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• Participants in CBT had more favorable gambling cognitions at posttreatment than minimal/no treatment. • Participants in CBT had more coping behaviors at posttreatment than minimal/no treatment. • Participants in CBT had more self-efficacy at posttreatment than minimal or no treatment control. • Results provide preliminary support for effectiveness of CBT on three mechanisms of change. • Significant heterogeneity was present in the magnitude of effect sizes. • Significant inconsistency in outcome measurement was noted. Objective: The current study was a systematic review and meta-analysis of cognitive behavioral treatment (CBT) for problem gambling and gambling disorder and whether it produced different outcomes than minimal or no treatment controls on three putative change mechanisms: 1) gambling cognitions, 2) coping, and 3) self-efficacy. Method: Studies were identified from five bibliographic databases (i.e., Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Embase, PsycINFO, and PubMed). Included studies were randomized controlled trials of CBT that included posttreatment data on putative mechanisms. Between-group Hedges's g effect sizes were calculated to examine outcomes of CBT relative to minimal or no treatment control on gambling cognitions, coping, and self-efficacy at posttreatment. Risk of bias was determined using the Cochrane Risk of Bias tool. Results: Fifteen studies, representing 1,536 participants, were eligible for analysis. Participants in CBT had more favorable gambling cognitions (g = -0.41), coping behaviors (g = 0.27), and self-efficacy (g = 1.12) at posttreatment than minimal or no treatment control. Conclusions: Results of the current study provided preliminary support for the effectiveness of CBT on three putative mechanisms of change among individuals experiencing problem gambling and gambling disorder. Although the results were promising, there was significant heterogeneity in the magnitude of effect sizes for all three outcomes, and outcomes were not consistently assessed with psychometrically established assessment tools. [ABSTRACT FROM AUTHOR]

• Gamblers can be classified into three clusters based on gambling and mental health. • Clusters differ in psychological variables, particularly alexithymia, and emotional dependence. • Classifying gamblers allows for more tailored treatment to be conducted. Interest in characterizing individuals involved in addictive behaviors has been growing, which allows tailoring prevention and intervention strategies to the gambler's needs. The study aimed to 1) identify clusters of gamblers according to gambling-related characteristics and mental health; and 2) analyze differences in psychological variables between the clusters. Methods. A total of 83 participants undergoing treatment for gambling disorder (M age = 45.52, 51.8 % female) completed a set of questionnaires. Hierarchical cluster analysis was performed to classify gambling based on gambling variables (i.e., gambling severity and gambling motives) and mental health (i.e., depression, anxiety, and hostility). Several ANOVAs were conducted to illustrate the distinguishing features of each cluster, encompassing both the variables included in the cluster analysis and other relevant psychological variables. Results. Findings suggest that gamblers can be classified into three clusters based on these variables: 1) "high gambling severity and good mental health," 2) "high gambling severity and poor mental health," and 3) "low gambling severity and good mental health." These clusters were differentiated as a function of psychological variables, such as emotional dependence, alexithymia, and stressful life events. Conclusions. Classifying gamblers according to their profile provides a better understanding of their needs and problems, allowing for a more tailored approach in terms of prevention and intervention strategies. [ABSTRACT FROM AUTHOR]

• People often use justifications to make desirable choices, but is this related to gambling problems? • Justifications are associated with problem gambling beyond gambling cognitions and impulsivity. • Justifications are positively correlated with urgency and gambling cognitions. • The use of justifications may represent a neglected aspect of gambling cognitions. People often use justifications to make desirable choices, but little is known about these justificatory thoughts in gambling. We conducted an exploratory Study 1 (n = 101) and a confirmatory Study 2 (n = 154) using online surveys, recruiting gamblers with prior and current experience of trying to reduce their gambling. Using justifications recognized in the domains of eating and consumer behavior (e.g., prior use of effort, feelings of achievement), we examined whether justifications were associated with problem gambling severity, and whether they explained additional variance above trait impulsivity and cognitive distortions. In both studies, justifications were positively associated with problem gambling severity, after accounting for trait impulsivity and cognitive distortions. Additionally, justifications were positively correlated with trait urgency and cognitive distortions, indicating that such thinking may not be antithetical to impulsivity. These data provide proof-of-principle evidence that justificatory thinking occurs in the context of gambling, is related to problem gambling severity, and may therefore represent a neglected aspect of gambling-related cognitions. [ABSTRACT FROM AUTHOR]

• Two survey cohorts of gambling help-seekers (2019, 2023) were recruited via the Swedish national gambling helpline. • Between 2019-2023, gambling consumption intensified, with online EGMs being the most prevalent form of gambling. • Psychiatric co-morbidities and gambling-related harms were common in both cohorts, with some significant increases in 2023. • Digitalisation of gambling is linked to harmful consequences, identifiable through systematic measurement approaches. Gambling is connected to a range of harms and negative consequences. Gambling is also evolving at a fast pace, particularly in digital environments. Understanding the effects of this on-going change and digitalisation of gambling markets requires systematic measuring of gambling consumption patterns, clinical characteristics, and gambling-related harms. The current study compares two cohorts of help-seekers for gambling in Sweden (2019; 2023), recruited via the Swedish national helpline. The aim is to assess harms and consumption across the two cohorts at a time of increased offer of digital gambling in Sweden. We used eight different screens to measure gambling-related behaviours and consequences, including the Gambling Disorder Identification Test (GDIT). Results were analysed using descriptive statistics, and differences across the two cohorts were tested for statistical significance. The results show that across 2019–2023, gambling consumption has intensified. Online EGMs are by far the most prevalent form of gambling among help-seekers. We also found that the experience of co-morbidities as well as most gambling-related harms were common in both cohorts, with some statistically significant increases in 2023. Harms were more commonly experienced amongst those who engaged in online EGM gambling in comparison to those who did not. The results suggest that the digitalisation of gambling and gambling products appears to be associated with a variety of harmful consequences. The results also show the importance of systematic and comprehensive measurement to capture different severity levels of harms and their wide range amongst those who gamble. [ABSTRACT FROM AUTHOR]

• First independent evaluation of safer gambling adverts as shown on UK television. • Operators' safer gambling adverts shown to increase gambling urges compared to control. • GambleAware's stigma reduction campaign were the only adverts to yield significant decreases in gambling urges. Public concern around gambling advertising in the UK has been met not by government action but by industry self-regulations, such as a forthcoming voluntary ban on front-of-shirt gambling sponsorship in Premier League soccer. "Safer gambling" (harm prevention) adverts are one recent example, and are TV commercials which inform viewers about gambling-related harm. The present work is the first independent evaluation of safer gambling adverts by both gambling operators and a charity called GambleAware. In an online experiment, we observed the change in participants' (N = 2,741) Gambling Urge Scale (GUS) scores after viewing either: a conventional financial inducement gambling advert, a gambling operator's safer gambling advert, an advert from the GambleAware "bet regret" campaign, an advert from the GambleAware "stigma reduction" campaign, or a control advert that was not about gambling. Relative to a neutral control advert, GUS scores increased after viewing a financial inducement or an operator's safer gambling advert. In comparison to the neutral control condition, GUS score changes were similar after viewing a bet regret advert, but showed a significant decrease after viewing a stigma reduction advert. Those at higher risk of harm reported larger decreases in GUS after watching a bet regret or stigma reduction advert. Overall, this study introduced a novel experimental paradigm for evaluating safer gambling adverts, uncovered a potential downside from gambling operators' safer gambling adverts, and revealed variation in the potential effectiveness of charity-delivered safer gambling adverts. [ABSTRACT FROM AUTHOR]

• Four profiles of gamblers' representations of gambling disorder (GD) were identified. • Gamblers with different GD representation profiles differed in GD symptoms and gambling behaviors. • A low-risk group characterized by a rational pattern of GD representations was identified. • A group characterized by weak GD representations was considered at risk for gambling problems. Gambling disorder (GD) is a behavioral addiction that causes serious harm to individuals' mental health and social functioning. This study aimed to explore whether gamblers' illness representations (IR) for GD are related to disordered and/or controlled patterns of gambling under the framework of commonsense model of self-regulation (CSM). Based on CSM, different facets of IR do not exist in isolation but together form a total illness schema; we hence used a person-centered analysis method, latent profile analysis (LPA), to classify gamblers by their overall IR for GD (including consequences, personal and treatment control, timeline cyclical, emotional representations, and coherence) into groups and then tested whether these groups differed in GD symptoms, controlled gambling behaviors, and help-seeking intention. An anonymous online survey was conducted on a social media platform, and valid responses from 589 past-year adult gamblers were collected. LPA results supported a four-profile model, revealing four profiles of GD representations: the weak-perception profile, average profile, tensed-up profile, and rational profile. Significant differences were found in all outcome variables in these four profile groups. In particular, the rational group exhibited the lowest levels of GD symptoms and impaired behavioral control, the highest levels of responsible and controlled gambling, and the highest levels of help-seeking intention, whereas the weak-perception group reported the lowest levels of responsible and controlled gambling behaviors. The findings provide empirical support for the application of CSM to addictive behaviors, as well as preliminary evidence for the potential use of CSM-based interventions for GD prevention. [ABSTRACT FROM AUTHOR]

