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Background: Gambling is a popular leisure activity in many countries, often expected to boost regional economies. Nevertheless, its negative impacts remain a significant concern. Gambling disorder is recognized as the most severe consequence; however, even non- or low-risk gamblers may also face negative impacts. This study aimed to estimate the number of Japanese gamblers experiencing gambling-related harm (GRH) and its distribution across six life domains, financial, relational, emotional, health, social and other aspects, based on the severity of their problem gambling risk. Methods: This cross-sectional study relied on an online survey conducted between August 5 and 11, 2020. Participants aged 20 years and above, who engaged in gambling during 2019 were recruited via a market research company. The survey assessed the prevalence of GRH 72 items among four gambler risk groups (non-problem, low-, moderate-, and high-risk), as categorized by the Problem Gambling Severity Index. The data was adjusted for population weighting using representative national survey data: the 2017 Comprehensive Survey of Living Conditions and the 2017 Epidemiological Survey on Gambling Addictions. Results: Out of the 28,016 individuals invited to the survey, 6,124 participated in the screening, 3,113 in the main survey, and 3,063 provided valid responses. After adjusting the survey data, it was estimated that 39.0 million (30.8%) of Japan's 126.8 million citizens gambled in 2019. Among them, 4.44 million (11.4%) experienced financial harm, 2.70 million (6.9%) health harm, 2.54 million (6.5%) emotional harm, 1.31 million (3.4%) work/study harm, 1.28 million (3.3%) relationship harm, and 0.46 million (1.2%) other harm. Although high-risk gamblers experienced severe harm at the individual level, over 60% of gamblers who experienced GRHs were non- and low-risk gamblers, with the exception of other harm, at the population level. Conclusions: The study highlighted the prevention paradox of gambling in Japan. While national gambling policies primarily focus on the prevention and intervention for high-risk gamblers, a more effective approach would involve minimizing GRH across the entire population. [ABSTRACT FROM AUTHOR]

Pachinko and pachislot are popular types of gambling activities in Japan. Prior studies in Japan have reported a concerning prevalence of problem gambling among adult players. While these studies have identified various gambling-related harms, Japanese research on harm-minimization strategies is scarce. Therefore, the present study aimed to compare differences of gambling-related harms among normal-, half-, and quarter-pachi players to the usefulness of low-investment pachinko and pachislot as a harm-reduction strategy. We considered gamblers who played games that cost the typical amount of money to be "normal-pachi players." Those who played low-investment games were categorized as "half-pachi players" and "quarter-pachi players," reflecting those who played games at half or one quarter the cost of a typical machine, respectively. To assess the harm-reduction effect, a one-way ANCOVA was conducted to compare the impact of the groups (normal-pachi players [n = 101], half-pachi players [n = 104], and quarter-pachi players [n = 100]) on dependent variables, namely the number of days players had gambled during the prior month; total time and amount of money spent on gambling; debts caused by gambling; gambling severity; cognitive distortion; depressive symptoms; and problems in work, family, and social life. We demonstrated that the amount of money spent by quarter-pachi players on gambling during the past month was lower than that of normal-pachi players. However, we did not find significant differences with respect to any other gambling-related harms among normal-, half-, and quarter-pachi players. Low-investment pachinko and pachislot players spends less the amount of money spent on gambling. Low-investment pachinko and pachislot would thus partly act as a harm-minimization strategy. Moreover, the results of the present study indicate that the problems at work affect various outcomes for gamblers. Given that 90% of the participants in this study were employed, the results of this study may have important implications for employed gamblers. [ABSTRACT FROM AUTHOR]

In a faraway apple orchard in Sannohe, a small town in Japan's Aomori Prefecture, a zushi miniature wooden shrine at the Nose Kannon Hall caught the media's attention with its unique adornment—the karuta playing cards with European-inspired abstract designs in bold red and black colors that were used during the early modern period for pastime and gambling. Because of this decoration, the Nose Kannon Hall is known by locals as the Karuta Hall, and the zushi that enshrines the Buddhist deity Bodhisattva Shō-Kanzeon is also believed to be the home of bakuchi no kamisama "the kami deity of gambling". Little is known about the nature of devotion to this bakuchi no kamisama or how the playing cards that were used for frivolous games came to be sacralized as items worthy to be used as decoration of a Buddhist shrine. This article considers the slippage between prayer and play in the regional Buddhist devotion by focusing on the Nose Kannon Hall, which presided at a key intersection along the northern trade route where the local community and outside visitors, such as pilgrims and traders, converged, especially during the Edo period (1603–1868). Marshaling historical records, televised interviews, and images provided by the town officials and guardian family of Nose Kannon Hall, I argue that the use of karuta playing cards on the miniature shrine at Nose Kannon Hall epitomizes a kind of localized early modern Shinto–Buddhist syncretism at the margins of the urban culture that is simultaneously devotional and tongue-in-cheek sacrilegious in a quintessentially Edo-esque way. [ABSTRACT FROM AUTHOR]

