Problem Gambling in Greece: Prevalence and Risk Factors During the Financial Crisis

Changes in some health and lifestyle behaviours are significantly associated with changes in gambling behaviours: Findings from a longitudinal New Zealand population study

Although a large number of studies have investigated associations between risky gambling behaviours and health, lifestyle and social factors, research has not focused on changes in these factors and associations with changes in gambling risk level. This study utilised existing data from the four waves of the longitudinal New Zealand National Gambling Study to examine associations between changes in substance use, mental and physical health, and quality of life and deprivation with changes in gambling risk level over time. A Markov chain transition model was used to perform these analyses using data from participants who had completed all four waves (11,080 data transitions). Although changes in various covariates were associated with changes in all gambling risk levels, the highest number of significant factors was for transitioning into risky gambling from non-problematic gambling, including development, or continuation, of several negative health and lifestyle factors that may possibly be alleviated by transitioning out of risky gambling. These findings highlight the importance of screening for gambling behaviours when assisting people with substance use, health issues, or social situations or conditions in order to provide appropriate and effective social, health and treatment supports for people whose gambling behaviour increases over time.

Problem gambling severity in a nationally representative sample of the Israeli population: the moderating role of ethnonational affiliation

Introduction

Gambling is a public health concern. Problem gambling is related to a range of psycho-social risk factors including ethnonational affiliation. Israel is an insightful case to probe problem gambling, given the socio-economic marginalization of Israeli Arabs, the continued exposure of Israelis to stress and the conservative Israeli gambling market. This study aimed to estimate problem gambling severity in Israeli society, characterize the sociodemographic, environmental, mental health, and gambling-related risk factors associated with problem gambling severity, and examine the role of ethnonational affiliation (Israeli Jewish/Arab) as a moderating factor in the associations between these risk factors and problem gambling severity.

Methods

A cross-sectional study based on a representative sample of 3,244 Israelis was conducted in 2022, of whom 1,626 had gambled in the previous year. Measurements included Problem Gambling Severity Index, Gambling Behaviors, Perceived Neighborhood Cohesion, Stress, the Patient Health Questionnaire-4, and sociodemographic variables.

Results

Low-risk, moderate-risk and problem gambling were reported by 16.7% of the total sample. The main risk factors for problem gambling were being an Israeli Arab, traditional, residing in a low socio-economic cluster, reporting anxiety symptoms, and higher gambling behaviors, specifically in legal/illegal online gambling. Ethnonational affiliation (Israeli Jewish/Arab) moderated the associations between gambling, illegal online gambling, and problem gambling severity. Higher neighborhood cohesion emerged as a risk factor for problem gambling solely for Israeli Arabs.

Discussion

As an excluded minority, Israeli Arabs may turn to gambling as a method to access the core republican community, thus, exposing themselves to a higher risk of developing problem gambling.

Prevalence of Problem Gambling: A Meta-analysis of Recent Empirical Research (2016-2022)

Gambling is widely considered a socially acceptable form of recreation. However, for a small minority of individuals, it can become both addictive and problematic with severe adverse consequences. The aim of this systematic review and meta-analysis is to provide an overview of prevalence studies published between 2016 and the first quarter of 2022 and an updated estimate of problem gambling in the general adult population. A systematic review and a meta-analysis were carried out using academic databases, Internet, and governmental websites. Following this search and utilizing exclusion criteria, 23 studies on adult gambling prevalence were identified, distinguishing between moderate risk/at risk gambling and problem/pathological gambling. This study found a prevalence of moderate risk/at risk gambling to be 2.43% and of problem/pathological gambling to be 1.29% in the adult population. As difficult as it may be to compare studies due to different methodological procedures, cutoffs, and time frames, the present meta-analysis highlights the variations of prevalence across different countries, giving due consideration to the differences between levels of risk and severity. This work intends to provide a starting point for policymakers and academics to fill the gaps on gambling research-more specifically in some countries where the lack of research in this field is evident-and to study the effectiveness of policies implemented to mitigate gambling harm.

