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Background and aims: This is the first nation‐wide register study based on a total population sample measuring the gender‐specific incidences of chronic diseases and conditions among adults diagnosed with gambling disorder (GD). Design, setting and participants: The study used aggregated data for 2011–22 retrieved from the Register of Primary Health Care visits, Care Register for Health Care and Care Register for Social Welfare, including specialized outpatient and inpatient health care, inpatient social care and institutional care and housing services with 24‐hour or part‐time assistance, set in mainland Finland. Participants comprised people aged 18–90+ years with GD diagnosis [corresponding to pathological gambling, International Classification of Diseases 10th revision (ICD‐10) code F63.0, n = 3605; men n = 2574, women n = 1031] and the general population (n = 4 374 192). Measurements: Incidences of somatic diseases and psychiatric disorders were calculated for the people with diagnosed GD and for the general population, separately for women and men. Findings After standardizing for age, the incidence of each diagnostic group was systematically higher for people with GD compared with the general population, except for cancer. The highest standardized incidence ratio (SIR) values were for psychiatric disorders [SIR = 234.2; 95% confidence interval (CI) = 226.1–242.4], memory disorders (SIR = 172.1; 95% CI = 119.1–234.8), nervous system diseases (SIR = 162.8; 95% CI = 152.8–173.1), chronic respiratory diseases (SIR = 150.6; 95% CI = 137.6–164.2), diabetes (SIR = 141.4; 95% CI = 127.9–155.5) and digestive diseases (SIR = 134.5; 95% CI = 127.1–142.2). Conclusions: In Finland, the incidence of chronic diseases and conditions among people with gambling disorder is higher compared with the general population, apart from cancer. [ABSTRACT FROM AUTHOR]

Co-occurrence between gambling disorder (GD) and other mental disorders is common, but its association with problematic pornography use (PPU) remains unexplored. This study aimed to investigate relationships between sociodemographic variables, personality measures, psychopathology, emotional regulation, and impulsivity and the co-occurrence of GD and PPU using structural equation modeling (SEM). The sample consisted of 359 adults seeking treatment for GD. The short version of the Problematic Pornography Consumption Scale (PPCS-6) identified patients with GD + PPU. Psychopathology, impulsivity, emotional regulation, and personality were also assessed. Higher impulsivity levels statistically predicted co-occurrence between GD and PPU. Impulsivity mediated the relationship between younger age, maladaptive personality features, and emotional dysregulation and co-occurrence. Psychopathological distress did not directly associate with GD + PPU co-occurrence. Impulsivity relates importantly to the co-occurrence of GD and PPU. Younger age, maladaptive personality, and emotional dysregulation contribute to increased impulsivity levels and co-occurrence. The findings highlight the importance of addressing impulsivity in understanding and treating co-occurring GD and PPU. • The sample consisted of 359 adults seeking treatment for GD. • Impulsivity relates importantly to the co-occurrence of GD and PPU. • Psychopathological distress did not directly associate with GD + PPU co-occurrence. [ABSTRACT FROM AUTHOR]

Problem gambling (PG) represents a significant public health concern with widespread effects in various cultures and regions globally, with younger individuals and males at a particularly higher risk. This disparity is attributed to a mix of cultural, developmental, and biological influences. To date, there has not been a comprehensive examination to determine whether this risk pattern holds consistently across different jurisdictions. We performed a systematic review and meta-analysis using the PRISMA framework, identifying 21 eligible studies from 18 countries, encompassing 156,249 participants (47.6% male and 52.4% female). The studies varied considerably by region (Asia: 19%, Europe: 52%, Oceania: 19%, North America: 10%), the diagnostic criteria for PG, and participation rates in gambling (ranging from 12% to 92%). Data on PG prevalence was categorised by gender and three age groups (young: 18–35, middle: 30–55, and older: 45–65). Using a random-effects meta-analysis, we found a global PG prevalence of 1.9%. Europe reported a significantly lower prevalence (1.3%) compared to North America (5.3%). Men were found to be 3.4 times more likely than women to engage in problem gambling, although the gap narrows in North America. The young demographic showed a 1.51 times higher likelihood of reporting PG compared to the middle-aged group, whereas older adults were 0.80 times less likely to report PG. Notably, age-related effects varied significantly across regions. Our findings confirm that age and gender significantly influence PG risk across cultures, with significant heterogeneity observed across jurisdictions. [ABSTRACT FROM AUTHOR]

Background: This study examined the association between Adverse Childhood Experiences (ACEs) and Gambling Severity (gambling severity), considering the mediating roles of internalizing, externalizing, and attention among youth online gamblers. Methods: 762 youth (agemean±SD= 15.03 ± 2.40; agerange = 10–18 years; 75.3% boys) completed the Persian Gambling Disorder Screening Questionnaire (GDSQ-P), Pediatric Symptom Checklist - Youth Report (Y-PSC), and Behavioral Risk Factor Surveillance System Questionnaire (ACE's section, modified by authors). The analysis was done using the SMART PLS software. Results: The reliability and discriminant validity of the provided model were assessed using Partial Least Squares-Structural Equation Modeling (PLS-SEM). According to the results of the PLS-SEM analysis, the present model demonstrated suitable levels of reliability and validity. Adverse Childhood Experiences (ACEs) significantly affected attention, internalizing, externalizing problems, and gambling severity. Additionally, the level of gambling was directly correlated with ACEs. Moreover, the indirect influence of the independent variable on the dependent variable via the mediators was found to be statistically significant (P <.001).These findings suggest that externalizing behaviors, attention problems, and internalizing symptoms mediate the effect of ACEs on gambling severity. Lastly, fitness indices indicated that our proposed model fit the data well (SRMR = 0.06, d_ULS = 1.15, Chi-square = 1291.461, and NFI = 0.71). Conclusion: Our study found that ACEs significantly influence gambling severity among youth online gamblers, with internalizing, externalizing, and attention problems mediating this relationship. Practical implications include integrating ACE screening and targeted interventions for associated mental health issues into youth gambling prevention programs to mitigate the risk of problematic gambling behavior. [ABSTRACT FROM AUTHOR]

The main purpose of this study was to evaluate the feasibility of an online psychological intervention for individuals with gambling-related problems, supported by ecological momentary assessments and interventions (EMAs and EMIs), along with weekly phone-calls, before conducting a randomized controlled trial. Participants were required to complete 3 of the 8 modules of the program based on cognitive-behavioral therapy (CBT) and extensions and innovations of CBT. The study measured the outcomes of feasibility (i.e., reach, appropriateness, technology literacy and technology usability, fidelity, and adherence). In terms of reach, 19.8% (n = 11) of the initial population met the inclusion criteria and completed the three modules (mean age = 41; 90.9% men). The perceived appropriateness and the technology usability after the first use were both excellent, fidelity and adherence to the online treatment (73.3%) were adequate. Adherence to the EMAs and the weekly phone calls were more modest (54.51% and 66.67%, respectively). The results of the present study show that an online treatment for gambling problems enhanced by EMA and EMI might be feasible but challenges were noted in terms of reach and adherence to these assessments and calls. These challenges are important to consider for future trials and the scalability of treatments for individuals with gambling disorders. [ABSTRACT FROM AUTHOR]

