Prevalence, risk factors, and psychosocial adjustment of problematic gambling in adolescents: Results from two representative German samples

Individual risk factors and prediction of gambling disorder in online sports bettors - the longitudinal RIGAB study

Introduction

While research in online sports betting is dominated by studies using objective player tracking data from providers to identify risky gambling behavior, basicresearch has identified various putative individual risk factors assumed to underlie the development of gambling disorder across all types of gambling. This study aims to examine individual risk factors and their longitudinal clinical relevance in online sports bettors.

Methods

German online sports bettors (N = 607, Mage = 34, 92% male) from a provider based sample took part in an online survey. The study team randomly preselected customers to be invited. N = 325 (53,45%) of the participants also took part in an online follow-up survey one year later. Crosssectional and longitudinal associations of putative risk factors and DSM-5 gambling disorder in online sports bettors were analyzed. These risk factors include alcohol and tobacco use, impulsivity, difficulties in emotion identification, emotion regulation strategies, comorbid mental disorders and stress.

Results

We found more pronounced impulsivity, difficulties in emotion identification, emotion suppression, comorbid mental disorders and stress were cross-sectionally associated with gambling disorder, and longitudinally predicted gambling disorder in online sports bettors (with the exception of emotion suppression). In an overall model only lack of premeditation and perceived helplessness remained significant as predictors for gambling disorder. Online sports bettors with gambling disorder predominantly showed more pronounced risk factors, which were also confirmed longitudinally as relevant for the maintenance of gambling disorder.

Discussion

Risk factors such as impulsivity and stress and appropriate coping mechanisms should consequently be integrated not only into prevention efforts to identify individuals at risk early, but also into intervention efforts to tailor treatment.

Gambling participation among Connecticut adolescents from 2007 to 2019: Potential risk and protective factors

Background and aims

Gambling in adolescents is a public health concern. This study sought to examine patterns of gambling among Connecticut high-school students using seven representative samples covering a 12-year period.

Methods

Data were analyzed from N = 14,401 participants in cross-sectional surveys conducted every two years based on random sampling from schools in the state of Connecticut. Anonymous self-completed questionnaires included socio-demographic data, current substance use, social support, and traumatic experiences at school. Chi-square tests were used to compare socio-demographic characteristics between gambling and non-gambling groups. Logistic regressions were used to assess changes in the prevalence of gambling over time and effects of potential risk factors on the prevalence, adjusted for age, sex, and race.

Results

Overall, the prevalence of gambling largely decreased from 2007 to 2019, although the pattern was not linear. After steadily declining from 2007 to 2017, 2019 was associated with increased rates of gambling participation. Consistent statistical predictors of gambling were male gender, older age, alcohol and marijuana use, higher levels of traumatic experiences at school, depression, and low levels of social support.

Discussion and conclusion

Among adolescents, older males may be particularly vulnerable to gambling that relates importantly to substance use, trauma, affective concerns, and poor support. Although gambling participation appears to have declined, the recent increase in 2019 that coincides with increased sports gambling advertisements, media coverage and availability warrants further study. Our findings suggest the importance of developing school-based social support programs that may help reduce adolescent gambling.

Annual Research Review: Emergence of problem gambling from childhood to emerging adulthood: a systematic review

BACKGROUND

The risk for problematic gambling and associated high-risk behaviors is elevated during adolescence and emerging adulthood. Activities with gambling-like features and novel forms of gambling may place youth at an increased risk for problem gambling.

AIM AND METHOD

The aim of this review is to provide an overview of the association between both activities with gambling-like features and novel gambling activities and problem gambling among youth while examining the role of psychopathology and cognitive processes. Six databases (PsychINFO, MEDLINE, PubMed, Social Work Abstracts, Technology Collection, and Scopus) were searched in November 2021 for peer-reviewed articles investigating the association between the aforementioned variables among youth up to the age of 25 years. Risk of bias was assessed using the Observational Study Quality Evaluation.

