This document summarizes a training presentation on technology trends related to gambling and gaming and the risks these pose, especially for youth and those in recovery from addiction. The presentation covers how gaming has blurred the line with gambling due to microtransactions and social features. It identifies populations like youth and those in recovery that are most at risk and discusses factors like dopamine activation that make electronic gaming potentially addictive. It provides recommendations for addressing the issues at individual, local, and systems levels through education, policy, controls, and open communication between parents and children.

1. Julie M. Hynes, MA, CPS
A training at ADAPT | December 10, 2015
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2. The complete slide deck & print-
friendly handouts are posted at:
www.preventionlane.org/
adapt
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3. Why Here? Why Now?
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4. Why Here? Why Now?
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5. Why Here? Why Now?
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More than ever, behavioral health
specialists need to be aware of
technology and the issues that face
populations from youth to those in
recovery for addictions.

6. Some Questions to Ask Ourselves
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How is our definition of “gambling” blurring?
Why are youth and people in recovery at risk for
disordered gambling by merely playing a free poker or
fantasy sports app?
How do we work in prevention, and with those in
recovery, who may be gaming excessively?

7. Today’s Objectives
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• Identify several recent trends, technological
issues and parallels related to gambling,
social gaming and fantasy sports.
• Identify which populations present the
greatest risk for harmful consequences
related to excessive online gaming behavior.
• Name at least four tools that can be used to
help reduce the risk of harmful
consequences of electronic gaming.

8. Caveat
This is focused mainly on
GAMING/GAMBLING
connections, but parallels
are likely to be seen with
many other internet /
tech-related disorders.
Image purchased by J. Hynes via cartoonstock.com; please do not duplicate.

9. Trigger Warnings
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Some content here could
present as a “trigger” to those in
recovery.

10. 10
TECHNOLOGY, TRENDS &
TIE-IN’S

11. Graphic source: http://www.cyber-scholar.com/
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12. Even
at the
Happiest
Place
On
Earth!
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13. Definitions:
Gambling
Definitions:
Gambling
______ something of value
in the _________________
something of greater
value.
hopes of obtaining
RISKING
Source: American Psychiatric Association - DSM-5 (2013).

14. 14
Prize: Anything of value the sponsor awards in a promotion. (Example:
goods/services with a monetary value or items of intrinsic value.)
Definitions:
Lottery.
Definitions:
Lottery.
Chance: A process beyond the participant's direct control determines
the outcome. (Example: an instant-win game at a fast food restaurant.)
Consideration: Requires $ or significant effort.
(Example: attending a sales presentation, downloading a file.)

15. Parallels: Gaming/Gambling
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Reasons for
Play
Theme/Genre
Rewards &
Reinforcements
Dopamine
Platforms

16. Center photo: Daniel Berman.
• Technology
• Speed
• Platforms
Changing Norms.
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17. We are mobile.
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As of October 2014*
●90% of American adults have a cell phone
●64% of American adults have a smartphone
●42% of American adults own a tablet
computer
Source: Pew Internet Project
*Latest data available, as of November 9, 2015

18. 19

19. From real gamblingFrom real gambling

20. “Freemium”“Freemium”
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* (WITH “IN-APP
PURCHASES.”)

21. Real money for pretend money.Real money for pretend money.

22. ● Higher wagers
● Inflated payouts
● Better odds
● Most popular
choice for youth
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Free Internet GamblingFree Internet Gambling

23. (By the way,
this was a
“pop-up” ad on
a children’s
game.)
Free Internet GamblingFree Internet Gambling

24. 25
Pop-up on my own kid’s game

25. 
pokerstars.net
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pokerstars.com

Subtle differences.Subtle differences.

26. Have you ever
experienced a
cognitive distortion?
What was the
experience like?

27. Have you ever
experienced a
cognitive distortion?
What was the
experience like?

28. 29
Oh, the Facebook invitations…Oh, the Facebook invitations…

29. 30

30. 31
Let’s take a look online together…Let’s take a look online together…

31. 32
Let’s take a look online together…Let’s take a look online together…

32. World Series of Poker 2015 presented by…
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Source: ESPN
Investors & Sponsors.Investors & Sponsors.

