The Prevalence and Clinical and Sociodemographic Factors of Problem Online Gambling: A Systematic Review

From policy to practice: assessing the impact of electronic gambling machines regulations on harmful gambling behaviour

BACKGROUND

Electronic gambling machines (EGMs) are among the most harmful forms of gambling. Their widespread availability has been linked to increased gambling activity and a rise in harmful gambling. However, it remains unclear whether restricting the availability and accessibility of EGMs is effective in reducing gambling harms at the population level. We investigate those issues by leveraging the natural experiment of the region of Piedmont in northwest Italy, which in 2018 set limits on the location and operating hours of EGMs.

METHODS

Data from the Gambling Adult Population Survey conducted in 2018 and 2022 were combined with information regarding the implementation of the policy in Piedmont municipalities and data on EGMs from the national monopoly holder. Our analysis uses a difference-in-difference design, which is appropriate given that only some municipalities in the region implemented the policy, each setting different operating time limits for EGMs. Sensitivity analyses were conducted to explore possible substitution effects towards bordering regions and online gambling.

RESULTS

Our findings reveal that policies aimed at reducing the operating hours of EGMs were effective in decreasing harmful gambling behaviour in the population, but only when a minimum daily operational suspension of 11 hours was implemented. No significant effect was observed from setting location limits, and no substitution effect was found.

CONCLUSIONS

While restricting EGM availability can help mitigate harmful gambling, it requires coordinated efforts across different levels of government to ensure uniform policy implementation, along with individual-level policies, such as banning advertising, and consideration of diverse gambling products and online gambling.

Limit-setting in online gambling: a comparative policy review of European approaches

BACKGROUND

Online gambling products involve a heightened risk of harm, but there are some possibilities to prevent and reduce these harms. Notably, mandatory identification in online gambling environments allows for a range of pre-commitment tools such as limit-setting. Previous research has found that limit-setting tools can be helpful, but effectiveness depends on how policies are outlined and implemented. Limits can be financial or temporal, voluntary or mandatory, and system-level or operator-based. The current paper presents a policy review of European approaches to limit-setting in online environments.

METHODS

We first compared legal provisions on pre-commitment and limit-setting in N = 30 European countries (27 European Union Member States, Great Britain, Norway, and Switzerland). Data were retrieved from Vixio Gambling Compliance country reports and verified against original legal texts. The analysis focused on financial, temporal, maximum wager limits, and any other limits pertaining to online gambling. Second, based on the policy review, we produced a more in-depth analysis of limit-setting provisions in countries with system-level pre-commitment (Finland, Norway, Germany).

RESULTS

Results show important divergence in terms of limit-setting across Europe. While almost all countries (n = 27) have some form of limit-setting, implementation details vary. Financial limits can include loss limits (n = 15 countries), deposit limits (n = 18), and wagering limits (n = 14), with the majority of countries providing several types of financial limits. Temporal limits were available in ten countries. Eleven countries had some mandatory limits, in other countries operators were expected to provide the option to set limits. Statutory maximum limits and lower limits for young adults were not common, but available in some countries. Germany was the only country with a system-level limit-setting scheme that covered multiple licensed operators.

CONCLUSIONS

Contextual variations in pre-commitment and limit-setting policies are likely to impact effectiveness in terms of preventing and reducing harm. Our review shows some promising practices, including system-level regimes, mandatory policies, reasonable maximum caps on limits and wagers, the possibility to set limits for various time periods, lower limits for young adults, and coupling limit-setting with other duty-of-care obligations. Learning from other jurisdictions can constitute good practice for future policies on pre-commitment.