Desire thinking, within the metacognitive model of addictive behaviors, is conceptualized as a transdiagnostic process linked to the escalation and maintenance of craving for various addictive disorders; however, its application to the understanding of gambling and the Chinese community remains at an early stage. The present study aimed to introduce desire thinking into gambling research in the Chinese context by: (1) testing the applicability of its two-factor conceptualization and assessment tool, the Desire Thinking Questionnaire (DTQ), and (2) exploring its association with dysregulated and regulated engagements in gambling (i.e., Gambling Disorder [GD] and responsible gambling [RG], respectively). We conducted a telephone survey in Macao, China, and obtained a probability sample of 837 Chinese adult past-year gamblers (48.5% men; age: M = 41.11, SD = 14.31) with a two-stage cluster random sampling method. Our data indicated the psychometric adequacy of the two-factor DTQ (i.e., verbal perseveration and imaginal prefiguration) for measuring Chinese gamblers' desire thinking about gambling. After controlling for craving and demographics, desire thinking contributed to an additional 12.1% and 18.9% variance explained in GD tendency and RG behaviors, respectively. This study provides the first empirical evidence of the utility of desire thinking and the DTQ in facilitating gambling research on Chinese gamblers. Our findings also suggest the value of incorporating desire thinking in detecting and treating GD and in promoting RG. [ABSTRACT FROM AUTHOR]

The Gambling Craving Scale (GACS) is a multifaceted measure of gambling craving. Initial validation work by Young and Wohl (2009) in university student samples showed that the GACS had a three-factor structure capturing dimensions of Desire, Anticipation, and Relief. Despite its potential clinical utility as a measure of craving, the GACS has yet to be validated in people seeking treatment for gambling problems. Accordingly, we examined the psychometric properties in a sample of people (N = 209; Mage = 37.66; 62.2% female) participating in a randomized controlled trial testing a novel online treatment for problem gambling. We predicted the GACS would have a three-factor structure. In addition, we also examined measurement invariance across sex and problem gambling risk status. Finally, we assessed concurrent validity of the factors with other measures of problem gambling severity and involvement. Exploratory structural equation modeling findings supported a three-factor structure that was invariant across the groups tested. Each of the Desire, Anticipation, and Relief subscales were significant positive predictors of problem gambling severity and symptoms, and some form of gambling behaviour. Findings show the GACS is a promising scale to assess multidimensional craving experiences among people in treatment for gambling problems. [ABSTRACT FROM AUTHOR]

Analyzing why being a victim of violence has led women to have problems with gambling is a field yet to be explored. Thus, the objectives of the present study were (I) analyze the relationship between gambling motives, received psychological violence, and early maladaptive schemas in women; (II) study differences in the study variables in women with and without gambling disorder (GD); (III) analyze the predictive role of violence and schemas in gambling motives; and (IV) analyze the mediating role of schemas in the relationship between violence and gambling motives. The sample comprised 61 women with GD (M = 48.43, SD = 12.78) and 342 women without GD (M = 26.91, SD = 11.47). The results of the present study revealed positive correlations between gambling motives, psychological violence received and early maladaptive schemas. In addition, women with GD scored higher on the study variables. It was also found that early maladaptive schemas based on subjugation and defectiveness may be a vulnerability factor for engaging in gambling to cope with the negative emotions produced by gender violence. From a clinical perspective, knowing the risk factors related to gambling motives in women is crucial to developing effective prevention and intervention programs. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

The co-occurrence between gambling disorder (GD) and problematic pornography use (PPU) has not yet been explored. Therefore, the present study compared (a) sociodemographic variables, (b) GD-related factors, (c) substance use, (d) psychopathology, (e) personality features, (f) impulsivity, and (g) emotion regulation between individuals with GD (GD group) and those with co-occurring GD and PPU (GD+PPU group). The sample consisted of 359 treatment-seeking individuals with GD: n = 332 individuals had GD only (GD group) and n = 37 individuals had GD and co-occurring PPU (GD+PPU group). GD severity, impulsivity, psychopathology, personality, emotion regulation, and other sociodemographic and clinical variables were assessed. No between-group differences in sociodemographic measures were observed. The GD+PPU group demonstrated greater GD severity and a higher likelihood of substance use compared to those without PPU. Furthermore, the presence of PPU was associated with worse psychopathology, higher impulsivity (except for lack of premeditation and positive urgency), more difficulties in emotion regulation (except for non-acceptance of emotions and limited access to emotions), and a personality profile characterized by lower levels of self-directedness and cooperativeness. The co-occurrence of GD and PPU seems associated with a more dysfunctional clinical profile. [ABSTRACT FROM AUTHOR]

Aims: To investigate the potential association between gambling disorder and symptoms of sleep problems (including insomnia and excessive daytime sleepiness). It was hypothesised that, compared to controls, individuals with gambling disorder would have significantly greater disturbance of sleep, as indicated by increased scores in: (1) sleep items on the Hamilton Anxiety Rating Scale (HAM-A) and Hamilton Rating Scale for Depression (HAM-D); (2) total score on the HAM-A and HAM-D; and (3) the Epworth Sleepiness Scale (ESS). Methods: Secondary analysis of previously published data from 152 young adults, aged 18–29 years. Individuals were stratified into three groups: controls, those at risk of gambling disorder, and those with gambling disorder. One-way ANOVAs with post-hoc tests were conducted to determine whether groups differed significantly in sleep item scores and total scores of the HAM-A and HAM-D, and the ESS. Results: HAM-D scale insomnia item scores were significantly higher in the disorder group, when compared to controls, this being particularly marked for middle and late insomnia. The HAM-A item score indicated significantly worse sleep quality in the disorder group, compared to at risk and control groups. Total HAM-A and HAM-D scores were significantly higher in the disorder group, but ESS scores did not differ significantly. Conclusion: Measures of disruptions in sleep were significantly higher in gambling disorder than controls. Anxiety and depressive symptom severity was also significantly higher in the gambling disorder group. Further research could have implications for identification and treatment of sleep disorders and psychiatric comorbidities in gambling disorder. [ABSTRACT FROM AUTHOR]

Gambling disorder is a severe condition that significantly compromises the lives of those affected. In light of this clinical relevance, the literature on the antecedents of this form of addiction is constant and continually evolving. Consistently with this framework, the present research aimed at investigating the role of some risk factors in gambling disorder, with a specific focus on alexithymia, dissociation, and locus of control. The research involved a sample of 290 participants (183 males and 107 females; Mage = 34.43, SD = 14.65) who practice gambling at least occasionally. They completed an online survey including the South Oaks Gambling Screen, Twenty-Items Toronto Alexithymia Scale, Dissociative Experience Scale‐II, and Locus of Control of Behavior. ANOVA and a moderated-mediation model were implemented to analyse the collected data. Results showed that 19.0% of the participants were At Risk and Problem Gamblers, while 27.6% fell into the category of Problematic Gamblers. Problematic Gamblers showed significantly higher levels of alexithymia, dissociation, and external locus of control. Moreover, a significant association between alexithymia and the severity of problematic gambling behaviour was found and was significantly mediated by absorption (a dissociation feature). Furthermore, the external locus of control significantly moderated this indirect effect. The role of gender as a covariate was also investigated. Such findings may offer further insights into the field of clinical research on gambling disorder and may provide useful information for effective clinical practice. [ABSTRACT FROM AUTHOR]

