Portrait des habitudes de jeu de patients atteints de la maladie de Parkinson

Le risque de développer un problème de jeu chez les personnes atteintes de la maladie de Parkinson (MP) est de plus en plus documenté. Un type de médicament visant à contrôler les symptômes moteurs, l’agoniste dopaminergique, serait l’un des principaux facteurs liés à son développement. Par le biais d’une synthèse narrative présentée dans le chapitre 3, les mécanismes neurobiologiques et les autres facteurs en lien sont discutés. Un important constat ressort toutefois : l’étude des habitudes de jeu de ces patients est pratiquement absente. Ce constat est surprenant puisque la littérature sur le jeu regorge d’informations à prendre en considération dans le développement de ce trouble, telles que les types de jeu pratiqués, les montants dépensés, les raisons pour jouer et la présence de proches. Le deuxième article consiste donc à répondre à cette lacune relevée en faisant le portrait de leurs habitudes de jeu. Vingt-cinq personnes souffrant de la MP ont été recrutées et parmi celles-ci, quinze ont joué dans les six derniers mois. L’examen de leurs habitudes de jeu révèle que les jeux préférés sont la loterie et la machine à sous et qu’elles ont, en majorité, débuté la pratique de ces jeux avant l’établissement du diagnostic de la MP. Les patients sont moins intéressés à jouer aux machines à sous comparativement à un échantillon de joueurs âgés de plus de 55 ans mais, en contrepartie, ce jeu est celui auquel les plus grands montants étaient dépensés chez les participants qui ont rapporté avoir développé un problème de jeu. Les participants jouent pour le plaisir ou pour gagner de l’argent, mais des raisons non répertoriées, liées à leur maladie, ont été relevées. Ces patients n’ont pas recours à des proches aidants pour les aider dans la pratique de leur jeu favori et ces derniers ont manifesté leur méconnaissance de la pratique de jeux de hasard et d’argent des participants. Parmi l’ensemble des participants rencontrés, trois d’entre eux se sont révélés être des joueurs à risque. En plus de jouer aux machines à sous, des croyances erronées et des motivations spécifiques à jouer ont été relevées chez ces derniers. La réflexion découlant de ces résultats pourra stimuler la recherche dans l’étude des variables psychosociales en lien avec le développement d’un problème de jeu chez ces patients.

Determinantes da utilização de sites de apostas online em Portugal

Com a proliferação da internet assistiu-se desde a década de 90 a um aumento exponencial das casas de jogo online, estando muitas delas traduzidas para português e aceitando euros. Sendo este um tema pouco estudado em Portugal, pretende-se desenvolver e validar um modelo conceptual que reflita os fatores que levam o consumidor a utilizar este tipo de sites. Numa altura em que o governo p g ês p de “ eg iz ” es ivid de, é igualmente interessante perceber qual o perfil do público-alvo, as suas motivações e preferências face à oferta existente. A análise fatorial exploratória, a análise de fiabilidade e os modelos de regressão linear foram as técnicas utilizadas para validar este modelo. Com base num questionário, este estudo mostrou que a expectativa de desempenho, influência social, condições facilitadoras, motivações hedónicas, valor do preço, hábito e o risco psicológico, financeiro e de tempo são fatores determinantes da intenção de utilização de sites de jogo online. Do estudo emergem relevantes implicações académicas e para o mundo empresarial.

“Adição ao Jogo online”

Esta dissertação visa compreender a adição ao jogo online, através de duas perspetivas complementares que se congregam num estudo de caso. Analisamos o discurso de um jogador predominantemente de Blackjack online adicto a esta prática (F.) em processo de desabituação, e desenvolvemos a mesma metodologia junto da mãe deste, enquanto fonte complementar de informação, através de entrevistas semi-estruturadas. Desta análise emergiram resultados que clarificam os fatores que funcionam como determinantes da adição, que a mantêm bem como elementos indispensáveis para compreender a decisão de paragem do jogo. Nesta dinâmica conjugamos a perspetiva de F e da sua mãe. A metodologia escolhida para análise dos dados de investigação foi a Grounded Analysis Theory, partindo das vozes dos dois participantes e tendo como objetivo a construção de uma narrativa alternativa e assim contribuir para uma melhor análise de compreensão dos dados obtidos. Através de um processo indutivo de produção de conhecimento organizado e obedecendo a uma sequência que busca uma maior complexidade de integração, tem como objetivo final gerar uma teoria sustentada nos dados recolhidos (Fernandes & Maia, 2001). Enquanto metodologia qualitativa permite-nos aceder aos significados múltiplos que emergiram da experiência destes dois participantes. O jogo online sustentado na sua fácil disponibilidade tem como consequência um maior isolamento do jogador, e uma vez que as recompensas financeiras são uma possibilidade alimenta o ciclo do comportamento aditivo. A observância de problemas físicos e psicológicos percebidos como graves, justificaram uma abordagem de tratamento multidisciplinar, envolvendo ajuda farmacológica, psicológica e social. Os estudos existentes sobre o jogo online são ainda muito escassos, justificandose o estudo qualitativo na construção do conhecimento, pela análise mais detalhada dos fatores que podem contribuir para uma melhor compreensão de todas as especificidades presentes, numa perturbação aditiva ao jogo online.