[Display omitted] • Shift work disrupts circadian rhythms, and night-shift work is associated with the occurrence of substance use disorders; however, there is no evidence to support a link between night-shift work and behavioral addictions. • In this cross-sectional study using an Internet survey, we examined the association between shift work and gambling, a potential risk behavior for behavioral addictions, among workers (n = 21,134), and the results showed an association between night-shift work and gambling participation (adjusted odds ratio [aOR], 1.39, 95 % confidence interval [CI], 1.25–1.53, p < 0.001). • When restricted to respondents with past-year gambling experience (n = 9,739), night-shift work was associated with problem gambling, defined as the problem gambling severity index score of 8 or greater (aOR 1.94, 95 % CI, 1.94–2.40, p < 0.001). • Night-shift work was associated with gambling in workers and with problem gambling among working and gambling respondents, suggesting that gambling might be a factor associated with shift work-related harms. Night-shift work disturbs sleep and is associated with poor health conditions among workers. We aimed to investigate the association between night-shift work and gambling among workers and the association between night-shift work and problem gambling in working and gambling participants. This cross-sectional study used data from an online survey conducted between February 6 and 27, 2023 in Japan. A total of 21,134 workers participated in this study, including 9,739 respondents who had gambled in the past year. We estimated the association between night-shift work and gambling among workers and the association between night-shift work and problem gambling among those who gambled at the survey. We defined problem gambling as a score ≥ 8 on the Problem Gambling Severity Index. All estimates were weighted using a nationally representative survey in Japan. We fitted multivariable weighted logistic regression models after adjusting for 14 confounders. The weighted prevalence of gambling among non-night and night-shift workers was 42.1 % and 55.4 %, respectively. When focusing on workers gambling in the survey, the prevalence of problem gambling among non-night and night-shift workers was 8.8 % and 24.2 %, respectively. The weighted multivariable logistic regression analyses showed that night-shift work was associated with gambling participation among workers (adjusted odds ratio [aOR], 1.39, 95 % confidence interval [CI] 1.25–1.53, p < 0.001). In addition, night-shift work was associated with problem gambling among those who gambled (aOR 1.94, 95 % CI 1.57–2.40, p < 0.001). Night-shift work was associated with gambling among workers and with problem gambling among those who gambled. [ABSTRACT FROM AUTHOR]

• SARS-CoV-2 pandemic impacted people's lives and habits, including gambling habits. • A significant reduction in frequency and expenditure of land-based gambling emerged. • Some types of online gambling increased, including online casino and skills games. • Sports betting declined due to the cancellation or suspension of major sport events. • A strong migration from land-based to online gambling emerged during the pandemic. Since the COVID-19 outbreak, people's habits changed radically. In fact, to limit the spread of SARS-CoV-2, governments implemented restrictive measures that influenced the lives of individuals. The aim of this systematic review is to analyze the impact of COVID-19 on gambling by examining three different outcomes: frequency, expenditure, and transition among possible types of gambling. All studies assessing the impact of restrictive measures implemented to limit the spread of SARS-CoV-2 on gambling were included. For the search, two different databases were used: Pubmed and CINAHL. Moreover, two different populations were analyzed: the general population, and subjects who used to gamble before SARS-CoV-2 pandemic. All qualitative studies, reports not based on peer-review, and papers in which the statistical unit was not the subject but the gambling or wagering operators were excluded. From the search, 408 reports were identified. Of these, 28 were included in the systematic review. From the studies, a strong reduction in the frequency and expenditure of land-based gambling emerged, while the results about online gambling were different among the studies. However, a reduction was observed assessing sports betting, and an increase emerged considering online casino and skill games. Finally, a significant migration from land-based gambling to online platforms was identified. The main reasons for these findings were the physical closures of land-based gambling venues and the more time spent at home, the suspension or cancelation of sporting events on which subjects used to bet, and more mental health issues during this challenging period. The COVID-19 pandemic greatly affected subjects' habits, including gambling, by reducing land-based gambling and sports betting, and increasing gambling on online platforms. This shift poses significant challenges, requiring a comprehensive approach to monitor and mitigate the negative consequences of this increase in online gambling caused by the pandemic. [ABSTRACT FROM AUTHOR]

• Gambling disorder (GD) and cocaine use disorder (CUD) share features. • Craving is relevant to GD and CUD. • Intrinsic connectivity distribution (ICD) is a novel data-driven approach. • ICD implicated posterior cingulate cortex (PCC) connectivity in GD and CUD craving. • PCC connectivity was decreased in a cue-diagnosis-related way in GD and CUD. Cue reactivity is relevant across addictive disorders as a process relevant to maintenance, relapse, and craving. Understanding the neurobiological foundations of cue reactivity across substance and behavioral addictions has important implications for intervention development. The present study used intrinsic connectivity distribution methods to examine functional connectivity during a cue-exposure fMRI task involving gambling, cocaine and sad videos in 22 subjects with gambling disorder, 24 with cocaine use disorder, and 40 healthy comparison subjects. Intrinsic connectivity distribution implicated the posterior cingulate cortex (PCC) at a stringent whole-brain threshold. Post-hoc analyses investigating the nature of the findings indicated that i ndividuals with gambling disorder and cocaine use disorder exhibited decreased connectivity in the posterior cingulate during gambling and cocaine cues, respectively, as compared to other cues and compared to other groups. Brain-related cue reactivity in substance and behavioral addictions involve PCC connectivity in a content-to-disorder specific fashion. The findings suggesting that PCC-related circuitry underlies cue reactivity across substance and behavioral addictions suggests a potential biomarker for targeting in intervention development. [ABSTRACT FROM AUTHOR]

• Affected family member status positively predicted negative mental health. • Affected family member status negatively predicted positive mental health. • Controlling for other harm influenced the strength of these relationships. • Religious coping intensified the affected family member-panic symptom relationship. Despite the impact of problem gambling on affected family members (AFMs), there are limited large-scale population level studies identifying the negative mental health (NMH) and positive mental health (PMH) characteristics of AFMs. Furthermore, no study has explored whether PMH characteristics are protective in the relationships between AFM status and NMH characteristics. This study involved secondary data analysis from the Third Social and Economic Impact Study of Gambling in Tasmania. Using a subsample of 1,869 adults (48.30 % male; mean age = 48.48; 4.67 % AFMs), this study aimed to explore whether: (1) AFM status is associated with NMH (depression, anxiety, panic, post-traumatic stress disorder, social anxiety, binge drinking, tobacco use, and drug use symptoms) and PMH (quality of life [QOL], personal growth/autonomy, interpersonal/social skills, coping skills) characteristics after separately controlling for sociodemographic, problem gambling severity, and other NMH characteristics; (2) PMH characteristics moderate (buffer) the relationships between AFM status and NMH characteristics; and (3) gender influences these relationships. AFM status, defined as exposure to family member gambling problems, significantly positively predicted NMH characteristics (depression, anxiety, panic, PTSD, and tobacco use symptoms) and negatively predicted QOL (physical, social) and planning coping. The strength of these relationships generally attenuated after controlling for various covariates. Gender did not moderate these relationships. Religious coping exacerbated the relationship between AFM status and panic disorder symptoms. These findings can inform the development of intervention initiatives for family members exposed to gambling problems. Future population-representative research is required using a range of affected other types, longitudinal study designs, and more comprehensive measures. [ABSTRACT FROM AUTHOR]

• Cashing out is a popular gambling feature that has been linked to problem gambling. • In our sample, 51.8% of participants reported using the cash out feature. • Using the cash out feature was associated with motivations to gamble to make money. • The cash out feature was associated with increased psychological vulnerabilities. • Motives for cashing out were to cut losses, gain money, and related to risk level. Cashing out is a popular feature of modern 'in-play' sports betting that allows sports bettors to withdraw a bet before the sporting event on which the bet was placed is finalized. Previous studies have shown that use of the cash out feature is positively related to problem gambling symptomatology. However, little is known about demographic and psychological characteristics of in-play sports bettors who use the cash out feature, or their motivations for use. To fill this knowledge gap, we recruited 224 adults (18 + years) from Ontario who engaged in in-play sports betting in the past three months. Participants completed self-report measures of psychological and gambling-related variables. Participants also provided qualitative responses for their motivations for using the cash out feature. Approximately half (51.8 %) of the participants reported using the cash out feature. No statistically significant demographic differences were found between participants who used and did not use the cash out feature. Participants who used the feature (compared to those who did not) reported higher problematic alcohol and cannabis use, feelings of depression, anxiety, and stress, and were motivated to gamble to make money. The primary reasons for cashing out were to access money immediately, to cut losses, and because cashing out felt like a less risky option. The current findings shed light on underlying psychological vulnerabilities associated with individuals who use the cash out feature, which can inform initiatives to reduce the harms associated with this popular feature of sports betting. [ABSTRACT FROM AUTHOR]

