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Gambling disorder is a recognised psychiatric disorder in the Diagnostic and statistical manual of mental disorders (DSM-5) and is classified as an addiction alongside alcohol and substance use disorders. The DSM-5 describes a past-year timeframe, episodic or persistent specifiers, early or sustained remission specifiers, and three gambling disorder severity specifiers (mild, moderate and severe). Although anyone can develop gambling disorder, there are known risk factors. In studies involving general adult populations, the likelihood of developing the disorder varies with the type of gambling, and is particularly high for internet gambling, casino table games and poker machines. Australia and New Zealand have shifted the focus of gambling disorder to the identification of gambling harm, in recognition that efforts targeting the prevention of harm may be more effective as they potentially influence a larger segment of the population. Temporal categories of gambling harm (crisis harms versus legacy harms) affect help-seeking and need for treatment. Crisis harms often motivate people to change their behaviour or seek help, whereas treatment addresses legacy harms, which emerge or continue to occur after gambling behaviour ceases. The evidence base and clinical guidelines recommend cognitive behavioural therapy and motivational interviewing but there are many gaps in our understanding of treatment for gambling disorder, including an absence of high quality evaluations that assess treatment effectiveness over the longer term, especially for treatment delivered in community settings. There is also an urgent need to understand how, why and for whom treatment works so that interventions can be optimised to individual needs, thereby facilitating client engagement. Because of limited access to health care and poor retention in treatment, in recent years there has been an increase in treatment choices in the form of internet therapies and smartphone applications., (© 2024 The Author(s). Medical Journal of Australia published by John Wiley & Sons Australia, Ltd on behalf of AMPCo Pty Ltd.)

Problematic pornography use (PPU) shares characteristics with behavioral addictions, such as gambling disorder (GD), and PPU and GD may frequently co-occur. In order to fill existing gaps in screening instruments for PPU validated in GD, the study examined the psychometric properties of the Spanish version of the Brief Pornography Screen (BPS) within a clinical sample of individuals with GD. A total of 200 individuals seeking treatment for GD were consecutively recruited. The psychometric properties of the BPS were examined by performing confirmatory factor analysis (CFA) and testing for evidence of convergent and discriminant validity. The CFA supported a one-factor solution showing high internal consistency (α = 0.81). The BPS showed convergent validity and correlated with psychological distress, general psychopathology, impulsive tendencies, and low self-directedness. The BPS demonstrated adequate psychometric properties and is therefore recommended as a brief screening tool for identifying probable PPU in individuals seeking treatment for GD., Competing Interests: Declarations. Conflict of interest: The authors have no conflicts of interest to report. Dr. Potenza discloses the following. Dr. Potenza has consulted for Opiant Therapeutics, Game Day Data, Boehringer Ingelheim, and Idorsia Pharmaceuticals; has been involved in a patent application with Yale University and Novartis; has received research support from Mohegan Sun Casino, Children and Screens, and the Connecticut Council on Problem Gambling; has participated in surveys, mailings or telephone consultations related to drug addiction, impulse-control disorders or other health topics; has consulted for and/or advised gambling and legal entities and non-profit organizations on issues related to impulse control, internet use, and addictive disorders; has performed grant reviews for research-funding agencies; has edited journals and journal sections; has given academic lectures in grand rounds, CME events, and other clinical or scientific venues; and has generated books or book chapters for publishers of mental health texts. F.F.-A. and S.J.-M. received consultancy and speaking honoraria from Novo Nordisk. Ethical Approval: All procedures followed were in accordance with the ethical standards of the review board of the Bellvitge University Hospital on human experimentation and with the Helsinki Declaration of 1975, as revised in 2000. Informed Consent: All participants provided signed consent prior to being included in the study., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Background and Aims: The South Oaks Gambling Screen (SOGS) is a commonly used tool for screening potential gambling problems. The SOGS score has been found to be correlated with the DSM-5 criteria for Gambling Disorder (GD). However, one of its main limitations is the high rate of false positives. The objective of this study was to establish more accurate cutoff points for the SOGS based on the DSM-5 criteria and severity levels, taking into account sex-specific samples. Additionally, we aimed to validate these cutoff points using external measures., Methods: The study sample comprised 4.516 patients (398 women and 4,118 men) who sought treatment for GD. Of these patients, 4.203 met the DSM-5 criteria for GD, while 313 did not meet the threshold for GD diagnosis., Results: The recommended cutoff value for the SOGS is eight for men (Sensitivity (Se): 82.9%, Specificity (Sp): 86.2%) and seven for women (Se: 85.6%, Sp: 77.4%). For moderate severity of GD, the cutoff points are nine for men (Se: 82.1%, Sp: 82.0%) and eight for women (Se: 86.3%, Sp: 73.3%), while for severe cases of GD, the cutoff point is ten for both sexes (Se: 83.0%, Sp: 56.7% for men; Se: 80.0%, Sp: 77.4% for women). These cutoff values are validated by evidence of worse psychopathological states, more dysfunctional personality traits, and risky behaviours commonly associated with GD., Discussion and Conclusions: These findings support adjusting the reference values for the SOGS to eight in males and seven in females to enhance the classification of individuals potentially experiencing GD. The use of higher cutoff values has significant implications for clinical and research purposes, enabling a more precise assessment of the diagnosis and severity of GD.

The Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST) screening tool has not previously been used to evaluate risk for gambling disorder (GD). We aimed to assess the level at which each specific substance involvement score (SSIS), measured by ASSIST, most optimally predicted GD among U.S. college students. Data were analyzed for 141,769 students from the National College Health Assessment (fall 2019-spring 2021) utilizing multivariable logistic regression models. Sensitivities and specificities were utilized to find optimal cutoffs that best identified those with GD, overall and by biological sex and age group. Lower threshold of substance risk related to prescription opioids, cocaine, and hallucinogens (all with SSIS cutoffs of 4) predicts gambling disorder compared to sedatives (SSIS cutoff of 19). Younger students had lower thresholds of substance risk predicting GD than older students for heroin, but for all other substance classifications students 25 years and older had lower thresholds of SSIS predicting GD than students 18-24 years old. This study aids in the understanding that substance use behavior may put students at risk for other addictive behaviors such as GD. This study is the first to utilize the ASSIST tool to predict GD among U.S. college students, extending its application beyond substance use disorders. The identification of optimal cutoffs for each SSIS provides a novel approach to concurrently screen for GD and substance use disorders. This unique contribution could enhance early detection and intervention strategies for GD in the college student population., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Problematic Gambling or Gambling Disorder (GD) can act by initiating and maintaining the problem of substance addiction. Despite this, there are no rapid screening tools validated in Spanish. The Brief Problem Gambling Screen (BPGS) has proven to be one of the most sensitive tools for detecting GD and populations at risk. This study aims to validate the Spanish version of the original five-item BPGS. A sample of 100 Spanish-speaking adults with substance use disorder were recruited from an addiction treatment center. The participants were administered the Spanish version of BPGS. It showed strong item reliability properties (Ω = 0.93). Sensitivity and specificity values were excellent (0.93 each), also positive (0.7) and negative (0.99) predictive values suggest high discriminant power when compared to non-GD subjects. Statistically significant strong correlation with a gold-standard measure (Problem Gambling Severity Index) was found (r = 0.8, p < 0.01). Similar psychometric properties were found in at-risk gambler patients. In conclusion, the BPGS seems to be an adequate screening instrument in Spanish-speaking clinical population, and also identifies at-risk of GD subjects.

