Risk perception in gambling: a systematic review

Betting on Your Feelings: The Interplay between Emotion and Cognition in Gambling Affective Task

Background: Gambling Disorder (GD) is a bio-psycho-social disorder resulting from the interaction of clinical, cognitive, and affective factors. Impulsivity is a crucial factor in addiction studies, as it is closely linked to cognitive distortions in GD by encompassing impulsive choices, motor responses, decision-making, and cognitive biases. Also, emotions, mood, temperament, and affective state are crucial in developing and maintaining GD. Gambling can be used as a maladaptive coping strategy to avoid or escape problems and distress. Methods: The aim of the present study is to explore differences in personality traits and emotion regulation of people suffering from GD, substance-dependent gamblers (SDGs), and healthy controls (HCs). Additionally, the study proposes a new experimental task: the "Gambling Affective Task" (GAT) to investigate the influence of affective priming on risk-taking behaviors. Results: Our findings indicate that participants placed lower bets following positive priming. Additionally, SDGs wagered significantly higher amounts than HCs, regardless of priming type. In general, participants exhibited longer response times after positive priming trials, compared to negative and neutral priming trials. These findings suggest that experiencing positive emotions can act as a protective factor by delaying and lengthening gambling behaviors. By comparing gamblers with and without substance comorbidity, we can gain insight into the exclusive factors of GD and improve our understanding of this disorder. Conclusions: By elucidating the impact of emotional states on risk-taking, the research also provides new insights into the prevention and treatment of GD.

Lateralization of self-control over the dorsolateral prefrontal cortex in decision-making: a systematic review and meta-analytic evidence from noninvasive brain stimulation

The dorsolateral prefrontal cortex (DLPFC) has been widely recognized as a crucial brain "control area." Recently, its causal role in promoting deliberate decision-making through self-control and the asymmetric performance of the left and right DLPFC in control functions have attracted the interest of many researchers. This study was designed to investigate the role of DLPFC in decision-making behaviors and lateralization of its control function by systematically examining the effects of noninvasive brain stimulation (NIBS) over the DLPFC on intertemporal choice, risk decision-making, and social fairness-related decision-making tasks. Literature searches were implemented at PubMed, Embase, Cochrane, Web of Science, Wanfang Data, China Science and Technology Journal Database, and China National Knowledge Infrastructure until May 10, 2022. Meta-analytic results for included studies were estimated by random-effect models. A total of 33 eligible studies were identified, yielding 130 effect sizes. Our results indicated that compared to sham group, excitatory NIBS over the left DLPFC reduced delay discounting rate (standardized mean differences, SMD = -0.51; 95% confidence interval, 95% CI: [-0.81, -0.21]) and risk-taking performance (SMD = -0.39, 95% CI [-0.68, -0.10]), and inhibitory NIBS over the right DLPFC increased self-interested choice of unfair offers (SMD = 0.50, 95% CI [0.04, 0.97]). Finding of current work indicated that neural excitement of the DLPFC activation improve individuals' self-control during decision-makings, whereas neural inhibition results in impaired control. In addition, our analyses furnish causal evidence for the presence of functional lateralization in the left and right DLPFC in monetary impulsive decision-making and social decision-making, respectively.

Longitudinal Associations Between Peer Victimization and Positive and Negative Social Risk Taking in Adolescence and Young Adulthood

Adolescence is characterized by heightened risk taking, along with salient peer relationships. This study leveraged data from 167 adolescents across five years (M(SD)_age = 15.05 (0.54) years at Time 1; 47% female) to examine how risk perception and peer victimization in adolescence interrelate and predict risk likelihood in young adulthood. Bivariate growth curve modeling revealed that higher initial levels of positive social risk perception predicted a slower decrease in relational victimization throughout adolescence. Higher initial levels of relational victimization in adolescence predicted higher negative social risk likelihood in young adulthood. Adolescents with heightened risk sensitivity to positive social risks may be vulnerable to relational victimization, and prevention efforts to reduce relational victimization may protect adolescents from future negative risk taking.

The role of attention in decision-making under risk in gambling disorder: An eye-tracking study

Gambling disorder (GD) is a behavioural addiction characterized by impairments in decision-making, favouring risk- and reward-prone choices. One explanatory factor for this behaviour is a deviation in attentional processes, as increasing evidence indicates that GD patients show an attentional bias toward gambling stimuli. However, previous attentional studies have not directly investigated attention during risky decision-making. 26 patients with GD and 29 healthy matched controls (HC) completed a mixed gambles task combined with eye-tracking to investigate attentional biases for potential gains versus losses during decision-making under risk. Results indicate that compared to HC, GD patients gambled more and were less loss averse. GD patients did not show a direct attentional bias towards gains (or relative to losses). Using a recent (neuro)economics model that considers average attention and trial-wise deviations in average attention, we conducted fine-grained exploratory analyses of the attentional data. Results indicate that the average attention for gains in GD patients moderated the effect of gain value on gambling choices, whereas this was not the case for HC. GD patients with high average attention for gains started gambling at less high gain values. A similar trend-level effect was found for losses, where GD patients with high average attention for losses stopped gambling at lower loss values. This study gives more insight into how attentional processes in GD play a role in gambling behaviour, which could have implications for the development of future treatments focusing on attentional training or for the development of interventions that increase the salience of losses.