Using artificial intelligence algorithms to predict self-reported problem gambling with account-based player data in an online casino setting

In recent years researchers have emphasized the importance of artificial intelligence (AI) algorithms as a tool to detect problem gambling online. AI algorithms require a training dataset to learn the patterns of a prespecified group. Problem gambling screens are one method for the collection of the necessary input data to train AI algorithms. The present study's main aim was to identify the most significant behavioral patterns which predict self-reported problem gambling. In order to fulfil the aim, the study analyzed data from a sample of real-world online casino players and matched their self-report (subjective) responses concerning problem gambling with the participants' actual (objective) gambling behavior. More specifically, the authors were given access to the raw data of 1,287 players from a European online gambling casino who answered questions on the Problem Gambling Severity Index (PGSI) between September 2021 and February 2022. Random forest and gradient boost machine algorithms were trained to predict self-reported problem gambling based on the independent variables (e.g., wagering, depositing, gambling frequency). The random forest model predicted self-reported problem gambling better than gradient boost. Moreover, problem gamblers showed a distinct pattern with respect to their gambling based on the player tracking data. More specifically, problem gamblers lost more money per gambling day, lost more money per gambling session, and deposited money more frequently per gambling session. Problem gamblers also tended to deplete their gambling accounts more frequently compared to non-problem gamblers. A subgroup of problem gamblers identified as being at greater harm (based on their response to PGSI items) showed even higher values with respect to the aforementioned gambling behaviors. The study showed that self-reported problem gambling can be predicted by AI algorithms with high accuracy based on player tracking data.

Risk Factors for Gambling Disorder: A Systematic Review

Gambling disorder is a common and problematic behavioral disorder associated with depression, substance abuse, domestic violence, bankruptcy, and high suicide rates. In the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), pathological gambling was renamed "gambling disorder" and moved to the Substance-Related and Addiction Disorders chapter to acknowledge that research suggests that pathological gambling and alcohol and drug addiction are related. Therefore, this paper provides a systematic review of risk factors for gambling disorder. Systematic searches of EBSCO, PubMed, and Web of Science identified 33 records that met study inclusion criteria. A revised study acknowledges as risk factors for developing/maintaining a gambling disorder being a single young male, or married for less than 5 years, living alone, having a poor education, and struggling financially.

Experience of LGBTQIA2S+ populations with gambling during the COVID-19 pandemic: protocol for a mixed-methods study

INTRODUCTION

Research undertaken since the beginning of the COVID-19 pandemic has provided us information about the impact of the pandemic on the gambling habits of the general population. However, very little is known about certain subgroups at increased risk of developing gambling disorder, such as the LGBTQIA2S+ population. The purpose of this study is to describe the impact of the COVID-19 pandemic on gambling behaviours among LGBTQIA2S+ individuals. In addition, we want to understand the experiences of the LGBTQIA2S+ population with gambling disorder and identify interventions that LGBTQIA2S+ people have found to be effective in addressing problem gambling during the COVID-19 pandemic.

METHODS AND ANALYSIS

This study has a sequential explanatory mixed-method design in two phases over 2 years. The first phase is a correlational study. We will conduct a cross-sectional survey using a stratified random sampling among Canadian residents who are 18 years of age or older, self-identify as sexually and gender-diverse (ie, LGBTQIA2S+) and have gambled at least once in the previous 12 months. This survey will be administered online via a web panel (n=1500). The second phase is a qualitative study. Semistructured interviews will be conducted with LGBTQIA2S+ people with problematic gambling (n=30).

ETHICS AND DISSEMINATION

This research project has been ethically and scientifically approved by the Research Ethics Committee and by the CIUSSS de l'Estrie-CHUS scientific evaluation committee on 3 March 2022 (reference number: 2022-4633-LGBTQ-JHA). Electronic and/or written informed consent, depending on the data collection format (online survey and online or in-person interviews), will be obtained from each participant. A copy of the consent form and contact information will be delivered to each participant.

