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Gambling disorder is a common and problematic behavioral disorder associated with depression, substance abuse, domestic violence, bankruptcy, and high suicide rates. In the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), pathological gambling was renamed “gambling disorder” and moved to the Substance-Related and Addiction Disorders chapter to acknowledge that research suggests that pathological gambling and alcohol and drug addiction are related. Therefore, this paper provides a systematic review of risk factors for gambling disorder. Systematic searches of EBSCO, PubMed, and Web of Science identified 33 records that met study inclusion criteria. A revised study acknowledges as risk factors for developing/maintaining a gambling disorder being a single young male, or married for less than 5 years, living alone, having a poor education, and struggling financially.

The need to use different and heterogeneous approaches and methodologies to investigate the phenomenon of pathological Gambling Disorder (GD) arises from a substantial difference in the literature results emerging in this area. Furthermore, investigating the executive functioning (EFs) of subjects with GD provides important information that can influence the treatment setting of these populations. In the present paper the involvement of EFs in the present disorder was investigated. The cognitive functioning of subjects with GD was deepened, both through the study of the cerebral correlates of executive functioning in GD and through empirical studies that investigate the behavioural deficits of GD. Furthermore, we considered the role of some specific behavioral tasks (such as the Iowa Gambling Task, IGT) for the assessment of EFs. Finally, the relationship between EFs and some other crucial factors, such as reward sensitivity, were focused. Indeed, the behavioural aspects of GD are multiple, and they include not only traditional functions such as inhibitory control and reduced levels of self-control, but also high sensitivity to reward.

Background and aims Blaszczynski and Nower (2002) conceptualized their Pathways Model by postulating the existence of three subtypes of problem gamblers who share common characteristics, but also present specific ones. Methods This study investigated how the psychological mechanisms postulated in the Pathways Model predict clinical status in a sample that combined treatment-seeking gamblers (n = 59) and non-problematic community gamblers (n = 107). To test the Pathways Model, we computed a hierarchic logistic regression in which variables associated with each postulated pathway were entered sequentially to predict the status of the treatment-seeking gambler. Self-report questionnaires measured gambling-related cognitions, alexithymia, emotional reactivity, emotion regulation strategies and impulsivity. Behavioural tasks measured gambling persistence (slot machine task), decision-making under uncertainty (Iowa Gambling Task) and decision-making under risk (Game of Dice Task). Results We showed that specific factors theorized as underlying mechanisms for each pathway predicted the status of clinical gambler. For each pathway, significant predictors included gambling-related cognitive distortions and behaviourally measured gambling persistence (behaviourally conditioned pathway), emotional reactivity and emotion regulation strategies (emotionally vulnerable pathway), and lack of premeditation impulsivity facet (impulsivist-antisocial pathway). Discussion and conclusions Our study adds to the body of literature confirming the validity of the Pathways Model and hold important implications in terms of assessment and treatment of problem gambling. In particular, a standardized assessment based on the Pathways Model should promote individualized treatment strategies to allow clinicians to take into account the high heterogeneity that characterizes gambling disorder.

Gambling disorder (GD) is a behavioral addiction associated with personal, social and occupational consequences. Thus, examining GD's clinical relationship with its neural substrates is critical. We compared neural fingerprints using diffusion tensor imaging (DTI) in GD subjects undergoing treatment relative to healthy volunteers (HV). Fifty-three (25 GD, 28 age-matched HV) males were scanned with structural magnetic resonance imaging (MRI) and DTI. We applied probabilistic tractography based on DTI scanning data, preprocessed and analyzed using permutation testing of individual connectivity weights between regions for group comparison. Permutation-based comparisons between group-averaged connectomes highlighted significant structural differences. The GD group demonstrated increased connectivity, and striatal network reorganisation, contrasted by reduced connectivity within and to frontal lobe nodes. Modularity analysis revealed that the GD group had fewer hubs integrating information across the brain. We highlight GD neural changes involved in controlling risk-seeking behaviors. The observed striatal restructuring converges with previous research, and the increased connectivity affects subnetworks highly active in gambling situations, although these findings are not significant when correcting for multiple comparisons. Modularity analysis underlines that, despite connectivity increases, the GD connectome loses hubs, impeding its neuronal network coherence. Together, these results demonstrate the feasibility of using whole-brain computational modeling in assessing GD.

