Is gambling like a virus?: A conceptual framework and proposals based on empirical data for the prevention of gambling addiction

OBJECTIVE

The objective of this study is to present a conceptual framework for the prevention of gambling disorder and try to corroborate some of its postulates. The assumption of gambling as if it were acting like a virus may have important considerations in terms of preventing gambling disorder in society and, therefore, it could be a relevant public health issue.

BACKGROUND

Like COVID-19, gambling disorder is a disease which is caused by the action of an external agent. The external agent was already in existence, but certain environmental conditions (absence of regulatory measures based on the prevention of gambling disorder) favored its propagation. Regarding immunization, for SARS-CoV-2, it is obtained through vaccination and prevention of exposure. However, it is unlikely that immunization can be developed for any gambling addiction prevention program to immunize everyone who is exposed to the "gambling virus". So, in the case of gambling disorder, preventive strategies should rather prevent gambling from affecting most people by limiting availability (supply) and accessibility (ease of access) to gambling.

STUDY DESIGN

This research is a quasi-experimental investigation aimed to evaluate the effects of anti-COVID measures on the frequency of gambling and evolution of gambling disorder. The present study analyzed gambling patterns and the problems caused by gambling in 2,903 people, including those who were at-risk gamblers or had a gambling disorder.

RESULTS

In general terms, restrictive measures to combat COVID-19 worked to prevent the consolidation of gambling habits and the appearance of gambling disorder, but they did not seem to be sufficient for people who already had this disorder. The most affected games were electronic games machines (EGMs) that took place in public places (gambling halls, bars and restaurants, etc.).

CONCLUSIONS

The findings of this work support the hypothesis that, just as the SAR-CoV-2 virus is responsible for the global pandemic of COVID-19, which can only be stopped with vaccines and social distancing, in the case of gambling, the absence of an effective vaccine for "gambling virus" can lead to an epidemic of gambling disorders in societies, if the environmental conditions that are favorable for the spread of such virus are not modified. Some preventive strategies that can be useful from a public health frame of reference are suggested.

The scratch card gambler: a hidden reality

Scratch cards-otherwise known as scratch tickets or instant lotteries-are a highly accessible type of lottery, due to its relative accessibility and affordability. In Portugal, the popularity of scratch cards has experienced substantial growth, with almost no regulatory reaction whatsoever. This study aims to describe the sociodemographic characteristics of scratch card gamblers, prevalent gambling habits, and their perceptions regarding scratch card gambling. This study also determines the constancy of pathological scratch card gambling, and the possible impact of regulatory measures. We found that about half of the participants studied were at risk of pathological gambling and scratch cards seem to have a clear potential for enticing higher spending in vulnerable consumers, compared to other forms of gambling games. Perception biases regarding gambling are frequent and almost no one afflicted seeks help. Regulatory measures are crucial to regulate potential problematic behaviors, specifically in high-risk persons. There is an urgent need to act, made clear by both present findings and numerous precedent warnings regarding scratch card gambling hazards.

The Role of Social Support and Belonging in Predicting Recovery from Problem Gambling

Research indicates a role for both social support and belonging in addiction recovery, however little is known about the role of these constructs in the recovery from problem gambling, and whether they relate to the effectiveness of mutual aid groups such as Gamblers Anonymous. The aim of this study was therefore to explore the relationship between social support and belonging, and to assess the role of demographics (including group membership of GA), social support and/or belongingness in predicting gambling addiction recovery in terms of gambling urges and quality of life. Using a cross sectional design, participants identifying as having problem gambling (n = 60) completed an online questionnaire with two independent variables (Social Support and Belonging), two dependent variables (Gambling Urges and Quality of Life) to assess gambling addiction recovery and measures of GA membership. The results showed no significant association between gender, age, ethnicity, education or employment status and gambling urges or quality of life. Membership to GA, and length of membership were significantly associated with gambling recovery indicating that being a member of GA and longer membership was associated with lower gambling urges and higher quality of life. Further, the results showed a high but not perfect correlation between social support and belonging (r(58) = .81, p =  < .01). A regression analysis showed that although there was a significant correlation between social support and belongingness, they played different roles in gambling addiction recovery. Social support alone predicted higher quality of life, but not a reduction in gambling urges; belonging (along with being a member of GA) predicted a reduction in gambling urges, but not an increase in quality of life. Social support and belonging have a differential impact on aspects of gambling addiction, and should be considered as different constructs. In particular, whilst the process underpinning reduced gambling urges is membership of GA and the sense of belonging it provides its members, social support per se is a better predictor of quality of life. These findings have implications for the development of treatment for problem gamblers in the future.

