Risk factors for pathological gambling

Gambling in a U.S. Census Matched Sample: Examining Interactions between Means and Motives in Predicting Problematic Outcomes

The influence of socioeconomic status (SES) on risk of Problem Gambling (PG) is complex, particularly given recent evidence that SES should be understood in both objective and subjective terms. Likewise, financial gambling motives have been found to be predictive of PG; however, financial motives are less understood in comparison to other gambling motives. Preliminary findings on SES and gambling points towards a pattern of social inequality in which those with the least financial resources (e.g., income) or that feel financially deprived relative to others (e.g., perceived deprivation) experience greater harm and problems. In a weighted, census matched sample of adults in the U.S. (N = 1,348), the present study examined the interaction between financial gambling motives and income and financial gambling motives and perceived deprivation in predicting PG. Findings provided support for both financial gambling motives and perceived deprivation as robust predictors of PG. Further, results provided unique insights into the role subjective economic standing may play in the relationship between financial motives for gambling and risk of PG.

Disordered gambling among people with psychotic disorders: a systematic review

Disorders of gambling are more common among the mentally ill, including in people with psychotic disorders. The aim of this study was to conduct a systematic review of the literature regarding the prevalence and correlates of gambling disorders in people with psychotic disorders. We systematically reviewed English-language literature through searches of six bibliographic databases, all run on 11 November 2022: Medline ALL, Embase, Emcare, APA PsycINFO, CINAHL and the Cochrane Library. Observational studies that reported the prevalence of gambling in psychotic disorders or psychosis among gamblers were included. Studies were critically appraised using the Joanna Briggs Institute Critical Appraisal Tools. Sixteen studies, including 1,116,103 participants, from across a range of settings, were included. Most studies were done on males and recruited participants with a mean age of 40 years. Most of the studies (n = 12) were cross-sectional, and the remaining were case control in design. Most of the studies rated fair in quality. The prevalence of gambling among psychotic population ranged from 0.32 to 19.3%, with the majority of the studies reporting rates between 6.4 and 17%. The rates were 5-25 times higher than in the general population. While there were no consistent associations found with socio-demographic indices, several studies reported an association between gambling behaviours and substance use disorder among those with psychotic illnesses. Our research suggests that clinicians should assess for comorbid gambling among those with psychotic illness, particularly in those with mood symptoms, impulsivity, and substance use disorders. Gambling can negatively impact on their financial and social situations. Future research should study specific strategies or therapies among those with comorbid gambling and psychotic disorders.

Associations between recollected rates of Category D fruit machine use as a child and adult gambling in a young adult sample

There have been recent restrictions to the range of gambling products made available to UK children, with the industry association Bacta introducing a minimum age of 18 for Category D fruit machines, which can otherwise be legally used by children. Any potential government action on Category D fruit machines may want to consider limitations in the current evidence base. The present study addressed this issue, by conceptually replicating previous results associating recollected usage of Category D fruit machine usage as a child and adult gambling. Compared to previous studies, the present study used a younger adult sample, and also tested for potential moderation by subjective confidence. Three out of four main tested associations were significant and in the hypothesised direction, and a lack of significance on interaction terms yielded no evidence of potential moderation by subjective confidence. The present study therefore added to the limited evidence base on potential risks of legal Category D fruit machine usage as a child.

Associations Between Heavy Episodic Drinking, Drinking While Gambling, and Risky Gambling

INTRODUCTION

Understanding how patterns of drinking are associated with risky gambling in Australia is needed to inform an effective approach to minimise harm.

METHODS

This cross-sectional questionnaire study reports on 2,704 subsampled participants who completed survey questions about their patterns of drinking. With logistic regressions, we examined whether frequency of heavy episodic drinking (HED) and alcohol use while gambling were associated with risky gambling while controlling for sociodemographic variables.

RESULTS

Occasional HED and monthly HED were associated with any gambling (versus no gambling), but frequent HED was not significantly associated with gambling. The opposite pattern was found when predicting risky gambling. Occasional HED (i.e. less than monthly) was not significantly associated, but a higher frequency of HED (at least weekly) was associated with a higher likelihood of risky gambling. Drinking alcohol while gambling was associated with risky gambling, over and above HED. The combination of HED and use of alcohol while gambling appeared to significantly increase the likelihood of risky gambling.

CONCLUSIONS

The association of HED and alcohol use while gambling with risky gambling highlights the importance of preventing heavy alcohol use among gamblers. The links between these forms of drinking and risky gambling further suggests that individuals who engage in both activities are specifically prone to gambling harm. Policies should therefore discourage alcohol use while gambling for example by prohibiting serving alcohol at reduced prices or to gamblers who show signs of being affected by alcohol and informing individuals of the risks associated with alcohol use while gambling.

Young male athletes at risk for problem gambling: Findings from a cross-sectional study in Sweden

Previous research has shown that male athletes at the elite level in Sweden have a higher proportion of gambling problems than the average male population in the country. However, there is a knowledge gap in the prevalence of gambling problems among young athletes. To address this gap, this study aimed to explore gambling behavior among young athletes and to examine the associations between individual and environmental factors and problem gambling. The cross-sectional survey comprised questions from the Problem Gambling Severity Index and the Alcohol Use Disorders Identification Test, in addition to self-constructed items on individual and environmental factors. The data were derived from a sample of 1,636 students from the National Sports Education Program (NIU) and 816 grassroots athletes of the same age (16-20 years old). The results showed that male athletes had a higher prevalence of problem gambling compared to female athletes, and that a large proportion of male athletes had gambled during school hours. The prevalence of problem gambling was almost zero for women. The prevalence of problem gambling among male athletes over 18 years of age was 9% in NIU athletes and 3.6% in grassroots athletes, while for men under 18 years of age, the prevalence was 4.9% in NIU athletes and 1.3% in grassroots athletes. The study highlights the importance of considering contextual factors such as the school and team environment in preventing problem gambling among young male athletes.

Gender Differences in the Propensity to Start Gambling

Gambling opportunities have greatly expanded in recent years leading to an alternative form of leisure but also raising social concerns. Participation in such activities may be conditioned by individual characteristics affecting the willingness of individuals to gamble, including gender, but also by time effects linked to the availability and exposure of gambling. Using data from Spain, estimates from a time-varying split population duration model show significant gender differences in the propensity to start gambling (men's episodes as non-gamblers were observed to be shorter than women's). Additionally, expansion of gambling opportunities over time is found to be correlated with an increase in the propensity to start gambling. Both men and women are clearly more likely to start gambling at earlier ages than before. These results are expected to improve knowledge of gender differences in terms of consumer decision making about gambling and to be helpful in designing public policies for gambling.

Gambling, tobacco use, and health among individuals in substance use disorder treatment

BACKGROUND AND OBJECTIVES

Gambling is highly comorbid with disordered use of tobacco and other drugs, and may increase relapse risk among substance use disorder (SUD) patients. We investigated associations between gambling and tobacco use behaviors among SUD patients to inform clinical care.

