TYPE Original Research
PUBLISHED

26 August 2022

DOI 10.3389/fpsyt.2022.979694

OPEN ACCESS
EDITED BY

Kwok Kit Tong,
University of Macau, Macao SAR, China
REVIEWED BY

Marina Cosenza,
University of Campania Luigi Vanvitelli,
Italy
En Li,
Central Queensland University,
Australia

Short-term cognitive impacts of
electronic gaming machines
with and without a skill-based
component: A comparative
laboratory study
Sally M. Gainsbury1 and Kahlil S. Philander1,2*

*CORRESPONDENCE

Kahlil S. Philander
kahlil.philander@wsu.edu

Faculty of Science, School of Psychology, Brain and Mind Centre, University of Sydney,
Camperdown, NSW, Australia, 2 School of Hospitality Business Management, Carson College of
Business, Washington State University, Everett, WA, United States

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This article was submitted to
Addictive Disorders,
a section of the journal
Frontiers in Psychiatry
RECEIVED 27 June 2022
ACCEPTED 08 August 2022
PUBLISHED 26 August 2022
CITATION

Gainsbury SM and Philander KS (2022)
Short-term cognitive impacts
of electronic gaming machines with
and without a skill-based component:
A comparative laboratory study.
Front. Psychiatry 13:979694.
doi: 10.3389/fpsyt.2022.979694
COPYRIGHT

© 2022 Gainsbury and Philander. This
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Commons Attribution License (CC BY).
The use, distribution or reproduction in
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owner(s) are credited and that the
original publication in this journal is
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or reproduction is permitted which
does not comply with these terms.

This study aimed to compare how consumers understand the role of skill
and chance, experience cognitive distortions, and experience immersion
based on use of either electronic gaming machines (EGMs) or skill gambling
machines (SGMs; EGMs with a skill-based component). Participants (N = 246,
Mage = 34 years, 56.91% female) in a laboratory experiment were randomly
assigned to play a real EGM or SGM without funds and self-reported
measures including intention to gamble, understanding of the role of skill
and chance, erroneous gambling beliefs, previous gambling and gaming,
and problem gambling severity. Participants demonstrated different deficits
in understanding of the role of skill vs. chance in determining outcomes
following play. SGM players were more likely to increase their belief that
a skill impacts outcomes and focused more on the game play experience.
EGM players focused more on wins and personal performance. Intention
to play both machines was predicted in both groups by greater experience
of immersion during play and breadth of previous gambling, but breadth
of previous gaming experience only predicted intent to play SGMs. The
results revealed that both EGM and SGM players fail to understand how
outcomes are determined, which is likely more problematic for EGM
players as this reflects clear cognitive distortions. Further real-world testing
is required to understand the extent to which SGMs harms may be
different than EGMs, however, these initial findings suggest that their
risks appear comparable to EGMs while attracting individuals with more
gaming experience.
KEYWORDS

skill gambling, problem gambling severity, immersion, electronic gaming machines,
irrational cognitions

Frontiers in Psychiatry

10.3389/fpsyt.2022.979694

Introduction

critical role in the development and maintenance of gambling
disorders (10–13) and related effects is therefore important to
understanding the riskiness of SGMs. Experience with gaming
may increase interest in SGMs given familiarity with a gambling
modality has been associated with a person feeling overconfident
in their ability and likelihood of winning (14, 15).
Some concerns have been raised regarding the extent to
which SGMs may contribute to gambling problems through
immersive experiences [see (9, 16)]. Video gaming elements
of SGMs provide an engaging and immersive experience
for players. This state of hyper-focus could persist following
cessation of the task, which suggests that immersion decreases
one’s ability to re-engage with the “real world” (17). Findings
are mixed about whether immersion in gambling is related
to escapism from negative emotions or a focus on gambling
outcomes (18, 19). Regardless, it can cause individuals to
lose track of time and their surrounding environment. This
can result in spending more time and money gambling than
intended (20). Immersion (sometimes termed “dissociation”
in the gambling literature) is argued to be linked to the
development and maintenance of gambling problems (21, 22).
Non-randomized studies found that SGMs were more likely
to be played by consumers who were younger, had experience
playing EGMs and/or mobile games, and had higher problem
gambling severity levels (23). Intent to play EGMs and SGMs
was predicted by the Theory of Reasoned Action (24), which
emphasizes the roles of positive personal attitudes and social
norms on future play. We refer to reported intent to play
EGMs and SGMs as intention to gamble. Intention can be
measured by self-report in an experimental setting and has been
demonstrated to be closely related to actual future behavior
(25, 26).
To expand previously conducted research, we sought to
understand three exploratory research questions:

The phenomenon of gambling-gaming convergence is
increasingly recognized across many channels and products
(1). Research has typically approached this convergence by
studying the incorporation of gambling elements into gaming
products (e.g., loot boxes, skins betting, social casino games).
This approach is driven by concerns that gambling-themed
games and mechanics may create a pathway to gambling and the
development of gambling problems in video game players [e.g.,
(2–4)].
The gambling industry has contributed to gambling-gaming
convergence with the development of skill-based gambling
machines (SGMs). SGMs vary in their design elements but are
a variant of electronic gaming machines (EGMs; also known as
slot/poker machines, video lottery terminals, fixed odds betting
terminals) that incorporate skill-based features into chancebased EGMs. SGMs allow skill to influence the house advantage
and often incorporate gaming-like themes, but still produce
negative expected value outcomes for players.
Despite the popularity of research in gaming products
with gambling elements, there is limited study of SGMs. This
lab-based study compares generic reel-based EGMs against
SGMs, with the aim of investigating the potential market
appeal and relevant cognitive and psychological impacts of
incorporating skill gaming elements into gambling products.
This approach of examining gambling products with gaming
components complements the growing literature on gamblinggaming convergence, which has largely focused on gaming
products with gambling components. Gambling policy makers
and regulators are increasingly focused on ensuring that
gambling products do not cause or exacerbate gambling
problems (5, 6). Consequentially, it is important to understand
whether newly developed gambling products may appeal to
vulnerable segments of the population who are at greater risk of
experiencing gambling-related harms or exacerbate risk-factors
believed to increase risk of harms.

1. Are there differences in beliefs and understanding of
how gaming machine outcomes are determined between
participants who played an EGM or SGM?
2. Are there differences in the experience of immersion
between participants who played an EGM or SGM?
3. What variables predict intention to play EGMs and SGMs
following an initial period of play in demonstration mode
of each machine?

Background: Electronic gaming
machines and skill-based
gambling machines
SGMs are designed to appeal to a market segment broader
than traditional EGM players, but the extent to which SGMs
appeal to individuals in populations vulnerable to gambling
problems is an open question. Previous research comparing
SGMs and EGMs shows that most participants believe EGMs
involve at least some element of skill despite the reality that
outcomes are purely chance-based (7, 8) and there are concerns
that SGMs emphasis of skill components may exacerbate
these effects (9). Cognitive distortions are believed to play a

Frontiers in Psychiatry

Materials and methods
This study took place in a laboratory setting using
commercial machines set to “demo” mode. Participants played
on the machines without inserting real-world money and there
were no real-world monetary outcomes (prizes) involved. Our
design provides an opportunity to study the impact of the
structural characteristics of each machine type without the

10.3389/fpsyt.2022.979694

(7.32%); unemployed (3.25%); and other (3.25%). The median
reported household income band was AU $78,000–$90,999 per
year. Using the problem gambling severity index (PSGI) (30),
participants were categorized as mostly experiencing no or
low-risk gambling problems (41.87 and 34.15%, respectively)
with smaller but notable proportions reporting moderaterisk (12.60%) or severe gambling problems (11.38%). Table 1
provides summary statistics by assignment condition.

confounding factor of random monetary outcomes. We have
reported on other aspects of the broader study in separate
publications (7).
The study tests outcomes in reported role of skill and chance,
cognitive distortions, and immersion as a function of random
assignment to an EGM or SGM. We explore intent to play based
on those factors, participation breadth and depth variables (9,
23, 27, 28), problem gambling severity (9), and demographic
variables including age, gender, and household income.

Recruitment
Pre-registration
Young adults were recruited via an online research
participant recruitment platform hosted by the School of
Psychology at the lead author’s institution. This platform allows
students to sign up to participate in research studies as part
of a voluntary research participation assessment component in
exchange for course credit. Students outside of the research
participation assessment scheme can also sign up to participate
in studies and are offered a monetary reimbursement for
their time. Regular EGM players were recruited by distributing
leaflets in a local licensed gambling venue and by posting
a recruitment notice in an e-newsletter distributed to club
members. Additional participants who reported playing EGMs
at least monthly were recruited through a recruitment agency.
Community members were recruited through word-of-mouth
and social media posts, and via a recruitment agency.

This analysis, including its aims and experimental protocol,
were part of a larger pre-registered study on the Open Science
Framework (7). The focus of this study was part of the
planned exploratory analyses. No changes were made to the preregistered procedure during or after data collection. All related
papers are linked to the pre-registration and do not overlap.