The role of dopamine in the pathophysiology of gambling disorder (GD) remains incompletely understood, with disparate research findings concerning presynaptic and postsynaptic structures and dopaminergic synthesis. The aim of this study was to investigate potential correlations between striatal dopamine transporter (DAT) lateralization and asymmetry index, as assessed by 123I-FP-CIT SPECT, and temperamental traits, as measured by Cloninger's Temperament and Character Inventory (TCI), in GD subjects. Significant associations were found between DAT binding asymmetries in the caudate and putamen and the temperamental dimensions of harm avoidance and novelty seeking. Specifically, high novelty seeking scores correlated with increased DAT binding in the left caudate relative to the right, whereas higher harm avoidance scores corresponded to increased DAT binding in the right putamen relative to the left. These observations potentially imply that the asymmetry in DAT expression in the basal ganglia could be an outcome of hemispheric asymmetry in emotional processing and behavioural guidance. In summary, our study provides evidence supporting the relationship between DAT asymmetries, temperamental dimensions and GD. Future investigations could be directed towards examining postsynaptic receptors to gain a more comprehensive understanding of dopamine's influence within the basal ganglia circuit in disordered gambling. If confirmed in larger cohorts, these findings could have substantial implications for the tailoring of individualized neuromodulation therapies in the treatment of behavioural addictions. [ABSTRACT FROM AUTHOR]

Objective: Although gender-specific evidence on Gambling Disorder (GD) is still limited, some studies reported specific differences, mainly in psychopathological profiles, gambling behavior patterns, and pathogenesis. In order to further examine the role of gender in GD, we conducted a multicenter investigation in a sample of Italian outpatients. Method: One hundred-four outpatients with a diagnosis of GD based on DSM-5 criteria were consecutively recruited at two clinics based in Milan. Socio-demographic and clinical variables were collected for the whole sample and analyzed for the effect of gender. The severity of illness was assessed using the Canadian Problem Gambling Index and the Gambling Attitudes and Beliefs (GABS). Results: Among females, a significantly higher mean age (52.23 ± 10.95 vs. 40.96 ± 15.76; p=0.005) and older age at illness onset emerged (43.5 ± 11.92 vs. 29.22 ± 14.26; p<0.001). Females showed a significantly higher rate of psychiatric comorbidities, lifetime suicide ideation, stressful events at GD onset, and positive family history for GD compared to males. A predictive effect of male gender was found for the GABS questionnaires by performing a linear regression model, with males showing a higher risk to reach higher scores compared to females (B= 11.833; t=2.177; p=0.034). Conclusions: Our study seems to confirm the hypotheses that gender in GD may influence psychopathological profiles, course, and comorbidity. GD in female gender is frequently a comorbid condition with other specific clinical characteristics compared to males. Identifying specific clinical factors by gender may prompt more focus on the public health of women in relation to gambling, while still recognizing that males are at-risk of earlier gambling problems. These findings should be considered in therapeutic perspectives. [ABSTRACT FROM AUTHOR]

Being the only city with legalized casinos in China, Macao has a long-term need for risk factor identification and assessment for gambling disorder. Responding to such a need, this study aimed to validate a translated Chinese version of the Metacognitions about Gambling Questionnaire (MGQ) among Chinese gamblers and apply such a tool to enhance the understanding of gambling disorder tendency and responsible gambling behavior from a metacognitive perspective. We obtained a probability sample of 604 lifetime adult gamblers in Macao, China, through a telephone survey, of which the data of 480 past-year gamblers (Mage = 41.81, SD = 14.73; 45.6% women) was used for data analyses. As its original version, the translated Chinese version of MGQ displayed the two-factor structure (i.e., positive and negative metacognitions regarding gambling) with satisfactory model fit (χ2 (32) = 67.69, CFI =.94, RMSEA =.07, SRMR =.05). Both these two factors had satisfactory reliability (α =.74 and.73) and validity (positive correlation with gambling disorder tendency and negative correlation with responsible gambling behavior). In addition, these metacognitions significantly accounted for the variances of gambling disorder tendency (i.e., positively correlated) and responsible gambling behavior (i.e., negatively correlated) after ruling out demographic and other confounding risk effects. In comparison, negative metacognitions cast a more salient impact than positive metacognitions on gambling disorder tendency and responsible gambling behavior. MGQ can provide a reliable and valid assessment of Chinese gamblers' metacognitions about gambling; it also displays a promising potential in delineating the underlying mechanism of gambling disorder tendency and responsible gambling behavior. [ABSTRACT FROM AUTHOR]

Few studies have analyzed the clinical profile of treatment-seeking patients with the comorbid presence of schizophrenia (SCZ) and gambling disorder (GD), which warrants new research to assess the network structure of this complex mental condition. The aim of this study was to explore the organization of the symptoms and other clinical correlates of SCZ with GD. Network analysis was applied to a sample of N = 179 SCZ patients (age range: 19–70 years, mean=39.5, SD=9.9) who met clinical criteria for gambling disorder-related problems. Variables included in the network were the core GD symptoms according to the DSM-5, psychotic and paranoid ideation levels, global psychological distress, GD severity measures (debts and illegal behavior related with gambling), substances (tobacco, alcohol, and illegal drugs), and personality profile. The nodes with the highest authority in the network (variables of highest relevance) were personality traits and psychological distress. Four empirical modules/clusters were identified, and linkage analysis identified the nodes with the highest closeness (bridge nodes) to be novelty seeking and reward dependence (these traits facilitate the transition between the modules). Identification of the variables with the highest centrality/linkage can be particularly useful for developing precise management plans to prevent and treat SCZ with GD. [ABSTRACT FROM AUTHOR]

Gambling disorder is a problem that is affecting increasingly more people. It is associated with difficulties in emotion regulation, gambling motives, blame, and shame. This study aims to study the relationship between gambling severity, blame, and shame, independently and together with emotion regulation and gambling motives; to analyse the mediating role of emotion regulation in the relationship between gambling severity and shame; and to compare mean differences in the study variables according to the sample group. For this purpose, a clinical and non-clinical sample of 158 individuals (119 males and 39 females) ranging in age from 12 to 30 years (M = 19.70, SD = 5.35) was divided into three groups. The questionnaires were administered online and on paper. The results showed that blame and shame are related to the severity of gambling. In the case of shame, this relationship was found to be partially mediated by the emotion regulation strategy of self-blame. Gambling severity, blame and shame were also found to be related to various gambling motives and different emotion regulation strategies. All this information can be of great use in the prevention and treatment of gambling problems. [ABSTRACT FROM AUTHOR]

Impulsivity-characterized executive function impairments have been hypothesized to represent mechanisms underlying the symptomology associated with gambling disorder (GD). Despite this, a clear profile of executive function within GD has yet to be established. Furthermore, it remains unclear whether executive function deficits represent a vulnerability marker for the disorder. This study assessed executive function performance within a GD sample compared to a sample of familial relatives and community controls. Using a family study methodology, a broad assessment of executive function was administered to analyze performance differences and their potential characterization by impulsivity between a sample of individuals meeting criteria for GD, their first-degree familial relatives, and a community control sample. Performance differences emerged regarding the capacity to delay gratification and inhibit automatic task-irrelevant responses between the GD and control samples. Results support the presence of impulsive choice and impulsive cognitive bias as components of the GD executive functioning profile. Similar difficulties inhibiting automatic attentional shifting were observed within the first-degree relative sample. Executive functioning within GD appears to be characterized by an impulsive pattern of behaviours/decisions but impacts processes differently. Evidence suggests that individuals diagnosed with GD demonstrate a statistically different capacity to delay gratification (e.g. a propensity towards smaller, more immediate rewards as opposed to larger delayed rewards) and inhibit cognitive biases (e.g. difficulty shifting attention away from task-irrelevant stimuli). This latter difference may represent a vulnerability marker of GD as preliminary evidence was provided for similar difficulties in a first-degree relative sample. Further research must replicate these findings and assess the impact of task modality, symptom severity, and comorbidity on the observation of executive functioning impairment. [ABSTRACT FROM AUTHOR]

