Prevalence of Problem Gambling Among Adolescents: A Comparison Across Modes of Access, Gambling Activities, and Levels of Severity

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 Factors of At-Risk/Problem Gambling Among Young Adult Spanish Students

The gambling industry in Spain has experienced sustained growth in recent years. This has raised concerns about its potential impact, particularly during emerging adulthood, which is a high-risk period for the development of problematic gambling behaviors. The aim of this study was to estimate the prevalence of problem gambling in young Spanish adults and to examine individual factors associated with at-risk or problem gambling. The participants were 2762 young adults studying at university and vocational schools (64.16% women, Mage = 19.47; SD = 1.64) recruited in three Spanish autonomous communities. Individuals completed an e-assessment including sociodemographic variables, gambling-related characteristics, and the Problematic Gambling Severity Index. A total of 3.51%, 2.14%, and 0.51% were low risk, moderate risk, and problem gamblers, respectively. Predictors of at-risk/problem gambling were early gambling onset (OR 0.790; 95% CI 0.672, .929), mixed versus offline modality gambling access (OR 2.216; 95% CI 1.396, 3.516), and having gambled in the previous year in a casino (OR 1.910; 95% CI 1.194, 3.056), sports betting (OR 1.597; 95% CI 1.003, 2.542), or electronic gaming machines (OR 2.111; 95% CI 1.064, 4.189). Gambling is ubiquitous in the general population and a high proportion of young adults present low and moderate risk of problem gambling. Addressing gambling is a public health challenge and policies to regulate it should be targeted at delaying the age of onset and restricting access to online gambling.

Nudging Online Gamblers to Withdraw Money: The Impact of Personalized Messages on Money Withdrawal Among a Sample of Real-World Online Casino Players

A number of scholars have argued that online gambling can be more problematic than land-based gambling. Motivating gamblers to withdraw money from their online gambling account could lower losses because there would be less money available to lose. Therefore, the present study investigated whether personalized messages are an effective way of 'nudging' gamblers to withdraw money from their online gambling account. The authors were given access to a secondary dataset by Nederlandse Loterij (the national Dutch Lottery operator) comprising 4049 online gamblers. Two types of messages were used to 'nudge' gamblers to withdraw money from their gambling account (i.e., a 'winning streak' message and a 'withdrawal' message). The findings indicated that (i) 38% of gamblers reading the 'winning streak' messages withdrew money from their gambling account on the same day, and (ii) 18% of gamblers reading the 'withdrawal' messages withdrew money from their gambling account on the same day. Gamblers who read personalized messages also withdrew larger amounts of money from their gambling accounts compared to gamblers who did not read personalized messages. The findings suggest that the personalized messages can have an impact on both the likelihood to withdraw money as well as the amount of money which was withdrawn and could help reduce gambling-related harm.

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.

What is known about population level programs designed to address gambling-related harm: rapid review of the evidence

BACKGROUND

Gambling and gambling-related harm attract significant researcher and policy attention. The liberalisation of gambling in most western countries is strongly associated with a marked rise in gambling activity and increases in gambling-related harm experienced at the population level. Programs to address gambling-related harm have traditionally focused on individuals who demonstrate problematic gambling behaviour, despite clear evidence of the effectiveness of a public health approach to high-risk activities like gambling. Little is known about the availability or efficacy of programs to address gambling-related harm at a population level.

METHODS

The Victorian Responsible Gambling Foundation commissioned a rapid evidence review of the available evidence on programs designed to reduce gambling-related harm at a population level. The review was conducted using a public health and harm reduction lens. MEDLINE, ProQuest Central and PsychInfo databases were searched systematically. Included studies were published in English between 2017 - 2023 from all countries with gambling policy contexts and public health systems comparable to Australia's; included primary data; and focused on primary and/or secondary prevention of gambling-related harm or problems.

RESULTS

One hundred and sixty-seven articles were eligible for inclusion. Themes identified in the literature included: risk and protective factors; primary prevention; secondary prevention; tertiary prevention; target population group; and public health approach. The evidence review revealed a gap in empirical evidence around effective interventions to reduce gambling-related harm at the population level, particularly from a public health perspective.

CONCLUSIONS

Addressing gambling-related harm requires a nuanced, multi-layered approach that acknowledges the complex social, environmental, and commercial nature of gambling and associated harms. Moreover, evidence demonstrates community programs to reduce gambling-related harm are more successful in reducing harm when based on sound theory of co-design and address the social aspects that contribute to harm.

Moderating effect of alexithymia between problem gambling and psychotic experiences in university students

BACKGROUND

Most of the young individuals with problem gambling (PG) or psychotic experiences (PEs) are less prone to seek medical help. Therefore, community-based studies investigating the relationship between these entities in non-clinical young people across a continuum of severity are warranted. To this end, the present study proposes to advance knowledge on the mechanisms that potentially underlie the association between PG and PEs, by examining the role of a potential moderator, i.e. alexithymia, in this relationship.

