Predatory monetization schemes in video games (e.g. 'loot boxes') and internet gaming disorder

Harmful compared to what? The problem of gaming and ambiguous causal questions

BACKGROUND AND AIMS

There has been much concern regarding potential harmful effects of video game-play in the past 40 years, but limited progress in understanding its causal role. This paper discusses the basic requirements for identifying causal effects of video game-play and argues that most research to date has focused upon ambiguous causal questions.

METHODS

Video games and mental health are discussed from the perspective of causal inference with compound exposures; that is, exposures with multiple relevant variants that affect outcomes in different ways.

RESULTS

Not only does exposure to video games encompass multiple different factors, but also not playing video games is equally ambiguous. Estimating causal effects of a compound exposure introduces the additional challenge of exposure-version confounding.

CONCLUSIONS

Without a comparison of well-defined interventions, research investigating the effects of video game-play will be difficult to translate into actionable health interventions. Interventions that target games should be compared with other interventions aimed at improving the same outcomes.

The associations between autistic characteristics and microtransaction spending

Microtransactions provide optional, virtual, video game goods that, for an additional cost to the player, provide additional game content and alter the gameplay experience. Loot boxes-a specific form of microtransaction-offer randomised rewards in exchange for payment, and are argued to be structurally and psychologically similar to gambling. Nascent research suggests that a link exists between autism and both problematic gaming and problematic gambling. Here, we investigated the relationships between autistic characteristics and experiences, and excessive video gaming and microtransaction expenditure. A sample of 1178 adults from Australia, Aotearoa, and The United States were recruited from Prolific Academic, and completed a survey measuring in-game expenditure, autistic characteristics and experiences, problematic gaming, problematic gambling, and risky loot box use. Analyses showed positive associations between autistic characteristics and experiences with problematic gaming and problem gambling symptomatology. However, results also showed a small, negative association between autistic characteristics and experiences and spending on loot boxes when problem gambling symptoms, problematic gaming, and risky loot box use were statistically controlled for. These results suggest that autistic gamers may be vulnerable to problematic gaming and gambling, but that this effect does not extend to the purchasing of microtransactions.

Normalization of Chance-Based Mechanisms in Mobile Games for Children: A Descriptive Analysis

Games for mobiles present strategies to monetize not only from selling a title but from financial exchanges that take place in the game. Those microtransactions motivate players to purchase random or surprise items (known as loot boxes) to customize game features or to overcome narrative obstacles necessary to progress to new levels. Researchers associate the practice with gambling if completing the transaction does not mean the acquisition of an item but the chance to receive it. This research quantified gambling-like features in games available for free, classified by Apple's marketplace as suitable for children from 4 to 8 years old, and from the top-downloaded list. The findings reveal normalization traces of chance-based mechanisms in most of the games. According to the research literature, early exposure to such features may result in problem gambling in adult life. This paper concluded that legal changes and more information provided by the marketplaces are needed to raise awareness of gambling-like practices in mobile games.

Exploring the relationships between psychological variables and loot box engagement, part 1: pre-registered hypotheses

Loot boxes are purchasable randomized rewards in video games that share structural and psychological similarities with gambling. Systematic review evidence has established reproducible associations between loot box purchasing and both problem gambling and problem video gaming, perhaps driven by a range of overlapping psychological processes (e.g. impulsivity, gambling-related cognitions, etc.) It has also been argued that loot box engagement may have negative influences on player financial and psychological wellbeing. We conducted a pre-registered survey of 1495 loot box purchasing gamers (LB cohort) and 1223 gamers who purchase other, non-randomized game content (nLB cohort). Our survey confirms 15 of our 23 pre-registered hypotheses against our primary outcome (risky loot box engagement), establishing associations with problem gambling, problem gaming, impulsivity, gambling cognitions, experiences of game-related 'flow' and specific 'distraction and compulsion' motivations for purchase. Results with hypotheses concerning potential harms established that risky loot box engagement was negatively correlated with wellbeing and positively correlated with distress. Overall, results indicate that any risks from loot boxes are liable to disproportionately affect various 'at risk' cohorts (e.g. those experiencing problem gambling or video gaming), thereby reiterating calls for policy action on loot boxes.

Loot box purchasing and indebtedness: The role of psychosocial factors and problem gambling

Introduction

Loot boxes are increasingly common random-reward monetization mechanisms in digital games. They are popular among gamblers and pose various risks due to their gambling-like nature, but little is known about psychosocial vulnerabilities and financial consequences of purchasing them. This article examined psychosocial associations with self-reported increase in loot box purchasing and indebtedness among past-year gamblers during the COVID-19 pandemic.

Methods

Cross-sectional survey data were collected in April 2021 from Finnish, Swedish, and British past-year gamblers aged 18 to 75 (n = 2,022). Measures of loneliness, psychological resilience, and problem gambling were studied in relation to loot box purchasing and indebtedness. Structural equation modeling was used as an analytical technique.

Results

Loneliness was positively associated with self-reported increase in loot box purchasing. No evidence was found regarding the protective role of psychological resilience in loot box purchasing. Increased loot box purchasing was associated with problem gambling. Problem gambling mediated the relationship between loot box purchasing and indebtedness.

