Adolescent online gambling in Cyprus: associated school performance and psychopathology

The Comparative Efficacy of Treatments for Children and Young Adults with Internet Addiction/Internet Gaming Disorder: An Updated Meta-Analysis

Internet gaming disorder (IGD) is a formal mental disorder leading to bad outcomes for children and adolescents. This study comprehensively compared the estimated effect of various pharmacotherapy and psychosocial interventions for IGD from randomized controlled trials (RCT) through updated meta-analysis, using meta-regression. A search of PubMed/MEDLINE, Cochrane Library, and Airiti Library between 2000 and 2017 was conducted for various IA/IGD intervention modalities. A total of 124 studies from 29 selected papers involving 5601 children and young adults with IA/IGD were found. Meta-analyzing the pooled standardized mean difference (SMD) revealed a preliminary random effect of 1.399 with a 95% confidence interval of 1.272–1.527, suggesting highly effective treatment of IA/IGD. After adjusting for the confounding risks of age, publication year, type of subjects, and type of study, this study revealed that combining pharmacotherapy with cognitive behavioral therapy (CBT) or multi-level counseling (MLC) was the most effective treatment option. Using a scale of time spent online or a severity of IA symptoms scale was a more effective measurement, with p-values = 0.006 and 0.002, respectively. IA/IGD patients with comorbid depression showed worse outcomes than youth with another comorbidity. The corresponding model goodness-of-fit indices were τ² = 1.188; I²-Residual = 89.74%; and Adjusted-R² = 16.10%. This systematic review indicates that pharmacotherapy combined with CBT or MLC might be an effective therapeutic strategy for youth with gaming disorder.

Predictive Effect of Internet Addiction and Academic Values on Satisfaction With Academic Performance Among High School Students in Mainland China

Academic performance occupies an important role in adolescent development. It reflects adolescents’ cognitive ability and also shapes their academic and career paths. Students who are satisfied with their school performance tend to show higher self-esteem, confidence, and motivation. Previous research has suggested that students’ problem behaviors, such as Internet Addiction (IA), and academic values, including intrinsic and utility values, could predict satisfaction with academic performance. However, the influence of IA and academic values has not been thoroughly explored in Chinese contexts where the pressure for academic success is heavy. This study examined the relationships between IA, academic values (intrinsic and utility value), and satisfaction with academic performance using two waves of data collected from secondary school students in four cities in mainland China. The matched sample included a total of 2,648 Grade 7 or 8 students (57.1% were boys with a mean age of 13.1 years at Wave 1). Participants completed the same questionnaire containing validated measures at both waves with a 1-year interval. In line with the hypotheses, multiple regression analyses showed that Wave 1 IA was a significant negative predictor of Wave 2 intrinsic value, utility value, and satisfaction with academic performance and their changes. Results of mediation analyses revealed that only intrinsic value, but not utility value, positively predicted satisfaction with academic performance. Structural equation modeling (SEM) analyses also showed similar findings. Two observations are concluded from the present findings: IA impaired students’ intrinsic value, utility value, and perceived satisfaction with academic performance; two aspects of academic values demonstrated different influences on satisfaction with academic performance. These findings provide implications for the promotion of academic satisfaction experienced by students and the prevention of negative effects of IA.

Problematic online gambling among adolescents: A systematic review about prevalence and related measurement issues

BACKGROUND AND AIMS

Despite its illegality among adolescents, online gambling is a common practice, which puts their mental health and well-being at serious risk. This systematic review summarises international scientific literature from the last 20 years on problematic online gambling among adolescents (11-21 years old) to determine its prevalence and to analyse related measurement issues.

METHODS

The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed and a protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO, IC: CRD42020162932). Five academic databases were consulted, which resulted in an initial sample of 658 papers.

RESULTS

Sixteen studies met the inclusion criteria for this review. All studies were cross-sectional and targeted students from elementary school, secondary school or university. Most followed a convenience sampling procedure. The primary measurement instruments used were the DSM-IV-MR-J and SOGS-RA. Between 0.77% and 57.5% of adolescents present some degree of problematic online gambling (problem, pathological or disordered) depending on the instruments used, the study samples and the timeframe analysed. Between 0.89% and 1% of adolescents exhibited an online gambling disorder.

DISCUSSION AND CONCLUSION

There is a great heterogeneity in the methodology of the reviewed studies (samples, measurement instruments, cut-off points and criteria applied). The limited number of studies and the limited generalizability of their results suggest the need for further research and for development of specific instruments to assess different levels of problematic online gambling in representative samples of adolescents based on clinical 'gold standard' criteria and more accurate cut-off points.