METHODS

A total of 399 participants enrolled in this study (mean age = 21.58 ± 3.20 years) participated in an online cross-sectional survey. The South Oaks Gambling Screen (SOGS), the Prodromal Questionnaire-Brief (PQ-B), and the Toronto alexithymia scale (TAS-20) were used.

RESULTS

Thirty-three (8.3%) participants had problem-gambling, whereas 13 (3.3%) were probable pathological gamblers. Moderation analysis results adjusted over confounders (age, household crowding index, marital status, personal history of mental disorder, other illegal drug use) showed that the interaction PG by alexithymia (p = .018) was significantly associated with PEs scores. At moderate (Beta = 1.93) and high (Beta = 3.38) levels of alexithymia, more PG was significantly associated with more PEs scores.

CONCLUSION

Findings suggest that GP may have a different impact on PEs depending on the individual's level of alexithymia. As such, both alexithymia and gambling behavior should be considered in the clinical assessment of young people who present with PEs, which can help in implementing more tailored and individualized treatment plans.

Annual Research Review: Emergence of problem gambling from childhood to emerging adulthood: a systematic review

BACKGROUND

The risk for problematic gambling and associated high-risk behaviors is elevated during adolescence and emerging adulthood. Activities with gambling-like features and novel forms of gambling may place youth at an increased risk for problem gambling.

AIM AND METHOD

The aim of this review is to provide an overview of the association between both activities with gambling-like features and novel gambling activities and problem gambling among youth while examining the role of psychopathology and cognitive processes. Six databases (PsychINFO, MEDLINE, PubMed, Social Work Abstracts, Technology Collection, and Scopus) were searched in November 2021 for peer-reviewed articles investigating the association between the aforementioned variables among youth up to the age of 25 years. Risk of bias was assessed using the Observational Study Quality Evaluation.

FINDINGS

Forty-five articles were included in the review. Positive associations were observed between engagement in activities with gambling-like features (e.g., video games, social casino games, loot boxes) and problem gambling. Increased involvement with novel forms of gambling (e.g., online sports betting, fantasy sports, and esports betting) were also associated with a greater risk for problematic gambling. Males reported higher rates of engagement in these activities and a greater risk of problem gambling than females. Impulsivity, risk taking, cognitive distortions, and specific emotional vulnerabilities were associated with an increased risk of problem gambling.

CONCLUSIONS

Despite the need for additional longitudinal research controlling for relevant confounders, these findings underline how engagement in activities with gambling-like features are relevant in the developmental trajectory toward problem gambling.

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

OBJECTIVE

Adolescent gambling is rapidly increasing recently. However, little is known about the core feature of adolescent gambling that should be the treatment target for adolescents. Thus, the objective of this study was to determine the core symptom of adolescent gambling using network analysis with large-scale data targeting community indwelling adolescents.

METHODS

We used dataset of the 2018 national survey on youth gambling problems collected by the Korea Center on Gambling Problems to explore symptom networks of gambling in adolescents. Of 17,520 respondents in the dataset of the 2018 national survey on youth gambling problems collected by the Korea Center on Gambling Problems, 5,619 adolescents with experience of gambling were included in the analysis. We computed an association network, a graphical least absolute shrinkage and selection operator, and a directed acyclic graph to model symptom interactions.

RESULTS

In each network of online, offline, and all gambling, stealing money or other valuable things in order to gamble or pay off gambling debts was the most centrally situated and skipping practice followed by dropping out of activities. Especially strong connections emerged between stealing money or other valuable things in order to gamble or pay off gambling debts and academic performance degradation due to gambling. Feeling bad due to gamble and skipping hanging out with friends who do not gamble emerged as a highly central node that might be distinctive to adolescents with online gambling.

CONCLUSION

These findings demonstrate central features of adolescent gambling. Different associations among specific network nodes suggest the existence of distinctive psychopathological constructs between online and offline gambling.

Cooling Off and the Effects of Mandatory Breaks in Online Gambling: A Large-Scale Real-World Study

The prevention of problematic online gambling behavior is a topic of major interest for regulators, the gambling industry, and researchers. Many gambling operators approach this issue by using responsible gambling tools. Among such tools, mandatory play breaks are used to interrupt long online gambling sessions, providing "cooling off" periods for players to take a reflective "time out". The present study investigated the effects of mandatory play breaks in a large-scale experiment with 23,234 online gamblers engaging in more than 870,000,000 gambling transactions on Norsk Tipping's gambling platform over a 1-month period. The gamblers were randomly assigned to several intervention groups with varying duration of mandatory play breaks and one control group with Norsk Tipping's standard play break duration. More specifically, the study analyzed the relationship between the mandatory break received and the gambler's acceptance of this tool, the interaction patterns with the tool, and how quickly they started to gamble again, as well as post-intervention effects on gambling behavior. Results showed that gamblers who were treated with longer mandatory breaks (i) tended to take longer voluntary breaks, and (ii) interacted more frequently with the tool (for instance, by clicking the "logout" button). Furthermore, gamblers appeared to accept longer mandatory play breaks. However, only a fraction of post-intervention effects remained, and mainly only for gamblers who received a substantial number of long mandatory play breaks. Overall, the present study provides actionable insights for both researchers and the gambling industry to improve the effectiveness of mandatory play breaks as a responsible gambling tool.

