Pathological gambling: an overview of assessment and treatment

Financial Literacy and Economic Attitudes as Protective Factors Against Pathological Gambling? A Systematic Review

Pathological gambling poses significant global issues, leading to economic, social, and psychological consequences such as debt, family breakdowns, and mental health problems. While various risk factors for gambling addiction, including comorbid addictions, psychiatric disorders, gender, age, and easy access to gambling venues, have been well-studied, less emphasis is placed on protective factors. Strong social support and higher education are key in mitigating gambling addiction. Higher education, in particular, equips individuals with better decision-making skills and risk management strategies, reducing the likelihood of addictive behaviors. Strengthening education and social support systems is essential for preventing gambling addiction. A systematic review was conducted across Scopus, PubMed, Web of Science, and EBSCO, focusing on studies published after 2000. Peer-reviewed studies written in English that examined the relationship between financial literacy and gambling were included. Studies focusing solely on financial topics or not in English were excluded. The review follows the PROSPERO protocol. Financial literacy is linked to lower rates of pathological gambling, although its impact varies based on cultural context and gambling accessibility. From 880 papers, 8 met the inclusion criteria. Six studies confirmed a relationship between higher financial literacy and reduced gambling behavior, while two studies indicated that the significance of this relationship depended on specific financial literacy dimensions or contextual factors. This research underscores the importance of incorporating consumer education and psychological factors into future gambling addiction prevention strategies, particularly for younger gamblers.

Psychosocial risk factors in disordered gambling: A descriptive systematic overview of vulnerable populations

BACKGROUND

Gambling is a behaviour engaged in by millions of people worldwide; for some, gambling can become a severely maladaptive behaviour, and previous research has identified a wide range of psychosocial risk factors that can be considered important for the development and maintenance of disordered gambling. Although risk factors have been identified, the homogeneity of risk factors across specific groups thought to be vulnerable to disordered gambling is to date, unexplored.

METHODS

To address this, the current review sought to conduct a systematic overview of literature relating to seven vulnerable groups: young people and adolescents, older adults, women, veterans, indigenous peoples, prisoners, and low socio-economic/income groups.

RESULTS

Multiple risk factors associated with disordered gambling were identified; some appeared consistently across most groups, including being male, co-morbid mental and physical health conditions, substance use disorders, accessibility and availability of gambling, form and mode of gambling, and experience of trauma. Further risk factors were identified that were specific to each vulnerable group.

CONCLUSION

Within the general population, certain groups are more vulnerable to disordered gambling. Although some risk factors are consistent across groups, some risk factors appear to be group specific. It is clear that there is no homogenous pathway in to disordered gambling, and that social, developmental, environmental and demographic characteristics can all interact to influence an individual's relationship with gambling.

A review of educational-based gambling prevention programs for adolescents

Educational-based problem gambling prevention programs are important avenues in targeting at-risk behaviors among adolescents to prevent an escalation of problematic behaviors into adulthood. The aim of this review is to examine features pertinent to effective educational-based programs in the area of adolescent problem gambling prevention in hopes of providing a foundation and future suggestions for preventive efforts. A stronger understanding of this research area will be essential in ensuring that past practical and theoretical advancements are integrated into the development of future programs.

Investigating Veterans' Pre-, Peri-, and Post-Deployment Experiences as Potential Risk Factors for Problem Gambling

Background and aims Gambling disorder and its comorbid diagnoses are observed at higher rates in military veterans than in the general population. A significant research gap exists regarding the relationships of veterans' life and service experiences to problematic gambling. The present study explored pre-, peri-, and post-deployment factors associated with problem gambling in veterans. Methods Veterans of Operation Iraqi Freedom, Operation Enduring Freedom, and Operation New Dawn (n = 738; 463 males, and 275 females) completed questionnaires via structured telephone interview. We conducted bivariate and multinomial logistic regression analyses exploring associations among problem-gambling severity and socio-demographic variables, psychiatric comorbidities, and 10 scales of the Deployment Risk and Resilience Inventory measuring experiences pre-, peri-, and post-deployment. Results Approximately 4.2% of veterans indicated at-risk or probable pathological gambling (ARPG) post-deployment (two or more DSM-IV criteria for pathological gambling). Bivariate analyses found more severe gambling in males, higher frequencies of post-traumatic stress disorder, substance dependence, traumatic brain injury, panic disorder, and depression in veterans with ARPG, and higher general harassment during deployment, and lower social support and more stressful life events post-deployment in those with ARPG. In multivariable models, both post-deployment factors remained significantly associated with ARPG. Discussion The study suggests that problem gambling among veterans is related to service experiences, and particularly to life experiences post-deployment. Conclusions Adverse service and life experiences and lack of social support may contribute to the risk of problem gambling in military veterans. Investigation of how Veterans Affairs clinical settings may serve veterans following deployment to prevent behavioral addictions is warranted.

Gaming the gamer? – The ethics of exploiting psychological research in video games

Purpose

The purpose of this paper is to investigate the ethical implications of video game companies employing psychologists and using psychological research in game design.

