Negative Mood States or Dysfunctional Cognitions: Their Independent and Interactional Effects in Influencing Severity of Gambling Among Chinese Problem Gamblers in Hong Kong

Clinical Differences of mild, Moderate, and Severe Gambling Disorder in a Sample of Treatment Seeking Pathological Gamblers in Sweden

INTRODUCTION

Gambling disorder (GD) is classified among the addictive disorders in the DSM-5 and the severity of the diagnosis can be specified as mild, moderate and severe. It has been seen that individuals with more severe gambling problems have a higher rate of comorbid disorders and other health problems compared to individuals with a milder clinical picture.

AIMS

The aim of this study was to explore clinical psychiatric differences related to the severity of disorder in treatment-seeking patients with GD.

METHOD

A sample of 163 patients with GD seeking treatment at an outpatient clinic was diagnosed using the SCI-GD, screened for comorbid diagnoses using the MINI, and further completed a range of self-report questionnaires measuring alcohol-, and drug-problems, symptoms of depression and anxiety, emotion regulation, cognitive distortions, and quality of life.

RESULTS

Greater severity was associated to more problems with alcohol and illicit drugs. Severe gamblers were more likely to gamble to "escape", and had more symptoms of depression and anxiety. Participants with moderate and severe gambling disorder had more difficulties with emotion regulation. Cognitive distortions were the same between severities. All groups had Quality-of-Life problems at a clinical level.

DISCUSSION

There are some distinctive differences between GD of different severities. The features shown by patients with severe GD indicates a more emotionally vulnerable group with increased symptom severity. Further knowledge about the features of GD severity levels is important for treatment planning in the clinic.

Risk Factors for Gambling Disorder: A Systematic Review

Gambling disorder is a common and problematic behavioral disorder associated with depression, substance abuse, domestic violence, bankruptcy, and high suicide rates. In the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), pathological gambling was renamed "gambling disorder" and moved to the Substance-Related and Addiction Disorders chapter to acknowledge that research suggests that pathological gambling and alcohol and drug addiction are related. Therefore, this paper provides a systematic review of risk factors for gambling disorder. Systematic searches of EBSCO, PubMed, and Web of Science identified 33 records that met study inclusion criteria. A revised study acknowledges as risk factors for developing/maintaining a gambling disorder being a single young male, or married for less than 5 years, living alone, having a poor education, and struggling financially.

Predicting Problem Gambling Severity: Interplay between Emotion Dysregulation and Gambling-related Cognitions

Understanding how emotion regulation and gambling-related cognitive distortions relate to gambling problems has direct relevance for problem gambling prevention and treatment. Although these factors have been identified as robust psychological correlates for problem gambling, the interplay between emotional regulation and cognitive biases in influencing problem gambling behaviours is yet to be fully understood. Accordingly, this study examined the explanatory role of cognitive distortions in the association between emotion regulation difficulties and problem gambling behaviours and also explored the interaction between emotion regulation and cognitive distortions in predicting gambling severity. A total of 301 adults (182 males and 119 females; age range: 18-71 years, M = 32.62, SD = 10.03) completed an online questionnaire comprising measures of emotional regulation difficulties, gambling-related beliefs and problem gambling severity. Analyses revealed that emotion regulation difficulties and erroneous gambling beliefs were positively related to problem gambling severity. Further, cognitive distortions partially accounted for the relationship between emotional regulation difficulties and problem gambling, although emotion regulation retained a direct relationship with problem gambling. There was no interaction between emotional regulation and cognitive distortions. The findings indicate that emotion regulation may serve as a precursor to the development of cognitive distortions, while also directly influencing problem gambling. Implications for assessment and treatment of problem gambling are discussed.