Making sense of the social world is an intricate process heavily influenced by cultural elements. Gambling is a prevalent leisure-time activity characterized by risk-taking conduct. While some individuals who engage in it do so without experiencing any harm, others will develop gambling problems. Judaism tends to perceive gambling negatively since it contradicts fundamental Jewish principles. The current study focuses on the Jewish Ultra-Orthodox community in Israel which is characterized as a cultural enclave with minimal interaction with the secular world. Hence, it provides a unique and novel socio-cultural context to inquire how individuals with gambling disorder (GD) from this community make sense of gambling. Following constructivist grounded theory guidelines, 22 Ultra-Orthodox men with GD were interviewed using a purposeful sampling design. Sixteen Rabbis were also interviewed, illuminating the socio-cultural context of Halachic regulations and norms regarding gambling in this community. An abductive analysis of the data, interwoven with Bourdieu's concept of habitus, yielded an overarching theme that we dub as "sense for gambling," encompassing matrices of Ultra-Orthodox external (e.g., a conservative cultural structure with numerous prohibitions and life marked by poverty) and internal (e.g., feelings of loneliness, dissatisfaction, and deviance) dispositions imprinted onto the body, creating diverse embodied reactions (emotional and sensory) to gambling, and leading to developing GD. We recommend placing the body, as the locus of internalized dispositions, at the core of examination when researching pathways to GD. We propose that this intricate interplay between external and internal dispositions shapes the decision-making regarding gambling, thus mitigating individual responsibility for GD. [ABSTRACT FROM AUTHOR]

FreeLudo is an innovative project targeting the primary prevention of DSM-5 Gambling Disorder (GD), addressing children aged between 6 and 8 years attending Primary School. An innovative platform has been developed, which enables hybrid online and offline interaction and provides children with questionnaires aimed at better understanding the potential risk factors for the development of GD. Online interaction consists in providing questionnaires through a simple platform video game; after the video game, the platform also proposes social interaction among children by assigning them social challenges and activities. While providing an interactive user awareness on the risk of Gambling Disorders, the platform allows data collection on potential risk behavior. The paper summarizes the preliminary results of the platform’s first testing phase, conducted on a heterogeneous sample of children aged 6 to 8 years, attending a primary school in the province of Taranto (Apulia, Italy). [ABSTRACT FROM AUTHOR]

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. 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. 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). 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. 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. [ABSTRACT FROM AUTHOR]

Whilst opportunities to participate in gambling have increased, access to support for problem gamblers is lacking behind. This lack of balance calls for improved and accessible intervention methods. The present double-blind randomized controlled trial (RCT) explored the effectiveness of two interventions targeting automatic cognitive processes, known as Attentional Bias Modification (AtBM) and Approach Bias Modification (ApBM). It was hypothesized these interventions would reduce gambling behavior and reduce or reverse targeted biases. Participants (N = 331) were community-recruited Flemish (35%) and Dutch (65%) adult problem gamblers motivated to reduce or stop their gambling who received either six sessions of active training (AtBM or ApBM) or of the corresponding sham-training (sham-AtBM or sham-ApBM). Due to high attrition rates (90.1% up to the intervention phase) the study was terminated before completion, since it would greatly limit the validity of any results. A post hoc qualitative study was performed on a subset of participants to gain insight into contributing factors for the high attrition rate. Issues negatively impacting participants' motivation to complete the program were identified, as well as elements of the program that received approval. The results from this study provide a first insight into the potential of the use of online cognitive bias modification (CBM) interventions in problem gambling (PG). Suggestions and directions for future studies are discussed. [ABSTRACT FROM AUTHOR]

A large body of previous research has provided support for the role of attentional bias as a maintaining factor in addiction. This systematic review aimed to investigate the extent and nature of attentional bias as a phenomenon which exists within problem gamblers. Studies were identified through searches of three databases (MedLine, PSYCHINFO, and Web of Science) and examination of the reference lists of the final studies meeting criteria for inclusion. The scope of the review included empirical studies making experimental comparisons of problem gamblers and non-problem gamblers across a range of attentional paradigms. A comparison of effect sizes was conducted across studies comparing problem to non-problem gamblers within and between attention paradigms. Twenty-two studies were reviewed systematically across ten experimental paradigms. Attentional bias was demonstrated in 16 of the 22 studies, with attentional bias effects varying across paradigms. Quality assessment revealed two main limitations across studies: lack of a priori power analysis, and failure to control for gambling frequency as a possible confounding variable. Findings support the role of attentional bias as a potential maintaining factor in problem gambling behaviour, in line with evidence for substance addiction. Recommendations for future studies are outlined alongside a discussion of clinical implications. [ABSTRACT FROM AUTHOR]

AbstractBackgroundMethodResultsConclusionsThe Problem Gambling Severity Index (PGSI) is a widely used assessment of disordered gambling. However, it has been claimed that instead of measuring a single factor of problem gambling severity, the PGSI measures two correlated factors of behavioral dependence and harms/consequences. The existing literature using exploratory and confirmatory factor analysis has notable limitations that mean these accounts cannot be discriminated.Secondary data from 13 nationally representative surveys of gamblers in the UK (n = 42,422) between 2007 and 2023 were used to examine five different approaches to specifying one- and two-factor models of the PGSI.Overall, the findings supported a single construct account. Fit indices provided slight support for a two-factor model. However, the composition and loadings of these factors did not replicate in the disaggregated datasets and demonstrated poor model-based reliability. The best-fitting model was a bifactor ESEM model with a general gambling severity factor and a group-specific factor subsuming additional covariance between the first three or four items.This study provides support for a unitary gambling severity construct and the use of total PGSI scores. The second factor observed elsewhere appears to consist of residual covariances between the first 3-4 PGSI items or a methods factor that can be explained by item framing (e.g. items that ask about gambling behavior). [ABSTRACT FROM AUTHOR]

Background: This longitudinal register study aimed to investigate the association between gambling disorder (GD) and work disability and to map work disability in subgroups of individuals with GD, three years before and three years after diagnosis. Methods: We included individuals aged 19–62 with GD between 2005 and 2018 (n = 2830; 71.1% men, mean age: 35.1) and a matched comparison cohort (n = 28 300). Work disability was operationalized as the aggregated net days of sickness absence and disability pension. Generalized estimating equation models were used to calculate adjusted odds ratios (AORs) and 95% confidence intervals (CIs) for the risk of long-term work disability (>90 days of work disability/year). Secondly, we conducted Group-based Trajectory Models on days of work disability. Results: Individuals with GD showed a four-year increased risk of long-term work disability compared to the matched cohort, peaking at the time of diagnosis (AOR = 1.89; CI 1.67–2.13). Four trajectory groups of work disability days were identified: constant low (60.3%, 5.6–11.2 days), low and increasing (11.4%, 11.8–152.5 days), medium–high and decreasing (11.1%, 65.1–110 days), and constant high (17.1%, 264–331 days). Individuals who were females, older, with prior psychiatric diagnosis, and had been dispensed a psychotropic medication, particularly antidepressants, were more likely to be assigned to groups other than the constant low. Conclusion: Individuals with GD have an increased risk of work disability which may add financial and social pressure and is an additional incentive for earlier detection and prevention of GD. [ABSTRACT FROM AUTHOR]