Enquadramento: O Gambling é uma área de estudo complexa que implica diferentes olhares e perspetivas disciplinares. Diversos estudos bibliométricos encontraram uma preponderância na área da investigação da tomada de decisão, entre outras áreas. Pretende‑se contextualizar essa preponderância, ao mesmo tempo que se atualiza tendências de investigação na área. Métodos: Conduziu‑se uma análise bibliométrica usando a base de dados Web of Science, onde se obteve um total de 4262 artigos publicados num intervalo (2019‑ 21 de março de 2022). Utilizou‑se a análise de resultados da WoS para realizar uma descrição dos resultados. Exportou‑se posteriormente esta mesma análise para o VOSviewer, por forma a identificar‑se campos de trabalho e tendências de investigação. Resultados: No que concerne a resultados, destacamos a existência de três grandes clusters de palavras‑chave correspondendo a gambling no geral; gambling disorder e decision making. Um quarto cluster emergiu, com menor representatividade, correspondendo a temas como addiction e metanálises. No que diz respeito a temas emergentes, identificámos palavras‑chave com tempo médio de publicação mais recente como: loot boxes; adolescents, covid‑19; stress; internet; gambling harm; internet gaming disorder, entre outros. Conclusões: Os resultados corroboram a tendência da literatura de aproximar os comportamentos relacionados com o gambling de outras patologias aditivas, nomeadamente o Substance Abuse, o uso problemático da internet e o gaming. Registamos ainda a temática do COVID‑19 como emergente quer em termos de palavras‑chave registadas quer ainda no que concerne aos artigos. Surgiram, na análise das palavras‑chave, três grandes clusters: um relacionado com o gambling e o problem gambling; um outro relacionado com o gambling disorder e um último em que o termo decision making assume um papel central. As palavras‑chave com mais impacto e com tempo de publicação mais recente foram COVID‑19, mas também algumas dimensões da internet, videojogos e as loot boxes em que a temática do gaming e o gambling se podem cruzar. info:eu-repo/semantics/publishedVersion

In recent years, the video game industry has introduced Loot Box (LB), a new type of microtransaction in which a gamer uses real currency to purchase a random virtual item within a video game. Recently, LBs became more widespread and there is evidence suggesting their similarity to online gambling. Although some studies have investigated the association between LBs with disordered gaming and disordered gambling, very few have done so with clinical indicators of these problems. Furthermore, to the best of our knowledge no longitudinal evidence of such relationships currently exists in the literature. Therefore, the present study aimed to 1) ascertain the stability of LB purchasing in minors and 2) investigate the associations between LB purchasing with gambling online and online gambling disorder within six months. A prospective cohort study was conducted at two time points six months apart. In total, 2.213 Spanish adolescents (1.067 [48.9%] boys) aged between 11 and 17 years participated in both waves. The purchase of LBs was prevalent and stable in the sample across the six months. While a positive relationship was found between purchasing LBs and online gambling six months later, the relationships between purchasing LBs and the presentation of online gambling disorder and gaming disorder require further study. Universidad Internacional de la Rioja (UNIR), Project “Cyberpsychology (Triennium 2017–2020 and 2020–2022). Open Access funding provided by University of Basque Country (UPV/EHU). The funders had no role in study design, data collection and analysis.

Gambling disorder is a common and problematic behavioral disorder associated with depression, substance abuse, domestic violence, bankruptcy, and high suicide rates. In the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), pathological gambling was renamed “gambling disorder” and moved to the Substance-Related and Addiction Disorders chapter to acknowledge that research suggests that pathological gambling and alcohol and drug addiction are related. Therefore, this paper provides a systematic review of risk factors for gambling disorder. Systematic searches of EBSCO, PubMed, and Web of Science identified 33 records that met study inclusion criteria. A revised study acknowledges as risk factors for developing/maintaining a gambling disorder being a single young male, or married for less than 5 years, living alone, having a poor education, and struggling financially.

Gambling problems are often associated with homelessness and linked to elevated psychiatric morbidity and homelessness chronicity. We performed a systematic review and meta-analysis on prevalence rates of problem gambling (PG) and gambling disorder (GD) in homeless people. Following PRISMA guidelines, we searched databases Medline, Embase and PsycINFO from inception of databases to 4th may 2021. We included studies reporting prevalence estimates on clinical gambling problems in representative samples of homeless people based on standardized diagnostics. Risk of bias was assessed. A random effects meta-analysis was performed, and subgroup analyses based on methodological characteristics of primary studies were conducted. We identified eight studies from five countries, reporting information on 1938 participants. Prevalence rates of clinically significant PG and GD ranged from 11.3 to 31.3%. There was evidence for substantial heterogeneity with I2 = 86% (95% CI 63–97%). A subgroup of four low risk of bias studies displayed a significantly lower results ranging from 11.3 to 23.6%. Additionally, high rates of subclinical problem gambling were reported (11.6–56.4%). At least one in ten homeless persons experiences clinically significant PG or GD. Social support and health care services for the homeless should address this problem by implementing models for early detection and treatment.