Alexithymia and Emotion Regulation Strategies in Adolescent Gamblers with and Without At-Risk Profiles

Alexithymia, difficulties in emotion regulation, and negative affect play an important role in adolescents who present pathological gambling. Therefore, the objectives of the present study were, firstly, to analyze the differences between alexithymia, difficulties in emotion regulation, and positive and negative affect in adolescents with and without risk of gambling problems. Secondly, the relationships between all the variables of the study in adolescents with and without risk of problem gambling were analyzed separately. Thirdly, we analyzed the mediating role of positive and negative affect in the relationship between alexithymia and dysfunctional emotion regulation strategies (ERS) in adolescents at risk of gambling problems. The sample was composed of 206 adolescents with ages ranging from 12 to 18 years (M = 15.52; SD = 1.43). They were divided into two groups according to the score obtained in the South Oaks Gambling Screen-Revised for Adolescents (SOGS-RA). Thus, 84 were included in the group without risk of gambling problems and 122 in the group at risk of gambling problems. The results obtained revealed higher scores in negative affect and pathological gambling in the group at risk of gambling problems. Likewise, positive relationships between alexithymia, maladaptive emotion regulation strategies (MERS), and affect were found. Mediation analyses showed that difficulties in identifying feelings were indirectly related to greater use of dysfunctional ERS through their relationship with negative affect in at-risk gamblers.

Contribution of sex on the underlying mechanism of the gambling disorder severity

Significant increasing prevalences have been observed in gambling disorder (GD) in the last decades. This study analyzed the underlying mechanisms of the gambling severity with path analysis (implemented through Structural Equation Modeling, SEM), and assessed the potential moderator effect of the patients’ sex. A sample of n = 512 treatment-seeking patients was assessed for sociodemographics and clinical state previously to the treatment. Results obtained in two separate SEM (for men and women) revealed differences in the direct effects and the mediational links. Among the male subsample, higher GD severity was directly related to the higher cognitive bias and the younger age of onset of the problematic gambling, while impulsivity levels and age of onset achieved an indirect effect on the disordered gambling mediated by the cognitive bias. Among females, GD severity was directly increased by younger age of onset, higher cognitive bias and lower self-directedness, while lower socioeconomic positions, and higher levels in harm avoidance achieved an indirect effect on the gambling severity mediated also by the distortions related to the gambling activity. These results provide new empirical evidence for a better understanding of the GD etiology, suggesting that the underlying complex links mediating the GD severity are strongly related to the patients’ sex. The results can also contribute to design more effectiveness and precise therapy programs of patient-centered care.

How learning misconceptions can improve outcomes and youth engagement with gambling education programs

BACKGROUND AND AIMS

Gambling education programs typically focus on promoting gambling as a high-risk activity with harmful effects; however, these programs demonstrate limited effects on the prevention of gambling problems. This paper proposes a clear theoretical framework to inform the content and delivery of gambling education initiatives and draws on psychological and pedagogical research to address some of the practical issues associated with its implementation.

METHODS

Literature was reviewed across fields of psychology, public health, and pedagogy to provide key recommendations to improve the outcomes of gambling education.

RESULTS

Four key recommendations were made for the development of future gambling education programs centering on theoretical approach, specialized content, and delivery.

DISCUSSION AND CONCLUSIONS

Recommended advancements are as follows: (a) evidence suggests shifting away from messages about gambling harms and instead applying a cognitive-developmental framework of problem gambling that may improve youth engagement by increasing personal relevance. (b) The cognitive model of problem gambling suggests that misconceptions about the profitability of gambling games (e.g., the gambler's fallacy) play an important role in the development of problems and should be a key target for education. However, exposing such misconceptions requires the challenge of teaching the mathematical principles that underpin them. (c) The pedagogical field provides valuable insights into teaching complex concepts. Research that applies the conceptual change model to science education suggests misconceptions also facilitate learning new complex information, such as gambling-related mathematical concepts (i.e., randomness and statistics). (d) In addition, improvements in computer-assisted teaching methods provide opportunities to use simulations and visualizations to help teach abstract concepts and correct such misconceptions.