Design/methodology/approach

The author first argues that exploiting psychology in video games may be more ethically problematic than familiar application domains like advertising, gambling and political rhetoric. Then an overview of the effects particular types of game design may have on user behavior is provided, taking into account various findings and phenomena from behavioral psychology and behavioral economics.

Findings

Finally, the author concludes that the corresponding ethical problems cannot – and should not – be addressed by means of regulation or rating systems. The author argues instead that a more promising countermeasure lies in using the same psychological research to educate gamers (children in particular) and thereby increase their capacity for meta-cognition.

Originality/value

The importance of this lies in the tremendous effect these behavior-modifying technologies may have upon our self-determination, well-being and social relations, as well as corresponding implications for the society.

SCRATCH THAT!—Two case reports of scratch-card gambling disorder

Gambling disorder is a common, clinically relevant condition that impacts significantly one's life. Given that approved pharmacological interventions are lacking, it is crucial to readily identify these cases to provide available interventions in psychiatric care services. Here, we present two uncommon cases of unique scratch-card gambling disorder, a specific type of pathological gambling that could be increasing as availability of these games are growing.

Pathological gambling treated with lithium: the role of assessing temperament

BACKGROUND AND AIMS

Pathological gambling is a condition for which there is still no FDA-approved treatment although some medications seem to be effective at reducing its symptoms. In DSM-V, it is now classified as an addiction disorder. Data show that baseline comorbidities in patients with gambling and substance misuse behavior are frequent. These might include not only major syndromes but also subclinical ones. Bipolar spectrum conditions are often among these comorbidities. Lithium has been showed to be effective in PG subjects with bipolar spectrum comorbidity, and we present a case where assessment of temperament was helpful in treatment selection.

CONCLUSIONS

This case illustrates the clinical benefits of how the assessment of temperament and comorbidities in pathological gambling patients may guide the clinician to a successful treatment choice. The case presented also corroborates previous evidence on the efficacy of lithium in patients with pathological gambling and comorbid bipolar spectrum conditions and euphoric temperament. Future clinical trials on pathological gambling pharmacotherapy should include temperament assessment to evaluate its influence on different outcomes.

An 8-week stress management program in pathological gamblers: a pilot randomized controlled trial

Stress plays a major role at the onset and relapse of pathological gambling (PG), but at the same time it can also be the aftermath of gambling behavior, thus revealing a reciprocal relationship. Although the role of stress has been well-documented, there is a paucity of studies investigating the effect of an adjunctive stress management program on PG. In this 8-week parallel randomized waitlist controlled trial pathological gamblers, already in the gamblers anonymous (GA) group, were assigned randomly in two groups, with the intervention group (n = 22) receiving an additional stress management program (consisting of education on diet and exercise, stress coping methods, relaxation breathing -RB- and progressive muscle relaxation -PMR). Self-reported measures were used in order to evaluate stress, depression, anxiety, sleep quality/disturbances, life-satisfaction and daily routine. The statistical analyses for the between group differences concerning the main psychosocial study outcomes revealed a statistically significant amelioration of stress, depression, anxiety symptoms and an increase of life-satisfaction and a better daily routine in participants of the intervention group. We hope that these will encourage researchers and clinicians to adopt stress management in their future work.

Gambling addiction: what the non-specialist needs to know

Gambling addiction can have numerous deleterious consequences for the gambler, his/her family and society, but most gamblers go undiagnosed and untreated because of various patient-and clinician-related factors. This article outlines gambling and related problems, and the screening, assessment and treatment of gambling addiction.

How psychological symptoms relate to different motivations for gambling: an online study of internet gamblers

BACKGROUND

Gambling can be motivated by both its hedonic value and by attempts to cope with dysphoric or stressful states. Thus, motivations constitute important mechanisms linking mood fluctuations and gambling. However, little is known about how different kinds of affective disturbance, such as mood elevation and dysphoria, motivate gambling behavior.

METHODS

To estimate relationships between different mood experiences and gambling motivations, we recruited 4125 Internet gamblers via hyperlinks placed on gambling Web sites. Mean (SD) age of respondents was 35.5 (11.8) years, with 79.1% (3263) being male and 68.8% (2838) UK residents. We collected ratings for 11 gambling motivations. We used principal components analysis, followed by hierarchical linear regression, to model the relationships between motivation factor scores and gambling behavior, depressive symptoms, hypomanic experiences, deliberate self-harm, and alcohol and substance misuse.

RESULTS

Gambling to regulate mood, gambling for monetary goals, and gambling for enjoyment were enhanced in individuals at heightened risk of problematic gambling, with mood regulation and enjoyment factors being enhanced in female compared with male problem gamblers. Lowered mood reduced the enjoyment motivation, whereas previous mood elevation enhanced it. Gambling problems alongside previous hypomanic experiences or current dysphoria enhanced gambling to regulate emotional states.

CONCLUSIONS

Recent theorizing argues that mood disorders and pathologic gambling may share aspects of pathophysiology. Different forms of emotional disturbance, such as mood elevation and dysphoric states, which confer heightened risk for bipolar disorder and depression, are associated with divergent motivations that might represent distinct pathways into gambling behavior.