Current suicidal ideation in treatment-seeking individuals in the United Kingdom with gambling problems

By Silvia Ronzitti, Emiliano Soldini, Neil Smith, Marc N. Potenza, Massimo Clerici, and Henrietta Bowden-Jones.

Background: Studies show higher lifetime prevalence of suicidality in individuals with pathological gambling. However, less is known about the relationship between pathological gambling and current suicidal ideation.

Objectives: We investigated socio-demographic, clinical and gambling-related variables associated with suicidality in treatment-seeking individuals.

Methods: Bivariate analyses and logistic regression models were generated on data from 903 individuals to identify measures associated with aspects of suicidality.

Results: Forty-six percent of patients reported current suicidal ideation. People with current suicidal thoughts were more likely to report greater problem-gambling severity (p < 0.001), depression (p < 0.001) and anxiety (p < 0.001) compared to those without suicidality. Logistic regression models suggested that past suicidal ideation (p < 0.001) and higher anxiety (p < 0.05) may be predictive factors of current suicidality.

Conclusions: Our findings suggest that the severity of anxiety disorder, along with a lifetime history of suicidal ideation, may help to identify treatment-seeking individuals with pathological gambling with a higher risk of suicidality, highlighting the importance of assessing suicidal ideation in clinical settings.

Ronzitti, S., Soldini, E., Smith, N., Potenza, M. N., Clerici, M., & Bowden-Jones, H. (2017). Current suicidal ideation in treatment-seeking individuals in the United Kingdom with gambling problems. Addictive Behaviors, 74, 33–40.

A meta-regression analysis of 41 Australian problem gambling prevalence estimates and their relationship to total spending on electronic gaming machines (open access)

By Francis Markham, Martin Young, Bruce Doran, and Mark Sugden.

Background: Many jurisdictions regularly conduct surveys to estimate the prevalence of problem gambling in their adult populations. However, the comparison of such estimates is problematic due to methodological variations between studies. Total consumption theory suggests that an association between mean electronic gaming machine (EGM) and casino gambling losses and problem gambling prevalence estimates may exist. If this is the case, then changes in EGM losses may be used as a proxy indicator for changes in problem gambling prevalence. To test for this association this study examines the relationship between aggregated losses on electronic gaming machines (EGMs) and problem gambling prevalence estimates for Australian states and territories between 1994 and 2016.

Methods: A Bayesian meta-regression analysis of 41 cross-sectional problem gambling prevalence estimates was undertaken using EGM gambling losses, year of survey and methodological variations as predictor variables. General population studies of adults in Australian states and territory published before 1 July 2016 were considered in scope. 41 studies were identified, with a total of 267,367 participants. Problem gambling prevalence, moderate-risk problem gambling prevalence, problem gambling screen, administration mode and frequency threshold were extracted from surveys. Administrative data on EGM and casino gambling loss data were extracted from government reports and expressed as the proportion of household disposable income lost.

Results: Money lost on EGMs is correlated with problem gambling prevalence. An increase of 1% of household disposable income lost on EGMs and in casinos was associated with problem gambling prevalence estimates that were 1.33 times higher [95% credible interval 1.04, 1.71]. There was no clear association between EGM losses and moderate-risk problem gambling prevalence estimates. Moderate-risk problem gambling prevalence estimates were not explained by the models (I 2 ≥ 0.97; R 2 ≤ 0.01).

Conclusions: The present study adds to the weight of evidence that EGM losses are associated with the prevalence of problem gambling. No patterns were evident among moderate-risk problem gambling prevalence estimates, suggesting that this measure is either subject to pronounced measurement error or lacks construct validity. The high degree of residual heterogeneity raises questions about the validity of comparing problem gambling prevalence estimates, even after adjusting for methodological variations between studies.

Children’s attitudes towards Electronic Gambling Machines: an exploratory qualitative study of children who attend community clubs (open access)

By Amy Bestman, Samantha Thomas, Melanie Randle and Hannah Pitt

This research sought to explore whether children’s visual and auditory exposure to Electronic Gambling Machines (EGMs) in community clubs contributed to shaping their attitudes towards these types of potentially harmful gambling products. This research also examined children’s knowledge of EGM behaviours in adults within their social networks.

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.

Prevention paradox logic and problem gambling: Does low-risk gambling impose a greater burden of harm than high-risk gambling? (Open access)

By Paul Delfabbro and Daniel King.

Background and aims: The aim of this paper is to examine the evidence and arguments in favor of prevention paradox (PP) logic in the context of problem gambling. Evidence from recent studies of gambling and the distribution of harm across lower and higher risk gamblers is reviewed to examine the contention that the absolute burden of harm is greater in low-risk (LR) gamblers than the problem gamblers.
Methods: The review examines a number of methodological and conceptual concerns about existing evidence in support of the PP.
Results: The principal problems identified include the misclassification of LR gamblers; the use of binary scoring method that understates the frequency of harms in high-risk populations; a tendency to confuse behavior and harm; and the use of potentially overly inclusive definitions of harm with low thresholds of severity.
Discussion and conclusions: This paper makes a number of recommendations for enhancement of this area of research, including the use of clear definitions of harm and LR behavior and a greater focus on harm with material impacts on people’s quality of life.

Moderate Risk and Problem Slot Machine Gamblers: A Typology of Gambling-Related Cognitions

By June St Clair Buchanan and Gregory Elliott.

Gambling has traditionally been a part of the national psyche in Australia. In more recent times, however, attitudes in much of the community are changing, with the result that governments are widely expected to develop increasingly restrictive public policies related to electronic gaming machines (EGMs). The purpose of this paper is to examine the relationships between government, business, and the broader community in the context of the gambling industry in New South Wales (NSW), Australia, and to explore the political and social policy implications of reconciling these competing stakeholder interests. The research draws on the results of 38 face-to-face interviews with key stakeholders in Nevada and NSW conducted during 2005 and 2006, with an additional two interviews in 2013 in NSW. Furthermore, 47 newspaper articles were analyzed to further identify key issues. Against a background of widespread community skepticism, we argue that governments have an important role in setting public policies and striking the appropriate balance between protecting those who have, or are susceptible to, gambling problems and the majority of people who play EGMs without any ensuing problems. However, businesses also have an important contribution to make by being proactively socially responsible, thereby increasing their legitimacy and negating the need for further government interventions.