Country- and individual-level determinants of probable problematic gambling in adolescence: a multi-level cross-national comparison

P.A.V.I.A. Study: Pervasiveness and Associated Factors of Video Slot Machine Use in a Large Sample of Italian Adolescents

Video slot machines (VSM) are considered a particularly harmful gambling format; however, scant data is available on their use among underage Italian individuals. Two surveys were conducted in 2018 and 2022 involving 7,959 underage high school students (57.8% female) in Pavia, Northern Italy. We estimated adjusted odds ratios (aOR) and corresponding 95% confidence intervals (CI) for lifetime experience and current regular (at least monthly) use of VSM, according to family, educational and behavioral factors. Overall, participants reporting lifetime VSM experience were 13.2% (95% CI: 12.5 - 13.9), 15.2% (95% CI: 14.0-16.4%) in 2018, and 12.0% (95% CI: 11.1-13.0%) in 2022. Current regular VSM users were 1.4% (95% CI: 1.1-1.7) in total, 1.2% (95% CI: 0.8-1.6%) in 2018 and 1.5% (95% CI: 1.1-1.8%) in 2022. VSM lifetime experience and current regular use were significantly more frequent in males (aORs: 1.55 and 4.81, respectively), students who failed a year (aORs: 2.07 and 3.44), or with daily gambling parents/siblings (aORs: 2.83 and 4.86). Lifetime use of alcohol, tobacco, or illicit substances was significantly directly associated with lifetime VSM use (aORs between 2.64 and 4.75); monthly alcohol, tobacco, or illicit substances use was significantly directly associated with current regular VSM use (aORs between 4.47 and 18.21). Sexting and voluntary self-injury were significantly more frequent among VSM lifetime/current regular users. VSM use, which is directly associated with other risky behaviors, may be pervasive among Italian minors. Such public health concern calls for legislative enforcements and integrated multidisciplinary health promotion and prevention strategies.

Emotions and motivations of gambling: A comparison between scratch card, slot-machines, and casino gamblers

INTRODUCTION

In the last 20 years, gambling has become more and more widespread in Italy. The aim of the present study is to compare the motivations for gambling and the emotions felt while gambling in three different subgroups: scratch card gamblers, slot-machine gamblers, and casino gamblers.

METHODS

Three versions of a questionnaire have been distributed in a casino, in scratch card vendors, and slot-machines venues. All versions included sociodemographic variables, the two-question Lie-Bet instrument, a scale for motivations toward gambling, and a list of positive and negative emotions felt while gambling.

RESULTS

Participants (N = 425, F 47.5%) are gamblers potentially pathological (N = 162, 38.1%) and not (N = 263, 61.9%). Different games seem connected to different motivations and emotions: the scratch gamblers show less Coping and Social Motivation and experience less Negative Emotion. However, the motivation and emotion most intensely experienced by the gamblers (Enhancement and the Positive Emotions) do not show differences between the different types of games.

CONCLUSION

The pathological gamblers have a more intense and internal connection with the game (have more Enhancement and Coping motives, Positive and Negative Emotion). In sum, our findings support the theoretical hypothesis that gambling can be a tool for regulating emotions.

Risk Behaviors among Migrant Adolescents in Italy

Adolescence is a critical period for engaging in health risk behaviors. Migrant adolescents may face unique challenges due to acculturation stress. This study aims to monitor substance use and problem gambling among migrant adolescents living in Italy. Data from the 2017/18 Health Behavior in School-Aged Children survey in Italy were analyzed. The 18,794 participants included 15-year-olds, categorized as native or migrants, with ethnic backgrounds from Western, Eastern European, or non-Western/non-European countries. Girls had higher smoking rates, while boys exhibited higher prevalence of alcohol-related risk behaviors, cannabis use, and gambling. Boys from Eastern European countries displayed a greater risk of drunkenness (OR: 1.58, 95% CI: 1.06-2.37), particularly in the first generation, while those from Western countries showed a higher risk of multiple substance use (OR: 1.44, 95% CI: 1.05-1.96). Girls from Eastern European and non-Western/non-European countries had a lower risk of alcohol consumption (OR: 0.50, 95% CI: 0.29-0.85; OR: 0.55, 95% CI: 0.33-0.91, respectively). Finally, boys, especially those from Eastern European and non-Western/non-European countries, had a significantly higher risk of problem gambling (OR: 1.83, 95% CI: 1.04-3.22; OR: 2.10, 95% CI: 1.29-3.42, respectively). This disparity was more pronounced in the first generation, possibly due to acculturation challenges and socio-economic factors. Risk behaviors in adolescents are influenced by complex interplays of gender, cultural factors, and migration generation. Preventive strategies should consider these factors to effectively address substance use and gambling in this heterogeneous population.

Prevalence and Possible Predictors of Gambling Disorder in a Sample of Students in the Healthcare Professions

The Italian version of the South Oaks Gambling Screen questionnaire (SOGS) and a socio-demographic questionnaire were administered to a sample of 275 healthcare professions students aged 19 to 58 years (mean age = 22.17; females = 81.1%) to address the research objectives: to examine the prevalence and correlates of problem gambling in a population of university healthcare professions students in Italy. Among the sample, 8.7% (n = 24) of participants showed problem gambling and 1.5% (n = 4) pathologic gambling. Lottery and scratch cards were the most frequent type of gambling in the sample, followed by cards and bingo. Compared to females, males tend to be more involved in problem gambling and pathological gambling. Males tend to be more involved than females in different types of gambling (such as cards, sports bets, gambling at the casino). Pathological gambling is positively associated with gender, being students lagging behind the regular schedule of exams and parents' level of education. These findings have important implications in terms of prevention and intervention on gambling and pathological gambling. Universities should make available educational programs and counselling services to address this issue.

The intergenerational transmission of gambling and other addictive behaviors: Implications of the mediating effects of cross-addiction frequency and problems

INTRODUCTION

This study examined the degree to which perceptions of familial and household participation in gambling and other addictive behaviors in youth was associated with frequency and problem severity of gambling, alcohol and/or drug use in participants as adults.

METHOD

The study measured perceived frequency of gambling, alcohol use, drug use and other potentially addictive behaviors in family/household members and the frequency and problem severity of gambling, alcohol, and drugs in an epidemiological sample of adults 18 and older (N = 3,499; m = 48.26 %, f = 51.74 %).

RESULTS

About 23.45 % of participants reported their father gambled when they were a child or adolescent, followed by mother (13.56 %), grandfather (9.73 %), or grandmother (7.83 %). A pathway model demonstrated cross-addiction inter- and intra-generational influences. Gambling by a father, mother or brother; substance use by a sister; and/or engagement in other behaviors by a brother, sister, grandmother or other household member was related to higher frequency of participant gambling (ps < 0.05), and, in turn, to higher levels of gambling, alcohol, and drug use problem severity (ps < 0.05).

DISCUSSION

Findings demonstrate the complex contributions of specific family and household members in the transmission of addictive behaviors. Frequency of gambling, alcohol use, and drug use mediated the relationship of perceived family behavior with and across addictions. In addition, perceptions regarding use of alcohol and/or other drugs, or engagement in other behaviors by family or household members was related not only to participants' alcohol and drug use but also to problem gambling frequency and severity.