Sampling strategy and descriptive
statistics
As part of the larger study, the sample drew from three target
groups within the Australian population: (i) young adults (aged
18–39 years), as this population is a potential target audience for
SGMs and is considered vulnerable given relatively high rates
of gambling and gaming-related problems; (ii) individuals who
play EGMs at least once per month, as such individuals would
likely encounter SGMs if they were made available in licensed
gambling venues; and (iii) community members with prior
EGM gambling experience, given it is important to understand
the potential appeal and impact of SGMs on individuals who
attend licensed gambling venues and may be interested in SGMs.
To participate, respondents had to be at least 18 years of age,
Australian residents, and fluent in English.
A priori sample size calculations used statistics from
prior SGM research (29) as inputs to our power calculation
assumptions. We performed a power analysis for an R-squared
test in a multiple linear regression with a similar specification
to the prior study, estimating a model with one tested covariate
and four control variables. Using the study’s pseudo R-squared
value of 0.43, assuming that the variable will add 0.02, and
specifying an α of 0.05 and 80% power, a sample of 218
individuals was required. Further details are provided in the
pre-registration documents.
A total of 246 participants completed the study. The
study sample self-reported as 56.91% female, 42.68% male,
and 0.41% other gender. On average, the sample was 34 years
old (SD = 17.32). Most of the sample were either students
or in the workforce: employed full-time (24.39%) or parttime (22.36%); students (39.43%); retired or voluntarily inactive

Frontiers in Psychiatry

Gambling stimuli
The gaming machines used for this study were provided by
an Australian gaming device manufacturer. In accordance with
Section 8(2) of the Gaming Machines Act 2001, approval to use
the gaming machines for research purposes was gained from the
state gambling regulatory authority prior to commencing the
study. Two types of machines were used: (i) a standard reelbased EGM, which was legally available in licensed gambling
venues at the time of conducting the present study; and (ii) an
EGM with reel spins and a skill-based video-gaming style feature
and video-game controller (SGM), which was not available
to local consumers at the time of the study. In contrast to
the EGM (on which outcomes are determined completely by
chance), outcomes on the SGM incorporate both chance and
skill elements: the reel-based component is entirely chancebased, but outcomes in the gaming component are fully based
on a player’s skill. The bonus round was a third-person-style
fantasy game that used separate controls that were similar
to a video game controller. In-game currency is awarded to
enable the player to improve their account’s in-game content.
Nonetheless, all SGM players, regardless of skill, have the same
rate of return to player (RTP). More skilled players will yield
more in-game assets, but cash win mechanics are unrelated to

10.3389/fpsyt.2022.979694

TABLE 1 Summary statistics by assignment condition.

Played EGM

Played SGM

Mean

SD

Min

Max

Mean

SD

Min

Max

Age

33.72

16.64

18.00

73.00

35.01

18.28

18.00

75.00

Gender*

0.43

0.51

0.00

2.00

0.44

0.50

0.00

1.00

Household income category

8.56

5.42

1.00

16.00

8.23

5.32

1.00

16.00

PGSI score

2.53

3.30

0.00

18.00

2.37

3.45

0.00

18.00

Observations

*Female, 0; Male, 1; Other, 2. One respondent in the EGM assignment condition identified as “Other.”

skill. This means that over a long period of time, all SGM players
have the same chances of winning small and large prizes. Both
machines were set to return to players a minimum percentage
of 90.5%, which is consistent with machine configurations
found in real-world gambling venues. Gaming credits were
pre-loaded so money was not required to initiate play and
participants were not awarded any monetary wins acquired
during play.

Measures

Laboratory testing procedure

Gambling involvement (pre-test)

Demographic information (pre-test)
Participants were asked to report their gender, age, highest
level of education completed, current employment status,
country of birth, primary language spoken at home, and
total annual household income before tax. Items and response
options were adapted from the Australian Bureau of Statistics
(31) census survey.

Participants reported how often they spent money on
eight different types of gambling activities in a typical month:
instant scratch tickets or lottery games; bingo or keno; private
betting (e.g., playing cards or mah-jong with friends and
family); poker; casino table games (e.g., blackjack, roulette);
poker/slot machines (EGMs); betting on horse/dog races; and
betting on sports (32). Responses were measured on a 5point scale (not at all = 0; 1–3 times per month = 2; once
a week = 4; several times a week = 12; daily = 30). Two
derivative variables were developed: (1) gambling breadth (a
scale ranging from 0 to 8), which is the count of the number
of gambling activities on which an individual reported spending
money (M = 2.52, SD = 2.29); and (2) gambling depth
(a scale ranging from 0 to 30), which is the highest level
of involvement in any single form of gambling (M = 4.96,
SD = 7.00).

