Gender-related differences in the characteristics of problem gamblers using a gambling helpline

Mediating Effect of Perceived Personal Luck in the Relationship Between Narcissism and Problem Gambling in Strategic Gamblers: An Exploratory Study

Gambling is becoming increasingly frequent among the French population, which has led to an increased number of individuals exhibiting problematic gambling patterns. Studies have found links between narcissism and cognitive distortions in relation to problem gambling, specifically among strategic gamblers, but none has tested perceived personal luck as one type of cognitive distortion in this regard. This study's purpose was to explore the relationship between narcissism, perceived personal luck and problem gambling among strategic gamblers, and to test for the mediating role of perceived personal luck in the relationship between narcissism and problem gambling. A total of 88 regular strategic gamblers were included (mean age = 37.8), with 49 non-problematic gamblers and 39 problematic gamblers. Participants completed the Problematic Gambling Severity Index, the Narcissistic Personality Inventory, and the Personal Luck Usage Scale. Results showed a significant relationship between narcissism and problem gambling, but no significant link between perceived personal luck and problem gambling and no significant mediation effect of perceived personal luck. These results may indicate a strong perception of personal skills compared to a weak perception of personal luck among problem gamblers of strategic games. This study emphasizes the importance of addressing types of gambling and types of cognitive distortions when investigating problem gambling.

Characteristics of Gambling Helpline Callers in Macao: A Regional Comparison

Despite the continued focus on profiling gambling helpline callers, little is known about the characteristics of callers in Macao. To address this gap, this study aims to investigate the characteristics of problem gamblers calling the helpline in Macao and explore the regional differences between callers from Macao, mainland China, and Hong Kong. Specifically, the study examined their demographics, helpline usage, and gambling-related characteristics. The study used data collected by SKHSSCO between 2015 and 2021. The results showed that, at the aggregate level, the helpline callers in Macao were male, young, and full-time employees. The majority used the telephone and reported problems with casino table games. In addition, the referral rate was relatively low, while the rate of suicidal ideation was comparatively high. The results also revealed that callers from Macao, mainland China, and Hong Kong were notably distinct in these characteristics. The findings shed light on how to increase helpline accessibility and create tailored interventions and prevention efforts to better support individuals affected by problem gambling.

Evolutionary perspectives on substance and behavioural addictions: Distinct and shared pathways to understanding, prediction and prevention

Addiction poses significant social, health, and criminal issues. Its moderate heritability and early-life impact, affecting reproductive success, poses an evolutionary paradox: why are humans predisposed to addictive behaviours? This paper reviews biological and psychological mechanisms of substance and behavioural addictions, exploring evolutionary explanations for the origin and function of relevant systems. Ancestrally, addiction-related systems promoted fitness through reward-seeking, and possibly self-medication. Today, psychoactive substances disrupt these systems, leading individuals to neglect essential life goals for immediate satisfaction. Behavioural addictions (e.g. video games, social media) often emulate ancestrally beneficial behaviours, making them appealing yet often irrelevant to contemporary success. Evolutionary insights have implications for how addiction is criminalised and stigmatised, propose novel avenues for interventions, anticipate new sources of addiction from emerging technologies such as AI. The emerging potential of glucagon-like peptide 1 (GLP-1) agonists targeting obesity suggest the satiation system may be a natural counter to overactivation of the reward system.

Exploring the Precipitating Events and Gambling-Related Activities that Prompt Problem Gamblers and Spouses/Cohabitants to Contact a Gambling Helpline

Gambling helplines have progressed to offer support and brief interventions for both the problem gambler (PG) and their spouse/cohabitant (S/C). S/Cs play an important role in assisting their partner with their recovery from a gambling disorder. However, few studies have investigated the concerns of both PGs and S/Cs who contact gambling helplines. The purpose of this study is to examine the reasons, gambling activities, and gambling locations/venues endorsed by PGs and S/Cs who contacted a state-wide gambling helpline. 938 individuals (809 PGs; 129 S/Cs) from the state of Florida contacted the Florida Council on Compulsive Gambling helpline to discuss gambling-related concerns. Helpline contacts (calls, texts, e-mails, and live chat interactions) between the period of July 1st, 2019, to June 30th, 2020, were examined. Callers/contacts provided information related to their demographic characteristics, the precipitating event leading to contact, the PG's primary gambling activity, and venue most often used by the PG. Chi-square tests were utilized to examine relationships and gender differences between PGs and S/Cs. Significant differences were found between the precipitating events for contacting the helpline and primary gambling locations/venues identified by PGs and S/Cs. Furthermore, gender differences were observed in the primary gambling activities and gambling locations/venues endorsed by the PG and S/C. The results suggest that PGs and S/Cs held different reasons when contacting the helpline. Future research should delve deeper into these disparities in order to build intervention programs tailored to the needs of both PGs and their S/Cs.

Nationwide, Multioperator Self-Exclusion and Psychiatric Comorbidity in Patients with Gambling Disorder: A Retrospective Chart Review Study from a Regional Treatment Unit

Gambling disorder is an addictive disorder that has been shown to have a detrimental effect on an individual's health, social, and financial situations. Voluntary self-exclusion is one way for patients to reduce harm in gambling disorder, but breaching one's self-exclusion appears to be common. In January 2019, Sweden launched a nationwide, multioperator self-exclusion instrument called Spelpaus (literally "game break"). Spelpaus is unique to Sweden, and there is limited research on the use of this type of nationwide, multioperator self-exclusion services, also in relation to gambling disorder and mental health. There is a reason to follow the clinical picture of treatment seeking for gambling disorder over time, and this study aims to explore clinical characteristics of patients seeking clinical gambling disorder treatment, including sex distribution and mental health comorbidity, as well as the use of Spelpaus amongst patients with gambling disorder and how frequently users gambled despite ongoing self-exclusion, in relation to sex and psychiatric comorbidities. A retrospective chart study was carried out on patients presenting to a regional gambling disorder treatment unit. Information regarding self-exclusions using Spelpaus, gambling despite self-exclusion, and the method of gambling despite self-exclusion as well as psychiatric comorbidities were extracted from medical records. Females were markedly more likely to report overall psychiatric comorbidities (48% vs. 25% among males, p < 0.001), affective, neurotic/anxiety-related (p < 0.001), and behavioral/emotional (p = 0.028) diagnoses and more likely to have two or more diagnoses excluding gambling disorder (p = 0.001). From 120 patients from whom information regarding self-exclusion was present, 114 (95%) had chosen to self-exclude. From the 114 self-excluders, 67 reported to have gambled despite self-exclusion, with unregistered websites being the most common method. Self-exclusion was not significantly related to sex (p = 0.146) or to psychiatric comorbidities (p = 0.178). In conclusion, psychiatric comorbidity was particularly common in female gambling disorder patients and gambling despite self-exclusion was common. Gambling regulations should be improved to help self-excluders avoid being able to gamble on unlicensed gambling operators. Further research should focus on sex differences and the association with psychiatric comorbidities.

