Gambling involvement and problem gambling correlates among European adolescents: results from the European Network for Addictive Behavior study

Influence of social determinants of health on gambling in adolescents. Analysis of the results of the ESTUDES 2022 survey

BACKGROUND

There is globally proliferation of pathological gambling among the adolescent population. This public health problem requires the development of effective preventive strategies based on the risk factors. The aim of this study is to analyse the social determinants of health which may be predictors of online and face-to-face gambling in young people.

METHODS

A descriptive cross-sectional study was carried out using the Survey on Drug Use in Secondary Education in Spain, ESTUDES (2021), as the main data collection tool. The selected sample consisted of N = 22 321.

RESULTS

Gender, age, academic performance and compulsive internet use were found to be predictors of online and face-to-face gambling. Gambling with money was statistically significantly related to male gender, age, presence of truancy, low academic achievement, compulsive internet use, mother's educational level and mother's employment status.

CONCLUSIONS

This study offers a detailed analysis of connection between social and demographic factors that precede gambling beginning and the presence of problem behaviours. Academic achievement and gender differences appear to relate to the pathological gambling in adolescents. These should be taken as a reference when generating preventive strategies that allow us to focus on the most vulnerable population.

Risk and Protective Factors for Gambling Among Youth by origin: Findings from the three waves of cross-sectional Finnish School Health Promotion Study among 238,939 Students

Gambling is a public health problem that can cause many kinds of harm. The aim of this study was to examine youth gambling by origin, and the risk and protective factors associated with it. The data was drawn from the School Health Promotion Study (n = 238,939) conducted in Finland, representative of the 14 to 16-year-old Finnish schoolchildren. Cross-tabulations and multivariate logistic regression were used in assessing the association between origin and weekly gambling. Interaction terms of origin and background variables related to substance use, peer and family relations and leisure time were then calculated to assess inter-group differences. The study showed that foreign-born, migrant origin and youth from mixed families were more likely to gamble weekly compared to youth with Finnish-born parents. The likelihood of gambling was particularly high among foreign-born and migrant-origin youth. Weekly gambling was significantly more common among boys than girls in all studied youth groups, and it was particularly common among foreign-born boys compared to other groups. Substance use was associated with weekly gambling and even more so among foreign-born youth. There were also differences by origin in the strength of association between other background factors and weekly gambling. Foreign-born boys appear to be especially vulnerable to multiple health and social risks including gambling, making them a particularly important group for targeted preventive programs. Preventive efforts are needed to enhance public awareness, boost parental supervision, and limit gambling-related risks. Special attention is needed to prevent migrant-origin boys from developing problems with gambling.

Mental health conditions of Colombian adolescent population: An approach to risk

OBJECTIVE

To determine the mental health conditions of adolescents in the city of Manizales, Colombia, and explore risk regarding gender-based differences.

MATERIALS AND METHODS

Quantitative, nonexperimental, descriptive research with associative scope. A total of 316 adolescents were assessed using five scales to evaluate mental health conditions: the Perceived Stress Scale, Patient Health Questionnaire-9, Generalized Anxiety Disorder Scale, Penn Alcohol Craving Scale and The Substance Dependence Severity Scale. Univariate and bivariate analysis was performed, Chi square and Odds Ratio were tested.

RESULTS

The findings indicated that being female is a risk factor for high levels of perceived stress, depressive episodes and anxiety. Additionally, adolescents who are not attending school are at higher risk for dependence and abuse of psychoactive substances. Conversely, being female acts as a protective factor against dependence on psychoactive substances.

CONCLUSIONS

The findings suggest a higher tendency among the participants towards experiencing depressive episodes. Regarding perceived stress, 71.5% of the participants fell into the low category, while 70.6% experienced a current episode of generalized anxiety.

Internet, App-Based, and Casino Gambling: Associations Between Modality, Problem Gambling, and Substance Use

Technology-based gambling prevalence is not well understood since relevant questions are not included in health and disease surveillance studies. The current study sought to estimate the prevalence of internet-based and smartphone app-based gambling, along with casino gambling, in a sample of U.S. young adults and determine if gambling modality was associated with problem gambling symptoms or substance use. The 2022 Rhode Island Young Adult Survey included N = 1,022 students between the ages of 18 to 25 years old who had lived in Rhode Island, with n = 414 lifetime gamblers (40.5%) included in this study. Odds of gambling via a smartphone app and on the internet, respectively, were greater in heterosexual cis-males compared to heterosexual cis-females (OR[95%CI] = 3.14 [1.25,7.91]; OR[95%CI] = 6.30 [2.05,19.3]). Internet gambling amongst employed students was less common than among those who were not a student and not employed (OR[95%CI] = 0.25 [0.06,1.00]). Odds of problem gambling symptoms were higher among those who gambled via a smartphone app (OR[95%CI] = 3.23 [1.21,8.60]). All forms of gambling were associated with alcohol consumption, although the strength of the association was stronger in app and internet gamblers. Casino gamblers were more likely to be high risk marijuana and illicit drug users. The rising availability of app gambling coupled with its social, psychological, and cultural context may presents an alternative pathway to problem gambling. Bans on internet gambling and/or strict guidelines on the frequency of wagers and cash placed per wager, should be considered as viable methods to mitigate associated consequences.

