Gambling Treatment Research Articles

The perceived influence of sports betting marketing techniques on disordered gamblers in treatment

ABSTRACT Research question: The proliferation of marketing stimuli to gamble on sports is a growing concern in many jurisdictions. However, little is known about the perceived influence of marketing among the most severe group of problem gamblers (i.e. those receiving treatment). This study aims to explore how problem sports bettors perceive gambling marketing is affecting them. Research methods: It examines the opinions of 43 sports bettors undergoing treatment for gambling disorder. Seven qualitative focus groups were carried out to understand their self-reported views on gambling marketing influence. Responses were analysed using a thematic analysis approach. Results and findings: The results showed three main marketing paths for impact: (i) mass-mediated marketing stimuli, (ii) personalised marketing, and (iii) stimuli inside betting shops. Price-related promotions (e.g. bonuses) were viewed as especially harmful. Also, the use of cognitive biases by bookmakers made it harder for sports bettors to stop gambling, and constantly facilitated their relapse. Implications: The paper provides evidence to substantiate regulatory action to restrict gambling promotions. In addition, it recommends that gambling companies develop responsible gambling measures to reduce the cognitive biases ingrained in their sports betting products.

Gambling in Two Regional Australian Aboriginal Communities: A Social Practice Analysis

Reflecting international patterns, Aboriginal people in Victoria are more likely to gamble and to experience gambling harm than non-Indigenous Victorians. This paper describes experiences of gambling reported by 50 Aboriginal people interviewed in regional Victoria in 2016 and 2017 as part of studies initiated by two Aboriginal community-controlled organisations. Data were analysed using social practice theory (SPT) and coded to the elements of ‘meaning’, ‘material’, ‘competence’, and ‘temporality’. Across each element we identified highly contradictory experiences. Gambling held meaning as an opportunity for community gatherings but was also regarded as a cause of domestic violence, conflict, isolation and shame. Materially, the venues that offered gambling were experienced by many Aboriginal people as safe and welcoming, but at the same time gambling produced a damaging affective sense of addiction for some. Gambling was a competency that some people valued and taught to children, but it was also seen as undermining cultural practices. While Aboriginal people were historically denied access to licensed venues offering commercial gambling, many participants now found opportunities to gamble inescapable. The intermingling of benefits and harms described above supports the need for a multi-faceted response to gambling in Aboriginal communities, which includes harm reduction as well as supply restriction and treatment. Some experiences of gambling related by our participants reflected those reported also by non-Indigenous Australians, while others were differently nuanced. Because SPT is used to understand collectively-shared practices, it facilitates the identification of gambling interventions at the level of the community, as recommended by our research participants.

What does it mean to recover from a gambling disorder? Perspectives of gambling help service users

Background: There is no consensus on how to best define recovery in gambling disorder. This minimizes clinicians’ abilities to apply optimal treatment goals and contributes to inconsistency in the use of outcome variables to evaluate interventions. Current understanding of recovery is largely based on professional opinion and theoretical models of gambling disorder. This study aimed to examine core features of recovery identified by service users with lived experiences.Methods: Thematic analysis was applied to qualitative data from 32 face-to-face interviews. Interviewees were at various stages of help-seeking for gambling problems mostly related to electronic gaming machines via self-exclusion and/or specialized gambling counseling.Results: Recovery was perceived by the participants as a continuous process that encompasses periods of improvement and decline. Several key themes of recovery emerged; participants highlighted the importance of developing insight into the psychological and environmental processes that contribute to their gambling problem. Insight helped participants feel empowered to successfully manage their gambling urges and behavior. Recovery extended to building a meaningful life beyond gambling, which involved engagement in alternative activities and fostering strong social relationships. It included stabilization of personal finances and achieving general psychological health and wellbeing.Conclusions: Findings challenge acute symptom-focused models of recovery by broadening the definitional boundaries to include sustained improvements across multiple psychosocial dimensions. Greater emphasis should be given to service user-defined elements of recovery in treatment and research. The long-term perspective of the recovery process has implications for extending standard follow-up assessment intervals in gambling treatment studies.

