I think you're asking a good question, but I would phrase it differently. I personally see addictions as a form of coping strategy for life problems (minor and major), in particular when it comes to behavioral addictions like gambling and online gaming.

Based on this, I would say that it is not so much about being genetically predisposed to an addiction which then manifests under certain structural conditions, as it is about finding an activity that allows you to cope with your life issues. Different internet applications have particular affordances, some of which may be well-suited to cope with certain issues. For example, the immersive qualities of online games may allow you to cope with temporary real life stress, or negative mood states following low self-esteem. This would explain the findings from psychological studies on internet addiction from a perspective of coping, rather than addiction, however, which is what my work revolves around.

This makes an investigation of the structural characteristics of internet applications (and other activities) important; but with a focus on their potential for facilitating coping strategies rather than somehow triggering a genetic predisposition. I believe the gaming industry would do well in sponsoring such research, as coping is neither exclusively positive or negative, but both.

You well summarize the problem and I see that you already bring answers to your questions. Only question 3 is "special" . A genetic predisposition to gambling is pretty unlikely. A gene gambling!

Addiction is an extreme response in the context of daily hedonic management of the individual. Factors, such as psychological distress, personality, psychopathology, can unbalance the hedonic management and bring the individual to focus excessively a particular hedonic solution (hedonic monopoly), which leads back withdrawal, tolerance, secondary suffering, distress, etc. .

Concerning the choice of the type of addiction, multiple current and historical factors control this choice. There is determination, but also chance ... The choice of gambling games requires their presence in the environment (casino, internet), maybe a family or social culture, sometimes a chance encounter. In its mechanism addiction has a lot with love romance, love at first sight, the effect of revelation, initiation, etc. . It is certain that many aspects of addictions keep their secrets and to win research grants it is better to speak about brain, molecules, control group, and statistic tests!

Don't forget that addiction can also be positive (not pathological) in a sensation seeking perspective. This phenomenon is complexe and multifactorial too!

Eric, you are saying that environment is essential, which I agree. Focusing on problem gambling, in my view any research should not separate the gambler from the game s/he plays. We study and treat the pair gambler-game and not only the gambler. It is like treating an infectious disease, when the patient of the physician is the infected patient plus the virus or bacteria in his organism. As any information on that virus/bacteria is important in patient's treatment, also in gambling we can find inner features of the games that might help in the prevention and treatment of pathological gambling. This is why I claim that research should have at least 30% of its current focus on the games, where mathematics can bring contributions.

There is also research into various psychotherapies used in treating gambling addiction;

See, for examples,

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3000184/

.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2789341/

.

Paul.

There is tons of research on non biologically-based etiology of pg: operant conditioning, erroneous cognitions about luck and probabilities, familial influences, motivations etc. In fact, a majority of the early research in the field had no bio component (see Custer, Rosenthal, Lesieur etc). Increasingly, with explorations into the D3 and the relationship of the dopaminergic pathway to addiction, the bio explanations gained popularity. However a majority of us still focus on nonbiological causes though it is clear there is an interplay among multiple factors to varying degrees in various sub-groups do disordered gamblers. Having said that, there is no designated federal funding for gambling, so those who get federal money either focus on bio, which is a priority, or piggyback gambling on other work that gets funded.

I think the biomedical focus on gambling has been driven by the biological commonalities between addiction to gaming and other substances of abuse. The prime example of this is recruitment of ventral striatal "reward" neurocircuitry by gambles, which is analagous to the brain response to drug reward cues in addicted people. In fact, one group holds out pathological gamblers as an ideal study population for research on motivational neurocircuit abnormalities in the addiciton-prone, inasmuch as no brain-altering chemicals have been actually consumed. c.f. PubMed ID- 24179792 Also, as a program official at NIDA*, I can agree with the previous comment that at least with NIH, there is really no programmatic "home" for pathological gambling in the wake of the failed (non-)merger between NIDA and NIAAA to create an above-the-neck addictions institute that may well have included gambling, internet addiction etc.....

