Risk and protective factors in problem gambling: an examination of psychological resilience

Psychological resilience – successful adaptation when faced with adversity – is a product of the balance of risk and protective factors relevant to an outcome. This study examined if protective factors (perceived resilience; mindfulness; grit; self-efficacy) explained variance in problem gambling tendencies (assessed with the Problem Gambling Severity Index) beyond the HEXACO personality traits (honesty-humility, emotionality, extraversion, agreeableness, conscientiousness, openness to experience) and risk factors for problem gambling (gender; age; socio-economic status; high frequency gambling behaviour; harsh unpredictable childhood environments; sensation-seeking; impulsivity; self-control; stress). This study used a crowdsourced community sample (n = 469) recruited from Amazon Mechanical Turk. Bivariate analyses showed that risk factors and some HEXACO traits (especially honesty-humility) were associated with problem gambling issues. Among protective factors, only trait mindfulness showed a bivariate association with problem gambling issues. Somewhat surprisingly, regression analyses revealed that protective factors did not explain variance in problem gambling beyond HEXACO traits and risk factors. However, in exploratory analyses, mindfulness and self-efficacy – both modifiable protective factors – moderated the relationship between high-frequency gambling (a key proximate antecedent of problem gambling) and problem gambling tendencies. These results suggest mindfulness and self-efficacy may serve as ‘buffers’ against the development of problem gambling issues and may be promising targets for clinical interventions.     

Co-morbidity of gambling and Internet use among Internet and land-based gamblers: classic and network approaches

This study investigated co-morbidity of problem gambling and problematic Internet use (PIU) among adolescent Internet and land-based gamblers, with the classic approach using sum-scores of symptoms and a promising new method, namely the network perspective. This perspective allows testing for how multiple disorders are associated, showing symptoms overlap and centralities. We used cross-sectional data from two population-based samples of adolescents aged 17 years in France (n = 2,240) and Switzerland (n = 944). Measures included Internet gambling, problem gambling and PIU. The classic approach showed that Internet gambling was associated with increased levels of disordered gambling and PIU, but that correlations between disorders were weak (R² min = 3.2%, R² max = 17.6%). The network perspective showed that the co-morbid network of Internet gamblers was more connected in comparison with land-based gamblers. Problem gambling and PIU appeared as separate disorders, but their relationship was increased among Internet gamblers in comparison with land-based gamblers. The network perspective appeared as a promising avenue for a better understanding of addictive disorders, but it should not replace the classic approach, which showed increased levels of addictive behaviours among Internet gamblers.     

Demand for gambling: development and assessment of a gambling purchase task

Self-report purchase tasks are a novel approach examining the reinforcing value of addictive behaviour relative to increasing monetary costs required to access the addictive behaviour (i.e. demand). These measures reveal a positive relationship between the indices of demand and addiction problem severity and can elucidate factors associated with motivation for substance use. Gambling is an addictive behaviour that has not been examined using this paradigm. This study seeks to adapt and examine the purchase task for gambling behaviour. A gambling purchase task was devised that asked individuals how often per month they would gamble at various cover charges. Participants were 73 adults from the community with either gambling disorder (n = 28) or alcohol use disorder (n = 24) or were a healthy control (n = 21). Both the alcohol and gambling purchase tasks were administered. Results demonstrate discriminant validity of the gambling purchase task, as individuals with gambling disorder have significantly greater demand for accessing gambling than other groups. The alcohol purchase task also evidenced discriminant validity in that individuals with alcohol use disorder have significantly greater demand for alcohol than other groups. These findings support the use of the gambling purchase task to assess the demand for gambling.     

Gambling-Related Harms Among Adolescents: A Population-Based Study

Internationally, and also in Europe, adolescent gambling is increasingly recognized as an important public health issue. Most research on adolescent gambling, however, is prevalence-focused and population-based studies are scarce. Few studies have examined gambling-related harms among adolescents. In a national sample, we examined self-experienced harms related to gambling and the relationship between reported harms and gambling behavior among Finnish adolescents. A national survey of 12–18-year-olds was conducted in Finland in 2011 (N = 4,566). Main measures were frequency of gambling and gambling-related harms reported during the past 6 months. The relationship between reported harms and gambling behavior was assessed using logistic regression analysis. Overall, 44% had gambled during the past 6 months. Of the sample, 12% were frequent gamblers (at least weekly) and 32% were occasional gamblers (monthly or less often). Compared to occasional gamblers, frequent gamblers were more likely to experience harms. The most commonly reported harms among frequent gamblers were “felt guilty or shameful due to gambling” (17%) followed by “problems with relationships” (13%) and “disruptions of daily rhythm” (10%). In age and gender-adjusted analysis, daily gamblers were significantly more likely to report all different types of harms when compared to other groups. These findings suggest that when planning and targeting youth gambling prevention and harm reduction strategies the nature and extent to which gambling may contribute to the different types of harms are important to consider.     