Crisis, What Crisis? The Effect of Economic Crises on Spending on Online and Offline Gambling in Spain: Implications for Preventing Gambling Disorder

(1) Background: In the period between 2008 and 2020, the world experienced two global economic crises that affected people's way of life and well-being: the financial crisis of 2008 and that precipitated by the COVID-19 pandemic. Despite the crises' radically different causes, their consequences for economic activity have been equally dramatic; (2) Methods: This article analyzes the consequences of both crises on gambling spending in Spain and compares traditional (offline) games with more recent online offerings. The data were collected from databases maintained by the Spanish government and gambling companies; (3) Results: The paper offers two main conclusions. The first is that, while traditional (offline) gambling has been significantly affected by economic crises, online gambling has exhibited consistent growth since its legalization. The second is that the measures implemented to resolve the two economic crises differed significantly and thus had different impacts on spending on the various types of gambling; (4) Conclusions: The key conclusion is that purchasing power (measured in terms of GDP) can only explain spending on less addictive gambling games, such as lotteries. However, the availability and accessibility of games are both directly related to spending on games of all types.

Isolation and worry in relation to gambling and onset of gambling among psychiatry patients during the COVID-19 pandemic: A mediation study

When the COVID-19 pandemic started spreading globally, there was a fear that addictive behaviors would increase due to changes in everyday life caused by restrictions due to COVID-19. Studies were carried out to explore if this was true for gambling, typically revealing no overall increase in gambling behavior, although individuals who had previous experience with gambling problems were more likely to increase gambling during the pandemic. However, these studies only included individuals with previous gambling problems. It remains unknown whether other vulnerable groups, such as individuals with common mental disorders increased their gambling. This study aimed to explore the level of gambling problems among individuals with a history of mental disorders, namely, (i) pre-pandemic gamblers and (ii) pandemic-onset gamblers. Furthermore, we explored if worry and isolation mediate gambling and problem gambling. The data were analyzed using descriptive statistics and a structural equation model to investigate mediation. The results showed a high prevalence of at-risk and problem gambling in both groups. The pre-pandemic gamblers had a high level of at-risk and problem gambling. Furthermore, the individuals that started to gamble during the pandemic had an even higher degree of at-risk and problem gambling. The mediation showed that the onset of gambling was linked with the worry of COVID-infection and that worry predicted the level of gambling problems. This study highlights that vulnerability factors, isolation, and worry can be triggers for individuals with common mental disorders to engage in gambling as well as the importance of screening this population for gambling problems.

Gamblers' Perceptions of the Impact of the COVID-19 Pandemic on Their Gambling Behaviours: Analysis of Free-Text Responses Collected through a Cross-Sectional Online Survey

The COVID-19 pandemic has brought drastic changes to the lives of a substantial portion of the world's population. Many stakeholders have expressed concern about the impact of the pandemic on gambling practices, which have historically increased during times of crisis. The purpose of this study was to provide a snapshot of the impact of the pandemic on gambling practices, focusing on the lived experiences of people who gamble. An online cross-sectional survey was conducted between 16 February and 15 March 2021. An open-ended question allowed the participants to describe in their own words the impact of the COVID-19 pandemic on their gambling practices. A qualitative analysis was conducted based on 724 responses to this question. Among the participants, 57% were problem gamblers, according to their Problem Gambling Severity Index score. Three themes were identified: (1) changes in gambling practices perceived by the respondents during the pandemic, (2) the impacts of these changes, and (3) the factors that influenced the changes in their gambling practices. A meaningful proportion of the sample of gamblers felt that their gambling practices had increased during the pandemic. Many of them did not report the deleterious effects of this increase, whereas others were devastated. Thus, variations in gambling practices during the pandemic must be interpreted with caution, as they may reflect a variety of realities.

