Cross-national comparisons of the prevalence of gambling, problem gambling in young people and the role of accessibility in higher risk gambling: A study of Australia, Canada, Croatia and Israel

Psychometric properties of the Reward Deficiency Syndrome Questionnaire among a non-clinical sample and its relationship with the characteristics of potentially addictive behaviors

Background and aims

The addiction literature conceptualizes problematic substance use and addictive behaviors (e.g., gambling disorder, gaming disorder) as having shared etiologies and phenomenologies. The reward deficiency syndrome (RDS) model proposes blunted responses to natural rewards that potentially contribute to the development of addictive behaviors. The 29-item Reward Deficiency Syndrome Questionnaire (RDSQ-29) was developed to assess RDS-related psychological-behavioral characteristics. The aim of the present study was to validate the Hebrew version of the RDSQ-29 and to provide empirical evidence for the relevance of RDS in addictive behaviors and related psychological features.

Methods

The sample comprised 961 Jewish Israeli young adults from the general community (age 19-27 years; M = 23.40 years [SD = 1.95]) who were assessed for personality characteristics (attachment styles, RDS, compulsive personality), internet gaming disorder (IGD), problematic use of social media use (PUSM), compulsive buying-shopping disorder (CBSD), and gambling disorder (GD).

Results

The analysis confirmed the validity and factor structure of the RDSQ-29. RDSQ-29 scores showed a significant but weak association with anxiety, avoidance, and compulsive personality. Also, weak to modest relationships were found between RDSQ-29 scores and the severity of the four potential behavioral addictions.

Discussion

The findings suggest that the Hebrew translation of the RDSQ-29 is a psychometrically sound instrument to assess RDS. Given that different potentially addictive and other problematic behaviors are associated with RDS, its assessment might be useful in prevention or screening.

Short-term effectiveness of gambling treatment in the Daily Clinic for Gambling Addiction

In response to the high prevalence of gambling addiction within the population, a specialised Daily Clinic for Gambling Addiction was established at the University Psychiatric Hospital "St. John" in Zagreb (Croatia). This clinic offers a unique three-month, semi-structured, intensive multidimensional and multidisciplinary treatment approach delivered by a team of specialised mental health professionals. Treatment interventions include individual and group psychotherapy, socioemotional skills training, family therapy, support groups and other modalities. In collaboration with researchers from the University of Zagreb Faculty of Education and Rehabilitation Sciences, the study team is conducting a scientific evaluation to determine the outcomes of the treatment. This study presents results on its' short-term effectiveness, based on a sample of N = 209 patients (Mean Age = 33.54; Males = 92.8%; Females = 7.2%) who underwent treatment between 2017 and 2021. To assess the effectiveness of the treatment, a research design incorporating two measurement sessions (pre-test and post-test) was employed. This design utilised a comprehensive battery of validated instruments, each targeting specific constructs or domains of psychosocial functioning that the intervention aims to address. The assessment tools included: (1) Problem Gambling Severity Index-PGSI, (2) Gambling Attitudes Scale-GAS, (3) Coping Inventory for Stressful Situations-CISS, (4) The Gambling Beliefs Scale-short version, (5) Problem Solving and Refusal Skills Scale, (6) Depression, Anxiety, Stress Scale-DASS-21, (7) Generalised Self-Efficacy Scale-GSE, and (8) Multidimensional Scale of Perceived Social Support. The results indicate significant positive improvements in gamblers' psychosocial functioning with the following large effect sizes: gambling-related consequences (r = 0.84), task oriented coping (Cohen's d = 0.79), emotion oriented coping (Cohen's d = 1.06), attitudes (r = 0.67), superstition (r = 0.61), illusion of control (r = 0.62), depression (r = 0.78), anxiety (r = 0.71), stress (r = 0.73), problem-solving skills (r = 0.73) and general self-efficacy (r = 0.61). The effects on refusal skills (Cohen's d = 0.48) as well as on alcohol (Cohen's d = 0.24) and marihuana (r = 0.26) were small to medium. Findings are discussed in terms of appropriate treatment approaches for gambling addiction, methodological challenges in measuring effects and implications for future evaluation research. In general, this treatment protocol provides promising effects for gambling addiction.

Problematic gambling in municipal social work in Tampere, Finland: Social workers' perceptions of service pathways before the casino opening and the health and social services reform

Aims: Gambling can lead to a variety of economic and social harms, many of which are of central concern to social work. However, the "invisibility" of gambling-related harms can impede professional assistance by delaying recognition in social and healthcare services. The present study illuminates how problematic aspects of gambling surface in social work encounters within municipal social services, and how municipal social workers of the City of Tampere, Finland, perceive the available service pathways for problem gambling help provision before the opening of a casino in the city in 2021 and before the health and social services reform of 2023. Methods: We conducted five focus group interviews with 15 social workers employed by the City of Tampere Social Services, utilizing the Reception Analytical Group Interview (RAGI) method. The data were analyzed thematically using ATLAS.ti. Results: Gambling-related harm is entangled with multiple other issues, often inadvertently revealed in daily social work encounters. Lack of time to adequately address clients' gambling issues and the absence of suitable services in the municipality were perceived as major structural obstacles to adequate help provision. The study participants recognized gambling-related shame, stigma and misconceptions as barriers to clients' help-seeking. However, they did not view the opening of the casino as likely to increase harms locally. Conclusions: The study highlights the importance of diverse approaches in providing appropriate services for individuals facing gambling-related harm. Furthermore, it underscores the necessity of addressing gambling issues in daily social work encounters and ensuring diverse, accessible service provision.

