Measuring self-efficacy in gambling: the Gambling Refusal Self-Efficacy Questionnaire

Validation of the psychoactive substance refusal Self-Efficacy Questionnaire (PSRSEQ) in adolescent case-clients of social workers in Hong Kong

BACKGROUND

Self-efficacy is a key concept in various behavioral theories. Refusal self-efficacy is important in understanding issues related to psychoactive substance use. To facilitate related research, this study translated and validated the Chinese version of the 14-item Psychoactive Substance Refusal Self-efficacy Questionnaire (PSRSEQ) among adolescents. There is a debate about whether such a refusal self-efficacy scale should be unidimensional or multidimensional.

METHODS

A survey was conducted among 601 adolescent case-clients of social workers in Hong Kong from July 2021 to June 2022. Various psychometric properties were examined.

RESULTS

The confirmatory factor analysis (CFA) supported the original 3-factor structure of the PSRSEQ (emotional relief, opportunistic, and social facilitation refusal self-efficacy), which showed satisfactory psychometric properties (internal consistency, convergent validity in terms of significant negative correlations with the intention of psychoactive substance use in the next year and psychoactive substance use behavior in the past six months, and the absence of floor effect) but ceiling effect was obvious. Notably, unacceptable discriminant validity of one subscale and strong correlations among the three subscales were observed. In another set of analyses using two split-half subsamples, the exploratory factor analysis identified a 1-factor 14-item structure, which was confirmed by CFA and showed satisfactory psychometric properties.

CONCLUSIONS

The 1-factor PSRSEQ, instead of the one having a 3-factor structure, was preferred and recommended to assess psychoactive substance refusal self-efficacy among Chinese adolescents. It is warranted to validate the scale in other adolescent and age groups in future studies.

Does cognitive-behavioral treatment affect putative mechanisms of change among individuals with problem gambling? A systematic review and exploratory meta-analysis

OBJECTIVE

The current study was a systematic review and meta-analysis of cognitive behavioral treatment (CBT) for problem gambling and gambling disorder and whether it produced different outcomes than minimal or no treatment controls on three putative change mechanisms: 1) gambling cognitions, 2) coping, and 3) self-efficacy.

METHOD

Studies were identified from five bibliographic databases (i.e., Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Embase, PsycINFO, and PubMed). Included studies were randomized controlled trials of CBT that included posttreatment data on putative mechanisms. Between-group Hedges's g effect sizes were calculated to examine outcomes of CBT relative to minimal or no treatment control on gambling cognitions, coping, and self-efficacy at posttreatment. Risk of bias was determined using the Cochrane Risk of Bias tool.

RESULTS

Fifteen studies, representing 1,536 participants, were eligible for analysis. Participants in CBT had more favorable gambling cognitions (g = -0.41), coping behaviors (g = 0.27), and self-efficacy (g = 1.12) at posttreatment than minimal or no treatment control.

CONCLUSIONS

Results of the current study provided preliminary support for the effectiveness of CBT on three putative mechanisms of change among individuals experiencing problem gambling and gambling disorder. Although the results were promising, there was significant heterogeneity in the magnitude of effect sizes for all three outcomes, and outcomes were not consistently assessed with psychometrically established assessment tools.

The Role of Self-Esteem and Self-Efficacy in Responsible Gambling

Responsible gambling (RG) refers to a set of protective strategies aiming at containing the negative consequences associated with gambling. To improve the effectiveness of RG, it is essential to understand factors influencing gamblers' adherence to RG. Past literatures on addictive behaviors have demonstrated that one's self-efficacy and self-esteem are associated with the adherence to protective behaviors of the specific addictive behaviors. The present study aims to test whether gamblers' self-esteem and RG self-efficacy can be applied to explain their adherence to protective gambling behaviors. Two hundred and thirty-six past-year gamblers were randomly selected to take part in a phone survey. Path analysis showed that both gamblers' RG self-efficacy and self-esteem were positively associated with gamblers' RG behaviors, while RG behaviors were negatively linked to the problem gambling tendency. The findings provided insight into potential promotion and intervention strategies based on self-esteem and self-efficacy and those strategies may be adopted in the primary prevention of gambling disorder.