Internationally, the prevalence of gambling disorder has been reported to be higher among homeless people than the general population; however, little is known about the factors associated with gambling disorder in this population. The present study aimed to investigate the prevalence of gambling disorder and its associated factors among homeless men using shelters in Osaka City. A cross-sectional survey was conducted from 30 to 2018 to 4 January 2019, using the 2017 Japanese National Survey of Gambling (JNSG) questionnaire, supplemented with questions about homeless experiences, drinking, and smoking. Using the South Oaks Gambling Screen, the presence of gambling disorder was determined by a score ≥ 5 out of 20. Multivariate logistic regression was conducted to explore factors associated with lifetime gambling disorder. Lifetime and past-year prevalence of gambling disorder among 103 participants was 43.7% (95% confidence interval [CI]: 34.5–53.3) and 3.9% (95% CI: 1.5–9.6), respectively, which are higher than the 6.7% and 1.5% found among men in the 2017 JNSG. Reasons reported for currently gambling less were primarily financial. Factors associated with lifetime GD included "more than 20 years since the first incidence of homelessness" (adjusted odds ratio [AOR]: 4.97, 95% CI: 1.50–16.45) and "more than five incidences of homelessness" (AOR: 4.51, 95% CI: 1.06–19.26). When homeless individuals with gambling disorder try to rebuild and stabilize their lives, the presence or resurgence of gambling disorder may hinder the process and pose a risk of recurring homelessness. Comprehensive support services for homeless individuals with gambling disorder are required. (250 words) [ABSTRACT FROM AUTHOR]

Aim : To develop and measure the psychometric properties of the Gambling and Gambling Problem Perception Questionnaire (GGPPQ); a scale to evaluate professionals' attitudes towards people with problem gambling in the Japanese context. Data collection : We held 12 workshops in Japan targeted at mental health professionals who consult people with gambling problems. Participants completed the survey before the workshop. Some were also asked to complete the survey after the workshop to measure workshop influence. Setting : Public and private healthcare facilities in all 47 prefectures of Japan. Participants : Medical doctors, nurses, social workers, clinical psychologists, and other professionals working in the aforementioned facilities (n = 653, response rate = 98.5%). Measurements : licence; knowledge about gambling and gambling problems (questionnaire); self-rating of knowledge and general confidence for helping problem gamblers; years of practice; frequency of working with clients; experience in attending workshops; overall satisfaction with the workshop. Results : A five-factor structure extracted by exploratory factor analysis showed a good fit by confirmatory factor analysis (CFI =.973, TLI =.967, RMSEA =.060, AIC = 28913.6, BIC = 29110.8). The GGPPQ showed good internal consistency and good concurrent validity with participants' self-rating of their knowledge, general confidence, frequency of working with clients who have gambling problems, and experience in attending workshops. The workshop had a positive influence on participants' attitudes. Japan's unique gambling industry and lack of training opportunities on problem gambling were assumed to have influenced the psychometric properties of the measurement tool. Conclusion : The GGPPQ is a valid tool to measure the attitudes of healthcare professionals towards people with gambling problems, as well as workshop effectiveness in Japan. [ABSTRACT FROM AUTHOR]

The predominant gambling policy to respond to the adverse consequences of excessive gambling has been the Reno Model, which places the responsibility for gambling-caused problems on gamblers themselves. The newly implemented Japanese gambling policy, which shares basic premises with the Reno Model, focuses on the individual pathology of gamblers. However, this model lacks other critical perspectives: environmental and structural factors. To fully understand the harms caused by gambling; it is important to also pay attention to the negative consequences for affected others. In this brief report, we explore family members' experiences of gambling problems within the specific context of the Japanese gambling policy. Interviews with family members reveal self-stigma of being bad parents which elicits shame and efforts to maintain secrecy, as well as public stigma involving labeling, isolation, risks of status loss, social exclusion and discrimination. The focus on individual pathology in Japanese legislation as well as in public and professional perception, reinforces self-blame, anxiety, and remorse on the part of affected family members. When contrasted with the lived experiences of gamblers' family members, the inconsistencies and unreasonableness of the individual pathology paradigm in Japanese gambling policy become evident. It is necessary to shift the focus of gambling policies from individual to socio-political-cultural factors, investigating how these factors influence gambling-caused harm, especially in the Japanese context. [ABSTRACT FROM AUTHOR]

