Gambling Related Cognitions Mediate the Association Between Thinking Style and Problem Gambling Severity

Association between endocrine and neuropsychological endophenotypes and gambling disorder severity

BACKGROUND

Neurobiological characteristics have been identified regarding the severity of gambling disorder (GD). The aims of this study were: (1) to examine, through a path analysis, whether there was a relationship between neuroendocrine features, potentially mediational GD variables, and GD severity, and (2) to associate neuroendocrine variables, with GD severity-related variables according to gambling preferences.

METHODS

The sample included 297 outpatients with GD. We analyzed endocrine concentrations of different appetite-related hormones (ghrelin, liver antimicrobial peptide 2 [LEAP-2], leptin, adiponectin), and neuropsychological performance (working memory, cognitive flexibility, inhibition, decision making, premorbid intelligence). Path analysis assessed mechanisms between neuroendocrine features and GD severity, including mediational GD variables (impulsivity traits and gambling-related cognitive distortions). Partial correlations evaluated the associations between neuroendocrine variables, including impulsivity traits, and variables related to GD severity (DSM-5, South Oaks Gambling Screen, illness duration, and gambling-related cognitive distortions).

RESULTS

Lower adiponectin concentrations predicted greater GD severity, while higher LEAP-2 concentrations predicted more gambling-related cognitive distortions. Likewise, better neuropsychological performance directly predicted GD severity, but worse neuropsychological performance was associated with GD severity through the mediational variables of impulsivity traits and gambling-related cognitive distortions. Also, in non-strategic individuals with GD, poor working memory was associated with gambling expectancies and predictive control. In strategic individuals with GD, poor cognitive flexibility was associated with illusion of control, predictive control, and inability to stop gambling.

CONCLUSIONS

These results provide updated information about the comprehension of the interaction between neuroendocrine features, clinical variables, and severity of GD. Thus, neurobiological functions seem to be strongly related to GD severity.

A Systematic Review on Intervention Treatment in Pathological Gambling

Over the last century, there has been a growing interest in researching pathological gambling, particularly in industrialized nations. Historically, gambling was widely perceived as morally questionable, condemned by religious groups. However, contemporary concerns have shifted towards the health repercussions of gambling disorders and broader societal impacts like increased crime and money laundering. Governments, aiming to mitigate social harm, often regulate or directly oversee gambling activities. The global surge in legal gambling has resulted in a substantial rise in its prevalence, popularity, and accessibility in the last two decades. This paper provides a comprehensive overview of global research on interventions for pathological gambling. Through a systematic search on platforms such as EBSCO, PubMed, and Web of Science, 13 relevant records were identified. The revised findings indicate a heightened occurrence of behavioral addictions, linking them to the early onset of gambling issues and their severe consequences. The research emphasizes the active role that clients play in the process of self-directed change and therapy. Therapists recognizing clients as both catalysts for change and potential obstacles can enhance their effectiveness. A common source of resistance arises when clients and therapists are in different stages of the change process, underlining the importance of therapists aligning with clients' readiness for change. Recognizing the urgent need for a better understanding of this problem in adolescents, this study emphasizes the necessity to tailor prevention and treatment plans based on gender and age-specific requirements.

Push Outcomes Bias Perceptions of Scratch Card Games

In the domain of scratch card gambling, "pushes" refer to outcomes in which a prize is won that is equal to the cost of a scratch card game. Despite resulting in no net monetary gain, these outcomes are categorized as wins by lottery operators, effectively inflating published scratch card information (e.g., posted odds of winning). Additionally, the experience of obtaining a push shares similarities (e.g., the revealing of matching symbols) with the experience of obtaining a win and thus may be experienced similarly to wins by gamblers. Across four studies (N = 1502), we examined the impact of push outcomes on participants' perceptions of scratch card games. In Studies 1 and 2, participants reported feeling more likely to win, more excitement to play, and a stronger urge to gamble when presented with a scratch card that categorized push outcomes as wins compared to when presented a scratch card that did not categorize these outcomes as wins. In Study 3, participants experiencing a push outcome prior to a loss reported feeling more likely to win compared to those not experiencing a push outcome yet experiencing the same net monetary loss. In Study 4, push outcomes were found to elicit more excitement and a stronger urge to gamble compared to losses but less excitement and a weaker urge to gamble compared to wins. Overall, the present investigation suggests that push outcomes, a prevalent feature of scratch card games, can bias gambling-related judgments and increase the appeal of scratch card games.

Cognitive Factors that Predict Gambling Fallacy Endorsement

Gambling fallacies are a collection of error-stricken beliefs about gambling and how gambling works. Gambling fallacies, while common in the general public, appear to increase as a function of gambling severity. This being the case, many interventions have focused on reducing gambling fallacies as a means of treating problem-gambling. Less research, however, has investigated what factors contributes to gambling fallacy susceptibility in the first place. Available studies have identified associations between gambling fallacy susceptibility and isolated individual differences in, for example, statistical reasoning/understanding, intelligence, or cognitive ability. The current study aimed to assess these cognitive factors in conjunction, and their relative predictive potential for gambling fallacy susceptibility. In an Australian university student sample (n = 90) it was found that there were moderate to strong association between gambling fallacy endorsement and general intelligence, probabilistic reasoning ability, rational cognitive style and the ability to suppress intuitive thought, however, only probabilistic reasoning, rational cognitive style and the ability to suppress intuitive thinking contributed to the prediction of fallacy endorsement. Importantly, each of these factors are malleable. Interventions for the correction of gambling-specific fallacious beliefs should focus on these factors.

