Gambling Symptoms Research Articles

Guided versus unguided chatbot-delivered cognitive behavioral intervention for individuals with moderate-risk and problem gambling: A randomized controlled trial (GAMBOT2 study)

BackgroundInternet-based interventions can be a promising option for individuals with problem gambling facing barriers to seeking help. This study aimed to directly compare the effects of therapist-guided Internet interventions with unguided ones on gambling-related behavior, cognition, and stage of change including help-seeking intention. MethodsWe conducted a participant-blinded randomized controlled trial of therapist-guided versus unguided groups with a 12-week follow-up. Both groups received self-help chatbot-delivered cognitive behavioral therapy. Additionally, at baseline and weeks 1, 2, 3, and 4, the guided group received personalized feedback messages from therapists based on their gambling diary and questionnaire responses. The unguided group received reminders of assessments from research assistants. The primary outcome was the change in scores on the Gambling Symptoms Assessment Scale (G-SAS) over 12 weeks. Secondary outcomes included the stage of change including help-seeking intention, money wagered, gambling frequency, and gambling-related cognitions. ResultsWe included 139 participants with a mean Problem Gambling Severity Index total score of 14.6 and a mean G-SAS total score of 27.0 who sought information about gambling problems. Both groups demonstrated substantial decreases in their G-SAS scores from baseline to week 12 (-10.2, 95% CI: −7.67 to −12.7 for the guided group, and 11.7, 95% CI: −9.05 to −14.3 for the unguided group). However, we did not find a significant between-group difference (1.49, 95% CI: −2.20 to 5.17). Regarding the stage of change including help-seeking intention, there were also no between-group differences. ConclusionsMinimum therapist support did not have an additive effect on the self-help chatbot intervention on gambling symptoms, behavior, and the stage of change including help-seeking intention.

Safety and efficacy of intensified electrical stimulation targeting dorsolateral prefrontal cortex for the treatment of gambling disorder associated with online sports betting: a case report

ABSTRACT The number of individuals with gambling disorders (GD) associated with online sports betting (OSB) is on the rise, despite the absence of effective treatment. Recently, the effectiveness of noninvasive brain stimulation (NIBS) techniques, such as transcranial direct current stimulation (tDCS) targeting the dorsolateral prefrontal cortex (DLPFC), has been demonstrated in treating various addictive disorders. Consequently, tDCS may be a promising treatment option. In the present case report, we evaluate the efficacy of a new intensified tDCS protocol (ten sessions, 2 mA for 20 min, two sessions daily, with 20 min intervals between daily sessions, one week in total) applied to the DLPFC (anode over the left and cathode over the right) in a patient with GD and OSB. Research variables were measured before, during, and after the intervention. The results indicate that the tDCS intervention improved gambling symptoms, impulsivity, depression, and anxiety states. The highest percentage of changes from before to after the intervention is associated with symptoms of gambling and depression. Our findings indicate that an intensified tDCS stimulation protocol of the left anodal/right cathodal DLPFC may effectively improve gambling behavior. Additional research on large patient populations is required to improve the generalizability of the current protocol.

Underage Problem Gambling: With Whom, Where and Why

Underage gambling is a widespread phenomenon with its own characteristics that differentiate it from adult gambling. In addition, problem gambling has shown a remarkable prevalence in previous studies. The present study examines underage gambling behaviour, studying its characteristics, as well as motivational and contextual aspects, and estimating the volume of problem gambling and possible moderating variables. A sample of 9,681 students aged between 12 and 17 years old reported their involvement in gambling and filled in the Brief Adolescent Gambling Screen (BAGS), with 4,617 of them completing a questionnaire about gambling behaviours. Almost a quarter (23.5%) of the students reported having gambled in their lifetime (16.2% in-person, 1.4% online and 6% in both modalities), and 1.9% presented symptoms of problem gambling (BAGS ≥ 4). In-person gamblers preferred sport-betting machines, usually gambled in bars, and did not have their age checked. Online gamblers reported mainly sports betting, doing so on websites and paying with PayPal-like services and credit cards. Most gambled with friends and to win money. Problem gamblers were similar but gambled more frequently. These results present an image of the gambling situation among minors and, more importantly, of its context and related variables.