Perceived Riskiness and Problem Gambling Across Different Forms of Gambling: A Focus on 'Soft' Gambling

Gambling encompasses a wide variety of activities, and the structural characteristics of each form contribute to its potential risk. However, the literature does not fully agree on the risk levels of certain gambling forms. In this study, we classify less risky gambling forms (soft forms) based on public perceptions of their riskiness. We examine the link between gambling experience and problem gambling prevalence. A survey was conducted in a model region of the Czech Republic, a post-socialist country with high gambling availability, with N = 2,498 respondents. A typology of gambling forms (lotteries, betting, and casino games) was created based on perceived risk similarities. Lotteries are the most frequently played gambling form, with 86.3% reporting lifetime participation. Among those who exclusively engage in lottery-type forms, 15 percentage points more women than men participated in the last year, and the gap widens to 31 points over a lifetime. Forms of gambling perceived as more risky show a lower proportion of non-problem gamblers, both for recent and lifetime participation. Furthermore, individuals who gambled within the past month or year are at higher risk of developing gambling problems compared to those whose gambling experiences were less recent.

The cards they're dealt: types of gambling activity, online gambling, and risk of problem gambling in European adolescents

OBJECTIVE

This study aims to identify risk factors associated with gambling engagement and the likelihood of problem behavior, distinguishing by type of gambling activity and examining the impact of online gambling.

METHODS

Data about 85,420 students aged 16 from 33 countries participating in the 2019 European School Survey Project on Alcohol and Other Drugs (ESPAD) were analyzed through a three-stage sequential probit model, specifically focusing on four types of activity: lotteries, slot machines, cards, and betting. Furthermore, predicted probabilities were calculated for subsamples of students engaging in different types of gambling activities to explore their influence on the likelihood of problem gambling behavior, conditioned on online gambling involvement.

RESULTS

Certain groups, such as males and those with a history of school difficulties, exhibit a higher likelihood of problematic gambling behavior. Online gaming significantly influences adolescent gambling behavior, with slot machines demonstrating the highest predicted probabilities of risky behavior when combined with online gaming.

POLICY IMPLICATIONS

The findings highlight that gambling is quite common among adolescents, and that gamblers and problem gamblers display different profiles, suggesting the importance of targeted interventions and support for vulnerable individuals. Public policies should prioritize the regulation of high-risk gambling activities, particularly slot machines, by enhancing the enforcement of age restrictions and the education on the real odds of winning and potential harms of gambling, particularly among adolescents. It is crucial to foster policies and interventions that address the risks associated with online gambling for this age group.

Severity of gambling behaviors: exploring associations with venues, legality, and substance use

INTRODUCTION

The COVID-19 pandemic has been linked to an increase in gambling behaviors, potentially leading to Gambling Disorder (GD) and adverse health and social consequences. Problematic gambling has received little research attention over the years in Israeli society and the issue of gambling is not high on the list of priorities of Israeli policymakers. The present study examined gambling behavior in Israel on a continuum of severity and its association with venues where the gambling occurs, legality, attitude toward the legalization of casinos and poker, and substance use.

METHODS

The study questionnaires were distributed to approximately 15,000 Jewish-Israeli adults via internet panel. From 3,088 Israeli adults who answered the questionnaire, 1,251 (40.5%) reported gambling in the last year and were included in the analyses.

RESULTS

Based on the Problem Gambling Severity Index, 60% of participants were classified as non-problem gamblers, 25% as at low-risk for a gambling problem, 11% as at moderate risk, and 4% as having a gambling problem. Most online gambling was practiced by non-problem gamblers (40%) and most illegal gambling was by low-risk gamblers (34%). The more severe the gambling behavior was on the continuum, the more it was associated with illegal substance use and positive attitudes toward legalized casinos in Israel. Logistic regression showed the odds of developing moderate and problem gambling were 3.8 times higher for online gamblers (OR = 3.8; CI 2.6-5.4; p < 0.000) and 3.3 times higher for illegal gamblers (OR = 3.3; CI 2.2-4.9; p < 0.000).

CONCLUSION

Though more research attention should be paid to gambling behaviors, harm reduction gambling interventions should be made available to all categories on the continuum of severity of gambling behaviors. The present study provides evidence-based information to promote health policies that aim to prevent and reduce harm for Israeli gamblers.

