And That is Where the Fun Ends – General Practitioners’ Conceptualisation of the Line between Recreational and Problem Gambling

Open access

Abstract

AIMS – Problem gambling is normally identified by fixed criteria of harm adapted from those of substance abuse and by focusing on the individual gambler. However, rigid definitions neglect institutional variations of gambling practices within different legislative configurations. This study proposes analysing the line between recreational and problem gambling by focusing on gambling behaviour and looking at the corruption of the defining factors of play (Caillois, 1958) in three different institutional contexts. DESIGN – A stimulated focus-group method (Reception Analytical Group Interview) was applied to seven groups of Finnish and French general practitioners each and three groups of German ones to study the variations of conceptualising the defining factors of play as introduced by Caillois. RESULTS – Corruption of play was distinguished by participants from all three countries as the dividing line between recreational and problem gambling, but cultural variations were found: the French and German GPs emphasised the loss of the exceptionality of gambling, whereas the Finnish GPs highlighted the invasion of the home by online gambling. Furthermore, the Finnish and German participants were more concerned about the use of gambling as an emotional regulator, while French GPs echoed the French medical model in discussing the adrenaline rush of problem gamblers. CONCLUSIONS – Caillois’ defining factors of play can be used to distinguish recreational from problem gambling and to offer a more encompassing definition of problem gambling. The perception of the line between recreational and problem gambling also seems to depend on the institutional and cultural context.

Abstract

AIMS – Problem gambling is normally identified by fixed criteria of harm adapted from those of substance abuse and by focusing on the individual gambler. However, rigid definitions neglect institutional variations of gambling practices within different legislative configurations. This study proposes analysing the line between recreational and problem gambling by focusing on gambling behaviour and looking at the corruption of the defining factors of play (Caillois, 1958) in three different institutional contexts. DESIGN – A stimulated focus-group method (Reception Analytical Group Interview) was applied to seven groups of Finnish and French general practitioners each and three groups of German ones to study the variations of conceptualising the defining factors of play as introduced by Caillois. RESULTS – Corruption of play was distinguished by participants from all three countries as the dividing line between recreational and problem gambling, but cultural variations were found: the French and German GPs emphasised the loss of the exceptionality of gambling, whereas the Finnish GPs highlighted the invasion of the home by online gambling. Furthermore, the Finnish and German participants were more concerned about the use of gambling as an emotional regulator, while French GPs echoed the French medical model in discussing the adrenaline rush of problem gamblers. CONCLUSIONS – Caillois’ defining factors of play can be used to distinguish recreational from problem gambling and to offer a more encompassing definition of problem gambling. The perception of the line between recreational and problem gambling also seems to depend on the institutional and cultural context.

References

  • American Psychiatric Association (2000). DSM-IV-TR diagnositc and statistical manual of mental disorders (4th ed.). Washington D.C.: American Psychiatric Association.

  • Becker H. (1970). Field Work Evidence. In H. Becker (Ed.) Sociological work: Method and substance. (pp. 39–62). New Brunswick: Transaction Books.

  • Binde P. (2009). Gambling motivation and involvement. A review of social science research. Östersund: Swedish National Institute of Public Health.

  • Blaszczynski A. & Nower L. (2002). A pathways model of problem and pathological gambling. Addiction 97 487–499.

    • Crossref
  • Bundesärztekammer (2013). Struktur der ärzteschaft 2011. Retrieved from http:// www.bundesaerztekammer.de

  • Caillois R. (1958). Les jeux et les hommes. (le masque et le vertige). Paris: Gallimard.

  • Christensen M. Patsdaughter C. & Babington L. (2001). Health care providers’ experiences with problem gamblers. Journal of Gambling Studies 17(1) 71–79.

    • Crossref
  • Demant J. (2012). Natural interactions in artificial situations: Focus groups as an active social experiment. In L. Naidoo (Ed.) An ethnography of global landscapes and corridors (pp. 57–88). Rijeka: InTech.