Versión en castellano e inglés El uso del teléfono móvil entre la población estudiantil española ha sido ampliamente analizado, pero se ha centrado en muestras universitarias, de secundaria o de primaria. El objetivo del presente estudio es analizar el uso del teléfono móvil, sus diferencias de género y su relación con el trastorno por juego en Internet y por juego de azar en Internet en el alumnado de Formación Profesional (FP). Se realizó un estudio ex post facto retrospectivo en el que se evaluaron usos habituales del teléfono móvil, experiencias relacionadas con el mismo, el trastorno por juego en Internet y el juego patológico en línea. La muestra estuvo compuesta por 1107 estudiantes de FP (55.1% varones) con una edad media de 18.8 años. El 7.9% de la muestra hacía un uso problemático del móvil y el 28.6% un uso con problemas ocasionales. Se observaron diferencias de género, con un uso más problemático entre las mujeres. Según el análisis de regresión, usar el móvil en horas lectivas, ser mujer y usuaria de películas y videojuegos fueron las variables que mejor diferenciaban aquellos participantes que presentaron un uso problemático. Para aquellos participantes que empleaban el móvil con las finalidades de juegos de azar y videojuegos, ambos en Internet, la variable que mejor diferenciaba la presencia de problemas con el uso del teléfono móvil fue el uso del mismo para jugar a videojuegos en línea. Si bien la prevalencia de problemas frecuentes con el uso del móvil es relativamente baja, el porcentaje de alumnado en riesgo no debe dejar indiferente a la comunidad educativa. Se sugiere fomentar el uso adecuado de las tecnologías en el alumnado de FP prestando especial consideración a las diferencias de género encontradas. Smartphone use by young Spanish students has been broadly explored, specifically among university, high school, and primary school students. The goal of this article is to analyze smartphone use, its gender differences, and its relationship with Internet gaming disorder and Internet gambling disorder in vocational education and training (VET) students. A retrospective ex post facto study was carried out in which habitual uses of the mobile phone, experiences related to it, Internet gaming disorder, and online pathological gambling were evaluated. The sample consisted of 1,107 VET students (55.1% male) with a mean age of 18.8 years. Problematic smartphone use was observed in 7.9% of the sample and 28.6% used it with occasional problems. Gender differences were obtained, with a higher presence of problematic use among females. According to the regression analysis, the variables that best differentiated participants who presented problematic smartphone use were using it in class, being female, and being a user of movies and videogames. Between videogames and gambling users, the variable that best differentiated participants who presented problematic smartphone use was videogame use. Although the prevalence of frequent problems with smartphone use is relatively low, the percentage of students at risk must not be disregarded by the educational community. It is recommended to promote the appropriate use of technologies in VET students. The gender differences found in this study should be addressed with special consideration. The study was partially funded by the Research Plan of the International University of La Rioja (UNIR) to the Cyberpsychology Research Group for the biennium 2020-2022.

Gambling disorder (GD) is a behavioural addiction characterized by impairments in decision-making, favouring risk- and reward-prone choices. One explanatory factor for this behaviour is a deviation in attentional processes, as increasing evidence indicates that GD patients show an attentional bias toward gambling stimuli. However, previous attentional studies have not directly investigated attention during risky decision-making. 26 patients with GD and 29 healthy matched controls (HC) completed a mixed gambles task combined with eye-tracking to investigate attentional biases for potential gains versus losses during decision-making under risk. Results indicate that compared to HC, GD patients gambled more and were less loss averse. GD patients did not show a direct attentional bias towards gains (or relative to losses). Using a recent (neuro)economics model that considers average attention and trial-wise deviations in average attention, we conducted fine-grained exploratory analyses of the attentional data. Results indicate that the average attention for gains in GD patients moderated the effect of gain value on gambling choices, whereas this was not the case for HC. GD patients with high average attention for gains started gambling at less high gain values. A similar trend-level effect was found for losses, where GD patients with high average attention for losses stopped gambling at lower loss values. This study gives more insight into how attentional processes in GD play a role in gambling behaviour, which could have implications for the development of future treatments focusing on attentional training or for the development of interventions that increase the salience of losses.

Background A first approach addressed to ascertain whether emotion regulation (ER) could be a transdiagnostic construct between eating disorders (EDs) and gambling disorder (GD) (through a joint clinical clustering analysis of both disorders) was performed by Munguía et al. (2021). Both conditions were represented by a severe, moderate, and low ER profile subgroups, according to the degree of ER difficulties. Results showed a linear relationship between the severity of ER difficulties and the severity of the disorder and the psychopathological state. Aims Based on the aforementioned cross-sectional study, the objective of this longitudinal research was to explore the treatment response of the different ER subgroups. Methods 459 adult patients (n = 277 ED; n = 182 GD) were included. Several clinical variables, as well as outcome indicators (after completing 16 weeks of cognitive-behavioral therapy), were evaluated. Results The three subgroups found in the previous cross-sectional study were taken for the performance of the present research. ED and GD distribution in each subgroup replicates the one exposed by Munguía et al. (2021), as well as their characterization, considering psychopathology, disorder severity and personality traits. The low ER subgroup reported a better response to treatment, whereas the severe group had the highest rates of non-remission and dropouts. Conclusions Our results suggest that greater difficulties in ER lead to poorer treatment outcomes. Therefore, tailored treatments for patients with poor ER abilities would be recommended to improve adherence and treatment outcomes.

