The Severity of Gambling and Gambling Related Cognitions as Predictors of Emotional Regulation and Coping Strategies in Adolescents

Are Today's Gamers Tomorrow's Gamblers? The Relationship Between Problem Gaming and Online Problem Gambling, and the Indirect Effect of Purchasing Loot Boxes' Risk

The present study aims to bridge the gap regarding the potential influence of problem gaming on problem gambling (PG) by examining the potential indirect effect of risky loot box use in this relationship. We also aim to examine these relationships in an understudied cultural context, that is, Eastern European, thus enlarging the current geographical scope of the research on problematic gaming and gambling. The research was conducted on a sample of 703 Romanians (56.5 percent male, 43.5 percent female), aged between 18 and 46 (M = 23.07; SD = 5.24), who play video games frequently. They completed instruments measuring problem gaming, online PG, and purchasing loot boxes risk. Our findings also indicate that risky engagement with loot box mechanism had a significant indirect effect on the association between the two types of problematic behavior (i.e., gaming and gambling). This suggests that excessive involvement in online gaming is linked with an increased propensity for problematic use of loot boxes, and further with a higher risk of PG. Our results indicate that higher involvement in video gaming may be associated with higher levels of risky engagement, which could plausibly lead to a greater likelihood of purchasing them and this more problematic relationship with loot boxes further increases the risk of PG. Our study contributes to advancing knowledge about these constructs while suggesting the negative impact of loot boxes in that their acquisition is related to higher involvement in online gambling.

Can Positive Play Deficits Explain the Associations Between Posttraumatic Stress Symptoms, Gambling Motives, and Problem Gambling? Results of a National U.S. Sample

Past research has demonstrated a consistent connection between symptoms of posttraumatic stress disorder (PTSD) and problematic gambling in both general and clinical United States (U.S.) populations. Little is known, however, about the mediating role that responsible gambling practices related to positive play might have in the relationships between symptoms of PTSD, problem gambling (PG) severity, and different motives for gambling. Therefore, using mediation analysis, this study investigated these associations within a census-matched national sample of U.S. adults (N = 2,806). Results indicated PTSD symptoms and PG often co-occur in this population (r = .43, p < .01), and coping motives for gambling were the key mechanism connecting PTSD symptoms to PG severity rather than deficits in positive play practices or other gambling motives. Moreover, it was found that the average gambler who had sought treatment for gambling in the past not only had more severe PTSD symptoms and PG but also had the strongest gambling motives, the largest deficits in positive play, and was more likely to be younger than 50 years old. In this sample, approximately 1 in 10 people who gambled in the past year were classified as problem gamblers, 1 in 5 met criteria for a provisional PTSD diagnosis, and 1 in 33 sought out gambling treatment previously. These findings provide further evidence for the relationship between symptoms of posttraumatic stress and problematic gambling behaviors in the U.S. population and offer critical insights into the explanatory roles of coping motives and positive play practices in this connection.

Dopamine mediates a directionally opposite correlation between empathy and the reinforcing effects of amphetamine and gambling in people with gambling disorder vs. healthy controls

Understanding the relationship between empathy, subjective effects of addictive reinforcers and dopamine function in people with gambling disorder (PGD) vs. healthy controls (HCs) may inform GD treatment. The current investigation addressed this issue via retrospective analysis of data from three studies using amphetamine and a slot machine (SLOTS) as reinforcers in PGD and HCs. The Empathy scale of Eysenck's Impulsiveness Questionnaire assessed trait Empathy. The Gamblers Beliefs Questionnaire assessed cognitive distortions. The Eysenck Lie scale assessed socially desirable responding. PET scans quantified dopamine receptor expression and amphetamine-induced dopamine release in Study 1. Pre-treatment with the D2-receptor (D2R)-preferring antagonist, haloperidol or D1R-D2R antagonist, fluphenazine before SLOTS tested the role of D2 autoreceptors and post-synaptic D2R in Study 2. Pre-treatment with the multi-system indirect dopamine agonist, modafinil before SLOTS assessed the reliability of correlations in PGD. Striatal D2R expression predicted greater Empathy and lower amphetamine 'Liking' in HCs, and predicted greater symptom severity in PGD. Empathy predicted lower 'Exciting' effects of SLOTS under placebo in HCs; no correlation emerged under either antagonist. Relative to placebo, haloperidol decreased, whereas fluphenazine increased, the positive correlation between Empathy and Exciting effects of SLOTS in PGD. Modafinil markedly reduced the positive correlation between Empathy and Exciting effects of SLOTS seen under placebo in PGD. Empathy predicted greater cognitive distortions in PGD in all studies. Lie scale variance influenced several primary effects. Prior research linking the insula with Empathy, reactivity to interoceptive signals for risky rewards (uncertainty), and cognitive distortions, provides a parsimonious account for these results.