  • Douglas M. (1986). How institutions think. New York: Syracuse University Press.

  • Egerer M. (2010). Gate keepers’ images of addiction in Finland France and Germany. The film-clips in the group interviews. Helsinki: Helsingin yliopisto sosiaalitieteiden laitos.

  • Egerer M. (2012). Alcoholism brief intervention and the institutional context: A focus-group study with French and Finnish general practitioners. Critical Public Health 22(3) 307–318.

    • Crossref
  • Egerer M. (2013). Problem drinking gambling and eating – three problems one understanding? A qualitative comparison between French and Finnish social workers. Nordic Studies on Alcohol and Drugs 30(1–2) 67–86.

    • Crossref
  • Elster J. (1999). Emotion and addiction: Neurobiology culture and choice. In J. Elster (Ed.) Addiction: Entries and exits (pp. 239–276). New York: Russell Sage Foundation.

  • Ferentzy P. & Turner N. (2012). Morals medicine metaphors and the history of the disease model of problem gambling. Journal of Gambling Issues October 2012(27) 1–27.

    • Crossref
  • Goudriaan A. E. Oosterlaan J. de Beurs E. & Van den Brink W. (2004). Pathological gambling: A comprehensive review of biobehavioral findings. Neuroscience & Biobehavioral Reviews 28(2) 123–141. doi:10.1016/j.neubiorev.2004.03.001

    • Crossref
  • Griffiths M. & Wood R. (2007). Lottery gambling and addiction: An overview of European research. Retrieved 26.9 2007 from https://www.european-lotteries.org

  • Hirschovits-Gerz T. Ahonen J. & Tammi T. (2012). Peli persoona vai tilanne? Rahapeliongelmaisia koskevat tyypittelyt tutkimuskirjallisuudessa ja arjen hoitotyössä. Janus 20(3) 231–248.

  • Hirschovits-Gerz T. Holma K. Koski- Jännes A. Raitasalo K. Blomqvist J. Cunningham J. et al. (2011). Is there something peculiar about Finnish views on alcohol addiction? – A cross-cultural comparison between four northern populations. Research on Finnish Society 4 41–54.

  • Huizinga J. (1939.). Homo ludens: Versuch einer bestimmung des spielelementes der kultur. Amsterdam: Pantheon.

  • INSEE. (2010). Médecins suivant le statut et la spécialité. Retrieved 05.10 2010 from http://www.insee.fr/fr/themes/tableau.asp?reg_id=0&ref_id=NATTEF06102

  • INSERM (Institut national de la santé et de la recherche médicale). (2008). Jeux de hasard et d’argent - contextes et addictions. Paris: Les éditions Inserm.

  • Jaakkola T. (2009). Finland. In G. Meyer T. Hayer & M. Griffiths (Eds.) Problem gambling in Europe (pp. 53–70). New York: Springer.

  • Klatetzki T. (2006). Der Stellenwert des Begriffs “Kognition” im Neo- Institutionalismus. In K. Senge & K. Hellmann. (Ed.) Einführung in den neo- Institutionalismus (pp. 48–61). Wiesbaden: VS Verlag.

  • Korn D. (2000). Expansion of gambling in Canada: Implications for health and social policy. Canadian Medical Association Journal163(1) 61–64.

  • Ladouceur R. & Walker M. (1998). The cognitive approach to understanding and treating pathological gambling. In A. Bellack & M. Hersen (Eds.) Comprehensive clinical psychology (pp. 288–301). New York: Pergamon.

  • Laging M. (2009). Die Inanspruchnahme formeller Hilfen durch Menschen mit problematischem oder pathologischem Glücksspielverhalten. Suchttherapie 10 68–74.

  • Lesieur H. & Blume S. (1987). The South Oaks Gambling Screen (SOGS): A new instrument for the identification of pathological gamblers. American Journal of Psychiatry 144 1184–1188.