Sports Gambling Intention Comparison Between Males and Females in the United States

The focus of this research is to understand the sports gambling intentions of Gen Z (those born between 1997 and 2012) that can potentially lead to problematic gambling behavior. Rooted in the theory of planned behavior, the study delves into the roles of attitude, subjective norms, and perceived behavior control in shaping these intentions. A cross-sectional study of 513 Gen Z's in the United States was conducted. The partial least square structural equation modeling was used to analyze the relationship and compare the differences between males and females with multigroup analysis. The results indicate that attitude and perceived behavior control have a significant impact on this intention, while subjective norms do not exert substantial influence. Notably, gender differences are observed, with males showing a stronger association with perceived behavior control and females with attitude. The model effectively accounts for significant variations in sports gambling intention, highlighting a higher inclination among females as compared to males. This study provides a new perspective for analyzing disparities in sports gambling intention between genders and delves into the underlying motivations that can potentially contribute to the development of problematic gambling disorders. Given the significant societal impact and the adverse effects that gambling disorders have on those affected, it is imperative to conduct research aimed at understanding the reasons behind Gen Z's engagement in gambling. The findings can then be harnessed to inform the development of preventive programs aimed at curbing problematic gambling behaviors.

Gambling and Aging: An Overview of a Risky Behavior

Gambling is a field of study that has grown since the 2000s. Much research has focused on adolescents and youth as a vulnerable population. The rate of aging gamblers is increasing; however, evidence-based knowledge of this population is still too sparse. After introducing the issue (1), this article provides a narrative review of older adults' gambling through three sections: (2) older adult gamblers (age, characteristics, and motivations), (3) gambling as a risky decision-making situation, and (4) gambling disorder related to older adults. By drawing on the existing literature from a problematization perspective, this type of review can highlight complex and original research topics and provoke thought and controversy to generate avenues for future research. This narrative review provides an overview of the existing literature on gambling among older adults and offers perspectives on how aging can affect decision-making and thus gambling for this population. Older adults are a specific population, not only in terms of the consequences of gambling disorders but also in terms of the motivations and cognitions underlying gambling behaviors. Studies on behavioral science focusing on decision-making in older adults could help in the development of public policy in terms of targeted prevention.

Exposure Therapy for Gambling Disorder: Systematic Review and Meta-analysis

Purpose of Review

Cognitive behaviour therapy is the gold standard for the treatment of gambling disorder. Obstacles remain regarding its efficacy, namely relapses and difficulty in implementing cognitive restructuring for some clients. Given these observations, behavioural interventions for gambling disorder, such as exposure therapy, which aims to decrease gambling craving, may be effective as a complementary or alternative intervention to cognitive behaviour therapy. This systematic review and meta-analysis aims to explore how exposure therapy for gambling disorder has been studied and to evaluate its efficacy. To answer these questions, 3406 studies, retrieved using PsycNet, Medline and Google Scholar, were screened.

Recent Findings

After two screenings, 13 papers were selected for the systematic review and five were statistically combined for the meta-analysis. Quantitative results support exposure therapy’s efficacy to decrease gambling craving at post-intervention (g =  − 0.955) and at last follow-up (6 or 12 months; − 1.010). Results also show a large decrease in gambling severity as documented by screening instruments (− 1.087) as well as time spent gambling (− 2.136) at post-intervention. Furthermore, a large decrease in gambling measured via screening instruments (− 1.162) and erroneous beliefs (− 1.308) was found at last follow-up.

Summary

This is the first meta-analysis on behavioural exposure therapy for gambling disorder. Results support that exposure therapy reduces gambling cravings and severity, as well as time spent gambling and erroneous beliefs. These results are discussed in comparison to other therapeutic approaches and are interpreted according to the high risk of bias in included studies.

GAMBLINGLESS IN-THE-MOMENT: Protocol for a micro-randomised trial of a gambling Just-In-Time Adaptive Intervention (Preprint)

Background

The presence of discrete but fluctuating precipitants, in combination with the dynamic nature of gambling episodes, calls for the development of tailored interventions delivered in real time, such as just-in-time adaptive interventions (JITAIs). JITAIs leverage mobile and wireless technologies to address dynamically changing individual needs by providing the type and amount of support required at the right time and only when needed. They have the added benefit of reaching underserved populations by providing accessible, convenient, and low-burden support. Despite these benefits, few JITAIs targeting gambling behavior are available.

