Youth at Stake: Alexithymia, Cognitive Distortions, and Problem Gambling in Late Adolescents

Gambling and virtual reality: unraveling the illusion of near-misses effect

Introduction

Studying gambling behavior is a crucial element in reducing the impact of problem gambling. Nevertheless, most current research is carried out in controlled laboratory settings rather than real-life situations, which raises concerns about how applicable the findings are in the broader context. Virtual reality (VR) has proven to be a valuable tool and has been utilized in various experimental scenarios. A limited number of studies have employed VR to investigate gambling behaviors, and few have explored them in an older adolescent context.

Methods

This study examined the behavioral and physiological effects of gambling behavior, including problem gambling, gaming addiction, and risk-taking decision-making in a sample of 36 high-school students aged between 18 to 20 years using an ad-hoc constructed VR scenario designed to simulate a slot-machine platform.

Results

The behavioral results highlighted that participants reporting more problem gambling were sensitive to near-misses: i.e., they bet more after near-misses than after losses. This result may reflect the false belief that gamblers, after near-misses, are closer to winning. Physiological data showed that participants exhibited heart rate deceleration during the anticipation of the outcome, which has been suggested to represent a marker of feedback anticipation processing and hyposensitivity to losses.

Discussion

Overall, this study provides evidence for a new VR tool to assess gambling behaviors and new insights into gambling-related behavioral and physiological factors. Implications for the treatment of problem gambling are discussed.

Gender and maladaptive personality correlates in problem gambling and over-indebtedness: Novel findings from a cross-sectional study in Sweden

Although most individuals consider gambling to be an innocent and fun activity, when it develops into problem gambling, it can have detrimental outcomes to one's life, such as over-indebtedness. This cross-sectional study explores the role of maladaptive personality traits and gender in both problem gambling and over-indebtedness, in an online sample of 1479 adult gamblers (65% males) in Sweden. Participants were administered the Problem Gambling Severity Index (PGSI), the Personality Inventory for DSM-5-Brief Form (PID-5-BF), and questions addressing subjective over-indebtedness and other risk factors. Quasi-Poisson loglinear models and logistic regression analyses demonstrated that Disinhibition (OR = 1.38, 95% CI [1.24, 1.53]), and Antagonism (OR = 1.23, 95% CI [1.14, 1.34]) showed the strongest associations to problem gambling, and that only Disinhibition (OR = 1.72, 95% CI [1.22, 1.43]) and Antagonism (OR = 2.00, 95% CI [1.52, 2.66]) were significantly related to over-indebtedness. The prevalence of problem gambling and over-indebtedness was more common among women, and gender moderated the univariate relationships of Negative Affectivity, Disinhibition and Psychoticism to problem gambling. These findings call for future research addressing maladaptive personality traits, problem gambling and over-indebtedness, and highlight the need for tailored interventions and prevention strategies, particularly for women who may be at higher risk.

Mentalizing Failures, Emotional Dysregulation, and Cognitive Distortions Among Adolescent Problem Gamblers

Over the past decade, several studies have investigated the relationship between cognitive distortions and emotion regulation among adolescent gamblers, demonstrating the exacerbating role of alcohol consumption when co-occurring with gambling problems. An important construct, that to date has been largely neglected, is mentalizing (i.e. the ability to reflect on one's own and others' mental states). The aim of the present study was (for the first time) to investigate the relative contribution of mentalization, emotional dysregulation, cognitive distortions, and alcohol consumption among adolescent gamblers. A total of 396 students (69.2% females) aged 14–19 years were recruited from secondary schools in Southern Italy. Assessment measures included the South Oaks Gambling Screen Revised for Adolescents (SOGS-RA), the Reflective Functioning Questionnaire (RFQ-8), the Difficulties in Emotion Regulation Scale (DERS), the Gambling Related Cognitions Scale (GRCS), and the Alcohol Use Disorders Identification Test (AUDIT). Regression analysis showed that, along with male gender, the best predictors of adolescent gambling were scores on two GRCS subscales (i.e., ‘inability to stop gambling’ and ‘interpretative bias’), the RFQ-8’s ‘uncertainty about mental states’ dimension, and the DERS ‘impulse control difficulties’ factor, with the overall model explaining more than one-third of the total variance. The results clearly indicated that, along with gambling-related cognitive distortions, uncertainty about mental states, and difficulties remaining in control of one’s behavior when experiencing negative emotions contributed significantly to problematic gambling among adolescents.