Smartphone Apps for Problem Gambling: A Review of Content and Quality

Purpose of review

Problem gambling can have profound consequences for affected individuals, yet only a small proportion of people with problem gambling seek treatment. Mobile phone applications (apps) may provide an effective and scalable therapeutic option. The purpose of this study was to evaluate publicly available mobile apps aimed at improving problematic gambling behavior.

Recent findings

To date, there are no published studies that have evaluated the quality of publicly available smartphone apps for problem gambling in the US. There is thus a significant gap in knowledge of existing apps for addressing problem gambling.

Summary

This study included a review of 14 problem-gambling-specific apps. Apps that incorporated cognitive-behavioral therapy concepts and in-app communities were associated with better aesthetics and information quality scores. Additionally, in-app communities were associated with better engagement scores. Our results highlight the importance of evidence-based and engaging features in apps designed to help people with problem gambling.

Autonomic responses during Gambling: the Effect of Outcome Type and Sex in a large community sample of young adults

Psychological theories consider autonomic arousal to be a reinforcer for problem gambling. Structural characteristics such as near-misses, which are non-win events that come close to a real win, have been shown to elicit win-like responses while increasing motivation and gambling persistence. This study investigated the autonomic and subjective responses of young adults to different gambling outcomes. This study also investigated sex differences in autonomic and subjective responses to different gambling outcomes.Participants from Sweden (n = 270) performed a computerized slot machine task that produced wins, near-misses (before and after payline) and full-misses. Phasic measurements of heart rate (HR) and skin conductance responses (SCR) were recorded during gambling performance and ratings of perceived chance of winning, pleasure and motivation to play were collected following each gambling outcome.Autonomic responses differed across slot machine outcomes as indicated by HR and SCR. Compared with other gambling outcomes, near-misses elicited the largest HR accelerations, and they also elicited larger HR decelerations and SCRs relative to full-misses. Near-misses before and after payline elicited differential psychophysiological responses and subjective reports, suggesting different emotional processing of near-miss subtypes. Females showed increased SCRs and motivation following win outcomes compared with males.In conclusion, wins, near-misses and full-misses generate differential physiological and subjective responses among young adults. Autonomic responses to wins differed between male and female players, emphasizing the need to consider sex differences when investigating the role of autonomic arousal in gambling.

Recovery capital in action: How is gender understood and employed by men and women recovering from gambling disorder?

Gender is a multidimensional construct that differentiates males and females according to its meanings in different socio-cultural contexts. Recovery capital (RC) describes the internal and external resources individuals employ and/or have access to when overcoming addictions. Negative RC refers to elements that hinder recovery. The literature on gender and RC is baffling since unlike quantitative studies that have found no differences between men and women in the levels of RC, qualitative comparisons indeed underscore differences. This study employed qualitative and quantitative research methods to explore how men and women with gambling disorder (GD) understand and employ gender as a factor in their recovery. Participants with GD (N = 133, 39 women) answered an open-ended question on gender as a component in their recovery. Content analysis revealed that 41.35% of the interviewees did not consider gender as a significant factor in recovery. By contrast, 58.65% viewed gender as important to recovery, indicating four gender-related elements that either enhance and/or hinder recovery: gender stereotypes, gender roles, mixed-gender therapeutic space, and sex in exchange for money for gambling. Chi-square analyses showed no differences between men and women in the distribution of the relevance of gender to recovery. Both groups reported similar perceptions of gender in relation to recovery, and identified similar gender-related specific elements that enhanced or hindered recovery from GD except for exchanging sex for money for gambling. These findings are explained by a combination of macro and micro-level theories that result in a new conceptualization of RC. We coined the term "Recovery Capital in Action" to show how the "RC toolkit" that individuals employ can hinder or enhance their recovery depending on cultural context, and that gender can be both a negative and a positive RC. Mental health professionals should consider the interplay between gender and the socio-cultural contexts during recovery.

Sex differences in neural substrates of risk taking: Implications for sex-specific vulnerabilities to internet gaming disorder

BACKGROUND AND AIMS

Sex differences in internet gaming disorder (IGD) remain unknown. Investigating sex-specific neural features that underlie the core risk factor (i.e., risk-taking) of IGD would help in understanding sex-specific vulnerabilities to IGD and advance sex-specific treatments and prevention for IGD.

METHODS

111 participants (28 IGD males, 27 IGD females, 26 recreational game user (RGU) males, 30 RGU females) completed a probability discounting task during fMRI scanning.

RESULTS

First, among RGUs, males showed a higher risk-taking tendency and greater neural activation associated with risk/value evaluation for reward (the ventromedial prefrontal cortex (vmPFC), anterior cingulate cortex (ACC), left putamen) and smaller activation associated with cognitive control (the inferior frontal gyrus) than females during the contrast of risky-safe choices. Moreover, males showed a greater modulatory effect of risky choices on the connection from the vmPFC/ACC to the left putamen than females. Second, IGD males showed decreased activation in the vmPFC/ACC and left putamen compared to RGU males, whereas this decrease did not exist in IGD females.