Attitudes toward gambling among adolescents

It is well documented that attitudes toward gambling are a good predictor of problem gambling during adolescence. However, so far, little is known about what factors are associated with adolescents' gambling attitudes. This study used cross-sectional data (N = 2055, response rate 70.4%) from a representative sample of 17-year-olds in Norway to investigate the relationship between demographic, personality, motivational and social variables and gambling attitudes. Overall, adolescents' attitudes toward gambling were slightly negative. A multivariate analysis revealed that more favourable attitudes toward gambling were most strongly associated with family/peer approval of gambling. In addition, significant associations were found for gender (males more favourable); Sensation Seeking (positive association); Agreeableness (negative association); and family/peer gambling history (positive association for lifetime gambling, negative association for problematic gambling). Although a variety of individual-level and social factors are associated with more favourable attitudes toward gambling, it appears that family and peer approval of gambling are most important.     

An exploratory study of multiple distinct gambling trajectories in emerging adults

This study uses data from a four-wave longitudinal survey of emerging adults (18–20 years of age in Wave 1) to examine whether there are multiple distinct trajectories of problem gambling risk severity and whether membership in these trajectory classes can be predicted by certain risk and protective factors. Four trajectory classes of gambling risk severity were identified – nonproblem-diminishing (73.9%), low-risk-stable (16.8%), marginal/nongambler-diminishing (7.1%), moderate-risk-increasing (2.2%) – with most youths' gambling involvement remaining stable or diminishing across the years and only the smallest most at-risk group showing a slight increase in severity across this transitional period. Three risk factors were significant predictors of class membership – being male, scoring higher on alcohol dependence, and escape-avoidance coping were all associated with increased probability of being in one of the more gambling involved trajectory classes, while lower alcohol dependence scores were associated with increased likelihood of being in the marginal/nongambling class.     

Defining a threshold of harm from gambling for population health surveillance research

The measurement of harm in the context of non-problem gambling has received little attention from researchers in the field. Using the combined data from six provincial gambling surveys conducted in Canada between 2001 and 2005 (N = 12,285), we compared how different thresholds of defining gambling-related harm impacts prevalence, the relationship with indicators of gambling intensity and the characteristics of non-pathological gamblers who report experiencing below threshold symptoms of problem gambling. Survey items defining harm were drawn from the Problem Gambling Severity Index (PGSI) of the Canadian Problem Gambling Index. Three definitions of harm – reporting one or more problem gambling symptoms, reporting two or more problem gambling symptoms and having a PGSI score ≥ 3 – demonstrated a strong relationship with indicators of gambling intensity, and reliably differentiated low-threshold and zero symptom problem gamblers in terms of gambling characteristics and other risk factors.     

Assessing the effectiveness of a responsible gambling behavioural feedback tool for reducing the gambling expenditure of at-risk players

The current study assessed the utility of a responsible gambling (RG) tool that provides players with behavioural feedback about their gambling. Data was obtained from 779 people (n = 694 male; n = 85 female) who gambled online with Svenska Spel (the Swedish gambling operator) and who opted to receive behavioural feedback via an RG tool (Playscan). Importantly, data was also obtained from a matched sample of 779 players who did not opt to receive behavioural feedback. Feedback took the form of a colour-coded risk rating (Green = no issues, Yellow = at-risk, Red = problematic), which was determined by a proprietary algorithm. Additionally, gambling expenditure data (amounts deposited and wagered) was gathered for the week in which players enrolled to use the RG tool, the subsequent week and 24 weeks later (this data was also gathered for the matched sample). Results showed that Yellow (i.e. at-risk) players who used the tool significantly reduced the amounts of money deposited and wagered compared to players who did not use the tool – an effect observed the week following enrolment as well as 24 weeks later. Thus, informing at-risk players who have opted to receive feedback about their gambling appears to have a positive impact on subsequent expenditures.     

