Manipulations of the Features of Standard Video Lottery Terminal (VLT) Games: Effects in Pathological and Non-Pathological Gamblers

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1 Journal of Gambling Studies, Vol. 17, No. 4, Winter 2001 ( 2002) Manipulations of the Features of Standard Video Lottery Terminal (VLT) Games: Effects in Pathological and Non-Pathological Gamblers Pamela Loba Sherry H. Stewart Raymond M. Klein James R. Blackburn Dalhousie University The present study was conducted to identify game parameters that would reduce the risk of abuse of video lottery terminals (VLTs) by pathological gamblers, while exerting minimal effects on the behavior of non-pathological gamblers. Three manipulations of standard VLT game features were explored. Participants were exposed to: a counter which displayed a running total of money spent; a VLT spinning reels game where participants could no longer stop the reels by touching the screen; and sensory feature manipulations. In control conditions, participants were exposed to standard settings for either a spinning reels or a video poker game. Dependent variables were self-ratings of reactions to each set of parameters. A set of 2(3) 2 2 (game manipulation [experimental condition(s) vs. control condition] game [spinning reels vs. video poker] gambler status [pathological vs. non-pathological]) repeated measures ANOVAs were conducted on all dependent variables. The findings suggest that the sensory manipulations (i.e., fast speed/sound or slow speed/no sound manipulations) produced the most robust reaction differences. Before advocating harm reduction policies such as lowering sensory features of VLT games to reduce potential harm to patho- Please address all correspondence to Pamela Loba, Dalhousie Gambling Laboratory, Department of Psychology, Dalhousie University, Life Sciences Centre, 1355 Oxford Street, Halifax, Nova Scotia, Canada B3H 4J1; vltstudy is.dal.ca. This research was supported by a grant from the Nova Scotia Gaming Foundation, Nova Scotia Department of Health, awarded to the second, third, and fourth authors /01/ $19.50/ Human Sciences Press, Inc.

2 298 JOURNAL OF GAMBLING STUDIES logical gamblers, it is important to replicate findings in a more naturalistic setting, such as a real bar. KEY WORDS: VLT manipulations; video lottery terminals; pathological gambling; harm reduction. Prevalence rates of pathological gambling have been reported to be between 1% 3% of the adult population (DSM-IV, APA, 1994; Beaudoin & Cox, 1999; Shaffer et al., 1999). Research has shown that increases in the availability of gambling are related to increases in the number of pathological gamblers (Beaudoin & Cox, 1999; Ladouceur, 1999; Ladouceur et al., 1994; Shaffer et al., 1999; Volberg, 1994). In Canada, video lottery terminals (VLTs) are now available in all provinces except British Columbia and Ontario. One Nova Scotia survey (Focal Research, 1998) found that VLT gambling accounts for 54% of the provincial revenue coming from total gambling activity. Further, 5.7% of regular VLT players contribute approximately 96% of the annual province net revenue for video gambling (Focal Research, 1998). VLT play has been described as a continuous form of gambling. That is, the time between wager and payout is short (Diskin & Hodgins, 1999; Griffiths, 1993). This characteristic is thought to be involved in the maintenance of problem gambling behaviour (Dickerson, 1990). Griffiths (1993) also found that the structural characteristics of fruit (slot) machines (i.e., pay out interval and rapid event frequency) have the potential to induce excessive gambling (p. 101). This is not surprising given the principles of operant conditioning and variable ratio schedules (Skinner, 1953). Habits (gambling) are conditioned through rewards (i.e., winning) presented intermittently, such that reinforcement of gambling behavior occurs. While numerous studies continue to examine the prevalence of and theories as to the cause of problem or pathological gambling, little has been done with actual VLT machine manipulations. MacLin et al. (1999) suggest that studying environmental contingencies and game or machine characteristics may be helpful in understanding the prevalence and maintenance of gambling activity. In particular, experimental manipulation of video lottery terminal (VLT) games could help study problem gambling as it pertains to the interaction between player and VLT. For example, Diskin and Hodgins (1999) found that

