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Challet-Bouju G, Caillon J, Leboucher J, Thiabaud E, Saillard A, Balem M, Grall-Bronnec M. Impact of Gambling on the Internet on Middle-Term and Long-Term Recovery from Gambling Disorder: A 2-Year Longitudinal Study. J Gambl Stud 2025; 41:567-592. [PMID: 39254777 DOI: 10.1007/s10899-024-10328-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/13/2024] [Indexed: 09/11/2024]
Abstract
Online gamblers are more likely to experience gambling problems. The main objective was to compare the frequency of recovery one (middle-term) and two (long-term) years after treatment initiation, according to the gambling medium (Internet vs. land-based gambling). The secondary objectives were (i) to compare online and offline gamblers at inclusion and (ii) to investigate whether the gambling medium was a predictive factor of recovery. Outpatients beginning treatment for a GD (n = 237) were assessed at inclusion (treatment initiation) and after 1 and 2 years. Bivariate analyses were performed to compare online and offline gamblers at inclusion and on the frequency of recovery at one and two years. Two multivariate logistic regressions were then performed to identify factors associated with middle- and long-term recovery. The majority of patients achieved middle (74.2%) and long-term (78.9%) recovery, with no difference between online and offline gamblers. The gambling medium was not a predictive factor of recovery. Patients with a higher perceived self-efficacy (OR = 1.04 [1.01-1.07], p = .046) and having no history of mood disorders (OR = 11.18 [2.53-49.50], p < .001) at inclusion were more likely to achieve middle-term recovery, while long-term recovery was associated with a lower level of sensation seeking (OR = 0.67 [0.48-0.92], p = .015) at treatment initiation. Online gambling did not seem to influence middle- and long-term recovery compared to offline gambling. Enhancement of perceived self-efficacy and treatment of mood disorders, and treatment strategies focused on sensation-seeking may represent helpful care strategies for favouring achievement of middle-term recovery and maintenance of long-term recovery, respectively. ClinicalTrials.gov NCT01248767, date of first registration: November 25, 2010.
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Affiliation(s)
- Gaëlle Challet-Bouju
- Nantes Université, CHU Nantes, UIC Psychiatrie et Santé Mentale, Nantes, F-44000, France.
- Nantes Université, Univ Tours, CHU Nantes, CHU Tours, INSERM, MethodS in Patients centered outcomes and HEalth ResEarch, SPHERE, Nantes, F-44000, France.
| | - Julie Caillon
- Nantes Université, CHU Nantes, UIC Psychiatrie et Santé Mentale, Nantes, F-44000, France
- Nantes Université, Univ Tours, CHU Nantes, CHU Tours, INSERM, MethodS in Patients centered outcomes and HEalth ResEarch, SPHERE, Nantes, F-44000, France
| | - Juliette Leboucher
- Nantes Université, CHU Nantes, UIC Psychiatrie et Santé Mentale, Nantes, F-44000, France
| | - Elsa Thiabaud
- Nantes Université, CHU Nantes, UIC Psychiatrie et Santé Mentale, Nantes, F-44000, France
| | - Anaïs Saillard
- Nantes Université, CHU Nantes, UIC Psychiatrie et Santé Mentale, Nantes, F-44000, France
| | - Marianne Balem
- Nantes Université, CHU Nantes, UIC Psychiatrie et Santé Mentale, Nantes, F-44000, France
- Nantes Université, Univ Tours, CHU Nantes, CHU Tours, INSERM, MethodS in Patients centered outcomes and HEalth ResEarch, SPHERE, Nantes, F-44000, France
| | - Marie Grall-Bronnec
- Nantes Université, CHU Nantes, UIC Psychiatrie et Santé Mentale, Nantes, F-44000, France
- Nantes Université, Univ Tours, CHU Nantes, CHU Tours, INSERM, MethodS in Patients centered outcomes and HEalth ResEarch, SPHERE, Nantes, F-44000, France
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Siste K, King DL, Hanafi E, Sen LT, Adrian A, Murtani BJ. Scrutinizing the Gateway Relationship Between Gaming and Gambling Disorder: Scoping Review With a Focus on the Southeast Asian Region. JMIR Serious Games 2025; 13:e59740. [PMID: 39819569 PMCID: PMC11753718 DOI: 10.2196/59740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2024] [Revised: 11/24/2024] [Accepted: 11/25/2024] [Indexed: 01/19/2025] Open
Abstract
Background The gaming and gambling overlap has intensified with new evidence emerging. However, the relationship between gaming and gambling in the digital space is still inconclusive, especially in resource-limited Asian countries. Objective This study aims to review available evidence on the possible interaction and focuses specifically on the gateway interaction between gambling and gaming. Additionally, this review delves into the state of evidence from the Southeast Asian region, providing an in-depth analysis of this underexplored area. Methods We performed a scoping review by sifting through the publications in five databases. We focused on the gateway interaction and provided a possible pathway model, while two other convergence relationships were provided for comparison. Results The scoping review identified a total of 289 publications, with the majority being empirical (n=181), although only 12 studies used longitudinal designs. A significant proportion of the publications (n=152) concentrated on the correlation or comorbidity between gaming and gambling. Most of the evidence has originated from Global North countries, with very limited research emerging from Southeast Asia (n=8). The most commonly studied gambling-like element in video games was loot boxes (n=105). Other elements investigated included esports betting, skin betting, token wagering, gambling advertisements, and gambling-like features. Several longitudinal studies have highlighted the risk of the gateway effect associated with gamblification involvement. However, emerging evidence suggests more nuanced underlying mechanisms that drive the transition from gaming to gambling. Conclusions Overall, there is early evidence of linkage between gambling and gaming, through shared structural and biopsychosocial characteristics. This association possibly extends beyond disparate comorbidity, as such engagement in one activity might influence the risk of partaking in the other behavior. The field requires further longitudinal data to determine the directionality and significant precipitating factors of the gateway effect, particularly evidence from Asia.
