Kim Mills: It used to be that if you wanted to gamble, you had to go to a casino or a racetrack to do it. But the expansion of online gambling and newly loosened laws around sports betting mean that people can now place bets from just about anywhere. Unlimited gambling opportunities are just a few clicks away on your smartphone. Now, psychologists and other researchers are investigating whether that increased access could lead to an increase in problem gambling.
Gambling disorder is the only behavioral addiction recognized in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR). Do new opportunities for gambling mean that more people are at risk of developing it, and who is at risk? Are there demographic, personality, or other factors that make people more likely to develop a gambling addiction? What treatments are available and what are the barriers people face in accessing treatment? What role does stigma play and what will it mean that exposure to gambling is increasing not just for adults, but also for kids via sports betting ads and gambling in video games?
Welcome to Speaking of Psychology, the flagship podcast of the American Psychological Association that examines the links between psychological science and everyday life. I’m Kim Mills.
We have two guests today. First is Dr. Lia Nower, a distinguished professor and director of the Center for Gambling Studies at Rutgers University. She’s a clinician and attorney who specializes in gambling disorder and other behavioral disorders. Her research focuses on online gambling and video gaming, sports wagering, the causes and treatment of gambling and gaming disorder, and gambling related policy issues. She’s a member of the board of directors and chairs the Research Committee of the National Council on Problem Gambling and won that organization’s 2019 Research Award and its 2022 Lifetime Research Award. She’s authored several policy initiatives regarding responsible gambling and co-edited the book The Wiley-Blackwell Handbook of Disordered Gambling.
Next is Dr. Shane Kraus, an assistant professor of psychology and director of the Behavioral Addictions Lab at the University of Nevada Las Vegas. He’s a licensed clinical psychologist and an expert in behavioral disorders, including gambling disorder. He studies the factors that contribute to the development of addictive behaviors and other co-occurring disorders, especially in at-risk groups such as military veterans. He’s also exploring effective screening approaches for identifying people with problem gambling. Thank you both for joining me today.
Shane Kraus, PhD: Thank you so much.
Lia Nower, PhD, JD: Thank you.
Mills: Let’s start by giving listeners some context about how the landscape around gambling has changed in the last decade or so. I mentioned it’s more available than ever. Dr. Nower, can you start by telling us briefly about why that is? What laws have changed and what other changes have occurred to make gambling easier to access?
Nower: Probably the major change has been overturning PASPA, which was a law that prohibited—I mean, it did a lot of things, but it prohibited sports wagering—in 2018. And in response to that, New Jersey was the first state after Nevada to actually start legalized online sports wagering, but a lot of other states have followed suit. Four years prior, New Jersey was one of the states that also initiated online casino gambling, which is in a murkier area and hasn’t had as much uptake from the states. But those things have really opened accessibility to pretty much everyone from their smartphone.
Mills: So let’s talk about problem gambling. I mentioned in the introduction that gambling addiction is the only behavioral addiction listed in the DSM-5-TR. What does that mean? What’s a behavioral addiction and how is it different from other addictions? Dr. Kraus, let’s start with you on that one.
Kraus: Yeah, sure. Thank you. So, as you know, gambling disorder is a behavioral addiction. Substance use—I think this came through many years ago, in 2013, when gambling went from pathological gambling to gambling disorder because of really great scholarship and research identifying those issues or really showing that it was addictive behavior. I think the reason it is an addiction or similar is because of the criteria of things like craving, loss chasing, failure to control oneself, really experiencing a lot of consequences.
Many of the similarities that we see with addictive behaviors or substance use disorders—there’s some slight differences, but really, the hallmark symptoms are similar—and that’s been shown through really good longitudinal work, clinical work, and research, demonstrating that very similar patterns—that gambling is an addictive disorder. And a behavioral addiction is just something that you don’t have to ingest the substance in your body to have a change or an impact to your body. And in this case, gambling itself can have profound changes to your body as well as your life, particularly when it’s problematic. So, I think that’s kind of the changes. And right now, gambling disorder is the only behavioral addiction for DSM-5-TR for treatment.
