How does the stigma of problem gambling influence help-seeking,treatment and recovery? a view from the counselling sector

Problem gambling attracts considerable public stigma and can cause significant self-stigma. However, little research has investigated the role of stigma during treatment-assisted recovery from problem gambling. This study aimed to examine gambling counsellors’ perspectives on whether and how the stigma associated with problem gambling influences problem acknowledgement, help-seeking, treatment and recovery. In-depth interviews with nine gambling counsellors from Victoria, Australia, were analysed to extract shared meanings of experiences using interpretative phenomenological analysis. Counsellors indicated that the burden of problem gambling is typically increased by the addition of stigma and its impacts. This stigma is created and maintained by a lack of public understanding about problem gambling and its causes, and internalization of self-stigmatizing beliefs, leading to delayed help-seeking, anxiety about attending treatment, concerns about counsellor attitudes, and fear of relapse. Counsellors maintained that, before effective gambling treatment could occur, they needed to help clients overcome their self-stigmatizing beliefs to establish confidence and trust in the counsellor, restore self-esteem, enhance stigma coping skills and foster a belief that recovery is possible. Harnessing support from significant others and preparing clients for relapse were also important inclusions to lower stigma. Addressing stigma early in treatment can help to improve treatment adherence and recovery.     

Gambling attitudes and beliefs associated with problem gambling: the cohort effect of Baby Boomers

Recreational and problem gamblers alike hold beliefs about gambling that are dysfunctional. These dysfunctional beliefs have been theorized to play a role in problem gambling behaviour. The current study sought to examine the effects of gambling attitudes and beliefs on problem gambling behaviour across three cohorts. A sample of 308 participants consisted of 101 individuals from Generation X, 139 from the Baby Boom cohort and 68 from the Silent Generation. Hierarchical multiple regressions showed that for Baby Boomers, higher scores on scales measuring beliefs about luck and illusions of control were associated with higher scores on measures of problem gambling than for the Silent Generation. Generation X’s higher scores on luck scales were associated with higher scores in problem gambling than the Baby Boom cohort. Attitudes associated with problem gambling did not differ among cohorts. These results suggest that while cohorts may not differ in types or levels of distorted beliefs, they differ in how such distortions relate to problem gambling. Future research should focus on determining whether such cohort effects are indicative of differences within the development and maintenance of problem gambling itself.     

The temporal relationship between gambling related beliefs and gambling behaviour: a prospective study using the theory of planned behaviour

The Theory of Planned Behaviour (TPB) has been successfully employed to investigate the role of gambling-related beliefs in the maintenance of gambling behaviour. However, there is a lack of research that examines the temporal relationships between the TPB predictor variables and gambling behaviour. Thus, the current study examines the utility of expectancies, normative beliefs, perceived behaviour control and gambling intentions in predicting gambling frequency, as assessed 12 months later. In addition, these gambling-related beliefs were reassessed at the 12-month follow-up survey to examine their stability and relationships with gambling behaviour. A total of 805 Australian adults, recruited via an online research panel, completed the baseline and follow-up online survey. Consistent with expectations, gambling-related beliefs explained gambling intentions and intentions predicted Wave 2 gambling frequency, after controlling Wave 1 gambling frequency. In relation to the stability of gambling-related beliefs, the Wave 2 measures explained additional variance in the Wave 2 gambling behaviour, although the type of beliefs associated with Wave 2 gambling frequency and problem gambling severity differed. These findings provide support for the notion that the perceived benefits of gambling and beliefs in skill are important areas to target in preventative and problem gambling initiatives.     

Development and validation of the Protective Gambling Beliefs Scale (PGBS)

This article aimed to develop and validate a measure of protective beliefs – distinct from the absence of erroneous beliefs – that may be associated with resistance to gambling problems. Study 1 was designed to determine the reliability and content validity of a preliminary set of protective belief items. Participants (N = 1479, 813 males) also completed the Problem Gambling Severity Index (PGSI). Most items were associated with reduced risk of problems; however, items relating to an awareness of gambling harm, and preparedness to lose money were positively correlated with gambling problems and were therefore not demonstrably protective. Study 2 sought to reduce scale size and assess the scale’s ability to predict risk of gambling problems. Participants (N = 1168, 625 males) completed belief items, the PGSI, and measures of gambling consumption and cognitive distortions. Results showed that endorsement of protective beliefs was negatively correlated with PGSI, gambling consumption and cognitive distortions, and predicted PGSI above that of cognitive distortions. Findings suggest that the Protective Gambling Beliefs Scale (PGBS) offers a unique tool for understanding resistance to the development of gambling problems. Future research should focus on exploring whether protective beliefs can diminish the likelihood of the onset of problem gambling.     