Objective

This study aims to redress this gap in service provision by developing and evaluating a theoretically informed and evidence-based JITAI for people who want to reduce their gambling. Delivered via a smartphone app, GamblingLess: In-The-Moment provides tailored cognitive-behavioral and third-wave interventions targeting cognitive processes explicated by the relapse prevention model (cravings, self-efficacy, and positive outcome expectancies). It aims to reduce gambling symptom severity (distal outcome) through short-term reductions in the likelihood of gambling episodes (primary proximal outcome) by improving craving intensity, self-efficacy, or expectancies (secondary proximal outcomes). The primary aim is to explore the degree to which the delivery of a tailored intervention at a time of cognitive vulnerability reduces the probability of a subsequent gambling episode.

Methods

GamblingLess: In-The-Moment interventions are delivered to gamblers who are in a state of receptivity (available for treatment) and report a state of cognitive vulnerability via ecological momentary assessments 3 times a day. The JITAI will tailor the type, timing, and amount of support for individual needs. Using a microrandomized trial, a form of sequential factorial design, each eligible participant will be randomized to a tailored intervention condition or no intervention control condition at each ecological momentary assessment across a 28-day period. The microrandomized trial will be supplemented by a 6-month within-group follow-up evaluation to explore long-term effects on primary (gambling symptom severity) and secondary (gambling behavior, craving severity, self-efficacy, and expectancies) outcomes and an acceptability evaluation via postintervention surveys, app use and engagement indices, and semistructured interviews. In all, 200 participants will be recruited from Australia and New Zealand.

Results

The project was funded in June 2019, with approval from the Deakin University Human Research Ethics Committee (2020-304). Stakeholder user testing revealed high acceptability scores. The trial began on March 29, 2022, and 84 participants have been recruited (as of June 24, 2022). Results are expected to be published mid-2024.

Conclusions

GamblingLess: In-The-Moment forms part of a suite of theoretically informed and evidence-based web-based and mobile gambling interventions. This trial will provide important empirical data that can be used to facilitate the JITAI’s optimization to make it a more effective, efficient, and scalable tailored intervention.

Trial Registration

Australian New Zealand Clinical Trials Registry (ANZCTR) ACTRN12622000490774; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=380757&isClinicalTrial=False

International Registered Report Identifier (IRRID)

PRR1-10.2196/38958

Perceived Gambling Availability and Adolescent Gambling Behavior: the Moderating Role of Self-Efficacy

Geographic accessibility has been linked to gambling behavior, but little is known about whether the perception of gambling availability in both offline and online venues is prospectively associated with adolescent gambling behavior. Further, relatively few studies have analyzed the interaction between environmental and individual factors in explaining adolescent gambling and problem gambling. This prospective study examined the association between perceived gambling availability, gambling frequency, and problem gambling among 554 adolescents aged 13–17 years (mean = 15.1, female 47.4%) and explored the moderating role of self-efficacy to control gambling in these associations. Participants completed assessments of perceived gambling availability and gambling self-efficacy at baseline. Gambling frequency and problem gambling were measured at follow-up. Two separate hierarchical regression models were applied to analyze the relationship of perceived gambling availability with gambling behavior and the moderating role of gambling self-efficacy. Results showed that a greater perception of gambling availability was associated with a higher gambling frequency and more problem gambling in adolescents. The impact of perceived gambling availability on gambling frequency and problem gambling was lower among participants with moderate gambling self-efficacy in comparison with participants with low gambling self-efficacy. In those adolescents with high self-efficacy to control gambling, perceived gambling availability was not associated either with gambling frequency or problem gambling. These results suggest the usefulness of implementing regulatory policies aimed at reducing gambling availability in adolescents, and the design of preventative interventions aimed at enhancing self-efficacy to control gambling.

The Effect of Shame and Self-Efficacy on Gambling Behaviour

Previous research has identified the benefits of increasing self-efficacy in problem gamblers, while other research has identified higher levels of shame and dysfunctional coping in problem gamblers. The primary aim of the present study was to examine the relationships between problem gambling behaviour, shame (as both a personality trait and an emotional state), gambling-related self-efficacy, and dysfunctional coping mechanisms. The sample consisted of 235 participants (172 male; mean age = 30.32, SD = 8.57), who completed an online, self-report questionnaire that assessed gambling severity, shame-proneness, post-gambling shame and guilt, and dysfunctional coping. Data were assessed using path analysis models. As hypothesised, more problematic gambling was significantly associated with dysfunctional coping. A pathway mediation model was determined and several mediator variables were found to operate in series, including: shame proneness, post-gambling shame, and gambling-related self-efficacy. This research supports and builds on previous research that has highlighted the detrimental effect of problem gambling and shame on coping mechanisms, and the benefits of gambling-related self-efficacy for subsequent coping. A limitation of the study was that 18.7% of the sample reported scores indicative of probable pathological gambling, while most of the remaining sample were representative of recreational gambling. Implications of this are discussed.