Comorbidity Patterns Among Patients With Opioid Use Disorder and Problem Gambling: ADHD Status Predicts Class Membership

Objective: Psychiatric comorbidities are highly prevalent among individuals affected by substance use disorders and those with non-substance-related addictive disorders such as gambling disorder. More recently, the frequent co-occurrence of substance use disorders and attention-deficit hyperactivity disorder (ADHD) has received particular attention. The aim of our study was to identify patterns of psychiatric comorbidity and to examine associations between patient group and ADHD status with class membership. Methods: Participants were patients with opioid use disorder enrolled in opioid maintenance treatment (OMT), either recruited from the community (n = 142; M age = 35.8 years; 38.7% female) or prison (n = 133; M age = 35.7 years; 21.8% female), and patients undergoing treatment for problem gambling (PrG; n = 80; M age = 43.1 years; 20% female). To enable direct comparisons, the following instruments were applied: Mini International Neuropsychiatric Interview, Adult ADHD self-report scale, Wender Utah Rating Scale, and European Addiction Severity Index. We used a latent class analysis (LCA) to identify psychiatric comorbidity patterns and a multinomial logistic regression to examine associations between patient group, ADHD status, age, and gender with class membership. Results: The LCA resulted in a three-class solution: (1) a class of individuals with a relatively low probability of current psychiatric comorbidities, except for a high probability of substance use disorders; (2) a class with markedly increased probabilities of current and recurrent psychiatric comorbidities, especially for major depression; and (3) a class with very low probabilities of psychiatric comorbidities, except for moderate probabilities of substance use disorders and antisocial personality disorder. Both OMT patients recruited from the community and those in prison were less likely than PrG patients to be assigned to the most burdened class with respect to psychiatric comorbidity (class 2). Further, both individuals with ADHD in childhood and those with adult ADHD were more likely members of class 2. Conclusions: PrG patients seem to be at an even higher risk for psychiatric comorbidities compared to OMT patients. Raising awareness among practitioners for the high prevalence of psychiatric comorbidities among patients with gambling disorder and individuals with ADHD is crucial to initiate adequate treatment and to improve response.

Brief interventions for problem gambling: A meta-analysis.

BackgroundBrief interventions have been increasingly investigated to promote early intervention in gambling problems; an accurate estimate of the impact of these interventions is required to justify their widespread implementation. The goal of the current investigation was to evaluate the efficacy of in-person brief interventions for reducing gambling behaviour and/or problems, by quantifying the aggregate effect size associated with these interventions in the published literature to date.MethodsRandomized controlled trials including the following design features were identified via systematic review: an adult sample experiencing problems associated with gambling; an in-person individual psychosocial intervention of brief duration (≤3 sessions); a control/comparison group; and an outcome related to gambling behaviour and/or problems.ResultsFive records compared brief interventions to assessment only control; using a random effect model, brief interventions were associated with a small but statistically significant reduction in gambling behaviour across short-term follow-up periods versus assessment only control (g = -.19, 95% CI [-.37, -.01]). Aggregate effect sizes for gambling problems and long-term follow-up periods were not statistically significant. Five records compared brief interventions to longer active interventions; there was no significant difference between brief interventions and longer active interventions.ConclusionsResults supported the efficacy of brief interventions for problem gambling compared to inactive control in the reduction of gambling behaviour; no differences were found across brief versus longer interventions for both gambling behaviour and problems. While these findings must be interpreted in the context of the limited number of studies and small magnitude of the combined effect sizes, the current meta-analysis supports the further investigation of the public health impact of these cost-effective interventions.

Prevalence and Determinants of Problem Gambling among Internal Migrants in Muse, Myanmar, near the Border with China

Strong cultural acceptance of gambling and the stress of migration are placing migrants at risk of developing gambling problems in Southeast Asia. This study aimed to assess the prevalence of problem gambling and its determinants among internal migrant workers in Muse, Myanmar, situated along the border with China. A cross-sectional study was conducted in April to May 2018 in Muse among 273 internal migrants. The prevalence of problem gambling was 58.2%. In a multiple logistic regression analysis, male gender, non-Burmese ethnicities, those aged 25 years and older, daily manual laborers/unemployed, and alcohol consumption remained significantly associated. Results suggest a high prevalence of problem gambling, which was associated with substance use. These findings emphasize the need to develop strategies for locally adaptive gambling prevention and interventions and further the need for routine screening process in community services and for training staff to be aware of and respond to gambling harms.