Problematic gaming risk among European adolescents: a cross-national evaluation of individual and socio-economic factors

BACKGROUND AND AIMS

Previous research has identified numerous risk and protective factors of adolescent problematic gaming (PG) at the individual and social levels; however, the influence of socio-economic indicators on PG is less known. This study aimed to measure the contribution of individual and socio-economic factors involved in PG risk among adolescents from 30 European countries.

DESIGN

Multi-level logistic regression analysis of survey data from the 2019 European School Survey Project on Alcohol and Other Drugs (ESPAD) cross-sectional study using self-administered anonymous questionnaires.

SETTING

Thirty European countries.

PARTICIPANTS

A representative cohort of 15-16-year-old students (n = 88 998 students; males = 49.2%).

MEASUREMENTS

The primary outcome measure was adolescents' (low and high) risk of PG. Individual key predictors included self-report assessments of socio-demographic characteristics, time spent gaming and family variables (parental regulation and monitoring, family support). Main country-level predictors comprised Gini coefficient for economic inequalities and benefits for families and children (% gross domestic product), retrieved from international public data sets and national thematic reports. The data analysis plan involved multi-level logistic regression.

FINDINGS

Participants who reported stronger parental regulation [odds ratio (OR) = 0.81, 95% confidence interval (CI) = 0.79-0.83] and higher family support (OR = 0.93, 95% CI = 0.91-0.95) reported lower risk of PG. At the country-level, economic inequalities (OR = 1.05, 95% CI = 1.03-1.07) were positively associated with the risk of PG, while benefits for families and children (OR = 0.78, 95% CI = 0.70-0.89) were negatively correlated with the risk of PG.

CONCLUSIONS

Supportive family environments, lower country-level economic inequalities and higher government expenditures on benefits for families and children appear to be associated with a lower risk of problematic gaming among European adolescents.

Systematic Review: Preventive Intervention to Curb the Youth Online Gambling Problem

This systematic review focuses on all the gambling addiction prevention programs carried out in schools, with the intention of making their effectiveness known and encouraging the creation of more such programs. During the third quarter of 2021, an exhaustive search was conducted using the databases of Scopus, Medline (via Pubmed), WOS, and PsycINFO. The search strategy was based on a combination of specific search terms: “Gambling Disorder [Mesh]”, “Online Gambling Disorder [Mesh]”, and “Prevention Programs [Mesh]”. A total of 15 articles were chosen for systematic review. All the programs analyzed show effective results, although there are several methodological shortcomings in the way they are conducted. Effective programs need to focus more on long-term results and the emotional aspects of gambling. We need professionals who can convey the causal nature of the problem the youth are facing.

Racial Associations Between Gambling and Suicidal Behaviors Among Black and White Adolescents and Young Adults

Purpose of Review

Suicide is the second leading cause of death among Black youth ages 10-19 years. Between 1991 and 2017, rates of suicide among Black youth have been increasing faster than rates among any other race/ethnic group. There are many factors that may explain this increase, with gambling being suggested as one such potential risk factor. This review examines the association between gambling and suicide behaviors, and how these associations may vary between Black and White youth and young adults. The current review examines these associations using data from the Missouri Family Study (MOFAM).

Recent Findings

Recent findings have revealed distinct patterns of substance use initiation and gambling behaviors between Black youth and White youth. While strong links between gambling and suicide behaviors have also been reported, whether the associations were consistent across race/ethnicity groups was not investigated, nor in these cross-sectional analyses was it possible to determine whether the gambling behaviors preceded or followed suicidality. Thus, there is a need to investigate whether there are differences in the associations of gambling and suicide behaviors at the race/ethnicity level in tandem with data that examine the sequence of the behaviors. The current report focuses on racial/ethnic differences using data that allow for sequencing the occurrence of the behaviors via the age of first gambling experience, and of first suicidal symptom, to better distinguish the nature of the association.

Summary

The current findings revealed that gambling initiation predicted suicide ideation among Black youth, while no significant association was found among White youth. This is of major public health concern, given the rising rates of suicide among Black youth, and the increased availability of gambling. The report did not find a link between gambling and suicide attempts. Culturally tailored interventions should be considered among schools, families, and clinicians/providers, to highlight the risk of adolescent gambling, particularly among Black youth.

The Importance of Family and School Protective Factors in Preventing the Risk Behaviors of Youth

The aim of this study was to examine cross-sectional associations of protective factors within a family and school context with adolescent risk behaviors. The study was conducted among adolescents (n = 9682) from five cities in Croatia. Mean age of participants was 16.2 years (SD = 1.2), and 52.5% were female. Multigroup structural equation modeling was used to examine relations between school attachment, school commitment, family communication, and family satisfaction with gambling, substance use, violence, and sexual risk behavior. Data analyses were conducted in two sets, the first using the full sample, and the second using a subsample (excluding Zagreb) for which there was data on sexual risk behavior. In the first model, school attachment was negatively associated with gambling and violence, while school commitment was negatively associated with students' gambling, substance use, and violence. Gambling was also associated with family satisfaction in this model. Results from the subsample model were similar with regards to school and family factors associated with gambling, substance use, and violence, with a few exceptions. In this model, family protective factors were found not to be significantly related with any risk behavior. These study results emphasize the importance of strengthening school protective factors, school attachment, and school commitment in preventing risk behaviors in adolescents.

Prevalence and Trends in Problem Gambling in Denmark with Special Focus on Country of Origin: Results from the Danish Health and Morbidity Surveys

Belonging to an ethnic minority has been described as a possible risk factor for problem gambling, but the literature is inconclusive whether this association is true or just a proxy for other underlying risk factors. Hence, the aims were to investigate: (1) past year prevalence of problem gambling in the adult Danish population and trends since 2005, (2) past year prevalence of problem gambling in 2017 and trends since 2010 by country of origin, and (3) whether a marginalisation by country of origin or problem gambling, respectively, is seen in various health-related indicators. Data were derived from the Danish Health and Morbidity Surveys in 2005, 2010, 2013, and 2017. The Lie/Bet Questionnaire was used to define problem gamblers. The overall prevalence of past year problem gambling has increased slightly from 2005 (1.0%) to 2017 (1.5%), but a more alarming increase was observed among men with non-western origin (3.1% in 2010 and 7.0% in 2017). A lower prevalence of good self-rated health and a higher prevalence of poor mental health was observed among individuals with a non-western origin compared to those with a Danish origin, although the differences became smaller between 2010 and 2017. The findings indicate a slightly increase in the prevalence of past year problem gambling and that particular attention should be paid to individuals with a non-western origin. The study also highlights the need for better differentiation of risk factors that may variously predispose different ethnic groups to develop gambling problems.

The negative consequences of sports betting opportunities on human capital formation: Evidence from Spain

The proliferation of on-site betting shops has received enormous public attention, becoming one of the most alarming health policy issues in contemporary cities. However, there is little evidence on whether its growing presence nearby vulnerable populations produce social harm beyond its known adverse individual effects. This study provides new evidence on the negative societal effects of betting houses. Our research design takes advantage of a new wave of openings in Madrid (Spain), which created a sudden increase in the supply of on-site gambling. Using a differences-in-differences design, we find that new betting houses decline nearby high schools' educational performance, especially in public schools in less advantaged areas. This effect is neither trivial nor diminishing with time. This evidence suggests that betting houses increase inequality of educational opportunities. The ubiquity of betting houses around vulnerable populations in multiple regions drives us to think that these findings have relevant policy implications for many countries currently designing policies tackling the increase of problem gambling.

