Julie M. Hynes, MA, RD, CPS
Youth Gambling Conference | Bridgeport, WV | Feb. 16, 2018

The complete slide
deck & print-friendly
handouts are posted at:
www.preventionlane.org/WV
9:07 AM

OBJECTIVES
1. Analyze the most recent features & forms of gaming
that affect youth: freemium games, daily fantasy
sports, esports, and “loot boxes.”
2. Explain how these new games & methods relate to
youth gambling & problem gambling.
3. Understand the implications for integrating these
issues into broader prevention settings (which will
lead us to the next session!).

HEADS UP
There may be content here that could present as
a trigger to some. Please take care of yourself
and give yourself a break if needed.

1. TRENDS.

- GAMIFICATION
- MARKETING
- BLURRINESS
Lottery machine at Sea-Tac Airport

We don’t think of these
things as gambling.
Therefore, we don’t
think our young
people are gambling.

Definition: Gambling
__________ something of value
in the ______________________
something of greater value.
hopes of obtaining
Risking
Source: American Psychiatric Association - DSM-5 (2013).

1. Prize:
DEFINITION: COMMON 3 WAYS FOR
DETERMINING GAMBLING
2. Chance:
3. Consideration:

1. PRIZE:
BLURRING LINES?
2. CHANCE:
3. CONSIDERATION:
Anything of value the sponsor awards in a promotion.
(Example: goods/services with a monetary value or
items of value.)
A process beyond the participant's direct control
determines the outcome. (Example: an instant-win
game at a fast food restaurant.)
Requires money or significant effort.
(Example: attending a sales
presentation.)

“FREEMIUM.”

LET’S LOOK AT “FREEMIUM.”
FREE* APPS…
* (WITH “IN-APP
PURCHASES.”)

DO RATINGS
STOP MOST
KIDS?

DO RATINGS
STOP MOST
KIDS?

REAL MONEY FOR PRETEND MONEY / PRIZES

AND CANDY!

Of 100 most popular Facebook games,
more than half (54%) include gambling
content (22% are slot-based)
Giroux, 2016

OOH!
WAYS TO LEVEL
UP FASTER!
TYPICAL FREEMIUM SCENARIO:
Source: Custer, R. & Rosenthal, M.
&@*$#!
IT’S GETTING
HARDER.
WOOHOO!
COOL FREE
GAME!

Most popular Apple
App Store
Categories in
October 2017, by
share of available
apps
Source: statista.com
IN-APP purchases=
$9 in every $10
spent!

“The Psychology of Freemium” : https://www.psychguides.com/interact/the-
psychology-of-freemium/
AT SOME POINT, YOU START FEELING “INVESTED.”

This = LEGAL in most states
[Here’s our super duper quick coverage of daily fantasy sports]

“DFS” - DEMONSTRATION:

LET’S PLAY “GUESS THE SPORT!”
J. Hynes | 2/16/18 | www.preventionlane.org/wv

LET’S PLAY “GUESS THE SPORT!”
J. Hynes | 2/16/18 | www.preventionlane.org/wv
Answer: League of Legends Pro League.
Source: http://espn.go.com/esports/story/_/id/14555655/latest-league-legends-news-esports

ESPORTS =
TRADITIONAL SPORTS ESPORTS
COMPETITIVE VIDEO GAMING
Etc… Etc…And new games keep coming…

NOV. 2017 BLIZZCON - >30K ATTENDEES

J. Hynes | 2/16/18 | www.preventionlane.org/wv
Source: “Competitive video
gaming will be a $1.5 billion
industry by 2020, researchers
say,” Jeff Dunn / Business
Insider / 3/27/17
http://www.businessinsider.com
/esports-popularity-revenue-
forecast-chart-2017-3

GAMBLING ON ESPORTS.
2. Betting “skins” on games
that can be purchased and
sold for real money
1. Betting on
professional
gaming teams
Image source: csgostash.com
3. Fantasy leagues
2017 Overwatch World Cup
Image source: pcgamer.com

SKINS BETTING:
REAL MONEY FOR VIRTUAL STUFF.
Esports betting = ~$2.3 billion market.
J. Hynes | 2/16/18 | www.preventionlane.org/wv
Source: http://www.bloomberg.com/features/2016-virtual-guns-
counterstrike-gambling/

LET’S TALK LOOT BOXES / LOOT CRATES

Prize.
Chance.
Consideration.

2. RELATIONSHIPS

RECALLING PROBLEM GAMBLING AS ON
A CONTINUUM.
No
Gambling Experimentation
Recreational At-Risk
Problem Gambling
(AKA “Gambling Disorder”)

Source: Brain Briefings (2007, October), Society for Neuroscience, Washington, DC
GAMING/GAMBLING & DOPAMINE
Dopamine not released when expecting a loss.
Flooded with dopamine when expecting a win!
It’s NOT about the money!

“ADDICTION” is the desired
industry term.

“Skin in the Game: Counter-Strike has spawned a wild multibillion-dollar world of online casino
gambling; it's barely regulated and open to any kid who wants in.” ESPN.com, 1/20/17

Struggle with
cutting back
Job/school
problems.
Withdrawal/
isolation
Preoccupation
Change in
friends
SIMILARITIES IN
SIGNS OF A PROBLEM.
Unusual amount of
$ or $ problemsUsing it as
an escape $!