Dopamine and Gambling Disorder: Prospects for Personalized Treatment.

To address variation in the severity of gambling disorder, this review evaluates the contribution of mesocorticolimbic dopamine neurons to potential behavioral endophenotypes, the influence of individual differences in the dopamine system on gambling and related behaviors, and the possible role for dopaminergic medications in the treatment of gambling disorder. Newer work has suggested that dopaminergic dysfunction can lead to increased reward anticipation and a greater sensitivity to uncertainty, which in turn may drive addictive gambling behaviors. In addition, increased impulsivity, a well-recognized risk factor for gambling disorder, has been linked to dopaminergic dysfunction. More recently, emerging evidence has suggested that dopaminergic medications can influence the discounting of delayed rewards. Dopaminergic drugs that increase the salience of long-term over short-term goals may ameliorate symptoms of impulsive individuals with gambling disorder. More broadly, improved understanding of intermediate behavioral and other phenotypes with a defined neurobiological substrate may allow for personalized treatment of gambling disorder and other psychiatric conditions.

Randomized controlled trial of an Internet intervention for problem gambling provided with or without access to an Internet intervention for co-occurring mental health distress

Background and aimsThe current randomized controlled trial tested whether there was benefit to providing an online gambling intervention and a separate self-help mental health intervention for anxiety and depression (i.e. MoodGYM) (G + MH), compared to only a gambling intervention (G only) among people with co-occurring gambling problems and mental health distress. The primary outcome of interest was improvement in gambling outcomes. Secondary analyses also tested for the impact of the combined intervention on depression and anxiety outcomes. MethodsParticipants who were concerned about their gambling were recruited to help evaluate an online intervention for gamblers. Those who met criteria for problem gambling were randomized to receive either the G only or the G + MH intervention. Participants were also assessed for current mental health distress at baseline, with three quarters (n = 214) reporting significant current distress and form the sample for this study. Participants were followed-up at 3- and 6-months to assess changes in gambling status, and improvements in depression and anxiety. ResultsFollow-up rates were poor (47% completed at least one follow-up). While there were significant reductions in gambling outcomes, as well as on measures of current depression and anxiety, there was no significant difference in outcomes between participants receiving the G only versus the G + MH intervention. Discussion and conclusionThere does not appear to be a benefit to providing access to an additional online mental health intervention to our online gambling intervention, at least among participants who are concerned about their gambling.Trial registration: ClinicalTrials.govNCT02800096; Registration date: June 14, 2016.

Pilot randomized controlled trial of an online intervention for problem gamblers

IntroductionThis pilot randomized controlled trial sought to evaluate whether an online intervention for problem gambling could lead to improved gambling outcomes compared to a no intervention control. Participants were recruited through a crowdsourcing platform. MethodsParticipants were recruited to complete an online survey about their gambling through the Mechanical Turk platform. Those who scored 5 or more on the Problem Gambling Severity Index and were thinking about quitting or reducing their gambling were invited to complete 6-week and 6-month follow-ups. Each potential participant who agreed was sent a unique password. Participants who used their password to log onto the study portal were randomized to either access an online intervention for gambling or to a no intervention control. ResultsA total of 321 participants were recruited, of which 87% and 88% were followed-up at 6 weeks and 6 months, respectively. Outcome analyses revealed that, while there were reductions in gambling from baseline to follow-ups, there was no significant observable impact of the online gambling intervention, as compared to a no intervention control condition. ConclusionsWhile the current trial observed no impact of the intervention, replication is merited with a larger sample size, and with participants who are not recruited through a crowdsourcing platform.Trial registration: ClinicalTrials.govNCT03124589

"Types of change strategies for limiting or reducing gambling behaviors and their perceived helpfulness: A factor analysis." Correction to Rodda et al. (2018).