Economic mobility moderates the effect of relative deprivation on financial gambling motives and disordered gambling

This study examined whether a positive association between personal relative deprivation and disordered gambling severity is mediated by the motivation to gamble for financial gain. We hypothesized that this would occur specifically among people who perceived a low personal capacity for upward economic mobility via conventional means of advancement. A sample of community gamblers (N = 196) completed measures of personal relative deprivation, perceptions about upward economic mobility, gambling motivations (financial, coping, enhancement and social) and disordered gambling severity. The predicted moderated mediation model was observed – among people who perceived a low capacity for upward economic mobility, relative deprivation predicted disordered gambling severity via the motivation to gamble for financial gain. This indirect effect did not hold among people who perceived a high capacity for upward mobility. These findings suggest the importance of addressing beliefs about upward economic mobility in gambling prevention and intervention strategies. Among gamblers who feel relatively deprived, it may be advantageous to highlight feasible avenues for upward economic mobility that do not involve gambling.     

Predictors of help-seeking for gambling disorder from the transtheoretical model perspective

Few gamblers seek treatment despite the severe negative impacts prolonged gambling can have. Research surrounding the predictors of help-seeking for problem gambling is often retrospective in design and inconsistent in findings. This study prospectively investigated whether transtheoretical model (TTM) constructs (readiness to change, ratings of temptations and self-efficacy, decisional balance and processes of change) have utility in predicting help-seeking among disordered gamblers. Community-recruited disordered gamblers (N = 136; 47.06% female; mean age = 44.5 years, SD = 12.8; 80.1% Caucasian) completed three assessments of TTM constructs, help-seeking behaviour, gambling problem severity, and other potential predictors of help-seeking. Informal help-seeking was common (6-month = 71.1%; 12-month = 79.6%); however, formal help-seeking was relatively infrequent (6-month = 22.7%; 12-month = 35.1%). Logistic regression demonstrated that gambling problem severity and the social liberation process of change (i.e. endorsing public awareness of gambling problems or non-gambling role models) consistently predicted formal help-seeking. Helping relationships and counter-conditioning (i.e. engaging in other activities as a replacement for gambling) processes of change uniquely predicted informal help-seeking at 12 months. Individuals most likely to seek formal help have greater problem severity and greater readiness to address problems. Seeking informal help is less predictable but more common.     

Toward a generation free of tuberculosis: TB disease and infection in individuals of college age in the United States

Objectives: To assess the magnitude of active TB disease and latent TB infection (LTBI) in young adults of college age. Participants: Individuals who were aged 18–24 years in 2011 were used as a proxy for college students. Methods: Active TB cases reported to the 2011 US National TB Surveillance System (NTSS) were included. LTBI prevalence was calculated from the 2011–2012 National Health and Nutrition Examination Survey. The 2011 American Community Survey was used to calculate population denominators. Analyses were stratified by nativity. Results: Active TB disease incidence among persons aged 18–24 years was 2.82/100,000, 18.8/100,000 among foreign-born individuals and 0.9/100,000 among US-born individuals. In 2011, 878 TB cases were reported; 629 (71.6%) were foreign-born. LTBI prevalence among persons of 18–24 years was 2.5%: 8.7% and 1.3% among foreign-born and US-born, respectively. Conclusion: Active screening and treatment programs for foreign-born young adults could identify TB cases earlier and provide an opportunity for prevention efforts.     

Disordered gambling and co-morbidity of psychiatric disorders among college students: An examination of problem drinking,anxiety and depression

We assessed the occurrence of co-morbid psychiatric disorders (i.e., problem drinking, anxiety, and depression) among college students who met the threshold for disordered gambling. The participants included a large sample of undergraduate students (n = 1,430) who were enrolled in an introductory health course at a large, southeastern university in Spring 2011 and completed an online assessment that included scales to assess disordered gambling, problem drinking, anxiety, and depression. We calculated screening scores, computed prevalence rates for each disorder, and calculated Pearson correlations and Chi square tests to examine correlations and co-morbid relationships between the four disorders. Analyses indicated that all disorders were significantly associated (p < .01) except for disordered gambling and anxiety. Because college students who experience disordered gambling (and other psychiatric disorders) are at increased risk of experiencing co-occurring disorders, it might be useful for college health professionals to concurrently screen and intervene for co-occurring disorders.     