Introduction: Excessive gambling can cause substantial biopsychosocial problems (e.g., difficulties with finances, relationships, mental, and physical health). For military Service Members, it can also result in security clearance denial or revocation, failure to achieve promotions, and premature career termination. Recent congressional mandates have obligated the U.S. Department of Defense to screen for problematic gambling, the predictive values of which are a function of (i) problem prevalence and (ii) tool sensitivity and specificity. This meta-review (i.e., systematic review of systematic reviews) on the screening properties of gambling assessment tools and the effectiveness of treatments for gambling disorder is to inform military services on responding to Service Members' gambling problems., Materials and Methods: EBSCO Discovery Service, PubMed, PsycINFO, Ovid Medline, Social Care Online, Epistemonikos, International Health Technology Assessment, and the Cochrane Central Register of Controlled Trials electronic databases were searched up to December 2022 for systematic reviews and meta-analyses on measurements of adult subclinical or gambling, and interventions targeting individuals with GD. Three and four studies were included in each section of the current meta-review (i.e., assessment tools and treatment). For review 1, the estimated risk of bias was assessed using the Risk of Bias in Systematic Reviews., Results: Thirty-one tools were identified through the three systematic reviews. All had modest sensitivities and specificities; combined with low prevalences in the general SM population, positive results would be incorrect 64-99% of the time. However, if screening were conducted with SMs referred for alcohol problems, a positive result on the best screening tools would be correct 76% of the time. Several commonly used treatment approaches had demonstrated efficacy for GD., Conclusions: The combination of low prevalence of GD and subclinical gambling problems in the general population, coupled with modest sensitivity and specificity, makes screening unfeasible in the general SM population. However, dual-phase screening in higher-prevalence subpopulations (i.e., SMs already identified with substance-abuse or mental-health problems) would be viable. Regarding treatment, several interventions-already used in military healthcare-with extensive empirical track records have been successfully used to treat adults with GD., (© The Association of Military Surgeons of the United States 2023. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Background: The fifth version of the Diagnostic and Statistical Manual for Mental Disorders (DSM-5) and its revised version (DSM-5-TR) propose severity levels for gambling disorder (GD) based on the number of criteria met. However, this taxonomy has some limitations. We aimed to assess the centrality of each criterion and its relationship by conducting a network analysis while considering sex differences., Methods: We performed a network analysis with the DSM-5 criteria for GD with data from 4,203 treatment-seeking patients (3,836 men and 367 women) diagnosed with GD who sought for treatment in a general tertiary hospital which has a unit specialized in behavioral addictions., Results: The withdrawal criterion ("Restless or irritable when attempting to cut down or stop gambling") showed the highest centrality values in both sexes. In men, the second most central criterion was the tolerance criterion ("Needs to gamble with increasing amounts of money in order to achieve the desired excitement"); while among women, the second was the chasing losses criterion ("After losing money gambling, often returns another day to get even")., Conclusions: The most central criteria identified are associated with compulsivity-driven behaviors of the addictive process. Taking into account the high relevance and transitive capacity of withdrawal in both men and women, as well as tolerance in men, and chasing losses in women, the recognition and understanding of these symptoms are fundamental for the accurate diagnosis and severity assessment of GD.

Background and Aims: While the concept of recovery is receiving increasing attention in the context of gambling disorder (GD), no consensus has yet been reached regarding its definition. This scoping review aims to map the literature on GD recovery, identify gaps, and provide insights for a more holistic and patient-centred perspective., Methods: A systematic search of three databases was conducted (PubMed, PsycINFO, and ScienceDirect). Based on the method by which the results of these studies were produced, the studies included were sorted into four categories (quantitative, instrument validation, qualitative, and mixed studies) and subsequently examined using conceptual analysis., Results: One hundred thirteen articles were included in this research after the screening process. In the quantitative and instrument validation studies, recovery was defined or operationalized in terms of abstinence, the absence of a GD diagnosis, or mild GD severity, or by reference to treatment outcomes or controlled gambling. A meta-synthesis of the results of the qualitative studies revealed four core features of recovery (insight, empowerment and commitment, wellbeing enhancement, and reconsideration of the issue of relapse)., Discussion: Discrepancies in definitions, outcomes, and variables used were evident across studies. Additionally, the quantitative and standardized approaches employed in most studies exhibited severe limitations with regard to defining recovery from the subjective and multidimensional perspectives of people recovering from GD., Conclusions: This lack of definitional clarity emphasizes the necessity for further qualitative research. This research should encompass multiple stakeholder perspectives to develop a working definition promoting recovery from a holistic, patient-centred, and tailored approach.

Objectives: The Gambling Disorder Identification Test (GDIT) is a recently developed self-report measure. The GDIT includes items with multiple response options that are either based on frequency or time, and item response theory evaluations of these could yield vital knowledge on its measurement performance., Methods: The GDIT was evaluated using Rasch analysis in a study involving 597 Swedish gamblers., Results: In a three-dimensional Rasch model, the item response difficulty range extended from -1.88 to 4.06 and increased with higher time- and frequency-based responses. Differential item functioning showed that some GDIT items displayed age and gender-related differences. Additionally, person-separation reliability indicated the GDIT could reliably be divided into three to four diagnostic levels., Conclusions: The frequency- and time-based item response options of the GDIT offer excellent measurement, allowing for elaborate assessment across both lower and higher gambling severity. The GDIT can be used to detect DSM-5 Gambling Disorder, thereby holding significance from both epidemiological and clinical standpoints. Notably, the 3-item GDIT Gambling Behavior subscale also shows potential as a brief screening tool for identifying at-risk gambling behavior., (© 2024 The Authors. International Journal of Methods in Psychiatric Research published by John Wiley & Sons Ltd.)

Background: Craving plays an important role in behavioural addictions such as Gambling Disorder (GD). However, it has only been included as a diagnostic criterion for substance addiction. Moreover, research on craving has focused mainly on adults, leaving out adolescents who can also be heavily involved in gambling behaviour. The purpose of this study was to investigate the psychometric properties of the most widely used craving assessment scale, the Gambling Craving Scale (GACS), in adolescent gamblers., Method: For the current study, 1246 adolescent gamblers attending secondary school were recruited to complete a self-report questionnaire online. The psychometric properties of the GACS were examined: Confirmatory factor analysis was conducted; reliability was examined using the internal consistency method; in terms of validity, the relationship between the GACS total and subscale scores with some risk factors for problem gambling, gambling frequency and gambling problem severity was analyzed., Results: The factor analysis supported the three-factor structure, and good internal consistency was found for the GACS total scale and its three subscales. As regards validity, the GACS subscales resulted to be significantly and positively associated with economic perception of gambling and outcome expectancy, gambling-related cognitive distortions, gambling frequency, and problem gambling., Limitations: The findings of this study were based on self-report data and only criterion validity was analyzed., Conclusions: The GACS is a valid and rapid self-report measure of gambling craving in adolescent gamblers. In terms of prevention, the multidimensionality of the GACS is important for interventions. Clinical samples of adolescents are needed to confirm the validity of the scale., Competing Interests: Declaration of competing interest All authors declare that they have no conflict of interests., (Copyright © 2023 Elsevier B.V. All rights reserved.)

Background and Aims: Numerous studies point to the comorbidity between gambling disorder (GD) and attention deficit hyperactivity disorder (ADHD). However, there is a lack of research exploring how ADHD symptoms might influence psychological treatment outcomes for GD. Therefore, we aimed to explore differences between patients with GD with and without self-reported ADHD symptoms regarding psychopathology, personality, sociodemographic and treatment outcome measures., Method: This longitudinal study included 170 patients with GD receiving cognitive behavioral therapy. Multiple self-reported instruments were used to assess clinical variables and sociodemographic measures prior to treatment., Results: A clinical profile characterized by greater GD severity, higher psychopathology and impulsivity, and less adaptive personality features was observed in patients with self-reported ADHD symptoms compared to those without. No significant differences in treatment response (measured by dropout and relapse rates) were observed between the two groups. However, patients with self-reported ADHD symptoms experienced more severe relapses (i.e., gambled more money) and GD patients who relapsed scored higher on measures of ADHD, particularly inattention., Conclusion: Individuals with GD and self-reported symptoms of ADHD may experience more severe relapses following treatment, suggesting a need for more vigilant follow-up and interventions for patients with this comorbidity., Competing Interests: Declaration of Competing Interest FFA and SJM received consultancy honoraria from Novo Nordisk. The rest of the authors declare no conflict of interest. The funders had no role in the design of the study, in the collection, analyses or interpretation of data, in the writing of the manuscript or in the decision to publish the results. Dr. Potenza has consulted for Opiant Pharmaceuticals, Idorsia Pharmaceuticals, AXA, Game Day Data, Baria-Tek and the Addiction Policy Forum; has been involved in a patent application with Yale University and Novartis; has received research support (to Yale) from Mohegan Sun Casino and Connecticut Council on Problem Gambling; and has consulted for and/or advised gambling and legal entities on issues related to impulse-control/addictive disorders., (Copyright © 2023 The Authors. Published by Elsevier Inc. All rights reserved.)