Exploring the associations between gambling cravings, self-efficacy, and gambling episodes: An Ecological Momentary Assessment study

AIMS

To explore reciprocal relationships between real-time gambling cravings and self-efficacy with gambling behaviour, and the moderating role of gambling, mental health, and addiction-related variables.

DESIGN

Secondary analysis of a 4-week Ecological Momentary Assessment (EMA) study conducted in Tasmania, Australia.

SETTING

Data were collected via telephone interviews (pre-EMA) and smartphones (EMA).

PARTICIPANTS

Ninety-seven regular gamblers (mean age: 45.90 years, 57.73% male) reported 5,113 observations.

MEASUREMENTS

EMA measures included gambling cravings (occurrence, frequency, intensity), self-efficacy (craving-related, gambling-related), and gambling behaviour (episodes, expenditure, duration). Pre-EMA measures included gambling (severity; harms; motives; high-risk situations), mental health (depressive symptoms; anxiety symptoms) and addiction-related (alcohol use; smoking; substance use) moderator variables.

FINDINGS

Mixed-effects binary logistic regression analyses revealed that gambling cravings predicted gambling episodes (OR = 2.23, 95% CI:1.61, 3.08), gambling self-efficacy and gambling duration were reciprocally related (OR = 4.65, 95% CI:1.08, 20.04; OR = 0.21, 95% CI:0.05, 0.93), and craving self-efficacy predicted gambling expenditure (OR = 0.30, 95% CI:0.10, 0.86). Moderation analyses revealed that: (1) craving self-efficacy exacerbated craving frequency with gambling expenditure; (2) coping motives exacerbated gambling self-efficacy with gambling expenditure; (3) high-risk positive reinforcement situations exacerbated craving intensity and gambling self-efficacy with gambling episodes, and gambling episode with craving occurrence; and (4) substance use exacerbated gambling self-efficacy with duration, and buffered gambling expenditure with craving intensity.

CONCLUSIONS

These findings have implications for the development of real-time gambling interventions that aim to reduce gambling cravings and increase self-efficacy, which could be targeted to vulnerable individuals, including people who frequently gambled for coping purposes or positive reinforcement, and people with comorbid substance use.

Beliefs About Gambling Mediate the Effect of Cognitive Style on Gambling Problems

Problem gambling is often accompanied by a range of irrational cognitions that promote excessive gambling. The cognitive basis for these beliefs has been largely overlooked in the gambling literature. Dual process theory suggests there are two parallel cognitive processing systems, an intuitive and an analytic system, and that there are potential individual differences in preference for one or the other cognitive style. The current study explored whether people's cognitive styles are an important factor in the development of specific beliefs about gambling that in-turn contribute to gambling problems. The sample consisted of 1168 regular gamblers (539 female, ranging from 18 to 78 years of age; M = 35.47, SD = 10.78) recruited via Mechanical Turk. Participants completed a survey assessing cognitive style, problem gambling severity, and measures of protective and erroneous beliefs. In a path model, greater analytical thinking and lower intuitive thinking was associated with fewer erroneous gambling beliefs, which in turn were related to fewer gambling problems. A second model showed that protective beliefs also mediated the relationship between cognitive style and gambling, demonstrating that greater analytical thinking and lower intuitive thinking was associated with protective beliefs that similarly reduced problem gambling severity. Results suggest that a person's cognitive style influences peoples gambling by contributing to the endorsement of irrational or unsafe beliefs about gambling. Encouraging people to think more analytically may be useful in reducing erroneous beliefs about gambling that promote problematic gambling behaviour.

Psychometric Properties of the Italian Versions of the Gambling Urge Scale (GUS) and the Gambling Refusal Self-Efficacy Questionnaire (GRSEQ)