Predicting gambling behaviour and problems from implicit and explicit positive gambling outcome expectancies in regular gamblers

Outcome expectancies are the positive or negative effects that individuals anticipate may occur from engaging in a given behaviour. Although explicit outcome expectancies have been found to play an important role in gambling, research has yet to assess the role of implicit outcome expectancies in gambling. In two studies, we investigated whether implicit and explicit positive gambling outcome expectancies were independent predictors of gambling behaviour (i.e. amount of time spent and money risked gambling; Study 1) and problem gambling severity (Study 2). In both studies, implicit positive gambling outcome expectancies were assessed by having regular gamblers (N = 58 in Study 1; N = 96 in Study 2) complete a gambling outcome expectancy reaction time (RT) task. A self-report measure of positive gambling outcome expectancies was used to assess participants' explicit positive gambling outcome expectancies. Both the RT task and self-report measure of positive gambling outcome expectancies significantly contributed unique as well as shared variance in the prediction of self-reported gambling behaviour (Study 1) and problem gambling severity (Study 2). Findings from the current research point to the importance of using both direct and indirect assessment modes when examining the role of outcome expectancies in gambling.     

Development of an assessment tool to evaluate the risk potential of different gambling types

Based on different characteristics of gambling types, this study aimed to develop an assessment tool to evaluate the risk potential of available and planned gambling types in German-speaking countries. In the first module, 26 experts were interviewed over the course of a Delphi study, and an analysis of those results led to the selection of relevant characteristics and scaling values. Building on the first module, the second module consisted of standardized data collection of nonproblem, problem and pathological gamblers (characteristics: n = 363; scales: n = 356), which served as an empirical validation. Ten characteristics were identified with different weights and differentiated scaling values to evaluate the risk potential, and a psychometric validation indicated that the assessment tool was reliable (α = 0.91; r _ik  = 0.50; r _it  = 0.33–0.80). The correlation measures from data of epidemiological studies (R ² = 0.84) and a treatment survey (p < 0.001) demonstrated that the assessment tool was valid. This assessment tool, which was verified by psychometric validation, can serve the legislation and jurisdiction, the gaming industry and consumers as a future basis for risk evaluation of gambling types.     

National survey on lifestyles and gambling in Serbia: gambling participation and problem gambling in adult population

The aim was to examine the association of socio-demographic and lifestyle characteristics with gambling severity level. The study was a part of the National Survey on Lifestyles in Serbia: Substance Abuse and Gambling, in 2014. The sample consisted of 5385 individuals. Based on the Problem Gambling Severity Index (PGSI) score participants were divided into non-problem gambling, low-/moderate-risk gambling and problem gambling. Prevalence of problem gambling was 0.5%, which was associated with having poor self-perceived financial status, having moderate or high risk for psychological distress, playing sports betting, casino games and slot machines. Low/moderate gambling was associated with having poor self-perceived financial status, number of drinking days per year, using any illicit drugs in the last 30 days, playing sports betting, slot machines, and online betting. Programmes of early detection of problem gambling should be developed, and regulation of availability of slot machines and sports betting.     

Complex Factors and Behaviors in the Gambling Population of Italy

Gambling has seen significant growth globally, and particularly in Italy: it has rapidly evolved from a simple recreational activity to represent 4% of Italian GDP in 2010.A sample of 4.494 gamblers was drawn from IPSAD-Italia^®2007-2008 (Italian Population Survey on Alcohol and Drugs) in order to examine different gambling patterns (assessed using the Canadian Problem Gambling Index Short form scale).Separate analysis was performed on young adults, age 15–24 (n = 1,241; male 56.2%), and adults, age 25–64 (n = 3,253; male 53.8%): compared with adults, Italian youth, although they gambled less (35.7% vs. 45.3%), appeared to have higher prevalence of low risk gambling (6.9% vs. 5.8%) and moderate risk or problem gambling (2.3% vs. 2.2%). Males are more likely to be moderate-risk or problem gamblers. Those with only a primary education are more likely to be moderate-risk or problem gamblers (young adults: RRR = 5.22; adults: RRR = 3.23) than those with a university education, just like those youth who use depressants, but only among younger (RRR = 3.38).A fundamental issue, “do not disapprove of gambling”, seems to relate to problematic gambling: a specific Italian legislation, the Abruzzi Decree Law, could have influenced the perception that gambling may contribute positively to provide additional funds to the government for social good as well as to add needed jobs. Regardless of such potential social benefits, gambling is a social epidemic and if this association should be confirmed by more focused studies, policy makers should evaluate ways to affect this perception as soon as possible.     