Gambling Disorders Among Young Women Regular Gamblers: The Unique and Common Contribution of Executive Thinking Style and Mindfulness

The aim of this study is to investigate the role played by mindfulness in the relationship between cognitive styles and gambling disorders in a sample of female young adults. Participants in this study (125 women; M_age = 18.64 years; SD = 1.7) were recruited in betting or bingo halls. They completed the South Oaks Gambling Screen, the Child and Adolescent Mindfulness Measure, and Sternberg's questionnaire on thinking styles. The results from the mediation analyses revealed that the executive thinking style increases gambling and that the deficit in mindfulness ability mediates this relationship. Theoretical and clinical implications are discussed.

Measuring Gambling Outcome Expectancies in Adolescents: Testing the Psychometric Properties of a Modified Version of the Gambling Expectancy Questionnaire

The Gambling Expectancy Questionnaire (GEQ; Gillespie et al. 2007a) is a 23-item scale assessing three positive outcome expectancies (Enjoyment/Arousal, Money, Self-Enhancement) and two negative outcome expectancies (Over-Involvement, Emotional Impact) related to gambling. It is the most used instrument to assess gambling outcome expectancies in adolescents and it has good psychometric properties. To allow a greater and more useful application of the scale, the present study aimed to modify the GEQ to make it usable with all adolescents, regardless of their gambling behaviour and to verify its psychometric properties. To that aim, the items were modified and the response scale was reduced from a seven-point to a five-point Likert scale. To verify the adequacy of the modified scale, two studies were conducted among Italian adolescents. In the first study (n = 501, 75% males, Mage = 16.74, SD = .88), after having removed four items and relocating another through explorative factor analysis, the original five-factor structure of the scale was confirmed by applying a confirmatory factor analysis. Reliability and validity evidence were also provided. The second study (n = 1894, 61% males, Mage = 15.68, SD = .71) attested its invariance across gambling behaviour status and gender. The modified version of the GEQ (GEQ - MOD) can be profitably used for research and preventive purposes with youth.

Risk and protective factors for the development of gambling-related harms and problems among Australian sexual minority men

Background

Sexual minority men (SMM) often experience stressful social environments dominated by stigma and discrimination. SMM are typically more likely than heterosexual men to engage in certain risky behaviours such as problem gambling. This study aimed to compare gambling behaviour among SMM and examine potential risk factors (erroneous gambling cognitions, gambling outcome expectancies, hazardous alcohol use, impulsivity, and psychological distress; as well as perceived stigma and discrimination for the SMM participants) and potential protective factors (resilience, social support, and community connectedness) for problem gambling severity and gambling-related harms among SMM living in Australia.

Methods

An online survey, with an over-representation of SMM participants and problem, moderate-risk, and low-risk gamblers, was completed by 101 SMM (mean age = 28.5) and 207 heterosexual men (mean age = 26.4).

Results

SMM were found to have significantly lower levels of problem gambling severity compared with heterosexual men, and report significantly lower gambling participation, frequencies and expenditure on any gambling activity, casino table games, horse racing/greyhound betting, sports betting, and keno. However, in the SMM group, 38.3% were classified in the problem gambling category of the Problem Gambling Severity Index and 27.6% were classified in the moderate-risk gambling category. There were no significant differences between groups in gambling-related harms. Multiple regression analyses revealed that problem gambling severity and related harms were independently predicted by higher levels of impulsivity and erroneous gambling cognitions for both groups.

Conclusions

Lower frequency of gambling behaviours among SMM and similar risk factors predicting problem gambling severity/harms for both groups suggests that problem gambling is not pronounced among SMM. This study adds new evidence to the gambling literature which can be used as comparative benchmarks for future research.

Supplementary Information

The online version contains supplementary material available at 10.1186/s40359-021-00597-4.

A Comparison of Gambling-Related Cognitions and Behaviors in Gamblers from the United States and Spain

Few studies have compared the clinical characteristics of gambling disorder (GD) from a cross-cultural perspective. In the present study, we aimed to examine differences in gambling-related cognitions, gambling preferences, GD severity and other clinical and sociodemographic variables in individuals with GD in the United States and Spain. Two groups of participants with GD (from the United States of America (US; n = 109) and Spain (n = 243) were compared using the South Oaks gambling screen and the gambling-related cognitions scale. In Spain, the prevalence of participants who reported only non-strategic gambling preferences was higher, whereas in the US, participants tended to engage in a wider breadth of gambling activities. Moreover, Spanish participants reported higher GD severity, while participants in the US endorsed greater gambling-related cognitions. Our findings suggest that there may jurisdictional or cultural differences in terms of gambling-related cognitions, gambling preferences, and GD severity levels among individuals in the US versus Spain. These differences, which may reflect cultural regulatory or other factors, should be investigated further, and considered when developing and implementing interventions for GD.

Impulsivity, Emotion Regulation, Cognitive Distortions and Attentional Bias in a Spanish Sample of Gambling Disorder Patients: Comparison between Online and Land-Based Gambling

Several risk factors have been related to the onset and maintenance of gambling disorder (GD). The aim of this study was to explore the differences in emotion dysregulation, impulsivity, cognitive distortions, and attentional bias between online and land-based gamblers. The sample consisted of 88 treatment-seeking patients from the Behavioral Addictions Unit at the Hospital de la Santa Creu i Sant Pau, Barcelona (Spain). Patients were divided into two groups by considering their main type of gambling, i.e., online (n = 26) and land-based gambling (n = 62). Online gamblers were younger, more often employed, with a higher educational level than land-based gamblers. Regarding the rest of the variables, statistically significant differences were only found in Positive Urgency, one of the UPPS-P subscales, in which the land-based gambling group scored higher than the online gambling group. In this exploratory study, individuals with online and land-based GD phenotypes did not differ either in difficulties in emotion regulation or in attentional and cognitive biases. However, land-based GD patients showed a higher tendency to succumb to strong impulses under the influence of positive emotions. These preliminary findings warrant the need to continue investigating GD phenotypes in larger patient samples.