Chasing the desire: An investigation on the role of craving, time perspective, and alcohol use in adolescent gambling

Chasing, or continuing to gamble to recoup losses, is a behavioral marker and a diagnostic criterion for gambling disorder. Research on chasing has focused mainly on adults, whereas the analysis of chasing behavior among adolescents has not received empirical attention in the gambling literature. The aim of the present study was to first investigate the interplay between chasing behavior, craving, temporal perspective, alcohol use, and gambling severity among Italian adolescents. Three hundred and sixty-four adolescents took part in the study. Participants completed the South Oaks Gambling Screen Revised for Adolescents (SOGS-RA), the Gambling Craving Scale (GACS), the 14-item Consideration of Future Consequences scale (CFC-14), the Alcohol Use Disorders Identification Test (AUDIT), and performed a computerized task assessing chasing behavior. Participants were randomly assigned to the control and the loss condition of the computerized task. Results indicated that the choice to continue playing, as well as chasing frequency did not vary as a function of experimental condition. Hierarchical logistic and linear regression analyses revealed that the decision to chase depended mostly on craving, whereas chasing propensity was affected by craving and alcohol misuse. Notably, gambling severity did not predict either the decision to chase, or the chasing persistence. The present study contributes important findings to the gambling literature, highlighting the role of craving alcohol use in facilitating the inability to stop within-sessions gambling among adolescents. These findings may provide evidence that nonchasers and chasers represent two different types of gamblers, and that the difference may be useful for targeting more effective therapies.

Cognitive Distortions in Gamblers and Non-gamblers of a Representative Spanish Sample

Cognitive biases or distortions related to gambling, present in all people, are considered a relevant factor in the development of gambling-related problems.

OBJECTIVE

to establish whether the presence of these biases or cognitive distortions, in gamblers and non-gamblers, is related to the presence of gambling problems.

METHOD

3000 people aged 18-81 years, representative of the Spanish adult population, underwent a structured survey.

RESULTS

the presence of distortions was relevant to distinguish gamblers according to their level of gambling engagement and problems. There is a constant and significant tendency to have more cognitive distortions as gambling problems increase. But not all distortions have the same ability to distinguish between the different groups of gamblers. The results seem to group gamblers into three groups according to the presence of cognitive distortions, from less to more: (1) non-gamblers, (2) low-risk and at-risk gamblers, and (3) problem and pathological gamblers. The relevance of this research and its practical implications for both treatment and prevention work is discussed.

Gambling Problems and Alexithymia: A Systematic Review

Among the factors that are thought to underlie gambling problems, alexithymia has been recognized to contribute to their development. For the first time, we reviewed the literature on the relationship between alexithymia and gambling. A systematic search of literature was run in the major reference databases including PubMed, Cochrane Database for Systematic Review, PsycINFO, Web of Science, Scopus until April 2019. The search produced 182 articles that produced 20 papers included in the review. Fourteen studies were conducted with community samples of pathological gamblers while six studies with clinical samples of disordered gamblers. All studies assessed alexithymia with the Toronto Alexithymia Scale while gambling problems were assessed mostly with the South Oaks Gambling Screen. Alexithymic features were significantly more prevalent in pathological gamblers both at the community and clinical levels, increased symptom severity, and showed interactive mechanisms with personality, psychiatric, and cognitive factors. Alexithymia is likely to associate with gambling as a coping behavior to increase emotional arousal and avoid negative emotions, according to the affect dysregulation model. Further studies are needed to widen the knowledge on this association.

The paradoxical relationship between emotion regulation and gambling-related cognitive biases

Background

Gambling behavior presents substantial individual variability regarding its severity, manifestations, and psychological correlates. Specifically, differences in emotion regulation, impulsivity, and cognitive distortions have been identified as crucial to describe individual profiles with implications for the prevention, prognosis, and treatment of gambling disorder (GD).