3 PAMELA LOBA ET AL. 299 pathological gamblers were slower than occasional gamblers in reacting to irrelevant stimuli when playing on a demonstration VLT machine. While MacLin et al. (1999) created a computerized slot machine simulation program to allow researchers to manipulate payoff probabilities, sequences of wins and losses, and visual displays of winning symbols, no published studies manipulating the characteristics of commercially available VLT machines have been conducted. The purpose of the present study was to determine which parameter manipulations on actual VLT machines may reduce the risk of abuse of VLTs by pathological gamblers while exerting minimal effects of the behavior of non-pathological gamblers. The study employed two manipulations of a standard VLT video poker game and three manipulations of a standard VLT spinning reels game. In both games (1) a counter might display a running total of money won/lost; and (2) several sensory features were manipulated together to make the game more or less exciting. The latter manipulations consisted of low sensory features wherein participants were exposed to slower speed of play with no sound, as well as high sensory features where speed of play was increased faster than normal and sound was on. A third manipulation only applied to the spinning reels game: participants could no longer stop the reels by touching the screen. All participants were also exposed to control conditions (i.e., standard VLT settings on both the video poker and spinning reel games). It was hypothesized that the manipulations involving the counter, low sensory features, and can not stop reels would make the VLT games less attractive to regular players, particularly to pathological gamblers. METHOD Participants Sixty regular VLT players (22 female, 38 male) were recruited via telephone interview following response to local television and newspaper ads. Participants were required to be regular VLT players (i.e., play at least twice a month). During the telephone screening, participants were advised of the general experimental procedure of the study.

4 300 JOURNAL OF GAMBLING STUDIES Measures Demographic Questionnaire. A questionnaire was used to obtain information on the participant s age, gender, education level (years of schooling), and annual income (on 7-point scale with anchors from up to $10,000 to more than $60,000 Canadian dollars per annum). Addictive Behaviors Measure. An author-compiled measure was used to assess certain addictive behaviors: smoking status (smoker, non-smoker), whether or not and how much the participant consumes alcohol while playing VLTs, and history of VLT use (i.e., frequency of VLT play per week, average amount spent playing VLTs, number of years playing VLTs). South Oaks Gambling Screen (SOGS; Lesieur & Blume, 1987). The SOGS is a 16-item self-report questionnaire that asks respondents to describe their lifetime gambling habits. Eleven items are used in scoring, and SOGS scores 5 are used to identify probable pathological gamblers (Lesieur & Blume, 1987). The SOGS has been shown to possess excellent internal consistency (alpha.97), adequate stability (test-retest r.71 over one month in a combined sample of inpatients/outpatients), and convergent validity with counselors independent assessment scores, family members ratings, and DSM-III-R (APA, 1987) pathological gambling scores (Lesieur & Blume, 1987). Survey of Subjective Reactions to VLT Manipulations. An author-compiled questionnaire was administered to participants after VLT play to assess their subjective reactions to the various game parameters. Variables such as excitement and enjoyment were assessed using a 7-point scale with anchors of 1 ( not at all ) to 7 ( absolutely ). In the case of tension-reduction and difficulty in stopping play, anchors were 1 ( worsened and easy, respectively) to 7 ( relieved and difficult, respectively). Apparatus Two authentic, commercially available VLTs were used in the study. The VLTs were set for playing a video poker game or a spinning reels game. The VLTs were identical in all respects, including games

5 PAMELA LOBA ET AL. 301 offered and odds of winning, to commercial VLTs appearing in licensed establishments across the province of Nova Scotia. Procedure All participants were tested individually in the gambling laboratory located in the Department of Psychology at Dalhousie University. The laboratory has been set up to resemble a bar. The red walls have posters advertising alcohol and the room contains a bar and two bar stools, as well as a TV and VCR (see Stewart et al., 2000, for a more detailed description of the Dalhousie Gambling Laboratory). Upon arriving, participants provided written informed consent. Participants completed the SOGS (Lesieur & Blume, 1987), and were then escorted into the gambling laboratory and randomly assigned such that 20 players went into each of the spinning reels games or the video poker game for the duration of the study. Game parameter variations included control (standard settings); low sensory features (speed of play is slowed, sound is turned off); high sensory features (speed of play is increased, sound is on); counter (a running total on the screen keeps count of money played); and for the spinning reels game only, a cannot stop reels manipulation. Pathological (N 29) gamblers and nonpathological (N 31) gamblers were randomly assigned to 1 of 3 possible experimental manipulations: (1) spinning reels 1 where they would play four 20 minute versions of the game (i.e., slow/no sound, fast/ sound, control, and counter present); (2) spinning reels 2 where they would play four 20 minute versions of the game (i.e., slow/no sound, fast/sound, control, and cannot stop reels); and (3) a video poker game with four 20 minute versions (i.e., slow/no sound, fast/sound, control, and counter present). For the purposes of this study, data collected from the spinning reels 2 condition participants who were exposed to cannot stop reels and speed manipulation variations simultaneously were not analyzed. Order of the four manipulation variations was randomly assigned to control for order effects. Participant s were given $50 compensation, divided evenly over the manipulation variations and told they could play as little or as much of the money as they wished. They were permitted to use their own money, as well, if they wished. However, only 5 of the 60 participants did so over the entire testing period (3 pathological gamblers and 2 non-pathological gamblers). Figure 1 provides a visual representation of the experimental design.