Background: The heterogeneity of gambling disorder (GD) has led to the identification of different subtypes, mostly including phenotypic features, with distinctive implications on the GD severity and treatment outcome. However, clustering analyses based on potential endophenotypic features, such as neuropsychological and neuroendocrine factors, are scarce so far., Aims: This study firstly aimed to identify empirical clusters in individuals with GD based on sociodemographic (i.e., age and sex), neuropsychological (i.e., cognitive flexibility, inhibitory control, decision making, working memory, attention, and set-shifting), and neuroendocrine factors regulating energy homeostasis (i.e., leptin, ghrelin, adiponectin, and liver-expressed antimicrobial peptide 2, LEAP-2). The second objective was to compare the profiles between clusters, considering the variables used for the clustering procedure and other different sociodemographic, clinical, and psychological features., Methods: 297 seeking-treatment adult outpatients with GD (93.6% males, mean age of 39.58 years old) were evaluated through a semi-structured clinical interview, self-reported psychometric assessments, and a protocolized neuropsychological battery. Plasma concentrations of neuroendocrine factors were assessed in peripheral blood after an overnight fast. Agglomerative hierarchical clustering was applied using sociodemographic, neuropsychological, and neuroendocrine variables as indicators for the grouping procedure. Comparisons between the empirical groups were performed using Chi-square tests (χ 2 ) for categorical variables, and analysis of variance (ANOVA) for quantitative measures., Results: Three-mutually-exclusive groups were obtained, being neuropsychological features those with the greatest weight in differentiating groups. The largest cluster (Cluster 1, 65.3%) was composed by younger males with strategic and online gambling preferences, scoring higher on self-reported impulsivity traits, but with a lower cognitive impairment. Cluster 2 (18.2%) and 3 (16.5%) were characterized by a significantly higher proportion of females and older patients with non-strategic gambling preferences and a worse neuropsychological performance. Particularly, Cluster 3 had the poorest neuropsychological performance, especially in cognitive flexibility, while Cluster 2 reported the poorest inhibitory control. This latter cluster was also distinguished by a poorer self-reported emotion regulation, the highest prevalence of food addiction, as well as a metabolic profile characterized by the highest mean concentrations of leptin, adiponectin, and LEAP-2., Conclusions: To the best of our knowledge, this is the first study to identify well-differentiated GD clusters using neuropsychological and neuroendocrine features. Our findings reinforce the heterogeneous nature of the disorder and emphasize a role of potential endophenotypic features in GD subtyping. This more comprehensive characterization of GD profiles could contribute to optimize therapeutic interventions based on a medicine of precision., Competing Interests: Declaration of Competing Interest Fernando Fernández-Aranda and Susana Jiménez-Murcia received consultancy honoraria from Novo Nordisk., (Copyright © 2023 The Authors. Published by Elsevier Inc. All rights reserved.)

The Structured Clinical Interview for Gambling Disorder (SCI-GD) has the potential to bridge a diagnostic clinical gap, but psychometric evaluations have been scarce, in particular in relation to self-reported diagnostic criteria. This study analyzed existing data, including Swedish gamblers ( N = 204) from treatment- and help-seeking contexts, self-help groups, and the general population, who were interviewed with the SCI-GD and completed self-report measures. The results indicated that fewer individuals fulfilled the diagnostic criteria for gambling disorder (GD) with the SCI-GD ( n = 110, 54%), compared to a self-report Diagnostic and Statistical Manual of Mental Disorders:5th Edition ( DSM-5 ) questionnaire on GD ( n = 145, 71%; p < .001). Agreement between interviews and self-reported criteria was generally low (Fleiss kappa range: 0.31-0.52; r range: 0.35-0.55). A Rasch analysis showed that specific diagnostic criteria varied in difficulty, indicating a general pattern of higher item difficulty for the SCI-GD compared to self-reported DSM-5 criteria. Both the SCI-GD and the self-reported DSM-5 criteria performed well in terms of internal consistency, convergent, and discriminant validity. We conclude that the SCI-GD is a reliable and valid diagnostic tool to assess GD among individuals with various gambling behavior patterns. Further research-related and clinical implications are discussed., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Aims: To determine whether dissociative experiences moderate online problem gambling treatment effectiveness, and to characterize the temporal persistence of the relationship between dissociation and problem gambling., Design: Repeatedly measured self-report data on a guided online cognitive behavioral therapy for problem gambling collected on four occasions: before treatment, after treatment, and at 6- and 12-month follow-ups., Setting and Participants: The data (N = 1243, 59.2% males) were collected in Finland between 2019 and 2021., Measurements: The primary outcome variable was the self-reported level of problem gambling. The predictors were the treatment phase and dissociative experiences, their interaction, and the demographic covariates of age, education, income, and gender., Findings: Problem gambling scores and dissociative experiences declined significantly following treatment and remained low through the follow-ups (retention rates: 52.6% [post-treatment], 26.3% [at the 6-month follow-up], and 16.1% [at the 12-month follow-up]). However, the treatment was significantly less effective in reducing problem gambling for individuals who kept experiencing dissociation after the treatment., Conclusions: Dissociation is an integral sign of problem gambling severity and sustained dissociative experiences may significantly reduce the long-term effectiveness of online problem gambling treatments. Treatment efforts should be customized to account for individual differences in dissociative tendencies, and future research should broaden the study of dissociative experiences to other behavioral addictions., Competing Interests: Declaration of Competing Interest Sari Castrén works at the Finnish Institute for Health and Welfare, and as a part-time private practitioner clinical psychologist at Addiktum Clinic Helsinki, Finland, treating mainly individuals with addiction problems, and at Mehiläinen Medical Center, Forum Helsinki, where she offers treatments for various psychological issues. She also trains professionals to treat gambling disorder (MI, CBT) as a part of her duty at the Finnish Institute for Health and Welfare and addictions in general privately. She has received fees from Helsinki University, Oulu University, Tampere City, Vocational School Stadi, and Mehiläinen for her lectures on behavioral addictions and for training professionals, and writer's fees from the Finnish Medical Society Duodecim, The Finnish Medical Association, the Finnish Association of Addiction Medicine, the Finnish Psychological Association, and Myllyhoitoyhdistys ry. She received fees from Svenska Spel (2021, 2022, 2023; Sweden) for evaluating grant proposals and received fees from Tampere University, Finland, for preliminary examination of PhD work, and received fees from Lund University, Sweden, for being the opponent for a PhD thesis. She declares no conflict of interest in relation to this manuscript. No other authors have any declarations of interest., (Copyright © 2023 The Authors. Published by Elsevier Inc. All rights reserved.)

Background: The 21st century has brought substantial changes to the manners in which people gamble and the types of things on which people gamble. These changes are particularly stark in the United States, where, over the past five years, sports betting has gone from being legal in only one location to being legal throughout the majority of the country, often via mobile applications and online betting websites., Method: In March of 2022, a sample of the U.S. population (n = 2806, Mage[SD] = 48.9[17.2]; 1365[48.6%] men; response rate = 87.6%) and an oversample of sports-wagering adults in the U.S. (n = 1557, Mage[SD] = 41.7[15.3]; 1043[67%] men; response rate = 78.7%) were recruited via YouGov. Participants completed measures of gambling activities, including various forms of sports betting, as well as measures of problem gambling activities., Results: In general, people who gamble on sports, when compared to people who do not bet on sports, reported greater frequency of gambling engagement (averaging between monthly and weekly play),a wider variety of gambling activities (with the majority reporting past year engagement in four or more gambling activities), and higher rates of problem gambling. Multinomial logistics regression revealed no distinct associations between any specific form of sports gambling and higher risk, instead demonstrating that breadth and depth of gambling engagement were the best predictors of high-risk gambling behaviors., Conclusions: In general, sports gambling is broadly associated with greater engagement in both breadth of gambling activities and frequency of gambling play. Additionally, people who gamble on sports seem to be at higher risk of problem gambling than people who do not bet on sports. However, in analyses controlling for breadth and depth of gambling activities, these links are attenuated, suggesting that the risks associated with sports gambling behaviors are related to the greater degree of gambling engagement., (Copyright © 2023 The Authors. Published by Elsevier Inc. All rights reserved.)

