Problem Gambling Research Articles

The influence of age on gambling problems worldwide: A systematic review and meta-analysis of risk among younger, middle-aged, and older adults.

Problem gambling (PG) represents a significant public health concern with widespread effects in various cultures and regions globally, with younger individuals and males at a particularly higher risk. This disparity is attributed to a mix of cultural, developmental, and biological influences. To date, there has not been a comprehensive examination to determine whether this risk pattern holds consistently across different jurisdictions. We performed a systematic review and meta-analysis using the PRISMA framework, identifying 21 eligible studies from 18 countries, encompassing 156,249 participants (47.6% male and 52.4% female). The studies varied considerably by region (Asia: 19%, Europe: 52%, Oceania: 19%, North America: 10%), the diagnostic criteria for PG, and participation rates in gambling (ranging from 12% to 92%). Data on PG prevalence was categorised by gender and three age groups (young: 18-35, middle: 30-55, and older: 45-65). Using a random-effects meta-analysis, we found a global PG prevalence of 1.9%. Europe reported a significantly lower prevalence (1.3%) compared to North America (5.3%). Men were found to be 3.4 times more likely than women to engage in problem gambling, although the gap narrows in North America. The young demographic showed a 1.51 times higher likelihood of reporting PG compared to themiddle-aged group, whereas older adults were 0.80 times less likely to report PG. Notably, age-related effects varied significantly across regions. Our findings confirm that age and gender significantly influence PG risk across cultures, with significant heterogeneity observed across jurisdictions.

Current approaches to the identification and management of gambling disorder: a narrative review to inform clinical practice in Australia and New Zealand.

Gambling disorder is a recognised psychiatric disorder in the Diagnostic and statistical manual of mental disorders (DSM-5) and is classified as an addiction alongside alcohol and substance use disorders. The DSM-5 describes a past-year timeframe, episodic or persistent specifiers, early or sustained remission specifiers, and three gambling disorder severity specifiers (mild, moderate and severe). Although anyone can develop gambling disorder, there are known risk factors. In studies involving general adult populations, the likelihood of developing the disorder varies with the type of gambling, and is particularly high for internet gambling, casino table games and poker machines. Australia and New Zealand have shifted the focus of gambling disorder to the identification of gambling harm, in recognition that efforts targeting the prevention of harm may be more effective as they potentially influence a larger segment of the population. Temporal categories of gambling harm (crisis harms versus legacy harms) affect help-seeking and need for treatment. Crisis harms often motivate people to change their behaviour or seek help, whereas treatment addresses legacy harms, which emerge or continue to occur after gambling behaviour ceases. The evidence base and clinical guidelines recommend cognitive behavioural therapy and motivational interviewing but there are many gaps in our understanding of treatment for gambling disorder, including an absence of high quality evaluations that assess treatment effectiveness over the longer term, especially for treatment delivered in community settings. There is also an urgent need to understand how, why and for whom treatment works so that interventions can be optimised to individual needs, thereby facilitating client engagement. Because of limited access to health care and poor retention in treatment, in recent years there has been an increase in treatment choices in the form of internet therapies and smartphone applications.

Unemployment as a risk factor for gambling disorder: A longitudinal study based on national registry data.

Unemployment rates are elevated among individuals with disordered gambling, yet the directionality of the relationship remains unclear. The present study investigated paid and unpaid unemployment as risk factors for future gambling disorder (GD). The study employed a case-control design, including all adult Norwegians receiving a GD diagnosis within specialist health services from January 2008 to December 2018 (n = 5,131). These individuals were compared with age- and sex-matched controls from the general population (n = 30,164), as well as controls with somatic and psychiatric diagnoses (n = 30,476). Logistic regressions showed that those in the highest quartile of unpaid unemployment days had more than double the odds (odds ratio [OR] 2.23 (95% CI [1.96, 2.52]) of developing GD compared to those with no unpaid unemployment days. Similarly, higher levels of paid unemployment were also found to increase the odds for GD, with those in the highest quartile having an OR of 1.86 (95% CI [1.50, 2.28]) compared to those with no paid unemployment days. Moreover, an interaction analysis indicated that the association between paid unemployment days and GD was significantly stronger among men compared to women. The present study suggests that both paid and unpaid unemployment constitute risk factors for GD. Programs aiming at obtaining and sustaining work have been found to improve health and future studies should examine ifthe risk for GD can be similarly mitigated.