Protective Action and Risky Beliefs: The Relationship Between Religion and Gambling Fallacies

A number of studies have explored the relationship between religious beliefs and gambling (including gambling fallacies and gambling harm) but report seemingly contradictory findings. While some studies have found religious belief to be positively associated with gambling fallacies, others have found it to be a protective factor from gambling harms. One explanation for these differing effects is that gambling fallacies and metaphysical religious belief share properties of supernatural and magical thinking. Nevertheless, social support and moral strictures associated with religion might help protect against an unhealthy engagement with gambling. Using a multidimensional measure of religiosity, we hypothesised that only the supernatural facet of religious adherence would present a risk for gambling fallacies. We analysed two archival data sources collected in Canada (Quinte Longitudinal Study: N = 4121, M_age = 46, SD_age = 14, Female = 54%; Leisure, Lifestyle and Lifecycle Project: N = 1372, M_age = 37, SD_age = 17, Female = 56%). Using the Rohrbaugh-Jessor Religiosity Scale, we confirmed that the supernatural theistic domain of religion was a positive risk factor for gambling fallacies. However, participation in ritual (behavioural) aspects, such as churchgoing, was negatively associated with risk, and no effect was observed for the consequential (moral) domain. We conclude that multidimensional aspects in religious measures may account for conflicting prior findings.

Longitudinal Changes in Gambling, Buying and Materialism in Adolescents: A Population-Based Study

Gambling disorder, gambling-related cognitive biases, compulsive buying, and materialistic values lead to impaired functioning in important areas of life. The aims of the present longitudinal study are (1) to evaluate the change produced after one year in those mentioned variables and (2) to examine the gender role in these changes and to analyze the mediational mechanisms among the variables of the study. The sample was composed of 182 adolescents (103 females and 79 males) from secondary education Spanish institutions who completed self-administered questionnaires. Structural equation modeling has been used to explore associations between the different variables. Our results show significant decreases in compulsive buying, materialism, and cognitive biases related to gambling after one year. Gambling disorder severity was directly related to cognitive distortions of gambling and being a man. Compulsive buying was associated with older age and the female gender. Materialism was associated with compulsive buying and the male gender. In conclusion, gambling disorder, gambling-related cognitive biases, compulsive buying, and materialistic values change over time in different ways, according to gender. The understanding of gambling disorder and compulsive buying in adolescents could potentially lead to early prevention and treatment programs for the specific needs of gender and age.

Gambling-Specific Cognitions Are Not Associated With Either Abstract or Probabilistic Reasoning: A Dual Frequentist-Bayesian Analysis of Individuals With and Without Gambling Disorder

BACKGROUND

Distorted gambling-related cognitions are tightly related to gambling problems, and are one of the main targets of treatment for disordered gambling, but their etiology remains uncertain. Although folk wisdom and some theoretical approaches have linked them to lower domain-general reasoning abilities, evidence regarding that relationship remains unconvincing.

METHOD

In the present cross-sectional study, the relationship between probabilistic/abstract reasoning, as measured by the Berlin Numeracy Test (BNT), and the Matrices Test, respectively, and the five dimensions of the Gambling-Related Cognitions Scale (GRCS), was tested in a sample of 77 patients with gambling disorder and 58 individuals without gambling problems.

RESULTS AND INTERPRETATION

Neither BNT nor matrices scores were significantly related to gambling-related cognitions, according to frequentist (MANCOVA/ANCOVA) analyses, performed both considering and disregarding group (patients, non-patients) in the models. Correlation Bayesian analyses (bidirectional BF10) largely supported the null hypothesis, i.e., the absence of relationships between the measures of interest. This pattern or results reinforces the idea that distorted cognitions do not originate in a general lack of understanding of probability or low fluid intelligence, but probably result from motivated reasoning.

Encouraging Gamblers to Think Critically Using Generalised Analytical Priming is Ineffective at Reducing Gambling Biases

Gambling has been associated with an array of fallacious beliefs that foster risky gambling decisions. Research into other belief systems suggests that the endorsement of non-evidence based beliefs, such as the paranormal or conspiracy theories, can be reduced when people think more analytically. The purpose of this study was to explore whether an intervention designed to elicit analytical thinking was effective in altering the gambling beliefs and simulated gambling behaviour of 178 regular electronic gaming machine (EGM) gamblers (102 males, 76 female). Participants were randomly allocated to complete either an analytic or a neutral priming task, followed by completion of belief measures (erroneous and protective) and play on a simulated EGM game. Results failed to show that priming for analytical thinking changed betting on an EGM; including features of bet size, bet change, persistence and theoretical losses. Contrary to expectations, results suggest that priming analytical thinking using generalised interventions does not appear to be effective in altering peoples' simulated gambling involvement or gambling beliefs. In fact, priming people to think more critically might be counterproductive by contributing to greater positive expectations about gambling outcomes. The results further suggested that the number of times a player alters their bet is a good indicator of theoretical gambling losses and is associated with irrational gambling cognitions. Interventions designed to promote safer thinking in gamblers should be implemented with care, as results from our study suggest that encouraging critical thinking in at-risk or problem gamblers may not be effective in reducing risky gambling.

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.

Training gamblers to re-think their gambling choices: How contextual analytical thinking may be useful in promoting safer gambling

BACKGROUND AND AIMS

Harmful gambling has been associated with the endorsement of fallacious cognitions that promote excessive consumption. These types of beliefs stem from intuitively derived assumptions about gambling that are fostered by fast-thinking and a lack of objective, critical thought. The current paper details an experiment designed to test whether a four-week online intervention to strengthen contextual analytical thinking in gamblers is effective in changing gamblers cognitions and encouraging safer gambling consumption.

