Youth Gambling Research Articles

The intergenerational transmission of gambling and other addictive behaviors: Implications of the mediating effects of cross-addiction frequency and problems

IntroductionThis study examined the degree to which perceptions of familial and household participation in gambling and other addictive behaviors in youth was associated with frequency and problem severity of gambling, alcohol and/or drug use in participants as adults. MethodThe study measured perceived frequency of gambling, alcohol use, drug use and other potentially addictive behaviors in family/household members and the frequency and problem severity of gambling, alcohol, and drugs in an epidemiological sample of adults 18 and older (N = 3,499; m = 48.26 %, f = 51.74 %). ResultsAbout 23.45 % of participants reported their father gambled when they were a child or adolescent, followed by mother (13.56 %), grandfather (9.73 %), or grandmother (7.83 %). A pathway model demonstrated cross-addiction inter- and intra-generational influences. Gambling by a father, mother or brother; substance use by a sister; and/or engagement in other behaviors by a brother, sister, grandmother or other household member was related to higher frequency of participant gambling (ps < 0.05), and, in turn, to higher levels of gambling, alcohol, and drug use problem severity (ps < 0.05). DiscussionFindings demonstrate the complex contributions of specific family and household members in the transmission of addictive behaviors. Frequency of gambling, alcohol use, and drug use mediated the relationship of perceived family behavior with and across addictions. In addition, perceptions regarding use of alcohol and/or other drugs, or engagement in other behaviors by family or household members was related not only to participants' alcohol and drug use but also to problem gambling frequency and severity.

Making sense of gambling. Swedish youth navigating between risk and responsibility

ABSTRACT Youth gambling is commonly described in policy and research as a high-risk behavior. To design relevant measures to prevent gambling problems among youth, it is important to understand how youth themselves relate to gambling. To explore how youth navigate their position on gambling in the context of their everyday lives, we conducted qualitative interviews with 35 participants aged 17–21 years in Sweden; 15 had gambled and 20 had experience of others’ gambling. The thematic analysis showed that both gamblers and non-gamblers overall had negative attitudes toward gambling and emphasized repeatedly discourses of personal responsibility in it. The participants used various neutralization techniques to navigate the economic and addictive risks of gambling. Youth who gambled distanced themselves from the risks of gambling by drawing a line between themselves and excessive gamblers, between safe and unsafe gambling, or highlighted how their skills and strategic thinking made gambling less problematic. Also, gambling in liminal circumstances abroad or in alcohol-serving venues offered a safe time and place for gambling by separating it from everyday life practices. The findings provide important cues to how young people locate gambling in their everyday life, which is useful knowledge for policy and prevention.

The politics and fantasy of the gambling education discourse: An analysis of gambling industry-funded youth education programmes in the United Kingdom

BackgroundThe provision of commercialised gambling products and services has changed radically in recent decades. Gambling is now provided in many places by multi-national corporations, with important implications for public health and policymaking. The United Kingdom is one of the most liberalised gambling markets globally, however there are few empirical analyses of gambling policy from a public health perspective. This study aims to provide a critical analysis of a core element of UK gambling policy, the provision of industry-funded youth gambling education programmes. MethodsAdopting a commercial determinants of health lens, a discourse theoretical analysis was conducted using the logics of critical explanation. The data comprised resources provided by three gambling industry-funded charities (GambleAware, GamCare and the Young Gamers and Gamblers Education Trust) and their partners. ResultsThe resources present a gambling education discourse that serves to reproduce the ‘responsible gambling’ agenda, while problematising children and young people. While the resources appear to offer educational content and opportunities for debate, the dominant focus is on teaching about personal responsibility and on the normalisation of gambling and gaming and their industries, while constraining the concept of agency. The resources encourage young people to act as individuals to control their impulses, and to correct what are portrayed as faulty cognitions with the aim of becoming responsible consumers. Our findings demonstrate how the gambling education discourse aligns with wider industry interests, serving to deflect from the harmful nature of the products and services they market while shifting responsibility for harm onto children, youth and their families. ConclusionsDespite being delivered in the name of public health, the resources construct a discourse favourable to corporate interests. Educators, parents, policymakers, and others need to be empowered to address the conflicts of interest that exist in the delivery of gambling industry-funded resources. The promotion of such industry-favoured interventions should not be allowed to undermine efforts to implement regulations to prevent gambling harms.