A Perspective on Age Restrictions and Other Harm Reduction Approaches Targeting Youth Online Gambling, Considering Convergences of Gambling and Videogaming

Internet gambling has become a popular activity among some youth. Vulnerable youth may be particularly at risk due to limited harm reduction and enforcement measures. This article explores age restrictions and other harm reduction measures relating to youth and young adult online gambling. A systematic rapid review was conducted by searching eight databases. Additional articles on online gambling (e.g., from references) were later included. To place this perspective into context, articles on adult gambling, land-based gambling, and substance use and other problematic behaviors were also considered. Several studies show promising findings for legally restricting youth from gambling in that such restrictions may reduce the amount of youth gambling and gambling-related harms. However, simply labeling an activity as "age-restricted" may not deter youth from gambling; in some instances, it may generate increased appeal for gambling. Therefore, advertising and warning labels should be examined in conjunction with age restrictions. Recommendations for age enforcement strategies, advertising, education, and warning labels are made to help multiple stakeholders including policymakers and public health officials internationally. Age restrictions in online gambling should consider multiple populations including youth and young adults. Prevention and harm reduction in gambling should examine how age-restriction strategies may affect problem gambling and how they may be best enforced across gambling platforms. More research is needed to protect youth with respect to online gambling.

Gambling involvement and problem gambling correlates among European adolescents: results from the European Network for Addictive Behavior study

PURPOSE

Worldwide, concern has grown over the expansion of gambling among adolescents, who have an increased likelihood of developing risk-taking behaviors. This study aimed to increase knowledge of problem gambling among adolescents in seven European countries and to assess the effect of demographic and lifestyle factors recorded in the European Network for Addictive Behavior survey (https://www.eunetadb.eu).

METHODS

A cross-sectional school-based study (n = 13,284) was conducted in Germany, Greece, Iceland, The Netherlands, Poland, Romania and Spain. Anonymous self-completed questionnaires included socio-demographic data, internet usage characteristics, school achievement, parental control, the Internet Addiction Test, the South Oaks Gambling Screen-Revised for Adolescents Test and Achenbach's Youth Self-Report.

RESULTS

12.5% of the participants reported last year gambling activities either online or offline. 3.6% of the study participants and 28.1% of gamblers (either online or offline) were at risk or had a gambling problem. The study results showed that a higher proportion of adolescents was either at risk or had a gambling problem among males, in the older age group, when the parental educational level was lower/middle, and in the absence of siblings. Furthermore, being at risk or having a gambling problem was associated with lower age at first use of the internet, lower school grades, using the internet 6-7 days per week, and problematic internet use. At risk or problem gamblers had higher scores on all scales of problem behavior and lower scores (lower competence) on activities and academic performance.

CONCLUSIONS

Our findings underline the need for better gambling legislation and suggest the importance of developing social responsibility tools that may help diminish adolescent gambling involvement, with special attention to males.

Gambling involvement, type of gambling and grade point average among 18-29-year-old Finnish men and women

AIMS

This study explores the associations between gambling involvement, type of gambling, at-risk and problem gambling (ARPG) and register-based grade point average (GPA), among Finnish people aged 18-29 years (N = 676). It is assumed that high gambling involvement and engaging in certain types of gambling are linked to ARPG, and that low school achievement is positively associated with these measures.

METHODS

A nationwide cross-sectional random sample was collected in 2015. The data were weighted based on gender, age and region. Analyses were carried out using logistic regression models.

RESULTS

Frequent gambling, playing several game types, online gambling and ARPG were more common among men than women. Those with low GPA played fast and low-paced daily lottery games and used online casinos significantly more often than men and women with average/high GPA. Men with a low GPA were also more likely to gamble on a weekly basis and played casino games and online poker more often. For women with a low GPA online gambling and playing slot machines were more common than for women with an average/high GPA. When controlling for sociodemographic variables and gambling involvement, men's participation in daily lottery games and online poker was significantly associated with a low GPA, but among women none of the game types remained statistically significant. Among women, playing several different game types was linked with a low GPA.

CONCLUSIONS

It seems that poorer school achievement is associated not only with frequent gambling, a large number of game types played and online gambling, but also, to some extent at least, with game type preferences.

Romanian National Prevalence Study - problem and pathological gambling in children and adolescents

Background and aims

The purpose of the present study was to measure the prevalence of problem and pathological gambling in children and adolescents at a national level, given that previous studies at regional level had demonstrated high rates of prevalence.

Methods

After designing the sample (2006 children and adolescents aged 11–19 years) we used two validated instruments for measuring the prevalence of problem and pathological gambling in children and adolescents – South Oaks Gambling Screen –Revised for Adolescents (SOGS-RA) and 20 Questions of Gamblers Anonymous Revised for Adolescents (20 GA-RA).

