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Dowling NA, Hawker CO, Merkouris SS, Rodda SN, Hodgins DC. Addressing Gambling Harm to affected others: A scoping review (part II: Coping, assessment and treatment). Clin Psychol Rev 2025; 116:102543. [PMID: 39854974 DOI: 10.1016/j.cpr.2025.102543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2021] [Revised: 12/23/2024] [Accepted: 01/07/2025] [Indexed: 01/27/2025]
Abstract
Public health definitions of gambling-related harm include risks to family members and friends. This scoping review broadly aims to identify recent research on addressing gambling harm to adult affected others, focusing on prevalence, socio-demographic profiles, gambling profiles, and harm (Part I); and coping strategies, assessment, and treatment (Part II). A systematic search of electronic databases identified 121 studies published from 2000, with 82 focusing on coping strategies (22.3 %), assessment (21.5 %), and treatment (39.7 %). Findings revealed affected others employ various coping strategies, which can be gambler- or family-focussed, before accessing other forms of support. Common strategies include financial strategies and informal support but few studies have assessed their effectiveness. Few brief fit-for-purpose instruments with adequate psychometric evaluation are available to assess affected other status, harm, coping, social support, and help-seeking. Affected others are under-represented in treatment (8 % in general practices, 15 %-26 % in online gambling services, 30 %-43 % in gambling helplines), largely due to various barriers, including a lack of service awareness and shame. Low-intensity internet-delivered interventions show promise and can reach affected others who would not otherwise receive professional help. Other affected other interventions, which can be gambler- and/or family-focused, demonstrate good acceptability but somewhat limited efficacy, while couple interventions demonstrate some promising outcomes, although more rigorous evaluations are needed. The diverse treatment needs and preferences of affected others, coupled with the relatively limited efficacy of current treatments, highlight the need for the development of tailored interventions. The findings of this review can be used to inform clinical, research, and policy decision-making.
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Affiliation(s)
- N A Dowling
- School of Psychology, Deakin University, Burwood, Australia; Melbourne Graduate School of Education, Parkville, Australia.
| | - C O Hawker
- School of Psychology, Deakin University, Burwood, Australia
| | - S S Merkouris
- School of Psychology, Deakin University, Burwood, Australia
| | - S N Rodda
- School of Psychology, Deakin University, Burwood, Australia; School of Population Health, University of Auckland, New Zealand
| | - D C Hodgins
- Department of Psychology, University of Calgary, Canada
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Spence K, Merkouris SS, Jackson AC, Wade AJ, Dowling NA. Negative and positive mental health characteristics of affected family members: Findings from a cross-sectional Australian general population gambling study. Addict Behav 2024; 155:107998. [PMID: 38598904 DOI: 10.1016/j.addbeh.2024.107998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Revised: 02/13/2024] [Accepted: 02/21/2024] [Indexed: 04/12/2024]
Abstract
Despite the impact of problem gambling on affected family members (AFMs), there are limited large-scale population level studies identifying the negative mental health (NMH) and positive mental health (PMH) characteristics of AFMs. Furthermore, no study has explored whether PMH characteristics are protective in the relationships between AFM status and NMH characteristics. This study involved secondary data analysis from the Third Social and Economic Impact Study of Gambling in Tasmania. Using a subsample of 1,869 adults (48.30 % male; meanage = 48.48; 4.67 % AFMs), this study aimed to explore whether: (1) AFM status is associated with NMH (depression, anxiety, panic, post-traumatic stress disorder, social anxiety, binge drinking, tobacco use, and drug use symptoms) and PMH (quality of life [QOL], personal growth/autonomy, interpersonal/social skills, coping skills) characteristics after separately controlling for sociodemographic, problem gambling severity, and other NMH characteristics; (2) PMH characteristics moderate (buffer) the relationships between AFM status and NMH characteristics; and (3) gender influences these relationships. AFM status, defined as exposure to family member gambling problems, significantly positively predicted NMH characteristics (depression, anxiety, panic, PTSD, and tobacco use symptoms) and negatively predicted QOL (physical, social) and planning coping. The strength of these relationships generally attenuated after controlling for various covariates. Gender did not moderate these relationships. Religious coping exacerbated the relationship between AFM status and panic disorder symptoms. These findings can inform the development of intervention initiatives for family members exposed to gambling problems. Future population-representative research is required using a range of affected other types, longitudinal study designs, and more comprehensive measures.