An exploratory study of anxiety-motivated gambling in adolescents: Associations with minority status and gambling, health and functioning measures

Gambling and anxiety are major public health concerns in adolescents and have been linked to emotion dysregulation and mood-modulating behaviors. While previous studies have shown links between positively reinforcing excitement-motivated gambling, health and functioning measures, and gambling perceptions and behavioral correlates in adolescents, few studies have examined such relationships relative to negatively reinforcing anxiety-motivated gambling (AMG). This study systematically examined relationships between adolescents reporting gambling to relieve anxiety (compared to those who gambled but did not report AMG) and measures of health/functioning and gambling-related measures. Participants included 1,856 Connecticut high-school students. Chi-square and logistic regression models were conducted. AMG was reported by 6.41% of the sample and was associated with identifying with a minority group (Black, Asian-American, Hispanic), at-risk/problem gambling, more permissive attitudes towards gambling, and higher odds of heavy alcohol, tobacco and other drug use, and violence-related measures. Adolescents with AMG were more likely to report non-strategic gambling, and gambling to escape/relieve dysphoria and due to feeling pressure. Additional between-group differences were found for gambling types, locations, motivations, and partners. Together, AMG may represent a mood-modulating behavior indicative of multiple problematic concerns, suggesting that emotional dysregulation may be an important factor in understanding the relationship between anxiety, problem gambling, and risky behaviors in youth. Additionally, the negative reinforcing motivations to gamble to relieve anxiety may be relevant particularly to adolescents from underrepresented minority racial/ethnic groups, and the specific factors underlying this relationship warrant further investigation.

HABITS AND FREQUENCY OF (ONLINE) GAMBLING AMONG YOUNG PEOPLE IN BOSNIA AND HERZEGOVINA

Gambling of young people as a risky behavior is an increasingly current social problem, but also the subject of numerous researches. The gambling industry is one of the fastest-growing industries in the world, and a significant increase in availability has taken place in the Bosnian and Herzegovinan society. Young people in BiH are entering the world of gambling more often and easier. Bad economic situation, social unrest, high poverty and unemployment rates contribute to this situation. World statistics show that the increase in gambling was significantly affected by the COVID-19 pandemic. Omnipresent digitalization during the pandemic, movement restrictions, but also existential uncertainty have opened a new path to online gambling. Therefore, an research was conducted in which the habits of young people (N=174) and their frequency of (online) gambling were examined. The questionnaire results showed that 70.5% of respondents had played games of chance at least once in their lives. Young people usually play one-time tickets and sports betting. Of particular concern is the fact that individuals play online games of chance on a daily basis. They usually invest a smaller amount of money and more than half of the respondents have lost money on betting at least once. The data show that gambling is most often out of boredom, fun and socializing, and they do not consider such behavior to be problematic. According to self-assessment, only 5.9% of respondents believe that their gambling is somewhat or completely problematic, while 3.7% state that the degree of gambling addiction is so high that they need professional help. On the other hand, Bosnia and Herzegovina lacks prevention programs aimed at problematic youth gambling, which is why they remain deprived of professional support. All of this suggests that serious investment in public health and social policies is needed to offer quality prevention and psychoeducational programs.

Mediating Role of Impulsivity in the Contributory Roles of Upward Versus Downward Counterfactual Thinking in Youth Gambling Intention.

The proliferation of gambling shops, and the growing gambling prevalence in Nigeria, youths have constantly engaged in gambling activities even during school period. This has raised concerns among therapists and parents as the trend could degenerate to problem gambling and its associated psychosocial problems if left unchecked. Our study examined the role of impulsivity as a mediator in the association between two types of counterfactual thinking (CFT) and gambling intention in a non-clinical sample. A self-report measure containing South Oaks Gambling Screen: Reversed for Adolescents (SOGS: RA), CFT, and impulsivity scales was completed by 371 Nigerian adolescents who had gambled for money (mean age = 17.37years; SD = 4.13). After controlling for age, increase in downward CFT was associated with decreased gambling intention, whereas increase in upward CFT and impulsivity were associated with increased gambling intention. Upward CFT contributed more to gambling intention than downward CFT. Mediation result showed that Impulsivity significantly mediated only the association between upward CFT and gambling intention. We concluded that gambling therapies should include treatment packages that enhance impulse control abilities and gambling-related downward CFT and at the same time, attenuate gambling-related upward CFT.