• Neurobiological features are associated with gambling disorder (GD) severity. • Lower adiponectin concentrations predicted greater GD severity. • LEAP-2 concentrations are associated with GD-cognitive distortions. • Neuropsychological performance is related to GD severity through a double role. • Impairment in different cognitive functions is linked with GD-cognitive distortions. Background: Neurobiological characteristics have been identified regarding the severity of gambling disorder (GD). The aims of this study were: (1) to examine, through a path analysis, whether there was a relationship between neuroendocrine features, potentially mediational GD variables, and GD severity, and (2) to associate neuroendocrine variables, with GD severity-related variables according to gambling preferences. Methods: The sample included 297 outpatients with GD. We analyzed endocrine concentrations of different appetite-related hormones (ghrelin, liver antimicrobial peptide 2 [LEAP-2], leptin, adiponectin), and neuropsychological performance (working memory, cognitive flexibility, inhibition, decision making, premorbid intelligence). Path analysis assessed mechanisms between neuroendocrine features and GD severity, including mediational GD variables (impulsivity traits and gambling-related cognitive distortions). Partial correlations evaluated the associations between neuroendocrine variables, including impulsivity traits, and variables related to GD severity (DSM-5, South Oaks Gambling Screen, illness duration, and gambling-related cognitive distortions). Results: Lower adiponectin concentrations predicted greater GD severity, while higher LEAP-2 concentrations predicted more gambling-related cognitive distortions. Likewise, better neuropsychological performance directly predicted GD severity, but worse neuropsychological performance was associated with GD severity through the mediational variables of impulsivity traits and gambling-related cognitive distortions. Also, in non-strategic individuals with GD, poor working memory was associated with gambling expectancies and predictive control. In strategic individuals with GD, poor cognitive flexibility was associated with illusion of control, predictive control, and inability to stop gambling. Conclusions: These results provide updated information about the comprehension of the interaction between neuroendocrine features, clinical variables, and severity of GD. Thus, neurobiological functions seem to be strongly related to GD severity. [ABSTRACT FROM AUTHOR]

• Examination of the identity components of self-investment and self-definition on problem and non-problem gambling. • In-group-based identities predict problematic vs. non-problematic gambling behaviours. • In-group-based identities predict increasing severity of problematic gambling. • How self-invested an individual is with their in-group and aspects associated with self-definition processes are both important predictors. • Perceived identity saliency (self-investment) and self-stereotyping (self-definition) are fundamental components in explaining gambling problems. Few studies have examined whether specific aspects of group identification predict problematic and non-problematic addictive behaviours and none have focused on gambling. Applying Leach et al.'s (2008) hierarchical model of in-group identification, we tested the associations between components of self-investment (satisfaction, solidarity, and centrality) and components of self-definition (individual self-stereotyping, in-group homogeneity) on distinguishing between problem and non-problem gambling (n = 10,157) and on the severity of problematic gambling behaviour (n = 2,568). Results showed that (i) in-group-based identities are important in predicting problematic vs. non-problematic gambling behaviours; (ii) in-group-based identities are important in predicting the severity of problematic gambling; (iii) how self-invested an individual is with their in-group and aspects associated with self-definition processes are both important predictors; (iv) perceptions related to how chronically salient one's group membership is for the self (centrality) are essential features of the self-investment mechanism; and (v) self-stereotypical beliefs about one's essential similarities to the prototypical gambling group member norm are fundamental for the defining oneself as a gambler. [ABSTRACT FROM AUTHOR]

• Impaired control (IC) is central to addictive disorders, including gaming disorder (GD). • IC has been found to be positively associated with gaming-related harms across 3 levels of severity and 5 distinct domains. • A survey of 513 gamers using the Impaired Control Over Gaming Scale (ICOGS) was used to assess harm severity across multiple domains. • Logistic regression results confirmed that IC was positively related to all levels of harm severity and across multiple domains. The concept of impaired control (IC) over gaming is an important element of assessment and interventions for problem gaming and gaming-related harm. Past studies have reported that gaming disorder (GD) is associated with various negative consequences, but there is limited research on the relationship between IC over gaming and negative outcomes. To address this gap, the study investigated the relationship between impaired control and gaming-related harm among individuals with self-identified gaming disorder. It was hypothesized that IC would be positively associated with gaming-related harm and harm severity. In addition, it was predicted that IC would be a significant predictor of harm when controlling for age, gender, psychological distress, and gaming urges. The current study recruited 513 participants through an online survey platform. The Impaired Control Over Gaming Scale (ICOGS) was used to measure IC, and modified items from Browne et al.'s taxonomy of gambling harms were used to assess gaming harm severity. The logistic regression results showed that IC was positively related to all forms of harm, after controlling for other variables. The predictive value of IC was similar across financial, psychological, relationship, social and work/school domains. These results supported the importance of IC as a mechanism that contributes to the experience of gaming-related harm, and the need to target IC in interventions for GD. [ABSTRACT FROM AUTHOR]

• Monetary limit setting protected against select in-play betting harms at the within- and between-person levels. • Time limit setting increased risk for select in-play betting harms at the between-person level. • Select responsible gambling strategies may be applicable to in-play betting. Self-regulation strategies, such as limit setting, can be effective in reducing harms associated with gambling. However, limited research has examined their applicability to in-play sports betting. The current study therefore examined the utility of self-regulation strategies in reducing in-play betting intensity and associated harms. Adults engaging in-play betting (N = 77; M age = 41.23 years, 71.43 % men) completed 14 days of ecological momentary assessment surveys in which they reported their in-play betting behaviours (number of bets placed, money spent), use of self-regulation strategies for in-play betting (setting monetary limits, setting time limits, stopping betting when no longer fun, taking frequent breaks), and in-play-betting-related harms. Multilevel models revealed that participants with a greater propensity to set monetary limits were overall less likely to experience financial, interpersonal, and health harms. In addition, participants were less likely to experience emotional/psychological harms following in-play betting occasions during which they set monetary limits (versus when they did not). In contrast, participants with a greater propensity to set time limits tended to spend more money on in-play bets, experienced more harms on average, and were overall more likely to experience financial and work/study harms. Results provide preliminary support for the utility of monetary limit setting, but not time limit setting, in reducing in-play-betting-related harms. Findings support the applicability of select self-regulation strategies originally proposed for more traditional forms of gambling to in-play sports betting, and highlight a need for further research investigating whether other responsible gambling strategies may be effective in reducing in-play-betting-related harms. [ABSTRACT FROM AUTHOR]

• We examined co-occurring patterns of gambling and substance/behavioural addictions. • The Quinte Longitudinal Study consisted of 4,121 participants followed over 5 years. • The largest co-occurring pattern consisted of concurrent decrease in gambling and addiction. • No co-occurring pattern of addiction substitution was identified. • Mental health, stress, and life satisfaction differentiated the co-occurring patterns. We examined the co-occurring patterns of problem gambling and substance/behavioral addiction severity over a five-year period and the predictors of the different co-occurring patterns of problem gambling and addiction severity. We conducted a secondary analysis of the Quinte Longitudinal Study (QLS) data. The QLS is a 5-year prospective longitudinal study of gambling and problem gambling in the Quinte Region in Southern Ontario. The QLS consists of a total of 4,121 participants, including a sample of participants at risk of developing problem gambling. Severity of problem gambling, substance use, and behavioral addictions were used to examine their co-occurring patterns over time. Predictors of the co-occurring patterns included the presence of mental health disorders, personality, stress, happiness, lifesatisfaction, social support, family history, and demographics. Six co-occurring patterns of problem gambling and addiction severity were identified. The largest co-occurring pattern was characterized by concurrent decrease in gambling and other addictive behaviors. Several co-occurring patterns were characterized by moderate-to-severe problem gambling and other addiction severity that remained stable over time. No co-occurring pattern represented a decrease in gambling followed by increase in other addictive behaviors (e.g., addiction substitution). The presence of mental health disorders, stress, and lifesatisfaction significantly predicted the different co-occurring patterns. Taken together, the results suggest that in a non-clinical sample, gambling and other co-occurring addictive behaviors are likely to simultaneously decrease over time. Comorbidity of mental health disorders significantly influences co-occurring patterns of gambling and other addictive behaviors. [ABSTRACT FROM AUTHOR]

• Randomised controlled trial testing positive-emotional and norm-based safer gambling messages. • Positive-emotional messages were rated most helpful and easily understood. • The highest-rated message was "only bet what you can afford" Effective gambling messages should curb time and money spent on gambling, since these are the behaviours proximal to gambling-related harm. Studies that aim to find what messages best achieve these objectives are scarce, and most focus on electronic gaming machine (EGM) gambling rather than sports and race betting. The present study aimed to gather longitudinal evidence on previously identified messaging strategies. In an experiment, two types of messages, positive-emotional and norm-based, were contrasted against a control condition with generic messages (e.g., gamble responsibly). By stratified random assignment, participants (N = 2,074, 36% female), were exposed to 3 unique messages in each of 3 weeks, exclusive of pre- and post-surveys in weeks 1 and 5, respectively. There were no significant differences by condition in amounts-bet commercially on sports or race betting, time spent gambling, gambling-harm experienced, gambling-urges nor risk-related gambling beliefs. However, there was a significant decrease in all these outcomes over weeks 1 through 5. The messages may not have been the factor that contributed to the decrease in outcomes over time, as participating in the study may have also prompted self-reflection on gambling expenditure. Positive-emotional messages were rated most helpful and easily understood, and the highest-rated message was the control message, "only bet what you can afford." Despite no differences found between the conditions, the present study provided evidence that self-reflection on gambling expenditure is well-rated by gamblers as being helpful. Future experiments should be conducted to gauge the robustness of this finding. [ABSTRACT FROM AUTHOR]