METHODS

Ninety-four regular gamblers who reported experiencing gambling-related harm were randomly allocated to either an experimental (n = 46) or control condition (n = 48), including 45 males, ranging from 19 to 65 years of age (M = 36.61; SD = 9.76). Following baseline measurement of gambling beliefs and prior week gambling consumption, participants in the experimental condition were required to complete an adaption of the Gamblers Fallacy Questionnaire designed to promote analytical thinking by educating participants on common judgement errors specific to gambling once a week for four weeks. Post-intervention measures of beliefs and gambling consumption were captured in week five.

RESULTS

The experimental condition reported significantly fewer erroneous cognitions, greater endorsement of protective cognitions, and reduced time spent gambling post-intervention compared to baseline. The control group also reported a reduction in cognitions relating to predicting and controlling gambling outcomes.

CONCLUSION

Cognitive interventions that encourage gamblers to challenge gambling beliefs by reflecting on gambling involvement and promoting critical thinking may be an effective tool for reducing the time people invest in gambling activities.

Gamble with Your Head and Not Your Heart: A Conceptual Model for How Thinking-Style Promotes Irrational Gambling Beliefs

Dual process theory suggests that people use two processing systems to filter information and form judgments that direct a course of action: an intuitive and an analytic system. While the intuitive system is necessary for efficient and effective daily functioning, reliance on fast, intuitive thinking when gambling is likely to result in biased or flawed decision-making. Those who gamble tend to endorse an array of fallacious or irrational beliefs that contribute to risky decision-making and excessive gambling. This paper argues that gambling beliefs may be developed and reinforced through underlying cognitive mechanisms described by dual process theory. More specifically, gamblers tend to apply assumptions and theories developed based on their understanding of the natural world to artificial gambling contexts where such rules do not apply. As a result, gamblers develop biased interpretations and understandings for how gambling works, which tend to align with personal schemas, experiences and gambling motivations. These beliefs are used in future gambling contexts to inform decision-making. Gamblers are often unlikely or unwilling to reflect on the veracity of beliefs as they are often used to justify gambling behaviours. Educating gamblers on how they make decisions and encouraging them to think more analytically may help to reduce the strength with which erroneous beliefs about gambling are endorsed, resulting in safer gambling decisions.

Proximal and Distal Risk Factors for Gambling Problems Specifically Associated with Electronic Gaming Machines

Electronic gaming machines (EGMs) are widely used and the gambling product most commonly associated with harmful gambling. Understanding factors that increase the risk of problematic EGM play is therefore important. Previous studies into risk factors for EGM gambling have used measures of problem gambling based on an individual's total gambling activity, which therefore do not distinguish harmful gambling specifically associated with EGMs. This study used an EGM-specific measure (PGSI-EGM) to achieve its aim of identifying risk factors specifically associated with problematic EGM play. By removing nuisance effects from other gambling forms that higher-risk gamblers typically engage in, this approach provides a more accurate assessment of the determinants of EGM-related problems. An online survey was completed by 1932 at-least monthly EGM players in Australia. It measured demographics, EGM gambling behaviour, motivations, gambling urges, gambling fallacies, trait self-control, alcohol misuse, and the PGSI-EGM. A penalised regression model identified the most important proximal predictors of higher-risk EGM gambling as: higher gambling urges, higher levels of erroneous cognitions, playing EGMs more frequently, higher session expenditure, longer sessions, usually playing EGMs alone, and playing EGMs in more venues. Lower trait self control was the strongest distal determinant. Higher-risk EGM players tended to be younger, male, more educated, never married, to have higher (although still modest) incomes, and be more likely to have alcohol problems. These findings can inform interventions such as treatment, consumer education and venue interventions.

The influence of chronological age on cognitive biases and impulsivity levels in male patients with gambling disorder

BACKGROUND AND AIMS

Due to the contribution of age to the etiology of gambling disorder (GD), there is a need to assess the moderator effect of the aging process with other features that are highly related with the clinical profile. The objective of this study is to examine the role of the chronological age into the relationships between cognitive biases, impulsivity levels and gambling preference with the GD profile during adulthood.

METHODS

Sample included n = 209 patients aged 18-77 years-old recruited from a Pathological Gambling Outpatients Unit. Orthogonal contrasts explored polynomial patterns in data, and path analysis implemented through structural equation modeling assessed the underlying mechanisms between the study variables.

RESULTS

Compared to middle-age patients, younger and older age groups reported more impairing irrational beliefs (P = 0.005 for interpretative control and P = 0.043 for interpretative bias). A linear trend showed that as people get older sensation seeking (P = 0.006) and inability to stop gambling (P = 0.018) increase. Path analysis showed a direct effect between the cognitive bias and measures of gambling severity (standardized effects [SE] between 0.12 and 0.17) and a direct effect between impulsivity levels and cumulated debts due to gambling (SE = 0.22).

CONCLUSION

Screening tools and intervention plans should consider the aging process. Specific programs should be developed for younger and older age groups, since these are highly vulnerable to the consequences of gambling activities and impairment levels of impulsivity and cognitive biases.

Impulsivity and cognitive distortions in different clinical phenotypes of gambling disorder: Profiles and longitudinal prediction of treatment outcomes

BACKGROUND

Impulsivity and cognitive distortions are hallmarks of gambling disorder (GD) but it remains unclear how they contribute to clinical phenotypes. This study aimed to (1) compare impulsive traits and gambling-related distortions in strategic versus non-strategic gamblers and online versus offline gamblers; (2) examine the longitudinal association between impulsivity/cognitive distortions and treatment retention and relapse.

