Motivation and emotion/Book/2014/Gambling addiction and emotion

Gambling addiction and emotion:
What role does emotion play in gambling addiction?

Multimedia presentation (5 min)

Overview

Human emotion is a broad, complex and transient biopsychosocial construct. Some theorists believe that emotion is a perceptual state (Prinz, 2006; Dolan 2002) or simply a reflection of biological structures and processes (Wheeler, Davidson, & Tomarken, 1993; Miller, 1996). This chapter examines the wonderful world of human emotion as it relates to Pathological Gambling (PG).

PG has become a major social problem that governments, community groups and families across the international community encounter on a daily basis; and the issue continues to attract increasing attention. PG causes mass chaos in marriages and families, and furthermore leads to divorce, violence and neglect. Empirical evidence has only recently started being collected and analysed, and it is common that individuals who identify as pathological gamblers experience other comorbid psychological conditions including depression and anxiety disorders, substance addictions and other emotional issues (Shaw, Forbush, Schlinder, Rosenman, & Black, 2007).

This chapter provides a clear analysis of emotion and the subsequent links to PG, developing theory in this field of psychological analysis. To do this, an in-depth analysis of emotion is presented and framed against the ‘Five perennial questions’ (Reeve 2009). However, the core objective of this book chapter is to explore the relationship that exists between emotion and gambling. It was found that deficits in emotional functions, impulse control issues, and improper coping function are the causal factors.

Gambling in Australia

The gambling industry operating in Australia is enormous, and is due to one simple reason: Australians love gambling. The activity bringing pleasure to millions every year is so entrenched and intertwined within Australian society and culture, that we as a nation are spending more (per capita) on gambling than any country across the international community (The Guardian 2014; Moore, & Ohtsuka, 1999). For example, the ABS (2006) reported that Australians spent in excess of $15 billion across all types of gambling throughout FY2005. There are casinos in every major city; poker machines in every sporting and community club/or pub; and having a “punt” at the races is observed commonplace. Other various types of gambling include:

• Lotteries and “scratchies”;
• Casual gambling, e.g. fantasy football;
• Club Keno and poker machines; and
• Sports Betting; for example, in 2013 punters gambled in excess of $68 million dollars on the Melbourne Cup race (IBIS, 2013).

These are some of the more traditional forms of gambling; however, a dangerous and frightening new trend has emerged: online gambling. In the advent of globalised world, and ever increasing connectedness, big betting agencies have shifted their strategic operations on-line. It is one of the great issues of the 21st century, where Gainsbury (2010) reports that over 30% of Australians over the age of 16 participate in on-line gambling. This high participation rate is particularly concerning as a large percentage of participants are actually under the age of 18. This issue will be discussed further through an analysis of adolescent gambling.

The five perennial questions

Todd Atkins, 2011. Managing emotions - Identifying feelings

1. What is an Emotion?
2. What Causes an Emotion?
3. How Many Emotions are there?
4. What Good are the emotions?
5. What is the difference between emotion and mood?

What is an emotion?

In the literature there exists a multitude of expressions, definitions and meanings of emotion; however, Cabanac (2002) explains that there lacks a universal consensus regarding the meaning. Most expressions of emotion refer to or discuss generalised lists of emotive feelings, including happiness, sadness, fear, disgust, and joy to name a few (Cabanac, 2002). However, Reeve (2009) discusses emotions as simply feelings - short lived, and aid human beings through significant life events. Although these are accurate definitions of emotion, they are broad and fairly ambiguous. Providing clarity in a sometimes clouded theoretical arena, Izard (1993) argues that emotion is multidimensional, existing as a social phenomenon, subjective, purposive, and biological (Izard, 1993). Therefore, it is evident that emotions are more complex than first encountered – a multi-dimensional phenomenon that all human beings experience. Reeve (2009, p. 300) discusses emotion as being comprised of the following four components:

1. Feelings: Experiences, considered subjective; awareness; and cognition.
2. Bodily Arousal: Motor responses; bodily preparedness; and physiological activity.
3. Sense of Purpose: Goals direction and motivation; functional aspect.
4. Social-Expressive: All forms of communication; including vocal and facial expression, and general social communication.

What causes an emotion?