Aims and method

The aim of the present study was to investigate the associations of gambling-related cognitions (measured according to the GRCS model) with impulsivity (UPPS-P model) and emotion regulation (CERQ model), in a sample of 246 gamblers with different levels of gambling involvement, using mixed-effects modelling to isolate theoretically relevant associations while controlling for the potentially confounding effects of sociodemographic and clinical covariates.

Results

Affective/motivational dimensions of UPPS-P impulsivity positive urgency and sensation seeking, on the one hand, and CERQ emotion regulation strategies reappraisal, rumination and blaming others, on the other, independently and significantly predicted distorted gambling-related cognitions.

Conclusions

These results (a) reinforce the ones of previous studies stressing the relevance of emotional and motivational processes in the emergence of gambling-related cognitive distortions; and (b) replicate the seemingly paradoxical finding that gamblers use emotion regulation strategies customarily considered as adaptive (i.e. reappraisal) to strengthen and justify their biased beliefs about gambling outcomes and controllability.

Decision-Making Styles, Negative Affectivity, and Cognitive Distortions in Adolescent Gambling

Evidences from the extant literature suggest that problem gamblers show higher cognitive distortions and reported experiencing higher levels of negative affective states than recreational gamblers. Furthermore, several studies reported that the more the gambling severity, the poorer the performance in behavioral tasks assessing affective decision-making. Although gambling research on decision-making has mostly focused on the functional or dysfunctional outcomes of the decisional process, no study examined the role of decision-making styles in gambling disorder. This study aimed to first investigate the interplay among negative affectivity, cognitive distortions, and decision-making styles in adolescent problem gambling. Four hundred and twenty-five adolescents, aged between 14 and 19 years, completed the South Oaks Gambling Screen Revised for Adolescents to assess problem gambling, the Depression Anxiety and Stress Scales-21 to measure negative affective states, and the Gambling Related Cognitions Scale as a measure of cognitive distortions about gambling, and the General Decision-Making Style tapping habitual patterns which individuals use in decision-making. Data were submitted to correlational analysis, univariate and mixed-model ANOVAs, and hierarchical regression analysis. Regression analysis indicated that, along with gender, interpretative bias and inability to stop gambling, depression, and spontaneous decision-making style significantly predicted gambling severity. These results extend further previous studies on the role of misconceptions about gambling, and negative affective states in adolescent gambling, and, interestingly, first demonstrate that also maladaptive decision-making styles may represent a risk factor for gambling disorder.

An experimental investigation of the role of delay discounting and craving in gambling chasing behavior

Chasing is a central feature of gambling disorder and refers to the attempt by individuals to recover financial losses by continuing to gamble. Although several efforts have been made to individuate the factors involved in the complex phenomenon of chasing, little is known regarding its association with delay discounting and craving, both considered important in the development and maintenance of gambling disorder. In the present study, the interplay between chasing, delay discounting, and craving (while controlling for gambling severity) was investigated. The sample comprised 128 adult gamblers aged between 18 and 67 years and consisted of non-problem gamblers (n = 58), problem gamblers (n = 18), and pathological gamblers (n = 52) based on the South Oaks Gambling Screen (SOGS) scores. Participants were administered the Monetary Choice Questionnaire (MCQ) and the Gambling Craving Scale (GACS), as well as completing the ChasIT, a computerized task assessing chasing behavior. Participants were randomly assigned to the control and the loss condition of the ChasIT. Results showed that pathological gamblers were more likely to chase and reported more severe chasing persistence. Regression analyses indicated that heightened levels of craving and the inability to tolerate delay in gratification, along with gambling severity, predicted both the decision to chase and chasing persistence. The present study contributes important findings to the gambling literature, highlighting the role of craving and delay discounting in facilitating the inability to stop within-sessions gambling. These findings may provide evidence that chasers and non-chasers represent two different types of gamblers, and that the difference may be useful for targeting more effective therapies.