Mills: So, if you were to look at the brain of somebody with a gambling addiction problem in an fMRI machine, for example, would it look like the brain of somebody who is, say, addicted to methamphetamine?
Kraus: Okay. Yeah. What I would say is that there are differences, but there are greater similarities in how cues or reactions or when we think about—there’s a dopamine or D(3) receptor in the brain. I think there’s a piece, the pathway looks similar between substance use and gambling, and that’s actually one of the reasons it was reclassified. All substances are slightly different because of the pathway and how they react in the brain. So we can’t say they’re the same, but they’re similar in a sense. The core ingredients, I would say, from a neurobiological perspective, are similarly there, which is why it was reclassified. They’re one of the many reasons it was reclassified as addictive behavior. So, how someone experiencing problem gambling might react to a cue—or a gambling cue, a lottery, a slot machine—those reactions in their brain and how it lights up are similar to someone who has substance use who sees cues as well. So, a little different, but also similar enough to say, “Yes, this is support for a biological mechanistic relationship in the brain here for addiction.”
Mills: Dr. Nower, let me ask you, do we know whether the increased availability of gambling is actually leading to an increase in people developing gambling disorder, or is it still too soon for researchers to tell?
Nower: It’s too soon for this particular wave of sports wagering. However, what we do know is areas—and I’ll use New Jersey, where I am, as an example—that have a lot more gambling opportunities, have higher rates. For example, our rate of high risk problem gambling in the state of New Jersey is six percent, which is three times what the last national prevalence study said was the rate for the country. And, what happens is as you have more availability, you have more acceptability, and more accessibility, over time, more and more people take it up, which means that very small percentage of people who are going to habituate and develop problems also grows. But it’s a slower process. We’re not going to see this nationwide for another five to 10 years.
Kraus: I would absolutely just agree that—absolutely, I agree 100% with that response. I think, when we look at other substance use disorders and other things—when we increase access to things—we generally see a pattern of increase of disordered or problematic use. It’s just not immediate. It’s a kind of slow start. And, I think what we are lacking right now systematically is epidemiological or really prevalence-based research for gambling, for sports wagering, things like that. I think we really don’t have—I think—have some trends here in Nevada. We also have some trends with data we’re collecting as well. But, I think we really need to be really looking at this because we don’t want to wait five years from now as just discussed, and then suddenly we go, "Oh, we have some concerns here." That’s too long, I think, to really wait, given the wide expansion of sports betting, which is now in 38 states, and a year ago, two years ago, it was 31. So, it’s drastically increasing.
Mills: What are the biggest risk factors for problem gambling? Are there demographic variables or personality traits or other things that put people at a higher risk?
Nower: I mean, there’s a lot of ideological factors, which is something that our group studies a lot of. Childhood maltreatment, so abuse, neglect, exposure to trauma, experiencing trauma. There’s certain personality variables, like higher rates of impulsivity and risk taking. There’s a lack of active stress coping styles such that certain subgroups of individuals use gambling to help them cope with stress. And then there’s also this intergenerational family modeling piece. So, one study that we did really sort of showed that people who were exposed to gambling in addition to other substances, they would increase their frequency, not just of that behavior, but of other addictive behaviors, and that then led to higher levels of problems, gambling severity. So, what you see at home and what you participate in as a child, very predictive of your patterns as you get older.
Kraus: Yeah. And, I would say that work in military, we know a risk group. We see strong, robust relationships with trauma, history and childhood, as well as PTSD; current trauma; many deployments; increased levels of mental health; other issues. So, gambling disorder unfortunately often co-occurs with other behaviors or in other issues. It does not happen in isolation. So, I think we see similar relationships.
I would say though, for sports betting and sports wagering, that we’re doing—our lab’s also doing some work in this area. I think we’re getting signals of younger, under 30 males. I think there are some demographics that we need to be thinking about, and part of that is technology. Who’s using the technology for gambling? And I think some of these technologies might be more used by younger populations, and that’s not necessarily a bad thing, but what are the safeguards? How do we look at to make sure we don’t have a problem developing for, critically, younger people? And, this is what we’re publishing and finding in our literature as well. So, I do think we need to be thinking about these issues for online activity that we’re on. I don’t know that we have all those answers yet.