Psychometric Properties of the South Oaks Gambling Screen Revised for Adolescents in Chinese Adolescent Gamblers

Objectives: Adolescent gambling is a public health concern of increasing importance. The lack of comprehensive evaluations on adolescent gambling disorder (GD) assessment tools hinders the timely detection of Chinese adolescents with gambling problems. This study aimed to evaluate the psychometric properties of South Oaks Gambling Screen-Revised for Adolescents (SOGS-RA) and determine its optimal screening cutoff score among Chinese adolescent gamblers to address this gap.

Methods: We surveyed 1407 Chinese secondary school students aged 11–19 years in Macao, China, among which 258 past-year gamblers’ data was used for assessing SOGS-RA’s performance in detecting risk for adolescent GD.

Results: SOGS-RA displayed satisfactory reliability and validity for assessing probable GD among Chinese adolescent gamblers. Under the DSM-5 GD framework, we proposed ≥4 as SOGS-RA’s optimal cutoff score of screening for probable GD and further identified 5.8% of past-year gamblers prone to probable GD in the present study.

Conclusion: SOGS-RA can provide a reliable and valid assessment of adolescent’ GD risk in the Chinese context, facilitate early identification of probable GD cases, and alleviate the public health concern for Chinese adolescents.

The relationship of gambling with sensation-seeking behavior and psychological resilience in university students

PURPOSE

We aimed to analyze the relationship of gambling with university students' sensation-seeking behavior and psychological resilience.

DESIGN AND METHODS

This cross-sectional and correlational research was performed with 650 students. Data collection tools were Personal Information Form, South Oaks Gambling Screen (SOGS), Zuckerman Sensation-Seeking Scale (ZSSS), and Brief Resilience Scale (BRS).

FINDINGS

Of the students, 1.2% were probably pathological gamblers. There was a positive relationship between students' SOGS and ZSSS scores (p < 0.05). However, there was no relationship between students' SOGS and BRS scores (p > 0.05).

PRACTICE IMPLICATIONS

Psychological support units and instructors take an active role in determining the gambling behaviors of students and related factors in advance, raising awareness of gambling, and preventing the negative effects of these behaviors in faculty campuses.

Emerging Gambling Problems and Suggested Interventions: A Systematic Review of Empirical Research

The goal of the present systematic review is to identify emerging gambling problems and the harm minimization strategies proposed to address them. Our interdisciplinary research team conducted this systematic literature review in 5 nations between which there is significant gambling research exchange. A keyword search of the Scopus and Web of Science databases followed by filtering using inclusion criteria identified 1292 empirical gambling studies from peer-reviewed journals. The data obtained from the articles were analyzed using the content analysis technique. We then used a unique approach to identify relationships between harm minimization strategies and gambling problems. The findings reveal that the most frequently reported gambling problems are related to young gamblers, online gambling, electronic gaming machines, and children and adolescents (underage gamblers). Harm minimization strategies to address these included creating educational and awareness programs, further restrictions on gambling advertising, developing an intervention mechanism for online gambling, and remote gambling-related help (i.e., online counseling, online treatment).

[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.

Socio-Demographics, Gambling Participation, Gambling Settings, and Addictive Behaviors Associated with Gambling Modes: A Population-Based Study

Online and land-based gambling differ in terms of participation and harms. Multimode gambling has also been distinguished as a separate mode. The current study uses the Finnish Gambling 2019 population study sample of 18–74-year-old past-year gamblers (N = 3,077) to evaluate how these gambling modes differ in terms of socio-demographics, gambling participation, gambling settings, and addictive behaviors. We used land-based gambling as the reference group in a multinomial regression model. Male gender (OR 1.48), age between 18 and 54 (OR 1.88), and high income (OR 1.87) were associated with online gambling. The odds of online gambling were higher among those who gambled at least monthly (OR 1.34) and among those with the highest gambling spending (OR 3.62). Younger age (OR 2.31), high income (OR 1.51), gambling at least four game types (OR 2.96), spending the most money on gambling (OR 4.56), and gambling in at least three gambling settings were associated with multimode gambling. Socio-demographics and gambling participation were indicators of gambling modes. Online gambling was more intensive while multimode gambling was more frequent and versatile than land-based gambling. However, this was not reflected as increased addictive behaviors, probably due to the harmful nature of Finnish land-based gambling.

