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Clune S, Ratnaike D, White V, Donaldson A, Randle E, O'Halloran P, Lewis V. What is known about population level programs designed to address gambling-related harm: rapid review of the evidence. Harm Reduct J 2024; 21:118. [PMID: 38890632 PMCID: PMC11184756 DOI: 10.1186/s12954-024-01032-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2024] [Accepted: 06/02/2024] [Indexed: 06/20/2024] Open
Abstract
BACKGROUND Gambling and gambling-related harm attract significant researcher and policy attention. The liberalisation of gambling in most western countries is strongly associated with a marked rise in gambling activity and increases in gambling-related harm experienced at the population level. Programs to address gambling-related harm have traditionally focused on individuals who demonstrate problematic gambling behaviour, despite clear evidence of the effectiveness of a public health approach to high-risk activities like gambling. Little is known about the availability or efficacy of programs to address gambling-related harm at a population level. METHODS The Victorian Responsible Gambling Foundation commissioned a rapid evidence review of the available evidence on programs designed to reduce gambling-related harm at a population level. The review was conducted using a public health and harm reduction lens. MEDLINE, ProQuest Central and PsychInfo databases were searched systematically. Included studies were published in English between 2017 - 2023 from all countries with gambling policy contexts and public health systems comparable to Australia's; included primary data; and focused on primary and/or secondary prevention of gambling-related harm or problems. RESULTS One hundred and sixty-seven articles were eligible for inclusion. Themes identified in the literature included: risk and protective factors; primary prevention; secondary prevention; tertiary prevention; target population group; and public health approach. The evidence review revealed a gap in empirical evidence around effective interventions to reduce gambling-related harm at the population level, particularly from a public health perspective. CONCLUSIONS Addressing gambling-related harm requires a nuanced, multi-layered approach that acknowledges the complex social, environmental, and commercial nature of gambling and associated harms. Moreover, evidence demonstrates community programs to reduce gambling-related harm are more successful in reducing harm when based on sound theory of co-design and address the social aspects that contribute to harm.
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Affiliation(s)
- Samantha Clune
- Australian Institute for Primary Care & Ageing (AIPCA), La Trobe University, Melbourne Campus, Victoria, 3086, Australia.
| | - Deepika Ratnaike
- Australian Institute for Primary Care & Ageing (AIPCA), La Trobe University, Melbourne Campus, Victoria, 3086, Australia
| | - Vanessa White
- Australian Institute for Primary Care & Ageing (AIPCA), La Trobe University, Melbourne Campus, Victoria, 3086, Australia
| | - Alex Donaldson
- Centre for Sport and Social Impact (CSSI), La Trobe Business School, La Trobe University, Melbourne Campus, Victoria, 3086, Australia
| | - Erica Randle
- Centre for Sport and Social Impact (CSSI), La Trobe Business School, La Trobe University, Melbourne Campus, Victoria, 3086, Australia
| | - Paul O'Halloran
- Centre for Sport and Social Impact (CSSI), La Trobe Business School, La Trobe University, Melbourne Campus, Victoria, 3086, Australia
- School of Psychology and Public Health, La Trobe University, Melbourne Campus, Victoria, 3086, Australia
| | - Virginia Lewis
- Australian Institute for Primary Care & Ageing (AIPCA), La Trobe University, Melbourne Campus, Victoria, 3086, Australia
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Malkin ML, Stacey M. Gambling Behavior Among LGBTQ + Individuals: The Role of Gender and Gender Identity. J Gambl Stud 2024; 40:1037-1060. [PMID: 38082023 DOI: 10.1007/s10899-023-10272-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/15/2023] [Indexed: 07/26/2024]
Abstract
While past literature suggests that LGBTQ + individuals may be at a greater risk for gambling related-harms and addiction, few studies have specifically looked at gambling behavior among LGBTQ + persons based on gender and gender identity. A study of LGBTQ + individuals in four U.S. States was conducted to assess differences in gender and gender identity for (1) gambling prevalence; (2) gambling behavior based on type and location; and (3) comorbidity with substance abuse and/or other problematic behaviors. Individuals assigned male at birth had greater prevalence of gambling than those assigned female at birth, regardless of current gender identity. Gender identity, on its own, is only significant for certain types of gambling and in some analysis only when combined with gender assigned at birth. Findings suggest that gender assigned at birth has a stronger relationship with gambling prevalence and behavior than adult gender identity.