The prevalence of gambling and problematic gambling: a systematic review and meta-analysis

BACKGROUND

Gambling behaviours have become of increased public health interest, but data on prevalence remain scarce. In this study, we aimed to estimate for adults and adolescents the prevalence of any gambling activity, the prevalence of engaging in specific gambling activities, the prevalence of any risk gambling and problematic gambling, and the prevalence of any risk and problematic gambling by gambling activity.

METHODS

We performed a systematic review and meta-analysis. We systematically searched for peer-reviewed literature (on MEDLINE, Embase, and PsycInfo) and grey literature to identify papers published between Jan 1, 2010, and March 4, 2024. We searched for any gambling, including engagement with individual gambling activities, and problematic gambling data among adults and adolescents. We included papers that reported the prevalence or proportion of a gambling outcome of interest. We excluded papers of non-original data or based on a biased sample. Data were extracted into a bespoke Microsoft Access database, with the Joanna Briggs Institute Critical Appraisal Tool used to identify the risk of bias for each sample. Representative population survey estimates were firstly meta-analysed into country-level prevalence estimates, using metaprop, of any gambling, any risk gambling, problematic gambling, and by gambling activity. Secondly, population-weighted regional-level and global estimates were generated for any gambling, any risk gambling, problematic gambling, and specific gambling activity. This review is registered on PROSPERO (CRD42021251835).

FINDINGS

We screened 3692 reports, with 380 representative unique samples, in 68 countries and territories. Overall, the included samples consisted of slightly more men or male individuals, with a mean age of 29·72 years, and most samples identified were from high-income countries. Of these samples, 366 were included in the meta-analysis. Globally, 46·2% (95% CI 41·7-50·8) of adults and 17·9% (14·8-21·2) of adolescents had gambled in the past 12 months. Rates of gambling were higher among men (49·1%; 45·5-52·6) than women (37·4%; 32·0-42·5). Among adults, 8·7% (6·6-11·3) were classified as engaging in any risk gambling, and 1·41% (1·06-1·84) were engaging in problematic gambling. Among adults, rates of problematic gambling were greatest among online casino or slots gambling (15·8%; 10·7-21·6). There were few data reported on any risk and problematic gambling among adolescent samples.

INTERPRETATION

Existing evidence suggests that gambling is prevalent globally, that a substantial proportion of the population engage in problematic gambling, and that rates of problematic gambling are greatest among those gambling on online formats. Given the growth of the online gambling industry and the association between gambling and a range of public health harms, governments need to give greater attention to the strict regulation and monitoring of gambling globally.

FUNDING

Australian National Health and Medical Research Council.

Evaluation of Effectiveness of the Unplugged Program on Gambling Behaviours among Adolescents: Study Protocol of the Experimental Controlled Study "GAPUnplugged"

Gambling risk behaviour is an emerging problem among adolescents. "Unplugged" is an effective Social Influence curriculum for preventing substance use among students. This study aims to develop and test a new component focused on gambling added to the Unplugged program. Schools of Piedmont region and Rome city were invited to participate in the study. A self-completed anonymous questionnaire including questions on socio-demographic characteristics, addictive behaviours, beliefs, attitudes and risk perceptions about gambling, normative perceptions, parental practices, school climate, refusal skills, impulsiveness, self-esteem, antisocial behaviours and sensation seeking was prepared for baseline and follow-up surveys. The protocol of the study was submitted and approved by the Novara Ethical Committee and registered in ClinicalTrials.gov (NCT05630157, Protocol ID: 080.742, 11/17/2022). Twenty-nine schools accepted to participate in the study. Sixty-three classes (1325 students) satisfied the eligibility criteria for intervention and were allocated to the intervention arm, and the other 61 (1269 students) were allocated to the control arm. Because of drop-out, absentees, refusals, and invalid questionnaires, data on 1874 students (998 in the intervention and 876 in the control arm), were available for the analysis at baseline. Data management of follow-up questionnaires is in progress. Results of the present study will be useful to clarify the effectiveness of prevention interventions in reducing gambling behaviours among adolescents. Moreover, this will be the first experience of evaluating a new component focused on a different risk behaviour, added to a curriculum previously shown as effective on other risk behaviours.