Motivation plays a dominant role in gambling progression. Most studies using motivational scales have revealed that certain motivations are associated with problem gambling. However, age differences were found to be negligible in gambling motivation. This study aimed to examine the role of motivation associated with age differences in problem gambling in Japan. A total of 160 participants over 20 years of age who had gambled within the past six months were randomly recruited from web monitors. In this study, the Japanese version of the modified Gambling Motivation Scale (J-MGMS) was used which comprises six systematic factors: intellectual challenge, excitement, socialization (coping and sociability), social recognition, monetary gain, and amotivation. The Japanese version of the South Oaks Gambling Screening (J-SOGS) was used to assess participants’ gambling-related problems. Demographic data, such as gambling frequency, were solicited. Using linear regression analysis, amotivation in all participants, social recognition in early adults (under 30), and amotivation in late adults (30 or over) were associated with J-SOGS scores (adjusted R2 = 0.170, 0.290, 0.156). Among late adults, social recognition was nearly significant, although negative (p = 0.0503). 1) Self-determinant (autonomous) motivations such as excitement and socialization do not contribute to the progression of problem gambling. 2) Two non-self-determinant (non-autonomous) motivations, social recognition in early adults and amotivation in late adults, are predictors of problem gambling. 3) Social recognition is a dichotomic and paradoxical motivation in the progress of problem gambling according to age. [ABSTRACT FROM AUTHOR]

The World Health Organization recognizes internet gaming disorder (IGD) as a disorder that causes problems in daily life as a result of excessive interest in online games. The causes of IGD have become more apparent in recent years. Because of prolonged exposure to games, the mechanisms controlling the reward system, such as the prefrontal cortex, limbic system, and amygdala of the cerebrum, do not function properly in IGD. This mechanism is similar to that of various behavioral addictions, such as gambling addiction. IGD is particularly risky in children and adolescents because it easily causes brain dysfunction, especially in the developing brain. IGD should be regarded as a new lifestyle-related disease in younger individuals, and lifestyle modifications, including counseling and family therapy, are critical for its management. [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]

Background: Since the Integrated Resort Bill was passed in 2017, Japan has been preparing to open casinos in Osaka and Nagasaki. Previous studies have shown that accessibility to casinos is positively correlated with the prevalence of gambling disorders. In response, the Japanese government has enacted the Basic Law against Gambling Addiction, and has started a fact-finding survey on gambling addiction every three years. This study aims to understand the prevalence of pathological gambling (PG) and gambling-related problems (e.g., multiple debt, child-rearing difficulties, suicide, depression and harm from significant others gambling, adverse childhood experiences; ACEs, etc.). Methods: A self-administered (paper and pencil or internet) questionnaire was mailed to 17,955 people from October to December 2020 using a random sampling based on the Basic Resident Register. PG was assessed using the South Oaks Gambling Screen (SOGS). In addition, gambling behavior (gambling experience, frequency, and bet amounts) and original or standardized scales regarding gamblingrelated problems were examined. Results: A total of 8,223 valid responses (3,955 men and 4,268 women) were obtained. The age-adjusted past-year prevalence of PG was 2.2% overall (95% confidence interval = 1.9-2.5); however, the prevalence was higher among those who responded on the Internet. A comparison of respondents with and without PG found that those with PG had higher rates of depression, suicidal ideation, suicide attempts, and ACEs. Conclusions: The prevalence of PG in Japan is relatively higher than in other countries. A survey method is necessary to obtain comparable yearly prevalence rates. [ABSTRACT FROM AUTHOR]

According to a survey by Japan's Ministry of Health, Labor, and Welfare in 2017, 3.6% of Japanese adults-equivalent to about 3.2 million people-have suffered from problem gambling at some point in their lifetime. This study examines the relationship between financial literacy, financial education, and gambling behavior (measured as gambling frequency) among the Japanese population. We hypothesize that financially literate and financially educated people who use their knowledge to make sound financial decisions are less likely to gamble. The data used in this study are from a nationwide survey in Japan from the Preference Parameters Study of Osaka University in 2010 (n = 3687). To control for endogeneity bias between financial literacy and gambling behavior, we use the education of respondents' fathers as an instrumental variable. The results from the probit-instrumental variable model show that financial literacy has a significantly negative relationship with gambling frequency, while financial education has no significant relationship with gambling frequency. Our findings suggest that problem gambling may be mitigated by promoting financial literacy, but no such conclusion can be drawn for financial education. [ABSTRACT FROM AUTHOR]