COVID-19 and resultant restrictions on gambling behaviour

Since the onset of COVID-19, studies suggest a significant increase in online gambling, potentially facilitated by increased time at home, social isolation and boredom. This study aimed to address what is known about the impact of the pandemic on gambling behaviour by conducting a mapping review. A systematic literature search was conducted using four online databases. Additional studies were identified using reference lists. Relevant studies were quality scored and their findings synthesised in terms of overall changes at the population level and potentially vulnerable groups. The weight of evidence from 35 relevant reports across 12 countries indicated reductions of gambling during the pandemic at the level of the general population. However, marked increases in gambling amongst vulnerable sub-populations including amongst young adults and people with pre-existing at-risk gambling were also noted. The impact of COVID-19 on gambling is highly contingent on context. If policy makers examine only population level data, this could overlook profound negative effects identified in those with at-risk gambling, gambling disorder, and amongst young adults.

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.

Correlates of gambling and gambling problems among Rhode Island young adults: a cross-sectional study

BACKGROUND

Numerous states in the USA have legalized sports betting due to recent legal decisions by the US Supreme Court. Here, sociodemographic correlates of current gambling and specific gambling activities associated with symptoms of gambling problems were identified.

METHODS

Cross-sectional data were obtained from the 2020 Rhode Island Young Adult Survey (RIYAS). RIYAS participants (n = 540) were a convenience sample of 18 to 25 year olds who lived in Rhode Island for at least part of 2020. Data were collected from May to October 2020. Four gambling activities were assessed (i.e. sports betting; betting on races; gaming tables at a casino; poker machines at a casino). Logistic regression models assessed main effects.

RESULTS

22.4% engaged in one or more gambling activities. 11.5% of participants had any gambling problems. Odds of gambling activities were higher among men; Black, Indigenous, People of Color; older young adults; and essential workers. Odds of gambling problems were 2.4 times higher among participants who engaged with sports betting.

CONCLUSIONS

Gambling activities are common among several population subgroups, and participation in sports betting may be a risk factor for the development of problem gambling. Comprehensive prevention policies are needed.

Predictors and patterns of gambling behaviour across the COVID-19 lockdown: Findings from a UK cohort study

The negative impact of the COVID-19 pandemic on the economy has raised concerns about negative coping behaviours to offset financial losses. We used a subset of a longitudinal study of UK adults (N = 19,963) to examine a range of predictors of (i) gambling during the first strict lockdown, (ii) gambling more frequently during this strict lockdown compared to before lockdown, and (iii) continued increased frequency of gambling during the relaxation of restrictions. Results from logistic regressions indicated that amongst other factors, those with progressively lower levels of education, were stressed due to boredom, frequently drank alcohol, and had high risk-taking tendencies were more likely to gamble during strict lockdown. Individuals who were more likely to have increased their frequency of gambling during strict lockdown compared to before the lockdown were stressed by boredom, employed, frequently drank alcohol, and had depression and anxiety, whilst men and current smokers were less likely. As lockdown restrictions eased, individuals of ethnic minority backgrounds, who were current smokers, and with lower educational attainment were more likely to continue gambling more than usual. Findings contribute to knowledge of who is most at risk for increasing their gambling during the COVID-19 pandemic.

Gambling in Canada During the COVID Lockdown: Prospective National Survey

The current study investigated the impact of the COVID pandemic lockdown on gambling and problem gambling in Canada. The AGRI National Project's online panel participants (N = 3449) provided baseline gambling data 6 months prior to the pandemic. Re-surveying this sample during the lockdown provided an opportunity to make quantitative comparisons of the changes. Nearly one-third of gamblers reported ceasing gambling altogether during the lockdown. For the continuing gamblers, quantitative data indicated significant decreases in gambling frequency, time spent in gambling sessions, money spent, and the number of game types played. Qualitative perceptions of changes in gambling were examined and the accuracy of these reports were not closely aligned with actual changes in gambling. Gambling platform was the only gambling engagement metric where increases were found with ~ 17% of the gambling sample migrating to online gambling during the lockdown. Although problem gambling within the sample generally declined, consistent with previous literature, it was also found that gambling online-among other biopsychosocial factors-was a significant predictor for classification as a problem gambler during the lockdown. COVID-specific influences on health, employment, leisure time and social isolation were moderately associated with problem gambling scores but were not independent predictors of changes in gambling engagement during lockdown. Future studies are required to assess if the pandemic related changes in gambling evidenced in this study remain stable, or if engagement reverts to pre-pandemic levels when the pandemic response allows for the re-opening of land-based gambling venues.