  • Livingstone C. & Woolley R. (2007). Risky business: A few provocations on the regulation of electronic gaming machines. International Gambling Studies 7(3) 361–376.

    • Crossref
  • Loba P. Stewart S. Klein R. & Blackburn J. (2001). Manipulations of the features of standard video lottery terminal (VLT) games: Effects in pathological and non-pathological gamblers. Journal of Gambling Studies 17(4) 297–320.

    • Crossref
  • Majamäki M. & Pöysti V. (2012). Vocabularies of gambling justification among Finnish and French players. European Journal of Cultural Studies 15(4) 496–512.

    • Crossref
  • Martignoni-Hutin J. (2005). Que peut apporter la sociologie dans le débat sur le jeu compulsif? Psychotropes 11(2) 55–86.

  • Miller M. (1996). Medical approaches to gambling issues – I: The medical condition. Wisconsins Medical Journal 95(9) 623–634.

  • Orford J. Sproston K. & Erens B. (2003). SOGS and DSM-IV in the british gambling prevalence survey: Reliability and factor structure. International Gambling Studies 3(1) 53–65.

    • Crossref
  • Pasternak A. & Fleming M. (1999). Prevalence of gambling disorders in a primary care setting. Archives of Family Medicine 8(6) 515–520.

    • Crossref
  • Pöysti V. & Majamäki M. (2013). Cultural understandings of the pathways leading to problem gambling: Medical disorder or failure of self-regulation? Addiction Research & Theory 21(1) 70–82.

  • Raylu N. & Oei T. (2002). Pathological gambling: A comprehensive review. 22 1009–1061.

    • Crossref
  • Raylu N. & Oei T. P. (2004). Role of culture in gambling and problem gambling. Clinical Psychology Review 23 1087–1114.

    • Crossref
  • Reichertz J. Niederbacher A. Möll G. Gothe M. & Hitzler R. (2010). Jackpot. Erkundungen zur kultur der spielhallen. Wiesbaden: VS Verlag.

    • Crossref
  • Reinarman C. (2005). Addiction as accomplishment – the discursive construction of disease. Addiction Research & Theory 13(4) 307–320.

    • Crossref
  • Reith G. & Dobbie F. (2011). Beginning gambling: The role of social networks and environment. Addiction Research & Theory 19(6) 483–493.

    • Crossref
  • Reith G. (2006). The experience of play. In J. Cosgrave (Ed.) Sociology of risk and gambling reader (pp. 255–290). London: Routledge.

  • Room R. (2003). The cultural framing of addiction. Janus Head 6(2) 221–234.

  • Rush B. Veldhuizen S. & Adlaf E. (2007). Mapping the prevalence of problem gambling and its association with treatment accessibility and proximity to gambling venues. Journal of Gambling Issues 20 193–214.

    • Crossref
  • Samuelsson E. Blomqvist J. & Christophs I. (2013). Addiction and recovery: Perceptions among professionals in the Swedish treatment system. Nordic Studies on Alcohol and Drugs 30(1-2) 51–66.

    • Crossref
  • Scott R. (1995). Institutions and organizations. Thousand Oaks: SAGE.

  • Silverman D. (2001). Interpreting qualitative data: Methods for analysing talk text and interaction (2nd Ed.). London: SAGE.

  • Sulkunen P. (2007). Images of addiction: Representations of addictions in films. Addiction Research & Theory 15(6) 543–559. doi:10.1080/16066350701651255

    • Crossref
  • Sulkunen P. & Egerer M. (2009.). Reception analytical group interview: A short introduction and manual. Helsinki: Helsingin yliopisto sosiologian laitos.

  • Sullivan S. Arroll B. Coster G. & Abbott M. (1998). Problem gamblers: A challenge for GPs. NZ Family Physician 25(1) 37–42.

