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Bahri MRZ, Tayim N, Fakhrou A, Davoudi M. Associations between Adverse Childhood Experiences and Gambling Severity in Youth Online Gamblers: The Mediating Roles of Internalizing, Attention and Externalizing Problems. J Gambl Stud 2024:10.1007/s10899-024-10320-8. [PMID: 38802628 DOI: 10.1007/s10899-024-10320-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/28/2024] [Indexed: 05/29/2024]
Abstract
BACKGROUND This study examined the association between Adverse Childhood Experiences (ACEs) and Gambling Severity (gambling severity), considering the mediating roles of internalizing, externalizing, and attention among youth online gamblers. METHODS 762 youth (agemean±SD= 15.03 ± 2.40; agerange = 10-18 years; 75.3% boys) completed the Persian Gambling Disorder Screening Questionnaire (GDSQ-P), Pediatric Symptom Checklist - Youth Report (Y-PSC), and Behavioral Risk Factor Surveillance System Questionnaire (ACE's section, modified by authors). The analysis was done using the SMART PLS software. RESULTS The reliability and discriminant validity of the provided model were assessed using Partial Least Squares-Structural Equation Modeling (PLS-SEM). According to the results of the PLS-SEM analysis, the present model demonstrated suitable levels of reliability and validity. Adverse Childhood Experiences (ACEs) significantly affected attention, internalizing, externalizing problems, and gambling severity. Additionally, the level of gambling was directly correlated with ACEs. Moreover, the indirect influence of the independent variable on the dependent variable via the mediators was found to be statistically significant (P < .001).These findings suggest that externalizing behaviors, attention problems, and internalizing symptoms mediate the effect of ACEs on gambling severity. Lastly, fitness indices indicated that our proposed model fit the data well (SRMR = 0.06, d_ULS = 1.15, Chi-square = 1291.461, and NFI = 0.71). CONCLUSION Our study found that ACEs significantly influence gambling severity among youth online gamblers, with internalizing, externalizing, and attention problems mediating this relationship. Practical implications include integrating ACE screening and targeted interventions for associated mental health issues into youth gambling prevention programs to mitigate the risk of problematic gambling behavior.
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Affiliation(s)
| | - Natalie Tayim
- Department of Psychology, School of Social Sciences and Humanities, Doha Institute for Graduate Studies, Doha, Qatar
| | - Abdulnaser Fakhrou
- Department of Psychological Sciences, College of Education, Qatar University, Doha, Qatar
| | - Mohammadreza Davoudi
- Department of Clinical Psychology, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
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Hing N, Russell AMT, Tulloch C, Lole L, Rockloff M, Browne M, Thorne H, Newall P. Feature preferences of sports betting platforms: A discrete choice experiment shows why young bettors prefer smartphones. J Behav Addict 2024; 13:134-145. [PMID: 38193920 PMCID: PMC10988403 DOI: 10.1556/2006.2023.00073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 11/26/2023] [Accepted: 11/27/2023] [Indexed: 01/10/2024] Open
Abstract
Background and aims Smartphone, computer and land-based betting platforms each have distinctive features. This study examined 1) preferred features of sports betting platforms amongst young adults and 2) whether feature preferences vary with gambling severity. Methods The study surveyed 616 Australians aged 18-29 years who bet at-least monthly on sports, esports and/or daily fantasy sports. Participants provided a simple rating of the importance of 24 features of betting platforms and then completed a discrete choice experiment to indicate their preferences amongst different groups of features. Results Smartphones were the only platform providing all preferred features. The most important feature was ability to bet instantly 24/7 from any location, followed by electronic financial transactions. Less important features were ability to access betting information online and to bet with multiple operators. Social and privacy features, and access to promotions, did not significantly predict platform choice. The experiment found no significant differences in preferred features by gambling severity group or by gender. The non-experimental descriptive data, however, indicated that participants in the moderate risk/problem gambling categories placed significantly more importance on privacy, ability to place in-play bets, bet with cash, bet with a credit card, see frequent promotions, and bet with multiple operators. Discussion and conclusions Most features that bettors prefer can intensify betting. Curtailment of betting promotions, in-play betting, and credit card betting are measures that can assist higher-risk gamblers without unduly affecting other gamblers. Consumer protection tools, including mandatory pre-commitment, need strengthening to help counter the unique risks of smartphone betting.