Predictors of Gambling Severity Among Female Gamblers: Cross-Country Study with Spanish and Italian Clinical Population

A large body of research has evidenced different risk factors associated with the severity of gambling. However, most of the research has been conducted with a male population, and consequently it has been inferred that the female population presents the same experiences and characteristics. Research on female gamblers is limited, with the result that their gambling-related problems are not effectively addressed. In light of this, the study aims were two-fold: (1) to identify differences between Spanish and Italian women seeking treatment for a gambling disorder, and (2) to examine variables associated with gambling severity in a clinical sample of women. For this study, a total of 106 women gamblers (Mage = 48.83; SD = 12.41) completed the assessment, evaluating gambling behavior, alexithymia, hopelessness, and mental health (depression, anxiety, and hostility). Results indicated that Spanish and Italian women showed differences in sociodemographic, psychological, and gambling-related variables. Furthermore, exhibiting higher levels of depressive symptoms, and experiencing difficulties in identifying emotions were related to the increased gambling severity. Also, received the Italian intervention was related to lower gambling severity. These findings emphasize the need to provide evidence-based treatments, as well as to improve existing treatments and develop prevention and intervention strategies adapted to the characteristics of female gamblers.

Digitalisation of gambling harm? Gambling consumption, negative consequences, and clinical characteristics among Swedish help-seekers

Gambling is connected to a range of harms and negative consequences. Gambling is also evolving at a fast pace, particularly in digital environments. Understanding the effects of this on-going change and digitalisation of gambling markets requires systematic measuring of gambling consumption patterns, clinical characteristics, and gambling-related harms. The current study compares two cohorts of help-seekers for gambling in Sweden (2019; 2023), recruited via the Swedish national helpline. The aim is to assess harms and consumption across the two cohorts at a time of increased offer of digital gambling in Sweden. We used eight different screens to measure gambling-related behaviours and consequences, including the Gambling Disorder Identification Test (GDIT). Results were analysed using descriptive statistics, and differences across the two cohorts were tested for statistical significance. The results show that across 2019-2023, gambling consumption has intensified. Online EGMs are by far the most prevalent form of gambling among help-seekers. We also found that the experience of co-morbidities as well as most gambling-related harms were common in both cohorts, with some statistically significant increases in 2023. Harms were more commonly experienced amongst those who engaged in online EGM gambling in comparison to those who did not. The results suggest that the digitalisation of gambling and gambling products appears to be associated with a variety of harmful consequences. The results also show the importance of systematic and comprehensive measurement to capture different severity levels of harms and their wide range amongst those who gamble.

Who is Getting the Message? Sociodemographic Factors and Gambling Behavior Associated with Awareness of the Swedish National Self-Exclusion Registry Spelpaus.se

Awareness and utilization of health interventions can be influenced by sociodemographic factors. These factors play a role in information processing, particularly regarding health messaging. The aim of this study is to analyze how different sociodemographic factors and gambling behaviors are associated with awareness of a (Swedish) gambling self-exclusion register. The study used data from the Swedish longitudinal gambling study (Swelogs) and analyzed n = 6720 participants from a stratified random sample of the Swedish population aged 18-84 years. Logistic regressions were conducted to analyze associations between sociodemographic characteristics, gambling behavior and awareness. Males with middle (OR = 1.70, 95% CI = 1.32-2.19) and high income (OR = 1.58, 95% CI = 1.19-2.09) and females with high (OR = 1.35, 95% CI = 1.03-1.76) and middle-level education (OR = 1.35, CI = 1.04-1.76), had higher awareness of Spelpaus.se. Online gamblers with problematic gambling behavior were three times (OR = 3.69, 95% CI = 2.15-6.37) more likely to be aware than non-gamblers. Online gamblers born in Sweden were twice (OR = 1.95, 95% CI = 1.19-3.19) as likely to be aware compared to those born outside of Europe. Males with high level of awareness had higher PGSI scores compared to women. Education could increase awareness of potential health risks and opportunities for intervention, particularly among women. Future interventions should be tailored to cater to the specific needs of individuals with lower levels of awareness, to facilitate enhancing their awareness and ultimately promoting a more equitable utilization of self-exclusion measures.

Cluster analysis based on gambling variables and mental health in a clinical population of gamblers

BACKGROUND

Interest in characterizing individuals involved in addictive behaviors has been growing, which allows tailoring prevention and intervention strategies to the gambler's needs. The study aimed to 1) identify clusters of gamblers according to gambling-related characteristics and mental health; and 2) analyze differences in psychological variables between the clusters.