  • Suomen Lääkäriliitto. (2010). Lääkärit 2010. Helsinki: Suomen Lääkäriliitto.

  • Törrönen J. (2002). Semiotic theory on qualitative interviewing using stimulus texts. Qualitative Research 2(3) 343–362.

    • Crossref
  • Turja M. Halme J. Mervola M. Järvinen- Tassopoulos J. & Ronkainen J. (2012). Suomalaisten rahapelaaminen 2011. raportti 14/2012. Helsinki: THL.

  • Valleur M. (2009). France. In G. Meyer T. Hayer & M. Griffiths (Eds.) Problem gambling in Europe (pp. 71–84). New York: Springer.

  • WHO. (1992). ICD-10 classification of mental and behavioural disorders. clinical descriptions and diagnostic guidelines. Geneva: World Health Organization.

  • Winters K. C. Specker S. & Stinchfield R. (1997). Brief manual for use of the diagnostic interview for gambling severity. Minneapolis MN: University of Minnesota Medical School.

  • Wohl M. Anisman H. Matheson K. & Young M. (2006). Personal luck outcome expectancies and subjective appraisals as predictors of health and readiness to seek treatment among young adults. final report to the ontario problem gambling research centre. Retrieved 06/16 2013 from http:// www.austgamingcouncil.org.au/images/ pdf/eLibrary/3108.pdf

If the inline PDF is not rendering correctly, you can download the PDF file here.

  • American Psychiatric Association (2000). DSM-IV-TR diagnositc and statistical manual of mental disorders (4th ed.). Washington D.C.: American Psychiatric Association.

  • Becker H. (1970). Field Work Evidence. In H. Becker (Ed.) Sociological work: Method and substance. (pp. 39–62). New Brunswick: Transaction Books.

  • Binde P. (2009). Gambling motivation and involvement. A review of social science research. Östersund: Swedish National Institute of Public Health.

  • Blaszczynski A. & Nower L. (2002). A pathways model of problem and pathological gambling. Addiction 97 487–499.

    • Crossref
  • Bundesärztekammer (2013). Struktur der ärzteschaft 2011. Retrieved from http:// www.bundesaerztekammer.de

  • Caillois R. (1958). Les jeux et les hommes. (le masque et le vertige). Paris: Gallimard.

  • Christensen M. Patsdaughter C. & Babington L. (2001). Health care providers’ experiences with problem gamblers. Journal of Gambling Studies 17(1) 71–79.

    • Crossref
  • Demant J. (2012). Natural interactions in artificial situations: Focus groups as an active social experiment. In L. Naidoo (Ed.) An ethnography of global landscapes and corridors (pp. 57–88). Rijeka: InTech.

  • Douglas M. (1986). How institutions think. New York: Syracuse University Press.

  • Egerer M. (2010). Gate keepers’ images of addiction in Finland France and Germany. The film-clips in the group interviews. Helsinki: Helsingin yliopisto sosiaalitieteiden laitos.

  • Egerer M. (2012). Alcoholism brief intervention and the institutional context: A focus-group study with French and Finnish general practitioners. Critical Public Health 22(3) 307–318.

    • Crossref
  • Egerer M. (2013). Problem drinking gambling and eating – three problems one understanding? A qualitative comparison between French and Finnish social workers. Nordic Studies on Alcohol and Drugs 30(1–2) 67–86.

    • Crossref
  • Elster J. (1999). Emotion and addiction: Neurobiology culture and choice. In J. Elster (Ed.) Addiction: Entries and exits (pp. 239–276). New York: Russell Sage Foundation.

  • Ferentzy P. & Turner N. (2012). Morals medicine metaphors and the history of the disease model of problem gambling. Journal of Gambling Issues October 2012(27) 1–27.