The increase of gambling opportunities in Japan has led to an urgent need to "realize a healthy lifestyle while gambling." Data on regular pachinko/pachislot players with scores below the cutoff value for a disorder in the Pachinko/Pachislot Playing Disorder Scale, who are assumed to have no disorder, are crucial for archiving this goal. This study's objective was to clarify these players' characteristics. We conducted a National Survey using the Pachinko/Pachislot Playing Disorder Scale and divided the respondents (N=582) who had played pachinko/pachislot in the last 12 months into four groups based on their scale score and participation level. Then, we examined each group's demographics and characteristics of play. Chi-square tests indicated that the groups differed in age and the preference for high- and low-stake machines. Residual analysis indicated that the frequent player with no disorder group consisted of many participants in their 60s and a few in their 20s; who also tended to use low-stake machines. Health management for a lifestyle with gambling is discussed based on these findings. [ABSTRACT FROM AUTHOR]

Prevalence studies on gambling participation and problem gambling in Japan have been limited. To obtain data showing the current status of gambling in Japan, we conducted an online survey on gambling participation and problem gambling among residents in Chiba City. The online data collection was conducted through an Internet research firm. Questionnaires were consisted of personal demographics, past-year gambling participation and severity of gambling risks. The Problem Gambling Severity Index (PGSI) was used as a survey instrument. Males (51.5%) were significantly more likely than females (25.5%) to have gambled in the past year. Problem gamblers (PGSI score ≧ 8) were 7.2% among males and 1.2% among females. Problem gambling was strongly correlated with frequent gambling, preference for Pachinko/Slot and smoking habit. The gambling participation rates were roughly lower than those reported in many overseas jurisdictions, whereas the problem gambling rates were considerably higher than those reported in the same jurisdictions. According to the total consumption model, it would be reasonable to consider that gambling participation rates show a positive correlation with problem gambling rates. The high levels of problem gambling may be due to the administration mode using online sampling, by which answers admitting unapprovable behaviors like problem gambling tend to increase. This suggests that the previous studies using conventional face-to-face or telephone methods may have underestimated problem gambling rates. [ABSTRACT FROM AUTHOR]

The prevalence of problem gambling has garnered considerable interest in numerous developed countries. In Japan, problem gambling may be far more prevalent than in other developed countries; however, there is little empirical research confirming this. Therefore, we estimated the prevalence of problem gambling in Japan using a standardized screening tool: The South Oaks Gambling Screen Revised (SOGS-R) and investigated the association between problem gambling and demographics such as gender, age, marital status, income, and educational background. We believe this study is necessary because gambling is a growing social problem in Japan that could worsen with the expected introduction of casinos in Japan due to the legalization of casino gambling in December 2016. Therefore, we surveyed participants' experience of casino games both on the internet and abroad. Cross-sectional data were collected via a web-based survey of 6576 Japanese adults 20 years old and older. We found that the prevalence rate of problem gambling in Japan was significantly high from an international perspective. Restricting casino accessibility for individuals with high-risk factors could be effective in reducing gambling problems. [ABSTRACT FROM AUTHOR]

The links between gambling and criminal offenses have been frequently reported, but the pathways from gambling to a particular offense have not. Our study applied a pathways model to predict participants' income-generating, drug-related, and violent offenses stemming from their craving for gambling. The participants were 332 male inmates in a Japanese local prison. They answered questionnaires on gambling behavior, alcohol addiction, Internet addiction, impulsivity, and psychopathy. Their official records with information on their current offense, sentence length, number of imprisonments, and length of education were also analyzed. The results show that 38.55% (n = 128) of the participants had a probable gambling disorder, a rate of problem gambling at least four times higher than that among the general Japanese population. Furthermore, their craving for gambling predicted their income-generating offenses, but not their drug-related and violent offenses. Their craving for gambling can thus be linked to their financial issues, rather than their emotional and impulsive issues. The pathways model explained the path not only from addiction/psychopathy to gambling, but also from gambling to committing an income-generating offense. [ABSTRACT FROM AUTHOR]