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.

Between two worlds: Exploring esports betting in relation to problem gambling, gaming, and mental health problems

BACKGROUND AND AIMS

Esports betting is an emerging gambling activity where individuals place bets on an organized video gaming competition. It represents only one of several gambling activities commonly endorsed by adolescents. To date, limited research has explored the relationship between esports betting and mental health among adolescents and its convergence with both problem gambling (PG) and problem video gaming (PVG). The present study examined the relation between esports betting, PG and PVG, and both externalizing and internalizing problems among adolescents while accounting for adolescents' video gaming intensity (i.e., how often they play 2 h or more in a day) and engagement in other gambling activities.

METHODS

Data was collected from 6,810 adolescents in Wood County, Ohio schools. A subset of 1,348 adolescents (M age = 14.67 years, SD = 1.73, 64% male) who had gambled and played video games during the past year were included in the analyses.

RESULTS

Approximately 20% (n = 263) of the included sample had bet on esports during the past year. Esports betting was positively correlated with other forms of gambling, both PG and PVG, and externalizing behaviors. Mediation analyses revealed esports betting was associated to both internalizing and externalizing problems through PVG and not PG.

CONCLUSIONS

Esports betting may be particularly appealing to adolescents who are enthusiastic video gamers. As such, regulators must be vigilant to ensure codes of best practices are applied to esports betting operators specifically for underaged individuals.

Alexithymia and Emotion Regulation Strategies in Adolescent Gamblers with and Without At-Risk Profiles

Alexithymia, difficulties in emotion regulation, and negative affect play an important role in adolescents who present pathological gambling. Therefore, the objectives of the present study were, firstly, to analyze the differences between alexithymia, difficulties in emotion regulation, and positive and negative affect in adolescents with and without risk of gambling problems. Secondly, the relationships between all the variables of the study in adolescents with and without risk of problem gambling were analyzed separately. Thirdly, we analyzed the mediating role of positive and negative affect in the relationship between alexithymia and dysfunctional emotion regulation strategies (ERS) in adolescents at risk of gambling problems. The sample was composed of 206 adolescents with ages ranging from 12 to 18 years (M = 15.52; SD = 1.43). They were divided into two groups according to the score obtained in the South Oaks Gambling Screen-Revised for Adolescents (SOGS-RA). Thus, 84 were included in the group without risk of gambling problems and 122 in the group at risk of gambling problems. The results obtained revealed higher scores in negative affect and pathological gambling in the group at risk of gambling problems. Likewise, positive relationships between alexithymia, maladaptive emotion regulation strategies (MERS), and affect were found. Mediation analyses showed that difficulties in identifying feelings were indirectly related to greater use of dysfunctional ERS through their relationship with negative affect in at-risk gamblers.

The rise of online sports betting, its fallout, and the onset of a new profile in gambling disorder: young people

HYPOTHESIS

Since 2015 the gambling trend may have changed among young people between 18 and 30 years old.

METHODOLOGY

Range of document review techniques obtained by therapeutic data regarding the personal development of each person in rehabilitation to analyze 13 different variables.

FINDINGS

Due to the new regulations legalizing online gambling in Spain, and the constant increase in its advertising, a shift could have taken place in the gamblers' profile: a preference for online sports betting and placing other bets using devices connected to the Internet, such as smartphones, laptops, tablets, and similar technologies. Gamblers who use online media to place their bets also incur debts over the Internet. We find a possible proliferation of online betting services, that could imply an increase of social, psychological, and family relationship problems affecting young gamblers, which may constitute a new profile of gambling disorder.

Social Ecological Model of Problem Gambling: A Cross-National Survey Study of Young People in the United States, South Korea, Spain, and Finland

Problem gambling among young people is an emerging trend globally. The online environment in particular offers various possibilities for gambling engagement. This is the first cross-national survey study using the social ecological model to analyze problem gambling, especially in the online context. The study aimed to analyze how different social ecological spheres explain problem gambling. Participants were young people aged 15–25 in the United States (n = 1212), South Korea (n = 1192), Spain (n = 1212), and Finland (n = 1200). The South Oaks Gambling Screen (SOGS) instrument measured problem gambling. The regression models analyzed problem gambling with measures of intrapersonal, interpersonal, organizational, and societal spheres. Spanish participants had the highest SOGS score for problem gambling. In all countries, the variations in problem gambling were best explained by the organizational sphere measures (26%) when compared to the intrapersonal (11%), interpersonal (5%), and societal (3%) spheres. In the full model, the organizational sphere measures had strong associations with problem gambling. These included consumer debt, online gambling community participation, online casino participation, and exposure to online pop-up advertisements. Problem gambling was also associated with conformity to group norms in the interpersonal sphere, and male gender and impulsivity in the intrapersonal sphere. Cross-national results were similar in different countries. Within the final model, gambling community participation had the strongest association with problem gambling (β = 0.23, p < 0.001). The online context plays a major role in problem gambling behavior. The social ecological model is a useful tool for tackling problem gambling and developing preventative measures.