METHODS

Patients (N = 651, 170 female) from 25 residential SUD treatment programs in California completed surveys about tobacco use, health, and gambling. Using multivariate regression, we examined associations between gambling, tobacco use behaviors, and mental and physical health.

RESULTS

Past-year gamblers were more likely than non-gamblers to be current smokers (adjusted odds ratio [AOR] = 1.44, 95% confidence interval [CI] = 1.03, 2.01). Smokers who gambled had higher mean Heaviness of Smoking Index (HSI) scores (mean difference = +0.32, 95% CI = 0.04, 0.60), and more often reported smokeless tobacco use (AOR = 1.73, 95% CI = 1.16, 2.58), compared to non-gambling smokers. Past-year problem gamblers were more likely than all others (non-gamblers and non-problem gamblers) to be current smokers (AOR = 1.44, 95% CI = 1.08, 1.90) and to report high psychosocial stress (AOR = 1.87, 95% CI = 1.34, 2.61). Smokers with problem gambling also had higher HSI scores (mean difference = +0.54, 95% CI = 0.14, 0.95) compared to smokers without problem gambling.

DISCUSSION AND CONCLUSIONS

Gambling and problem gambling were associated with tobacco use and heavier smoking. SUD patients with gambling comorbidity may be heavier smokers and may need concurrent treatment for tobacco use and problem gambling.

SCIENTIFIC SIGNIFICANCE

This study provides novel data regarding gambling and tobacco use behaviors among SUD patients.

Childhood Use of Coin Pusher and Crane Grab Machines, and Adult Gambling: Robustness to Subjective Confidence in a Young Adult USA Sample

Gambling as a youth is a risk factor for experiencing gambling-related harm as an adult. Most youth gambling research focuses on illegal engagement with age-restricted products, but youth can also gamble legally, by for example betting with friends, or via coin pusher and crane grab machines. Research has associated recollected rates of usage of these machines as a child with adult gambling participation and problems, but only in the UK and Australia, and has not tested for robustness to subjective confidence. The present study conceptually replicated these prior studies by investigating the association between recollected childhood use of coin push and crane grab machines, and adult gambling behavior, in a young adult USA sample. Participants rated their subjective confidence to test if individual differences in recollection biases provided a better account for any observed associations. Results found high recollected engagement rates for both coin pusher (87.2%) and crane grab machines (97.0%), and 5 of the 6 tested associations between youth machine usage and adult gambling engagement and problems were significant and in the hypothesized direction. Rates of subjective confidence were on average high (83.3 and 89.2 on a 0 to 100 scale), and generally did not interact with participants' recollected rates of machine use. These findings extend prior research on potential public health concerns around children's legal engagement with coin pusher and crane grab machines to a new country, the USA.

Disordered gambling in a longitudinal birth cohort: from childhood precursors to adult life outcomes

BACKGROUND

Despite its introduction into the diagnostic nomenclature over four decades ago, there remain large knowledge gaps about disordered gambling. The primary aims of the present study were to document the long-term course, childhood precursors, and adult life outcomes associated with disordered gambling.

METHODS

Participants enrolled in the population-representative Dunedin Study were prospectively followed from birth through age 45. Disordered gambling was assessed six times from age 18; composite measures of childhood social class, general intelligence, and low self-control were based on assessments obtained from birth through age 15; adult socioeconomic, financial, and legal outcomes were obtained through age 45. Lifetime disordered gambling was predicted from the three childhood precursors and the adult outcomes were predicted from lifetime disordered gambling.

RESULTS

Past-year disordered gambling usually occurred at only a single time point and recurrence was relatively uncommon. Lower childhood social class, general intelligence, and self-control significantly predicted lifetime disordered gambling in adulthood. In turn, lifetime disordered gambling in adulthood significantly predicted occupational, educational, and financial problems in adulthood (ds = 0.23-0.41). These associations were markedly reduced and sometimes rendered nonsignificant after adjusting for childhood precursors (ds = 0.04-0.32).

CONCLUSIONS

Socioeconomic, financial, and legal outcomes in adulthood are not merely consequences of disordered gambling, but also are predicted from childhood precursors. Deflecting the trajectories of young people at risk for developing disordered gambling may help to ameliorate not just the development of later disordered gambling, but also other associated adverse outcomes.

Non-problem gamblers show the same cognitive distortions while playing slot machines as problem gamblers, with no loss of control and reduced reality control, though - An experimental study on gambling

Background

Cognitive distortions can result in maladaptive interpretations of events and maladaptive behavior. In the case of gambling, such distortions can contribute to the maintenance of the disorder. Our current research aimed to conduct an experiment to possibly detect cognitive biases characteristic of persons with gambling addiction in a non-gambling sample of the general population, and to study the effect of "big win" on cognitive distortions.

Methods

A specifically designed and preprogrammed slot machine simulation was carried out, with 90 rounds split into 3 sections. During the simulation every participant verbalized their thoughts and feelings; the verbalizations were recorded. Then a content analysis was conducted to search for indications of cognitive distortions. The sample was separated into two experimental groups: one of the groups experienced the "big wins" in the first section, while the other group had them in the second section of the experiment.

Results

Content analysis revealed numerous cognitive biases. Cognitive distortions usually present in problem gambling were detected in our sample from the general population as well. However, we could not distinguish cognitive biases indicating serious loss of control, or distortion of reality control. A further finding is that early losses provoke the emergence of more cognitive distortions, while early big win leads to more intense loss-chasing in the later stages of gambling.

Conclusion

The appearance of reality-checking uncertainty or loss of control can be alarming for the development of gambling. Losses and big wins can provoke different cognitive distortions, encouraging the person into further gambling behavior.

Crisis, What Crisis? The Effect of Economic Crises on Spending on Online and Offline Gambling in Spain: Implications for Preventing Gambling Disorder

(1) Background: In the period between 2008 and 2020, the world experienced two global economic crises that affected people's way of life and well-being: the financial crisis of 2008 and that precipitated by the COVID-19 pandemic. Despite the crises' radically different causes, their consequences for economic activity have been equally dramatic; (2) Methods: This article analyzes the consequences of both crises on gambling spending in Spain and compares traditional (offline) games with more recent online offerings. The data were collected from databases maintained by the Spanish government and gambling companies; (3) Results: The paper offers two main conclusions. The first is that, while traditional (offline) gambling has been significantly affected by economic crises, online gambling has exhibited consistent growth since its legalization. The second is that the measures implemented to resolve the two economic crises differed significantly and thus had different impacts on spending on the various types of gambling; (4) Conclusions: The key conclusion is that purchasing power (measured in terms of GDP) can only explain spending on less addictive gambling games, such as lotteries. However, the availability and accessibility of games are both directly related to spending on games of all types.