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.

What game we are playing: the psychosocial context of problem gambling, problem gaming and poor well-being among Italian high school students

Gambling and gaming are not infrequent among adolescents and preventing low-risk youth from becoming at-risk appears to be a priority of public health strategies. Greater scrutiny of the risk and protective factors in the relationships and community of young people appears crucial in steering prevention initiatives adequately. This study aimed to explore the role of the qualities of relational networks (i.e. family functioning, perceived social and class support), family and peer approval and view of the social environment in predicting problem gambling, problem gaming and overall well-being among adolescents. High-school students aged 14-18 years (N: 595; female: 68,7%) completed a survey including the target variables. A multivariate multiple regression analysis was performed to examine the role of socio-demographic characteristics and psychosocial predictors on gaming, gambling, and well-being. Multivariate multiple regressions identify a common core underpinning problem gambling, gaming and poor well-being but also the distinct roles of psychosocial variables: being male, with low parental monitoring, and an anomic view of the social environment all predict problem gambling and gaming, which were also found to be associated. Low social support predicts problem gambling but not problem gaming; poor family functioning predicts problem gaming but not problem gambling. All the target psychosocial variables, except approval of gambling, predict poor well-being. On the whole the findings suggest the need to look more closely at the way adolescents, their system of activity and their culture participate in constructing the meaning of gambling and gaming activities and their impact on adolescents' well-being, so that future studies and strategies can more effectively examine the relational dynamics in which problem gambling and gaming develop.

How Do State Gambling Monopolies Affect Levels of Gambling Harm?

Purpose of Review

This systematic literature review evaluates the potential of gambling monopolies to affect gambling harms. It compares the occurrence of gambling harms in jurisdictions with gambling monopolies to jurisdictions with license-based regimes.

Recent Findings

The review identified 21 publications concerning three gambling-related harm indicators: problem gambling prevalence, total consumption, and the appearance of conflicts of interest. Due to the dearth of literature, concept papers and older publications were also included.

Summary

Results show that there is a paucity of empirical research on the effectiveness of different regulatory regimes in affecting gambling harms. Available research demonstrates that monopolistic regimes appear to perform somewhat better in terms of problem gambling prevalence and total consumption but may also be more prone to conflicts of interest than license-based regimes. Monopolistic configurations also differ between themselves, and issues such as availability, accessibility, product range, scope of preventive work, monitoring, as well as the recognition of the public health approach may better predict the levels of harm in society than the existence of a monopoly.

Social Ecological Model of Problem Gambling: A Cross-National Survey Study of Young People in the United States, South Korea, Spain, and Finland

Problem gambling among young people is an emerging trend globally. The online environment in particular offers various possibilities for gambling engagement. This is the first cross-national survey study using the social ecological model to analyze problem gambling, especially in the online context. The study aimed to analyze how different social ecological spheres explain problem gambling. Participants were young people aged 15–25 in the United States (n = 1212), South Korea (n = 1192), Spain (n = 1212), and Finland (n = 1200). The South Oaks Gambling Screen (SOGS) instrument measured problem gambling. The regression models analyzed problem gambling with measures of intrapersonal, interpersonal, organizational, and societal spheres. Spanish participants had the highest SOGS score for problem gambling. In all countries, the variations in problem gambling were best explained by the organizational sphere measures (26%) when compared to the intrapersonal (11%), interpersonal (5%), and societal (3%) spheres. In the full model, the organizational sphere measures had strong associations with problem gambling. These included consumer debt, online gambling community participation, online casino participation, and exposure to online pop-up advertisements. Problem gambling was also associated with conformity to group norms in the interpersonal sphere, and male gender and impulsivity in the intrapersonal sphere. Cross-national results were similar in different countries. Within the final model, gambling community participation had the strongest association with problem gambling (β = 0.23, p < 0.001). The online context plays a major role in problem gambling behavior. The social ecological model is a useful tool for tackling problem gambling and developing preventative measures.

An Analysis of Consumer Protection for Gamblers Across Different Online Gambling Operators in Ireland: A Descriptive Study

The aim of the present study was to evaluate the responsible gambling tools which are available to online gamblers at Irish online gambling websites. The present study used a similar methodology to a recent study carried out on the world’s most popular websites (Bonello and Griffiths Gaming Law Review and Economics, 21, 278–285, 2017), where 50 of the most advertised online gambling websites were evaluated in relation to their responsible gambling (RG) practices. The present study evaluated 39 gambling websites with either a “.ie” or “.com/ie” domain. Each website was evaluated by checking for a number of RG practices, including presence of a dedicated RG page; age verification; access to gambling account history; the availability of RG tools, such as limit setting facilities and exclusion settings; and links to limit-setting options on the deposit page. Descriptive statistics were then performed on the results from each website. Of the 39 online gambling operators identified, 22 redirected gamblers to a “.com” domain, while 17 operators remained as a “.ie” domain. Thirty-five websites (89.7%) visited had a dedicated RG page. Responsible gambling features were evaluated and demonstrated to be available in an inconsistent manner across online gambling websites. Irish websites were shown to perform poorly in comparison with non-Irish counterparts in the provision of RG tools. The researchers of the present study are not aware of any similar studies conducted to date in Ireland.

Gambling in Young Adults Aged 17-24 Years: A Population-Based Study

A large contemporary UK cohort study, the Avon Longitudinal Study of Parents and Children, was used to investigate gambling behavior and to explore the antecedents of regular gambling in the 17–24-year age group. Participants completed computer-administered gambling surveys in research clinics, on paper, and online. The sample sizes were 3566 at age 17 years, 3940 at 20 years, and 3841 at 24 years; only 1672 completed all three surveys. Participation in gambling in the last year was reported by 54% of 17-year-olds, rising to 68% at 20 years, and 66% at 24 years, with little overall variance. Regular (weekly) gambling showed a strong gender effect, increasing among young men from 13% at 17 years to 18% at 20 years, and 17% at 24 years. Although gambling frequency increased between the ages of 17 and 20 years, gambling behaviors showed little variance between 20 and 24 years, except online gambling and betting on horseraces. The commonest forms of gambling were playing scratchcards, playing the lottery, and private betting with friends. Gambling on activities via the internet increased markedly between 17 and 24 years, especially among males. In the fully adjusted model, individual antecedents of regular gambling were being male, and having a low IQ, an external locus of control, and high sensation seeking scores. Parental gambling behavior and maternal educational background were associated with regular gambling in both sexes. Regular gambling was associated with smoking cigarettes and frequent and harmful use of alcohol, but no associations with depression were found.