Longitudinal Changes in Gambling, Buying and Materialism in Adolescents: A Population-Based Study

Gambling disorder, gambling-related cognitive biases, compulsive buying, and materialistic values lead to impaired functioning in important areas of life. The aims of the present longitudinal study are (1) to evaluate the change produced after one year in those mentioned variables and (2) to examine the gender role in these changes and to analyze the mediational mechanisms among the variables of the study. The sample was composed of 182 adolescents (103 females and 79 males) from secondary education Spanish institutions who completed self-administered questionnaires. Structural equation modeling has been used to explore associations between the different variables. Our results show significant decreases in compulsive buying, materialism, and cognitive biases related to gambling after one year. Gambling disorder severity was directly related to cognitive distortions of gambling and being a man. Compulsive buying was associated with older age and the female gender. Materialism was associated with compulsive buying and the male gender. In conclusion, gambling disorder, gambling-related cognitive biases, compulsive buying, and materialistic values change over time in different ways, according to gender. The understanding of gambling disorder and compulsive buying in adolescents could potentially lead to early prevention and treatment programs for the specific needs of gender and age.

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.

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.

Covid-19-Pandemie und Verhaltenssüchte

Zusammenfassung. Einführung und Zielsetzung: Die COVID-19 Pandemie und die entsprechenden Lockdown-Maßnahmen verdeutlichen, dass besondere Strategien der Verhaltens- und Verhältnisprävention für Online-Verhaltenssüchte notwendig sind. Begründung: Die Wahrscheinlichkeit ist hoch, dass die COVID-19 Krise und die begleitenden Maßnahmen zu deren Eindämmung die Risiken für die Entwicklung von Verhaltenssüchten erhöht haben. Dazu tragen Faktoren wie Fortfall von terrestrischen Angeboten, soziale Isolation und erzwungene Inaktivität sowie Bedeutungsgewinn von Online-Angeboten bei. Gleichzeitig können als Folge bei bereits bestehenden Störungen die Schwere zu- und Remissionschancen abgenommen haben. Auch von einem erhöhten Rückfallrisiko kann ausgegangen werden. Schlussfolgerung: Es sind epidemiologische Studien notwendig, um veränderte Prävalenzen, Versorgungsbedarfe und geänderte Risikofaktoren zu erfassen. Es besteht die Notwendigkeit, Maßnahmen der Verhältnis- und Verhaltensprävention zu entwickeln und umzusetzen. Die Identifizierung von Risikoverhalten wäre durch Tracking des Online-Verhaltens möglich und könnte Ausgangspunkt für Maßnahmen wie Spiel- oder Anwendungspausen, Warnhinweise und Verbraucherschutzinformationen sowie konkrete Angebote der Frühintervention oder weitergehende Hilfen sein. Die Anbieter stehen hier in der Pflicht, Verantwortung für ihre Produkte zu übernehmen, das Risiko von Verhaltenssüchten zu minimieren und Maßnahmen von Frühentdeckung und Intervention zu ermöglichen und bereitzustellen.

Psychosocial risk factors in disordered gambling: A descriptive systematic overview of vulnerable populations

BACKGROUND

Gambling is a behaviour engaged in by millions of people worldwide; for some, gambling can become a severely maladaptive behaviour, and previous research has identified a wide range of psychosocial risk factors that can be considered important for the development and maintenance of disordered gambling. Although risk factors have been identified, the homogeneity of risk factors across specific groups thought to be vulnerable to disordered gambling is to date, unexplored.

METHODS

To address this, the current review sought to conduct a systematic overview of literature relating to seven vulnerable groups: young people and adolescents, older adults, women, veterans, indigenous peoples, prisoners, and low socio-economic/income groups.

RESULTS

Multiple risk factors associated with disordered gambling were identified; some appeared consistently across most groups, including being male, co-morbid mental and physical health conditions, substance use disorders, accessibility and availability of gambling, form and mode of gambling, and experience of trauma. Further risk factors were identified that were specific to each vulnerable group.

CONCLUSION

Within the general population, certain groups are more vulnerable to disordered gambling. Although some risk factors are consistent across groups, some risk factors appear to be group specific. It is clear that there is no homogenous pathway in to disordered gambling, and that social, developmental, environmental and demographic characteristics can all interact to influence an individual's relationship with gambling.

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

PURPOSE

Worldwide, concern has grown over the expansion of gambling among adolescents, who have an increased likelihood of developing risk-taking behaviors. This study aimed to increase knowledge of problem gambling among adolescents in seven European countries and to assess the effect of demographic and lifestyle factors recorded in the European Network for Addictive Behavior survey (https://www.eunetadb.eu).