    • Crossref
  • Goudriaan A. E. Oosterlaan J. de Beurs E. & Van den Brink W. (2004). Pathological gambling: A comprehensive review of biobehavioral findings. Neuroscience & Biobehavioral Reviews 28(2) 123–141. doi:10.1016/j.neubiorev.2004.03.001

    • Crossref
  • Griffiths M. & Wood R. (2007). Lottery gambling and addiction: An overview of European research. Retrieved 26.9 2007 from https://www.european-lotteries.org

  • Hirschovits-Gerz T. Ahonen J. & Tammi T. (2012). Peli persoona vai tilanne? Rahapeliongelmaisia koskevat tyypittelyt tutkimuskirjallisuudessa ja arjen hoitotyössä. Janus 20(3) 231–248.

  • Hirschovits-Gerz T. Holma K. Koski- Jännes A. Raitasalo K. Blomqvist J. Cunningham J. et al. (2011). Is there something peculiar about Finnish views on alcohol addiction? – A cross-cultural comparison between four northern populations. Research on Finnish Society 4 41–54.

  • Huizinga J. (1939.). Homo ludens: Versuch einer bestimmung des spielelementes der kultur. Amsterdam: Pantheon.

  • INSEE. (2010). Médecins suivant le statut et la spécialité. Retrieved 05.10 2010 from http://www.insee.fr/fr/themes/tableau.asp?reg_id=0&ref_id=NATTEF06102

  • INSERM (Institut national de la santé et de la recherche médicale). (2008). Jeux de hasard et d’argent - contextes et addictions. Paris: Les éditions Inserm.

  • Jaakkola T. (2009). Finland. In G. Meyer T. Hayer & M. Griffiths (Eds.) Problem gambling in Europe (pp. 53–70). New York: Springer.

  • Klatetzki T. (2006). Der Stellenwert des Begriffs “Kognition” im Neo- Institutionalismus. In K. Senge & K. Hellmann. (Ed.) Einführung in den neo- Institutionalismus (pp. 48–61). Wiesbaden: VS Verlag.

  • Korn D. (2000). Expansion of gambling in Canada: Implications for health and social policy. Canadian Medical Association Journal163(1) 61–64.

  • Ladouceur R. & Walker M. (1998). The cognitive approach to understanding and treating pathological gambling. In A. Bellack & M. Hersen (Eds.) Comprehensive clinical psychology (pp. 288–301). New York: Pergamon.

  • Laging M. (2009). Die Inanspruchnahme formeller Hilfen durch Menschen mit problematischem oder pathologischem Glücksspielverhalten. Suchttherapie 10 68–74.

  • Lesieur H. & Blume S. (1987). The South Oaks Gambling Screen (SOGS): A new instrument for the identification of pathological gamblers. American Journal of Psychiatry 144 1184–1188.

  • Livingstone C. & Woolley R. (2007). Risky business: A few provocations on the regulation of electronic gaming machines. International Gambling Studies 7(3) 361–376.

    • Crossref
  • Loba P. Stewart S. Klein R. & Blackburn J. (2001). Manipulations of the features of standard video lottery terminal (VLT) games: Effects in pathological and non-pathological gamblers. Journal of Gambling Studies 17(4) 297–320.

    • Crossref
  • Majamäki M. & Pöysti V. (2012). Vocabularies of gambling justification among Finnish and French players. European Journal of Cultural Studies 15(4) 496–512.

    • Crossref
  • Martignoni-Hutin J. (2005). Que peut apporter la sociologie dans le débat sur le jeu compulsif? Psychotropes 11(2) 55–86.

  • Miller M. (1996). Medical approaches to gambling issues – I: The medical condition. Wisconsins Medical Journal 95(9) 623–634.

  • Orford J. Sproston K. & Erens B. (2003). SOGS and DSM-IV in the british gambling prevalence survey: Reliability and factor structure. International Gambling Studies 3(1) 53–65.

    • Crossref
  • Pasternak A. & Fleming M. (1999). Prevalence of gambling disorders in a primary care setting. Archives of Family Medicine 8(6) 515–520.