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Affiliation(s)
- Nerilee Hing
- Experimental Gambling Research Laboratory, School of Health, Medical and Applied Sciences, CQUniversity, Australia
| | - Alex M. T. Russell
- Experimental Gambling Research Laboratory, School of Health, Medical and Applied Sciences, CQUniversity, Australia
| | - Catherine Tulloch
- Experimental Gambling Research Laboratory, School of Health, Medical and Applied Sciences, CQUniversity, Australia
| | - Lisa Lole
- Experimental Gambling Research Laboratory, School of Health, Medical and Applied Sciences, CQUniversity, Australia
| | - Matthew Rockloff
- Experimental Gambling Research Laboratory, School of Health, Medical and Applied Sciences, CQUniversity, Australia
| | - Matthew Browne
- Experimental Gambling Research Laboratory, School of Health, Medical and Applied Sciences, CQUniversity, Australia
| | - Hannah Thorne
- Experimental Gambling Research Laboratory, School of Health, Medical and Applied Sciences, CQUniversity, Australia
| | - Philip Newall
- Experimental Gambling Research Laboratory, School of Health, Medical and Applied Sciences, CQUniversity, Australia
- School of Psychological Science, University of Bristol, United Kingdom
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Fannin M, Collard S, Davies S. Power, intersectionality and stigma: Informing a gender- and spatially-sensitive public health approach to women and gambling in Great Britain. Health Place 2024; 86:103186. [PMID: 38428064 DOI: 10.1016/j.healthplace.2024.103186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Revised: 01/04/2024] [Accepted: 01/27/2024] [Indexed: 03/03/2024]
Abstract
In Britain more men participate in gambling than women, although the gender gap is narrowing; and online gambling is increasing among women and men. Gambling practices differ between men and women but also between different groups of women, with evidence that younger women are diversifying to gamble in different ways from older women. Complex and powerful spatial, socio-cultural and economic forces shape women's experiences of gambling, the problems gambling may cause, and wider societal efforts to minimise these harms. This paper presents the findings of a Rapid Evidence Assessment (REA) of research on women and gambling and conceptual reflections on these findings to argue for greater attention to the gendered and spatial dimensions of gambling in three ways. First, we discuss the geographical focus and scope of the research we reviewed on women and gambling; second, we analyse the changing geographies of where women gamble; and finally, we consider how qualitative notions of space as experiential and co-constitutive can offer a more nuanced conceptual framework for understanding women's lived experience of gambling and gambling harm. We identify areas for further research on gambling and gambling harm that attends to gendered and spatial dimensions of gambling, including online spaces; the intersectional dynamics that shape gambling practice and gambling harms; and the experiences of those affected by others' gambling.
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Affiliation(s)
- Maria Fannin
- School of Geographical Sciences, University of Bristol, Bristol, BS8 1SS, UK.
| | - Sharon Collard
- Personal Finance Research Centre, School of Geographical Sciences, University Road, Bristol, BS8 1SS, UK.
| | - Sara Davies
- Personal Finance Research Centre, School of Geographical Sciences, University Road, Bristol, BS8 1SS, UK.
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Hing N, Browne M, Rockloff M, Russell AMT, Tulloch C, Lole L, Thorne H, Newall P. Situational features of smartphone betting are linked to sports betting harm: An ecological momentary assessment study. J Behav Addict 2023; 12:1006-1018. [PMID: 38015207 PMCID: PMC10786227 DOI: 10.1556/2006.2023.00065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 10/26/2023] [Accepted: 11/06/2023] [Indexed: 11/29/2023] Open
Abstract
Background and aims Smartphones extend the situational characteristics of sports betting beyond those available with land-based and computer platforms. This study examined 1) the role of situational features and betting platforms in harmful betting behaviours and short-term betting harm, and 2) whether people with more gambling problems have preferred situational features, engage more in harmful betting behaviours, and experience more severe short-term betting harm. Methods An ecological momentary assessment analysed 1,378 betting sessions on sports, esports or daily fantasy sports, reported by 267 respondents (18-29 years; 50.9% male) over 10 weeks. Results Factor analysis revealed five situational features of betting sessions: 1) quick, easy access from home, 2) ability to bet anywhere anytime, 3) privacy while betting, 4) greater access to promotions and betting options, and 5) ability to use electronic financial transactions. Regression models underpinned the analyses. Greater short-term betting harm was significantly associated with the ability to bet anywhere anytime, privacy when betting, and greater access to promotions and betting options. Betting sessions when these features were prioritised were more likely to involve impulsive betting, use of betting inducements, and betting with more operators. Respondents with more gambling problems were more likely to prioritise privacy and the ability to bet anywhere anytime; and to bet on in-game events, use promotional inducements, bet with more operators, and report greater betting harm. Discussion and conclusions Certain situational features of sports betting are empirically associated with engagement and subsequent harm. Only smartphone betting combines all three features associated with betting harm.