METHODS

Participants seeking treatment for GD (n = 245) were assessed for gambling modality (clinical interview), impulsive traits (Urgency, Premeditation, Perseverance and Sensation Seeking [UPPS] scale) and cognitive distortions (Gambling Related Cognitions Scale) at treatment onset, and for retention and relapse (as indicated by the clinical team) at the end of treatment. Treatment consisted of 12-week standardized cognitive behavioral therapy, conducted in a public specialized clinic within a general public hospital.

RESULTS

Strategic gamblers had higher lack of perseverance and gambling-related expectancies and illusion of control than non-strategic gamblers, and online gamblers had generally higher distortions but similar impulsivity to offline gamblers. Lack of perseverance predicted treatment dropout, whereas negative urgency and distortions of inability to stop gambling and interpretative bias predicted number of relapses during treatment.

CONCLUSIONS

Individuals with online and strategic GD phenotypes have heightened gambling related biases associated with premature treatment cessation and relapse. Findings suggest that these GD phenotypes may need tailored treatment approaches to reduce specific distortions and impulsive facets.

Beyond "Facebook Addiction": The Role of Cognitive-Related Factors and Psychiatric Distress in Social Networking Site Addiction

The use of social networking sites (SNSs) is rapidly increasing as billions of individuals use SNS platforms regularly to communicate with other users, follow the news, and play browser games. Given the widespread use of SNS platforms, investigating the potential predictors of addictive SNS use beyond Facebook use has become paramount given that most studies so far focused on "Facebook addiction." In this study, a total of 511 English-speaking SNS users (58.1% young adults aged 20-35 years; 64.6% female) were recruited online and asked to complete a battery of standardized psychometric tools assessing participants' sociodemographic characteristics, SNS preferences and patterns of use, SNS addiction, preference for online social interaction, maladaptive cognitions, fear of missing out (FoMo), dysfunctional emotion regulation, and general psychiatric distress. Overall, about 4.9% (n = 25) of all participants could be classed as having a high SNS addiction risk profile. Moreover, the results further indicated that FoMo (β = 0.38), maladaptive cognitions (β = 0.25), and psychiatric distress (β = 0.12) significantly predicted SNS addiction (i.e., p < 0.0001) and accounted for about 61% of the total variance in SNS addiction, with FoMo providing the strongest predictive contribution over and above the effects of sociodemographic variables and patterns of SNS use. The implications of the present findings were discussed in light of extant literature on behavioral addictions and Facebook addiction and further considerations were provided regarding the potential clinical implications for cognitive-based psychological treatment approaches to SNS addiction.

The intergenerational transmission of problem gambling: The mediating role of offspring gambling expectancies and motives

INTRODUCTION

The risk for developing a gambling problem is greater among offspring who have a problem gambling parent, yet little research has directly examined the mechanisms by which this transmission of problem gambling occurs. For this reason, the present study sought to examine the degree to which children's expectancies and motives relating to gambling explain, at least in part, the intergenerational transmission of problem gambling.

METHODS

Participants (N=524; 56.5% male) were recruited from educational institutions, and retrospectively reported on parental problem gambling. Problem gambling was measured using the Problem Gambling Severity Index and a range of positive and negative expectancies and gambling motives were explored as potential mediators of the relationship between parent-and-participant problem gambling.

RESULTS

The relationship between parent-and-participant problem gambling was significant, and remained so after controlling for sociodemographic factors and administration method. Significant mediators of this relationship included self-enhancement expectancies (feeling in control), money expectancies (financial gain), over-involvement (preoccupation with gambling) and emotional impact expectancies (guilt, shame, and loss), as well as enhancement motives (gambling to increase positive feelings) and coping motives (gambling to reduce or avoid negative emotions). All mediators remained significant when entered into the same model.

CONCLUSIONS

The findings highlight that gambling expectancies and motives present unique pathways to the development of problem gambling in the offspring of problem gambling parents, and suggest that gambling cognitions may be potential candidates for targeted interventions for the offspring of problem gamblers.

The role of affect-driven impulsivity in gambling cognitions: A convenience-sample study with a Spanish version of the Gambling-Related Cognitions Scale

Background and aims Abnormal cognitions are among the most salient domain-specific features of gambling disorder. The aims of this study were: (a) to examine and validate a Spanish version of the Gambling-Related Cognitions Scale (GRCS; Raylu & Oei, 2004) and (b) to examine associations between cognitive distortion levels, impulsivity, and gambling behavior. Methods This study first recruited a convenience sample of 500 adults who had gambled during the previous year. Participants were assessed using the Spanish version of GRCS (GRCS-S) questionnaire, the UPPS-P impulsivity questionnaire, measures of gambling behavior, and potentially relevant confounders. Robust confirmatory factor analysis methods on half the sample were used to select the best models from a hypothesis-driven set. The best solutions were validated on the other half, and the resulting factors were later correlated with impulsivity dimensions (in the whole n = 500 factor analysis sample) and clinically relevant gambling indices (in a separate convenience sample of 137 disordered and non-disordered gamblers; validity sample). Results This study supports the original five-factor model, suggests an alternative four-factor solution, and confirms the psychometric soundness of the GRCS-S. Importantly, cognitive distortions consistently correlated with affect- or motivation-driven aspects of impulsivity (urgency and sensation seeking), but not with cognitive impulsivity (lack of premeditation and lack of perseverance). Discussion and conclusions Our findings suggest that the GRCS-S is a valid and reliable instrument to identify gambling cognitions in Spanish samples. Our results expand upon previous research signaling specific associations between gambling-related distortions and affect-driven impulsivity in line with models of motivated reasoning.