FINDINGS

Forty-five articles were included in the review. Positive associations were observed between engagement in activities with gambling-like features (e.g., video games, social casino games, loot boxes) and problem gambling. Increased involvement with novel forms of gambling (e.g., online sports betting, fantasy sports, and esports betting) were also associated with a greater risk for problematic gambling. Males reported higher rates of engagement in these activities and a greater risk of problem gambling than females. Impulsivity, risk taking, cognitive distortions, and specific emotional vulnerabilities were associated with an increased risk of problem gambling.

CONCLUSIONS

Despite the need for additional longitudinal research controlling for relevant confounders, these findings underline how engagement in activities with gambling-like features are relevant in the developmental trajectory toward problem gambling.

Parental gambling frequency and adolescent gambling: A cross-sectional path model involving adolescents and parents

INTRODUCTION

Nowadays, most of the research studies in the field of adolescent gambling are focused on individual factors related to problem gambling. The aim of this study was to test an integrated model to explain adolescent problem gambling involving both individual (i.e., correct gambling knowledge, superstitious thinking, and gambling-related cognitive distortions) and environmental factors (i.e., parental gambling frequency). In detail, the aim was to better understand the role of parental gambling behavior on adolescents' gambling frequency and problem gambling severity, to draw indications for prevention.

METHODS

Participants were 680 parents (36% men; Mage = 48.32, SD = 6.14 years) of 680 high school students (51% boys; Mage = 15.51, SD = .55 years) attending the second year of different high schools in Tuscany (Italy). Data collection occurred within the school prevention program PRIZE (Prevention of gambling risk among adolescents).

RESULTS

A path model showed was conducted to detect direct and indirect effects from individual and environmental factors to gambling problem severity. Analyses showed that correct gambling knowledge and superstitious thinking were directly related-respectively in a negative and a positive direction-both to gambling-related cognitive distortions and adolescents' gambling frequency. Parental gambling frequency was directly associated with adolescents' gambling frequency. Correct gambling knowledge and superstitious thinking were indirectly related to adolescents' gambling problem severity through the mediational role of gambling-related cognitive distortions and gambling frequency. Parental gambling frequency was indirectly linked to gambling problem severity by passing through adolescents' gambling frequency.

CONCLUSIONS

The current cross-sectional results confirm that parental gambling behavior has an important role for adolescents' gambling behavior and severity. Thus, results highlight the need for innovative prevention programs which involve adolescents' adult reference figures and integrate the individual risk and protective factors with the environmental ones.

Childhood use of coin pusher and crane grab machines, and adult gambling: A conceptual replication of Newall et al. (2021)

BACKGROUND AND AIMS

Youth gambling research mainly focuses on the illegal use of age-restricted machines, but coin pusher and crane grab machines are gambling machines that can be used by people of any age in the UK, and are also in use internationally. Previous cross-sectional evidence has associated recollected childhood usage of these machines with adult gambling participation and levels of problem gambling amongst adult gamblers. We attempted to conceptually replicate the findings of one of these studies (Newall et al., 2021), while addressing some limitations of that study.

METHODS

A cross-sectional survey of 2,000 UK-based and -born participants aged 19-24 years. The measures were participants' recollected usage of coin pusher and crane grab machines as a child, whether they had gambled in the past 12-months or not, and the PGSI for past 12-month gamblers.

RESULTS

Overall, 5 of 7 tested associations were significant and in the hypothesized direction. Logistic regression models showed that adult gamblers were more likely to recollect using, and used at higher levels of frequency, coin pusher and crane grab machines, than non-gamblers. Then, negative binomial regression analysis showed that adults who recollected using crane grab machines at higher levels of frequency showed more gambling-related problems.

DISCUSSION AND CONCLUSIONS

These results suggest that childhood usage of coin pusher and crane grab machines may act as an underappreciated risk factor for the development of gambling-related harm across the lifespan. This information may be considered for further youth gambling research and policy.