Offline and Online Gambling in a Swiss Emerging-Adult Male Population

Faced with the rapid expansion of the online gambling offer, a growing number of jurisdictions around the world are developing legislation to regulate online gambling. The new Swiss Act on gambling extends legalization of online gambling from already authorized lottery-type to casino-type gambling. In this context, the present study examines offline and online gambling behaviors in emerging-adult males as a particularly at-risk population for gambling addiction. A sample of 1,869 young males completed a questionnaire assessing offline and online gambling behaviors as well as severity of problem gambling. Results show that 62.1% of the respondents were lifetime gamblers while 46.7% were past-year gamblers. Among the latter, 76.4% had gambled only within offline venues, 21.4% had gambled at both offline and online sites, and 2.2% had gambled online only. Furthermore, 17.6% of past-year gamblers were at moderate-risk of developing problem gambling whilst 3.6% were problem gamblers. Association analysis showed that, compared to non-problem gamblers, at-risk and problem gamblers played online at higher rates. These findings contribute to the growing literature on youth gambling behaviors and on offline-online transitions. In the context of the growing online gambling supply, the evolution of youth gambling behaviors should be monitored through periodical assessments.

The Prevalence and Correlates of Gambling in Australian Secondary School Students

Youth gambling is associated with a range of harms. This study aimed to examine, among Australian adolescents, the prevalence of gambling (ever, in the last month, at-risk and problem), the most frequent gambling types and modalities, and to explore the student characteristics associated with gambling in the last month and with at-risk or problem gambling. Students aged 12–17 years from Victoria and Queensland answered gambling questions as part of the Australian Secondary School Alcohol and Drug (ASSAD) Survey in 2017. The ASSAD also included a series of questions about smoking, alcohol and other drug use, and mental health. A total of 6377 students from 93 schools were included in analysis. The prevalence of ever gambling and gambling in the last month was 31% and 6% respectively. Of students who had gambled in the last month, 34% were classified as at-risk and 15% were classified as problem gamblers. The most frequent types of gambling in the last month were horse or dog race and sports betting. Students who gambled in the last month did so most frequently via a parent or guardian purchasing or playing for them, at home or at a friends’ house, and online or using an app. Regression analysis indicated that male gender, having money available to spend on self, alcohol consumption in the last seven days, the number of types of advertisements seen in the last month, and the number of peer or family members who gambled in the last month, were significantly associated with the likelihood of students gambling in the last month. Male gender, some age categories, and exposure to more types of gambling advertising were also significant predictors of being classified as an at-risk or problem gambler. This large study of youth gambling provides data on gambling behaviours and related variables from a large sample of Australian secondary school students. Student characteristics, including male gender and exposure to more types of gambling advertising, were associated with an increased likelihood of gambling in the last month and of being classified as an at-risk or problem gambler. Further implications of the study findings are discussed.

Short-Term Effectiveness of the Youth Gambling Prevention Program "Who Really Wins?"-Results from the First National Implementation.

As a response to significant adolescent gambling involvement, a Croatian team of researchers and practitioners developed a universal, comprehensive, evidence-based youth gambling prevention program called “Who Really Wins?”. This study presents the results on its short-term effectiveness following the first national implementation in 18 Croatian cities, with a total of 629 high school students (66.5% male) who completed the program. A design with two measurement sessions (pre-test and post-test) was used to explore the short-term effects of the program on gambling-related knowledge and cognition, frequency of gambling, and various socio-emotional skills. The results showed significant effects when it comes to knowledge, cognitive distortions, and the frequency of sports betting and playing lottery games. Furthermore, the program had no harmful effects on any of the measured variables. The results are interpreted in terms of methodological challenges in measuring effects, possible improvements of the program, and implications for future evaluation research.

Pre-Teen Gang Involvement Is Associated With Teenage Gambling Behavior: Exploratory Findings From a Longitudinal Cohort Study of Pacific Youth in New Zealand

Pacific youth in New Zealand have a disproportionately high risk for gambling and gang involvement compared with New Zealand European youth. Limited evidence indicates that youth gang involvement is associated with problem gambling; no research shows if it is associated with gambling. We conducted exploratory secondary analyses of data from 1063 Pacific youth and their mothers using data from two time points (age nine and 14 years) from a longitudinal cohort study. Gang involvement at age nine years was significantly associated with gambling at age 14 years, with adjusted odds of 2.25 (95% CI [1.16, 4.37]). Of confounders, having a mother with a partner and Cook Islands ethnicity appeared protective against gambling at age 14 years. Despite some study limitations, as youth gambling can lead to subsequent adult problem gambling, our findings highlight the importance of understanding why Pacific youth join gangs, to inform public health policies to reduce the potential for future development of harmful behaviors.