METHODS

A total of 83 participants undergoing treatment for gambling disorder (Mage = 45.52, 51.8 % female) completed a set of questionnaires. Hierarchical cluster analysis was performed to classify gambling based on gambling variables (i.e., gambling severity and gambling motives) and mental health (i.e., depression, anxiety, and hostility). Several ANOVAs were conducted to illustrate the distinguishing features of each cluster, encompassing both the variables included in the cluster analysis and other relevant psychological variables.

RESULTS

Findings suggest that gamblers can be classified into three clusters based on these variables: 1) "high gambling severity and good mental health," 2) "high gambling severity and poor mental health," and 3) "low gambling severity and good mental health." These clusters were differentiated as a function of psychological variables, such as emotional dependence, alexithymia, and stressful life events.

CONCLUSIONS

Classifying gamblers according to their profile provides a better understanding of their needs and problems, allowing for a more tailored approach in terms of prevention and intervention strategies.

Understanding the Emergence of Comorbidity between Problematic Online Gaming and Gambling: A Network Analysis Approach

BACKGROUND/OBJECTIVES

Problematic online gaming and gambling tend to co-occur. The exact mechanisms underlying this phenomenon and the potential effects of gender differences remain unknown. This study aimed to identify the early clustering patterns of problematic online gaming and gambling in a community sample of young adults without a lifetime history of psychiatric treatment.

METHODS

Data were collected through an online survey and analyzed using partial correlations and Bayesian networks.

RESULTS

Altogether, 1441 individuals (aged 18-40 years, 51.4% females) participated in the survey. Both problematic online behaviors were weakly interrelated, suggesting that they serve as distinct constructs. Men's networks appeared to be more complex and had significantly higher global connectivity. Moreover, men and women differed with respect to the specific nodes that bridged both constructs. In men, the bridge nodes were "being criticized because of betting or being told about gambling problems", "loss of previous interests due to gaming", "deceiving other people because of gaming", and "health consequences of gambling". Among women, the bridge nodes were "feeling guilty because of gambling", "loss of previous interests because of gaming", "social consequences of gaming", and "continued gaming problems with other people". In men, the strongest edge was found between "borrowing money/selling anything to gamble" and "financial problems because of gambling", while in women, the strongest edge appeared between "betting more than afforded to be lost" and "tolerance symptoms of gambling".

CONCLUSIONS

The findings indicate that problematic online gaming and gambling tend to emerge in different ways among men and women. Therapeutic interventions should be planned considering gender differences.

Gambling in a U.S. Census Matched Sample: Examining Interactions between Means and Motives in Predicting Problematic Outcomes

The influence of socioeconomic status (SES) on risk of Problem Gambling (PG) is complex, particularly given recent evidence that SES should be understood in both objective and subjective terms. Likewise, financial gambling motives have been found to be predictive of PG; however, financial motives are less understood in comparison to other gambling motives. Preliminary findings on SES and gambling points towards a pattern of social inequality in which those with the least financial resources (e.g., income) or that feel financially deprived relative to others (e.g., perceived deprivation) experience greater harm and problems. In a weighted, census matched sample of adults in the U.S. (N = 1,348), the present study examined the interaction between financial gambling motives and income and financial gambling motives and perceived deprivation in predicting PG. Findings provided support for both financial gambling motives and perceived deprivation as robust predictors of PG. Further, results provided unique insights into the role subjective economic standing may play in the relationship between financial motives for gambling and risk of PG.

Gambling in Victoria: Changes in Participation, Problem Gambling and Gambling Environment Between 2008 and 2018