Conclusions

The findings bring valuable insight into the psychosocial vulnerabilities and financial consequences in loot box purchasing. Loot box purchasing can add to one's financial strain particularly among vulnerable individuals such as problem gamblers, making it crucial to regulate such monetization practices.

Effectiveness of an integrated motivational cognitive-behavioral group intervention for adolescents with gaming disorder: a randomized controlled trial

AIMS, DESIGN AND SETTING

The aim of this study was to test the efficacy of the integrated cognitive-behavioral therapy with a strength-based motivational approach [integrated cognitive-behavioral therapy (ICBT)] intervention to change gaming disorder (GD) symptoms and other outcomes and to study the therapeutic mechanism. A two-arm parallel randomized waiting-list controlled trial with 3- and 6-month follow-ups were conducted in a secondary vocational school in mainland China.

PARTICIPANTS

Participants comprised 77 Chinese adolescents with GD symptoms with a mean age of 16.36 years [standard deviation (SD) = 0.93]; 88.3% were male INTERVENTIONS: Participants were randomized into an ICBT group (n = 38) and a waiting-list control (WLC, n = 39) group. ICBT intervention comprised eight weekly sessions to encourage participants to identify their interests and strengths and set goals for developing personally meaningful real-life activities.

MEASUREMENTS AND FINDINGS

The outcomes were measured at pre-treatment (t0 ), post-treatment (t1 ), 3-month (t2 ) and 6-month (t3 ) follow-ups. The primary outcome was GD symptoms at t3. Secondary outcomes included GD symptoms at t1 and t2 , and gaming motivation, maladaptive gaming cognition, depression and anxiety symptoms at t1 , t2 and t3 . With the intention-to-treat principle, the GD scores at t3 were significantly different between the CBT and WLC groups [mean difference 62.08 (SD = 10.48) versus 73.64 (SD = 11.70); Hedges' g = 1.15, 95% confidence interval = 0.67-1.62]. Linear mixed-effects modeling showed significant group × time interaction for the secondary outcomes (P < 0.01), with a moderate to strong between-group effect size in the reduction in depression symptoms (g = 0.67-0.84) and anxiety symptoms (g = 0.6-0.64). Path analysis shows ICBT leads to GD reduction through reducing gaming motivation and maladaptive gaming cognition.

CONCLUSIONS

An integrated cognitive-behavioral therapy with strength-based motivational approach intervention reduced gaming disorder symptoms and time spent gaming over a 6-month period by decreasing maladaptive gaming motivation and cognition.

The Potential Harm of Gambling Streams to Minors

Video games are designed to attract the attention of a potentially diverse audience. One of the most popular video game-related content distributor sites is Twitch, which provides daylong access to all kinds of gaming-related content through independent content creators. This platform, compared with YouTube (the world's popular video-based content distributor), has one important difference. Namely, it dominantly provides real-time video content sharing (ie, streaming). The total audience of gaming live streaming in 2021 was approximately 810 million gamers worldwide, expected to grow to 921 million in 2022. While most of the viewers are adults, 17% of male viewers and 11% of female viewers are minors, between 10 and 20 years of age.1 Risk assessment in this field is still missing, while some dangers are presumably related to the type of content shared. As gambling-related videos draw more and more viewers, the possible risk of age-inappropriate content access has appeared. Future research and policy making should consider exploring this area to protect young consumers.

Gaming disorder: A summary of its characteristics and aetiology

The emergence, development, and maintenance of gaming disorder (GD) is the result of an interplay between gaming-related factors, individual factors, and environmental factors. None of these alone are sufficient to cause a disordered state, but it is the interactive co-occurrence of all these factors, which in some cases leads to GD. The goal of the present paper is to discuss in detail these three factors based on relevant and recent findings of the literature. Among gaming-related factors, we discuss online vs. offline videogames, the role of game genres, structural characteristics, game design elements, as well as some important monetization techniques. Among individual factors demographic risk factors, personality traits, motivational factors, comorbid psychopathology, genetic predisposition, and neurobiological processes are considered. Finally, among environmental factors we discuss family factors, early life experiences, the role of peers and school-related factors, as well as the broader context of culture including the popularity of esports.

Spending Money in Free-to-Play Games: Sociodemographic Characteristics, Motives, Impulsivity and Internet Gaming Disorder Specificities

Free-to-Play games (F2P) have spread widely all over the world in recent years. The current economic model for these games is based on microtransactions, where gamers can purchase additional items or services inside the game. The aim of the present study was (1) to describe the profiles and gaming patterns of F2P gamers, and (2) to compare F2P gamers who spend money and those who do not, in terms of sociodemographic characteristics, gaming experience, motivations, impulsivity, and risk of Internet gaming disorder (IGD), in a representative sample of 5062 French online gamers. Among the total sample, 68.6% were past-year F2P gamers. Among the F2P gamers, 26.1% had spent money in the game. Spending in the game was strongly associated with IGD (6.9% of F2P gamers were disordered gamers). Flow (gaming experience) and escape (motivation) were strongly associated with spending in the game and IGD. Negative urgency (impulsivity) was positively associated with spending in the game while positive urgency was positively associated with IGD. Given the strong association between spending in the game and IGD, these results highlight the importance of prevention and regulation in the field.