Suomalaisten julkisesti listattujen senttiosakkeiden suoriutuminen verrattuna OMX Helsinki Small Cap -indeksin muihin osakkeisiin

Senttiosakkeista tehtyjä tutkimuksia on olemassa hyvin rajoitetusti, ja ne ovat keskittyneet lähinnä senttiosakelistautumisiin. Tässä tutkielmassa tarkastellaan suomalaisia julkisesti noteerattuja senttiosakkeita ja niiden suoriutumista kymmenen vuoden ajanjaksolla vuosina 2006–2015. Tavoitteena oli selvittää, onko suomalaisiin julkisesti noteerattuihin senttiosakkeisiin sijoittaminen kannattavaa toimintaa ja minkälaisia tuottoja on odotettavissa senttiosakkeisiin sijoittamalla. Tutkimusaineisto koostui tutkielmassa tehdyn määritelmän mukaisista senttiosakkeista ja muista Small Cap -indeksin osakkeista, joita kutsuttiin puolestaan ei-senttiosakkeiksi. Tuotot laskettiin osakkeiden päivittäisistä tuottoindekseistä. Tuottoja verrattiin lyhyellä, keskipitkällä ja pitkällä aikavälillä. Tuottojen tarkastelun tueksi senttiosakkeille ja ei-senttiosakkeille laskettiin seuraavat menestysmittarit: Sharpen luku, Treynorin indeksi ja Jensenin alfa. Lopuksi verrattiin vielä seuraavia tunnuslukuja: ROE (%), E/P-luku, P/B-luku, osinkotuotto-% ja velan suhde omaan pääomaan (%). Saatujen tulosten perusteella suomalaiset julkisesti noteeratut senttiosakkeet ovat lyhyellä aikavälillä kannattavia sijoituskohteita, mutta mitä pidemmäksi tarkasteluperiodi kasvoi, sitä huonommin ne suoriutuivat. Lisäksi senttiosakkeet hävisivät kaikilla tarkasteluperiodeilla ei-senttiosakkeille. Suurimmat positiiviset tuotot olivat kuitenkin yksittäisillä senttiosakkeilla. Senttiosakkeisiin havaittiin liittyvän paljon riskejä, kuten suuri volatiliteetti, suuret negatiiviset tuotot ja konkurssin mahdollisuus. Myös kaikki menestysmittarit ja tunnusluvut indikoivat senttiosakkeiden olevan ei-senttiosakkeita huonompia sijoituskohteita. Sijoittajien on oltava erityisen tarkkoja senttiosakkeiden kanssa, sillä niihin sijoittaminen on pitkälti verrattavissa uhkapelaamiseen.

Neural representations of social and non-social uncertainty in human decision making