DISCUSSION

Males show a higher risk-taking tendency than females. Altered neural substrates associated with risky decision-making exist in IGD males but not in IGD females.

CONCLUSIONS

The present findings fill the gap in information on the behavioral and neural substrates underlying IGD among females and demonstrate that a high risk-taking tendency is a risk factor and core symptom only in IGD males but not in IGD females. It is necessary to design and adopt distinct treatments and prevention strategies for IGD in males and females.

Assessing the mediating role of impulsivity between methamphetamine-induced psychotic disorders and increased gambling severity in methamphetamine-dependent individuals

Pathological gambling (PG) and methamphetamine-induced psychotic disorders (MIPD) both frequently occurs in methamphetamine-dependent individuals. The current study examined whether impulsivity mediated the relationship between MIPD and gambling severity. The sample consisted of 320 pathological gamblers with methamphetamine dependence (mean age 32.6 years, ranging from 15 to 64 years) voluntarily recruited from three rehabilitation centers in Hunan, China. The semistructured clinical interview of DSM-IV-TR Axis I Disorders Patient Edition was used to diagnosis the presence of MIPD and PG by registered psychiatrists. The severity of gambling symptoms was assessed using the global assessment of functioning scale, and the Barratt Impulsiveness Scale-11 provided a measure of impulsivity. Of the sample, 53.4% of participants (n = 171) met diagnostic criteria for MIPD. Individuals with a dual diagnosis of MIPD were associated with higher levels of impulsivity and greater gambling severity. Notably, support for our hypothesized mediation model was found such that impulsivity mediated the association between MIPD and gambling severity. Our findings imply that impulsivity appears to be a transdiagnostic process, which may be targeted in treatment among pathological gamblers with a dual diagnosis of MIPD to reduce gambling behaviors. Limits and future directions for research are discussed.

Differences in problem and pathological gambling: A narrative review considering sex and gender

Background and aim

A wide range of studies indicates that men and women with Problem (PrG) and Pathological Gambling (PG) differ in several clinical and sociodemographic characteristics. However, evidence for sex differences, such as the telescoping effect, is contradictory, and it is still unclear whether sex differences observed in offline gambling can also be found for online gambling. Furthermore, reviews have so far focused on binary sex differences but neglect gender aspects. In this study, an updated literature survey of sex- and gender-related differences in PrG and PG was conducted.

Methods

We searched PsyInfo, Medline/Pubmed, and the Web of Science databases from 2005 to 2020 for studies investigating sex and gender differences in gambling. A total of 126 papers were included in the literature survey.

Results

We are presenting our findings according to the categories 'prevalence' (offline, online, LGBTQI*), 'sociodemographic factors', 'preferred gambling type', 'gambling motives', 'severity', 'progression of gambling problems', 'use of professional help/motivation for treatment', 'comorbidity', 'trauma', 'violence and criminality/delinquency'. The studies indicate that, despite some robust sex differences (e.g., concerning prevalence rates), results for most areas were mixed or suggest no sex differences (e.g., violence, gambling motives).

Discussion and conclusion

To date, there is a lack of studies assessing gender, and not only sex, warranting further research in this area.

Gambling, Gaming, and Internet Behavior in a Sexual Minority Perspective. A Cross-Sectional Study in Seven European Countries

Background

Addictive behavior of gambling, gaming and internet activity is partly a new research domain and has not been well investigated with regard to sexual minority populations. Although health disparities between sexual minorities and the general population are well documented, there is a lack of inclusion of sexual minorities in both research and clinic. Among lesbian, gay and bisexual populations certain features could be present that play a role for the development of addictive behaviors, such as social isolation and increased risk of other psychiatric problems. The aim of this study was to investigate problem gambling, problem gaming and problematic internet behavior in a European context and if it is affected by sexual orientation status.

Methods

An online web-survey was distributed among web-panels in England, Poland, Switzerland, Italy, Spain, Denmark, and Sweden in 2017-2018.

Result

10 983 complete answers were collected. 7.1% of the participants had a sexual minority status (n = 774). Regression models found that there was no difference in gambling, gaming and internet behavior among heterosexual and sexual minority men. Sexual minority women were associated with problematic gambling and gaming behavior, when also controlling for age and nationality. When also controlling for psychological distress, women defining as having another sexual minority status than lesbian and bisexual remained significant for having a problematic gaming behavior (AOR = 2.3).

Conclusion

An awareness of female sexual minority perspectives is relevant in facilities treating behavioral addiction as well as in future research in behavioral addiction. More research is needed in problematic gambling and gaming behavior in different sexual minority populations with regard to psychiatric comorbidity and living conditions. An inclusion of sexual minority groups defining as other than gay and bisexual is needed in future research. No significant differences were found between heterosexual and sexual minority men in adjusted analysis in this study.

Delay Discounting in Gambling Disorder: Implications in Treatment Outcome

Impulsive choice, measured by delay discounting (DD) tasks, has been shown in patients with gambling disorders (GD). However, the impact of DD and treatment outcome has been scarcely explored in GD patients. The aims of this study were: (1) to examine the baseline association between DD and clinical variables in GD patients depending on their age and gambling preferences (strategic vs. non-strategic); and (2) to estimate the predictive role of DD on poorer outcomes of cognitive-behavioral therapy (CBT) when considering also the effect of other clinical variables. 133 treatment-seeking male GD patients were evaluated at baseline with a DD task and measures of GD severity, personality traits and psychopathology. Treatment outcome was measured in terms of dropout from CBT and relapses. Results showed baseline associations between DD and GD severity (correlation coefficient R = 0.408 among strategic gamblers and R = 0.279 among mixed gamblers) and between DD and positive/negative urgency (R = 0.330 for the youngest patients, R = 0.244 for middle age, and around R = 0.35 for gamblers who reported preferences for strategic games). Other personality traits such as high harm avoidance and low cooperativeness were also related to DD at baseline (R = 0.606 among strategic gamblers). Regarding treatment outcome, a steeper discount rate predicted a higher risk of relapses in strategic gamblers (odds ratio OR = 3.01) and middle-age ones (OR = 1.59), and a higher risk of dropout in younger gamblers (OR = 1.89), non-strategic gamblers (OR = 1.70) and mixed gamblers (R = 4.74). GD severity mediated the associations between age, DD, personality traits and poor CBT outcome. In conclusion, impulsive choice affects treatment response in individuals with GD and may interfere with it to a significant extent. Considering DD in GD, patients seeking treatment could help control its impact on treatment adherence and relapses.