Background: The clinical characteristics and prognosis of gambling disorder (GD) seeking treatment at Japanese addiction medical institutions are unknown. Therefore, we conducted a multicenter 1-year follow-up study of GD outpatients. In the current study, we focused on gambling-related cognition (GRC) and aimed to clarify the relationship between the distortions of GRC and treatment prognosis. Methods: A total of 202 patients who were diagnosed with GD by DSM-5 (male = 96. 5%; mean age = 36.3 ± 8.7) were enrolled from February to September 2021. The facility's medical staff conducted baseline interviews and distributed questionnaires. During the follow-up period, self-administered questionnaires were e-mailed or mailed to the registered address at 1, 3, 6, 9, and 12 months after enrollment. The 12-month follow-up rate was 72.7%. The gambling-related cognition scale (GRCS) was used to measure cognitive distortions. The GRCS consists of five subscales: Illusion of Control (IC), Predictive Control (PC), Interpretative Bias (IB), Gambling Expectancy (GE), and Perceived Inability to Stop Gambling (IS). The evaluation of the treatment prognosis included gambling behavior and social functioning. Results: Mean scores for all GRCS except IC decreased when compared at baseline and at the 6-month follow-up. IC=6.70→7.15, PC=18.8→13.9, IB=15.99→11.0, GE=13.42→9.94, IS=19.9→14.8. Moreover, at the 6-month follow-up, higher mean GRCS scores were associated with more frequent gambling behavior. The oneyear prognosis will be explained on the day of the presentation. Conclusions: Delayed GRC recovery in GD may be associated with a negative prognosis. [ABSTRACT FROM AUTHOR]

Background: Few longitudinal studies in clinical samples have addressed the prevalence of gaming disorder. The aim of this study was to examine the prevalence of gaming disorder and changes using several screening scales among adolescent and young adult outpatients. Method: We conducted a longitudinal survey among outpatients aged 9 to 29 years old who had problematic gaming use assessed by their psychiatrist or pediatrician. The Internet Gaming Disorder Scale (IGDS), the Gaming Disorder Scale for Adolescents (GADIS-A), and the GAMES test were included to assess gaming disorder. We assessed the proportions of gaming disorder at baseline and 6-month follow-up. This study was approved by the IRB of Tokyo Medical Dental University. Results: Among the participants at baseline (N=82), 60 participants responded to the follow-up survey (follow-up rate: 73.2%). The prevalence of gaming disorder at the baseline was about 50% (IGDS: 48.3%, GADIS-A: 46.6%, GAMES test: 54.6%). Approximately, 70% of the participants who corresponded to gaming disorder at the baseline still met the criterion of gaming disorder at the follow-up. About 26-29% of the participants who corresponded to gaming disorder at the baseline did not meet the criterion of gaming disorder at the follow-up. About 16-23% of the participants who did not correspond to gaming disorder at the baseline subsequently met the criterion at follow-up. Conclusions: Although most of participants still had gaming disorder six months later, about 30% showed an improvement in their condition. It is important to investigate factors that interfere or promote gaming disorder recovery in future studies. [ABSTRACT FROM AUTHOR]

Background: To understand the clinical situation of GD who visited medical institutions and to clarify the effectiveness of treatment programs in Japan. Methods: Subjects were recruited with the cooperation of 20 medical institutions treating GD in Japan. Baseline data were acquired at their respective medical institutions, and an online follow-up survey using ICT was conducted. Results: 202 subjects were enrolled (men = 96.5%). The average age was 36.2 ± 8.7 years for men and 39.1 ± 9.8 years for women. The average age at which gambling began for the participants was 19.1 ± 3.3 years for men and 20.1 ± 3.1 years for women. Pachinko was the most common form of gambling, with an experience rate of 64.1% for men and 85.7% for women. The median total amount of debt each participant carried was ¥5 million for men and ¥5.75 million for women. All the subjects met the diagnostic criteria for GD on the DSM-5--36.4% of men and 42.9% of women had severe symptoms (a score of 8 points or more). A total of 144 (71.2%) subjects responded to the survey 6 months after the first visit. 78 patients (54.6%) remained on treatment. 81 cases (56.3%) were not gambling 6 months after the examination. Conclusions: A follow-up study using ICT investigated the prognosis of GD treatment. In the symposium, a follow-up survey after 12 months will be added to discuss the factors that influence prognosis. [ABSTRACT FROM AUTHOR]

Background: Since opening Japan's first alcoholism treatment ward in 1963, our center has functioned as a national center for the treatment and research of alcoholism. Recently, we have been actively working on behavioral addictions, such as gambling disorder (GD) and Internet/gaming disorders. Currently, GD is treated on an outpatient and inpatient basis. The mainstay of treatment is a cognitive behavioral therapy-based (CBT) short-term program. CBT has been shown to be effective, with little change in the environment during hospitalization; however, after discharge, its relapse prevention effect and long-term sustainability are limited. Therefore, at the Department of Occupational Therapy, we developed self-care and pre-discharge preparation programs, in addition to CBT, for the purpose of long-term relapse prevention for inpatients with GD. Methods: The self-care programs consist of relaxation, impulse control, and cognitive improvement to acquire appropriate alternatives to addictive behaviors. On the other hand, the pre-discharge preparation programs focused on life rhythms, work, and daytime activities that are likely to cause problems after discharge. This program includes facility tours and information from support facilities. Results: Both programs seem to provide participants with an opportunity to consider specific measures to prevent relapse before discharge. Participants responded positively and had improved access to support after discharge. In addition, as a new tool, we have just started to provide afterdischarge care using a web application. Conclusions: On the day of the symposium, we will report on the preliminary effects of post-discharge aftercare using a web application. [ABSTRACT FROM AUTHOR]