• We assessed chatbot effects on problem gambling, with or without therapist support. • Gambling problems were improved regardless of the presence or absence of therapist support. • Therapist support showed no additional effect on gambling symptoms. • Examining the appropriate intensity and modality of therapist support is needed. Internet-based interventions can be a promising option for individuals with problem gambling facing barriers to seeking help. This study aimed to directly compare the effects of therapist-guided Internet interventions with unguided ones on gambling-related behavior, cognition, and stage of change including help-seeking intention. We conducted a participant-blinded randomized controlled trial of therapist-guided versus unguided groups with a 12-week follow-up. Both groups received self-help chatbot-delivered cognitive behavioral therapy. Additionally, at baseline and weeks 1, 2, 3, and 4, the guided group received personalized feedback messages from therapists based on their gambling diary and questionnaire responses. The unguided group received reminders of assessments from research assistants. The primary outcome was the change in scores on the Gambling Symptoms Assessment Scale (G-SAS) over 12 weeks. Secondary outcomes included the stage of change including help-seeking intention, money wagered, gambling frequency, and gambling-related cognitions. We included 139 participants with a mean Problem Gambling Severity Index total score of 14.6 and a mean G-SAS total score of 27.0 who sought information about gambling problems. Both groups demonstrated substantial decreases in their G-SAS scores from baseline to week 12 (-10.2, 95% CI: −7.67 to −12.7 for the guided group, and 11.7, 95% CI: −9.05 to −14.3 for the unguided group). However, we did not find a significant between-group difference (1.49, 95% CI: −2.20 to 5.17). Regarding the stage of change including help-seeking intention, there were also no between-group differences. Minimum therapist support did not have an additive effect on the self-help chatbot intervention on gambling symptoms, behavior, and the stage of change including help-seeking intention. [ABSTRACT FROM AUTHOR]

• Changes in substance use behaviors are significantly associated with changes in gambling behavior. • Changes in mental health status are not significantly associated with changes in gambling behavior. • Changing lifestyle factors and sustained negative health factors have the most significant associations with becoming a risky gambler. Although a large number of studies have investigated associations between risky gambling behaviours and health, lifestyle and social factors, research has not focused on changes in these factors and associations with changes in gambling risk level. This study utilised existing data from the four waves of the longitudinal New Zealand National Gambling Study to examine associations between changes in substance use, mental and physical health, and quality of life and deprivation with changes in gambling risk level over time. A Markov chain transition model was used to perform these analyses using data from participants who had completed all four waves (11,080 data transitions). Although changes in various covariates were associated with changes in all gambling risk levels, the highest number of significant factors was for transitioning into risky gambling from non-problematic gambling, including development, or continuation, of several negative health and lifestyle factors that may possibly be alleviated by transitioning out of risky gambling. These findings highlight the importance of screening for gambling behaviours when assisting people with substance use, health issues, or social situations or conditions in order to provide appropriate and effective social, health and treatment supports for people whose gambling behaviour increases over time. [ABSTRACT FROM AUTHOR]

• Loot box spending was positively correlated with problem gambling and problem videogaming in China. • Loot box spending was negatively associated with impulsiveness and only weakly positively correlated with sensation seeking tendencies and past-year gambling participation. • Loot box spending was not correlated with worse mental health and negatively associated with psychological distress. • The Risky Loot Box Index was the best predictor for loot box spending and is an effective cross-cultural tool for assessing potential loot box harms. Loot boxes can be bought with real-world money to obtain random content inside video games. Loot boxes are viewed by many as gambling-like and are prevalently implemented globally. Previous Western and international studies have consistently found loot box spending to be positively correlated with problem gambling. Previous Western studies presented mixed results as to the correlations between loot box purchasing and gambling-related risk factors, mental wellbeing, and psychological distress. A large-scale survey of adult video game players from the People's Republic of China (PRC) (N = 2601) was conducted through Tencent Survey. The positive correlations between loot box spending and problem gambling, and between loot box spending and problem videogaming, were successfully replicated. However, other potential risk factors (i.e. , impulsivity/impulsiveness; binary past-year gambling participation status; and sensation-seeking tendencies) either did not positively correlate with loot box spending or only did so weakly. Contrary to expectations, high impulsivity was negatively associated with loot box engagement. The Risky Loot Box Index (RLI) most strongly positively correlated with, and was the best predictor in multiple linear regression models for, loot box spending. The RLI may be effective at measuring loot box harms cross-culturally. A surprising weak positive correlation was found between loot box engagement and PRC players' mental wellbeing, and high psychological distress unexpectedly negatively predicted loot box purchasing. Although gambling-like, the risk and protective factors of loot boxes are seemingly different, meaning they should rightfully be treated as novel products. Cross-cultural research can contribute to a better understanding of loot box harms. [ABSTRACT FROM AUTHOR]

Cognitive distortions in gambling are irrational thoughts that cause an individual to overestimate their level of control over the outcome of the game and diminish the role of chance. Due to their strong relation to gambling disorders, they are a particularly important characteristic to assess and understand in gamblers. Although numerous measures of gambling-related cognitive distortions exist, studies assessing criterion validity are scarce. In this study, we develop several tests of the Gamblers Belief Questionnaire (GBQ), a versatile and widely used scale. A sample of 184 U.S. adults was recruited through Amazon Mechanical Turk to complete an online study that included measurement of the GBQ and an assessment of the perceived role of skill and chance in various gambling and non-gambling activities. In addition to a confirmatory factor analysis of the scale, three novel validation tests were developed to understand whether the GBQ subscales can identify and discriminate measures of illusion of control and gambler's fallacy distortions. Our validation tests demonstrate that the scale does measure both distortions, providing information about gamblers' cognition that is unexplained by gambling problems, frequency of play, and demographics. Conversely, our analysis of the factor structure does not show good fit. We conclude that the GBQ measures gambling-related cognitive distortions, but there may be an opportunity to reduce the number of scale items and further refine precision of the two subscales. [ABSTRACT FROM AUTHOR]

This study aimed to first investigate the interplay among self-rated ability in both retrospective and prospective memory, time perspective, and negative affectivity to gambling severity. Two hundred and three habitual players took part in the study. Participants were administered the South Oaks Gambling Screen (SOGS), the Consideration of Future Consequences scale (CFC-14), the Prospective and Retrospective Memory Questionnaire (PRMQ), as well as the Depression, Anxiety and Stress Scales-21 (DASS-21). Overall, data indicated that the higher the involvement in gambling, the higher the depression levels and the shorter the time horizon. The results of linear regression analysis showed that, along with gender, years of education, depression, and inattention to the future consequences of actual behavior, the negative self-perception of prospective memory functioning represents a significant predictor of gambling severity. Finally, to clarify if depression was on the path from prospective memory to gambling severity or if prospective memory was the mediator of the impact of depression on gambling severity, data were submitted to path analysis. Results indicated that depression has a direct effect on gambling severity and mediates the association between prospective memory and gambling involvement. The relation between gambling severity and prospective memory scores suggests that impairment in prospective memory plays a key role in adult problematic gambling. [ABSTRACT FROM AUTHOR]

Loot boxes are virtual items in many video games that let players "gamble" on an item of chance. Loot boxes bring an element of gambling into video games, which might prime video game users to engage in online gambling activities. However, few studies have focused on this emerging issue. The present study investigated the relationships between loot box purchases and both problem video gaming and problem gambling severity. Cross-sectional, self-report data were collected from 618 adult video gamers (M = 27 years of age, SD = 8.9, 63.7% male) via an online survey. Nearly half of the sample (44.2%) spent money on loot box purchases in the past year. Loot box purchasers played video games and gambled online more frequently, reported more extended gaming and online gambling sessions, and endorsed higher levels of problem video gaming and problem gambling severity as well as greater mental distress relative to those who did not buy loot boxes. Results from a series of path analyses revealed that loot box purchasing was directly related to problem video gaming and problem gambling severity as well as indirectly through increased video gaming/online gambling engagement, which in turn is related to elevated psychological distress. The present findings provide insight into the role of loot box purchasing in the transition from recreational engagement in video gaming and online gambling to problem video gaming and/or problem gambling. [ABSTRACT FROM AUTHOR]