*The views expressed are explicitly my own.

Your premise is incorrect and therefore the discussion limited. Lia Nower is correct: there is considerable non-biological research focusing on gambling. In fact, a review of the literature will show that the majority of research on gambling is non-biological. Next, as Jame Bjork points out, absent a federal program that might guide gambling research, there is evidence that the genetic influence toward addiction is non-specific, just as treatments are non-specific. That is, there are multiple influences that cause and treat addiction. This absence of specificity encouraged the Syndrome Model of Addiction. This is a young field and we have a long way to go. But it is worth noting that our assumptions are likely going to present our greatest challenges.

Professor Shaffer,

Maybe a terminology clarification is needed. I called "biological research" any research focused on the individual in either his inner biological structure or behavior. I did not called biological only that research dealing with, say, chemicals, neural system or brain. Non-biological research would be that focused on environment, including the games (of course, any biological research will relate with elements from environment and any non-biological research will still relate with the individual, as its final goal). So I considered the studies on behavior in relation with the environment or society as biological. Under this definition, the majority of research, which is in the form of psychological empirical studies in the form of surveys (most of them testing hypotheses related to behavior), is biological (psychological). As far as I know, there was little research on the games in the field of problem gambling (include here Dr. K. Harrigan's statistical works on slots). With this clarification, I hope you to give me credit on my premise. I must also make another clarification - after a comment of Professor Nower: My question applies for research on pathway-1 gamblers.

I think most observers would be very confused by your definition of biological. Psychological matters involve much more than biology. Some might even suggest that biological considerations of behavior are reductionistic. Nonetheless, whether we use your unique definition of biology or the standard definition of biology, most gambling research is not biological. For example, youthful fields targeting deviant behavior (e.g., statistically deviant) often begin by studying the epidemiology (i.e., distribution and determinants) of the behavior. Epidemiological work is population based and certainly not biological. The majority of gambling research to this point has been epidemiological. Recently, there has been a bifurcation of the field with studies focusing on gambling or gambling disorders. It often has been said that if you buy the premise, you buy the story; I don't buy your premise. This of course doesn't make me right because the question is empirical. In our published research on the nature of gambling research, we describe the types of gambling research extant in the field.

I would like to point out that the field of Behavior Analysis studies pathological gambling and its environmental influences.

If you have the time, and are willing, look up Dr. Mark R. Dixon. His research on gambling as it relates to behavior is quite exstensive. And he provides a model towards rehabilitation of pathological gambling based on the functions of the problem behavior.

Because addiction is a biological disease in which the brain is changed both structurally and functionally in the reward=pleasure neural pathways involving the VTA, nucleus accumbens hippocampus, and amygdala, whether it's cocaine, sex or gambling--the same areas of the brain are affected. Focusing on the brain changes will lead to effective pharmacological interventions. Dr. Ben Kelch

Most Societies have not had the will nor financial input to undertake the research. Period.

Gambling is nearly 99% a societal problem and society, institutions, and individuals need to take the bull-by-the-horns and take responsibility for the legal opportunities that they permit in terms of gambling. Gamer theory from all kinds of different fields show how, in the long and short terms, gambling is more often than not NOT BENEFICIAL TO THE PARTICIPANTS--aside from those who make money off it regularly.

Mathematics has shown us the fallacies of all kinds of approaches to waging and gambling.

e.g. http://ibmathsresources.com/2013/10/12/the-gamblers-fallacy-and-casino-maths/

The same facets of society, though, which permit legal gaming also allow stock markets and financial instruments to thrive, for example vulture funds and predatory lending. Again resources and training is needed in society to show people errors of their ways and their society's ways.

