Problem Gambling and Delinquent Behaviours Among Adolescents: A Scoping Review

Income Inequality and the Odds of Online Gambling Among a Large Sample of Adolescents in Canada

Consistent evidence points to the detrimental effects of income inequality on population health. Income inequality may be associated with online gambling, which is of concern since gambling is a risk factor for adverse mental health conditions, such as depression and suicide ideation. Thus, the overall objective of this study is to study the role of income inequality on the odds of participating in online gambling. Data from 74,501 students attending 136 schools participating in the 2018/2019 Cannabis, Obesity, Mental health, Physical activity, Alcohol, Smoking, and Sedentary behaviour (COMPASS) survey were used. The Gini coefficient was calculated based on school census divisions (CD) using the Canada 2016 Census linked with student data. We used multilevel modeling to explore the association between income inequality and self-reported participation in online gambling in the last 30 days, while controlling for individual- and area-level characteristics. We examined whether mental health (depressive and anxiety symptoms, psychosocial wellbeing), school connectedness, and access to mental health programs mediate this relationship. Adjusted analysis indicated that a standardized deviation (SD) unit increase in Gini coefficient (OR = 1.17, 95% CI 1.05, 1.30) was associated with increased odds of participating in online gambling. When stratified by gender, the association was significant only among males (OR = 1.12, 95% CI 1.03, 1.22). The relationship between higher income inequality and greater odds for online gambling may be mediated by depressive and anxiety symptoms, psychosocial well-being, and school connectedness. Evidence points to further health consequences, such as online gambling participation, stemming from exposure to income inequality.

Problem Gambling Among Adolescents in Uganda: A Cross-sectional Survey Study

In recent years, gambling has evolved and grown substantially with new gambling activities and facilities being introduced, making gambling products and opportunities more available than ever before in Uganda. While the growth of gambling industry is considered to have a beneficial impact on the economy, it is increasingly becoming a social and public health issue especially among a minority of young people who experience problem gambling, which can damage personal, family, vocational, and academic pursuits. The present study estimated the prevalence of problem gambling and identified the socio-demographic, school, environmental and health risks of problem gambling among secondary school students in Mbarara Municipality, Uganda. A cross-sectional study was conducted among secondary school students in Mbarara Municipality. A total of 921 students from 12 schools were recruited using cluster sampling. An ordinal logistic regression model was used to explore the relationship between problem gambling and the socio-demographic, academic, environmental and health variables. Of 905 participants, 362 reported having ever gambled (40%), and 160 were classified as problem gamblers (17.7%; 44.2% among those who had ever gambled). Problem gambling was significantly associated with being male, being non-religious, other religion (African traditional religion), having employment (outside of school), distance to nearest gambling venue, parental gambling, peer gambling, substance use, risky sexual behavior, and psychological distress. The present study found a very high prevalence of problem gambling among Ugandan secondary school students. Therefore, there is need to institute public health measures towards raising awareness, prevention and treatment of problem gambling among Ugandan adolescents.

Behavior Change Techniques and Delivery Modes in Interventions Targeting Adolescent Gambling: A Systematic Review

BACKGROUND

Adolescent gambling can lead to significant harms, yet participation rates continue to rise. Interventions targeting gambling reduction have been implemented in this population. However, it is not clear which behavior change techniques (BCTs) and modes of delivery (MOD) are most effective at reducing gambling.

OBJECTIVE

The objective of the study was to identify 'promising' BCTs and MODs by systematically reviewing interventions targeting adolescent gambling behavior. 'Promising' was defined as those present in at least 25% of all interventions and in at least two effective interventions.

METHODS

Three databases were searched (PsycINFO, Medline, and Scopus) from database inception to May 2021. Interventions were eligible if they were randomized controlled trials; targeting adolescents (aged 10-25 years); and assessing gambling behavior post-intervention. BCTs were identified using the Behavior Change Technique Taxonomy v1.