Nower: I think that’s true. I think with the emerging adult population, we just got the Center of Excellence grant to look at emerging adults who gamble in a national prevalence study. So we’re going to be able to tell whether or not there’s higher rates in states that are gambling involved versus those that have less gambling. It might be interesting; that may not be as much of a driver as we think it is.
Mills: Dr. Kraus, I know that part of your research is on developing effective screening methods for gambling disorder. How much screening is done now in places like primary care doctors offices or other settings and what does effective screening look like?
Kraus: Yeah, so I think the short answer, the first answer is that there’s not enough. So, not surprising. Oh my gosh, there’s really not a lot. I think there’s just really not a lot of standard screening. I think you can screen—so, we did a study a number of years ago in VA and veterans health care and primary care, and we show that you can screen. Three-item screeners are very effective and could be useful. I don’t think it takes a lot of time to screen. I mean, you can be screening in primary care in one or two minutes. The issue is we’re not having conversations with medical providers, mental health providers, with people around problem gambling. This is why we call it the hidden epidemic or the hidden issue, hidden addiction.
I think some organizations—the VA, for example—Veterans Affairs, I think is really embracing more standardized screening. That’s a lot of our work that we’re doing. It’s a group that serves 10 million patients. So, from my perspective, if I can make a big change, I’m going to make it in the largest health care organization in the country. And, I think those are inroads that we’re making. And, I think we’ve established effective screening tools. The brief biosocial gambling screener, the BBGS, is quite good. So, I think there are effective ways, but I think getting people to be invested and realize, “Wow, I need to screen my patients for gambling just like I do for alcohol, depression, suicide.” It should be an annual screen given that people who have gambling disorder often go 10, 20 years before they get help, after they really have had a lot of profound issues, whether legal or—yeah.
Mills: How do you get past people’s tendency to basically lie? I mean, this is something that if you’ve lost the house, you’re going to be feeling an awful lot of shame. So how can you screen for people who aren’t going to tell you the truth?
Nower: Well, so the veterans, Shane’s group, they’ve done a fabulous job of really raising awareness in their population. I can tell you in the studies that we’re doing, we’ve developed this short kind of gambling intervention to use in doctor’s offices, other settings. We’ve had that exact problem, where if the word gambling is mentioned—so, Shane mentioned the brief biosocial gambling screen—that mentions the word gambling. So, we have had to adapt all of our materials such that people are asked about activities and only when they’re locked into the activities do we then ask them questions about gambling. Because gambling is acceptable, but it’s also highly stigmatizing to be a gambler. And people who buy lottery tickets or buy raffle tickets or whatever, will say, "Well, I don’t gamble," because they don’t want that label on themselves. So, right now, I’d say things are where alcohol was in the 50s and where cigarettes were in the 40s—we’re really in the glamorized/stigmatized stage right now.
Kraus: Yeah, absolutely. Yeah. And, part of our project was to train medical nurses and doctors and therapists just to ask these basic questions. And, really, it wasn’t that—once they realized the importance of it. So, when we found, identified people with gambling that almost all of them were suicidal and had high risk that was unknown due to gambling, and they go, “Oh, when I screen for gambling and I do find it and I can treat someone who’s high risk for suicide.” So, part of it is really that knowledge, but I think it has to happen from—there are many reasons we need to change our attitude around providing free access to treatment for gambling in each state. And, we have to have changed the culture around gambling as mentioned earlier. It’s just not there.
Mills: For our listeners who might be thinking about whether they buy lottery tickets or go online and do sports betting, what are the hallmarks of having a problem? How do you know when you’ve stepped over the line from, “I’m just an occasional gambler and this is kind of fun” to, “this is a problem.”
