Factor Structure and Psychometric Properties of the Italian Version of the Gambling Related Cognitions Scale (GRCS-I)

Gambling and virtual reality: unraveling the illusion of near-misses effect

Introduction

Studying gambling behavior is a crucial element in reducing the impact of problem gambling. Nevertheless, most current research is carried out in controlled laboratory settings rather than real-life situations, which raises concerns about how applicable the findings are in the broader context. Virtual reality (VR) has proven to be a valuable tool and has been utilized in various experimental scenarios. A limited number of studies have employed VR to investigate gambling behaviors, and few have explored them in an older adolescent context.

Methods

This study examined the behavioral and physiological effects of gambling behavior, including problem gambling, gaming addiction, and risk-taking decision-making in a sample of 36 high-school students aged between 18 to 20 years using an ad-hoc constructed VR scenario designed to simulate a slot-machine platform.

Results

The behavioral results highlighted that participants reporting more problem gambling were sensitive to near-misses: i.e., they bet more after near-misses than after losses. This result may reflect the false belief that gamblers, after near-misses, are closer to winning. Physiological data showed that participants exhibited heart rate deceleration during the anticipation of the outcome, which has been suggested to represent a marker of feedback anticipation processing and hyposensitivity to losses.

Discussion

Overall, this study provides evidence for a new VR tool to assess gambling behaviors and new insights into gambling-related behavioral and physiological factors. Implications for the treatment of problem gambling are discussed.

Near-Misses Predict Youth Gambling Intention via Illusion of Control

We examined the moderating role of an illusion of control (IOC) in the differential contributions of forms of near-miss (NM) in youths intent to gamble in Nigeria (n = 60, mean age = 18.05, SD = 3.81) using a randomized group design. Data were obtained by means of the gambling episode stimulus material that varied NM into early-miss, late-miss, near-win and near-loss groups, and self-report measures of IOC and gambling intention. One-way analysis of variance (ANOVA) result showed that NM groups differed significantly on gambling intention. HAYES PROCESS macro moderation analysis results of NM categories as dummy variables showed that early miss had a non-significant negative effect on gambling intention, late miss had a significant positive effect on gambling intention, near win had a significant positive effect on gambling intention, IOC had a negative effect on gambling intention, and negatively moderated the effect of early win on gambling.

Validation of Gambling Related Cognitions Scale-Iranian Version (GRCS-IR)

Background

The change in gambling forms, a wide variety of advertising methods, the access to gambling, as well as the increase in participation in online gambling have made it important to know and investigate gambling, particularly as pathological gambling leads to psychological and physical damage.

Methods

The present study investigated the factor structure of the Gambling Related Cognitions Scale (GRCS) proposed by Raylu and Oei in addiction. The study sample included 574 participants (40.2% male, 59.8% female) between 18 and 56 years of age. The instruments used in the present study included the GRCS, the South Oaks Gambling Screen Questionnaire (SOGS), the Victorian Gambling Screen (VGS), and the Problem Gambling Severity Index (PGSI).

Findings

A 5-factor GRCS model provided the best fit to the data, and gambling-related cognitions were a strong predictor of disordered gambling among adults. All subscales presented good internal consistency and scalability. The findings showed that the total score of the GRCS-IR was significantly different among men and women.

Conclusion

The findings of this study confirmed that the Iranian version of the GRCS-IR is an effective multidimensional instrument that accurately measures cognitive distortions related to gambling. Consequently, it can be utilized as a valuable tool for assessing GRC (Gambling Related Cognitions) to understand the severity of pathological gambling and has the potential capacity to measure treatment outcomes.

Alter Game: A Study Protocol on a Virtual "Serious Game" for Relapse Prevention in Patients With Gambling Disorder

Cognitive behavioral therapy (CBT) is the most successful protocol in gambling disorder (GD) treatment. However, it presents some weaknesses, especially concerning relapse prevention (RP). RP is one of the most important therapeutic steps, aiming at managing cravings and to avoid future relapse increasing perceived self-efficacy. Encouraging results come from the blending of psychotherapy and virtual reality (VR), containing gambling cues. The goal of Alter Game (approved by the Ethical Commission, Prot. No. 69346) is verifying the efficacy of an innovative psychological treatment for GD based on the integration of traditional CBT therapy and an immersive VR cue exposure therapy using a serious virtual game, which is a game designed for purposes other than entertainment. RP in virtual cue-exposure therapy allows pathological gamblers to manage the urge to gamble and to avoid relapse by becoming aware of which internal and external triggers are related to craving. We hypothesize that the integrated intervention will be more effective than simple CBT with regard to self-efficacy, craving, and gambling-related distortions. Four virtual ecological environments were developed, and a virtual app, Exludo, interfaced with a computerized multiparametric acquisition system for biofeedback, was created. A sample of about 60 patients aged between 18 and 65 with GD referring to the Addiction Medicine Unit of Verona (Rossi Hospital) will be recruited. Patients will be randomly assigned to the CBT group (16 CBT sessions) or the CBT + VR group (8 CBT sessions + 8 VR cue-exposure therapy sessions). The MCMI-III, the BIS-11, and the SOGS will be used to evaluate inclusion and exclusion criteria, while the Gambling Related Cognitions Scale and the Multidimensional Gambling Self-Efficacy Scale will be used to verify changes as a function of the treatment. Craving will be evaluated through VAS, and psychophysiological variables will be assessed through biofeedback. A pre-test/post-test experimental design with a 1-month follow-up will be conducted. This study will examine an innovative psychotherapeutic protocol for GD treatment, and it will help in identifying new virtual tools to increase the efficacy of traditional therapeutic approaches that could also be applied to treat other addictions.