Ethical aspects of this study were approved by the lead
author’s institutional Human Research Ethics Committee
(project number 2019/738) prior to commencing data
collection. Participants provided informed consent by reading
the Participant Information Statement and submitting a signed
consent form prior to commencing the pre-test questionnaire.
Up to six participants were included in each session.
Upon arrival, consenting participants completed pre-test
questionnaires using tablet devices. Once all participants had
completed the pre-test questionnaire, they were taken by a
researcher to a room housing three EGMs and three SGMs.
The researcher instructed each participant to sit at the specific
gaming machine corresponding to the experimental condition
to which they had been randomly assigned. Participants
were instructed to play the machines for 20 min. If after
10 min the game feature had not naturally occurred, the
researcher manually triggered the feature (via back-end
activation) to ensure it was experienced by all participants.
The EGM had a traditional free game feature in which
participants can choose “red” or “black” on a card flip. The
SGM’s third-person-style game was a longer bonus round
where the player’s character would fight enemy characters
using weapons and spells. Participants were then asked to
complete the post-test questionnaire using tablet devices. Once
all participants had completed the post-test questionnaire,
the researcher provided a verbal debrief to ensure that
participants understood the experimental protocol, and the
true role of skill and chance in determining outcomes in each
machine type.

Frontiers in Psychiatry

Gaming involvement (pre-test)
Four questions assessed gaming involvement in relation
to frequency across different gaming platforms. Monthly
frequency of video game play across four platform types
(console games, such as Xbox, Nintendo, PlayStation; mobile
phone games; PC/computer games; arcade games) was assessed
using a 4-item scale adapted from Delfabbro et al. (33).
Responses were measured on a 5-point scale (not at all = 0;
1–3 times per month = 2; once a week = 4; several times a
week = 12; daily = 30). Two derivative variables were developed:
(1) gaming breadth (a scale ranging from 0 to 4), which is the
count of the number of gaming activities on which an individual
reported non-zero participation (M = 1.88, SD = 1.34); and (2)

10.3389/fpsyt.2022.979694

Immersion (post-test)

gaming depth (a scale ranging from 0 to 30), which is the highest
level of involvement in any single form of gaming (M = 11.07,
SD = 11.78).

The 31-item immersion questionnaire from experiment 3 of
Jennett et al. (17) was used to measure participants’ experience
of immersion in the machine play session. Immersion is
examined across five factors: cognitive involvement, real world
dissociation, challenge, emotional involvement, and control.
Participants were instructed to respond to the questions on a 5point scale (not at all = 1; a lot = 5) based on how they felt at the
end of the game. After reverse-coding six items, item scores are
summed to yield a total immersion score. Internal consistency
was excellent (Cronbach’s α = 0.94).

Gambler’s beliefs questionnaire
(pre-test/post-test)
The 21-item Gamblers’ Beliefs Questionnaire [GBQ;
(34)] is a widely used psychometric measure of gamblingrelated cognitive distortions consisting of two subscales:
luck/perseverance (13 items) and illusions of control (8
items). Responses are assessed on a 7-point Likert-type scale
(strongly agree = 1; strongly disagree = 7), reverse-coded,
and summed to yield an overall score. Higher scores indicate
higher levels of gambling-related cognitive distortions. The
GBQ demonstrated excellent internal consistency in this
sample (Cronbach’s α = 0.91). Respondents were administered
the GBQ both before (pre-GBQ) and after (post-GBQ) the
experiment.

Understanding of gaming machine outcomes
(post-test)
Participants indicated their agreement with ten statements
about the way outcomes are determined on the type of machine
they played. Eight items assessed understanding regarding the
short- and long-term outcomes and profitability of machine
play on a 5-point Likert scale (strongly disagree = 1; strongly
agree = 5). The remaining two items assessed understanding
regarding the influence of skill vs. chance on outcomes, and
the extent of a player’s control over game outcomes. We
replicate the summative score variables for SGM and EGM game
understanding from Philander and Gainsbury (8).

Erroneous estimates of winning
(pre-test/post-test)
Participants completed the Erroneous Estimates and
Irrational Beliefs Questionnaire (35) both before and after
machine play. The four items assess participants’ estimates
about the chances of different outcomes when playing EGMs:
winning; losing; breaking even; and winning the maximum
prize. Responses are measured by participants indicating their
responses on a rating scale from 0 to 100%.

Statistical analysis
First, we tested for differences in individual items from
the understanding of gaming machine outcome variables
(assessed after using the machines). We estimated two-sample
Welch’s t-tests for each variable based on the SGM/EGM
assignment condition. Since this analysis is exploratory and
not confirmatory, we did not adjust critical values for
multiple pairwise tests.
Second, we tested measures related to beliefs about the
role of skill and control on EGMs and SGMs. We focused
on those beliefs because skill and control characterize the
primary design difference between EGMs and SGMs. Both the
Erroneous Estimates and Irrational Beliefs Questionnaire and
the Gamblers’ Beliefs Questionnaire assess multiple dimensions
of subjective beliefs and cognitive distortions that extend beyond
skill and control. We reviewed each of the items in both
scales for mention of skill or control. The two items from the
Erroneous Estimates and Irrational Beliefs Questionnaire (35)
that relate to skill and control:

Intention to gamble on gaming machines
(post-test)
Participants indicated their agreement with two items
regarding their intentions to gamble on the machine they played
on in the next year, assuming such machines were accessible
(29), “I want to gamble on the machine I just played on in the
next year,” and “There is a chance I could gamble on the machine
I just played on in the next year” (strongly disagree = 1, strongly
agree = 5). Participants also responded to one question adapted
from experiment 3 of Jennett et al. (17), “Would you like to
play the game again?” (definitely not = 1; definitely yes = 5).
The items demonstrated good internal consistency (Cronbach’s
α = 0.86).

