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A Focus Group Study of Predictors of Relapse in Electronic Gaming Machine Problem Gambling, Part 2: Factors that ‘Pull’ the Gambler Away from Relapse

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Abstract

This study aimed to develop an empirically based description of relapse in Electronic Gaming Machine (EGM) problem gambling (PG) by describing the processes and factors that ‘pull’ the problem gambler away from relapse contrasted with the ‘push’ towards relapse. These conceptualisations describe two opposing, interacting emotional processes occurring within the problem gambler during any relapse episode. Each relapse episode comprises a complex set of psychological and social behaviours where many factors interact sequentially and simultaneously within the problem gambler to produce a series of mental and behaviour events that end (1) with relapse where ‘push’ overcomes ‘pull’ or (2) continued abstinence where ‘pull’ overcomes ‘push’. Four focus groups comprising thirty participants who were EGM problem gamblers, gamblers’ significant others, therapists and counsellors described their experiences and understanding of relapse. The groups were recorded, recordings were then transcribed and analysed using thematic textual analysis. It was established that vigilance, motivation to commit to change, positive social support, cognitive strategies such as remembering past gambling harms or distraction techniques to avoid thinking about gambling to enable gamblers to manage the urge to gamble and urge extinction were key factors that protected against relapse. Three complementary theories emerged from the analysis. Firstly, a process of reappraisal of personal gambling behaviour pulls the gambler away from relapse. This results in a commitment to change that develops over time and affects but is independent of each episode of relapse. Secondly, relapse may be halted by interacting factors that ‘pull’ the problem gambler away from the sequence of mental and behavioural events, which follow the triggering of the urge and cognitions to gamble. Thirdly, urge extinction and apparent ‘cure’ is possible for EGM gambling. This study provides a qualitative, empirical model for understanding protective factors against gambling relapse.

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References

  • Abbott, M., & Volberg, R. (1996). The New Zealand national survey of problem and pathological gambling. Journal of Gambling Studies, 12, 143–160.

    Article  Google Scholar 

  • Abbott, M., Volberg, R., Bellringer, M., & Reith, G. (2004). A review of research aspects of problem gambling. Auckland: Auckland University of Technology.

    Google Scholar 

  • Avery, L., & Davis, D. (2008). Women’s recovery from compulsive gambling: Formal and informal supports. Journal of Social Work Practice in the Addictions, 8(2), 171–191.

    Article  Google Scholar 

  • Battersby, M., Pols, R., Oakes, J., Smith, D., McLaughlin, K., & Baigent, M. (2009). The definition and predictors of relapse in problem gambling. From http://www.gamblingresearch.org.au.

  • Blaszczynski, A., McConaghy, N., & Frankova, A. (1991). A comparison of relapsed and non-relapsed abstinent pathological gamblers following behavioural treatment. British Journal of Addiction, 86, 1485–1489.

    Article  PubMed  CAS  Google Scholar 

  • Breen, R. (2006). A practical guide to focus-group research. Journal of Geography in Higher Education, 30(3), 463–475.

    Article  Google Scholar 

  • Callan, M., Ellard, J., Will Shead, N., & Hodgins, D. (2008). Gambling as a search for justice: Examining the role of personal relative deprivation in gambling urges and gambling behaviour. Personality and Social Psychology Bulletin, 34(11), 1514–1529.

    Article  PubMed  Google Scholar 

  • Diaz, J. (2000). Religion and gambling in Sin-city: A statistical analysis of the relationship between religion and gambling patterns in Las Vegas residents. Social Science Journal, 37(3), 453–458.

    Article  Google Scholar 

  • DiClemente, C. C., & Prochaska, J. O. (1982). Self-change and therapy change of smoking behavior: A comparison of processes of change in cessation and maintenance. Addictive Behaviors, 7(2), 133–142.

    Article  PubMed  CAS  Google Scholar 

  • Echeburua, E., Fernandez-Montalvo, J., & Baez, C. (2000). Relapse prevention in the treatment of slot-machine pathological gambling: Long-term outcome. Behaviour Therapy, 31(2), 351–364.

    Article  Google Scholar 

  • Gamblers Anonymous. (2009). Gamblers anonymous. From http://www.gansw.org.au/index.htm. Retrieved 2 Jan 2010.

  • Gernstein, D., Hoffman, J., Larison, C., Engelman, L., Murphy, S., Palmer, A., et al. (1999). Gambling impact and behavior study report to the national gambling impact study commission. New York: National Opinion Research Centre at the University of Chicago.

