Predictors of Relapse in Problem Gambling: A Prospective Cohort Study

To explore the variation of predictors of relapse in treatment and support seeking gamblers. A prospective cohort study with 158 treatment and support seeking problem gamblers in South Australia. Key measures were selected using a consensus process with international experts in problem gambling and related addictions. The outcome measures were Victorian Gambling Screen (VGS) and behaviours related to gambling. Potential predictors were gambling related cognitions and urge, emotional disturbance, social support, sensation seeking traits, and levels of work and social functioning. Mean age of participants was 44 years (SD = 12.92 years) and 85 (54 %) were male. Median time for participants enrolment in the study was 8.38 months (IQR = 2.57 months). Patterns of completed measures for points in time included 116 (73.4 %) with at least a 3 month follow-up. Using generalised mixed-effects regression models we found gambling related urge was significantly associated with relapse in problem gambling as measured by VGS (OR 1.29; 95 % CI 1.12–1.49) and gambling behaviours (OR 1.16; 95 % CI 1.06–1.27). Gambling related cognitions were also significantly associated with VGS (OR 1.06; 95 % CI 1.01–1.12). There is consistent association between urge to gamble and relapse in problem gambling but estimates for other potential predictors may have been attenuated because of methodological limitations. This study also highlighted the challenges presented from a cohort study of treatment and support seeking problem gamblers.     

Problem Gambling Among Urban and Rural Gamblers in Limpopo Province,South Africa: Associations with Hazardous and Harmful Alcohol Use and Psychological Distress

Little is known about the mental health correlates of problem gambling in low- and-middle-income countries such as South Africa and whether these correlates vary by urbanicity. To address this gap, we examined mental health factors associated with problem gambling among gamblers in Limpopo Province, South Africa disaggregated by rural, peri-urban and urban location. A survey of gambling behaviour and mental health was conducted among 900 gamblers. Overall, 28.3 % were at high risk and 38.1 % were at moderate risk for problem gambling. For the entire sample, hazardous/harmful alcohol use was associated with almost twofold increased chance of being at moderate risk (AOR 1.83; 95 % CI 1.08, 3.11) and almost sevenfold greater odds (AOR 6.93; 95 % CI 4.03–11.93) of being at high risk for problem gambling. Psychological distress was associated with being at high risk for problem gambling only (AOR 1.18; 95 % CI 1.14–1.22). After stratifying by urbanicity, hazardous/harmful alcohol use and psychological distress remained associated with high risk gambling across all locations. We found little knowledge of a free gambling helpline and other gambling services—particularly in less urbanised environments [χ² (2), 900 = 40.4; p < 0.001]. These findings highlight the need to increase awareness of free helpline services among gamblers and to ensure gambling services include screening and treatment for common mental disorders.     

Adolescent gambling and problem gambling: examination of an extended theory of planned behaviour

Adolescent problem gambling is acknowledged as a public health concern. To better understand adolescent gambling and problem gambling behaviour, the present study investigated the relationships between psychological correlates of gambling frequency and problem gambling using an extended theory of planned behaviour (TPB; i.e. intentions, attitudes, subjective norms, perceptions of behavioural control) that includes negative anticipated emotions as a factor associated with gambling intentions. Four hundred and nineteen high school students were surveyed in the Montreal (Canada) region. The findings generally support the applicability of an extended TPB model for explaining gambling behaviour frequency and gambling problems among adolescents. The results reveal that negative anticipated emotions, attitudes and perceptions of behavioural control influence gambling intentions. The results further reveal that intentions and attitudes have a direct relationship with gambling frequency, while intentions and perceptions of behavioural control are directly related to problem gambling behaviours. These findings suggest that adolescent problem gambling prevention and intervention efforts should consider targeting negative anticipated emotions and other TPB components in order to postpone initiation to gambling (a risk factor for problem gambling) and to promote gambling decision-making.     