Reports an error in "Types of change strategies for limiting or reducing gambling behaviors and their perceived helpfulness: A factor analysis" by Simone N. Rodda, Kathleen L. Bagot, Alison Cheetham, David C. Hodgins, Nerilee Hing and Dan I. Lubman (Psychology of Addictive Behaviors, 2018[Sep], Vol 32[6], 679-688). In the article the ethics approval details appearing in the last sentence of the second paragraph of the Participants section are incorrect and should appear instead as follows: Ethics approval for the study was gained by Eastern Health Research and Ethics Committee (study registration number LR22/1314). (The following abstract of the original article appeared in record 2018-44923-008.) Gamblers engage with a broad range of resources and strategies to limit or reduce their gambling. However, there is limited research examining the uptake and helpfulness of the full range of strategies gamblers employ. The aim of this study was to compile a comprehensive inventory of change strategies and then group these using principal component analysis based on perceived helpfulness. We also aimed to determine whether there are differences in the helpfulness of strategies by demographic, gambling severity, and readiness indicators. The Change Strategies Questionnaire-Version 1 contained 99 strategies, and 489 gamblers (including 333 problem gamblers) identified the most frequently endorsed strategy as remind yourself of negative consequences of gambling (92%) and think about how money could be better spent (92%). Principal components analysis identified 15 strategy groupings: cognitive, well-being, consumption control, behavioral substitution, financial management, urge management, self-monitoring, information seeking, spiritual, avoidance, social support, exclusion, planning, feedback, and limit finances. There were differences in the helpfulness of strategies by age and gambling severity. Few strategies were correlated with confidence to manage an urge to gamble. Overall, change strategies were viewed as moderately helpful. The top five strategies were all used by at least 90% of gamblers, and these strategies were all cognitive in nature. This study provides important information for the development of interventions targeting gambling behavior. Furthermore, it suggests that interventions for problem gambling should target cognitive, feedback, planning, and urge management strategies. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Intimate Partner Violence in Treatment Seeking Problem Gamblers

The co-occurrence of Intimate Partner Violence (IPV) and gambling disorder is an emerging area of research but no studies, as yet, have examined these within a gambling treatment-seeking population from the UK. In a sample of 204 patients, the study utilised routine clinical data and the Jellinek–Inventory for assessing Partner Violence (J-IPV) to determine the prevalence of IPV perpetration and victimisation. 20.1% of participants reported any IPV in the past year; 12.3% reported perpetration and 14.1% reported victimisation in the past year. Clinical scores were greater among patients disclosing IPV; higher anxiety and depression scores coupled with victimisation, alongside greater problem gambling severity; age, anxiety, depression and debt scores among those reporting IPV perpetration. There is need for enhanced vigilance and first-line responses to IPV in problem gambling treatment services. There is also a need for professional support for the clinicians working with these clients.

Online Self-Directed Interventions for Gambling Disorder: Randomized Controlled Trial.

Self-directed treatments for gambling disorder have been developed to attract individuals who are reluctant to seek formal treatment. Self-directed treatments provide individuals with information and support to initiate a recovery program without attending formal treatment. In this study, an online version of a previously evaluated telephone-based intervention package is compared to a brief online normative feedback intervention called Check Your Gambling. In a randomized controlled trial design, participants with gambling problems who were not interested in formal treatment (N = 181) were recruited through media announcements. After a baseline telephone assessment, participants were assigned to have access to either the brief Check Your Gambling, or the extended self-management tools intervention. Follow-up assessments were conducted at 3, 6, and 12months post baseline by blinded interviewers. Participant nominated collaterals were contacted to validate self-reported gambling involvement. The follow-up rate at 12months was 78%. Participants in both conditions showed significant reductions in days of gambling and problem severity but no differences between conditions were found, contrary to the primary hypothesis. Lack of previous treatment for gambling and higher baseline self-efficacy predicted fewer days of gambling in both conditions. Self-efficacy increased over time but did not appear to mediate changes in gambling. Participants who were most engaged in the extended online program showed better outcomes. Those with low engagement showed a slower trajectory of change but equivalent improvements by 12months. The extended online intervention was not associated with better outcomes than the brief Check Your Gambling intervention. Future research needs to explore the attractiveness, uptake, and effectiveness of online interventions with and without therapist support to understand their potential role in gambling disorder treatment systems.Trial Registration ISRCTN06220098.

