Trajectories of social and economic outcomes and problem gambling risk in Australia [open-access government working paper].

Introduction: Researchers are increasingly recognising the importance of longitudinal data in providing valuable information on individuals to better understand gambling behaviour, trajectories, risks and consequences. However, relatively few longitudinal surveys have a significant focus on gambling.
This paper makes use of a longitudinal data source that has, for the first time, included questions on gambling behaviour in Australia: the Household, Income and Labour Dynamics in Australia (HILDA) survey. The HILDA survey included gambling questions for the first time in 2015 (wave 15). Although the HILDA survey currently provides data on gambling at a single point in time, there are data on the individuals back to 2001, in most cases. This paper uses selected social, economic and health variables, and analyses their trajectories over time across the gambling risk categories measured in 2015. The paper explores economic variables (household income, employment, qualifications, financial hardship, risk and stress) and selected social variables (life satisfaction, psychological distress, alcohol intake and smoking) from multiple HILDA waves.
The analysis clearly shows that problem gamblers experience significantly worse outcomes than those without gambling problems, and poor outcomes go back a number of years. In a number of cases, outcomes are becoming progressively poorer, which may suggest either increasingly risky gambling behaviour or the cumulative effects of a sustained period of problem gambling. Low- and moderate-risk gamblers have better economic, social and health outcomes than problem gamblers, but, in most cases, worse outcomes than those without gambling-related problems. Again, these differences go back a number of years. Exploring these particular variables in respect of problem gambling risk provides insights that may inform prevention and early intervention strategies to reduce gambling harm. Working paper available online

Reference: Fogarty, M., Taylor, M., & Gray, M. (2018). Trajectories of social and economic outcomes and problem gambling risk in Australia [CSRM Working Paper No. 9]. ANU Centre for Social Research and Methods, ANU, Canberra. Retrieved from https://openresearch-repository.anu.edu.au/handle/1885/154612

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Deposit limit prompt in online gambling for reducing gambling intensity: A randomized controlled trial – open access online article.

Introduction: Pre-commitment tools – allowing users of gambling services to pre-set a limit for how much money they may spend – are relatively common. However, there exist no clear evidence of their effectiveness in preventing gamblers from spending more money than they otherwise planned. The aim of the study was to compare gambling intensity between users of an online gambling service prompted to set a deposit limit and non-prompted customers, both in the whole sample and among most active users based on the total number of gambling days. Prospective customers of a publicly governed gambling operator from Finland were randomized to receive a prompt to set a voluntary deposit limit of optional size either (1) at registration, (2) before or (3) after their first deposit, or (4) to an unprompted control condition.
Data on customers from Finland with online slots as a preferred gambling category (N = 4328) were tracked in the platform for 90 days starting at account registration, gambling intensity being measured with aggregated net loss. The intervention groups did not differ from each other in either proportion of participants with positive net loss or size of positive net loss. The pooled intervention group did not differ from the control group regarding proportion of gamblers with positive net loss (OR = 1.0; p = 0.921) or size of net loss (B = -0.1; p = 0.291).
The intervention groups had higher rates of limit-setters compared to the control condition (ORat-registration/pre-deposit/post-deposit = 11.9/9.2/4.1). Customers who have increased/removed a previously set deposit limit had higher net loss than the limit-setters who have not increased/removed their limit (Bat-registration/pre-deposit/post-deposit/control = 0.7/0.6/1.0/1.3), and unprompted limit-setters lost more than unprompted non-setters (B = 1.0).
Prompting online gamblers to set a voluntary deposit limit of optional size did not affect subsequent net loss compared to unprompted customers, motivating design and evaluation of alternative pre-commitment tools. Setting a deposit limit without a prompt or increasing/removing a previously set limit may be a marker of gambling problems and may be used to identify customers in need of help.
Access online article

Reference: Ivanova E., Magnusson K., & Carlbring P. (2019). Deposit limit prompt in online gambling for reducing gambling intensity: A randomized controlled trial. Frontiers in Psychology, 10:639. doi: 10.3389/fpsyg.2019.00639

Measuring Gambling Reinforcers, Over Consumption and Fallacies: The Psychometric Properties and Predictive Validity of the Jonsson-Abbott Scale (open access)

By Jonsson, J., Abbott, M. W., Sjöberg, A., & Carlbring, P.