Childhood use of coin pusher and crane grab machines, and adult gambling: A conceptual replication of Newall et al. (2021)

BACKGROUND AND AIMS

Youth gambling research mainly focuses on the illegal use of age-restricted machines, but coin pusher and crane grab machines are gambling machines that can be used by people of any age in the UK, and are also in use internationally. Previous cross-sectional evidence has associated recollected childhood usage of these machines with adult gambling participation and levels of problem gambling amongst adult gamblers. We attempted to conceptually replicate the findings of one of these studies (Newall et al., 2021), while addressing some limitations of that study.

METHODS

A cross-sectional survey of 2,000 UK-based and -born participants aged 19-24 years. The measures were participants' recollected usage of coin pusher and crane grab machines as a child, whether they had gambled in the past 12-months or not, and the PGSI for past 12-month gamblers.

RESULTS

Overall, 5 of 7 tested associations were significant and in the hypothesized direction. Logistic regression models showed that adult gamblers were more likely to recollect using, and used at higher levels of frequency, coin pusher and crane grab machines, than non-gamblers. Then, negative binomial regression analysis showed that adults who recollected using crane grab machines at higher levels of frequency showed more gambling-related problems.

DISCUSSION AND CONCLUSIONS

These results suggest that childhood usage of coin pusher and crane grab machines may act as an underappreciated risk factor for the development of gambling-related harm across the lifespan. This information may be considered for further youth gambling research and policy.

Socio-Demographic Factors, Gambling Behaviour, and the Level of Gambling Expenditure: A Population-Based Study

The aim of this study was to examine the relationship between socio-demographic factors, gambling behaviour, and the level of gambling expenditure. The data were drawn from the population-based Gambling Harms Survey 2016 and 2017 conducted in Finland. The data were linked to register-based variables. Past-year gamblers were included (Wave 1; n = 5 805, both Waves; n = 2 165). The study showed that of the 4.2 % of gamblers that produced 50.0 % of the total GE in 2016, 33.1 % of the GE was produced by those with a gambling problem and 43.3 % by those with at-risk gambling pattern. Compared to gamblers in the lowest GE group, those in the highest GE group were more likely to be men, aged 25 or older, with upper secondary education, have a high income, be on disability pension or sickness allowance, be frequent gamblers, gambling at least six game types, and showing at-risk and problem gambling patterns. Cumulative weekly GE by income tertiles remained fairly stable between the years. The results suggest that GE is highly concentrated. Among the small group of high-intensity consumers, the majority of the revenue comes from at-risk and problem gambling. Participants in the low GE group differ from those in the intermediate and high GE groups in terms of socio-demographics and gambling behaviour.

One size does not fit all. Should gambling loss limits be based on income?

Background

Previous research has suggested empirically based gambling loss limits, with the goal of preventing gambling related harm in the population. However, there is a lack of studies relating gambling loss limits to individual factors such as income. The current study examines whether gambling loss limits should be income-specific.

Materials and methods

The dataset was derived from three representative cross-sectional surveys of the Norwegian population and consisted of 14,630 gamblers. Four income groups, based on a quartile approximation, were formed. Gambling related harm was measured with the Problem Gambling Severity Index (PGSI), and precision-recall (PR) analyses were used to identify loss limits for the different income groups at two levels of gambling severity: moderate-risk gambling and problem gambling.

Results

For both levels of gambling severity, we found the lowest income group to have the lowest gambling loss limits, and the highest income group to have the highest loss limits, which compared to the loss limits for the total sample, were lower and higher, respectively. Calculating the cut-offs for moderate-risk gamblers, we found a consistently ascending pattern from the lowest to the highest income group. Calculating the cut-offs for problem gamblers, we found a similar pattern except for the two middle income groups.

Conclusion

The results suggest that income moderates empirically derived gambling loss limits. Although replication is required, income-based gambling loss limits may have higher applied value for preventing gambling related harm, compared to general loss limits aimed at the entire population.

Mental illness and socio-economic situation of women and men diagnosed with gambling disorder (GD) in Sweden - nationwide case-control study

The present study aimed to compare men and women with gambling disorder (GD) regarding presence of psychiatric comorbidity and socio-economic vulnerability, and to examine whether these factors appear before or after the gambling disorder. This is a retrospective case-control study, based on registers from The National Board of Health and Welfare and Statistics Sweden. A total of 3592 adults with GD were matched with two controls based on age and gender, including a total of 10776 individuals in the study. The study included psychiatric comorbidity through the presence of relevant diagnostic codes or pharmacological codes, and socio-economic vulnerability data through the presence of unemployment, social welfare payments and sickness/activity/rehabilitation compensation. Time between GD and psychiatric comorbidity/socio-economic vulnerability was calculated by subtracting dates between diagnoses/first incidence of socio-economic vulnerability factor and GD diagnosis. Women with GD were more likely to have a psychiatric comorbidity, compared to men. Overall, women were also more likely to receive their psychiatric diagnosis prior to GD diagnosis, while men were more likely to receive the diagnoses concurrently. Social welfare payments, and sickness support were more common among women, while there was no difference in unemployment between genders. Women were also more likely to receive sickness/activity/rehabilitation compensation prior to GD, than men who were more likely to receive these types of support after GD diagnosis. In conclusion, women appear to be at higher risk of psychiatric comorbidity and socio-economic vulnerability alongside GD. They are in general also more likely to receive have their psychiatric and psycho-social problems identified prior to GD, than men who are more likely to receive diagnoses concurrently.

Not Too Much, Not Too Often, and Not Too Many: the Results of the First Large-Scale, International Project to Develop Lower-Risk Gambling Guidelines

Until now, there has been no evidence-based, specific advice for people who gamble who want to reduce their risk of experiencing gambling harms. This paper presents the results from the first large-scale, comprehensive, international project to develop lower-risk gambling guidelines. Specifically, we calculated relative risk estimates to determine risk of harm across the range of possible limits for gambling frequency, expenditure, and number of types of gambling engaged in; conducted an online survey (n = 4583) of people who gamble to assess whether they understood and found credible the proposed quantitative limits; conducted a series of interviews and focus groups with people who gamble to assess self-control strategies and reactions to proposed quantitative limits; conducted a meta-analysis of problem gambling risk factors in the general population; and consulted with a pan-Canadian, multi-sectoral committee of stakeholders. Project outcomes were examined and deliberated by a working group of scientists who decided upon a set of recommendations for lower-risk gambling. This paper presents these recommendations.

Prevalence and Trends in Problem Gambling in Denmark with Special Focus on Country of Origin: Results from the Danish Health and Morbidity Surveys

Belonging to an ethnic minority has been described as a possible risk factor for problem gambling, but the literature is inconclusive whether this association is true or just a proxy for other underlying risk factors. Hence, the aims were to investigate: (1) past year prevalence of problem gambling in the adult Danish population and trends since 2005, (2) past year prevalence of problem gambling in 2017 and trends since 2010 by country of origin, and (3) whether a marginalisation by country of origin or problem gambling, respectively, is seen in various health-related indicators. Data were derived from the Danish Health and Morbidity Surveys in 2005, 2010, 2013, and 2017. The Lie/Bet Questionnaire was used to define problem gamblers. The overall prevalence of past year problem gambling has increased slightly from 2005 (1.0%) to 2017 (1.5%), but a more alarming increase was observed among men with non-western origin (3.1% in 2010 and 7.0% in 2017). A lower prevalence of good self-rated health and a higher prevalence of poor mental health was observed among individuals with a non-western origin compared to those with a Danish origin, although the differences became smaller between 2010 and 2017. The findings indicate a slightly increase in the prevalence of past year problem gambling and that particular attention should be paid to individuals with a non-western origin. The study also highlights the need for better differentiation of risk factors that may variously predispose different ethnic groups to develop gambling problems.