Mediating Role of Impulsivity in the Contributory Roles of Upward Versus Downward Counterfactual Thinking in Youth Gambling Intention

The proliferation of gambling shops, and the growing gambling prevalence in Nigeria, youths have constantly engaged in gambling activities even during school period. This has raised concerns among therapists and parents as the trend could degenerate to problem gambling and its associated psychosocial problems if left unchecked. Our study examined the role of impulsivity as a mediator in the association between two types of counterfactual thinking (CFT) and gambling intention in a non-clinical sample. A self-report measure containing South Oaks Gambling Screen: Reversed for Adolescents (SOGS: RA), CFT, and impulsivity scales was completed by 371 Nigerian adolescents who had gambled for money (mean age = 17.37 years; SD = 4.13). After controlling for age, increase in downward CFT was associated with decreased gambling intention, whereas increase in upward CFT and impulsivity were associated with increased gambling intention. Upward CFT contributed more to gambling intention than downward CFT. Mediation result showed that Impulsivity significantly mediated only the association between upward CFT and gambling intention. We concluded that gambling therapies should include treatment packages that enhance impulse control abilities and gambling-related downward CFT and at the same time, attenuate gambling-related upward CFT.

Representations of depression and schizophrenia in the community: The role of illness and risk perceptions on help-seeking intentions

Objective

Illness perceptions (IPs) are important in understanding human reactions to illnesses, including mental health disorders. They influence risk perceptions and several variables relevant to the adjustment to a disorder, treatment seeking, and health outcomes. This study sought to compare IP, risk perception, and help-seeking intention for depression and schizophrenia in a community sample and to assess the mediating role of risk perception in the relationship between IP and help-seeking intention.

Materials and methods

A total of 380 adults participated in this study and filled out self-report measures of IPs, risk perceptions, and help-seeking intention. The previous diagnosis of depression was used to control the comparisons between the two disorders. A structural equation model (SEM) was used to test the mediation relationship.

Results

Perceived consequences, expected timeline, lack of personal control, and symptom identity were higher for schizophrenia, while lack of treatment control and concern were higher for depression. An interaction occurred with a previous diagnosis of depression for several dimensions of IP. Concerning the SEM, a valid model was obtained for depression, explaining 15.5% of help-seeking intentions, but not for schizophrenia.

Conclusion

The results show that the general population represents depression and schizophrenia differently. These representations are influenced by having experienced depression, and that illness and risk perceptions contribute to explaining the intention to seek help. Considering these illness representations makes it possible to understand the general population's emotional and cognitive reactions to mental health disorders.

Does "lottery culture" affect household financial decisions? Evidence from China

In recent years, China's "lottery culture" has developed vigorously. Moreover, the investment participation rate of Chinese families in the formal financial market is low, whereas that in the informal financial market is high. Is there a certain relationship between "lottery culture" and family financial decision-making? If so, what is the underlying mechanism? Based on the 2017 CHFS data and lottery sales data of provinces, this study explores the impact of "lottery culture" on household participation in the formal and informal financial markets and the diversity of household financial portfolios. Results show that "lottery culture" can impede household participation in the formal financial market and the diversity of household financial portfolios while promoting household participation in the informal financial market in China. Furthermore, we analyze two channels of "lottery culture" impacts on household financial decisions: (1) risk attitude and (2) human capital. Results illustrate that "lottery culture" can influence household financial decisions by increasing risk tolerance and reducing the human capital of households.

No effect of short term exposure to gambling like reward systems on post game risk taking

Is engaging with gambling-like video game rewards a risk factor for future gambling? Despite speculation, there are no direct experimental tests of this “gateway hypothesis”. We test a mechanism that might support this pathway: the effects of engaging with gambling-like reward mechanisms on risk-taking. We tested the hypothesis that players exposed to gambling-like rewards (i.e., randomised rewards delivered via a loot box) would show increased risk-taking compared to players in fixed and no reward control conditions. 153 participants (M_age = 25) completed twenty minutes of gameplay—including exposure to one of the three reward conditions—before completing a gamified, online version of the Balloon Analogue Risk Task (BART). Self-reports of gambling and loot box engagement were collected via the Problem Gambling Severity Index, and Risky Loot-Box Index. Bayesian t-tests comparing BART scores across reward conditions provided moderate to strong evidence for a null effect of condition on risk-taking (BF = 4.05–10.64). Null effects were not moderated by players’ problem gambling symptomatology. A Spearman correlation between past loot box engagement and self-reported gambling severity (r_s = 0.35) aligned with existing literature. Our data speak against a “gateway” hypothesis, but add support to the notion that problem gambling symptoms might make players vulnerable to overspending on loot boxes.

Sex differences in neural substrates of risk taking: Implications for sex-specific vulnerabilities to internet gaming disorder

BACKGROUND AND AIMS

Sex differences in internet gaming disorder (IGD) remain unknown. Investigating sex-specific neural features that underlie the core risk factor (i.e., risk-taking) of IGD would help in understanding sex-specific vulnerabilities to IGD and advance sex-specific treatments and prevention for IGD.

METHODS

111 participants (28 IGD males, 27 IGD females, 26 recreational game user (RGU) males, 30 RGU females) completed a probability discounting task during fMRI scanning.

RESULTS

First, among RGUs, males showed a higher risk-taking tendency and greater neural activation associated with risk/value evaluation for reward (the ventromedial prefrontal cortex (vmPFC), anterior cingulate cortex (ACC), left putamen) and smaller activation associated with cognitive control (the inferior frontal gyrus) than females during the contrast of risky-safe choices. Moreover, males showed a greater modulatory effect of risky choices on the connection from the vmPFC/ACC to the left putamen than females. Second, IGD males showed decreased activation in the vmPFC/ACC and left putamen compared to RGU males, whereas this decrease did not exist in IGD females.