パチンコ依存症者への社会資源を活用した支援の方法やその有効性を明らかにすることを目的とし，パチンコ依存の状態にあるA氏に対し，自己実現を支える継続的な心理支援を実施した。約10ヶ月にわたる心理支援の結果，社会資源を活用した余暇活動の広がりがみられ，それに比例してA氏のパチンコ店に行く頻度は減少した。また，他者とのやり取りや自己肯定感の高まりが，自身のパチンコ依存の問題解決に向けての意欲向上に繋がったと考えられる。

This study aims to identify the characteristics of patients who sought treatment for gambling disorder in the province of Samsun. The study data were obtained from the files of individuals who were referred to the AMATEM polyclinic for gambling problems. Almost all of the individuals with gambling disorders were males. The mean age was 35.7 +/- 9 years, the mean age of onset of gambling was 24.1 +/- 8 years, and the mean time spent on gambling was 10 +/- 2 years. Of the patients, 88.2% were smokers, 67.6% were alcohol users, and 11.8% were substance users. The most favored games included Sports Toto/Loto/Bets and online gambling and betting games. Of the patients, 64.7% were gambling every day. The rate of harm suffered due to gambling behavior was 85.6%. The most affected area was family relationships, followed by financial problems. Gambling disorder leads to detrimental effects in many areas similar to those of alcohol and substance use disorders. The rate of harm suffered by the individuals because of their gambling behavior is quite high. It is necessary to create support opportunities that people can easily access before they lose control of their gambling behavior.

ギャンブルへの過度な従事により日常生活や身体的健康・精神的健康に悪影響を及ぼしている状態はギャンブル障害と呼ばれ, 治療と介入が必要な精神疾患として扱われている. 海外ではギャンブル障害に関して様々な国・地域で様々な方法を用いた疫学調査が実施されており, 多くの有病率データが得られている. 日本でも国や地方自治体による疫学調査が実施されているが, 使用されているスクリーニングテストや調査方法が異なることから正確な有病率データが得られているとは言い難い状況である. そこで, 本論文では海外での疫学調査のレビュー研究を基に, 今後日本で実施するべき疫学調査の調査方法に関して提言を行った.

Funder: Finnish Foundation for Alcohol Studies; Id: http://dx.doi.org/10.13039/100016238, Funder: Päivikki and Sakari Sohlberg Foundation; Id: http://dx.doi.org/10.13039/501100004212, Funder: Finnish Cultural Foundation; Id: http://dx.doi.org/10.13039/501100003125, Funder: Turku University Foundation; Id: http://dx.doi.org/10.13039/501100022793, Funder: Michael J. Fox Foundation; Id: http://dx.doi.org/10.13039/100000864, Funder: Finnish Parkinson Foundation, Funder: Province of British Columbia, Funder: British Columbia Lottery Corporation (BCLC), Funder: National Association for Gambling Studies, Funder: National Center for Responsible Gaming; Id: http://dx.doi.org/10.13039/100003977, Funder: GambleAware; Id: http://dx.doi.org/10.13039/501100008625, Funder: Gambling Research Exchange Ontario; Id: http://dx.doi.org/10.13039/501100007553, Funder: Finnish Medical Foundation; Id: http://dx.doi.org/10.13039/100008723, Funder: Instrumentarium Research Foundation, Gambling disorder (GD) is major public health issue. The disorder is often characterized by elevated impulsivity with evidence from analogous substance use disorders underlining prominent roles of brain monoamines in addiction susceptibility and outcome. Critically, GD allows the study of addiction mechanisms without the confounder of the effects of chronic substances. Here, we assessed the roles of striatal dopamine transporter binding and extrastriatal serotonin transporter binding in GD as a function of impulsivity using [123 I]FP-CIT SPECT imaging in 20 older adults with GD (DSM-5 criteria; mean age 64 years) and 40 non-GD age- and sex-matched controls. We focused on GD in older individuals because there are prominent age-related changes in neurotransmitter function and because there are no reported neuroimaging studies of GD in older adults. Volume-of-interest-based and voxelwise analyses were performed. GD patients scored clearly higher on impulsivity and had higher tracer binding in the ventromedial prefrontal cortex than controls (p < 0.001), likely reflecting serotonin transporter activity. The binding in the medial prefrontal cortex positively correlated with impulsivity over the whole sample (r = 0.62, p < 0.001) as well as separately in GD patients (r = 0.46, p = 0.04) and controls (r = 0.52, p < 0.001). Striatal tracer binding, reflecting dopamine transporter activity was also positively correlated with impulsivity but showed no group differences. These findings highlight the role of prefrontal serotonergic function in GD and impulsivity. They identify cerebral coordinates of a potential target for neuromodulation for both GD and high impulsivity, a core phenotypic dimensional cognitive marker in addictions.