Gambling Outlets Location in Urban Areas: A Case Study of Madrid

Cities are certainly a key factor in the location of gambling facilities. This paper aims to map the location of gambling outlets in urban areas and to examine potential links between neighborhoods socioeconomic and demographic characteristics and gambling supply, taking into account spatial dependencies of neighboring areas. This correlation is of interest because neighborhood characteristics may attract sellers, and because the presence of gambling sellers may cause changes in neighborhood demographics. Using detailed official data from the city of Madrid for the year 2017, three spatial econometric approaches are considered: spatial autoregressive (SAR) model, spatial error model (SEM) and spatial lag of X (explicative variables) model (SLX). Empirical analysis finds a strong correlation between neighborhoods characteristics and co-location of gambling outlets, highlighting a specific geographic patterning of distribution within more disadvantaged urban areas. This may have interesting implications for gambling stakeholders and for local governments when it comes to the introduction and/or increase of gambling availability.

Addictions in patients with atopic dermatitis: a cross-sectional pilot study in Germany

BACKGROUND

Atopic dermatitis (AD) is the most common chronic inflammatory skin disease worldwide and displays many atopic, but also non-atopic comorbidities. Among the latter, mental health disorders such as depression have been extensively studied. However, data on addictions are still rare.

OBJECTIVES

The aim of this study was to assess the prevalence of different kinds of addictions in adult AD patients using a single-centre approach.

METHODS

This non-interventional cross-sectional study was performed from 03/2020 to 05/2020 at the Department of Dermatology of a large German university hospital. Participants with a diagnosis of AD confirmed by a dermatologist answered questions about disease severity (patient-oriented eczema measure, POEM), quality of life (Dermatology Life Quality Index, DLQI) and smoking habits. They were screened for problematic alcohol consumption, drug abuse, internet addiction and pathological gambling using internationally established and validated questionnaires.

RESULTS

157 patients (56.1% female; mean age of 49.9 ± 20.4) with an average POEM of 13.7 ± 7.5 and DLQI of 6.1 ± 5.4 were evaluated. 14.1% were identified as regular smokers, 12.1% screened positive for alcohol dependency, 6.4% for drug use disorders, 4.5% for Internet addiction and 3.2% for pathological gambling. Co-occurrences of different addictions were observed, and a positive correlation was noted between DLQI scores and smoking.

CONCLUSIONS

In summary, this study hints at elevated positive screening rates for problematic alcohol consumption, drug use disorders, Internet addiction and problem gambling compared with the general population. Screening routinely for addictions may improve patient-centred health care of AD patients.

A Comparison of Gambling-Related Cognitions and Behaviors in Gamblers from the United States and Spain

Few studies have compared the clinical characteristics of gambling disorder (GD) from a cross-cultural perspective. In the present study, we aimed to examine differences in gambling-related cognitions, gambling preferences, GD severity and other clinical and sociodemographic variables in individuals with GD in the United States and Spain. Two groups of participants with GD (from the United States of America (US; n = 109) and Spain (n = 243) were compared using the South Oaks gambling screen and the gambling-related cognitions scale. In Spain, the prevalence of participants who reported only non-strategic gambling preferences was higher, whereas in the US, participants tended to engage in a wider breadth of gambling activities. Moreover, Spanish participants reported higher GD severity, while participants in the US endorsed greater gambling-related cognitions. Our findings suggest that there may jurisdictional or cultural differences in terms of gambling-related cognitions, gambling preferences, and GD severity levels among individuals in the US versus Spain. These differences, which may reflect cultural regulatory or other factors, should be investigated further, and considered when developing and implementing interventions for GD.

The transition time to gambling disorder: The roles that age, gambling preference and personality traits play

BACKGROUND AND AIMS

Gambling Disorder (GD) is considered a heterogeneous, multidimensional pathology with high personal and social consequences. The transition time (TT) between problematic gaming and pathological gambling, which varies significantly across patients, may predict the disorder's severity. As only limited studies have investigated the factors implicated in the TT, the current study set out to identify its predictors and their relationships with GD severity.

METHODS

Correlation were performed in 725 male GD patients to identify factors associated to TT and GD severity, including: age of onset of gambling behaviors, alcohol/drug use, personality traits and gambling preferences (i.e., strategic, non-strategic, and mixed). Then a regression analysis was performed to identify predictors of TT to GD.

RESULTS

Longer TT correlated with higher GD severity, early age of onset of problematic gambling, substance use and a non-strategic gambling preference. Personality traits including low self-directedness, high novelty seeking, and low cooperativeness were also related with longer TT. The strongest associations with GD severity were substance use, and some of the personality traits (i.e., low self-directedness and cooperativeness, high harm avoidance and self-transcendence). Factors significantly predicting longer transition to GD were older ages, low self-directedness, and non-strategic gambling.

CONCLUSIONS

A clinical profile characterized by a longer TT and more severe GD symptoms pertains to older patients with low self-directedness, and preference for non-strategic gambling. Other relevant factors associated with this profile of patients included early age of onset problematic gambling, substance consumption, high novelty seeking and low cooperativeness.

Five-year follow-up on a sample of gamblers: predictive factors of relapse

BACKGROUND AND AIMS

Few studies have been conducted on the long-term evolution of gambling disorder (GD). The aim of this study was to identify factors that could predict GD relapse.

METHODS

Data were part of a dataset from a large 5-year cohort of gamblers who were assessed at inclusion and each year thereafter. Participants were recruited from an outpatient addiction treatment center, from various gambling places and through the press. For this specific study, inclusion criteria included (i) transitioning from GD to recovery at a follow-up time and (ii) undergoing at least one follow-up visit afterwards. Participants were evaluated using a structured clinical interview and self-report questionnaires assessing sociodemographic, gambling and clinical characteristics. "Relapse" was defined as the presence of GD (according to the DSM-5) at the N+1th visit following the absence of GD at the Nth visit. A Markov model-based approach was employed to examine predictive factors associated with relapse at a subsequent follow-up visit.

RESULTS

The sample consisted of 87 participants, aged 47.6 years (sd = 12.6), who were predominantly male (65%). Among the participants, 49 remained in recovery, whereas 38 relapsed. Participants who reported not having experienced at least one month of abstinence and those with a low level of self-directedness at the previous follow-up visit were more likely to relapse.