    • Crossref
  • Pöysti V. & Majamäki M. (2013). Cultural understandings of the pathways leading to problem gambling: Medical disorder or failure of self-regulation? Addiction Research & Theory 21(1) 70–82.

  • Raylu N. & Oei T. (2002). Pathological gambling: A comprehensive review. 22 1009–1061.

    • Crossref
  • Raylu N. & Oei T. P. (2004). Role of culture in gambling and problem gambling. Clinical Psychology Review 23 1087–1114.

    • Crossref
  • Reichertz J. Niederbacher A. Möll G. Gothe M. & Hitzler R. (2010). Jackpot. Erkundungen zur kultur der spielhallen. Wiesbaden: VS Verlag.

    • Crossref
  • Reinarman C. (2005). Addiction as accomplishment – the discursive construction of disease. Addiction Research & Theory 13(4) 307–320.

    • Crossref
  • Reith G. & Dobbie F. (2011). Beginning gambling: The role of social networks and environment. Addiction Research & Theory 19(6) 483–493.

    • Crossref
  • Reith G. (2006). The experience of play. In J. Cosgrave (Ed.) Sociology of risk and gambling reader (pp. 255–290). London: Routledge.

  • Room R. (2003). The cultural framing of addiction. Janus Head 6(2) 221–234.

  • Rush B. Veldhuizen S. & Adlaf E. (2007). Mapping the prevalence of problem gambling and its association with treatment accessibility and proximity to gambling venues. Journal of Gambling Issues 20 193–214.

    • Crossref
  • Samuelsson E. Blomqvist J. & Christophs I. (2013). Addiction and recovery: Perceptions among professionals in the Swedish treatment system. Nordic Studies on Alcohol and Drugs 30(1-2) 51–66.

    • Crossref
  • Scott R. (1995). Institutions and organizations. Thousand Oaks: SAGE.

  • Silverman D. (2001). Interpreting qualitative data: Methods for analysing talk text and interaction (2nd Ed.). London: SAGE.

  • Sulkunen P. (2007). Images of addiction: Representations of addictions in films. Addiction Research & Theory 15(6) 543–559. doi:10.1080/16066350701651255

    • Crossref
  • Sulkunen P. & Egerer M. (2009.). Reception analytical group interview: A short introduction and manual. Helsinki: Helsingin yliopisto sosiologian laitos.

  • Sullivan S. Arroll B. Coster G. & Abbott M. (1998). Problem gamblers: A challenge for GPs. NZ Family Physician 25(1) 37–42.

  • Suomen Lääkäriliitto. (2010). Lääkärit 2010. Helsinki: Suomen Lääkäriliitto.

  • Törrönen J. (2002). Semiotic theory on qualitative interviewing using stimulus texts. Qualitative Research 2(3) 343–362.

    • Crossref
  • Turja M. Halme J. Mervola M. Järvinen- Tassopoulos J. & Ronkainen J. (2012). Suomalaisten rahapelaaminen 2011. raportti 14/2012. Helsinki: THL.

  • Valleur M. (2009). France. In G. Meyer T. Hayer & M. Griffiths (Eds.) Problem gambling in Europe (pp. 71–84). New York: Springer.

  • WHO. (1992). ICD-10 classification of mental and behavioural disorders. clinical descriptions and diagnostic guidelines. Geneva: World Health Organization.

  • Winters K. C. Specker S. & Stinchfield R. (1997). Brief manual for use of the diagnostic interview for gambling severity. Minneapolis MN: University of Minnesota Medical School.

  • Wohl M. Anisman H. Matheson K. & Young M. (2006). Personal luck outcome expectancies and subjective appraisals as predictors of health and readiness to seek treatment among young adults. final report to the ontario problem gambling research centre. Retrieved 06/16 2013 from http:// www.austgamingcouncil.org.au/images/ pdf/eLibrary/3108.pdf

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