Loot boxes are virtual goods in video games that produce randomly-generated in-game rewards, and have attracted scrutiny because of a resemblance to gambling. This study tests relationships between gaming involvement, engagement with loot boxes, and their associations with disordered gambling and gambling-related cognitions. Online questionnaires were completed by 144 adults via MTurk (Study 1) and 113 undergraduates (Study 2). Gaming and loot box-related variables included estimated time spent gaming and monthly expenditure, the Internet Gaming Disorder Scale (IGDS), and questions that assessed perceptions and behaviours related to loot boxes. Most participants thought loot boxes were a form of gambling (68.1% & 86.2%). A subset of items were condensed into a unidimensional "Risky Loot-box Index" (RLI) via exploratory factor analysis. In Study 1, the RLI showed significant associations with the Problem Gambling Severity Index (r = .491, p < .001) and the Gambling Related Cognitions Scale (r = .518, p < .001). Overall, gambling-related variables predicted 37.1% (p < .001) of the variance in RLI scores. Findings were replicated, though attenuated, in Study 2. These results demonstrate that besides the surface similarity of loot boxes to gambling, loot box engagement is correlated with gambling beliefs and problematic gambling behaviour in adult gamers. [ABSTRACT FROM AUTHOR]

Background and Aims: Subjects with buying-shopping disorder (BSD) continue to buy offline as well as online despite negative consequences. Previous studies indicate that subjects with BSD show cue-reactivity and craving when exposed to shopping cues and have problems in long-term advantageous decision-making. The current study aimed at investigating the effect of online-shopping cues on decision-making, and whether addiction-relevant concepts such as cue-reactivity/craving and the symptom severity of BSD are related to decision-making.Methods: A non-clinical sample of 57 participants played a version of the modified Iowa Gambling Task (IGT), with online-shopping-related pictures shown either on the advantageous decks or on the disadvantageous decks (with control pictures on the opposing ones). Symptom severity of online-BSD and the craving to buy were assessed using questionnaires. In addition, the online-shopping pictures were rated concerning arousal, valence, and urge to buy.Results: The participants who played the IGT with the online-shopping pictures displayed on the disadvantageous decks performed significantly poorer than the other group with online-shopping pictures on the advantageous decks. The between-group differences were moderated by craving reactions and the symptom severity of online-BSD: When online-shopping pictures were displayed on the disadvantageous decks, this only interfered with IGT performance in participants who had high craving reactions towards shopping cues and/or high symptom severity of online-BSD.Conclusion: Results indicate that exposure to online-shopping cues interferes with advantageous decision-making, especially in individuals with craving reactions and high symptoms of online-BSD. Results contribute to the question of why some people continue to buy despite negative consequences. [ABSTRACT FROM AUTHOR]

Objectives: To examine the relationships between gambling disorder, pain, and suicide attempts among US military veterans using Veterans Health Administration (VHA) pain-related services.Methods: Retrospective cohort analysis of 221,817 veterans using pain services was included in the analysis. First, differences in sociodemographic and clinical characteristics (i.e., psychiatric comorbidities and pain-related variables) were analyzed according to gambling disorder. Second, we performed logistic regression analyses to assess the association between gambling disorder and suicide attempts.Results: Female sex, depressive, alcohol, drug and tobacco use disorders are positively associated with gambling disorders, while severe pain score is negatively associated with gambling disorders. Logistic regression analysis showed that gambling disorder diagnosis was associated suicide attempt in veterans who received a visit for pain in VHA in the past year.Conclusions: Our findings suggest that gambling disorder in female veterans and suicide attempts in veterans with gambling disorder should not be underestimated and warrants further consideration. Moreover, the result that veterans with severe pain may be less likely to have a diagnosis of gambling disorder needs to be confirmed. [ABSTRACT FROM AUTHOR]

Both research and clinical practice acknowledge the importance of craving as a maintenance and relapse factor in gambling disorder. The elaborated intrusion theory (EIT; Kavanagh et al., 2005) of desire has been extensively investigated in relation to psychoactive substance or food cravings but, to date, has scarcely been studied in relation to gambling. In such a context, developing an assessment tool of gambling craving based on the EIT is warranted. To fill this gap in the literature, we aimed to develop and test the psychometric properties of a gambling-adapted version of the Craving Experience Questionnaire (CEQ; May et al., 2014), which is the best established measure of craving theoretically anchored in the EIT. An online survey that included the gambling CEQ (g-CEQ) and a craving induction procedure was administered to 274 community participants involved in gambling at least a few times a year. Concurrent and convergent validity were explored through correlations with a scale that measured gambling urge and with a series of questionnaires that measured disordered gambling symptoms, gambling cognitions, and gambling motives. The confirmatory factor analyses supported the validity of the expected three-factor model of the "strength" and "frequency" forms of the g-CEQ and showed better model fit than a one-factor solution, corroborating the initial structure of the CEQ. Furthermore, the scale has good internal consistency and its validity is supported by correlations with gambling-related constructs. The g-CEQ is thus a theoretically and psychometrically sound instrument to measure gambling craving based on the EIT. [ABSTRACT FROM AUTHOR]

The availability of and participation in gambling has increased substantially the past several decades, however studies of military members' gambling behaviors are limited. The present study aimed to investigate potential problematic gambling and its association with demographics and behavioral characteristics in a US military cohort. We analyzed cohort data from a telephone survey during 2015-2016 of 1553 Ohio Army National Guard members. We assessed potential problematic gambling by using the 3-item National Opinion Research Center Diagnostic Screen-Loss of Control, Lying, and Preoccupation Screen (NODS-CLiP). Potential correlates examined were demographics, depression, suicidal ideation, smoking status, alcohol use, legal and financial problems, perceived general health status, pain, and impulsivity. Results indicated past-year frequent gambling (at least once per week) and lifetime potential problematic gambling was reported by 13% and 8% of respondents, respectively. Problematic gambling and past-year gambling behaviors were associated in a dose-response relationship from 18% among soldiers gambling once per week to 44% among those gambling 4 or more times per week. Correlates of screening positive for potential problematic gambling included the following: being male, currently unmarried, having left the Guard or retired, minor depression, alcohol dependence, legal problems, and increased pain. Given the higher prevalence of frequent gambling in this military cohort (8%), nearly twice the US prevalence (5%), and the association with negative psychological and behavioral outcomes, routine screening of gambling frequency and problem gambling may be needed to ensure military and veteran populations live the healthiest lives possible. [ABSTRACT FROM AUTHOR]

Chasing is a central feature of gambling disorder and refers to the attempt by individuals to recover financial losses by continuing to gamble. Although several efforts have been made to individuate the factors involved in the complex phenomenon of chasing, little is known regarding its association with delay discounting and craving, both considered important in the development and maintenance of gambling disorder. In the present study, the interplay between chasing, delay discounting, and craving (while controlling for gambling severity) was investigated. The sample comprised 128 adult gamblers aged between 18 and 67 years and consisted of non-problem gamblers (n = 58), problem gamblers (n = 18), and pathological gamblers (n = 52) based on the South Oaks Gambling Screen (SOGS) scores. Participants were administered the Monetary Choice Questionnaire (MCQ) and the Gambling Craving Scale (GACS), as well as completing the ChasIT, a computerized task assessing chasing behavior. Participants were randomly assigned to the control and the loss condition of the ChasIT. Results showed that pathological gamblers were more likely to chase and reported more severe chasing persistence. Regression analyses indicated that heightened levels of craving and the inability to tolerate delay in gratification, along with gambling severity, predicted both the decision to chase and chasing persistence. The present study contributes important findings to the gambling literature, highlighting the role of craving and delay discounting in facilitating the inability to stop within-sessions gambling. These findings may provide evidence that chasers and non-chasers represent two different types of gamblers, and that the difference may be useful for targeting more effective therapies. [ABSTRACT FROM AUTHOR]

Human laboratory studies and twin research investigating relationships between alcohol use/pathology and gambling generally have yielded contradictory results, sometimes suggesting causal relationships and common genetic risk factors. 2860 individuals (mean age: 25.60, s.d = 3.21, 50.62% female) from separate clinical (n = 636) and community based (twin) samples (n = 2224) were used to assess associations between past year alcohol use and frequency of past year gambling behaviors (gambling frequency). After adjustment for demographic and psychiatric covariates, individual-level analyses detected that increased alcohol use was associated with more frequent gambling behaviors in twin and clinical samples. Co-twin control models were then used to test potential causal (direct) relationships between alcohol use and gambling frequency. Controlling for all covariates and shared genetic/environmental factors, we found increased alcohol use directly predicted more frequent gambling behaviors (consistent with causality). Our study also suggests shared genetic and/or environmental risk factors contribute to the association between increased alcohol use and frequent gambling behavior, a finding that may be more pronounced in males. The present study helps bridge the gap between twin research and human laboratory studies on gambling and alcohol use and corroborates findings across community and clinical samples. Overall, our findings support both common risk factors between alcohol use and gambling as well as a direct relationship between alcohol use and gambling frequency. Recognizing these dual processes could prove useful for gambling-related prevention/intervention programs. [ABSTRACT FROM AUTHOR]