RESULTS

From the initial 3,315 studies, the removal of duplicates and ineligible articles resulted in sixteen studies included in the review. Eleven of these reported successfully reducing gambling behavior. Eighteen BCTs and six MODs were used across the interventions. The BCTs identified as promising were '4.2. Information about antecedents', '4.4. Behavioral experiments', '5.3. Information about social and environmental consequences', and '5.6. Information about emotional consequences'. Promising MODs were 'face-to-face', 'computer', and 'playable electronic storage'.

CONCLUSIONS

The study reviewed the content of interventions targeting adolescent gambling behavior. Four BCTs were identified as promising and should therefore be adopted in future interventions. To facilitate the delivery of these techniques, the study also identified three promising MODs. Interventions developed using these BCTs and MODs may successfully reduce adolescent gambling behavior.

Relations Among Gambling Behavior, Associated Problems, Game Type, and Risk Factors in a Rural, African American, Adolescent Sample

Problem gambling is a rising concern among adolescent populations; youth gamble more frequently than adults, and those who gamble are more susceptible than adults to maladaptive outcomes. Research shows that gambling problems are exacerbated among minorities, despite lower rates of gambling frequency. Minority youth are at especially high risk for problematic gambling outcomes, though they have not been widely studied. The objectives of this study were to (a) investigate gambling frequency and rates of associated problems among rural, African American youth, (b) examine risk factors associated with gambling problems, and (c) explore preferences for game type. Hypotheses were tested with survey data from 270 African American youth from rural communities in Georgia, ages 14-17. Past-year gambling prevalence was 38% (48% of males and 28% of females), and 30% of those who gambled (11% of the total sample) reported at least one problem behavior associated with gambling. Confirmatory factor analysis established a distinction between games of skill versus luck. Gambling problems were associated with skill games, and youth played skill games more than luck games. Substance use and anger scores predicted gambling frequency, and gambling frequency predicted gambling problems. Depression scores provided no predictive utility. Poverty status was negatively associated with skill gambling, and there was no association between poverty status and luck gambling. Males gambled more frequently, had more gambling problems, and were more likely to engage in skill gambling relative to females.

Parental Gambling as a Moderator of the Child Delinquency-Gambling Relationship: Does Having a Role Model in the Home Make a Difference?

The relationship between delinquency and gambling has drawn significant attention from researchers in the behavioral and social sciences, yet there are aspects of this relationship that remain largely unexplored. The role of "third variables" in moderating the connection between child delinquency and gambling involvement is one such aspect. Accordingly, the current study set out to examine the impact of parent gambling involvement on the child delinquency-gambling relationship in a sample of 3089 adolescents (1576 males, 1513 females) from Cohort K of the Longitudinal Study of Australian Children (LSAC-K). Using cross-sectional data from Wave 7 of the LSAC, the current study tested the possibility that gambling involvement in parents may moderate the relationship between delinquency and gambling in their offspring. Results obtained from a regression analysis revealed that the link between delinquency, conceptualized as an early marker of general deviance, and gambling variety, as measured across ten different forms of wagering (e.g., Casino gambling, sports betting, horse and dog racing, scratch tickets), changed as a function of parental involvement in these same ten behaviors. In seeking clarity on this relationship, it was noted that the association between child delinquency and gambling involvement grew in proportion to the strength of parental involvement in gaming activities. Hence, having a gambling role model in the home may increase opportunities and incentive for gambling in children predisposed to antisocial behavior or general deviance.

Gambling, Substance Use and Violence in Male and Female Adolescents

The study systematically examined the link between history of gambling, and substance-use and violence-related measures in male and female adolescents, and compared association differences between genders in representative youth risk behavior surveillance data. An anonymous survey was administered to 2425 9th- to 12th-grade students in the state of Connecticut to assess risk behaviors that impact health. Reported past-12-months gambling was the independent variable of interest. Chi squares and adjusted odds-ratios were computed to determine gambling associations with demographic variables, substance-use, and violence-related measures, and whether associations were different between genders. Among students, 18.6% reported gambling. Reported gambling in males and females associated with lifetime use of any drugs, marijuana, cocaine, inhalants, heroin, methamphetamines, ecstasy, synthetic marijuana, non-medical pain-relievers, and injected drugs, in addition to past-30-days cigarette smoking, alcohol and heavy alcohol drinking, and marijuana use. Gambling associated with reported weapon-carrying, being threatened or injured with a weapon, forced sexual intercourse, bullying, and electronic bullying in males; physical dating violence in females; and physical fighting and sexual dating violence in both groups. Gambling and gender interaction terms did not associate with outcome measures except synthetic marijuana use, which trended towards significance (P = 0.052). Gambling in adolescence was similarly linked to risk behaviors involving substance-use in males and females, though gambling relationships with different violence-measures varied between genders. Assessing gambling behavior may be important for targeted preventions focused on adolescents at risk for substance-use disorder and physical violence.