Do problematic gamblers and loot boxers share similar fallacies of thought? A comparative analysis of cognitive biases

Cognitive biases are associated with the beginning and maintenance of addictive behaviours. While these biases have been studied in gambling, they have yet to be thoroughly investigated in the context of loot boxes (LBs), largely because of the relatively recent emergence of this phenomenon. This study compared cognitive biases in problematic gamblers, non-problematic gamblers, LB purchasers, and free-LB openers. For this aim, 279 participants (63.1% males) with a mean age of 23.65 years (SD = 8.66) completed a self-report. The results showed no differences between problematic gamblers, LB purchasers and LB openers on illusion of control and predictive control. In contrast to LB openers, problematic gamblers and LB purchasers obtained statistically similar scores on interpretative biases, gambling-related expectancies and the total score of the Gambling Related Cognitions Scale (GRCS). Only problematic gamblers experienced a higher perceived inability to stop gambling. Moreover, problematic gamblers, LB purchasers and LB openers scored higher on all biases compared to non-problematic gamblers. Eighty-six participants simultaneously gambled and used LBs. When this overlap was controlled, problematic gamblers and loot boxers shared all cognitive biases but the perceived inability to stop gambling; and scored statistically higher than non-problematic gamblers in all cognitive biases except for the illusion of control. The study provides additional evidence of the relationship between gambling and LBs.

Associations between Adverse Childhood Experiences and Gambling Severity in Youth Online Gamblers: The Mediating Roles of Internalizing, Attention and Externalizing Problems

BACKGROUND

This study examined the association between Adverse Childhood Experiences (ACEs) and Gambling Severity (gambling severity), considering the mediating roles of internalizing, externalizing, and attention among youth online gamblers.

METHODS

762 youth (agemean±SD= 15.03 ± 2.40; agerange = 10-18 years; 75.3% boys) completed the Persian Gambling Disorder Screening Questionnaire (GDSQ-P), Pediatric Symptom Checklist - Youth Report (Y-PSC), and Behavioral Risk Factor Surveillance System Questionnaire (ACE's section, modified by authors). The analysis was done using the SMART PLS software.

RESULTS

The reliability and discriminant validity of the provided model were assessed using Partial Least Squares-Structural Equation Modeling (PLS-SEM). According to the results of the PLS-SEM analysis, the present model demonstrated suitable levels of reliability and validity. Adverse Childhood Experiences (ACEs) significantly affected attention, internalizing, externalizing problems, and gambling severity. Additionally, the level of gambling was directly correlated with ACEs. Moreover, the indirect influence of the independent variable on the dependent variable via the mediators was found to be statistically significant (P < .001).These findings suggest that externalizing behaviors, attention problems, and internalizing symptoms mediate the effect of ACEs on gambling severity. Lastly, fitness indices indicated that our proposed model fit the data well (SRMR = 0.06, d_ULS = 1.15, Chi-square = 1291.461, and NFI = 0.71).

CONCLUSION

Our study found that ACEs significantly influence gambling severity among youth online gamblers, with internalizing, externalizing, and attention problems mediating this relationship. Practical implications include integrating ACE screening and targeted interventions for associated mental health issues into youth gambling prevention programs to mitigate the risk of problematic gambling behavior.

Stressful Life Events and Problem Gambling Among Chinese Lottery Gamblers: The Mediating Effects of Coping Strategies and Magical Thinking

Problem gambling poses serious harm to individuals and societies worldwide. This study aims to investigate the relationship between stressful life events and problem gambling, and further explore the mediating role of coping strategies and magical thinking. Currently, the research on problem gambling is widely conducted worldwide. However, due to the unique characteristics of China's gambling industry, research on problem gambling conducted in the Chinese mainland has always been an underrepresented area in international gambling research. This study recruited participants from a province in central China, and data from 483 of them were ultimately analyzed. The data analysis results indicate that task-oriented coping, emotion-oriented coping, avoidance-oriented coping, and magical thinking all serve as mediators in the relationship between stressful life events and problem gambling. Emotion-oriented coping and magical thinking, avoidance-oriented coping and magical thinking, all serve as serial mediators in the relationship between stressful life events and problem gambling. Task-oriented coping and magical thinking did not act as serial mediators in this relationship. This study demonstrates that helping problem gamblers develop effective coping strategies and reduce their level of magical thinking is crucial for treating their problem gambling.