Problem gambling severity (post-test)
The 9-item PSGI (30) is a reliable and accurate screen
for presence and severity of gambling problems. Respondents
indicate frequency of experiencing symptoms of problem
gambling during the past 12 months on a 4-point scale
(never = 0; almost always = 3). Items are summed, and
overall scores are classified as follows: non-problem gambling
(score of 0); low-risk gambling (score of 1 or 2); moderate
risk gambling (score between 3 and 7); and problem gambling
(score of 8 or more).

Frontiers in Psychiatry

1. How much control do you think that you have over the
outcome of a game on an EGM? (IBQ1; scale ranging from
0 to 100)
2. How much do you think a player’s skill impacts on the
outcome of a game on an EGM? (IBQ2; scale ranging from
0 to 100)

10.3389/fpsyt.2022.979694

The four items from the Gamblers’ Beliefs Questionnaire
(34) that relate to skill and control:

breadth, gaming depth, gaming breadth, PGSI score, immersion,
pre-GBQ, understanding of gaming machine outcomes, age,
gender, and household income. Since one of the items from
the immersion scale is used as an item in the intention factor,
we removed the item from the immersion scale to avoid a
tautological result.
All analyses were estimated using Stata 15.

1. My knowledge and skill in gambling contribute to the
likelihood that I will make money. (GBQ1; strongly
disagree = 1; strongly agree = 7)
2. My choices or actions affect the game on which I am betting.
(GBQ2; strongly disagree = 1; strongly agree = 7)
3. My gambling wins are evidence that I have skill
and knowledge related to gambling. (GBQ3; strongly
disagree = 1; strongly agree = 7)
4. I have more skills and knowledge related to gambling than
most people who gamble. (GBQ4; strongly disagree = 1;
strongly agree = 7)

Results
Understanding of skill and chance
In Figure 1, we illustrate the results of our t-tests of
the post-session game understanding items across the EGM
and SGM assignment conditions. Full results are provided in
Supplementary Appendix 1. We find that individuals assigned
to the EGM are more likely to somewhat disagree that they
understand how a player’s skill impacts the outcomes, that
players can improve their outcomes with practice, and that a
player of greater skill is more likely to win money over the short
and longer term, compared to players assigned to SGMs. SGMassigned players were more likely to provide neutral responses,
indicating a lack of agreement or disagreement with these
statements. EGM players had stronger agreement that small ingame wins and the game outcomes are randomly determined
than SGM players. Both groups similarly tended to agree that
jackpot wins are randomly determined and that over the long
term all players will lose money. Further, there was no significant
difference in responses based on EGM vs. SGM players that
winning money over 50 h of play is based more on chance, and
that players have a small amount of control over the outcome
of winning money.

Repeated measures were taken before and after the
simulated gambling session. Since GBQ3 asks respondents about
wins and the respondent may have randomly won or loss based
on the short trial period, it was excluded from the analysis.
We estimated a principal factor analysis with the remaining
variables to assess whether they loaded onto the same factor. As
shown in Table 2, all the items except for GBQ4 had acceptably
large factor loadings onto Factor 1 (36). We therefore dropped
GBQ4 from the analysis. Removing GBQ4 increased Cronbach
α of the included items from 0.71 to 0.75.
We used Welch’s t-tests to measure differences in responses
before the simulated gambling session and after the simulated
gambling session, with the two-samples grouped by the
SGM/EGM assignment condition.
Third, we tested for differences in game immersion after
play using immersion scale items. We estimated two-sample
Welch’s t-tests for each variable, based on the SGM/EGM
assignment condition. Since this analysis is exploratory and
not confirmatory, we did not adjust critical values for
multiple pairwise tests.
Fourth, we explored differences in intention to play the
gambling devices using a stepwise modeling approach that
enables us to consider differences in correlates across a
wide range of plausible behavioral and psychometric correlate
measures. Since the intention factor variable is non-categorical,
we estimated a forward selection stepwise OLS model, with
an α = 0.05 significance level for addition to the model.
Included as potential variables were gambling depth, gambling

Change in beliefs about the role of skill
and control on electronic gaming
machines
Some changes in beliefs about the role of skill and control
were observed after the experiment and these changes differed
based on the assignment condition. Individuals assigned to
EGMs had no change in their reported control over the machine
outcome (IBQ1: M = −0.25, SD = 1.90). Individuals assigned to
SGMs had an increase in their reported control over the machine
outcome (IBQ1: M = 0.40, SD = 2.07). The groups showed
a statistically significant difference in their mean responses,
t(235) = −2.55, p = 0.01.
Individuals assigned to EGMs had a decrease in their
reported belief that a player’s skill impacts on the outcome of
a game (IBQ2: M = −0.51, SD = 2.46), whereas individuals
assigned to SGMs showed an increase (IBQ2: M = 0.36,

TABLE 2 Factor loadings (pattern matrix) and unique variances.