DISCUSSION

Males show a higher risk-taking tendency than females. Altered neural substrates associated with risky decision-making exist in IGD males but not in IGD females.

CONCLUSIONS

The present findings fill the gap in information on the behavioral and neural substrates underlying IGD among females and demonstrate that a high risk-taking tendency is a risk factor and core symptom only in IGD males but not in IGD females. It is necessary to design and adopt distinct treatments and prevention strategies for IGD in males and females.

Identifying available addictive disorder screening tests validated in primary care: A systematic review

BACKGROUND

Substance use disorders and non-substance addictive behaviors are major, growing health concerns. Efficient screening primary care settings encouraged but its widespread implementation is restricted without an appropriate screening approach for clinical practice or guidance for practitioners choose an appropriate screening test. This study aims to identify addictive disorder screening tests which are validated in primary care and suggest steps to help practitioners select the appropriate test.

METHOD

A systematic review of the literature through Pubmed, PsycINFO and The Cochrane Library was performed from database inception to December 21, 2020. The search strategy included three research topics: screening, addictive disorders, and primary care. Selection criteria included published studies evaluating the validity of an addictive disorder screening test in primary care settings.

RESULTS

8638 papers were selected, and 50 studies were included. Seventeen questionnaires validated in primary care covered the main substance use disorders, but none screened for non-substance addictive behaviors. Tests such as ASSIST, S2BI, SUBS and TAPS screen for a variety of substance use disorders while others such as TICS and CAGE-AID only have a few questions to improve feasibility. However, some shorter tests had weaker psychometric properties.

CONCLUSIONS

Seventeen addictive disorder screening tests validated in primary care are available. The feasibility and acceptability in primary care of the shorter tests needs to be assessed. A transversal screening test, adapted to the constraints of primary care, that enables clinicians to detect substance use disorders and non-substance addictive behaviors is needed.

The assessment of physical risk taking: Preliminary construct validation of a new behavioral measure

Risk taking is a complex heterogeneous construct that has proven difficult to assess, especially when using behavioral tasks. We present an exploratory investigation of new measure–the Assessment of Physical Risk Taking (APRT). APRT produces a variety of different outcome scores and is designed as a comprehensive assessment of the probability of success and failure, and magnitude of reward and punishment of different types of simulated physically risky behaviors. Effects observed on the simulated behaviors are hypothesized to reflect similar effects on real world physical risks. Participants (N = 224) completed APRT in a laboratory setting, half of whom had a 1.5 s delay interposed between button presses. Exploratory analyses utilizing generalized estimating equations examined the main effects and two-way interactions among five within-subject factors, as well as two-way interactions between the within-subject factors and Delay across four APRT outcome scores. Results indicated that Injury Magnitude and Injury Probability exerted stronger effects than any of the other independent variables. Participants also completed several self-report measures of risk taking and associated constructs (e.g., sensation seeking), which were correlated with APRT scores to assess the preliminary convergent and divergent validity of the new measure. After correcting for multiple comparisons, APRT scores correlated with self-reported risk taking in thrilling, physically dangerous activities specifically, but only for those who did not have a delay between APRT responses. This promising exploratory investigation highlights the need for future studies comparing APRT to other behavioral risk taking tasks, examining the robustness of the observed APRT effects, and investigating how APRT may predict real-world physical risk taking.

Short-Term Effectiveness of the Youth Gambling Prevention Program "Who Really Wins?"-Results from the First National Implementation

As a response to significant adolescent gambling involvement, a Croatian team of researchers and practitioners developed a universal, comprehensive, evidence-based youth gambling prevention program called "Who Really Wins?". This study presents the results on its short-term effectiveness following the first national implementation in 18 Croatian cities, with a total of 629 high school students (66.5% male) who completed the program. A design with two measurement sessions (pre-test and post-test) was used to explore the short-term effects of the program on gambling-related knowledge and cognition, frequency of gambling, and various socio-emotional skills. The results showed significant effects when it comes to knowledge, cognitive distortions, and the frequency of sports betting and playing lottery games. Furthermore, the program had no harmful effects on any of the measured variables. The results are interpreted in terms of methodological challenges in measuring effects, possible improvements of the program, and implications for future evaluation research.

The role of cultural worldviews in predicating gambling risk perception and behavior in a Chinese sample

OBJECTIVES

We investigated the relationships between cultural worldviews, gambling risk perception, and gambling behavior with a sample of tourists in Macao.

METHODS

Participants were enrolled at famous landmarks and casinos in Macao, China. Data were collected using several instruments to assess an individual's cultural worldviews, gambling risk perceptions, and gambling intentions.

RESULTS

We found that the three-dimensional solution was valid for the Chinese version of the gambling expectancy scale. Correlational and mediational analyses revealed that the relationship between an individualistic worldview and gambling intention was fully mediated by gambling risk perception. Respondents with an egalitarian worldview perceived greater risk associated with gambling than those with other worldviews.

CONCLUSION

These findings demonstrated the important influence of cultural variables on perceived risk and behavior in gambling. Moreover, understanding gamblers' worldviews could be beneficial for problem gambling interventions. Future research directions and the limitations of the findings were discussed.

