Online Gambling among Treatment-Seeking Patients in Singapore: A Cross-Sectional Study [Full-text]

Melvyn Zhang, Yi Yang, Song Guo, Chris Cheok, Kim Eng Wong and
Gomathinayagam Kandasami – International Journal of Environmental Research and Public Health — Open Access Journal

Abstract: Given that technology has greatly facilitated easier access to gambling in previous years, it is timely to look in-depth into online gambling activities and behaviors. There have been several studies that examined online gambling. However, most of the current studies to date have focused on determining the prevalence and the epidemiology of problem gambling arising from online gambling in Western cohorts. There remains a paucity of research looking at the problem of online gambling among Asian individuals. The objectives of the current study are to elucidate the characteristics of online gambling among an Asian cohort and to explore the harm associated with online gambling and the potential mechanisms by which harm associated with online gambling could be minimized.

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Post Traumatic Stress and Gambling Motives [Full text]

Joshua B. Grubbs1, Heather Chapman2, Lauren Milner3, Ian A. Gutierrez2,4, and David F. Bradley2, 5

1Bowling Green State University, 2Louis Stokes Cleveland VA Medical Center, 3Meridian Behavioral Health Services, 4University of Connecticut, 5Case Western Reserve University

Abstract: Problem gambling and gambling disorder are associated with a range of mental health concerns that extend beyond gambling behaviors alone. Prior works have consistently linked gambling disorder with symptoms of post-traumatic stress and post-traumatic stress disorder, both crosssectionally and over time. However, very little work has examined the specific relationships between these two disorders. The present work postulated that post-traumatic stress is likely associated with unique beliefs about gambling behaviors and unique motivations to gamble. Using two samples—an inpatient sample of U.S. Armed Forces veterans (N = 332) seeking treatment for gambling related problems and a web-sample of gambling adults (N = 881)—we examined these ideas. Results from both samples indicated that post-traumatic stress symptoms were related to positive gambling expectancies and coping motivations for gambling. Additionally, in both samples, positive gambling expectancies were associated with greater coping motivations for gambling. Structural equation models revealed that positive gambling expectancies were consistent predictors of coping motivations for gambling. The findings indicate that post-traumatic stress symptoms are likely associated with unique beliefs about and motivations for gambling behaviors. Given the high comorbidity between symptoms of posttraumatic stress and gambling disorder, these specific relationships are likely of clinical interest in populations seeking treatment for either post-traumatic stress or for problems with gambling behaviors.

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A Comparison of Online Versus Offline Gambling Harm in Portuguese Pathological Gamblers: An Empirical Study

By Hubert, P., & Griffiths, M. D.

Abstract: Over the past decade, gambling has become a very popular activity across Europe including the growth of Internet gambling. Portugal is one of the few European countries where little research has been carried out. Given the lack of studies, a Portuguese sample (N = 1,599) was surveyed concerning their online and offline gambling habits. More specifically, the aim of this study was to identify and compare from the total sample, online pathological gamblers (PGON) (n = 171) and offline pathological gamblers’ (PGOF) (n = 171) characteristics, and eventual risk factors for the development of problem gambling. Results demonstrated that PGON had different profiles compared to PGOF, although there were also similarities. Situational characteristics were much more significant for PGON than PGOF (e.g., availability, accessibility, affordability), but PGOF had higher scores than PGON on factors concerning individual characteristics (e.g., intensity of feelings while gambling, depression, suicidal ideation, etc.). Findings also showed differences concerning attitudes toward responsible gambling measures. The fact that situational characteristics are more attractive to online gamblers confirms differences between PGON and PGOF and suggests that this preferred attractiveness may enhance problem gambling potential. Further research is needed to better understand the interaction between Internet situational characteristics and the individual characteristics of gamblers, as well as the profile of the growing population of gamblers that uses both online and offline modes to gamble.

Hubert, P., & Griffiths, M. D. (2017). A Comparison of Online Versus Offline Gambling Harm in Portuguese Pathological Gamblers: An Empirical Study. International Journal of Mental Health and Addiction., P., & Griffiths, M. D. (2017). A Comparison of Online Versus Offline Gambling Harm in Portuguese Pathological Gamblers: An Empirical Study. International Journal of Mental Health and Addiction.


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.

Recovery, relapse, or else? Treatment outcomes in gambling disorder from a multicenter follow-up study

K.W. Müller, K. Wölfling, U. Dickenhorst, M.E. Beutel, J. Medenwaldt, A. Koch.

Purpose: Gambling disorder is associated with various adverse effects. While data on the immediate effectiveness of treatment programs are available, follow-up studies examining long-term effects are scarce and factors contributing to a stable therapy outcome versus relapse are under-researched.

Materials and methods: Patients (n = 270) finishing inpatient treatment for gambling disorder regularly participated in a prospective multicenter follow-up study (pre-treatment, post-treatment, 12-month follow-up). Criteria for gambling disorder, psychopathology, functional impairment were defined as endpoints. Changes in personality were defined as an additional parameter.

Results: At follow-up, three groups were identified: subjects maintaining full abstinence (41.6%), patients still meeting criteria for gambling disorder (29.2%), and subjects still participating in gambling without meeting the diagnostic criteria for gambling disorder (29.2%). Every group had improvements in functional impairment, abstinent subjects showed the lowest psychopathology. Significant decreases in neuroticism and increases in both extraversion and conscientiousness were found among abstinent subjects but not in patients still meeting criteria for gambling disorder.

Discussion: One year after treatment, a considerable percentage of patients kept on gambling but not all of them were classified with gambling disorder leading to the question if abstinence is a necessary goal for every patient.

Conclusions: The changes of personality in abstinent patients indicate that after surmounting gambling disorder a subsequent maturing of personality might be a protective factor against relapse.

Müller, K. W., Wölfling, K., Dickenhorst, U., Beutel, M. E., Medenwaldt, J., & Koch, A. (n.d.). Recovery, relapse, or else? Treatment outcomes in gambling disorder from a multicenter follow-up study. European Psychiatry.

The cost of virtual wins: An examination of gambling-related risks in youth who spend money on social casino games (full text)

Methods An online survey was administered to 555 adolescents, including 130 SCG players (78 non-paying and 52 paying users).

Pharmacotherapy and group cognitive behavioral therapy enhance follow-up treatment duration in gambling disorder patients

Choi, S.-W., Shin, Y.-C., Youn, H., Lim, S.-W., & Ha, J.

Longer treatment duration is important for the successful treatment of gambling disorder (GD). This retrospective study investigated the factors and interventions that might enhance treatment duration in GD patients in South Korea.

A total of 758 outpatients with a primary diagnosis of GD, who were treated in a clinical practice from 2002 to 2011, were assessed by retrospective chart review. We compared the treatment duration according to pharmacotherapy and group cognitive behavioral therapy (CBT).

Pharmacotherapy contributed to a longer duration of treatment maintenance, despite the patients’ gambling severity (p < 0.001). Participation in group CBT (p < 0.001) and antidepressants (p = 0.009) were associated with a longer treatment duration after adjusting for age, depression, and gambling severity. The treatment maintenance duration was the longest in those receiving combined antidepressant pharmacotherapy and group CBT (F = 35.79, p < 0.001).

Group CBT and antidepressants seem to enhance treatment follow-up duration in GD patients. Additional studies are needed to advance GD prevention and treatment strategies.