- Barbara Jacquelyn Sahakian, Christelle Langley, Henrietta Bowden-Jones and Sam Chamberlain
- The conversation*
Many people have turned to online gambling during the pandemic.
And while most of us are able to gamble recreationally without serious adverse effects, the pandemic has led to an increase in gambling addiction.
The UK, for example, has seen the largest ever increase in the number of women seeking help.
This addiction can cause mental, cognitive, and relationship health problems, as well as lead to bankruptcy and crime.
Unlike alcohol and drug addiction, the symptoms of which are physically obvious, gambling addiction has less obvious signs.
Our new article, published in The Lancet Psychiatry magazine, examines research on gambling addiction and offers advice on the best way to prevent and treat the condition.
Gambling is a big deal. According to the most recent estimate by the World Health Organization (WHO), in 2016 the global annual losses due to players were estimated at 400 billion dollars.
In 2021, the UK Gambling Commission estimated the prevalence of compulsive gambling disorder at 0.4% of the population.
Another survey showed that the highest rates of problem gambling were in Asia, followed by Australasia and North America, with the lowest rates in Europe.
Researchers have developed gambling simulations (which they call “tasks”) to measure gambling addiction, such as the Iowa Gambling Task and the CANTAB Cambridge Gambling Task.
In the second, which evaluates decision making and risky bets, participants are asked to guess whether a yellow chip is hidden in a blue or red box, with the proportions of the blue and red boxes changing over time.
They can then decide how many of their points to bet on their choice.
If they are correct, the points are added to their total, but if they lose, the points are subtracted. They must be careful not to “crash”, ie not to lose any points.
This task identifies players who are at risk of developing compulsive gambling, but who may not be there yet, especially if they show signs of impulsiveness.
Through these tasks, research has shown that gambling, in healthy individuals, is more common among people between the ages of 17 and 27 and decreases with age.
Another study revealed that gamblers with addiction problems tend to increase their game over time and eventually go bankrupt.
Alcohol and nicotine addiction have also been associated with increased gambling compulsion.
The player’s brain
Neuroimaging studies clearly show that different brain regions are associated with gambling.
Research has shown that important regions associated with risky decision making include the ventromedial prefrontal cortex (involved in decision making, memory, and emotion regulation), the orbital frontal cortex (which helps the body respond to emotions), and the insula (which regulates the autonomic nervous system).
Compulsive gamblers can therefore show increased activity in these areas.
When players observe the outcome of their bet, they also show increased brain activation in the brain’s reward system, particularly in the caudate nucleus. And this can be especially strong in gambling addicts.
Dopamine, a neurotransmitter that helps nerve cells communicate, is also known to be an important chemical in the brain’s reward system.
One study showed that compulsive gamblers had significantly higher levels of arousal when dopamine was released in the brain, compared to healthy people.
The release of dopamine appears to increase the compulsion to play by increasing arousal levels, reducing the inhibition of risky decisions or a combination of the two.
Furthermore, the nucleus accumbens, which plays a role in reward processing, has been shown to be involved in risky behaviors in adolescents and adults.
This region is rich in dopamine and suggests an additional role for dopamine in risk behaviors.
How to beat gambling addiction
Currently, compulsive gambling disorder is diagnosed using the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association.
The UK’s National Institute for Healthcare Excellence (NICE) is also developing guidelines for the treatment and management of this disorder, scheduled for publication in 2024.
Current treatment options include some forms of cognitive behavioral therapy (which can help people change their thinking patterns) and self-help groups.
Some medications, such as selective serotonin reuptake inhibitors (SSRIs), may be effective in reducing certain aspects of compulsive gambling disorder symptoms, such as depression.
We also know that opioid receptors in the brain help process rewards and have long been suspected as addictive factors.
We found that there is evidence that a drug called Naltrexone, which blocks opioid receptors, can help some people with compulsive gambling disorder.
But more research is needed before it becomes standard treatment.
There are also things you can do on your own to control your gambling. The NHS Live Well website contains information on the services available to problem gamblers.
He gives advice on how to pay bills before the game, spend time with friends and family who don’t play, and deal with debt.
Players should also avoid viewing gambling as a means of making money, stop bottling up worries about their gambling habit, and avoid using credit cards to pay for bets.
As with all mental health problems, the key is to get early help and treatment.
This is especially important so that normal rewards, such as spending time with family, walking or exercising, remain enjoyable and the reward system is not “hijacked” by the game.
* Barbara Jacquelyn Sahakian is Professor of Clinical Neuropsychology at the University of Cambridge, UK.
Christelle Langley is a postdoctoral researcher in cognitive neuroscience at the University of Cambridge.
Henrietta Bowden-Jones is an honorary researcher at the University of Cambridge.
Sam Chamberlain is Professor of Psychiatry at the University of Southampton, also in the UK.
This article was originally published on the academic news site The Conversation and republished here under a Creative Commons license. Read the original version here.