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Affiliation(s)
- Michelle L Malkin
- Department of Criminal Justice and Criminology, East Carolina University, 238 Rivers Building, Greenville, NC, 27858, USA.
| | - Michele Stacey
- Department of Criminal Justice and Criminology, East Carolina University, 238 Rivers Building, Greenville, NC, 27858, USA
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Lee BN, Grubbs JB. Problem gambling within sexual and gender minorities: A systematic review. Addict Behav 2023; 144:107742. [PMID: 37121088 DOI: 10.1016/j.addbeh.2023.107742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 02/24/2023] [Accepted: 04/20/2023] [Indexed: 05/02/2023]
Abstract
A body of literature now suggests that sexual and gender minorities (SGMs) experience a distinct set of stressors in the form of minority stress, which may function as a risk factor for the development of negative psychological and behavioral health outcomes. A systematic review of the literature was conducted through June 1st, 2022. Inclusion was limited to peer-reviewed publications in academic journals, with prospective and retrospective studies of a quantitative nature included for synthesis. Articles were required to contain an empirical measure of gambling cognitions, behaviors, motives, or outcomes. Studies that did not include sexual minorities within the sample or did not provide quantitative results which shed light on gambling in sexual minorities were excluded from the present review.In total, 12 eligible studies were identified for the current review. In general, this review highlighted methodological weaknesses within the literature and suggested that little is known about gambling in this population. Given conflicting findings across studies, further research is necessary to understand gambling in sexual and gender minorities. From a methodological standpoint, there is a need for clearer conceptualization and standardized measurement of gambling-related variables in vulnerable populations. Further, longitudinal research would be beneficial to understand the nuances of gambling disorder across sexual orientations and gender identities, as well as aid in the development of holistic intervention options that meet the needs of these more vulnerable groups.
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Affiliation(s)
- Brinna N Lee
- Department of Psychology, 822 E Merry Ave, Bowling Green State University, Bowling Green, OH 43403, USA.
| | - Joshua B Grubbs
- Department of Psychology, 822 E Merry Ave, Bowling Green State University, Bowling Green, OH 43403, USA
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Brodeur M, Roberge P, Cotton JC, Monson E, Morvannou A, Poitras ME, Lacasse A, Jutras-Aswad D, Couturier Y, Loignon C, Audette-Chapdelaine S, Auger AM, Bertrand K, Dorceus S, Simon O, Hudon C. Experience of LGBTQIA2S+ populations with gambling during the COVID-19 pandemic: protocol for a mixed-methods study. BMJ Open 2023; 13:e066231. [PMID: 36754562 PMCID: PMC9922879 DOI: 10.1136/bmjopen-2022-066231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/10/2023] Open
Abstract
INTRODUCTION Research undertaken since the beginning of the COVID-19 pandemic has provided us information about the impact of the pandemic on the gambling habits of the general population. However, very little is known about certain subgroups at increased risk of developing gambling disorder, such as the LGBTQIA2S+ population. The purpose of this study is to describe the impact of the COVID-19 pandemic on gambling behaviours among LGBTQIA2S+ individuals. In addition, we want to understand the experiences of the LGBTQIA2S+ population with gambling disorder and identify interventions that LGBTQIA2S+ people have found to be effective in addressing problem gambling during the COVID-19 pandemic. METHODS AND ANALYSIS This study has a sequential explanatory mixed-method design in two phases over 2 years. The first phase is a correlational study. We will conduct a cross-sectional survey using a stratified random sampling among Canadian residents who are 18 years of age or older, self-identify as sexually and gender-diverse (ie, LGBTQIA2S+) and have gambled at least once in the previous 12 months. This survey will be administered online via a web panel (n=1500). The second phase is a qualitative study. Semistructured interviews will be conducted with LGBTQIA2S+ people with problematic gambling (n=30). ETHICS AND DISSEMINATION This research project has been ethically and scientifically approved by the Research Ethics Committee and by the CIUSSS de l'Estrie-CHUS scientific evaluation committee on 3 March 2022 (reference number: 2022-4633-LGBTQ-JHA). Electronic and/or written informed consent, depending on the data collection format (online survey and online or in-person interviews), will be obtained from each participant. A copy of the consent form and contact information will be delivered to each participant.