Gambling-related Irrational Beliefs in the Maintenance and Modification of Gambling Behaviour

Abstract

The present study investigated a primary assumption of the cognitive theory of problem gambling, that gambling-related irrational beliefs lead directly to problematic gambling behaviour. Participants (N =114) received a message designed to increase their illusion of control (IOC) over a computerised roulette game, a message designed to decrease their IOC, or a neutral message. Participants then played the game, during which their gambling behaviour was recorded and irrational beliefs were measured. Based on the cognitive model, it was expected that those receiving the IOC enhancement message would evidence greater levels of irrational beliefs and correspondingly more intense gambling behaviour and that those in the IOC reduction condition would show decreased levels of both irrational beliefs and behaviour. However, although conditions differed as to levels of irrational beliefs, there were no significant differences in gambling behaviour. Results are discussed and implications of the results on the cognitive theory of problematic gambling are explored.     

The Temporal Relationship Between Faulty Gambling Cognitions and Gambling Severity in Young Adults

Disordered gambling in young adults is hypothesized as being related to mistaken gambling-related cognitions. Few studies have examined the temporal order of this relationship using longitudinal data. The purpose of this study is to understand the directionality of the relationship between gambling cognitions and gambling severity in a longitudinal sample of young adults. Young adults (N = 578), initially aged 18–21 years, completed the Manitoba Longitudinal Survey of Young Adults at two time points approximately 2–3 years apart. Measures of beliefs about randomness related to gambling and gambling severity, as measured by the Problem Gambling Severity Index, were utilized. A cross-sectional relationship between gambling severity and gambling-related cognitions was observed with greater gambling severity being associated with increased endorsement of mistaken cognitions. Evidence for a bidirectional longitudinal relationship was observed with faulty gambling cognitions leading to later problematic gambling behaviors and vice versa when examining a total beliefs scale. When examining specific beliefs about randomness, initial gambling group membership predicted later endorsement of certain beliefs about randomness while initial belief ratings did not impact later gambling group membership. The results of this study suggest a bidirectional relationship between gambling severity and erroneous gambling-related cognitions. However, when examining specific beliefs about randomness, evidence was found for problem gambling behaviors leading to erroneous gambling beliefs. These findings suggest that prevention efforts targeting cognitions may not be as effective in impacting those not yet demonstrating disordered gambling behaviors.     

Internet Gamblers Differ on Social Variables: A Latent Class Analysis

Online gambling has gained popularity in the last decade, leading to an important shift in how consumers engage in gambling and in the factors related to problem gambling and prevention. Indebtedness and loneliness have previously been associated with problem gambling. The current study aimed to characterize online gamblers in relation to indebtedness, loneliness, and several in-game social behaviors. The data set was obtained from 584 Internet gamblers recruited online through gambling websites and forums. Of these gamblers, 372 participants completed all study assessments and were included in the analyses. Questionnaires included those on sociodemographics and social variables (indebtedness, loneliness, in-game social behaviors), as well as the Gambling Motives Questionnaire, Gambling Related Cognitions Scale, Internet Addiction Test, Problem Gambling Severity Index, Short Depression–Happiness Scale, and UPPS-P Impulsive Behavior Scale. Social variables were explored with a latent class model. The clusters obtained were compared for psychological measures and three clusters were found: lonely indebted gamblers (cluster 1: 6.5%), not lonely not indebted gamblers (cluster 2: 75.4%), and not lonely indebted gamblers (cluster 3: 18%). Participants in clusters 1 and 3 (particularly in cluster 1) were at higher risk of problem gambling than were those in cluster 2. The three groups differed on most assessed variables, including the Problem Gambling Severity Index, the Short Depression–Happiness Scale, and the UPPS-P subscales (except the sensation seeking subscore). Results highlight significant between-group differences, suggesting that Internet gamblers are not a homogeneous group. Specific intervention strategies could be implemented for groups at risk.     