Differences in problem and pathological gambling: A narrative review considering sex and gender

Background and aim

A wide range of studies indicates that men and women with Problem (PrG) and Pathological Gambling (PG) differ in several clinical and sociodemographic characteristics. However, evidence for sex differences, such as the telescoping effect, is contradictory, and it is still unclear whether sex differences observed in offline gambling can also be found for online gambling. Furthermore, reviews have so far focused on binary sex differences but neglect gender aspects. In this study, an updated literature survey of sex- and gender-related differences in PrG and PG was conducted.

Methods

We searched PsyInfo, Medline/Pubmed, and the Web of Science databases from 2005 to 2020 for studies investigating sex and gender differences in gambling. A total of 126 papers were included in the literature survey.

Results

We are presenting our findings according to the categories 'prevalence' (offline, online, LGBTQI*), 'sociodemographic factors', 'preferred gambling type', 'gambling motives', 'severity', 'progression of gambling problems', 'use of professional help/motivation for treatment', 'comorbidity', 'trauma', 'violence and criminality/delinquency'. The studies indicate that, despite some robust sex differences (e.g., concerning prevalence rates), results for most areas were mixed or suggest no sex differences (e.g., violence, gambling motives).

Discussion and conclusion

To date, there is a lack of studies assessing gender, and not only sex, warranting further research in this area.

Phenotype of Gambling Disorder Patients with Lotteries as a Preferred Form of Gambling

Lottery gambling can become an addictive behavior which can significantly interfere with daily functioning. The objectives of this work were to estimate the prevalence of lottery gambling, to assess the profile related to this gambling type in a large clinical sample of patients who met criteria for gambling disorder (GD), and to compare this profile with the other two non-strategic forms of gambling (slot-machines and bingo). Sample included n = 3,531 patients consecutively attended for treatment-seeking due to gambling-related problems. All the participants met criteria for GD and were into the range of 18 to 85 years old. Sociodemographic variables, GD severity, psychopathological state, and personality traits were assessed. Statistical comparisons between the groups defined by the patients’ gambling preference (lotteries versus other gambling activities) were conducted, with chi-square test and analysis of variance. The prevalence of lotteries as the only gambling activity was 2.5%, 8.9% for lottery gambling as primary activity with other secondary gambling types, and 20.6% for lotteries as primary or secondary gambling activity. Lottery gambling and bingo gambling were more prevalent among women (bingo included the highest percentage of women). Compared to slot machine gambling, lotteries and bingo grouped older patients and those with later age of onset of the gambling-related problems. Bingo gambling showed the highest psychological distress and the most dysfunctional personality traits. This study shows the high frequency of lottery gambling among treatment-seeking for GD patients, and it provides empirical evidence about the profile associated with this gambling activity compared to other non-strategic gambling forms. The likelihood of lottery gambling is higher for women, patients married or living with a stable partner, and those within higher social position indexes.

Attitudes, Risk Factors, and Behaviours of Gambling among Adolescents and Young People: A Literature Review and Gap Analysis

Gambling is occurring in a rapidly changing landscape, with new trends and technologies affecting gambling behaviour and problem gambling across a range of populations. Gambling activity among adolescents and young people has received considerable research attention due to a high prevalence of gambling reported among these groups in recent years. Despite legislation worldwide to constrain gambling among adolescents and young people, modern technology, such as online gaming apps and online gambling venues, has significantly increased their exposure to the risks of problem gambling. It is important, therefore, to have up to date information about what is currently known about gambling and to explore gaps in our knowledge. This gap analysis presents the results of a systematic approach to reviewing the current literature on gambling behaviour, attitudes, and associated risk factors for gambling and problem gambling among adolescents and young adults (aged 10-25 years). The review included studies published between January 2015 and August 2020 and included 85 studies for final synthesis. Findings reveal further research is needed on the implications for young people of emerging technologies and new trends in gambling in the digital age. The current gap analysis reveals that this should include more research on the development and impact of both treatment and intervention strategies, and policy and regulatory frameworks from a public health perspective.