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Affiliation(s)
- Magaly Brodeur
- Department of Family Medecine and Emergency Medecine, Université de Sherbrooke, Sherbrooke, Quebec, Canada
| | - Pasquale Roberge
- Department of Family Medecine and Emergency Medecine, Université de Sherbrooke, Sherbrooke, Quebec, Canada
| | - Julie-Christine Cotton
- Department of Community Health Sciences, Université de Sherbrooke, Sherbrooke, Quebec, Canada
| | - Eva Monson
- Department of Community Health Sciences, Université de Sherbrooke, Sherbrooke, Quebec, Canada
| | - Adele Morvannou
- Department of Community Health Sciences, Université de Sherbrooke, Sherbrooke, Quebec, Canada
| | - Marie-Eve Poitras
- Department of Family Medecine and Emergency Medecine, Université de Sherbrooke, Sherbrooke, Quebec, Canada
| | - Anaïs Lacasse
- Department of Health Sciences, Université du Québec en Abitibi-Témiscamingue, Rouyn-Noranda, Quebec, Canada
| | - Didier Jutras-Aswad
- Department of Psychiatry and Addiction, Université de Montréal, Montreal, Quebec, Canada
| | - Yves Couturier
- School of Social Work, Universite de Sherbrooke, Sherbrooke, Quebec, Canada
| | - Christine Loignon
- Department of Family Medecine and Emergency Medecine, Université de Sherbrooke, Sherbrooke, Quebec, Canada
| | - Sophie Audette-Chapdelaine
- Department of Family Medecine and Emergency Medecine, Université de Sherbrooke, Sherbrooke, Quebec, Canada
| | - Anne-Marie Auger
- Department of Family Medecine and Emergency Medecine, Université de Sherbrooke, Sherbrooke, Quebec, Canada
| | - Karine Bertrand
- Department of Community Health Sciences, Université de Sherbrooke, Sherbrooke, Quebec, Canada
| | - Sabruna Dorceus
- Department of Career Counseling, Universite de Sherbrooke, Sherbrooke, Quebec, Canada
| | - Olivier Simon
- Department of Psychiatry, Lausanne University Hospital, Lausanne, Vaud, Switzerland
| | - Catherine Hudon
- Department of Family Medecine and Emergency Medecine, Université de Sherbrooke, Sherbrooke, Quebec, Canada
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Karvonen M, Karukivi M, Kronström K, Kaltiala R. The nature of co-morbid psychopathology in adolescents with gender dysphoria. Psychiatry Res 2022; 317:114896. [PMID: 37732850 DOI: 10.1016/j.psychres.2022.114896] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 10/07/2022] [Accepted: 10/08/2022] [Indexed: 10/31/2022]
Abstract
Gender-referred adolescents (GR) have been reported to present with considerable psychiatric symptomatology compared to their age-peers. There is, however, little research on how they compare to adolescents referred due to mental health problems (MHR). We set out to compare psychopathology in adolescents referred to our specialized gender identity unit (n = 84) and adolescents referred to a general adolescent psychiatric clinic (n = 293) in a university hospital setting in Finland. Of the GR adolescents, 40.9% had not received any psychiatric diagnosis during adolescence. Eating disorders were less common in the GR than in the MHR group, but otherwise the prevalences of disorders did not differ statistically significantly. At the symptom level, the GR adolescents displayed significantly more suicidal ideation and talk and less alcohol abuse and eating disorder symptoms than did the MHR adolescents, but otherwise their symptom profiles were comparable. Additionally, the GR adolescents had significantly fewer total externalizing symptoms than did the MHR adolescents. Adolescents seeking gender affirming treatments present with psychiatric symptoms and disorders comparable to those seen among adolescent psychiatric patients. Medical gender affirming care may not be a sufficient intervention for treating psychiatric comorbidities of adolescents with gender dysphoria.
