title: Electronic gaming machines and gambling disorder: A cross-cultural comparison between treatment-seeking subjects from Brazil and the United States.
abstract: OBJECTIVE
  The objective of this paper is to perform a cross-cultural comparison of gambling disorder (GD) due to electronic gaming machines (EGM), a form of gambling that may have a high addictive potential. Our goal is to investigate two treatment-seeking samples of adults collected in Brazil and the United States, countries with different socio-cultural backgrounds. This comparison may lead to a better understanding of cultural influences on GD.
  
  
  METHODS
  The total studied sample involved 733 treatment-seeking subjects: 353 men and 380 women (average age=45.80, standard deviation ±10.9). The Brazilian sample had 517 individuals and the American sample 216. Subjects were recruited by analogous strategies.
  
  
  RESULTS
  We found that the Brazilian sample was younger, predominantly male, less likely to be Caucasian, more likely to be partnered, tended to have a faster progression from recreational gambling to GD, and were more likely to endorse chasing losses.
  
  
  CONCLUSIONS
  This study demonstrated that there are significant differences between treatment-seeking samples of adults presenting GD due to EGM in Brazil and in the United States. These findings suggest that cultural aspects may have a relevant role in GD due to EGM.
authors.affiliation: Department of Psychiatry, University of São Paulo, São Paulo, SP, Brazil. Electronic address: gcmedeiros@live.com.
authors.forename: Gustavo C
authors.initials: GC
authors.lastname: Medeiros
authors.affiliation: Department of Psychiatry, University of Chicago, Chicago, IL, United States.
authors.forename: Eric W
authors.initials: EW
authors.lastname: Leppink
authors.affiliation: Department of Psychiatry, University of São Paulo, São Paulo, SP, Brazil.
authors.forename: Ana
authors.initials: A
authors.lastname: Yaemi
authors.affiliation: Department of Psychiatry, University of São Paulo, São Paulo, SP, Brazil.
authors.forename: Mirella
authors.initials: M
authors.lastname: Mariani
authors.affiliation: Department of Psychiatry, University of São Paulo, São Paulo, SP, Brazil.
authors.forename: Hermano
authors.initials: H
authors.lastname: Tavares
authors.affiliation: Department of Psychiatry, University of Chicago, Chicago, IL, United States.
authors.forename: Jon E
authors.initials: JE
authors.lastname: Grant
mesh_terms: D000328:Adult; D001938:Brazil / Q000453:epidemiology; D003431:Cross-Cultural Comparison; D003469:Culture; D018450:Disease Progression; D005260:Female; D005715:Gambling / Q000453:epidemiology / Q000208:ethnology* / Q000523:psychology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000208:ethnology*; D011998:Recreation / Q000523:psychology; D014481:United States / Q000453:epidemiology; D018910:Video Games / Q000523:psychology*
keywords: Cross-cultural psychiatry; Electronic gaming machines; Gambling; Gambling disorder