Background: Gambling disorder (GD) is a behavioural addiction in which a person faces negative consequences due to uncontrolled gambling, such as financial, personal, or relational difficulties. GD more often affects men but both men and women face severe consequences of GD. Psychiatric comorbidity is the rule rather than the exception and suicidality is abundant. Health issues such as obesity and cardiovascular disease are also common. Financial difficulties are common and might be both a consequence of and a risk factor for GD.Aim and methods: To examine, through registry and qualitative research, comorbidity, intentional self-harm, suicide and mortality in GD. In Study I, standardized mortality ratios for men and women with GD were compared to the general population and potential risk factors for suicidality and mortality were investigated (N=2099). In Study II, the effect of comorbid alcohol and drug use disorders on intentional self-harm in individuals with GD was examined (N=2099). In Study III, the effects of psychiatric and socioeconomic risk factors on intentional self-harm (N=848) were examined, and in Study IV, a gender- and age-matched cohort was utilized to investigate the association between GD,suicide, and general mortality in relation to known risk factors in men and women (N=10,792). Finally,a qualitative interview study (V) investigated, through qualitative content analysis (N=7), experiences of suicidality in women with GD and potential mediators of suicidality. Results: In the first study, mortality and suicide levels were greatly elevated in GD. Depression was associated with suicide death, and age and cardiovascular disease predicted general mortality. However,in the fourth study, GD did not appear to be a significant risk factor for the increase in suicide and general mortality when controlling for previously known risk factors. In the second and third studies,female gender, and psychiatric comorbidity such as substance use diagnoses, anxiety and depression were important risk factors for intentional self-harm. In the fifth study, the themes “internal shame and stigma”, “chaotic life circumstances due to gambling (such as eviction)” and “external stigmatization” appeared important in the development of suicidality.Conclusion: Individuals with GD suffer from increased suicide levels as well as high rates of intentional self-harm. Shame, stigma, and chaotic life circumstances might be mediators for suicidality in women with GD. Psychiatric comorbidity including substance use disorders appears to increase the risk of intentional self-harm and depression might increase the risk of suicide. This research could no tdetermine whether GD is an independent risk factor for suicide and further research is needed.Mortality levels are higher and might be due to cardio-vascular comorbidity.

To assess reinforcement learning, confidence, and their interaction in the context of goal-directed behavior in gambling disorder (GD), we utilize a reinforcement learning task as described in ((Lebreton et al., 2019), Experiment 2). This task allows us to derive various indicators that can be compared between healthy controls and people with GD

Gambling disorder (GD) is a behavioral addiction characterized by persistent and recurrent gambling behavior that disrupts personal, social or professional life. Studies have revealed that GD shares many features with alcohol and substance use disorders, but little is known about potential unique features in GD and to what extent characteristics are shared. One shared feature is reward-related decision-making and individuals with GD display deficits in decision-making. The rat gambling task (rGT) has been developed to enable preclinical studies of reward-related decision-making and underlying neurobiological mechanisms. The aim of this thesis was to explore individual differences in decision-making strategies in the rGT and underlying behavioral phenotypes and neurobiology. Paper I: three groups with different decision-making strategies in the rGT were identified: the strategic, risky and safe group. The rGT strategies were shown to be stable over time, even after multiple interruptions and other behavioral testing. Rats with risky rGT strategies had higher voluntary alcohol intake but not elevated sexual behavior. Naltrexone treatment resulted in an overall lowered motivation in the rGT but had no effect on choice behavior. Paper II: individual differences in gambling strategies were found in the rGT and corresponding strategy groups were replicated from Paper I. Moreover, brain functional connectivity was assessed using resting-state functional Magnetic Resonance Imaging. Differences in rGT strategies were associated with connectivity in regions in or associated with brain reward networks. Paper III: levels of neurotransmitters and metabolites were explored using matrix-assisted laser desorption/ionization mass spectrometry imaging in selected brain regions. The strategy groups were revealed to differ in levels of neurotransmitters and metabolites in regions of importance for decision-making and reward. Paper IV: decision-making strategies in humans, using the Iowa gambling task, and in rats, using the rGT, were explored. Results showed that most humans and rats learned to favor the advantageous choices and showed similar variability in individual choice preferences during end performance. This thesis has provided new information about individual decision-making strategies in the rGT and associations with other reward-related behaviors as well as neurobiology. Characterization of the strategy groups indicates a shared underlying mechanism between rGT strategies and alcohol intake but not natural rewards. Neurobiological differences in regions important for reward processing were also revealed. Lastly, similar variability in individual choice preference was found in humans and rats and it is concluded that both clinical and preclinical research would benefit from more detailed analyses on individual variations in decision-making.