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Affiliation(s)
- Nerilee Hing
- Experimental Gambling Research Laboratory, School of Health, Medical and Applied Sciences, CQUniversity, Australia
| | - Matthew Browne
- Experimental Gambling Research Laboratory, School of Health, Medical and Applied Sciences, CQUniversity, Australia
| | - Matthew Rockloff
- Experimental Gambling Research Laboratory, School of Health, Medical and Applied Sciences, CQUniversity, Australia
| | - Alex M. T. Russell
- Experimental Gambling Research Laboratory, School of Health, Medical and Applied Sciences, CQUniversity, Australia
| | - Catherine Tulloch
- Experimental Gambling Research Laboratory, School of Health, Medical and Applied Sciences, CQUniversity, Australia
| | - Lisa Lole
- Experimental Gambling Research Laboratory, School of Health, Medical and Applied Sciences, CQUniversity, Australia
| | - Hannah Thorne
- Experimental Gambling Research Laboratory, School of Health, Medical and Applied Sciences, CQUniversity, Australia
| | - Philip Newall
- Experimental Gambling Research Laboratory, School of Health, Medical and Applied Sciences, CQUniversity, Australia
- School of Psychological Science, University of Bristol, United Kingdom
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Rolando S, Ferrari C, Beccaria F. "To me, it was Just a Vice". Stigma and Other Barriers to Gambling Treatment in Piedmont, Italy. J Gambl Stud 2023; 39:1909-1925. [PMID: 37166746 DOI: 10.1007/s10899-023-10214-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/29/2023] [Indexed: 05/12/2023]
Abstract
In Piedmont (northwestern Italy), as in the rest of the Western world, only a small percentage of the estimated problem gamblers (10-20%) turn to a treatment service to overcome their addiction issues. The study sought to gain a better understanding of the cultural factors that stand in the way of seeking help, thorough qualitative in-depth individual interviews with gamblers both in and out of treatment. A total of 30 interviews were conducted in three different health districts, most via video-call. Data were then analyzed using an abductive approach. The findings appear to indicate that the processes of stigma affecting problem gamblers and public gambling treatment services are the main barriers to seeking help. According to the interviewees, awareness of the problem is a necessary but not sufficient motivator for embarking on treatment, since social stigmatization leads them to hide the problem. Moreover, self-stigmatization processes seem to undermine the sense of self-efficacy that plays a key role in recovery. To encourage help-seeking, the study thus suggests that priority should be given to efforts to reduce stigma, i.e., through informational and educational measures together with advocacy interventions, which aim primarily to reframe the gambling problem, shifting responsibility from the individual to the collective level.
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Affiliation(s)
- Sara Rolando
- Eclectica, Institute for Training and Research, Via S. Pellico 1, Turin, 10125, Italy.
| | | | - Franca Beccaria
- Eclectica, Institute for Training and Research, Via S. Pellico 1, Turin, 10125, Italy
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Helmert C, Fleischer T, Speerforck S, Ulke C, Altweck L, Hahm S, Muehlan H, Schmidt S, Grabe HJ, Völzke H, Schomerus G. An explorative cross-sectional analysis of mental health shame and help-seeking intentions in different lifestyles. Sci Rep 2023; 13:10825. [PMID: 37402843 PMCID: PMC10319876 DOI: 10.1038/s41598-023-37955-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Accepted: 06/30/2023] [Indexed: 07/06/2023] Open
Abstract
To identify und support particular target groups for mental health prevention, we explore the links between shame and help-seeking intentions concerning mental health in different lifestyles (based on socioeconomic status as well as health-related behaviors). Lifestyles were operationalized by nine confirmatory, homogenous clusters of the sample. These clusters are based on individuals' similarities in sociodemographic aspects and health behavior. Analyses included t tests, Chi-square, ANOVA, regressions investigating in sociodemographic characteristics. Hierarchical linear models examining cross-sectional associations of shame and willingness to seek help for different lifestyles of participants of the Study of Health in Pomerania (SHIP-START-1 and SHIP-START-3, data collected 2002-2006 and 2014-2016; n = 1630). Hierarchical linear models showed small context effects for lifestyle-related associations of shame and willingness to seek help. For younger as well as male participants, lifestyles indicated different associations of shame and help-seeking intentions: Especially the lifestyles with unhealthy behaviors and high as well as low socioeconomic status resulted in higher shame being associated with low help-seeking intentions in case of mental illness. Lifestyle clusters might be a useful tool to identify marginalized groups with unhealthy behaviors, which should be addressed by interventions and prevention programs.
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Affiliation(s)
- Claudia Helmert
- Department of Psychiatry and Psychotherapy, University of Leipzig, Medical Center, Leipzig, Germany.