6 302 JOURNAL OF GAMBLING STUDIES Figure 1 Visual Representation of Study Design *Excluded from data analysis Participants were told that each version of the game may or may not be similar to other VLT games they had played in the past. They were then invited to play the first of four 20-minute play sessions. After each 20-minute play session the participants were asked to complete the VLT survey to assess subjective reactions to each particular game variation. The first 20-minute session of play was conducted on the first of the two VLTs and the second 20-minute session on the second VLT (order of assignment of each machine to each session was counterbalanced within gambler status groups). After these first two play sessions were completed, participants were escorted out of the lab and asked to fill out the demographics questionnaire while the experimenter changed the VLT parameters. Immediately after filling out the demographics and addictive behaviors questionnaires, participants returned to the lab to play the final two 20-minute sessions, again on VLT machines one and two (order counterbalanced), respectively. The entire experiment took approximately two hours.

7 PAMELA LOBA ET AL. 303 RESULTS We first ensured that continuous study variables were normally distributed within the current sample. All continuous variables showed skew values that were within acceptable limits suggesting that the distributions were approximately normal. Control Variables On average, participants were 34.7 (SD 11.6) years of age. The average income code on the 1 7 scale was 3.1 (SD 1.8), and participants had completed an average of 13.7 (SD 2.0) years of schooling. Thirty-eight (63%) of the participants were male and 22 (37%) were female. Thirty-six (68%) were single, divorced, or widowed, and the rest (32%) were married or cohabiting. The majority of participants (63%) were smokers, and the majority (57%) reported consuming alcohol when playing VLTs. The average SOGS score in the total sample was 5.2 (SD 4.2). According to SOGS scores, 29 participants (48%) could be classified as probable pathological gamblers (Lesieur & Blume, 1987). On average, participants reported playing VLTs 2.6 (SD 1.8) times per week and had been playing VLTs for an average of 5.5 (SD 3.0) years. Control variables (demographics, addictive behaviors) were examined as a function of game and gambler status to ensure that random assignment to games was effective in balancing groups on potentially confounding variables. A set of 2 2 (game: spinning reels vs. video poker gambler status: pathological vs. non-pathological) Analyses of Variance (ANOVAs) and chi square ( 2 ) analyses were performed on the control variables. Analysis revealed no significant between-condition differences in age, marital status, educational history, or annual income. The game and gambler status between-conditions differences were not statistically significant for drink while playing VLTs, smoker status, years playing VLTs, or time (in hours) spent playing the VLTs. However, the gambler status condition did differ significantly in gender composition, SOGS total score, times per week playing VLTs and how much money on average was spent playing VLTs. Pathological gamblers were more likely to be male, have greater SOGS scores (the variable used in gambler status group creation), play VLTs more times