Adolescent Problem Gambling in Rural Ghana: Prevalence and Gender Differentiation

Problem gambling among young people is now a public health challenge in sub-Saharan Africa. However, the behaviour remains understudied, particularly, among rural-dwelling young people in countries within the subregion. We aimed to estimate the 12 months prevalence of problem gambling and to describe the overall and gender differences and commonalities in personal factors and social adversities associated with problem gambling among adolescents in rural Ghana. We conducted a cross-sectional survey involving a random sample of 1101 in-school adolescents aged 10–19 years in a rural district in Eastern Ghana; we used the DSM-IV-Multiple Response-Juvenile (DSM-IV-MR-J) questionnaire to assess problem gambling during the previous 12 months. Personal lifestyle and psychosocial variables were assessed using adopted items from the 2012 WHO–Global School-based Student Health Survey. Overall, three in 10 adolescents (3 in 10 females; 4 in 10 males) in rural Ghana reported problem gambling in the previous 12 months. Female adolescents who experienced problem gambling were more likely to report family-related social adversities, while adolescent male problem gambling was associated with school-related factors and interpersonal factors outside the family context. Regardless of gender, sexual abuse victimisation was associated with three times increase in the odds of experiencing problem gambling. Relative to the prevalence of gambling among adolescents in urban contexts in other countries within sub-Saharan Africa, the estimates of problem gambling among in-school rural adolescents in Ghana are higher. Although further studies are needed to understand the nuances of the behaviour, the evidence of this study underscores the need for general and targeted health promotion, intervention and prevention efforts to mitigate the family, school, and interpersonal social adversities associated with adolescent problem gambling in rural Ghana.

Gambling in Transition: Assessing Youth Narratives of Gambling in Nigeria

Nigeria has witnessed some significant changes in gambling which have resulted in more people becoming interested in the activity. In an attempt to increase participation, bookmakers have introduced a variety of innovations. Literature has established that this increased participation is inter-generational, cross-cultural, and inter-religious. Particularly among Nigerian youth, participation in gambling cuts across all age groups, socio-economic status, and gender. Both financial and social rewards have been identified as reasons why many youths gamble. Through a qualitative lens, this study investigates how the dynamics of gambling in recent times have affected the biographies of youth within a relatively deprived socio-economic locality in Kwara State, Nigeria. Thirty young gamblers between the ages of 15 and 29 were engaged in a semi-structured interview session. Drawing from the meaning of 'youth' from a sociological lexicon, one can advance this unique narrative of the transitions in gambling activities which can occur as a result of the youths' biographies and socio-economic status. Nigerian youth adopt three specific gambling types as a coping strategy in the face of a crisis-ridden socio-economic structure characterised by poverty, and unemployment. As such, gambling has become a normative activity experimented by the youth to survive the harsh economic conditions. This study therefore argues the need to situate the discourse of youth gambling within the social, cultural, and economic context in which they are located in Nigeria. In addition, the authors provide a framework for understanding the complexity of youth gambling in Nigeria.

Gambling in adolescence: a narrative review of the last 20 years

BACKGROUND

Gambling has increasingly become a problem in adolescence over the last 20 years. Previous research has failed to identify exactly the level of involvement of adolescents in gambling, yet a relevant presence of addictive behaviors was noticed.

OBJECTIVE

This narrative review highlights the implications of adolescent gambling, taking into consideration the main risk and protection factors aimed at limiting gambling activity, as well as the main links with the impulse-control disorder, addiction, and behavioral addiction.

METHODS

The review process was conducted through Medline, Scopus, Web of Science and Google Scholar search engines. The considered keywords were "Gambling" AND "Adolescence," "Behavioral addiction," AND "Adolescence." The articles related to gambling and adolescence in the last 20 years were included in compliance with inclusion and exclusion criteria, to perform a consistent analysis of the phenomenon and the related maintenance factors.

RESULTS

Starting from 1067 articles, 107 were selected to denote the main thematic areas involved in the gambling problem. The online search was completed on December 13, 2019.

CONCLUSIONS

The narrative review of literature can facilitate the analysis of gambling problems in adolescence, as the main studies in the last 20 years showed the complexity of the problem, the links between addiction, and the most effective methods of prevention and treatment.

Interaction of Socioeconomic Status with Risky Internet Use, Gambling and Substance Use in Adolescents from a Structurally Disadvantaged Region in Central Europe

BACKGROUND AND AIMS

The current level of knowledge concerning the effect of socioeconomic status (SES) on internet use, gambling, and substance use in structurally disadvantaged regions is scarce. The objective of this study was an investigation of the relationship between SES and risky internet use, gambling and substance use in a structurally disadvantaged region in Central Europe.

METHODS

A cross-sectional survey was conducted among high school students (n = 1063) in a Czech structurally disadvantaged region in autumn 2017. Binary Logistic Regression models were applied to data from the modified Excessive Internet Use scale (mEIUS), a standard tool for measuring the risk of addictive behavior on the internet and the risk of excessive gaming. Other data were collected using the Lie/Bet (problematic gambling), CAGE (acronym of the key words: cut, angry, guilty and eye-opener), and the Cannabis Abuse Screening Test (CAST) (problematic alcohol/cannabis use) tools.

RESULTS

There were statistically significant differences between at-risk and not-at-risk groups in addictive behavior on the internet and gaming, while none were found in problematic gambling. Individual dimensions of SES showed significant effects on substance use. Regarding parenting styles, significant differences were found only in the risk of addictive behavior on the internet or gaming between the authoritarian and authoritative styles. Being engaged in behavioral addictions with one´s parents increased the odds of the behavioral addiction risk and decreased the odds of the substance addiction risk. Engagement with one´s parents in substance addictions decreased the odds of the behavioral addiction risk and increased the odds of the substance addiction risk.

DISCUSSION AND CONCLUSIONS

The results point at specific relations between SES and the risk of addictive behaviors on the internet and gaming within structurally disadvantaged regions. The results of SES and/or structurally disadvantaged region measures obtained in research, policy-making, and care-provision may improve the focus of actions taken.

Gambling among 16-year-olds and associated covariates: A Nordic comparison

Aims: This study aimed to compare the prevalence in different gambling types as well as problem gambling in the Nordic countries, examining gambling, leisure activities, school truancy, parental relations and consumption of alcohol and other substances as covariates for problem gambling. Methods: Cross-country data were provided by the European Survey Project on Alcohol and Other Drugs (ESPAD) 2015. Prevalence of gambling and potential covariates were analysed for Denmark, Finland, Iceland Norway and Sweden (N=13,172 respondents aged 16 years), while analyses regarding problem gambling only included countries that participated in the optional questions on gambling problems (Denmark, Finland and Sweden; N=8108). We tested variables for problem gambling by bivariate logistic regression and multivariate logistic regression. Results: Cross-country differences were found in gambling and problem gambling, as well as differences in covariates for problem gambling. Sweden had the lowest rate of problem gambling. No significant difference was found between Denmark and Finland. Reports of too much gaming, inhalants, slots, betting and online gambling were positively associated with problem gambling, while parental monitoring and parental caring had a negative association. The relevance of the covariates varied across countries. Conclusions: Results indicate that although gambling regulation and its implementation have an important impact on gambling behaviour, we need more research on social, economic and cultural factors and how youth understand and interact with them. Contexts and regulations in other related fields should inform gambling research, policies and interventions.

