Gambling involvement, type of gambling and grade point average among 18-29-year-old Finnish men and women

Nationwide, Multioperator Self-Exclusion and Psychiatric Comorbidity in Patients with Gambling Disorder: A Retrospective Chart Review Study from a Regional Treatment Unit

Gambling disorder is an addictive disorder that has been shown to have a detrimental effect on an individual's health, social, and financial situations. Voluntary self-exclusion is one way for patients to reduce harm in gambling disorder, but breaching one's self-exclusion appears to be common. In January 2019, Sweden launched a nationwide, multioperator self-exclusion instrument called Spelpaus (literally "game break"). Spelpaus is unique to Sweden, and there is limited research on the use of this type of nationwide, multioperator self-exclusion services, also in relation to gambling disorder and mental health. There is a reason to follow the clinical picture of treatment seeking for gambling disorder over time, and this study aims to explore clinical characteristics of patients seeking clinical gambling disorder treatment, including sex distribution and mental health comorbidity, as well as the use of Spelpaus amongst patients with gambling disorder and how frequently users gambled despite ongoing self-exclusion, in relation to sex and psychiatric comorbidities. A retrospective chart study was carried out on patients presenting to a regional gambling disorder treatment unit. Information regarding self-exclusions using Spelpaus, gambling despite self-exclusion, and the method of gambling despite self-exclusion as well as psychiatric comorbidities were extracted from medical records. Females were markedly more likely to report overall psychiatric comorbidities (48% vs. 25% among males, p < 0.001), affective, neurotic/anxiety-related (p < 0.001), and behavioral/emotional (p = 0.028) diagnoses and more likely to have two or more diagnoses excluding gambling disorder (p = 0.001). From 120 patients from whom information regarding self-exclusion was present, 114 (95%) had chosen to self-exclude. From the 114 self-excluders, 67 reported to have gambled despite self-exclusion, with unregistered websites being the most common method. Self-exclusion was not significantly related to sex (p = 0.146) or to psychiatric comorbidities (p = 0.178). In conclusion, psychiatric comorbidity was particularly common in female gambling disorder patients and gambling despite self-exclusion was common. Gambling regulations should be improved to help self-excluders avoid being able to gamble on unlicensed gambling operators. Further research should focus on sex differences and the association with psychiatric comorbidities.

Compulsory School Achievement and Future Gambling Expenditure: A Finnish Population-Based Study

Background: Gambling is associated with many conditions that can compromise young people’s health and wellbeing, such as substance use and poor school achievement. Conversely, low school achievement can be linked to lower socio-economic position. Thus, the aim of this study is to examine whether compulsory school achievement is linked with gambling participation and gambling expenditure (GE) later in youth and whether GE is linked with lower socio-economic position. Methods: The Finnish Gambling Harms survey data (n = 7186) were used. The data were collected in three regions during spring 2017. Participants aged 18–29 years old were selected from the data. Past-year GE was examined using two measures: weekly gambling expenditure (WGE, in €) and relative gambling expenditure (RGE, in %). Logistic regression and log-linear regression models for past-year gambling, WGE and RGE were created. Results: Persons who had no more than a mediocre grade point average (GPA) had a 25% higher WGE and 30% higher RGE in 2016 than those who had an outstanding GPA in the compulsory school. Compared with persons with an outstanding GPA, those with a satisfactory to very good GPA spent 13% more on gambling, and their RGE was 17% higher. Additionally, those with lower socio-economic status (SES) had a higher WGE and RGE compared with higher SES. Conclusions: Even after controlling for other crucial background characteristics, early life success, in the form of compulsory school outcomes, seems to correlate with gambling expenditures later in youth. This suggests that the gambling behaviour can be linked to the cognitive ability of an individual. Our findings also imply that gambling could be more heavily concentrated on individuals that are already more socially disadvantaged. However, it is worth noting that individual factors such as traumas, antisocial personality, anxiety and depression are all associated with gambling and poor academic achievement. Overall, this suggests that various educational tools at a younger age can be effective in preventing gambling-related problems in later life.

Gamblers' use of measures to prevent gambling problems and reduce harm

In this study, the use of measures to control gambling were investigated. Data from gamblers (N = 5,878) participating in a cross-sectional survey in 2019 based on random sampling from the Norwegian Population Registry, were analysed. The survey included questions about use of eight measures, which comprised the dependent variables. Questions about sociodemographics, gambling behaviour, gambling problems, self-reported impact from gambling advertisement and beliefs in measures to control gambling comprised the predictor variables. Logistic regression analyses were employed to identify significant predictors. Use of measures varied, ranging from 0.8% (contacting help services) to 23.2% (pre-commitment to affordable loss limits). All predictors had at least one significant association with the actual use of measures. Being a moderate risk or problem gambler was the most consistent predictor and was associated with the use of all eight measures. Being born outside Norway in a western or non-western country was associated with use of seven of the eight measures, whereas gambled online and participated in low-risk game only (inversely) were associated with use of six measures. Gender, age, game spending and beliefs in the usefulness of measures were associated with use of four measures. Participation in random games only was inversely associated with use of three measures. Self-reported impact from gambling advertisement was only (inversely) associated with self-testing for gambling problems. Several mechanisms responsible for the associations between predictors and the dependent variables are suggested, e.g., younger gamblers and moderate risk or problem gamblers may use these measures as they may acknowledge personal susceptibilities for developing gambling problems, such as impaired impulse control. Online gambling on the other hand was associated with use of various measures as the latter more often are integrated in online than offline gambling. Notably, the beliefs in measures as helpful was a significant predictor of use of four of the measures, which illustrates that positive views on the use of measures are not consistently associated with actual use of all the measures. Characteristics of the gamblers (e.g., place of birth, moderate risk or problem gambler), the game itself and the online distribution seem to be the most consistent predictors.