The social landscape is filled with an intricate web of species-specific desired objects and course of actions. Humans are highly social animals and, as they navigate this landscape, they need to produce adapted decision-making behaviour. Traditionally social and non-social neural mechanisms affecting choice have been investigated using different approaches. Recently, in an effort to unite these findings, two main theories have been proposed to explain how the brain might encode social and non-social motivational decision-making: the extended common currency and the social valuation specific schema (Ruff & Fehr 2014). One way to test these theories is to directly compare neural activity related to social and non-social decision outcomes within the same experimental setting. Here we address this issue by focusing on the neural substrates of social and non-social forms of uncertainty. Using functional magnetic resonance imaging (fMRI) we directly compared the neural representations of reward and risk prediction and errors (RePE and RiPE) in social and non- social situations using gambling games. We used a trust betting game to vary uncertainty along a social dimension (trustworthiness), and a card game (Preuschoff et al. 2006) to vary uncertainty along a non-social dimension (pure risk). The trust game was designed to maintain the same structure of the card game. In a first study, we exposed a divide between subcortical and cortical regions when comparing the way these regions process social and non-social forms of uncertainty during outcome anticipation. Activity in subcortical regions reflected social and non-social RePE, while activity in cortical regions correlated with social RePE and non-social RiPE. The second study focused on outcome delivery and integrated the concept of RiPE in non-social settings with that of fairness and monetary utility maximisation in social settings. In particular these results corroborate recent models of anterior insula function (Singer et al. 2009; Seth 2013), and expose a possible neural mechanism that weights fairness and uncertainty but not monetary utility. The third study focused on functionally defined regions of the early visual cortex (V1) showing how activity in these areas, traditionally considered only visual, might reflect motivational prediction errors in addition to known perceptual prediction mechanisms (den Ouden et al 2012). On the whole, while our results do not support unilaterally one or the other theory modeling the underlying neural dynamics of social and non-social forms of decision making, they provide a working framework where both general mechanisms might coexist.

La fiebre del juego ataca a Tío Sam

Fondo Margaritainés Restrepo

Commentary on: Are we overpathologizing everyday life? A tenable blueprint for behavioral addiction research: On functional and compulsive aspects of reinforcement pathologies

Background: This paper is a commentary to a debate article entitled: "Are we overpathologizing everyday life? A tenable blueprint for behavioral addiction research", by Billieux et al. (2015). Methods and aim: This brief response focused on the necessity to better characterize psychological and related neurocognitive determinants of persistent deleterious actions associated or not with substance utilization. Results: A majority of addicted people could be driven by psychological functional reasons to keep using drugs, gambling or buying despite the growing number of related negative consequences. In addition, a non-negligible proportion of them would need assistance to restore profound disturbances in basic learning processes involved in compulsive actions. Conclusions: The distinction between psychological functionality and compulsive aspects of addictive behaviors should represent a big step towards more efficient treatments.

Défices cognitivos em pacientes com depressão unipolar: Influência das variáveis idade, género e história anterior de tentativas de suicídio

Tese de Doutoramento, Psicologia, Faculdade de Ciências Humanas e Sociais, Universidade do Algarve, 2015

Caracterización del mercado informal de juegos con máquinas de azar en el barrio Samaria de la ciudad de Pereira

Con el presente trabajo de investigación se determinaron las principales características que presenta el mercado informal de juegos de azar, localizados con Máquinas Electrónicas Tragamonedas (METs) en un barrio de la ciudad de Pereira (Samaria) -- Mercado que funciona en locales de tipología tradicional, la cual está constituida por los negocios como tiendas, misceláneas, cafeterías, graneros, licoreras, heladerías y otros, es decir, locales cuya actividad comercial principal no son los juegos de azar ni el entretenimiento, que optan por incluir en sus portafolios una o dos máquinas electrónicas de juego -- Dichos instrumentos de juego se instalan dentro del espacio de su local y no están inscritas ni cuentan con el permiso de operación de la entidad reguladora de esta actividad en Colombia, que es Coljuegos -- Por tal razón no hay un registro de su magnitud ni mucho menos de los recursos financieros que genera, así como tampoco de las condiciones contractuales en las que opera -- Al ser los juegos de azar localizados una actividad estrictamente regulada por el Estado, el caracterizar la operación informal adquiere relevancia tanto para el Estado como para las compañías formalmente constituidas en la actividad, los cuales ven en ello un competidor informal que captura una participación de mercado de juegos de azar localizados con máquinas de juego

The compleat gamester : or, Full and easy instructions for playing at above twenty several games upon the cards with variety of diverting fancies and tricks upon the same now first added ; as likewise at all the games on the tables, together with the royal game of chess and billiards.

Mode of access: Internet.

Effects of affective and anxiety disorders on outcome in problem gamblers attending routine cognitive-behavioural treatment in South Australia