No effect of short term exposure to gambling like reward systems on post game risk taking

Is engaging with gambling-like video game rewards a risk factor for future gambling? Despite speculation, there are no direct experimental tests of this “gateway hypothesis”. We test a mechanism that might support this pathway: the effects of engaging with gambling-like reward mechanisms on risk-taking. We tested the hypothesis that players exposed to gambling-like rewards (i.e., randomised rewards delivered via a loot box) would show increased risk-taking compared to players in fixed and no reward control conditions. 153 participants (M_age = 25) completed twenty minutes of gameplay—including exposure to one of the three reward conditions—before completing a gamified, online version of the Balloon Analogue Risk Task (BART). Self-reports of gambling and loot box engagement were collected via the Problem Gambling Severity Index, and Risky Loot-Box Index. Bayesian t-tests comparing BART scores across reward conditions provided moderate to strong evidence for a null effect of condition on risk-taking (BF = 4.05–10.64). Null effects were not moderated by players’ problem gambling symptomatology. A Spearman correlation between past loot box engagement and self-reported gambling severity (r_s = 0.35) aligned with existing literature. Our data speak against a “gateway” hypothesis, but add support to the notion that problem gambling symptoms might make players vulnerable to overspending on loot boxes.

Loot boxes use, video gaming, and gambling in adolescents: Results from a path analysis before and during COVID-19-pandemic-related lockdown in Italy

Loot Boxes (LBs), i.e., virtual items embedded within video games with numerous features reminiscent of gambling, are increasingly widespread among adolescents. LB use is associated with problem gambling in youth, but few studies have been conducted on the association between LB use and gambling behavior considering adolescents. Thus, the mechanisms underlying this relationship are not clear. As LB use is a significant and positive risk factor for video gaming severity, and video gaming is associated with problem gambling, we hypothesized that LB use would be related to gambling frequency and problem gambling through the intermediary role of video gaming frequency and problem video gaming. We tested our hypothesis before COVID-19-pandemic-related lockdown and during COVID-19-pandemic-related lockdown, in Italy. Study 1 was conducted with 1,078 high school students (39% boys, mean age = 16.46, SD = 1.28) before COVID-19-pandemic-related lockdown, and Study 2 was conducted with 1,204 high school students (57% boys, mean age = 15.62, SD = 0.64) during COVID-19-pandemic-related lockdown. A path analysis was carried out to analyze the significance of indirect effects from LB use to gambling behavior and problem gambling through video gaming and problem video gaming. In both the studies, results showed that LB use exerted significant and positive direct effects on video gaming frequency, problem video gaming, and gambling frequency. Moreover, LB use had indirect significant and positive effects on problem gambling through video gaming frequency, problem video gaming, and gambling frequency. Findings attest that LB use can be related to problem gambling through a greater involvement in videogames. Thus, a specific subtype of young gamblers can develop Gambling Disorder symptoms from the use of LBs and through an intense use of video games. Practical implications for prevention and treatment are discussed.

Understanding the mechanics and consumer risks associated with play-to-earn (P2E) gaming

BACKGROUND AND AIMS

Play-to-earn (P2E) gaming is a newly emerging form of gaming increasingly based on blockchain technology. In this paper, we examine the mechanics and business model of these games and their potential benefits and risks for players.

METHODS

The paper draws upon and critically synthesises the developing published literature on predatory monetization in gaming as well as objective market data drawn from credible online sources.

RESULTS

P2E gaming blurs the boundaries between gaming and trading and may not yield many of the benefits promoted to consumers or otherwise conveyed through marketing and social media messaging. Particular risks include the deflationary nature of reward currencies and the asymmetric reward structures that heavily favour early investors and exploit late adopters.

DISCUSSION AND CONCLUSIONS

This paper highlights the need for greater consumer awareness of the mechanics and risks of these new gaming models. It will be important for business models to be more transparent and designed so as to encourage more equitable game outcomes, sustainable returns, a balance between intrinsic and extrinsic rewards, and protection for potentially vulnerable players.

“These People Had Taken Advantage of Me”: A Grounded Theory of Problematic Consequences of Player Interaction with Mobile Games Perceived as “Designed to Drive Spending”

Many games which incorporate microtransactions—uncapped, repeated in-game purchases—are described by players as having had their 'dynamics designed to drive spending'. Such games are perceived by players as designed primarily to encourage spending, rather than with the improvement of the player experience in mind. However, it is unknown how playing these games affects players. We addressed the research question of “What consequences might there be of interaction with games perceived as having had their dynamics designed to drive spending?” considering adult players. We conducted semi-structured interviews and used a grounded theory method of analysis. Our findings revealed five life areas of problematic consequences: financial issues, problems at work and education due to distraction and lack of productivity, emotional consequences for self-perception, problems sleeping, and social consequences. These outcomes emerge from the interaction of players with certain vulnerability traits with these game mechanics. We discuss these findings in the context of gaming disorder and the gamblification of games.