Relations Among Gambling Behavior, Associated Problems, Game Type, and Risk Factors in a Rural, African American, Adolescent Sample.

Problem gambling is a rising concern among adolescent populations; youth gamble more frequently than adults, and those who gamble are more susceptible than adults to maladaptive outcomes. Research shows that gambling problems are exacerbated among minorities, despite lower rates of gambling frequency. Minority youth are at especially high risk for problematic gambling outcomes, though they have not been widely studied. The objectives of this study were to (a) investigate gambling frequency and rates of associated problems among rural, African American youth, (b) examine risk factors associated with gambling problems, and (c) explore preferences for game type. Hypotheses were tested with survey data from 270 African American youth from rural communities in Georgia, ages 14-17. Past-year gambling prevalence was 38% (48% of males and 28% of females), and 30% of those who gambled (11% of the total sample) reported at least one problem behavior associated with gambling.Confirmatory factor analysis established a distinction between games of skill versus luck. Gambling problems were associated with skill games, and youth played skill games more than luck games. Substance use and anger scores predicted gambling frequency, and gambling frequency predicted gambling problems. Depression scores provided no predictive utility. Poverty status was negatively associated with skill gambling, and there was no association between poverty status and luck gambling. Males gambled more frequently, had more gambling problems, and were more likely to engage in skill gambling relative to females.

A Perspective on Age Restrictions and Other Harm Reduction Approaches Targeting Youth Online Gambling, Considering Convergences of Gambling and Videogaming.

Internet gambling has become a popular activity among some youth. Vulnerable youth may be particularly at risk due to limited harm reduction and enforcement measures. This article explores age restrictions and other harm reduction measures relating to youth and young adult online gambling. A systematic rapid review was conducted by searching eight databases. Additional articles on online gambling (e.g., from references) were later included. To place this perspective into context, articles on adult gambling, land-based gambling, and substance use and other problematic behaviors were also considered. Several studies show promising findings for legally restricting youth from gambling in that such restrictions may reduce the amount of youth gambling and gambling-related harms. However, simply labeling an activity as “age-restricted” may not deter youth from gambling; in some instances, it may generate increased appeal for gambling. Therefore, advertising and warning labels should be examined in conjunction with age restrictions. Recommendations for age enforcement strategies, advertising, education, and warning labels are made to help multiple stakeholders including policymakers and public health officials internationally. Age restrictions in online gambling should consider multiple populations including youth and young adults. Prevention and harm reduction in gambling should examine how age-restriction strategies may affect problem gambling and how they may be best enforced across gambling platforms. More research is needed to protect youth with respect to online gambling.

Machine learning-based analysis of adolescent gambling factors.

Problem gambling among adolescents has recently attracted attention because of easy access to gambling in online environments and its serious effects on adolescent lives. We proposed a machine learning-based analysis method for predicting the degree of problem gambling. Of the 17,520 respondents in the 2018 National Survey on Youth Gambling Problems dataset (collected by the Korea Center on Gambling Problems), 5,045 students who had gambled in the past 3 months were included in this study. The Gambling Problem Severity Scale was used to provide the binary label information. After the random forest-based feature selection method, we trained four models: random forest (RF), support vector machine (SVM), extra trees (ETs), and ridge regression. The online gambling behavior in the past 3 months, experience of winning money or goods, and gambling of personal relationship were three factors exhibiting the high feature importance. All four models demonstrated an area under the curve (AUC) of >0.7; ET showed the highest AUC (0.755), RF demonstrated the highest accuracy (71.8%), and SVM showed the highest F1 score (0.507) on a testing set. The results indicate that machine learning models can convey meaningful information to support predictions regarding the degree of problem gambling. Machine learning models trained using important features showed moderate accuracy in a large-scale Korean adolescent dataset. These findings suggest that the method will help screen adolescents at risk of problem gambling. We believe that expandable machine learning-based approaches will become more powerful as more datasets are collected.