Impulsivity Moderates the Association Between Anxiety and Problem Gambling Among Canadian Undergraduates

Tension reduction theory suggests anxious people gamble to cope with negative affect. Literature demonstrates mixed associations between anxiety and gambling behaviours, hence, the important of examining moderators. This study examined how impulsivity moderated anxiety and problem gambling as well as gambling to cope. Given key gender differences, moderation was examined across genders. A sample of 484 undergraduate students who endorsed gambling behaviours completed anxiety, impulsivity, and problem gambling measures. Results showed men with higher levels of anxiety scored higher on problem gambling at both high (B = 0.706, SE = 0.073, p < 0.0001, f2 = 0.20) and low (B = 0.262, SE = 0.103, p = 0.01, f2 = 0.01) impulsivity, though the effect sizes were much larger for men with high impulsivity. This moderation effect was not found in women (B = 0.000, SE = 0.009, p = 0.959). Results showed men with higher levels of anxiety scored higher on coping motives for gambling at both high (B = 0.253, SE = 0.046, p < 0.0001, f2 = 0.06) and low B = 0.141, SE = 0.063, p = 0.026, f2 = 0.01) impulsivity, though the effect sizes were larger for men with high impulsivity. Again, this moderation effect was not found in women (B = - 0.101, SE = 0.006, p = 0.100). Findings from this may help inform impulsivity-focused interventions, such as strengthening impulse control and instilling more adaptive coping strategies to lower gambling risk among university men.

Neural cue-reactivity in pathological gambling as evidence for behavioral addiction: a systematic review

Increasing incidence of problem gambling has led to prioritizing the problem from the point of view of public health. Additionally, gambling disorder has been recently classified as a behavioral addiction, with implications for both its diagnosis and treatment. However, the shared neural substrate of addictions, to substances and behavioral, is still discussed. Thus, this systematic review aims to provide up-to-date knowledge from the past five years (2017-2022) concerning the neural correlates of gambling related stimuli (cue-reactivity) on the basis of a previous review (Brevers et al., Cognitive, Affective and Behavioral Neuroscience 18:718-729, 2019). A total of five studies were included in the review. Activation of brain areas related to memory, reward and executive functions could be the underlying mechanism of this behavioral addiction. Specifically, nucleus accumbens and striatum (ventral and dorsal), parahippocampal regions, the right amygdala and several prefrontal cortex regions have systematically been found more active in those subjects exposed to gambling-related cues. Also, the insula could play a pivotal role connecting these three systems in a highly integrated neural network with several implications for reward processing modulation, associative learning and top-down attentional regulation to improve saliency of addiction-related cues. These results are consistent with previous findings on other substance addictions, such as alcohol, tobacco, marijuana or cocaine. The study of neural reactivity to stimuli related to addiction could be useful as a biomarker of the severity of the disorder, the efficacy of the treatment, the risk of relapse, in addition to being an objective criterion to measure the effectiveness of prevention campaigns.

Research on Gambling in Young People: A Co-Occurrence Analysis

Gambling as a risk factor in youth development, particularly its causes and consequences, has been the subject of a growing number of studies. However, the literature relating to young people has yet to be compiled in a systematic form. The present study adopts a descriptive bibliometric approach to map global research on gambling in young people using metadata from the Web of Science database. The results show that research on gambling in young people at a country level has increased in recent years, though some regions are underrepresented. Co-occurrence analysis revealed the frequent use of several terms. It is hoped that these findings will assist in future research on the subject.

Perceived Gambling Availability and Adolescent Gambling Behavior: the Moderating Role of Self-Efficacy

Geographic accessibility has been linked to gambling behavior, but little is known about whether the perception of gambling availability in both offline and online venues is prospectively associated with adolescent gambling behavior. Further, relatively few studies have analyzed the interaction between environmental and individual factors in explaining adolescent gambling and problem gambling. This prospective study examined the association between perceived gambling availability, gambling frequency, and problem gambling among 554 adolescents aged 13–17 years (mean = 15.1, female 47.4%) and explored the moderating role of self-efficacy to control gambling in these associations. Participants completed assessments of perceived gambling availability and gambling self-efficacy at baseline. Gambling frequency and problem gambling were measured at follow-up. Two separate hierarchical regression models were applied to analyze the relationship of perceived gambling availability with gambling behavior and the moderating role of gambling self-efficacy. Results showed that a greater perception of gambling availability was associated with a higher gambling frequency and more problem gambling in adolescents. The impact of perceived gambling availability on gambling frequency and problem gambling was lower among participants with moderate gambling self-efficacy in comparison with participants with low gambling self-efficacy. In those adolescents with high self-efficacy to control gambling, perceived gambling availability was not associated either with gambling frequency or problem gambling. These results suggest the usefulness of implementing regulatory policies aimed at reducing gambling availability in adolescents, and the design of preventative interventions aimed at enhancing self-efficacy to control gambling.