Opening Pandora’s Loot Box: Weak Links Between Gambling and Loot Box Expenditure in China, and Player Opinions on Probability Disclosures and Pity-Timers

Loot boxes are quasi-gambling virtual products in video games that provide randomised rewards of varying value. Previous studies in Western contexts have identified a positive correlation between loot box purchasing and problem gambling severity. A preregistered survey of People’s Republic of China (PRC) video game players (N = 879) failed to replicate this correlation. We observed statistically significant but weak positive correlations between loot box expenditure and past-year gambling participation, and between loot box expenditure and impulsiveness. This study cannot prove that loot boxes are not disproportionately purchased by people with problem gambling symptomatology in the PRC or that PRC players are not potentially at risk of loot box-related harms. Instead, the evidence suggests that the relationship between loot boxes and gambling might be weaker in the PRC than in Western countries. We identified multiple unique factors about the PRC that might be affecting this relationship. For example, the lotteries are the only legally permitted form of gambling. More gamified electronic gambling products are unavailable. The limited availability of gambling meant that a low level of gambling participation (n = 87) was observed, which is a limitation of this study. Additionally, the PRC is presently the only country to legally require loot box probability disclosures as a consumer protection measure. Most loot box purchasers (84.6%) reported seeing loot box probability disclosures, but only 19.3% of this group reported consequently spending less money. Most loot box purchasers (86.9%) thought that pity-timers, which increase the winning probabilities of obtaining rarer rewards, are appropriate for implementation. Future loot box research should give greater consideration to differing cultural contexts and novel consumer protection measures.

Profiling the Potential Risks and Benefits of Emerging “Play to Earn” Games: a Qualitative Analysis of Players’ Experiences with Axie Infinity

The invention of blockchain technology, coupled with the growing interest in cryptocurrencies, has given rise to a new form of monetised gaming known as “Play to Earn” (PTE). “Axie Infinity” (AI) is currently the most popular PTE game, occupying a large portion of the online gaming market. In this paper, we profile the risks and benefits of PTE gaming, with a specific focus on AI. Qualitative data in the form of online chat threads was evaluated via a Thematic Analysis (TA) approach. The analysis revealed a number of themes including the dominance of extrinsically motivated gameplay in conjunction with negative appraisals of game quality, the benefits and costs of play, and the potential for PTE scholarship models to be associated with exploitation. The results did, however, indicate awareness of potential consumer risks. The findings have implications for informing consumer education, regulation, as well as areas of focus in future quantitative research.

Loot box engagement: relationships with educational attainment, employment status and earnings in a cohort of 16 000 United Kingdom gamers

BACKGROUND AND AIMS

Loot boxes are purchasable randomised rewards in video games that share structural and psychological similarities with gambling. Systematic review evidence has established reproducible associations between loot box purchasing and both problem gambling and problem video gaming. We aimed to measure the association between loot box engagement and socioeconomic correlates.

DESIGN

The study was a cross-sectional online survey using the recruitment platform, Prolific.

SETTING

United Kingdom (UK).

PARTICIPANTS

A cohort of 16 196 UK adults (18 + years) self-reporting as video gamers.

MEASUREMENTS

Respondents were asked about their game-related purchasing behaviour (including loot boxes), recent monthly spend on loot boxes and gambling engagement (gambling in any form; gambling online; playing 'social casino' games). A range of demographic variables were simultaneously captured, including age, sex, ethnicity, earnings, employment and educational attainment.

FINDINGS

Overall, 17.16% of gamers in our cohort purchased loot boxes, with a mean self-reported monthly spend of £29.12. These loot box purchasers are more likely to gamble (45.97% gamble) than people who make other types of game-related purchases (on aggregate, 28.13% of non-loot box purchasers gamble), and even greater still than those who do not make any game related purchases (24.38% gamble P < 0.001). Loot box engagement (as binary yes/no or as monthly spend normalised to earnings) was significantly associated with younger age (P < 0.001 and P < 0.001; respectively, for binary yes/no and monthly spend, adjusted for false discovery rate correction), male sex (P < 0.001 and P = 0.025), non-university educational attainment (P < 0.001 and P < 0.001) and unemployment (P = 0.003 and P = < 0.001). Lower earners spent a higher proportion of monthly earnings on loot boxes (P < 0.001).

CONCLUSIONS

The demographic associations of video game loot box engagement (younger age, male sex, non-university educational attainment and unemployment) mirror those of other addictive and problematic behaviours, including disordered gambling, drug and alcohol misuse.

Loot box spending is associated with problem gambling but not mental wellbeing

There are emerging concerns that loot boxes-digital video game items that can be purchased for a chance at randomized rewards-are associated with problematic gambling behaviours and, in turn, are potentially harmful. Current research suggests consistent correlations between loot box spending (LS) and problematic gambling symptomology; however, little research has looked at relationships with mental wellbeing. Here, we used a Bayesian hypothesis testing framework to assess the relative strength of evidence for relationships between LS, excessive gaming, problem gambling, mental wellbeing and psychological distress. Two thousand seven hundred twenty-eight participants who reported playing games containing loot box mechanics in the past month answered a survey assessing the above measures, as well as other forms of digital spending. The results showed extremely strong evidence for a positive correlation between LS and problem gambling; however, there was no evidence to suggest relationships between such spending and mental wellbeing or psychological distress. Exploratory results suggested that individuals who spend money on loot boxes also spend more across a range of digital purchases generally. The findings highlight an urgent need to understand what constitutes harm when considering LS effects and provide further context for discussions regarding how best to regulate such mechanisms.

