Gambling, Video Gaming, Internet Use and More: Opening Up the Field to Other Behavioural Addictions Nina Littman-Sharp, MSW, RSW Discovery Conference, April 15, 2013
Presentation goals Contextualize gambling as one of a variety of addictive behaviours Look at prevalence, parallels and characteristics Look at co-occurring disorders Outline CAMH programming for transition-age youth with behavioural addictions Discuss Community of Practice resources and how to access them 1
Some addictive behaviours Gambling Shopping Sexual behaviours Internet Gambling Gaming Browsing Social networking Online shopping Pornography Sexual networking 2
Crossovers Internet gambling and excessive internet use Slots resembling video games Video games with gambling elements OLG s future vision: gaming and gambling fusion Casinos as part of an integrated entertainment complex Games and gambling both available on smartphones 3
Role of technology Ubiquity of the internet Integral to many addictive behaviours Excessive becomes normative New applications Abstinence increasingly unrealistic 4
Prevalence of Addictive Behaviours by Population Problem Behaviour Prevalence Range Population Internet use 2% Video gaming 12% Shopping Sexual behaviours 4% 13% 3.5% 6% 10.3% 3% U.S. adults U.S. adults Ontario students (grades 7 12) U.S students (age 14 18) U.S. adults Canadian college students (age 19) U.S adults 5
Case example - gaming 22-year-old university student Lives with parents, who support him Presents with concerns about time spent online 5-10 hours a day playing online multiplayer game World of Warcraft Failing classes. Rarely wakes before 3 pm Presents as Isolated, withdrawn, anxious, depressed School history positive academically, poor socially: history of being bullied; social anxiety Many online friends; almost none in real life 6
Parallels Preoccupation, craving, tolerance Addiction cycle Function pleasure, excitement, socialization, self-soothing, escape, self-esteem, etc. Vulnerabilities and risk factors Past and current family systems issues Peer and family influences 7
Neurobiology Evidence that behavioural addictions and substance use disorders share same neural circuitry Reward-deficiency hypothesis Dopamine released by psychoactive chemicals as well as by gambling, gaming and other highly repetitive behaviours Intermittent reinforcement and constant novelty maintains dopamine release Pharmacological interventions shown to reduce urges for substances have also had some success in trials with behavioural addictions, including gambling, Internet, sexual and shopping addictions 8
Some characteristics Video gaming Alternate, immersive worlds powerful game elements Sleep impacts Technology impacts Shopping Marketing and consumerism triggers Sexual behaviours Vast capacity of internet Anonymity 9
Co- occurring disorders Problem video gaming clients frequently suffer from social anxiety and depression. Also ADHD, Asperger's, learning disorders Shopping addiction co-occurs with mood, substance use and eating disorders. (Kuzma and Black 2006) Sexual addictions co-occur with mood, anxiety and substance use disorders (Garcia and Thibaut 2010) Paraphilias correlated with personality disorders (Kaplan and Krueger 2010) 10
Advanced Clinical Education Services (ACES) at CAMH Small clinic for transition-age youth 18-24 and their families Excessive / addictive behaviours, co-occurring mental health problems Most clients engaged in online gaming, MMOG (Massively Multiplayer Online Games). Typical presentations: School issues, chronic problems functioning, family conflict Co-occurring disorders 11
Eating Disorder/Body Dysmorphic Disorder 5% Asperger's 9% ACES Co-occurring disorders Substance 10% ANXIETY 27% Learning Disorder 6% ADD/ADHD 14% DEPRESSION 29% 12
ACES treatment Address co-occurring disorders Educational assessments CBT, MI Family therapy Parenting groups 13
ACES educational resources Problem Gambling, Gaming & Internet Use Community of Practice Discussion board Youth & Technology 101 Online Tutorial Youth and Interactive Media, Games and Social Networks brochure Dr. Bruce Ballon s Blog Courses and Webinars Resources for presentations 14
More resources Documents on Cyber bullying Video gaming Problem gambling & internet addiction Youth Lifestyle Screener Bibliography Coping with the Wired World And more! 15
To join the Community of Practice and access resources Contact Colleen Tessier (colleen.tessier@camh.ca) 16