Does Confinement Affect Treatment Dropout Rates in Patients With Gambling Disorder? A Nine-Month Observational Study

Background and Aims: COVID-19 pandemic and confinement have represented a challenge for patients with gambling disorder (GD). Regarding treatment outcome, dropout may have been influenced by these adverse circumstances. The aims of this study were: (a) to analyze treatment dropout rates in patients with GD throughout two periods: during and after the lockdown and (b) to assess clinical features that could represent vulnerability factors for treatment dropout.

Methods: The sample consisted of n=86 adults, mostly men (n=79, 91.9%) and with a mean age of 45years old (SD=16.85). Patients were diagnosed with GD according to DSM-5 criteria and were undergoing therapy at a Behavioral Addiction Unit when confinement started. Clinical data were collected through a semi-structured interview and protocolized psychometric assessment. A brief telephone survey related to COVID-19 concerns was also administered at the beginning of the lockdown. Dropout data were evaluated at two moments throughout a nine-month observational period (T1: during the lockdown, and T2: after the lockdown).

Results: The risk of dropout during the complete observational period was R=32/86=0.372 (37.2%), the Incidence Density Rate (IDR) ratio T2/T1 being equal to 0.052/0.033=1.60 (p=0.252). Shorter treatment duration (p=0.007), lower anxiety (p=0.025), depressive symptoms (p=0.045) and lower use of adaptive coping strategies (p=0.046) characterized patients who abandoned treatment during the lockdown. Briefer duration of treatment (p=0.001) and higher employment concerns (p=0.044) were highlighted in the individuals who dropped out after the lockdown. Treatment duration was a predictor of dropout in both periods (p=0.005 and p<0.001, respectively).

Conclusion: The present results suggest an impact of the COVID-19 pandemic on treatment dropout among patients with GD during and after the lockdown, being treatment duration a predictor of dropout. Assessing vulnerability features in GD may help clinicians identify high-risk individuals and enhance prevention and treatment approaches in future similar situations.

Gambling and the COVID-19 pandemic: A scoping review

BACKGROUND

The impact of COVID-19 on mental health is tremendous. Since the beginning of the pandemic, several actors have raised concerns about the impact of the pandemic on gambling. Many actors fear a switch to online gambling in the context of the closure of many land-based gambling activities due to the restrictions imposed by public health authorities, such as physical distancing and lockdowns. This switch is worrisome because online gambling is considered a high-risk game. In that context, we need to know more about the impacts of the pandemic on gambling. This scoping review aims to summarize the literature that addresses the impacts of the COVID-19 pandemic on gambling. To our knowledge, this is the first review to focus on this subject.

METHODS

An electronic literature search involving a strategy using keywords related to COVID-19 and gambling was conducted using MEDLINE, Academic Search Complete, CINAHL, PsychINFO, Social Works Abstract, and Socio Index databases on February 25th 2021. This search was combined with a manual search in Google Scholar. To be included, studies had to discuss gambling and COVID-19 as a primary theme, be written in English, and be published in a peer-reviewed journal. After collecting the information, we collated, summarized, and reported the results using narrative synthesis.

RESULTS

The search identified 181 articles. After the removal of duplicates and screening, 24 full-text articles were reviewed and included in this study: 14 original articles, 8 commentaries or editorials, and 2 protocols. Contrary to expectations, preliminary evidence suggested that gambling behavior often either decreased or stayed the same for most gamblers during the pandemic. However, for the minority who showed increased gambling behavior, there was frequently an association with problem gambling.