Results

The following data have been found: gambling at risk is 7.1% and problem and pathological gambling is 4%, when results were analyzed by SOGS-RA; prevalence of problem gambling is 10.1% and pathological gambling is 2.6% when results were analyzed by 20 GA-RA.

Conclusions

High rates of prevalence are noticed in Romania, similar to other European countries. This rates are based on self-reported questionnaires, meaning that real rates may be higher than reported, being known that children and adolescents tend to give socially expected response. An important issue is that we found pathological gambling at the age of only 11 years. Our results compared to those of other studies from Romania are very similar to those from other European countries.

Factors associated with social casino gaming among adolescents across game types

Background

With the proliferation of social casino games (SCGs) online, which offer the opportunity to gamble without monetary gains and losses, comes a growing concern regarding the effects of these unregulated games on public health, particularly among adolescents. However, given the limited research pertaining to SCG use, little is currently known about the manner in which adolescents engage with this new gambling medium. The present study aims to identify the factors that characterize adolescent social casino gamers, and to determine whether these factors differ by SCG type. Moreover, the study examines the extent to which social casino gaming is associated with monetary gambling and problem gambling in this cohort.

Method

Data were obtained from students in Grades 9 to 12 (n = 10,035) residing in the Canadian provinces of Ontario, Saskatchewan, and Newfoundland and Labrador. Participants completed the Youth Gambling Survey (YGS), which is a supplementary instrument administered alongside the Canadian Student Tobacco, Alcohol and Drugs Survey (CSTADS). Logistic regression was used to assess the factors associated with SCG play.

Results

Overall, 12.4% of respondents reported having participated in SCGs in the past three months. Compared to adolescents who did not report playing SCGs, SCG players were typically more likely to participate in monetary gambling activities, and were more prevalently classified as problem gamblers of low-to-moderate severity or high severity. Although profiles of SCG players differed across SCG game types, factors significantly associated with the playing of SCGs were gender, weekly spending money, having friends and parents who gamble, and screen time. It was also shown that current smokers were significantly more likely to participate in simulated slots online relative to adolescents who did not play SCGs.

Conclusion

Significant associations exist between SCG play, monetary gambling, and problem gambling among adolescents. Gambling intervention efforts directed at this population should aim to identify personal and environmental factors associated with social casino gaming, and should be tailored to different types of SCGs.

Patterns of Gambling Activities and Gambling Problems Among Italian High School Students: Results from a Latent Class Analysis

This study aims to provide an estimate of the prevalence of gambling among Italian adolescents and a description of their patterns of gambling activities (PGAs) using a latent class analysis on 13 different types of games. A nationwide sample of 10,959 Italian high school students was recruited in 2013. We assessed problem gambling using the South Oaks Gambling Screen: Revisited for Adolescent (SOGS-RA) scale. Approximately half (50.6%) of students reported gambling at least once in the previous year; 5.0% of them were problem gamblers and 9.1% were at-risk gamblers according to their SOGS-RA scores. Eight PGAs were identified, among which heavy players (1.7% of students) could be classified as problem gamblers and broad skill players (2.0%) and lotteries & sports players (2.4%) as "at-risk" players. These high-risk classes were consistently associated with risky behaviours in terms of substance use, school performance, money spent on gambling and family environment; the other five classes identified low-risk players associated with safe behaviours. To the best of our knowledge, this is the first study to identify PGAs among Italian adolescents. Problem gamblers are not a homogeneous group in terms of patterns of gambling activities and are associated with different risk factors, among which environmental factors, such as parents' gambling attitude and behaviour, deserve special attention. The acknowledgment of such patterns and risk factors could be useful in developing sensible public policies addressing prevention strategies and regulatory instruments.

Problematic Online Betting Among Turkish Adolescents

Problematic online betting among adolescents has attracted considerable public attention internationally for the last two decades. Although the online betting prevalence rate in Turkey is unclear, some reports indicate that it could be more pervasive than is currently estimated. The aim of this study was to determine the prevalence of problematic online betting, common behaviors of youth related to betting, and to identify the effect of family on online betting among Turkish adolescents. We surveyed 6116 adolescents aged between 12 and 18 in Istanbul to determine if they are problematic Internet users for betting. Although 756 (12.4%) adolescents reported that they play online betting, only 176 adolescents (2.9%) were classified as problematic Internet users. Thus, we collected further data from those 176 adolescents, 14.8% of which were female. A significant positive correlation was found between Internet Addiction (IA) and duration of betting. Almost 61% of participants expressed that they prefer to be online because they do not have better things to do. Almost a quarter of the participants started online betting between 10 and 12 years of age. All participants know someone who bets online. In terms of frequency, these are friends, relatives, siblings, and parents, respectively. Although there is no relationship between family structure and IA among adolescents who are problematic users, participants who live in an unstable family have higher IA scores than participants who live in a stable family.