A Longitudinal Analysis of Gambling Predictors among Adolescents

Although gambling is forbidden for minors, the prevalence of gambling among adolescents is increasing. In order to improve preventive interventions, more evidence on predictors of gambling onset is needed. A longitudinal study was proposed to (1) establish the prevalence of gambling; (2) identify factors associated with gambling behavior the following year; and (3) adjust a model to predict gambling behavior. A cohort of 1074 students (13-18 years old) was followed for 12 months. The prevalence of gambling reached 42.0% in the second measure. Boys gambled 2.7 times more than girls, and the highest percentages of gambling onset showed up between 13 and 14 years old. Gambling onset and maintenance was associated with gender, age, sensation-seeking, risk perception, self-efficacy for not gambling, parents' attitude towards gambling, group pressure (friends), subjective norm, exposure to advertising, accessibility, normative perception, gambling in T₁ and parents gambling behavior. Gender, gambling in T₁ and risk perception were significant in all three logistic adjusted regression models, with the fourth variable being sensation seeking, peer pressure (friends) and accessibility, respectively. It is suggested that universal prevention should be aimed preferably at children under 15 years old and to alert regulators and public administrations to the directly proportional relationship between accessibility and gambling onset.

Cognitive Distortions in Gamblers and Non-gamblers of a Representative Spanish Sample

Cognitive biases or distortions related to gambling, present in all people, are considered a relevant factor in the development of gambling-related problems.

OBJECTIVE

to establish whether the presence of these biases or cognitive distortions, in gamblers and non-gamblers, is related to the presence of gambling problems.

METHOD

3000 people aged 18-81 years, representative of the Spanish adult population, underwent a structured survey.

RESULTS

the presence of distortions was relevant to distinguish gamblers according to their level of gambling engagement and problems. There is a constant and significant tendency to have more cognitive distortions as gambling problems increase. But not all distortions have the same ability to distinguish between the different groups of gamblers. The results seem to group gamblers into three groups according to the presence of cognitive distortions, from less to more: (1) non-gamblers, (2) low-risk and at-risk gamblers, and (3) problem and pathological gamblers. The relevance of this research and its practical implications for both treatment and prevention work is discussed.

Influence of Demographic and Psychological Factors on Attitudes Toward Sport Betting Among Young Adults in Southwest Nigeria

Prediction and wager on the outcome of games/matches are known as sports betting. Positive attitudes toward sports betting may, in the long run, predict sports betting behavior and gambling-related problems. This study, therefore, examined the influence of gender, age, sports betting knowledge and peer-based gambling on attitudes toward sports betting among young adults in Nigeria. The ex-post facto design was adopted in this cross-sectional survey. The participants were 749 students (42.9% females) of a large tertiary institution in southwest Nigeria. A standardized questionnaire comprising demographics and measures of attitudes toward sports betting, sports betting knowledge and perception of peer gambling behavior was utilized in the study. Results revealed that attitudes toward sports betting are positive for older males who are knowledgeable about sports betting and have friends who gamble. Sports betting knowledge and peer-based gambling stood out as significant predictors of attitudes toward sports betting. The social circles of young adults may be the starting points for initiatives to develop healthy attitudes toward sports betting and preventing gambling-related problems.

Examining the Extended Parallel Process Model for communicating about cardiovascular disease to an at-risk population utilising a think aloud methodology

Background:Previous research has raised a number of questions about the core propositions of the Extended Parallel Process Model (EPPM). Very few previous examinations of the model have included qualitative assessments.Methods:The current study utilised a mixed method approach to experimental test EPPM-based threat-to-efficacy ratios in health risk messages about CVD and the associated health behaviours among older adults (60+ years) who would be at an alleviated risk of CVD. The current focus is on the qualitative aspect of this assessment and utilised a think aloud methodology in order to gain greater insight into participants’ thinking and problem-solving processes when presented with EPPM-based communications about cardiovascular disease (CVD). 24 participants (4 per group; Female = 14; Age,M= 74.38,SD= 7.16) were randomly assigned to one of six EPPM threat-to-efficacy ratio CVD message groups.Results:A thematic analysis was conducted, and the important themes were those of different threat perceptions for varying CVD manifestations (heart disease versus stroke), and the role of comparative (versus personal) threat and efficacy perceptions for all participants. The difference between threat appraisals for stroke versus other CVD manifestations was a novel finding.Conclusions: For the EPPM and other theories of health risk and decision-making, the impact of comparative risk and social examples for individual threat and efficacy perceptions needs to be counted.

Gamblers' (mis-)interpretations of Problem Gambling Severity Index items: Ambiguities in qualitative accounts from the Swedish Longitudinal Gambling Study

The Problem Gambling Severity Index (PGSI) is a screening instrument frequently used to identify risk and problem gambling. Even though the PGSI has good psychometric properties, it still produces a large proportion of misclassifications.

Aims:

To explore possible reasons for misclassifications in problem gambling level by analysing previously classified moderate-risk gamblers’ answers to the PGSI items, in relation to their own current and past gambling behaviours.

Methods:

Semi-structured telephone interviews were conducted with 19 participants reporting no negative consequences from gambling. They were asked the PGSI questions within an eight-year time frame (2008 to 2016). Ambiguous answers to PGSI items were subject to content analysis.

Results:

Several answers to the PGSI items contained ambiguities and misinterpretations, making it difficult to assess to what extent their answers actually indicated any problematic gambling over time. The item about feelings of guilt generated accounts rather reflecting self-recrimination over wasting money or regretting gambling as a meaningless or immoral activity. The item concerning critique involved mild interpretations such as being ridiculed for buying lottery tickets or getting comments for being boring. Similar accounts were given by the participants irrespective of initial endorsement of the items. Other possible reasons for misclassifications were related to recall bias, language difficulties, selective memory, and a tendency to answer one part of the question without taking the whole question into account.