Introduction: Only a few studies have investigated the relationship between risk for gambling disorder (GD) and mentalization difficulties. However, these results on positive correlations were all from cross-sectional studies; therefore, it would be important to investigate the longitudinal relationship between the constructs., Aims: It was aimed to identify subgroups of gamblers with different joint growth trajectories of risk for GD and hypomentalization (i.e., uncertainty of understanding own and others' mental states) and to compare the identified latent classes along impulsivity, sensation seeking and depression., Methods: Data from waves 1-3 of the Budapest Longitudinal Study were used. The final sample included 219 young adult gamblers who completed the study questionnaire and reported past-year gambling in all three waves (Females: N = 93 [42.29%]; Mean age: 28.36 years [SD = 4.29]). Standardized questionnaires were administered to measure the main constructs., Results: A four-class model was retained based on latent class growth analysis. Class 1 had consistently moderately high risk for GD and hypomentalization, and Class 4 presented consistently low risk for GD and hypomentalization. Classes 2-3 were characterized by low risk for GD and increasing hypomentalization. Class 1 had significantly higher sensation seeking and depression compared with the other subgroups in multiple cases. Class 4 showed significantly lower impulsivity and sensation seeking than the other classes., Conclusions: Elevated hypomentalization was presented among individuals with risk for GD. However, there is little empirical evidence to support that the two constructs have convergently changing trajectories. A cautious interpretation of the results is recommended due to low symptom presence., Competing Interests: Declaration of Competing Interest The University of Gibraltar receives funding from the Gibraltar Gambling Care Foundation, an independent, not-for-profit charity. ELTE Eötvös Loránd University receives funding from Szerencsejáték Ltd. (the gambling operator of the Hungarian government) to maintain a telephone helpline service for problematic gambling. None of these funding sources are related to this study, and the funding institution had no role in the study design or the collection, analysis, and interpretation of the data, the writing of the manuscript, or the decision to submit the paper for publication., (Copyright © 2023 The Authors. Published by Elsevier Inc. All rights reserved.)

Background: Converging evidence supports that gaming and gambling disorders are associated with executive dysfunction. The involvement of different components of executive functions (EF) in these forms of behavioural addiction is unclear., Aim: In a systematic review, we aim to uncover the association between working memory (WM), a crucial component of EF, and disordered gaming and gambling. Note that, in the context of this review, gaming has been used synonymously with video gaming., Methods: Adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), we systematically searched for studies published from 2012 onwards., Results: The search yielded 6081 records after removing duplicates, from which 17 peer-reviewed journal articles were eligible for inclusion. The association between WM and problem or disordered gaming and gambling have been categorized separately to observe possible differences. Essentially, problem gaming or gambling, compared to disorder, presents lesser severity and clinical significance. The results demonstrate reduced auditory-verbal WM in individuals with gambling disorder. Decreased WM capacity was also associated with problem gambling, with a correlation between problem gambling severity and decreased WM capacity. Similarly, gaming disorder was associated with decreased WM. Specifically, gaming disorder patients had lower WM capacity than the healthy controls., Conclusion: Working memory seems to be a significant predictor of gambling and gaming disorders. Therefore, holistic treatment approaches that incorporate cognitive techniques that could enhance working memory may significantly boost gambling and gaming disorders treatment success., Competing Interests: Declaration of Competing Interest The University of Gibraltar receives funding from the Gibraltar Gambling Care Foundation, an independent, not-for-profit charity. ELTE Eötvös Loránd University receives funding from Szerencsejáték Ltd. (the gambling operator of the Hungarian government) to maintain a telephone helpline service for problematic gambling. However, none of these funding sources is related to this study and the funding institutions had no role in the study design or the collection, analysis, and interpretation of the data, writing the manuscript, or the decision to submit the paper for publication., (Copyright © 2023 The Author(s). Published by Elsevier Inc. All rights reserved.)

Objective: The Global Appraisal of Individual Needs (GAIN-SS) is a screening instrument evaluating internalizing/externalizing behaviors. This study examines the validity evidence of the GAIN-SS in Spanish adolescents and explores sex differences in its performance., Method: Participants were 1,547 Spanish adolescents from the community (females = 48.2%, mean [ SD ] age = 15.20 [0.74]). A cross-sectional online assessment was used to evaluate past-month substance use and gambling involvement. Problems associated to these behaviors were assessed using the GAIN-SS, the South Oaks Gambling Screen-Revised for Adolescents (SOGS-RA), and the Rutgers Alcohol Problem Index (RAPI). Factor analyses were conducted to examine the internal structure of the GAIN-SS., Results: Results revealed four subscales accounting for 47.03% of the variance related to externalizing (EDScr), internalizing (IDScr), substance use disorders (SDScr), and crime/violence problems (CVScr). Concurrent validity was supported through significant correlations between the GAIN-SS subscales, alcohol-related problems, and gambling behavior, with the exception of the IDScr. Past-month gamblers or substance users evidenced higher scores in the CVScr. Females reported more internalizing symptoms, whereas males reported higher scores in CVScr., Conclusions: The GAIN-SS is a valid screener for substance use and gambling in Spanish adolescents. Sensitivity of the GAIN-SS to sex differences suggests that it may be useful to design gender-sensitive interventions.

One of the most pressing social and scientific issues, as reflected in the current priority lines of the National Drugs Plan (PNSD), is the development of screening tools for the early detection of addictions, particularly behavioral addictions, due to the impact that these problems are having on the growth of addictions in recent years, especially in adolescents and young people., Goal: The main goal of this research was to develop a screening tool for technological addictions (video games, mobile and social networks) and gambling for early detection in people suffering this kind of behavioral addiction., Procedure: With technologies, in the absence of agreed clinical criteria, those participants who perceived themselves as having problems and, in addition, had received treatment for it, were selected. Regarding gambling, the diagnostic criteria of the DSM-5 were used. The three items that scored the highest Positive Predictive Values (PPV) in each of the four validated tests were selected. These indicators serve to distinguish those who use the technologies and/or gamble in a functional way and do not have any problems from those who already have an addictive problem with video games, mobile, social networks or gambling., Results: This paper shows the finished screening tool with its main psychometric properties, which can be used by professionals working with adolescents in order to detect people who could have some addictive problem, in which case the psychologist can refer them to a specialized healthcare resource.

Contemporary literature and recent classification systems have expanded the field of addictions to include problematic behaviours such as gambling and sexual addiction. However, conceptualisation of behavioural addictions is poorly understood and gender-based differences have emerged in relation to how these behaviours are expressed. The current research conducted partial-correlation and Bayesian network analyses to assess the symptomatic structure of gambling disorder and sexual addiction. Convenience community sampling recruited 937 adults aged 18 to 64 years (315 females, M age  = 30.02; 622 males, M age  = 29.46). Symptoms of problematic behaviours were measured using the Online Gambling Disorder Questionnaire (OGDQ) and the Bergen Yale Sex Addiction Scale (BYSAS). Results indicate distinct gender-based differences in the symptom networks of sexual addiction and gambling disorder, with a more complex network observed amongst men for both conditions. Addiction salience, withdrawal and dishonesty/deception were important components of the addictive network. Interpersonal conflict was more central for women while intrapsychic conflict a more prominent issue for men. Differences in the two symptom networks indicate separate disorders as opposed to a single underlying construct. Treating practitioners and community initiatives aimed at addressing sexual addiction and disordered gambling should consider gender, when designing educational or therapeutic interventions., Competing Interests: Declaration of Competing Interest The authors of the present study do not report any conflict of interest., (Copyright © 2023. Published by Elsevier B.V.)

Introduction: There is evidence that gambling disorder shares similarities with other types of addictive behavior, such as occurs in substance abuse. In addition, co-morbidity of gambling with mental disorders has been established in school-going students., Aim: This study aimed at determining the comorbidity of DSM-V gambling disorder with DSM-V mental disorders and substance abuse in high school, college and university students in Kenya., Methods: This was a cross-sectional study among 536 high school, college and university students. We collected data on socio-demographic characteristics, economic indicators, DSM-V diagnosis including DSM-V gambling disorder and substance use disorders using the WHO ASSIST tool. Descriptive and inferential analyses were done., Results: A total of 536 students participated in the study, of which 11.4% (61 out of 536) had DSM-V gambling disorder. Male gender (AOR = 12.0, 95% CI: 4.99-34.3), antisocial personality disorder (AOR = 3.42, 95% CI: 1.34-8.54), tobacco use (AOR = 4.42, 95% CI: 1.15-18.3) and conduct disorder (AOR = 7.56, 95% CI: 2.34-25.1) were predictors of gambling disorder., Conclusion: Gambling is highly prevalent in Kenya learning institutions at 11.4% and is associated with mental disorders and substance use. There is a need for public awareness of gambling among Kenyan youths., (© 2023. The Author(s).)