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Affiliation(s)
- Kristiana Siste
- Department of Psychiatry, Faculty of Medicine, Universitas Indonesia – Dr. Cipto Mangunkusumo National Referral Hospital, Jakarta, Indonesia
| | - Daniel L King
- College of Education, Psychology and Social Work, Flinders University, Adelaide, Australia
- School of Psychology, The University of Adelaide, Adelaide, Australia
| | - Enjeline Hanafi
- Department of Psychiatry, Faculty of Medicine, Universitas Indonesia – Dr. Cipto Mangunkusumo National Referral Hospital, Jakarta, Indonesia
| | - Lee Thung Sen
- Department of Psychiatry, Faculty of Medicine, Universitas Indonesia – Dr. Cipto Mangunkusumo National Referral Hospital, Jakarta, Indonesia
| | - Adrian Adrian
- Department of Psychiatry, Faculty of Medicine, Universitas Indonesia – Dr. Cipto Mangunkusumo National Referral Hospital, Jakarta, Indonesia
| | - Belinda Julivia Murtani
- Department of Psychiatry, Faculty of Medicine, Universitas Indonesia – Dr. Cipto Mangunkusumo National Referral Hospital, Jakarta, Indonesia
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Wardle H, Degenhardt L, Marionneau V, Reith G, Livingstone C, Sparrow M, Tran LT, Biggar B, Bunn C, Farrell M, Kesaite V, Poznyak V, Quan J, Rehm J, Rintoul A, Sharma M, Shiffman J, Siste K, Ukhova D, Volberg R, Salifu Yendork J, Saxena S. The Lancet Public Health Commission on gambling. Lancet Public Health 2024; 9:S2468-2667(24)00167-1. [PMID: 39491880 DOI: 10.1016/s2468-2667(24)00167-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 07/07/2024] [Accepted: 07/16/2024] [Indexed: 11/05/2024]
Affiliation(s)
- Heather Wardle
- School of Social and Political Sciences, University of Glasgow, Glasgow, UK.
| | - Louisa Degenhardt
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW, Australia
| | - Virve Marionneau
- Centre for Research on Addiction, Control and Governance, University of Helsinki, Helsinki, Finland
| | - Gerda Reith
- School of Social and Political Sciences, University of Glasgow, Glasgow, UK
| | - Charles Livingstone
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Malcolm Sparrow
- Harvard Kennedy School, Harvard University, Cambridge, MA, USA
| | - Lucy T Tran
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW, Australia
| | - Blair Biggar
- School of Social and Political Sciences, University of Glasgow, Glasgow, UK
| | - Christopher Bunn
- School of Social and Political Sciences, University of Glasgow, Glasgow, UK; Malawi Epidemiology and Intervention Research Unit, Lilongwe, Malawi
| | - Michael Farrell
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW, Australia
| | - Viktorija Kesaite
- School of Social and Political Sciences, University of Glasgow, Glasgow, UK; Medical Research Council Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - Vladimir Poznyak
- Alcohol, Drugs and Addictive Behaviours Unit, WHO, Geneva, Switzerland
| | - Jianchao Quan
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Jürgen Rehm
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, ON, Canada; Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada; Department of Psychiatry, University of Toronto, Toronto, ON, Canada; Center for Interdisciplinary Addiction Research, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Angela Rintoul
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia; Health Innovation and Transformation Centre, Federation University, Churchill, VIC, Australia; Centre for Mental Health and Community Wellbeing, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
| | - Manoj Sharma
- Department of Clinical Psychology, Govindaswamy Centre, National Institute of Mental Health and Neuro Sciences, Bengaluru, India
| | - Jeremy Shiffman
- School of Advanced International Studies, Bloomberg School of Public Health, John Hopkins University, Baltimore, MD, USA
| | - Kristiana Siste
- Department of Psychiatry, Faculty of Medicine, Universitas Indonesia-Dr Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
| | - Daria Ukhova
- School of Social and Political Sciences, University of Glasgow, Glasgow, UK
| | - Rachel Volberg
- School of Public Health and Health Sciences, University of Massachusetts Amherst, Amherst, MA, USA
| | | | - Shekhar Saxena
- Department of Global Health and Population, Harvard TH Chan School of Public Health, Harvard University, Cambridge, MA, USA