‘Got to gamble,but I’ve got no money.’ A qualitative analysis of gambling careers in South Italy

With its geographical differences, Italy provides an interesting case study for analysing the cultural and contextual origin of gambling-related problems. By investigating gambling careers, the study sought to scrutinize the interplay between the personal and environmental factors – including social and cultural aspects – that influence changes in gambling habits among gamblers in Naples (South Italy). The convenience sample consisted of 42 problem and recreational gamblers, male and female, aged between 23 and 71 years, with different employment status and educational level. Results clarify how Neapolitans’ gambling habits have moved towards individualization over time, how availability contributes to increasing gambling in various ways, and how employment status and concerns about money can increase the risk of gambling-related problems, thereby increasing socio-economic inequalities. Confirming previous studies, the study casts doubt on the idea that problem gambling is a chronic and progressive disease, and suggests that periods of excessive gambling can be followed by periods of regulated activity, even without turning to formal treatment. However, life events – either positive or negative – can hinder attempts to regulate gambling.     

The relationship between explicit and implicit learning processes and probable pathological gambling

This paper reports the findings of a study of explicit and implicit learning and gambling with non-problem (n = 107), sub-clinical problem gamblers (n = 13), and probable pathological gamblers (n = 46). Two probability learning tasks modeled after gambling games and an artificial grammar task were used to explore how people learn patterns. In each of the two probability learning tasks, the outcome of the game was biased during the first part (learning phase) of the task. The results showed that many of the participants in the experimental conditions learned the bias and gradually unlearned the bias during the extinction phase of the study. Probable pathological gamblers showed less retention of the bias during two probability tasks and repeated the same errors during the artificial grammar task suggesting that they emphasize explicit learning strategies rather than implicit learning strategies. The results are consistent with the idea that pathological gamblers are more likely to utilize explicit rules than implicit rules.     

From Adolescent to Adult Gambling: An Analysis of Longitudinal Gambling Patterns in South Australia

Although there are many cross-sectional studies of adolescent gambling, very few longitudinal investigations have been undertaken. As a result, little is known about the individual stability of gambling behaviour and the extent to which behaviour measured during adolescence is related to adult behaviour. In this paper, we report the results of a 4-wave longitudinal investigation of gambling behaviour in a probability sample of 256 young people (50 % male, 50 % female) who were interviewed in 2005 at the age of 16–18 years and then followed through to the age of 20–21 years. The results indicated that young people showed little stability in their gambling. Relatively few reported gambling on the same individual activities consistently over time. Gambling participation rates increased rapidly as young people made the transition from adolescence to adulthood and then were generally more stable. Gambling at 15–16 years was generally not associated with gambling at age 20–21 years. These results highlight the importance of individual-level analyses when examining gambling patterns over time.     

Gambling Behavior and Problem Gambling Reflecting Social Transition and Traumatic Childhood Events Among Greenland Inuit: A Cross-Sectional Study in a Large Indigenous Population Undergoing Rapid Change

An increase in social pathologies is a key feature in indigenous populations undergoing transition. The Greenland Inuit are a large indigenous population constituting a majority in their own country, which makes it possible to investigate differences within the population. This led us to study gambling behavior and problem gambling among Greenland Inuit in relation to the ongoing social transition and traumatic events during childhood. A large representative cross-sectional study was conducted among Greenland Inuit (n = 2,189). Data was collected among adults (18+) in 9 towns and 13 villages in Greenland from 2005 to 2010. Problem gambling, gambling behavior and traumatic childhood events were measured through a self-administered questionnaire. The lie/bet screen was used to identify past year and lifetime problem gambling. Social transition was measured as place of residence and a combination of residence, education and occupation. The lifetime prevalence of problem gambling was 16 % among men and 10 % among women (p < 0.0001); and higher in towns (19 %) compared to the capital of Nuuk (11 %) and in villages (12 %) (men only, p = 0.020). Lifetime problem gambling was associated with social transition (p = 0.023), alcohol problems in childhood home (p = 0.001/p = 0.002) and sexual abuse in childhood (women only, p = 0.030). A comparably high prevalence of lifetime problem gambling among Greenland Inuit adds problem gambling to the list of social pathologies in Greenland. A significant association between lifetime problem gambling, social transition and traumatic childhood events suggests people caught between tradition and modern ways of life are more vulnerable to gambling problems.