Positive Illusions: The Role of Cognitive Distortions Related to Gambling and Temporal Perspective in Chasing Behavior

Chasing, or continuing to gamble to recoup previous losses, is a behavioral marker and a diagnostic criterion for gambling disorder. Even though chasing has been recognized to play a central role in gambling disorder, research on chasing is still relatively scarce. This study first empirically investigated the interplay between cognitive distortions related to gambling, temporal perspective, and chasing behavior in a sample of habitual gamblers. Two hundred and fifty-five adults took part in the study. Participants completed the South Oaks Gambling Screen (SOGS), the Gambling Related Cognitions Scale (GRCS), the 14-item Consideration of Future Consequences scale (CFC-14), and performed a computerized task assessing chasing behavior. Participants were randomly assigned to three experimental conditions (Control, Loss, and Win). Hierarchical logistic regression analysis showed that the decision to chase depended on scores on the CFC-14 Immediate scale and the GRCS dimensions Gambling Expectancies and Interpretative Bias. Hierarchical linear regression analysis indicated that, chasing frequency was affected by Loss condition, distortions related to gambling expectancies and predictive control, as well as by myopia for the future. Interestingly, the results of path analysis clearly indicated that some cognitions related to gambling predict chasing frequency not only directly, but also indirectly via shortened time horizon. Notably, gambling severity did not predict either the decision to chase, or the chasing persistence. These findings provide further evidence that nonchasers and chasers seem to belong to two quite distinct subtypes of gamblers. Such a difference could be useful for targeting more effective intervention strategies in gambling disorder treatment.

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.

Testing the transdiagnostic hypothesis of inhibitory control deficits in addictions: An experimental study on gambling disorder

BACKGROUND AND AIMS

Many psychopathologies, including addictions, are characterized by inhibitory control deficits. In this regard, recent studies on substance-related disorders (SRD) have shown an impairment in the ability to inhibit potentially interfering memories, despite preserved motor inhibition. To investigate whether the same dissociation could also characterize gambling disorder (GD) in a transdiagnostic perspective, we tested both cognitive and motor inhibitory processes through dedicated tasks, for the first time in this behavioral addiction.

METHODS

30 outpatients with GD and 30 healthy controls performed a go/no-go task addressing the integrity of motor inhibition, and the Retrieval Practice Paradigm, a task addressing the integrity of memory inhibition as indexed by the Retrieval-Induced Forgetting (RIF) effect. Self-report questionnaires assessing impulsivity were also administered.

RESULTS

Whereas RIF was similar across the two groups, patients showed more commission errors in the go/no-go task, and higher self-rated scores of impulsivity than controls.

DISCUSSION

The present findings suggest preserved memory inhibition and impaired motor response inhibition in GD, a pattern of inhibitory deficits opposite to that previously reported for SRD. Therefore, although both GD and SRD are characterized by altered inhibitory processing, a more fine-grained analysis revealed a specific inhibitory profile indicating vulnerability in different inhibitory components.

CONCLUSION

The present study highlights the need to investigate the multifaceted construct of inhibition more thoroughly, using performance measures able to assess its various components. This approach would enable to both better characterize different psychopathologies and orient their treatment.