Development of the Gambling Disorder Identification Test (G-DIT): Protocol for a Delphi Method Study.

BackgroundResearch on the identification and treatment of problem gambling has been characterized by a wide range of outcome measures and instruments. However, a single instrument measuring gambling behavior, severity, and specific deleterious effects is lacking.ObjectiveThis protocol describes the development of the Gambling Disorder Identification Test (G-DIT), which is a 9- to 12-item multiple-choice scale with three domains: gambling consumption, symptom severity, and negative consequences. The scale is analogous to the widely used Alcohol Use Disorders Identification Test (AUDIT) and the Drug Use Disorders Identification Test (DUDIT).MethodsThe G-DIT is developed in four steps: (1) identification of items eligible for the G-DIT from a pool of existing gambling measures; (2) presentation of items proposed for evaluation by invited expert researchers through an online Delphi process and subsequent consensus meetings; (3) pilot testing of a draft of the 9- to 12-item version in a small group of participants with problem gambling behavior (n=12); and (4) evaluation of the psychometric properties of the final G-DIT measure in relation to the existing instruments and self-reported criteria of the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5), among individuals with problem gambling and nonproblematic recreational gambling behaviors (n=600). This protocol article summarizes step 1 and describes steps 2 and 3 in detail.ResultsAs of October 2018, steps 1-3 are complete, and step 4 is underway.ConclusionsImplementation of this online Delphi study early in the psychometric development process will contribute to the face and construct validity of the G-DIT. We believe the G-DIT will be useful as a standard outcome measure in the field of problem gambling research and serve as a problem-identification tool in clinical settings.International Registered Report Identifier (IRRID)RR1-10.2196/12006

Internet-Based Interventions for Problem Gambling: Scoping Review.

BackgroundThis study seeks to give an overview of academic research on internet-based interventions that are used to address problem gambling. The rate of treatment seeking has been demonstrated to be low across several research environments. This is in part because of the systemic barriers that treatment seekers face to accessing traditional face-to-face treatment. Making treatment resources for problem gambling available through the internet is one way to reduce the impact of those systemic barriers. The use of internet-based resources to address problem gambling has been growing, and a field of research evaluating it has developed as well. However, little has been done to summarize this collection of research.ObjectiveThis study aimed to provide a scoping review of the use of internet-based interventions for problem gambling treatment and prevention to provide an understanding of the current state of the field.MethodsA scoping review was performed for 6 peer-reviewed research databases (Web of Science, PsycINFO, Cumulative Index to Nursing and Allied Health Literature, MEDLINE, Social Science s, and Scopus) and 3 gray literature databases (MedEdPortal, Proquest: Dissertations, and OpenGrey). Article inclusion criteria were as follows: published over the 10-year period of 2007 to 2017, including an intervention for problem gambling, and involving the use of internet to deliver that intervention.ResultsA total of 27 articles were found that met the review criteria. Studies were found from several different areas, with particularly strong representation for Australia, New Zealand, and Scandinavia. Cognitive behavioral therapy was the most common form of internet-based intervention. Internet-based interventions were generally shown to be effective in reducing problem gambling scores and gambling behaviors. A wide range of interventions that made use of internet resources included text-based interactions with counselors and peers, automated personalized and normative feedback on gambling behaviors, and interactive cognitive behavioral therapies. A lack of diversity in samples, little comparison with face-to-face interventions, and issues of changes in the treatment dynamic are identified as areas that require further investigation.ConclusionsInternet-based interventions are a promising direction for treatment and prevention of problem gambling, particularly in reducing barriers to accessing professional help. The state of the current literature is sparse, and more research is needed for directly comparing internet-based interventions and their traditional counterparts.