Behavioral Intention to Gamble Among Adolescents: Differences Between Gamblers and Non-gamblers-Prevention Recommendations

Gambling is a rapidly growing phenomenon among adolescents associated with negative psychosocial effects. To prevent this public health problem, it is necessary to identify the factors that cause and maintain adolescent gambling. Based on the theory of planned behavior (TPB), structural equation models were used in a sample of 1174 adolescents (aged 12-20 years) to study the effect of attitudes, subjective norms and self-efficacy on gambling intention in adolescent gamblers (n = 432) and non-gamblers (n = 742). Measurement invariance was assessed and then structural model was tested separately in gamblers and non-gamblers. The influence of past gambling experience on the TPB model was also studied through multigroup analysis. All models showed adequate fit to the data. The relationships between attitudes and self-efficacy with gambling intention were significantly stronger in gamblers subsample. These results confirmed that gambling experience increases the predictive ability of the TPB model in gamblers. TPB independent variables explained 16.2% of variance of gambling intention in non-gamblers and 32.4% in gamblers. Subsequently, the TPB model for gamblers explained 19% of variance of gambling frequency. In this last model, gambling intention partially mediates the influence of self-efficacy on gambling behavior. The subjective norm was the variable with the greatest effect on gambling intention in non-gamblers, while self-efficacy to control gambling was the exogenous variable with greatest effect on gambling frequency. The findings suggest the possibility of specific gambling prevention in adolescent gamblers and non-gamblers.

Machine learning-based analysis of adolescent gambling factors

BACKGROUND AND AIMS

Problem gambling among adolescents has recently attracted attention because of easy access to gambling in online environments and its serious effects on adolescent lives. We proposed a machine learning-based analysis method for predicting the degree of problem gambling.

METHODS

Of the 17,520 respondents in the 2018 National Survey on Youth Gambling Problems dataset (collected by the Korea Center on Gambling Problems), 5,045 students who had gambled in the past 3 months were included in this study. The Gambling Problem Severity Scale was used to provide the binary label information. After the random forest-based feature selection method, we trained four models: random forest (RF), support vector machine (SVM), extra trees (ETs), and ridge regression.

RESULTS

The online gambling behavior in the past 3 months, experience of winning money or goods, and gambling of personal relationship were three factors exhibiting the high feature importance. All four models demonstrated an area under the curve (AUC) of >0.7; ET showed the highest AUC (0.755), RF demonstrated the highest accuracy (71.8%), and SVM showed the highest F1 score (0.507) on a testing set.

DISCUSSION

The results indicate that machine learning models can convey meaningful information to support predictions regarding the degree of problem gambling.

CONCLUSION

Machine learning models trained using important features showed moderate accuracy in a large-scale Korean adolescent dataset. These findings suggest that the method will help screen adolescents at risk of problem gambling. We believe that expandable machine learning-based approaches will become more powerful as more datasets are collected.

Immigrant status and problem-gambling severity in adolescents: Evidence for moderation by sensation seeking

Despite the multidimensional/ecological integrative perspective that suggests that the risk for problem gambling in adolescents can be determined by an interactive effect of different risk factors, few studies have investigated how different individual factors may affect the risk for problem gambling in a multiplicative way. This study aimed at exploring the interaction between immigrant status (IS) and sensation seeking (SS) on adolescent problem-gambling severity. The study involved 994 Italian adolescents (64% boys, M_age = 16.57, SD = 1.62). Participants' IS, SS and problem-gambling severity were individually assessed through, respectively, a socio-demographic questionnaire, the Brief Sensation Seeking Scale (BSSS) and the South Oaks Gambling Screen - Revised for Adolescents (SOGS-RA). Results showed that, among immigrant adolescents, there were higher levels of problem-gambling severity and a higher distribution of at-risk and problem gamblers with respect to non-immigrant adolescents. Both IS and SS had significant direct effects on problem-gambling severity, with IS and higher levels of SS being predictors of greater severity. A moderation analysis - controlling for gender and age - showed that adolescents with high scores of SS were more prone to experience gambling problems if they were also immigrant. These results have important implications for practice as they emphasize that specific interventions aimed at preventing problem gambling would be required for adolescents from immigrant families. In particular, it would be important to consider the role of SS in this specific youth target.