CONCLUSIONS

Our findings suggest the existence of factors that are predictive of relapse in individuals with GD who had previously achieved recovery. These results can inspire the development of measures to promote long-term recovery.

The structure and subtypes of gambling activities: Genetic, psychiatric and behavioral etiologies of gambling frequency

The multitude of gambling activities has given rise to heterogeneous ways of analyzing these behaviors and may partially underlie the lack of replication in gambling research. The current study used complementary analyses to investigate the structure, typology and etiology of gambling behaviors in a discovery sample of 2,116 twins (54.86% female; M_age = 24.90) and a replication sample of 619 siblings (30.37% female; M_age = 28.00). Our approach was twofold. First, we used confirmatory factor analyses to investigate the structure across the frequency of eight gambling activities. Second, we used factor mixture models to identify gambling frequency subtypes. We assessed associations with gambling frequency as well as conducted genetically informed analyses to estimate the role of genetic and environmental influences. Across samples, a two-factor model fit the data best, with a Common Gambling factor influencing all activities and a separate factor for Skill Gambling. Our study identified four gambling frequency subtypes, which resembled the typology from the Pathways Model. We found distinct demographic, psychiatric, behavioral and genetic risk profiles for the different gambling factors and subtypes with robust associations observed for male sex, risk-taking, sensation seeking, alcohol dependence and problem gambling. Controlling for shared genetic and environmental influences (via co-twin control modeling), we found that sensation seeking directly increased Common Gambling frequency. In sum, we illustrated the utility of multi-dimensional statistical techniques for disentangling the structure and typology from complex multivariate gambling data.

Gambling Behaviour: Prevalence, Risk Factors and Relation with Acculturation in 2007-2018 North Cyprus Adult Household Surveys

In this study, the prevalence of gambling behaviors among the North Cyprus (NC) in 2018 is compared with the data of 2007, 2012, 2014 and the relationship between acculturation and problem and pathological gambling (PPG) is examined. The population of the study consists of Turkish-speaking individuals between 18 and 65 years of age living in NC. 799 people were consequently selected according to gender, age and geographical region with a multi-stage stratified (randomized) quota. For the collection of the data, a demographic questionnaire, the Turkish version of the Revised South Oaks Gambling Screen (SOGS) and cultural attitude scale (CAS) were used. The prevalence data were compared with the research done by the same researchers in 2007 (n = 1012), 2012 (n = 996) and 2014 (n = 958) which were conducted by same method and questionnaire. The vast majority of participants (70.6%) participated in one or more of the 17 types of gambling activities at least once during their lifetime. Pathologic gambling doubled and rose to 4.5% in 2007-2018 periods. Being male, age range of 18-29, single, living alone and marry less than 5 years are the risk factors for PPG. Separation and integration attitude were related with PPG among Cyprus-born individuals. The study shows that gambling behavior is widespread in the NC and pathologic gambling is increasingly rapidly. High rates of gambling addiction, should be assessed in its own social structure for each community and it should be taken into consideration that acculturation is an effective factor in increasing PPG.

Exploring the associations between gambling cravings, self-efficacy, and gambling episodes: An Ecological Momentary Assessment study

AIMS

To explore reciprocal relationships between real-time gambling cravings and self-efficacy with gambling behaviour, and the moderating role of gambling, mental health, and addiction-related variables.

DESIGN

Secondary analysis of a 4-week Ecological Momentary Assessment (EMA) study conducted in Tasmania, Australia.

SETTING

Data were collected via telephone interviews (pre-EMA) and smartphones (EMA).

PARTICIPANTS

Ninety-seven regular gamblers (mean age: 45.90 years, 57.73% male) reported 5,113 observations.

MEASUREMENTS

EMA measures included gambling cravings (occurrence, frequency, intensity), self-efficacy (craving-related, gambling-related), and gambling behaviour (episodes, expenditure, duration). Pre-EMA measures included gambling (severity; harms; motives; high-risk situations), mental health (depressive symptoms; anxiety symptoms) and addiction-related (alcohol use; smoking; substance use) moderator variables.

FINDINGS

Mixed-effects binary logistic regression analyses revealed that gambling cravings predicted gambling episodes (OR = 2.23, 95% CI:1.61, 3.08), gambling self-efficacy and gambling duration were reciprocally related (OR = 4.65, 95% CI:1.08, 20.04; OR = 0.21, 95% CI:0.05, 0.93), and craving self-efficacy predicted gambling expenditure (OR = 0.30, 95% CI:0.10, 0.86). Moderation analyses revealed that: (1) craving self-efficacy exacerbated craving frequency with gambling expenditure; (2) coping motives exacerbated gambling self-efficacy with gambling expenditure; (3) high-risk positive reinforcement situations exacerbated craving intensity and gambling self-efficacy with gambling episodes, and gambling episode with craving occurrence; and (4) substance use exacerbated gambling self-efficacy with duration, and buffered gambling expenditure with craving intensity.

CONCLUSIONS

These findings have implications for the development of real-time gambling interventions that aim to reduce gambling cravings and increase self-efficacy, which could be targeted to vulnerable individuals, including people who frequently gambled for coping purposes or positive reinforcement, and people with comorbid substance use.

Population Screening of Gambling Behavior: Playing to Escape From Problems May Be a Key Characteristic of At-Risk Players

The increase in gambling availability and the inclusion of gambling disorder as an addiction in DSM-5 highlight the importance of brief screening measures aiming to identify at-risk gamblers. The current study, using a brief telephone survey, assessed demographic characteristics and gambling behaviors in 2,118 adults. Questions were developed based on DSM-5 criteria for Gambling Disorder and common assessment tools. A 7% prevalence of as at-risk gamblers was identified. Male gender, low monthly income, high frequency of gambling behavior, large amounts of money spent, and gambling to escape from everyday problems or for amusement, specifically for men, were found to be the characteristics that can help in the early identification of at-risk gamblers. Gambling for financial gain and as a way to socialize, age, and employment status were not significant predictors of gambling severity. This study shows that the above characteristics can be assessed easily through phone screening of large populations, aiding in prevention practices to reduce the problematic use of gambling activities.

Use of Self-control Strategies for Managing Gambling Habits Leads to Less Harm in Regular Gamblers

There is little research on the control strategies used by the general public to self-manage gambling habits and avoid harmful consequences. The current study sought to identify the most common self-control strategies of people who gamble regularly, the characteristics of those who use them, and assess the effectiveness of limit-setting strategies in reducing gambling-related harm. We recruited a large sample (N = 10,054) of Canadian adults who reported gambling activity in the past 12 months. Participants completed a survey that assessed gambling habits, use of control strategies including quantitative limit setting, and gambling related harm. The most common control strategies were setting predetermined spending limits, tracking money spent, and limiting alcohol consumption. The number of self-control strategies used by gamblers was positively associated with gambling involvement, annual income, problem gambling severity and playing electronic gaming machines. Approximately 45% of respondents failed to adhere to self-determined quantitative limits for spending, frequency, and time spent gambling. People who stayed within their gambling limits were less likely to report harm even after controlling for other risk factors. However, the effectiveness of remaining within one's personal spending limit decreased for those whose limits exceed $200CAN monthly. The findings support public health interventions that promote lower-risk gambling guidelines aimed at helping gamblers stay within spending, frequency and duration limits.