8 304 JOURNAL OF GAMBLING STUDIES per week, and spend more money on average playing VLTs than the non-pathological gamblers. Sensory Feature Manipulation: Speed and Sound A series of 3 (sensory features: slow/no sound vs. control/sound vs. fast/sound) 2 (game: video poker vs. spinning reels) 2 (gambler status: pathological vs. non-pathological) repeated measures AN- OVA s was conducted on VLT survey ratings for all 40 participants who were involved in the sensory features manipulation portion of the study. Sensory features served as the repeated measures factor. For the question on whether participants believed that they noticed a change, we found main effects of sensory features (F (2, 70) 19.67, p.001) and game (F (1, 35) 6.23, p.05). Mean (and SD) scores were 6.3 (1.5), 3.6 (2.1), and 6.0 (1.9) for the slow speed/no sound, control, and fast speed/sound conditions, respectively, and 5.7 (0.7) and 4.9 (1.0) for the spinning reels and video poker games, respectively. Thus, all participants accurately noticed changes to sensory features, and sensory feature changes were noticed more so when participants played the spinning reels game than when they played the video poker game. For self-ratings of whether the change bothered them, we found a main effect of game (F (1, 32) 6.13, p.05), with participants less bothered by sensory feature changes to the video poker game (M 3.5; SD 1.6) than the spinning reels game (M 4.7; SD 1.1). The ANOVA also revealed a significant main effect of sensory features (F (2, 64) 11.29, p.001) which was qualified by a significant sensory feature game interaction (F (2, 64) 5.50, p.01), and a marginally significant sensory feature gambler status interaction (F (2, 64) 3.04, p.06). For the latter interaction, further analysis revealed simple main effects of sensory features for both the non-pathological gamblers (F (2, 36) 4.26, p.05) and the pathological gamblers (F (2, 32) 13.00, p.001). Tukey s tests showed that the non-pathological gamblers were bothered by fast speed/sound relative to control sensory setting (p.05) but not relative to slow speed/no sound. However, pathological gamblers were bothered both by slow speed/no sound relative to control (p.05), and by slow speed/no sound relative to fast speed/sound (p.05) (see Figure 2). Further analyses of the sensory features game inter-

9 PAMELA LOBA ET AL. 305 Figure 2 Mean Bothered by Change Rating as a Function of Sensory Manipulation and Gambler Status (Higher scores indicate more bothered by manipulation.) action revealed simple main effects of sensory features for the spinning reels game (F (2, 34) 20.44, p.001) but not the video poker game (F (2, 34) 1.51, ns.). For the spinning reels game, participants were bothered by both fast speed/sound (M (and SD) 5.5 (2.1)) relative to control (M (and SD) 2.4 (1.9)), and slow speed/ no sound (M (and SD) 6.0 (1.6)) relative to control (both p s.05). For enjoyment ratings, we found a main effect of sensory features

10 306 JOURNAL OF GAMBLING STUDIES (F (2, 72) 7.69, p.005), which was qualified by a significant sensory features gambler status interaction (F (2, 72) 4.17, p.05). Analysis of the simple effects of sensory features at each level of gambler status showed significant simple main effects of sensory features in both the pathologicals (F (2, 36) 8.87, p.005) and the non-pathologicals (F (2, 40) 4.94, p.05). However, the pattern of enjoyment ratings across levels of sensory features varied across the pathological and non-pathological gamblers. Tukey s tests showed that among the pathological gamblers, the slow speed/no sound condition was rated as less enjoyable than both the control (p.05) and fast speed/sound (p.05) conditions. In contrast, among the nonpathological gamblers, the fast speed/sound condition was rated as less enjoyable than the control condition (p.05) with enjoyment ratings of the slow speed/no sound condition falling in between but failing to differ from the other two sensory feature conditions (see Figure 3). For excitement ratings, we found a main effect of sensory features (F (2, 72) 9.84, p.001) and a sensory features gambler status interaction (F (2, 72) 8.65, p.001). These effects were qualified by a significant sensory features gambler status game interaction (F (2, 72) 3.11, p.05). Simple effects analysis revealed significant sensory features gambler status interactions for both the video poker (F (2, 36) 3.66, p.05) and the spinning reels (F (2, 36) 7.71, p.005) games. For the video poker game, a simple main effect of sensory features was observed for the pathological gamblers (F (2, 24) 7.68, p.005) but not among the non-pathological gamblers (F (2, 12) 0.17, n.s.). Among the pathological gamblers playing the video poker game, the slow speed/no sound condition was reported to be less exciting than both the control (p.05) and the fast speed/sound (p.05) conditions. For the spinning reels game, a simple main effect of sensory features was observed for both the pathological gamblers (F (2, 10) 8.75, p.01) and for the non-pathological gamblers (F (2, 26) 7.70, p.005). As with the video poker game, the pathological gamblers playing the spinning reels game reported the slow speed/no sound condition to be less exciting than both the control (p.05) and the fast speed/ sound (p.05) conditions. However, among the non-pathological gamblers playing the spinning reels game, both the slow speed/no sound and fast speed/sound conditions were reported as less exciting