From sign-tracking to attentional bias: Implications for gambling and substance use disorders

Sign-tracking behavior in Pavlovian autoshaping is known to be a relevant index of the incentive salience attributed to reward-related cues. Evidence has accumulated to suggest that animals that exhibit a sign-tracker phenotype are especially vulnerable to addiction and relapse due to their proneness to attribute incentive salience to drug cues, and their relatively weak cognitive and attentional control over their behavior. Interestingly, sign-tracking is also influenced by reward uncertainty in a way that may promote gambling disorder. Research indicates that reward uncertainty sensitizes sign-tracking responses and favors the development of a sign-tracker phenotype, compatible with the conditioned attractiveness of lights and sounds in casinos for problem gamblers. The study of attentional biases in humans (an effect akin to sign-tracking in animals) leads to similar observations, notably that the propensity to develop attraction for conditioned stimuli (CSs) is predictive of addictive behavior. Here we review the literature on drug addiction and gambling disorder, highlighting the similarities between studies of sign-tracking and attentional biases.

The Impact of Addictive Behaviors on Adolescents Psychological Well-Being: The Mediating Effect of Perceived Peer Support

Studies exploring excessive Internet use and gambling are rapidly expanding concerns regarding its impact on mental health, especially in young people due to the increased prevalence of Internet and gambling addictions. Research suggests that perceived peer support plays a significant role in adolescents' psychological well-being. However, no empirical study has dealt with the mediating effect of perceived peer support on the relationship between Internet and gambling addictions and psychological well-being. Thus, the present study aimed to examine whether perceived peer support mediates the relation between Internet and gambling addictions and psychological well-being of adolescents. A sample of 347 Iranian adolescents aged 14 to 18 (Mean age 16.14, 50.4% male) who were studying in Kuala Lumpur, Malaysia participated in this study. Subjective Vitality Scale (SVS), Compulsive Internet Use Scale (CIUS), Six-item Social Support Questionnaire (SSQ6), and The South Oaks Gambling Screen (SOGS) were used to collect data. Mediation analyses showed a significant indirect effect of compulsive Internet use and problem gambling on psychological well-being through perceived peer support. The total effects of compulsive Internet use and problem gambling on psychological well-being were negative. This study implies the significance of strengthening the knowledge about the impact of peer relationships among adolescents.

Pathways connecting socioeconomic variables, substance abuse and gambling behaviour: a cross-sectional study on a sample of Italian high-school students

OBJECTIVES

The aim of this study was to elucidate the pathway of associations linking gambling, alcohol intake, smoking habit, cannabis consumption between each other and with demographic and socioeconomic variables.

SETTING AND PARTICIPANTS

A survey was conducted in 2017 on a representative sample of 15 602 Italian 14-year-olds to 17-year-olds attending 201 secondary schools.

OUTCOME MEASURES

Structural Equation Models analysis was used to assess the pathway between gambling, alcohol intake, smoking, cannabis consumption, demographics and socioeconomic factors.

RESULTS

Irrespective of socioeconomic or demographic variables, gambling is positively associated with alcohol and cannabis consumption, while cannabis consumption is predicted by smoking and by alcohol intake, smoking is predicted by alcohol intake. Adolescents with a higher weekly income are more at risk of gambling, drinking alcohol and smoking, while the degree of economic dissatisfaction was positively associated with alcohol intake, cannabis consumption and smoking. Maternal employment appeared to be positively associated with adolescents' smoking, alcohol intake and cannabis consumption.

CONCLUSIONS

This is one of the first studies to shed light on the pathways of associations connecting various health-risk behaviours among adolescents with demographic and socioeconomic factors.

Gambling involvement and problem gambling correlates among European adolescents: results from the European Network for Addictive Behavior study

PURPOSE

Worldwide, concern has grown over the expansion of gambling among adolescents, who have an increased likelihood of developing risk-taking behaviors. This study aimed to increase knowledge of problem gambling among adolescents in seven European countries and to assess the effect of demographic and lifestyle factors recorded in the European Network for Addictive Behavior survey (https://www.eunetadb.eu).

METHODS

A cross-sectional school-based study (n = 13,284) was conducted in Germany, Greece, Iceland, The Netherlands, Poland, Romania and Spain. Anonymous self-completed questionnaires included socio-demographic data, internet usage characteristics, school achievement, parental control, the Internet Addiction Test, the South Oaks Gambling Screen-Revised for Adolescents Test and Achenbach's Youth Self-Report.

RESULTS

12.5% of the participants reported last year gambling activities either online or offline. 3.6% of the study participants and 28.1% of gamblers (either online or offline) were at risk or had a gambling problem. The study results showed that a higher proportion of adolescents was either at risk or had a gambling problem among males, in the older age group, when the parental educational level was lower/middle, and in the absence of siblings. Furthermore, being at risk or having a gambling problem was associated with lower age at first use of the internet, lower school grades, using the internet 6-7 days per week, and problematic internet use. At risk or problem gamblers had higher scores on all scales of problem behavior and lower scores (lower competence) on activities and academic performance.

CONCLUSIONS

Our findings underline the need for better gambling legislation and suggest the importance of developing social responsibility tools that may help diminish adolescent gambling involvement, with special attention to males.

Facilitated attention for gambling cues in adolescent problem gamblers: An experimental study

BACKGROUND

Studies investigating attentional biases in gambling have observed that problem gamblers' attention is biased toward gambling cues. Despite the increase of gambling among adolescents, to date, no study has ever examined the role of attentional bias in adolescent gambling, as well as the relationships between adolescent gambling severity, craving, and alcohol use.

METHODS

The present study comprised 87 adolescent participants. Based on South Oaks Gambling Screen Revised for Adolescents (SOGS-RA) scores, participants were assigned to non-problem or problem gamblers groups. Participants performed a modified Posner Task (with cue presentation times at 100 and 500 ms) to assess attentional biases. Following the experiment, participants completed the Gambling Craving Scale (GACS) and the Alcohol Use Disorders Identification Test (AUDIT).

RESULTS

Compared to non-problem gamblers, problem gamblers displayed facilitation bias for gambling cues at 500 ms and reported higher levels of craving and alcohol consumption. Results also indicated that alcohol use correlated with facilitation bias.

LIMITATIONS

The recruitment of a predominantly male sample and the use of an indirect measure of attentional bias may have affected the findings concerning attentional processes.

CONCLUSIONS

The present study provides the first empirical evidence of attentional processes in adolescent gambling, and confirms the role of attentional biases, craving, and alcohol use being associated factors in adolescent problem gambling. The results of the present study stress the importance of attentional biases in the initial stages of problem gambling and suggest the need for clinical interventions aimed at reducing attentional bias before they became automatic. Overall, the present study stressed the role of attentional bias as both facilitator and a consequence of gambling involvement.

Problem gambling among Czech adolescents: An exploration of its relationship to early initiation of tobacco smoking

BACKGROUND AND AIMS

Gambling in adolescence is often related to licit and illicit substance use. Some evidence shows that teenage smokers gamble more than non-smokers. The aim of the study is to analyze the relationship between problem gambling and smoking among Czech adolescents.

METHODS

Data on 6,082 adolescents (50.1% boys and 49.9% girls) aged 15-19 years were collected as part of the ESPAD study in the Czech Republic in 2015. Logistic regression and linear regression models were used to test the hypothesis that the early onset of daily smoking increases the risk of problem gambling.