Pachinko is a type of mechanical gambling game that originated in Japan and resembles an upright pinball machine. Pachinko parlors are located in many parts of Japan and are open to anyone of legal age (18 years old). Due to the availability of pachinko, gambling in Japan is unique. The Integrated Resort Bill, which was passed in Japan in 2018, attempted to institutionalize casinos; however, they remain illegal to date since no corporations have government permission to operate. Although gambling is harmless for most individuals, in some cases it can be addictive and problematic, with severe negative consequences. Therefore, the expansion of legalized gambling is an important public health concern. Researchers worldwide have investigated the epidemiology of gambling to reveal the incidence of gambling disorders and the effectiveness of policies implemented to prevent harmful gambling. However, in Asia, studies within this field are relatively scarce. This symposium aims to present data on the current situation of gambling, prevalence of gambling disorder and gambling disorder treatments and their outcomes in Japan. [ABSTRACT FROM AUTHOR]

The prevalence of probable gaming disorder (GD) among people in Japan, aged between 10 and 29 years old and those aged between 10 and 79 years old, was estimated in 2019 at 5.1% and 2.8%, respectively. Several Japanese government ministries have been involved in the prevention of GD, but measures taken so far have been less than robust, especially in comparison to government promotion of the gaming industry, which it views as a key industry to attract overseas interest. However, there are authorities at local government level that are active in prevention activities, such as establishing ordinances targeting GD prevention and the holding of camp programs for adolescents engaged in excessive gaming. Based on an increasing treatment demand, the number of medical facilities providing specialist treatment has constantly increased since 2011 and stands at approximately 200 in 2023, but this is insufficient to meet demand. In addition, these facilities are unevenly distributed and concentrated in urban areas. Overflow patients with GD often have little choice but to visit child and adolescent psychiatrists or pediatricians who lack expertise in addiction treatment. Various types of treatment programs including CBT-based, day-treatment, inpatient, and camp programs have been developed, but with some exceptions, an assessment of their efficacy has yet to be conducted. At our center, capacity building for treatment experts has been undertaken since 2014, with support from the government. To tackle increasing problems associated with GD, concerted efforts are required from a range of sectors. In order to achieve this goal, the establishment of an act, similar to the Basic Act on Measures against Gambling Addiction, targeting the prevention of GD is necessary. [ABSTRACT FROM AUTHOR]

Background: Gambling disorder (GD) is a common behavioral addiction which affects the well-being of patients and those around them in multiple ways (e.g., large debts and interpersonal problems). Although imminent casino opening and the high prevalence of GD in Japan, countermeasures to tackle GD are behind schedule. This delay might stem from diverse factors. These factors are exemplified by stigma, large treatment gaps, low treatment persistence and lack of effective pharmacotherapy. To tackle this situation, incorporating different perspectives, such as neuroimaging findings, might help to establish better intervention and prevention. Methods: Summarizing our functional and structural magnetic resonance imaging studies of GD, clinical implication will be proposed. Results: Some of our studies of showed associations between neural activity or connectivity strength and the duration of illness or abstinence of GD. Other studies showed heterogeneity in GD. Discussion: These findings underscore the importance of early diagnosis and intervention as well as the need for the importance of subtype-based interventions, providing insight regarding how to refine interventions for GD. [ABSTRACT FROM AUTHOR]

Background: Internationally, the prevalence of gambling disorder has been reported to be higher among homeless people than the general population; however, little is known about the correlates with gambling disorder in this population. The present study aimed to investigate the prevalence of gambling disorder and its correlates among homeless men using shelters in Osaka City. Methods: A cross-sectional survey was conducted from 30 December 2018 to 4 January 2019, using the 2017 Japanese National Survey of Gambling (JNSG) questionnaire, supplemented with questions about homeless experiences, drinking, and smoking. Using the South Oaks Gambling Screen, the presence of gambling disorder was determined by a score≥5 out of 20. Multivariate logistic regression was conducted to explore factors associated with lifetime gambling disorder. Results: Lifetime and past-year prevalence of gambling disorder among 103 participants was 43.7% (95% confidence interval [CI]: 34.5-53.3) and 3.9% (95% CI: 1.5-9.6), respectively, which are higher than the 6.7% and 1.5% found among men in the 2017 JNSG. Factors associated with lifetime GD included "more than 20 years since the first incidence of homelessness" (adjusted odds ratio [AOR]: 4.97, 95% CI: 1.50-16.45) and "more than five incidences of homelessness" (AOR: 4.51, 95% CI: 1.06-19.26). Conclusions: When homeless individuals with gambling disorder try to rebuild and stabilize their lives, gambling disorder may make the process difficult and pose a risk of recurring homelessness. Comprehensive support services for homeless individuals with gambling disorder are required. [ABSTRACT FROM AUTHOR]