11 PAMELA LOBA ET AL. 307 Figure 3 Mean Enjoyment Rating as a Function of Sensory Manipulation and Gambler Status (Higher scores indicate greater subjective enjoyment.) than the control (both p s.05). In effect, non-pathological gamblers find any sensory manipulation less exciting than control, but only in the case of the spinning reels game. Pathological gamblers find the slow speed/no sound condition less exciting than the other conditions regardless of game (see Figure 4). For tension reduction ratings, we found a main effect of sensory feature (F (2, 70) 6.94, p.005) which was qualified by a significant sensory feature x gambler status interaction (F (2, 70) 3.52, p.05). Further analyses revealed simple main effects of sensory fea-

12 308 JOURNAL OF GAMBLING STUDIES Figure 4 Mean Excitement Rating as a Function of Sensory Manipulation and Game and Gambler Status (Higher scores indicate greater subjective excitement during play.) tures for both the pathological gamblers (F (2, 34) 7.24, p.005) and the non-pathological gamblers (F (2, 40) 3.96, p.005). However, the pattern of tension reduction ratings across levels of sensory features varied across the pathological and non-pathological gamblers. For the non-pathological gamblers, the fast speed/sound condition was reportedly less tension-reducing relative to the control condition (p.05), with the slow speed/no sound falling in between but not differing significantly from the other two conditions. In contrast, for

13 PAMELA LOBA ET AL. 309 Figure 5 Mean Tension-Reduction Rating as a Function of Sensory Manipulation and Gambler Status (Higher scores indicate greater perceived tension-reduction from play.) the pathological gamblers, the slow speed/no sound condition was reportedly less tension-reducing relative to the control condition (p.05) with the fast speed/sound falling in between but not differing significantly from the other two conditions (see Figure 5). For difficulty stopping play, we found a main effect of sensory features (F (2, 72) 4.62, p.05) which was qualified by a sensory features gambler status interaction (F (2,72) 3.05, p.05).

14 310 JOURNAL OF GAMBLING STUDIES Figure 6 Mean Difficulty in Stopping Play Rating as a Function of Sensory Manipulation and Gambler Status (Higher scores indicate greater perceived difficulty stopping play.) Further analyses revealed a simple main effect of sensory features for pathological gamblers (F (2, 36) 5.70, p.01) but not for nonpathological gamblers (F (2, 40) 0.13, n.s.). Pathological gamblers reportedly found it easier to stop playing in the slow speed/no sound condition relative to both the control (p.05) and the fast speed/ sound (p.05) conditions (see Figure 6). For desire to play again, we found a main effect of sensory features (F (2, 72) 4.86, p.05), a main effect of game (F (1,

15 PAMELA LOBA ET AL. 311 Figure 7 Mean Desire to Play Again Rating as a Function of Sensory Manipulation and Game and Gambler Status (Higher scores indicate greater desire to play again.) 36) 4.18, p.05), and a significant sensory features game interaction (F (2,72) 5.84, p.005). These effects were qualified by a significant sensory features game gambler status interaction (F (2, 72) 3.83, p.05). Simple effects analyses within the non-pathological gamblers revealed a significant sensory features game interaction (F (2, 38) 12.08, p.001). No simple main effect of sensory features was revealed for the video poker game (F (2, 12) 1.48,

16 312 JOURNAL OF GAMBLING STUDIES Table 1 F values for Sensory Manipulation Analysis Enjoy Excite Reduce Tension Easy to Stop Sensory Features 7.69*** 9.85**** 6.95*** 4.62* Game Gambler Status Sensory Features Game Sensory Features Gambler Status 4.18* 8.66**** 3.53* 3.05* Game Gambler Status Sensory Feature Game Gambler Status * Play Again Notice Difference Bothered Sensory Features 4.86** 19.68**** 11.29**** Game 4.18* 6.24* 6.13* Gambler Status Sensory Features Game 5.84*** ** Sensory Features Gambler Status * Game Gambler Status Sensory Feature Game Gambler Status 3.83* Notes: Significant F s are indicated by asterisks as follows: *p 0.05; **p 0.01; ***p 0.005; ****p Enjoy Did you enjoy the game you played?; Excite Was it exciting?; Reduce tension Did playing relieve/reduce your tensions and worries?; Easy to stop Did you find it easy or difficult to stop playing the game?; Play again Would you choose to play the same game again?; Notice difference Did you notice any differences between the game you just played and other VLT games?; and Bothered Did this change bother you?

