Ecological Momentary Assessment of the Relationship between Positive Outcome Expectancies and Gambling Behaviour.

Stephanie S Merkouris,Kimberley Spence,Nicki A Dowling

doi:10.3390/jcm10081709

Abstract

Relapse prevention models suggest that positive outcome expectancies can constitute situational determinants of relapse episodes that interact with other factors to determine the likelihood of relapse. The primary aims were to examine reciprocal relationships between situational positive gambling outcome expectancies and gambling behaviour and moderators of these relationships. An online survey and a 28 day Ecological Momentary Assessment (EMA) were administered to 109 past-month gamblers (84% with gambling problems). EMA measures included outcome expectancies (enjoyment/arousal, self-enhancement, money), self-efficacy, craving, negative emotional state, interpersonal conflict, social pressure, positive emotional state, financial pressures, and gambling behaviour (episodes, expenditure). Pre-EMA measures included problem gambling severity, motives, psychological distress, coping strategies, and outcome expectancies. No reciprocal relationships between EMA outcome expectancies and gambling behaviour (episodes, expenditure) were identified. Moderations predicting gambling episodes revealed: (1) cravings and problem gambling exacerbated effects of enjoyment/arousal expectancies; (2) positive emotional state and positive reframing coping exacerbated effects of self-enhancement expectancies; and (3) instrumental social support buffered effects of money expectancies. Positive outcome expectancies therefore constitute situational determinants of gambling behaviour, but only when they interact with other factors. All pre-EMA expectancies predicted problem gambling severity (OR = 1.61–3.25). Real-time interventions addressing gambling outcome expectancies tailored to vulnerable gamblers are required.

Highlights

The Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition; DSM-5) [1] classifies Gambling Disorder as an addiction and related disorder
This study explored the moderating role of other factors implicated in the relapse prevention models: phasic responses (EMA-measured self-efficacy, craving, negative emotional state, interpersonal conflict, social pressure, positive emotional state, and financial pressures) and tonic processes [12,13]; the concordance between the phasic (EMA-measured) and tonic positive outcome expectancies; and the associations between tonic positive outcome expectancies and problem gambling severity
The associations between Ecological Momentary Assessment (EMA) positive outcome expectancies and subsequent gambling episodes were moderated by several phasic responses (EMA cravings, positive emotional state) and tonic processes. These findings suggest that transient changes in positive outcome expectancies do constitute phasic determinants of gambling episodes, but only when they interact with these tonic and phasic processes [13]

Summary

Introduction

The Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition; DSM-5) [1] classifies Gambling Disorder (pathological gambling) as an addiction and related disorder. Estimates of the standardised global past-year prevalence of adult problem gambling range from 0.5 to 7.6%, with an average of 2.3% [4]. Problem gambling is associated with a high burden of harm that is comparable to depression and alcohol use disorders [7]. Harms most often occur across financial, relationship, and emotional domains, with smaller proportions of gamblers reporting physical health problems, cultural harm, reduced work or study performance, and criminal activity [8]. Problem gambling is associated with a range of comorbid mental health issues, including mood and anxiety disorders, alcohol and other drug use disorders, and personality disorders [9,10,11]

Objectives

Methods

Results

Discussion

Conclusion