Gambling and its impacts are an important public health issue. The relationship between gambling, problem gambling and gambling harm is complex and dynamic. Replicate prevalence studies are useful for surveillance and monitoring gambling impacts within jurisdictions. The purpose of this study was to compare changes in gambling and problem gambling in the Victorian adult population between 2008 and 2018 by investigating individual gambling activities and exploring their relationship with the Victorian gambling ecosystem. Gambling participation has decreased; problem gambling prevalence has not. Investigation beyond these summary measures reveals important details: (a) Electronic Gaming Machines (EGMs), casino table games, race and sports betting ('high-risk activities'), informal private betting, and Keno, and their associations with problem gambling endure. Further, the strength of this association is unaffected by changes in product technology, delivery, or the Victorian environment in which they reside, (b) participation in high-risk activities, excluding EGMs, increased while for other activities they decreased, (c) EGMs continue to pose the greatest risk for Victorians, (d) males and young adults continue having a higher problem gambling prevalence rate and preferring both online gambling and high-risk activities (excluding racing favoured by an ageing, older cohort, and Keno, by all ages), and (e) gambling access and exposure proliferated enabling single site multiple gambling opportunities on high-risk activities. Young adults represented a new vulnerable group as they reach the legal gambling age. The most effective interventions (based on major falls in real expenditure (losses) on EGMs, the highest risk activity) were the smoking bans, removal of ATMs from venues and decreases in bet size. There is great potential for prevention, intervention, and minimising harm in the gambling environment.

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

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

The prevalence of gambling and problematic gambling: a systematic review and meta-analysis

BACKGROUND

Gambling behaviours have become of increased public health interest, but data on prevalence remain scarce. In this study, we aimed to estimate for adults and adolescents the prevalence of any gambling activity, the prevalence of engaging in specific gambling activities, the prevalence of any risk gambling and problematic gambling, and the prevalence of any risk and problematic gambling by gambling activity.

METHODS

We performed a systematic review and meta-analysis. We systematically searched for peer-reviewed literature (on MEDLINE, Embase, and PsycInfo) and grey literature to identify papers published between Jan 1, 2010, and March 4, 2024. We searched for any gambling, including engagement with individual gambling activities, and problematic gambling data among adults and adolescents. We included papers that reported the prevalence or proportion of a gambling outcome of interest. We excluded papers of non-original data or based on a biased sample. Data were extracted into a bespoke Microsoft Access database, with the Joanna Briggs Institute Critical Appraisal Tool used to identify the risk of bias for each sample. Representative population survey estimates were firstly meta-analysed into country-level prevalence estimates, using metaprop, of any gambling, any risk gambling, problematic gambling, and by gambling activity. Secondly, population-weighted regional-level and global estimates were generated for any gambling, any risk gambling, problematic gambling, and specific gambling activity. This review is registered on PROSPERO (CRD42021251835).

FINDINGS

We screened 3692 reports, with 380 representative unique samples, in 68 countries and territories. Overall, the included samples consisted of slightly more men or male individuals, with a mean age of 29·72 years, and most samples identified were from high-income countries. Of these samples, 366 were included in the meta-analysis. Globally, 46·2% (95% CI 41·7-50·8) of adults and 17·9% (14·8-21·2) of adolescents had gambled in the past 12 months. Rates of gambling were higher among men (49·1%; 45·5-52·6) than women (37·4%; 32·0-42·5). Among adults, 8·7% (6·6-11·3) were classified as engaging in any risk gambling, and 1·41% (1·06-1·84) were engaging in problematic gambling. Among adults, rates of problematic gambling were greatest among online casino or slots gambling (15·8%; 10·7-21·6). There were few data reported on any risk and problematic gambling among adolescent samples.

INTERPRETATION

Existing evidence suggests that gambling is prevalent globally, that a substantial proportion of the population engage in problematic gambling, and that rates of problematic gambling are greatest among those gambling on online formats. Given the growth of the online gambling industry and the association between gambling and a range of public health harms, governments need to give greater attention to the strict regulation and monitoring of gambling globally.

FUNDING

Australian National Health and Medical Research Council.

Individual risk factors and prediction of gambling disorder in online sports bettors - the longitudinal RIGAB study

Introduction

While research in online sports betting is dominated by studies using objective player tracking data from providers to identify risky gambling behavior, basicresearch has identified various putative individual risk factors assumed to underlie the development of gambling disorder across all types of gambling. This study aims to examine individual risk factors and their longitudinal clinical relevance in online sports bettors.