| | - Toni Fleischer
- Department of Psychiatry and Psychotherapy, University of Leipzig, Medical Center, Leipzig, Germany
| | - Sven Speerforck
- Department of Psychiatry and Psychotherapy, University of Leipzig, Medical Center, Leipzig, Germany
| | - Christine Ulke
- Department of Psychiatry and Psychotherapy, University of Leipzig, Medical Center, Leipzig, Germany
| | - Laura Altweck
- Department of Health and Prevention, Greifswald University, Greifswald, Germany
| | - Stefanie Hahm
- Department of Health and Prevention, Greifswald University, Greifswald, Germany
| | - Holger Muehlan
- Department of Health and Prevention, Greifswald University, Greifswald, Germany
| | - Silke Schmidt
- Department of Health and Prevention, Greifswald University, Greifswald, Germany
| | - Hans J Grabe
- Department of Psychiatry and Psychotherapy, Greifswald University, Medical Center, Greifswald, Germany
| | - Henry Völzke
- Institute for Community Medicine, Greifswald University, Medical Center, Greifswald, Germany
| | - Georg Schomerus
- Department of Psychiatry and Psychotherapy, University of Leipzig, Medical Center, Leipzig, Germany
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Akbari M, Bahadori MH, Khanbabaei S, Milan BB, Horvath Z, Griffiths MD, Demetrovics Z. Psychological predictors of the co-occurrence of problematic gaming, gambling, and social media use among adolescents. COMPUTERS IN HUMAN BEHAVIOR 2022. [DOI: 10.1016/j.chb.2022.107589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Hing N, O’Mullan C, Mainey L, Greer N, Breen H. An integrative review of research on gambling and domestic and family violence: Fresh perspectives to guide future research. Front Psychol 2022; 13:987379. [PMID: 36312076 PMCID: PMC9606773 DOI: 10.3389/fpsyg.2022.987379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Accepted: 09/20/2022] [Indexed: 11/13/2022] Open
Abstract
This paper presents an integrative review of research on domestic and family violence (DFV), including intimate partner violence (IPV), experienced by victims and perpetrators with a gambling problem. It aims to review, critique, and synthesize research on this topic to generate fresh and alternative perspectives to guide future research. Based on a systematic search of the academic literature and a targeted search of gray literature, the paper summarizes findings from empirical studies pertaining to the prevalence of perpetration and victimization, characteristics of perpetrators and victims, and explanations for this violence. Based on this review, the paper suggests several potential improvements that can be considered in future studies. These include a shift from focusing on situational violence to also include coercive control; greater sensitivity in research design and interpretation to gender differences in experiences of violence; and the need to include economic abuse as a form of DFV/IPV. Adopting a public health lens is also recommended to broaden the research focus from victims and perpetrators to also consider contextual factors. In particular, gambling research should examine the contribution of gambling products, practices, environments, and marketing to DFV/IPV and how this might be ameliorated. While research to date has drawn much needed attention to the risks that gambling presents for DFV/IPV, this review provides some suggestions for future research so that it can provide more nuanced findings to inform policy and practice.
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Affiliation(s)
- Nerilee Hing
- School of Health, Medical and Applied Sciences, Central Queensland University, Bundaberg, QLD, Australia
- *Correspondence: Nerilee Hing,
| | - Cathy O’Mullan
- School of Health, Medical and Applied Sciences, Central Queensland University, Bundaberg, QLD, Australia
| | - Lydia Mainey
- School of Nursing and Midwifery, Central Queensland University, Cairns, QLD, Australia
| | - Nancy Greer
- School of Health, Medical and Applied Sciences, Central Queensland University, Bundaberg, QLD, Australia
| | - Helen Breen
- Faculty of Business and Law and Arts, Southern Cross University, Lismore, NSW, Australia
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O'Mullan C, Hing N, Mainey L, Nuske E, Breen H. Understanding the Determinants of Gambling-Related Intimate Partner Violence: Perspectives From Women Who Gamble. Violence Against Women 2022; 28:3037-3059. [PMID: 34817274 DOI: 10.1177/10778012211051399] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Rates of intimate partner violence (IPV) victimization are higher among women with a gambling problem. However, women's experiences of this violence, from a gendered perspective, have not been examined. Based on interviews with 24 women, this study explored how problem gambling contributes to IPV against women across three levels of influence. Findings reveal that problem gambling did not directly cause IPV, but interacts where gendered drivers and reinforcers are present to exacerbate this violence. Reducing violence against women with a gambling problem requires a coordinated, integrated multidisciplinary approach targeting different levels of influence.
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Affiliation(s)
- Cathy O'Mullan
- 527836Central Queensland University, Bundaberg, Queensland, Australia
| | - Nerilee Hing
- 527836Central Queensland University, Bundaberg, Queensland, Australia
| | - Lydia Mainey
- 527828Central Queensland University, Cairns, Queensland, Australia
| | - Elaine Nuske
- 4571Southern Cross University, Lismore, Australia
| | - Helen Breen
- 4571Southern Cross University, Lismore, Australia
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Delfabbro P, Hundric DD, Ricijas N, Derevensky JL, Gavriel-Fried B. What Contributes to Public Stigma Towards Problem Gambling?: A Comparative Analysis of University Students in Australia, Canada, Croatia and Israel. J Gambl Stud 2021; 38:1127-1141. [PMID: 34800241 DOI: 10.1007/s10899-021-10086-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/17/2021] [Indexed: 10/19/2022]
Abstract
Stigma refers to the attribution of negative sentiments towards a particular entity, object or individual. Stigma can be public, perceived, or self-referential and can have negative consequences for individuals, including losses of self-esteem, self-efficacy, social isolation and a reluctance to seek help. Problem gambling is known to be a stigmatized activity, but less is known about what factors are associated with this perception and how it might vary in different countries. The current study examines the relationship between perceived stigma towards problem gamblers and gambling attitudes. perceptions of gambling regulations, gambling involvement, perceived accessibility to gambling, and exposure to people with gambling problems. The sample comprised 1787 university students aged 18-30 years from four countries: Australia, Canada, Croatia and Israel. The results indicated that greater perceived stigma was associated with more negative gambling attitudes, less engagement with gambling, and lower perceived social accessibility (the perception that others approve of the activity). Respondents from Croatia, the country with a newer gambling market, reported the most stigma towards problem gamblers as compared with Australia and Canada where gambling is longer established. The findings appear consistent with exposure-adaptation theory, in which tolerance towards people with problem gambling can develop over time in line with greater social acceptance or familiarity with the activity and its consequences. It is suggested that community campaigns and educational programs draw a distinction between attitudes towards gambling in general and those who are negatively affected by the activity.