In tandem with the legalization of casinos in Japan, the Japanese government established the Basic Act on Measures against Gambling Addiction in 2018, which marked the true start of the treatment response for gambling disorder (GBD) in Japan. The extent of the treatment gap for GBD is a serious issue in this country. The main treatment modality is a CBT-based program, and a standardized program developed by our center has been widely used in the clinical context. The results of a recent multi-treatment center study on the effectiveness of GBD indicated favorable treatment outcomes. Consultation services provided by mental health and welfare centers, which have been established in each prefecture and in large cities in Japan are gradually expanding. Similarly, while the number of facilities providing recovery support is limited these are gradually increasing. Back in 1989, Gamblers Anonymous was launched in Japan and is now available throughout the country. Unlike GBD, a basic act has not been developed or even considered for gaming disorder (GMD). While the number of facilities providing specialized treatment has constantly increased since 2011, this has failed to keep pace with the growing demand. Moreover, these facilities are unevenly distributed and concentrated in urban areas, limiting access for many people. Various treatment programs have been developed, including CBT-based day-treatment, inpatient, and camp programs. At our center, capacity building for treatment experts has been undertaken since 2014, with support from the government. To tackle increasing CMD-related problems, concerted efforts are required by a range of sectors. [ABSTRACT FROM AUTHOR]

The relationship between geographical accessibility to gambling venues and the prevalence of pathological gambling is still unknown. This study aimed to reveal this relationship in Japan as well as its variation by subpopulation. A cross-sectional study was conducted, based on an original web-based survey to understand the level of pathological gambling depending on accessibility topachinkoparlours. Pathological gamblers were measured using the Japanese version of the South Oaks Gambling Screen. Accessibility to gambling venues was defined as the number ofpachinkoparlours within a 1.5 km radius from home. Moreover, the study adopted the instrumental variable approach to solve the potential endogeneity problem. The results showed that the accessibility was not significantly associated with pathological gambling in general, but that the effects of accessibility varied by subpopulation. Accessibility was significantly and positively correlated with pathological gambling for men and people in low-income areas, but this was not so for women and people in high-income areas. The study’s findings show the importance of the neighbourhood environment and could help in implementing more effective interventions for pathological gamblers. [ABSTRACT FROM PUBLISHER]

The South Oaks Gambling Screen (SOGS) was originally developed to screen for pathological gamblers in clinical settings, and its use has been expanded to other settings such as prevalence studies of pathological gambling in general populations. There are few studies of pathological gambling in Japan, except for the two studies on the development of the modified Japanese version of the SOGS. The present study examines the reliability and validity of the modified Japanese version of the SOGS using two different groups: a university student group (N=96) and a gambler group (N=66). Analyses of the modified Japanese version of the SOGS showed that there was sufficient internal consistency ([alpha]=.898) and reliability. The modified Japanese version of the SOGS demonstrated satisfactory validity in differentiating the university student group from the gambler group. [ABSTRACT FROM AUTHOR]

Background: Change and sustain talks (negative and positive comments) on gambling have been relevant for determining gamblers' outcomes but they have not been used to clarify the abstinence process in anonymous gambler meetings.Objective: The aim of this study was to develop a change talk model for abstinence based on data extracted from web-based anonymous gambler chat meetings by using an automatic change talk classifier.Methods: This study used registry data from the internet. The author accessed web-based anonymous gambler chat meetings in Japan and sampled 1.63 million utterances (two-sentence texts) from 267 abstinent gamblers who have remained abstinent for at least three years and 1625 nonabstinent gamblers. The change talk classifier in this study automatically classified gamblers' utterances into change and sustain talks.Results: Abstinent gamblers showed higher proportions of change talks and lower probability of sustain talks compared with nonabstinent gamblers. The change talk model for abstinence, involving change and sustain talks, classified abstinent and nonabstinent gamblers through the use of a support vector machine with a radial basis kernel function. The model also indicated individual evaluation scores for abstinence and the ideal proportion of change talks for all participants according to their previous utterances.Conclusions: Abstinence likelihood among gamblers can be increased by providing personalized evaluation values and indicating the optimal proportion of change talks. Moreover, this may help to prevent severe mental, social, and financial problems caused by the gambling disorder. [ABSTRACT FROM AUTHOR]