17 PAMELA LOBA ET AL. 313 n.s.), but a significant simple main effect of sensory features was revealed for the spinning reels game (F (2, 26) 19.10, p.001). Tukey s tests showed that non-pathological gamblers reported desiring to play the control condition more relative to both conditions involving sensory manipulations for the spinning reels game (both p s.05). Simple effects analyses within the pathological gamblers did not reveal a significant sensory features game interaction (F (2, 34) 0.32, n.s.) but did reveal a significant simple main effect of sensory features (F (2, 34) 3.97, p.05). Although Tukey s tests showed no single significant comparison, the pattern of means revealed that pathological gamblers desired to play the slow speed/no sound condition less relative to both the control and the fast speed/ sound conditions (see Figure 7). No other main effects or interactions were seen with our VLT survey variables for the sensory features manipulation (see Table 1 for all F values for each main effect and interaction for all survey variables). Counter ( Running Total Spent ) Manipulation A series of 2 (counter: counter on vs. counter off) 2 (gambler status: pathological vs. non-pathological) 2 (game: video poker vs. spinning reels) repeated measures ANOVA s were conducted on VLT survey ratings for those 40 participants who were involved in the counter manipulation portion of the study. Counter served as the repeated measures variable. For the question on whether participants noticed a change, we found a significant main effect of counter (F (1, 36) 13.95, p.05). Mean (and SD) scores were 5.5 (1.9) for counter on and 3.7 (2.1) for counter off conditions, respectively. Thus, both pathological and non-pathological gamblers accurately noticed the counter was present, regardless of game. For tension reduction, we found a significant main effect of counter (F (1, 36) 10.39, p.05). Mean (and SD) scores were 3.9 (1.4) for counter on and 4.6 (1.4) for counter off. Thus, independent of gambler status or game, having the counter on interfered with self-perceived tension reduction (i.e., less tension relief when counter was on). For difficulty stopping play, we found a marginally significant counter gambler status interaction (F (1, 36) 3.80, p.06). We

18 314 JOURNAL OF GAMBLING STUDIES Figure 8 Mean Difficulty in Stopping Play Rating as a Function of Counter Manipulation and Gambler Status (Higher scores indicate greater perceived difficulty stopping play.) found a significant simple main effect of counter among pathological gamblers (F (1, 18) 4.43, p.05) but not among non-pathological gamblers (F (1, 20) 0.70, n.s.). Having the counter on made it easier for pathological gamblers to stop play relative to the no counter control condition (see Figure 8). No other main effects or interactions were seen with our VLT survey variables for the counter manipulation (see Table 2 for all F values for each main effect and interaction for all survey variables).

19 PAMELA LOBA ET AL. 315 Table 2 F Values for Counter Manipulation Analysis Enjoy Excite Reduce Tension Easy to Stop Counter *** 2.04 Game Gambler Status Counter Game Counter Gambler Status * Game Gambler Status Counter Game Gambler Status Play Again Notice Difference Bothered Counter **** 0.00 Game * Gambler Status Counter Game Counter Gambler Status Game Gambler Status Counter Game Gambler Status Notes: Significant F s are indicated by asterisks as follows: *p 0.05; **p 0.01; ***p 0.005; ****p Enjoy Did you enjoy the game you played?; Excite Was it exciting?; Reduce tension Did playing relieve/reduce your tensions and worries?; Easy to stop Did you find it easy or difficult to stop playing the game?; Play again Would you choose to play the same game again?; Notice difference Did you notice any differences between the game you just played and other VLT games?; and Bothered Did this change bother you? Control of Reels Manipulation We analysed VLT survey variables in a series of 2 (Control of reels: can vs. cannot stop) 2 (Gambler status: pathologicals vs. non-pathological) ANOVA s with repeated measures for all 20 participants involved in the control of reels manipulation portion of the study. Control of reels served as the repeated measures factor. There was no game variable in this set of analyses because this manipulation only applied to the spinning reels game.