33. 34

34. “Game of Skill”
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Free Internet GamblingFree Internet Gambling

35. 91%
of profits
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Image source: http://www.businessinsider.com/skilled-players-win-daily-fantasy-sports-2015-10

36. 37
Join Free!Join Free!

37. 38
Join Free! (We do a live
demonstration here…)
Join Free! (We do a live
demonstration here…)

38. 41

39. (& Skirting Them)
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FREE!*

40. • Made it illegal for banks and credit card companies to
allow money to be transferred to online casinos or
gambling websites
• Fostered growth in third party (PayPal-esque) accounts
for money transfers
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Unlawful Gambling Enforcement
Act of 2006
Unlawful Gambling Enforcement
Act of 2006

41. • Switched gears
• Gambling technically not ILLEGAL
• Up to the states to decide
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U.S. Dept of Justice Opinion, 2011U.S. Dept of Justice Opinion, 2011

42. Source: http://www.nytimes.com/interactive/2015/10/15/us/sports-betting-daily-fantasy-games-
fanduel-draftkings.html

43. Individual states sometimes have very specific, restrictive laws
about online gambling.
Some states expressly prohibit online gambling by residents while
others have no clear laws.
States currently
with legalized
online gambling:
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NV
NJ
DE
States Decide.States Decide.

44. 48
Data source: http://www.legalsportsreport.com/daily-fantasy-sports-blocked-allowed-states/
States NOT Allowing Daily
Fantasy to date (in blue) – 12/8/15
States NOT Allowing Daily
Fantasy to date (in blue) – 12/8/15

45. Connections and Concerns.
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46. This is the first
generation of
widely available
electronic gaming
& gambling.
We really don’t
know the effects
yet.
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Much like the
technology
itself,
the research is
new.

47. Background
Suggested link between adolescent
video game playing and adoption of
gambling in later life.
Brown, 1989; Griffiths, 1999.
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Mark Griffiths, 2015 - http://www.cnn.com/2015/01/21/opinion/gaming-addiction-risks/

48. Background
highly frequent and problem players of
both gambling machines and video
games report entering dissociative-
like states when playing.
(Jacobs 1988; Wood et al. 2007).
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“Internet Gaming Disorder”
A condition warranting more clinical
research and experience before it might
be considered for inclusion in the main
book as a formal disorder.
Source: http://www.dsm5.org/Documents/Internet%20Gaming%20Disorder%20Fact%20Sheet.pdf
The DSM-5The DSM-5

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51. 57
“ADDICTION” is the desired
term…

52. • DraftKings ad
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53. “Executives love to hear the phrase "addictive
gameplay.“ Game designers, speaking for myself
and those I know… find the concept intriguing but
simultaneously dangerous.”
– Erin Hoffman, Video Game Designer
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54. Bejeweled (2009)Bejeweled (2009)
Article source: Life, Addictive Game Mechanics, And The Truth Hiding In
Bejeweled. Image source: ea.com
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55. Article: imore.com
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56. Convenience
Speed &
Intensity
“Relationships”
Discovery
(new content)
Competition
Components of Addiction?Components of Addiction?
Rewards &
Reinforcements
“FOMO”“FOMO”

57. http://www.nytimes.com/2015/11/23/sports/fantasy-sports-addiction-gambling-draftkings-fanduel.html

58. Gentile, D. (2009). Pathological video-game use among youth ages 8-18: A national study.
Psychological Science, 20, 594-602. Click here for article. 64
“Pathological” Video Gamers“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)

59. FAMILIAR CRITERIA
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60. 66
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
“Pathological” Video Gamers“Pathological” Video Gamers

61. The
PREFRONTAL
CORTEX is the
LAST PART to
develop.
25years old!
The brain
is still
developing
until
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62. What
we know
about
youth
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63. 69
Oregon data: Volberg, Hedberg & Moore, 2008

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

65. Electronics: about the action. Sound familiar?
“ALMOST
WINNING”:
dopamine is
activated the
same as
ACTUALLY
winning.
Problem
gamblers are
more likely to
see their near
misses as
“NEAR WINS”
People play
LONGER
when
machines
give them
NEAR
MISSES.
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66. Addressing the Issues.