Proximal and Distal Risk Factors for Gambling Problems Specifically Associated with Electronic Gaming Machines

Electronic gaming machines (EGMs) are widely used and the gambling product most commonly associated with harmful gambling. Understanding factors that increase the risk of problematic EGM play is therefore important. Previous studies into risk factors for EGM gambling have used measures of problem gambling based on an individual's total gambling activity, which therefore do not distinguish harmful gambling specifically associated with EGMs. This study used an EGM-specific measure (PGSI-EGM) to achieve its aim of identifying risk factors specifically associated with problematic EGM play. By removing nuisance effects from other gambling forms that higher-risk gamblers typically engage in, this approach provides a more accurate assessment of the determinants of EGM-related problems. An online survey was completed by 1932 at-least monthly EGM players in Australia. It measured demographics, EGM gambling behaviour, motivations, gambling urges, gambling fallacies, trait self-control, alcohol misuse, and the PGSI-EGM. A penalised regression model identified the most important proximal predictors of higher-risk EGM gambling as: higher gambling urges, higher levels of erroneous cognitions, playing EGMs more frequently, higher session expenditure, longer sessions, usually playing EGMs alone, and playing EGMs in more venues. Lower trait self control was the strongest distal determinant. Higher-risk EGM players tended to be younger, male, more educated, never married, to have higher (although still modest) incomes, and be more likely to have alcohol problems. These findings can inform interventions such as treatment, consumer education and venue interventions.

Segmenting Chinese Gamblers Based on Gambling Forms: A Latent Class Analysis

Segmentation of gamblers is useful for understanding their distinctive characteristics and enforcing customized measures in harm minimization work. Previous research has commonly adopted gambling motivation and involvement as segmentation criteria. However, these criteria are less identifiable through observation. Gambling forms, used in recent gambling segmentation research, are more observable, facilitating the prevention and treatment work of governments and practitioners, as the identified segments have distinctive gambling disorder symptoms. As gambling is widespread in the Chinese population and little is known about this ethnic group in terms of gambling form segments, latent class analysis was used to classify 855 Chinese gamblers in Macau based on their participation in 11 gambling forms in the previous 12 months. The analysis identified three distinct segments: casino gamblers, lottery gamblers, and sociable gamblers. Socio-demographic differences between the three segments were revealed. Casino gamblers, compared with their counterparts, were more likely to have DSM-V symptoms, particularly escape and bailouts. Lottery gamblers and sociable gamblers only differed in one symptom, the latter having a higher probability of chasing their losses. Based on these results, Macau policymakers are advised to prioritize their harm minimization measures such as requiring casinos to provide training to workers to help to identify gambling disorder symptoms and that workers should intervene when the symptoms of escape and bailouts were identified from the gamblers. Special attention should be given to Macau casino gamblers who are male, unemployed, or with highest education of high school diploma.

Online Survey of Gambling Participation and Problem Gambling in Chiba City: Problem Gambling Rates May be Strongly Influenced by the Administration Mode

Prevalence studies on gambling participation and problem gambling in Japan have been limited. To obtain data showing the current status of gambling in Japan, we conducted an online survey on gambling participation and problem gambling among residents in Chiba City. The online data collection was conducted through an Internet research firm. Questionnaires were consisted of personal demographics, past-year gambling participation and severity of gambling risks. The Problem Gambling Severity Index (PGSI) was used as a survey instrument. Males (51.5%) were significantly more likely than females (25.5%) to have gambled in the past year. Problem gamblers (PGSI score ≧ 8) were 7.2% among males and 1.2% among females. Problem gambling was strongly correlated with frequent gambling, preference for Pachinko/Slot and smoking habit. The gambling participation rates were roughly lower than those reported in many overseas jurisdictions, whereas the problem gambling rates were considerably higher than those reported in the same jurisdictions. According to the total consumption model, it would be reasonable to consider that gambling participation rates show a positive correlation with problem gambling rates. The high levels of problem gambling may be due to the administration mode using online sampling, by which answers admitting unapprovable behaviors like problem gambling tend to increase. This suggests that the previous studies using conventional face-to-face or telephone methods may have underestimated problem gambling rates.

Emotion regulation interacts with gambling motives to predict problem gambling among emerging adults

BACKGROUND

It is presently estimated that as much as 10% of emerging adults are at risk for a gambling disorder. The consequences stemming from problematic gambling engagement include increased substance use, mental health disorders, suicidality, financial strain and legal issues. The present study explores whether deficits in specific dimensions of emotion regulation coupled with the motivation to escape negative emotions (i.e., coping motives) increases the likelihood of problem gambling severity, while controlling for variables such as gambling frequency, age, and sex.

METHODS

A sample of 919 emerging adult gamblers (M_age = 21.16 years-old, SD = 2.90, 48.1% female) completed an online survey including an assessment of problematic engagement in gambling over the past year, gambling motivations, and difficulties in emotion regulation. In total, 15.2% and 8.1% of this sample were at moderate or high risk for gambling disorder.

RESULTS

A series of six moderation analyses revealed that the total models accounted for approximately 37-38% of the variance in problem gambling and that coping motives interacted with less difficulties engaging in goal-directed behavior, increased lack of emotional clarity, and increased lack of emotional awareness to create a toxic mixture for problem gambling.

CONCLUSIONS

These findings reveal the importance of considering both psychological factors such as emotion regulation and motivational factors in understanding who is at greatest risk for gambling problems.

Gambling formats, involvement, and problem gambling: which types of gambling are more risky?

Background

The recognition of problem gambling as a public health issue has increased as the availability of gambling expands. Research has found that some formats of gambling are more closely linked to problem gambling than others. Conflicting evidence, however, has emerged, suggesting that the most important consideration is involvement (i.e., number of gambling formats an individual participates in). This debate has important implications for the regulation of gambling formats and for the allocation of problem gambling prevention and treatment services.

Method

Analyses utilized the Baseline General Population Survey (BGPS) and the Baseline Online Panel Survey (BOPS) of Massachusettscollected in 2013–2014. The BGPS contains a representative sample of 9523 Massachusetts adults and the BOPS contains a sample of 5046 Massachusetts adults. All participants were administered the same comprehensive survey of their past year gambling behavior and problem gambling symptomology. Only those who gambled regularly in the past 12 months (n = 5852) were included. The Problem and Pathological Gambling Measure was used to classify gambling behavior. Within the sample, there were 446 problem gamblers. We assessed: 1) whether some gambling formats are more related to problem gambling; 2) whether problem gambling is positively related to high involvement in gambling; 3) the relationship between involvement in gambling and intensity of gambling; and 4) whether gambling formats mediate the relationship between gambling involvement and problem gambling.