Methods

German online sports bettors (N = 607, Mage = 34, 92% male) from a provider based sample took part in an online survey. The study team randomly preselected customers to be invited. N = 325 (53,45%) of the participants also took part in an online follow-up survey one year later. Crosssectional and longitudinal associations of putative risk factors and DSM-5 gambling disorder in online sports bettors were analyzed. These risk factors include alcohol and tobacco use, impulsivity, difficulties in emotion identification, emotion regulation strategies, comorbid mental disorders and stress.

Results

We found more pronounced impulsivity, difficulties in emotion identification, emotion suppression, comorbid mental disorders and stress were cross-sectionally associated with gambling disorder, and longitudinally predicted gambling disorder in online sports bettors (with the exception of emotion suppression). In an overall model only lack of premeditation and perceived helplessness remained significant as predictors for gambling disorder. Online sports bettors with gambling disorder predominantly showed more pronounced risk factors, which were also confirmed longitudinally as relevant for the maintenance of gambling disorder.

Discussion

Risk factors such as impulsivity and stress and appropriate coping mechanisms should consequently be integrated not only into prevention efforts to identify individuals at risk early, but also into intervention efforts to tailor treatment.

The Efficacy of Voluntary Self-Exclusions in Reducing Gambling Among a Real-World Sample of British Online Casino Players

Online gambling is a socially acceptable means of entertainment, but it can also have a negative impact on many areas of life and lead to problem gambling for a minority of individuals. In recent years, gambling operators have increasingly implemented responsible gambling tools to help at-risk gamblers control and limit their gambling. One such tool is voluntary self-exclusion (VSE), where gamblers can exclude themselves from the gambling platform for a self-selected period of time. Despite the widespread use of VSE, there are few published studies on the efficacy of VSE among online gamblers and none on whether (and what type of) gamblers return to gambling after self-exclusion and how VSE affects their wagering if they return. Using a secondary dataset, the present study empirically analyzed a real-world sample of 3,203 British online casino players who opted for a VSE between January 2021 and August 2022. Analysis showed that most players who took a short-term VSE (up to 38 days) started gambling again on the platform after their self-exclusion ended, while players who opted for long-term self-exclusion (more than 90 days) did not start gambling again on the platform. A return to the gambling platform after VSE was positively associated with (i) a shorter duration of the self-exclusion, (ii) being female, (iii) gambling on more days, (iv) placing more bets, (v) playing fewer type of games, and (vi) having a lower average number of deposits per day. Players who returned from VSE did not change their wagering compared to a matched control group. These results suggest that short-term VSE may not be as effective as long-term VSE in reducing gambling. Overall, the present findings suggest that gamblers returning from VSE should be closely monitored, especially if the reason for self-exclusion is related to problem gambling.

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.

Problematic online behaviors and psychopathology in Australia

This study aimed to ascertain frequency rates and predictors of six problematic online behaviors (POBs) in an Australian sample. Participants (N = 1626) completed instruments measuring problematic online gaming, cyberchondria, problematic cybersex, problematic online shopping, problematic use of social networking sites, problematic online gambling, anxiety, depression and attention deficit/hyperactivity disorder (ADHD). Each POB was presumed to be present based on the cut-off score on the corresponding instrument and at least one indicator of interference with functioning. Generalized linear model analyses were used to determine socio-demographic and psychopathological predictors of each POB. The most common POB was problematic online shopping (12.2%), followed by problematic online gambling (11.4%), problematic use of social networking sites (6.0%), problematic cybersex (5.3%), problematic online gaming (5.2%) and cyberchondria (4.6%). Age group 27-36 had the highest rates of POBs. The intensity of ADHD symptoms predicted all POBs, whereas younger age predicted all POBs except for problematic cybersex and online gambling. Female gender predicted lower scores on the measures of problematic online gaming and cybersex. These findings have implications for age- and gender-adapted education, prevention and treatment efforts and suggest that specific POBs should be investigated separately instead of lumping them together under the umbrella terms such as "Internet addiction".