Cognitive distortions and ADHD in pathological gambling: A national longitudinal case-control cohort study

Introduction The primary outcome of our study was to assess the links between the level of cognitive distortions and the severity of gambling disorder. We also aimed at assessing the links between patient gambling trajectories and attention deficit and hyperactivity disorder (ADHD). Materials and methods The study population (n = 628) was comprised of problem and non-problem gamblers of both sexes between 18 and 65 years of age, who reported gambling on at least one occasion during the previous year. Data encompassed socio-demographic characteristics, gambling habits, the South Oaks Gambling Screen, the Gambling Attitudes and Beliefs Survey - 23, the Wender Utah Rating Scale - Child, and the Adult ADHD Self-report Scale. Results The cognitive distortions with the greatest correlation to the severity of gambling disorder were the "Chasing" and "Emotions." These two dimensions were able to distinguish between problem gamblers seeking treatment or not. While age of onset of gambling and length of gambling practice were not associated with the level of distorted cognitions, a period of abstinence of at least 1 month was associated with a lower level of distorted cognitions. The presence of ADHD resulted in a higher level of distorted cognitions. Conclusion Cognitive work is essential to the prevention, and the treatment, of pathological gambling, especially with respect to emotional biases and chasing behavior. The instauration of an abstinence period of at least 1 month under medical supervision could be a promising therapeutic lead for reducing gambling-related erroneous thoughts and for improving care strategies of pathological gamblers.

Gambling among European professional athletes. Prevalence and associated factors

In Europe, the prevalence of gambling disorders in the general population ranges from 0.15 to 6.6%. Professional athletes are known for having risk factors for addictive behaviors, such as young age or sensation seeking, though no study has yet tried to evaluate the prevalence of gambling and gambling disorders among this specific population. The goals of this study were to estimate the prevalence of gambling, problematic or not, among European professional athletes and to explore the factors that are associated with gambling practice and gambling problems in professional athletes. A self-completion questionnaire was specifically designed for this study. The questionnaires were distributed by European Union athletes to professional ice hockey, rugby, handball, basketball, football, indoor football, volleyball, and cricket teams in Spain, France, Greece, Ireland, Italy, Sweden, and the United Kingdom. Socio-demographic variables (age, sex, education, marital and parental status, sport, country of birth, and country of practice), variables linked to gambling (gambling habits, screening of gambling problems with the Lie/Bet questionnaire, and gambling related cognitions), and impulsive behavior data (urgency, premeditation, perseverance, and sensation seeking [UPPS]-Short Form questionnaire) were gathered. There were 1,236 questionnaires filled out. The percentage of professional athletes that had gambled at least once during the previous year was 56.6%. The prevalence of problem gambling, current or past, was 8.2%. A certain number of variables were associated with the gambling status. In particular, betting on one's own team (OR = 4.1, CI_95% [1.5-11.5]), betting online (OR = 2.9, CI_95% [1.6-5.4]), gambling regularly (OR = 4.0, CI_95% [2.1-7.6]), and having a high positive urgency score (OR = 1.5, CI_95% [1.3-1.7]) were associated with gambling problems, current or past, among professional athletes. Professional athletes are particularly exposed to both gambling and problem gambling.

Pathological Gambling Associated With Aripiprazole or Dopamine Replacement Therapy: Do Patients Share the Same Features? A Review

BACKGROUND

In the last 10 years, dopamine replacement therapy (DRT) has become a well-known risk factor for developing an impulse control disorder, such as gambling disorder (GD). Another medication, aripiprazole (ARI), has been more recently identified as another risk factor. Dopamine replacement therapy and ARI share a dopamine agonist action. Our work aimed at comparing patients with PG according to their treatment with DRT or ARI.

METHODS

Two methods were combined-a systematic review concentrated on case reports and the analysis of a French disordered gamblers cohort focused on patients using ARI or DRT at inclusion.

RESULTS

We reported 48 cases of GD possibly due to DRT and 17 cases of GD possibly due to ARI. Because of their standardized assessment, only the EVALJEU patients could be compared. Two clinical patterns emerged. Patients in the ARI group were young, impulsive, and high novelty seekers and had a history of substance misuse. Their first gambling experience occurred during adolescence. Conversely, patients in the DRT group were old, and they began gambling late in life. They showed low levels of gambling-related cognition.

CONCLUSIONS

Patients in the ARI group seemed to be more severe pathological gamblers than patients in the DRT group. Aripiprazole is a partial D2 receptor agonist, whereas DRT includes full D2 receptor agonist. The trigger mechanism of PG development is complex and cannot only be attributed only to the pharmacodynamic effects of dopaminergic drugs. Indeed, individual vulnerability factors and environmental factors need to be considered.

Delusions of expertise: the high standard of proof needed to demonstrate skills at horserace handicapping

Gamblers who participate in skill-oriented games (such as poker and sports-betting) are motivated to win over the long-term, and some monitor their betting outcomes to evaluate their performance and proficiency. In this study of Australian off-track horserace betting, we investigated which levels of sustained returns would be required to establish evidence of skill/expertise. We modelled a random strategy to simulate 'naïve' play, in which equal bets were placed on randomly selected horses using a representative sample of 211 weekend races. Results from a Monte Carlo simulation yielded a distribution of return-on-investments for varying number of bets (N), showing surprising volatility, even after a large number of repeated bets. After adjusting for the house advantage, a gambler would have to place over 10,000 bets in individual races with net returns exceeding 9 % to be reasonably considered an expert punter (α = .05). Moreover, a record of fewer bets would require even greater returns for demonstrating expertise. As such, validated expertise is likely to be rare among race bettors. We argue that the counter-intuitively high threshold for demonstrating expertise by tracking historical performance is likely to exacerbate known cognitive biases in self-evaluation of expertise.

