggests that disordered gambling is more prevalent among men than among women. Recent studies have observed that women are now as likely to have gambled within the past year as men. We are now seeing new investigations focused on how gender differences might influence the development and treatment of the disorder. Do women with gambling problems and other addictive disorders have a unique experience compared to men?

In the plenary session Women and Gambling: Does Gender Make a Difference?, Drs. Debi LaPlante and Sharon Wilsnack will discuss these questions using the findings about women and addiction they each have found in their own research.

Dr. Wilsnack will provide the historical context for understanding women and addiction. Her groundbreaking research has focused primarily on alcohol use disorders and problem drinking in women, includinga a 20-year national longitudinal study of U.S. women (the National Study of Health and Life Experiences of Women [NSHLEW]), in which the investigators re-interviewed the same women at five-year intervals between 1981 and 2001 (about 1600 women in total). During the session, she will share some the findings from the NSHLEW, including some of the risk factors for problem drinking that were identified in the study. Research into gambling addiction in women has revealed that women with gambling-related problems seem to have some of the same characteristics as problem drinking women, as well as some of the same special treatment needs. (Click here for more information on Dr. Wilsnack’s current research.)

Dr. LaPlante, whose research has examined disordered gambling and other addictions in minorities and women, will discuss how gender operates both independently and in conjunction with other factors that predict addictive behavior. She also will discuss the gambling-related gender differences that seem to have endured, despite greater social acceptance of female gamblers, as well as gender differences that seem to be disappearing.

The Women in Gambling session is scheduled for Tuesday, Nov. 14 at 8:30 a.m. To access Dr. LaPlante’s gender-related research on problem gambling, visit the Institute for Research on Pathological Gambling and Related Disorders’ NCRG Conference Resource Page. When prompted, please enter the case-sensitive password: institute.

Global Perspectives on Responsible Gaming Practices

2006-11-08T16:07:00.000-08:00

As the gaming industry expands into non-U.S. jurisdictions, casino companies are recognizing the importance of adapting their responsible gaming education and outreach programs to the needs of the population centers in which they are opening and operating properties. As part of its Government and Industry conference track, the NCRG’s 7th Annual Conference on Gambling and Addiction will feature a two-part series in which both research experts and industry insiders will discuss the many issues involved with international expansion and how the industry can develop culturally-sensitive responsible gaming programs.

On Sunday, Nov. 12, Global Gaming, Part 1: Asian and Australian Approaches to Responsible Gaming, will explore the challenges facing Australia, which has one of the most highly regulated gaming industries in the world. Panelists will also discuss how native and foreign companies developing new properties in Asia may have to adjust responsible gaming messages and tactics to better suit Asian employees and customers. The impressive line-up of panelists for the session includes Ivan YIU, head of the youth and family section and coordinator of addiction counseling services of Tung Wah Group Hospitals in Hong Kong, Vicki Flannery, the first CEO of the Australian Gaming Council, and Andrew Abboud, director of government relations and community development for the Las Vegas Sands Corporation.

In Global Gaming, Part 2: Three Continents’ Approaches to Responsible Gaming, which will take place on Monday, Nov. 13, cultural perspectives from the U.S., Great Britain, South Africa and Holland will be shared. Panelists will offer their views on how casinos in each country can use science to further refine and improve the effectiveness of their responsible gaming programs. They will explore which guidelines are most effective in differentiating junk science from legitimate research and which approaches resonate most among each of their unique populations. Speakers include Peter Dean, CBE, chairman of the U.K. Gambling Commission, Clive Keegan, research manager of the South African Responsible Gaming Programme and Pieter Remmers, managing director of the Jellinek Consultancy in the Netherlands.

View the conference program for session times – both sessions will be held in the Palma room.

Internet Accountability: Responsible Gaming in Cyberspace

2006-11-02T15:54:00.000-08:00

In October, Congress passed the Unlawful Internet Gambling Enforcement Act of 2006. The law aims to choke off financial transactions related to online gambling in order to prevent Americans from gambling over the Internet. The new legislation and the discussion that have sprung up around it raise a number of legal, economic and political questions, including questions about connections between online gambling and addiction.

On the Monday of the 7th Annual NCRG Conference on Gambling and Addiction, the session Internet Accountability: Responsible Gaming in Cyberspace will examine the conventional wisdom that asserts online gambling poses a public health risk. Concerns have been raised about people who gamble alone in their homes without the social controls of other types of gambling; the allure of Internet gambling for young people; and the speed of play associated with online gambling. In fact, Rep. Robert Goodlatte has claimed that all of the risks of gambling are magnified on the Web: “There are family problems, bankruptcy problems, gambling addiction, gambling by minors…It does not help our society.”

Until now, there has been only sparse empirical research to examine these concerns. During this session at the NCRG conference, Dr. Richard LaBrie of Harvard Medical School will report on a new study of the gambling patterns of more than 40,000 sports gambling customers of bwin Interactive Entertainment AG, an online gambling company based in Vienna, Austria. It is the first study of its kind, and should shed new light onto how we view online gambling and online gamblers. Joining him on the panel will be Wolfgang Schwens, corporate social responsibility manager for bwin, who will discuss the company’s responsible gaming measures, including self-limit programs and an online self-help guide for customers worried about their gambling. Schwens also will address the challenges of implementing responsible gaming programs online and how bwin is evaluating the effectiveness of the programs it has implemented.