Clinical Differences of mild, Moderate, and Severe Gambling Disorder in a Sample of Treatment Seeking Pathological Gamblers in Sweden

INTRODUCTION

Gambling disorder (GD) is classified among the addictive disorders in the DSM-5 and the severity of the diagnosis can be specified as mild, moderate and severe. It has been seen that individuals with more severe gambling problems have a higher rate of comorbid disorders and other health problems compared to individuals with a milder clinical picture.

AIMS

The aim of this study was to explore clinical psychiatric differences related to the severity of disorder in treatment-seeking patients with GD.

METHOD

A sample of 163 patients with GD seeking treatment at an outpatient clinic was diagnosed using the SCI-GD, screened for comorbid diagnoses using the MINI, and further completed a range of self-report questionnaires measuring alcohol-, and drug-problems, symptoms of depression and anxiety, emotion regulation, cognitive distortions, and quality of life.

RESULTS

Greater severity was associated to more problems with alcohol and illicit drugs. Severe gamblers were more likely to gamble to "escape", and had more symptoms of depression and anxiety. Participants with moderate and severe gambling disorder had more difficulties with emotion regulation. Cognitive distortions were the same between severities. All groups had Quality-of-Life problems at a clinical level.

DISCUSSION

There are some distinctive differences between GD of different severities. The features shown by patients with severe GD indicates a more emotionally vulnerable group with increased symptom severity. Further knowledge about the features of GD severity levels is important for treatment planning in the clinic.

Gambling harm prevention and harm reduction in online environments: a call for action

BACKGROUND

Gambling is increasingly offered and consumed in online and mobile environments. The digitalisation of the gambling industry poses new challenges on harm prevention and harm reduction. The digital environment differs from traditional, land-based gambling environments. It increases many risk-factors in gambling, including availability, ease-of-access, but also game characteristics such as speed and intensity. Furthermore, data collected on those gambling in digital environments makes gambling offer increasingly personalised and targeted.

MAIN RESULTS

This paper discusses how harm prevention and harm reduction efforts need to address gambling in online environments. We review existing literature on universal, selective, and indicated harm reduction and harm prevention efforts for online gambling and discuss ways forward. The discussion shows that there are several avenues forward for online gambling harm prevention and reduction at each of the universal, selective, and indicated levels. No measure is likely to be sufficient on its own and multi-modal as well as multi-level interventions are needed. Harm prevention and harm reduction measures online also differ from traditional land-based efforts. Online gambling providers utilise a variety of strategies to enable, market, and personalise their products using data and the wider online ecosystem.

CONCLUSION

We argue that these same tools and channels should also be used for preventive work to better prevent and reduce the public health harms caused by online gambling.

Qualitative Experience of Self-Exclusion Programs: A Scoping Review

Gambling disorder is a major public health issue in many countries. It has been defined as a persistent, recurrent pattern of gambling and is associated with substantial distress or impairment, lower quality of life, and living with a plurality of psychiatric problems. Many people suffering from gambling disorder seek help in ways other than formal treatment seeking, including self-management strategies. One example of responsible gambling tools that has gained popularity in recent years is self-exclusion programs. Self-exclusion entails individuals barring themselves from a gambling venue or a virtual platform. The aim of this scoping review is to summarize the literature on this topic and to explore participants' perceptions and experiences with self-exclusion. An electronic literature search was conducted on 16th May 2022 in the following databases: Academic Search Complete, CINAHL Plus with Full Text, Education Source, ERIC, MEDLINE with Full Text, APA PsycArticles, Psychology and Behavioral Sciences Collection, APA PsychInfo, Social Work Abstracts, and SocINDEX. The search yielded a total of 236 articles, of which 109 remained after duplicates were removed. After full-text reading, six articles were included in this review. The available literature shows that although there are many barriers and limitations to the current self-exclusion programs, self-exclusion is generally viewed as an effective responsible gambling strategy. There is a clear need to improve the current programs by increasing awareness, publicity, availability, staff training, off-site venue exclusion, and technology-assisted monitoring, as well as by adopting more holistic management approaches to gambling disorders in general.