Examining factors that hinder the efficacy of responsible gambling messages: modeling predictors and effects of responsible gambling message fatigue

ABSTRACT Message fatigue is an aversive psychological state that is characterized as feelings of boredom resulting from repeated exposure to messages promoting the same health behavior. Because responsible gambling messages are widely distributed, it is possible that feelings of fatigue could reduce their efficacy. This cross-sectional study of N = 822 U.S. adults recruited from an online panel (i.e. Amazon’s Mechanical Turk) explores potential predictors of fatigue and examines the effects of fatigue on gambling related outcomes through reactance and inattention using a structural equation modeling approach. The results indicated that industry employment history, problem gambling status, and gambling frequency emerged as significant predictors of fatigue. Fatigue was significantly associated with participants’ psychological reactance and inattention to responsible gambling messages. Both reactance and inattention were associated with participants’ gambling intentions and intentions to share responsible gambling messages with others. Responsible gambling messages could be improved by using strategies that can help to mitigate feelings of fatigue.

Factor analysis of impulsivity in gaming disorder and internet gaming disorder

BackgroundResearch suggests that a two-factor model of impulsivity predicts Substance Use Disorder and Gambling Disorder. We aimed to determine whether a similar factor structure was present for Gaming Disorder (GD) and Internet Gaming Disorder (IGD).MethodsSecondary data analysis was conducted on survey responses from 372 participants who had completed a series of questions on facets of impulsivity and their involvement in gaming. Participants were sampled from gaming forums and an online recruitment website. Exploratory factor analysis was conducted on the measures of trait impulsivity, and the identified factors were then analyzed against measures of Gaming Disorder and Internet Gaming Disorder. A confirmatory factor analysis was then run to confirm the model.ResultsThe exploratory results suggested a five-factor model of impulsivity, with gaming being related to all five factors. Interestingly, only two of those factors (Urgency (Positive Urgency, Negative Urgency, Delay Discounting) and (Impaired) Inhibitory Control (False Button Presses on Go/No-Go Tasks)) predicted symptom counts above the clinical cut-off for IGD. In addition, Urgency was related to symptom counts above 7/9 criteria for IGD, as well as symptom counts above the suggested clinical cut-off for GD. The confirmatory factor analysis suggested that this two-factor model of impulsivity had ‘good fit.’ConclusionsThis two-factor model of impulsivity is similar to those found in established addiction disorders, in that one factor appears to predict more problematic involvement than the other. However, the results indicate that Urgency predicts higher symptom counts than (Impaired) Inhibitory Control. This contrasts with previous findings on substance use and gambling, where (Impaired) Inhibitory Control was the factor predicting problematic use. However, there was evidence to suggest that gaming is similar to alcohol consumption, where socially acceptable, “healthy,” use is related to impulsivity at some level, but Urgency is key in the transition from recreational to disordered behavior.

Methodological and Conceptualisation Issues in the Measurement of Gambling Harm

Abstract Purpose of Review In this paper, we review recent developments in the conceptualisation and measurement of gambling harm. Recent Findings We review the strengths and limitations of gambling-harm measures, including the Short Gambling Harm Screen (SGHS) and 7-item Domain- General Harm Screen (DGHS-7). We also review evidence concerning the distribution of harm across the risk continuum. The paper shows that there is consensus around the principal domains of harm and that there are now reliable and valid measures to index general levels of harm, but that further development may be required to capture more nuanced assessments of the severity and types of harm. Summary We argue that burden-of-harm studies which show a high concentration of harm in lower risk groups are of good quality, but that important methodological issues remain. These include: the sensitivity of these estimates to measurement differences; the need for more consideration of the severity rather than the prevalence of harm ‘instances’; and, whether life-time problem gambling or legacy harms need to be taken into account when assessing the status of lower risk gamblers.

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.

Spanish Validation of the Brief Pornography Screen Within a Clinical Sample of Individuals with Gambling Disorder.

Problematic pornography use (PPU) shares characteristics with behavioral addictions, such as gambling disorder (GD), and PPU and GD may frequently co-occur. In order to fill existing gaps in screening instruments for PPU validated in GD, the study examined the psychometric properties of the Spanish version of the Brief Pornography Screen (BPS) within a clinical sample of individuals with GD. A total of 200 individuals seeking treatment for GD were consecutively recruited. The psychometric properties of the BPS were examined by performing confirmatory factor analysis (CFA) and testing for evidence of convergent and discriminant validity. The CFA supported a one-factor solution showing high internal consistency (α = 0.81). The BPS showed convergent validity and correlated with psychological distress, general psychopathology, impulsive tendencies, and low self-directedness. The BPS demonstrated adequate psychometric properties and is therefore recommended as a brief screening tool for identifying probable PPU in individuals seeking treatment for GD.

