Basic Beliefs About Behavioural Addictions Among Finnish and French Treatment Professionals

Gambling Disorder and Stigma: Opportunities for Treatment and Prevention

Purpose of Review

Gambling disorder is among the most stigmatized mental health problems. More research is needed to understand the mechanisms that underlie this stigma and the effects of stigma-reduction interventions. This paper reviews extant literature on the stigma of gambling disorder and highlights evidence from this research and the broader mental illness stigma literature to help advance research on the prevention and reduction of gambling-related stigma.

Recent Finding

The public stigma of gambling disorder includes stereotypes of affected individuals as “greedy” and “irresponsible,” beliefs that affected individuals are to blame for their problems, and desire to avoid social contact with affected individuals. Stigmatizing attitudes held by the public are often internalized by individuals with gambling disorder, which leads to problem concealment, reduced treatment-seeking, and decreased self-esteem. Women with gambling disorder, as well as those with more severe gambling problems and who perceive greater stigma by the public, are most vulnerable to self-stigma. There is evidence that certain beliefs may underlie the stigmatization of gambling disorder, including beliefs about its causes. Contact- and education-based interventions show efficacy for the reduction of mental illness-related stigma more broadly; additional research is needed to determine the efficacy of various stigma reduction strategies for gambling disorder specifically.

Summary

Gambling disorder is highly stigmatized relative to other mental health problems, in part because it is viewed as more likely to be caused by controllable factors. Interventions that emphasize the biopsychosocial etiology of gambling disorder may help to prevent and reduce the blame and stigmatization of affected individuals. Structural stigma within domains such as legislation, healthcare, and the gambling industry, interventions to reduce self-stigma, stigma among mental health professionals, and the influence of culture on stigma and its reduction are critical issues for future research.

Perception of Gamblers: A Systematic Review

It is generally assumed that gamblers, and particularly people with gambling problems (PG), are affected by negative perception and stigmatisation. However, a systematic review of empirical studies investigating the perception of gamblers has not yet been carried out. This article therefore summarises empirical evidence on the perception of gamblers and provides directions for future research. A systematic literature review based on the relevant guidelines was carried out searching three databases. The databases Scopus, PubMed and BASE were used to cover social scientific knowledge, medical-psychological knowledge and grey literature. A total of 48 studies from 37 literature references was found. The perspective in these studies varies: Several studies focus on the perception of gamblers by the general population, by subpopulations (e. g. students or social workers), or by gamblers on themselves. The perspective on recreational gamblers is hardly an issue. A strong focus on persons with gambling problems is symptomatic of the gambling discourse. The analysis of the studies shows that gambling problems are thought to be rather concealable, whereas the negative effects on the concerned persons‘ lives are rated to be quite substantial. PG are described as “irresponsible” and “greedy” while they perceive themselves as “stupid” or “weak”. Only few examples of open discrimination are mentioned. Several studies however put emphasis on the stereotypical way in which PG are portrayed in the media, thus contributing to stigmatisation. Knowledge gaps include insights from longitudinal studies, the influence of respondents‘ age, culture and sex on their views, the relevance of the type of gambling a person is addicted to, and others. Further studies in these fields are needed.

An overview of gambling disorder: from treatment approaches to risk factors

Gambling disorder (GD) has been reclassified recently into the "Substance-Related and Addictive Disorders" category of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), a landmark occurrence for a behavioral addiction. GD is characterized by recurrent, maladaptive gambling behavior that results in clinically significant distress. Although the number of randomized controlled trials assessing the effectiveness of pharmacological treatments is limited, some pharmacological treatments, notably opiate antagonists, have been employed in the treatment of GD. Patients with GD often present cognitive distortions and specific personality traits, making treatment more difficult. Cognitive behavioral therapy has become the most common psychological intervention for treating gambling problems, and it is effective in reducing gambling behavior. In this brief overview, we provide a report on the state of pharmacological and psychological treatments for gambling disorder. Risk factors and potential future lines of research are addressed.