The Mediating Roles of Self-compassion and Emotion Regulation in the Relationship among Alexithymia, Gambling Frequency, Risky Decision-Making, and Gambling Severity in Online Gamblers

BACKGROUND

The research literature about the relationship between alexithymia, risky decision-making, and gambling severity has been contradictory and limited. Besides, there is no study on the mediating roles of self-compassion and emotion regulation in online gambling. Moreover, the role of these mediators in gambling frequency has not been studied. Thus, the present study aimed to investigate the relationship between alexithymia, risky decision-making, and gambling frequency by considering the mediating role of self-compassion and emotion regulation in online gamblers.

METHODS

A total of 319 Iranians who gambled online at least once a week in the past three months were investigated using an online survey including Farsi Toronto Alexithymia Scale-20 (FTAS-20), Difficulties in Emotion Regulation Scale (DERS), and Gambling Disorder Screening Questionnaire-Persian (GDSQ-P). Statistical analyses were conducted by SPSS 26.0 for Windows. The relationships between the variables were analyzed using correlation analysis. In cases where significant relationships were observed, the hypotheses of the regression model were tested.

FINDINGS

The mean age of the participants was 24.6±6.06 and 253 participants (73.9%) were male. Furthermore, no significant differences were observed between men and women in terms of risky decision-making (P=0.051), gambling severity (P=0.59), and age (P=0.293).

CONCLUSION

Alexithymia had both a direct and indirect relationship with gambling severity through the mediating roles of emotion regulation and self-compassion. Moreover, alexithymia was significantly associated with risky decision-making and gambling frequency, through the mediating role of difficulties in emotion regulation, both directly and indirectly.

The relationship between structural characteristics and gambling behaviour: An online gambling player tracking study

Structural characteristics of games have been regarded as important aspects in the possible development of problematic gambling. The most important factors along with individual susceptibility and risk factors of the individual gambler are the structural characteristics such as the speed and frequency of the game (and more specifically event frequency, bet frequency, event duration, and payout interval). To date, the association between structural characteristics and behavior has not been studied in an online gambling environment. The present study investigated the association between structural characteristics and online gambling behavior in an ecologically valid setting using data from actual gamblers. The authors were given access to data from a large European online gambling operator with players from Germany, Austria, UK, Poland, and Slovenia. The sample comprised 763,490 sessions between November 27, 2020 and April 15, 2021 utilizing data from 43,731 players. A machine learning tree-based algorithm with structural characteristics and session metrics explained 26% of the variance of the number of games played in a session. The results also showed that only 7.7% of the variance in the number of bets placed in a session was explained by the game's structural characteristics alone. The most important structural characteristic with respect to the number of games played in a session was the event frequency of the game followed by the maximum amount won on a single bet in a session.

Testing the spectrum hypothesis of problematic online behaviors: A network analysis approach

The validity of the constructs of problematic Internet or smartphone use and Internet or smartphone addiction has been extensively debated. The spectrum hypothesis posits that problematic online behaviors (POBs) may be conceptualized within a spectrum of related yet distinct entities. To date, the hypothesis has received preliminary support, and further robust empirical studies are still needed. The present study tested the spectrum hypothesis of POBs in an Australian community sample (n = 1,617) using a network analysis approach. Psychometrically validated self-report instruments were used to assess six types of POBs: problematic online gaming, cyberchondria, problematic cybersex, problematic online shopping, problematic use of social networking sites, and problematic online gambling. A tetrachoric correlation matrix was computed to explore relationships between online activities and a network analysis was used to analyze relationships between POBs. Correlations between online activities were positive and significant, but of small magnitude (0.051 ≤ r ≤ 0.236). The community detection analysis identified six distinct communities, corresponding to each POB, with strong relationships between items within each POB and weaker relationships between POBs. These findings provide further empirical support for the spectrum hypothesis, suggesting that POBs occur as distinct entities and with little overlap.

Clinical differences between men and women in a Swedish treatment-seeking population with gambling disorder

INTRODUCTION

The purpose of this study was to explore clinical differences in Swedish treatment-seeking men and women with gambling disorder (GD). As the prevalence of GD is increasing among women, even though men are still highly overrepresented, the characteristic differences between men and women seeking treatment become increasingly important.