The association between traumatic experiences and substance and behavioral addictions in late adolescence: A role for PTSD and cPTSD as potential mediators

BACKGROUND & AIM

Traumatic experiences (TEs) are a risk factor for behavioral and substance addictions (SBAs). However, the role of post-traumatic stress disorder (PTSD) and complex PTSD (cPTSD) deserves further elucidation. The present study assesses the association between different types of TEs on cannabis, alcohol, gambling, and problematic internet use in late adolescents. Furthermore, this study aims at evaluating the role of PTSD and cPTSD as potential mediators.

METHODS

An observational cross-sectional study was conducted on one thousand ten late adolescents (510 males, 498 females; age: mean = 18.7, SD = 0.65). Data regarding intentional (iTEs) and unintentional TEs (uTEs), cannabis, alcohol, gambling and problematic use of the internet (PIU), PTSD, and cPTSD were collected. Association between TEs, SBAs, and PTSD/cPTSD symptoms were explored by means of logistic regressions. Mediation was assessed using a path analysis.

RESULTS

uTEs were associated with cannabis use (OR = 1.34 [1.13,1.59]) and alcohol use (OR = 1.21 [1.10,1.35]), iTEs were associated with cannabis use (OR = 1.15 [1.06,1.25]), alcohol use (OR = 1.08 [1.02,1.13]), and PIU (OR = 1.17 [1.10,1.24]). PTSD was associated with alcohol use (OR = 1.59 [1.03,2.46]) and PIU (OR = 1.92 [1.18,3.13]). cPTSD was associated with cannabis use (OR = 3.54 [1.56,8.04]) and PIU (OR = 5.13 [2.71,9.70]). cPTSD mediated 58.75% of the total effect of iTEs on cannabis. Regarding PIU, PTSD mediated 68.18% of the effect of uTEs; the effect of iTEs on PIU was mediated by 65.5% via cPTSD and 34.45% via PTSD.

CONCLUSION

cPTSD and SBAs show a complex pattern of association. A thorough assessment of stress-related conditions, including cPTSD, is of pivotal importance in treating SBAs.

Wanna Bet? Investigating the Factors Related to Adolescent and Young Adult Gambling

For many adolescents and young adults, gambling can represent an attractive and exciting form of entertainment, a way to take risks and explore new experiences. However, gambling also poses a significant risk for this age group. Research suggests that adolescents and young adults are particularly vulnerable to the negative consequences of gambling, including addiction, financial difficulties, and mental health issues. This paper aims to critically examine data on adolescent and young adult gambling, focusing on the risk factors associated with gambling behavior. A total of 326 subjects (Mage = 19.01; SD =2.72), of whom 65.5% were female, completed a protocol containing a demographic sheet, the Lie/Bet Questionnaire, the Seven Domains Addiction Scale (7DAS), a subscale of the Addictive Behavior Questionnaire and the Coping Inventory for Stressful Situations (CISS). Specifically, we explored the impact of sociodemographic, environmental, psychological, and cognitive factors on adolescent and young adult gambling behavior. Clinical implications and future directions are discussed.

The Role of Attachment in Gambling Behaviors and Gambling Disorder: A Systematic Review

In recent years, a growing number of attachment-based studies have contributed to the understanding of both substance and behavioral addictions. Although gambling is a form of addictive behavior widespread all over the world, both among young people and adults, the evidence on the association between attachment-related phenomena and gambling has not yet been systematized in literature. The aim of the present study, therefore, is to provide a systematic literature review aimed at summarizing the empirical evidence on this topic. Following the updated 2020 PRISMA guidelines, a systematic search in four electronic scientific databases (Scopus, PubMed, PsycInfo and Web of Science) was conducted. After removing duplicates, 146 records were double-screened, with 12 articles meeting the inclusion criteria. Additionally, by means of a backward search a further article was selected. Altogether, 13 articles were selected for the present systematic review. With few exceptions, the results underline the significant role played by attachment-related phenomena in gambling behaviors, highlighting that specific attachment contexts have a different influence on gambling, also depending on whether gamblers are youths or adults. In particular, while secure attachment has proven to be a protective factor for the onset of gambling behavior, insecure attachment has emerged to be a vulnerability factor in two ways. On the one hand, it directly favors gambling behaviors; on the other, it affects coping strategies and the individual's ability to identify and regulate emotions, which in turn predict gambling. Limitations, strengths, and implications of the present systematic review are discussed.

Differences in problem and pathological gambling: A narrative review considering sex and gender

Background and aim

A wide range of studies indicates that men and women with Problem (PrG) and Pathological Gambling (PG) differ in several clinical and sociodemographic characteristics. However, evidence for sex differences, such as the telescoping effect, is contradictory, and it is still unclear whether sex differences observed in offline gambling can also be found for online gambling. Furthermore, reviews have so far focused on binary sex differences but neglect gender aspects. In this study, an updated literature survey of sex- and gender-related differences in PrG and PG was conducted.

Methods

We searched PsyInfo, Medline/Pubmed, and the Web of Science databases from 2005 to 2020 for studies investigating sex and gender differences in gambling. A total of 126 papers were included in the literature survey.