Results

Groups of monthly gamblers participating in casino gambling, bingo, and sports betting contained a higher proportion of problem gamblers. High gambling involvement was also positively associated with problem gambling; however, a large minority of gamblers experienced problems when engaging in only one or two forms of gambling. Gambling involvement was also positively associated with intensity of gambling. Therefore, intensity of gambling may be partly driving the relationship between involvement and problem gambling. Specific gambling formats mediated the relationship between involvement and problem gambling.

Conclusions

The gambling format an individual participates in is connected to whether an individual is likely to experience problem gambling. We also found that the level of involvement (and its relationship to intensity) may affect the likelihood that an individual will experience problematic gambling behavior. Ultimately, the type of gambling format an individual partakes in does mediate the relationship between problem gambling and involvement. In Massachusetts, participating in casino gambling was more closely associated with problem gambling than other formats across all levels of involvement.

Comorbidity, family history and personality traits in pathological gamblers compared with healthy controls

Background

While DSM-5 classified pathological gambling as an addictive disorder, there is debate as to whether ICD-11 should follow suit. The debate hinges on scientific evidence such as neurobiological findings, family history of psychiatric disorders, psychiatric comorbidity, and personality variables.

Methods

In the “Baden-Württemberg Study of Pathological Gambling”, we compared a group of 515 male pathological gamblers receiving treatment with 269 matched healthy controls. We studied differences in sociodemographic characteristics, gambling-related variables, psychiatric comorbidity (lifetime), family history of psychiatric conditions, as well as personality traits such as impulsivity (Barratt Impulsiveness Scale), sensation seeking (Zuckerman's Sensation Seeking Scale) and the NEO-FFI big five. Personality traits were validated in an age- and ethnicity-matched subsample of “pure” gamblers without any psychiatric comorbidity (including nicotine dependence). Data were analyzed using two-sample t-tests, Chi2 analyses, Fisher's exact test and Pearson correlation analysis, as appropriate. Bonferroni correction was applied to correct for multiple comparisons.

Results

Only 1% of the gamblers had been diagnosed with an impulse control disorder other than gambling (ICD-10). Notably, 88% of the gamblers in our sample had a comorbid diagnosis of substance dependence. The highest axis I comorbidity rate was for nicotine dependence (80%), followed by alcohol dependence (28%). Early age of first gambling experience was correlated with gambling severity. Compared to first-degree relatives of controls, first-degree relatives of pathological gamblers were more likely to suffer from alcohol dependence (27.0% vs. 7.4%), pathological gambling (8.3% vs. 0.7%) and suicide attempts (2.7% vs. 0.4%). Significant group differences were observed for the NEO-FFI factors neuroticism, agreeableness and conscientiousness. Gamblers were also more impulsive than controls, but did not differ from controls in terms of sensation seeking.

Conclusions

Our findings support classifying pathological gambling as a behavioural addiction in the ICD-11. This decision will have a significant impact on the approaches available for prevention (e.g. age limits) and treatment.

Problem Gambling in Greece: Prevalence and Risk Factors During the Financial Crisis

In Greece no study has ever been conducted on the prevalence of problem gambling. Therefore, a cross-sectional survey was carried out amid the recession aiming to (1) estimate past year prevalence of problem gambling, (2) explore socio-economic and demographic differences among gamblers and non gamblers, (3) explore socio-economic and demographic differences among gamblers who started gambling prior and during the downturn and (4) identify its risk factors with a special interest in the influence of the recession. To this end, data emanating from a telephone and patron survey were combined. A random and representative sample of 3.404 people participated in the telephone survey and 2.400 in the patron survey. The interview schedule was the same in both studies. The presence of problem gambling was assessed with the Canadian Problem Gambling Index. Information on participants' socio-economic and demographic characteristics as well as their ways of dealing financially with the crisis were collected. Findings indicated that 2.4% of respondents met criteria for problem gambling. Male gender, minority status, living with family of origin, low educational level and low to zero income were found to constitute the risk factors of the disorder. Moreover, having started gambling during the recession increased the odds of suffering from problem gambling; however this finding was gender-specific. Thus, people end up in problem gambling through various pathways, with these trajectories being different for men and women. Any intervention should address the complexity of the issue and be tailored by gender.

Current pharmacotherapy for gambling disorder: a systematic review

Introduction: Gambling disorder is classified as an addictive disorder and is associated with significant distress and impairment in personal, social, occupational or other important areas of functioning. Although no pharmacotherapy has a formal indication for gambling disorder, data suggest potential benefits of specific medications.Area covered: This systematic review evaluated findings from 19 randomized controlled trials testing pharmacotherapies for the treatment of gambling disorder.Expert opinion: Few randomized controlled trials have studied pharmacotherapies for gambling disorder. Though results are limited, opioid antagonists like naltrexone showed promise in the pharmacological treatment of gambling disorder. Pharmacotherapy combined with psychotherapy treatments for gambling disorder may provide better rates of patient retention in comparison to pharmacology-only treatments, though further research is needed in this area. Future studies should address gaps relating to considerations of racial, ethnic, gender and other individual differences in clinical studies. Because gambling disorder often co-occurs with other psychiatric disorders, additional research is needed to test treatments for dually diagnosed patients.

Psychosocial risk factors in disordered gambling: A descriptive systematic overview of vulnerable populations

BACKGROUND

Gambling is a behaviour engaged in by millions of people worldwide; for some, gambling can become a severely maladaptive behaviour, and previous research has identified a wide range of psychosocial risk factors that can be considered important for the development and maintenance of disordered gambling. Although risk factors have been identified, the homogeneity of risk factors across specific groups thought to be vulnerable to disordered gambling is to date, unexplored.

METHODS

To address this, the current review sought to conduct a systematic overview of literature relating to seven vulnerable groups: young people and adolescents, older adults, women, veterans, indigenous peoples, prisoners, and low socio-economic/income groups.

RESULTS

Multiple risk factors associated with disordered gambling were identified; some appeared consistently across most groups, including being male, co-morbid mental and physical health conditions, substance use disorders, accessibility and availability of gambling, form and mode of gambling, and experience of trauma. Further risk factors were identified that were specific to each vulnerable group.

CONCLUSION

Within the general population, certain groups are more vulnerable to disordered gambling. Although some risk factors are consistent across groups, some risk factors appear to be group specific. It is clear that there is no homogenous pathway in to disordered gambling, and that social, developmental, environmental and demographic characteristics can all interact to influence an individual's relationship with gambling.