Validation of a Spanish Adaptation of the Gambling Symptom Assessment Scale (G-SAS) in Persons with Recent History of Gambling

Gambling is becoming increasingly frequent and problematic, especially due to the explosion of online alternatives. Evaluating the severity of gambling symptomatology is therefore more important than ever. However, innovations in the gambling field have generally focused on its treatment rather than its evaluation. The Gambling Symptom Assessment Scale (G-SAS) is a well-established measure of gambling-related symptomatology (e.g., gambling urges, gambling-related thoughts and behaviours, and interpersonal functioning). The aim of this study is to validate a Spanish adaptation of the G-SAS so that individual differences in gambling symptomatology can be assessed by clinicians and researchers. The internal structure of the G-SAS was investigated using an exploratory factor analysis with a sample of 364 individuals from the general population in Spain (mean age = 28.84 years, SD = 11.73; 54% males). A four-factor structure was preferred considering fit indices (Chi-square = 22.62, p = .162, RMSEA = 0.030, CFI = 0.998, TLI = 0.995) and internal consistency estimates (0.67 ≤ α ≤ 0.89). The factors were labelled gambling-related symptoms, control of gambling urges/thoughts, interference, and arousal. Regarding construct validity, the four factors of the G-SAS were positively and significantly (all p < .001) correlated with measures of problematic gambling severity (0.40 ≤ r ≤ .73), problematic gambling diagnostic (0.40 ≤ r ≤ .67), gambling cognitions (0.48 ≤ r ≤ .57), impulsivity (0.26 ≤ r ≤ .42), anxiety (0.22 ≤ r ≤ .38), and depression (0.16 ≤ r ≤ .42), and negatively with quality of life (-0.24 ≤ r≤-.42). In sum, this study provides Spanish clinicians and researchers with a tool that serves to assess the status of individuals in relation to gambling symptomatology, which can be used to screen for at-risk profiles and evaluate treatment response.

“I was Treated by the Program, the Therapist, and Myself”: Feasibility of an Internet-Based Treatment Program for Gambling Disorder

The majority of people with problematic gambling behavior never seek or receive professional help. Internet-based treatment approaches have been shown to help patients overcome practical and psychological barriers associated with face-to-face therapy. In this uncontrolled pilot study, we explored the feasibility of the eight-module therapist-guided internet-based treatment program SpilleFri (“Free from Gambling”) for patients with gambling disorder (GD). We included 24 patients seeking treatment at a Danish hospital-based treatment clinic. The focus of the feasibility study was evaluation of recruitment and retention rates, data completion rates, treatment response, satisfaction, and program utility. In addition, a series of semi-structured interviews were conducted to explore patient-perceived acceptability and potential barriers to treatment completion and positive outcome. Treatment acceptability among therapists was examined in a focus group interview. Sixteen of the included patients completed the program, yielding an acceptable treatment dropout rate (29.17%), and 82.35% of treatment completers provided full data at all assessment points. Overall, patients were satisfied with the treatment received, and patient interviews highlighted multiple psychological as well as practical benefits associated with the treatment form and content. Patients with more severe gambling symptoms at baseline might be more likely to drop out before treatment completion than patients with less severe symptoms. The results suggest that SpilleFri may be a feasible alternative to face-to-face treatment for GD. However, the uncontrolled design and small sample size of the study limit the robustness of the findings. In the future, the effect of SpilleFri treatment should be examined in a randomized controlled trial.Clinical trial registrations: The study protocol was prospectively registered at clinicaltrials.gov (TRN: NCT05051085; registration date: September 21, 2021).

The associative learning roots of affect-driven impulsivity and its role in problem gambling: Areplication attempt and extension of Quintero etal. (2020).

Negative/positive urgency (NU/PU) refers to the proneness to act rashly under negative/positive emotions. These traits are proxies to generalized emotion dysregulation, and are well-established predictors of gambling-related problems. We aimed to replicate a previous work (Quintero etal., 2020) showing NU to be related to faulty extinction of conditioned stimuli in an emotional conditioning task, to extend these findings to PU, and to clarify the role of urgency in the development of gambling-related craving and problems. 81 gamblers performed an acquisition-extinction task in which neutral, disgusting, erotic and gambling-related images were used as unconditioned stimuli (US), and color patches as conditioned stimuli (CS). Trial-by-trial predictive responses were analyzed using generalized linear mixed-effects models (GLME). PU was more strongly related than NU to craving and severity of gambling problems. PU did not influence acquisition in the associative task, whereas NU slightly slowed it. Extinction was hampered in individuals with high PU, and a follow-up analysis showed this effect to depend on relative preference for skill-based and casino games. Results suggest that resistance to extinction of emotionally conditioned cues is a sign of malfunctioning emotion regulation in problematic gambling. In our work, the key effect was driven by PU (instead of NU), and gambling craving and symptoms were also more closely predicted by it. Future research should compare the involvement of PU and NU in emotion regulation and gambling problems, for gamblers with preference for different gambling modalities (e.g., pure chance vs skill games).