Results

We are presenting our findings according to the categories 'prevalence' (offline, online, LGBTQI*), 'sociodemographic factors', 'preferred gambling type', 'gambling motives', 'severity', 'progression of gambling problems', 'use of professional help/motivation for treatment', 'comorbidity', 'trauma', 'violence and criminality/delinquency'. The studies indicate that, despite some robust sex differences (e.g., concerning prevalence rates), results for most areas were mixed or suggest no sex differences (e.g., violence, gambling motives).

Discussion and conclusion

To date, there is a lack of studies assessing gender, and not only sex, warranting further research in this area.

Qualitative Descriptive Study of Illegal Behaviors among Those with Gambling Disorder in South Korea: Their Efforts for Recovery and Role of Mental Health Care Providers

The prevalence of Gambling Disorder among Koreans suggests that it is relatively higher than other countries. This study explored gambling-related crimes and related mental health care needs of those with Gambling Disorder on a case-by-case basis. Participants (n = 6) included men attending Gamblers Anonymous in South Korea with gambling debts and histories of illegal acts. Thematic analysis of qualitative interviews identified themes: (1) Meaning of Gambling Disorder in life, (2) Initiation of illegal acts stemming from Gambling Disorder, and (3) Life after addiction, efforts for recovery, and mental health care needs. Gambling Disorder destroyed lives and created criminal victims thereby threatening familial and community health.

Investigating Adolescents' Video Gaming and Gambling Activities, and Their Relationship With Behavioral, Emotional, and Social Difficulties: Protocol for a Multi-Informant Study

Background

Growing empirical evidence suggests that adolescents have a relatively greater propensity to develop problematic video gaming or gambling habits.

Objective

The main objectives of this study are to estimate the prevalence of potential pathological gambling and video game use among adolescent students and to evaluate their risk factors.

Methods

This is a cross-sectional multi-informant study based on an online survey. It will include a sample of adolescents attending secondary schools located in Brescia, northern Italy, their schoolteachers, and parents. The survey includes extensive data on adolescents’ (1) demographic, social, economic, and environmental characteristics; (2) behavioral, emotional, and social problems and adaptive functioning; (3) emotional and social loneliness; (4) perception of the reasons to use social networks; (5) video game habits and pathological use of video gaming; and (6) gambling behaviors.

Results

This protocol was approved by the Institutional Ethics Board of the Spedali Civili of Brescia (Italy). We expect to collect data from 793 or more adolescent students, as determined by our sample size calculation.

Conclusions

This multisite project will make a substantial contribution to (1) the implementation of a system for identifying pathological gambling and pathological video game use among adolescents, allowing for interventions aimed at improving adolescents’ financial, emotional, and social well-being; and (2) the identification of distinct profiles of gamblers and pathological video gamers that will contribute to setting up effective targeted prevention measures. Understanding the causes and impact of gambling and pathological video gaming on adolescents is a public health issue.

International Registered Report Identifier (IRRID)

DERR1-10.2196/33376

The Explanation of Adolescent Delinquent Behaviors Based on Jessor's Problem Behavior Theory (PBT) in Iran: The Role of Individual Vulnerability, Opportunity Risk Availability, and Perceived Support

This study tested the generality of Problem Behavior Theory (PBT) in explaining adolescents' problem behavior in Iran. Data were collected from 392 adolescents (Mage = 15.97, SD = 1.12, 55.4% girls) who completed the Adolescent Health and Development Questionnaire (AHDQ) to assess the individual vulnerability, opportunity risk availability, perceived support, and delinquent behaviors. Results indicated that individual vulnerability and opportunity risk availability had a significant relationship with delinquent behaviors and a significant interaction with perceived support in their influence on delinquent behaviors. Further, perceived support was negatively associated with delinquent behaviors. Our results were consistent with PBT's explanatory model for adolescents' problem behavior in Western countries and are informative about problem behavior involvement among Iranian adolescents and the design of interventions.

Gambling in Spanish Adolescents: Prevalence and Association with Mental Health Indicators

Concern about the development of behavioral addictions in adolescence, including gambling, has increased in recent years. Evidence shows that problem gambling can lead to personal, social, or health problems. However, even though gambling is an illegal activity, studies on this problem are quite limited in Spain. The main objective of this study was to analyze the prevalence of gambling in adolescents in Spain. Moreover, gambling behaviors were examined according to gender and age, and their possible relationship with several mental health indicators was analyzed. The results showed that 20.6% of the adolescents who participated in the study had gambled money in the past year. The highest gambling prevalence was found in boys and in adolescents from the age of 16 years old. Moreover, the results showed that gambling behavior was related to different mental health indicators.