Loot box spending is associated with problem gambling but not mental wellbeing

There are emerging concerns that loot boxes-digital video game items that can be purchased for a chance at randomized rewards-are associated with problematic gambling behaviours and, in turn, are potentially harmful. Current research suggests consistent correlations between loot box spending (LS) and problematic gambling symptomology; however, little research has looked at relationships with mental wellbeing. Here, we used a Bayesian hypothesis testing framework to assess the relative strength of evidence for relationships between LS, excessive gaming, problem gambling, mental wellbeing and psychological distress. Two thousand seven hundred twenty-eight participants who reported playing games containing loot box mechanics in the past month answered a survey assessing the above measures, as well as other forms of digital spending. The results showed extremely strong evidence for a positive correlation between LS and problem gambling; however, there was no evidence to suggest relationships between such spending and mental wellbeing or psychological distress. Exploratory results suggested that individuals who spend money on loot boxes also spend more across a range of digital purchases generally. The findings highlight an urgent need to understand what constitutes harm when considering LS effects and provide further context for discussions regarding how best to regulate such mechanisms.

Exploring the association between loot boxes and problem gambling: Are video gamers referring to loot boxes when they complete gambling screening tools?

Concerns regarding the similarities between video game 'loot boxes' and gambling have been supported by correlations in survey studies between loot box engagement and problem gambling scores. It is generally noted that this correlation could reflect loot box users migrating to conventional gambling, and/or people with gambling problems being attracted to loot boxes when they play video games. We describe a third possibility, that when gamers complete problem gambling screens they may be referring to harms incurred from their loot box use. Using three secondary datasets from cross-sectional online surveys, we explore this account in two ways. First, in participants who do not endorse any participation in conventional forms of gambling, we compare rates of positive (i.e. non-zero) scores on the Problem Gambling Severity Index (PGSI) in participants with and without loot box use. Second, noting that some PGSI items have less relevance to loot box use versus gambling, we compare endorsement rates of individual PGSI items, in gamers versus gamblers, and loot box users vs non-loot box users (focusing on item 3 "going back another day to win back the money you lost"). In analysis 1, positive PGSI scorers among non-gamblers were significantly elevated in loot box users vs non-loot box users, although absolute numbers were low overall. In analysis 2, there were no reliable differences (gamers vs gamblers, loot box users vs non-loot box users) in PGSI item 3 endorsement rates. We conclude that these results provide partial support for this third option, and highlight a need for future studies to consider this possibility more directly.

Gambling Features and Monetization in Video Games Create Challenges for Young People, Families, and Clinicians

Video gaming (also known as computer gaming or electronic gaming) has stirred scientific interest since its widespread adoption as a recreational activity in the 1980s. Initial research focused on the negative consequences of violent content and the development of excessive or addictive use by players. Based on evidence showing that some players develop clinically significant addiction-like symptoms such as loss of control and impaired individual, social, and occupational functioning,¹ Gaming Disorder has been recognized as an official diagnosis in the International Classification of Diseases, 11^thedition (ICD-11).² However, recent changes in video games have again produced qualitatively new problems.

Motives to engage with or refrain from gambling and loot box content: an exploratory qualitative investigation

This study examined motives to engage or refrain from engaging with gambling and loot boxes (i.e., in-game "boxes" that can be won within a game or purchased with in-game currency or real money, and which contain a random selection of prizes or objects). University students (n = 321) and community members (n = 279) completed an online questionnaire that included open-ended motives questions. Qualitative inductive content analysis was used to identify a number of overlapping motives to engage with or refrain from gambling and loot box content. Themes associated with motives to gamble included enjoyment, the chance to win, boredom, and charitable intentions. Self-reported reasons to engage with loot boxes included enjoyment, the chance to win, game progression, and passive engagement. In contrast, themes associated with refraining from gambling included negative consequences (e.g., addiction), uncertain outcomes, disinterest, finances, and accessibility. Similarly, reasons to refrain from loot boxes included negative consequences, gambling concerns, disinterest, finances, and accessibility. Overall, these findings, and particularly the overlapping themes between gambling and loot boxes engagement, provide further context and insight into the burgeoning research on loot boxes and assist in delineating their relation to gambling.Motives to engage with or refrain from gambling and loot box content: An exploratory qualitative investigation.

Associations Between Addictive Behaviors, Individual Characteristics, and the Use of Gambling Services Within the World of Gaming: Cross-sectional Survey Study

Background

Gambling within the world of gaming is an emerging phenomenon that may share common conceptual characteristics with traditional forms of gambling. The current literature suggests a higher degree of problematic behaviors in this gambling pattern, but studies are few, prompting for further research regarding individual characteristics and comorbid conditions associated with this activity.

Objective

The aim of the study is to investigate correlations between the use of gambling services within the world of gaming and individual characteristics and addictive behaviors including problem gambling.

Methods

A cross-sectional web survey was distributed to an existing panel of online respondents in Sweden. A total of 2001 respondents were included. Chi-square and Mann-Whitney U tests, followed by a logistic regression, were used in order to determine independent variables associated with gambling in the context of gaming.