Conduct problems and depressive symptoms in association with problem gambling and gaming: A systematic review

BACKGROUND AND AIMS

Behavioral addictions such as gambling and gaming disorder are significant public health issues that are of increasing importance to policy makers and health care providers. Problem gambling and gaming behaviors have been identified as being associated with externalizing and internalizing problems, with theoretical models suggesting that both conduct problems and depressive symptoms may be significant risk factors in the development of problem gambling and gaming. As such, the purpose of this systematic review is to provide an overview of research identifying the relationship between conduct problems, depressive symptoms and problem gambling and gaming among adolescents and young adults.

METHODS

Systematic literature searches in accordance with PRISMA guidelines found 71 eligible studies that met the inclusion criteria, 47 for problem gambling, 23 for problem gaming and one for both problem behaviors.

RESULTS

Based on cross-sectional evidence, both problem gambling and gaming are consistently concurrently associated with conduct problems and depressive symptoms. Longitudinal evidence appears to be clearer for conduct problems as a risk factor for problem gambling, and depressive symptoms as a risk factor for problem gaming. However, both risk factors appear to increase the risk for these problem behaviors.

DISCUSSION AND CONCLUSIONS

Results from the literature review suggest that problem gambling and gaming are associated with the presence of conduct problems and depressive symptoms, with the potential of sharing common etiological factors. Additional research is necessary to confirm these longitudinal relationships with an emphasis on investigating the interaction of both early conduct problems and depressive symptoms.

The influence of chronological age on cognitive biases and impulsivity levels in male patients with gambling disorder

BACKGROUND AND AIMS

Due to the contribution of age to the etiology of gambling disorder (GD), there is a need to assess the moderator effect of the aging process with other features that are highly related with the clinical profile. The objective of this study is to examine the role of the chronological age into the relationships between cognitive biases, impulsivity levels and gambling preference with the GD profile during adulthood.

METHODS

Sample included n = 209 patients aged 18-77 years-old recruited from a Pathological Gambling Outpatients Unit. Orthogonal contrasts explored polynomial patterns in data, and path analysis implemented through structural equation modeling assessed the underlying mechanisms between the study variables.

RESULTS

Compared to middle-age patients, younger and older age groups reported more impairing irrational beliefs (P = 0.005 for interpretative control and P = 0.043 for interpretative bias). A linear trend showed that as people get older sensation seeking (P = 0.006) and inability to stop gambling (P = 0.018) increase. Path analysis showed a direct effect between the cognitive bias and measures of gambling severity (standardized effects [SE] between 0.12 and 0.17) and a direct effect between impulsivity levels and cumulated debts due to gambling (SE = 0.22).

CONCLUSION

Screening tools and intervention plans should consider the aging process. Specific programs should be developed for younger and older age groups, since these are highly vulnerable to the consequences of gambling activities and impairment levels of impulsivity and cognitive biases.

Prevalence of gambling behaviours and their associations with socioemotional harm among 11-16 year olds in Wales: findings from the School Health Research Network survey

BACKGROUND

Gambling opportunities are increasingly available and acceptable to many adolescents. Adolescent problem gambling has been associated with poor outcomes, such as lower reported physical and mental health. While much research has focussed on 'problem' gambling, analysing the distribution and determinants of experimentation with gambling is important in order to understand its normalization and population level consequences. This study describes the distribution of inequalities and socioemotional harms associated with adolescent gambling.