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Coloma-Carmona A, Carballo JL, Sancho-Domingo C, Rodríguez-Espinosa S, Miró-Llinares F, C Aguerri J. Engagement in New Gambling Practices and its Association with Gambling Disorder, Impulsivity, and Cognitive Distortions: Findings from a Nationally Representative Sample of Spanish Gamblers. J Gambl Stud 2024:10.1007/s10899-024-10361-z. [PMID: 39373778 DOI: 10.1007/s10899-024-10361-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/28/2024] [Indexed: 10/08/2024]
Abstract
Most epidemiological surveys focus on adult gambling behaviors related to traditional gambling forms, while studies on novel forms often focus on loot boxes and cryptocurrency trading individually. This study examines the co-ocurrence of emergent gambling and gambling-like practices, analyzing the demographic and psychological characteristics of involved gamblers. A cross-sectional study surveyed 1429 Spanish individuals aged 18-65, using a web-based questionnaire. The survey assessed participation in 19 gambling (e.g., lotteries, sports betting) and gambling-like activities (e.g., trading of cryptocurrencies and other assets, buying loot-boxes), along with sociodemographic and substance use. Problem gambling (PGSI), Impulsivity (UPPS-P), and cognitive distortions (Labrador's cognitive distortions scale) were also assessed. Participants who gambled over the past year (n = 921) were classified into four groups: traditional gambling (TG) only (64.5%, n = 594), TG with trading activities (27.5%, n = 253), TG with gambling withing video games or streaming platforms (2.5%, n = 23), and TG with both trading and video gambling (5.5%, n = 51). Most gamblers engaged exclusively in traditional formats, but 35.5% also participated in novel gambling forms. Those involved in both trading and video gambling were generally younger, male, with higher levels of impulsivity and gambling-related cognitive distortions compared to TG-only gamblers (p < 0.001). This group also exhibited higher rates of problem gambling and substance use (p < 0.001). This study emphasize the importance of including emerging gambling activities, which are particularly prevalent among high-risk gamblers, in epidemiological surveys. Identifying new gambling patterns and associated risk factors could help optimize public policies and develop more effective regulatory and prevention strategies.
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Affiliation(s)
| | - José L Carballo
- Center for Applied Psychology, Miguel Hernández University of Elche, Elche, Spain
| | - Clara Sancho-Domingo
- Center for Applied Psychology, Miguel Hernández University of Elche, Elche, Spain
| | | | - Fernando Miró-Llinares
- CRÍMINA Research Center for the Study and Prevention of Crime, Miguel Hernández University of Elche, Elche, Spain
| | - Jesús C Aguerri
- CRÍMINA Research Center for the Study and Prevention of Crime, Miguel Hernández University of Elche, Elche, Spain
- University of Zaragoza, Zaragoza, Spain
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Gavriel-Fried B, Malka I, Levin Y. The Dual Burden of Emerging Adulthood: Assessing Gambling Severity, Gambling-Related Harm, and Mental Health Challenges. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:702. [PMID: 38928948 PMCID: PMC11203917 DOI: 10.3390/ijerph21060702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/01/2024] [Revised: 05/26/2024] [Accepted: 05/28/2024] [Indexed: 06/28/2024]
Abstract
Growing concerns over gambling problems across age groups have sparked research in public health and psychology. During emerging adulthood, individuals are more susceptible to mental health problems and more likely to develop gambling problems than in other age groups. This study explored the potential differences between emerging adults and adults aged 30+ in terms of problem gambling severity (PGS), gambling-related harm (GRH), depression and anxiety, and the mediating role of depression and anxiety in the association between age, PGS, and GRH. A representative online sample of 3244 Israelis aged 18 and over was divided into two groups: 740 emerging adults aged 18-29 and 2504 adults aged 30+. Gambling behaviors, the Problem Gambling Severity Index, the Short Gambling Harm Screen, and the Patient Health Questionnaire-4 assessing depression and anxiety were administered. Emerging adults had significantly higher levels of GRH, PGS, and depression-anxiety than their older counterparts, above and beyond gender and education. Depression-anxiety fully mediated the associations between age and gambling-related outcomes. These findings underscore the importance of considering psychological well-being in efforts to address problem gambling and gambling-related harms, especially in emerging adults.