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Affiliation(s)
- Paul Delfabbro
- School of Psychology, University of Adelaide, Adelaide, Australia.
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Abstract
It is generally assumed that gamblers, and particularly people with gambling problems (PG), are affected by negative perception and stigmatisation. However, a systematic review of empirical studies investigating the perception of gamblers has not yet been carried out. This article therefore summarises empirical evidence on the perception of gamblers and provides directions for future research. A systematic literature review based on the relevant guidelines was carried out searching three databases. The databases Scopus, PubMed and BASE were used to cover social scientific knowledge, medical-psychological knowledge and grey literature. A total of 48 studies from 37 literature references was found. The perspective in these studies varies: Several studies focus on the perception of gamblers by the general population, by subpopulations (e. g. students or social workers), or by gamblers on themselves. The perspective on recreational gamblers is hardly an issue. A strong focus on persons with gambling problems is symptomatic of the gambling discourse. The analysis of the studies shows that gambling problems are thought to be rather concealable, whereas the negative effects on the concerned persons‘ lives are rated to be quite substantial. PG are described as “irresponsible” and “greedy” while they perceive themselves as “stupid” or “weak”. Only few examples of open discrimination are mentioned. Several studies however put emphasis on the stereotypical way in which PG are portrayed in the media, thus contributing to stigmatisation. Knowledge gaps include insights from longitudinal studies, the influence of respondents‘ age, culture and sex on their views, the relevance of the type of gambling a person is addicted to, and others. Further studies in these fields are needed.
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Yan XJ, Luo QQ, Qiu HY, Ji CF, Chen SL. The impact of stigma on medication adherence in patients with functional dyspepsia. Neurogastroenterol Motil 2021; 33:e13956. [PMID: 33184967 DOI: 10.1111/nmo.13956] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Revised: 07/02/2020] [Accepted: 07/08/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND Psychological factors contribute to the pathogenesis of functional dyspepsia (FD). Antidepressant agents are beneficial in treatment of refractory FD. However, their efficacy is greatly hindered by the poor treatment adherence. Stigma is present in patients with chronic diseases or mental disorders and could affect adherence. The present study was aimed to evaluate stigma prevalence in FD patients and to explore the impact of stigma on treatment adherence to antidepressants. METHODS Functional dyspepsia patients unsatisfied with the regular first-line treatment and received newly initiated antidepressant medicine were recruited and subjected to antidepressant treatment for 8 weeks. Stigma scales and symptom scores of dyspepsia, depression, and anxiety were analyzed before and after treatment. Associations between stigma and medication adherence were evaluated. KEY RESULTS One hundred and ten of the enrolled 138 participants reported minimal disease-related internalized stigma, and 28 reported mild stigma before antidepressant therapy. Male gender, lower education, and higher scores of dyspepsia, depression, and anxiety were predictors of stigma before treatment. The mean stigma scores increased after 8-week antidepressant treatment. A proportion (36.4%-89.9%) of patients showed stigma attached to antidepressant therapy in the 4-question survey. Post-treatment stigma scores negatively correlated with treatment adherence and efficacy. Patients with decreased post-treatment stigma scores displayed better medication adherence and symptom improvement compared to those with elevated or unaltered post-treatment stigma scores. CONCLUSIONS Patients with refractory FD report stigma attached to the disease and antidepressants. It is an obstacle to treatment adherence and efficacy of antidepressant medication in FD therapy.
