Brief Interventions For Disordered Gambling In College Students

March Madness refers not just to the National Collegiate Athletic Association’s basketball tournament, but also to the uptick in gambling activity that ranges from office pools to betting online. An increased awareness during this time of year about gambling on college sports usually leads to questions about gambling by college students. Consequently, we have devoted the March edition of Issues & Insights to new research on college gambling.

The Task Force on College Gambling Policies emphasized the importance of using evidence-based strategies to help students with gambling problems in itsCall to Actionreport published in September 2009, but raised concerns about the dearth of research on interventions tailored for this population. A recently published study by Dr. Nancy Petry and colleagues fills a serious gap in the literature. Dr. Petry and Dr. Jeremiah Weinstock summarize the findings of this study of brief interventions for disordered gambling in college students (Petry, Weinstock, Morasco, & Ledgerwood, 2009).

College students are in a transition from adolescence to adulthood. This period is important developmentally and marked by increasing responsibility, independence, exploration and identity formation (Arnett, 2000). Unfortunately, engagement in risky behaviors also increases during this time, and gambling is one such risky behavior.

Although most college students gamble without problems, some do develop difficulties, and these difficulties can persist for years (Gourdiann, Slutske, Krull, & Sher, 2009). The prevalence of disordered gambling in college students ranges from 3 percent to 14 percent (Shaffer, Hall, & Vander Bilt, 1999). Disordered gambling is associated with poor academic performance, heavy alcohol consumption, illicit drug use, nicotine use and suicide attempts. (In the context of this article, disordered gambling refers to both problem and pathological gambling.)

Despite the prevalence and adverse consequences of disordered gambling in college students, very few college students seek treatment for gambling. Thus, active identification of students with problems is necessary. In our study, we advertised on college campuses for free and confidential gambling screening and treatment services. We also actively screened students for gambling problems and provided a small incentive (e.g., a pen or candy bar) for students to complete the gambling screen.

Students identified with problem or pathological gambling in the screening process were invited to participate in a brief intervention study. We evaluated three brief interventions that focused on reducing gambling behavior in comparison to an assessment-only control condition (i.e., they were assessed for gambling problems but were not involved in an intervention). The interventions were: 10 minutes of brief advice; one session of motivational enhancement therapy[1]; and one session of motivational enhancement therapy plus three sessions of cognitive behavioral therapy.[2]

A total of 117 college students with disordered gambling participated in the study and were randomly assigned to one of the three interventions or the assessment-only control condition. We assessed demographics and gambling behavior three times: at the beginning of the study, six weeks later, and nine months later.

The vast majority of student participants were male, with a mean age of 20 years. The average age they started gambling was 14 years, and about a third met criteria for pathological gambling (with the remainder classified as problem gamblers). The most common form of problematic gambling in the sample was betting on card games, endorsed by about half the participants.

In comparison to the assessment-only condition, students randomized to any of the brief interventions significantly decreased the number of days gambled and dollars wagered. On average, they gambled about 14 days per month at the start of the study. Nine months later, those who had received the brief interventions reduced the number of days gambled per month to approximately five to six days, while those assigned to the assessment-only control condition were still wagering an average of 10 days per month. In comparison to the assessment-only control condition, students who received the motivational enhancement intervention were almost three–and-a-half times more likely to demonstrate clinically significant reductions in gambling, defined as wagering less than 10.5 percent of their incomes.

Overall, results from this study show that administering very brief intervention strategies – such as one session of motivational enhancement therapy – can assist in substantially decreasing gambling for up to at least a nine-month period in almost two-thirds of college students with disordered gambling. Given the lack of efficacious interventions for this population, these results are noteworthy. As awareness of gambling problems on college campuses grows, more counselors, administrators and professors are expressing interest in learning about this disorder, and this study provides support for brief interventions in college students.

Nancy M. Petry, Ph.D., is professor of psychiatry at the University of Connecticut Health Center. Dr. Jeremiah Weinstock is assistant professor in the Calhoun Cardiology Center, University of Connecticut Health Center.

References

Arnett, J.J. (2000). Emerging adulthood: A theory of development from the late teens through the twenties.American Psychologist, 55, 469-480.

Gourdiann, A.E., Slutske, W.S., Krull, J.L., & Sher, K.J. (2009).Longitudinal patterns of gambling activities and associated risk factors in college students.Addiction, 104, 1219-1232.