Nower: So, it sort of starts with being preoccupied. You’re thinking about it at times you should be doing other things. And then there are some symptoms that parallel substances, like experiencing withdrawal when you’re not doing it, having to gamble with more and more money to achieve the same level of excitement. There’s also, then, more serious symptoms, like you recognize you’re doing this to escape from your problems. You’re losing jobs, you’re losing relationships. You’re borrowing money in the form of bailouts from other people to pay your bills. So, as it goes along, the symptoms get progressively—and then you’re chasing your losses. So, you go back another day to try to recoup the money that you lost the day before. And, when you start to see these symptoms sort of pile up, you then know you’re kind of moving across this spectrum toward disorder.
Kraus: Yeah, absolutely. When I do trainings—I was just going to say that chasing losses is a big one. That’s often the turning point when someone’s like, “Oh, I’m going to go back the next day. I know I can win it back.” That to me, I always tell people, when you hear that, I want the hair on the back of your neck to stand up immediately. Yeah, I literally say that in trainings. I think that’s a big one. It’s a turning point when you’re losing more money than you can afford. When you’re losing money you can’t afford to lose is when you’re really having issues.
Mills: What kinds of treatments and therapies are available to treat gambling disorder and how effective are they?
Kraus: I would just say that treatments for gambling work. I think there’s a couple of big issues. As mentioned, we’re kind of in the 50s, 60s for addictions, how we think about it. So, stigma is a big thing. People, they have a lot of shame and stigma. We morally judge people for gambling if they have an issue, but if they have substance use, we’ll go, “Oh yeah, it’s a brain disease,” and we have a little bit more—and, I think they’re both addictions. We should not have that differential. We shouldn’t make a difference. So, I think people often go a long time before getting help, but if they’re engaged in treatment, we know evidence-based treatments, cognitive behavioral therapy can be very effective. We know psychoeducation can be effective. We know groups can be effective, group therapy, Gamblers Anonymous. I think what matters is when someone’s working towards treatment, that’s helpful.
Treatment works, but gambling is an addiction. People have to know that relapse is common. I always tell people, they’re like, “Oh, I slipped.” And I say, “Oh, well, thank you for being honest. And, I expected that; this is part of the struggle.” I think, personally, our lab, we’re looking more at things like mindfulness-based relapse prevention or more kind of newer terms, helping people slow down, connect with their body. Because gambling just doesn’t happen. It’s not automatic. It’s a process. So, treatment does work, and I always want people to have hope, but they also have to disclose they have an issue and seek help and talk to someone. And, I think there are many programs out there who’ll work with them, and I think it’s important to find the treatment that works, but we know from really good established literature that brief treatments work.
So sometimes a 45-minute conversation with someone who’s early in having some issues can make some profound changes—and that’s a wonderful thing—versus someone who might’ve had issues for many years. We’re thinking about medication is, like an off-label medication for naltrexone or something like that, with psychotherapy. So, it’s really about matching the treatment based on the severity and where that person’s at. And, my goal is always to get people very early and not 20 years later. And I do both, but 20 years later is three divorces, homelessness, $200,000 in debt with often lots of issues rather than, they’re having some struggles, let’s hook them up right now.
Nower: And, I also think it’s important to identify the underlying risk factors that I mentioned before, because what I’ve seen in my own practice and in my research is this addiction shifting where people can have the best gambling treatment, but then they’re not telling anyone they’ve developed a sex addiction or they’re binge eating. So, they’re shifting these addictions and those things go back to these ideological risk factors like trauma, like impulsivity, like these different things that, if left unaddressed, you’re just going to be moving the little shell under this shell to the other shell.
Mills: So, where can individuals go to get this kind of effective treatment? I mean, if most primary care physicians are not even screening, I would assume that they’re also not treating, but how do you get effective treatment?
Nower: Well, it’s state by state, sadly. I mean, this goes to what’s lacking in the U.S., which I know is not an answer to this question, but if you ask it, I have a lot of thoughts. But, it’s on a state by state basis. And, I’m just going to speak to New Jersey, because that’s where I live. I mean, we have one of the most robust networks, as you do in Nevada, where it’s free treatment, not just for the individual with the gambling problem, but also their families. You can get resources pretty much everywhere in the state. And now, the state has begun certifying whole treatment centers to treat throughout the state multiculturally so that we’re making sure we get people of different races, ethnicities, sexual orientations. We have counselors who are going to meet people where they are. But some states don’t even have free treatment.