Spotlight on Research: Natural Recovery Among Pathological Gamblers

2006-10-31T15:08:00.000-08:00

Dr. Wendy Slutske of the University of Missouri-Columbia published a study earlier this year finding that approximately one-third of pathological gamblers experience "natural recovery" from the disorder, meaning they get better without seeking or accepting formal treatment.

Results of the study contradict what previously has been thought about gambling addiction. The American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) describes pathological gambling as a chronic and persisting disorder, yet Slutske’s study points out that recent research shows gambling-related problems aren’t always chronic, suggesting natural recovery might be common.

To further investigate these areas, Slutske documented the rates of overall recovery, treatment-seeking and natural recovery among individuals who met the DSM-IV criteria for pathological gambling in two large and representative U.S. national surveys. In her analysis, Slutske found that about 33-36 percent of pathological gamblers recovered on their own.

Slutske will discuss her research and its potential impact on pathological gambling treatment and public health policy during the conference session Getting Well on Your Own: New Research on Natural Recovery Among Disordered Gamblers, scheduled for 10 a.m. on Monday, Nov. 13. You can access Slutske’s full study here, or on the Institute for Research on Pathological Gambling and Related Disorders’ NCRG Conference Resource Page. When prompted, please enter the case-sensitive password: institute.

Spotlight on Research: Genetic Links of Disordered Gambling

2006-10-27T11:14:00.000-07:00

In research published earlier this year, Dr. Donald W. Black of the University of Iowa found that pathological gambling runs in families. Though clinicians have long suspected that genetics play a role in the development of gambling disorders, Black’s study is the first to confirm that suspicion with solid research.

While Black’s research isn’t the first to examine a connection between heredity and disordered gambling, it is the first study of its kind to include detailed interviews with family members of pathological gamblers. By tracing the families of a group of pathological gamblers and of control subjects, Black discovered, among other findings, that lifetime rates of pathological gambling disorders were significantly higher among the families of pathological gamblers.

Black’s initial study was funded by the NCRG, and now, the National Institute on Drug Abuse is supporting an expanded study in which he will analyze about three times the number of people.

Black will discuss his research and its important implications for the assessment and treatment of pathological gambling during the conference session Runs in the Family: New Research on Genetic Links of Disordered Gambling, scheduled for 11:30 a.m. on Monday, Nov. 13. You can access Black’s full study directly here, or on the Institute for Research on Pathological Gambling and Related Disorders’ NCRG Conference Resource Page. When prompted, please enter the case-sensitive password: institute.

Welcome from your Conference Hosts

2006-10-25T10:40:00.000-07:00

On behalf of the NCRG, the Institute for Research on Pathological Gambling and Related Disorders, and the Division on Addictions, we want to welcome you to the blog for the 7th Annual NCRG Conference on Gambling and Addiction. At this year’s conference, we continue our efforts to bring together individuals committed to looking beyond their experiences as clinicians, researchers, gaming industry personnel, regulators and public officials to consider how we all can work together to reduce gambling-related harms.

Our theme this year, Lost in Translation? The Challenge of Turning Good Research into Best Practices, represents our organizations’ mutual commitment to bridging the gap between scientific research and best practices. To this end, our distinguished speakers will explore how what we know about gambling—both healthy and disordered—can be translated into responsible gaming practices, prevention programs, diagnosis, treatment, public health policy and gaming regulations. The NCRG conference blog team will make sure our speakers’ messages don’t get lost in translation, keeping you informed by posting entries on the latest happenings at the conference.

As you can see by viewing the full conference program, the sessions this year tackle both timely and timeless questions. We encourage you to stay tuned to the blog during the coming weeks to get a preview of these questions and the important topics that will be addressed at the conference. We hope to see you in Las Vegas next month.

Howard J. Shaffer, Ph.D., C.A.S.
Associate Professor of Psychology in Psychiatry, Harvard Medical School
Director, Division on Addictions, The Cambridge Health Alliance

Phil Satre
Chairman, National Center for Responsible Gaming

Welcome to the NCRG Conference on Gambling and Addiction Blog

2006-10-18T08:24:00.000-07:00

We're just a little less than a month away from the 7th annual NCRG Conference on Gambling and Addiction, scheduled for Nov. 12-14 at the Rio All-Suite Hotel & Casino in Las Vegas and co-sponsored by the National Center for Responsible Gaming (NCRG) and the Institute for Research on Pathological Gambling and Related Disorders, a program of the Division on Addictions at Cambridge Health Alliance, a teaching affiliate of Harvard Medical School.

Themed Lost in Translation: The Challenge of Turning Good Research into Best Practices, this year’s conference will bring together more than 400 leaders from the government, gaming industry, and research and treatment communities to discuss the latest research on pathological gambling and related disorders and how its findings can inform the development of practical solutions to prevent and treat disordered gambling. The conference also will explore various approaches to responsible gaming across the country and around the world.

To learn more about the NCRG Conference on Gambling and Addiction, review the full conference schedule and browse through our “Conference Resources” located in the sidebar. Keep checking in with our blog in the coming weeks to read special previews of the research, topics and trends that will be covered at the conference. And don’t miss our on-site reports from the conference as we bring you up-to-the-minute details on our most provocative sessions. Make sure you’re not missing out – sign up for our RSS feed (select one of the icons in the Subscribe section of the sidebar) to have blog updates automatically delivered to you.

We're looking forward to a great conference this year and invite you to join us for this one-of-a-kind event. Register for the conference today, and we'll see you in Las Vegas, Nov. 12-14!