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Updated: Jan 14, 2026

Transcranial Direct Current Stimulation for Online Gamers
Published on: November 9, 2019
Gaming's hidden gamble: are we betting more than we realise?
Carlos Sánchez Belmar1, Narayanan Subramanian1
1Midwest Mental Health Services, East Clare Community Mental Health, HSE West, https://ror.org/04zke5364Ennis Day Hospital, Ennis, Co. Clare, Ireland.
Abstract:
The integration of gambling-like features in modern gaming blurs the line between gaming and gambling. Rapidly evolving monetisation strategies in games, especially microtransactions like loot boxes, exploit psychological reward processes similar to gambling disorder. These include variable ratio schedules, positively reinforced wins, and near-miss effects, among others. Such mechanisms encourage impulsive spending, prolonged engagement, and the development of problematic habits. The risks involved are especially concerning for younger players and individuals with comorbid mental health disorders, who may be more vulnerable to these features. Despite these clear parallels with gambling, regulatory frameworks often fail to address the overlap, leaving consumers exposed to financial and psychological harm. This editorial highlights the urgent need for an updated gambling definition in the context of gaming, increased transparency in game design, stricter age restrictions, and stronger regulatory oversight to safeguard player well-being as the industry continues to expand.
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