Variable

Factor 1

Factor 2

Uniqueness

GBQ1

0.64

0.22

0.54

GBQ2

0.53

0.22

0.66

GBQ4

0.24

0.25

0.88

IBQ1

0.67

−0.26

0.48

IBQ2

0.75

−0.20

0.40

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10.3389/fpsyt.2022.979694

FIGURE 1

Game understanding item mean responses based on EGM/SGM assignment condition. *p < 0.05, **p < 0.01, ***p < 0.001.

SD = 1.89). The groups showed a statistically significant
difference in their mean responses, t(228) = −3.07, p < 0.01.
Individuals assigned to EGMs had a decrease in their
reported agreement that their knowledge and skill in gambling
contribute to their likelihood of making money (GBQ1:
M = −0.75, SD = 1.73). Individuals assigned to SGMs had no
change in their reported values (GBQ1: M = −0.21, SD = 1.41).
The groups showed a statistically significant difference in their
mean responses, t(233) = −2.66, p < 0.01.
Individuals assigned to EGMs had no change in their
reported agreement that their choices or actions affect the game
on which they are betting (GBQ2: M = −0.22, SD = 2.11).
Individuals assigned to SGMs also had no change (GBQ2:
M = −0.28, SD = 2.03). The groups showed no difference in
their mean responses, t(239) = 0.23, p < 0.82.
We observe statistically significant differences in both
items from the Erroneous Estimates and Irrational Beliefs
Questionnaire (see Figure 2). Individuals assigned to SGMs
have greater beliefs that they have more control and more
skill-related impact on outcomes compared to individuals
assigned to EGMs. We also observe a statistically significant
difference in one of the GBQ items. Individuals assigned
to SGMs have greater beliefs that their skill contributes
to winning.

SGM assignment conditions. Compared to individuals assigned
to EGMs, SGM players found the game less easy, more
challenging, and felt that they put more effort into the
game. Compared to individuals assigned to SGMs, EGM
players enjoyed the graphics and imagery more, were more in
suspense, wanted to win more, and thought they performed
better. There were no differences between the groups at
the factor level for the majority of immersion items and
no clear differences based on subscales with challenge and
cognitive dissociation items reported by both groups, and no
differences in items for the real world dissociation or emotional
involvement items. Full results of the tests are provided in
Supplementary Appendix 2.

Intention to play
Our stepwise model produced a small number of variables
that predicted intention to play the game in the future.
Results are displayed in Table 3. Both models reported
immersion as a predictive variable, which may be a result
of the importance of immersion to attitudes in a machine
play task that did not involve any value at risk. Interestingly,
both models produced gambling breadth as a significant
variable but only the SGM model produced gaming breadth
as a significant variable. This suggests that individuals
who play more gambling types have higher intention to
play both games, but individuals who play more gaming
types only have higher intention to play SGMs but not
EGMs in our study.

Immersion
As shown in Figure 3, our tests of immersion items
showed statistically significant differences between EGM and

Frontiers in Psychiatry

10.3389/fpsyt.2022.979694

FIGURE 2

Boxplot of t-test data regarding change in beliefs about the role of skill and control on electronic gaming machines.

FIGURE 3

Immersion questionnaire item mean responses based on EGM/SGM assignment condition. *p < 0.05, **p < 0.01, ***p < 0.001.

Frontiers in Psychiatry

10.3389/fpsyt.2022.979694

TABLE 3 Results of stepwise OLS regression predicting
intention to play.

