Pathological Gambling Treatment - Review

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.

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.

Brief Virtual Workshop on Gambling Disorder to Raise Knowledge and Awareness Among Health Service Providers

Gambling disorder is a "hidden disease" due to the lack of visible markers. It often negatively affects multiple domains of a person's life and predicts adverse physical, mental, social, and financial outcomes. Health service settings are suited for early detection of gambling disorder because of its comorbid medical conditions and due to the trust patients have in their health service providers (HSPs). However, HSPs often lack the knowledge needed to screen for this disorder and to make appropriate referrals. This paper reports a quasi-experimental wait-list control study (experimental group n = 18; wait-list control group n = 14), with cross-over and a twelve-week follow-up which assessed whether a brief virtual gambling disorder training entitled Gambling Know More could improve gambling disorder knowledge among HSPs. Results showed workshop participation caused a significant increase in gambling disorder knowledge immediately after the workshop and twelve weeks later. Participation in Gambling Know More bodes well for increasing early detection of gambling disorder and appropriate treatment referrals among HSPs. Findings have important policy implications for the training of HSPs.

Treatment of gambling disorder: review of evidence-based aspects for best practice

PURPOSE OF REVIEW

Despite a significant body of literature related to the treatment of gambling disorder, there are still an insufficient number of evaluation studies regarding their effectiveness or firm conclusions on specific treatment elements that contribute to it. The aim of this article was to provide a review of scientific results regarding the treatment of gambling disorder, to present the most commonly applied modalities of treatment and to explore the elements of the most successful therapeutic interventions.

RECENT FINDINGS

A substantial body of literature has shown that the most successful therapeutic protocols are psychological interventions, especially based on cognitive-behavioral therapy/methods and/or motivational interviewing. Other interventions with promising results include different self-help interventions and mindfulness. Interventions such as couples therapy and support groups, may have positive effects in terms of increasing therapeutic adherence and retention, while pharmacotherapy is especially useful in patients with comorbidities.

SUMMARY

Gambling disorder is a complex mental health problem caused by a wide spectrum of different biological, psychological, and social risk factors. Treatment options for gambling disorder need to be wide, flexible, accessible, and economically justified, providing early inclusion, retention, and sustainability of long-term effects of the treatment, that is, abstinence and higher quality of psychosocial functioning.

Exploring online problem gamblers' motivation to change

Background

In order to improve interventions for problem gambling, there is a need for studies that can highlight psychological factors that support the desire to reduce gambling.

Objective

To explore online problem gamblers' motivation for change by studying participants' reactions to an online treatment referral website designed to motivate at-risk gamblers to seek help.

Design

A qualitative evaluation study, combining focus groups and in-depth interviews. Data were analyzed using the general inductive approach.

Informants

The informants included 19 male, treatment- and non-treatment seeking, online gamblers who played a variety of games, including poker, sports betting and online casino.

Results

Motivation to change emerged as two processes including (a) empathy with others, which included projection of their thoughts and feelings onto others, and (b) dissonance between gambling behavior and ideal self-image. Dissonance included two subthemes: (i) dissonance due to positive feelings towards sports and athletics, and (ii) dissonance due to gambling among family.

Conclusions

The findings have implications for interventions designed to evoke motivation early in treatment of online problem gambling. Inducing problem gamblers to reflect on the thoughts and feelings of concerned significant others, real or fictional, could be a viable strategy to motivate online problem gamblers to consider change.

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We identified three sources of motivation for changing gambling behavior:

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Empathy with concerned significant others, real or fictional

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Cognitive dissonance due to positive feelings towards sports and athletics

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Cognitive dissonance due to gambling among family members

Problem Gambling among Young People in Sub-Saharan Africa

Gambling is a cross-cultural and global activity which typically involves the wagering of money or an item of monetary value on an outcome that is governed by chance. Although gambling is positioned as a legitimate recreational and leisure activity within sub-Saharan Africa (SSA), there is widespread recognition among healthcare professionals and policy-makers that gambling has the capacity to become dysfunctional in a minority. Emerging knowledge suggests that problem gambling is rapidly evolving in to a public health concern in SSA, especially among youth. This article focuses on problem gambling among young people in SSA with an emphasis on three key themes: (1) gambling behavior and patterns in SSA; (2) public health and socioeconomic implications of gambling in SSA; and (3) public health policies and interventions for addressing this issue. We believe that collaborative efforts between government, prevention specialists, legislators, researchers, treatment providers, and other stake holders can influence the uptake of research findings necessary to implement social policies and design effective public health intervention options to combat problem gambling and its associated implications among young people in SSA.