Psychological online interventions for problem gambling and gambling disorder - A meta-analytic approach

OBJECTIVE

The Covid-19 pandemic has reignited discussions about the prevalence of and treatment options for problem gambling and gambling disorder (PGGD). Since affected persons seldom seek professional help, online interventions can improve accessibility. Thus, this study aimed to investigate the effectiveness of psychological online interventions on PGGD.

METHODS

We conducted a systematic review and meta-analysis and searched in PubMed, PsycINFO, and Google Scholar for peer-reviewed experimental and quasi-experimental research published between 2010 and 2021. We calculated two meta-anlyses, one for treatment control comparisons (TCC), and one for pre-post-comparisons (PCC).

RESULTS

We included six studies (ten TCC and n = 2076) in meta-analysis 1 and five studies (six PCC and n = 781) in meta-analysis 2. Online interventions turned out to be effective in both analyses with Hedges g = 0.41, 95% confidence interval = [0.22 to 0.60], p < .001, for meta-anaylsis 1 and Hegdes g = 1.28, 95% confidence interval = [0.85 to 1.71], p < .001, for meta-analysis 2.

CONCLUSIONS

We identified significant effects of online interventions on PGGD in both analyses, indicating the potential of online applications. We discuss methodological aspects and further research directions.

Development and Validation of a Near Miss Scale for Assessing Gambling Tendency

Although near-miss is an important tendency indicator for gambling addiction, no scale has been developed to evaluate these feelings. In this study, the aim is to develop a Near Miss Scale (NMS) to assess the tendency of gambling. In the first step, a 38-item measurement tool was prepared by the first author, which was examined by 8 experts. According to their comments and opinions, a 32-item 5-point Likert-type pre-form was created. The study was conducted with 600 gamblers in Northern Cyprus between December 2018-March 2019 and data from 563 of them were included in the statistical analysis. In the questionnaire, Socio-demographic form, Gambling Craving Scale (GCS), South Oaks Gambling Screening Test (SOGST) and NMS were used. With the SPSS 23 and R Studio statistical programs, after calculating the item-total correlations of the items in the NMS form, items with low item total-correlation values were excluded from the scale and 30 items were analysed statistically. In the study, it was seen that the factor loads of the relevant items in NMS were between .715 and .896. Confirmatory factor analysis (CFA) showed that a single factor model in the scale was valid. NMS had a positive correlation with SOGST (r = 0.601) and GCS (r = 0.752). The 2-week test-retest results of NMS with a Cronbach alpha of 0.981 were determined as 0.972. The validity and reliability results suggest that NMS is a valid and reliable as 30-item, one-dimensional measurement tool for assessing gambling tendency among gamblers.

Exploring the experience of Gamblers Anonymous meetings during COVID-19: a qualitative study

Whilst much research has explored the possible causes and consequences of gambling, Gamblers Anonymous (GA) − one of the most accessed forms of support for gamblers - has been largely overlooked and, to date, only a few studies have explored how members experience this programme. Core to GA is the social interaction between members. From March 2020, however, the COVID-19 pandemic forced GA to move their meetings online. The present qualitative study therefore explored how GA members experienced these online meetings in the absence of actual face to face interactions with others. Individual telephone or video call interviews (n = 21) were carried out with members of GA in the UK and analysed using Thematic Analysis. The results described three main themes: (1) ‘practicalities of GA in lockdown’, which highlighted the practical benefits of online meetings such as more opportunity to attend different meetings, which in turn expanded participants’ perspectives and social networks; (2) ‘the importance of relationships in GA’, reflecting strong and enduring social networks that were created, maintained, and strengthened by feelings of solidarity; and (3) ‘therapeutic elements of the meetings’, such as psychological contract making which helped participants to stay abstinent. Transcending these themes was a tension between individual versus group identity with interviewees reporting a shift to focusing more on their own needs rather than those of the group. Overall, whilst still providing a lifeline during COVID-19 and offering some practical benefits, the online GA meetings were not able to completely replicate the value individuals gained from face to face meetings. This transition also resulted in disruptions both to group dynamics and to individual interactions within each group, ultimately resulting in participants behaving more individualistically and less collectively than in face-to-face meetings.

Motives for gambling, cognitive distortions, and irresponsible gambling: Proposal for an explanatory model of gambling addiction in university students

There are many factors that appear to be directly related to the development of gambling addiction problems, and it is important to understand these relationships from a clinical perspective in order to develop prevention and intervention programs. This research seeks to analyze the relationships these problems have with gambling motives, cognitive distortions and irresponsible gambling behavior, and proposes an explanatory model of gambling addiction. The sample was made up of 258 adults residing in the province of Valencia (59.5% women), with a mean age of 20.95 years (SD = 2.19). A series of questionnaires were applied to measure the variables involved, and bivariate correlations, simple and multiple linear regressions and a structural equation model were analyzed. The results indicated that gambling motives were positively related to cognitive distortions, acting as predictors of these. Additionally, the proposed theoretical model showed goodness of fit on various indices and explained 69% of variance in cognitive distortions, 37% of that in irresponsible gambling and 43% of that in gambling addiction. The main limitation of this research is that the sample belongs to a very specific population, who did not necessarily have gambling problems. The main contributions are uncovering some of the relationships between gambling motives and cognitive distortions and the proposal of a mediating role of irresponsible gambling in the relationship between cognitive distortions and the development of gambling problems. If the proposed model replicates, it can be of help to research and health professionals.