Kraus: Yeah. Yeah. I was just going to say, I think the first thing, I think, if someone’s not sure, I think sometimes looking at their local place—I think the National Center for Problem Gambling, the NCPG, I think if you go to their website, you can search and we can give you some links on that. But yeah, in Nevada, for example, I’m actually sitting on that board where we spend over $2 million a year for free treatment for problem gambling. And Nevada and New Jersey really lead this way. And, I think that should be standard. If a state has legalized gambling, they should be offering free treatment to the individual, their families, their spouses. Because gambling affects spouses and family members and children. It’s devastating. And, I think Nevada is something that they do that, and so does New Jersey and other states as well, California, and there are other states as well, but it should be universal.
I think if you’re going to operate any gambling, there should be free treatment. And, when we’re waging $15 billion for Super Bowl Sunday in one day, I don’t think there’s any excuses that the money’s not there. When Nevada spends about $2 million—which I would argue we need a little bit more money—but, I really think if we did this across the states, we’re not looking at billions of dollars. I mean, really, there’s plenty of funding there, and it’s really quite unfortunate for that.
But again, I think people, if they have insurance, they should be searching. I think most states have great programs that are doing problem gambling work and will connect people, but there’s also some national organizations that, if they’re not sure, they can look them up and they can type in their zip code and they’ll find it right away. And we’ll also send you some links as well that we can provide on this podcast as well for folks.
Nower: And, you want to make sure that whoever you go to is a certified gambling counselor. I mean, those of us that treat in this field have had to mop up complete messes from people who just are schooled in substance use counseling and don’t know a thing about gambling.
Mills: Now, it’s not just adults who have increased exposure to gambling these days, kids and teens do as well. And, one thing I understand that you gambling researchers are interested in is video game loot boxes. Now, for listeners who aren’t familiar with this term, what are loot boxes?
Nower: Loot boxes are a little sort of prize. So, let’s say your child, like mine, begins on Roblox at a young age. Loot boxes pop up all the time. Do you want to skip levels? You pay a certain amount of Robux. If you want a particular sword or a particular item, but there’s usually a chance element to it. You’re not sure which one you’re going to get, and some are worth a lot and will really help you and some aren’t worth anything. And in the higher level games, the adult games, these things can cost a lot of money and you can then sell them on a secondary market. And people spend thousands of dollars, and this is gambling and children are primed at a very young age for loot boxes.
Kraus: Yeah, I would say that—and some of the research, I think we need more really longitudinal research—we really have to understand what’s happening early in life course versus adulthood. But, there’s definitely some relationships, more correlational, but still important that earlier loot box is somewhat predicting or kind related to a younger adulthood developing into gambling behaviors, which keeps going. So this is where having these longitudinal designs are important.
I would say, I also have a young child, he’s almost nine, and I’m always surprised. We always travel, so we go those play arcades, and I remember arcades of my—I’m a child of the 80s, I’ll just admit that—and the arcades of the 80s and 90s are very different to today, when so many of the games in arcades look very much like slot machines or acts of gambling. And, I think we’re mirroring that and what does that mean for very young people? And, we don’t want to panic, but at the same time, we have a moral responsibility to be looking at that. And, I think that’s not necessarily happening as much as it should be with really high quality research.
Mills: You’ve both done research on problem gambling in military veterans. Why is that a group you’re particularly interested in?
Nower: Shane, you’re the expert.
Kraus: I think it actually just started years ago when I was at the Bedford VA in Massachusetts. I started the behavioral addiction clinic there. The first one; it was outpatient. And, I started immediately getting these gambling veterans with gambling. And at the time—I was doing more of the work in sexual behavior and other areas in trauma—and, I just said, “Wow.” And, I realized there’s not as much—there are people like Dr. Heather Chapman who’s in Cleveland VA, who’s doing amazing work and there’s some really great folks in the VA—but, I realized, wow, this is a problem. And, then we started doing the research and I said, “Well, let me start looking at the medical records. Let’s start publishing.” And we found, holy moly, there are problems, right? There really are some issues. And I think it’s that narrative with trauma.