Impulsivity, gambling cognitions, and the gambler's fallacy in university students

The present study explored the associations among impulsivity, gambling cognitions, and behavioral adherence to the gambler's fallacy in university students (N = 142). Both impulsivity and gambling cognitions were significant predictors of non-problem and problem gambler categories as defined the Problem Gambling Severity Index. A logistic regression analysis showed that the independent contribution of cognition was statistically significant but that the contribution of impulsivity was not. A behavioral measure of gambling was obtained by asking participants to play an online game of roulette for a maximum of 15 min. Only outside bets were permitted whereby participants were to bet on the color of the winning number. Adherence to the gambler's fallacy was indexed by the likelihood of betting on an alternation in the color of the winning number as the number of consecutive outcomes of the other color increased. Gambling cognitions and gender, but not impulsivity, were associated with adherence to the gambler's fallacy. Tracing the sources of specific influences on gambling behavior may benefit from a framework that distinguishes between "hot" (emotional) and "cold" (non-emotional) mechanisms that promote problem gambling.

Personal gambling expectancies among Asian American and White American college students

Many college students are involved in gambling behavior as a recreational activity. Their involvement could potentially develop into problem gambling, an issue of increasing concern to student health. At the same time, evidence suggests that Asian Americans are overrepresented amongst problem gamblers in this age period. Research on factors related to initiation and development of problem gambling in college students is necessary to inform the development of effective and culturally-sensitive prevention efforts against gambling. The relationships between personal gambling expectancies at two levels of specificity (two general and six specific types of expectancies) and college student gambling at two levels of behavior (initiation and problems) were examined in a sample of 813 Asian American and White American college students. The study aimed to address (a) whether expectancies explained ethnic differences in gambling, (b) ethnic similarities and differences in the pattern of relationships between expectancies and gambling, and (c) whether expectancies that emerged in both ethnic groups have a greater risk or protective effect for one group than another. Results showed that Asian American students reported more problem gambling than White American students, but expectancies did not account for this group difference. Risk and protective factors for initiation were relatively similar between groups, but different patterns of risk emerged for each group for problem gambling. Implications for college primary prevention and harm reduction programs are discussed.

Disordered gambling: the evolving concept of behavioral addiction

The reclassification of gambling disorder within the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) addictions category marks an important step for addiction science. The similarities between gambling disorder and the substance use disorders have been well documented. As gambling is unlikely to exert actively damaging effects on the brain, the cognitive sequelae of gambling disorder may provide insights into addictive vulnerabilities; this idea is critically evaluated in light of recent structural imaging data. The second part of the review analyzes a fundamental question of how a behavior can become addictive in the absence of exogenous drug stimulation. The relative potency of drug and nondrug rewards is considered, alongside evidence that cognitive distortions in the processing of chance (for example, the illusion of control and the gambler's fallacy) may constitute an important added ingredient in gambling. Further understanding of these mechanisms at neural and behavioral levels will be critical for the classification of future behavioral addictions, and I consider the current research data for obesity and binge eating, compulsive shopping, and internet gaming disorder.

A comparison of university student and community gamblers: Motivations, impulsivity, and gambling cognitions

BACKGROUND AND AIMS

The present study tested whether the associations among motivational, cognitive, and personality correlates of problem gambling severity differed across university student gamblers (n = 123) and gamblers in the general adult community (n = 113).

METHODS

The participants completed a survey that included standardized measures of gambling motivation, gambling related cognitions, and impulsivity. The survey also asked participants to report the forms of gambling in which they engaged to test whether gambling involvement (number of different forms of gambling) was related to problem gambling severity. After completing the survey, participants played roulette online to examine whether betting patterns adhered to the gambler's fallacy.

RESULTS

Gambling involvement was significantly related to problem gambling severity for the community sample but not for the student sample. A logistic regression analysis that tested the involvement, motivation, impulsivity and cognitive correlates showed that money motivation and gambling related cognitions were the only significant independent predictors of gambling severity. Adherence to the gambler's fallacy was stronger for students than for the community sample, and was associated with gambling related cognitions.

DISCUSSION

The motivational, impulsivity and cognitive, and correlates of problem gambling function similarly in university student gamblers and in gamblers from the general adult community. Interventions for both groups should focus on the financial and cognitive supports of problem gambling.

Treatment of problem gambling: development, status, and future

Purpose

– The purpose of this paper is to seek to present an overview of past, present, and future approaches to the treatment of problem gambling.

Design/methodology/approach

– This paper reviews the literature concerning conceptual, historical, and clinical research perspectives on the treatment of problem gambling.

Findings

– Perspectives on the etiology, maintenance, conceptualization, and treatment of problem gambling have evolved over time. Once seen as a failure of moral character, problem gambling is now considered to be an addictive disorder with similarities to substance abuse disorders. Empirical research into the treatment of problem gambling is progressing, but is relatively sparse compared to the body of research in other addictive disorders. Methodological issues have been identified that will need to be addressed in future research. Currently, cognitive-behavioral approaches have received the most attention and have the greatest amount of research support. Brief interventions, pharmacological interventions, family therapy, and Gamblers Anonymous are also in use. Future directions for problem gambling treatment that are being researched and implemented are mindfulness-based interventions and internet-based treatment approaches.

Originality/value

– This review should be useful to those seeking general information about problem gambling treatment, its development, status, and future directions.