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Affiliation(s)
- Xiu-Juan Yan
- Division of Gastroenterology and Hepatology, Key Laboratory of Gastroenterology and Hepatology, Ministry of Health, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai Institute of Digestive Disease, Shanghai, China
| | - Qing-Qing Luo
- Division of Gastroenterology and Hepatology, Key Laboratory of Gastroenterology and Hepatology, Ministry of Health, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai Institute of Digestive Disease, Shanghai, China
| | - Hong-Yi Qiu
- Division of Gastroenterology and Hepatology, Key Laboratory of Gastroenterology and Hepatology, Ministry of Health, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai Institute of Digestive Disease, Shanghai, China
| | - Chen-Feng Ji
- Department of Psychological Medicine, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Sheng-Liang Chen
- Division of Gastroenterology and Hepatology, Key Laboratory of Gastroenterology and Hepatology, Ministry of Health, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai Institute of Digestive Disease, Shanghai, China
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13
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What Can be Done to Reduce the Public Stigma of Gambling Disorder? Lessons from Other Stigmatised Conditions. J Gambl Stud 2020; 36:23-38. [PMID: 31520273 DOI: 10.1007/s10899-019-09890-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Gambling is embedded in Australian cultural history, and perceived as a normal, legitimate leisure activity. Despite this normalisation, people who experience gambling problems are heavily stigmatised which can lead to a variety of harms that extend beyond the individual. The stigma from the general public appears to be based on a stereotype of a typical "problem gambler"-selfish, greedy, impulsive and irresponsible. However, research suggests that people experiencing gambling problems have widely varying characteristics and do not conform to this stereotype. Regardless of whether the stigma is justified, it is both present and problematic. Gamblers experiencing problems delay help-seeking due to feelings of shame and, not unwarranted, expectations of negative judgement because of the heavy stigma associated with the stereotype. As stigma is a primary barrier to treatment and a reason why gambling problems can take longer to acknowledge, it is important to understand and address how stigma can be reduced to minimise the negative consequences of gambling on individuals, their families and friends and the wider community. There is little research on reducing gambling-related stigma, so there is a need to examine strategies used in other stigmatised conditions, such as mental health, to understand the general principles of effective stigma reduction measures. Because gambling disorder is unique, well-hidden and consequently not well understood, there is a need to recognise that techniques used in other domains may differ in their effectiveness within the context of gambling stigma.
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Granero R, Valero-Solis S, Fernández-Aranda F, Gómez-Peña M, Moragas L, Mena-Moreno T, del Pino-Gutierrez A, Codina E, Martín-Romera V, Casalé G, Agüera Z, Baenas-Soto I, Valenciano-Mendoza E, Mora-Maltas B, Sánchez I, Lozano-Madrid M, Menchón JM, Murcia SJ. Response trajectories of gambling severity after cognitive behavioral therapy in young-adult pathological gamblers. J Behav Addict 2020; 9:140-152. [PMID: 32359237 PMCID: PMC8935189 DOI: 10.1556/2006.2020.00008] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND AND AIMS The significant increase in the prevalence of gambling disorder (GD) among young adults in recent years has attracted interest in determining therapeutic efficiency in this sector of the population. The aim of this work was to estimate the response trajectories of gambling severity during the six-month follow-up after a cognitive behavioral therapy (CBT) program in young adult patients and to identify the main variables associated with each trajectory. METHODS The sample included n = 192 patients, aged 19-35 years old, seeking treatment for GD. Response trajectories were identified through latent class growth analysis. RESULTS Three trajectories emerged: T1 (n = 118, 61.5%), composed of patients with severe GD at pre-treatment and good evolution to recovery; T2 (n = 62, 32.3%), with patients with moderate-high GD affectation at baseline and good evolution to recovery; and T3 (n = 12, 6.3%), with participants with severe baseline GD severity and poor evolution after CBT (Abbott, 2019). The highest risk of poor therapeutic outcomes was related to lower social index positions, high emotional distress, high scores in harm avoidance and low scores in self-directedness. DISCUSSION AND CONCLUSIONS Differences in the response trajectories at short-term follow-up after CBT reveal heterogeneity in the samples including young and young-adult GD patients. Patients' phenotype at baseline should be considered when developing efficient, person-centered intervention programs, which should comprise strategies aimed at increasing emotional regulation capacities, self-esteem and self-efficacy, with the aim of avoiding relapses in the medium-long term after therapy.
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Affiliation(s)
- Roser Granero
- CIBER Fisiopatologia Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Barcelona, Spain,Departament de Psicobiologia i Metodologia, Autonomous University of Barcelona, Barcelona, Spain
| | - Susana Valero-Solis
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain
| | - Fernando Fernández-Aranda
- CIBER Fisiopatologia Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Barcelona, Spain,Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain,Department of Clinical Sciences, School of Medicine, University of Barcelona, Barcelona, Spain
| | - Mónica Gómez-Peña
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain
| | - Laura Moragas
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain
| | - Teresa Mena-Moreno
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain
| | - Amparo del Pino-Gutierrez
- Department of Public Health, Mental Health and Mother-Infant Nursing, University School of Nursing, University of Barcelona, Barcelona, Spain