Gambling motivation model for older women addicted and not addicted to gambling - a qualitative study

Objectives: This article presents the results of a study conducted on older women who have retired from work and who gamble regularly. The aim of the study was an in-depth analysis of the motivation to gamble in older professional inactive women addicted and not addicted to gambling.Method: In-depth interviews were conducted with 34 women aged 55+ years. Motivation factors for gambling among women addicted to gambling (n = 8) and those not addicted to gambling (n = 26) were subjected to in-depth thematic analysis of the content of the interviews.Results: Five major categories were distinguished: sensations, money, activity, socialisation and escape. The most important factors for the women who were not addicted to gambling were sensations and money, followed by activity and socialisation. Women addicted to gambling, on the other hand, were mostly motivated by sensations, escape and socialisation.Conclusions: The results show the need for an in-depth analysis of the motivational factors in this group. Models built on the basis of adults are not reflected in older women. For example, the financial motive, typical of addicted gamblers, is dominant among non-addicted female seniors. Qualitative analysis helps to understand this specificity.

Clinical differences between men and women in a Swedish treatment-seeking population with gambling disorder

INTRODUCTION

The purpose of this study was to explore clinical differences in Swedish treatment-seeking men and women with gambling disorder (GD). As the prevalence of GD is increasing among women, even though men are still highly overrepresented, the characteristic differences between men and women seeking treatment become increasingly important.

METHOD

A sample of 204 patients with GD (26.5% women and 73.5% men) at an outpatient clinic were diagnosed using the SCI-GD, screened for comorbid diagnoses using the MINI, and further completed a range of self-report questionnaires measuring demographics, GD, alcohol and other drug problems, symptoms of depression and anxiety, and pathways into gambling problems.

RESULTS

Several characteristics differed between treatment-seeking men and women in our sample. Examples of differences between genders included age, onset age, living situation, duration, alcohol and drug problems, comorbidity, and pathways leading to gambling problems.

DISCUSSION

The most evident difference was that women, in addition to GD, showed more symptoms of anxiety and depression than men, while men had a higher degree of substance use problems compared to women. The differences in clinical features between men and women are important to consider in treatment planning and possibly for future gender-based interventions.

Women and gambling disorder: Assessing dropouts and relapses in cognitive behavioral group therapy

BACKGROUND

Gender-specific literature focused on gambling disorder (GD) is scarce, and women with GD have been understudied. Therefore, the aim of this study was to estimate the short-term effectiveness in women with GD (n = 214) of a group standardized cognitive-behavioral therapy (CBT) and to identify the most relevant predictors of the primary therapy outcomes (dropout and relapse).

METHODS

The manualized CBT consisted of 16 weekly outpatient group sessions. Women were provided with resources to obtain a better understanding of the GD, to improve self-control and to manage risk situations.

RESULTS

The dropout risk was higher for women with lower GD severity and higher psychopathological distress. Among other factors, lower education levels were a significant predictor of the relapse risk and and the frequency of relapses was higher for divorced women with a preference for non-strategic gambling and with substances consumption.

CONCLUSIONS

Our findings evidence women-specific predictors of the primary therapy outcomes. The results highlight the need to design psychological interventions that address dropout and relapse risk factors in women.

Clinical Features of Gambling Disorder Patients with and Without Food Addiction: Gender-Related Considerations

Although food addiction (FA) is a debated condition and it is not currently recognized as a formal diagnosis, it shares features with other addictions, such as gambling disorder (GD). However, the prevalence of FA in GD and the clinical correlates are incompletely understood, especially within women versus men. To investigate FA in patients presenting with GD. The sample included 867 patients diagnosed with GD (798 males and 69 females) attending a specialized behavioral addictions unit. FA was observed in 8.3% of GD patients (18.8% of women, 7.4% of men). More psychopathology and harm avoidance, greater body mass indices and less self-directedness and cooperativeness were associated with FA. In women, FA was associated with a longer GD duration. In men, FA was associated with earlier GD onset, greater GD and problematic alcohol use severities. Among patients with GD, FA was associated with more psychopathology and gambling patterns suggestive of more protracted or severe GD. Screening for and addressing FA condition in patients with GD may help optimize preventive and therapeutic approaches. Future studies should consider testing guidelines to improve healthy eating habits, increase physical exercise and better manage stress and other negative emotions in order to target FA in GD.

Updating an empirical investigating risk perceptions associated with national ID cards in the wake of the global Covid-19 pandemic

National ID cards have been debated for some time, especially with the recent Covid-19 global pandemic and increases in technological capabilities, coupled with the need for higher national security. This paper is an empirical extension of Smith's work but in light of the current economic and political turmoil. These differences were inspected from a gender perspective, but the distrust was generally universal. As the beneficial reasons why National ID cards should be implemented (e.g., enhanced security, convenience, and enhancing CRM concepts), still many professionals exhibit numerous fears and are concerned with the risks involved.

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.

Prevalence of Problem Gambling Among Women Using Shelter and Drop-in Services

People experiencing poverty/homelessness have higher rates of problematic gambling than the general population. Yet, research on gambling among this population is sparse, notably among women. This study examined prevalence of problematic gambling among women using shelter and drop-in services in Ontario, Canada. The NORC Diagnostic Screen for Disorders was administered to women during visits to 15 sites using time/location methodology. Within a sample of 162 women, the prevalence of at-risk (6.2%), problem (9.3%), and pathological gambling (19.1%) was higher than the general population. Among women who scored at-risk or higher, 55.4% met criteria for pathological gambling. The findings suggest that women seeking shelter and drop-in services are vulnerable to problematic gambling. Creating awareness of this vulnerability within the shelter and drop-in service sector is an important first step to support women with gambling problems who face financial and housing precarity.