  • Gomes, K., & Pascual-Leone, A. (2009). Primed for change: Facilitating factors in problem gambling treatment. Journal of Gambling Studies, 25(1), 1–17.

    Article  PubMed  Google Scholar 

  • Goudriaan, A., Oosterlaan, J., De Beurs, E., & Van Den Brink, W. (2008). The role of self-reported impulsivity and reward sensitivity versus neurocognitive measures of disinhibition and decision-making in the prediction of relapse in pathological gamblers. Psychological Medicine, 38(1), 41–50.

    Article  PubMed  CAS  Google Scholar 

  • Hodge, D., Andereck, K., & Montoya, H. (2007). The protective influence of spiritual—Religious lifestyle profiles on tobacco use, alcohol use, and gambling. Social Work Research, 31(4), 211–219.

    Article  Google Scholar 

  • Hodgins, D., & El-Guebaly, N. (2004). Retrospective and prospective reports of precipitants to relapse in pathological gambling. Journal of Consulting and Clinical Psychology, 72(1), 72–82.

    Article  PubMed  Google Scholar 

  • Hodgins, D., & el-Guebaly, N. (2010). The influence of substance dependence and mood disorders on outcome from pathological gambling: Five-year follow-up. Journal of Gambling Studies, 26(1), 117–127.

    Article  PubMed  Google Scholar 

  • Hodgins, D., Ching, L., & McEwen, J. (2009). Strength of commitment language in motivational interviewing and gambling outcomes. Psychology of Addictive Behaviors, 23(1), 122–130.

    Article  PubMed  Google Scholar 

  • Hollander, J. (2004). The social context of focus groups. Journal of Contemporary Ethnography, 33, 602–637.

    Article  Google Scholar 

  • Ingle, P., Marotta, J., McMillan, G., & Wisdom, J. (2008). Significant others and gambling treatment outcomes. Journal of Gambling Studies, 24(3), 381–392.

    Article  PubMed  Google Scholar 

  • Ladouceur, R., Sylvain, C., Boutin, C., Lachance, S., Doucet, C., Leblond, J., et al. (2001). Cognitive treatment of pathological gambling. The Journal of Nervous and Mental Disease, 189(11), 774–780.

    Article  PubMed  CAS  Google Scholar 

  • Ledgerwood, D., & Petry, N. (2006). What do we know about relapse in pathological gambling? Clinical Psychology Review, 26, 216–218.

    Article  PubMed  Google Scholar 

  • MacKillop, J., Anderson, E., Castelda, B., Mattson, R., & Donovick, P. (2006). Divergent validity of measures of cognitive distortions, impulsivity and time perspective in pathological gambling. Journal of Gambling Studies, 22, 339–354.

    Article  PubMed  Google Scholar 

  • Miles, M., & Huberman, M. (1994). An expanded source book. Qualitative data analysis, London (2nd ed.). New Dehli: Sage Publications.

    Google Scholar 

  • Nelson, S., LaPlante, D., LaBrie, R., & Shaffer, H. (2006). The proxy effect: Gender and gambling problem trajectories of Iowa gambling treatment program participants. Journal of Gambling Studies, 22(2), 221–240.

    Article  PubMed  Google Scholar 

  • Oakes, J., Battersby, M., Pols, R., & Cromarty, P. (2008). Exposure therapy for problem gambling via videoconferencing: A case report. Journal of Gambling Studies, 24(1), 107–118.

    Article  PubMed  Google Scholar 

  • Oakes, J., Pols, R., Battersby, M., Lawn, S., Pulvirenti, M., & Smith, D. (2011). A focus group study of predictors of relapse in electronic gaming machine problem gambling, part 1: Factors that ‘push’ towards relapse. Journal Gambling Studies. doi:10.1007/s10899-011-9264-y.

  • Oei, T., & Gordon, L. (2008). Psychosocial factors related to gambling abstinence and relapse in members of gamblers anonymous. Journal of Gambling Studies, 24(1), 91.

    Article  PubMed  Google Scholar 

  • Patford, J. (2009). For worse, for poorer and in ill health: how women experience, understand and respond to a partner’s gambling problems. International Journal of Mental Health and Addiction, 7(1), 177–189.

    Article  Google Scholar 

  • Petry, N. (2003). Patterns and correlates of gamblers anonymous attendance in pathological gamblers seeking professional treatment. Addictive Behaviors, 28, 1049–1062.

    Article  PubMed  Google Scholar 

  • Petry, N., & Weiss, L. (2009). Social support is associated with gambling treatment outcomes in pathological gamblers. American Journal on Addictions, 18(5), 402–408.