Miller, W.R., Zweben, A., DiClemente, C.C., & Rychtarik, R.G. (1994).Motivational enhancement therapy manual: A clinical research guide for therapists treating individuals with alcohol abuse and dependence.Project MATCH Monograph Series, Vol. 2. DHHS Publication No. 94-3723. Rockville MD: NIAAA.

Petry, N.M., Weinstock, J., Morasco, B.J., & Ledgerwood, D. M. (2009). A randomized trial of brief interventions for problem and pathological gambling college students.Addiction, 104, 1569-1578.

Reilly, C., & Shaffer, H.J. (2007). Roads to recovery from gambling addiction. InRoads to Recovery from Gambling Addiction(pp. 2-5). Washington, DC: National Center for Responsible Gaming.Shaffer H.J., Hall M.N., & Vander Bilt, J. (1999). Estimating the prevalence of disordered gambling behavior in the United States and Canada: A research synthesis.American Journal of Public Health,89, 1369-1376.

[1]According to theMotivational Enhancement Therapy Manualpublished by the National Institute on Alcohol Abuse and Alcoholism, “Motivational Enhancement Therapy is based on principles of motivational psychology and is designed to produce rapid, internally motivated change. This treatment strategy does not attempt to guide and train the client, step by step, through recovery, but instead employs motivational strategies to mobilize the client’s own resources.” (Miller, Zweben, DiClemente, & Rychtarik, 1994).

[2]Using cognitive behavioral therapy (CBT) for gambling problems involves a focus on reducing the individual’s excessive gambling by correcting erroneous perceptions about probability, skill and luck that only reinforce problematic gambling behaviors. Cognitive behavioral treatment techniques include: cognitive correction, social skills training, problem solving training and relapse prevention (Reilly & Shaffer, 2007).

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Advancing The Science Of Gambling Research Through Peer Review

The Institute for Research on Gambling Disorders this week announced significant changes in its competitive research grants program. These modifications, the product of a recent review of the grants program by the Institute’sScientific Advisory Board, will offer twice as many grants, provide new opportunities for researchers beginning to explore gambling disorders and enhance the quality of research funded by the Institute—while increasing the number of investigators working in the field. (Details about our new grant categories and funding priorities can be found in theProject Grantssection.)

In addition to these developments, the Institute is focused on improving its review of grant applications by following the recent recommendations from theNational Institutes of Health(NIH), the primary federal agency for conducting and supporting medical research in the United States. These recommendations are discussed in the“Enhancing Peer Review”report, released in March 2008, which describes NIH’s self-study of its peer review procedures.

Peer review, the process of subjecting scientific or scholarly work to the scrutiny of fellow experts in the field, has been the cornerstone of NCRG-funded grant programs since their 1997 inception. All grant applications submitted to the Institute, the independent program of the NCRG charged with administering the research grant programs, are evaluated by researchers who are experts in the field of addictive behaviors. Rigorous review ensures that scientific merit solely determines the basis upon which the projects receive support. Peer review also ensures that a firewall exists between NCRG funders (the gaming industry), and the investigators.

Our goals are for the Institute’s peer review system to be rigorous, fair, efficient and effective. For example, we have adopted the NIH’s revised rating system, which provides peer reviewers with the opportunity to grade applications on a broader scale so that clearer distinctions can be made between different research proposals. As the NIH report observes, “The most reliable, consistent rating system is one that reflects reviewers’ abilities to discriminate” (National Institutes of Health, 2008).

Another challenge we face, similar to that of the NIH, is assembling the pool of peer reviewers. Although the NCRG and the Institute have been fortunate to have had distinguished expert researchers participating in our peer review panels during the past 13 years, recruitment of reviewers has become more difficult because of the time commitment required to travel to meetings. Beginning in 2010, all of the Institute’s peer review meetings will be convened by telephone conference call, as is now standard practice at the NIH. This will allow us to expand the number of experienced reviewers evaluating applications and recruit reviewers who previously were unable to participate due to time or travel restrictions. It also will save money, which will allow us to fund more grants.

The quality of peer review is an issue of vital public interest. The Internet has become one of the leading sources of health information for the public, and in a 24/7 news environment that churns out scientific news at a prolific rate, it can be hard for the public to distinguish between studies that are scientifically sound and studies with numerous flaws. If we can teach the public about the importance of peer review and explain why it helps to safeguard scientific integrity and quality, the public will reject the latest fads and junk science and be more discriminating consumers of information about science and health. Funding sources and scientific journals should be as transparent as possible about the peer review process to strengthen the public’s understanding of new scientific developments. As we roll out the new system, we will keep everyone informed and continue the discussion about our grants program and how we are working to improve the public’s health.