If Catalin's assumption is true, namely "The majority of researchers in problem gambling are medical doctors or psychologists. The other type of research would involve other disciplines – for instance, mathematics – whose final results must contribute to the same biological/social sciences, and such interdisciplinary collaboration is difficult.", society's other fields of research need to ante up and pay for better and more wide-ranging research on gambling.

Of course, pathological gambling has neurobiological bases, but it doesn't mean that it is only biological disorder. There is also a psychosocial component. For instance, for some populations gambling behevaior declares as an anxiety reducing mechanism (Begoyan, Julfakyan & Torosyan, 2015). 

Yes, brain is changed both structurally and functionally , but it is possibe to change back or construct a new (antagonist) neurobiological pattern using only psychotherapy.

There was an experiment on addiction done about 4 decades ago which indicates that the it is 'the cage one is in" that leads to addiction.  As long as there are enough alternative (and better) choices in a cage, rats and mice who may have normally become addicted to a particular drug will avoid taking the drug excessively over time.

The same point needs to be made of a pathology, such as gambling, as long as avoidance opportunities and alternatives are provided, overtime, an addict to gambling can avoid the traps and turn to alternatives.  If the cage we live in does not provide alternatives, we are left turning again to our addiction preference. 

Hi Kevin,

You are thinking of Bruce Alexander's work.

See attached PDF,

and for a non-academic discussion;

http://www.stuartmcmillen.com/comics_en/rat-park/

.

Enjoy,

Paul.

The fallacy that pathological gambling is a "brain disease" has spread like an axiom driven by psychiatry interested in “pathologize”, to give drugs and obtain benefits for it. The brain changes that are attributed to addiction (either to the game or to substances) are not necessarily evidence of disease, but sometimes vulnerabilities, being pre-addiction and favoring their establishment and maintenance. As Kevin and Paul said, the experiment of rat park, replicated countless times over the last decade in the paradigm of environmental enrichment, definitely rejects the concept of "disease" and places addictive behaviours in an evolutionary context in which the learning history, experience, alternatives, cultural conditionants and much other environmental elements interact with the biology of the individual in lead to a loss of control and automated compulsive behavior. It is time to reject old dogmas and study phenomena from scientific knowledge. Addiction is not, in any case, a disease but a complex behavioral framework that results in changes in the structure and brain function, as in many other cases that no one would call "disease" (i.e., romantic infatuation).

Hi Eduardo,

See;

>

(Link below to full text).

and also;

>

(Link below to full-text).

Regards,

Paul.

Article Addiction: Current Criticism of the Brain Disease Paradigm

Article The Brain Disease Model of Addiction: Is It Supported by the...

Absolutely agree, Paul. At present, there is an outcry in the scientific world to overthrow the solid castle that certain psychiatry affine to the pharmaceutical industry has erected around the concept of addiction. Nothing, absolutely nothing, in scientific knowledge supports this view. Everything else is a political structure that allows provide care for people with addictive problems in countries like USA that lack public health, and must justify that private insurance address these problems. This is what recently stated in Madrid the great defender of brain disease model, and NIDA Director, Nora Volkow. It is surprising that there are still practitioners and researchers who, bona fide, still assume the disease model in the absence of scientific evidence to support it.

From Peel, for several decades, until very recent publications (http://journal.frontiersin.org/researchtopic/1036), the smoother than can be said is that the model of addiction as a brain disease is a fallacy (http://journal.frontiersin.org/article/10.3389/fpsyt.2013.00141/abstract).

http://journal.frontiersin.org/article/10.3389/fpsyt.2013.00141/abstract

http://journal.frontiersin.org/researchtopic/1036

Dear Professor Pedrero-Perez

In my view, the pharmaceutical industry had nothing to do with the development of the brain disease rhetoric, which was first coined in 1995. It was simply packaging to make addiction seem more like a conventional disease: the kind that belongs at the NIH. Don't get me wrong, I think the NIH (via NIDA) should study addiction, but framing it as a brain disease is deeply misleading (as you acknowledge) and, as  I said, pharmaceutical co had nothing to do with it. That said, they are in a good position to benefit from such a model.