20 316 JOURNAL OF GAMBLING STUDIES Table 3 F Values for Reel Manipulation Analysis Enjoy Excite Reduce Tension Easy to Stop Reels Gambler Status Reels Gambler Status Play Again Notice Difference Bothered Reels 4.06* * Gambler Status Reels Gambler Status Notes: Significant F s are indicated by asterisks as follows: *p 0.05; **p 0.01; ***p 0.005; ****p Enjoy Did you enjoy the game you played?; Excite Was it exciting?; Reduce tension Did playing relieve/reduce your tensions and worries?; Easy to stop Did you find it easy or difficult to stop playing the game?; Play again Would you choose to play the same game again?; Notice difference Did you notice any differences between the game you just played and other VLT games?; and Bothered Did this change bother you? In the analysis of whether players explicitly noticed a change, there were no significant effects revealed, indicating that regardless of gambler status, players were not very accurate in detecting the control of reels manipulation. However, when we asked them if the change bothered them, we found a significant main effect of control of reels (F (1, 13) 5.92, p.05). Regardless of gambler status, players were more bothered by not being able to stop the reels (M 4.3; SD 2.5) relative to when they could stop the reels (M 2.6; SD 1.9). Similarly, for desire to play again, we found a marginal main effect of control of reels (F (1, 18) 4.05, p.06). Regardless of gambler status, participants reported they would be more likely to choose to play the game where they can stop the reels (M 5.3; SD 1.8) than the game where they cannot stop reels (M 4.2; SD 2.4) in future. No other significant effects were detected in the analyses of responses to the control of reels manipulation (see Table 3 for all F values for each main effect and interaction for all survey variables).

21 PAMELA LOBA ET AL. 317 DISCUSSION This study was conducted to determine which manipulations might help reduce the risk of abuse of VLTs by pathological gamblers. Results uniquely affecting pathological gamblers (i.e., machine manipulation gambler status interactions) show that for the sensory features manipulation, decreasing speed and turning off sound decreased ratings of enjoyment, excitement, and tension-reduction for pathological gamblers relative to non-pathological gamblers. Pathological gamblers also found it more difficult to stop playing than non-pathological gamblers, but only at control settings and at fast speed with sound. Results for the counter manipulation revealed that pathological gamblers (but not non-pathological gamblers) found it easier to stop playing when the counter was displayed relative to when the counter was not displayed. The present study would seem to lend support to Griffiths (1993) notion of the importance of structural characteristics such as sound and pay out interval. Our study found that pathological gamblers dislike decreasing the speed of play and turning off the sound. They also report a lack of willingness to play the game again if a running total in cash (as opposed to credits) played is displayed. These findings suggest that these modifications to VLT machines could decrease the VLTs addictiveness potential (Griffiths, 1993, p. 101). Griffiths (1993) proposed that if the gambler was to consider the actual money spent and lost during gambling, he/she might not gamble as much. Our findings would seem to support this suggestion, at least among pathological gamblers. Specifically, the pathological gamblers reported a relative unwillingness to play when the counter was displaying money played rather than just the usual credit display. Similarly, slowing down the speed of play is slowing down the pay out interval. The player has more time between plays to consider what he/ she is spending a consideration that may even be intensified by lack of exciting bells and siren sounds normally accompanying play. Both White (1989) and Griffiths (1990) state that the noise and visual stimulation of gaming machines is important in that it gives the impression of fun and activity, is attractive to gamblers, and may stimulate further playing. One other possible explanation for our sensory findings could be Diskin and Hodgins (1999) notion that a problem gambler s level of

22 318 JOURNAL OF GAMBLING STUDIES arousal is maintained and reinforced by narrowed attention and intense concentration thus providing the gambler with an escape from their daily problems. Perhaps the slow speed and no sound manipulation does not lend itself to a narrowed and intense concentration, thus explaining the pathological gamblers relative dislike of this particular manipulation. One would hypothesize that having the stop reels function on a spinning reels game would be attractive to gamblers not just because it shortens even further the pay out interval, but also because it lends the player the illusion of control over the machine. We were surprised at our general lack of effects with this particular manipulation. While we did find all players reporting they would be more likely to play the game when they can stop the reels, and that they were bothered by this manipulation relative to the control settings, no interaction with gambler status was found. This lack of effect may have been at least partially due to the lack of explicit recognition of this change by the VLT players overall (i.e., no significant effect of cannot stop reels manipulation on question about whether players noticed the change). In fact, Focal Research (1998) reports that only 5% of all VLT players report using the stop reels function. Unfortunately, we did not collect data on whether individual players in our study typically used this feature, so we could not limit analyses to those players who are familiar with this feature. Nonetheless, a manipulation to a game feature only used by a small minority of players is unlikely to have major harm reduction potential. We have obtained data suggesting concrete changes to VLTs that should make the game less addictive to the problem gambler while not decreasing VLTs entertainment value for the casual player. Nevertheless, several improvements might be implemented in future research. Although our bar-lab was set up to be as naturalistic as possible, these manipulations were evaluated in a research setting where participants were not permitted to smoke or drink alcohol while playing and where there was no opportunity to interact with other gamblers. Moreover, participants were well aware that their reactions were being monitored by the experimenter. This awareness may have somehow altered their reactions to the manipulations. Harm reduction policies such as lowering the sensory features of VLT games to reduce the potential harm to pathological gamblers can be recommended on the basis of our significant findings. Such recommendations could be made more