Machine learning-based analysis of adolescent gambling factors

Background and aimsProblem gambling among adolescents has recently attracted attention because of easy access to gambling in online environments and its serious effects on adolescent lives. We proposed a machine learning-based analysis method for predicting the degree of problem gambling.MethodsOf the 17,520 respondents in the 2018 National Survey on Youth Gambling Problems dataset (collected by the Korea Center on Gambling Problems), 5,045 students who had gambled in the past 3 months were included in this study. The Gambling Problem Severity Scale was used to provide the binary label information. After the random forest-based feature selection method, we trained four models: random forest (RF), support vector machine (SVM), extra trees (ETs), and ridge regression.ResultsThe online gambling behavior in the past 3 months, experience of winning money or goods, and gambling of personal relationship were three factors exhibiting the high feature importance. All four models demonstrated an area under the curve (AUC) of >0.7; ET showed the highest AUC (0.755), RF demonstrated the highest accuracy (71.8%), and SVM showed the highest F1 score (0.507) on a testing set.DiscussionThe results indicate that machine learning models can convey meaningful information to support predictions regarding the degree of problem gambling.ConclusionMachine learning models trained using important features showed moderate accuracy in a large-scale Korean adolescent dataset. These findings suggest that the method will help screen adolescents at risk of problem gambling. We believe that expandable machine learning-based approaches will become more powerful as more datasets are collected.

Traumatic brain injuries and problem gambling in youth: Evidence from a population-based study of secondary students in Ontario, Canada

Traumatic brain injury (TBI) is characterized by a change in brain function after an external force or sudden movement to the head. TBI is associated with risk-taking, impulsivity, psychological distress, substance abuse, and violent crime. Previous studies have also linked problem gambling to TBI, but these studies have not controlled for possible confounding variables such as mental health problems and hazardous drinking which are also linked to TBI. This study examines the relationship between problem gambling and TBI among adolescents. Data were obtained from the 2011, 2013 and 2015 cycles of the OSDUHS, a biennial cross-sectional school-based study of children in grades 7 to 12 (N = 9,198). Logistic regression was used to estimate adjusted odds ratios (AOR) in controlled and uncontrolled analyses. Adjusting for sex and grade only, problem gambling was associated with a history of TBI (AOR = 2.8). This association remained significant after adjusting for hazardous drinking and suicidality (AOR = 2.0). In addition, problem gambling had a statistically significant relationship with being male (AOR = 4.7), hazardous drinking (AOR = 4.5), and suicidality (AOR = 3.1). This study provides further data to suggest a link between TBI and problem gambling. However, research is needed on the causal relationship between these variables and the potential implications for treatment and prevention.

Recollected usage of legal youth gambling products: Comparisons between adult gamblers and non-gamblers in the UK and Australia

The UK is rare in allowing a number of gambling forms to be used legally by children under the age of 18. Some previous research indicates that adult problem gamblers are more likely to recollect using these products as children. However, no research has as yet assessed recollected levels of use irrespective of adult gambling status, or investigated these issues in other countries. This is relevant given that at least two of the tested products, coin push machines and crane grab machines, exist in other countries. The present research involves cross-sectional surveys conducted amongst UK (N = 2010) and Australian adults (N = 640), associating recollected legal youth gambling usage with past 12-month gambling, and levels of problem gambling amongst adult gamblers. Adult gamblers recollected using more legal youth gambling products than non-gamblers. For example, 66.6% of UK gamblers reported legally buying National Lottery tickets aged 16–17, compared to 20.9% of UK non-gamblers; 60.8% of Australian gamblers reported using coin push machines as a child, compared to 48.6% of Australian non-gamblers. Overall, 18 of 19 tested associations were significant and in the hypothesized direction for the UK sample, compared to five of eight for the Australian sample. The legal provision of gambling to children is a topic for further international research and policy consideration.