Conclusions:

Answers to the PGSI can contain a variety of meanings based on the respondents’ subjective interpretations. Reports of lower levels of harm in the population should thus be interpreted with caution. In clinical settings it is important to combine use of screening instruments with interviews, to be able to better understand gamblers’ perceptions of the gambling behaviour and its negative consequences.

Public Awareness and Practice of Responsible Gambling in Macao

Responsible gambling (RG) is a relatively new concept to the Macao gambling industry. Although recent studies reported a heightened public awareness of RG, the prevalence of disordered gambling is still high. This discrepancy may suggest an existing gap between RG awareness and gambling practices, pinpointing aspects that need to be improved by different RG stakeholders. The gap may be attributable to people's limited knowledge toward practices favoring RG. To explore means for enhancing the RG campaign, we studied Macao residents' interpretation and adoption of RG practices. In Study 1, a random community sample was collected to assess the extent to which common RG practices were adopted. Results suggested that there was a fair proportion of gamblers not adhering to them and gambling disorder tendency was related to the adoption of RG practices. It implied a successful promotion of RG practices may reduce gambling problems. In Study 2, focus group discussions were conducted to explore how RG was conceptualized. Twenty-five participants (including 11 casino employees) took part in four focus group interviews. All participants were aware of RG but their knowledge of RG practices was limited. Very few of them were able to identify major practices such as putting constraints on gambling amount and time and the application for self-exclusion. We argue that future RG promotion needs to be more specific and behavior-oriented and it should also address various procedural concerns on how RG practices can be implemented.

Estimating everyday risk: Subjective judgments are related to objective risk, mapping of numerical magnitudes and previous experience

We aimed to investigate individual differences that associate with peoples' acute risk perception for activities such as walking and giving birth, including objective risk and the mapping of numerical magnitudes. The Amazon Mechanical Turk platform was used, with 284 participants recruited (40% female) ranging between 19 and 68 years. Participants had to indicate the positions of (1) the relative death risk of activities on a horizontal-line with 'very low risk of death' and 'very high risk of death' as left and right anchors respectively and (2), numerical magnitudes on a horizontal-line ranging 0-1000. The MicroMort framework was used to index acute risk of death (one/million chance of dying from an accident). Previous experience with the activities, handedness, along with risk propensity and unrealistic optimism were also measured. Linear mixed-effects modelling was used to investigate predictors of subjective MicroMort judgments. Individuals subjectively judged activities to be riskier if the activity was objectively riskier, if they over-estimated on the numerical task (more so for low-risk activities as compared to high-risk), or if they had not experienced the activity previously. The observed relationship between the number line task and everyday risk judgments is in keeping with the idea of a common magnitude representation system. In conclusion, individuals are able to discriminate between activities varying in risk in an absolute sense, however intuition for judging the relative differences in risk is poor. The relationship between the misjudging of both risks and numerical magnitudes warrants further investigation, as may inform the development of risk communication strategies.

Investigating Longitudinal Associations Between Sexual Assault, Substance Use, and Delinquency Among Female Adolescents: Results From a Nationally Representative Sample

PURPOSE

Few studies have explored relations among sexual assault and prospective development of high-risk behaviors among adolescent girls.

METHODS

The present study examined longitudinal associations among child sexual assault (CSA) and high-risk behaviors (nonexperimental alcohol and drug use; delinquent behavior) in a nationally representative sample of adolescent girls aged 12-17.

RESULTS

Using path modeling, findings provided support for the link between CSA and nonexperimental alcohol use, drug use, and delinquent behavior after controlling for demographic characteristics and Time 1 functioning. Additionally, past 6-month post-traumatic stress disorder assessed at Time 1 was significantly associated with CSA and delinquency measured at Time 2, although the indirect effects did not reach traditional levels of significance.

CONCLUSIONS

These findings suggest that CSA may potentiate risk for a number of public health problems.

Alterations in the Emotional Regulation Process in Gambling Addiction: The Role of Anger and Alexithymia

This study aims at the assessment of alexithymia and anger levels in 100 treatment-seeking pathological gamblers compared with controls, who were matched for age, gender and education. Furthermore a positive correlation between alexithymia, anger and severity of gambling disorder and a relationship between gambling behaviour and anger after controlling for alexithymia, are investigated. Finally the role that gender plays in anger in pathological gamblers was also evaluated. Psychological assessment includes the South Oaks Gambling Screen, State-Trait Anger Expression Inventory-2 and the twenty-item Toronto Alexithymia Scale. Statistical analysis of the results shows a higher level of anger in pathological gamblers than in controls, together with alterations in emotional processing. Severity of gambling behaviour positively correlates with alexithymia scores, state-anger and trait-anger. Moreover, a significant contribution of anger in predicting gambling behaviour was suggested after controlling for alexithymia. In conclusion, anger and alexithymia must be regarded as relevant components of the assessment of pathological gamblers, in order to select the best therapeutical strategies to prevent self-defeating behaviours and to reduce drop-out from treatments.