Gambling disorder in adolescents: prevalence, new developments, and treatment challenges

Research on adolescence gambling over the past twenty years has revealed significant incidence and prevalence rates and highlighted the possible negative effects on an adolescent’s well-being. Several risk and protective factors have also been identified. Over the course of the past few years, technological advances have heralded the advent of new avenues for gambling as well as new opportunities to gamble without any direct monetary exchange. This review article examines those established trends as well as the new issues that we are faced with, in order to accurately portray the current challenges in research, prevention, and treatment.

Prevalence of Adolescent Problem Gambling: A Systematic Review of Recent Research

Previous research has shown that gambling is a popular activity among adolescents. Following a rapid expansion of legalized gambling opportunities and the emergence of new forms of gambling, many researchers have carried out studies on adolescent gambling and problem gambling. The present paper reviews studies that have been conducted worldwide since 2000, and then presents a more detailed picture of adolescent gambling research in Europe, by providing a country-by country analysis. After an extensive search on academic databases and following an exclusion process, 44 studies were identified. The findings showed that 0.2–12.3 % of youth meet criteria for problem gambling, notwithstanding differences among assessment instruments, cut-offs, and timeframes. However, despite this variability, several demographic characteristics were associated with adolescent gambling involvement and problem gambling. It is concluded that a small but significant minority of adolescents have gambling-related problems. Such findings will hopefully encourage more research into youth gambling to further understand the determinants of this phenomenon.

Gender Differences and Psychopathological Features Associated With Addictive Behaviors in Adolescents

BACKGROUND

The aims of the study were to assess prevalence and gender differences of addictive behaviors (substance- and non-substance-related) in an adolescent population, and their association with psychopathological features and academic performance.

MATERIAL AND METHODS

A sample of high school Italian students (n = 996; M = 240, F = 756) was examined using a self-report survey concerning sociodemographic characteristics, cigarette smoking, alcohol and substance use, perceived academic performance, activities, and behaviors (Internet use, gambling, and physical exercising). The Internet Addiction Test, the South Oaks Gambling Screen-revised Adolescent, and the Exercise Addiction Inventory-Short Form were administered to identify problematic behaviors. The Barratt Impulsiveness Scale for Adolescent, the Snaith-Hamilton Pleasure Scale, the Dissociative Experience Scale for Adolescent, and the Toronto Alexithymia Scale were used to investigate psychopathological dimensions.

RESULTS

Frequent alcohol intake and lifetime substances consumption were more common among males. The occurrence of other addictive behaviors was 22.1% for problematic Internet use (M = F), 9.7% for at-risk/problematic gambling (M > F), and 6.2% for maladaptive physical exercise (M = F). We also found an association between substance-/non-substance-related addictive behaviors and psychopathological dimensions. Addictive behaviors were more frequent among students reporting poor school performance.

CONCLUSION

Our study showed a relevant prevalence of addictive behaviors in a sample of Italian high school students, with specific gender differences. We underlined the cooccurrence of substance and non-substance-related addictive behaviors, and their association with worse school performance. Dissociative proneness, anhedonia, alexithymia, and impulsivity were associated with addictive behaviors in adolescents and might represent vulnerability factors for the development of psychiatric disorders in adulthood. A better understanding of psychopathological features associated with addictive behaviors might be useful for the prevention/early intervention.

Unhealthy Gambling Amongst New Zealand Secondary School Students: An Exploration of Risk and Protective Factors

This study sought to determine the prevalence of gambling and unhealthy gambling behaviour and describe risk and protective factors associated with these behaviours amongst a nationally representative sample of New Zealand secondary school students (n = 8,500). Factor analysis and item response theory were used to develop a model to provide a measure of ‘unhealthy gambling’. Logistic regressions and multiple logistic regression models were used to investigate associations between unhealthy gambling behaviour and selected outcomes. Approximately one-quarter (24.2 %) of students had gambled in the last year, and 4.8 % had two or more indicators of unhealthy gambling. Multivariate analyses found that unhealthy gambling was associated with four main factors: more accepting attitudes towards gambling (p < 0.0001); gambling via gambling machines/casinos/track betting (p = 0.0061); being worried about and/or trying to cut down on gambling (p < 0.0001); and, having attempted suicide (p = 0.0009). Unhealthy gambling is a significant health issue for young people in New Zealand. Ethnic and social inequalities were apparent and these disparities need to be addressed.