An Economic Model of Gambling Behaviour: A Two-Stage Approach

Gambling can cause significant harms and these can result in a net negative utility from participation, although lower levels of participation have potential benefits and can yield positive net utility. It is therefore important to understand and distinguish between these two stages of gambling behaviour. Currently, economic models have had limited focus on explaining why someone would gamble despite it yielding a negative utility. Here, we present a two-stage model, motivated by empirical literature and intuitive assumptions, that improves on existing economic models by distinguishing between the likelihood of gambling participation and of gambling that yields a negative utility. The model's predictions are empirically testable, consistent with existing literature, and add new insights. The model's ability to distinguish between the two stages helps to inform interventions that aim to reduce the prevalence of gambling-related harm while avoiding the need for restrictive approaches that aim to eliminate gambling altogether.

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

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

Validation of Gambling Related Cognitions Scale-Iranian Version (GRCS-IR)

Background

The change in gambling forms, a wide variety of advertising methods, the access to gambling, as well as the increase in participation in online gambling have made it important to know and investigate gambling, particularly as pathological gambling leads to psychological and physical damage.

Methods

The present study investigated the factor structure of the Gambling Related Cognitions Scale (GRCS) proposed by Raylu and Oei in addiction. The study sample included 574 participants (40.2% male, 59.8% female) between 18 and 56 years of age. The instruments used in the present study included the GRCS, the South Oaks Gambling Screen Questionnaire (SOGS), the Victorian Gambling Screen (VGS), and the Problem Gambling Severity Index (PGSI).

Findings

A 5-factor GRCS model provided the best fit to the data, and gambling-related cognitions were a strong predictor of disordered gambling among adults. All subscales presented good internal consistency and scalability. The findings showed that the total score of the GRCS-IR was significantly different among men and women.

Conclusion

The findings of this study confirmed that the Iranian version of the GRCS-IR is an effective multidimensional instrument that accurately measures cognitive distortions related to gambling. Consequently, it can be utilized as a valuable tool for assessing GRC (Gambling Related Cognitions) to understand the severity of pathological gambling and has the potential capacity to measure treatment outcomes.

Gambling Disorder among Porto's University Students

BACKGROUND

Gambling disorder is an emerging problem among young adults and must be researched to provide the necessary support. This study aims to characterise gambling disorders in Porto's university students.

METHODS

A cross-sectional study distributed an online questionnaire to Porto's university students. The authors developed a self-administered questionnaire that included the South Oaks Gambling Screen questionnaire-Portuguese Version (SOGS-PV).

RESULTS

A total of 1123 responses were included. The participants' average age was 22.4 years (SD = 6.2), and 60.9% were women. Gambling activities were performed by 66.4% of the students, most commonly online or video games, "scratch card" games, skill games, lotteries, and sports bets. The final scores of the SOGS-PV suggested 19.7% (95% CI: 17.4-22.0) of students may have a gambling disorder, with 16.6% (95% CI: 14.4-18.8) being "probable pathological gamblers" and 3.1% (95% CI: 2.1-4.1) being "problem gamblers". Gambling in the stocks/commodities market/virtual coins, sports bets, playing cards for money, and the numbers or betting on lotteries presents a higher risk of gambling disorder. The age (OR: 0.953; 95% CI: 0.922-0.986), being male (OR: 2.756; 95% CI: 1.899-4.000), the highest daily gambling amount (OR: 3.938; 95% CI: 2.580-6.012), the effects of the COVID-19 pandemic (OR: 0.129; 95% CI: 0.087-0.191), a mother with gambling disorder (OR: 5.284; 95% CI: 1.038-26.902), the personal services education area (OR: 2.858; 95% CI: 1.179-6.929), and the linguistics education area (OR: 2.984; 95% CI: 1.538-5.788) stand out as contributing factors to the development of this disorder.

CONCLUSIONS

This study reveals a high level of possible gambling disorder among university students and emphasises the importance of this problem in the academic community. Physician awareness and prevention programmes are needed in this population.

Childhood use of coin pusher and crane grab machines, and adult gambling: A conceptual replication of Newall et al. (2021)

BACKGROUND AND AIMS

Youth gambling research mainly focuses on the illegal use of age-restricted machines, but coin pusher and crane grab machines are gambling machines that can be used by people of any age in the UK, and are also in use internationally. Previous cross-sectional evidence has associated recollected childhood usage of these machines with adult gambling participation and levels of problem gambling amongst adult gamblers. We attempted to conceptually replicate the findings of one of these studies (Newall et al., 2021), while addressing some limitations of that study.

METHODS

A cross-sectional survey of 2,000 UK-based and -born participants aged 19-24 years. The measures were participants' recollected usage of coin pusher and crane grab machines as a child, whether they had gambled in the past 12-months or not, and the PGSI for past 12-month gamblers.