The steamy mirror of adolescent gamblers: Mentalization, impulsivity, and time horizon

This study aimed to first investigate the role that general impairment in mentalization plays in gambling disorder and to analyze the interplay among mentalizing, impulsivity, and time perspective in adolescent gambling. Four hundred and ten late adolescents took part in the study. Participants were administered the South Oaks Gambling Screen Revised for Adolescents (SOGS-RA), the Reflective Functioning Questionnaire (RFQ-8), the Functional and Dysfunctional Impulsivity Scale (FDIS), and the 14-item Consideration of Future Consequences scale (CFC-14). The results showed that male adolescents are far more likely at-risk/problem gamblers than female adolescents. Furthermore, data indicated that the higher the gambling severity, the higher the dysfunctional impulsivity and the shorter the time horizon. Linear regression analysis showed that impairments in mentalizing represent a significant predictor of gambling severity. Finally, to clarify if dysfunctional impulsivity was on the path from uncertain mentalizing to gambling severity or if mentalizing was the mediator of the impact of functional impulsivity on gambling severity, data were submitted to path analysis. Results indicated that deficit in mentalizing has a direct effect on gambling severity and mediates the association between dysfunctional impulsivity and gambling involvement. The relation between gambling severity and RFQ-8 scores suggests that general impairment in mentalizing plays a key role in adolescent problematic gambling.

Tempting fate: Chasing and maladaptive personality traits in gambling behavior

Chasing, or continuing to gamble in an attempt to recoup losses, is a salient feature of problematic gambling. This study, which controlled for gambling severity and alcohol consumption, investigated the association between chasing and maladaptive personality trait domains among habitual gamblers. Participants comprised 126 adult habitual gamblers (73% males) aged between 18 and 69 years. They were administered the South Oaks Gambling Screen (SOGS), the Personality Inventory for DSM-5-Brief Form (PID-5-BF), the Alcohol Use Disorders Identification Test (AUDIT), and a computerized task developed to assess chasing behavior. Participants were randomly assigned to two chasing conditions (Control and Loss). Data were submitted to correlational analysis, univariate and mixed-model ANOVAs, logistic and linear regression analyses. Results showed that the decision to chase was strongly associated with the PID-5-BF Disinhibition domain scores, whereas chasing proneness was related to the Disinhibition, Detachment and Psychoticism domains. Interestingly, chasers scored higher than nonchasers on maladaptive personality dimensions, even after controlling for gender, age, chasing condition, alcohol consumption, and gambling severity. Since these findings support the idea that chasers and nonchasers are different subtypes of gamblers, clinical interventions should take into account the additive role of chasing in gambling disorder.

Conceptualizing gambling disorder with the process model of emotion regulation

Introduction Nowadays, gambling disorder (GD) is a worldwide health issue and there is a growing need to both improve our understanding of this disorder and to tailor specific interventions for its treatment. Moreover, theoretical models and preliminary empirical results suggest that difficulty in regulating emotional states might be involved in GD. However, literature describing clinical and theoretical aspects of emotional dysregulation among pathological gamblers (PGs) shows a lack of systematic description. Objectives We aimed to provide, within an exhaustive theoretical framework of emotion regulation (ER) processing, empirical evidence supporting a conceptual model of GD as an ER affliction. Methods We commented on empirical evidence on the relationship between ER and GD in the light of two main conceptual models of emotion (dys)regulation. Results The results suggest there are actual deficits of ER processing among PGs, manifesting themselves through different ways and in different steps of the ER timeline. In addition, dysregulation of positive emotions may play a central role in GD. From a clinical point of view, we pointed out that deficits in ER might be multiple in nature and an assessment for GD should be accurate to identify the specific components accounting for the development and maintenance of the disorder. It should also orientate the clinician in selecting therapeutic objectives. Conclusions The nature of emotional states that are difficult to regulate might account for the GD severity and indicate the subtype of PGs the patient belongs to. Treatment programs should be tailored on the specificity of PGs.

The Blurred Future of Adolescent Gamblers: Impulsivity, Time Horizon, and Emotional Distress