Youth and gambling disorder: What about criminal behavior?

BACKGROUND AND AIMS

The commission of illegal acts has been associated with gambling disorder (GD). However, little is known about young adults with GD who commit GD-related crimes. Therefore, the main aim of this study was to compare sociodemographic, clinical, personality and psychopathological features among young adults with GD with and without a history of illegal behaviors. Our second aim was to analyze the specific associations between these factors through a path analysis.

METHODS

A total of 808 treatment-seeking young adults who met criteria for GD were assessed at a public hospital unit specialized in behavioral addictions. Participants completed self-reported questionnaires to explore GD, personality traits, and psychopathological symptomatology.

RESULTS

Of the total sample, 291 patients (36.0%) had committed GD-related offences. Illegal acts were related to younger age and unemployment status. Greater levels of psychopathology, as well as earlier GD onset, longer GD duration and greater GD severity were also associated with the presence of criminal behaviors. Differences in personality traits were also found between these two groups.

DISCUSSION AND CONCLUSIONS

The GD group with a history of illegal acts showed dysfunctional personality traits and higher levels of psychopathology. Therefore, specific GD treatments and harm reduction interventions should be designed for these patients.

Attitudes, Risk Factors, and Behaviours of Gambling among Adolescents and Young People: A Literature Review and Gap Analysis

Gambling is occurring in a rapidly changing landscape, with new trends and technologies affecting gambling behaviour and problem gambling across a range of populations. Gambling activity among adolescents and young people has received considerable research attention due to a high prevalence of gambling reported among these groups in recent years. Despite legislation worldwide to constrain gambling among adolescents and young people, modern technology, such as online gaming apps and online gambling venues, has significantly increased their exposure to the risks of problem gambling. It is important, therefore, to have up to date information about what is currently known about gambling and to explore gaps in our knowledge. This gap analysis presents the results of a systematic approach to reviewing the current literature on gambling behaviour, attitudes, and associated risk factors for gambling and problem gambling among adolescents and young adults (aged 10-25 years). The review included studies published between January 2015 and August 2020 and included 85 studies for final synthesis. Findings reveal further research is needed on the implications for young people of emerging technologies and new trends in gambling in the digital age. The current gap analysis reveals that this should include more research on the development and impact of both treatment and intervention strategies, and policy and regulatory frameworks from a public health perspective.

Machine learning-based analysis of adolescent gambling factors

BACKGROUND AND AIMS

Problem gambling among adolescents has recently attracted attention because of easy access to gambling in online environments and its serious effects on adolescent lives. We proposed a machine learning-based analysis method for predicting the degree of problem gambling.

METHODS

Of the 17,520 respondents in the 2018 National Survey on Youth Gambling Problems dataset (collected by the Korea Center on Gambling Problems), 5,045 students who had gambled in the past 3 months were included in this study. The Gambling Problem Severity Scale was used to provide the binary label information. After the random forest-based feature selection method, we trained four models: random forest (RF), support vector machine (SVM), extra trees (ETs), and ridge regression.

RESULTS

The online gambling behavior in the past 3 months, experience of winning money or goods, and gambling of personal relationship were three factors exhibiting the high feature importance. All four models demonstrated an area under the curve (AUC) of >0.7; ET showed the highest AUC (0.755), RF demonstrated the highest accuracy (71.8%), and SVM showed the highest F1 score (0.507) on a testing set.

DISCUSSION

The results indicate that machine learning models can convey meaningful information to support predictions regarding the degree of problem gambling.