RESULTS

The age of initiation of daily smoking seems to be a more reliable marker of the risk of problem gambling than smoking status or intensity of smoking. More than 20% of smokers who started smoking daily at the age of 12 years or earlier are at risk of problem gambling, which shows a significantly increased probability compared to non-smokers (OR = 2.7). Other factors that increase the chances of becoming a problem gambler include being male, of higher age, and a student of a secondary school.

DISCUSSION AND CONCLUSIONS

The relationship between adolescent smoking and gambling is complex and is likely to be influenced by other underlying factors. Early daily smokers and at-risk gamblers tend in a similar way to risky behavior as a result of impulsivity. Interventions targeting early smoking and other substance-use behavior should not only aim at quitting smoking but could also include preventing smokers from developing problem gambling.

Romanian National Prevalence Study - problem and pathological gambling in children and adolescents

Background and aims

The purpose of the present study was to measure the prevalence of problem and pathological gambling in children and adolescents at a national level, given that previous studies at regional level had demonstrated high rates of prevalence.

Methods

After designing the sample (2006 children and adolescents aged 11–19 years) we used two validated instruments for measuring the prevalence of problem and pathological gambling in children and adolescents – South Oaks Gambling Screen –Revised for Adolescents (SOGS-RA) and 20 Questions of Gamblers Anonymous Revised for Adolescents (20 GA-RA).

Results

The following data have been found: gambling at risk is 7.1% and problem and pathological gambling is 4%, when results were analyzed by SOGS-RA; prevalence of problem gambling is 10.1% and pathological gambling is 2.6% when results were analyzed by 20 GA-RA.

Conclusions

High rates of prevalence are noticed in Romania, similar to other European countries. This rates are based on self-reported questionnaires, meaning that real rates may be higher than reported, being known that children and adolescents tend to give socially expected response. An important issue is that we found pathological gambling at the age of only 11 years. Our results compared to those of other studies from Romania are very similar to those from other European countries.

Prevalence of youth gambling and potential influence of substance use and other risk factors throughout 33 European countries: first results from the 2015 ESPAD study

BACKGROUND AND AIMS

Although generally prohibited by national regulations, underage gambling has become popular in Europe, with relevant cross-country prevalence variability. This study aimed to estimate the prevalence of underage gambling in Europe stratified by type of game and on-/off-line mode and to examine the association with individual and family characteristics and substance use.

DESIGN

Our study used data from the 2015 European School Survey Project on Alcohol and Other Drugs (ESPAD) cross-sectional study, a survey using self-administered anonymous questionnaires.

SETTING

Thirty-three European countries.

PARTICIPANTS

Sixteen-year-old-year-old students (n = 93 875; F = 50.8%).

MEASUREMENTS

The primary outcome measure was prevalence of past-year gambling activity. Key predictors comprised individual behaviours, substance use and parenting (regulation, monitoring and caring).

FINDINGS

A total of 22.6% of 16-year-old students in Europe gambled in the past year: 16.2% on-line, 18.5% off-line. High prevalence variability was observed throughout countries both for mode and types of game. With the exception of cannabis, substance use shows a higher association with gambling, particularly binge drinking [odds ratio (OR) = 1.46, 95% confidence interval (CI) = 1.39-1.53), life-time use of inhalants (OR = 1.57, 95% CI = 1.47-1.68) and other substances (OR = 1.78, 95% CI = 1.65-1.92)]. Among life habits, the following showed a positive association: truancy at school (OR = 1.26, 95% CI = 1.18-1.35), going out at night (OR = 1.32, 95% CI = 1.26-1.38), participating in sports (OR = 1.30, 95% CI = 1.24-1.37). A negative association was found with reading books for leisure (OR = 0.82%, 95% CI = 0.79-0.86), parents' monitoring of Saturday night activities (OR = 0.81, 95% CI = 0.77-0.86) and restrictions on money provided by parents as a gift (OR = 0.89, 95% CI = 0.84-0.94).

CONCLUSIONS

Underage gambling in Europe appears to be associated positively with alcohol, tobacco and other substance use (but not cannabis), as well as with other individual behaviours such as truancy, going out at night and active participation in sports, and is associated negatively with reading for pleasure, parental monitoring of evening activities and parental restriction of money.

Problem gambling and psychological distress: a cross-national perspective on the mediating effect of consumer debt and debt problems among emerging adults

Background

Severe economic difficulties are common among younger generations who currently have an easy access to consumer credit and payday loans in many Western countries. These accessible yet expensive short-term loans may lead to more severe financial difficulties, including default and debt enforcement, both which are defined as debt problems within this study. This study hypothesized that consumer debt and debt problems mediate the relationship between problematic gambling and psychological distress. Excessive gambling can be funded with consumer debt, which in turn leads to the accumulation of financial stressors and, eventually, psychological distress.

Methods

Three studies were conducted to examine the hypotheses. Study 1 used a demographically balanced sample of Finnish participants aged 18 to 25 years (n = 985, 50.76% female). Study 2 used a sample collected from Finnish discussion forums and social networking sites, with participants ranging from 18 to 29 years of age (n = 205, 54.63% female). Study 3 used a demographically balanced sample of American youths aged 18 to 25 years (n = 883, 50.17% female). Analyses were based on generalized structural equation models examining the role of problem gambling, consumer debt, and debt problems (i.e., default and debt enforcement) on psychological distress. Additional mediation analysis was run with treating both instant loans and debt problems as mediators.

Results

All three studies showed that problem gambling was associated with consumer debt, which was further associated with debt problems. Both consumer debt (studies 1 and 2) and debt problems (study 3) were associated with psychological distress. Problem gambling was also directly associated with psychological distress in studies 1 and 3, but not in study 2. In Finland, consumer debt mediated the relationship between problem gambling and psychological distress (studies 1 and 2), while study 3 underlined the mediating role of debt problems in the USA, where consumer debt itself was not positively associated with psychological distress.

Conclusions

The results of the three studies indicate that problem gambling-related psychological distress is partly explained by consumer debt. Consumer credit and payday loans may provide resources for gamblers that enable them to keep up with the habit. This may eventually lead to debt problems and psychological distress. Cross-national differences exist, but in both Nordic and American models, similar mechanisms prevail. The results imply that limiting consumer debt among emerging adults could cushion the financial and psychological costs of problem gambling.

Problem Gambling and Delinquent Behaviours Among Adolescents: A Scoping Review

Despite many studies indicating an association between problem gambling and delinquent behaviours among adolescents, there has been no effort to systematically analyze the state of the literature on this relationship. To fill this gap, we conducted a scoping review of the literature published between 2000 and 2016 on problem gambling and delinquent behaviours among adolescents. We searched twelve databases and reviewed reference lists to identify eligible studies. Search terms included a combination of medical subject headings and keywords for gambling, youth, and delinquency, which were combined with the Boolean operator "AND". 1795 studies were identified through the literature search. Nine studies were eligible for inclusion. All of the studies were conducted in North America, with primarily male participants, and most of the data were cross-sectional. No qualitative studies met the inclusion criteria. Screening tools used to measure problem gambling were inconsistent, making comparisons across studies difficult. We found a consistent moderate to strong association between problem gambling and delinquent behaviour. Only one study presented associations by socio-economic status and none considered gender, sex or ethnic differences. Studies in the review showed that problem gambling is associated with both violent and non-violent behaviours among adolescents. These associations may suggest that problem gambling and delinquent behaviours have common risk factors and reflect a syndrome of risky behaviours best targeted through prevention and treatment that is holistic and considers the context in which the youth is situated. Further research is warranted to better understand the relationship between problem gambling and delinquent behaviours.