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

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

Decision-Making Styles, Negative Affectivity, and Cognitive Distortions in Adolescent Gambling

Evidences from the extant literature suggest that problem gamblers show higher cognitive distortions and reported experiencing higher levels of negative affective states than recreational gamblers. Furthermore, several studies reported that the more the gambling severity, the poorer the performance in behavioral tasks assessing affective decision-making. Although gambling research on decision-making has mostly focused on the functional or dysfunctional outcomes of the decisional process, no study examined the role of decision-making styles in gambling disorder. This study aimed to first investigate the interplay among negative affectivity, cognitive distortions, and decision-making styles in adolescent problem gambling. Four hundred and twenty-five adolescents, aged between 14 and 19 years, completed the South Oaks Gambling Screen Revised for Adolescents to assess problem gambling, the Depression Anxiety and Stress Scales-21 to measure negative affective states, and the Gambling Related Cognitions Scale as a measure of cognitive distortions about gambling, and the General Decision-Making Style tapping habitual patterns which individuals use in decision-making. Data were submitted to correlational analysis, univariate and mixed-model ANOVAs, and hierarchical regression analysis. Regression analysis indicated that, along with gender, interpretative bias and inability to stop gambling, depression, and spontaneous decision-making style significantly predicted gambling severity. These results extend further previous studies on the role of misconceptions about gambling, and negative affective states in adolescent gambling, and, interestingly, first demonstrate that also maladaptive decision-making styles may represent a risk factor for gambling disorder.

Time Perspectives and Gambling in Adolescent Boys: Differential Effects of Present- and Future-Orientation

Adolescent boys are characterised by increased risk-taking behavior, including a relatively high propensity to develop problem gambling habits. The association between gambling and sensitivity to immediately available rewards is well-established, suggesting that gamblers are less influenced by potential future consequences than non-gamblers. Nevertheless, existing studies have considered present- and future-orientation as two ends of the same continuum, and have not investigated the possibility that present and future perspectives might make independent contributions to gambling behavior. In the current study, we adopted Zimbardo's multidimensional approach, which discriminates between not only present and future perspectives, but also between a hedonistic and fatalistic present-orientation (in addition to positive and negative orientations towards the past). The participants were 223 male adolescents (mean age = 16.7 years). We investigated the effects of time perspectives on gambling frequency and gambling problem severity, after taking into account the effects of age, sensation seeking, and gambling-related cognitive distortions. Gambling frequency was significantly predicted by the present fatalistic perspective, and problem gambling was significantly (negatively) related to the future perspective. The present hedonistic and past negative perspectives were also significantly related to both gambling frequency and gambling problems, although they did not explain additional variance in gambling behavior when the effects of the other factors were controlled. Overall, these results offer a fresh perspective on the role of time perspectives in gambling behavior, with potential implications for understanding the origins of gambling problems and the development of novel interventions.

Post-traumatic stress and gambling related cognitions: Analyses in inpatient and online samples

Individuals with gambling disorder (GD) report much higher rates of post-traumatic stress symptoms and post-traumatic stress disorder (PTSS/D) than the general population, and individuals with both PTSS/D and GD often report much greater distress and impairment in daily life in comparison to individuals with GD alone (Grubbs, Chapman, Milner, Gutierrez, & Bradley, 2018). Despite these associations, little is known about the specific ways in which PTSS/D and GD might influence each other. To address this gap in research, the present work sought to examine how PTSD might be related to the expression and experience of gambling related cognitions. Specifically, it was hypothesized that individuals with PTSD or symptoms of PTSD (i.e., subclinical levels of post-traumatic stress) would demonstrate greater cognitive distortions and erroneous beliefs about gambling. To test these hypotheses, we analyzed data from two samples, an inpatient sample of U.S. Armed Forces veterans seeking treatment for gambling disorder (n = 332) and an online sample of largely recreational gambling U.S. adults (n = 589). Results consistently revealed that, in both samples, individuals with PTSD or symptoms of PTSD were likely to report greater gambling related cognitions. These findings persisted, even when gambling symptom severity and trait neuroticism were held constant. Collectively, these results suggest that PTSD is uniquely associated with greater cognitive distortions and erroneous beliefs about gambling behaviors. These findings bear distinct implications for current understandings of how PTSS/D and GD are related, as well as for treatment of individuals with dealing with this comorbidity.

Profiling Online Poker Players: Are Executive Functions Correlated with Poker Ability and Problem Gambling?

Poker playing and responsible gambling both entail the use of the executive functions (EF), which are higher-level cognitive abilities. This study investigated if online poker players of different ability showed different performances in their EF and if so, which functions were the most discriminating for their playing ability. Furthermore, it assessed if the EF performance was correlated to the quality of gambling, according to self-reported questionnaires (PGSI, SOGS, GRCS). Three poker experts evaluated anonymized poker hand history files and, then, a trained professional administered an extensive neuropsychological test battery. Data analysis determined which variables of the tests correlated with poker ability and gambling quality scores. The highest correlations between EF test results and poker ability and between EF test results and gambling quality assessment showed that mostly different clusters of executive functions characterize the profile of the strong(er) poker player and those ones of the problem gamblers (PGSI and SOGS) and the one of the cognitions related to gambling (GRCS). Taking into consideration only the variables overlapping between PGSI and SOGS, we found some key predictive factors for a more risky and harmful online poker playing: a lower performance in the emotional intelligence competences (Emotional Quotient inventory Short) and, in particular, those grouped in the Intrapersonal scale (emotional self-awareness, assertiveness, self-regard, independence and self-actualization).