Comparing public perceptions of substance addictions and behavioural addictions

INTRODUCTION

Identifying addictions in peers is vital for early referral and improving outcomes. Substance addictions such as alcoholism and cocaine addiction have been recognised for a long time whereas behavioural addictions such as gambling and especially gaming are relatively new addictions. This study aims to evaluate public perceptions of substance addictions compared to behavioural addictions.

METHODS

The six ICD-10 characteristics of dependence were incorporated into a series of vignettes. Participants in an online survey were asked to use a Likert scale to judge the presence and severity of addictions. The responses were analysed using the Wilcoxon Sum Rank test to allow the groups to be compared.

RESULTS

Of the 247 participants, participants were more likely to say someone was addicted to gambling in the not addicted questions and lightly addicted question sets than the other addictions studied. Alcohol addiction was the poorest identified addiction amongst participants in the lightly addicted questions and was also poorly identified in the heavily addicted questions. Lightly addicted behaviour was poorly identified by participants in all four addictions studied.

CONCLUSIONS

The hypothesis that substance addictions are recognised better than behavioural addictions was unsubstantiated. Gambling was seen as the most addictive behaviour/substance of the four addictions whilst alcohol addiction was not recognised when minor dependent traits were exhibited and poorly recognised with heavily dependent traits. Public interventions may be needed to improve peer identification of alcohol addiction in their peers. This study indicates that the general public does not identify any minor addictions in their peers sufficiently to improve outcomes for patients.

Gambling Patterns and Problem Gambling Among Youth in Sub-Saharan Africa: A Systematic Review

Mounting evidence suggests that youth in sub-Saharan Africa (SSA) find themselves increasingly drawn to gambling related activities; an issue, that if left unchecked, can lead to adverse consequences including financial difficulties, crime and mental health problems. To better understand the psychosocial mechanisms underlying problem gambling, there is a pressing need to conduct more research on gambling related disorders amongst this vulnerable stratum of society. Against this background, the present review explores gambling patterns, attitudes and behaviors among youth in SSA-in a manner aligning with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We systematically searched 8 databases including PubMed, Science Direct, Scopus, ProQuest, Wiley Online, Google Scholar, PsycINFO and PsycARTICLES for published research articles up until July 2019. A total of 1624 articles were screened, of which, only 13 studies met inclusion criteria. All of these studies were cross-sectional in nature and the quality of each study was evaluated using the Newcastle-Ottawa Scale. Studies varied considerably ranging from neuropsychological and personality trait assessment to application of item response theory. Due to this study heterogeneity we could not conduct a meta-analysis. The results presented here suggest that the existing body of evidence pertaining to patterns of gambling-related harm among youth in SSA is weak. This study highlights the need for additional good quality studies focusing on gambling related behaviors and prevalence levels among the continent's youth. Additionally, the findings reported herein emphasise the need for implementing social policies alongside effective public health interventions to tackle gambling addiction.

Mind the GAP! Pathological gambling, a modern defy to public health

Due to its clinical aspects, pathological gambling is of paramount interest for Psychology and Psychiatry; however, it also has such characteristics that call for the interest and the intervention of Public Health, both at national and international level. This pathology is a growing problem in our society, particularly in some groups of vulnerable people; has a strong psycho-social impact on the individuals, their families, their social environment and the society as a whole; requires an organized, competent, structured and integrated intervention of the Public Health care services and of specialized private organizations; and, finally, it represents important economic implications. As far as the Italian situation is concerned, it is estimated that up to 50% of the population has experienced gambling at least once; consequently, the political world has taken interest in the problem, producing in 2016 a governmental Report on Pathological Gambling to the Parliament; moreover, pathological gambling has been included into the 2017 revision of the Essential Levels of Health Care Regulations, whose validity is nationwide, provided that, usually, the Regions legislate autonomously on health assistance aspects. Recently, the Observatory on Contrast to Pathological Gambling and to Serious Gambling Addiction has published specific ad hoc guidelines and the Italian Parliament approved a law forbidding every form of gambling advertising (Law No. 96/2018). However, even considering the interest of the National Health Service in contrasting pathological gambling, the problem is far from its solution; firstly, because the State itself earns a considerable amount of money from the taxation of "legal" gambling, thus creating a resounding conflict of interest; secondly, because the peripheral branches of the National Health Service have responded unevenly so far when trying to organize the contrast. What is needed for the future is an effort of coordination between the National Health Service - at State, Region and local level - and the Non-Governmental Organizations, in order to face the cultural, political, communicational, organizational, technological and public health aspects of such a contrast, balancing incentives and disincentives wisely.