GAMING ADDICTION THE DSM…Not yet.
“INTERNET GAMING DISORDER” (IGD) is…
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders: DSM-5. Washington, D.C: Author.

✓
✓
✓
✓
✓
✓
✓
✓
= Internet Gaming Disorder
criteria checklist (Petry, et al., 2014)
✓

WORLD HEALTH ORGANIZATION:
Coming Soon in the ICD-11: Gaming
Disorder
Source: World Health Organization. (2018). ICD-11 Beta Draft. https://icd.who.int/dev11/l-
m/en#/http%3a%2f%2fid.who.int%2ficd%2fentity%2f1448597234

WORLD HEALTH ORGANIZATION:
Coming Soon in the ICD-11: Hazardous
Gaming
Source: World Health Organization. (2018). ICD-11 Beta Draft. https://icd.who.int/dev11/l-
m/en#/http%3a%2f%2fid.who.int%2ficd%2fentity%2f1448597234

Much like the
technology
itself,
research
is new.

CAVEAT before viewing research
We should be very careful not to
pathologize all gaming behavior.

RESEARCH IN A NUTSHELL:
• There is not yet much research on newer forms
of gambling, such as DFS and esports.
• Kids who play free online games are far more
likely to develop gambling problems
• Characteristics of online gaming addiction are
almost identical to those of problem gambling
• There are key correlations with other mental
health and addiction issues.
J. Hynes | 2/16/18 | www.preventionlane.org/wv

THE FREEMIUM ISSUE.
Adolescents playing simulated
gambling games more likely
to later move to real gambling…
…and are also more likely to have later
gambling problems
King et al., 2010

SOCIAL CASINO GAMING & GAMBLING:
• Those who play social games are more likely to gamble, and have
gambling problems1
• Those who engage in “micro-transactions are far more likely to
migrate to “real” gambling.
1. Gainsbury, S., Russell, A., King, D.L., ; Delfabbro, P., Hing, N. (2016, October).
Migration from social casino games to gambling: Motivations and characteristics of gamers who gamble.
Computers in Human Behavior, 63, pp.59-67

MOTIVATIONS: FROM FREE TO PAYING
• Peer influence
• Incentives
• Ads
• Inflated payout rates
Kim, Wohl, Gupta & Derevensky, 2017

MOTIVATIONS: FROM FREE TO PAYING
Kim, Wohl, Gupta & Derevensky, 2017
“
”

MOTIVATIONS: WHY DO THEY KEEP PLAYING?
• Wealth – in-game rewards
• Achievement– pursuing goals
• Inadequacy – keeping up
King, Herd & Delfabbro, 2018

n=3,034 – grades 3, 4, 7 & 8
9%pathological gaming
●Less empathy
●More impulsivity
Source: Gentile, Choo, Liau, et al. (2011). Pathological video game use
among youth: A two year longitudinal study. Pediatrics, 127, e319-29
YOUTH “PATHOLOGICAL” VIDEO
GAMERS

Gentile, D. (2009). Pathological video-game use among youth ages 8-18: A national study.
Psychological Science, 20, 594-602.
YOUTH “PATHOLOGICAL” VIDEO
GAMERS • Sample of 1,178 youth in
the U.S.: 8.5% of youth
gamers were classified
as “pathological gamers”
• >80% play video games
at least occasionally
• “Pathological” gaming:
(using 5 of 10 of DSM-IV;
this was prior to DSM-5)

Similarities between those with internet
gaming disorder (IGD) & pathological
gamblers:
• Less sensitive to loss
• More reactive
to gaming and gambling cues
• More impulsive choices
Fauth-Büler, M., Mann, K. (2015, Nov.) Neurobiological correlates of internet gaming disorder: Similarities to
pathological gambling. Journal of Addictive Behaviors
IGD & PATHOLOGICAL GAMBLING:

3. IMPLICATIONS FOR
PREVENTION

Source: Brain Briefings (2007, October), Society for Neuroscience, Washington, DC
GAMING/GAMBLING & DOPAMINE
J. Hynes | 2/16/18 | www.preventionlane.org/wv
Dopamine not released when expecting a loss.
Flooded with dopamine when expecting a win
It’s NOT about the money!

5.6% college age (18-24)
2½ % all adults (18+)
4% teens (13-17)
YOUNG PEOPLE AT HIGHEST RISK...
~1% older adults (65+)
And
electronic
forms of
gaming are
most
addictive,
fastest at
addicting.

The
PREFRONTAL
CORTEX is the
LAST PART to
develop.
25
The brain
is still
developing
until
…AND MOST SENSITIVE TO DOPAMINE.

Availability/
Convenience
Speed &
Intensity
Isolation, lack of
connection.
Discovery
(always new
stuff)
Competition
PROBLEM GAMING & GAMBLING:
LIKELY MOST COMMONLY SHARED RISK FACTORS.
Stakes:
Rewards &
ReinforcementsDissociation
& Escape. $!

OK…SO
THEN
WHAT?

We’ll talk prevention initiatives
and what could be realistic here
in WV!
After the break…