When an individual encounters or experiences a significant life event, emotions are generally generated through a combination cognitive and biological factors and processes (Reeve, 2009). But what actually causes an emotion? In the literature there are various psychological perspectives concerning this question; including, biological, psychoanalytical, cognitive, sociological and physiological. However, the focus generally centers upon the dichotomous biological versus cognitive debate (Cicchetti, Ackerman, & Izard, 1995). Both perspectives provide a comprehensive and holistic representation of the emotion process: but which is primary? (Reeve, 2009).

Biological perspective

Carol Izzard, Jaak Panksepp and Paul Ekman are all proponents for the biological perspective as the basis and or cause of emotion (Reeve, 2009). Within psychological literature, there exists various arguments for this perspective, including the mediation and management of non-cognitive emotion through subcortical structures (Reeve, 2009). However, Panskepp (as cited in Reeve, 2009, p. 305) provides a comprehensive rationale:

1. As emotional states are hard to communicate, emotional antecedents must originate via non-cognitive means.
2. Interestingly, procedures such as electrical brain stimulation can induce emotional states.
3. Infants, and other non-human animals such as chimpanzees experience a wide array of emotions.

Cognitive perspective

Proponents for cognitive activity being the primary basis of emotion argue that individuals respond emotionally only when first appraising/examining a significant event (Reeve, 2009). Essentially, cognition is a prerequisite for emotion. Lazarus (as cited in Reeve, (2009) argues that an individual’s well-being and therefore emotional state, is only influenced when the life event has the potential to destabilise the status-quo. Furthermore, Weiner’s 1986 attribution theory (as cited in Reisenzein, 1986), explains that an emotional state occurs based upon reflection of previously experienced events.

How many emotions are there?

There are many contributing factors to the biological versus cognitive debate; including questions concerning the number of emotions human beings experience. The biological take on the amount of emotions an individual may experience is limited; and this is due to the finite neural structures within the brains biology. Generally speaking, the biological perspective emphasises such as anger, happiness and fear - otherwise classified as primary emotions (Reeve, 2009). Whereas the cognitive perspective or orientation, emphasises secondary emotions. These are considered more complex due to the influence of individual, cultural and social emotional experiences (Reeve, 2009).

What good are the emotions?

Lövheim cube of emotion: Original version published in the article Lövheim H. A new three-dimensional model for emotions and mono amine neurotransmitters.

All human beings internally contemplate the use or utility of emotions; especially when life presents challenging, or devastating events that triggers sadness, fear and distraught. However, emotion has a very understated and important role in the evolution, and maintenance of human beings; and may be segmented into two functions: (i) evolutionary and coping; and (ii) social (Reeve, 2009). The utility of emotion was first cited in Charles Darwin’s work – The Expressions of Emotions in Man and Animals; arguing that both humans and animals, in order they evolve, adapt to their surroundings through emotion (Reeve, 2009). Furthermore, emphasising the functional view of emotional behaviour – coping mechanisms allow individuals to manage the various challenges life presents. For example, if confronted with a threatening stimulus, the elicited emotion may be fear, causing the individual to run and seek protection (Reeve, 2009). Therefore it can be argued that “bad” emotions do not exists. Yes there are emotions that can make an individual feel “bad”, but all in order to serve a purpose.

Secondary to evolutionary and coping functions, Reeve (2009, p. 319) explains that emotions also serve a social function aiding human beings to;

1. Communicate feelings;
2. Influence the action of others;
3. Participate and organise social interactions; and
4. Manage intimate and social relationships.

What is the difference between emotion and mood?

The last fundamental or perennial question discussed by Reeve (2009) is what is the difference between emotion and mood? There are various distinguishing features of emotion and mood that set them apart; however, the literature divides these variances into three categories: different antecedences or precursors, different action specificity, and different time course (Reeve, 2009, p. 322; Beedie, Terry, & Lane, 2005). The varied array of emotions are experienced when individuals are confronted with significant life events; whereas moods arise from other ill-defined causes, and largely defined as “good” (positive affect) or “bad” (negative affect). For instance, positive affect leads to a pleasurable engagement, enthusiasm and alertness; whereas negative affect may lead to boredom and irritability (Reeve, 2009, p. 322; Beedie, Terry, & Lane, 2005).