Public Awareness of Responsible Gambling and Gambling Behaviours in Ontario

This study reports the findings of a general population telephone survey (N =2500) conducted in Ontario, which was designed to examine behaviour, knowledge and attitudes related to responsible and problem gambling using a combination of closed- and open-ended questions. When asked to identify ‘signs and symptoms of problem gambling’ or to define responsible gambling, most respondents focused on financial issues suggesting that the general population has a very narrow view of the issue of problem gambling. The majority (65.8%) are not aware of any initiatives to reduce problem gambling; however, we found that people who participate in slots and instant lotteries were more likely to report being aware of initiatives to reduce problem gambling. These findings suggest that people do notice the presence of the help-line number on tickets and slot machines. The survey also examined responsible gambling behaviour and biases in beliefs about gambling.     

Measuring Self-efficacy in Gambling: The Gambling Refusal Self-Efficacy Questionnaire

This paper reports on the development and psychometric properties of a Gambling Refusal Self-Efficacy Questionnaire (GRSEQ). Two hundred and ninety-seven gamblers from both normal and clinical populations completed an initial set of 31-items of which 26 were selected for inclusion in the final version of the GRSEQ. A series of factor analyses showed four clear factors accounting for 84% of the variance. These factors can be summarised as situations and thoughts associated with gambling, the influence of drugs on gambling, positive emotions associated with gambling and negative emotions associated with gambling. The GRSEQ total score and factors scores showed high internal consistency (Cronbach’s alpha ranging from 0.92 to 0.98). Participants experiencing problems with gambling scored significantly lower on the GRSEQ, and discriminant analyses showed that the scale is able to correctly classify the non-problem (i.e., community and student samples) and problem gamblers (i.e., clinical sample). Furthermore, the GRSEQ showed significant negative relationships with other gambling-related variables (gambling urge and gambling-related cognitions) and negative mood states (depression, anxiety and stress) and was shown to be sensitive to change in treatment of pathological gambling. The results suggest that the GRSEQ is a useful measure of gambling refusal self-efficacy that is suitable for assessment of gamblers from both normal and clinical populations.     

Problem Gambling Family Impacts: Development of the Problem Gambling Family Impact Scale

Although family members of problem gamblers frequently present to treatment services, problem gambling family impacts are under-researched. The most commonly endorsed items on a new measure of gambling-related family impacts [Problem Gambling Family Impact Measure (PG-FIM: Problem Gambler version)] by 212 treatment-seeking problem gamblers included trust (62.5 %), anger (61.8 %), depression or sadness (58.7 %), anxiety (57.7 %), distress due to gambling-related absences (56.1 %), reduced quality time (52.4 %), and communication breakdowns (52.4 %). The PG-FIM (Problem Gambler version) was comprised of three factors: (1) financial impacts, (2) increased responsibility impacts, and (3) psychosocial impacts with good psychometric properties. Younger, more impulsive, non-electronic gaming machine (EGM) gamblers who had more severe gambling problems reported more financial impacts; non-EGM gamblers with poorer general health reported more increased responsibility impacts; and more impulsive non-EGM gamblers with more psychological distress and higher gambling severity reported more psychosocial impacts. The findings have implications for the development of interventions for the family members of problem gamblers.     

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.     

The Development of an Internet-Based Treatment for Problem Gamblers and Concerned Significant Others: A Pilot Randomized Controlled Trial

Problem gambling creates significant harm for the gambler and for concerned significant others (CSOs). While several studies have investigated the effects of individual cognitive behavioral therapy (CBT) for problem gambling, less is known about the effects of involving CSOs in treatment. Behavioral couples therapy (BCT) has shown promising results when working with substance use disorders by involving both the user and a CSO. This pilot study investigated BCT for problem gambling, as well as the feasibility of performing a larger scale randomized controlled trial. 36 participants, 18 gamblers and 18 CSOs, were randomized to either BCT or individual CBT for the gambler. Both interventions were Internet-delivered self-help interventions with therapist support. Both groups of gamblers improved on all outcome measures, but there were no differences between the groups. The CSOs in the BCT group lowered their scores on anxiety and depression more than the CSOs of those randomized to the individual CBT group did. The implications of the results and the feasibility of the trial are discussed.     

