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The biggest winners and losers are in New Jersey — in terms of gambling that is. In 2020 alone, bettors wagered $6 billion on New Jersey sports books and subsequently lost $393.2 million, both records in any state for any year, according to the state’s Department of Gaming Enforcement. The same year, the state raked in $2.88 billion in gross gaming revenue. Gambling has traditionally been big business in New Jersey, but with new online options and legalized sports betting, the prevalence of problem gambling has increased, experts say.

People gamble for a variety of reasons beyond the thrill of possibly winning big, but not everyone who gambles has a gambling problem. The World Health Organization estimates 1-6% of the population suffers from problem gambling. What makes one person a recreational gambler and one a problem gambler? That’s something Dr. Mack Costello has been asking himself a lot in the last decade.

“What problem gambling looks like will vary quite a bit, but what it will come down to is that someone gambles too much for their life,” he says. “It absorbs a large amount of their time and resources — cognitive and otherwise — to the point where it interferes with their relationships and anything else they want to do or used to do. There’s a lot that makes it complicated. What becomes clear with problem gambling — it’s under-treated and understudied.”

Costello is an expert in problem gambling or gambling disorder, as officially classified by the American Psychological Association in the DSM-5. Gambling disorder was first categorized as an impulse control disorder, called pathological gambling, in the 1980s. But its modern definition as a behavioral addiction better addresses the brain’s reward system associated with gambling.

Look at the reinforcement system of a slot machine. Press the button or pull the lever and watch the reels align. Hit triple cherries, you win. Try again, lose. Try again, lose. The random nature of the game combined with the chance of a reward can be incredibly addictive for some.

“It’s a very simple reinforcement schedule, but a very powerful one,” Costello says. “That random-ratio schedule is what all gambling or games of chance rely on."

Other games like poker and blackjack are presented as skill-based games that require more strategic thought than a slot machine. Players have choices they can make throughout the game, which may give some a sense of control regarding the outcome.

“You may have somebody who’s losing a lot, but has some idea that they can win,” Costello says. “That’s going to be a hard thing to get somebody to stop doing even if they have some awareness of their illusion of control. The game has some things that you just can’t control.”

For some, the punishment of losing money isn’t enough to dissuade them from continuing to gamble. Instead, they may double down or continue to gamble for an extended period of time. Costello likes to look at one’s days and dollars gambled to evaluate both factors.

“Even if it doesn’t seem like they’re gambling too much in frequency, they could be gambling too much in magnitude and could lose a lot of money, which could ruin their lives and compound other problems,” he says. “There’s a lot of ways the problems can start and maintain themselves. It can be too much time or money involved. A lot of times it’s both when someone really gets themselves in trouble with gambling and seeks help.”

The costs of gambling addiction are high, for the individual and public health. Those with gambling-related problems tend to have poor to fair general health. Some research cites comorbidity rates as high as 90% for problem gamblers, who may suffer from other illnesses and disorders such as depression, substance abuse and personality disorders. The National Council on Problem Gambling estimates that one in five gambling addicts attempts suicide, the highest rate for any kind of addiction.

There are a number of treatment and intervention options available, from programs like Gamblers Anonymous and 1-800-GAMBLER that provide support groups to self-help programs. As a Doctoral Board Certified Behavior Analyst, Costello uses applied behavior analysis to treat gambling addiction. This approach strives to find new behaviors for people to engage in to replace gambling and manage those behaviors with a rewards system.

“When you look at most successful behavioral interventions for addiction, still the most common outcome of that or any addiction treatment is relapse. You have to be ready for that,” he says. “What you want the person to have are these skills to do other things or deal with the urge or whatever it is that leads them to gamble.”

Most treatments strive for abstinence from gambling, but some tend to focus on harm reduction as total abstinence may not be the most realistic goal for everyone. Matching the correct treatment method to the person is key to a productive intervention, Costello says. Enrolling in treatment, getting treatment early and staying committed to it are all frequent problems related to addressing gambling addiction. There are large dropout rates in clinical studies for gambling addiction treatment, up to 50% in a study published in Clinical Psychology Review.

“I think a sad reality is that things just get too bad,” Costello says. “A lot of times, when someone goes to treatment it’s likely they’re going to present that it’s taken over their life and that’s a tough situation to be in. How do you catch something like this early and stop it? There’s a lot of ideas about that, but we don’t really have clear solutions.”

Growing up in Florida, Costello had exposure to gambling. Sure, poker, dice games, slots and other casino favorites are wagered on in Florida, but the state also has a history of betting on dog and horse races and one of the fastest (literally, in terms of speed) sports in the world, jai alai.

“The presentation of gambling is different for certain people in certain places. In Florida, there are things that people in other places don’t even know what I’m talking about, like jai alai,” he says. “It’s a high-action sport that kind of exists for betting like horse racing. I’m a kid growing up so I didn’t realize that not everyone understands gambling this way. That became really clear when I started studying it and talking to others who study it. I feel like I have something to add.”

Costello’s interest in risky behavior and problem gambling led him to New Jersey, which has some of the highest rates of problem gambling. Recent data cites a 6.3% rate of gambling disorders among residents — triple the rate in comparison to other populations.

Shortly after joining Rider’s Department of Psychology as an assistant professor in 2015, he began the process to secure slot machines for the department. After much back and forth with the state, Costello acquired four casino slot machines to join a range of computer-based and table games in Rider’s Gambling Research Lab. Located on the third floor of the Science and Technology Center, the lab has been vital for Costello and his students.

Prior to the COVID-19 pandemic, walk-in volunteers, many of whom were students, a particularly high-risk category for potential gambling addiction, would spend time playing the slot machines, while Costello and his students observed their behaviors. The researchers sought to establish some general population benchmarks for how people play — how long, how much they bet, how many wins and loses.

“Everybody in behavioral-related psychologies will understand that what you have happen in the lab is going to be different from what happens in other environments,” Costello says. “We have this slightly more valid laboratory and we can get good data to benchmark what happens in there with what happens in casinos.”

Avisha Patel ’20 was part of the research team as a graduate student in Rider’s applied psychology program. She observed participants’ interactions with slot machines in the Gambling Research Lab and at Parks Casino in Bensalem, Pa. Although overall differences appear in the final data set, Patel noted many similarities between the students studied in the lab and the real-world casino-goers.

“The data we collected helped showcase how much time people spent on gambling, which can lead to addiction, and their motivation for going to casinos and sitting at slot machines,” she says. “A lot of the research can be generalized to similar experiences in the lab or at casinos.”

In some cases, those in the lab who had pretty consistent losing streaks tended to quit quickly, Patel says. Some who had a little success building their imaginary profit became invested in chasing a win, personifying the addictive nature of gambling, even without any real money involved.

“They were more inclined to stay a little longer. It could be a fake voucher for $2,500, but it was interesting to see those who wanted to utilize that amount of fake money,” Patel says. “They really wanted to see where the fake money would take them.”