This study evaluated the influence of 12-month affective and anxiety disorders on treatment outcomes for adult problem gamblers in routine cognitive–behavioural therapy. A cohort study at a state-wide gambling therapy service in South Australia. Primary outcome measure was rated by participants using victorian gambling screen (VGS) ‘harm to self’ sub-scale with validated cut score 21? (score range 0–60) indicative of problem gambling behaviour. Secondary outcome measure was Work and Social Adjustment Scale (WSAS). Independent variable was severity of affective and anxiety disorders based on Kessler 10 scale. We used propensity score adjusted random-effects models to estimate treatment outcomes for sub-populations of individuals from baseline to 12 month follow-up. Between July, 2010 and December, 2012, 380 participants were eligible for inclusion in the final analysis. Mean age was 44.1 (SD = 13.6) years and 211 (56 %) were males. At baseline, 353 (92.9 %) were diagnosed with a gambling disorder using VGS. For exposure, 175 (46 %) had a very high probability of a 12-month affective or anxiety disorder, 103 (27 %) in the high range and 102 (27 %) in the low to moderate range. For the main analysis, individuals experienced similar clinically significant reductions (improvement) in gambling related outcomes across time (p\0.001). Individuals with co-varying patterns of problem gambling and 12 month affective and anxiety disorders who present to a gambling help service for treatment in metropolitan South Australia

The prevalence of comorbid personality disorders in treatment-seeking problem gamblers: a systematic review and meta-analysis

The aim of this study was to systematically review and meta-analyze the prevalence of comorbid personality disorders among treatment-seeking problem gamblers. Almost one half (47.9%) of problem gamblers displayed comorbid personality disorders. They were most likely to display Cluster B disorders (17.6%), with smaller proportions reporting Cluster C disorders (12.6%) and Cluster A disorders (6.1%). The most prevalent personality disorders were narcissistic (16.6%), antisocial (14.0%), avoidant (13.4%), obsessive-compulsive (13.4%), and borderline (13.1%) personality disorders. Sensitivity analyses suggested that these prevalence estimates were robust to the inclusion of clinical trials and self-selected samples. Although there was significant variability in reported rates, subgroup analyses revealed no significant differences in estimates of antisocial personality disorder according to problem gambling severity, measure of comorbidity employed, and study jurisdiction. The findings highlight the need for gambling treatment services to conduct routine screening and assessment of co-occurring personality disorders and to provide treatment approaches that adequately address these comorbid conditions.

Experiences and perceptions of problem gamblers on cognitive and exposure therapies when taking part in a randomised controlled trial: a qualitative study

In South Australia (SA) problem gambling is mainly a result of the widespread availability of electronic gaming machines. A key treatment provider in SA offers free cognitive and behavioural therapy (CBT) to help-seeking problem gamblers. The CBT program focuses on the treatment of clients' urge to gamble using exposure therapy (ET) and cognitive therapy (CT) to restructure erroneous gambling beliefs. The aim of this study was to explore treatment specific and non-specific effects for CT alone and ET alone using qualitative interviews. Interviewees were a sub-sample of participants from a randomised trial that investigated the relative efficacy of CT versus ET. Findings revealed that all interviewees gained benefit from their respective therapies and their comments did not appear to favour one therapy over another. Both treatment specific and treatment non-specific effects were well supported as playing a therapeutic role to recovery. Participants' comments in both therapy groups suggested that symptom reduction was experienced on a gambling related urge-cognition continuum. In addition to symptom improvement from therapy-specific mechanisms, ET participants described a general acquisition of "rational thought" from their program of therapy and CT participants had "taken-over" their gambling urges. The findings also highlighted areas for further improvement including therapy drop-out.

The influence of depression and other co-occurring conditions on treatment outcomes for problem gamblers : a cohort study

Objective: To examine the influence of co-occurring conditions on gambling treatment outcomes.

Design, setting and participants: Prospective cohort study of problem gamblers. Participants were recruited from consecutive referrals to a gambling therapy service in 2008. Inclusion criteria were: (i) assessed as a problem gambler based on a screening interview including DSM-IV criteria for pathological gambling, and (ii) suitable for admission to a treatment program. Cognitive-behavioural therapy was based on graded exposure-to-gambling urge. One-to-one treatment was conducted with 1-hour sessions weekly for up to 12 weeks.

Main outcome measures: Problem gambling screening and co-occurring conditions including depression, anxiety and alcohol use.

Results: Of 127 problem gamblers, 69 were males (54%), mean age was 43.09 years, and 65 (51%) reported a duration of problem gambling greater than 5 years. Median time for participants’ enrolment in the study was 8.9 months. Results from mixed effects logistic regression analysis indicated that individuals with higher depression levels had a greater likelihood (13% increase in odds [95% CI, 1%–25%]) of problem gambling during treatment and at follow-up.

Conclusion: Addressing depression may be associated with improved treatment outcomes in problem gambling; conversely, treatment of problem gambling improves affective instability. We therefore recommend a dual approach that treats both depression and problem gambling.