Gambling urges and gambling refusal self-efficacy beliefs play a major role in the development and maintenance of problem gambling. This study aimed to translate the Gambling Urge Scale (GUS) and the Gambling Refusal Self-Efficacy Questionnaire (GRSEQ) from English to Italian (GUS-I, GRSEQ-I) and to test their factor structure, internal consistency, construct validity, concurrent validity, and gender differences in 513 individuals from the Italian community. Factor structure and construct validity were tested through Confirmatory Factor Analysis, internal consistency through Cronbach’s alpha, concurrent validity through correlations with gambling-related cognitions (GRCS-I), probable pathological gambling (SOGS-I), and gambling functioning (GFA-R-I). Results confirmed that the 6 items of the GUS-I load highly on one dimension of Gambling Urge, and each of the 26 items of the GRSEQ-I load highly on their relevant sub-dimension, among the following: situations/thoughts, drugs, positive emotions, negative emotions. Both scales are internally consistent and show concurrent validity with gambling-related cognitions, probable pathological gambling, and gambling functioning. Males score higher than females at the GUS-I; females score higher than males at the GRSEQ-I. The findings from the present study suggest that the GUS-I and the GRSEQ-I are internally consistent and valid scales for the assessment of gambling urges and gambling refusal self-efficacy in Italian individuals from the community, with significant repercussions in terms of assessment, prevention, and intervention.

Development of the Gambling Disorder Identification Test (G-DIT): Protocol for a Delphi Method Study

Background

Research on the identification and treatment of problem gambling has been characterized by a wide range of outcome measures and instruments. However, a single instrument measuring gambling behavior, severity, and specific deleterious effects is lacking.

Objective

This protocol describes the development of the Gambling Disorder Identification Test (G-DIT), which is a 9- to 12-item multiple-choice scale with three domains: gambling consumption, symptom severity, and negative consequences. The scale is analogous to the widely used Alcohol Use Disorders Identification Test (AUDIT) and the Drug Use Disorders Identification Test (DUDIT).

Methods

The G-DIT is developed in four steps: (1) identification of items eligible for the G-DIT from a pool of existing gambling measures; (2) presentation of items proposed for evaluation by invited expert researchers through an online Delphi process and subsequent consensus meetings; (3) pilot testing of a draft of the 9- to 12-item version in a small group of participants with problem gambling behavior (n=12); and (4) evaluation of the psychometric properties of the final G-DIT measure in relation to the existing instruments and self-reported criteria of the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5), among individuals with problem gambling and nonproblematic recreational gambling behaviors (n=600). This protocol article summarizes step 1 and describes steps 2 and 3 in detail.

Results

As of October 2018, steps 1-3 are complete, and step 4 is underway.

Conclusions

Implementation of this online Delphi study early in the psychometric development process will contribute to the face and construct validity of the G-DIT. We believe the G-DIT will be useful as a standard outcome measure in the field of problem gambling research and serve as a problem-identification tool in clinical settings.

International Registered Report Identifier (IRRID)

RR1-10.2196/12006

Negative Mood States or Dysfunctional Cognitions: Their Independent and Interactional Effects in Influencing Severity of Gambling Among Chinese Problem Gamblers in Hong Kong

Gambling-related cognitions and negative psychological states have been proposed as major factors in the initiation and maintenance of problem gambling (PG). While there are a substantial number of studies supporting the role of cognitive dysfunctions in the initiation and maintenance of PG, very few empirical studies have explored the specific role of negative psychological states in influencing PG behaviours. In addition, very few studies have examined the interaction effects of cognitive dysfunctions and negative psychological states in exerting influence on PG behaviours. Therefore, the present study aims to examine the main and interaction effects of gambling-related cognitions and psychological states on the gambling severity among a group of problem gamblers in Hong Kong. A cross-sectional research design was adopted. A purposive sample of 177 problem gamblers who sought treatment from a social service organization in Hong Kong completed a battery of standardised questionnaires. While gambling-related cognitions were found to exert significant effects on gambling severity, negative psychological states (i.e. stress) significantly moderated the relationship between gambling cognitions and gambling severity. In essence, those participants who reported a higher level of stress had more stable and serious gambling problems than those who reported a lower level of stress irrespective of the level of gambling-related cognitions. The findings of the moderating role of negative emotions in the relationship between cognitive distortions and severity of gambling provide insight towards developing an integrated intervention model which includes both cognitive-behavioural and emotion regulation strategies in helping people with PG.

Effectiveness of a Self Help Cognitive Behavioural Treatment Program for Problem Gamblers: A Randomised Controlled Trial

The study aimed to strengthen the scarce literature on self-help treatments for Problem Gambling (PG) by comparing the effectiveness of a Self-Help Cognitive Behavioral Treatment (SHCBT) program (n = 23) with a 6-week Waitlist condition (n = 32) in problem gamblers. Participants were community volunteers with gambling problems and were randomly allocated to the Waitlist and treatment conditions. Results showed significant improvements at post-treatment in gambling behaviors including frequency of gambling, average amount gambled per day and PG symptoms as well as a number of gambling correlates including psychological states (e.g., depression, anxiety and stress), gambling cognitions, gambling urges, gambling related self-efficacy, satisfaction with life, and quality of life among those who completed the SHCBT program, when compared with the waitlist condition. The effect size (partial η ²) ranged from .25 to .57 for all assessed outcomes that showed significant improvement from pre- to post-treatment. It was concluded that a self-help CBT program can be beneficial for treating community problem gamblers.