Coping Strategies in Analyzing the Stress Impact of Online Gambling Addiction for Children and Adults

Increased internet accessibility has opened up opportunities for people to engage in various types of gaming, such as poker, online casinos, sports betting, and slot machines. This research aims to describe coping strategies for minimizing the stressful impact of online gambling addiction. This research uses a qualitative approach with a literature study. The results of this research reveal that online gambling addiction has a serious impact on people's stress levels in Indonesia. Factors such as financial losses, uncertainty of gambling outcomes, and interpersonal tension due to excessive involvement in online gambling activities are the main causes of increased stress levels. Coping strategies to minimize the stressful impact of online gambling addiction are achieved by focusing efforts on financial management, social support, and developing entertainment alternatives. The study found that dependence on online gambling triggers significant stress in both children and adults. The stress was caused by a variety of factors, including financial loss, impaired social relationships, and psychological impacts such as anxiety and depression.

Implications of genetic attributions for addiction among addiction professionals

Given increasing emphasis on understanding the role of genes in the etiology of addictive disorders, the present study aimed to investigate the implications of genetic explanations of addiction for attitudes and beliefs about patients among addiction treatment providers. Participants were recruited from addiction-related professional organizations. The sample included professionals with medical backgrounds (n = 153) and with nonmedical backgrounds (n = 232). They viewed a description of a fictitious patient with either alcohol use disorder or gambling disorder, which was experimentally varied to indicate the presence or absence of a genetic cause. They completed measures of their genetic attributions for the patient's symptoms as well as their attitudes and beliefs about the patient. The presence of a genetic explanation increased genetic attribution ratings but did not significantly affect other measured variables. However, participants' genetic attributions for the patient's symptoms were associated with significantly lower ascriptions of blame to the patient and greater belief in the effectiveness of medication, but also with reduced confidence in the effectiveness of psychotherapy and with pessimism about the patient's prognosis. Geneticized, biomedical conceptualizations of addiction may have implications for treatment providers' attitudes toward patients.

중독회복자의 심리적 고통과 삶의 질 관계에서 회복자본의 매개효과

The aim of this study was to explore the level of quality of life among individuals in addiction recovery and to examine whether psychological distress affects the quality of life and recovery capital has a mediating effect on this relationship. To do this, original data from the ‘Stigma Perceived by Individuals with Addiction Study’ conducted by the Korea Addicts Right Center in 2023 were used. Recovering individuals who used community addiction organizations and facilities for alcohol, drug, and gambling problems participated in a self-report survey both online and offline. Using SPSS PROCESS macro, mediation analysis was conducted with a sample of 226 recovering addicts. First, the level of quality of life among recovering individuals was found to be low. Second, psychological distress had a direct effect on the quality of life among recovering individuals. Third, recovery capital had a mediating effect on the relationship between psychological distress and quality of life. Based on these findings, suggestions were made to alleviate psychological distress and enhance recovery capital to improve the quality of life for individual in addiction recovery.

Expectations of the effects of nicotine on gambling behavior

ABSTRACT Nicotine is commonly consumed while gambling and its use among those who gamble has been associated with gambling harms. Individuals’ expectations of the effects of substances (e.g. alcohol, cannabis) have been associated with gambling harms. The present study explored the expected effects of nicotine while gambling using a sample of individuals who gamble at least weekly (n = 472), recruited through Amazon Mechanical Turk. Respondents reported their nicotine use, gambling behaviors, and their perceived likelihood of experiencing various effects of nicotine while gambling. All nicotine expectation items were significantly and positively associated with one another and were significantly and positively associated with gambling harm. At least 75% of the sample reported that all nicotine expectations were at a least ‘a little likely’, including expectations that nicotine would reduce adverse psychological states, improve their cognitive performance, and increase their chances of winning while gambling. Additionally, participants who reported past month nicotine use endorsed expectations that nicotine would affect their gambling with a significantly greater perceived likelihood than those who did not. The present study demonstrates that expectations for the effects of nicotine while gambling are common and should be considered by clinicians when treating individuals experiencing gambling problems who consume nicotine.