[Spanish adaptation of the Gambling Advertising Impact Scale for adolescents]

La presión mediática de publicidad de apuestas ha alcanzado niveles preocupantes. Constituye un riesgo para la salud mental de los jóvenes y adolescentes al promover una actitud favorable hacia las apuestas, una mayor frecuencia de juego y una percepción de mayor accesibilidad. En la actualidad no se dispone de un instrumento capaz de evaluar el impacto de la publicidad de apuestas.

Objetivo

Adaptar y validar la Escala de Impacto de Publicidad de Apuestas (IGAS, Impact of Gambling Advertising Scale).

Diseño

Investigación instrumental. La escala IGAS fue traducida del inglés garantizando su equivalencia lingüística, conceptual y métrica. A continuación, se comprobaron las propiedades psicométricas.

Emplazamiento

Comunidad Valenciana (España).

Participantes

1.724 adolescentes con una media de 16,52 años (DT = 0,759).

Intervención Se administró un cuestionario autoaplicado en formato de papel en una única medida.

Principales medidas

Impacto de la publicidad, severidad e intención de apostar, y accesibilidad.

Resultados

La consistencia interna y la fiabilidad dos mitades fueron buenas, α de Cronbach = 0,782 y 0,70, respectivamente. El análisis factorial confirmatorio concluyó que la versión española reproduce la original de tres dimensiones. Los análisis de la validez convergente mostraron relaciones directas y significativas con diferentes aspectos de la conducta de juego, y otros factores predictores.

Conclusión

La versión adaptada de la IGAS es una medida fiable y válida para la evaluación del impacto de la publicidad en adolescentes. La escala es un instrumento útil para el diagnóstico del nivel de riesgo y la evaluación de intervenciones preventivas.

Money used in gaming is associated with problem gambling: Results of the ESPAD 2019 Finland

BACKGROUND AND AIMS

The convergence of gaming and gambling may pose a risk for adolescents. Thus, it is important to find out how these behaviours are associated with other addictive behaviours in order to develop efficient preventive measures for youth. The aim of this study was to examine 1) whether problematic gaming and money used for gaming activities are risk factors for gambling, and 2) what kind of impact adolescents' substance use along with other factors related to friends and parents have on this association.

METHODS

The European School Survey Project on Alcohol and Other Drugs data, 2019 of Finnish adolescents aged 15 to 16 (N = 4595). Cross-tabulations with Rao-Scott's chisquare tests were applied to study the associations of the background factors with gambling in the past 12 months. A multinomial logistic regression model was fitted for the outcome variable (gambling in the past 12 months) adjusted for all independent and background variables.

RESULTS

Problematic gaming alone was not associated with gambling participation, whereas using money for digital games increased the risk of gambling. Boys gamble more than girls. The use of alcohol and drugs increased the risk of gambling. Parental monitoring reduced the risk of gambling, whereas hanging around weekly with friends increased the risk.

DISCUSSION AND CONCLUSIONS

Using money on gaming sites may put some adolescents at risk of developing problems with either gaming or gambling. The link between using money in digital games and gambling participation calls for preventive measures, intervention and regulatory acts.

How Does Psychological Distress Due to the COVID-19 Pandemic Impact on Internet Addiction and Instagram Addiction in Emerging Adults?

International research has underlined a worrying increase in Internet and Instagram addiction among emerging adults during the COVID-19 pandemic. Although the role played by alexithymia and psychological distress due to COVID-19 has been evidenced, no study has explored their complex relationship in predicting emerging adults' Internet and Instagram addiction. The present study aimed to verify whether peritraumatic distress due to the COVID-19 pandemic mediated the relationship between emerging adults' alexithymia and their Internet/Instagram addiction, in a sample composed of n = 400 Italian emerging adults. Results showed that females had higher peritraumatic distress due to COVID-19 than males, whereas males had higher externally oriented thinking and higher levels of Internet addiction than females. Emerging adults' psychological distress due to COVID-19 significantly mediated the effect of alexithymia on Internet and Instagram addiction. Our findings supported the presence of a dynamic relationship between individual vulnerabilities and the co-occurrence of other psychological difficulties in predicting emerging adults' Internet and Instagram addiction during the pandemic, with important clinical implications.

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.

Problematic online gambling among adolescents: A systematic review about prevalence and related measurement issues

BACKGROUND AND AIMS

Despite its illegality among adolescents, online gambling is a common practice, which puts their mental health and well-being at serious risk. This systematic review summarises international scientific literature from the last 20 years on problematic online gambling among adolescents (11-21 years old) to determine its prevalence and to analyse related measurement issues.

METHODS

The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed and a protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO, IC: CRD42020162932). Five academic databases were consulted, which resulted in an initial sample of 658 papers.

RESULTS

Sixteen studies met the inclusion criteria for this review. All studies were cross-sectional and targeted students from elementary school, secondary school or university. Most followed a convenience sampling procedure. The primary measurement instruments used were the DSM-IV-MR-J and SOGS-RA. Between 0.77% and 57.5% of adolescents present some degree of problematic online gambling (problem, pathological or disordered) depending on the instruments used, the study samples and the timeframe analysed. Between 0.89% and 1% of adolescents exhibited an online gambling disorder.