Problem drinking and gambling are addictive behaviours experienced by young adults and commonly occur with narcissism. Research has acknowledged two distinct forms of narcissism: grandiose and vulnerable. There has been work that has examined the relationship between grandiose and vulnerable narcissism and addictive behaviours, but it has been limited, particularly with vulnerable narcissism. Evidence suggests vulnerable narcissism, but not grandiose narcissism, is associated with greater negative affect. Accordingly, shame, a potent social emotion could be a mediator in the narcissism-addiction pathway. Shame has been implicated in both vulnerable narcissism and problem drinking and gambling. Thus, we hypothesized that shame would mediate the relationship between vulnerable narcissism and addictive behaviours. Young adults (N = 210) completed self-report baseline (Time 1) and 1-month follow-up (Time 2) assessments of shame, narcissism, problem drinking, and gambling. As predicted, those with elevated vulnerable narcissism at Time 1 had increased shame at Time 2, which predicted problem drinking and gambling at Time 2. This relationship was not observed for grandiose narcissism. Overall, our results suggest that feelings of shame are essential to understanding the vulnerable narcissism-addiction pathway, and an important consideration when designing clinical interventions for at-risk young adults. [ABSTRACT FROM AUTHOR]

Cryptocurrencies are emerging digital currencies that allow anonymity in accessing various risk-taking activities through the Internet (e.g., drugs, gambling). However, given conceptual links to high-risk stocks, the present study sought to assess the association between trading cryptocurrencies and problem gambling. Data was collected through a cross-sectional online survey. Advertisement for the survey was posted on Amazon's Mechanical Turk. Participants were adults who had gambled at least monthly in the past year (N = 876; 58.33% male; M = 33.74 years, SD = 9.73). Participants completed the Problem Gambling Severity Index, Patient Health Questionnaire (2-item version), and Generalized Anxiety Disorder scale (2-item version). Trading cryptocurrencies is strongly associated with problem gambling severity (r = 0.53, p < .001). Results from a linear regression with backwards elimination revealed that sports betting, daily fantasy sports, high-risk stock trading, and problem gambling severity contribute to trading cryptocurrencies more frequently in the past year, whereas gambling in on-land casinos contributed to less cryptocurrency trading. Finally, trading cryptocurrencies overlapped strongly with trading high-risk stocks. Moreover, gamblers who engaged in both forms of trading reported greater problem gambling and depression and anxiety symptoms relative to those trading either cryptocurrencies or high-risk stocks, but not both. The present results suggest that trading cryptocurrencies may be appealing to gamblers that are exhibiting greater problem gambling severity. Future research should begin to include cryptocurrency trading in screening, assessment, and treatment protocols, particularly with regular gamblers. [ABSTRACT FROM AUTHOR]

The current study aimed to examine the relationship between implicit memory associations, gambling involvement, and problem gambling in a large representative group of Canadian adults. The sample consisted of 3078 (48.1% males, mean age 43.93, SD = 15.82) adult online panelists from across Canada that included 388 problem and pathological gamblers. Memory associations were assessed using a 10-item measure of word associations and a 10-item measure of behavioural associations. Gambling involvement was assessed via self-report of involvement, and problem gambling was assessed using the Problem and Pathological Gambling Measure (PPGM). Significant associations were found between measures of memory associations and both level of gambling involvement and problem gambling, with the magnitude of the correlations ranging from 0.262 to 0.388. Behavioural associations tended to have a stronger relationship with gambling involvement and problem gambling than word associations. The results of this study suggest that implicit associations may have utility in the assessment of problem gambling. [ABSTRACT FROM AUTHOR]

Background: Harms related to gambling have been found not only to affect problem gamblers, but also to occur amongst low- and moderate-risk gamblers. This has resulted in calls for a public health approach to address a possible 'prevention paradox' in gambling related harm. The aim of this study was to evaluate the systematic review evidence base on the effects of prevention and harm reduction interventions on gambling behaviours, and gambling related harm. We also aimed to examine differential effects of interventions across socio-demographic groups.Methods: Systematic methods were used to locate and evaluate published systematic reviews of prevention and harm reduction interventions. We designed the review using the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) Equity extension Guidelines. Four databases were searched from their start date until May 2018. The quality of the included articles was determined using A MeaSurement Tool to Assess systematic Reviews (AMSTAR 2).Results: Ten systematic reviews were identified reporting 55 unique relevant primary studies. Much of the review evidence-base related to pre-commitment and limit setting (24%), self-exclusion (20%), youth prevention programmes (20%), and machine messages/feedback (20%). The effectiveness of harm reduction interventions are limited by the extent to which users adhere to voluntary systems. Less than half of studies examining youth prevention programmes demonstrated positive effects on behaviour. No review extracted data or reported on the differential effects of intervention strategies across sociodemographic groups. The quality of the included reviews (and their primary studies) were generally poor and clear gaps in the evidence base have been highlighted.Conclusions: The evidence base is dominated by evaluations of individual-level harm reduction interventions, with a paucity of research on supply reduction interventions. Review conclusions are limited by the quality and robustness of the primary research. Future research should consider the equity effects of intervention strategies. [ABSTRACT FROM AUTHOR]

Exploring perceptions, experiences and determinants of youth gambling is crucial for understanding both the impact of youth gambling now and the antecedents of future behaviour. Qualitative research plays an important role in exploring these processes, yet to date, there has been no systematic review of qualitative scientific literature of youth gambling behaviour. A rapid review of three databases (PubMed, Scopus, Web of Science) and grey literature was conducted to map what qualitative research has been conducted, to identify gaps and discern emerging theories or themes about youth gambling behaviour. Peer-reviewed studies were included if they qualitatively explored youth experiences or perceptions of gambling. Narrative and thematic synthesis identified key descriptive and analytical themes covered by the studies. From 75 studies, 21 papers were included. Studies focused on youth perceptions of gambling (including advertising) and/or the factors shaping behaviour. Those which examined perceptions highlighted the normalcy of gambling in the minds of youth and its embeddedness in everyday life but also ambiguity and nuance around their differing perceptions of what gambling is. Studies emphasised the relationship between people (family, peers), place, technology and advertising as key facilitators of behaviour. This review shows young people's perceptions of gambling differs from legal and legislative definitions, which risks underestimating the nature and extent of youth gambling behaviour. There are also notable gaps in knowledge, specifically around the role of technology in shaping gambling behaviours beyond consideration of access and availability. There is a pressing need to better understand the whole techno-ecosystem in which gambling is situated and young people's relationship with it to understand youth gambling. [ABSTRACT FROM AUTHOR]

Background and Objectives: Symptoms of depression are highly prevalent among individuals with gambling disorder, and severity of depression is associated with severity of gambling problem. Yet, little is known about the psychological mechanisms by which symptoms of depression lead to greater gambling severity. In this study, we tested whether cognitive distortions represent one such mechanism, as cognitive distortions are key characteristics in both depression and gambling disorder and have been shown to be associated with gambling severity.Methods: A mediation model was tested among 345 treatment-seeking individuals with gambling disorder in Sao Paulo, Brazil. The diagnosis of gambling disorder was made using semi-structured clinical interviews and participants completed psychometrically sound self-report measures of depression symptoms (Beck Depression Inventory-I), gambling-related cognitive distortions (Gamblers' Beliefs Questionnaire), and gambling severity (Gambling Symptom Assessment Scale).Results: As hypothesized, increased symptoms of depression were significantly associated with both increased disordered gambling severity and increased gambling-related cognitive distortions. Further, gambling-related cognitive distortions predicted greater disordered gambling severity when controlling for depression symptomology. Results from the bootstrapping method indicated that the relationship between symptoms of depression and increased disordered gambling severity is mediated by gambling-related cognitive distortions.Conclusions: Consistent with our predictions, gambling-related cognitive distortions mediated the relationship between depression symptoms and gambling severity among a sample of treatment-seeking disordered gamblers. These results suggest that cognitive distortions may be a key intervention target for the treatment of concurrent depression and gambling disorder. [ABSTRACT FROM AUTHOR]

Background and Aims: Gambling is an activity that for some can become disordered, with severe negative consequences. Existing literature does little to inform us regarding changing gambling habits of treatment seeking gamblers; the current study sought to measure trends and patterns in UK treatment seeking gambler behaviour and demographics over a 15-year period.Methods: Case files for 768 gamblers seeking residential treatment with the Gordon Moody Association (GMA) were analysed, collected between 2000 and 2015. Case files comprised initial assessment questionnaires, demographic data, current gambling behaviour, mental and physical health status, and a risk assessment. Chi-squared analyses were used to measure change in categorical distribution.Results: Prevalence of different forms of gambling identified as problematic have changed over time: Fixed Odds Betting Terminals (FOBTs), sports betting, and poker have become more common; horse and dog racing, and the National Lottery have become less common. Online gambling has also increased over time. In more recent years, gamblers are also more likely to have attempted suicide, to report a co-occurring mental health disorder, and to start treatment having already been prescribed medication.Discussion and Conclusions: This is the first study to demonstrate that UK treatment seeking gambler behaviour has changed over time; major changes relate to the forms of gambling engaged in problematically, and the mental health of disordered gamblers. Whilst much media focus is directed towards one form of gambling, this should not detract focus from other forms and associated disorders, and the impact of the legislative environment. [ABSTRACT FROM AUTHOR]