This mechanistic study aims to investigate the potential therapeutic effects of ketamine, an NMDA-receptor antagonist, on gambling cue reactivity, cognitive distortions, and craving in individuals at risk for gambling disorder. The study also explores the neurobiological mechanisms underlying the cognitive and therapeutic effects of ketamine, specifically focusing on enhanced long-term potentiation (LTP) as measured through visual evoked potentials using electroencephalogram (EEG). A total of 39 participants were recruited, with 23 participants included in the EEG sub-arm. Participants were randomised into two groups, receiving either ketamine or placebo following a memory reactivation procedure involving exposure to gambling cues. Cue reactivity, cognitive distortions, and gambling severity were assessed at baseline and in three follow-up sessions. Additionally, arterialised blood samples were collected to measure plasma levels of ketamine and its metabolites. EEG recordings comprised a visual LTP task, auditory mismatch negativity, and resting recordings conducted at baseline and post-administration. The results from this study will contribute to the understanding of the potential therapeutic benefits of ketamine for gambling disorder and further elucidate the neurobiological mechanisms underlying its effects.

This project entails multiple parts, including 18F-DOPA PET imaging, neuromelanin MRI (nMRI), cognitive tasks and clinical questionnaires for people with gambling disorder (GD) and a matched healthy control (HC) group.

Background and aims Skin gambling uses in-game items (skins) acquired in video games, to gamble on esports, games of chance, other competitive events and privately with friends. This study examined characteristics of adolescent skin gamblers, their engagement in monetary gambling, and relationships between skin gambling and at risk/problem gambling. Methods Two samples of Australian adolescents aged 12–17 years were recruited to an online survey through advertisements (n = 843) and an online panel provider (n = 826). Results In both samples, past-month skin gamblers (n = 466 advertisements sample; n = 185 online panel sample) were more likely to have lower wellbeing, score as having an internet gaming disorder on the IGD, engage in more types of monetary gambling, and meet criteria for problem gambling on the DSM-IV-MR-J. Past-month skin gambling uniquely predicted problem gambling when controlling for past-month gambling on 11 monetary forms and the total number of monetary gambling forms. Discussion and conclusions Underage participation in skin gambling is a growing concern. The strong convergence between engagement in skin gambling and monetary gambling suggests common risk factors may increase the propensity of some adolescents to gamble on these multiple forms. Nonetheless, past-month skin gambling predicted problem gambling even when controlling for past-month monetary gambling, indicating its unique contribution to gambling problems and harm. While the study was based on non-probability samples, its results strengthen the case for regulatory reforms, age restrictions and public health education to prevent underage skin gambling and its potentially harmful consequences for children and young people.

Researchers have raised concerns about mental health in elite athletes, including problem gambling, where research hitherto is scarce. While gambling has been assessed in the younger student-athlete population, neither gambling nor the recently recognized behavioral addiction of gaming disorder has been sufficiently addressed in the elite athlete population. The present systematic literature review aimed to summarize research knowledge on the prevalence and correlates of problem gambling and problem gaming in elite athletes. Research papers were searched systematically using the Scopus, PsycINFO, and PubMed/MEDLINE databases and evaluated following a PRISMA paradigm. For the elite athlete population, eight reports on problem gambling and one report on problem gaming were found. While at least five papers indicated an increased risk of problem gambling in elite athletes compared to the general population, one study from Australia indicated the opposite. Problem gambling was generally more common in male athletes. Knowledge of problem gaming prevalence is thus far limited. It is concluded that increased research in problem gambling and problem gaming in elite athletes is warranted.

Altres ajuts: Delegación del Gobierno para el Plan Nacional sobre Drogas (2019I47 and 2021I031). CIBER Fisiología Obesidad y Nutrición (CIBERobn) is an initiative of Intituto de Salud Carlos III. ZD's contribution was supported by the Hungarian National Research, Development and Innovation Ofce (KKP126835, K131635). The online version contains supplementary material available. Few studies have analyzed the clinical profle 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 profle. The nodes with the highest authority in the network (variables of highest relevance) were personality traits and psychological distress. Four empirical modules/clusters were identifed, and linkage analysis identifed the nodes with the highest closeness (bridge nodes) to be novelty seeking and reward dependence (these traits facilitate the transition between the modules). Identifcation of the variables with the highest centrality/linkage can be particularly useful for developing precise management plans to prevent and treat SCZ with GD.

The RIGAB study aims to characterize online sports bettors with and without gambling disorder concerning individual risk factors and subsequently use this characterization to predict the development, progression and onset of gambling disorder. The RIGAB study is a longitudinal study and consists of three parts: an initial online survey, an in-person study with a selected subsample and a shorter follow-up online survey after one year with the entire sample. This preregistration pertains to the in-person study. The other parts of the study are preregistred separately.