Background: In 1990, the United States' Institute of Medicine promoted the principles of outcomes monitoring in the alcohol and other drugs treatment field to improve the evidence synthesis and quality of research. While various national outcome measures have been developed and employed, no global consensus on standard measurement has been agreed for addiction. It is thus timely to build an international consensus. Convened by the International Consortium for Health Outcomes Measurement (ICHOM), an international, multi-disciplinary working group reviewed the existing literature and reached consensus for a globally applicable minimum set of outcome measures for people who seek treatment for addiction. Methods: To this end, 26 addiction experts from 11 countries and 5 continents, including people with lived experience (n = 5; 19%), convened over 16 months (December 2018–March 2020) to develop recommendations for a minimum set of outcome measures. A structured, consensus-building, modified Delphi process was employed. Evidence-based proposals for the minimum set of measures were generated and discussed across eight videoconferences and in a subsequent structured online consultation. The resulting set was reviewed by 123 professionals and 34 people with lived experience internationally. Results: The final consensus-based recommendation includes alcohol, substance, and tobacco use disorders, as well as gambling and gaming disorders in people aged 12 years and older. Recommended outcome domains are frequency and quantity of addictive disorders, symptom burden, health-related quality of life, global functioning, psychosocial functioning, and overall physical and mental health and wellbeing. Standard case-mix (moderator) variables and measurement time points are also recommended. Conclusions: Use of consistent and meaningful outcome measurement facilitates carer–patient relations, shared decision-making, service improvement, benchmarking, and evidence synthesis for the evaluation of addiction treatment services and the dissemination of best practices. The consensus set of recommended outcomes is freely available for adoption in healthcare settings globally. [ABSTRACT FROM AUTHOR]

Introduction: New knowledge was projected into the ICD-11 classification in clinical manifestation of mental disorder associated with gambling. The independent diagnostic category of gambling disorder according to ICD-11 should not be assessed, contrary to pathological gambling in ICD-10, if the onset of impaired control over gambling behaviour is corresponding to use of the methamphetamines. The aim of the study: To detect the prevalence of gambling/pathological gambling according to ICD-10 classification among methamphetamine users with dependence in treatment, and with selected micro case-illustrations indicate the necessity to revise the diagnosis by the implementation of new ICD-11criteria. Patients and methods: It was retrospective, descriptive, clinical study of the medical records of 178 patients treated for methamphetamine dependence with the addition of three selected micro case-illustrations, which provided the opportunity to present different diagnostic assessment according to ICD-11 and its patognomic significance. results: Gambling behaviour was detected in 30% of the patients treated for dependence on methamphetamines, in the same time 18% had the the diagnosis of pathological gambling according to ICD-10. The new diagnostic approach according to ICD-11 was documented with use of qualitative method by three micro case-illustrations. Discussion and conclusion: The findings of the study have shown the high prevalence of the impaired control over gambling behaviour among the patients in treatment due to dependence on methamphetamines, which in large part of them, had the neurobiological base due to the direct effects of dopamine on the CNS, so as it is sometimes in the treatment of Parkinson disease by dopamine agonists. According to ICD-11 it is not an independent diagnostic category, but it is only behavioural sign induced by psychoactive substance. Finally, the authors are discussing the consequences of the change in diagnostic assessment and the number of inevitable changes in the clinical practice after the adoption of ICD-11. [ABSTRACT FROM AUTHOR]

Background and aims: The ICD-11 chapter on mental, behavioral and neurodevelopmental disorders contains new controversial diagnoses including compulsive sexual behavior disorder (CSBD), intermittent explosive disorder (IED) and gaming disorder. Using a vignette-based methodology, this field study examined the ability of mental health professionals (MHPs) to apply the new ICD-11 diagnostic requirements for impulse control disorders, which include CSBD and IED, and disorders due to addictive behaviors, which include gaming disorder, compared to the previous ICD-10 guidelines. Methods: Across eleven comparisons, members of the WHO's Global Clinical Practice Network (N 5 1,090) evaluated standardized case descriptions that were designed to test key differences between the diagnostic guidelines of ICD-11 and ICD-10. Results: The ICD- 11 outperformed the ICD-10 in the accuracy of diagnosing impulse control disorders and behavioral addictions in most comparisons, while the ICD-10 was not superior in any. The superiority of the ICD-11 was particularly clear where new diagnoses had been added to the classification system or major revisions had been made. However, the ICD-11 outperformed the ICD-10 only in a minority of comparisons in which mental health professionals were asked to evaluate cases with non-pathological high involvement in rewarding behaviors. Discussion and Conclusions: Overall, the present study indicates that the ICD-11 diagnostic requirements represent an improvement over the ICD-10 guidelines. However, additional efforts, such as training programs for MHPs and possible refinements of diagnostic guidance, are needed to avoid over-diagnosis of people who are highly engaged in a repetitive and rewarding behavior but below the threshold for a disorder. [ABSTRACT FROM AUTHOR]

Background and aims: Decisions and learning processes are under metacognitive control, where confidence in one's actions guides future behaviour. Indeed, studies have shown that being more confident results in less action updating and learning, and vice versa. This coupling between action and confidence can be disrupted, as has been found in individuals with high compulsivity symptoms. Patients with Gambling Disorder (GD) have been shown to exhibit both higher confidence and deficits in learning. Methods: In this study, we tested the hypotheses that patients with GD display increased confidence, reduced action updating and lower learning rates. Additionally, we investigated whether the action-confidence coupling was distorted in patients with GD. To address this, 27 patients with GD and 30 control participants performed a predictive inference task designed to assess action and confidence dynamics during learning under volatility. Action-updating, confidence and their coupling were assessed and computational modeling estimated parameters for learning rates, error sensitivity, and sensitivity to environmental changes. Results: Contrary to our expectations, results revealed no significant group differences in action updating or confidence levels. Nevertheless, GD patients exhibited a weakened coupling between confidence and action, as well as lower learning rates. Discussion and conclusions: This suggests that patients with GD may underutilize confidence when steering future behavioral choices. Ultimately, these findings point to a disruption of metacognitive control in GD, without a general overconfidence bias in neutral, non-incentivized volatile learning contexts. [ABSTRACT FROM AUTHOR]

Background and aims: Smartphone, computer and land-based betting platforms each have distinctive features. This study examined 1) preferred features of sports betting platforms amongst young adults and 2) whether feature preferences vary with gambling severity. Methods: The study surveyed 616 Australians aged 18-29 years who bet at-least monthly on sports, esports and/or daily fantasy sports. Participants provided a simple rating of the importance of 24 features of betting platforms and then completed a discrete choice experiment to indicate their preferences amongst different groups of features. Results: Smartphones were the only platform providing all preferred features. The most important feature was ability to bet instantly 24/7 from any location, followed by electronic financial transactions. Less important features were ability to access betting information online and to bet with multiple operators. Social and privacy features, and access to promotions, did not significantly predict platform choice. The experiment found no significant differences in preferred features by gambling severity group or by gender. The non-experimental descriptive data, however, indicated that participants in the moderate risk/problem gambling categories placed significantly more importance on privacy, ability to place in-play bets, bet with cash, bet with a credit card, see frequent promotions, and bet with multiple operators. Discussion and conclusions: Most features that bettors prefer can intensify betting. Curtailment of betting promotions, in-play betting, and credit card betting are measures that can assist higher-risk gamblers without unduly affecting other gamblers. Consumer protection tools, including mandatory pre-commitment, need strengthening to help counter the unique risks of smartphone betting. [ABSTRACT FROM AUTHOR]