Results

A total of 2.9% (58/1984) of respondents reported past-year gambling within gaming. Significant associations were found with male sex, younger age, history of treatment-seeking for alcohol problems, and higher Gaming Addiction Scale scores.

Conclusions

The demonstrated findings strengthen previously found associations between gambling in gaming and younger age, male sex, and problematic gaming behaviors. Additionally, the association with a history of treatment needs for alcohol problems adds to the previous impression of increased problem severity and comorbidity in within-gaming gamblers.

How can the potential harms of loot boxes be minimised?: Proposals for understanding and addressing issues at a national level

Background and aims

Loot boxes are in-game items which distribute rewards to players via random-number generation; many games require players to make in-game payments to access their contents. The combination of financial outlay and random rewards has raised concern about similarities to gambling. This debate paper presents a series of themes identified by an inter-institutional working group in Finland, alongside suggested actions, and are presented with the intention of stimulating debate among stakeholders.

Methods

This work uses an exploratory research approach to gather data from a range of sources, including state-of-the-art reports from several fields and qualitative content analysis of invited presentations from a range of stakeholders, including affected individuals, practitioners, and field-specific experts.

Results and Discussion

Several significant themes emerged from the work and are presented alongside a series of proposed action points. Based on this preliminary exploration we propose a series of, non-exhaustive, actions for both primary and secondary prevention. Furthermore, the group identified the potential for responsible gaming practices to be adopted which would help to minimize the harm from overspending in gaming activities. Finally, we identified the need for further research in the field, for example the use of player data and both longitudinal and qualitative studies.

Conclusions

The emergent themes are discussed in relation to both the views of the presenters and existing research in the field and are intended to promote discussion concerning the viability of context-specific approaches to an issue of global reach and significance.

Problem mobile gaming: The role of mobile gaming habits, context, and platform

Aims: Mobile gaming is a dominant form of gaming, known for its portability and for game characteristics that motivate continuous play and spending. Such involvement may also turn problematic, but research on problem gaming (PG) has tended to focus on non-mobile forms of gaming. The study was based on a cross-sectional observational design where students in upper secondary schools were recruited to a survey about mobile gaming. The age of the respondents ranged from 16 to 23 years (n = 519; 52.4% men; mean age = 17.2 years, SD = 1.1). Methods: We examined (1) gaming frequency, gaming contexts, and in-game spending in relation to PG; (2) gaming context in relation to academic achievement and sleep quality; and (3) PG according to gaming platform (i.e., playing on mobile, console/computer, or mixed platforms) with Kruskal−Wallis tests, chi-square tests and Spearman rank-order correlations. Results: PG was positively associated with mobile gaming hours per week (η² = .02, p < .01), minutes per session (η² = .03, p < .001), making in-app purchases (Cramer's V = .15, p < .05), and gaming during homework (Cramer's V = .14, p < .05). Statistically significant associations were found between mobile gaming in bed and later sleep midpoint for weekdays (r_s = .18, p < .001) and weekends (r_s = .11, p < .05). Mixed platform gamers had increased likelihood of PG, console/computer gamers had increased likelihood of being at risk for PG, and mobile gamers had lower risk for PG (Cramer's V = .18, p < .001). Conclusion: Future studies should include specific measures of mobile gaming as it appears implicated in problem gaming, albeit to a lesser degree than console and computer gaming.

What’s in the box? Exploring UK players’ experiences of loot boxes in games; the conceptualisation and parallels with gambling

Loot boxes are a popular mechanic within many video games, but it remains unclear if some forms of loot boxes can be seen of as gambling. However, the perspectives of players are often neglected, such as whether they see them as ‘fair’ game elements and how closely they feel this aligns with gambling. In this paper, we synthesise a conceptualisation for loot boxes through players’ actual experience and explore if there are any parallels with gambling. Twenty-one participants who played video games took part in the research through either an interview or online survey. Thematic analysis suggested that six themes were core to exploring loot boxes: Random Chance Effects, Attitudes Towards Content, Implementation, Parallels with Gambling, Game Design, and The Player. The results suggested both indirect and direct parallels with gambling from the players experiences. Implications of game design and classifying loot boxes as gambling are discussed in relation to game design and risk factors of gambling and purchasing behaviour.

Factors related to the dual condition of gambling and gaming disorders: A path analysis model

BACKGROUND AND AIMS

Gaming disorder has experienced rapid growth in the last decade among youth and adult populations, in parallel to the expansion of the videogame industry. The objective of this study was to explore the underlying process to explain the dual diagnosis of gaming with gambling disorder.

METHODS

The sample included n = 117 patients who met clinical criteria for gaming disorder, recruited from a tertiary care unit specialized in the treatment of behavioral addictions. Path analysis (implemented through structural equation modeling) assessed the direct and mediational mechanisms between the dual condition of gaming + gambling disorder and sociodemographic variables and personality traits.

RESULTS

The comorbid gaming + gambling disorder was met for 14.5% of the participants (additionally, 6.0% of the sample also met criteria for problematic gambling). The dual diagnosis was directly related to an older age at onset of the addiction problems, a higher level of the novelty seeking trait and being in active work. Employment status also mediated the relationship between persistence levels and chronological age. Greater psychopathological distress was related to females, higher levels of harm avoidance and persistence and lower levels of self-directedness.

