Mark R Dixon amp Alyssa Wilson Southern Illinois University The Road to Somewhere Problem gambling is not the problem Problem gambling is the outcome of deeper rooted clinical problem Treatment should be designed to treat what the cause of the gambling is not just the gambling ID: 440091
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Slide1
Bridging the Gap between Research and Practice
Mark R. Dixon & Alyssa Wilson
Southern Illinois UniversitySlide2
The Road to Somewhere…..Slide3
Problem gambling is not the problem.
Problem gambling is the outcome of deeper rooted clinical problem.
Treatment should be designed to treat what the “cause” of the gambling is, not just the gambling itself.
Life is not just “fine”
except
for problems with gambling. Slide4
Popular Treatment Approaches
Gamblers Anonymous
Disease model
Client is a victim
You never “beat” the disease
No active treatment. Social support group.
Self-Exclusion Programs
Self or court orders gambler to be banned from gaming establishments
No way to ban online or illegal local gambling
Medication
Certain dopamine blockers can be effective at suppressing gambling for some people
Remove the medication, the problem returns
Psycho-educational
Teach people about game odds
Teach about risk to self or others from repeated gamblingSlide5
Classic Behavioral Treatments
Aversive Conditioning
Thought suppression
Self-monitoring/reinforcementSlide6
Contemporary Behavioral Contributions
Contingency-based ModelsSlide7
Response CostSlide8Slide9
Behavioral Contributions
Contingency-based Models
Language-based Models
External rulesSlide10
Dixon (2000) – The Psychological Record
Subjects: 5 Recreational roulette players
Baseline: Wagered on numbers they picked or the experimenter picked.
Intervention: Provided rules to the subjects
Roulette is easy to win; the more you play the more you win; the best way to win is to pick your own numbers
Roulette is a losing game; the more you play the more you lose; the experimenter can not predict good/bad numbers
Outcome: relative rise and decline in wagers while contingencies remained the same
Conclusion: Rules matter – contingencies do not Slide11
Dixon, Hayes, & Aban (2000) – The Psychological Record
Subjects: 45 Recreational roulette players
Baseline: Wagered on numbers they picked or the experimenter picked.
Intervention: Provided one set of rules to the subjects
Roulette is easy to win; the more you play the more you win; the best way to win is to pick your own numbers
OR---
Roulette is a losing game; the more you play the more you lose; the experimenter can not predict good/bad numbers
Outcome: relative rise and decline in wagers while contingencies remained the same
Conclusion: Rules matter – contingencies do not Slide12
Behavioral Contributions
Contingency-based Models
Language-based Models
Delivered Rules
Self-RulesSlide13
Recent Attention Paid to Near-MissSlide14Slide15Slide16
Procedure
Participants – 18 recreational slot machine players
Setting - small room, computer, video camera, observation mirror. Three computerized slot machines available concurrently.
Method –
100 trials
w
/ 20% chance of a win on every trial
100 trials
w
/ 0% chance of a win on every trial
Various densities of near-misses on each “slot machine”
Reinforcement densities were constant on each slot machineSlide17Slide18Slide19
What we know:
Subjects will rate near-miss displays as:
Closer to wins
More pleasurable / less aversive to look at
Subjects will prefer near-misses in concurrent operant preparations
Density effect of NM
Extinction conditions alter preference
Neurological traces of the near-miss
Near-misses produce different levels of dopamine in brain
Pathological gamblers react neurologically different than non-pathological Slide20
What we don’t know:
What behavioral process produces a near-miss effect?
Will the near-miss effect be demonstrated with other casino games?
Can the near-miss effect be assessed independently of the by-chance
reinforcers
that occur during gamblingSlide21
What Actually is the Near-Miss Effect?
Product of Stimulus Generalization
Current display looks structurally similar to a reinforced display, and thus it serves reinforcing function
A Discriminative Stimulus
Signals the availability of an upcoming
reinforcer
Product of Verbal Construction
Or, an interaction of all the above?Slide22
Almost winning…A verbal event
“Almost”Slide23
“9 + 4 = 14”
“9 + 4 = 14”
Antecedent
“Almost” + GCR
“What is 9 + 4 ?”
Speaker
Listener
Math Time
Behavior
Consequence
“What is 9 + 4 ?”
Verbal Construction
Note: GCR might be < for “almost” than for “correct”Slide24
Looking for House #34
See House #26
“Almost There”
Arrive Soon at House #34
Antecedent
Behavior
ConsequenceSlide25
Looking for House #34
See Gas Station
“Almost There”
Arrive Soon at House #34
Antecedent
Behavior
Consequence
See Sign for Off Ramp
See Sign for Sunset Blvd
See House #26Slide26
“Almost”
Desired Outcome
In Close ProximitySlide27Slide28
Methods
16 participants with history of gambling
Rating of 100 various slot machine displays
Near miss - loss - win
HOW CLOSE IS THIS DISPLAY TO A WIN?