Abstract: Traditionally, gambling and problem gambling research relies on cross-sectional and retrospective designs. This has compromised identification of temporal relationships and causal inference. To overcome these problems a new questionnaire, the Jonsson-Abbott Scale (JAS), was developed and used in a large, prospective, general population study, The Swedish Longitudinal Gambling Study (Swelogs). The JAS has 11 items and seeks to identify early indicators, examine relationships between indicators and assess their capacity to predict future problem progression. The aims of the study were to examine psychometric properties of the JAS (internal consistency and dimensionality) and predictive validity with respect to increased gambling risk and problem gambling onset. The results are based on repeated interviews with 3818 participants. The response rate from the initial baseline wave was 74 %. The original sample consisted of a random, stratified selection from the Swedish population register aged between 16 and 84. The results indicate an acceptable fit of a three-factor solution in a confirmatory factor analysis with “Over consumption”, “Gambling fallacies” and “Reinforcers” as factors. Reinforcers, Over consumption and Gambling fallacies were significant predictors of gambling risk potential and Gambling fallacies and Over consumption were significant predictors of problem gambling onset (incident cases) at 12 month follow up. When controlled for risk potential measured at baseline, the predictor Over consumption was not significant for gambling risk potential at follow up. For incident cases, Gambling fallacies and Over consumption remained significant when controlled for risk potential. Implications of the results for the development of problem gambling, early detection, prevention and future research are discussed.

Jonsson, J., Abbott, M. W., Sjöberg, A., & Carlbring, P. (2017). Measuring Gambling Reinforcers, Over Consumption and Fallacies: The Psychometric Properties and Predictive Validity of the Jonsson-Abbott Scale. Frontiers in Psychology, 8. https://doi.org/10.3389/fpsyg.2017.01807

 

Similarities and Differences between Individuals Seeking Treatment for Gambling Problems vs. Alcohol and Substance Use Problems in Relation to the Progressive Model of Self-stigma (open access)

By Belle Gavriel-Fried and Tal Rabayov.

Aims: People with gambling as well as substance use problems who are exposed to public stigmatization may internalize and apply it to themselves through a mechanism known as self-stigma. This study implemented the Progressive Model for Self-Stigma which consists four sequential interrelated stages: awareness, agreement, application and harm on three groups of individuals with gambling, alcohol and other substance use problems. It explored whether the two guiding assumptions of this model (each stage is precondition for the following stage which are trickle-down in nature, and correlations between proximal stages should be larger than correlations between more distant stages) would differentiate people with gambling problems from those with alcohol and other substance use problems in terms of their patterns of self-stigma and in terms of the stages in the model.

Method: 37 individuals with gambling problems, 60 with alcohol problems and 51 with drug problems who applied for treatment in rehabilitation centers in Israel in 2015–2016 were recruited. They completed the Self-stigma of Mental Illness Scale-Short Form which was adapted by changing the term “mental health” to gambling, alcohol or drugs, and the DSM-5-diagnostic criteria for gambling, alcohol or drug disorder.

Results: The assumptions of the model were broadly confirmed: a repeated measures ANCOVA revealed that in all three groups there was a difference between first two stages (aware and agree) and the latter stages (apply and harm). In addition, the gambling group differed from the drug use and alcohol groups on the awareness stage: individuals with gambling problems were less likely to be aware of stigma than people with substance use or alcohol problems.

Conclusion: The internalization of stigma among individuals with gambling problems tends to work in a similar way as for those with alcohol or drug problems. The differences between the gambling group and the alcohol and other substance groups at the aware stage may suggest that public stigma with regard to any given addictive disorder may be a function of the type of addiction (substance versus behavioral).

Gavriel-Fried, B., & Rabayov, T. (2017). Similarities and Differences between Individuals Seeking Treatment for Gambling Problems vs. Alcohol and Substance Use Problems in Relation to the Progressive Model of Self-stigma. Frontiers in Psychology, 8. https://doi.org/10.3389/fpsyg.2017.00957

Risk Factors for Gambling Problems on Online Electronic Gaming Machines, Race Betting and Sports Betting (open access)