DISCUSSION AND CONCLUSION

There is a great heterogeneity in the methodology of the reviewed studies (samples, measurement instruments, cut-off points and criteria applied). The limited number of studies and the limited generalizability of their results suggest the need for further research and for development of specific instruments to assess different levels of problematic online gambling in representative samples of adolescents based on clinical 'gold standard' criteria and more accurate cut-off points.

Mentalizing Failures, Emotional Dysregulation, and Cognitive Distortions Among Adolescent Problem Gamblers

Over the past decade, several studies have investigated the relationship between cognitive distortions and emotion regulation among adolescent gamblers, demonstrating the exacerbating role of alcohol consumption when co-occurring with gambling problems. An important construct, that to date has been largely neglected, is mentalizing (i.e. the ability to reflect on one's own and others' mental states). The aim of the present study was (for the first time) to investigate the relative contribution of mentalization, emotional dysregulation, cognitive distortions, and alcohol consumption among adolescent gamblers. A total of 396 students (69.2% females) aged 14–19 years were recruited from secondary schools in Southern Italy. Assessment measures included the South Oaks Gambling Screen Revised for Adolescents (SOGS-RA), the Reflective Functioning Questionnaire (RFQ-8), the Difficulties in Emotion Regulation Scale (DERS), the Gambling Related Cognitions Scale (GRCS), and the Alcohol Use Disorders Identification Test (AUDIT). Regression analysis showed that, along with male gender, the best predictors of adolescent gambling were scores on two GRCS subscales (i.e., ‘inability to stop gambling’ and ‘interpretative bias’), the RFQ-8’s ‘uncertainty about mental states’ dimension, and the DERS ‘impulse control difficulties’ factor, with the overall model explaining more than one-third of the total variance. The results clearly indicated that, along with gambling-related cognitive distortions, uncertainty about mental states, and difficulties remaining in control of one’s behavior when experiencing negative emotions contributed significantly to problematic gambling among adolescents.

Substance Use and Addictive Behavior in Spanish Adolescents in Secondary School

The detection and prevention of addictive behaviour at an early age is essential given the relationship between the age of the onset of consumption and the appearance of addiction disorders. The aim of this study was to describe the behavior related to substance use and addictive behaviors in adolescents at secondary school from 12 to 16 years of age. A cross-sectional descriptive study has been conducted. The prevalence of consumption of different addictive substances (alcohol, tobacco, cannabis, cocaine) and addictive behaviours (use of social networks and video games) were collated, and the influence of the surrounding social environment and risk perception were evaluated. The final sample was 1298 students. Alcohol, tobacco and cannabis use reflect the prevalence of last month’s consumption: 14% (11.8–15.6), 15% (13.4–17.4) and 3% (1.9–2.7) respectively. 76% of the sample frequently use the Internet (5–7 days per week). There is a positive association between the frequency of use and use in the immediate environment. The relationships found show the need for educational and preventive intervention aimed at parents and students that will allow them to know and effectively deal with possible problems associated with the consumption of addictive substances.

Attitudes, Risk Factors, and Behaviours of Gambling among Adolescents and Young People: A Literature Review and Gap Analysis

Gambling is occurring in a rapidly changing landscape, with new trends and technologies affecting gambling behaviour and problem gambling across a range of populations. Gambling activity among adolescents and young people has received considerable research attention due to a high prevalence of gambling reported among these groups in recent years. Despite legislation worldwide to constrain gambling among adolescents and young people, modern technology, such as online gaming apps and online gambling venues, has significantly increased their exposure to the risks of problem gambling. It is important, therefore, to have up to date information about what is currently known about gambling and to explore gaps in our knowledge. This gap analysis presents the results of a systematic approach to reviewing the current literature on gambling behaviour, attitudes, and associated risk factors for gambling and problem gambling among adolescents and young adults (aged 10-25 years). The review included studies published between January 2015 and August 2020 and included 85 studies for final synthesis. Findings reveal further research is needed on the implications for young people of emerging technologies and new trends in gambling in the digital age. The current gap analysis reveals that this should include more research on the development and impact of both treatment and intervention strategies, and policy and regulatory frameworks from a public health perspective.