The Core Symptoms of Adolescents Online and Offline Gambling in South Korea Using Network Analysis.

Adolescent gambling is rapidly increasing recently. However, little is known about the core feature of adolescent gambling that should be the treatment target for adolescents. Thus, the objective of this study was to determine the core symptom of adolescent gambling using network analysis with large-scale data targeting community indwelling adolescents. We used dataset of the 2018 national survey on youth gambling problems collected by the Korea Center on Gambling Problems to explore symptom networks of gambling in adolescents. Of 17,520 respondents in the dataset of the 2018 national survey on youth gambling problems collected by the Korea Center on Gambling Problems, 5,619 adolescents with experience of gambling were included in the analysis. We computed an association network, a graphical least absolute shrinkage and selection operator, and a directed acyclic graph to model symptom interactions. In each network of online, offline, and all gambling, stealing money or other valuable things in order to gamble or pay off gambling debts was the most centrally situated and skipping practice followed by dropping out of activities. Especially strong connections emerged between stealing money or other valuable things in order to gamble or pay off gambling debts and academic performance degradation due to gambling. Feeling bad due to gamble and skipping hanging out with friends who do not gamble emerged as a highly central node that might be distinctive to adolescents with online gambling. These findings demonstrate central features of adolescent gambling. Different associations among specific network nodes suggest the existence of distinctive psychopathological constructs between online and offline gambling.

The Predictive Role of Tolerance and Health Problems in Problem Gambling: A Cross-Sectional and Cross-Lagged Network Analyses

The existing symptomatic networks of problem gambling are all based on cross-sectional data. Thus, there is a need to explore longitudinal symptom networks of problem gambling. Moreover, the replicability of cross-sectional symptom networks can be limited; therefore, further research should assess the convergence between cross-sectional networks of problem gambling symptoms. The present study aimed (i) to examine cross-sectional networks of problem gambling symptoms and evaluate their replicability and (ii) to examine a longitudinal cross-lagged network of problem gambling symptoms. The study included a representative sample of young adult gamblers (born between 1984 and 2000) from the first two waves of the Budapest Longitudinal Study (original sample: N = 2777; final sample: N = 335). The Problem Gambling Severity Index was used to assess symptoms of problem gambling. Cross-sectional symptom networks showed differences in the centrality of nodes. Correlations between the two cross-sectional networks were low in the presence vs. absence of edges, rank order of edge weights, and centrality estimates. However, network invariance tests indicated non-significant differences between them. The cross-lagged network revealed that the symptoms of tolerance and health problems could predict the subsequent presence of multiple problem gambling symptoms. Overall, limited evidence demonstrated the replicability of cross-sectional symptom networks of problem gambling. Future research needs to explore the utility of cross-sectional networks of problem gambling and assess more precisely causal relationships between problem gambling symptoms by distinguishing within- and between-subject effects.

E-Estesia: A Serious Game for Reducing Arousal, Improving Emotional Regulation and Increasing Wellbeing in Individuals with Gambling Disorder.

Gambling disorder (GD) is associated with deficits in emotion regulation and impulsivity-related personality traits. In recent years there has been an increase in the use of serious games (SG) to address these factors with positive results. The aim of this study was to analyze the efficacy of the intervention with a new SG (e-Estesia), as an adjunct to a CBT intervention for GD. The sample comprised two groups (experimental group (n = 40) and control group (n = 64)) of patients with GD diagnosis. Both groups received 16 weekly CBT sessions and, concurrently, only the experimental group received 15 additional sessions with e-Estesia. Pre-post treatment with e-Estesia administered in both groups were: DSM-5 Criteria, South Oaks Gambling Screen, Symptom Checklist-Revised and measure of relapses, dropout and compliance of treatment. As regards the experimental group were also administered: Difficulties in Emotion Regulation Scale, Emotion Regulation Questionnaire, and Impulsive Behavior Scale. No statistically significant differences in the general psychopathological state, emotion regulation or impulsivity were found when comparing the groups. However, patients enrolled in the e-Estesia intervention had significantly less relapses and better indicators of treatment compliance than the control group. Considering these results, the use of complementary tools such as SG are useful for addressing GD.