This study aimed to first investigate the role that general impairment in mentalization plays in gambling disorder and to analyze the interplay among mentalizing, impulsivity, and time perspective in adolescent gambling. Four hundred and ten late adolescents took part in the study. Participants were administered the South Oaks Gambling Screen Revised for Adolescents (SOGS-RA), the Reflective Functioning Questionnaire (RFQ-8), the Functional and Dysfunctional Impulsivity Scale (FDIS), and the 14-item Consideration of Future Consequences scale (CFC-14). The results showed that male adolescents are far more likely at-risk/problem gamblers than female adolescents. Furthermore, data indicated that the higher the gambling severity, the higher the dysfunctional impulsivity and the shorter the time horizon. Linear regression analysis showed that impairments in mentalizing represent a significant predictor of gambling severity. Finally, to clarify if dysfunctional impulsivity was on the path from uncertain mentalizing to gambling severity or if mentalizing was the mediator of the impact of functional impulsivity on gambling severity, data were submitted to path analysis. Results indicated that deficit in mentalizing has a direct effect on gambling severity and mediates the association between dysfunctional impulsivity and gambling involvement. The relation between gambling severity and RFQ-8 scores suggests that general impairment in mentalizing plays a key role in adolescent problematic gambling. [ABSTRACT FROM AUTHOR]

Individuals with gambling disorder (GD) report much higher rates of post-traumatic stress symptoms and post-traumatic stress disorder (PTSS/D) than the general population, and individuals with both PTSS/D and GD often report much greater distress and impairment in daily life in comparison to individuals with GD alone (Grubbs, Chapman, Milner, Gutierrez, & Bradley, 2018). Despite these associations, little is known about the specific ways in which PTSS/D and GD might influence each other. To address this gap in research, the present work sought to examine how PTSD might be related to the expression and experience of gambling related cognitions. Specifically, it was hypothesized that individuals with PTSD or symptoms of PTSD (i.e., subclinical levels of post-traumatic stress) would demonstrate greater cognitive distortions and erroneous beliefs about gambling. To test these hypotheses, we analyzed data from two samples, an inpatient sample of U.S. Armed Forces veterans seeking treatment for gambling disorder (n = 332) and an online sample of largely recreational gambling U.S. adults (n = 589). Results consistently revealed that, in both samples, individuals with PTSD or symptoms of PTSD were likely to report greater gambling related cognitions. These findings persisted, even when gambling symptom severity and trait neuroticism were held constant. Collectively, these results suggest that PTSD is uniquely associated with greater cognitive distortions and erroneous beliefs about gambling behaviors. These findings bear distinct implications for current understandings of how PTSS/D and GD are related, as well as for treatment of individuals with dealing with this comorbidity. [ABSTRACT FROM AUTHOR]

Electronic Gaming Machines (EGMs) are regarded as a relatively harmful gambling product, and are associated with psychological immersion (the 'machine zone') and physiological arousal. Specifically, immersion is a phenomenon of attention manifesting as an intense focus on the game at the expense of peripheral stimuli and goals. Past research has indicated significant levels of immersion in response to modern multi-line EGMs when the overall bet is increased, which further scales with risk for problem gambling (Dixon et al., 2014). The present study sought to separate the effects of multi-line play and bet size, on measures of immersion and cardiac activity. Seventy-six male undergraduate students played an authentic EGM on each of 4 pre-defined play strategies while providing electrocardiogram data. The strategies varied the number of paylines and the bet multiplier. From the physiological data, we extracted Respiratory Sinus Arrhythmia (RSA), a marker of task attention derived from heart rate variability. We found that immersion ratings were significantly greater when both paylines and bet-size were high. Importantly, selectively increasing the paylines, but not bet multiplier, produced significant increases in immersion. RSA change indicated parasympathetic withdrawal, consistent with increases in attention during EGM use, but did not differentiate game settings. These results suggest that multi-line EGMs capture attention across a range of play-styles, and that immersion may be effectively amplified by multi-line play. [ABSTRACT FROM AUTHOR]

• Veterans are uniquely vulnerable to gambling related problems, yet less is known about gambling in this population relative to the general population. • Gamblers' preferences for strategic vs. non-strategic gambling relate to thoughts and motives for gambling. • Among U.S. Armed Forces Veterans receiving inpatient treatment for Gambling Disorder, gambling preferences are associated with psychiatric comorbidities. • Veterans who preferred strategic gambling activities were more likely to be younger and to be men and less likely to have a nicotine use disorder or PTSD. • Nonstrategic gambling activities may be particularly risky for veterans with PTSD and should be evaluated in future research among military personnel and veterans. Armed Forces Veterans are uniquely vulnerable to problem gambling and gambling disorder. Even so, research regarding the full clinical profile of veterans with gambling problems lags. Gambling activities vary widely from each other, but most gambling activities can be understood as either strategic (i.e., involving some measure of skill and decision-making as a part of the gambling practice) or non-strategic (i.e., gambling activities that are entirely based on chance). Prior works have found that gamblers that prefer strategic gambling activities and those that prefer nonstrategic gambling activities often differ from each other in key ways, with the two preferences being linked to varying motivations for gambling, varying cognitions about gambling, and the course of gambling disorder. The present work sought to examine how preferences for strategic vs. nonstrategic gambling might be related to psychiatric comorbidities among U.S. Armed Forces Veterans receiving inpatient treatment for Gambling Disorder. Data from U.S. Armed Forces Veterans (N = 401) receiving residential treatment for GD between the years of 2010–2016 were analyzed. Results demonstrated that gamblers that preferred strategic gambling, as opposed to non-strategic gambling, were more likely to be younger, more likely to be men, less likely to have a nicotine use disorder, and less likely to have PTSD. Such findings suggest that gamblers with PTSD are likely to prefer nonstrategic games and may imply a unique vulnerability to gambling problems related to non-strategic gambling among armed forces veterans. [ABSTRACT FROM AUTHOR]

Evidence for approach bias tendencies to underly automatic behavioural impulses towards seeking out gambling activities in the presence of appetitive salient cues was first shown by Boffo et al. (2018) in a Dutch sample. Relative to non-problem gamblers, moderate-to-high-risk gamblers demonstrated stronger approach tendencies towards gambling-related stimuli compared with neutral ones. Moreover, gambling approach bias was associated with past-month gambling behaviour and predictive of gambling activity persistence over time. The current study aimed to replicate these findings within a Canadian sample evaluating the concurrent and longitudinal correlates of gambling approach bias. The study was conducted online, available throughout Canada. Twenty-seven non-treatment-seeking moderate-to-high-risk gamblers and 26 non-problem gamblers community-recruited via multiple channels (i.e., internet and newspaper advertisements, land-based flyers, and university recruitment portals). Participants completed two online assessment sessions 6-months apart. Each session included (1) self-report measures of gambling behaviour (frequency, duration, and expenditure), (2) self-report assessment of problem gambling severity (PGSI), and (3) a gambling approach-avoidance task, utilising culturally relevant stimuli tailored to individual gambling habits. However, our study failed to replicate Boffo et al. (2018) findings in a Canadian sample. Relative to non-problem gamblers, moderate-to-high-risk gamblers did not exhibit greater approach bias tendencies towards gambling-related stimuli compared to neutral stimuli. Moreover, gambling approach bias was not predictive of prospective gambling behaviour (frequency, duration, or expenditure) or severity of gambling problems. Reported results do not provide evidence for approach tendencies contributing to problematic gambling behaviour in a Canadian sample of moderate-to-high-risk gamblers compared to non-problematic gambler controls. Further replications on the topic are needed. Future research should evaluate approach tendencies within the gambling context, considering the potential impact of task reliability to assess approach bias in light of individual gambling modality preferences. [ABSTRACT FROM AUTHOR]

Background and Aims: Gambling disorder (GD) is a highly heterogeneous condition with high rates of chronicity, relapses and treatment dropout. The aim of this study was to longitudinally explore the associations between trait impulsivity, impulsivity-compulsivity related cognitive domains, and treatment outcome in an outpatient sample of adult patients with GD.Methods: 144 adult male participants diagnosed with GD undergoing cognitive-behavioural treatment (CBT) at a specialized outpatient service completed a series of neuropsychological tests to assess executive functioning (including cognitive flexibility, inhibition control and decision making) and psychometric questionnaires.Results: Trait impulsivity predicted low compliance [UPPS-P negative urgency (B = 0.113; p = 0.019)] and relapse [UPPS-P negative urgency (B = 0.140; p = 0.015)] at 5 weeks of treatment and dropout at the end of treatment [(UPPS-P sensation seeking B = 0.056; p = 0.045)]. Cognitive flexibility performance predicted: dropout rates at the end of treatment [WCST perseverative errors (B = 0.043; p = 0.042)]; dropout [WCST categories completed (B = -1.827; p = 0.020)] and low compliance or relapses at follow-up [WCST perseverative errors (B = 0.128; p = 0.020)]; and time to first relapse [WCST failure to maintain set (B = -0.374; p = 0.048)] and time to dropout [WCST perseverative errors (B = 0.0198; p = 0.019)].Conclusions: Our findings indicate impulsivity-compulsivity levels may influence response to GD treatment (i.e.: low compliance and dropout or relapse rates) thus representing a potential target for improving treatment outcomes. [ABSTRACT FROM AUTHOR]