Gambling addiction and emotion

Jeff Kubina, 2006. A slot machine

The relationship between emotion and gambling

PG was added to the DSM as a psychological disorder in in 1980. The current edition of the DSM has re-classified the disorder, equating this particular addiction to a chemical addiction (Jacobsen, Knudsen, Krogh, Pallesen, & Molde, 2007). This finding, or update to DSM criterion is additionally supported by the Illinois Institute for Addiction Recovery . As discussed, the debate between the biological and cognitive perspectives generally directs the literature pertaining to emotion. Moreover, similar to a substance addiction, causal links between certain subgroups are common including sociocultural, psychological, biological and cognitive factors. These factors assist medical professionals and scholars alike to explain the aetiology of this disease in individuals, while prescribing treatment methods (Blaszczynski, & Nower, 2002).

Paradoxically, both depressive and pleasurable emotional states reinforce gambling behaviour, and are casual factors in PG. In some instances gambling behaviour is reinforced through pleasurable and rewarding emotions – essentially they become addicted to the pleasurable emotional states that gambling can induce. Furthermore, this idea supports the notion that emotions are a core motivator behind gambling behaviour in some people (Hills, Hill, Mamone, & Dickerson, 2001). In other cases, individuals may gamble to disassociate from society. Gambling, provides an escape from society, and themselves; veiling negative emotions for a period of time. In the research, dissociation or escape is considered the most common emotional motivator (Gee, Coventry, & Birkenhead, 2005; Blume, 1995). As a final point, as more research is completed in this field, scholars have found that a pathological addiction to gambling is inextricably linked to the heightened and emotionally charged environmental conditions that exist. Such conditions include the structural characteristics of gambling machines (light or noise), complimentary beverages, and other external influences on behavioural outcomes (Jacobsen et al., 2007) The next section will discuss the biological and cognitive factors behind the previously stated paradox; and furthermore, take a closer look at the influences that emotional regulation and impulse control have on gambling behaviour.

Biological relationship

Biological models of behaviour are underpinned by the body's unique composition of structures. Brain structures and chemistry, genetics and various deficiencies within these systems influence behavioural output. Therefore, each individuals unique biological make-up influences their predilection towards gambling behaviour (Blaszczynski, & Nower, 2002). As touched upon earlier, addiction may originate through several sub-groups; and therefore, what causes one person to become addicted to an activity or substance may not cause the same reaction in another. Genetic vulnerability, the over activity of certain neural pathways, and the behaviour of some receptor genes play a major role in addiction. Like substance abusers, pathological gamblers tend to possess a certain dopamine allele receptor gene (D2A1). This particular gene in linked with addictive behaviour, while also related to diminishing receptor reward pathways (Blaszczynski, & Nower, 2002). Structural deficits, and certain gene activity or inactivity lead to emotional vulnerability, impulse control issues, and other emotional deficits cause individuals to seek out pleasure generating activities like gambling.

Cognitive relationship

While there is a lack of consensus in this field of analysis, cognitive processes are undoubtedly and inextricably linked with PG. A "Pathways Model of Gambling", discussed by Blaszczynski, and Nower (2002, p. 491) suggest that distorted cognitive schemas appear as the frequency of gambling increases. These schemas shape an individual’s beliefs, skills and bias concerning their control over certain outcomes (Blaszczynski, & Nower, 2002). In other words, this affect may be categorised or surmised as cognitive distortion, where pathological gamblers have irrational beliefs about money, and the ability to control various outcomes . These principals of cognitive processes foster the “loss of control” gamblers experience; resulting in emotional breakdown, anxiety and depression - amongst other comorbid disorders.

Emotional regulation and impulse control

Considered a core aspect or feature of the self, the ability to control and regulate one’s emotions, impulses, and behaviours is a major predictor of happiness and success (Tice, Bratslavsky, & Baumeister, 2001). As previously discussed, the failure to self-regulate and control impulses can have disastrous outcomes. The construct of emotional regulation is rather complex; however, it may be referred to as the intrinsic and extrinsic structures and processes responsible for monitoring, managing, evaluating and adjusting emotional output (reactions) to certain life events. Moreover, emotional regulation may be considered as an individual’s ability to behave in a manner deemed socially acceptable – essentially society has a predetermined notion of how people are meant to behave emotionally when confronted with certain social stimuli (Tice, Bratslavsky, & Baumeister, 2001; Cole, Martin, & Dennis, 2004). Optimal self-regulation, the ability to make rational responsible decisions is reliant upon long range focus on goals (Tice, Bratslavsky, & Baumeister, 2001). Alternatively, a largely biological function – lapses in impulse control have been associated with deficits in dopamine reward pathways and diminished D2 receptor density (Blaszczynski, & Nower, 2002).