Religiosity and Chance Beliefs in Persons with DSM-IV Pathological Gambling Enrolled in a Longitudinal Follow-Up Study

This study investigates the association of public, private and intrinsic religiosity and chance beliefs (superstition, illusion of control) with gambling behavior in a longitudinal follow-up study of younger and older adult subjects with DSM-IV pathological gambling (PG) and an older adult comparison group without PG. One-hundred sixty-three subjects were enrolled including 60 younger adults with PG (≥ 18/< 40 years), 53 older adults with PG (≥ 60 years), and 50 older adults without PG (≥ 60). Subjects were assessed at baseline and every 6 months thereafter. The Duke University Religion Index for Religious Assessment and the Drake Beliefs About Chance scales were administered at baseline. Follow-up was a mean (SD) of 2.6 (1.4) years. Older adults with PG scored lower on measures of public and intrinsic aspects of religiosity than older adults without PG, and scored higher on superstition and illusion of control. Older adults with PG also scored higher than younger adults with PG on private and intrinsic religiosity, but not public religiosity. Superstition predicted intrinsic, but not other aspects of religiosity. Importantly, during follow-up, higher levels of public and intrinsic religiosity were protective against problematic (levels 2, 3) gambling; were protective against chronic PG; and were predictive of PG remission status. Lower illusion of control ratings were protective against problematic gambling and chronic PG; lower superstition ratings were predictive of remission. We conclude that higher levels of public and intrinsic religiosity and lower levels of chance beliefs are associated with a more benign PG course.

Emotion regulation in emerging adult gamblers and its mediating role with depressive symptomology

BACKGROUND

It is presently estimated that as much as 10% of emerging adults are at risk for a gambling disorder. The consequences stemming from problematic gambling engagement include increased substance use, mental health disorders, suicidality, financial strain and legal issues. The present study explores whether deficits in emotion regulation explain the association between problem gambling severity and depression.

METHODS

A sample of 820 emerging adult gamblers (M_age = 21.14 years-old, SD = 2.90, 50.9% female) completed an online survey including an assessment of problematic engagement in gambling over the past year, levels of anxious/depressive symptomology, and difficulties in emotion regulation. In total, 15.6% and 8.2% of this sample were at moderate or high risk for gambling disorder.

RESULTS

Results from a linear regression model revealed that difficulties with impulse control positively contributed to problem gambling scores and engagement in goal-directed behavior positively contributed to problem gambling scores, even after accounting for symptoms of depression. Moreover, results from a mediation model revealed that the association between problem gambling and depression was explained by participants' deficits in non-acceptance, goals, strategies, and clarity.

LIMITATIONS

Limitations include the use of self-report and cross-sectional data making it difficult to infer causality.

CONCLUSIONS

These findings add to our understanding of the mechanisms that appear to explain for the first time the affective consequences of problem gambling. Enhancing specific dimensions of emotion regulation will allow for tailored interventions among gamblers with depression, ultimately achieving better mental health outcomes.

A Cross-Cultural Study of Weekly Sports Bettors in Australia and Spain

Betting on sport is one of the fastest developing forms of gambling internationally. Sports betting is attracting considerable scholarly, media, and regulatory attention due to the cultural salience of sport, and the rising public health concerns about the rapid proliferation and penetration of betting products in everyday life. Despite its global expansion, little is known regarding the comparative impact sports betting is having in different territories. This study aims to examine a sample of Australian (n = 738) and Spanish (n = 361) weekly sports bettors to assess their similarities and differences concerning sociodemographic characteristics, channels (i.e., online vs. offline) and devices used, in-play betting, and problem gambling severity. The findings showed high problem gambling scores among sports bettors in both countries, and consistent similarities in the association between problem gambling, in-play betting, and offline betting. Also, clear trends were observed between problem gambling, higher educational level, and female sport betting, particularly in the Australian sample. These results suggest a common pattern of risk factors for problematic sports betting and can help to inform worldwide regulatory efforts to tackle harmful sports betting-specific features such as in-play betting.

Spatial and sociodemographic correlates of gambling participation and disorder among female Filipino migrant workers in Macao, People's Republic of China

BACKGROUND AND AIMS

Correlates and risk factors for gambling disorder among vulnerable or transient populations such as transnational migrant workers are unknown. The current study examined sociodemographic and spatial correlates of gambling disorder among female Filipino domestic workers in Macao (SAR), China.

DESIGN

Survey-based, respondent-driven sampling study administered from November 2016 to August 2017.

SETTING

Macao (SAR), which encompassed 38 casinos within its 30.4 km² area at the time of this study.

PARTICIPANTS

Representative sample of N = 1194 female Filipino domestic workers in Macao.

MEASUREMENTS

Symptoms of gambling disorder based on Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). Correlates evaluated included sociodemographic information, proximity to venues, perceived social support, and symptoms of depression and anxiety.

FINDINGS

Prevalence of gambling disorder was 5.1%. Multivariable regression analyses indicated that likelihood of gambling participation (i.e., ever gambling) was associated with current indebtedness (RR = 1.56, 95%CI = 1.08-2.25, p = .017) and worse self-reported health (RR = 1.31, 95%CI = 1.04-1.65, p = .02). Increased symptoms of gambling disorder were independently associated with lower perceived social support (RR = 0.92, 95%CI = 0.87-0.98, p = .006), increased dependents relying upon monthly remittances (RR = 1.10, 95%CI = 1.06-1.16, p < .001), increased depression severity (RR = 1.16, 95%CI = 1.07-1.25, p < .001), decreased salary quintile (RR = 0.97, 95%CI = 0.94-1.00, p = .04), and proximity to the nearest Mocha Club gaming venues (RR = 1.04, 95%CI = 1.02-1.07, p = .005). The association between proximity to casinos and increased symptoms of gambling disorder was significant only for domestic workers living apart from employers (RR = 1.07, 95%CI = 1.00-1.14, p = .04).

CONCLUSIONS

Increased spatial proximity to gambling venues and greater financial and psychosocial burdens are associated with gambling disorder among domestic workers in Macao.

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.

Exploring online problem gamblers' motivation to change

Background

In order to improve interventions for problem gambling, there is a need for studies that can highlight psychological factors that support the desire to reduce gambling.

Objective

To explore online problem gamblers' motivation for change by studying participants' reactions to an online treatment referral website designed to motivate at-risk gamblers to seek help.

Design

A qualitative evaluation study, combining focus groups and in-depth interviews. Data were analyzed using the general inductive approach.

Informants

The informants included 19 male, treatment- and non-treatment seeking, online gamblers who played a variety of games, including poker, sports betting and online casino.

Results

Motivation to change emerged as two processes including (a) empathy with others, which included projection of their thoughts and feelings onto others, and (b) dissonance between gambling behavior and ideal self-image. Dissonance included two subthemes: (i) dissonance due to positive feelings towards sports and athletics, and (ii) dissonance due to gambling among family.

Conclusions

The findings have implications for interventions designed to evoke motivation early in treatment of online problem gambling. Inducing problem gamblers to reflect on the thoughts and feelings of concerned significant others, real or fictional, could be a viable strategy to motivate online problem gamblers to consider change.

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We identified three sources of motivation for changing gambling behavior:

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Empathy with concerned significant others, real or fictional

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Cognitive dissonance due to positive feelings towards sports and athletics

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Cognitive dissonance due to gambling among family members