Emotional regulation in eating disorders and gambling disorder: A transdiagnostic approach

BACKGROUND AND AIMS

Difficulties in Emotion Regulation (ER) are related to the etiology and maintenance of several psychological disorders, including Eating Disorders (ED) and Gambling Disorder (GD). This study explored the existence of latent empirical groups between both disorders, based on ER difficulties and considering a set of indicators of personality traits, the severity of the disorder, and psychopathological distress.

METHODS

The sample included 1,288 female and male participants, diagnosed with ED (n = 906) and GD (n = 382). Two-step clustering was used for the empirical classification, while analysis of variance and chi-square tests were used for the comparison between the latent groups.

RESULTS

Three empirical groups were identified, from the most disturbed ER profile (Subgroup 1) to the most functional (Subgroup 3). The ER state showed a linear relationship with the severity of each disorder and the psychopathological state. Different personality traits were found to be related to the level of emotion dysregulation.

DISCUSSION AND CONCLUSION

In this study, three distinct empirical groups based on ER were identified across ED and GD, suggesting that ER is a transdiagnostic construct. These findings may lead to the development of common treatment strategies and more tailored approaches.

A comparison of fraud to fund gambling with fraud for other reasons

In order to compare the characteristics, including diagnosed mental disorder, of people who commit fraud offences to fund gambling with those who committed fraud for other reasons, we examined a complete series of reports prepared for legal proceedings by two of the authors from between January 2002 and June 2019. A total of 160 fraud offenders were located, of whom 48 (30%) reported offending to fund gambling. Females made up 47.5% of the total sample and 43.8% of the gamblers. Of the problem gambling group, 44% had diagnoses of anxiety or depression, 44% had substance use disorder, 17% had bipolar and other psychosis, and 38% reported childhood trauma. There were no significant differences in the frequencies of diagnosis of mental illness or previous criminal convictions compared to the non-gambling group. Two thirds reported only gambling on poker machines. Only 19% of gamblers reported seeking treatment prior to being charged.

Characteristics of Gamblers Who Use the French National Problem Gambling Helpline and Real-Time Chat Facility: Longitudinal Observational Study

Background

Problem gambling is a growing public health issue that is characterized by low rates of face-to-face help seeking. Helplines and real-time chat services could reduce shortfalls in treatment.

Objective

This study aimed to (1) describe the characteristics of gamblers contacting a government-funded help service, (2) study the evolution of their characteristics over time, (3) evaluate the differences between subgroups (ie, gender, media used for gambling, and media used to contact the service), and (4) explore factors influencing referral to care.

Methods

From January 2011 to December 2015, a government-funded gambling helpline and real-time chat website in France received 9474 contacts from gamblers. Counselors filled in a form for each contact, collecting demographics, gambling characteristics, and referrals. Time-series analyses were performed. Univariate logistic models were used to assess differences across subgroups. A multivariate analysis was conducted to determine the variables related to an actual referral.

Results

Gamblers were predominantly men (7017/9474, 74.07%); the average age was 41 years (SD 14). Compared with the men, the women were older (mean 50.7 years, SD 14.0 vs mean 37.9 years, SD 13.0, respectively; P<.001), were more often solely offline gamblers (1922/2457, 78.23% vs 4386/7017, 62.51%, respectively; P<.001), and had different gambling patterns. Compared with helpline contacts, real-time chat contacts were more often men (124/150, 82.7% vs 3643/4881, 74.64%, respectively; P=.04), younger (mean 32.8 years, SD 12.9 vs mean 41.3 years, SD 14.3, respectively; P<.001), more often poker gamblers (41/150, 27.3% vs 592/4881, 12.13%, respectively; P<.001), and more often web-based gamblers (83/150, 55.3% vs 1462/4881, 29.95%, respectively; P<.001). Referral was positively associated with betting (adjusted odds ratio [aOR] 1.46, 95% CI 1.27-1.67; P<.001), casino gambling (aOR 1.38, 95% CI 1.21-1.57; P<.001), scratch cards (aOR 1.83, 95% CI 1.58-2.12; P<.001), poker gambling (aOR 1.35, 95% CI 1.14-1.61; P<.001), lottery (aOR 1.27, 95% CI 1.03-1.56; P=.03), weekly gambling (aOR 1.73, 95% CI 1.40-2.15; P<.001), request for referral (aOR 17.76, 95% CI 14.92-21.13; P<.001), and a history of suicide attempts (aOR 2.13, 95% CI 1.51-3.02; P<.001), and it was negatively associated with web-based gambling (aOR 0.86, 95% CI 0.75-0.98; P=.030) and refusal to be referred (aOR 0.35, 95% CI 0.26-0.49; P<.001).

Conclusions

The governmental helpline and chat contacts included a broad range of sociodemographic profiles. Compared with the helpline, real-time chat exchanges reached a younger population of web-based gamblers, which was the target population. The development of the gambling helpline and help online website is a considerable challenge for the future.

The Effects of Perceived Gambling Availability on Problem Gambling Severity

The aim of this study was to determine the moderating effects of sociodemographic characteristics, substance use, and psychosocial problems on the relationship between perceived gambling availability and problem gambling severity. Bivariate and multivariate regression analyses of the 2008 and 2009 Social and Economic Impacts of Gambling in Alberta surveys found problem gambling severity was 1.25-1.39 times higher for those reporting gambling opportunities were 'too widely available'. Factors such as age, gender, place of residence, and psychosocial problems had significant moderating effects. Our findings indicate that the perception of gambling availability has a statistically significant impact on problem gambling severity.