Understanding the Relationship Between Sports-Relevant Gambling and Being At-Risk for a Gambling Problem Among American Adolescents

Fantasy sports is a growing industry with a reported 56.8 million individuals participating in the United States and Canada alone in 2015. Whereas this activity has attracted considerable public attention, little research has examined its impact on adolescents in spite of their high rates of gambling. The current study examined the relationship between regular participation (more than once a month) in sport-relevant gambling activities among adolescents and those identified as being at-risk for a gambling problem. Questionnaire responses were collected from high school students (N = 6818; 49 % male) in Wood County, Ohio, United States. Statistical analyses revealed that regular involvement in sports betting, fantasy sports betting, and daily fantasy sports betting among adolescents was associated with a higher risk of gambling problems. Further, although males participate more frequently in these activities, females who participate have a stronger likelihood of being at-risk. Students aged 16–19 years old are at a higher risk for developing a gambling problem compared to younger adolescents when regularly engaging in sports-related gambling. Moreover, regularly participating in daily fantasy sports is the strongest predictor of at-risk gambling behavior in 13–15 year old students. A hierarchical logistic regression supports that controlling for gender and age, all forms of sport-relevant gambling activities are significant predictors of at-risk gambling. This study contributes to a more comprehensive understanding of the impact of sports betting and fantasy sports on adolescents and establishes an initial step for future studies to further investigate these relationships.     

Differences between Poker Players and Non-Poker-Playing Gamblers

Since approximately 2003, the popularity of poker has quickly risen to unprecedented heights. This study examined poker play among university students who gamble on a regular basis. A total of 513 undergraduate students (females = 344, males = 170; mean age = 22.1) who gamble in some form at least two times per month completed an online questionnaire; 62.2 per cent (n = 319) of the respondents reported playing poker for money in the past year. A logistic regression analysis showed that poker players were more likely to be male, younger, have higher scores on an index of alcohol abuse, spend more time gambling and gamble more frequently compared to non-poker players. A second logistic regression showed that online/casino poker players were more likely to be male, have higher scores on an index of problem gambling, spend more time and money gambling, and gamble more often compared to social/non-poker players. These results are discussed in terms of the potential of poker's newfound popularity to lead to an increase in addictive behaviours, particularly among adolescents and young males.     

Exposure to Gambling Advertisements and Gambling Behavior in Young People

A cross-sectional survey of 4617 adolescents and young adults from 38 schools in two German states was conducted in 2014 to assess the association between gambling advertisements and gambling behavior. Exposure to ten gambling advertisements was measured with masked ad images; students indicated contact frequency and brand recall. Main outcomes were several gambling behaviors including probable pathological gambling assessed with the South Oaks Gambling Screen (SOGS ≥ 5). A total of 65.4 % of the students reported gambling at least once in their life; 42.2 % gambled in the last 12 months; 6.9 % gambled in the last week, and 2.8 % reported probable pathological gambling. The average frequency that one of the selected ads had been seen at least once was 29.5 %, the average brand recall rate was 9.4 %. After adjustment for confounding, multilevel mixed-effects logistic regressions revealed that high gambling ad exposure was positively related to all assessed gambling outcomes, with the strongest association for weekly gambling. Future studies need to clarify the temporal sequence and specificity of these associations.     

Improving Gambling Survey Research Using Dual-Frame Sampling of Landline and Mobile Phone Numbers

Gambling prevalence studies are typically conducted within a single (landline) telephone sampling frame. This practice continues, despite emerging evidence that significant differences exist between landline and mobile (cell) phone only households. This study utilised a dual-frame (landline and mobile) telephone sampling methodology to cast light on the extent of differences across groups of respondents in respect to demographic, health, and gambling characteristics. A total of 2,014 participants from across Australian states and territories ranging in age from 18 to 96 years participated. Interviews were conducted using computer assisted telephone interviewing technology where 1,012 respondents from the landline sampling frame and 1,002 from the mobile phone sampling frame completed a questionnaire about gambling and other health behaviours. Responses across the landline sampling frame, the mobile phone sampling frame, and the subset of the mobile phone sampling frame that possessed a mobile phone only (MPO) were contrasted. The findings revealed that although respondents in the landline sample (62.7 %) did not significantly differ from respondents in the mobile phone sample (59.2 %) in gambling participation in the previous 12 months, they were significantly more likely to have gambled in the previous 12 months than the MPO sample (56.4 %). There were no significant differences in internet gambling participation over the previous 12 months in the landline sample (4.7 %), mobile phone sample (4.7 %) and the MPO sample (5.0 %). However, endorsement of lifetime problem gambling on the NODS-CLiP was significantly higher within the mobile sample (10.7 %) and the MPO sample (14.8 %) than the landline sample (6.6 %). Our research supports previous findings that reliance on a traditional landline telephone sampling approach effectively excludes distinct subgroups of the population from being represented in research findings. Consequently, we suggest that research best practice necessitates the use of a dual-frame sampling methodology. Despite inherent logistical and cost issues, this approach needs to become the norm in gambling survey research.     