CONCLUSIONS

The results of this study provide empirical evidence for the specific factors that increase the likelihood of the dual gaming + gambling disorder. Clinical settings should consider these features to improve gaming diagnosis and treatment. Preventive programs should also be focused on the most vulnerable groups to prevent onset and progression of this comorbid condition.

Skin gambling predicts problematic gambling amongst adolescents when controlling for monetary gambling

BACKGROUND AND AIMS

Skin gambling uses in-game items (skins) acquired in video games, to gamble on esports, games of chance, other competitive events and privately with friends. This study examined characteristics of adolescent skin gamblers, their engagement in monetary gambling, and relationships between skin gambling and at risk/problem gambling.

METHODS

Two samples of Australian adolescents aged 12-17 years were recruited to an online survey through advertisements (n = 843) and an online panel provider (n = 826).

RESULTS

In both samples, past-month skin gamblers (n = 466 advertisements sample; n = 185 online panel sample) were more likely to have lower wellbeing, score as having an internet gaming disorder on the IGD, engage in more types of monetary gambling, and meet criteria for problem gambling on the DSM-IV-MR-J. Past-month skin gambling uniquely predicted problem gambling when controlling for past-month gambling on 11 monetary forms and the total number of monetary gambling forms.

DISCUSSION AND CONCLUSIONS

Underage participation in skin gambling is a growing concern. The strong convergence between engagement in skin gambling and monetary gambling suggests common risk factors may increase the propensity of some adolescents to gamble on these multiple forms. Nonetheless, past-month skin gambling predicted problem gambling even when controlling for past-month monetary gambling, indicating its unique contribution to gambling problems and harm. While the study was based on non-probability samples, its results strengthen the case for regulatory reforms, age restrictions and public health education to prevent underage skin gambling and its potentially harmful consequences for children and young people.

Contentious Issues and Future Directions in Adolescent Gambling Research

Background. There is currently considerable public policy and regulatory interest in the nature and prevalence of underage gambling. Research in this area has purported to show that adolescents are at elevated risk of problem gambling and that early exposure to gambling or gambling-like activities could be a potential precursor to future harm. Method. In this commentary, we provide a critical appraisal of these arguments with reference to major studies in the field of gambling studies. It is argued that adolescent gambling research is a contentious area. Some questions remain concerning the validity of adolescent problem gambling measures, the strength of the association between adolescent and adult gambling and the impact of simulated gambling activities. Results. The paper summarises the conceptual and methodological issues that should be considered and addressed in future studies to strengthen the validity of research in this area. Conclusion. The paper encourages the greater use of harm-based measures, longitudinal and individual-level transition analyses and questions that capture the influence of activities rather than just their temporal sequencing.

Psychosocial Adjustment and Mental Distress Associated With In-Game Purchases Among Japanese Junior High School Students

In-game purchases, including microtransactions and loot box spending, are the monetization systems of free-to-play online games. Although some studies have suggested that excessive in-game purchases increase the risk of psychosocial maladjustment and mental distress as well as predict future problematic gaming and gambling practices, empirical studies on problematic behavioral patterns related to in-game purchasing among adolescents are lacking. This study sought to explore whether knowing the style of in-game purchases (non-purchase, planned purchase, or unplanned purchase) could be useful when characterizing maladaptive behavior among adolescents from the perspective of psychosocial adjustment and mental distress. A total of 335 junior high school students (aged 12–15 years) participated in the survey and completed a questionnaire assessing daily online gaming usage, in-game purchases, psychosocial adjustment, and mental distress. The results showed that (1) 30.7% of students had previously made in-game purchases, and at least 14.0% had made unplanned in-game purchases; (2) 19.2% of the users who had made unplanned purchases had spent greater than or equal to their actual monthly allowance within the past month, and (3) unplanned purchase gamers exhibited more behavioral problems and peer problems regarding psychosocial adjustment compared to planned purchase gamers, and more overall difficulties compared to non-purchasers. Meanwhile, more hyperactivity/inattention was seen among in-game purchasers compared to non-purchasers, regardless of whether the purchase was planned or unplanned. These findings support that understanding whether adolescents make unplanned in-game purchases could be a useful approach to describing the characteristics of online gamers with maladaptive tendencies.

Moderating Effect of Impulsivity on the Association Between Entrapment and Problem Gambling

Impulsivity as measure by delay discounting and entrapment have been known to influence gambling, but their individual and joint influence on problem gambling among Soccer gamblers are not yet understood. We examine the direct and moderation influences of entrapment and delay discounting on problem gambling among 174 Soccer gamblers in Nigeria. Data were obtained by means of self-report questionnaires of entrapment, delay discounting and problem gambling. Results from Hayes PROCESS moderated regression showed that delay discounting moderated the association between entrapment and problem gambling such that the association between entrapment and problem gambling was strong when delay discounting was high and diminished when delay discounting was low. Our findings provide insight into the conditional effect of delay discounting on the entrapment-problem gambling association.