Using latent class analysis to identify Finnish gambler types and potential risk

ABSTRACT The trend of increasing liberalization in gambling markets has been matched by a need for both effective approaches to promote responsible gambling practices and for improved prevention strategies. Given that the majority of players do not experience problematic gambling, it is in the public interest that knowledge is generated which helps identify activities or clusters of activities which are associated with at-risk behaviors. This study uses a representative sample of the Finnish population aged 15–74, to identify distinct types of gamblers based on their behavioral patterns and predictors of class membership via Latent Class Analysis. Cross-sectional random sample data were collected in 2019 (n = 3148). In addition to confirming existing knowledge for gamblers characterized by high engagement and high risk, it offered insights into three further classes: the largest (ME-HR, 45%), was characterized by moderate engagement, but participated in activities associated with higher levels of risk. Additionally, low-risk classes were differentiated by both gambling preferences and demographic characteristics. Given that the largest class was associated with significant potential for the development of problematic behaviors, this work makes several recommendations for preventative actions, including targeted awareness campaigns and psychoeducation addressing erroneous beliefs about gambling.

The severity of gambling in clinical samples of gamblers: profiles and prediction of the impulsivity and emotions.

Impulsivity and emotion impairments have been noted in individuals with gambling disorder (GD). However, little research has investigated the influence of impulsivity and emotions on the severity of gambling in clinical populations. This study aimed to examine: (i) differences in emotions and impulsivity traits according to the severity of gambling in individuals with GD, (ii) the mediating effects of emotion in the relationship between impulsivity traits and gambling severity, and (iii) the predictive effects of emotion and impulsivity traits on GD severity. The study included 214 participants seeking treatment for GD who completed assessments for emotions (Patient Health Questionnaire-9 [PHQ-9], 7-item Generalized Anxiety [GAD-7]), impulsivity traits (Barratt Impulsiveness Scale [BIS], Self-control Scale [SCS]), and GD severity (DSM-5). Participants were categorized into mild (n = 78), moderate (n = 63), and severe (n = 73) gambling severity groups. Significant differences in emotions and impulsivity traits were observed across these groups. The severe GD group exhibited higher levels of depression, anxiety, and impulsivity traits, along with lower self-control, compared to the moderate and mild groups. Mediation analyses demonstrated that negative emotions mediated the association between impulsivity traits and the severity of gambling. More specifically, the indirect effects of impulsivity traits through PHQ-9 and GAD-7 were found to be significant, indicating a mediating role of emotions. Moreover, a predictive model incorporating emotion and impulsivity traits showed moderate accuracy in predicting the severity of gambling, with an area under the receiver operating characteristic curve of 0.714. This study highlights the distinct pathways through which impulsivity traits operate and emphasizes the need for prevention and treatment strategies that consider impulsivity traits and emotions for different levels of gambling severity.

Automatic detection of problem-gambling signs from online texts using large language models.

Problem gambling is a major public health concern and is associated with profound psychological distress and economic problems. There are numerous gambling communities on the internet where users exchange information about games, gambling tactics, as well as gambling-related problems. Individuals exhibiting higher levels of problem gambling engage more in such communities. Online gambling communities may provide insights into problem-gambling behaviour. Using data scraped from a major German gambling discussion board, we fine-tuned a large language model, specifically a Bidirectional Encoder Representations from Transformers (BERT) model, to predict signs of problem-gambling from forum posts. Training data were generated by manual annotation and by taking into account diagnostic criteria and gambling-related cognitive distortions. Using cross-validation, our models achieved a precision of 0.95 and F1 score of 0.71, demonstrating that satisfactory classification performance can be achieved by generating high-quality training material through manual annotation based on diagnostic criteria. The current study confirms that a BERT-based model can be reliably used on small data sets and to detect signatures of problem gambling in online communication data. Such computational approaches may have potential for the detection of changes in problem-gambling prevalence among online users.

Emotional Working Memory Training Treatment for Young Adult Problem Online Sports Bettors: A Preliminary Randomized Controlled Trial.

One of the key features of gambling disorder (GD) is impairment in cognitive-emotional control. Considering the negative consequences of GD, the present study investigated the effectiveness of emotional working memory training (eWMT) in improving cognitive control, attention, working memory capacity, and cognitive emotion regulation strategies (CERS) among young adults with GD compared to a placebo group. Following the initial assessment in the pre-test phase, eligible participants were randomly assigned to one of two groups: experimental (n = 34) and placebo (n = 30). These groups completed eWMT and a feature matching task for 20 sessions respectively. The post-test and follow-up measures indicated that eWMT significantly improved cognitive control, attention, working memory capacity, and the use of maladaptive cognitive emotion regulation strategies, but it had no significant effect on adaptive CERS. The promising results of the present study suggest the use of eWMT as a new intervention to improve cognitive-emotional control among individuals with online gambling problems.