    PubMed  Google Scholar 

  • Pokies Anonymous. (2010). From http://www.hotfrog.com.au/Companies/Pokies-Anonymous. Retrieved 11 Feb 2010.

  • Productivity Commission. (1999). Australia’s gambling industries (report no. 10). Canberra: AusInfo.

    Google Scholar 

  • Rutter, M. (1985). Resilience in the face of adversity: Protective factors and resistance to psychiatric disorder. British Journal of Psychiatry, 147, 598–611.

    Google Scholar 

  • Slutske, W., Caspi, A., Moffitt, T., & Poulton, R. (2005). Personality and problem gambling: A prospective study of a birth cohort of young adults. Archives of General Psychiatry, 62(7), 769–775.

    Article  PubMed  Google Scholar 

  • Stein, S., Eadington, W., & Cornelius, J. (1993). The role of support in recovery from compulsive gambling. Gambling Behavior and Problem Gambling, 15, 627–640.

    Google Scholar 

  • Strauss, A., & Corbin, J. (1990). Basics of qualitative research. Grounded theory procedures and techniques. Newbury Park, CA: Sage.

    Google Scholar 

  • Sylvain, C., Ladouceur, R., & Boisvert, J. (1997). Cognitive and behavioural treatment of pathological gambling: A controlled study. Journal of Consulting and Clinical Psychology, 65(5), 001–006.

    Article  Google Scholar 

  • Thomas, S., & Jackson, A. (2008). Report to the department of justice. Risk and protective factors in problem gambling University of Melbourne. Monarsh: Monarsh University and the Victorian Government.

    Google Scholar 

  • Thygesen, L., & Hodgins, D. (2003). Quitting again: Motivations and strategies for terminating gambling relapses. eGambling The Journal of Gambling Studies. doi:http://www.camh.net/egambling/issue9v1/research/thygesen/index.html.

  • Walker, M. (1992). Irrational thinking among slot machine players. Journal of Gambling Studies, 8(3), 245–261.

    Article  Google Scholar 

  • Welte, J., Barnes, G., Wieczorek, W., Tidwell, M., & Parker, J. (2001). Alcohol and gambling pathology among US adults: prevalence, demographic patterns and comorbidity. Journal of Studies on Alcohol, 62(5), 706–712.

    PubMed  CAS  Google Scholar 

  • Worthington, A., Brown, K., Crawford, M., & Pickernell, D. (2007). Gambling participation in Australia: Findings from the national household expenditure survey. Review of Economics of the Household, 5(2), 209–221.

    Article  Google Scholar 

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Acknowledgments

The researchers would like to acknowledge Gambling Research Australia (GRA) who has commissioned this study and the support from the Office for Problem Gambling, Department for Families and Communities South Australia during the period of this study. We thank the participants who gave freely of their time and to our colleagues in the Statewide Gambling Therapy Service (SGTS) who provided excellent support in recruitment and follow up. We would also like to acknowledge the assistance and support of Gambling Helpline, Relationships Australia, Pokies Anonymous and OARS in recruitment and ongoing support for the follow up of Participants.

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Authors and Affiliations

  1. Flinders Human Behaviour and Health Research Unit, Department of Psychiatry, Flinders University, GPO Box 2100, Adelaide, SA, 5001, Australia

    J. Oakes, R. Pols, M. Battersby, S. Lawn & D. Smith

  2. Statewide Gambling Therapy Service, Flinders Medical Centre, E2 The Flats, Flinders Drive, Bedford Park, SA, 5042, Australia

    J. Oakes

  3. Suite 4A 151, Consultation Liaison Psychiatry Service, Flinders Medical Centre, Flinders Drive, Bedford Park, SA, 5042, Australia

    R. Pols

  4. Discipline of Public Health School of Medicine, Flinders University, GPO Box 2100, Adelaide, SA, 5001, Australia

    M. Pulvirenti

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  1. J. Oakes
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  2. R. Pols
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  3. M. Battersby
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  4. S. Lawn
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  5. M. Pulvirenti
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  6. D. Smith
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Correspondence to J. Oakes.

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Oakes, J., Pols, R., Battersby, M. et al. A Focus Group Study of Predictors of Relapse in Electronic Gaming Machine Problem Gambling, Part 2: Factors that ‘Pull’ the Gambler Away from Relapse. J Gambl Stud 28, 465–479 (2012). https://doi.org/10.1007/s10899-011-9267-8

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  • DOI: https://doi.org/10.1007/s10899-011-9267-8

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