Background and Aims: There is a growing interest in determining the specific role of obsessive-compulsive features in different behavioral addictions. However, more studies comparing sizable clinical populations with different addictions are needed.Therefore, a main aim of the present study was to explore the presence of obsessive-compulsive features among people with different behavioral addictions (gambling disorder, internet gaming disorder, compulsive sexual behavior disorder and compulsive buying-shopping concerns). Through a clustering procedure, the existence of empirical clusters among treatment-seeking patients based on obsessive-compulsive measures was explored., Materials and Methods: The Symptom Checklist-Revised, and the Temperament and Character Inventory-Revised were obtained from 4,010 treatment-seeking patients. Obsessive-compulsive features were measured with the obsessive-compulsive subscale of the Symptom Checklist-Revised and the harm avoidance and persistence dimensions of the Temperament and Character Inventory-Revised. Cluster analysis was applied to explore the existence of empirical groups based on obsessive-compulsive features., Results: Patients with compulsive sexual behavior disorder and compulsive buying-shopping disorder reported the highest scores on the obsessive-compulsive subscale, while patients with gambling disorder showed the lowest scores on harm avoidance, and patients with internet gaming disorder the lowest scores on persistence. Two mutually exclusive clusters were identified. Cluster 1 exhibited a more maladaptive psychopathological and personality profile than cluster., Discussion and Conclusions: These results provide new evidence regarding obsessive-compulsive features in specific behavioral addictions. Therapeutic approaches should consider that different addictions may present distinct levels of obsessive-compulsive features., Competing Interests: Declaration of Competing Interest FFA and SJM received consultancy honoraria from Novo Nordisk and FFA editorial honoraria as EIC from Wiley. The rest of the authors declare no conflict of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, or in the decision to publish the results., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

Background: Marital status is a robust correlate of disordered gambling, but few studies have examined the direction of this association., Methods: The present study used a case-control design by including all adults receiving their first gambling disorder (GD) diagnosis between January 2008 to December 2018 (Norwegian Patient Registry, n = 5,121) and compared them against age and gender matched individuals with other somatic/psychiatric illnesses (Norwegian Patient Registry, n = 27,826) and a random sample from the general population (FD-Trygd database, n = 26,695). The study examined marital status before GD, getting divorced as a risk factor for future GD, and becoming married as a protective factor of future GD., Results: The findings indicated an 8-9 percentage points higher prevalence of unmarried people and about a 5 percentage points higher prevalence of separation/divorce among those that subsequently experienced GD compared to controls. Logistic regressions showed that transition through divorce was associated with higher odds of future GD compared to illness controls (odds ratio [OR] = 2.45, 95% CI [2.06, 2.92]) and the general population (OR = 2.41 [2.02, 2.87]). Logistic regressions also showed that transition through marriage was associated with lower odds of future GD compared to illness controls (OR = 0.62, CI [0.55, 0.70]) and the general population (OR = 0.57, CI [0.50, 0.64])., Conclusions: Social bonds have previously been shown to impact physical and mental health, and the findings of the study emphasize the importance of considering social network history and previous relationship dissolution among individuals with GD., (© 2023. The Author(s).)

The novel gambling disorder identification test (GDIT) was recently developed in an international Delphi and consensus process. In this first psychometric evaluation, gamblers ( N = 603) were recruited from treatment- and support-seeking contexts ( n = 79 and n = 185), self-help groups ( n = 47), and a population sample ( n = 292). Participants completed self-report measures, a GDIT retest ( n = 499), as well as diagnostic semistructured interviews assessing gambling disorder (GD; n = 203). The GDIT showed excellent internal consistency reliability (α = .94) and test-retest reliability (6-16 days, intraclass correlation coefficient = 0.93). Confirmatory factor analysis yielded factor loadings supporting the three proposed GDIT domains of gambling behavior, gambling symptoms, and negative consequences. Receiver operator curves and clinical significance indicators were used to estimate GDIT cut-off scores in relation to recreational (<15) and problem gambling (15-19), any GD (≥20), mild GD (20-24), moderate GD (25-29), and severe GD (≥30). The GDIT can be considered a valid and reliable measure to identify and predict GD severity, as well as problem gambling. In addition, the GDIT improves content validity in relation to an international research agreement concerning features of gambling outcome measures, known as the Banff Consensus Agreement.

Objectives: Adolescent gambling is a public health concern of increasing importance. The lack of comprehensive evaluations on adolescent gambling disorder (GD) assessment tools hinders the timely detection of Chinese adolescents with gambling problems. This study aimed to evaluate the psychometric properties of South Oaks Gambling Screen-Revised for Adolescents (SOGS-RA) and determine its optimal screening cutoff score among Chinese adolescent gamblers to address this gap. Methods: We surveyed 1407 Chinese secondary school students aged 11-19 years in Macao, China, among which 258 past-year gamblers' data was used for assessing SOGS-RA's performance in detecting risk for adolescent GD. Results: SOGS-RA displayed satisfactory reliability and validity for assessing probable GD among Chinese adolescent gamblers. Under the DSM-5 GD framework, we proposed ≥4 as SOGS-RA's optimal cutoff score of screening for probable GD and further identified 5.8% of past-year gamblers prone to probable GD in the present study. Conclusion: SOGS-RA can provide a reliable and valid assessment of adolescent' GD risk in the Chinese context, facilitate early identification of probable GD cases, and alleviate the public health concern for Chinese adolescents., Competing Interests: The authors declare that they do not have any conflicts of interest., (Copyright © 2022 Zhou, Chen, Ling, Tong and Wu.)

Gambling-related harms are increasingly recognised as public health concerns internationally. One response is to improve identification of and support for those affected by gambling-related harms, including individuals who gamble and those close to them, 'affected others'. Adult social care services have been identified as a setting in which screening for gambling-related harms is suitable and desirable. To achieve this, a tool is required which can identify gambling-related harms experienced by individuals and affected others. This scoping review aimed to identify whether any brief (i.e. three questions or less) screening tools are being used and, if so, how brief screening for gambling-related harm is being implemented in health and social care-related contexts. An international English language scoping review of research and grey literature was undertaken between April and July 2021. The search included single-item and brief screening tools which have been developed to identify gambling-related harms for individuals and affected others across a range of health and social care-related contexts. Findings show that screening tools for gambling-related harms have been developed for use in health settings rather than in social care contexts. For example within gambling, mental health or substance misuse support services. We found no evidence of a brief or single-item screening tool for identifying harms to individuals and affected others which is of adequate quality to strongly recommend for use in an adult social care setting. Development of a validated brief or single-item screening tool is recommended to assist adult social care practitioners to effectively screen, identify, support and signpost people affected by gambling-related harms., (© 2022 The Authors. Health and Social Care in the Community published by John Wiley & Sons Ltd.)

The South Oaks Gambling Screen-Revised Adolescent (SOGS-RA) is one of the most widely used screening tools for problem gambling among adolescents. In this study, item response theory was used for computing measures of problem gambling severity that took into account how much information the endorsed items provided about the presence of problem gambling. A zero-inflated mixture two-parameter logistic model was estimated on the responses of 4,404 adolescents to the South Oaks Gambling Screen-Revised Adolescent to compute the difficulty and discrimination of each item, and the problem gambling severity level (θ score) of each respondent. Receiver operating characteristic curve analysis was used to identify the cutoff on the θ scores that best distinguished daily and nondaily gamblers. This cutoff outperformed the common cutoff defined on the sum scores in identifying daily gamblers but fell behind it in identifying nondaily gamblers. When screening adolescents to be subjected to further investigations, the cutoff on the θ scores must be preferred to that on the sum scores.

Background: This study investigates a broad spectrum of psychiatric disorders, substance use disorders, gambling, and internet gaming disorders in Swedish 18-year-old boys and girls with the aim of estimating the prevalence of disorders and comorbidity., Methods: We used a two-phase design with screening to detect candidates for clinical interviews. Screening included 949 adolescents (55.6% girls), out of which 758 adolescents (57.0% girls) were selected for interview with at least one of four instruments: M.I.N.I., ADDIS, NODS and IGDS. Of these, 387 (61.2% girls) were interviewed. Gender separated prevalence was estimated on the assumption that those selected but not interviewed had the same distribution as those interviewed based on similar outcomes above screening cut-offs. Comorbidity between types of disorders was estimated on similar assumptions. In addition, comorbidity between dyads of the ten most common specified disorders was calculated based on recorded data without these assumptions., Results: We estimated that 14.6% met the criteria of a substance use disorder (SUD), mostly concerning alcohol and more frequent in girls than in boys. Those meeting the criteria lifetime of at least one of 16 other psychiatric disorders were 26.7%, more than twice as frequent in girls compared to boys, and with depression being the most common disorder. Gambling and gaming disorders were found almost exclusively in boys, of which 5.8% met the criteria for gambling, and 2.3% for gaming disorders. Of girls with a SUD, 40% also had a psychiatric disorder, while on the other hand more than 28% of girls with a psychiatric disorder also had a SUD. In boys with a SUD, 22% had another psychiatric disorder, while 15% of those with a psychiatric disorder also had a SUD., Conclusions: Psychiatric comorbidity is common in SUDs in adolescents, which calls for screening and diagnostic efforts in young patients presenting with symptoms of SUDs. Girls with SUDs are at higher risk of also suffering from psychiatric conditions. Gambling and gaming disorders appear in a substantial minority of adolescents and warrant further study of their comorbidity. Since prevalences and comorbidity were estimated on the assumptions mentioned, some caution in interpreting the results is needed., (© 2022. The Author(s).)