Internet-Based Delivery of Cognitive Behaviour Therapy Compared to Monitoring, Feedback and Support for Problem Gambling: A Randomised Controlled Trial

The aim of this study was to investigate the efficacy of an Internet-based cognitive behavioural therapy program (I-CBT) for the treatment of problem gambling, when compared to a waitlist control and an active comparison condition consisting of monitoring, feedback, and support (I-MFS). Participants (N = 174) were randomly allocated to the three conditions. Variables of interest were gambling outcome and related mental health measures. Participants in the active conditions (I-CBT and I-MFS) completed six online modules. Both I-CBT and I-MFS conditions resulted in significant treatment gains on gambling severity. However, I-CBT was also associated with reductions in a range of other gambling-related and mental health outcomes. Compared with I-MFS, I-CBT produced greater effects across seven outcomes measures, relating to gambling urges, cognitions, stress, and life satisfaction. I-CBT participants also rated the program as significantly more satisfactory. Treatment gains observed for both active conditions were found to be stable through to 12 month follow up. The results indicate that the benefits of I-CBT were more than simply the non-specific effects of engaging in online treatment or receiving motivation, feedback, and support. Online treatments for gambling may be a valuable tool in increasing help-seeking and treatment engagement in this population, and be integrated as part of stepped care approaches to treatment.

Conceptualizing gambling disorder with the process model of emotion regulation

Introduction Nowadays, gambling disorder (GD) is a worldwide health issue and there is a growing need to both improve our understanding of this disorder and to tailor specific interventions for its treatment. Moreover, theoretical models and preliminary empirical results suggest that difficulty in regulating emotional states might be involved in GD. However, literature describing clinical and theoretical aspects of emotional dysregulation among pathological gamblers (PGs) shows a lack of systematic description. Objectives We aimed to provide, within an exhaustive theoretical framework of emotion regulation (ER) processing, empirical evidence supporting a conceptual model of GD as an ER affliction. Methods We commented on empirical evidence on the relationship between ER and GD in the light of two main conceptual models of emotion (dys)regulation. Results The results suggest there are actual deficits of ER processing among PGs, manifesting themselves through different ways and in different steps of the ER timeline. In addition, dysregulation of positive emotions may play a central role in GD. From a clinical point of view, we pointed out that deficits in ER might be multiple in nature and an assessment for GD should be accurate to identify the specific components accounting for the development and maintenance of the disorder. It should also orientate the clinician in selecting therapeutic objectives. Conclusions The nature of emotional states that are difficult to regulate might account for the GD severity and indicate the subtype of PGs the patient belongs to. Treatment programs should be tailored on the specificity of PGs.

The development and initial evaluation of the Pornography-Use Avoidance Self-Efficacy Scale

Background and aims This study employed a newly developed questionnaire to evaluate whether men's self-efficacy to avoid using pornography in each of 18 emotional, social, or sexually arousing situations was associated with either their typical frequency of pornography use or their hypersexuality. Methods Using an Internet-based data collection procedure, 229 male pornography users (M_age = 33.3 years, SD = 12.2) who had sought or considered seeking professional help for their use of pornography completed questionnaires assessing their situationally specific self-efficacy, history of pornography use, self-efficacy to employ specific pornography-reduction strategies, hypersexuality, and demographic characteristics. Results Frequency of pornography use was significantly negatively associated with level of confidence in 12 of the 18 situations. In addition, lower hypersexuality and higher confidence to employ pornography-use-reduction strategies were associated with higher confidence to avoid using pornography in each of the 18 situations. A principal axis factor analysis yielded three clusters of situations: (a) sexual arousal/boredom/opportunity, (b) intoxication/locations/easy access, and (c) negative emotions. Discussion and conclusions This questionnaire could be employed to identify specific high-risk situations for lapse or relapse and as a measure of treatment outcome among therapy clients, but we recommend further examination of the psychometric properties and clinical utility of the questionnaire in treatment samples. Because only one of the three clusters reflected a consistent theme, we do not recommend averaging self-efficacy within factors to create subscales.