23 PAMELA LOBA ET AL. 319 confidently, however, if our laboratory findings were replicated in a more naturalistic setting, such as a real bar. Additionally, due to the fact that our sensory features manipulation included simultaneous changes to speed and sound, it would be prudent to study the impact of each manipulation separately in order to determine exactly which factor(s) is/are producing the observed effects. Since our dependent measures were all self-report, future research might seek to determine whether these promising findings translate into actual behavioral changes when pathological vs. non-pathological gamblers interact with modified machines following initial exposure to game manipulations. After exposure to sensory feature, counter, or reel game manipulations, do pathological gamblers play for a shorter time and/or spend less money on the manipulated game than a standard game? REFERENCES American Psychiatric Association. (1987). Diagnostic and statistical manual of mental disorders, Third edition revised (DSM-III-R). Washington, DC: Author. American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders, Fourth edition revised (DSM-IV-R). Washington, DC: Author. Beaudoin, C. M., & Cox, B. J. (1999). Characteristics of problem gambling in a Canadian context: A preliminary study using a DSM-IV-based questionnaire. Canadian Journal of Psychiatry, 44, Cahalan, D., Cisin, I. H., & Crossley, H. M. (1969). American drinking practices: A national study of drinking behavior and attitudes. New Brunswick, NJ: Rutgers Center of Alcohol Studies. Dickerson, M. (1990). Gambling: The psychology of a non-drug compulsion. Drug and Alcohol Review, 9, Diskin, K. M., & Hodgins, D. C. (1999). Narrowing of attention and dissociation in pathological video lottery gamblers. Journal of Gambling Studies, 15, Focal Research (1998). Nova Scotia Video Lottery Players Survey 1997/98. Nova Scotia Department of Health, Problem Gambling Services. Griffiths, M. D. (1990). The acquisition, development and maintenance of fruit machine gambling in adolescence. Journal of Gambling Studies, 6, Griffiths, M. D. (1993). Fruit machine gambling: The importance of structural characteristics. Journal of Gambling Studies, 9, Ladouceur, R. (1999). The prevalence of pathological gambling in Canada. Journal of Gambling Studies, 12, Ladouceur, R., Dube, D., & Bujold, A. (1994). Prevalence of pathological gambling and related problems among college students in the Quebec metropolitan area. Canadian Journal of Psychiatry, 39, Lesieur, H. R., & Blume, S. B. (1987). The South Oaks Gambling Screen (SOGS): A new instrument for the identification of pathological gamblers. American Journal of Psychiatry, 144, Murray, J. B. (1993). Review of research in pathological gambling. Psychological Reports, 72, Shaffer, H.J., Hall, M.N., & Vander Bilt, J. (1999). Estimating the prevalence of disordered gambling behavior in the United States and Canada: A research synthesis. American Journal of Public Health, 89, Skinner, B. F. (1953). Science and human behavior. New York: Macmillan.

24 320 JOURNAL OF GAMBLING STUDIES Stewart, S. H., Blackburn, J. R., & Klein, R. M. (2000). Against the odds: Establishment of a video lottery terminal research laboratory in a naturalistic setting. The Nova Scotia Psychologist, Spring, 3 6. Volberg, R. A. (1994). The prevalence and demographics of pathological gamblers: Implications for public health. American Journal of Public Health, 84, White, S. (1989). Against the odds. Young People Now, April, Received January 16, 2001; final revision April 20, 2001; accepted August 8, 2001.

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