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And that is where the fun ends – General practitioners' conceptualisation of the line between recreational and problem gambling

Aims Problem gambling is normally identified by fixed criteria of harm adapted from those of substance abuse and by focusing on the individual gambler. However, rigid definitions neglect institutional variations of gambling practices within different legislative configurations. This study proposes analysing the line between recreational and problem gambling by focusing on gambling behaviour and looking at the corruption of the defining factors of play (Caillois, 1958) in three different institutional contexts. Design A stimulated focus-group method (Reception Analytical Group Interview) was applied to seven groups of Finnish and French general practitioners each and three groups of German ones to study the variations of conceptualising the defining factors of play as introduced by Caillois. Results Corruption of play was distinguished by participants from all three countries as the dividing line between recreational and problem gambling, but cultural variations were found: the French and German GPs emphasised the loss of the exceptionality of gambling, whereas the Finnish GPs highlighted the invasion of the home by online gambling. Furthermore, the Finnish and German participants were more concerned about the use of gambling as an emotional regulator, while French GPs echoed the French medical model in discussing the adrenaline rush of problem gamblers. Conclusions Caillois' defining factors of play can be used to distinguish recreational from problem gambling and to offer a more encompassing definition of problem gambling. The perception of the line between recreational and problem gambling also seems to depend on the institutional and cultural context.


Introduction
Problem gambling is often considered an individual condition. Factors ranging from cognitive deficiencies to a lack of control and biological proneness to ad-dictive behaviour have been put forward to explain why some individuals develop problematic gambling practices, while for the majority, gambling remains a leisure pursuit (Blaszczynski & nower, 2002;Goudriaan et al., 2004). This individualistic view of problem gambling has recently been challenged by research highlighting that gambling behaviours are embedded in specific institutional or cultural settings (Raylu & oei, 2004;Reith & Dobbie, 2011;Pöysti & Majamäki, 2013). This study, not only develops this contextually inspired research by taking an institutional rather than a psychological perspective, but goes one step further in switching the gaze from the gambler's characteristics towards the characteristics of play. It compares general practitioners' (GPs) understandings of the characteristics of play that define problem or recreational gambling in three european countries: France, Finland and Germany.
Gambling can be understood as a form of play (Huizinga, 1939;Caillois, 1958;Reith, 2006). Following the definition of one of the classical thinkers of gambling research, Roger Caillois (1958), play, as a general term, is characterised by six fundamental attributes: voluntariness, separation from everyday life, uncertainty, unproductivity, establishing a second reality, and acknowledging rules. Playing is voluntary, not a duty, but it is governed by rules that need to be acknowledged.
Play also constitutes a second reality that separates it from the ordinary life. The outcome of play is not known beforehand, making the realm of play that of uncertainty. In addition, play is a source of enjoyment rather than a productive activity.
However, for Caillois (1958)  Gambling remains recreational if it is not corrupted by the everyday world and if it remains a leisure activity that is not taken too seriously (Caillois 1958) and vice versa, 'disregard for the rules and confines of play can turn what used to be a leisure pursuit into a passion or even an obsession' (Caillois, 1958, p. 103;transl. by authors). However, extending the definition of gambling as play also allows considering other forms of corruption. This study looks into these forms of corrupted play in their institutional frame by asking a) whether GPs distinguish recreational from problem gambling in terms of (corrupted) characteristics of play, and b) whether differences regarding how the line between recreational and problem gambling is conceptualised are manifested in the three institutional contexts.
GPs are an important group to study due to their position as gatekeepers in identifying problem gambling (Miller, 1996;Sul-livan et al., 1998;Pasternak & Fleming, 1999 (Christensen et al., 2001). Their responses to gambling problems are rather influenced by institutional contexts, including gambling provision, popular gambling practices, social conceptualisations of problem gambling, and the organisation of treatment services in a particular society.
Comparing discourses from three different institutional contexts, this study aims at putting forward the contextual embeddedness of the conceptualisation of problem gambling and of gambling as play.