Zusammenfassung. Der Beitrag informiert über die Eingliederung der Suchtstörungen in die 11. Auflage der International Classification of Diseases (ICD-11) der Weltgesundheitsorganisation (WHO). Die Revision der ICD soll einem gewandelten Verständnis der Suchtstörungen und deren Diagnostik Rechnung tragen und die klinische Anwendbarkeit vereinfachen. Im Bereich der substanzbezogenen und nicht substanzbezogenen Störungen sind gegenüber der Vorgängerversion erhebliche Neuerungen eingeführt worden. Die wichtigsten Änderungen betreffen ein erweitertes Angebot an Stoffklassen, deutliche (vereinfachende) Anpassungen in den konzeptuellen und diagnostischen Leitlinien der substanzbezogenen Störungsbilder und insbesondere der „Abhängigkeit“, sowie die Einführung der Kategorie der „abhängigen Verhaltensweisen“ und damit verbunden die Zuordnung der „Glücksspielstörung“ zu den Suchtstörungen sowie die Aufnahme der neuen (bildschirmbezogenen) „Spielstörung“. Zudem findet eine Erweiterung der diagnostischen Optionen für frühe, präklinische Phänotypen der Suchtstörungen („Episodisch Schädlicher Gebrauch“) erstmals Eingang in den ICD-Katalog. Im vorliegenden Beitrag werden die Änderungen Episodisch schädlicher Gebrauch für den Bereich der Suchtstörungen aus kinder- und jugendpsychiatrischer Sicht zusammenfassend dargestellt und diskutiert.

Illegal behaviors have been reported in gambling disorder (GD) as well as in individuals with attention deficit hyperactivity disorder (ADHD). Likewise, ADHD symptomatology has been observed in patients with GD. We aimed to examine the association between ADHD symptomatology, personality traits and impulsivity in a sample of treatment-seeking patients with GD (n = 204) with and without a criminal report. The subjects were evaluated before starting treatment using different self-administered instruments. Among those who had committed an illegal act, two groups were made depending on whether or not the criminal conduct had legal repercussions (n = 64 without legal consequences; n = 32 with legal consequences). Structural equation modeling (SEM) was used to explore the interrelationships between personality traits, ADHD, impulsivity levels, gambling-related criminal behavior and other gambling-related factors. Greater ADHD symptomatology was found in patients with reported illegal behaviors, as well as higher impulsivity levels. Those individuals who presented legal consequences due to the criminal behavior showed higher impulsivity levels and harm avoidance and lower persistence and cooperativeness. Our findings uphold that patients with GD and ADHD symptomatology have greater impulsivity and are more vulnerable to committing an illegal act. Therefore, specific harm-prevention interventions and treatment approaches are needed for this population.

Background and aim Evidence on the course of gambling disorder (GD) in clients seeking help from outpatient addiction care facilities is sparse. To close this knowledge gap, this longitudinal one-armed cohort study portrays the development of GD in help-seeking clients over a 3-year timeframe. Methods We investigated changes in severity of GD as well as in gambling frequency and intensity in 145 gamblers in outpatient treatment in Bavaria using generalized estimation equations (GEEs). To investigate potentially different trajectories between study participants with and without migration background (MB), additional analyses were applied with time*migration interaction. All analyses were adjusted for age, gender, education, electronic gambling machine (EGM) gambling, MB, GD, related help sought before and treatment status. Results Within the entire study population, improvements in severity of GD (reduction of 39.2%), gambling intensity (reduction of 75.6%) and gambling frequency (reduction of 77.0%) were observed between baseline and 36 months of follow-up. The declines were most pronounced between baseline and follow-up 1 and stabilized thereafter. Participants with MB improved consistently less than participants without MB. Discussion and conclusion Our study suggests that severity of GD and gambling patterns improve in the context of outpatient treatment. The beneficial results furthermore persist for 36 months after treatment termination. As clients with MB seem to profit less than clients without MB, improvements in outpatient gambling services to the specific needs of this clientele are required.

Context: Gambling disorder is a mental health condition in which a person repeatedly engages in gambling behaviour despite various negative consequences. The condition is also known as gambling addiction, pathological gambling or compulsive gambling. Recent studies have demonstrated the efficacy of Cognitive Behaviour Therapy in treating gambling disorder. Aim: In the present study, the efficacy of cognitive behaviour therapy in treatment of an adult patient with gambling disorder was examined. Settings and Designs: A single case design with pre- and post-assessments on clinician-rated scales were adopted. Materials and Methods: Fourteen bi-weekly sessions of Cognitive Behaviour Therapy were conducted on an inpatient basis. Assessments were carried out on Gambling Symptom Assessment Scale and Hamilton Anxiety Rating Scale, at pre- and post-therapy points. Analysis: Pre- and post-therapy changes were examined using the method of clinical significance. Results: A significant decline was seen on the Gambling Symptom Assessment Scale, and Hamilton Anxiety Rating Scale Conclusion: Application of CBT was effective in treating the anxiety, and gambling symptoms in the patient with Gambling Disorder