CONCLUSION

Machine learning models trained using important features showed moderate accuracy in a large-scale Korean adolescent dataset. These findings suggest that the method will help screen adolescents at risk of problem gambling. We believe that expandable machine learning-based approaches will become more powerful as more datasets are collected.

Gambling among 16-year-olds and associated covariates: A Nordic comparison

Aims: This study aimed to compare the prevalence in different gambling types as well as problem gambling in the Nordic countries, examining gambling, leisure activities, school truancy, parental relations and consumption of alcohol and other substances as covariates for problem gambling. Methods: Cross-country data were provided by the European Survey Project on Alcohol and Other Drugs (ESPAD) 2015. Prevalence of gambling and potential covariates were analysed for Denmark, Finland, Iceland Norway and Sweden (N=13,172 respondents aged 16 years), while analyses regarding problem gambling only included countries that participated in the optional questions on gambling problems (Denmark, Finland and Sweden; N=8108). We tested variables for problem gambling by bivariate logistic regression and multivariate logistic regression. Results: Cross-country differences were found in gambling and problem gambling, as well as differences in covariates for problem gambling. Sweden had the lowest rate of problem gambling. No significant difference was found between Denmark and Finland. Reports of too much gaming, inhalants, slots, betting and online gambling were positively associated with problem gambling, while parental monitoring and parental caring had a negative association. The relevance of the covariates varied across countries. Conclusions: Results indicate that although gambling regulation and its implementation have an important impact on gambling behaviour, we need more research on social, economic and cultural factors and how youth understand and interact with them. Contexts and regulations in other related fields should inform gambling research, policies and interventions.

Risk of problem gambling among occupational groups: A population and registry study

Aims:

To identify which occupational groups have elevated levels of regular gambling participation and at-risk and problem gambling, and to explore job-specific factors associated with elevated levels.

Methods:

Statistical analyses were performed on data from the 2015 Swedish population study on gambling and health. The principal registry variable was occupation, classified according to the Swedish version of the International Standard Classification of Occupations (ISCO-08). Two gambling variables were studied: regular gambling participation and at-risk and problem gambling, as measured by the Problem Gambling Severity Index (PGSI). For statistical regression analyses, socio-demographic data were used such as gender, income, and country of origin.

Results:

We found significant differences between occupational groups with regard to the two gambling variables. In general, manual jobs with predominantly male workers scored high, especially when there was no fixed workplace. Several significant differences remained when we controlled for gender. We also found support for three types of workers having elevated levels on the gambling variables: (1) building, construction and service, mobile, (2) vehicle drivers, and (3) monotonous manual indoor work. These results were confirmed by comparisons with propensity score matched controls.

Conclusion:

A policy implication of this study is that some occupational groups should be prioritised in the prevention of problem gambling. Theoretically, the study shows that occupational categories represent real-life cultures and contexts of gambling and non-gambling as distinct from the abstract socio-demographic factors that are usually considered in relation to gambling participation and problem gambling.

Factors associated with youth gambling: longitudinal study among high school students

OBJECTIVES

Non-substance addictive behaviours such as problem gambling among the youth have been a growing public health concern. However, the knowledge on risk and protective factors associated with this relatively new problem is still limited. It inhibits the development of informed preventive programs and interventions. The study was aimed at identifying psychosocial and behavioural factors associated with gambling involvement among 16- to 18-year-old adolescents.

STUDY DESIGN

Longitudinal study.

METHODS

The sample includes 511 adolescents (57.5% of men), who participated in a longitudinal study. Classrooms were randomly selected from public/non-public general, technical high schools and basic vocational schools from Warsaw. The self-administered anonymous questionnaire was completed during school lessons. Data reported in this study were from wave 1 (10th grade) and wave 2 (12th grade) with a response rate of about 65%. Gambling involvement was measured by combining a measure of six types of gambling behaviours and gambling-related problems in the last year. Gambling-related problems were measured by the Polish adaptation of the South Oaks Gambling Screen Revised for Adolescents. Both protective and risk factors measured in the study were selected from four broad domains representing (1) individual characteristic, (2) peer, (3) parental/familial and (4) school influences.