Adolescent Gambling-Oriented Attitudes Mediate the Relationship Between Perceived Parental Knowledge and Adolescent Gambling: Implications for Prevention

Although substantial research has provided support for the association between parental practices and adolescent gambling, less is known about the role of adolescent attitudes in this relationship. The primary purpose of this study was to test an integrative model linking perceived parental knowledge (children's perceptions of their parents' knowledge of their whereabouts and companions) with adolescent gambling while evaluating the mediating effects of adolescents' own gambling approval, risk perception of gambling, and descriptive norms on gambling shared with friends. The data were drawn from the ESPAD® Italia 2012 (European School Survey Project on Alcohol and Other Drugs) study, which is based on a nationally representative sample of Italian adolescent students aged 15-19. The analysis was carried out on a subsample of 19,573 subjects (average age 17.11, 54 % girls). Self-completed questionnaires were administered in the classroom setting. The results revealed that adolescents who perceived higher levels of parental knowledge were more likely to disapprove of gambling and show higher awareness of its harmfulness, which were in turn negatively related to gambling frequency. They were also less likely to perceive their friends as gamblers, which was also negatively related to gambling frequency. These findings suggest that gambling prevention efforts should consider perceived parental knowledge and gambling-oriented attitudes (self-approval, risk perception, and descriptive norms) as factors that may buffer adolescent gambling behavior in various situations.

Daily Fantasy Football and Self-Reported Problem Behavior in the United States

Traditional, season-long fantasy sport participation has grown considerably since the late 1990s, and in an attempt to capitalize on this growing demand, daily fantasy sports (DFS) providers have created a new game where money changes hands instantly. This change has led some legal commentators and state agencies to believe the game is a form of Internet gambling similar to online poker, blackjack, and sports wagering, and thus, it requires increased regulation or even prohibition. Little is known, however, about the gambling behavior associated with DFS participation. Thus, the purpose of the current study was to examine problem gambling severity in conjunction with DFS participant motives, perceptions, and consumption behavior. Over 500 DFS participants were surveyed, and the results suggest DFS participants behave similarly with participants in other forms of gambling activities. In addition, the findings suggest additional consumer protections may be needed to prevent further problem behavior such as chasing.

Problem Gambling among Adolescent Girls in Croatia-The Role of Different Psychosocial Predictors

Although, compared to boys, adolescent girls gamble less often and less problematically, prevalence studies still show significant numbers of at risk/problem gamblers among girls. However, girl gambling has been on the sidelines of adolescent gambling research. The available studies usually focus only on a narrow set of correlates often ignoring that adolescent gambling is a complex phenomenon determined by various factors. Also, they often measure gambling related consequences with instruments that are not specifically developed for use on adolescents. In order to contribute to a better understanding of adolescent gambling this study focuses on problem gambling among girls. We consider different social, cognitive, motivational and behavioral factors as predictors of girl problem gambling. A total of 1,372 high-school girls from 7 Croatian cities participated in the study. They provided data on their gambling activities, peer gambling, cognitive distortions related to gambling, motivation for gambling, and levels of general risky behavior. As the only instrument developed specifically for use on adolescents, the Canadian Adolescent Gambling Inventory was used to examine adverse gambling consequences. Results show 7.4% of girls can be considered regular gamblers, and out of those who gambled at least once in their lifetime (n = 862), 11.2% already experience mild adverse consequences because of their gambling (at risk gamblers), with 3.2% experiencing serious consequences (problem gamblers). In general, girls seem to prefer lotto and scratch cards, but sports betting seems to be the preferred game of choice among regular girl gamblers. A hierarchical regression model confirmed the importance of much the same factors identified as risky for the development of problem gambling among adolescent boys—cognitive distortions, motives to earn money, to be better at gambling and to relax, the experiences of winning large and the drive to continue gambling, together with social factors such as having friends who also gamble, being involved in other risky and delinquent behavior and higher gambling frequency. Results call into question the importance of the motive to feel better for adolescent girls problem gambling. We discuss implications of our findings for both universal and indicated youth gambling prevention programs.

Recognizing the Two Faces of Gambling: The Lived Experiences of Korean Women Gamblers

PURPOSE

The aim of this study was to explore the lived experiences of women problem gamblers, focusing on the meaning of gambling to them, how and why these women continue to gamble or stop gambling, and their needs and concerns. In order to effectively help women problem gamblers, practical in-depth knowledge is necessary to develop intervention programs for prevention, treatment, and recovery among women problem gamblers.

METHODS

The hermeneutic phenomenology approach was used to guide in-depth interviews and team interpretation of data. Sixteen women gamblers who chose to live in the casino area were recruited through snowball sampling with help from a counseling center. Participants were individually interviewed from February to April 2013 and asked to tell their stories of gambling. Transcribed interviews provided data for interpretive analysis.

RESULTS

In the study analysis one constitutive pattern was identified: moving beyond addiction by recognizing the two faces of gambling in their life. Four related themes emerged in the analysis-gambling as alluring; gambling as 'ugly'; living in contradictions; and moving beyond.

CONCLUSION

Loneliness and isolation play a critical role in gambling experiences of women gamblers in Korea. In other words, they are motivated to gamble in order to escape from loneliness, to stop gambling for fear of being lonely as they get older, and to stay in the casnio area so as not to be alone. The need for acceptance is one fo the important factors that should be considered in developing intervention program for women.