CONCLUSION

The available literature on COVID-19 and gambling is limited and the impact of the COVID-19 pandemic on gambling behavior and gambling problems is still unclear. Therefore, there is a need for more research on this topic, both qualitative and mixed methods studies, to better understand the impact of the pandemic on gambling. Considering the results, we need to be careful, particularly with problem gamblers and other subgroups of the population who seem to be more vulnerable to increased gambling habits during this pandemic period.

Changes in Self-Reported Web-Based Gambling Activity During the COVID-19 Pandemic: Cross-sectional Study

Background

The COVID‑19 pandemic has affected not only somatic health with over 3.7 million deaths worldwide, but also has had a huge impact on psychological health, creating what amounts to a mental health crisis. The negative effect of the pandemic on traditional addictions is well described and concerning, and the same has been seen for gambling.

Objective

This study explores self-reported web-based gambling behavior during the COVID‑19 pandemic in Sweden. We investigated overall changes, but also changes in specific web-based gambling types, and whether they are associated with certain risk factors or lifestyle changes.

Methods

Our study is based on an anonymous web-based survey of web panel participants in Sweden (N=1501) designed to study a range of behavioral changes during the COVID‑19 pandemic. Increases in gambling were analyzed using logistic regression models against sociodemographic data and psychological distress.

Results

The majority of the respondents who gambled reported no changes in their gambling habits during the COVID‑19 pandemic. We found significant associations with the problem gambling severity index (PGSI), the Kessler score (indicating psychological distress), employment status, changes in alcohol habits, and self-exclusion when looking at overall changes in gambling activity in the pandemic. In the subgroup that reported an increase in gambling activity, we found an association with both the PGSI and Kessler scores. The PGSI score was also an independent predictor for all specific web-based gambling (horses, sports, poker, and casino) whereas the Kessler score only had a significant impact on changes in casino gambling. In addition, male gender was an independent predictor for gambling on sports and casino gambling.

Conclusions

The majority of respondents who gambled reported no changes in their gambling activity during the COVID‑19 pandemic. The group that reported an increase in overall gambling activity during the COVID-19 pandemic represent a group with gambling problems and psychological distress. The group that reported increased sports and casino gambling were often male, and this group seemed to experience more psychological distress.

Gambling and the COVID-19 pandemic in the province of Quebec (Canada): protocol for a mixed-methods study

INTRODUCTION

The COVID-19 pandemic has major collateral impacts on mental health. Gambling is among the major public health issues that seems to have been transformed by the pandemic. In the province of Quebec in Canada, gambling is an important leisure activity. About two out of three adults are in Quebec gamble. The objective of this study is to draw a portrait of the impacts of the COVID-19 pandemic on gamblers and to learn more about their experiences during the pandemic in the province of Quebec.

METHOD AND ANALYSIS

This study has a sequential explanatory mixed-method design in two phases. The first phase is a cross-sectional online survey with Quebec residents who are 18 years of age or older and have gambled at least once in the previous 12 months. The second phase will be a qualitative study. Semistructured interviews will be conducted with gamblers, family members, addiction counsellors and state representatives selected through purposing sampling.

ETHICS AND DISSEMINATION

This study is one of the first mixed-methods studies on the impacts of the COVID-19 pandemic on gambling. This study will generate new scientific knowledge on a worrisome public health issue, that is, gambling, and provide a better understanding of the experiences and gambling behaviours of gamblers during the pandemic. This study is funded by the Ministry of Health and Social Services of the Government of Quebec and was approved on 27 October 2020 by the Scientific and Research Ethics Committee of the CIUSSS de l'Estrie-CHUS. This is a 2-year study that will be completed in June 2022.