Illegal behaviors as a consequence of gambling disorder.

Gambling disorder has been associated with illegal behaviors; however, research using validated scales and in-person assessments has been less common. Four hundred and twenty-sevenpeople with gambling disorders taking part in clinical trials completed multiple instruments and select cognitive tasks. Two groups were identified: those with illegal behaviors linked to gambling disorder and those without. Differences between the groups were examined. 43.3% of people with gambling disorders reported gambling-related illegal behaviors. Illegal behaviors were associated with earlier gambling symptom onset, higher levels of depressive symptoms, worse quality of life, and higher non-planning impulsivity. In those with illegal behaviors, the most common activities reported were writing bad checks/paying bills from accounts that no longer had funds (75.1%), and theft (9.6%). People with illegal gambling-related behaviors did not differ from those without, in terms of levels of symptom severity, or likelihood of responding to treatment in the subsequent clinical trials. Illegal behaviors are commonplace in people with gambling disorders and linked to worse quality of life, but people with gambling-related illegal behaviors respond to core treatments to the same extent as people without these behaviors. The findings from this study extend previous research and support the novel notion that rather than more intensive treatment being indicated for gambling disorders linked to illegal activities, it may be prudent to consider illegal behaviors as part of a wider profile of gambling-related harms that merit interventions in their own right.

Symptoms of Problem Gambling Among US Adults Who Wager on Sports

This survey study assesses levels of problem-gambling risk across 4 categories of sports-related wagering among US adults.

Relationships of Problematic Internet Use, Online Gaming, and Online Gambling with Depression and Quality of Life Among College Students

Young adults on college campuses have easy access to information and communications technology (ICT) which they use extensively for study, work, and leisure. The purpose of this study was to investigate the prevalence and extent of problematic Internet use, online gaming behavior, and online gambling behavior (together referred to as dysfunctional online behaviors), and their relationships with depression and quality of life among college students. Two hundred and twenty two valid surveys were used in the data analyses. Five instruments, Beck Depression Inventory-II (BDI-II), the WHO Quality of Life Scale-BREF (WHOQOL-BREF), the Internet Addiction Test (IAT), the Problematic Online Gaming Questionnaire (POGQ), and the Online Gambling Symptom Assessment Scale (OGSAS), were selected to measure the variables being studied. A non-experimental research design was employed to answer one descriptive and two research questions. The results of the analyses indicated that dysfunctional online behaviors predicted a higher level of depression (R2 = .14, p &lt; .05) and a lower level of quality of life (R2 = .20, p &lt; .05). The findings of the current study inform clinical practice and the treatment of dysfunctional online behaviors among college students.

No effect of short term exposure to gambling like reward systems on post game risk taking

Is engaging with gambling-like video game rewards a risk factor for future gambling? Despite speculation, there are no direct experimental tests of this “gateway hypothesis”. We test a mechanism that might support this pathway: the effects of engaging with gambling-like reward mechanisms on risk-taking. We tested the hypothesis that players exposed to gambling-like rewards (i.e., randomised rewards delivered via a loot box) would show increased risk-taking compared to players in fixed and no reward control conditions. 153 participants (Mage = 25) completed twenty minutes of gameplay—including exposure to one of the three reward conditions—before completing a gamified, online version of the Balloon Analogue Risk Task (BART). Self-reports of gambling and loot box engagement were collected via the Problem Gambling Severity Index, and Risky Loot-Box Index. Bayesian t-tests comparing BART scores across reward conditions provided moderate to strong evidence for a null effect of condition on risk-taking (BF = 4.05–10.64). Null effects were not moderated by players’ problem gambling symptomatology. A Spearman correlation between past loot box engagement and self-reported gambling severity (rs = 0.35) aligned with existing literature. Our data speak against a “gateway” hypothesis, but add support to the notion that problem gambling symptoms might make players vulnerable to overspending on loot boxes.