Best

Sally Satel MD

Thanks, Paul for the attached article above.  I actually had been reminded of Alexander's work early this month when I watched this program on addiction in the USA and other lands.  

http://www.democracynow.org/2015/2/4/johann_hari_everything_we_know_about

Adding to Eduardo's comments above, it is true that people like me, who have ADD, etc.. likely have our brains a bit differently wired than others.  This in turn can lead to predisposition to gambling--and therefore, we need to be encouraged to avoid it. 

Looking for individual vulnerabilities and predispositions that cause gambling problems plays right into the interests of gambling providers, a theme exploited by many other businesses including the alcohol and tobacco industries. 

My advice is to start with the substantial profits that are derived from the small percentage of extremely heavy gamblers - for example, the most recent report of the Australian Productivity Commission found that 2.6 % of a casino's loyalty program members account for 76% of membership revenues.  The most recent studies in Canada found that 5.2 % of slots players are high-severity problem gamblers and generate about 32% of slots revenues.  A whopping 12.2 % of table game players are high severity problem gamblers and generate  56% of table game revenue. 

Accordingly, it is in the interests of providers to actively involve themselves in increasing the frequency and duration of gambling, along with the average bet size.  They do this in two principal ways.  First, they build deception/disinformation into games to maximize the duration of gambling sessions and to increase bet size (I'll not go into specifics here in the interests of space).  Second, they enroll as many patrons as possible in loyalty/reward programs, where frequency, duration, average bet size per session, win/loss status per session, and cumulative loss status are closely monitored.  As these metrics begin to climb (in response to deceptive game design in large part), gambling providers introduce unsolicited inducements to gamble more - limousine rides, offers of hotel stays in presidential suites, VIP seats in entertainment shows, and time-limited coupons to match bets up to $500 and more.  

Added to this toxic mix are patrons who have lost more than they can afford and are chasing losses in hopes that they will get out of debt - I've seen records of patrons who are over $5 million in debt and experience winning streaks of $200,000 in their desperate attempts to extricate themselves.  The natural volatility of table games in particular  reinforces beliefs among these gamblers that they can actually come out ahead. 

Here's the rub: there are no brakes on these processes, only accelerators - casinos are under no constraints to stop extracting money from a patron, regardless of reckless intensity of play or amounts lost.  I've  seen loyalty program records that show a patron gambling 26 days a month, 24 hours a day (and extending into subsequent days), betting $31,000 per one minute hand, and losing over $1 million per day on more than one occasion.  These losses are cultivated by the casino, where such patrons are described in fishing terms as the biggest catch of all - whales.  Special staff are assigned to them to lever as much income as possible.

In the final analysis, problem" (or pathological" if you want to subscribe to the medical model) gamblers are patrons who respond exactly as intended. Whether they have some sort of biological predisposition is largely a fatuous argument - gambling harm would be substantially prevented if casinos were prohibited from predatory and exploitive practices.  Here in Canada, alcohol providers owe a duty of care to their patrons and are prohibited from acquiescing to patron demands for excessive consumption on penalty of negligent liability.  No parallel duty has been imposed by the courts to date, nor have governments introduced any meaningful policy constraints on gambling providers - they too share in the profits, and would just as soon look the other way. 

You are correct in anticipating that gambling interests' control of research funds steers the focus toward individual predispositions (as well as to treatment modalities that kick in only after substantial profit has been realized). This is most evident in the US, but pops up in most jurisdictions. The most vocal of researchers who argue for "individual responsibility" and predisposing vulnerabilities have been well supported by gambling interests, including the Canadian Gaming Association in my country. 

In my view, the only thing that will stop the carnage is a successful court case that establishes a duty of care.  Believe me when I say that gambling interests are prepared to spend unlimited amounts to make sure this doesn't happen.