Effects of Affective and Anxiety Disorders on Outcome in Problem Gamblers Attending Routine Cognitive–Behavioural Treatment in South Australia

This study evaluated the influence of 12-month affective and anxiety disorders on treatment outcomes for adult problem gamblers in routine cognitive–behavioural therapy. A cohort study at a state-wide gambling therapy service in South Australia. Primary outcome measure was rated by participants using victorian gambling screen (VGS) ‘harm to self’ sub-scale with validated cut score 21+ (score range 0–60) indicative of problem gambling behaviour. Secondary outcome measure was Work and Social Adjustment Scale (WSAS). Independent variable was severity of affective and anxiety disorders based on Kessler 10 scale. We used propensity score adjusted random-effects models to estimate treatment outcomes for sub-populations of individuals from baseline to 12 month follow-up. Between July, 2010 and December, 2012, 380 participants were eligible for inclusion in the final analysis. Mean age was 44.1 (SD = 13.6) years and 211 (56 %) were males. At baseline, 353 (92.9 %) were diagnosed with a gambling disorder using VGS. For exposure, 175 (46 %) had a very high probability of a 12-month affective or anxiety disorder, 103 (27 %) in the high range and 102 (27 %) in the low to moderate range. For the main analysis, individuals experienced similar clinically significant reductions (improvement) in gambling related outcomes across time (p < 0.001). Individuals with co-varying patterns of problem gambling and 12 month affective and anxiety disorders who present to a gambling help service for treatment in metropolitan South Australia gain similar significant reductions in gambling behaviours from routine cognitive–behavioural therapy in the mid-term.     

Gambling Behaviour in Adolescents with Learning Disorders

The present study examined the prevalence of disordered gambling behaviours in a community-based sample of adolescents (N = 532) living in eastern central Ontario. Of particular interest was examining the hypothesis that adolescents with learning disorders are at elevated risk for disordered gambling. Rates of disordered gambling in male adolescents with learning disorders were found to be significantly higher than adolescents without learning problems, even after controlling for negative affectivity and ADHD symptomatology. The implications for treatment and intervention of gambling problems in adolescence are discussed.     

Racial and Ethnic Differences in Problem Gambling among College Students

The college years are a formative period where the risk for development of problematic gambling is high. Research examining racial and ethnic differences in gambling behaviors has been limited and inconsistent. The aims of this study were to examine racial and ethnic differences in problem gambling among a large sample of college students. Undergraduates (N = 3058) from a large southern university completed an online screening questionnaire which included demographics, gambling frequency, gambling expenditure (i.e. money lost) in the previous 6 months, and the South Oaks Gambling Screen (SOGS). Negative binomial regression results indicated that Asian participants gambled less frequently than participants who were Caucasian or Hispanic/Latino(a), but spent more money than participants who were African-American (AA)/Black or Hispanic/Latino(a). A significantly larger proportion of Asian students met probable pathological gambling criteria (SOGS 5+; 7.8 %) and at-risk gambling criteria (SOGS 3+; 16.3 %)) than Caucasian (5.2; 10.1 %), AA/Black (3.9; 10.2 %), or Hispanic/Latino(a) (3.6; 9.4 %) students. Additionally, a significantly larger proportion of Asian students endorsed problematic gambling indicators such as lying about losses, feeling guilty about gambling, feeling like they had a gambling problem, being criticized for their gambling, feeling like they couldn’t stop gambling, losing time from school or work due to gambling, having a family history of problem gambling, and arguing with close others about their gambling than Caucasian, AA/Black or Hispanic/Latino(a) students. Results suggest that Asian students may be a high-risk sub-group of college gamblers, and that there is a critical need for targeted interventions for this population.     