METHOD

A sample of 204 patients with GD (26.5% women and 73.5% men) at an outpatient clinic were diagnosed using the SCI-GD, screened for comorbid diagnoses using the MINI, and further completed a range of self-report questionnaires measuring demographics, GD, alcohol and other drug problems, symptoms of depression and anxiety, and pathways into gambling problems.

RESULTS

Several characteristics differed between treatment-seeking men and women in our sample. Examples of differences between genders included age, onset age, living situation, duration, alcohol and drug problems, comorbidity, and pathways leading to gambling problems.

DISCUSSION

The most evident difference was that women, in addition to GD, showed more symptoms of anxiety and depression than men, while men had a higher degree of substance use problems compared to women. The differences in clinical features between men and women are important to consider in treatment planning and possibly for future gender-based interventions.

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

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

Efficacy of an internet-based psychological intervention for problem gambling and gambling disorder: Study protocol for a randomized controlled trial

Gambling Disorder is a prevalent non-substance use disorder, which contrasts with the low number of people requesting treatment. Information and Communication Technologies (ICT) could help to enhance the dissemination of evidence-based treatments and considerably reduce the costs. The current study seeks to assess the efficacy of an online psychological intervention for people suffering from gambling problems in Spain. The proposed study will be a two-arm, parallel-group, randomized controlled trial. A total of 134 participants (problem and pathological gamblers) will be randomly allocated to a waiting list control group (N = 67) or an intervention group (N = 67). The intervention program includes 8 modules, and it is based on motivational interviewing, cognitive-behavioral therapy (CBT), and extensions and innovations of CBT. It includes several complementary tools that are present throughout the entire intervention. Therapeutic support will be provided once a week through a phone call with a maximum length of 10 min. The primary outcome measure will be gambling severity and gambling-related cognitions, and secondary outcome measures will be readiness to change, and gambling self-efficacy. Other variables that will be considered are depression and anxiety symptoms, positive and negative affect, difficulties in emotion regulation strategies, impulsivity, and quality of life. Individuals will be assessed at baseline, post-treatment, and 3-, 6-, and 12-month follow-ups. During the treatment, participants will also respond to a daily Ecological Momentary Intervention (EMI) in order to evaluate urges to gamble, self-efficacy to cope with gambling urges, gambling urge frequency, and whether gambling behaviour occurs. The EMI includes immediate automatic feedback depending on the participant's responses. Treatment acceptance and satisfaction will also be assessed. The data will be analysed both per protocol and by Intention-to-treat. As far as we know, this is the first randomized controlled trial of an online psychological intervention for gambling disorder in Spain. It will expand our knowledge about treatments delivered via the Internet and contribute to improving treatment dissemination, reaching people suffering from this problem who otherwise would not receive help.

TRIAL REGISTRATION

Clinicaltrials.gov as NCT04074681. Registered 22 July 2019.

Online betting intensity is linked with Extraversion and Conscientiousness

INTRODUCTION

Extraversion and Conscientiousness are well-studied personality traits associated with reward processing and goal prioritization, respectively, and bear on individual differences in financial risk-taking. Using unique large datasets, we investigated the link between these traits and male online gamblers' actual betting participation and intensity.

METHOD

We combined datasets containing online horse betting data (during 2015-2016) from the Finnish monopoly betting company, administrative registry data from Statistics Finland, and personality trait measures from the Finnish Defence Forces corresponding to Extraversion and Conscientiousness as defined in the five-factor model. We modelled associations between these traits and betting participation (n = 471,968) and intensity (n = 11,217) among male horse bettors (age = 36-53).

RESULTS

Controlling for demographics and IQ, individuals scoring high on Conscientiousness (or Extraversion) were less (or more) likely to bet and less (or more) intensive bettors-even when personality was measured 16-34 years before betting occurred. One SD personality score increase represented an annual decrease (Conscientiousness) or increase (Extraversion) of €570-754 in spending.

CONCLUSIONS

Extraversion and Conscientiousness are implicated in real-life financial behavior with tangible consequences for individuals. These effects are stronger than for many known demographic variables used in gambling studies and persist up to 34 years after personality has been measured.