Problem and non-problem gamblers: a cross-sectional clustering study by gambling characteristics

OBJECTIVES

Gambling characteristics are factors that could influence problem gambling development. The aim of this study was to identify a typology of gamblers to frame risky behaviour based on gambling characteristics (age of initiation/of problem gambling, type of gambling: pure chance/chance with pseudoskills/chance with elements of skill, gambling online/offline, amount wagered monthly) and to investigate clinical factors associated with these different profiles in a large representative sample of gamblers.

DESIGN AND SETTING

The study is a cross-sectional analysis to the baseline data of the french JEU cohort study (study protocol : Challet-Bouju et al, 2014). Recruitment (April 2009 to September 2011) involved clinicians and researchers from seven institutions that offer care for or conduct research on problem gamblers (PG). Participants were recruited in gambling places, and in care centres. Only participants who reported gambling in the previous year between 18 and 65 years old were included.Participants gave their written informed consent, it was approved by the French Research Ethics Committee.

PARTICIPANTS

The participants were 628 gamblers : 256 non-problem gamblers (NPG), 169 problem gamblers without treatment (PGWT) and 203 problem gamblers seeking treatment (PGST).

RESULTS

Six clustering models were tested, the one with three clusters displayed a lower classification error rate (7.92%) and was better suited to clinical interpretation : 'Early Onset and Short Course' (47.5%), 'Early Onset and Long Course' (35%) and 'Late Onset and Short Course' (17.5%). Gambling characteristics differed significantly between the three clusters.

CONCLUSIONS

We defined clusters through the analysis of gambling variables, easy to identify, by psychiatrists or by physicians in primary care. Simple screening concerning these gambling characteristics could be constructed to prevent and to help PG identification. It is important to consider gambling characteristics : policy measures targeting gambling characteristics may reduce the risk of PG or minimise harm from gambling.

TRIAL REGISTRATION NUMBER

NCT01207674 (ClinicalTrials.gov); Results.

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.

The Disillusioned Comfort with COVID-19 and the Potential of Convalescent Plasma and Cell Therapy

Coronavirus disease 2019 or COVID-19 is highly infectious, which can lead to acute and chronic debilitating symptoms, as well as mortality. The advent of safe and effective vaccines or antiviral drugs remains distant in the future. Practical public health measures, such as social distancing, hand washing, and wearing a face mask, are the current recommended guidelines by the Centers for Disease Control and Prevention for limiting the spread of the virus. Weakened immune system and aberrant inflammation represent a major pathological symptom of COVID-19 patients. Based on the unique immunomodulatory properties of both convalescent plasma and stem cells, we discuss here their potential use for treating COVID-19.

Treatment-Seeking Problem Gamblers: Characteristics of Individuals Who Offend to Finance Gambling

The relationship between crime and gambling is well established; however, few studies have examined offending specifically to finance gambling within a UK gambling treatment-seeking population. A total of 1226 treatment-seeking gamblers completed the Problem Gambling Severity Index (PGSI), Patient Health Questionnaire and the Generalized Anxiety Disorder 7 item scale, and were asked whether they had committed any illegal behaviours to finance gambling. A total of 42.5% reported offending behaviour. A greater proportion of the offending group was single or married/cohabiting, had a lower level qualifications, lower income, had experienced childhood abuse, family mental health problems and gambling-related harms compared with the non-offending group. Offenders reported higher anxiety, depression and disordered gambling scores. Disordered gamblers who offend make up a discrete and complex subgroup with distinct vulnerabilities. Findings will be useful to clinicians involved in the assessment and management of problematic gambling. Gamblers who offend to finance gambling may have different treatment needs and treatment providers should administer appropriate clinical interventions to address vulnerabilities.

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.

Similar roles for recovery capital but not stress in women and men recovering from gambling disorder

BACKGROUND

Understanding gender-related differences is important in recovery processes. Previous studies have investigated gender-related differences in factors associated with gambling disorder (GD), but none to date have considered both positive and negative resources related to recovery. Using a recovery capital (RC) framework that considers multiple resources available during recovery, this study examined gender-related similarities and differences in associations between positive resources (RC, spirituality) and negative experiences and states (stressful life events, depression, and anxiety) and GD symptom improvement.

METHOD

One hundred and forty individuals with lifetime GD (101 men) were assessed using DSM-5 diagnostic criteria for GD (past-year and lifetime prior to past-year), the Brief Assessment of RC, the Intrinsic Spirituality Scale, the Stressful Life-events Scale, the Generalized Anxiety Disorder Scale, and the Patient Health Questionnaire 9 for depression. Multiple linear regression and Bayesian statistical analyses were conducted.

RESULTS

RC was positively and significantly associated with GD symptom improvement in women and men. Stressful life events were negatively associated with GD symptom improvement only in men.

CONCLUSIONS

RC is an important positive resource for men and women recovering from GD and should be considered in treating both women and men. Understanding specific RC factors across gender groups and stressors, particularly in men, may aid in developing improved interventions for GD.

An Exploratory Study of Relationships Among Five-Factor Personality Measures and Forms of Gambling in Adults With and Without Probable Pathological Gambling

The present study explored relationships between personality domains and gambling forms in individuals with and without probable pathological gambling (PPG). Associations among personality domain scores obtained from the NEO Personality Inventory-Revised, endorsements of gambling activities on the South Oaks Gambling Screen (SOGS), and PPG as determined by the SOGS were examined with bivariate and logistic regression analyses. Compared to recreational gamblers, those with PPG scored significantly higher in neuroticism and lower in agreeableness and conscientiousness. Agreeableness was inversely associated with gambling on cards, sports, bingo, stock market, dice, and skill games. Conscientiousness was inversely associated with gambling on sports and animal racing. Extraversion was positively associated with gambling on cards, dice, and stocks. Neuroticism and openness were positively associated with gambling on animal racing and stock gambling, respectively. Significant interactions indicated stronger inverse associations between agreeableness and gambling in casinos, on sports, and on skill games and stronger positive associations between openness and gambling on stocks and skill games in individuals with PPG compared to those without. The results suggest different relationships between personality domain measures and specific forms of gambling in individuals with and without PPG. Future research efforts should examine how personality factors may be used to enhance policy, prevention, and treatment efforts.