Prevalence of Adolescent Problem Gambling,Related Harms and Help-Seeking Behaviours Among an Australian Population

Epidemiological studies have consistently reported prevalence rates ranging between 0.9 and 23.5% for problem gambling among young people. With such a large range reported in the literature, it is clear that more research in this area would be of value. The current study investigated the prevalence rate of adolescent gambling and problem gambling and explored types of harm-related and help-seeking behaviours associated with gambling specific to this population in an Australian setting. A self-administered battery of questionnaires was distributed to 252 students aged 12–18 years, attending four private schools in the Eastern suburbs of Sydney, Australia. The battery included a self-administered socio-gambling demographic questionnaire, the Diagnostic and Statistical Manual Fourth Edition Multiple Response Juvenile (DSM-IV-MR-J) diagnostic instrument to assess problem gambling status, the Gambling Attitudes Scale, and questionnaires using a Likert scale to measure gambling-related harms and help-seeking behaviours. The prevalence rate among this group was found to be 6.7%. The study found further support for previous findings suggesting that a significant proportion of young people meet criteria for problem gambling, that males are at-risk and that few adolescents are able to recognise when gambling is problematic or access mental health professionals for assistance.     

The Social and Psychological Impacts of Gambling in the Cree Communities of Northern Québec

A detailed survey of gambling, addiction and mental health was conducted with randomly selected respondents (n = 506) from four Cree communities of Northern Quebec. The study examined the current patterns of gambling in relation to demographic, social, and psychological factors. Instruments included the Canadian Problem Gambling Index, Addiction Severity Index, Beck Depression Inventory and the computerized Diagnostic Interview Schedule for psychiatric diagnoses. Overall, 69.2 % of the total sample participated in any gambling/gaming activities over the past year; 20.6 % of this group were classified as moderate/high risk gamblers, and 3.2 % were classified in the highest “problem gambling” category. Considering the entire sample, the overall prevalence of problem gambling was 2.2 %. Women were significantly more likely to play bingo (56.6 %) compared to men (35.1 %) and they played more frequently; 20.8 % of women versus 3.8 % of men played once/week or more often. Compared to the no/low risk gamblers, a greater proportion of moderate/high risk gamblers were cigarette smokers (44.8 vs. 56.3 %), they were more likely to meet DSM-IV diagnostic criteria for alcohol dependence (21.2 vs. 46.2 %), and they were more likely to report moderate to severe depressive symptoms in the past month. Risk factors for problem gambling included traumatic life events (physical and emotional abuse), anxiety and depression, as well as drug/alcohol abuse. The high rates of comorbidity between problem gambling, tobacco dependence, substance abuse and other psychological problems demonstrate that gambling among some Cree adults is part of a pattern of high-risk factors for negative long-term health consequences. The results also have implications for treatment, suggesting that interventions for gambling disorders should not focus on gambling alone but rather the constellation of high-risk behaviours that pose a risk to recovery and well-being.     

Association Between Internet Gambling and Problematic Internet Use Among Adolescents

The study objectives were to evaluate the correlates and psychosocial implications of internet gambling among adolescents, as well as the association between internet gambling and problematic internet use. A cross-sectional study design was applied among a random sample (N = 484) of adolescents (71.2% boys; 28.8% girls; mean age ± standard deviation, SD = 14.88 ± 0.55 years). Self-completed questionnaires, including internet gambling practices, internet use characteristics, Young Internet Addiction Test, and Strengths and Difficulties Questionnaire were utilized. The prevalence of internet gambling was 15.1%. Internet gambling was associated with psychosocial maladjustment, including Abnormal Conduct Problems (gender adjusted odds ratio, AOR = 3.83; 95% confidence interval, 95% CI: 1.86–7.92) and Borderline Peer Problems (AOR = 2.04; 95% CI: 1.09–3.85). The likelihood of concomitant problematic internet use was significantly higher among internet gamblers (AOR = 1.81; 95% CI: 1.03–3.19). Multivariate regression analyses indicated that among all characteristics of internet use assessed, utilizing the internet for the purposes of gambling practices was independently associated with problematic internet use among adolescents (AOR = 3.43; 95% CI: 1.40–8.39). Thus, the study findings suggest that adolescents who participate in internet gambling practices are more likely to concomitantly present with problematic internet use.     