I think people go through really difficult things and they cope differently. And I think, sometimes, it’s alcohol and drugs and cannabis, and sometimes, it’s pornography or sexual behavior, and sometimes, it’s gambling. And, sometimes these things earlier in life are not problematic, but when trauma and other mental health is intermixed, they become problematic. And, I think veterans have higher rates of trauma and other mental health disorders, depression, anxiety, other things, and divorces, separations, deployments. When you mix all that in, it’s not really surprising.
The other thing is that they also have a lot of gambling on overseas bases. Each yea, the bases make about $100 million in slot machines, of which none of the revenue goes for treatment or research, which I just want to put that out there.
So, I think—doesn’t mean that necessarily people at 18, 19, 20 in the military developing a problem—but, when they’re under stress, deployed, away from family, we have seen many patients starting to have issues at a young age that continue once they discharge from the military. So, I think we need to be doing a better job of preventive, and we’re not, I think, right now. And, the issue is that we see this all over in the VA, and our publications demonstrate veterans have high rates of mental health and addictive disorders, including gambling, including pornography, sex—you name it. Because, I think, of the trauma component. I think that’s one of the key factors that has been discussed.
Mills: I didn’t realize that about slot machines on military bases. Is that being supported by our military? I mean, are they the ones who are doing this or are they outsourcing this to contractors?
Kraus: So it’s outsourced, but they, in a sense, it’s for the military, it’s for recreation and leisure, and they use the money internally on the bases overseas, not in the states. But there’s really lack of prevention or education or psychoeducation happening. There’s really not a lot of responsible gaming or gambling messaging happening. So, it’s been happening for many years. It’s kind of a big secret. So whenever I tell people, I do these talks, they go, “No way.” And I said, “Oh, yes, yes way.” It’s a big deal. A hundred million a year, and not penny of it goes for treatment or for prevention. And, I think, “Give us $5 million of that $100 million, and we can do a lot of good for our military.” So, just putting that out there.
Mills: Given the laws that we have right now, what’s the most important policy change you think could be made to help mitigate the harms and protect people from developing gambling disorder?
Nower: So, this is my huge bandwagon. The federal government needs to take the hands off their eyes, their ears, and their mouth and get involved. The federal government gets enormous amounts of tax revenue from legalized gambling. But unlike in the UK, where there is a federal organization that oversees all these different regulations, etc., for gambling to have some uniformity, there is no presence at the federal level. There is no money, not a dollar for research. People like Shane and me, we have been very entrepreneurial to just stay in this field. A lot of people leave because there’s money for alcohol, drugs, everything else, but not gambling. And there’s nobody regulating advertising. There’s nobody policing operators or ensuring that there are standards that give the person a fair playing field. It’s terrible. And it’s my biggest sorrow is that we just have no federal presence.
Kraus: I would just say, yeah, absolutely. I couldn’t agree with that more. It’s just really surprising, too, given the amount of revenue and the expansion of gambling. And, you kind of think as a preemptive, let’s put in some money into the research and prevention, let’s just make sure, let’s just spend $50 million, expand free treatment, just to prevent it. Because we know those with gambling disorder are more likely to kill themselves. They’re more likely to have—everything you can think of that’s bad news bears, as we say, is going to happen, right? Partly because they go eight to 10 years before they tell someone. So, they destroyed their life versus with substance use, if my patients are really actively using for four or five days and I see them, I go, “Hey, what’s going on? I can tell something’s up.” But with gambling, you can walk to the slot machine or the casino, lose $50,000 in a day, and I can’t tell.
So, this is why they’re different. But I think with this massive expansion and a lot of revenue, it’s really irresponsible at this point. And, I think sports betting, the revenue from that is just, I mean, wow, even for me, I’m shocked at how much it is, and yet, that isn’t being entered—none of that’s going back into a new federal agency or some regulatory body. And, I think it’s really irresponsible. And, I do think in the next four or five years, we’re going to really, might be paying for it. And, we don’t need to be doing cleanup crew five years from now. We need to be preventing people from suffering rather than treating suffering later.