From recreational to problem gambling
Studies considering the line between recreational and problem gambling have typically centred on characteristics of individual gamblers rather than characteristics of play. Factors such as lacking cognitive control mechanisms (Ladouceur & Walker, 1998;Wohl et al., 2013) or lacking competence (Reichertz et al., 2010) and the inability to resist external triggers (Rush et al., 2007;Loba et al., 2001) (Lesieur & Blume, 1987), and the DIGS (Diagnostic Interview for Gambling Severity) (Winters et al., 2002). adapted from research on substance abuse (Ferentzy & Turner, 2012), such criteria are meant to be used to provide an impartial tool to dissociate recreational gamblers from 'problem' or 'pathological' gamblers.
While we acknowledge that diagnostic tools like the DSM (american Psychiatric association, 2000) aim at describing behaviour, descriptions such as 'chasing losses' (criterion 312, 31.a (6)) describe the motivation of the individual pathological gambler rather than the characteristics of play itself. Despite their popularity in research, treatment as well as policy making, such classifications have also been criticised due to problems of applicability, weak scientific basis and lack of cultural sensitivity (orford et al., 2003;Room, 2003;Reinarman, 2005). Some competing models, more sensitive to social factors, have been developed but their focus has remained on the individual gambler and his/her motivation (e.g. Binde, 2009).
attributing gambling problems to individuals has not only theoretical consequences but has also been argued to exonerate gambling suppliers from due responsibility (Livingstone & Woolley 2007). To emphasise institutionally contextualised play, the term 'problem gambling' is pre-

Problem gambling in an institutional framework
There has been a general lack of consensus on the role of institutions in gambling studies, largely due to the small numbers of comparative studies in the field. The institutional context of play, like cultural factors, is often taken for granted when merely one context is studied. Yet, it has not only been shown that institutional availability of gambling products is connected to the prevalence rates of problem gambling (Raylu & oei, 2002;Korn, 2000) but also that institutional contexts influence how social issues, including problem The term institution can be defined as state structures such as gambling offer or legal providers, but also more generally as a repertoire of dispositions for thinking and acting. as Scott (1995) has put forward, we think and act in line with these dispositions and take them for granted, Conceptualisations and forms of treatment proposed for problem gambling also vary between the countries compared.
In France, a disease model, consisting of clinical interventions by health care professionals and psychiatrists, has been dominant (Valleur, 2009). The context of treatment has also been found to be reflected in the understanding of French players about problem gambling as a medical condition beyond individual control (Pöysti & Majamäki, 2013). In Finland, treatment has been rather based on social work and 'non-medical' approaches (Jaakkola, 2009;Hirschovits-Gerz et al., 2012)

Methods and data
To study GPs' understandings of problem gambling, group interviews were conducted in France, Finland and Germany. The The assumption was that forms of acceptable and problematic play are usually not actively reflected upon, but instead, the participants' institutional framework guides the perspective on the line between recreational and problem gambling. Institutional dispositions of acting and thinking have been argued to be constantly reproduced by their members in action and interaction (Douglas, 1986;Klatetzki, 2006

Results
The focus group discussion was filmed and transcribed verbatim. The transcripts were then thematically coded based on the characteristics of play defined by Caillois, as well as social embeddedness, a factor that was added due to its prevalence in the data (see Table 1). In this thematic coding a participants' uninterrupted statement serves as one unit. This table has to be seen as an intermediate step of the analysis, surveying the corpus of data quantitatively (Silverman, 2001) in the spirit of quasi statistics (Becker, 1970). This numerical overview only serves to summarise the results, not as an analysis in its own right, as as the quote shows, the blurring of the line between the real world and the world of game can also create a new group in risk of developing gambling problems, that of online gamblers. The idea was, however, not shared by the French and German GPs who rather voiced concern for gambling becoming commonplace when no longer separated from everyday life. In these two institutional contexts, more characterised by holiday and leisure time gambling, play was not considered problematic as long as it was only connected to special occasions. This became obvious in the discus-  The French GPs also discussed a possible rational side to gambling. However, their concern was more for gamblers who take the game too seriously: The friend is described as a recreational gambler since he does not take the game seriously but enjoys it as a form of play.
The German GPs' approach to the uncertainty was similar and it was emphasised that setting a limit beforehand ensures that play remains enjoyable and therefore recreational.

Unproductivity
For Caillois (1958), all play is unproductive, even when not corrupted. unproductivity refers to the fact that no surplus is

Second reality
The participants also did not share Caillois' (1958)

Conclusion
This study has presented a way to distinguish between recreational and problem gambling, not through the individual gambler, but by drawing on the characteristics of play defined by Caillois (1958). In comparison with recreational gambling, problem gambling is not voluntary, enjoyable, separate from reality, rational, productive or social. It can, therefore, be concluded that Caillois' theoretical model is an operational tool for studying problem gambling.
GPs offer early intervention for problem gambling (Sullivan et al., 1998)