The impact of affectivity on the behaviour of Portuguese adolescents / El impacto de la afectividad en la conducta de los adolescentes portugueses

The theoretical literature about affectivity shows its influence over positive and negative behaviour. This study analyses the impact of affectivity on the behaviour of Portuguese adolescents, as this knowledge is considered relevant to promoting skills and decreasing risky behaviours in adolescents. A total of 696 students (M = 15.22 years old; SD = 1.4) participated in this study by responding to the PANAS-N (Positive and Negative Affect Schedule) and SDQ (Strengths and Difficulties Questionnaire). The former measures the level of affect while the latter measures prosocial behaviours, emotional symptoms and behavioural problems. The results showed that positive affect positively influences prosocial behaviour. Emotional symptoms and behaviour problems are negatively affected by positive affect, and positive symptoms and behaviours by negative affect. Moreover, boys had higher scores on behaviour problems, while girls had higher scores in prosocial behaviour and emotional symptoms. For these reasons, affectivity should be considered in programmes to reduce behaviour problems and emotional symptoms.     

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.     

Exploring the Relationship Between Stimulant Use and Gambling in College Students

Both gambling and stimulant use are common and can lead to problems on college campuses with consequences that impact the financial, emotional, academic and physical well-being of students. Yet few studies have been conducted to understand the co-occurrence of these conditions and the increased risk factors if any that may exist for gambling and related problems. The present study is among the first to document the co-occurrence of these behaviors in both a random sample of students (N = 4640), and then to explore to what extent stimulant use impacts subsequent gambling and related problems 12 months later in an at-risk sample (N = 199). Results revealed a three-fold higher rate of recent problem gambling for those who used stimulants versus those who had not (11 vs. 4 %). For those already gambling, stimulant use predicted an increased frequency in gambling 12 months later. Implications for prevention and screening are discussed.     

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.     

Italian Adult Gambling Behavior: At Risk and Problem Gambler Profiles

The present study examined adult gambling behaviours from a local perspective in order to assess the adult at risk and problem gambler’s profile stratified by genre and by different forms of game. 4773 Italian adults from 18 to 94 years old were administered a survey to assess socio-cultural information related to gambling behaviour and the SOGS to evaluate gambling behaviour severity. Logistic regression evidenced that both at risk and problem gamblers are associated with male gender, players that use to play to more than one game, gambling with strategy-based games. People with a gambler father or both parents who used to gamble were significantly more associated with problem gambling behaviour than participants with non-gambler parents. These results present adult profiles of at risk and problem providing a more clear understanding about the relationships between gambling behavior severity and type of gambling.     

Associations between gambling,substance misuse and recidivism among Canadian offenders: a multifaceted exploration of poor impulse control traits and behaviours

Moderate correlations among gambling, substance use and crime suggest these three behaviours may each be indicators of a single underlying problem trait, such as poor impulse control. We tested whether self-reported traits prospectively predicted future criminal recidivism, when accounting for incarcerated adult offenders' past criminal behaviour, substance use and gambling behaviour. We took a multi-construct approach to measuring components of impulse control, utilizing three questionnaires that assess sensation seeking, poor premeditation, and reward sensitivity. Male participants incarcerated in two federal institutions were invited to complete self-report booklets; participation was self-selected and fully voluntary. Results indicated moderate correlations between measures of trait impulse control, self-reported drug use, and official criminal history (N = 140). Gambling problems prospectively predicted post-release criminal recidivism (n = 83), even when accounting for past criminal behaviour, impulse control traits and substance misuse. Although they represent a small percentage of this sample, results suggest offenders with high gambling problems represent a particularly at-risk group for future crime, who were more than four times likely to reoffend compared to offenders without problem gambling. These results suggest there may be mutual impact of problem behaviours on life outcomes above the contribution of poor impulse control.