Gambling-Related Distortions and Problem Gambling in Adolescents: A Model to Explain Mechanisms and Develop Interventions

Although a number of gambling preventive initiatives have been realized with adolescents, many of them have been developed in absence of a clear and explicitly described theoretical model. The present work was aimed to analyze the adequacy of a model to explain gambling behavior referring to gambling-related cognitive distortions (Study 1), and to verify the effectiveness of a preventive intervention developed on the basis of this model (Study 2). Following dual-process theories on cognitive functioning, in Study 1 we tested a model in which mindware gap, i.e., susceptibility to the gambler's fallacy, and contaminated mindware, i.e., superstitious thinking, were the antecedents of gambling-related cognitive distortions that, in turn, affect gambling frequency and problem gambling. Participants were 306 male adolescents (Mage = 17.2 years). A path analysis indicated that cognitive distortions have a mediating role in the relationship that links probabilistic reasoning fallacy and superstitious thinking with problem gambling. Following these findings, in Study 2 we developed a school-based intervention aimed to reduce gambling-related cognitive distortions acting on the above cited mindware problems. A pre- and post-test design - with a 6 months follow-up - was performed with 34 male adolescents (Mage = 16.8), randomly assigned to two groups (Training and No Training), and their baseline equivalence was verified. A Mixed 2 × 2 ANOVA attested a significant Time X Group interaction, indicating a significant reduction of the cognitive distortions from pre-test to post-test only in the Training group. The follow-up attested to the stability of the training effects and the reduction of gambling frequency over time. These findings suggest that prevention strategies should address mindware problems, which can be considered as predictors of gambling-related cognitive distortions.

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.

Decision making, cognitive distortions and emotional distress: A comparison between pathological gamblers and healthy controls

BACKGROUND AND OBJECTIVES

The etiology of problem gambling is multifaceted and complex. Among others factors, poor decision making, cognitive distortions (i.e., irrational beliefs about gambling), and emotional factors (e.g., negative mood states) appear to be among the most important factors in the development and maintenance of problem gambling. Although empirical evidence has suggested that cognitive distortions facilitate gambling and negative emotions are associated with gambling, the interplay between cognitive distortions, emotional states, and decision making in gambling remains unexplored.

METHODS

Pathological gamblers (N = 54) and healthy controls (N = 54) completed the South Oaks Gambling Screen (SOGS), the Iowa Gambling Task (IGT), the Gambling Related Cognitions Scale (GRCS), and the Depression Anxiety Stress Scale (DASS-21).

RESULTS

Compared to healthy controls, pathological gamblers showed poorer decision making and reported higher scores on measures assessing cognitive distortions and emotional distress. All measures were positively associated with gambling severity. A significant negative correlation between decision making and cognitive distortions was also observed. No associations were found between poor decision making and emotional distress. Logistic regression analysis indicated that cognitive distortions, emotional distress, and poor decision making were significant predictors of problem gambling.

LIMITATIONS

The use of self-report measures and the absence of female participants limit the generalizability of the reported findings.

CONCLUSIONS

The present study is the first to demonstrate the mutual influence between irrational beliefs and poor decision making, as well as the role of cognitive bias, emotional distress, and poor decision making in gambling disorder.

Exploring the measurement structure of the Gambling Related Cognitions Scale (GRCS) in treatment-seekers: A Bayesian structural equation modelling approach

Knowledge of a problem gambler's underlying gambling related cognitions plays an important role in treatment planning. The Gambling Related Cognitions Scale (GRCS) is therefore frequently used in clinical settings for screening and evaluation of treatment outcomes. However, GRCS validation studies have generated conflicting results regarding its latent structure using traditional confirmatory factor analyses (CFA). This may partly be due to the rigid constraints imposed on cross-factor loadings with traditional CFA. The aim of this investigation was to determine whether a Bayesian structural equation modelling (BSEM) approach to examination of the GRCS factor structure would better replicate substantive theory and also inform model re-specifications. Participants were 454 treatment-seekers at first presentation to a gambling treatment centre between January 2012 and December 2014. Model fit indices were well below acceptable standards for CFA. In contrast, the BSEM model which included small informative priors for the residual covariance matrix in addition to cross-loadings produced excellent model fit for the original hypothesised factor structure. The results also informed re-specification of the CFA model which provided more reasonable model fit. These conclusions have implications that should be useful to both clinicians and researchers evaluating measurement models relating to gambling related cognitions in treatment-seekers.