| | - Ester Codina
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain
| | - Virginia Martín-Romera
- Departamento de Educación y Psicología, Centro Universitario Cardenal Cisneros, Universidad de Alcalá, Madrid, Spain
| | - Gemma Casalé
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain
| | - Zaida Agüera
- CIBER Fisiopatologia Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Barcelona, Spain,Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain
| | - Isabel Baenas-Soto
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain
| | | | - Bernat Mora-Maltas
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain
| | - Isabel Sánchez
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain
| | - María Lozano-Madrid
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain
| | - José M. Menchón
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain,Department of Clinical Sciences, School of Medicine, University of Barcelona, Barcelona, Spain,CIBER Salud Mental (CIBERsam), Instituto de Salud Carlos III, Barcelona, Spain
| | - Susana Jiménez Murcia
- CIBER Fisiopatologia Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Barcelona, Spain,Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain,Department of Clinical Sciences, School of Medicine, University of Barcelona, Barcelona, Spain,Corresponding author. Department of Psychiatry, Bellvitge University Hospital-IDIBELL and CIBERObn, c/Feixa Llarga s/n, 08907, Hospitalet de Llobregat, Barcelona, Spain. Tel.: +34 93 260 79 88; fax: +34 93 260 76 58. E-mail:
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15
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Dąbrowska K, Wieczorek Ł. Perceived social stigmatisation of gambling disorders and coping with stigma. NORDIC STUDIES ON ALCOHOL AND DRUGS 2020; 37:279-297. [PMID: 35308320 PMCID: PMC8899262 DOI: 10.1177/1455072520902342] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Accepted: 12/17/2019] [Indexed: 11/17/2022] Open
Abstract
Aim: This study concerns perceived social stigmatisation of gambling disorder and its determinants, the self-perceptions of people with gambling disorder (self-stigma) and how they cope with stigma. Design: In total, 30 interviews with persons with gambling disorder and 60 with professionals were conducted. Selective sampling procedures were employed in the recruitment phase. In the case of professionals, the inclusion criteria were employment in facilities where treatment of gambling disorder is offered, and profession. For people with gambling disorder, the criterion was a diagnosis confirmed by a psychiatrist. Results: Elements revealed in past research on stigma-creation processes were reflected in respondents’ statements. The type of gambling, the occurrence of negative consequences, the possibility of hiding, personal responsibility, social status and contact with stigmatised populations are perceived determinants of problem gamblers’ stigmatisation. Gambling disorder sufferers experience anxiety associated with the possibility of rejection and a fear related to their condition being revealed to others. Various manifestations of cognitive distancing and hiding were coping mechanisms identified in the study. Conclusions: People with gambling disorder experience anxiety associated with the possibility of rejection, and they often conceal their disorder, which may hinder their treatment. Therefore the issue of stigma should be addressed in therapy.
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16
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Granero R, Jiménez-Murcia S, Del Pino-Gutiérrez A, Mora B, Mendoza-Valenciano E, Baenas-Soto I, Gómez-Peña M, Moragas L, Codina E, López-González H, Mena-Moreno T, Mestre-Bach G, Valero-Solís S, Rivas S, Agüera Z, Vintró-Alcaraz C, Lozano-Madrid M, Menchón JM, Fernández-Aranda F. Gambling Phenotypes in Online Sports Betting. Front Psychiatry 2020; 11:482. [PMID: 32547432 PMCID: PMC7270333 DOI: 10.3389/fpsyt.2020.00482] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Accepted: 05/12/2020] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND AND OBJECTIVES The Internet provides easy access to multiple types of gambling and has led to changes in betting habits. A severe rise in problematic gambling has been predicted among all sectors of the population, and studies are required to assess the emerging phenotypes related to the new structures of gambling activities. This study aimed to explore the existence of latent classes associated with gambling habits among treatment-seeking gamblers due to Online Sports Betting (OSB). METHOD Initial sample included n = 4,516 patients consecutively admitted for treatment in a hospital unit specialized in behavioral addictions. Two-step clustering analysis was used within the subsample of n = 323 patients who reported problems related with OSB, within a set of indicators including sociodemographics, psychopathological distress, personality, and severity of the gambling activity. RESULTS The prevalence of OSB as a main type of gambling problem in the study was 7.2% (95% confidence interval: 6.4 to 7.9%). Two latent clusters were identified, with differences in sociodemographics and clinical status. Cluster 1 (n = 247, 76.5%) grouped patients that were more affected due to the OSB behaviors, and it was characterized by non-married patients, lower socioeconomic position index, higher comorbidity with other substance related addictions, younger age, and early onset of the gambling activity, as well as higher debts due to the OSB, higher psychopathological distress, and a more dysfunctional personality profile. Cluster 2 (n = 76, 23.5%) grouped patients that were less affected by OSB, mostly married (or living with a stable partner), with higher social position levels, older age and older onset of the gambling activity, as well as a more functional psychopathological and personality profile. CONCLUSION The increasing understanding of latent classes underlying OSB phenotypes is essential in guiding the development of reliable screening tools to identify individuals highly vulnerable to addictive behaviors among Internet gamblers, as well as in planning prevention and treatment initiatives focused on the precise profiles of these patients.