About the Authors

Linda B. Cottler, Ph.D., M.P.H., is professor of epidemiology in the department of psychiatry at Washington University School of Medicine in St. Louis, MO, and chair of the Institute’s Scientific Advisory Board.Christine Reillyis the executive director of the Institute for Research on Gambling Disorders.

Reference

National Institutes of Health. (2008).2007-2008 Peer Review Self-Study. Washington, DC. Retrieved fromhttp://enhancing-peer-review.nih.gov/diagnostic_phase.html.

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Creating Partnerships Between American Indian Communities And Researchers

To understand why tribal governments are reluctant to allow “outside” researchers to study their communities, consider the following story. In 2004, the Havasupai Tribe filed a lawsuit against Arizona State University (ASU) charging that ASU researchers had misused blood samples taken from tribal members who had been told that the sample material would be used for a study on the genetics of diabetes. The Havasupai later learned that the samples were also used for research on schizophrenia, inbreeding and migration patterns, without the tribe’s consent. This case reinforced Indian Country’s suspicions of research and the assumption that findings would be used to harm and humiliate Native Americans (Santos, 2008; Sahota, 2007).

Researchers interested in studying the impact of gambling on American Indian communities must understand the history this story illustrates, as well as the new research regulations some tribal governments have adopted to protect themselves by exerting more control over investigations conducted on their communities. We offer the following recommendations to researchers who are thinking about studying gambling and gambling disorders among American Indians.

Observe Proper Protocol

Issues of proper protocol can make or break a research project in Indian Country. As sovereign nations, American Indian tribal governments have the right and responsibility to regulate research on their lands, and some have created their own Institutional Review Boards (IRB) for the purpose of evaluating proposals for research on their communities (Sahota, 2007). Investigators should take care to follow the community’s research regulations when submitting the project to the tribe’s IRB.

We find that researchers are often reluctant to approach a tribal government about potential projects. One simple guideline for dealing with tribal leaders is to consider them as one would the President of the United States or a member of the U.S. Congress. Elected tribal chairs and members of tribal councils are the chosen representatives of sovereign peoples. They carry a heavy mantle of responsibility and should be accorded great respect. If the leaders and members believe that the concept of tribal sovereignty is understood and honored by researchers, they will be more cooperative and forthcoming and more likely to contribute their ideas and support to research among their community members.

Strive for Cultural Competence

The recommendation to develop a project that is culturally competent might sound like obvious advice. However, in our experience, researchers often fail to do their homework or invest time in trying to understand the community’s perspective on important issues. Learn as much as you can about the history, culture, traditions and circumstances of the community you would like to study. For example, try to understand the pace and rhythm of life in the community, which may not always proceed in accordance with your project’s timetable or deadlines. Ceremonies and rituals often take precedence, even over previously scheduled interviews with investigators.

In addition to examining your own personal preconceptions, take a critical look at the existing methodology for cultural bias. For example, current screening instruments for gambling problems have not been validated for use in American Indian populations. You might also consider how the view of gambling among Indian tribes might influence your investigation. Whereas the dominant American culture often seems ambivalent about gambling, despite the large percentage of Americans who gamble, many tribes view their own traditional gambling activities as an important and positive part of their history and culture. Additionally, for many tribal governments, gaming revenues provide the only source of governmental income and, therefore, tribal gaming’s political impacts are understood to outweigh any potential or actual social impacts.

Aim for a True Partnership

Most importantly, community leaders and tribal members should be involved from the inception of the research project as more than just human subjects to be studied. You should expect them to monitor your research project and to request continuous consultation and conversation. Be prepared to explain your project again and again to leaders, small groups and individuals and to incorporate feedback along the way.

Reciprocity should be the hallmark of research projects with American Indian communities. If investigators make use of the subjects’ time and participation, they should give back to the community by providing resources and skills and by focusing on projects that the community itself is seeking. Hiring tribal members to assist in research activities is a common practice that can benefit the tribe and also make it less likely that research participants will be exploited or exposed to unnecessary risk (Caldwell et al., 2005).

Conclusions

These are just a few of the many issues involved in the study of American Indian populations. Despite the many challenges, we are confident that researchers who make the effort to conduct community-based, collaborative research in Indian Country will succeed in producing enlightening studies that will benefit both the tribes and the gambling field.