The Iowa Gambling Task (IGT) is one of the most common behavioral decision-making tasks used in clinical and research settings. Less-than-expected performance among healthy adults generates concerns about the validity of this task, and it is possible the particular scoring approach utilized could impact interpretation. We examined how performance patterns changed across several scoring approaches, utilizing a large, college student sample, both with ( n = 406) and without ( n = 1,547) a self-reported history of psychiatric or other diagnosis. Higher net scores were seen when participants selected decks with a low loss frequency than decks with high long-term outcomes; however, participants overall underperformed the IGT normative data sample. Receiver operating characteristic curves examining multiple scoring approaches revealed no threshold of impaired performance that both maximized sensitivity and minimized false positive rate on the IGT. Scoring approach matters in the determination of impaired decision making via the IGT in adults.

Concerns regarding the similarities between video game 'loot boxes' and gambling have been supported by correlations in survey studies between loot box engagement and problem gambling scores. It is generally noted that this correlation could reflect loot box users migrating to conventional gambling, and/or people with gambling problems being attracted to loot boxes when they play video games. We describe a third possibility, that when gamers complete problem gambling screens they may be referring to harms incurred from their loot box use. Using three secondary datasets from cross-sectional online surveys, we explore this account in two ways. First, in participants who do not endorse any participation in conventional forms of gambling, we compare rates of positive (i.e. non-zero) scores on the Problem Gambling Severity Index (PGSI) in participants with and without loot box use. Second, noting that some PGSI items have less relevance to loot box use versus gambling, we compare endorsement rates of individual PGSI items, in gamers versus gamblers, and loot box users vs non-loot box users (focusing on item 3 "going back another day to win back the money you lost"). In analysis 1, positive PGSI scorers among non-gamblers were significantly elevated in loot box users vs non-loot box users, although absolute numbers were low overall. In analysis 2, there were no reliable differences (gamers vs gamblers, loot box users vs non-loot box users) in PGSI item 3 endorsement rates. We conclude that these results provide partial support for this third option, and highlight a need for future studies to consider this possibility more directly., (Copyright © 2022 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Background: From a clinical perspective, knowledge of the psychological processes involved in maintaining gambling disorder has been lacking. This qualitative study formulated hypotheses on how gambling disorder is maintained by identifying clinically relevant behaviors at an individual level, as a means to guide the development of new cognitive behavioral interventions., Methods: Six individuals from a treatment study, diagnosed with gambling disorder and with diverse symptom profiles of psychiatric comorbidity, were recruited. Participants were interviewed using an in-depth semi-structured functional interview and completed self-report measures assessing gambling behavior., Results: Functional analysis was used as a theoretical framework for a thematic analysis, which yielded the following categories: 1) antecedents that may increase or decrease gambling; 2) experiences accompanying gambling; 3) control strategies; 4) consequences of gambling behavior; and 5) events terminating gambling behavior. Few differences were identified in relation to symptom profiles of psychiatric comorbidity, although some gamblers did not report experiencing abstinence when not being able to gamble., Conclusions: Gambling is a secluded activity mainly triggered by access to money. Positive and negative emotions could be both antecedents and functions of gambling behavior. Avoidance-based strategies used to control gambling might result in a failure to learn to control gambling behavior. Anticipation, selective attention, and chasing could be important reinforcers, which should be addressed in new developments in cognitive behavioral treatment for gambling disorder., (© 2022. The Author(s).)

The National Opinion Research Center (NORC) Diagnostic Screen for Gambling Problems (NODS) is one of the most used outcome measures in gambling intervention trials. However, a screen based on DSM-5 gambling disorder criteria has yet to be developed or validated since the DSM-5 release in 2013. This omission is possibly because the criteria for gambling disorder only underwent minor changes from DSM-IV to DSM-5: the diagnostic threshold was reduced from 5 to 4 criteria, and the illegal activity criterion was removed. Validation of a measure that captures these changes is still warranted. The current study examined the psychometric properties of an online self-report past-year adaptation of the NODS based on DSM-5 diagnostic criteria for gambling disorder (i.e., NODS-GD). A diverse sample of participants (N = 959) was crowdsourced via Amazon's TurkPrime. Internal consistency and one-week test-retest reliability were good. High correlations (r = 0.74-0.77) with other measures of gambling problem severity were observed in addition to moderate correlations (r = 0.21-0.36) with related but distinct constructs (e.g., gambling expenditures, time spent gambling, other addictive behaviors). All nine of the DSM-5 criteria loaded positively on one principal component, which accounted for 40% of the variance. Classification accuracy (i.e., sensitivity, specificity, predictive power) was generally very good with respect to the PGSI and ICD-10 diagnostic criteria. Future studies are encouraged to establish a gold standard self-report measure of gambling problems and develop agreed-upon recommendations for the use and interpretation of crowdsourced addiction data., (Copyright © 2022 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Background and Aims: Recovery is a challenge for individuals coping with a gambling disorder (GD). Recovery capital (RC) is a conceptual framework describing positive external and internal (e.g., human, social, community and financial) resources that promote recovery. Negative RC relates to external and internal obstacles to recovery. To date, no scale has captured both positive and negative RC items in the gambling field. Based on the RC framework, this pilot study aimed to develop The Holistic Recovery Capital in Gambling Disorder (HRC-GD) instrument, and to explore its associations with recovery status, measures of psychopathology and happiness. We hypothesized that higher HRC-GD scores will be positively related to recovery and subjective happiness, but negatively linked to depression, anxiety, and gambling severity., Method: Recovered and non-recovered individuals with a lifetime DSM-5 GD (n = 164) completed the HRC-GD instrument, the DSM-5 GD diagnostic criteria, and measures of depression, anxiety, and subjective happiness., Results: Through a process of item reduction, which included a principal components analysis, 19 items were retained. Since exploratory factor analysis (EFA) yielded uninterpretable findings, an index score reflecting human, financial, community, and social resources and obstacles was calculated. HRC-GD index scores were negatively correlated with anxiety, depression, and GD symptom severity, but positively related with subjective happiness. Index scores were significantly associated with recovery status., Conclusions: The HRC-GD index holds promise as a new tool for measuring RC in GD. Additional research is needed to validate this index using larger and more ethnically and gender diverse clinical and community samples of individuals with GD.

Background: Both the Problem Gambling Severity Index (PGSI) and the Short Gambling Harms Screen (SGHS) purport to identify individuals harmed by gambling. However, there is dispute as to how much individuals are harmed, conditional on their scores from these instruments. We used an experienced utility framework to estimate the magnitude of implied impacts on health and wellbeing., Methods: We measured health utility using the Short Form Six-Dimension (SF-6D), and used this as a benchmark. All 2603 cases were propensity score weighted, to balance the affected group (i.e., SGHS 1+ or PGSI 1+ vs 0) with a reference group of gamblers with respect to risk factors for gambling harm. Weighted regression models estimated decrements to health utility scores attributable to gambling, whilst controlling for key comorbidities., Results: We found significant attributable decrements to health utility for all non-zero SGHS scores, as well as moderate-risk and problem gamblers, but not for PGSI low-risk gamblers. Applying these coefficients to population data, we find a similar total burden for both instruments, although the SGHS more specifically identified the subpopulation of harmed individuals. For both screens, outcomes on the SF-6D implies that about two-thirds of the 'burden of harm' is attributable to gamblers outside of the most severe categories., Conclusions: Gambling screens have hitherto provided nominal category membership, it has been unclear whether moderate or 'at-risk' scores imply meaningful impact, and accordingly, population surveys have typically focused on problem gambling prevalence. These results quantify the health utility decrement for each category, allowing for tracking of the aggregate population impact based on all affected gamblers., (© 2022. The Author(s).)