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Affiliation(s)
- Roser Granero
- Department of Psychobiology and Methodology, Universitat Autònoma de Barcelona-UAB, Barcelona, Spain.,Ciber Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, Madrid, Spain
| | - Susana Jiménez-Murcia
- Ciber Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, Madrid, Spain.,Department of Psychiatry, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain.,Psychiatry and Mental Health Group, Neuroscience Program, Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain.,Department of Clinical Sciences, School of Medicine, Universitat de Barcelona-UB, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Amparo Del Pino-Gutiérrez
- Department of Psychiatry, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain.,Department of Public Health, Mental Health and Perinatal Nursing, School of Nursing, Universitat de Barcelona-UB, Barcelona, Spain
| | - Bernat Mora
- Department of Psychiatry, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Eduardo Mendoza-Valenciano
- Department of Psychiatry, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain.,Ciber Salut Mental (CIBERsam), Instituto Salud Carlos III, Madrid, Spain
| | - Isabel Baenas-Soto
- Department of Psychiatry, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Mónica Gómez-Peña
- Department of Psychiatry, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Laura Moragas
- Department of Psychiatry, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Ester Codina
- Department of Psychiatry, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain.,Department of Public Health, Mental Health and Perinatal Nursing, School of Nursing, Universitat de Barcelona-UB, Barcelona, Spain
| | - Hibai López-González
- Department of Psychiatry, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Teresa Mena-Moreno
- Ciber Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, Madrid, Spain.,Department of Psychiatry, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Gemma Mestre-Bach
- Ciber Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, Madrid, Spain.,Department of Psychiatry, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Susana Valero-Solís
- Department of Psychiatry, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Sandra Rivas
- Department of Psychiatry, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Zaida Agüera
- Ciber Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, Madrid, Spain.,Department of Psychiatry, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Cristina Vintró-Alcaraz
- Department of Psychiatry, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain
| | - María Lozano-Madrid
- Ciber Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, Madrid, Spain.,Department of Psychiatry, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain
| | - José M Menchón
- Department of Psychiatry, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain.,Ciber Salut Mental (CIBERsam), Instituto Salud Carlos III, Madrid, Spain
| | - Fernando Fernández-Aranda
- Ciber Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, Madrid, Spain.,Department of Psychiatry, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain.,Psychiatry and Mental Health Group, Neuroscience Program, Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain.,Department of Clinical Sciences, School of Medicine, Universitat de Barcelona-UB, L'Hospitalet de Llobregat, Barcelona, Spain
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17
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Exploration of Intervention Strategies to Reduce Public Stigma Associated with Gambling Disorder. J Gambl Stud 2019; 36:713-733. [PMID: 31440874 DOI: 10.1007/s10899-019-09888-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Stigma associated with gambling disorder is complex, and is a key obstacle that prevents sufferers from seeking early help for their condition. However, little research has addressed how best to reduce gambling stigma. This study explored the effectiveness of video intervention styles, that have been used to reduce public stigma for conditions such as mental illness and substance use disorders. This was done to determine which would be most suitable, considering the unique characteristics of gambling disorder. An online survey of 164 people living in Australia was conducted which examined attitudes toward gamblers experiencing problems before and after an intervention. Participants were randomly allocated to one of three interventions (contact, education, advocacy) or a control video. The study found that each intervention was associated with changes to different components of stigma. Importantly, the education intervention increased labelling, but reduced stereotype endorsement and anger. Advocacy also reduced anger, attributions of character flaws, and anticipated discrimination and recoverability. While these interventions were generally effective at reducing stigma, the contact intervention was mixed, effectively intervening for some aspects of stigma, but increasing stigma on others. No single intervention reduced all aspects of stigma, suggesting that a complementary approach utilising specific elements of each intervention style could be used to deliver relevant information and effectively reduce stigma. Taken together, this suggests that research should be conducted into comprehensive, combined interventions, that include aspects of all three intervention styles, in an attempt to reduce more aspects of stigma simultaneously.
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Lopez-Gonzalez H, Estévez A, Griffiths MD. Can Positive Social Perception and Reduced Stigma be a Problem in Sports Betting? A Qualitative Focus Group Study with Spanish Sports Bettors Undergoing Treatment for Gambling Disorder. J Gambl Stud 2019; 35:571-585. [PMID: 30116945 DOI: 10.1007/s10899-018-9799-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
The way society perceives problem gambling, and its effects on how problem gamblers perceive themselves have significant consequences on the wellbeing of people experiencing gambling disorder. Associated with social perception, stigma and other social perception-related features have an impact on the way problem gamblers identify themselves, seek for help, and recover. However, not all gambling types are identically perceived by the society. The present paper examines the case of the social perception of sports betting in the context of Spain. A total of 43 male sports bettors undergoing treatment for gambling disorder were interviewed within seven focus group discussions. Using a qualitative thematic analysis technique, participants reported two fundamental characteristics of sports betting social perception: (1) the absence of negative connotations associated with sports betting comparative to other gambling forms; and (2) the presence of positive connotations that sanitised sports betting as a harmless practice. The study reports aspects such as the lack of stereotypes, the low-involvement of betting as a product, the novelty of online sports betting, the social construction of the normal bettor, and the workplace gambling normalisation as elements that could lead to an increase in gambling-related harm. This is the first study to explore the social perception of sports betting in a subgroup of problem sports bettors and suggests that policymakers should be cognizant of these perceptions in order to inform responsible gambling regulation .
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Affiliation(s)
- Hibai Lopez-Gonzalez
- Psychology Department, University of Deusto, Av de las Universidades, 24, 48007, Bilbao, Spain.
| | - Ana Estévez
- Psychology Department, University of Deusto, Av de las Universidades, 24, 48007, Bilbao, Spain
| | - Mark D Griffiths
- International Gaming Research Unit, Psychology Department, Nottingham Trent University, Nottingham, UK
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