Using the Risk-Return Model to Explain Gambling Disorder Symptoms in Youth: An Empirical Investigation with Italian Adolescents

Historically, individual differences research has sought to explain problem-gambling severity in adolescence by means of unitary "risk-taking" traits, such as sensation seeking and impulsivity, implying that these personality traits account for risk-taking tendencies across different types of behaviors and situations. However, increasing empirical evidence suggests that risk taking seems to be better conceptualized as a domain-specific construct. In the current study, we adopted a psychological risk-return framework, which posits that perceptions of perceived risks and benefits predict gambling risk attitudes, which in turn, account for variance in Gambling Disorder (GD) symptoms in adolescents. The study involved 296 Italian adolescents (68% boys, M_age = 17.76, SD = 1.17). Participants completed the risk-taking, risk perception, and expected benefits scales from the Adolescent Domain Specific Risk Taking (DOSPERT) scale (Barkley-Levenson et al. in Dev Cognitive Neurosci 3: 72-83, 2013), as well as the Gambling Behavior Scale for Adolescents (GBS-A; as reported (Primi et al. in Gambling Behavior Scale for Adolescents in, Hogrefe, Florence, 2015) were administered. Consistent with predictions, risk-taking scores for the Gambling domain predicted adolescent gambling outcomes, relative to the other DOSPERT risk-domains (Ethical, Health/Safety, Recreational, Social). Additionally, we found that greater Gambling risk perceptions were associated with lower risk-taking scores, whereas greater perceived expected benefits were associated with higher risk-taking scores. Moreover, we found significant indirect effects between perceived risks and benefits and problem-gambling severity, mediated via Gambling risk-taking scores, though expected benefits demonstrated a stronger indirect effect. These results have important implications for practice as they emphasize that specific interventions aimed at preventing problem gambling in adolescents should address their perceptions about gambling benefits.

Gambling in children and adolescents

INTRODUCTION

Children are susceptible to problems with gambling because of developmental and cognitive immaturities, as well as a sensitivity to peer pressure and marketing.

SOURCES OF DATA

This review uses recent UK data from the Gambling Commission and from the Avon Longitudinal Study of Parents and Children, and evidence from recent reviews of gambling in children and adolescents.

AREAS OF AGREEMENT

The prevalence of gambling in children worldwide and in the UK is stable, having generally decreased since 2013. Online gambling is increasing in children and young people. A small minority of adolescents who gamble develop a gambling disorder. Adolescents who have problems with gambling tend to have lower self-esteem and a history of hyperactivity and impulsivity, are more likely to have parents who gamble, report less parental supervision and to use more alcohol than their peers.

AREAS OF CONTROVERSY

Children's access to slot machines, the relationship between gaming and gambling, and social media advertizing of gambling targeting children.

GROWING POINTS

An increase in online gambling and in-play sports betting by adolescents and the use of skins betting in video gaming.Areas timely for developing research: impact on young people of betting on e-gaming. How best to protect children from early exposure to gambling in the current internet age.

IMPLICATIONS FOR CLINICIANS

Need to be aware of the growing and complex phenomenon of gaming and gambling, and implications for the mental health of children and adolescents. The effective management of gambling disorders in children and adolescents requires close working with families.

A Longitudinal Analysis of Gambling Predictors among Adolescents

Although gambling is forbidden for minors, the prevalence of gambling among adolescents is increasing. In order to improve preventive interventions, more evidence on predictors of gambling onset is needed. A longitudinal study was proposed to (1) establish the prevalence of gambling; (2) identify factors associated with gambling behavior the following year; and (3) adjust a model to predict gambling behavior. A cohort of 1074 students (13-18 years old) was followed for 12 months. The prevalence of gambling reached 42.0% in the second measure. Boys gambled 2.7 times more than girls, and the highest percentages of gambling onset showed up between 13 and 14 years old. Gambling onset and maintenance was associated with gender, age, sensation-seeking, risk perception, self-efficacy for not gambling, parents' attitude towards gambling, group pressure (friends), subjective norm, exposure to advertising, accessibility, normative perception, gambling in T₁ and parents gambling behavior. Gender, gambling in T₁ and risk perception were significant in all three logistic adjusted regression models, with the fourth variable being sensation seeking, peer pressure (friends) and accessibility, respectively. It is suggested that universal prevention should be aimed preferably at children under 15 years old and to alert regulators and public administrations to the directly proportional relationship between accessibility and gambling onset.

Sensation Seeking and Gambling Behavior in Adolescence: Can Externalizing Problems Moderate This Relationship?

Gambling is a widespread phenomenon during adolescence. Among different risk factors involved in the onset of adolescent gambling behaviors, one factor that is studied is the sensation seeking personality trait. However, the literature is heterogeneous and a direct relationship between sensation seeking and gaming behaviors has not always been highlighted. This suggests that the relationship can be influenced by other factors. In particular, we explored the moderating role of externalizing problems in this relationship. A total of 363 adolescents (232 males and 131 females) aged 14 to 20 (M = 16.35, SD = 1.36) completed a battery of questionnaires aimed to assess their gambling behaviors, as well as the levels of externalizing problems and sensation seeking. The results showed that sensation seeking was associated with gambling severity, but this relationship was significant when externalizing problems were high and medium. On the contrary, when externalizing problems were low, the relationship between sensation seeking and gambling severity was not significant. Overall, sensation seeking in adolescence can favor the implementation of risk behaviors, such as gambling, but only in association with the presence of externalizing problems. Limitations, strengths, and social and clinical implications of the present study are discussed.