RESULTS

About 50% of students were involved in some form of gambling at least once in their lifetime. The most prevalent forms of gambling among study participants included lottery games, scratch cards, card games and participation in sports betting. Approximately 3-4% of adolescents have had symptoms of increased gambling involvement. Generalised linear model analysis showed that male gender, wave 1 gambling, sensation seeking, delinquency and cyberbullying were the risk factors. Positive relationships with parents and meaningful activities were found as protective factors against gambling involvement.

CONCLUSION

The results of our study indicate that prevention programs/interventions based on positive parent-child relation building and meaningful activities allowing satisfaction of the need to take risks in a socially acceptable manner can be effective in counteracting increased gambling involvement among youth.

Weapon-carrying is associated with more permissive gambling attitudes and perceptions and at-risk/problem gambling in adolescents

BACKGROUND AND AIMS

A recent call to action highlighted the need to understand the relationship between problem gambling, violence, and health/functioning. As weapon-carrying and gambling behaviors are prevalent in adolescents, this study systematically examined relationships between weapon-carrying status and measures of problem gambling severity and gambling perceptions and attitudes, as well as how weapon-carrying status moderated relationships between problem gambling severity and measures of health/functioning and gambling behavior.

METHODS

Participants were 2,301 Connecticut high-school adolescents. χ² and logistic regression models were conducted.

RESULTS

Weapon-carriers reported greater problem gambling severity, more permissive gambling perceptions, greater parental approval of gambling, and more family gambling concerns, compared to non-weapon-carriers. At-risk/problem gambling was more strongly associated with family, peers, and adult gambling partners among non-weapon-carriers (vs. weapon-carriers) and with machine gambling among weapon-carriers (vs. non-weapon-carriers).

DISCUSSION AND CONCLUSIONS

Greater problem gambling severity and more permissive gambling perceptions and perceived parental approval of gambling in weapon-carrying adolescents suggest that parent-child relationships are important to be considered in prevention efforts. The moderated relationship by weapon-carrying status between problem gambling severity and gambling partners suggests a problem gambling risk group that may be less linked to gambling with traditional social support groups, and this group may benefit from targeted interventions.

Gambling Behavior and Risk Factors in Preadolescent Students: A Cross Sectional Study

Although gambling was initially characterized as a specific phenomenon of adulthood, the progressive lowering of the age of onset, combined with earlier and increased access to the game, led researchers to study the younger population as well. According to the literature, those who develop a gambling addiction in adulthood begin to play significantly before than those who play without developing a real disorder. In this perspective, the main hypothesis of the study was that the phenomenon of gambling behavior in this younger population is already associated with specific characteristics that could lead to identify risk factors. In this paper, are reported the results of an exploratory survey on an Italian sample of 2,734 preadolescents, aged between 11 and 14 years, who replied to a self-report structured questionnaire developed ad hoc. Firstly, data analysis highlighted an association between the gambling behavior and individual or ecological factors, as well as a statistically significant difference in the perception of gambling between preadolescent, who play games of chance, and the others. Similarly, the binomial logistic regression performed to ascertain the effects of seven key variables on the likelihood that participants gambled with money showed a statistically significant effect for six of them. The relevant findings of this first study address a literature gap and suggest the need to investigate the preadolescent as a cohort in which it identifies predictive factors of gambling behavior in order to design effective and structured preventive interventions.

The use of self-management strategies for problem gambling: a scoping review

Background

Problem gambling (PG) is a serious public health concern that disproportionately affects people experiencing poverty, homelessness, and multimorbidity including mental health and substance use concerns. Little research has focused on self-help and self-management in gambling recovery, despite evidence that a substantial number of people do not seek formal treatment. This study explored the literature on PG self-management strategies. Self-management was defined as the capacity to manage symptoms, the intervention, health consequences and altered lifestyle that accompanies a chronic health concern.