Variable

Played EGM

Played SGM

DV: Intention factor

DV: Intention factor

Immersion scale

0.0249***

0.022***

Gambling breadth

0.116**

Gaming breadth
Constant

examine the extent to which changes remain after sessions, are
strengthened across sessions, and may be specific to experiences
with individual products or brands.
We did not find any indication of significant differences in
the experience of immersion immediately following EGM or
SGM play, particularly in relation to real world or emotional
dissociation (e.g., losing track of time, awareness of everyday
concerns and surroundings, or engagement in the game). This is
somewhat inconsistent with focus groups which indicated that
the skill feature of SGMs was more engaging and immersive
than EGM reel-spins (37). However, our results did show that
SGM players reported putting more effort into the game and
that it was challenging (and less easy). EGM players were more
focused on outcomes and wins. Although these findings are
limited due to the laboratory setting and lack of real money
wagered, they provide an initial indication that engagement
in the skill aspect of SGMs does not result in any significant
changes beyond what may be observed in standard EGM play
that would contribute to ongoing or persistent gambling and
potential harmful consequences.
Higher immersion scores did predict whether individuals
would be likely to play EGMs and SGMs in the future,
indicating that this may be a desirable state or outcome
following a session of play. Breadth of gambling experience
predicted intent to play both machines. This may indicate
that if introduced, SGMs would be popular with existing
gambling customers rather than relying on novel customers
who do not play EGMs. However, as mentioned, experience
with gaming appears to impact the likelihood of interest in
SGMs, supporting the potential consumer market for these
games which includes overlap as well as distinction from
existing gambling consumers. There was no indication that
individuals potentially vulnerable to experiencing gambling
problems, including problem gambling severity score, existing
high gambling-related cognitive distortions, or understanding
of how outcomes are determined impacted the likelihood that
participants would play either machine in the future.

0.086**
0.136**

−2.293***

−2.595***

N

Adj. R2

0.538

0.466

Included as potential variables were gambling depth, gambling breadth, gaming depth,
gaming breadth, PGSI score, immersion, GBQ (prior to play), understanding of gaming
machine outcomes, age, gender, and household income.
*p < 0.05, **p < 0.01, ***p < 0.001.

Discussion
This study investigated factors predicting intention to
gamble on traditional reel-based EGMs and SGMs with a
reel and separate skill feature. In addition, we investigated
immediate post-play effects on self-reported immersion,
cognitive distortions, and understanding of the relative roles of
skill vs. chance in determining game outcomes.
Perceptions of the role of chance and skill were influenced
by the machine type individuals played. This finding suggests
that SGMs and EGMs have differing structural characteristics
that may impact understanding of machines and cognitive
distortions. Overall, SGM players appeared to be uncertain
about the role of skill in determining outcomes, including
whether practice can improve outcomes. Although EGM players
indicated outcomes are somewhat determined by chance, the
responses of participants after playing these machines did not
demonstrate a definitive understanding that skill has no role.
We observed a similar perceived lack of understanding of skill
vs. chance. This is a concern given that skill plays no role at
all in EGMs. The results revealed that both EGM and SGM
players fail to understand how outcomes are determined, which
is likely more problematic for EGM players as this reflects clear
cognitive distortions.
Our research provides novel findings about structural
characteristics to which players have not been previously
exposed. We observed that EGM player perception about the
role of skill and chance stayed relatively stable before and
after a session of play: views on the impact of player actions
and control over machine outcomes were stable, although
there was a decrease in perception of skill on outcomes. In
contrast, SGM play resulted in increases in perception of
reported control and impact of skill on the outcomes, but not in
impact of skill or choices on monetary outcomes. These results
demonstrate that the structural design and experience of games
can immediately impact cognition. Future research is needed to

Frontiers in Psychiatry

Limitations and future research
The composition of our sample affects how the study results
should be interpreted. The large student cohort conflates young
age with other characteristics that might be relevant to findings.
For example, young students from a nationally top-performing
university are more likely to have above average intelligence
and be more career-focused. The community sample of nonstudents were recruited because of their past involvement
with gambling machines. That is, the community sample had
an additional screening criterion (prior machine gambling
involvement) so at the outset, we may find that older gamblers
are more involved in machine gambling, which relates to
recruitment methods rather than population-wide behavior.

10.3389/fpsyt.2022.979694

a player’s skill impacts outcomes,” fell near the mid-point of the
agreement/disagreement Likert scale at a mean of 3.105.
This paper represents an important contribution to the
literature as it reports on the immediate impact of novel
structural features of an EGM with an incorporated skill
component. As the gambling industry increasingly incorporates
gaming aspects into gambling products, ongoing research is
needed to provide a strong evidence base to inform responses
by regulators and policy-makers. In situ testing is needed to
understand which players are likely to engage with SGMs
in their various configurations immediately and over time.
Greater understanding is also needed about the impact of these
machines on cognitive and behavioral factors that may impact
the experience of gambling problems. In line with a proposed
framework for addressing emerging technology with potential
harmful consequences (38), we recommend that researchers,
industry, government, and community stakeholders collaborate
to investigate further, and make proactive efforts to prevent and
minimize any potential problems.