Exploring the experience of Gamblers Anonymous meetings during COVID-19: a qualitative study

Whilst much research has explored the possible causes and consequences of gambling, Gamblers Anonymous (GA) − one of the most accessed forms of support for gamblers - has been largely overlooked and, to date, only a few studies have explored how members experience this programme. Core to GA is the social interaction between members. From March 2020, however, the COVID-19 pandemic forced GA to move their meetings online. The present qualitative study therefore explored how GA members experienced these online meetings in the absence of actual face to face interactions with others. Individual telephone or video call interviews (n = 21) were carried out with members of GA in the UK and analysed using Thematic Analysis. The results described three main themes: (1) ‘practicalities of GA in lockdown’, which highlighted the practical benefits of online meetings such as more opportunity to attend different meetings, which in turn expanded participants’ perspectives and social networks; (2) ‘the importance of relationships in GA’, reflecting strong and enduring social networks that were created, maintained, and strengthened by feelings of solidarity; and (3) ‘therapeutic elements of the meetings’, such as psychological contract making which helped participants to stay abstinent. Transcending these themes was a tension between individual versus group identity with interviewees reporting a shift to focusing more on their own needs rather than those of the group. Overall, whilst still providing a lifeline during COVID-19 and offering some practical benefits, the online GA meetings were not able to completely replicate the value individuals gained from face to face meetings. This transition also resulted in disruptions both to group dynamics and to individual interactions within each group, ultimately resulting in participants behaving more individualistically and less collectively than in face-to-face meetings.

COVID-19 Related Distress in Gambling Disorder

The COVID-19 pandemic has exerted a dramatic impact on everyday life globally. In this context, it has been reported that the lockdown and social distancing may have exerted an impact even on gambling behavior, not only by increasing gambling behavior in those affected by this disorder but even contributing to the occurrence of new cases. To explore such a possibility, we designed a cross-sectional web survey addressing a general population sample that lasted 3 weeks (March 23-April 20). Participants completed a survey including a demographic information section, a question regarding the presence of pathological gambling in the past and several questionnaires. These included the Perceived Stress Scale (PSS), the Kellner's Symptom Questionnaire (SQ), and the version of The Yale Brown Obsessive Compulsive Scale adapted for Pathological Gambling (PG-YBOCS) that investigated the presence of gambling behaviors in the last week. The final sample was composed by 254 subjects (112 males, 44.1%; 142 females, 55.9%). According to PG-YBOCS total score, pathological gambling has been found in 23.6% (n = 60) of the sample (53 males, 88.3%; 7 females, 11.7%), which is a high frequency compared to that reported by the existing literature. Among gamblers, 20.9% (n = 53) reported both past and current problem gambling (they have been defined as "chronic gamblers"), whereas 2.8% (n = 7) did not report to use gambling platforms in the past but only in the last week (defined as "new gamblers"). Data analysis showed a statistically significant difference between gamblers and people who do not gamble in age but not in education, and higher level of perceived stress, distress, and hostility in both chronic and new gamblers compared to those who did not report gambling behavior. A consistent proportion of business owners and unemployed individuals reported problem gambling during the lockdown period.

Impact of COVID-19 on Online Gambling - A General Population Survey During the Pandemic

The COVID-19 pandemic may have severe impact on mental health, and concerns have been raised about potentially increased online behavior and possibly increased gambling problems, such as in sports bettors at risk of transfer to even riskier forms of gambling during sports lock-down. Given the need for objective data about gambling behavior during the pandemic, the present analysis, from a project assessing online gambling in Sweden, aimed to study past-30-day gambling patterns in online gamblers in Sweden. The study, carried out in May, 2020, during the pandemic and its restrictions on society, included past-year online gamblers (N = 997). Past-30-day gambling for several gambling types was lower compared to a previous study in online gamblers in the same setting, while online non-sports gambling remained at high levels. Those reporting sports betting even during a period with decreased sports betting occasions proved to have markedly higher gambling problems. COVID-19 may alter gambling behaviors, and online gamblers who maintain or initiate gambling types theoretically reduced by the crisis may represent a group at particular risk.

