Gambling Problem Trajectories and Associated Individuals Risk Factors: A Three-Year Follow-Up Study Among Poker Players

Risk Factors for Gambling Disorder: A Systematic Review

Gambling disorder is a common and problematic behavioral disorder associated with depression, substance abuse, domestic violence, bankruptcy, and high suicide rates. In the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), pathological gambling was renamed "gambling disorder" and moved to the Substance-Related and Addiction Disorders chapter to acknowledge that research suggests that pathological gambling and alcohol and drug addiction are related. Therefore, this paper provides a systematic review of risk factors for gambling disorder. Systematic searches of EBSCO, PubMed, and Web of Science identified 33 records that met study inclusion criteria. A revised study acknowledges as risk factors for developing/maintaining a gambling disorder being a single young male, or married for less than 5 years, living alone, having a poor education, and struggling financially.

Problem Gambling Poker Players: Do They Fit into Blaszczynski and Nower's Pathways Model?

Blaszczynski and Nower's (Addiction 97:487-499, 2002) Pathways Model, an integrative model based on problem gamblers' paths and comorbidities, aids in understanding the heterogeneity of problem gamblers' profiles by classifying them into three subgroups. The profiles of problem gamblers may be linked to the type of gambling practiced. Poker is a popular game, primarily due to the involvement of both chance and strategy in its outcome. However, no study has attempted to fit poker players into the Pathways Model. We recruited an online sample of 245 regular poker players (including 146 non-problem gamblers, 83 problem-gambling poker players, and 16 probable pathological gamblers). We assessed multiple variables (impulsivity, sensation seeking, alcohol and tobacco consumption, anxiety, depression, cognitive distortions) from the Pathways Model to determine whether the profiles of poker players fit into one or more gambler subgroups. Cluster analysis showed that poker players had a unique profile with a gambling practice intensity gradient. Compared to non-problem gamblers, problem gamblers displayed significantly higher levels of depression, impulsivity, gambling-related cognitive distortions, and alcohol consumption. Our results suggest that problem-gambling poker players fit into Blaszczynski and Nower's behaviorally conditioned gamblers group. This study opens avenues for both research into and treatment for problem gambling among poker players.

Perspective of Internet Poker Players on Harm-Reduction Strategies: A Cross-Sectional Study

Background: Internet gambling may increase rates of gambling harm. This current study aimed to assess Internet poker players’ views on various harm-reduction (HR) strategies. It also examined differences in these views according to the games played (poker only vs. poker plus other gambling activities), indebtedness, and problem gambling severity. Methods: Internet poker players (n = 311; 94.2% Male) recruited online between 2012 and 2014 were included in the analyses and completed a survey on indebtedness, problem gambling severity index, and ten statements regarding HR features. Results: Among the whole sample, the most frequently endorsed HR strategy was setting money limits, specialized online help, and peer support forums. People who play poker only (70%) are less prone to endorse the utility of information on excessive gambling and specialized healthcare centers. No differences were found between those people with debt versus those without regarding HR assessment. Participants with severe problem gambling were more skeptical about HR strategies based on information on specialized healthcare centers. Conclusion: Setting money limits, online help, and peer support forums are the most commonly endorsed strategies. Future research is needed to evaluate the effectiveness of online harm reduction strategies.

Tilt in Online Poker: Loss of Control and Gambling Disorder

Online poker is a form of gambling where an element of skill may influence the outcome of the game. 'Tilt' in poker describes an episode during which the player can no longer control their game by rational decisions. It leads to a loss of control over the game, a loss of emotional regulation, higher cognitive distortion, and a loss of money. This phenomenon, experienced by most players, could be the gateway to excessive gambling. The aim of this study was to assess the links between the frequency of tilt episodes, cognitive distortion, anxiety, depression, sensation seeking and excessive online poker gambling. Our sample is composed of 291 online poker players, with a mean age of 33.8 years (SD = 10.6). Participants completed an online self-assessment questionnaire, measuring the frequency of tilt episodes, cognitive distortion, anxiety, depression and impulsivity. The findings indicated that the frequency of tilt episodes and cognitive distortion were the only significant predictors of excessive online gambling (respectively, r = 0.49 and r = 0.20). Tilt frequency and cognitive distortion were strongly correlated (GRCS, r = 0.60), moderate to low correlations were found for tilt and anxiety (HADS, r = 0.40), and positive and negative urgency (UPPS, r = 0.27). To date, tilt has seldom been studied, and could improve our understanding of online poker gamblers. It could be a new means of identifying at risk gamblers, and thus facilitating preventive measures specifically adapted to this population.

Once online poker, always online poker? Poker modality trajectories over two years

•

For most players, poker trajectories remained stable over two years (i.e. stable land-based and online poker).

•

Gambling behaviors (number of gambling activities, severity of problems) were the only predictors of poker trajectories.

•

Future research should examine how poker players explain stable and unstable trajectories.

Online poker is considered more at-risk than land-based poker in terms of intense gambling behaviors and gambling problems. The development of many online gambling sites has raised public health concerns about the potential increase in online poker players. Longitudinal studies are useful to better understand the evolution of gambling behaviors; however, very few consider online poker players. Using a prospective design, this study aims to identify online and land-based trajectories over a two-year period and the factors influencing those trajectories.

Results are based on data collected at three time-points over the course of a prospective cohort study conducted in Quebec (n = 304). A latent class growth analysis was performed to determine trajectories based on the main poker modality played, either online or land-based poker. Multinomial multivariable logistic regression analyses were conducted to determine the correlates of poker playing trajectories.

Over two years, three poker playing trajectories were identified, comprising two stable trajectories [stable land-based (51.5%) and stable online (36.3%)] and an unstable trajectory [unstable online land-based (12.1%)]. The second trajectory included online poker players at baseline who transitioned to land-based poker. Number of gambling activities increased the odds of being in the first trajectory as compared to the others. Severity of gambling problems was a significant predictor of the second “unstable” or the third “stable online” trajectories, but not for the first “stable land-based” poker trajectory.

The majority of poker players remained in either the land-based or online trajectories over two years. No poker players transitioned from land-based to online poker.

Ability to Discriminate Online Poker Tilt Episodes: A New Way to Prevent Excessive Gambling?

Tilt is a very common term in online poker players' vocabulary, it describes a state where the player is no longer able to make rational decisions because they are overwhelmed by strong emotions. This study aims to explore the relation existing between the frequency of Tilt episodes, the player's perception of these episodes and excessive gambling in online poker. The sample is composed of 291 adult French-speaking online poker players. All participants completed an online self-assessment questionnaire. The results of the classification analysis showed that the sample could be divided into three groups. The first group, named ''players in control'' included low excessive gambling tendencies with low perceived and measured Tilt frequencies. The two other groups showed high measured tilt levels, with perceived tilt levels that were different from the measured levels. Furthermore, these two groups present a moderate usage risk of developing an excessive gambling tendency in a money-based game of chance. These results show the existence of a relation between the player's capacity to perceive tilt and the online poker player's behavior.