Methods

We searched 10 databases to identity interdisciplinary articles from the social sciences, allied health professions, nursing and psychology, between 2000 and June 28, 2017. We reviewed records for eligibility and extracted data from relevant articles. Studies were included in the review if they examined PG self-management strategies used by adults (18+) in at least a subset of the sample, and in which PG was confirmed using a validated diagnostic or screening tool.

Results

We conducted a scoping review of studies from 2000 to 2017, identifying 31 articles that met the criteria for full text review from a search strategy that yielded 2662 potential articles. The majority of studies examined self-exclusion (39%), followed by use of workbooks (35%), and money or time limiting strategies (17%). The remaining 8% focused on cognitive, behavioural and coping strategies, stress management, and mindfulness.

Conclusions

Given that a minority of people with gambling concerns seek treatment, that stigma is an enormous barrier to care, and that PG services are scarce and most do not address multimorbidity, it is important to examine the personal self-management of gambling as an alternative to formalized treatment.

Electronic supplementary material

The online version of this article (10.1186/s12889-019-6755-8) contains supplementary material, which is available to authorized users.

Risk Factors Associated With Gambling Involvement among a National Sample of African American and European American Young Adults

In the current research, we examined the association of key risk and protective factors for gambling involvement from the domains of family environment, conduct problems/delinquency, substance use, and depressive psychopathology in a nationally representative sample. The sample was comprised of 13,291 young adults (ages 18-26; Meanage = 22.8) self-identifying as European American (n=9,939) or African American (n=3,335) who participated in Wave III (n = 15,170) of the restricted-use National Longitudinal Study of Adolescent to Adult Health. We used separate logistic regressions to study participation in specific gam bling categories (lottery games, casino-type games, other games). Childhood neglect, physical discipline, and current alcohol use was associated across each of the three gam bling categories. Our results also revealed differences between European American and African American subjects. Current cannabis use was associated with all three categories among African Americans, while current cigarette use was associated among European Americans for lottery games, and depression (female) was associated with other games. We also applied multinomial logistic regression to study gambling involvement based on the number of gam bling categories that the participant engaged in 2 or more (referent), only 1, or none at all. Our results revealed that delinquency/conduct symptoms (AOR=0.83) along with cannabis use (African American; AOR =0.66), cigarette use (European American; AOR =0.83), current alcohol use (AOR=0.66) were associated with gambling in two categories vs. gambling in one category. Childhood physical discipline (AOR=0.75) and childhood neglect (AOR=0.75) were associated with gam bling in two categories vs. no gambling. Further are needed to investigate the developmental pathways leading to increased gam bling involvement among African American and European American adolescents and young adults.

Gambling Disorder Treatment Referrals Within the Irish Mental Health Service: A National Survey Using Freedom of Information Requests

Gambling disorder is an increasingly recognised problem amongst healthcare professionals and the general public but there is little information on what services are provided within the Irish healthcare system for the disorder. The aim of the present study (adapted from a study in the UK by Rigbye and Griffiths [International Journal of Mental Health and Addiction, 9, 276–281, 2011] was to ascertain how referrals for gambling disorder are processed and what services are available for gambling disorder within the Irish healthcare system. Email requests for information on gambling disorder referrals were sent to the main super-catchment areas in Ireland known as Community Healthcare Organisations (CHOs) and part of the national Health Executive Service (HSE). Email requests were also sent to Primary Care services and Regional and Local Drug Task forces in Ireland. Each request asked a number of questions related to gambling disorder referrals (adapted from the study by Rigbye and Griffiths). Responses were received from seven of the nine CHOs (77.8%) and eight of the 24 Drug Task Forces (33.3%), as well as from Primary Care services. Four of the CHOs surveyed (50%) offered some form of service for gambling disorder as a part of their Community Mental Health Team (CMHT), most commonly through a Clinical Nurse Specialist (CNS) in Addictions. Referrals varied between 10 and 39 referrals in a 12-month period per CHO. Half of the Drug Task Forces surveyed offered a service for gambling disorder as part of their overall service and the majority offered onward referral to either a residential programme or a self-help organisation. Primary care services did not provide any specific services for gambling disorder. There is an evident need for a consistent and dedicated pathway for the referral and management of gambling disorder within the HSE.