Pay-to-Win Gaming and its Interrelation with Gambling: Findings from a Representative Population Sample

Pay-to-Win gaming describes a common type of video game design in which players can pay to advance in the game. The frequency and value of payments is unlimited, and payments are linked to players' competitiveness or progress in the game, which can potentially facilitate problematic behavioral patterns, similar to those known from gambling. Our analyses focus on assessing similarities and differences between Pay-to-Win and different forms of gambling. Based on a survey among 46,136 German adult internet users, this study presents the demographic and socio-economic profile of (1) Pay-to-Win gamers who make purchases in such games, (2) heavy users who conduct daily payments, and (3) gamers who are also gamblers. Motives for making payments were assessed and participation, frequency and spending in gambling by Pay-to-Win gamers are presented. To assess the similarity of Pay-to-Win gaming and gambling, we tested whether Pay-to-Win participation, frequency of payments and problematic gaming behavior are predictors for gambling and cross-tested the opposite effects of gambling on Pay-to-Win. We find that Pay-to-Win gamers are a distinct consumer group with considerable attraction to gambling. High engagement and problematic behavior in one game form affects (over)involvement in the other. Common ground for Pay-to-Win gaming and gambling is the facilitation of recurring payments.

An Evaluation of Gaming-Related Harms in Relation to Gaming Disorder and Loot Box Involvement

The specific nature of harm and functional impairment in the context of gaming disorder (GD) has received limited attention. In this study, we present one of the first concerted attempts to measure the types and degree of harm experienced by people displaying signs of problem gaming. Attempts were made to assess the extent to which types of harm were attributable to gaming as opposed to other factors. The study also investigated potential behavioural indicators of harmful involvement, including exposure to loot boxes. A sample of 471 regular gamers (M = 380, F = 73), recruited through the online platform Prolific, completed a survey where problem gaming was identified using Petry et al.’s (2014) checklist. Individuals who met the cut-off for gaming disorder scored higher than the non-problem group on most dimensions of harm, with physical and psychological types being the most common issues. Loot box expenditure was low (M = $25 in 3 months, for the 10.8% of respondents who played loot boxes) but significantly positively associated with the degree of gaming-related financial harm. This study shows that problem gaming is most strongly associated with physical or psychological harm and that financial harms may manifest in gaming activities that facilitate continuous spending options.

Secondary analysis of loot box data: Are high-spending "whales" wealthy gamers or problem gamblers?

INTRODUCTION

Loot boxes are purchasable randomised reward mechanisms in video games. Due to structural and psychological similarities with gambling, there are fears that loot box purchasing may be associated with problematic gambling. Whilst monthly expenditure is typically modest (i.e. < $20), the distribution is highly skewed, with a small number of high-level spenders, sometimes referred to as "whales". It is not known what proportion of industry profits are derived from such players, and whether they are typically wealthy individuals and/or problem gamblers.

METHODS

We used structured literature searches to identify surveys of gamers with open-access loot box data. The resulting datasets were aggregated, and correlations between loot box expenditure, problem gambling and earnings investigated using Spearman's rho correlations.

RESULTS

The combined open-access data comprised 7,767 loot box purchasers (5,933 with self-report earnings). Secondary analysis of this self-report data confirmed that disproportionate revenue appears to be generated from high-level spenders: the top 5% of spenders (> $100/month) represent half of loot box revenue. Previously reported correlations between problem gambling and loot box expenditure were confirmed, with an aggregate correlation of ρ = 0.34, p < .001. In contrast, there was no significant correlation between loot box spend and earnings ρ = 0.02, p = .10.

CONCLUSION

Our secondary analysis suggests that games developers (unwittingly or not) are disproportionately profiting from moderate and high-risk gamblers, rather than high earning customers. Such patterns of spending mirror those observed with gambling revenues, and have implications for harm minimisation and ongoing policy debates around loot boxes.

Loot Boxes, Gambling, and Problem Gambling Among Young People: Results from a Cross-Sectional Online Survey

With the introduction of gambling-like features within video games (e.g., loot boxes) new forms of hybrid-gambling products have emerged, yet little is known about their relationship to gambling and problem gambling among those most likely to engage: young people. This article examines the relationship between the purchase of loot boxes, gambling behavior, and problem gambling among young people ages 16–24. Cross-sectional data were analyzed from wave 1 of the Emerging Adults Gambling Survey, an online survey of 3,549 people, aged 16–24. Data were weighted to reflect the age, sex, and regional profile of Great Britain. Measured included past-year purchase of loot boxes, engagement in 17 different forms of gambling (weekly, yearly, and weekly spend); and problem gambling status. Other covariates include impulsivity and sociodemographic status. Young adults who purchase loot boxes are more likely to be gamblers and experience problem gambling than others. In unadjusted regression models, the odds of problem gambling were 11.4 (95% confidence interval [CI] 7.6 to 16.9; p < 0.001) times higher among those who purchased loot boxes with their own money. This relationship attenuated but remained significant (odds ratio 4.5, 95% CI 2.6–7.9) when gambling participation, impulsivity, and sociodemographic factors were taken into account. The purchase of loot boxes was highly associated with problem gambling, the strength of this association being of similar magnitude to gambling online on casino games or slots. Young adults purchasing loot boxes within video games should be considered a high-risk group for the experience of gambling problems.