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Affiliation(s)
- Belle Gavriel-Fried
- The Bob Shapell School of Social Work, Tel Aviv University, Tel Aviv-Yafo 6997801, Israel;
| | - Inbar Malka
- The Bob Shapell School of Social Work, Tel Aviv University, Tel Aviv-Yafo 6997801, Israel;
| | - Yafit Levin
- Department of Social Work, Ariel University, Ariel 40700, Israel;
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Marionneau V, Kristiansen S, Wall H. Harmful types of gambling: changes and emerging trends in longitudinal helpline data. Eur J Public Health 2024; 34:335-341. [PMID: 38389465 PMCID: PMC10990548 DOI: 10.1093/eurpub/ckae024] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/24/2024] Open
Abstract
BACKGROUND Gambling products differ in terms of their harm potential. Products are also constantly developing and changing. However, little research has addressed changes and trends in the types of gambling that are associated with harms. The current study explores trends in the gambling product categories identified as harmful in longitudinal helpline data from three Nordic countries. METHODS We use data collected by national helplines in Denmark (StopSpillet), Finland (Peluuri) and Sweden (Stödlinjen) in their daily operations (N = 46 646). The data consist of information collected on gamblers and concerned significant others who have contacted these helplines between January 2019 and December 2022. We analyse which gambling products are mentioned as harmful by clients. The analysis uses linear regression with the interaction term (country) times time regressed over the outcome variable (proportion per month). RESULTS The results show that an increased share of contacts concern online gambling. Online casino products have become the most harmful category across contexts. The share of reported harms from online betting and new emerging online forms is also increasing. The share of land-based products as a reported source of harms has decreased across 2019-22. CONCLUSIONS The results suggest that online gamlbing environments, and particularly online casino products, are associated with increasing harms to help-seekers. The harmfulness of different gambling products may not be stable, but change over time. Further harm prevention efforts are needed to address the online gambling field, including emerging formats.
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Affiliation(s)
- Virve Marionneau
- Centre for Research on Addiction, Control, and Governance (CEACG), Faculty of Social Sciences, University of Helsinki, Helsinki, Finland
| | - Søren Kristiansen
- Department of Sociology and Social Work, Aalborg University, Aalborg, Denmark
| | - Håkan Wall
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Stockholm Health Care Services, Stockholm County Council, Stockholm, Sweden
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Marionneau V, Ruohio H, Karlsson N. Gambling harm prevention and harm reduction in online environments: a call for action. Harm Reduct J 2023; 20:92. [PMID: 37481649 PMCID: PMC10362766 DOI: 10.1186/s12954-023-00828-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 07/16/2023] [Indexed: 07/24/2023] Open
Abstract
BACKGROUND Gambling is increasingly offered and consumed in online and mobile environments. The digitalisation of the gambling industry poses new challenges on harm prevention and harm reduction. The digital environment differs from traditional, land-based gambling environments. It increases many risk-factors in gambling, including availability, ease-of-access, but also game characteristics such as speed and intensity. Furthermore, data collected on those gambling in digital environments makes gambling offer increasingly personalised and targeted. MAIN RESULTS This paper discusses how harm prevention and harm reduction efforts need to address gambling in online environments. We review existing literature on universal, selective, and indicated harm reduction and harm prevention efforts for online gambling and discuss ways forward. The discussion shows that there are several avenues forward for online gambling harm prevention and reduction at each of the universal, selective, and indicated levels. No measure is likely to be sufficient on its own and multi-modal as well as multi-level interventions are needed. Harm prevention and harm reduction measures online also differ from traditional land-based efforts. Online gambling providers utilise a variety of strategies to enable, market, and personalise their products using data and the wider online ecosystem. CONCLUSION We argue that these same tools and channels should also be used for preventive work to better prevent and reduce the public health harms caused by online gambling.
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Affiliation(s)
- Virve Marionneau
- Faculty of Social Sciences, Centre for Research on Addiction, Control, and Governance, University of Helsinki, Unioninkatu 33, 00014, Helsinki, Finland.
| | - Heidi Ruohio
- Finnish Institute for Health and Welfare, Mannerheimintie 166, 00271, Helsinki, Finland
| | - Nina Karlsson
- Finnish Institute for Health and Welfare, Mannerheimintie 166, 00271, Helsinki, Finland
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