ICD-11 will discriminate 3 subcategories of harmful patterns of substance use and 5 subcategories of dependence. According to a pre-version, the 6 diagnostic criteria of substance dependence in ICD-10 will be condensed in 3 pairs in ICD-11. The term "persistent substance use despite clear evidence of overly harmful consequence" shall be replaced by "substance use often continues despite the occurrence of problems". Pathological gambling and pathological gaming will be listed as addictive behaviors next to substance use disorders.The reduction from 6 to 3 criteria of substance dependence may be problematic in some cases. First studies report an increase of alcohol and cannabis dependence under use of ICD-11. The change of the description of "persistent substance use despite clear evidence of overly harmful consequence" to "substance use often continues despite the occurrence of problems" could imply legal and social problems, which could lead to pathologization of social problems., Competing Interests: Die Autoren geben an, dass kein Interessenkonflikt besteht., (Thieme. All rights reserved.)

Media pressure from gambling advertising has reached worrying levels. It constitutes a risk to the mental health of young people and adolescents by promoting a favourable attitude towards gambling, a higher frequency of gambling and a perception of greater accessibility. Currently, there is no instrument available to assess the impact of gambling advertising., Objective: The present study aims to adapt and validate the Impact of Gambling Advertising Scale (IGAS)., Design: The IGAS scale was translated from English ensuring its linguistic, conceptual and metric equivalence. The psychometric properties were then tested. SITE: Comunidad Valenciana (España)., Participants: 1724 adolescents with a mean age of 16.52 years (SD=.759)., Intervention: Self-administered, paper-based questionnaire in a single measure., Main Measurements: Advertising impact, and gambling intention, severity and availability., Results: Internal consistency and two-half reliability were good, Cronbach's α=.782 and α=.70, respectively. Confirmatory factor analysis concluded that the Spanish version replicates the original three-dimensional version. Convergent validity analyses showed direct and significant relationships with different aspects of gambling behaviour, and other predictors., Conclusion: The adapted version of the IGAS is a reliable and valid measure for the assessment of the impact of advertising on adolescents. The scale is a useful instrument for the diagnosis of risk level and the evaluation of preventive interventions., (Copyright © 2021 The Authors. Publicado por Elsevier España, S.L.U. All rights reserved.)

Background: In the DSM-5, gambling disorder is recognized as the only behavioral addiction. The number of people with mental health disorders is increasing in Lebanon, especially since the economic crisis and the COVID-19 pandemic. The South Oaks Gambling Screen (SOGS), the most used tool in the world in terms of pathological gambling, has never been translated to Arabic, culturally adapted in a way that suits the Lebanese population and validated. This study's objectives were to validate an Arabic-language version of the SOGS and assess factors associated with probable pathological gambling among Lebanese adults., Methods: This study was carried out between February and April 2021, during the lockdown period imposed by the Lebanese government. A total of 601 individuals participated in this study by filling the online questionnaire., Results: A factor analysis, using the principal component analysis, was performed on the SOGS scale items. The SOGS items were able to explain 73.35% of the variance, with an internal reliability of KR20 = 0.947 for the total scale. The results of the confirmatory factor analysis confirmed the results of the factor analysis. More problematic alcohol use (aOR = 1.17), and more depression (aOR = 1.13) were significantly associated with higher odds of probable pathological gambling, whereas females (aOR = 0.27) had significantly lower odds of probable pathological gambling compared to males., Conclusion: Our study validated an Arabic-language version of the South Oaks Gambling Screen (SOGS) for use in Lebanon, and showed some factors associated with probable pathological gambling (male gender, alcohol use disorder and depression). This reliable and valid version will hopefully contribute towards better screening for gambling disorder in Lebanon., (© 2022. The Author(s).)

Gambling Disorder (GD) has recently been reclassified from an impulse-control disorder to a behavioural addiction and, as in other addictive disorders, the dopaminergic reward system is involved. According to neuroimaging studies, alterations within the striatal dopaminergic signalling can occur in GD. However, the findings to date are controversial and there has been no agreement yet on how the reward system is affected on a molecular basis. Within the last 20 years, there has been growing evidence for a higher risk to develop GD in response to certain dopaminergic medication. Especially the dopamine agonists pramipexole and ropinirole, and the dopamine modulator aripiprazole seem to increase the likelihood for GD. The goal of this study was to examine the association between a prescription for either of the three pharmaceuticals and a GD diagnosis in a large cross-sectional study of the Swedish population. Compared to patients with any other dopaminergic drug prescription (38.7% with GD), the diagnosis was more common in patients with a dopamine agonist prescription (69.8% with GD), resulting in an odds ratio of 3.2. A similar association was found between aripiprazole prescriptions and GD diagnoses, which were analysed within the subgroup of all patients with schizophrenia or a schizotypal, delusional, or another non-mood psychotic disorder. An aripiprazole prescription increased the likelihood of GD (88.8%) in comparison to patients without an aripiprazole prescription (71.2%) with an odds ratio of 3.4. This study contributes to the increasingly reliable evidence for an association between several dopaminergic drugs and a higher risk for developing GD. Therefore, one future research goal should be a better understanding of the neurobiology in GD to be able to design more selective dopaminergic medication with less severe side effects. Additionally, this knowledge could enable the development of pharmacotherapy in GD and other addictive disorders., Competing Interests: I have read the journal’s policy and the authors of this manuscript have the following competing interests: Mirjam Wolfschlag declares no competing interests. Anders Håkansson holds a position at Lund University which is supported by the stateowned Swedish gambling operator AB Svenska Spel as part of its responsible gambling policies, and also has research funding from the research councils of that body and from the research council of the Swedish alcohol monopoly, Systembolaget. Håkansson also has been the national sub- nvestigator of a pharmaco-epidemiological survey, carried out by the independent research institute Triangle Research Institute, United States, and financed by the pharmaceutical company Shire. No direct fees or ompensations were paid to the individual sub-investigator. Also, a clinical follow-up study has been planned in collaboration with the company Kontigo care, which provides follow-up devices free of charge for a clinical treatment trial in gambling disorder, but without any further financial support to the research group or its members. None of the bodies mentioned above had any role in or influence on the present research and this does not alter our adherence to PLOS ONE policies on sharing data and materials.

Objective: Recovery from Gambling Disorder lacks established operational criteria and a dedicated outcome measure. Cross-study comparisons and treatment efficacy determinants are difficult without a valid and widely used tool to assess recovery. The current article describes the development and psychometric evaluation of the Recovery Index for Gambling Disorder (RIGD). Method: Item development was based on an integration of academic, clinical, and consumer perspectives of recovery. Expert feedback and cognitive interview techniques were employed to review and refine the initial item pool. An empirical evaluation of the RIGD was conducted using 204 adult participants (63.7% male) with experience of seeking formal help for gambling problems. Results: Partial-least squares structural equation modeling resulted in a 32-item solution across 6 recovery dimensions: gambling reduction, urge coping, recovery wisdom, life functioning, interpersonal relationships, and mental health. The RIGD structural model explained 71.9% of variance in an external self-report global measure of recovery. Convergent validity was evidenced by significant correlations between all RIGD dimensions and other related measures, with the exception of recovery wisdom. Criterion-related validity was demonstrated as RIGD composite scores accurately classified nonproblem from problem gamblers, with a conservative cut-off score of 45. Test-retest reliability was established over a 2-week interval. Conclusions: The RIGD is an empirically supported instrument designed to broadly measure recovery from Gambling Disorder. Valid and uniform measurement of recovery is important given its central role in advancing effective treatments and shaping gambling help service policy internationally. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Objectives: Diverse instruments are used to measure problem gambling and Gambling Disorder intervention outcomes. The 2004 Banff consensus agreement proposed necessary features for reporting gambling treatment efficacy. To address the challenge of including these features in a single instrument, a process was initiated to develop the Gambling Disorder Identification Test (GDIT), as an instrument analogous to the Alcohol Use Disorders Identification Test and the Drug Use Disorders Identification Test., Methods: Gambling experts from 10 countries participated in an international two-round Delphi (n = 61; n = 30), rating 30 items proposed for inclusion in the GDIT. Gambling researchers and clinicians from several countries participated in three consensus meetings (n = 10; n = 4; n = 3). User feedback was obtained from individuals with experience of problem gambling (n = 12) and from treatment-seekers with Gambling Disorder (n = 8)., Results: Ten items fulfilled Delphi consensus criteria for inclusion in the GDIT (M ≥ 7 on a scale of 1-9 in the second round). Item-related issues were addressed, and four more items were added to conform to the Banff agreement recommendations, yielding a final draft version of the GDIT with 14 items in three domains: gambling behavior, gambling symptoms and negative consequences., Conclusions: This study established preliminary construct and face validity for the GDIT., (© 2020 The Authors. International Journal of Methods in Psychiatric Research published by John Wiley & Sons Ltd.)