1
(not at all)
5 10
(very much like a win)Slide29
Methods
Phase 1:
Rate slot machine images
Phase 2:
Develop 3 three member stimulus classes
Attempt to derive “almost” to non-near miss display
Phase 3:
Repeat exposure to Phase 1 taskSlide30Slide31Slide32
More than Slots
Many more types of near misses occur while gambling:
Blackjack
Roulette
CrapsSlide33
BlackjackSlide34
Near Miss: Blackjack
Participants
:
5 undergrads with history of playing cards for money
Paid 50 dollars in lotto drawing based on # of chips left
50 trials (1o practice trials)
Data Collection
Self-recorded data
Experimenter IOR on 30% trials
End of trial – circle number 1-9 on how close their hand was to a win
1 = no chance ; moderate chance; good chance (as anchors)
Record their score, dealer’s score and if they won or not on that given handSlide35
Results
2 factor Near-Miss Effect
Non-bust loss
Mathematical difference between dealer and player
Minimal Difference between player and dealer cards
Non-Bust (under 21)
Near
Miss
Minimal Difference between player and dealer cards
Bust
(over 21)
No Near MissSlide36
Average Loss TrialsSlide37
All Loss Trials (all players combined)Slide38
RouletteSlide39Slide40
Near Miss: Roulette
Participants:
28 College Undergraduates
(run concurrently)
Extra credit value based on winnings
First 5 students to hit a number = 10 x points
Next 5 = 5 x points
Remainder of students = 1 x point
Played 60 trials of roulette
1 single bet on a single number
(1:38 odds of winning)
Rating of outcome
“How close to a win was this outcome for you?”
Scale 1 to 10Slide41Slide42Slide43
Alternative Methods
Self-reports of:
How close to win
How much do you like
Preference for near-misses during gambling
Interaction between display and superstitious reinforcement
Can we show a “preference” for near-misses absent of the reinforcement interaction?Slide44
Paired-Choice Near- Miss
Participants
34 College Undergraduates
Awarded course extra credit
Randomly assigned to 2 groups of 17
Instructed to choose between two slot images.
“Which one would you rather see if you were playing a slot machine?”
Procedures
Exposure to 120 trials of 3 trial types
Win
vs
Loss
Win
vs
Near Miss
Near Miss
vs
Loss
Experimental Group
5 min intervention
Control Group
5 min break in hallwaySlide45
Intervention Details
Prior research suggests that rules are effective ways of altering gambling behavior
Dixon (2000); Dixon,
Aban
, & Hayes (2000)
Dixon & Delaney (2006)
Prior research also suggests that the
deliteralization
of language can alter the current functions of a specific verbal stimulus
Aka:
defusion
in therapy contextsSlide46
Experimental Intervention: (one slide)
Almost winning is not winning at all
Almost winning is a trick played on you by the slot machine
Almost winning makes you feel good, but it is false feeling
Losing is losing is losing is losing is losing is losing
Repeat for 2 minutesSlide47
Which One??
A
BSlide48
Which One??
A
BSlide49
Which One??
A
BSlide50Slide51Slide52Slide53
Variations of Effect
The Near-Miss effect varies
Not based exclusively on physical characteristics of the stimulus
Core behavioral process rests on altering of psychological function of the stimulus (stimuli)
Altering psychological function will alter the type of stimulus that is considered a near-missSlide54
Variations of Assessment
The Near-Miss Effect can be assessed with novel methods and produce similar effects
Verbally based interventions for gamblers who are under control of near-misses appear promisingSlide55
Nastally
and Dixon (2011): The Psychological Record
N=3 Pathological gamblers
MBL across participants
Baseline Computerized slot machine play
50, 70, 90 trials at baseline
Report out loud how close each outcome was to a win
1 (very far from a win) to 10 (very close to a win)Slide56
SIMULATIONSlide57
SIMULATION
Visible Symbols
on WheelSlide58
Treatment
Intervention
ACT intervention targeted each of the 6 components
Intervention delivered via PowerPoint presentation each 5 min in length
Slides consisted of words/pictures in form of directions + experiential exercises
Each component was delivered at equal length of time
Return to computerized slot machine playSlide59
Psychological
FlexibilitySlide60
Baseline Play and Self-Ratings
Baseline Play and Self-Ratings
Baseline Play and Self-Ratings
30 min ACT
30 min ACT
30 min ACT
Post-Treatment Play and Self Ratings
Post-Treatment Play and Self Ratings
Post-Treatment Play and Self Ratings
Time
Client 1
Client 2
Client 3