METHODS

Data were drawn from a subsample of students (N = 37 363) who completed gambling questions as part of the 2017 School Health Research Network Student Health and Wellbeing Survey, representing 193 secondary schools in Wales. Using imputations, we estimated a series of single-predictor and multi-predictor regressions for count of gambling behaviours, any gambling in the past 12 months and socioemotional harms of gambling.

RESULTS

Approximately two-fifths (41.0%) of respondents reported gambling in the past 12 months, of whom 16.2% reported feeling bad as a result of their own gambling. We found significant sex differences in gambling, with boys gambling more frequently than girls. Adolescents from more affluent families reported a higher count of gambling behaviours and socioemotional harms, although paradoxically, increasing affluence was also associated with lower prevalence of gambling in the last year. Non-White British ethnicities and students who felt less connected to school were more likely to engage in gambling and experience socioemotional harms.

CONCLUSIONS

Our findings provide important new insights regarding risk factors in adolescence associated with gambling behaviours and socioemotional harms.

Design and Measurement Properties of the Online Gambling Disorder Questionnaire (OGD-Q) in Spanish Adolescents

Gambling disorder is of great clinical and social relevance since it seriously affects people who suffer from it. More recently, the Internet has exacerbated the problem with online casinos, poker, and sports betting. However, there is little evidence of this problem, and we know of no diagnostic questionnaire. The main objectives of this study were to develop the Online Gambling Disorder Questionnaire (OGD-Q) for adolescents, evaluate its main psychometric properties, and establish diagnostic criteria to differentiate pathological from non-pathological online gamblers. We conducted a study in 16 schools across seven regions of Spain, sampling 2691 adolescents, 883 of whom had reported some online gambling experience. Of those, 602 were boys (68.2%) and 281 were girls (31.8%) Sampling was non-probabilistic and incidental. Mean age and standard deviation were 14.25 ± 1.55 (11-19 years). Confirmatory factor analysis yielded a one-dimensional model with a good fit. The reliability indicators were satisfactory (>0.94). The scores on the OGD-Q were related to other constructs, such as Internet gaming disorder, problematic Internet use, and nomophobia. Participants classified as having problems or being at risk of online gambling disorder presented significantly more stress, anxiety, and depression. Participants categorized as having online gambling disorder comprised 0.89% (n = 24) of the total sample and 2.71% of those who have gambled at some time. We discuss these findings and their practical implications in this article and propose future lines of research.

Gambling habits, gambling norms, and problem gambling in foreign born and native populations in Denmark - A general population survey

Background

Being foreign born, i.e. not born in the reception country or belonging to an ethnic minority, has been described as a risk factor of problem gambling, although research so far has been inconclusive. Also, there is limited knowledge about whether this association is caused by differing gambling norms. The present study aimed to study whether foreign origin is associated with problem gambling, when controlling for several potential risk factors, gambling frequency and beliefs about peer gambling, i.e. gambling norms.

Methods

Cross-sectional web survey including 1970 adult individuals from the general population in Denmark (50% female), in April 2018. Binary analyses and hierarchical logistic regression with respect to associations between foreign origin, relevant co-factors and problem gambling.

Results

Problem gambling was more common in individuals with foreign origin (15 vs 10%, p = 0.01). In logistic regression, problem gambling was associated with male sex, gambling frequency, foreign origin, psychological distress, smoking, and number of gambling types used. Beliefs about peer gambling did not differ with respect to foreign origin, but were associated with problem gambling until one's own gambling frequency was entered into the model.

Conclusions

When controlling for a number of relevant risk factors, foreign origin still appears to predict problem gambling. Gambling patterns or gambling norms are unlikely to be the sole explanation of the increased prevalence. The findings have implications for preventive work in the foreign born population, and gambling norms may be targeted in screening for at-risk gamblers.

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In the population, problem gambling was more common in first or second generation immigrants.

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The association with problem gambling was not explained by increased gambling norms in the immigrant population instead demonstrated lower beliefs about peer gambling.

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Instead, immigrants demonstrated lower beliefs about peer gambling

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Beliefs about peer gambling were associated with own's problem gambling risk