Problematic Online Betting Among Turkish Adolescents

Problematic online betting among adolescents has attracted considerable public attention internationally for the last two decades. Although the online betting prevalence rate in Turkey is unclear, some reports indicate that it could be more pervasive than is currently estimated. The aim of this study was to determine the prevalence of problematic online betting, common behaviors of youth related to betting, and to identify the effect of family on online betting among Turkish adolescents. We surveyed 6116 adolescents aged between 12 and 18 in Istanbul to determine if they are problematic Internet users for betting. Although 756 (12.4%) adolescents reported that they play online betting, only 176 adolescents (2.9%) were classified as problematic Internet users. Thus, we collected further data from those 176 adolescents, 14.8% of which were female. A significant positive correlation was found between Internet Addiction (IA) and duration of betting. Almost 61% of participants expressed that they prefer to be online because they do not have better things to do. Almost a quarter of the participants started online betting between 10 and 12 years of age. All participants know someone who bets online. In terms of frequency, these are friends, relatives, siblings, and parents, respectively. Although there is no relationship between family structure and IA among adolescents who are problematic users, participants who live in an unstable family have higher IA scores than participants who live in a stable family.

The multiplicative effect of combining alcohol with energy drinks on adolescent gambling

PURPOSE

There has been increased concern about the negative effects of adolescents consuming a combination of alcohol mixed with energy drinks (AmED). To date, few studies have focused on AmED use and gambling. The present study analyzed the multiplicative effect of AmED consumption, compared to alcohol alone, on the likelihood of at-risk or problem gambling during adolescence.

METHODS

Data from the ESPAD®Italia 2015 study, a cross-sectional survey conducted in a nationally representative sample of students (ages 15 to 19years) were used to examine the association between self-reported AmED use (≥6 times,≥10 times, and ≥20 times during the last month) and self-reported gambling severity. Multivariate models were used to calculate adjusted prevalence ratios to evaluate the association between alcohol use, AmED use, and gambling among a representative sample of adolescents who reported gambling in the last year and completed a gambling severity scale (n=4495).

RESULTS

Among the 19% students classed as at-risk and problem gamblers, 43.9% were classed as AmED consumers, while 23.6% were classed as alcohol consumers (i.e. did not mix alcohol with energy drinks). In multivariate analyses that controlled for covariates, AmED consumers were three times more likely to be at-risk and problem gamblers (OR=3.05) compared to non-consuming adolescents, while the effect became less pronounced with considering those who consumed alcohol without the addition of energy drinks (OR=1.37).

CONCLUSIONS

The present study clearly established that consuming AmED might pose a significantly greater risk of experiencing gambling-related problems among adolescents.

Relative deprivation and disordered gambling in youths

BACKGROUND

Previous research has found that area-level income inequality and individual-level relative deprivation both contribute to disordered gambling in adults. However, the socioeconomic factors that contribute to disordered gambling in youths and protective factors in their social environment have not been fully explored. This study examined the association between relative deprivation and youth disordered gambling and the potential moderating role of social support in this association.

METHODS

We used data on family material assets and self-reported symptoms of disordered gambling symptoms in 19 321 participants of the 2013/2014 Italian Health Behaviour in School-aged Children study. Relative deprivation was measured using the Yitzhaki index and classmates as a social reference group. Its association with disordered gambling was tested using multilevel negative binomial regression analyses. We also tested moderated effects of relative deprivation on disordered gambling by four sources of social support: families, peers, teachers and classmates.

RESULTS

Relative deprivation related to a fourfold increase in the rate of disordered gambling symptoms (incidence rate ratio=4.18) after differences in absolute family wealth and other variables were statistically controlled. Symptoms were also more prevalent in males, first-generation immigrants and less supported youth. Peer support moderated the association between relative deprivation and symptoms, suggesting that high deprivation and low peer support have interactive links to disordered gambling.

CONCLUSION

Relative deprivation among classmates relate to youth symptoms of disordered gambling. Youth who live in economically unequal settings and perceive a lack of social support may be at greatest risk.

Gambling disorder in adolescents: prevalence, new developments, and treatment challenges

Research on adolescence gambling over the past twenty years has revealed significant incidence and prevalence rates and highlighted the possible negative effects on an adolescent’s well-being. Several risk and protective factors have also been identified. Over the course of the past few years, technological advances have heralded the advent of new avenues for gambling as well as new opportunities to gamble without any direct monetary exchange. This review article examines those established trends as well as the new issues that we are faced with, in order to accurately portray the current challenges in research, prevention, and treatment.

Prevalence of Adolescent Problem Gambling: A Systematic Review of Recent Research

Previous research has shown that gambling is a popular activity among adolescents. Following a rapid expansion of legalized gambling opportunities and the emergence of new forms of gambling, many researchers have carried out studies on adolescent gambling and problem gambling. The present paper reviews studies that have been conducted worldwide since 2000, and then presents a more detailed picture of adolescent gambling research in Europe, by providing a country-by country analysis. After an extensive search on academic databases and following an exclusion process, 44 studies were identified. The findings showed that 0.2–12.3 % of youth meet criteria for problem gambling, notwithstanding differences among assessment instruments, cut-offs, and timeframes. However, despite this variability, several demographic characteristics were associated with adolescent gambling involvement and problem gambling. It is concluded that a small but significant minority of adolescents have gambling-related problems. Such findings will hopefully encourage more research into youth gambling to further understand the determinants of this phenomenon.

Adolescent Gambling-Oriented Attitudes Mediate the Relationship Between Perceived Parental Knowledge and Adolescent Gambling: Implications for Prevention

Although substantial research has provided support for the association between parental practices and adolescent gambling, less is known about the role of adolescent attitudes in this relationship. The primary purpose of this study was to test an integrative model linking perceived parental knowledge (children's perceptions of their parents' knowledge of their whereabouts and companions) with adolescent gambling while evaluating the mediating effects of adolescents' own gambling approval, risk perception of gambling, and descriptive norms on gambling shared with friends. The data were drawn from the ESPAD® Italia 2012 (European School Survey Project on Alcohol and Other Drugs) study, which is based on a nationally representative sample of Italian adolescent students aged 15-19. The analysis was carried out on a subsample of 19,573 subjects (average age 17.11, 54 % girls). Self-completed questionnaires were administered in the classroom setting. The results revealed that adolescents who perceived higher levels of parental knowledge were more likely to disapprove of gambling and show higher awareness of its harmfulness, which were in turn negatively related to gambling frequency. They were also less likely to perceive their friends as gamblers, which was also negatively related to gambling frequency. These findings suggest that gambling prevention efforts should consider perceived parental knowledge and gambling-oriented attitudes (self-approval, risk perception, and descriptive norms) as factors that may buffer adolescent gambling behavior in various situations.