67. Recommendations:
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68. 74
●Gambling-Like Monetized Games
●Responsible Gaming Features
●Age Controls
●Data Driven Research
●Education Of Players
From: Social Games Consumer Protection Guidelines, National Council on Problem Gambling
(2013, Draft, v. 3)

69. Recommendations:
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2. Local Systems Level.

70. 76
● Education integration:
● Addictions.
● Internet safety.
● Cyberbullying.
● Brain development.
● Program/policy integration.
● Codes of conduct.
● Treatment recommendations.

71. 77
Current policy:
www.oregonpgs.org/treatment/internet-gaming-policy
 OK to treat if:
 history of gambling disorder
 co-occurring problem gambling
 a concerned other of a problem gambler

72. Recommendations:
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2. Local Systems Level.
3. Individual Level.

73. YES!!
Individual Level

74. For people in
recovery:
• Friends
• Sponsors
• Etc
Hey man, you’ve been holed up
for 8 hours. Let’s go eat.
Cu in 5
You told me to text
you…remember your deal.
Shutup give me a few
OK OK
Jordan
6:49PM
5:11PM
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Counselors: Be
mindful of HIPAA!

75. ●By searching on the app store/Google play
(etc.) for apps, mobile users can
inadvertently trigger themselves ☹
●(Kind of like any online searches for help)
●DISCONNECT payment!
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76. 82

77. 83

78. 84

79. 85

80. 86

81. ●CONTROLS: set them (your mobile carriers’,
not just the device!)
●CREDIT CARD: don’t link it.
● MONITOR: Keep computer use in open area –
if you can (desktop computer).
Other tips for those in
recovery & in general
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82. Recommendations
for Youth
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83. It’s not about TRUST,
it’s about keeping them
SAFE!
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84. Kimberly S. Young, PhD – Available on Amazon / Kindle
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85. COMMUNICATE
expectations.
Use tech
to your
advantage.
Remember about when you
need to shut the game off.
☺ love u
Jordan. phone goes off. Now.
Minecraft, mom.
K
Mom
9:46PM
9:31PM
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9:13 PM
9:45 PM
9:45 PM
9:46 PM

86. My 80’s
Frogger game
Image source: eBay user duramax1989
CONSEQUENCES
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87. 93

88. ● Check out the games/apps WITH your kids
● Play with your kids or sit with them while they play.
You will have fun and learn about their gaming, too.
● Check the ratings of the games your kids want to
play. Most games at retail stores are described and
rated by the Entertainment Software Rating Board
(ESRB). Use these ratings as you discuss the most
appropriate games with your child or teen. Note that
many of these ratings list “E” for everyone!
________________________
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89. ● Major mobile services (e.g., AT&T, T-Mobile, Verizon)
offer family protection plans
● Features include: GPS, purchase blocking, turning
off browsing/data/texting, time of day, etc.
● See www.preventionlane.org/online-safety for a list
of helpful links to these services
Practicality alert: Some features CANNOT be blocked when user has
access to WiFi (so…you may need to change your WiFi password
often!)
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90. ●Pay attention to clues: restless,
withdrawal, lack of interest, different
friends, signs you know from problem
gambling
●INTERVENE if you see warning signs.
(Get intervention tips:
www.drugfree.org/intervene)
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91. And…last but not least!
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92. preventionlane.org
Julie.Hynes@co.lane.or.us
facebook.com/
preventionlane
Thank You!
Questions, Resources, Connections :
twitter.com/PreventionLane
twitter.com/HynesUO
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