Surprisingly high prevalence rates of severe psychological distress among consumers who purchase loot boxes in video games

Loot boxes are randomised rewards available in some video games, often purchasable for real-world money. Loot boxes have been likened to conventional forms of gambling and may satisfy legal requirements to be considered bona fide gambling in some jurisdictions. Research has consistently shown that people with problem gambling symptoms report spending more on these mechanisms than people without such symptoms. However, a significant gap in our current understanding is whether engaging with these mechanisms is associated with harm. Here we examine the prevalence rates of severe psychological distress among purchasers of loot boxes relative to non-purchasers. A reanalysis of two cross-sectional surveys collected online via online collection platforms. Participants were 2432 Aotearoa New Zealand, Australian, and United States residents recruited through online survey. Our results show that purchasers of loot boxes are at approximately 1.87 times higher risk of severe psychological distress on a standardised clinical screening tool than people who do not purchase loot boxes. These relative risk rates are not due to gender, age, spending on other video game related purchases, or problem gambling symptoms. Individuals who purchased loot boxes appeared to also have higher risk of severe psychological distress irrespective of demographic characteristics or problem gambling status. Loot boxes appear to be associated with significantly higher risk of experiencing psychological harm even for players without problem gambling symptoms.

Pharmacological interventions for the treatment of disordered and problem gambling.

Pharmacological interventions for the treatment of disordered and problem gambling.

Do You Gamble? Gambling Behavior, Problem Symptoms, and Self-Awareness among Social Workers and Other Mental Health Providers

ABSTRACT Purpose To explore the personal gambling behavior and problem symptoms of social workers and other mental health providers to gauge their level of self-awareness, an important prerequisite to identifying and assisting clients who gamble. Method A survey was conducted with a convenience sample of 2,317 social workers and other mental health providers. Results Bivariate and regression analyses found that than 76% of participants reported gambling in the past year, and nearly 30% gambled at moderate or high frequency. About 5% reported one or more problem gambling symptom. Nearly 78% of participants, endorsing between two and ten gambling activities, denied they gambled, and 23% gambled at moderate to high frequency. Overall, 55% of all participants with at least one problem gambling symptom denied gambling. Discussion/Conclusion It is critical for providers to receive training and education to understand their own gambling behaviors and problem symptoms, which could adversely impact the therapeutic relationship.

A Gambling Just-In-Time Adaptive Intervention (GamblingLess: In-The-Moment): Protocol for a Microrandomized Trial.

BackgroundThe presence of discrete but fluctuating precipitants, in combination with the dynamic nature of gambling episodes, calls for the development of tailored interventions delivered in real time, such as just-in-time adaptive interventions (JITAIs). JITAIs leverage mobile and wireless technologies to address dynamically changing individual needs by providing the type and amount of support required at the right time and only when needed. They have the added benefit of reaching underserved populations by providing accessible, convenient, and low-burden support. Despite these benefits, few JITAIs targeting gambling behavior are available.ObjectiveThis study aims to redress this gap in service provision by developing and evaluating a theoretically informed and evidence-based JITAI for people who want to reduce their gambling. Delivered via a smartphone app, GamblingLess: In-The-Moment provides tailored cognitive-behavioral and third-wave interventions targeting cognitive processes explicated by the relapse prevention model (cravings, self-efficacy, and positive outcome expectancies). It aims to reduce gambling symptom severity (distal outcome) through short-term reductions in the likelihood of gambling episodes (primary proximal outcome) by improving craving intensity, self-efficacy, or expectancies (secondary proximal outcomes). The primary aim is to explore the degree to which the delivery of a tailored intervention at a time of cognitive vulnerability reduces the probability of a subsequent gambling episode.MethodsGamblingLess: In-The-Moment interventions are delivered to gamblers who are in a state of receptivity (available for treatment) and report a state of cognitive vulnerability via ecological momentary assessments 3 times a day. The JITAI will tailor the type, timing, and amount of support for individual needs. Using a microrandomized trial, a form of sequential factorial design, each eligible participant will be randomized to a tailored intervention condition or no intervention control condition at each ecological momentary assessment across a 28-day period. The microrandomized trial will be supplemented by a 6-month within-group follow-up evaluation to explore long-term effects on primary (gambling symptom severity) and secondary (gambling behavior, craving severity, self-efficacy, and expectancies) outcomes and an acceptability evaluation via postintervention surveys, app use and engagement indices, and semistructured interviews. In all, 200 participants will be recruited from Australia and New Zealand.ResultsThe project was funded in June 2019, with approval from the Deakin University Human Research Ethics Committee (2020-304). Stakeholder user testing revealed high acceptability scores. The trial began on March 29, 2022, and 84 participants have been recruited (as of June 24, 2022). Results are expected to be published mid-2024.ConclusionsGamblingLess: In-The-Moment forms part of a suite of theoretically informed and evidence-based web-based and mobile gambling interventions. This trial will provide important empirical data that can be used to facilitate the JITAI’s optimization to make it a more effective, efficient, and scalable tailored intervention.Trial RegistrationAustralian New Zealand Clinical Trials Registry (ANZCTR) ACTRN12622000490774; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=380757&isClinicalTrial=FalseInternational Registered Report Identifier (IRRID)PRR1-10.2196/38958