Psychometric Characteristics of a New Scale for Measuring Self-efficacy in the Regulation of Gambling Behavior

Since its introduction in 1977, self-efficacy has proven to be a fundamental predictor of positive adjustment and achievement in many domains. In problem gambling studies, self-efficacy has been defined mainly as an individual's ability to avoid gambling in risky situations. The interest in this construct developed mainly with regard to treatment approaches, where abstinence from gambling is required. Very little is known, however, regarding self-efficacy as a protective factor for problem gambling. This study aims to fill this gap, proposing a new self-efficacy scale which measures not only the ability to restrain oneself from gambling but also the ability to self-regulate one's gambling behavior. Two studies were conducted in which the data from two Italian prevalence surveys on problem gambling were considered. A total of about 6,000 participants were involved. In the first study, the psychometric characteristics of this new self-efficacy scale were investigated through exploratory and confirmatory factor analyses. The results indicated the presence of two different factors: self-efficacy in self-regulating gambling behavior and self-efficacy in avoiding risky gambling behavior. The second study confirmed the replicability of the two-factor solution and displayed high correlations among these two self-efficacy dimensions and different measures of gambling activities as well as other psychological variables related to gambling (gambling beliefs, gambling motivation, risk propensity, and impulsiveness). The results of logistic regression analyses showed the particular importance of self-regulating gaming behavior in explaining problem gambling as measured by Problem Gambling Severity Index and South Oaks Gambling Screen, thus proving the role of self-efficacy as a pivotal protective factor for problem gambling.

The Application of an Etiological Model of Personality Disorders to Problem Gambling

Problem gambling is a significant mental health problem that creates a multitude of intrapersonal, interpersonal, and social difficulties. Recent empirical evidence suggests that personality disorders, and in particular borderline personality disorder (BPD), are commonly co-morbid with problem gambling. Despite this finding there has been very little research examining overlapping factors between these two disorders. The aim of this review is to summarise the literature exploring the relationship between problem gambling and personality disorders. The co-morbidity of personality disorders, particularly BPD, is reviewed and the characteristics of problem gamblers with co-morbid personality disorders are explored. An etiological model from the more advanced BPD literature-the biosocial developmental model of BPD-is used to review the similarities between problem gambling and BPD across four domains: early parent-child interactions, emotion regulation, co-morbid psychopathology and negative outcomes. It was concluded that personality disorders, in particular BPD are commonly co-morbid among problem gamblers and the presence of a personality disorder complicates the clinical picture. Furthermore BPD and problem gambling share similarities across the biosocial developmental model of BPD. Therefore clinicians working with problem gamblers should incorporate routine screening for personality disorders and pay careful attention to the therapeutic alliance, client motivations and therapeutic boundaries. Furthermore adjustments to therapy structure, goals and outcomes may be required. Directions for future research include further research into the applicability of the biosocial developmental model of BPD to problem gambling.

Interactions between risk and protective factors on problem gambling in Asia

This study examined the relationships between risk (i.e., gambling cognitions, gambling urges, psychological distress) and protective factors (i.e., life satisfaction, resilience, gambling refusal self-efficacy) and problem gambling among 310 Singaporeans aged between 18 and 73 years. Data on demographics, risk and protective factors, and gambling behavior were collected through electronic and paper surveys. Hierarchical multiple regression was employed to assess the contributions of the risk and protective factors in predicting problem gambling. Three risk factors (i.e., gambling cognitions, gambling urges, psychological distress) and two protective factors (i.e., resilience, gambling refusal self-efficacy) were found to significantly and uniquely predict problem gambling. Furthermore, the risk factors significantly interacted with the protective factors to moderate gambling severity. Gambling refusal self-efficacy shows significant protective effects against problem gambling, while the effects of resilience on gambling vary across settings. Both factors need to be taken into account in the understanding of problem gambling.

Psychometric properties of the Gambling Related Cognitions Scale (GRCS) in young Italian gamblers

INTRODUCTION

The involvement in gambling activities is increasing among adolescents, together with the risk of developing gambling problems. Given the important role of erroneous beliefs on adolescent problematic gambling behavior, the aim of this study was to investigate the adequacy of the Gambling Related Cognitions Scale (GRCS; Raylu & Oei, 2004) to assess gambling-related distortions among youth in Italy.

METHODS

The scale was administered to 1656 Italian high school students (65% males, mean age=16.15 years, SD=1.44), and analyses were carried out with respondents who have gambled during the previous year (N=1224).