Digitalisation of gambling harm? Gambling consumption, negative consequences, and clinical characteristics among Swedish help-seekers

Gambling is connected to a range of harms and negative consequences. Gambling is also evolving at a fast pace, particularly in digital environments. Understanding the effects of this on-going change and digitalisation of gambling markets requires systematic measuring of gambling consumption patterns, clinical characteristics, and gambling-related harms.The current study compares two cohorts of help-seekers for gambling in Sweden (2019; 2023), recruited via the Swedish national helpline. The aim is to assess harms and consumption across the two cohorts at a time of increased offer of digital gambling in Sweden. We used eight different screens to measure gambling-related behaviours and consequences, including the Gambling Disorder Identification Test (GDIT). Results were analysed using descriptive statistics, and differences across the two cohorts were tested for statistical significance.The results show that across 2019–2023, gambling consumption has intensified. Online EGMs are by far the most prevalent form of gambling among help-seekers. We also found that the experience of co-morbidities as well as most gambling-related harms were common in both cohorts, with some statistically significant increases in 2023. Harms were more commonly experienced amongst those who engaged in online EGM gambling in comparison to those who did not.The results suggest that the digitalisation of gambling and gambling products appears to be associated with a variety of harmful consequences. The results also show the importance of systematic and comprehensive measurement to capture different severity levels of harms and their wide range amongst those who gamble.

What are escapists made of, and what does it have to do with excessive gambling and gaming?

AbstractResearch shows that escapism and frustration of basic psychological needs are linked with gambling and gaming problems, but an effect of escapism combined with restricted autonomy, competence, and relatedness on excessive gambling and gaming remains unclear. The purpose of this study is to identify shared characteristics of people who engage in escapist behavior and analyze to what extent the interaction of escapism and basic psychological need frustration predicts excessive gambling and gaming. We conducted a five-wave longitudinal survey with Finnish residents aged 18–75 years (n = 1530, 50.33% male) from April 2021 (T1) to April–May 2023 (T5). Measures included the Problem Gambling Severity Index, the ten-item Internet Gaming Disorder Test, and three escapism-specific questions. We analyzed the Basic Psychological Need Satisfaction and Frustration Scale, sociodemographic controls, and personality traits using multilevel regression models. We found that escapism was related to autonomy frustration, competence frustration, male gender, impulsivity, openness, and having a significant other who has experienced gambling problems. Escapism predicted excessive gambling, and competence frustration moderated this association. Escapism also predicted excessive gaming, and autonomy frustration and competence frustration moderated this association. Research on and treatment of excessive gambling and gaming should consider these underlying factors driving escapism.

Internet-based cognitive behavioral therapy for individuals with gambling disorder in Indonesia: protocol for a pilot and feasibility study.

Gambling disorder (GD) has become a wide concern in Indonesia, as many negative consequences arise from this psychiatric condition. Prompt treatment with an appropriate method of delivery is required to achieve optimal outcomes in GD patients. This protocol paper outlines a study to determine the effectiveness, acceptability, and feasibility of internet-based cognitive behavioral therapy (iCBT) in treating GD in Indonesia. This non-randomized pilot and feasibility study will recruit 20 people with GD. All participants will receive the iCBT intervention through self-learning videos and guided weekly group sessions. The effectiveness of the intervention will be assessed at baseline (week 0), post- treatment completion (week 10), and 6 weeks post-treatment (week 16). The outcomes measured will be the change in gambling symptoms, gambling urges, cognitive distortions, readiness to change, emotional problems, and quality of life of the participants. The feasibility of iCBT for GD patients in Indonesia will be assessed by this study. The study's results will give an indication of the acceptability of the intervention and the feasibility of a subsequent conclusive trial. The delivery of iCBT may help to address the issue of treatment access in an extensive geographical region and provide immediate implications as a treatment resource for GD in practice.

Gambling Economy and Social Protests in Macao: A Happy Problem?

Gambling has both negative and positive impacts on every economy. The existing literature of gambling-related protests has mostly centered on “cost-challenging protests,” referring to resistance against social costs such as legalized gambling, problem gambling, and environmental deterioration. In this article, we adopt alternative types of collective action, namely “benefit-sharing protests,” referring to those that seek state or casino companies to share economic benefits. By analyzing 754 protests in Macao from 2000 to 2021, this study examines the trends and characteristics of gambling-related movements in the Chinese special administrative region. The results indicate that most protests were benefits-sharing in nature rather than cost-challenging. The conclusion strongly supports the thesis that improved performance by the gambling sector can help alleviate conflicts within society. Interestingly, as revenue from the gambling sector increases, there is a corresponding rise in benefit-sharing protests, which acknowledge the contributions of the gambling industry and advocate for enhanced welfare transformation for residents. These findings offer a novel perspective on understanding protests related to gambling in the context of Macao’s well-established gambling economy.