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Affiliation(s)
- K Spence
- School of Psychology, Deakin University, Geelong, Australia.
| | - S S Merkouris
- School of Psychology, Deakin University, Geelong, Australia.
| | - A C Jackson
- Melbourne School of Psychological Sciences, University of Melbourne, Australia; Faculty of Education, University of Melbourne, Australia.
| | - A J Wade
- Centre for International Research on Education Systems, Mitchell Institute, Victoria University, Australia.
| | - N A Dowling
- School of Psychology, Deakin University, Geelong, Australia.
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Jin Y, Zhang Z, Zhang B, Wang J, Tian Y. Stressful Life Events and Problem Gambling Among Chinese Lottery Gamblers: The Mediating Effects of Coping Strategies and Magical Thinking. J Gambl Stud 2024; 40:1-18. [PMID: 38066244 DOI: 10.1007/s10899-023-10270-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/15/2023] [Indexed: 07/26/2024]
Abstract
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.
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Affiliation(s)
- Yijun Jin
- School of Education Science, Shanxi University, Taiyuan, 030000, Shanxi, China.
| | - Zongshuai Zhang
- School of Education Science, Shanxi University, Taiyuan, 030000, Shanxi, China
| | - Baolu Zhang
- School of Education Science, Shanxi University, Taiyuan, 030000, Shanxi, China
| | - Jiaqing Wang
- School of Education Science, Shanxi University, Taiyuan, 030000, Shanxi, China
| | - Yueming Tian
- Mental Health Education and Counseling Center for College Students, Taiyuan Institute of Technology, Taiyuan, 030000, Shanxi, China
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Stefanovics EA, Potenza MN, Tsai J, Pietrzak RH. Prevalence and Clinical Characteristics of Recreational and At-Risk/Problematic Gambling in a National Sample of U.S. Military Veterans. J Gambl Stud 2023; 39:1077-1097. [PMID: 36378356 DOI: 10.1007/s10899-022-10165-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/29/2022] [Indexed: 11/16/2022]
Abstract
Gambling among U.S. military veterans is common, with more extensive involvement linked to gambling disorder and associated problems. This study examined associations between recreational gambling (RG) and at-risk/problem gambling (ARPG), and clinical measures (psychiatric disorders, substance use), behaviors (suicidality, homelessness, arrests) and functioning in a nationally representative sample of U.S. military veterans. Data were analyzed from 4069 veterans who participated in the National Health and Resilience in Veterans Study. Chi-square tests, analyses of variance (ANOVAs) and logistic regressions were conducted to examine unadjusted and adjusted associations between gambling group status and lifetime and current psychiatric diagnoses and behavioral and functioning measures. A significant minority of U.S. veterans reported gambling, with 27.3% (95% confidence interval [CI] 25.5-29.1%) exhibiting RG and 4.9% (95% CI 4.0-5.9%) screening positive for ARPG. The prevalence of ARPG was higher among younger, non-White, male veterans, while RG was more prevalent among retired veterans and those with higher household incomes relative to non-gambling (NG) individuals. ARPG was associated with greater trauma burden, lifetime and current psychiatric diagnoses, mental health treatment, alcohol and drug use disorders, suicidal ideation, homelessness, arrests, and poorer functioning relative to NG and RG, with stronger magnitude differences relative to NG. RG was associated with substance use disorders and arrest histories relative to NG. Results of the current study provide an up-to-date estimate of the current prevalence of RG and ARPG among U.S. veterans and underscore the importance of routine screening and monitoring of gambling problems, as well as interventions for ARPG in this population.
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Affiliation(s)
- Elina A Stefanovics
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA.
- U.S. Department of Veterans Affairs New England Mental Illness Research and Education Clinical Center (MIRECC), VA Connecticut Healthcare System (116A-4), 950 Campbell Avenue, Building 36, West Haven, CT, 06516, USA.
| | - Marc N Potenza
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- Yale Child Study Center, Yale University, New Haven, CT, USA
- Connecticut Mental Health Center, New Haven, CT, USA
- Connecticut Council on Problem Gambling, Wethersfield, CT, USA
- Department of Neuroscience, Yale University, New Haven, CT, USA
- Wu Tsai Institute, Yale University, New Haven, CT, USA
| | - Jack Tsai
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- National Center on Homelessness Among Veterans, U.S. Department of Veterans Affairs, Tampa, FL, USA
- Department of Management, Policy, and Community Health, School of Public Health, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Robert H Pietrzak
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- U.S. Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, VA Connecticut Healthcare System, West Haven, CT, USA
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