Gambling During the COVID-19 Crisis - A Cause for Concern

: The COVID-19 pandemic has the potential to worsen mental health problems in the general population, including increasing engagement in addictive behaviors. Here, we describe observations suggesting that the current crisis and its sequelae may worsen problem gambling. The current pandemic may impact financial and psychological well-being due to social isolation during spatial distancing, and these stressors in conjunction with substantial changes in gambling markets (land-based, online) during the pandemic may significantly influence gambling behaviors. This situation calls for rapid research initiatives in this area and preventive and regulatory measures by multiple stakeholders.

Beyond loot boxes: a variety of gambling-like practices in video games are linked to both problem gambling and disordered gaming

A variety of practices have recently emerged which relate to both video games and gambling. These range from opening loot boxes, to esports betting, real-money video gaming, token wagering, and social casino spending. It is unknown either how harmful or how widespread many of these activities are. A sample of 1,081 adults from the UK aged 18+ was therefore recruited. This sample was purposively recruited via quota sampling to represent the UK population in terms of sex, age, and ethnicity. Engagement in all forms of gaming-related practices were significantly associated with both problem gambling and disordered gaming. A total of 18.5% of the sample had engaged in these activities at least once in the new year. These results suggest a convergent ecosystem of practices that relate to both video games and gambling. Engagement in each of these activities is linked to problem gambling. However, it remains unclear whether engagement in these activities causes problem gambling.

Online Gambling in the Midst of COVID-19: A Nexus of Mental Health Concerns, Substance Use and Financial Stress

This study examined the emerging impact of COVID-19 on gambling during the first 6 weeks of emergency measures in Ontario, Canada. A cross-sectional online survey of 2005 gamblers, including a sub-sample of 1081 online gamblers (age 18 years and older), was administered to assess risky gambling behaviours and motivations, financial impacts from COVID-19, the influence of COVID-19 on online gambling, mental health concerns and substance use. A series of odds ratio comparisons and measures of association were carried out. Results show significant likelihood of online gambling among those classified as high-risk gamblers (according to the Problem Gambling Severity Index) and those with past experience of online gambling, though migration from land-based gambling was apparent. Among high-risk online gamblers, the most predictive risk factors included moderate and severe anxiety and depression, reduced work hours, being influenced to gamble due to COVID-19, gambling under the influence of cannabis or alcohol and risky gambling motives tied to mental health concerns, including gambling because it helps with nervousness and depression, chasing gambling losses and seeking to earn income. This study has confirmed many of the risk associations presented in emerging COVID-19-related studies and past research on global economic crisis relating to gambling risk, mental health concerns and substance use. However, unlike many past studies, the present paper takes note of all of these elements holistically and provides incremental clarity on online gambling risk factors during the pandemic, specifically.

Changes in Gambling Behavior during the COVID-19 Pandemic-A Web Survey Study in Sweden

The COVID-19 pandemic has dramatically changed everyday life, and policy makers have raised concerns about possible changes in gambling patterns during the pandemic. This study aimed to examine whether self-reported gambling has increased during the pandemic, and to examine potential correlates of such a change. This general population survey study in Sweden collected self-report data from 2016 web survey members (51 percent men, nine percent moderate-risk/problem gamblers). Correlates of increased gambling and increased gambling specifically due to COVID-19-related cancellation of sports were calculated. Four percent reported an overall gambling increase during the pandemic. The proportion of individuals reporting an increase, compared to individuals reporting a decrease, was markedly higher for online casinos (0.62), online horse betting (0.76) and online lotteries (0.73), and lower for sports betting (0.11). Overall, gambling increases were independently associated with gambling problems and increased alcohol consumption. In the sub-group, where there was an increase in specific gambling types in response to cancelled sports betting events, rates of gambling problems were high. In conclusion, only a minority report increased gambling in response to the pandemic, but this group has markedly higher gambling problems and changes in alcohol consumption, and may represent a sub-group with a particularly high vulnerability. This calls for preventive action in people with higher gambling risks in response to the pandemic.