RESULTS

Overall, 5 of 7 tested associations were significant and in the hypothesized direction. Logistic regression models showed that adult gamblers were more likely to recollect using, and used at higher levels of frequency, coin pusher and crane grab machines, than non-gamblers. Then, negative binomial regression analysis showed that adults who recollected using crane grab machines at higher levels of frequency showed more gambling-related problems.

DISCUSSION AND CONCLUSIONS

These results suggest that childhood usage of coin pusher and crane grab machines may act as an underappreciated risk factor for the development of gambling-related harm across the lifespan. This information may be considered for further youth gambling research and policy.

Update on Gambling Disorder

Gambling disorder (GD) is estimated to be experienced by about 0.5% of the adult population in the United States. The etiology of GD is complex and includes genetic and environmental factors. Specific populations appear particularly vulnerable to GD. GD often goes unrecognized and untreated. GD often co-occurs with other conditions, particularly psychiatric disorders. Behavioral interventions are supported in the treatment of GD. No medications have a formal indication for the GD, although clinical trials suggest some may be helpful. Noninvasive neuromodulation is being explored as a possible treatment. Improved identification, prevention, and treatment of GD are warranted.

Optimizing large-scale gambling prevention with adolescents through the development and evaluation of a training course for health professionals: The case of PRIZE

In the field of adolescent gambling prevention, there is a lack of intervention studies reporting and assessing training courses for the intervention providers. The present work fills this gap by realizing a dissemination study inside the PRIZE program aimed at modifying a set of cognitive protective factors and affective risk factors. The purpose of this work was twofold: To develop and evaluate a training course with the intervention providers (Study 1), and to assess the short- and long-term effects of the intervention itself (Study 2). The training course was delivered to 44 health professionals (32 females, Mage = 39.34 years). Results showed a significant increase of correct knowledge about gambling and a significant reduction of their susceptibility to probabilistic reasoning biases. Participants also actually learnt the main competencies to conduct the educational activities, they were satisfied for the training course received, and they felt high levels of self-efficacy. The intervention was implemented with 1894 high school students (61% males; Mage = 15.68 years). In the short term, we found a significant increase of adolescents' correct gambling knowledge, random events knowledge, and probabilistic reasoning ability, and a significant decrease of superstitious thinking, monetary positive outcome expectation, and gambling-related erroneous thoughts and fallacious behavioral choices. In the long-term, a significant decrease of gambling frequency, gambling versatility, and gambling problem severity was obtained. Overall, this work highlights the importance to train prevention program providers in order to optimize the effectiveness of large-scale gambling intervention programs towards adolescents.

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.

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

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

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.

Coping associated with compulsive buying tendency

Research on general coping is limited within compulsive buying (CB) literature. Nevertheless, other behavioural addictions and hoarding might provide insights into coping in CB. One-hundred and ninety-nine participants (M age = 52.72, SD = 16.06; 50.3% female, 1% unknown sex) completed online questionnaires. Mental and behavioural disengagements were hypothesized to predict greater self-reported CB tendency. Whilst these relationships were found in the correlations, a regression analysis indicated that only mental disengagement significantly predicted CB tendency. Additionally, the exploration of denial and substance use identified that denial was an important predictor of CB tendency coping. The relationship between CB tendency and substance use could not be explored given the large degree of participants reporting minimal scores. CB tendency is associated with maladaptive mental disengagement, denial and lack of acceptance coping strategies, which could be useful to consider in therapy.

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.

Contribution of sex on the underlying mechanism of the gambling disorder severity

Significant increasing prevalences have been observed in gambling disorder (GD) in the last decades. This study analyzed the underlying mechanisms of the gambling severity with path analysis (implemented through Structural Equation Modeling, SEM), and assessed the potential moderator effect of the patients’ sex. A sample of n = 512 treatment-seeking patients was assessed for sociodemographics and clinical state previously to the treatment. Results obtained in two separate SEM (for men and women) revealed differences in the direct effects and the mediational links. Among the male subsample, higher GD severity was directly related to the higher cognitive bias and the younger age of onset of the problematic gambling, while impulsivity levels and age of onset achieved an indirect effect on the disordered gambling mediated by the cognitive bias. Among females, GD severity was directly increased by younger age of onset, higher cognitive bias and lower self-directedness, while lower socioeconomic positions, and higher levels in harm avoidance achieved an indirect effect on the gambling severity mediated also by the distortions related to the gambling activity. These results provide new empirical evidence for a better understanding of the GD etiology, suggesting that the underlying complex links mediating the GD severity are strongly related to the patients’ sex. The results can also contribute to design more effectiveness and precise therapy programs of patient-centered care.