Background and aims: COVID-19 lockdowns limited access to gambling but simultaneously elevated psychosocial stressors. This study assessed the relative effects of these changes on gambling risk status during and after the Australian COVID-19 lockdown from late-March to late-May 2020. Methods: The study administered three surveys to people who had gambled within the past year at T1. Wave 1 asked about before (T1, N 5 2,125) and during lockdown (T2, N 5 2,125). Subsequent surveys focused on one year (T3; N 5 649) and two years after lockdown (T4, N 5 458). The dependent variable was changes in reporting any problem gambling symptoms (PGSI 0 vs 1+). Bivariate analyses and multinomial logistic regression tested for significant associations with: demographics, psychosocial stressors (perceived stress, psychological distress, loneliness, health anxiety about COVID, financial hardship, stressful life events), gambling participation and gambling frequency. Results: Gambling participation and at-risk gambling decreased between T1 and T2, increased at T3, with little further change at T4. When gambling availability was curtailed, decreased gambling frequency on EGMs, casino games, sports betting or race betting, and lower psychosocial stress, were associated with transitions from at-risk to non-problem gambling. When gambling availability resumed, increased EGM gambling frequency, decreased online gambling frequency, and higher psychosocial stress were associated with transitions from non-problem to at-risk gambling. Discussion and conclusions: Gambling availability appears a stronger influence on gambling problems, at the population level, than psychosocial risk factors. Reducing the supply of high-risk gambling products, particularly EGMs, is likely to reduce gambling harm. [ABSTRACT FROM AUTHOR]

Gambling disorder is a severe mental health and behavioural problem with harmful consequences, including financial, relationship and mental health problems. The present paper initiates discussion on the use of psychedelics combined with psychotherapeutic support as a potential treatment option for people living with a gambling disorder. Recent studies have shown promising results using psychedelic-assisted therapy (PAT) to treat anxiety, depression, post-traumatic stress disorder, and various substance use disorders. Considering the similarities in the underlying psychosocial and neurobiological mechanisms of gambling disorder and other addictive disorders, the authors suggest that psychedelic-assisted therapy could be effective in treating gambling disorder. The paper also underscores the need for further research into the viability and effectiveness of psychedelic-assisted therapy for gambling disorder. [ABSTRACT FROM AUTHOR]

This study focused on mothers and childless women in recovery from a gambling disorder (GD) in the context of risk society. Mothers with GD suffer from dual social stigma as gamblers and as women who put their children at risk. Mothers in "risk society" tend to recognize that their choices can affect their children's future. The recovery capital (RC) toolkit comprises internal and external resources and barriers enacted in recovery. This longitudinal study: (a) compared the RC toolkits of mothers versus childless women and their effects on these women's dropout and relapse rates; (b) explored the resources and barriers that predict dropout and relapse in each group. Analysis of the clinical data of 211 women with GD (N = 146 mothers) who received cognitive behavioral therapy for 16 weeks in Spain indicated that mothers reported lower levels of education and were from more disadvantaged socioeconomic groups, were older, and developed gambling-related problems in older age. Mothers had significantly lower relapse rates but not lower dropout rates. There were more personal predictors of dropout among childless women, whereas low levels of family support and the absence of gambling debts predicted dropout in the mothers' group. These findings were interpreted by combining the concepts of risk society and recovery capital in action, highlight the differences between resources and barriers in the RC toolkits used by mothers versus childless women and their interplay with the sociocultural contexts of risk society and childfree lifestyles. Therapists and policymakers should consider these differences during recovery. Public Policy Relevance Statement: Women with gambling disorders cope with multiple challenges during their recovery, especially if they are also mothers. This study compared and examined mothers' versus childless women's recovery capital toolkits and their effect on dropout and relapse rates. The differences between the two are interpreted by the interplay between these toolkits and the sociocultural contexts that mothers and childless women encounter in their daily lives. Policymakers and therapists should consider these contexts and the ways they may enhance or hinder women's recovery from gambling disorder. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Objective: This study protocol describes the RIGAB study, a prospective case‐control‐study assessing online sports betting behaviour and underlying risk factors for the development of gambling disorder (GD). It has two aims: (1) to characterise sports bettors concerning putative risk factors and their gambling behaviour, and (2) to predict the development of GD from these factors. Methods: At baseline, online sports bettors took part in an online survey comprising a GD screening (DSM‐5), questions on gambling behaviour and on the putative risk factors emotion regulation, impulsivity, comorbidities, stress, and substance use. Participants were reinvited for a 1‐year follow‐up online survey. In a nested design, a subsample was invited in‐person to take part in a cognitive‐behavioural task battery and a clinical interview. Results: Of the initial 6568 online sports bettors invited, 607 participated at baseline (rate: 9.2%), 325 took part in the 1‐year follow‐up and 54 participated in the nested in‐person assessment. Conclusion: The RIGAB study combines different fields of GD studies: player tracking data and putative risk factors from self‐report and behavioural tasks. The results of this study will support the development of preventive measures for participants of online gambling based on the combined findings from previously rather distinct research fields. [ABSTRACT FROM AUTHOR]

We investigated the demographics, gambling-related harms, and risk for gambling disorder (GD) associated with an illegal national lottery-type game called Jogo do Bicho that is culturally unique to Brazil in a sample of 5407 representative Brazilian lottery players. Participants reported on demographics, gambling behaviors, gambling-related harms, and GD. A total of 27.0% of the participants reported playing Jogo do Bicho in the past year. Jogo do Bicho was associated with greater risk of GD with 5.7% of current Jogo do Bicho players meeting diagnostic criteria. Jogo do Bicho was also associated with greater gambling-related harms. Older participants, males, individuals who self-identified as Black, and who were widowed were more likely to be current Jogo do Bicho players. Jogo do Bicho is a popular activity among legal lottery players in Brazil despite its illegal status and is associated with greater harms and increased risk of GD. [ABSTRACT FROM AUTHOR]

Background: Based on social cognitive theory, this study aimed to examine whether and how social abilities (i.e., cognitive empathy and emotional empathy) are associated with gambling disorder (GD) by incorporating attitudes toward general risk (i.e., risk aversion) and responsible gambling as potential mediators of this link. Methods: A convenience sample of 580 past-year lottery gamblers (Mage = 34.07, SD = 13.36; 50.4% female), recruited near lottery sales shops, completed an anonymous paper-version questionnaire on site. Data were collected using the DSM-5 diagnostic criteria for GD, Interpersonal Reactivity Index, Risk Aversion Scale, Positive Play Scale, and demographic items. Path analysis and mediation analysis were applied to examine the effects of cognitive empathy and emotional empathy on GD and the mediating roles of risk aversion and responsible gambling attitude. Results: Our results showed that cognitive empathy, but not emotional empathy, was significantly and negatively correlated with GD. Also, the effect of cognitive empathy on GD was fully mediated by risk aversion and responsible gambling attitude, whilst the total indirect effect of emotional empathy on GD was nonsignificant. As hypothesized, the indirect paths from both types of empathy to GD were significantly and serially mediated by risk aversion and responsible gambling attitude. Conclusion: Cognitive empathy, distinct from emotional empathy, was a statistically significant correlate of GD. Moreover, the path model results also suggest that responsible gambling attitude was a salient protective factors against GD. Future GD prevention efforts may benefit from paying more attention to the role of responsible gambling attitude. [ABSTRACT FROM AUTHOR]