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Affiliation(s)
- M Karvonen
- Department of Adolescent Psychiatry, Tampere University Hospital, Tampere, Finland.
| | - M Karukivi
- Department of Adolescent Psychiatry, University of Turku and Turku University Hospital, Turku, Finland
| | - K Kronström
- Department of Adolescent Psychiatry, University of Turku and Turku University Hospital, Turku, Finland
| | - R Kaltiala
- Department of Adolescent Psychiatry, Tampere University Hospital, Tampere, Finland; Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland; Vanha Vaasa Hospital, Vaasa, Finland
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Mattelin E, Fröberg F, Korhonen L, Khanolkar AR. Health and health-related behaviours in refugees and migrants who self-identify as sexual or gender minority - A National population-based study in Sweden. EClinicalMedicine 2022; 52:101641. [PMID: 36313143 PMCID: PMC9596319 DOI: 10.1016/j.eclinm.2022.101641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2022] [Revised: 08/12/2022] [Accepted: 08/12/2022] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND To examine health and health-related behaviors in migrant and refugee individuals who identify as sexual or gender minority, and in comparison to their heterosexual peers. METHODS The study included 168,952 individuals (aged 16-84 years, males: 45·9%, sexual or gender minorities: 3·1%) who answered the Swedish National Public Health Survey in 2018 and 2020. Participants were grouped into Swedish-and Western-born (White) heterosexual, White sexual- or gender minority, migrant heterosexual, migrant sexual- or gender minority, refugee heterosexual, and refugee sexual- or gender minority. Outcomes included mental health (for example suicidal ideation, wellbeing), general health, risky behaviors (risk alcohol use, risk gambling, and substance use), and experiences of violence. Associations between 1) sexual- or gender -ethnic identities and 2) gender-ethnic identities and all outcomes were analyzed using logistic and linear regression adjusting for sex, age, and educational level. FINDINGS Being a sexual- or gender minority, regardless of ethnic minority status, was associated with worse general health and mental ill-health compared to heterosexual peers including suicidal ideation in refugee sexual- or gender minority individuals (OR 2·42, 95 % CI 1·44-4·08). Ethnic minorities (heterosexual and sexual- or gender minority migrants and refugees) had lower odds of drug and risk alcohol use compared to White heterosexual peers but higher odds of risk gambling (1·88, 1·49-2·37 for refugee heterosexuals). Transgender refugees had high odds for risk gambling (8·62, 1·94-38·40) and exposure to physical violence (7·46, 2·97-18·70). INTERPRETATION In this national population-based study, sexual and gender minority individuals have worse mental and general health regardless of ethnic minority status. We did not find evidence for worse health in sexual- or gender minority refugees in comparison to migrant, and White sexual- or gender minorities and their heterosexual peers. Transgender individuals (White and ethnic minority) experienced significantly higher levels of physical violence. Public health policy should emphasize preventive measures to reduce exposure to violence and discrimination in sexual- and gender minority individuals, increase access and use of mental healthcare services and sensitise healthcare professionals about higher rates of health and related issues faced by sexual- and gender minority individuals including those with multiple minority identities. FUNDING We received no external funding for this study and hence the funder had no role in the study design, data collection, data analysis, data interpretation, writing of the manuscript and the decision to submit.