About the Authors

Eileen Luna-Firebaugh(Choctaw/Cherokee), J.D., M.P.A., is associate head of American Indian Studies and associate professor of American Indian Studies at the University of Arizona and is a current member of the scientific advisory board of the Institute for Research on Gambling Disorders.

Katherine Spilde, M.B.A., Ph.D., is chair of theSycuan Institute on Tribal Gamingbased at San Diego State University (SDSU) and associate professor in the SDSU School of Hospitality & Tourism Management.

References

Caldwell, J.Y., Davis, J.D., Du Bois, B., Echo-Hawk, H., Erickson, J.S., Goins, R. T., Hill, C., Hillabrant, W., Johnson, S.R. et al. (2005).American Indian and Alaska Native Mental Health Research: The Journal of the National Center,12,(1), 1-21.

Legaspi, A., & Orr, E. (2007). Disseminating Research on Community Health and Well-being: A Collaboration between Alaska Native Villages and the Academe.American Indian and Alaska Native Mental Health Research, 14(1), 24-42.

Sahota, P. C. (2007). Research Regulation in American Indian/Alaska Native Communities: Policy and Practice Considerations.National Congress of American Indians (NCAI) Policy Research Center.

Santos, L. (2008). Genetic Research in Native Communities.Progress in Community Health Partnerships: Research, Education, and Action, 2(4), 321-326.

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Money, Money, Money: Current Issues Affecting Research, Recovery And Responsible Gaming

The theme of this year’s NCRG Conference on Gambling and Addiction may seem a bit simplistic. After all, isn’t winning money the currency of gambling addiction? But as the conference program shows, there are a variety of layers to this topic. First and foremost, there is new research on how people make decisions about money. Made possible by advances in brain imaging technology, investigations of the neurobiology of decision-making will shed light on why some people make poor decisions by gambling beyond their means and continue to do so in spite of adverse consequences. But suchresearchalso has implications for all of us, especially during this economic downturn that has highlighted unwise decisions about finance.

The nature and quality of decision-making also affects recovery and responsible gaming. Why do so many people with gambling problems, and with other addictive disorders, resist going to formal treatment? (Suurvali et al., 2008) This is a pivotal question because public health planners need direction to meet the varying needs of both people who are subclinical (i.e., experiencing symptoms but do not meet criteria for the most severe form of the disorder) and those who are suffering with a full-blown gambling disorder. Developers of responsible gaming programs and gaming regulators will benefit from a better understanding of decision-making by, for example, taking into account how to help gaming customers make informed decisions about their gambling (Blaszczynski et al., 2008).

The economic recession has taken its toll on resources for helping people with gambling addiction and related mental health problems. Because of diminished revenues at the state and municipal levels, funding for addressing gambling disorders has been cut or reassigned to meet other fiscal needs in several states. These budget adjustments are creating new hurdles for already-stressed treatment providers, public health officials, and community organizations. The provision of free treatment services in some states is more important than ever as people lose jobs and access to health insurance.

Money—or lack of it—also affects scientific research on gambling disorders. Since 1996, the NCRG has provided seed money that enabled scientists to conduct pilot research that is essential to securing highly competitive grants from the National Institutes of Health, the major source of funding for research in the United States. However, the exponential growth of the gambling field in recent years has not been matched by support from the National Institutes of Health for gambling research. Will young investigators enter the gambling field or mid-career scientists switch their focus to gambling if prospects for funding seem limited?

These challenges require creative and thoughtful solutions. The NCRG and the Institute are pleased to support dialogue on these issues this month as researchers, health care professionals, regulators and industry representatives from across the U.S. and around the world convene at the NCRG Conference on Gambling and Addiction.

References

Blaszczynski, A., Ladouceur, R., Nower, L., & Shaffer, H. J. (2008). Informed choice and gambling: Principles for consumer protection.Journal of Gambling Business and Economics, 2(1), 103-118.

Suurvali, H., Hodgins, D., Toneatto, T., & Cunningham, J. (2008). Treatment seeking among Ontario problem gamblers: Results of a population survey.Psychiatric Services, 59, 1343-1346

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New Research Shows Connections Between Gambling Disorders And Schizophrenia

As the body of research on gambling disorders continues to grow, scientific evidence is beginning to show that some vulnerable and special needs populations appear to be at a higher risk for developing gambling disorders than the general population. The National Center for Responsible Gaming (NCRG) and the Institute for Research on Gambling Disorders have made research on these groups a priority, supporting investigations of gambling problems among young people, women, homeless individuals and African-American adolescents.