Background: Based on social cognitive theory, this study aimed to examine whether and how social abilities (i.e., cognitive empathy and emotional empathy) are associated with gambling disorder (GD) by incorporating attitudes toward general risk (i.e., risk aversion) and responsible gambling as potential mediators of this link. Methods: A convenience sample of 580 past-year lottery gamblers (Mage = 34.07, SD = 13.36; 50.4% female), recruited near lottery sales shops, completed an anonymous paper-version questionnaire on site. Data were collected using the DSM-5 diagnostic criteria for GD, Interpersonal Reactivity Index, Risk Aversion Scale, Positive Play Scale, and demographic items. Path analysis and mediation analysis were applied to examine the effects of cognitive empathy and emotional empathy on GD and the mediating roles of risk aversion and responsible gambling attitude. Results: Our results showed that cognitive empathy, but not emotional empathy, was significantly and negatively correlated with GD. Also, the effect of cognitive empathy on GD was fully mediated by risk aversion and responsible gambling attitude, whilst the total indirect effect of emotional empathy on GD was nonsignificant. As hypothesized, the indirect paths from both types of empathy to GD were significantly and serially mediated by risk aversion and responsible gambling attitude. Conclusion: Cognitive empathy, distinct from emotional empathy, was a statistically significant correlate of GD. Moreover, the path model results also suggest that responsible gambling attitude was a salient protective factors against GD. Future GD prevention efforts may benefit from paying more attention to the role of responsible gambling attitude. [ABSTRACT FROM AUTHOR]

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. 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. 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. The findings of this study were based on self-report data and only criterion validity was analyzed. 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. • The GACS confirmed a multidimensional structure • Internal consistency of the GACS is adequate • The GACS shows adequate criterion validity • the GACS is a brief, multidimensional, valid and reliable instrument [ABSTRACT FROM AUTHOR]

Gambling problems have consistently been linked to suicidality, including suicidal ideation, attempts, and suicide. However, the magnitude of the relationship has varied significantly across studies and the potential causal link between gambling problems and suicidality is currently unclear. A meta-analytic literature review was conducted to (a) synthesize pooled prevalence rates of suicidality among individuals with gambling problems; (b) determine if individuals with gambling problems had an increased likelihood of reporting suicidality compared to individuals without gambling problems; and (c) review evidence on causality and directionality. A search in Web of Science, APA PsycInfo, APA PsycNet, Medline, CINAHL, ProQuest, Embase, and Google Scholar electronic databases identified 107 unique studies (N = 4,691,899) that were included for review. Studies were included if they were available in any European language and provided sufficient data for the calculation of prevalence rates or effect sizes. Two researchers extracted the data independently using a predefined coding schema that included the Newcastle–Ottawa Quality Assessment Scale. Random-effects meta-analyses yielded pooled prevalence rates of 31.6% (95% CI [29.1%, 34.3%]) for lifetime suicidal ideation and 13.2% (95% CI [11.3%, 15.5%]) for lifetime suicide attempts. Individuals with gambling problems had significantly increased odds of reporting lifetime suicidal ideation (OR = 2.17, 95% CI [1.90, 2.48]) and lifetime suicide attempts (OR = 2.81, 95% CI [2.23, 3.54]) compared to individuals without gambling problems. Two studies reported that individuals with pathological gambling had an increased risk of dying by suicide. Metaregression analyses suggested that the risk of study bias was positively related to the prevalence rates of suicidal ideation. Sex proportions were found to moderate the odds of suicidal ideation, but the direction of the effect was inconsistent. For suicide attempts, psychiatric comorbidity and sample size were positively and inversely, respectively, associated with prevalence rates. The synthesis indicates that suicidality is common among individuals with gambling problems and hence should be addressed by help agencies. Inferences on causality and directionality are hampered by a lack of longitudinal studies. Public Significance Statement: This meta-analytic literature review of 107 studies shows that lifetime suicidal ideation and suicide attempt(s) are commonly reported among individuals with gambling problems and that individuals with gambling problems have an increased likelihood of reporting lifetime suicidal ideation, suicide attempt(s), and dying by suicide compared to the general population. The observed increased likelihood of suicidality should be noted and addressed by help agencies and policymakers. Little is known about the directionality and mechanisms underlying this relationship, which needs to be investigated in future high-quality longitudinal research. [ABSTRACT FROM AUTHOR]

Gambling always carries risks for the player's mental health, as it can provoke the development of gaming addiction. A direct connection between the socio-psychological portrait of the player, his gaming behavior, and the risks of game addiction can be traced. The purpose of the work is to form a socio-psychological portrait of a "pathological" gambler. The work was performed based on the State Institution "Institute of Forensic Psychiatry of the Ministry of Health of Ukraine". Methods used: CAWI (Computer Assisted Web Interviewing) questionnaires in online gambling establishments; CAPI (Computer Assisted Personal Interviews - server event tracking method) in land-based casinos (more than 9,000 people were interviewed); statistical (for selection and analysis of materials). A questionnaire specially developed by the authors with a point evaluation of the results (from 71 to 90 points) allows us to conclude that the interviewee is a pathological gambler. For the first time in Ukraine, the survey was conducted exclusively among gamblers at gambling establishments. The obtained results made it possible to form a statistically reliable р<0.05 socio-psychological portrait of a pathological gambler, mostly men (87.7%) aged 25-35 years (52.4%) with secondary special (43.4%) or higher education (37.7%). In this group, 94% of people declared their inability to resist the desire to play, and 83.0% thought about stealing money to continue. Of pathological gamblers, 85.0% consider gaming as a means of earning money. All interviewed pathological gamers have experienced continuous gaming for more than 5 hours; 79.2% play almost every day. Such players in 95.0% noticed that they lost more money or spent more time than they planned, 96.0% felt culpable for the game, and 95.0% started the day with a game. Based on this portrait, the authors derived quantitative criteria that the organizer of gambling games can use to prevent gambling addiction among players within the framework of the application of the principles of responsible gaming [ABSTRACT FROM AUTHOR]

Background: Data implicate overlaps in neurobiological pathways involved in appetite regulation and addictive disorders. Despite different neuroendocrine measures having been associated with both gambling disorder (GD) and food addiction (FA), how appetiteregulating hormones may relate to the co-occurrence of both entities remain incompletely understood. Aims: To compare plasma concentrations of ghrelin, leptin, adiponectin, and liver-expressed antimicrobial peptide 2 (LEAP-2) between patients with GD, with and without FA, and to explore the association between circulating hormonal concentrations and neuropsychological and clinical features in individuals with GD and FA. Methods: The sample included 297 patients diagnosed with GD (93.6% males). None of the patients with GD had lifetime diagnosis of an eating disorder. FA was evaluated with the Yale Food Addiction Scale 2.0. All patients were assessed through a semi-structured clinical interview and a psychometric battery including neuropsychological tasks. Blood samples to measure hormonal variables and anthropometric variables were also collected. Results: From the total sample, FA was observed in 23 participants (FA+) (7.7% of the sample, 87% males). When compared participants with and without FA, those with FA+ presented both higher body mass index (BMI) (p < 0.001) and leptin concentrations, after adjusting for BMI (p = 0.013). In patients with FA, leptin concentrations positively correlated with impulsivity, poorer cognitive flexibility, and poorer inhibitory control. Other endocrine measures did not differ between groups. Discussion and conclusions: The present study implicates leptin in co-occurring GD and FA. Among these patients, leptin concentration has been associated with clinical and neuropsychological features, such as impulsivity and cognitive performance in certain domains. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Gamblers enrolled in the Swiss Multi-Venue Exclusion Program completed a written questionnaire three times, at six-month intervals. In addition to sociodemographic information, they provided details of their gambling behavior, and completed the South Oaks Gambling Screen-Revised (SOGS-R). The excluded gamblers were compared to a control group of non-excluded gamblers who also completed the questionnaire. The baseline survey demonstrated that there was a significant association between gamblers status (excluded n = 87 and non-excluded n = 259) and income (p =.039), as well as debt situation (p <.001) and SOGS-R score classification (p <.001). Over the course of three surveys, 242 gamblers participated. Of these, 133 respondents were not excluded from casinos at any time, 33 were excluded at the time of the first survey wave and remained so, while the exclusion status of 76 respondents changed over time, thus they were excluded for a minimum of one wave. Overall, 12.1% of excluded individuals stopped gambling altogether. Although exclusion is circumvented by some gamblers, it is associated with significant reductions in frequency, duration, and expenditure, as well as severity of problem gambling. The effects were more significant among gamblers who were excluded from casinos during the entire survey period. The results suggest that the duration of an exclusion should be at least six months instead of the current three months. 62.6% of the excluded gamblers had at least one exclusion lifted during the survey period. Further research is needed to investigate the implications of repeated exclusions for gambling-specific problems. [ABSTRACT FROM AUTHOR]