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.

Adult ADHD Is Associated With Gambling Severity and Psychiatric Comorbidity Among Treatment-Seeking Problem Gamblers

Objective: The aim of this study is as follows: (a) exploring retrospective childhood and adult ADHD symptomatology in treatment-seeking gamblers, (b) providing detailed characteristics of the association between pathological gambling (PG) and ADHD, and (c) identifying risk factors for a history of ADHD. Method: Eighty problem gamblers (20% female) were examined using a standardized interview (PG: Diagnostic and Statistical Manual of Mental Disorders [4th ed.; DSM-IV] criteria, Gambling Attitudes and Beliefs Survey; ADHD: Wender Utah Rating Scale-deutsche Kurzform, Adult ADHD Self-Report Scale; comorbidities: Mini International Neuropsychiatric Interview). Results: Forty-three percentage of patients screened positive for childhood ADHD, and in 11%, ADHD persisted in adulthood. Patients with adult ADHD had more severe gambling problems (p = .009, d = 1.03) and a higher number of psychiatric comorbidities (p < .001, d = 1.62) compared with those without ADHD. Substance abuse/dependence constituted a predictor for having a history of ADHD (odds ratio [OR] = 4.07, p = .025). Conclusion: ADHD-PG comorbidity is linked to factors that worsen the prognosis. Thus, screening for ADHD and verifying persistence in adulthood should be an integral component in the interdisciplinary treatment of problem/pathological gamblers.

Gambling disorder

Gambling disorder is characterized by a persistent, recurrent pattern of gambling that is associated with substantial distress or impairment. The prevalence of gambling disorder has been estimated at 0.5% of the adult population in the United States, with comparable or slightly higher estimates in other countries. The aetiology of gambling disorder is complex, with implicated genetic and environmental factors. Neurobiological studies have implicated cortico-striato-limbic structures and circuits in the pathophysiology of this disorder. Individuals with gambling disorder often go unrecognized and untreated, including within clinical settings. Gambling disorder frequently co-occurs with other conditions, particularly other psychiatric disorders. Behavioural interventions, particularly cognitive-behavioural therapy but also motivational interviewing and Gamblers Anonymous, are supported in the treatment of gambling disorder. No pharmacological therapy has a formal indication for the treatment of gambling disorder, although placebo-controlled trials suggest that some medications, such as opioid-receptor antagonists, may be helpful. Given the associations with poor quality of life and suicide, improved identification, prevention, policy and treatment efforts are needed to help people with gambling disorder.

Gender-related differences in neural responses to gaming cues before and after gaming: implications for gender-specific vulnerabilities to Internet gaming disorder

Backgrounds

More males than females play video games and develop problems with gaming. However, little is known regarding how males and females who game on the Internet may differ with respect to neural responses to gaming cues.

Methods

Behavioral and functional magnetic resonance imaging (fMRI) data were recorded from 40 female and 68 male Internet gamers. This study included three components including participation in a pre-gaming cue-craving task, 30 min of online gaming and a post-gaming cue-elicited-craving task. Group differences were examined at pre-gaming, post-gaming and post- vs pre-gaming times. Correlations between brain responses and behavioral performance were calculated.

Results

Gaming-related cues elicited higher cravings in male vs female subjects. Prior to gaming, males demonstrated greater activations in the striatum, orbitofrontal cortex (OFC), inferior frontal cortex and bilateral declive. Following gaming, male subjects demonstrated greater activations in the medial frontal gyrus and bilateral middle temporal gyri. In a post–pre comparison, male subjects demonstrated greater thalamic activation than did female subjects.

Conclusions

Short-term gaming elicited in males vs females more craving-related activations to gaming cues. These results suggest neural mechanisms for why males may be more vulnerable than females in developing Internet gaming disorder.

Utilisation patterns of helpline and Web chat services among gamblers in Singapore

We evaluated the utilisation of a helpline and Web chat system by the public for gambling-related services in Singapore over a period of 12 months. The profile of callers, call characteristics and actions taken were descriptively analysed using aggregate data. The majority of helpline calls and Web chats were from gamblers aged 40-49 years (23.3%, n = 644). Gamblers made 85.4% (n = 8,010) of the calls to the helpline and 73.3% (n = 546) of the Web chats. About four-fifths of the gamblers were Chinese (79.5%, n = 6,381) and employed full time (79.9%, n = 4,125). Table games (67.6%, n = 2,605) were the most popular gambling activity reported by callers, 55.8% of which involved local casinos. Enquiries were mostly casino related (92.4%, n = 5,739). Approximately 1,827 calls were received per month during the study period and 185 referrals were made to the clinic, 80.5% of whom sought treatment.

Gender Moderates the Partial Mediation of Impulsivity in the Relationship Between Psychiatric Distress and Problematic Online Gaming: Online Survey

BACKGROUND

Research has shown that some individuals can develop problematic patterns of online gaming, leading to significant psychological and interpersonal problems. Psychiatric distress and impulsivity have been suggested to contribute to problematic online gaming (POG).

OBJECTIVE

This study aimed to investigate the potential mediating or moderating mechanisms of impulsivity and gender-related differences in possible associations between psychiatric distress and POG.

METHODS

A total of 596 matched female and male participants, ranging in age from 14 to 38 years (mean 21.4, SD 4.5), were chosen from a large cross-sectional, nationwide Hungarian online gaming sample. Participants completed online questionnaires about self-reported impulsivity, psychiatric distress, and POG.

RESULTS

Psychiatric distress directly predicted POG, and impulsivity partially mediated the relationship between psychiatric distress and POG. However, this mediation effect was found only for the impatience factor of impulsivity. Impulsivity did not moderate the relationship between psychiatric distress and POG. A moderating effect of gender was not found in the direct relationship between psychiatric distress and POG. However, a moderated mediation analysis revealed that impatience mediated the association between psychiatric distress and POG in males, whereas the indirect effect of impatience was not significant in females.