Psychiatric patients constitute another population that has been identified by several studies as more vulnerable to excessive gambling. Numerous studies have documented the high rate of co-occurring psychiatric and addictive disorders among individuals with gambling problems.1, 2However, to date, there has been no systematic examination of gambling behaviors in individuals in outpatient treatment for psychotic disorders.

A new study by Yale University researchers Rani Desai, PhD, MPH and Marc Potenza, MD, PhD has filled this gap. The results of their study were recently published online in theJournal of Clinical Psychiatry, the third most cited psychiatric journal in the world,3in the article “A Cross-Sectional Study of Problem and Pathological Gambling in Patients with Schizophrenia/Schizoaffective Disorder.”4The study was funded by the NCRG.

The researchers interviewed a sample of 337 patients diagnosed with and in outpatient treatment for schizophrenia/schizoaffective disorder. Using the DSM-IV criteria for pathological gambling and structured psychiatric assessments, the researchers found that these patients may be at a particularly high risk for gambling disorders. While 46 percent of the participants were categorized as non-gamblers and 34.7 percent as recreational gamblers (i.e., those who gamble and are able to do so without adverse consequences), 19.3 percent were classified as either problem or pathological gamblers.4Of the group with gambling problems, 9.8 percent met the threshold for pathological gambling, the most severe form of the disorder.4Recent national studies have estimated the rate of pathological gambling among the general adult population at one percent and lower.5, 6

Desai and Potenza conjecture that several reasons might predispose this population to gambling problems. First, the cognitive disturbances associated with psychotic disorders may make it difficult for these patients to control their gambling or understand the risks of excessive gambling. Second, both schizophrenia/schizoaffective disorder and pathological gambling show evidence of impaired impulse control. The authors note that, “Clinically, this finding is important, because co-occurring addictions can complicate treatment of schizophrenia/schizoaffective disorder itself, and because even if patients are in recovery from one addictive behavior (eg, alcoholism), they may be vulnerable to substituting another (eg, problem gambling).”4

They also note that clinicians should be aware of the potential for excessive gambling in patients with schizophrenia/schizoaffective disorder and screen such patients for gambling problems, especially those who are either in recovery or actively abusing drugs or alcohol.

Third, the study showed significantly higher scores for depression among the patients with gambling problems, which can increase vulnerability to excessive gambling. The authors also note that depressive symptoms can be a response to the typical consequences of pathological gambling, such as financial stress.

This study represents a great advance as one of the largest to directly examine gambling patterns in a sample of people with schizophrenia/schizoaffective disorder. It demonstrates the importance of screening patients with psychotic disorders for gambling problems. These findings also provide a roadmap for future research, suggesting that future investigations should identify the factors that place these patients at risk for developing a gambling disorder. Finding effective therapies for this population is another priority for future investigations because current clinical trials for treatment of gambling disorders typically exclude subjects with psychotic disorders.

References

1.Cunningham-Williams RM, Cottler LB, Compton WM, 3rd, Spitznagel EL. Taking chances: problem gamblers and mental health disorders–results from the St. Louis Epidemiologic Catchment Area Study.Am J Public Health.Jul 1998;88(7):1093-1096.

2.Grant JE, Levine L, Kim D, Potenza MN. Impulse control disorders in adult psychiatric inpatients.Am J Psychiatry.Nov 2005;162(11):2184-2188.

3.ISI Web of Knowledge.Journal of Citation Reports: Thomas Reuters; 2008. Available athttp://thomsonreuters.com/products_services/science/science_products/scholarly_research_analysis/research_evaluation/journal_citation_repoAccessed September 4, 2009.

4.Desai RA, Potenza MN. A cross-sectional study of problem and pathological gambling in patients with schizophrenia/schizoaffective disorder.J Clin Psychiatry.Jun 16 2009.

5.Petry NM, Stinson FS, Grant BF. Comorbidity of DSM-IV pathological gambling and other psychiatric disorders: results from the National Epidemiologic Survey on Alcohol and Related Conditions.J Clin Psychiatry.May 2005;66(5):564-574.

6.Kessler RC, Hwang I, LaBrie R, et al. DSM-IV pathological gambling in the National Comorbidity Survey Replication.Psychol Med.Sep 2008;38(9):1351-1360.