RESULTS

The adequacy of the five-factor model was confirmed (both among male and female adolescent gamblers), as well as the reliability of the total scale and subscales. Evidence for the validity of the GRCS among adolescents was provided confirming the relationship between gambling-related cognitions and problem gambling found in previous studies. Research on the validity of the scale was also extended by investigating the relationship between cognitive distortions about gambling and the frequency of engaging in different gambling activities.

CONCLUSIONS

Our results confirm that the GRCS is an effective multidimensional instrument which accurately measures young gamblers' cognitive distortions relating to gambling. As such, it can be used as a useful tool in the assessment and treatment of juvenile gambling.

Chinese attitudes, norms, behavioral control and gambling involvement in Macao

This study tested the applicability of the theory of planned behavior (TPB) on gambling intention and involvement in a representative Chinese sample in Macao, recruited by a random residential number dialing method. We successfully interviewed 685 respondents, with about one-third of them reporting that they had participated in gambling activities during the 12 months prior to the interview. The results of structural equation modeling suggested that favorable attitudes toward superstition and techniques, poor sense of perceived behavioral control over gambling refusal, and high gambling intention increased vulnerability to excessive gambling involvement. These findings generally support the efficacy of the TPB in explaining gambling intention and involvement among both Chinese gamblers and non-gamblers. Some practical implications of the findings are discussed within the Chinese context.

Validation of the Gambling Refusal Self-Efficacy Questionnaire for Chinese Undergraduate Students

Although research on self-efficacy in the gambling literature took place more than 25 years ago, only in the recent decade did researchers attempt to develop valid and reliable measures of gambling-related self-efficacy. Recently Casey et al. (J Gambl Stud 24:229-246, 2008) developed the Gambling Refusal Self-Efficacy Questionnaire (GRSEQ) in an Australian sample, which is a valuable tool for gambling research. The first objective of this study is to validate the measure in a new sample. Given that previous research on Chinese's gamblers' self-efficacy is lacking, and that related research often used ad-hoc measures of the construct, a second objective of this study is to evaluate whether the GRSEQ is suitable for Chinese people. A sample of 427 university students (56.4 % females, 50.7 % gamblers) answered a questionnaire with measures including the GRSEQ, subjective norms, intentions toward gambling, general self-efficacy, impulsiveness, and pathological gambling symptoms. Evidence was found for the four-factor structure, internal consistency, criterion-related validity, and discriminant validity of the Chinese version of the GRSEQ among this young Chinese group.

Problem gambling of Chinese college students: application of the theory of planned behavior

The present study, using the theory of planned behavior (TPB), investigated psychological correlates of intention to gamble and problem gambling among Chinese college students. Nine hundred and thirty two Chinese college students (aged from 18 to 25 years) in Hong Kong and Macao were surveyed. The findings generally support the efficacy of the TPB in explaining gambling intention and problems among Chinese college students. Specifically, the results of the path analysis indicate gambling intention and perceived control over gambling as the most proximal predictors of problem gambling, whereas attitudes, subjective norms, and perceived control, which are TPB components, influence gambling intention. Thus, these three TPB components should make up the core contents of the prevention and intervention efforts against problem gambling for Chinese college students.

Gambling-related cognitive biases and pathological gambling among youths, young adults, and mature adults in Chinese societies

This study investigated the extent to which gambling-related cognitive biases would associate with various levels of gambling pathology among 2,835 youths, 934 young adults, and 162 mature adults in Chinese societies. Results showed that gambling cognitive biases, especially biases in perceived inability to stop gambling and positive gambling expectancy, were salient correlates of pathological gambling across the three age cohorts. Analyses of variances on total cognitive biases also showed a gambling pathology main effect and an age cohort × gambling pathology 2-way interaction effect. It was noted that the probable pathological gambling group had greater cognitive biases than the probable problem gambling group, which in turn had greater cognitive biases than the non-problem gambling group. In the non-problem gambling group, mature adults had greater cognitive biases than youths and young adults, but this pattern was reversed in the probable problem gambling group. In the probable pathological gambling group, youths had greater cognitive biases than young and mature adults. Specific categories of cognitive biases also varied according to gender and gambling pathology. While men as compared to women in the non-problem and probable problem gambling groups reported a greater bias in their perceived inability to stop gambling, no significant gender difference in this bias was found in the probable pathological gambling group. Men generally had greater perceived gambling expectancy bias than women.