CONCLUSIONS

The results of this work highlight gender-related difference among online gamers in the mediation effect of impulsivity between psychiatric distress and POG and provide novel insights regarding clinical implications for preventing or treating POG.

Retrospective and prospective assessments of gambling-related behaviors across the female menstrual cycle

BACKGROUND AND AIMS

Despite increases in female gambling, little research investigates female-specific factors affecting gambling behavior (GB). Although research suggests that some addictive behaviors may fluctuate across menstrual cycle phase (MCP), gambling requires further investigation. In two studies, we examined associations between MCP and three risky GBs: time spent gambling, money spent gambling, and the probability of consuming alcohol while gambling. Associations between MCP and negative affect were also examined in Study 2. We predicted that, consistent with self-medication theory, increases in negative affect (Study 2) and risky GBs (Studies 1 and 2) would occur premenstrually/menstrually relative to other phases.

METHODS

Data were obtained from 33 female gamblers using a retrospective timeline followback procedure (Study 1) and from 20 female gamblers using a prospective 32-day, daily diary method (Study 2). In Study 2, salivary progesterone levels verified self-reported MCP validity.

RESULTS

Findings revealed significant, but somewhat inconsistent, MCP effects on GBs across studies. The self-medication hypothesis was partially supported. Increases relative to another MCP(s) were found for alcohol consumption while gambling premenstrually, time spent gambling menstrually/premenstrually, money spent gambling menstrually, and negative affect premenstrually. Unexpectedly, findings more consistently indicated that GBs increased during ovulation, suggestive of enhanced reward sensitivity. Progesterone assays validated self-reported MCP (Study 2).

DISCUSSION AND CONCLUSIONS

The results suggest a role of ovarian hormones on negative affect and GBs in females. This research could lead to the identification of female-specific factors affecting gambling and the development of more effective interventions for females with, or at risk for, problematic gambling.

Gender-related functional connectivity and craving during gaming and immediate abstinence during a mandatory break: Implications for development and progression of internet gaming disorder

BACKGROUND

Although males more frequently develop Internet gaming disorder (IGD) as compared with females, few studies have examined gender-related neurocognitive differences in IGD. TASK AND DESIGN: fMRI and subjective data were collected from 119 subjects (IGD, male 29, female 25; recreational game use (RGU), male 34, female 31) when they were actively playing games and during a forced mandatory break. Analyses investigating effects of group (IGD, RGU) and gender (male, female) on the functional connectivity (FC) of executive control and reward systems linked to the dorsolateral prefrontal cortex (DLPFC) and striatum, respectively, were performed. Correlations between FC and subjective craving measures were also calculated.

RESULTS

Gaming-group-by-gender interactions were observed. During gaming in males but not in females, the FC between the DLPFC and superior frontal gyrus was relatively decreased, and that between the striatum and thalamus was relatively increased. During the mandatory break, changes in the FC between DLPFC and superior frontal gyrus and the FC between the striatum and thalamus varied by gender with greater RGU-IGD differences observed in females. Significant correlations between FC and self-reported craving were observed.

CONCLUSIONS

During both gaming and a forced mandatory break, brain regions implicated in executive control and reward processing showed changes in FC that varied by gender. Brain regions implicated in executive control showed differential FC in males during gaming, and FC during the forced mandatory break appeared relevant to both genders, and perhaps particularly for females. The findings suggest possible neural mechanisms for why males appear more likely to develop IGD, and why it may be particularly difficult for individuals with IGD to cease gaming.

Heterogeneity in Disordered Gambling: Decision-Making and Impulsivity in Gamblers Grouped by Preferred Form

Background: Previous research has indicated that disordered gamblers display deficits in impulsivity and risky decision-making, compared to healthy control groups. However, disordered gamblers are not a homogenous group, and differences in performance on neurocognitive tasks may be related to the form of gambling in which an individual chooses to engage. The present study used neurocognitive tasks and questionnaire measures to ascertain group differences in gamblers grouped by preferred form of gambling. Method: Treatment-seeking pathological gamblers from the National Problem Gambling Clinic, London (n = 101), completed a neurocognitive assessment comprising the Cambridge gamble task (CGT), the stop-signal task (SST), a probabilistic reversal learning task (PRL), and the Kirby Monetary Choice Questionnaire, as well as questionnaire measures of gambling severity, impulsivity, depression, and anxiety. Analyses compared gamblers who favored fixed-odds betting terminals (FOBTs) (the modal form) to gamblers who preferred other forms of gambling (non-FOBT). Results: The FOBT group showed impaired decision-making under risk on the CGT compared to the non-FOBT group, choosing the likely option less on more uncertain decisions. The FOBT group made fewer perseverative errors on the PRL task, had lower depression and anxiety scores, and were less likely to have a family history of problem gambling than the non-FOBT group. Discussion: Decision-making and cognitive flexibility differences between gamblers grouped by gambling type supports preferred form as an important source of heterogeneity in gambling disorder. Decision-making strategies and risk attitudes should be considered when approaching cognition-focused treatment strategies, allowing interventions to be targeted at specific cognitive deficits.

On the Processes Underlying the Relationship Between Alexithymia and Gambling Severity

A great number of individuals with persistent problematic gambling behavior exhibit alexithymic tendencies, greater impulsivity, impaired working memory and poor mood. However, the relationship between these cognitive, affective and personality factors in problem gambling remains poorly understood. Our aim was to investigate multiple pathways of the alexithymia and problem gambling relationship. One hundred and six male subjects with different levels of gambling problem severity were recruited. Alexithymia, impulsivity and verbal working memory were evaluated, and their relationships to disordered gambling was examined by means of a path analysis. Results indicate that alexithymia is related to an increase in the severity of gambling indirectly, i.e., through distress severity. In addition, a rise of alexithymic tendencies was also associated with problem gambling severity through enhanced impulsivity that directly increased distress. Working memory capacity failed to significantly impact our path model. Overall, our findings contribute a new finding to the literature by highlighting the importance of alexithymia, in addition to impulsivity, in the understanding of gambling problem severity and its clinical course.