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Cultivating The Next Generation Of Gambling Researchers

When the New Investigator category of our project grants program debuted in 2004, we sought to attract talented young researchers to the field of gambling studies. This year, with the award of a grant to Dr. Serena King of Hamline University in St. Paul, Minn., the National Center for Responsible Gaming and the Institute for Research on Gambling Disorders have supported a total of five new investigators with more than $250,000 in project grants.

The New Investigator award category is modeled on the career development grants awarded by the National Institutes of Health (NIH), including the requirement to work with a senior scientist as a mentor. But this award is more than a training grant. Past recipients of this award have made significant contributions to the field. Dr. Catharine Winstanley at the University of British Columbia, whose groundbreaking research on animal models of gambling was published in the highly regarded journal Neuropsychopharmacologyand featured in last month’sIssues & Insights, told me that the support “was invaluable to me in terms of getting my research program off the ground.” Other past New Investigator grantees, Drs. Shelly Flagel (University of Michigan) and Anna Goudriaan (University of Amsterdam) also have published their findings in competitive journals.

In addition to publishing in highly competitive journals, some have used the grant as seed money for support from the National Institutes of Health. I was very excited to learn that Dr. Silvia Martins, assistant scientist at the John Hopkins University School of Public Health, was recently awarded a grant from the National Institute on Child Health and Human Development for the expansion of the project, “Predictors of Pathological Gambling among African-American Young Adults,” for which she received a New Investigator grant in 2004.

King, our 2009 New Investigator grant recipient, is focusing her research project on one of the oldest questions in the field – why do some people develop a gambling disorder? It’s the type of fundamental issue that will not be resolved overnight. But King’s research represents a significant step forward. An assistant professor of psychology at Hamline University, King will work with mentor Dr. Ken Winters of the University of Minnesota to examine the roles that behavioral problems, genes and environment play in gambling behaviors from adolescence to young adulthood by reviewing data collected in the Minnesota Twin Family Study. King’s research will help fill a gap in the field as there has been little research to-date that specifically examines the developmental periods of adolescence to early adulthood and contribute insights that will help in the development of more effective screening and prevention strategies. As one of the peer reviewers for the New Investigator grant applications noted, “This developmental approach is important if we are to gain a foothold on understanding the precursors to pathological gambling.”

The need for more research regarding how and why people develop gambling disorders is echoed in the second project grant awarded by the Institute this year, this time in the Public Health category. In his research proposal, Dr. Adam Goodie of the University of Georgia argued there is little evidence to support the notion of a single “addictive personality,” but there is a great deal of evidence to support connections between specific personality traits and an increased likelihood of gambling problems. Goodie’s project will test whether certain personality types may have a direct, causal link to pathological gambling. The goal of the project is to improve understanding of the determining factors that contribute to the development of gambling disorders to help inform prevention and treatment of different kinds of disordered gamblers. The peer review panel convened by the Institute to review the public health research proposals praised Goodie’s project for its innovative approach, sophisticated statistical modeling procedures, and strong team of researchers.

Details about the 2009 grant recipients are available in our recentpress release, as well as in theProject Grantssection of the Web site. TheProjects Grantssection also provides information about past grant awards.

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A New Chapter In Gambling Research

Welcome to the Institute for Research on Gambling Disorders and the first edition ofIssues & Insights. Here we’ll keep you updated on the latest issues and research on gambling disorders and related topics, including feature posts from some of the leading researchers in this field. For this inaugural edition, we’re reflecting on a new chapter for both the Institute and the field of research on gambling disorders.

In 1996, when I was appointed the executive director of theNational Center for Responsible Gaming(NCRG)—the organization that provides the Institute’s funding—our understanding of why some people develop a gambling addiction was very limited. To remedy this knowledge gap, we launched the first competitive grants program for research on the disorder. At our first review meeting, Dr. Jim Langenbucher of Rutgers University, a member of the distinguished peer review panel, likened the field of gambling research to the “Wild, Wild West” and recommended a grants program that welcomed all types of investigations, from studies of the genetics of gambling disorders, to drug trials, to public health research.

The infusion of money, the openness to a wide range of topics and a commitment to the most rigorous scientific standards have created a burgeoning field that continues to expand thanks to the work of scientists around the world. NCRG-funded grants awarded through the Institute have yielded the publication of more than 150 articles in influential, peer-reviewed journals. We’re proud that the NCRG and Institute have played a role in launching the gambling research field.