Risk Factors for Gambling Problems: An Analysis by Gender

Differences in problem gambling rates between males and females suggest that associated risk factors vary by gender. Previous combined analyses of male and female gambling may have obscured these distinctions. This study aimed to develop separate risk factor models for gambling problems for males and for females, and identify gender-based similarities and differences. It analysed data from the largest prevalence study in Victoria Australia (N = 15,000). Analyses determined factors differentiating non-problem from at-risk gamblers separately for women and men, then compared genders using interaction terms. Separate multivariate analyses determined significant results when controlling for all others. Variables included demographics, gambling behaviour, gambling motivations, money management, and mental and physical health. Significant predictors of at-risk status amongst female gamblers included: 18-24 years old, not speaking English at home, living in a group household, unemployed or not in the workforce, gambling on private betting, electronic gaming machines (EGMs), scratch tickets or bingo, and gambling for reasons other than social reasons, to win money or for general entertainment. For males, risk factors included: 18-24 years old, not speaking English at home, low education, living in a group household, unemployed or not in the workforce, gambling on EGMs, table games, races, sports or lotteries, and gambling for reasons other than social reasons, to win money or for general entertainment. High risk groups requiring appropriate interventions comprise young adults, especially males; middle-aged female EGM gamblers; non-English speaking populations; frequent EGM, table games, race and sports gamblers; and gamblers motivated by escape.

Impulsivity, implicit attitudes and explicit cognitions, and alcohol dependence as predictors of pathological gambling

Impulsivity, implicit attitudes and explicit cognitions regarding gambling, and alcohol abuse have been pointed out by past research as significant contributors to the development and maintenance of gambling disorders. In this study, we tested the relationship among these contributors and pathological gambling. Forty-four pathological gamblers (DSM-5 criteria), of whom 23 were active gamblers and 17 were alcohol dependent, were compared with 100 controls, consisting of patients with a lifetime history of alcohol use disorder in remission for at least 2 years. The following protocol was used for the comparison: National Opinion Research Center Diagnostic Screen for Gambling Disorders, Barratt Impulsiveness Scale Version 11 (BIS-11), Gambling Related Cognitions Scale (GRCS), Obsessive Compulsive Drinking Scale, Alcohol Use Disorders Identification Test, and Gambling Implicit Association Test (IAT). Impulsivity (BIS-11) and changes in implicit attitudes (IAT) were able to discriminate between pathological gamblers and controls, the latter being less impulsive and having fewer implicit attitudes towards gambling. Cognitive impulsivity (BIS-11), explicit gambling cognitions (GRCS), and alcohol dependence were able to discriminate between active and non-active pathological gamblers, the latter having less cognitive impulsivity and less explicit gambling cognitions and alcohol dependence. Using these simple tools can help clinicians in the assessment of pathological gambling.

Validation of the 8-item Attitudes Towards Gambling Scale (ATGS-8) in a British population survey

INTRODUCTION

Public opinions concerning gambling are an important factor in shaping public policy. Little empirical attention has been given to assessing gambling attitudes within the general population. The aim of the present study is to validate the 8-item Attitudes Towards Gambling Scale (ATGS-8) in British individuals and to investigate associations of these attitudes with frequency of gambling and gambling problems.

METHODS

Data were derived from 7746 individuals participating in the British Gambling Prevalence Survey 2010, a comprehensive interview-based survey conducted in Great Britain between November 2009 and May 2010. Confirmatory factor analysis and separate regression analyses were applied.

RESULTS

The one-dimensional structure of the ATGS-8 was confirmed in the community sample and by gender. Furthermore, more positive attitudes towards gambling were positively related to frequency of gambling and gambling problems.

CONCLUSIONS

The present study extends the previous evaluations of the scale by providing detailed evidence for the utility and usefulness of the ATGS-8 in a community sample and across gender. The ATGS-8 is a valid instrument to assess public opinion on gambling among the general population.

Dimensionality of Cognitions in Behavioral Addiction

Cognitive constructs provide conceptual frameworks for transpathological characterization and improved phenotyping of apparently disparate psychiatric groups. This dimensional approach can be applied to the examination of individuals with behavioral addictions, for example, towards gambling, video-games, the internet, food, and sex, allowing operationalization of core deficits. We use this approach to review constructs such as impulsivity, compulsivity, and attention regulation, which may be most relevant, applicable, and successful for the understanding and subsequent treatment of the addictions.

Adolescent online gambling in Cyprus: associated school performance and psychopathology

This paper presents results from the study of gambling behaviors in a representative sample of Cypriot high-school students. The aim of the study was to ascertain epidemiology of adolescent online gambling in Cyprus and possible correlates. The sample consisted of 2,684 students (48.5% boys, 51.5% girls) from the first grades of junior (Gymnasium) and senior (Lyceum) high school. Our results indicate that gamblers presented with lower school achievement and related expectations while scoring consistently higher on measures of Internet addiction, parental bonding and psychopathology. Discriminant analysis revealed two profiles which explained the most variance in gambling behavior; the first profile that corresponded to more explained variance was the student with higher psychopathology, less prosocial behavior, higher Internet addiction score with higher frequencies of online activities and moderate levels of truancy and lower expectation of school achievement. The second profile was that of a student who reported less psychopathology, more prosocial behavior, less involvement with the Internet in general but skipped classes more and his prospects on finishing high school were even slimmer. These results will be utilized in the design of a comprehensive prevention program in an effort to combat online addictive behaviors.