Generally speaking, PG has been linked to emotional regulation deficits otherwise referred to as dysregulation; while additionally having high comorbidity with many other "axis one" disorders such as anxiety, depression, bi-polar and substance abuse (Williams, 2012). In a study completed by Williams, and Grisham (2012), it was found that pathological gamblers, when compared to individuals within a "healthy" sample, displayed poor emotional clarity, increased emotional impulsivity and significantly diminished abilities to appraise their environment and life events. Furthermore, emotional distress causes the individual to focus on their immediate pleasure and happiness, while neglecting their long term distal goals (Tice, Bratslavsky, & Baumeister, 2001). Williams (2012) in a similar study, found that in addition to the above, pathological gamblers simply have difficulty accepting their emotions. This lack of acceptance when paired with stubborn perseverance (e.g. win back their losses) leads to disastrous consequences.

|}

Adolescent gambling

This section will examine the growing issue of adolescent gambling. When the subject of PG arises, many people regard the issue as only being restricted to adults. Unfortunately this is not the case (Parker, Taylor, Eastabrook, Schell, & Wood, 2008). Research indicates that the prevalence of adolescent gambling in consistently increasing, and the advent of online gaming cannot be underplayed (Parker et al., 2008). The consequent impacts are not unlike those previously discussed. Gamblers under the age of 18 report outcomes that include poor or declining academic achievement and school truancy, criminal behaviour, depression, anxiety, and the deterioration of social and familial relationships (Parker et al., 2008). Furthermore, Bergevin, Gupta, Derevensky, and Kaufman (2006) suggest the early onset gambling is more prevalent amongst adolescent males rather than females.

There has yet to be a consensus regarding the reasons why adolescent gambling continues to rise; however, Parker et al. (2008, p. 175) has further attributed this increase due to a “blurring” of gambling activities with other recreational behaviours. More time expended on the internet has essentially led to more time gambling online (poker, blackjack, or simulated gaming machines). Another concerning development is the rise of gambling smart phone applications, either downloaded through IOS (Apple) or Android systems. Most of these applications are “free” to download; however, once downloaded one can simply buy online credits, classified as in-game purchases. The games are generally skewed towards adolescents, and facilitate positive outcomes then negative, making them even more attractive and addictive (Sturmer, 2013). These types of applications compounds gambling behaviour in adolescents, which may in turn lead to long lasting emotional and psychological issues.

In a study completed by ANU researchers Delfabbro, Lahn, and Grabosky (2005), theory pertaining to adolescent gambling was developed. The authors surveyed 926 students from Government, Independent and Catholic schools, ranging from years 7 to 12. The scope of the study was limited to schools and participants within the ACT. The survey was specifically designed for the following reasons:

Objectives
Objective 1	Examine/assess the prevalence and problem of gambling amongst adolescents.
Objective 2	Identify the various risk factors.
Objective 3	The relationship between psychological and social aspects and gambling.
Objective 4	Adolescent gambling beliefs.
Objective 5	The role of advertising in adolescent gambling.
Objective 6	The way in which adolescents seek help regarding this issue.

Table 1: Delfabbro, Lahn, and Grabosky (2005)

The prevalence of gambling within the ACT’s adolescent population is concerning, with only 29.6% of the sample stating they had never gambled. Interestingly, the study found that more traditional forms of gambling (card games, ‘scratchies’, bingo, and betting on the races) were more popular that online gambling. Reinforcing Bergevin et al., (2006) findings, Delfabbro, Lahn, and Grabosky (2005) found that problem gambling had a higher prevalence in the male sample. Reaffirming some of the discussion throughout the book chapter, poor mood states, and coping dysfunction led to higher incidents of problem gambling behaviour. It should be noted, the participants who leaned on the problem or pathological side of the activity explained that their parents participated in gambling behaviour.