As we randomly assigned individuals in our experiment, this
consideration is less relevant to the experimental findings than
to the correlational analyses. A strength of this study is that
multiple recruitment methods were used to ensure a diverse
sample in terms of age and previous engagement with gambling
and gaming. Statistically, we treated regression variables as
continuous in a linear model, which may not reflect their
underlying relationship. All participants were exposed to SGMs
for the first time as they were not available in Australia
at the time of the study. This provides some control for
past SGM experience.
Other limitations include the use of machines without the
risk of money or possibility of monetary outcomes, which
likely limit engagement with the game through low ecological
validity. Only one type of EGM and SGM were used, limiting
the ability to extrapolate to other machine designs, which are
highly varied for SGMs. We relied on self-report measures, so
future studies should use implicit measures of cognition and
relevant behavioral measures. Where possible, more realistic
testing scenarios, including controlled trials in gambling venues,
will provide further important findings related to SGM appeal
and impact. Trials are needed to examine medium and longterm impacts after the initial novelty of a newly introduced
gambling product reduces.
Individuals assigned to SGMs had greater beliefs that their
skill contributes to winning, which is true regarding in-game
items but over the long-run all players have a negative expected
cash value with return to players set to 90.5%. Accordingly, it
may be appropriate for future studies to validate the extent to
which common measures of gambling distortions are effective
scales for SGM users.

Data availability statement
The original contributions presented in this study are
included in the article/Supplementary material, further
inquiries can be directed to the corresponding author/s.

Ethics statement
The studies involving human participants were reviewed
and approved by the University of Sydney Human Research
Ethics Committee (project number: 2019/738). The
patients/participants provided their written informed consent
to participate in this study.

Conclusion
Consideration of structural characteristics is important
when assessing the potential of a gambling activity or product
to contribute to harms, including the mechanisms and nature
of impacts for individuals currently experiencing or at risk
of developing gambling problems. Laboratory studies are an
important test of a new gambling product to identify any
immediate potential for gambling harms before a product is
licensed, even in a limited capacity for real gambling. Our labbased study found that the experience of in-session immersion
and higher levels of previous gambling predict intention to
play EGMs and SGMs. Previous gaming experience additionally
predicts likelihood to play SGMs. There was no evidence that
EGM or SGM play resulted in differential levels of immersion
immediately following the session of play. However, the session
did impact perceptions of skill and chance, showing that SGM
players can perceive a role of skill in the new machines, although
they are relatively uncertain about the extent to which this
influences outcomes as responses to the item, “I understand how

Frontiers in Psychiatry

Author contributions
SG led the recruitment and data collection. KP led the
data analysis. Both authors contributed to the design and
writing of this study.

Funding
This work received funding from Wymac Gaming and
was supported by an Australian Research Council Discovery
Early Career Research Award (DE1060100459) awarded to SG.
Wymac Gaming provided further support for this research by
providing EGMs and SGMs that were housed at a laboratory at
the University of Sydney. Liquor and Gaming NSW approved
the use of EGMs for the purpose of this research.

10.3389/fpsyt.2022.979694

Conflict of interest

reimbursement for travel from the National Conference of
State Legislators, National Council for Problem Gambling,
International Association of Gaming Advisors, National Centre
for Responsible Gambling, Responsible Gambling Council
of Canada, North American State and Provincial Lottery
Association, Evergreen Council on Problem Gambling, Global
Gaming Expo Asia, and Alberta Gambling Research Institute.
He was formerly the Director of Social Responsibility at the
British Columbia Lottery Corporation.

This work received funding from Wymac Gaming and
was supported by an Australian Research Council Discovery
Early Career Research Award (DE1060100459) awarded to SG.
Wymac Gaming provided further support for this research by
providing EGMs and SGMs which were housed at a laboratory
at the University of Sydney. Liquor and Gaming NSW approved
the use of EGMs for the purpose of this research. Neither
Wymac Gaming, Liquor and Gaming NSW or the ARC had
any involvement in any aspects of the research including, but
not limited to, the research questions, methodology, selection
of research participants, research conduct, or analysis of
results. Between 2017–2021 SG has worked on projects that
have been received funding and in-kind support through her
institution from Commonwealth Bank of Australia, GameCo,
ClubsNSW, Crown Resorts and Wymac Gaming. SG has
received honorarium and travel costs for research, presentations
and advisory services from Credit Suisse, Oxford University,
ClubsNSW, Clubs4Fun, Centrecare WA, Gambling Research
Exchange Ontario, Crown, Community Clubs Victoria,
Clayton Utz, Greenslade, Generation Next, KPMG, Stibbe
and QBE. KP has received consulting payments from British
Columbia Lottery Corporation, Responsible Gambling Council
of Canada, Intralot, the Commonwealth of The Bahamas,
West Virginia Lottery, Indiana Gaming Commission, and
iDevelopment and Economic Association. He has received

Publisher’s note
All claims expressed in this article are solely those of the
authors and do not necessarily represent those of their affiliated
organizations, or those of the publisher, the editors and the
reviewers. Any product that may be evaluated in this article, or
claim that may be made by its manufacturer, is not guaranteed
or endorsed by the publisher.

Supplementary material
The Supplementary Material for this article can be
found online at: https://www.frontiersin.org/articles/10.3389/
fpsyt.2022.979694/full#supplementary-material

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