Attachment and emotion regulation in substance addictions and behavioral addictions

Background Risky behaviors have been related to emotional regulation and attachment, which may constitute risk factors for developing an addictive behavior. However, there may also be differences between substance and non-substance-related addictions. Aims This study aimed to examine the relationship of emotional regulation and attachment, with substance (alcohol and drug abuse), and non-substance-related addictions (gambling disorder, video game addiction, and problematic Internet use) in adolescents and emerging adults. The study also aimed to examine gender differences for such predictors. Methods The sample comprised 472 students aged 13-21 years recruited from high schools and vocational education centers. Results Findings demonstrated that emotion regulation was predictive of all addictive behaviors assessed in this study (alcohol and drug abuse, gambling disorder, video game addiction, and problematic Internet use), whereas attachment predicted non-substance-related addictions (gambling disorder, video game addiction, and problematic Internet use). In addition, gender differences were found, with females scoring significantly higher in maternal and peer attachment, whereas males scored significantly higher in gambling disorder and video game addiction. Conclusion The findings may be useful for preventive and clinical interventions conducted with youth regarding addictive behaviors.

Income Inequality and Adolescent Gambling Severity: Findings from a Large-Scale Italian Representative Survey

Background: Studies have shown that problems related to adult gambling have a geographical and social gradient. For instance, adults experiencing gambling-related harms live in areas of greater deprivation; are unemployed, and have lower income. However, little is known about the impact of socioeconomic inequalities on adolescent problem gambling. The main purpose of the present study was to investigate the contextual influences of income inequality on at-risk or problem gambling (ARPG) in a large-scale nationally representative sample of Italian adolescents. A secondary aim was to analyze the association between perceived social support (from family, peers, teachers, and classmates) and ARPG. Methods: Data from the 2013-2014 Health Behavior in School-aged Children Survey (HBSC) Study was used for cross-sectional analyses of ARPG. A total of 20,791 15-year-old students completed self-administered questionnaires. Region-level data on income inequality (GINI index) and overall wealth (GDP per capita) were retrieved from the National Institute of Statistics (Istat). The data were analyzed using the multi-level logistic regression analysis, with students at the first level and regions at the second level. Results: The study demonstrated a North-South gradient for the prevalence of ARPG, with higher prevalence of ARPG in the Southern/Islands/Central Regions (e.g., 11% in Sicily) than in Northern Italy (e.g., 2% in Aosta Valley). Students in regions of high-income inequality were significantly more likely than those in regions of low-income inequality to be at-risk or problem gamblers (following adjustment for sex, family structure, family affluence, perceived social support, and regionale wealth). Additionally, perceived social support from parents and teachers were negatively related to ARPG. Conclusions: Income inequality may have a contextual influence on ARPG. More specifically, living in regions of highest income inequality appeared to be a potential factor that increases the likelihood of becoming an at-risk or problem gambler. Findings of the study suggest that wealth distribution within societies affected by economic policies may indirectly have an influence adolescent gambling behaviors.

A large-scale national study of gambling severity among immigrant and non-immigrant adolescents: The role of the family

AIM

The primary aim of the present study was to examine the association between immigrant generation, family sociodemographic characteristics, and problem gambling severity in a large-scale nationally representative sample of Italian youth.

METHOD

Data from the 2013-2014 Health Behaviour in School-aged Children (HBSC) Survey were used for cross-sectional analyses of adolescent problem gambling. Self-administered questionnaires were completed by a representative sample of 20,791 15-year-old students. Respondents' problem gambling severity, immigrant status, family characteristics (family structure, family affluence, perceived family support) and socio-demographic characteristics were individually assessed.

FINDINGS

Rates of adolescent at-risk/problem gambling were twice as high among first generation immigrants than non-immigrant students; the odds of being at-risk/problem gamblers were higher among first-generation immigrants than adolescents of other immigrant generations or non-immigrant. Not living with two biological or adoptive parents appears to be a factor that increases the risk of becoming a problem gambler in first generation immigrants.

CONCLUSIONS

Immigrant status and family characteristics may play a key role in contributing to adolescent problem gambling.

Validation of the Portuguese DSM-IV-MR-J

Youth problem gambling is viewed as an emergent public health issue in many countries, and is also an emerging area of public concern in Portugal. However, there is currently no Portuguese instrument that focuses specifically on the measurement of problem gambling among young people. Consequently, the present study aimed to validate the DSM-IV-MR-J for use among Portuguese adolescents and to examine its’ psychometric properties. A cross-cultural adaption of this instrument to the Portuguese language was performed using the translation and back translation method. The final version of the instrument was administered to 753 Portuguese high school and first year college students. The findings revealed an acceptable internal reliability and replicated the one-factor structure of this scale. Based on these findings, the Portuguese DSM-IV-MR-J appears to be a valid and reliable instrument, and provides a much needed psychometric tool for the development of more research on youth gambling in Portugal.

"I Am Becoming More and More Like My Eldest Brother!": The Relationship Between Older Siblings, Adolescent Gambling Severity, and the Attenuating Role of Parents in a Large-Scale Nationally Representative Survey Study

The present study examined the association between having older siblings who gamble and adolescent at-risk/problem gambling and how parents (i.e., parental knowledge of their whereabouts) and peers might moderate such effects. Data were drawn from the ESPAD^®Italia2012 survey (European School Survey Project on Alcohol and Other Drugs) comprising a nationally representative Italian sample of adolescents. The analysis was carried out on a subsample of 10,063 Italian students aged 15-19 years (average age = 17.10; 55 % girls) who had at least one older sibling and who had gambled at some point in their lives. Respondents' problem gambling severity, older gambler sibling, gambler peers, parental knowledge, and socio-demographic characteristics were individually assessed. Multinomial logistic regression analyses including two- and three-way interactions were conducted. The odds of being an at-risk/problem gambler were higher among high school students with older siblings that gambled and those with peers who gambled. Higher parental knowledge (of who the adolescent was with and where they were in their leisure time) was associated with lower rates of at-risk/problem gambling. There was also an interaction between gamblers with older siblings and parental knowledge. The combination of having siblings who gambled and a greater level of parental knowledge was associated with lower levels of problem gambling. The present study confirmed the occurrence of social risk processes (older siblings and peers who gambled) and demonstrated that gambling among older siblings and peers represents an important contextual factor for increased at-risk/problem gambling. However, parental knowledge appears to be sufficient to counterbalance the influence of older siblings.

Adolescent gambling and impulsivity: Does employment during high school moderate the association?

The aim of the present study was to examine the potential moderating relationships between adolescent gambling and impulsivity traits (negative urgency, positive urgency, lack of premeditation, lack of perseverance and sensation seeking) with employment status. High-school students (N=400; 69% male; mean age=18.35years; SD=1.16; past year gamblers) were surveyed to provide data on impulsivity and employment. Multiple linear regression analysis was applied to examine associations with gambling and related problems. Positive urgency was associated with stronger scores of both gambling frequency and problem gambling. Students in employment had substantially higher frequency of gambling and greater problem gambling. Moreover, the combination of having a job and low perseverance was associated with a particularly high frequency on gambling. These findings further support the importance of positive urgency and employment status in adolescent gambling. The study highlights unique moderating relationship between gambling and lack of perseverance with employment status. Youth with a low perseverance and having a job may have particular need for interventions to reduce gambling.