The co-occurrence of gambling disorder (GD) and attention-deficit/hyperactivity disorder (ADHD) has been widely reported. In this study, we aimed to investigate the social background, clinical characteristics, and clinical course of initial-visit GD patients with and without ADHD in a Japanese psychiatric hospital. We recruited 40 initial-visit GD patients and collected comprehensive information by self-report questionnaires, direct interviews, and medical records. 27.5% of the GD patients had comorbid ADHD. Compared to the GD patients without ADHD, those with ADHD had significantly higher comorbidity rates of autism spectrum disorder (ASD), lower rates of marriage, slightly less years of education and marginally lower employment rates. On the other hand, the GD patients with ADHD showed higher treatment retention rates and participation rates in the mutual support group. Despite presenting with disadvantageous characteristics, GD patients with ADHD exhibited a more favourable clinical course. Therefore, clinicians should be mindful of the possibility of ADHD comorbidity and the potential for better clinical outcomes among GD patients with ADHD. [ABSTRACT FROM AUTHOR]

Methamphetamine use disorder (MAUD) and gambling disorder (GD) frequently co-occur. Individuals with both conditions are typically more difficult to treat than those with either disorder alone. This study aimed to investigate the co-occurrence and clinical characteristics of people with MAUD and GD. Between March 2018 and August 2020, 350 men with methamphetamine use entering a compulsory drug rehabilitation center in Changsha, Hunan Province received semi-structured interviews. Participants completed the Barratt Impulsiveness Scale-11 and provided information on childhood upbringings and drug use characteristics. Independent sample t-tests compared differences between individuals with MAUD and with and without co-occurring GD. Dichotomous logistic regression was used to statistically predict co-occurring GD. The prevalence of GD was 45.1%. Most individuals (39.1% overall) had post-onset methamphetamine use (PoMAU-GD). The number of MAUD symptoms, history of gambling by family members, age of first sexual activity, and non-planning impulsivity statistically predicted PoMAU-GD, jointly explaining 24.0% of the total variance. The regression model fit well (HLχ2 = 5.503, p = 0.70), in which the specificity was 0.80, the sensitivity was 0.64, and the area under the curve was 0.79 (95%CI: 0.75–0.84). This study clarifies the prevalence of and potential risk factors for GD among individuals engaging in compulsory MAUD treatment in China. The high prevalence and associated clinical features of GD in the MAUD group highlight the importance of screening for GD in this population and intervening accordingly. [ABSTRACT FROM AUTHOR]

The majority of people with problematic gambling behavior never seek or receive professional help. Internet-based treatment approaches have been shown to help patients overcome practical and psychological barriers associated with face-to-face therapy. In this uncontrolled pilot study, we explored the feasibility of the eight-module therapist-guided internet-based treatment program SpilleFri ("Free from Gambling") for patients with gambling disorder (GD). We included 24 patients seeking treatment at a Danish hospital-based treatment clinic. The focus of the feasibility study was evaluation of recruitment and retention rates, data completion rates, treatment response, satisfaction, and program utility. In addition, a series of semi-structured interviews were conducted to explore patient-perceived acceptability and potential barriers to treatment completion and positive outcome. Treatment acceptability among therapists was examined in a focus group interview. Sixteen of the included patients completed the program, yielding an acceptable treatment dropout rate (29.17%), and 82.35% of treatment completers provided full data at all assessment points. Overall, patients were satisfied with the treatment received, and patient interviews highlighted multiple psychological as well as practical benefits associated with the treatment form and content. Patients with more severe gambling symptoms at baseline might be more likely to drop out before treatment completion than patients with less severe symptoms. The results suggest that SpilleFri may be a feasible alternative to face-to-face treatment for GD. However, the uncontrolled design and small sample size of the study limit the robustness of the findings. In the future, the effect of SpilleFri treatment should be examined in a randomized controlled trial. Clinical trial registrations: The study protocol was prospectively registered at clinicaltrials.gov (TRN: NCT05051085; registration date: September 21, 2021). [ABSTRACT FROM AUTHOR]

Studies show a compelling association between gambling disorder and posttraumatic stress disorder. However, there have been no randomized controlled trials for this co-morbidity. The aim of the current study was to compare two evidence-based models, one that addresses both disorders and another that addresses gambling alone. Sixty-five men and women with gambling disorder and posttraumatic stress disorder were randomized to one of two treatment conditions delivered via telehealth, Seeking Safety (integrated treatment for gambling and posttraumatic stress disorder) or Cognitive-Behavioral Therapy for Pathological Gambling (for gambling alone), in a randomized controlled non-inferiority trial. Primary outcomes were net gambling losses and number of sessions gambling. Secondary outcomes were posttraumatic stress disorder symptoms, coping skills, general psychiatric symptoms, global functioning, and gambling cognitions. Assessment occurred at baseline, 6-weeks, 3 months (end of treatment) and 1-year. On most measures, including primary outcomes, participants improved significantly over time with no difference between treatment conditions. Seeking Safety patients had significantly higher session attendance. Effect sizes were large for gambling, posttraumatic stress disorder and coping. All other measures except one showed medium effect sizes. Therapeutic alliance, treatment satisfaction, and the telehealth format were all rated positively. This was the first randomized trial of Seeking Safety in a gambling disorder population. Seeking Safety showed comparable efficacy to an established gambling disorder intervention; and significantly higher Seeking Safety attendance indicates especially strong engagement. Our finding of overall comparable results between the two treatments is consistent with the comorbidity treatment literature. Trial registration: ClinicalTrials.gov NCT02800096; Registration date: June 14, 2016. [ABSTRACT FROM AUTHOR]

The existing symptomatic networks of problem gambling are all based on cross-sectional data. Thus, there is a need to explore longitudinal symptom networks of problem gambling. Moreover, the replicability of cross-sectional symptom networks can be limited; therefore, further research should assess the convergence between cross-sectional networks of problem gambling symptoms. The present study aimed (i) to examine cross-sectional networks of problem gambling symptoms and evaluate their replicability and (ii) to examine a longitudinal cross-lagged network of problem gambling symptoms. The study included a representative sample of young adult gamblers (born between 1984 and 2000) from the first two waves of the Budapest Longitudinal Study (original sample: N = 2777; final sample: N = 335). The Problem Gambling Severity Index was used to assess symptoms of problem gambling. Cross-sectional symptom networks showed differences in the centrality of nodes. Correlations between the two cross-sectional networks were low in the presence vs. absence of edges, rank order of edge weights, and centrality estimates. However, network invariance tests indicated non-significant differences between them. The cross-lagged network revealed that the symptoms of tolerance and health problems could predict the subsequent presence of multiple problem gambling symptoms. Overall, limited evidence demonstrated the replicability of cross-sectional symptom networks of problem gambling. Future research needs to explore the utility of cross-sectional networks of problem gambling and assess more precisely causal relationships between problem gambling symptoms by distinguishing within- and between-subject effects. [ABSTRACT FROM AUTHOR]