Professional Help-Seeking for Gambling Problems: Awareness,Barriers and Motivators for Treatment

Despite the negative consequences associated with gambling, few problem gamblers seek professional help. This study aimed to examine awareness of professional sources of help and help-seeking behaviour amongst regular and problem gamblers. Australian gamblers (N = 730) were recruited from the general population, multicultural gambling venues, and gambling helplines and treatment services. Surveys measured awareness of professional help services, help-seeking behaviour and motivators and barriers to seeking help. Gamblers demonstrated low awareness of professional help services. Problem gamblers born in Australia or who were divorced were more likely to seek help. Problem gamblers who were reluctant to seek help due to a desire solve the problem on their own and feeling ashamed for themselves or their family pride were more likely to have overcome these barriers to seek help. However, significant barriers related to denial of problem severity and concerns about the ability to access low cost services that cater for multicultural populations predicted a lower likelihood of having sought help. Public education should aim to de-mystify the treatment process and educate gamblers about symptoms of problem gambling to reduce shame, stigma, and denial and encourage help-seeking. Ongoing education and promotion of help services is required to increase awareness of the resources available, including targeted promotions to increase awareness of relevant services among specific populations.     

Anxiety,Depression and Emotion Regulation Among Regular Online Poker Players

Poker is a type of gambling that has specific features, including the need to regulate one’s emotion to be successful. The aim of the present study is to assess emotion regulation, anxiety and depression in a sample of regular poker players, and to compare the results of problem and non-problem gamblers. 416 regular online poker players completed online questionnaires including sociodemographic data, measures of problem gambling (CPGI), anxiety and depression (HAD scale), and emotion regulation (ERQ). The CPGI was used to divide participants into four groups according to the intensity of their gambling practice (non-problem, low risk, moderate risk and problem gamblers). Anxiety and depression were significantly higher among severe-problem gamblers than among the other groups. Both significantly predicted problem gambling. On the other hand, there was no difference between groups in emotion regulation (cognitive reappraisal and expressive suppression), which was linked neither to problem gambling nor to anxiety and depression (except for cognitive reappraisal, which was significantly correlated to anxiety). Our results underline the links between anxiety, depression and problem gambling among poker players. If emotion regulation is involved in problem gambling among poker players, as strongly suggested by data from the literature, the emotion regulation strategies we assessed (cognitive reappraisal and expressive suppression) may not be those involved. Further studies are thus needed to investigate the involvement of other emotion regulation strategies.     

Superstitious Beliefs in Gambling Among Problem and Non-Problem Gamblers: Preliminary Data

Superstitious beliefs, defined as a strong conviction based on the erroneous perception of a cause-effect association between two independent events, are considered to play an instrumental role in the maintenance of gambling behaviour. In this preliminary study, responses to eight items assessing superstitious beliefs were compared among 56 electronic gaming machine (EGM) problem gamblers, 22 non-problem EGM and 23 non-EGM non-problem gamblers. Results suggested that problem gamblers endorsed more superstitious beliefs than non-problem gamblers and that such beliefs were correlated with gambling intensity. Further research is required to determine if superstitious beliefs represent a vulnerability factor for the development of problem gambling or emerge as a consequence of involvement in gambling.     

Illusory Control, Gambling, and Video Gaming: An Investigation of Regular Gamblers and Video Game Players

There is a paucity of empirical research examining the possible association between gambling and video game play. In two studies, we examined the association between video game playing, erroneous gambling cognitions, and risky gambling behaviour. One hundred and fifteen participants, including 65 electronic gambling machine (EGM) players and 50 regular video game players, were administered a questionnaire that examined video game play, gambling involvement, problem gambling, and beliefs about gambling. We then assessed each groups' performance on a computerised gambling task that involved real money. A post-game survey examined perceptions of the skill and chance involved in the gambling task. The results showed that video game playing itself was not significantly associated with gambling involvement or problem gambling status. However, among those persons who both gambled and played video games, video game playing was uniquely and significantly positively associated with the perception of direct control over chance-based gambling events. Further research is needed to better understand the nature of this association, as it may assist in understanding the impact of emerging digital gambling technologies.     

