Understanding the aetiology and treatment of disordered gambling: exploring the interaction of products, environment, and individual susceptibility

Gambling is acknowledged as a mental health disorder. In the DSM-5, gambling was reclassified from an Impulse Control Disorder to an Addictive Disorder, but although previous research has identified similarities between gambling disorder and substance use disorders, less is known regarding the interaction between the motivational properties of different forms of gambling, the gambling environment, individual susceptibility, gambling related harms, and how these factors are related to treatment seeking and treatment outcomes. This portfolio of research will address this knowledge gap by advancing the traditional experimental paradigms used to investigate gambling behaviour, by utilising existing relationships with gambling treatment providers and experts by experience to better understand gambling related harms and factors that contribute to positive and negative treatment outcomes, by better understanding the role of gambling cues in gambling disorder, and by developing a novel treatment methodology to support those seeking treatment for gambling disorder. Therefore, the proposed body of work will be developed and expanded across four major objectives that will further understanding of gambling disorder development, treatment and ultimately inform policy and reduce gambling related harm.

First, I will use virtual reality to better understand how events that happen whilst gambling, influence gambling behaviour. For example, on a slot machine, a gambler can experience an event called a near-miss where the reels line up in a configuration that appears close to winning. These types of events encourage continued gambling, however the psychological mechanisms behind this are unclear. The research can also look at other events important in gambling such as speed of play, and stake size limits, all in safe, realistic virtual environments and establish which product features can be adjusted to decrease gambling harm. This is important to better understand how specific gambling product features influence gambling behaviour, and gambling related harm.

Second, the research aims to generate a deeper understanding of gambling related harms, and treatment outcomes. Harms experienced by the gambler themselves and those close to them can be extremely damaging; working with some of the biggest treatment providers in the UK, this research aims to better understand harms, and how they relate to treatment outcomes. We will also work to calculate the social and economic costs of gambling which will further reveal the negative impact of disordered gambling across different parts of society.

Third, I will use a variety of measures to understand how gamblers react to specific gambling cues. I will use different outcome measures, such as skin conductance, heart rate, and eye tracking. This is important as physiological arousal to gambling cues is an important factor in craving, which can lead to increased gambling or relapse in gamblers in recovery. By better understanding these mechanisms, we can reduce gambling related harm.

Fourth, the research will combine the virtual reality work, and the knowledge generated through working with experts and treatment providers to develop a new treatment methodology for disordered gambling. To be piloted through existing treatment providers, the research will examine outcomes for treatment delivered in virtual environments that can be tailored to the specific circumstances of the individual, compared to more traditional treatment delivery methodologies.