METHODS

A cross-sectional school-based study (n = 13,284) was conducted in Germany, Greece, Iceland, The Netherlands, Poland, Romania and Spain. Anonymous self-completed questionnaires included socio-demographic data, internet usage characteristics, school achievement, parental control, the Internet Addiction Test, the South Oaks Gambling Screen-Revised for Adolescents Test and Achenbach's Youth Self-Report.

RESULTS

12.5% of the participants reported last year gambling activities either online or offline. 3.6% of the study participants and 28.1% of gamblers (either online or offline) were at risk or had a gambling problem. The study results showed that a higher proportion of adolescents was either at risk or had a gambling problem among males, in the older age group, when the parental educational level was lower/middle, and in the absence of siblings. Furthermore, being at risk or having a gambling problem was associated with lower age at first use of the internet, lower school grades, using the internet 6-7 days per week, and problematic internet use. At risk or problem gamblers had higher scores on all scales of problem behavior and lower scores (lower competence) on activities and academic performance.

CONCLUSIONS

Our findings underline the need for better gambling legislation and suggest the importance of developing social responsibility tools that may help diminish adolescent gambling involvement, with special attention to males.

Problem gambling in adolescents: what are the psychological, social and financial consequences?

BACKGROUND

The paper examines the roles of sociodemographic traits, family quality and risk behaviour in adolescent problem gambling, with focus on the psychological, social and financial consequences from the socio-ecological model approach. This model emphasizes the most important risk-protective factors in the development and maintenance of problem gambling on an individual level, a relationship level, as well as a community and societal level.

METHODS

The research was done using the Canadian Adolescent Gambling Inventory with a sample of 366 participants, 239 females (65.3%) using descriptive statistics and t-test, ANOVA, correlation and hierarchical regression analysis.

RESULTS

Males reported significantly higher gambling consequences on all scales (p < .001) and significantly more risk behaviour (p < .05). Age was significant for psychological consequences (p < .01), problem gambling (p < .01) and risk behaviour (p < .001) with older participants scoring higher. Students with lower school success reported significantly higher psychological consequences of gambling (p < .01), higher risk behaviour activity (p < .001) and lower family life satisfaction (p < .001). The psychological, financial and social consequences were positively correlated with problem gambling (p < .001). Age (p < .05), gender (p < .001), school success (p < .01) and the father's education level (p. < 05) were significant predictors of problem gambling, with older male adolescents who struggle academically and have lower educated fathers being at greater risk.

CONCLUSIONS

Results indicate an important relation between adolescent gambling behaviour and very serious psychological, social and financial consequences. There is a constellation of risk factors that likely place certain individuals at high risk for problem gambling.

Online Gambling of Pure Chance: Wager Distribution, Risk Attitude, and Anomalous Diffusion

Online gambling sites offer many different gambling games. In this work we analyse the gambling logs of numerous solely probability-based gambling games and extract the wager and odds distributions. We find that the log-normal distribution describes the wager distribution at the aggregate level. Viewing the gamblers’ net incomes as random walks, we study the mean-squared displacement of net income and related quantities and find different diffusive behaviors for different games. We discuss possible origins for the observed anomalous diffusion.

The association between problem gambling and psychotic experiences: Findings from the Adult Psychiatric Morbidity Survey 2007

BACKGROUND

Studies on the association between psychotic experiences (PEs) and problem gambling are lacking. Thus, we examined the association between PEs and problem gambling in the general UK population.

METHODS

This study used community-based, cross-sectional data from the 2007 Adult Psychiatric Morbidity Survey (APMS) (n = 7403). Ten items from the DSM-IV criteria and the British Gambling Prevalence Survey studies were used to ascertain problem gambling among individuals who gambled in the past 12 months. Respondents were classified as no problem (0 criteria), at-risk (1 or 2 criteria) and problem gambling (≥3 criteria). Past 12-month PE was assessed with the Psychosis Screening Questionnaire. Multivariable logistic regression models were constructed to assess the association between gambling status (exposure variable) and PE (outcome variable).

RESULTS

The final sample consisted of 7363 people aged ≥16 years with no definite or probable psychosis [mean (SD) age 46.4 (18.6) years; 51.2% females]. The prevalence of PE in those with no problem, at-risk, and problem gambling were 5.1%, 11.1%, and 29.7%, respectively. In the model adjusted for sociodemographics, common mental disorders and risky health behaviors, at-risk (OR = 1.88; 95% CI: 1.11-3.19) and problem gambling (OR = 4.64; 95% CI: 1.78-12.13) were associated with an increased odds for PE.

CONCLUSION

Problem gambling and PE tend to co-exist. Further research is needed to gain a better understanding of the mechanisms that underlie the association observed.