A principal theme throughout the literature is that adolescent problem gamblers are less psychologically adjusted or balanced when compared to their peers. Affected by poorer coping skills, regulatory processes, and impulse control issues – biological and cognitive processes discussed throughout the book chapter (Derevensky, & Gupta, 1998; Bergevin et al., 2006). There is a tendency toward maladaptive coping strategies and mechanisms, classified as avoidance-oriented coping. This type of coping emphasises risk taking behaviour, dissociation and avoiding reality: escaping from unhappiness and or trauma. This can be due to unhappy family lives, bullying and various other comorbid disorders such as anxiety or depression (Bergevin et al., 2006; Delfabbro, Lahn, & Grabosky, 2005). To conclude, adolescents that have a gambling problem tend not to seek treatment (Gupta, & Derevensky, 2000); and can be correlated with a lack of awareness, and treatment programs and facilities. However, when treatment is conducted, cognitive behavioural therapy, psychodynamic therapy and pharmacological treatments have succeeded and quelling the problem (Gupta, & Derevensky, 2000).

Quiz

Point added for a correct answer:
Points for an incorrect answer:
Ignore the questions' coefficients:

1 Which is not one of the Five Perennial Questions?

	What good are the emotions?
	What is the difference between emotion and motivation?
	What is an emotion?
	What is the difference between emotion and mood?

2 The basis of emotion debate mainly emphasises the following two areas of psychological analysis;

	Cognitive and behavioural?
	Cognitive and psychoanalytic?
	Biological and behavioural?
	Biological and cognitive?

3 What is considered a core aspect of the self?

	Being happy?
	Emotional regulation?
	The ability to control outcomes?
	Behaving appropriately?

4 What is one of the main causes adolescents do not seek treatment for gambling addiction?

	Lack of services and awareness?
	To shy?
	School and family burdens?
	Bulling and peer pressure?

Conclusion

The psychological phenomenon and construct of emotion is enormously complex. This chapter provided insight into the wonderful world of human emotion. As discussed, there are various psychological perspectives that form the basis of emotion; however, the literature generally centers upon the biology versus cognition debate. Some insight was provided into the "Five perennial questions', but the core focus of this book chapter was assess the relationship between emotion and PG – or vice versa. Whether it is emotional dysfunctions or deficits (cognitive) or impulse control issues (biological), there exists an undeniable relationship between human emotion and problem gambling. There are similarities between the causality of gambling addiction in adults and adolescents. Paradoxically, pleasure and depression both lead to gambling, and this is due to the unique make-up of human beings. As a final point, the concerning issue of adolescent gambling was discussed. It is evident that wider society, instead of taking steps towards gambling cessation in adolescents, are making the problem worse through technology, and the failure to act. |}

See also

• 2011 Motivation and Emotion Book Chapter Gambling
• 2011 Motivation and Emotion Book Chapter Gambling Glossary
• Wikipedia page Gambling
• Wikipedia page Emotion
• Gambling Help

References

Australian Bureau of Statstics, (2006). Gambling Services, Australia, 2004-2005. Retrieved from the ABS website: http://www.abs.gov.au/ausstats/[email protected]/mf/8684.0

Beedie, C., Terry, P., & Lane, A. (2005). Distinctions between emotion and mood. Cognition & Emotion, 19(6), 847-878.

Bergevin, T., Gupta, R., Derevensky, J., & Kaufman, F. (2006). Adolescent Gambling: Understanding the Role of Stress and Coping. Journal of Gambling Studies, 22(2), 195-208.

Blaszczynski, A., & Nower, L. (2002). A pathways model of problem and pathological gambling. Addiction, 97(5), 487-499.

Blume, S. B. (1995). Pathological gambling. BMJ: British Medical Journal, 311(7004), 522.

Cabanac, M. (2002). What is Emotion. Behavioural Processes, 60(2), 69-83.

Cicchetti, D., Ackerman, B. P., & Izard, C. E. (1995). Emotions and emotion regulation in developmental psychopathology. Development and Psychopathology, 7(01), 1-10.

Cole, P. M., Martin, S. E., & Dennis, T. A. (2004). Emotion regulation as a scientific construct: Methodological challenges and directions for child development research. Child development, 75(2), 317-333.

Delfabbro, P., Lahn, J., & Grabosky, P. (2005). Adolescent gambling in the ACT. Canberra, Australia: Centre for Gambling Research, ANU.

Derevensky, J., & Gupta, R 1998. Child and adolescent gambling problems: a program of research. Canadian Journal of School Psychology, 14(1), 55-58.