Background: Video game loot boxes, which can typically be purchased by players or are given as reward, contain random virtual items, or loot, ranging from simple customization options for a player's avatar or character, to game-changing equipment such as weapons and armor. Loot boxes have drawn concern, as purchasing loot boxes might lead to the development of problematic gambling for adolescents. Although parental problem gambling is associated with adolescent problem gambling, no studies have evaluated the prevalence of loot box purchases in adolescents' parents. Objective: This study investigated the association between loot box purchasing among adolescents and parents, and problem online gaming in population-based samples. Methods: In total, 1615 adolescent (aged 14 years) gamers from Japan responded to a questionnaire regarding their loot box purchasing and problem online gaming behaviors. Problem online gaming was defined as four or more of the nine addictive behaviors from the Diagnostic and Statistical Manual of Mental Disorders. The adolescents' primary caregivers were asked about their loot box purchasing. Results: Of the 1615 participants, 57 (3.5%) reported loot box purchasing. This prevalence did not differ according to primary caregivers' loot box purchasing, but adolescents who purchased loot boxes were significantly more likely to exhibit problem online gaming (odds ratio 3.75, 95% CI 2.17-6.48). Conclusions: Adolescent loot box purchasing is linked to problem online gaming, but not with parents' loot box purchasing. Measures to reduce these behaviors should target reducing addictive symptoms in young video gamers. JMIR Serious Games 2021;9(1):e23886 doi:10.2196/23886 [ABSTRACT FROM AUTHOR]

In Japan, problem gambling has been assumed to be a serious issue, but until recently, no reliable epidemiological data for the country have been available. One of our responsibilities is to monitor their actual effectiveness and the extent of gambling-related problems, which will contribute to improved understanding of measures targeting GD in Japan and around the globe. [Extracted from the article]

Background: This study was conducted to investigate the relationship between symptoms of gambling problems, gambling behaviours, and cognitive distortions among a university student population in Japan ages 20 to 29 years. We aimed to address the gap in knowledge of gambling disorders and treatment for this population.Methods: Data were obtained from 1471 Japanese undergraduate students from 19 universities in Japan. Descriptive statistics and hierarchical multivariate regression analysis were used to investigate whether the factors of gambling cognitive distortions would have predictive effects on gambling disorder symptoms.Results: Results indicated that 5.1% of the participants are classifiable as probable disordered gamblers. The bias of the gambling type to pachinko and pachislot was unique to gamblers in Japan. Of the students sampled, 342 self-reported gambling symptoms via the South Oaks Gambling Screen. Hierarchical multivariate regression analysis indicated that one domain of gambling cognitive distortions was associated significantly with gambling symptoms among the 342 symptomatic participants: gambling expectancy (β = 0.19, p < .05). The multivariate model explained 47% of the variance in the gambling symptoms.Conclusion: This study successfully contributed to the sparse research on university student gambling in Japan. Specifically, our results indicated a statistically significant relationship between gambling cognitive distortions and gambling disorder symptoms. These results can inform the development of preventive education and treatment for university students with gambling disorder in Japan. The report also describes needs for future research of university students with gambling disorder. [ABSTRACT FROM AUTHOR]

Background: The Problem Gambling Severity Index (PGSI) has been the most frequently used instrument for prevalence studies of problem gambling in the 2010s. However, the Japanese version of the PGSI has yet to be developed.Objective: To develop the Japanese version of the PGSI and to investigate its reliability and validity.Materials and Methods: We translated and back-translated the original version of the PGSI into Japanese. The author of the original PGSI confirmed the semantic equivalence between the original PGSI and its Japanese version. We examined the reliability and validity of the Japanese version of the PGSI using data from a nationwide prevalence study of problem gambling conducted in Japan in 2017.Results: Usable responses were obtained from 5365 residents. The PGSI had excellent internal consistency (Cronbach's alpha coefficient: 0.89) and moderate test-retest reliability after 45-60 days (intraclass coefficient: 0.54). Exploratory factor analysis revealed the unidimensionality of the PGSI. As for criterion validity, using the diagnosis of gambling disorder in DSM-5 as a reference standard, the stratum specific likelihood ratios of the PGSI score of 0 = non-problem; 1-2 = low risk; 3-7 = moderate risk; and 8-27 = problem gambling were 0.00; 0.68 (95% confidence interval: 0.21 to 2.22); 8.71 (5.2 to 14.5); and 67.9 (35.6 to 129.5) respectively.Conclusions: We recommend including the PGSI in future prevalence studies of problem gambling in Japan. [ABSTRACT FROM AUTHOR]