Nower: I talked to a journalist from the UK and he said, “When I look at the U.S., I feel like I’m watching a car crash but can’t look away.” And I thought that was a beautiful way of capturing it.
Mills: So, what are you both researching now? What are the big questions that you’re trying to answer? Dr. Nower, you want to start with that one?
Nower: So we do all the big data analysis on every bet placed in the state of New Jersey, even online or sports. So, we’re looking at trends, patterns, problematic play patterns, responsible gambling, and harm reduction strategies. We just got this grant from the International Center for Responsible Gaming, a Center of Excellence grant to look at gambling among emerging adults. So, we’re looking at genetics that are paired with the sort of etiological risk factors we’ve been talking about. We’re doing a national prevalence study on emerging adults in highly involved versus low or moderately involved gambling states. Gosh, we’re trying to pilot this brief treatment in health settings, just a few of the things we’re doing. We’re doing lots of stuff.
Mills: Dr. Kraus, what about you?
Kraus: Oh, same here. We’re doing lots of stuff. So, I think some of the big things we’re doing with VA—so, we’re looking here, working with our local VA here, and this is Southern Nevada Healthcare System here—and, we’re looking at treatments. So, we’re looking at psychopharmacology, in this case Vivitrol or Naltrexone, with co-occurring substance use and gambling. Is that helpful? We’re also looking at mindfulness-based relapse prevention broadly for gambling, including substance use. It’s been shown to be effective. We’ve published kind of a pilot on that, but we want to explore that. We’re also doing some community-based work here, trying to understand—really, actually getting great data here in our community—around barriers to care, why people don’t get help in our community. Why? Because we know our population. Nevada is growing, and how do we increase Spanish speaking services? Lots of things. We really need to adapt.
And so, I think that’s that. We also have sports wagering. ICRG has funded a grant. We’re on year two now with my colleague, Dr. Joshua Grubbs, University of New Mexico. And we’re looking at—we’re getting the fourth wave of data longitudinally on sports betting. So we’re going to be hoping to look at risk factors for sports betting as well, or wagering, particularly within groups, because we really need longitudinal and these epidemiological. People say, “Well, how bad is it?” And I go, “I don’t know.” Like in Nevada—it’s kind of amazing—Nevada hasn’t had a prevalence study in over 20-something years, yet our population’s tripled and our revenue’s up, and it’s great. It’s a lot of positive things for Nevada, but yet, we need a prevalence. We need true, accurate prevalence to understand our community and risk factors for a lot of people, and we don’t have that. So, those are things we’re working on.
Mills: Well, this is all really interesting. I want to thank you both for joining me today. I think you’ve given us a lot of good information, and I hope our listeners will find it useful.
Nower: Thank you.
Kraus: Thank you so much.
Mills: You can learn more about psychologists’ research on gambling in the July issue of APA’s magazine, Monitor on Psychology. Go to www.apa.org/monitor. You can find previous episodes of Speaking of Psychology on our website at www.speakingofpsychology.org or on Apple, Spotify, YouTube, or wherever you get your podcasts. And, if you like what you’ve heard, please leave us a review. If you have comments or ideas for future podcasts, you can email us at speakingofpsychology@apa.org. Speaking of Psychology is produced by Lea Winerman. Our sound editor is Chris Condayan. Thank you for listening. For the American Psychological Association, I’m Kim Mills.
Shane Kraus, PhD, is an assistant professor of psychology at the University of Nevada, Las Vegas. He is interested in the study of psychopathology, substance use disorders, gambling disorder, and compulsive sexual behavior disorder. He is particularly interested in using behavioral, epidemiological, and neurobiological methods to assess factors that contribute to the development of addictive behaviors and other co-occurring psychiatric disorders among high-risk groups (e.g., U.S. military veterans, young adults). Kraus received his PhD in clinical psychology (emphasis: community psychology) from Bowling Green State University in 2013.