Gambling Behaviors in Adolescent Male and Female Regular and Non-Regular Gamblers: A Study of Central Italian Adolescents

Gambling is a widespread and popular phenomenon among adolescents. However, little is known specifically about adolescent gambling behaviors in Italy. The aim of the present study was to explore the prevalence and frequency of gambling behaviors, the types of bets most frequently chosen, the amount of money spent on gambling, and the more frequent problem gambling behaviors, taking into account the type of gambler (regular and non-regular), gender, and age. For this propose, 1255 adolescents (59.1% males) aged 13 to 19 years (M = 16.06; SD = 1.47), were recruited for the study. Results of a series of chi-squared tests show that 70.8% of adolescents had gambled at least once in the previous year, with more than 68% of minors declaring that they had gambled. Among those who claimed to have gambled, 24% were regular gamblers who spent more money, had more gambling-related problems, and chose games more at risk for developing gambling addiction, compared to non-regular gamblers. Regarding gender, results show that males gambled more, more frequently, spent more, and presented more gambling-related problems than females. About age, adolescents of age gambled more on some games that involved going to places to bet than minors but no differences between minors and of-age adolescents emerged on the amount of money spent and in being a regular gambler or not. However, gender and age differences emerged only in the non-regular group, whereas in the regular-gambling group, males and females and minor and of-age adolescents did not differ on any aspect analyzed.

Social Networks Consumption and Addiction in College Students during the COVID-19 Pandemic: Educational Approach to Responsible Use

Within the framework of digital sustainability, the increase in Internet consumption, and especially online social networks, offers social benefits, but is not without its drawbacks. For example, it can lead to psychological and/or psychiatric disorders in some people. Numerous researches are highlighting the similarities of these addictions with the consumption of toxic substances. University students are heavy users of the Internet and, in certain situations, addiction to online social networks can be the result of depression, harassment, and anxiety, among others, affecting their daily life, including their academic responsibilities. In recent months, an anomaly has occurred that may have contributed to intensifying this problem, namely the confinement produced by the COVID-19 pandemic, which has affected the whole world to a greater or lesser extent. In this cross-sectional study, with a descriptive and quantitative methodology, students from 14 Spanish universities were investigated in the first wave of the COVID-19 pandemic in order to understand the effects of this situation on the problem described. The results show a high consumption of social networks during that time, with significant incidences of addiction. In parallel, the presence of comorbidity has been determined. In this scenario, it would be necessary to implement university educational programs to redirect these addictive behaviors, as well as preventative recommendations and actions to minimize negative impacts. This is a major problem that is growing, exacerbated by the global pandemic produced by the SARS-CoV-2 coronavirus. Situations of this gravity call for the development of preventive and educational measures for the responsible and sustainable use of ICT.

Internet society, internet addiction, and pathological social withdrawal: the chicken and egg dilemma for internet addiction and hikikomori

PURPOSE OF REVIEW

Internet society has made our daily life more convenient, while its negative consequences especially internet, smartphone, and gaming addiction are emerging. At the same time, the phenomenon of pathological social withdrawal called 'hikikomori' has been increasingly highlighted as a problematic behavior in Japan. Now hikikomori is becoming a global mental health issue. The interaction between internet society, internet addiction, and hikikomori has not been well clarified.

RECENT FINDINGS

A case vignette survey among psychiatrists suggested that hikikomori cases could be comorbid with internet addiction. In reality, hikikomori cases with internet addiction have been reported internationally. A recent survey among college/university students in Japan has indicated positive interactions between internet addiction, smartphone addiction, gaming internet disorder, and hikikomori-tendencies.

SUMMARY

The cause of hikikomori has not been well understood, and the emergence of internet may be one of the important contributing factors for the occurrence of hikikomori. Whether pathological social withdrawal creates internet addiction, or internet overuse creates hikikomori remains unclear. Both possibilities exist, and we herein propose the conceptual model of these hypothetical interactions. Clarifying the mechanisms of both conditions will help to solve these crucial issues for contemporary urban societies.

Behavioral Addictions: Excessive Gambling, Gaming, Internet, and Smartphone Use Among Children and Adolescents

The introduction of behavioral addictions is a relatively new concept in psychiatry. It was not until 2010 that the term behavioral addictions was added to the official classification of psychiatric diagnoses in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Gambling, typically thought to be an adult behavior, has become commonplace among adolescents. Although technological advances have made accessing information and communication easier, excessive use of the Internet and smartphones can result in multiple mental and physical health issues. Gambling disorders, gaming disorders, Internet use disorder, and excessive smartphone use often begin during childhood and adolescence.