After 13 years of grant-making, the NCRG decided that sustained focus on key issues should be the next step to promote seminal research. Consequently, we restructured and renamed the Institute (formerly the Institute for Research on Pathological Gambling and Related Disorders) to support the newNCRG Centers of Excellence in Gambling Research, which currently are located at Yale University and the University of Minnesota. The centers will zero in on basic issues such as how to identify young adults at risk for disordered gambling and what factors affect treatment outcomes. Although we have retooled our funding strategy to better meet the needs of a changing research landscape, our commitment to the highest standards and to the ultimate goal of effective prevention and treatment remains paramount.

Those familiar with the NCRG and the Institute may be asking, why the name change? Like our refocused grant-making strategy, our new moniker also has a direct correlation with the changing research landscape. The new name, Institute for Research on Gambling Disorders, reflects recent research that questions the term “pathological gambling” as used in the American Psychiatric Association’sDiagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV). This diagnostic code does not provide for the levels of severity of disordered gambling behavior that have been observed in research and in clinical practice. The new name better conveys this concept and, as such, more accurately reflects the conditions of the individuals we hope will be helped by our research and programs.

I hope you’ll continue to visit us atwww.gamblingdisorders.orgfor updates on our research and education programs, as well as new editions ofIssues & Insightsand our other publications.

Christine Reilly Executive Director, Institute for Research on Gambling DisordersIssues & Insights

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Risk-taking Rats May Help Advance Treatments For Gambling Disorders

At first glance, research on lab rats who “gamble” might seem either fodder for jokes or irrelevant to the search for solutions for gambling disorders; however, recently published findings of an NCRG-funded investigation at the University of British Columbia demonstrates that such research represents, as Dr. Marc Potenza of Yale University observed, a “significant step forward” that could eventually lead to new treatments for pathological gambling.

The article, “Serotonergic and Dopaminergic Modulation of Gambling Behavior as Assessed Using a Novel Rat Gambling Task,”1was published last month in Neuropsychopharmacology, the fifth-most cited psychiatry journal in the world. The authors reported that rats were able to successfully learn to “play the odds” in a gambling task, modeling human gambling behavior. According to theVancouver Sun, Dr. Catharine Winstanley, one of the study’s authors, called the study “an important first step in offering clues into what neurotransmitters or what brain chemicals are involved in regulating gambling behavior.” In 2006, Winstanleyreceived a New Investigator Grantof $57,500 from the National Center for Responsible Gaming (NCRG), through the Institute for Research on Pathological Gambling and Related Disorders (now the Institute for Research on Gambling Disorders), to help support this investigation.

During the task, the rats were able to choose from four options that differed in the probability and magnitude of food rewards and timeouts (i.e., penalty periods during which no food would be dispensed). High-stake options offered more sugar pellets, but choosing the high-stakes options also was more likely to trigger longer timeouts. According to the study, rats learned how to be “successful” gamblers, selecting the option with the optimum level of risk and reward to maximize their sugar pellet profits over time.

The study also found the rats’ decision-making became significantly impaired in the gambling task when they were treated with drugs that affected the levels of dopamine and serotonin – two neurotransmitters in the brain implicated in impulse control and drug addiction. According to the study, this suggests a role for these neurochemicals in moderating gambling behavior and a potential method of researching new leads for the development of pharmacological treatments for this disorder.

Michael Bozarth, associate professor of psychology at the University of Buffalo, the State University of New York, underscored the significance of animal models for research on gambling: “The development of adequate animal models such as that reported by Winstanley and her coworkers opens the door to studying the impact of direct manipulation of brain function and to exploring the effects of illicit drugs on gambling behavior. These types of studies, not possible in human subjects, are likely to lead to important breakthroughs in our understanding of pathological gambling just like comparable animal models were crucial to a better understanding of drug addiction.”

Dr. Winstanley established the Laboratory of Molecular and Behavioural Neuroscience at the University of British Columbia. She currently is a Michael Smith Early Career Scholar and has received numerous awards for her research, including the 2008 Wyeth Award for outstanding research in Preclinical Psychopharmacology.

References

1Zeeb FD, Robbins TW, Winstanley CA. Serotonergic and Dopaminergic Modulation of Gambling Behavior as Assessed Using a Novel Rat Gambling Task. Neuropsychopharmacology. Jun 17 2009.

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