Background: Aripiprazole has been linked to cases of problem gambling (PBG), but evidence supporting this association remains preliminary. Additionally, data specific to PBG in individuals with first-episode psychosis (FEP) receiving aripiprazole are limited to a few case reports, even though aripiprazole is widely used among this population that might be especially vulnerable to PBG., Methods: To examine this association, a nested case-control study was conducted in a cohort of 219 patients followed at a FEP program located in the Quebec City, Quebec, Canada, metropolitan area. Fourteen cases meeting the PBG criteria according to the Problem Gambling Severity Index were identified and matched for gender and index date to 56 control subjects., Results: In the univariable conditional logistic regression analysis, the use of aripiprazole was associated with an increased risk of PBG (odds ratio [OR] 15.2; 95% confidence interval [CI] 2.1-670.5). Cases were more likely to have a prior gambling history (either recreational or problematic) than controls at admittance in the program; they were also more frequently in a relationship and employed. After adjustment for age, relationship status, employment and Cluster B personality disorders, the use of aripiprazole remained associated with an increased risk of PBG (OR 8.6 [95% CI 1.5-227.2])., Conclusions: Findings from this study suggest that FEP patients with a gambling history, problematic or not, may be at increased risk of developing PBG when receiving aripiprazole. They also highlight the importance of systematically screening for PBG all individuals with psychotic disorders, as this comorbidity hinders recovery. While the results also add credence to a causal association between aripiprazole and PBG, further prospective studies are needed to address some of the limitations of this present study.

Background and Aims: In psychiatric diagnosis, different symptoms of gambling problems are usually aggregated into a single indicator of disorder severity, which has resulted in a knowledge gap on the specific roles of the different issues with which some gamblers struggle. This study estimated the association between baseline symptoms of gambling problems and (i) other symptoms, (ii) the overall severity of gambling problems after 12 months, and the estimated stability rates of various gambling problems after (iii) 12 months and (iv) 5 years. Design and Setting Secondary analysis of data derived from the Swedish Longitudinal Gambling Study (SWELOGS), a prospective representative cohort study conducted between 2008 and 2014 in Sweden., Participants: A total of 8165 respondents from 16-84 years of age recruited in a stratified random sampling procedure. Among them, 6021 answered the 1-year follow-up survey and 3559 answered the 5-year follow-up survey., Measurements: Nine symptoms related to gambling were assessed using the Problem Gambling Severity Index (excessive gambling, tolerance, chasing, loans, insight, health problems, criticism, financial problems, and guilt)., Findings: Excessive gambling, tolerance, chasing, loans and guilt significantly increased the risk of a range of other symptoms. Chasing and tolerance also tripled the risk of transitioning to more severe gambling problems (OR = 2.9, 95% CI = [1.5-5.5], P = 0.001 and OR = 2.7, 95% CI = [1.6-4.5], P < 0.001, respectively). Stability rates of the different symptoms ranged between 22% (95% CI = [12-31%]) and 42% (95% CI = [35-48%]) after 1 year and 3% (95% CI = [0-10%]) and 19% (95% CI = [7-30%]) after 5 years with chasing being the most stable problem (42% [95% CI = (35-48%)] after 1 year and 17% [95% CI = (6-28%)] after 5 years)., Conclusions: In psychiatric diagnosis, four symptoms of problem gambling (chasing, tolerance, excessive gambling and guilt) appear to have prognostic validity in assessing gambling-related risk. The symptoms of tolerance and chasing appear to increase the risk of progressing to more severe gambling problems., (© 2020 The Authors. Addiction published by John Wiley & Sons Ltd on behalf of Society for the Study of Addiction.)

Individuals with schizophrenia are over three times more likely to have problem and pathological gambling (PPG) than the general population (Cunningham-Williams et al., 1998; Desai and Potenza, 2009), but little is known about this co-occurrence and how PPG relates to specific symptom dimensions of psychotic disorders. Although cognitive distortions in PPG have been linked to gambling motivations (e.g., distorted thoughts about odds of winning), how psychotic symptoms in schizophrenia or related disorders relate to gambling motivations have not been examined systematically to date. Individuals with schizophrenia or schizoaffective disorder (n = 170) completed structured face-to-face interviews regarding problem-gambling severity, gambling motivations, and five symptom factors of psychosis (Positive, Negative, Disorganized/Concrete, Depressed, and Excited). Different symptom dimensions of psychosis showed distinct patterns of relationships with motivations to gamble and gambling onset. PPG in schizophrenia was associated with elevated scores on the Depressed factor. Psychotic symptom severity was associated with increased motivation to gamble for financial reasons and decreased motivations to gamble for service, and possibly social or interpersonal, reasons. Age of gambling onset was inversely associated with psychotic symptom severity, particularly positive features. Our findings suggest that motivations for gambling may differ in the context of schizophrenia and relate to specific symptom clusters., Competing Interests: Declarations of Competing Interests The authors report no conflicts of interests with respect to the content of this manuscript. Over the past three years, Dr. Potenza has received financial support (to Yale or personally) for the following. He has consulted for and advised Rivermend Health, Game Day Data, Addiction Policy Forum, AXA and Opiant Therapeutics; received research support from the Mohegan Sun Casino and the National Center for Responsible Gaming; consulted for or advised legal and gambling entities on issues related to impulse control and addictive behaviors; provided clinical care related to impulse-control and addictive behaviors; performed grant reviews; edited journals/journal sections; given academic lectures in grand rounds, CME events and other clinical/scientific venues; and generated books or chapters for publishers of mental health texts., (Copyright © 2020 Elsevier B.V. All rights reserved.)

A multitude of psychological and social factors likely contribute to the development and maintenance of addictive disorders. As different people develop different addictions, it is important to understand whether psychosocial factors are related differently to different types of addictive disorders. In this study, we examined the unique interaction of personality traits, family environment, and life events in predicting substance (drugs, alcohol) and behavioral (gambling, sex) addictive disorders, among 207 participants suffering from an addictive disorder and 79 controls. Results identified several psychosocial factors, including impulsivity and reported negative life events, that predicted all types of addictive disorders. There was also a unique prediction model for each addiction. Drug and alcohol use disorders were predicted by lower agreeableness and less intellectual-cultural family orientation, with alcohol use disorder further predicted by lower extraversion and higher family organization. Gambling disorder was predicted by a family with lower intellectual-cultural orientation and higher organization and control, whereas compulsive sexual behavior was predicted by lower extraversion and agreeableness and higher neuroticism, and by higher family control. These findings suggest that the complex interplay among psychosocial factors is manifested differently across addictive disorders and may thus have important implications for research, prevention, and intervention., Competing Interests: Declarations of interest Prof. Gal Yadid serves as the Chair of the Research Committee for the Israel Anti-Drug Authority. None of the other authors have any potential conflict of interests regarding this research., (Copyright © 2020 Elsevier B.V. All rights reserved.)

It has been reported that decision making is impaired in suicide attempters. Decision making is a complex process and little is known about its different components. Yet, this information would help to understand the functioning of suicidal minds. In this study, the Prospect Valence-Learning (PVL) computational model was applied to the Iowa Gambling Task (IGT) to investigate and compare decision-making components in patients with affective disorder and with/without history of suicide attempts and in healthy controls. To this aim, 116 inpatients with current major depressive episode (among whom 62 suicide attempters) and 38 healthy controls were recruited. Decision-making performance was measured using the IGT. The Bayesian computational PVL model was applied to compare the feedback sensitivity, loss aversion, learning/memory, and choice consistency components of decision making in the different groups. Depressive symptomatology was assessed using the Beck Depression Inventory short form (BDI-SF). The total IGT net score and the loss aversion and learning/memory scores were lower in suicide attempters than in healthy controls. The choice consistency score was low in all patients (with/without suicide history) compared with healthy controls. Moreover, patients with high BDI score showed a positive relationship between the choice consistency score and suicide attempt. These findings suggest that decision-making impairment in depressed patients with and without suicidal history might be the result of underlying problems in feedback processing and task learning, which influence the building of long-term strategies. All these impairments should be targeted in therapeutic strategies for suicidal patients., (Copyright © 2020. Published by Elsevier B.V.)