Dolan, R. J. (2002). Emotion, cognition, and behavior. Science, 298(5596), 1191-1194.

Franken, I. H. (2003). Drug craving and addiction: integrating psychological and neuropsychopharmacological approaches. Progress in Neuro-Psychopharmacology and Biological Psychiatry, 27(4), 563-579.

Gainsbury, S. (2010). Response to the Productivity Commission Inquiry Report into Gambling: Online gaming and the Interactive Gambling Act. Gambling Research: Journal of the National Association for Gambling Studies (Australia), 22(2), 1-10.

Gee, P., Coventry, K. R., & Birkenhead, D. (2005). Mood state and gambling: Using mobile telephones to track emotions. British Journal of Psychology, 96(1), 53-66.

Gupta, R, & Derevensky, J. (2000). Adolescents with gambling problems: from research to treatment. Journal of Gambling Studies, 16(2/3), 315-342.

Hills, A. M., Hill, S., Mamone, N., & Dickerson, M. (2001). Induced mood and persistence at gaming. Addiction, 96(11), 1629-1638.

IBIS, (2013). Racegoers to splurge on style thus Melbourne Cup Carnival. Retrived from IBIS World website: http://www.ibisworld.com.au/media/2013/10/10/racegoers-splurge-style-melbourne-cup-carnival/

Izard, C. E. (1993). Four systems for emotion activation: Cognitive and non-cognitive processes. Psychological Review, 100, 68-90.

Jacobsen, L. H., Knudsen, A. K., Krogh, E., Pallesen, S., & Molde, H. (2007). An overview of cognitive mechanisms in pathological gambling. Nordic Psychology, 59(4), 347-361.

Miller, G. A. (1996). How we think about cognition, emotion, and biology in psychopathology. Psychophysiology, 33(6), 615-628.

Moore, S. M., & Ohtsuka, K. (1999). The prediction of gambling behavior and problem gambling from attitudes and perceived norms. Social Behavior and Personality: an international journal, 27(5), 455-466.

Parker, J. D., Taylor, R. N., Eastabrook, J. M., Schell, S. L., & Wood, L. M. (2008). Problem gambling in adolescence: Relationships with internet misuse, gaming abuse and emotional intelligence. Personality and Individual Differences, 45(2), 174-180.

Prinz, J. J. (2006). Is emotion a form of perception?. Canadian Journal of Philosophy, 36(1), 137-160.

Reeve, J. (2009). Understanding Motivation and Emotion (5th ed.). Hoboken, NJ: John Wiley & Sons, Inc.

Reisenzein, R. (1986). A structural equation analysis of Weiner's attribution—affect model of helping behavior. Journal of Personality and Social Psychology, 50(6), 1123-1133.

Shaw, M. C., Forbush, K. T., Schlinder, J., Rosenman, E., & Black, D. W. (2007). The effect of pathological gambling on families, marriages, and children. CNS spectrums, 12(8), 615-622.

Sturmer, J. (2013), Warnings over gambling apps targeting youth market. ABC News. Retrieved from http://www.abc.net.au/news/2013-05-20/warnings-over-gambling-apps-targeting-youth-market/4701863

The Guardian, (2014). Gambling: Australians bet more and lose more than anyone else. The Guardian. Retrieved from The Guardian website: http://www.theguardian.com/society/2014/feb/04/gambling-australians-bet-more-lose-more

Tice, D. M., Bratslavsky, E., & Baumeister, R. F. (2001). Emotional distress regulation takes precedence over impulse control: if you feel bad, do it!. Journal of personality and social psychology, 80(1), 53-67.

Wheeler, R. E., Davidson, R. J., & Tomarken, A. J. (1993). Frontal brain asymmetry and emotional reactivity: A biological substrate of affective style. Psychophysiology, 30(1), 82-89.

Wilber, M.K. & Potenza, M.N. (2006). Adolescent gambling: Research and clinical implications. Psychiatry (Edgmont), 3(10), 40‐48.

Williams, A. D. (2012). Comparison of emotion regulation deficits and impulsivity in pathological gamblers and compulsive buyers. Journal of the National Association for Gambling Studies (Australia), 23(2), 1-12.

Williams, A. D., & Grisham, J. R. (2012). Impulsivity, emotion regulation, and mindful attentional focus in compulsive buying. Cognitive therapy and research, 36(5), 451-457.