Opioidergic and dopaminergic manipulation of gambling tendencies: a preliminary study in male recreational gamblers

Gambling is characterized by cognitive distortions in the processing of chance and skill that are exacerbated in pathological gambling. Opioid and dopamine dysregulation is implicated in pathological gambling, but it is unclear whether these neurotransmitters modulate gambling distortions. The objective of the current study was to assess the effects of the opioid receptor antagonist naltrexone and the dopamine D2 receptor antagonist haloperidol on gambling behavior. Male recreational gamblers (n = 62) were assigned to receive single oral doses of naltrexone 50 mg, haloperidol 2 mg or placebo, in a parallel-groups design. At 2.5 h post-dosing, participants completed a slot machine task to elicit monetary wins, "near-misses," and a manipulation of personal choice, and a roulette game to elicit two biases in sequential processing, the gambler's fallacy and the hot hand belief. Psychophysiological responses (electrodermal activity and heart rate) were taken during the slot machine task, and plasma prolactin increase was assessed. The tasks successfully induced the gambling effects of interest. Some of these effects differed across treatment groups, although the direction of effect was not in line with our predictions. Differences were driven by the naltrexone group, which displayed a greater physiological response to wins, and marginally higher confidence ratings on winning streaks. Prolactin levels increased in the naltrexone group, but did not differ between haloperidol and placebo, implying that naltrexone but not haloperidol may have been functionally active at these doses. Our results support opioid modulation of cognition during gambling-like tasks, but did not support the more specific hypothesis that naltrexone may act to ameliorate cognitive distortions.

Irrational choice under uncertainty correlates with lower striatal D(2/3) receptor binding in rats

Individual differences in dopamine (DA) signaling, including low striatal D(2/3) receptors, may increase vulnerability to substance abuse, although whether this phenotype confers susceptibility to nonchemical addictions is unclear. The degree to which people use "irrational" cognitive heuristics when choosing under uncertainty can determine whether they find gambling addictive. Given that dopaminergic projections to the striatum signal reward expectancy and modulate decision-making, individual differences in DA signaling could influence the extent of such biases. To test this hypothesis, we used a novel task to model biased, risk-averse decision-making in rats. Animals chose between a "safe" lever, which guaranteed delivery of the wager, or an "uncertain" lever, which delivered either double the wager or nothing with 50:50 odds. The bet size varied from one to three sugar pellets. Although the amount at stake did not alter the options' utility, a subgroup of "wager-sensitive" rats increased their preference for the safe lever as the bet size increased, akin to risk aversion. In contrast, wager-insensitive rats slightly preferred the uncertain option consistently. Amphetamine increased choice of the uncertain option in wager-sensitive, but not in wager-insensitive rats, whereas a D(2/3) receptor antagonist decreased uncertain lever choice in wager-insensitive rats alone. Micro-PET and autoradiography using [(11)C]raclopride confirmed a strong correlation between high wager sensitivity and low striatal D(2/3) receptor density. These data suggest that the propensity for biased decision-making under uncertainty is influenced by striatal D(2/3) receptor expression, and provide novel support for the hypothesis that susceptibility to chemical and behavioral addictions may share a common neurobiological basis.

Distorted expectancy coding in problem gambling: is the addictive in the anticipation?

BACKGROUND

Pathologic gamblers are known to have abnormal neural responses associated with experiencing monetary wins and losses. However, neural responsiveness during reward and loss expectations in pathologic gamblers has not yet been investigated.

METHODS

We used a functional magnetic resonance imaging paradigm that allowed us to investigate the dissociable reward- and loss-related expectancies with various probabilities of winning or losing different amounts of money in 15 patients with problem gambling (PRGs) and 16 healthy control subjects (HCs).

RESULTS

Compared with HCs, PRGs showed stronger activation in the bilateral ventral striatum to 5 euro than to 1 euro trials. PRGs also showed more activation of the bilateral ventral striatum and left orbitofrontal cortex associated with gain-related expected value than HCs. In addition, regression analyses indicated a highly significant negative correlation between gambling severity scores and right amygdala activation associated with gain-related expected value coding. There were no group differences in brain activation for loss-related expected value.

CONCLUSIONS

PRGs show higher activity in the reward system during reward expectation than HCs, whereas we observed no difference between PRGs and HC in the loss value system. Furthermore, the negative relation between gambling severity and amygdala activation in gain expected value coding suggests that more severe PRGs are less likely to be risk aversive during gambling. Our study provides evidence that PRGs are characterized by abnormally increased reward expectancy coding, which may render them overoptimistic with regard to gambling outcomes.

Impulsivity and cognitive distortions in pathological gamblers attending the UK National Problem Gambling Clinic: a preliminary report

BACKGROUND

Pathological gambling (PG) is a form of behavioural addiction that has been associated with elevated impulsivity and also cognitive distortions in the processing of chance, probability and skill. We sought to assess the relationship between the level of cognitive distortions and state and trait measures of impulsivity in treatment-seeking pathological gamblers.

METHOD

Thirty pathological gamblers attending the National Problem Gambling Clinic, the first National Health Service clinic for gambling problems in the UK, were compared with 30 healthy controls in a case-control design. Cognitive distortions were assessed using the Gambling-Related Cognitions Scale (GRCS). Trait impulsivity was assessed using the UPPS-P, which includes scales of urgency, the tendency to be impulsive in positive or negative mood states. Delay discounting rates were taken as a state measure of impulsive choice.

RESULTS

Pathological gamblers had elevated impulsivity on several UPPS-P subscales but effect sizes were largest (Cohen's d>1.4) for positive and negative urgency. The pathological gamblers also displayed higher levels of gambling distortions, and elevated preference for immediate rewards, compared to controls. Within the pathological gamblers, there was a strong relationship between the preference for immediate rewards and the level of cognitive distortions (R2=0.41).

CONCLUSIONS

Impulsive choice in the gamblers was correlated with the level of gambling distortions, and we hypothesize that an impulsive decision-making style may increase the acceptance of erroneous beliefs during gambling play.