A Latent Class Analysis of Gambling Activity Patterns in a Canadian University Sample of Emerging Adults: Socio-demographic, Motivational, and Mental Health Correlates

This analysis of gambling habits of Canadian university students (ages 18-25) dovetails two recent developments in the field of gambling studies. First, the popularity of latent class analysis to identify heterogeneous classes of gambling patterns in different populations; second, the validation of the Gambling Motives Questionnaire (with financial motives) among university students-specifically to understand both how and why emerging adults gamble. Our results support a four-class model of gambling activity patterns, consisting of female-preponderant casual and chance-based gambling groups, and male-preponderant skill-based and extensive gambling groups. Each class shows a specific combination of motives, underscoring the necessity for nuanced responses to problem gambling among emerging adults. More specifically, gambling for the skill-based group appears primarily to be a source of thrill and a way to cope; for the chance-based group, gambling appears but one symptom of a set of wider issues involving depression, anxiety, substance use, and low self-esteem; while extensive gamblers seem to seek excitement, sociality, and coping, in that order. Only the chance-based group was significantly more likely than casual gamblers to be motivated by financial reasons. Situating our analysis in the literature, we suggest that interventions for the predominantly male subtypes should address gambling directly (e.g. re-focusing excitement seeking into other activities, instilling more productive coping mechanisms) while interventions for predominantly female subtypes should address low self-esteem in conjunction with depression, substance abuse, and problematic levels of gambling. We conclude future research should focus on links between self-esteem, depression, substance abuse, and financial motives for gambling among female emerging adults.

Prevalence of youth gambling and potential influence of substance use and other risk factors throughout 33 European countries: first results from the 2015 ESPAD study

BACKGROUND AND AIMS

Although generally prohibited by national regulations, underage gambling has become popular in Europe, with relevant cross-country prevalence variability. This study aimed to estimate the prevalence of underage gambling in Europe stratified by type of game and on-/off-line mode and to examine the association with individual and family characteristics and substance use.

DESIGN

Our study used data from the 2015 European School Survey Project on Alcohol and Other Drugs (ESPAD) cross-sectional study, a survey using self-administered anonymous questionnaires.

SETTING

Thirty-three European countries.

PARTICIPANTS

Sixteen-year-old-year-old students (n = 93 875; F = 50.8%).

MEASUREMENTS

The primary outcome measure was prevalence of past-year gambling activity. Key predictors comprised individual behaviours, substance use and parenting (regulation, monitoring and caring).

FINDINGS

A total of 22.6% of 16-year-old students in Europe gambled in the past year: 16.2% on-line, 18.5% off-line. High prevalence variability was observed throughout countries both for mode and types of game. With the exception of cannabis, substance use shows a higher association with gambling, particularly binge drinking [odds ratio (OR) = 1.46, 95% confidence interval (CI) = 1.39-1.53), life-time use of inhalants (OR = 1.57, 95% CI = 1.47-1.68) and other substances (OR = 1.78, 95% CI = 1.65-1.92)]. Among life habits, the following showed a positive association: truancy at school (OR = 1.26, 95% CI = 1.18-1.35), going out at night (OR = 1.32, 95% CI = 1.26-1.38), participating in sports (OR = 1.30, 95% CI = 1.24-1.37). A negative association was found with reading books for leisure (OR = 0.82%, 95% CI = 0.79-0.86), parents' monitoring of Saturday night activities (OR = 0.81, 95% CI = 0.77-0.86) and restrictions on money provided by parents as a gift (OR = 0.89, 95% CI = 0.84-0.94).

CONCLUSIONS

Underage gambling in Europe appears to be associated positively with alcohol, tobacco and other substance use (but not cannabis), as well as with other individual behaviours such as truancy, going out at night and active participation in sports, and is associated negatively with reading for pleasure, parental monitoring of evening activities and parental restriction of money.

Gambling Disorder Treatment Referrals Within the Irish Mental Health Service: A National Survey Using Freedom of Information Requests

Gambling disorder is an increasingly recognised problem amongst healthcare professionals and the general public but there is little information on what services are provided within the Irish healthcare system for the disorder. The aim of the present study (adapted from a study in the UK by Rigbye and Griffiths [International Journal of Mental Health and Addiction, 9, 276–281, 2011] was to ascertain how referrals for gambling disorder are processed and what services are available for gambling disorder within the Irish healthcare system. Email requests for information on gambling disorder referrals were sent to the main super-catchment areas in Ireland known as Community Healthcare Organisations (CHOs) and part of the national Health Executive Service (HSE). Email requests were also sent to Primary Care services and Regional and Local Drug Task forces in Ireland. Each request asked a number of questions related to gambling disorder referrals (adapted from the study by Rigbye and Griffiths). Responses were received from seven of the nine CHOs (77.8%) and eight of the 24 Drug Task Forces (33.3%), as well as from Primary Care services. Four of the CHOs surveyed (50%) offered some form of service for gambling disorder as a part of their Community Mental Health Team (CMHT), most commonly through a Clinical Nurse Specialist (CNS) in Addictions. Referrals varied between 10 and 39 referrals in a 12-month period per CHO. Half of the Drug Task Forces surveyed offered a service for gambling disorder as part of their overall service and the majority offered onward referral to either a residential programme or a self-help organisation. Primary care services did not provide any specific services for gambling disorder. There is an evident need for a consistent and dedicated pathway for the referral and management of gambling disorder within the HSE.