Gambling has been found to be related to different motives, such as enhancement, social, and behavioral and emotional coping. The most used instrument in this field is the Gambling Motives Questionnaire (GMQ; Stewart & Zack, 2008), which has not been validated in clinical samples. This study aimed to validate a Spanish version of the GMQ in a sample of adult pathological gamblers and to analyze its relationship with pathological gambling, anxiety, depression, and perceived stress. A sample of 164 gamblers was recruited from centers for the treatment of pathological gambling. The three-factor structure (enhancement, social, and coping motives) of the GMQ was validated through exploratory and confirmatory factorial analyses, and its convergent validity was proven. Gambling motives correlated with pathological gambling, anxiety, depression, and perceived stress. Enhancement motives predicted pathological gambling, while controlling for the effect of anxiety, depression, and perceived stress. These results are relevant for clinical evaluation and intervention with adult pathological gamblers. [ABSTRACT FROM AUTHOR]

Background: Alcohol and gambling problems are common in young adults. Self-medication theory states that young adults with depression drink and/or gamble to escape negative emotions. Research shows that depression is a risk factor for drinking/gambling problems, but more work is needed to examine mediators underlying these associations. One potential mediator is shame. Shame is a self-directed emotion that follows a negative life event and is characterized by intense feelings of inferiority, worthlessness, and embarrassment. Depressed individuals are especially susceptible to shame (and associated emotions). Shame has also been implicated in risk for addiction. Accordingly, we predicted that elevated shame would explain why depression is associated with both alcohol and gambling problems.Methods: A longitudinal design was used to examine this hypothesis. Undergraduates (N = 210) completed self-reports of depression at baseline (Time 1) and then completed self-reports of shame, alcohol misuse, gambling problems one month later (Time 2).Results: Results showed that individuals with elevated depression at Time 1 endorsed high levels of shame at Time 2, which in turn predicted more gambling (β = .038, 95% CI [.010, .087]) and alcohol problems (β = .249, 95% CI [.123, .435]) at Time 2. We found that increased levels of shame explained the effects of depression on problem drinking and gambling.Conclusions: Study findings improve our understanding of the depressive pathway to addiction by providing evidence for shame as a potential mechanism of this pathway.Impact: Reducing shame can be a target of clinical interventions for young adults with depression and alcohol/gambling problems. [ABSTRACT FROM AUTHOR]

Purpose: There has been increased concern about the negative effects of adolescents consuming a combination of alcohol mixed with energy drinks (AmED). To date, few studies have focused on AmED use and gambling. The present study analyzed the multiplicative effect of AmED consumption, compared to alcohol alone, on the likelihood of at-risk or problem gambling during adolescence.Methods: Data from the ESPAD®Italia 2015 study, a cross-sectional survey conducted in a nationally representative sample of students (ages 15 to 19years) were used to examine the association between self-reported AmED use (≥6 times,≥10 times, and ≥20 times during the last month) and self-reported gambling severity. Multivariate models were used to calculate adjusted prevalence ratios to evaluate the association between alcohol use, AmED use, and gambling among a representative sample of adolescents who reported gambling in the last year and completed a gambling severity scale (n=4495).Results: Among the 19% students classed as at-risk and problem gamblers, 43.9% were classed as AmED consumers, while 23.6% were classed as alcohol consumers (i.e. did not mix alcohol with energy drinks). In multivariate analyses that controlled for covariates, AmED consumers were three times more likely to be at-risk and problem gamblers (OR=3.05) compared to non-consuming adolescents, while the effect became less pronounced with considering those who consumed alcohol without the addition of energy drinks (OR=1.37).Conclusions: The present study clearly established that consuming AmED might pose a significantly greater risk of experiencing gambling-related problems among adolescents. [ABSTRACT FROM AUTHOR]

Background: Despite the strong associations between personality disorders and problem/pathological gambling, few studies have investigated the relationships between personality disorders, problem-gambling severity and suicidal thoughts/behaviors.Objectives: We examined the relationships between problem-gambling severity and personality disorders among individuals with differing levels of suicidality (none, thoughts alone, attempts).Methods: We analyzed data from 13,543 participants of the National Epidemiologic Survey of Alcohol and Related Conditions (NESARC) study. First, differences in sociodemographic characteristics and prevalence of personality disorders were analyzed according to problem-gambling severity and suicidality status. Second, we performed a logistic regression to assess among the relationship between problem-gambling severity and DSM-IV Axis II psychopathology according to suicidality level.Results: At-risk or problem/pathological gambling groups showed higher rates of a wide range of personality disorders compared to non-gamblers. Logistic regression showed that at-risk pathological gamblers had a higher odds ratio for any personality disorder in the group with no history of suicidality, particularly for cluster-B personality disorders. Odds ratio interaction analysis identified the relationship between problem-gambling severity and personality disorders, particularly those in cluster B, differ according to suicidality status.Conclusions: Our findings suggest a complex relationship between suicidality, problem-gambling severity and personality disorders. The stronger relationship between problem-gambling severity and personality disorders in people with no suicidality as compared to some suicidality suggests that some of the relationship between greater problem-gambling severity and Axis II psychopathology is accounted for by increased suicidality. The findings have implications for clinical interventions targeting suicidality in individuals with gambling disorders. [ABSTRACT FROM AUTHOR]

Research indicates that the evidential bases for many harm reduction policies targeting hazardous consumptions (including tobacco, alcohol and gambling) have been distorted by commercial industries that derive revenue from such commodities. These distortions are best illustrated by research on tobacco and alcohol, which indicates similar tactics used by industries to determine favourable policy environments through engineering of evidence, among other approaches. Although there is concern that gambling research is similarly vulnerable to commercial interests, the relevant literature lags far behind other fields and the aim of this paper is to increase familiarity with tactics used by industries for influencing research. It summarises the conceptual and empirical bases for expecting conflicts between goals of public health and companies that profit from hazardous consumptions. It also summarises evidence describing practices deployed by tobacco corporations, which include third-party techniques and the selective funding of research to manufacture doubt and deflect attention away from the consequences of smoking. It then reviews both early and emerging evidence indicating similar strategies used by alcohol industry, and uses this literature to view practices of the gambling industry. It argues that parallels regarding selective funding of research and third-party techniques provide grounds for strong concern about commercial influences on gambling research, and implementation of precautionary approaches to management of vested interests. [ABSTRACT FROM AUTHOR]

Background: Young adulthood is a developmental period frequently associated with occurrence of impulsive behaviors including gambling. It is estimated that 73% of children and 87% of adults in the United States regularly use caffeine. Questions remain, however, concerning the role of caffeine in the development and maintenance of impulsive behaviors such as gambling.Methods: Sixty-one young adults with at least some degree of disordered gambling were recruited from two Mid-Western university communities in the United States using media advertisements. Caffeine intake over the preceding month was quantified using the Caffeine Use Questionnaire. Clinician rating scales, questionnaires, and cognitive tests germane to impulsivity were completed. Relationships between caffeine intake and demographic, gambling symptom, and neurocognitive measures were evaluated using the statistical technique of partial least squares (PLS).Results: Average weekly caffeine intake in the gamblers was 1218.5mg (a figure higher than previously reported in the general population). PLS yielded an optimal model with one latent factor, which explained 14.8% of variation in demographic/clinical/cognitive measures and 32.3% of variation in caffeine intake. In this model, higher caffeine intake was significantly associated with earlier age at first gambling, higher personality-related impulsiveness, more nicotine consumption, older age, and more impulsive decision-making.Conclusions: These data suggest a particularly strong relationship between caffeine intake, earlier age of first gambling, and certain types of impulsivity in gamblers. Providing education about healthy caffeine use may be especially valuable in gamblers. Future work should explore whether the relationship between caffeine use and gambling is due to a common predisposing factor (impulsive tendencies) or, rather, constitutes a form of self-medication in gamblers (or a means of sustaining gambling habits for longer). [ABSTRACT FROM AUTHOR]

The field of gambling studies has extensively focused on isolating risk factors for developing a gambling disorder. Conversely, little attention has been paid to identifying protective factors against gambling disorder among people who choose to not gamble at all. Moreover, the limited number of studies that have focused on non-gamblers have neglected to differentiate current from lifetime non-gamblers. The purpose of the present study was to examine motives for not gambling among a diverse sample of adult lifetime non-gamblers recruited from the community and to compare these motives to an undergraduate student sample of non-gamblers from a previous study. Participants consisted of 219 lifetime non-gamblers (45.2% male) from the United States recruited via Amazon's Mechanical Turk. The previously recruited sample consisted of Canadian undergraduate students (n=196). Eight distinct categories of motivations for not gambling were identified in the sample of adult community non-gamblers, which corresponded closely with previous findings from the student sample. However, comparisons between the two samples revealed that adult lifetime non-gamblers were more likely to provide financial motives as reasons for not gambling. Whereas, the student sample was more likely to mention disinterest and the influence of others as reasons to avoid gambling. Results suggest that the choice not to gamble among lifetime non-gamblers may reflect a more conscious, values-based decision when compared to undergraduate non-gamblers. [ABSTRACT FROM AUTHOR]