Gambling in Transition: Assessing Youth Narratives of Gambling in Nigeria

Nigeria has witnessed some significant changes in gambling which have resulted in more people becoming interested in the activity. In an attempt to increase participation, bookmakers have introduced a variety of innovations. Literature has established that this increased participation is inter-generational, cross-cultural, and inter-religious. Particularly among Nigerian youth, participation in gambling cuts across all age groups, socio-economic status, and gender. Both financial and social rewards have been identified as reasons why many youths gamble. Through a qualitative lens, this study investigates how the dynamics of gambling in recent times have affected the biographies of youth within a relatively deprived socio-economic locality in Kwara State, Nigeria. Thirty young gamblers between the ages of 15 and 29 were engaged in a semi-structured interview session. Drawing from the meaning of 'youth' from a sociological lexicon, one can advance this unique narrative of the transitions in gambling activities which can occur as a result of the youths' biographies and socio-economic status. Nigerian youth adopt three specific gambling types as a coping strategy in the face of a crisis-ridden socio-economic structure characterised by poverty, and unemployment. As such, gambling has become a normative activity experimented by the youth to survive the harsh economic conditions. This study therefore argues the need to situate the discourse of youth gambling within the social, cultural, and economic context in which they are located in Nigeria. In addition, the authors provide a framework for understanding the complexity of youth gambling in Nigeria.

The Role of Narcissism, Hyper-competitiveness and Maladaptive Coping Strategies on Male Adolescent Regular Gamblers: Two Mediation Models.

The present study aimed to explore the unique and common role that some cognitive, personality and relational characteristics play in male adolescents' regular gambling behavior. Participants were 273 male adolescents and young adults aged 15-19 recruited in sports betting centers. They completed the South Oaks Gambling Screen, the Narcissistic Admiration and Rivalry Questionnaire, the Hypercompetitive Attitude scale, and The Coping Strategy Indicator. The relationship between narcissistic rivalry and gambling was mediated by hyper-competitiveness and avoidant coping strategy. These findings suggest that narcissistic features and maladaptive coping strategies might be involved in the development of disordered gambling in youth, supporting a compensatory model of this addictive behavior and claiming for preventative actions that take into account the psychological vulnerabilities of adolescents and young adults.

Associations between recalled use of legal UK youth gambling products and adult disordered gambling.

The UK allows a number of gambling products to be legally used by people under the age of 18. The aim of this study was to explore associations between recalled legal usage of five youth gambling products and adult disordered gambling. A retrospective cross-sectional study of 1,057 adult UK gamblers, aged 18-40. Recalled legal use of five youth gambling products (category D fruit machines, coin push machines, crane grab machines, the National Lottery, and National Lottery scratchcards) was correlated with adult disordered gambling symptoms as measured by the Problem Gambling Severity Index (PGSI). Recalled rates of legal engagement with each product ranged from 50.9% for Category D fruit machines to 96.6% for coin push machines. For category D fruit machines, the National Lottery, and National Lottery scratchcards, merely having legally engaged with these products as a child was associated with adult disordered gambling. Furthermore, higher levels of recalled legal youth usage with each of the five products was also associated with adult disordered gambling. These results relate to recent government proposals to increase the National Lottery scratchcard legal age to 18, and add to a wider literature on youth gambling and subsequent gambling-related harm.

Excitement-Seeking Gambling in Adolescents: Health Correlates and Gambling-Related Attitudes and Behaviors.

Motivational characteristics such as excitement-seeking are key components of models of addiction, including problem gambling. Previous studies have established associations between excitement-seeking and problem gambling in youth. However, these studies have employed dimensional psychological assessments which are unlikely to be routinely administered. Other approaches to conceptualize excitement-seeking could be of value. In the present study, we employed a single question (What are the reasons that you gamble?) to identify adolescents who reported excitement-seeking motivation for gambling. Cross-sectional data from 2030 adolescent gamblers who participated in a Connecticut high-school survey were examined. Gambling perceptions and correlates of problem-gambling severity were examined relative to excitement-seeking and non-excitement-seeking gambling. Gambling perceptions were more permissive and at-risk/problem gambling was more frequent among adolescents with excitement-seeking gambling versus non-excitement-seeking gambling. A weaker relationship between problem-gambling severity and moderate and heavy alcohol use was observed for excitement-seeking versus non-excitement-seeking gambling. Excitement-seeking gambling is associated with more permissive gambling-related attitudes and riskier gambling behaviors and may account for some variance in adolescent risk of heavy alcohol use. A single question may provide important information for identifying adolescents who are at elevated risk of problem gambling and associated negative outcomes, although the utility of the question in specific settings warrants direct examination, especially given the observed high prevalence of excitement-seeking motivations for gambling.