Gambling knowledge and experience among clinical social workers

ABSTRACT Despite the rapid expansion of legalized gambling, few social workers are trained to identify problem gambling symptoms. This study explored gambling knowledge, behavior, and problem symptoms in a sample of 1,777 clinical social workers through an online survey. Findings indicate about 77% of social workers gambled and more than 4% of those who gambled reported at least one problem gambling symptom. Participants answered less than half of the knowledge questions correctly, and a majority were unaware of the current diagnostic classification for gambling disorder or the legal age for gambling. Results of a multivariate regression analysis found that social workers in practice 8 to 15 years, employed in substance treatment facilities or universities, and/or with training in gambling treatment had higher levels of knowledge about gambling and gambling treatment. Findings underscore the need for social work schools and organizations to prioritize education and training for problem gambling identification and treatment.

Mental Health Over Time and Financial Concerns Predict Change in Online Gambling During COVID-19.

This study examined online gambling behavior during COVID-19 land-based gambling restrictions and associations with changes in mental health, impacts on household income due to the pandemic, financially focused motivations, and symptoms of gambling problems. A repeated online survey was administered to adult gamblers in Ontario, Canada. Wave 1 was conducted at the beginning of the first COVID-19 lockdown (April 2020) and wave 2 in August 2020. Respondents (N = 940) completed validated self-report questionnaires related to depression and anxiety, financial motivation, financial impacts due to the pandemic, online gambling behaviors, and problem gambling symptomatology. A cluster analysis identified three subgroups: no online gambling (subgroup 1), engagement in a range of gambling games online and change in gambling involvement (i.e., some increased and some decreased gambling; subgroup 2), and predominantly online lottery play with no change in online gambling (subgroup 3). Respondents who reported increased anxiety and depression symptom severity between the two waves and those who experienced greater symptoms of problem gambling and negative impacts on household income due to COVID-19 were most likely to be found in subgroup 2. Greater financial focus was also noted in this group. Results indicate a link between change in online gambling involvement during COVID-19 and increased mental health problems, elevated problem gambling severity, negative impacts on household income, and a greater financially focused self-concept. These results may help generate novel research questions examining short and long-term effects of the pandemic on online behaviors that inform policy and practice.

Emotion regulation-enhanced group treatment for gambling disorder: a non-randomized pilot trial

BackgroundDespite the association of Gambling Disorder (GD) with poor mental health, treatment options generally lack components targeting emotional difficulties. This study investigated the feasibility and acceptability of adding strategies of emotion regulation to an eight-session weekly group treatment.MethodThis non-randomized pilot study recruited 21 treatment-seeking adults with GD, (mean age = 36.3, 19% females) from addiction care. In a mixed methods design, measures of within-group changes in self-reported symptoms of GD were complemented with thematic analysis of post-treatment interviews regarding the feasibility of the treatment.ResultsWithin-group scores on the Gambling Symptoms Assessment Scale (G-SAS) showed a 47% decrease (β: -0.1599, 95% CI: − 0.2526 to − 0.0500) from pre-treatment to 12-month follow-up, with Hedges’ g = 1.07 (CI: 0.57–1.60).The number of GD-symptoms according to the Structured Clinical Interview for Gambling Disorder (SCI-GD) decreased from 7.0 (SD = 1.60) at pre-treatment to 2.1 (SD = 2.36) at 12-month follow-up. Participants completed an average of 6.3 sessions and rated the intervention high in satisfaction and acceptability. Feasibility interviews showed no noticeable negative effects or ethical issues. Furthermore, helpful components in the treatment were: increased awareness of emotional processes and strategies to deal with difficult emotions.ConclusionsAdding emotion regulation strategies in the treatment of GD is feasible and acceptable and warrants further investigation in a controlled trial.Trial registrationThis study was registered with ClinicalTrials.gov (Identifier NCT03725735).