An online gambling intervention using the realization effect

Betting more after losses (i.e. ‘loss chasing’) is a central clinical feature of disordered gambling. According to Prospect Theory, increasing risk-seeking following losses could arise from a failure to ‘re-reference’. Successful re-referencing between successive decisions closes the mental account, and any losses are regarded as final or realized. In experimental work in healthy participants, when losses were realized via a cash transfer between successive gamble, the tendency to chase losses was reduced (Imas, 2016). This is termed the ‘realization effect’. The present study examined this effect in a more ecologically-valid context of an online gambling task, and tested whether the effects of realizing losses varied across gamblers with 3 levels of problem gambling severity.

Regular gamblers (n = 689) were recruited from Prolific in 3 stratified groups using the Problem Gambling Severity Index: non-problem gamblers (PGSI = 0), at-risk gamblers (PGSI 1-7), gambling problems (PGSI 7+). Participants completed a 9-trial lottery task online. The dependent variable was the percentage bets from their current balance. After the 6th trial, participants were randomized to a cash-out manipulation (where they withdrew their funds from one gambling website and re-deposited them in a second gambling website) or a feedback-only condition (in which they were shown their account balance but stayed on the same website).

In a regression model, cashing out significantly reduced the bet amount compared to the feedback-only condition, in the reference group of non-problem gamblers (B = -6.95, p = .020). This effect is in line with the previously reported ‘realization effect’. The cash-out vs feedback conditions did not significantly interact with gambling group (B_(at-risk:cashout) = 5.00, p = .285; B_(problematic:cashout )= 1.44, p = .785).

The realization effect can be elicited online and in a gambling context and may have utility as a harm reduction tool for people with gambling problems.