The main purpose of this study was to investigate the interplay of functional and dysfunctional impulsivity, delay discounting, time perspective, and emotional negative states on gambling severity in Italian adolescents. A second aim of the study was to analyze the developmental trajectories of gambling involvement, functional and dysfunctional impulsivity, delay discounting, consideration of future consequences, and negative affectivity in a cross-sectional perspective. One thousand and ten Italian adolescents aging between 12 and 19 years were administered the South Oaks Gambling Screen Revised for Adolescents (SOGS-RA), the Functional and Dysfunctional Impulsivity Scale (FDIS), the Monetary Choice Questionnaire (MCQ), the Consideration of Future Consequences Scale (CFC-14), and the Depression, Anxiety and Stress Scales-21 (DASS-21). Data analyses were conducted using correlational analysis, Chi-square test, analysis of variance, and hierarchical regression analysis. Results indicated that, relative to non-gamblers and non-problem gamblers, at-risk and problem gamblers showed higher levels of impulsivity, steeper delay discounting, shorter time horizon, and reported experiencing significantly higher levels of depression, anxiety, and stress. Results of hierarchical regression analysis, with SOGS-RA scores as the dependent variable, and gender, age, FDIS, MCQ, CFC-14, and DASS-21 scores as independent variables, indicated that, along with gender and age, low scores of future orientation and high scores of dysfunctional impulsivity, depression, anxiety, present orientation, and delay discounting significantly predicted gambling severity. These findings provide further evidence that the higher the gambling involvement, the greater the tendency to devalue delayed rewards and to focus on the immediate consequences of one's behavior. Interestingly, for the first time these results reveal an association between gambling severity and both dysfunctional impulsivity and negative affective states across adolescence. Finally, results of cross-sectional analyses suggest that gambling severity contributes more than age in shaping the developmental trajectories of functional and dysfunctional impulsivity, delay discounting, time perspective, and negative affective states.

Decision making, cognitive distortions and emotional distress: A comparison between pathological gamblers and healthy controls

BACKGROUND AND OBJECTIVES

The etiology of problem gambling is multifaceted and complex. Among others factors, poor decision making, cognitive distortions (i.e., irrational beliefs about gambling), and emotional factors (e.g., negative mood states) appear to be among the most important factors in the development and maintenance of problem gambling. Although empirical evidence has suggested that cognitive distortions facilitate gambling and negative emotions are associated with gambling, the interplay between cognitive distortions, emotional states, and decision making in gambling remains unexplored.

METHODS

Pathological gamblers (N = 54) and healthy controls (N = 54) completed the South Oaks Gambling Screen (SOGS), the Iowa Gambling Task (IGT), the Gambling Related Cognitions Scale (GRCS), and the Depression Anxiety Stress Scale (DASS-21).

RESULTS

Compared to healthy controls, pathological gamblers showed poorer decision making and reported higher scores on measures assessing cognitive distortions and emotional distress. All measures were positively associated with gambling severity. A significant negative correlation between decision making and cognitive distortions was also observed. No associations were found between poor decision making and emotional distress. Logistic regression analysis indicated that cognitive distortions, emotional distress, and poor decision making were significant predictors of problem gambling.

LIMITATIONS

The use of self-report measures and the absence of female participants limit the generalizability of the reported findings.

CONCLUSIONS

The present study is the first to demonstrate the mutual influence between irrational beliefs and poor decision making, as well as the role of cognitive bias, emotional distress, and poor decision making in gambling disorder.

Psychometric properties of the Gambling Related Cognitions Scale (GRCS) in young Italian gamblers

INTRODUCTION

The involvement in gambling activities is increasing among adolescents, together with the risk of developing gambling problems. Given the important role of erroneous beliefs on adolescent problematic gambling behavior, the aim of this study was to investigate the adequacy of the Gambling Related Cognitions Scale (GRCS; Raylu & Oei, 2004) to assess gambling-related distortions among youth in Italy.

METHODS

The scale was administered to 1656 Italian high school students (65% males, mean age=16.15 years, SD=1.44), and analyses were carried out with respondents who have gambled during the previous year (N=1224).

RESULTS

The adequacy of the five-factor model was confirmed (both among male and female adolescent gamblers), as well as the reliability of the total scale and subscales. Evidence for the validity of the GRCS among adolescents was provided confirming the relationship between gambling-related cognitions and problem gambling found in previous studies. Research on the validity of the scale was also extended by investigating the relationship between cognitive distortions about gambling and the frequency of engaging in different gambling activities.

CONCLUSIONS

Our results confirm that the GRCS is an effective multidimensional instrument which accurately measures young gamblers' cognitive distortions relating to gambling. As such, it can be used as a useful tool in the assessment and treatment of juvenile gambling.