Italian Adolescent Gambling Behaviour: Psychometric Evaluation of the South Oaks Gambling Screen: Revised for Adolescents (SOGS-RA) among a sample of Italian students

Since no Italian validated instrument focuses specifically on the measurement of pathological gambling in very young people, with this study, we aim to adapt an international instrument (SOGS-RA) and assess its psychometric properties in a sample (n = 14.910) of young Italian students aged between 15 and 19 years. Cross-cultural adaptation of the instrument was performed through translation, synthesis of translation, back-translation, expert committee review, and pre-testing. The kappa statistic for test-retest concordance ranged from 0.53 to 0.80. Internal validity was assessed by the MCA that identified one principal component with eigenvalue equal to 3,875: the Divgi index and very simple structure analysis also pointed out one common factor, so uni-dimensionality of the SOGS-RA was accepted. Moreover the SOGS-RA was found to have acceptable internal consistency (α = 0.780). Cronbach's alpha was also assessed separately among males and females (respectively 0.786 and 0.707). The SOGS-RA was assessed in relation to gambling frequency, alcohol and drug use: Chi squared test revealed a strong association both for males and females with gambling frequency (p value ≤ 0.0001), frequent use of illicit drugs (for each drug p value ≤ 0.0001) and having had 3 or more occasions of binge drinking in the last month (p value ≤ 0.0001). At the end we can say that, the results of our study suggest that the SOGS-RA screen may be useful to assess at-risk or problem gambling for both genders in comprehensive youth surveys.

Social influence on risk perception during adolescence

Adolescence is a period of life in which peer relationships become increasingly important. Adolescents have a greater likelihood of taking risks when they are with peers rather than alone. In this study, we investigated the development of social influence on risk perception from late childhood through adulthood. Five hundred and sixty-three participants rated the riskiness of everyday situations and were then informed about the ratings of a social-influence group (teenagers or adults) before rating each situation again. All age groups showed a significant social-influence effect, changing their risk ratings in the direction of the provided ratings; this social-influence effect decreased with age. Most age groups adjusted their ratings more to conform to the ratings of the adult social-influence group than to the ratings of the teenager social-influence group. Only young adolescents were more strongly influenced by the teenager social-influence group than they were by the adult social-influence group, which suggests that to early adolescents, the opinions of other teenagers about risk matter more than the opinions of adults.

An Expert Map of Gambling Risk Perception

The purpose of the current study was to investigate the moderating or mediating role played by risk perception in decision-making, gambling behaviour, and disordered gambling aetiology. Eleven gambling expert clinicians and researchers completed a semi-structured interview derived from mental models and grounded theory methodologies. Expert interview data was used to construct a comprehensive expert mental model 'map' detailing risk-perception related factors contributing to harmful or safe gambling. Systematic overlapping processes of data gathering and analysis were used to iteratively extend, saturate, test for exception, and verify concepts and emergent themes. Findings indicated that experts considered idiosyncratic beliefs among gamblers result in overall underestimates of risk and loss, insufficient prioritization of needs, and planning and implementation of risk management strategies. Additional contextual factors influencing use of risk information (reinforcement and learning; mental states, environmental cues, ambivalence; and socio-cultural and biological variables) acted to shape risk perceptions and increase vulnerabilities to harm or disordered gambling. It was concluded that understanding the nature, extent and processes by which risk perception predisposes an individual to maintain gambling despite adverse consequences can guide the content of preventative educational responsible gambling campaigns.

Gambling and sexual behaviors in African-American adolescents

OBJECTIVES

Late adolescence represents a developmental risk period when many youth become involved in multiple forms of high-risk behaviors with adverse consequences. This study assessed the degree to which two such behaviors, adolescent sexual behaviors and gambling, were associated in a community-based sample with a large African-American presence.

STUDY DESIGN

Data are derived from a cohort study. This study focuses on 427 African-American participants with complete information on gambling and sexual behaviors by age 18 (72% of original cohort). Gambling involvement and related problems were based on responses to the South Oaks Gambling Screen - Revised for Adolescents. Several questions assessed sexual behaviors, including age of initiation. Multivariable logistic regression models adjusted for demographics, intervention status, impulsivity, depressive and anxiety symptoms, and alcohol and illegal drug use.

RESULTS

Almost half of the sample (49%, n=211) had gambled at least once before age 18. More gamblers than non-gamblers had initiated sexual intercourse by age 18 (aOR: 2.29 [1.16, 4.52]). Among those who had initiated sexual activity, more gamblers than non-gamblers with high impulsivity levels at age 13 (vs. low impulsivity levels) had become pregnant or had impregnated someone. Among those who had initiated sexual activity by age 18, more male gamblers had impregnated someone by age 18 as compared to female gamblers becoming pregnant.

CONCLUSIONS

Gambling and sexual behaviors often co-occur among adolescents. Such findings prompt the need for the inclusion of gambling, an often overlooked risky behavior, in behavioral prevention/intervention programs targeting adolescents.

Gambler Risk Perception: A Mental Model and Grounded Theory Analysis

Few studies have investigated how gamblers perceive risk or the role of risk perception in disordered gambling. The purpose of the current study therefore was to obtain data on lay gamblers' beliefs on these variables and their effects on decision-making, behaviour, and disordered gambling aetiology. Fifteen regular lay gamblers (non-problem/low risk, moderate risk and problem gamblers) completed a semi-structured interview following mental models and grounded theory methodologies. Gambler interview data was compared to an expert 'map' of risk-perception, to identify comparative gaps or differences associated with harmful or safe gambling. Systematic overlapping processes of data gathering and analysis were used to iteratively extend, saturate, test for exception, and verify concepts and themes emerging from the data. The preliminary findings suggested that gambler accounts supported the presence of expert conceptual constructs, and to some degree the role of risk perception in protecting against or increasing vulnerability to harm and disordered gambling. Gambler accounts of causality, meaning, motivation, and strategy were highly idiosyncratic, and often contained content inconsistent with measures of disordered gambling. Disordered gambling appears heavily influenced by relative underestimation of risk and overvaluation of gambling, based on explicit and implicit analysis, and deliberate, innate, contextual, and learned processing evaluations and biases.