Does gambling type moderate the links between problem gambling,emotion regulation,anxiety, depression and gambling motives

The aim of this study is to assess the link between emotion regulation, depression, anxiety and gambling motives among a population of regular gamblers, distinguishing between strategic and chance game players. We recruited 287 regular gamblers online, including both problem (PG) and non-problem gamblers (NPG). All participants completed online questionnaires to screen for problem gambling (SOGS) and to assess emotion regulation (ERQ), anxiety and depression (HADS) and gambling motives (GMQ-F). In this sample, 33.4% of participants were PG. PG scored significantly higher than NPG on the GMQ-F (except for the social subscale) and HADS, but not in ERQ. Gamblers who played both strategic and chance games displayed more frequent and severe gambling problems and had higher depression and anxiety scores than those playing only strategic games. Overall, enhancement and financial motives and depression significantly predicted PG. Finally, the study found that gambling type moderates the relationship between problem gambling and expressive suppression, depression and gambling motives. The results show the intricate relationship between gambling motives and psychiatric symptoms (in particular, depression) in PG. Mixed and strategic gamblers share common motives, but coping, financial and enhancement were stronger among PG. Finally, they emphasize the differences between different types of gamblers.     

Gambling Harm and Crime Careers

Incarcerated populations across the world have been found to be consistently and significantly more vulnerable to problem gambling than general populations in the same countries. In an effort to gain a more specific understanding of this vulnerability the present study applied latent class analysis and criminal career theory to gambling data collected from a sample of English and Scottish, male and female prisoners (N = 1057). Theoretical links between gambling and crime were tested through three hypotheses: (1) that prisoners in the UK would have higher rates of problem gambling behaviour than the national population; (2) that if the link between gambling and crime is coincidental, gambling behaviour would be highly prevalent in an offending population, and (3) if connections between gambling behaviour and offending are co-symptomatic a mediating factor would show a strong association. The first of these was supported, the second was not supported and the third was partially supported. Latent class analysis found six gambling behaviour clusters measured by responses to the Problem Gambling Severity Index, primarily distinguished by loss chasing behaviour. Longitudinal offending data drawn from the Police National Computer database found four criminal career types, distinguished by frequency and persistence over time. A significant association was found between higher level loss chasing and high rate offending in criminal careers suggesting that impulse control may be a mediating factor for both gambling harm and criminal careers.     

Beliefs About Gambling Problems and Recovery: Results from a General Population Telephone Survey

Respondents were asked their beliefs about gambling abuse as part of a general population telephone survey. The random digit dialing survey consisted of 8,467 interviews of adults, 18 years and older, from Ontario, Canada (45% male; mean age = 46.2). The predominant conception of gambling abuse was that of an addiction, similar to drug addiction. More than half of respondents reported that treatment was necessary and almost three-quarters of respondents felt that problem gamblers would have to give up gambling completely in order to overcome their gambling problem. Problem gamblers (past or current) were less likely than non- or social gamblers to believe that treatment was needed, and current problem gamblers were least likely to believe that abstinence was required, as compared to all other respondents. Strong agreement with conceptions of gambling abuse as disease or addiction were positively associated with belief that treatment is needed, while strong agreement with conceptions of disease or wrongdoing were positively associated with belief that abstinence is required.     

Effectiveness of a Self Help Cognitive Behavioural Treatment Program for Problem Gamblers: A Randomised Controlled Trial

The study aimed to strengthen the scarce literature on self-help treatments for Problem Gambling (PG) by comparing the effectiveness of a Self-Help Cognitive Behavioral Treatment (SHCBT) program (n = 23) with a 6-week Waitlist condition (n = 32) in problem gamblers. Participants were community volunteers with gambling problems and were randomly allocated to the Waitlist and treatment conditions. Results showed significant improvements at post-treatment in gambling behaviors including frequency of gambling, average amount gambled per day and PG symptoms as well as a number of gambling correlates including psychological states (e.g., depression, anxiety and stress), gambling cognitions, gambling urges, gambling related self-efficacy, satisfaction with life, and quality of life among those who completed the SHCBT program, when compared with the waitlist condition. The effect size (partial η ²) ranged from .25 to .57 for all assessed outcomes that showed significant improvement from pre- to post-treatment. It was concluded that a self-help CBT program can be beneficial for treating community problem gamblers.