Problematic Online Betting Among Turkish Adolescents

Problematic online betting among adolescents has attracted considerable public attention internationally for the last two decades. Although the online betting prevalence rate in Turkey is unclear, some reports indicate that it could be more pervasive than is currently estimated. The aim of this study was to determine the prevalence of problematic online betting, common behaviors of youth related to betting, and to identify the effect of family on online betting among Turkish adolescents. We surveyed 6116 adolescents aged between 12 and 18 in Istanbul to determine if they are problematic Internet users for betting. Although 756 (12.4%) adolescents reported that they play online betting, only 176 adolescents (2.9%) were classified as problematic Internet users. Thus, we collected further data from those 176 adolescents, 14.8% of which were female. A significant positive correlation was found between Internet Addiction (IA) and duration of betting. Almost 61% of participants expressed that they prefer to be online because they do not have better things to do. Almost a quarter of the participants started online betting between 10 and 12 years of age. All participants know someone who bets online. In terms of frequency, these are friends, relatives, siblings, and parents, respectively. Although there is no relationship between family structure and IA among adolescents who are problematic users, participants who live in an unstable family have higher IA scores than participants who live in a stable family.

Behavior analysis of virtual-item gambling

From the gambling logs of an online lottery game we extract the probability distribution of various quantities (e.g., bet value, total pool size, waiting time between successive gambles) as well as related correlation coefficients. We view the net change of income of each player as a random walk. The mean-squared displacement of these net income random walks exhibits a transition between a superdiffusive and a normal diffusive regime. We discuss different random-walk models with truncated power-law step lengths distributions that allow us to reproduce some of the properties extracted from the gambling logs. Analyzing the mean-squared displacement and the first-passage time distribution for these models allows us to identify the key features needed for observing this crossover from superdiffusion to normal diffusion.

Gambling disorder in adolescents: prevalence, new developments, and treatment challenges

Research on adolescence gambling over the past twenty years has revealed significant incidence and prevalence rates and highlighted the possible negative effects on an adolescent’s well-being. Several risk and protective factors have also been identified. Over the course of the past few years, technological advances have heralded the advent of new avenues for gambling as well as new opportunities to gamble without any direct monetary exchange. This review article examines those established trends as well as the new issues that we are faced with, in order to accurately portray the current challenges in research, prevention, and treatment.

Gender Differences and Psychopathological Features Associated With Addictive Behaviors in Adolescents

BACKGROUND

The aims of the study were to assess prevalence and gender differences of addictive behaviors (substance- and non-substance-related) in an adolescent population, and their association with psychopathological features and academic performance.

MATERIAL AND METHODS

A sample of high school Italian students (n = 996; M = 240, F = 756) was examined using a self-report survey concerning sociodemographic characteristics, cigarette smoking, alcohol and substance use, perceived academic performance, activities, and behaviors (Internet use, gambling, and physical exercising). The Internet Addiction Test, the South Oaks Gambling Screen-revised Adolescent, and the Exercise Addiction Inventory-Short Form were administered to identify problematic behaviors. The Barratt Impulsiveness Scale for Adolescent, the Snaith-Hamilton Pleasure Scale, the Dissociative Experience Scale for Adolescent, and the Toronto Alexithymia Scale were used to investigate psychopathological dimensions.

RESULTS

Frequent alcohol intake and lifetime substances consumption were more common among males. The occurrence of other addictive behaviors was 22.1% for problematic Internet use (M = F), 9.7% for at-risk/problematic gambling (M > F), and 6.2% for maladaptive physical exercise (M = F). We also found an association between substance-/non-substance-related addictive behaviors and psychopathological dimensions. Addictive behaviors were more frequent among students reporting poor school performance.

CONCLUSION

Our study showed a relevant prevalence of addictive behaviors in a sample of Italian high school students, with specific gender differences. We underlined the cooccurrence of substance and non-substance-related addictive behaviors, and their association with worse school performance. Dissociative proneness, anhedonia, alexithymia, and impulsivity were associated with addictive behaviors in adolescents and might represent vulnerability factors for the development of psychiatric disorders in adulthood. A better understanding of psychopathological features associated with addictive behaviors might be useful for the prevention/early intervention.