Transformation of Sports Betting into a Rapid and Continuous Gambling Activity: a Grounded Theoretical Investigation of Problem Sports Betting in Online Settings

There is an increasing trend for online sports betting to be identified in gambling treatment services as the principal gambling activity that leads to harmful consequences. The structure of sports betting in online settings has changed extensively in the last 5 years in response to developing information technology, and these changes appear to have increased the inherent risk associated with online sports betting. There is a current need to understand disordered patterns of sports betting in online settings, in order to commence the development of strategies to identify and, where possible, mitigate harm. Therefore, a systematic grounded theory study was conducted, utilising behavioural data and in-depth interviews with a sample of 19 online sports bettors who met the criteria for problem gambling, to produce a substantive outline of the salient sources of harmful participation in modern online sports betting. The core category to emerge was an Online Sports Betting Loop that was facilitated by new structural features of modern online sports betting such as live betting, cash out, micro-event betting and instant depositing. In addition, participants indicated that the immediate accessibility and the ubiquity of online sports betting marketing made it challenging to control sports betting involvement. The emergent findings demonstrate that attention must be directed towards creating mechanisms to reduce patterns of continuous online sports betting by increasing breaks in play in the structure of the activity and enabling customers to restrict usage of features that are associated with disordered play, such as live betting.

Gender differences in mental health and substance use disorders and related healthcare services utilization.

Pathological gambling often co-occurs with other psychiatric disorders. Gender differences in treatment-seeking behaviors among patients with pathological gambling diagnosis remain poorly understood. This study assessed gender differences in healthcare services utilization in patients seeking treatment for pathological gambling, substance use, and mental health co-occurring conditions. Study data were derived from a representative sample of the Massachusetts All Payers Claims Database for the period 2009-2013. Descriptive analyses were performed by gender using group t-tests and Pearson's chi-square tests. Bootstrap analysis was used to account for skewed distribution of healthcare services utilization data. Multiple linear regressions were used to evaluate the association between healthcare services utilization and gender while controlling for patient's age, county, and ICD-9-CM diagnosis codes. Over two-thirds of the patients were males. Moreover, two in five patients seeking treatment had pathological gambling as principal or primary diagnosis. Females had a significantly greater number of three or more co-occurring psychiatric conditions than males. Having a diagnosis of episodic mood disorder, neurotic disorder, or adjustment reaction significantly increased the utilization of healthcare services for both genders. Females had a greater utilization of healthcare services than males for the same psychiatric diagnosis. Healthcare services utilization significantly varies by gender and type of mental health and substance use diagnosis. There are significant differences by gender in the utilization of healthcare services for the same psychiatric disorders. There is a need to address gender differences in psychiatric conditions and their related healthcare needs. (Am J Addict 2019;28:9-15).

Extinction of gambling cue-reactivity: A pilot study in a problem gambling treatment setting

Copyright: © Riley BJ (2018). This Article is distributed under the terms of Creative Commons Attribution 4.0 International License

Behaviour Change Strategies Endorsed by Gamblers Subtyped by Psychological Distress, Risky Alcohol Use, and Impulsivity.

Problem gambling is often accompanied by co-morbid psychiatric disorders and maladaptive personality traits. Subtyping gamblers based on these pervasive comorbidities has been attempted so as to aid understanding of the aetiology of problem gambling and inform treatment options. However, there has been less focus on subtyping gamblers with (past or current) or without a history of problem gambling, or on providing more specific treatment or self-help recommendations. The current study sought to subtype current-, past-, and non-problem gamblers using three common comorbidities; psychological distress, risky alcohol use, and impulsivity. Participants' endorsement of helpful behaviour change strategies was also examined by subtype membership. A total of 385 participants were recruited who had a current gambling problem (n = 128; 33%), a past gambling problem (n = 131, 34%) or never had a gambling problem (n = 126, 33%). Hierarchical cluster analysis identified distinct subtypes of current (i.e., low comorbidity, high psychological distress, risky alcohol use and high comorbidity), past (i.e., low comorbidity, high psychological distress and high comorbidity) and non-problem gamblers (i.e., low comorbidity, high psychological distress, risky alcohol use and moderate impulsivity). The most helpful change strategies for current and past gamblers were similar across subtypes (i.e., accept that gambling needs to change, remind yourself of the negative consequences). Non-problem gamblers reported the most helpful strategy as setting financial limits. This study indicated that treatment of psychological distress, risky alcohol use or impulsivity may be important for all gamblers regardless of their level of risk.

The crucial role of recovery capital in individuals with a gambling disorder.