High Recreational Gamblers Show Increased Stimulatory Effects of an Acute Laboratory Gambling Challenge

Gambling in moderation is a socially acceptable behavior and over 60% of the Swedish population gambles every year. It has been seen that slot machines are one of the most addictive and problematic forms of gambling and contribute highly to an addictive behavior. It is unclear why some individuals intensify their gambling behavior over time to extreme levels while others do not. Initial positive response of a drug or as in this case a gambling behavior, most likely influences the likelihood of continuing use in non-addicted individuals. Therefore, we wanted to investigate if recreational gamblers show an altered subjective response to an online gambling challenge, e.g. to casino gambling. The present study was designed to examine the subjective effects after an acute gambling challenge, in healthy recreational gamblers compared with non-gamblers. Eighty-two subjects participated in the study. They were challenged with an acute online slot machine gambling challenge and self-report questionnaires of mood and blood pressure were taken before and after gambling. The gamblers, and more specifically the high recreational gamblers, reported increased stimulative effects after the gambling challenge in comparison to the non-gamblers. Findings suggests that gamblers experience significantly higher arousal effects to an acute online slot machine challenge. This response may be a uniquely predictive behavior for increased risk of gambling addiction.

An Overview of Structural Characteristics in Problematic Video Game Playing

PURPOSE OF REVIEW

There are many different factors involved in how and why people develop problems with video game playing. One such set of factors concerns the structural characteristics of video games (i.e., the structure, elements, and components of the video games themselves). Much of the research examining the structural characteristics of video games was initially based on research and theorizing from the gambling studies field. The present review briefly overviews the key papers in the field to date.

RECENT FINDINGS

The paper examines a number of areas including (i) similarities in structural characteristics of gambling and video gaming, (ii) structural characteristics in video games, (iii) narrative and flow in video games, (iv) structural characteristic taxonomies for video games, and (v) video game structural characteristics and game design ethics. Many of the studies carried out to date are small-scale, and comprise self-selected convenience samples (typically using self-report surveys or non-ecologically valid laboratory experiments).

SUMMARY

Based on the small amount of empirical data, it appears that structural features that take a long time to achieve in-game are the ones most associated with problematic video game play (e.g., earning experience points, managing in-game resources, mastering the video game, getting 100% in-game). The study of video games from a structural characteristic perspective is of benefit to many different stakeholders including academic researchers, video game players, and video game designers, as well as those interested in prevention and policymaking by making the games more socially responsible. It is important that researchers understand and recognize the psycho-social effects and impacts that the structural characteristics of video games can have on players, both positive and negative.

The Challenge of Online Gambling: The Effect of Legalization on the Increase in Online Gambling Addiction

It is possible that the growth and promotion of online gambling will result in substantially increased use of these types of games in countries where they are legal. This may be especially true for young people due to their interest in such games. In this context, it is important to note that online gambling is more addictive than any other type of game due its structural characteristics, such as immediacy, accessibility, ease of betting, and so on. This study examined the effect of online gambling in Spain 2 years after its legalization. The sample included 1277 pathological gamblers in recovery at 26 gambling addiction treatment centers. Our results showed a significant increase in young pathological gamblers since the legalization of this activity. This is a very relevant issue because, as in the case of Spain, many countries are currently in process of legalization of many types of online games. Scientific research can be useful to adapt the adequate gambling policies in order to prevent the gambling addiction.

Development and validation of a stock addiction inventory (SAI)

BACKGROUND

Investing in financial markets is promoted and protected by the government as an essential economic activity, but can turn into a gambling addiction problem. Until now, few scales have widely been used to identify gambling addicts in financial markets. This study aimed to develop a self-rating scale to distinguish them. In addition, the reliability and validity of the stock addiction inventory (SAI) were demonstrated.

METHODS

A set of questionnaires, including the SAI, south oaks gambling screen (SOGS), and DSM-5 diagnostic criteria, for gambling disorder was completed by 1005 participants. Factor analysis, internal consistency testing, t tests, analysis of variance, and partial correlation analysis were conducted to verify the reliability and validity of SAI.

RESULTS

The factor analysis results showed the final SAI consisting of two factors and nine items. The internal consistency and concurrent validity of SAI were verified. The Cronbach's α for the total scale was 0.892, and the SAI and its factors were significantly correlated with SOGS.

CONCLUSIONS

This study developed a specific scale for financial market investments or trading; this scale proved to be reliable and valid. Our scale expands the understanding of gambling addiction in financial markets and provides a diagnostic reference.