Episodic and Binge Gambling: An Exploration and Preliminary Quantitative Study

Distinguishing Persistent Versus Episodic Clusters of At-Risk Respondents on the Problem Gambling Severity Index

The Problem Gambling Severity Index (PGSI) is a popular tool for assessing past-year problems related to gambling. Multiple categorization schemes have been proposed, with scores 3-7 variously interpreted as reflecting a 'moderate' degree of problems. Crucially, it is possible to land in this Moderate-risk category by reporting one or two persistent problems, or up to seven problems that occur more sporadically. Given that DSM-V gambling disorder may occur either persistently or episodically, this confounding of problems' occurrence and their frequency necessitates the development of a method for delineating the PGSI's Moderate-risk category. We propose a variance clustering approach for understanding Moderate-risk cases on the PGSI. Using 3,868 Moderate-risk cases from an existing database of 18,494 Canadian online gamblers, we use K-means clustering to identify distinct subgroups within the variances of collected PGSI surveys. We find that three clusters (which correspond to lower [61.83%], higher [8.85%], and intermediate [29.32%] variance cases) are not equal in size, and are separated at cutoffs equal to 0.40 and 0.81. These clusters differ in terms of the number of PGSI items endorsed, and multiple dimensions of participants' sociodemographic background. These variance boundaries, and the case clusters they separate, are easy to compute and offer useful context that further informs summed survey scores falling in the Moderate-risk category of the PGSI. Additional applications, and avenues for further research are discussed.

Gambling as a precipitating factor in deaths by suicide in the National Violent Death Reporting System

OBJECTIVES

The public health burden of gambling remains difficult to estimate, given the lack of relevant, available data. Death by suicide, represents a substantial and quantifiable public health cost. The current study reviews data from the National Violent Death Reporting System to detect cases where gambling was identified as a meaningful contextual factor to a death by suicide.

STUDY DESIGN

This study is an exploratory content analysis.

METHODS

We analysed narrative data from cases of death by suicide, collected from 2003 to 2020 recorded in the Restricted Access Data of the National Violent Death Reporting System. Gambling-related cases identified in our analysis were compared against all other cases on demographic characteristics, case characteristics, US state, and incident year. Chi-square tests of independence and the Wilcoxon ranked sum tests were used in bivariate comparisons.

RESULTS

Overall, 1306 of 296 317 cases were classified as gambling-related. This represented 0.44% of total cases. Gambling-related classification was over-represented among those identified as Asian (7.0% vs 2.2%) and under-represented among those identified as Black or African American (4.0% vs 6.4%) compared with all other deaths by suicide. Gambling-related cases were also over-represented in cases where alcohol use was suspected (28.0% vs 21.2%), where there were significant financial problems (50.3% vs 8.6%), where there were intimate partner problems (31.5% vs 25.6%), and under-represented in cases where there was a previous mental health diagnosis (35.1% vs 38.8%). The rate of gambling-related cases in Nevada was approximately nine times greater than the rate in the overall sample (4.0% vs 0.44%).

CONCLUSIONS

Administrative data can be used to study the impacts of gambling on public health in the absence of quality representative survey data. However, these sources are still likely to underestimate the public health burden of gambling with current structures and procedures. Requiring intentional collection of gambling-related information in cases of suicide would be a significant step towards better quantifying the public health burden of gambling in the United States.

Associations of binge gaming (5 or more consecutive hours played) with gaming disorder and mental health in young men

BACKGROUND

Video gaming is a popular activity among young people. Time spent with gaming was found to be only moderately associated with gaming disorder. However, patterns of binge gaming (playing more than 5 h consecutively) were rarely considered in research on gaming. This study explores how binge gaming frequency is related with gaming disorder and mental health.

METHODS

The sample came from the Cohort study on substance use risk factors (C-SURF) and comprised 5,358 young men aged 28.26 years (SD = 1.27). ANCOVA was conducted to estimate the association between binge gaming frequency (gaming at least 5 h consecutively) and gaming disorder (measured with the Game Addiction Scale) as well as indicators of mental health.

RESULTS

A total of 33.3% of the sample engaged in binge gaming at least once in the previous year, and 6.1% at least weekly. Frequency of binge gaming was associated with gaming disorder score in a linear dose-response relationship (linear trend = 2.30 [2.14, 2.46]) even if adjusted for time spent gaming (linear trend = 1.24 [1.03, 1.45). More frequent binge gaming was associated with lower life satisfaction and sleep quality, and with more major depression and social anxiety disorder symptoms.

CONCLUSIONS

Binge gaming patterns, especially daily or almost daily binge gaming, are important to consider with regard to gaming disorder and mental health. Asking about binge gaming may be a promising screening question for gaming related problems. Encouraging regular breaks from gaming may be a valuable prevention strategy to reduce negative outcomes of gaming.

Variability of Pornographic Content Consumed and Longest Session of Pornography Use Associated With Treatment Seeking and Problematic Sexual Behavior Symptoms

INTRODUCTION

Most of the previous studies on problematic pornography use and related behavior have focused on such descriptors of pornography use habits as frequency or time devoted to pornography use.

AIM

We argue that this constitutes a narrow view and indicators that characterize other aspects of explicit content consumption, namely (i) longest session of pornography viewing (which may be related to binge behavior), as well as (ii) variability of consumed pornographic content, can also be useful indicators.

METHODS

An online study based on a sample of 132 heterosexual men seeking treatment for problematic pornography use, referred by therapists after their initial visit and 437 non-treatment seekers in the control group.

MAIN OUTCOME MEASURES

The main outcomes of this study are reported longest, non-stop session of viewing pornography, variability in consumed pornographic content (including paraphilic and violent pornography), actual treatment seeking for problematic pornography use and severity of symptoms, and average weekly time devoted to pornography use.

RESULTS

Our analysis showed that longest session of viewing pornographic content as well as the variety of consumed pornography influenced the decision to seek treatment and the severity of symptoms even when the sheer amount of time devoted to pornography use was controlled.

CONCLUSION

This is one of the few studies examining the role of engagement in prolonged sessions of pornography use and the variability of consumed pornographic content in the clinical context of problematic sexual behavior. The study's main limitations are its relatively narrow method of operationalization of variability of pornographic content and longest session of pornography viewing, as well as its cross-sectional, online, and anonymous character. As the described factors have an important influence on treatment seeking and the severity of experienced symptoms, they should be considered in the process of assessing compulsive sexual behavior disorder and related symptoms. Lewczuk K, Leśniak J, Lew-Starowicz M, et al. Variability of Pornographic Content Consumed and Longest Session of Pornography Use Associated With Treatment Seeking and Problematic Sexual Behavior Symptoms. Sex Med 2021;9:100276.