Background and aimsThe concept of recovery capital (RC) describes the internal and external resources that individuals draw upon to initiate and sustain the processes of addiction recovery. This concept has been primarily applied to individuals recovering from substance addictions. In this study, the RC concept was applied to individuals with a gambling disorder (GD) to test its associations with the diagnosis and severity of GD and with levels of psychopathology as manifested in depression and anxiety.MethodsA sample of 140 individuals who recovered or did not recover from a GD was drawn from lists of former and currently treated individuals in five gambling treatment centers in Israel. The DSM-5 diagnostic criteria for GD, Assessment of Recovery Capital and Brief Assessment of Recovery Capital Scales adapted to Gambling, Generalized Anxiety Disorder Scale, and the Patient Health Questionnaire 9 which measures depression were used.ResultsRC clearly distinguishes between individuals who have recovered from GD and those who have not. A structural equation model showed significant negative associations between RC and GD severity, depression, and generalized anxiety. The associations between GD severity and depression and anxiety were not significant. However, when omitting the path between RC and depression/anxiety, the associations between GD and depression/anxiety became significant.ConclusionsRC plays an important role in GD severity and diagnosis, as well as in psychopathology. This study extends the concept of RC to the area of gambling and contributes to the growing body of studies that have found parallels and common denominators between substance addiction and behavioral addictions.

Prevention and Treatment of Problem Gambling Among Older Adults: A Scoping Review

Gambling is a socially acceptable form of recreation for older adults, but excessive gambling can lead to negative financial consequences and mental health problems. The lack of attention given to gambling problems among older adults has been highlighted in the literature for over a decade. The objectives of this review were to examine relevant literature on interventions for prevention and treatment of problem gambling (PG) among older adults and to identify research gaps. To this end, we conducted a scoping review of both quantitative and qualitative research, focusing on adult studies. Because of the lack of PG research specific to older adults, we focused our review on prevention and treatment among adult studies that covered a wide age range. Our literature search, conducted in a range of bibliographic databases, located 7,632 titles. After duplicates were eliminated, 4,268 records remained; 2,321 were excluded based on title and 1,247 remained after abstract review. Three independent assessors reviewed the full text of 700 articles and found 247 that met our inclusion/exclusion criteria. We identified a paucity of research on prevention and treatment of problem gambling specific to older adults, with the gaps in evidence even greater for prevention. We found only six studies specific to adults aged 55 years and older. Studies on older women are severely lacking. We conclude with some suggestions for future research.RésuméLe jeu est une forme de loisir socialement acceptable pour les personnes en âge avancé, mais le jeu excessif peut entraîner des conséquences financières graves et des problèmes de santé mentale. Depuis plus d’une décennie, le manque d’attention accordée aux problèmes de jeu chez les personnes âgées a été souligné dans la littérature. Cette étude avait pour but d’examiner les ouvrages portant sur les interventions de prévention et le traitement du jeu problématique chez les personnes âgées et de cerner les lacunes dans la recherche. À cette fin, on a entrepris un examen de l’étendue de la recherche quantitative et qualitative axée sur les études sur les adultes. En raison de l’absence de recherche sur le jeu compulsif propre aux adultes âgés, nous avons axé notre examen sur la prévention et le traitement dans les études pour adultes couvrant plusieurs tranches d’âge. Notre revue de la littérature, menée dans diverses bases de données bibliographiques, a permis de répertorier 7 632 titres. Après l’élimination des doublons, il est resté 4268 titres; 2321 ont été exclus sur la base du titre et nous en avons conservé 1247 après la lecture des résumés. Trois évaluateurs indépendants ont examiné le texte intégral de 700 articles et ont repéré 247 articles qui répondaient à nos critères d’inclusion/d’exclusion. Nous avons constaté un manque de recherche sur la prévention et le traitement du jeu problématique propre aux personnes âgées, et des lacunes encore plus évidentes au chapitre de la prévention. Nous avons trouvé seulement six études portant spécifiquement sur les adultes âgés de 55 ans et plus. Les études sur les femmes d’âge mûr font cruellement défaut. Nous avons conclu en donnant quelques suggestions pour de futures recherches.