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Affiliation(s)
- Erica Mattelin
- Barnafrid, Swedish National Center on Violence Against Children, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
- Center for Social and Affective Neuroscience, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
- Corresponding author.
| | - Frida Fröberg
- Barnafrid, Swedish National Center on Violence Against Children, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Laura Korhonen
- Barnafrid, Swedish National Center on Violence Against Children, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
- Center for Social and Affective Neuroscience, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
- Department of Child and Adolescent Psychiatry and Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Amal R. Khanolkar
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
- Department of Population Health Sciences, School of Life Course & Population Sciences, King's College London, London, United Kingdom
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Ruppert R, Kattari SK, Sussman S. Review: Prevalence of Addictions among Transgender and Gender Diverse Subgroups. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18168843. [PMID: 34444595 PMCID: PMC8393320 DOI: 10.3390/ijerph18168843] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 08/16/2021] [Accepted: 08/17/2021] [Indexed: 12/25/2022]
Abstract
We conducted an analysis of the prevalence of substance and behavioral addictions across different transgender and gender diverse (TGD) subgroups. We performed a scoping review using MEDLINE and Google Scholar databases and examined 12 addictions, including alcohol, nicotine, cannabis, illicit drugs, gambling, eating/food, internet, sex, love, exercise, work, and shopping. We presented prevalence rates for each addiction as a function of an individual’s gender identity (stratified into transgender females, transgender males, and gender nonconforming), and used cisgender women and men as reference groups. We included 55 studies in our final analysis, the majority of which investigated substance use disorders among TGD subgroups. Overall findings indicated that substantial differences in substance use exist among US TGD subgroups. There were far fewer publications that examined the prevalence of behavioral addictions across TGD subgroups. However, despite limited research in this area, findings still suggest that notable differences in behavioral addictions may exist between individual TGD subgroups. The conclusions of our review may provide clinicians with a better ability to screen for and treat at-risk individuals within the TGD community.
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Affiliation(s)
- Ryan Ruppert
- Keck School of Medicine of USC, Los Angeles, CA 90033, USA;
- Correspondence: or ; Tel.: +1-302-358-6852
| | - Shanna K. Kattari
- School of Social Work, University of Michigan, Ann Arbor, MI 48109, USA;
| | - Steve Sussman
- Keck School of Medicine of USC, Los Angeles, CA 90033, USA;
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Riley BJ, Oster C, Rahamathulla M, Lawn S. Attitudes, Risk Factors, and Behaviours of Gambling among Adolescents and Young People: A Literature Review and Gap Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:984. [PMID: 33499418 PMCID: PMC7908209 DOI: 10.3390/ijerph18030984] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Revised: 01/19/2021] [Accepted: 01/20/2021] [Indexed: 01/10/2023]
Abstract
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.
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Affiliation(s)
- Ben J. Riley
- College of Medicine and Public Health, Flinders University, Adelaide, SA 5042, Australia; (B.J.R.); (C.O.)
| | - Candice Oster
- College of Medicine and Public Health, Flinders University, Adelaide, SA 5042, Australia; (B.J.R.); (C.O.)
| | - Mubarak Rahamathulla
- Faculty of Health and Medical Sciences, Social Work, University of Western Australia, Perth, WA 6000, Australia;
| | - Sharon Lawn
- College of Medicine and Public Health, Flinders University, Adelaide, SA 5042, Australia; (B.J.R.); (C.O.)
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King DL, Russell A, Hing N. Adolescent Land-Based and Internet Gambling: Australian and International Prevalence Rates and Measurement Issues. CURRENT ADDICTION REPORTS 2020. [DOI: 10.1007/s40429-020-00311-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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