Exploration of Intervention Strategies to Reduce Public Stigma Associated with Gambling Disorder

Effects of Positive versus Negative Framing on Stigma toward Individuals Recovering from Methamphetamine Use Disorder during Randomized Brief Video Exposure

Eighty-two Australians (mean age = 30.07; 61% female) were blindly randomized to view either a video edited to depict a positive or negative presentation of individuals in recovery from methamphetamine use disorder. Participants completed the Social Distance Scale for Substance Users, Dangerousness Scale for Substance Users and Affect Scale for Substance Users before and after video exposure. Following video exposure, those exposed to the positive video portrayal reported lower desire for social distance (p < .001), lower perceptions of dangerousness (p = .011), and more favorable affective reactions (p < .001). Participants' previous level of contact with the target group did not predict baseline stigma or moderate the experimental effect. Participants' qualitative responses to the experiment were assessed via content analysis and indicated mainly positive or ambivalent attitudes, unchanged by the video; however, 18% of those receiving the positive video reported attitudes becoming more sympathetic/favorable. Findings suggest that media depictions which include people with methamphetamine use disorder displaying friendliness and recovery narratives may improve community perceptions of people recovering from methamphetamine use disorder, and conversely, unsmiling portrayals focusing on harm done to others increases desire for social distance and perceived dangerousness.

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.

What Contributes to Public Stigma Towards Problem Gambling?: A Comparative Analysis of University Students in Australia, Canada, Croatia and Israel

Stigma refers to the attribution of negative sentiments towards a particular entity, object or individual. Stigma can be public, perceived, or self-referential and can have negative consequences for individuals, including losses of self-esteem, self-efficacy, social isolation and a reluctance to seek help. Problem gambling is known to be a stigmatized activity, but less is known about what factors are associated with this perception and how it might vary in different countries. The current study examines the relationship between perceived stigma towards problem gamblers and gambling attitudes. perceptions of gambling regulations, gambling involvement, perceived accessibility to gambling, and exposure to people with gambling problems. The sample comprised 1787 university students aged 18-30 years from four countries: Australia, Canada, Croatia and Israel. The results indicated that greater perceived stigma was associated with more negative gambling attitudes, less engagement with gambling, and lower perceived social accessibility (the perception that others approve of the activity). Respondents from Croatia, the country with a newer gambling market, reported the most stigma towards problem gamblers as compared with Australia and Canada where gambling is longer established. The findings appear consistent with exposure-adaptation theory, in which tolerance towards people with problem gambling can develop over time in line with greater social acceptance or familiarity with the activity and its consequences. It is suggested that community campaigns and educational programs draw a distinction between attitudes towards gambling in general and those who are negatively affected by the activity.

Making EGMs Accountable: Can an Informative and Dynamic Interface Help Players Self-regulate?

Electronic gaming machines (EGMs) are recognised as one of the most harmful gambling forms, because they promote high-speed repetitive gambling and automatically reinvest winnings. These features, amongst others, make it difficult for EGM gamblers to keep track of their play. Tools to assist gamblers exist, but have limited effectiveness because they require user registration and manual activation, leading to low uptake. The present study aimed to evaluate the effect of a more informative interface (including removal of automatic reinvestment of winnings) and pop-up messages on gambling behaviour, and on player experience. A total of 213 Australian participants, recruited through social media, played a simulated online EGM. The experiment was a two (standard vs. informative interface) × two (pop-ups absent vs. present) between-subjects design. The informative interface: promoted keeping track of spins played; increased accurate estimation of amount spent (as did pop-up messages) and time played; and provided game usage figures which acted as cues to quit play. Once the initial deposit (but not winnings) was expended, informative interface users could opt to reinvest their winnings, although many opted to exit at that point. No difference in total spending or dissociation was observed between experimental groups. Informative interface users reported no reduction in enjoyment. Pop-up messages reduced enjoyment with the standard interface, but increased enjoyment when paired with an informative interface. These findings indicate that a more informative interface and pop-up messages may be useful in reducing the harmful nature of EGMs.

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.