By  Nerilee Hing, Alex M. Russell and Matthew Browne

Growth of Internet gambling has fuelled concerns about its contribution to gambling problems. However, most online gamblers also gamble on land-based forms, which may be the source of problems for some. Studies therefore need to identify the problematic mode of gambling (online or offline) to identify those with an online gambling problem. Identifying most problematic form of online gambling (e.g., EGMs, race betting, sports betting) would also enable a more accurate examination of gambling problems attributable to a specific online gambling form. This study pursued this approach, aiming to: (1) determine demographic, behavioral and psychological risk factors for gambling problems on online EGMs, online sports betting and online race betting; (2) compare the characteristics of problematic online gamblers on each of these online forms. An online survey of 4,594 Australian gamblers measured gambling behavior, most problematic mode and form of gambling, gambling attitudes, psychological distress, substance use, help-seeking, demographics and problem gambling status. Problem/moderate risk gamblers nominating an online mode of gambling as their most problematic, and identifying EGMs (n = 98), race betting (n = 291) or sports betting (n = 181) as their most problematic gambling form, were compared to non-problem/low risk gamblers who had gambled online on these forms in the previous 12 months (n = 64, 1145 and 1213 respectively), using bivariate analyses and then logistic regressions. Problem/moderate risk gamblers on each of these online forms were then compared. Risk factors for online EGM gambling were: more frequent play on online EGMs, substance use when gambling, and higher psychological distress. Risk factors for online sports betting were being male, younger, lower income, born outside of Australia, speaking a language other than English, more frequent sports betting, higher psychological distress, and more negative attitudes toward gambling. Risk factors for online race betting comprised being male, younger, speaking a language other than English, more frequent race betting, engaging in more gambling forms, self-reporting as semi-professional/professional gambler, illicit drug use whilst gambling, and more negative attitude toward gambling. These findings can inform improved interventions tailored to the specific characteristics of high risk gamblers on each of these online activities.

Food Addiction in Gambling Disorder: Frequency and Clinical Outcomes

By Susana Jiménez-Murcia, Roser Granero, Ines Wolz, Marta Baño, Gemma Mestre-Bach, Trevor Steward, Zaida Agüera, Anke Hinney, Carlos Diéguez, Felipe F. Casanueva, Ashley N. Gearhardt, Anders Hakansson, José M. Menchón, and Fernando Fernández-Aranda.

Background: The food addiction (FA) model is receiving increasing interest from the scientific community. Available empirical evidence suggests that this condition may play an important role in the development and course of physical and mental health conditions such as obesity, eating disorders, and other addictive behaviors. However, no epidemiological data exist on the comorbidity of FA and gambling disorder (GD), or on the phenotype for the co-occurrence of GD+FA.

Objectives: To determine the frequency of the comorbid condition GD+FA, to assess whether this comorbidity features a unique clinical profile compared to GD without FA, and to generate predictive models for the presence of FA in a GD sample.

Method: Data correspond to N = 458 treatment-seeking patients who met criteria for GD in a hospital unit specialized in behavioral addictions.

Results: Point prevalence for FA diagnosis was 9.2%. A higher ratio of FA was found in women (30.5%) compared to men (6.0%). Lower FA prevalence was associated with older age. Patients with high FA scores were characterized by worse psychological state, and the risk of a FA diagnosis was increased in patients with high scores in the personality traits harm avoidance and self-transcendence, and low scores in cooperativeness (R2 = 0.18).

Conclusion: The co-occurrence of FA in treatment-seeking GD patients is related to poorer emotional and psychological states. GD treatment interventions and related behavioral addictions should consider potential associations with problematic eating behavior and aim to include techniques that aid patients in better managing this behavior.

The Relationship Between Impulsivity And Problem Gambling In Adolescence

Secades-Villa R, Martínez-Loredo V, Grande-Gosende A and Fernández-Hermida JR

Gambling has become one of the most frequently reported addictive behaviors among young people. Understanding risk factors associated with the onset or maintenance of gambling problems in adolescence has implications for its prevention and treatment. The main aim of the present study was to examine the potential relationships between impulsivity and problem gambling in adolescence. Participants were 874 high school students (average age: 15 years old) who were surveyed to provide data on gambling and impulsivity. Self-reported gambling behavior was assessed using the South Oaks Gambling Screen – Revised for Adolescents (SOGS-RA) and impulsivity was measured using the Impulsive Sensation Seeking Questionnaire (ZKPQ), the Barratt Impulsiveness Scale (BIS-11-A), and a delay discounting task. The data were analyzed using both a prospective-longitudinal and a cross-sectional design. In the longitudinal analyses, results showed that the impulsivity subscale of the ZKPQ increased the risk of problem gambling (p =.003). In the cross-sectional analyses, all the impulsivity measures were higher in at-risk/problem gamblers than in non-problem gamblers (p = .04; .03 and .01 respectively). These findings further support the relationship between impulsivity and gambling in adolescence. Moreover, our findings suggest a bidirectional relationship between impulsivity and problem gambling in adolescence. These results have consequences for the development of prevention and treatment programs for adolescents with gambling problems.