Gambling disorder (GD) is associated with a higher prevalence of adverse childhood experiences (ACEs). Whether this applies to groups such as U.S. veterans, who already have elevated ACEs, is not known. In this pilot study, we extracted ACEs from the charts of a random sample (n = 19) male veterans in residential GD treatment and compared them to those from a general veteran sample (n =154, 30 females, 124 males). The GD group had an elevated prevalence (79% vs. 37%) of three or more ACEs and a lower prevalence (5% vs. 49%) of one or fewer ACEs. Within groups with elevated ACEs, higher ACE load may still confer a higher risk of adult GD.

Most of the available literature has shown that gambling disorder (GD) is often associated with several psychiatric conditions. Comorbidities with mood disorders, impulsiveness, personality traits, and impairments in cognitive function have also been frequently investigated. However, it is currently uncommon to study this disorder in individuals without comorbid substance abuse; therefore, the primary aim of our study was to compare the psychological profile of individuals with GD with and without substance use disorder. A total of 60 participants (100% male), including 20 individuals with GD, 20 substance-dependent gamblers (SDGs), and 20 healthy controls (HCs), were assessed with several clinical measures to investigate impulsivity, hostility, mood, and personality traits, as well as with cognitive tasks (i.e., decision-making tasks). Our results showed differences in both experimental groups compared with the HC group in mood disorders, impulsivity, and hostility traits. The ‘‘pure’’ GD group differed from the SDG group only in characteristics related to mood disorders (e.g., State-Trait Anxiety Inventory-Y2, Beck Depression Inventory-II, and assault dimension), whereas greater impairment in decision making processes related to risky choices was shown in the SDG group. This study suggests the importance of studying pure GD to clarify the underlying mechanisms without the neurotoxic effects of the substances. This could provide an important contribution to the treatment and understanding of this complex disorder.

E. J. Langer's paper, 'The illusion of control' (1975), showed that people act in ways that suggest they hold illusory beliefs in their ability to control the outcome of chance-determined games. This highly cited paper influenced the emerging field of gambling studies, and became a building block for cognitive approaches to problem gambling. Over time, this work has inspired therapeutic approaches based on cognitive restructuring, preventative programmes focused upon gambling myths and regulatory scrutiny of skill mechanics in modern gambling products. However, the psychological mechanisms underlying the 'illusion of control' remain elusive.

The RIGAB study aims to characterize online sports bettors with and without gambling disorder concerning individual risk factors and subsequently use this characterization to predict the development, progression and onset of gambling disorder (GD). The RIGAB study is a longitudinal study and consists of three parts: an initial online survey, an in-person study with a randomly selected subsample and a shorter follow-up online survey after one year with the entire sample. This preregistration pertains to the follow-up online survey. The other parts of the study are or will be preregistred separately.

Objective The aim of the present study was to investigate whether the remission of preoperative food addiction is associated with increases or new onset of other addictions within the first year following bariatric surgery. Methods One hundred and twenty-five bariatric surgery patients were assessed before surgery (t1) and at 6 months (t2) and 1 year (t3) follow-ups. The assessments included the Yale Food Addiction Scale 2.0 (YFAS 2.0) and standardized questionnaires to measure symptoms of problematic alcohol use, gambling disorder, internet-use disorder, buying-shopping disorder, hypersexual disorder and exercise dependence. Results Forty-nine (39.2%) patients were assigned to the food addiction (FA+ ) and 76 patients (60.8%) to the non-food addiction group (FA- ) based on their preoperative YFAS scores. Overall, BMI and symptoms of food addiction decreased significantly from baseline to follow-ups. Preoperative food addiction status was not associated with postoperative increases or new onset of other addictions. Elevated symptoms of buying-shopping disorder, internet-use and hypersexual behaviour at baseline in the FA+ -group decreased over time and were comparable to the FA- -group at follow-ups. Conclusion The 'addiction transfer' or 'cross addiction' hypothesis was not supportive for alcohol addiction, gambling addiction or other behaviours that may be addictive. Further studies are needed that investigate larger samples and longer observation periods, as well as other substance-use disorders.

Gambling is legal in most countries. However, despite having some economic benefits, certain characteristics of gambling can have health consequences, rendering it a public health issue. The effects can be summarized according to the following three “laws” of ethical gambling: “Gambling Dynamics Law”: companies’ economic gains come directly from players’ losses; “Expected Loss Law”: the more one gambles, the greater the probability of losing; and “Addiction Law”: the more one gambles, the greater the need to play again, leading to further losses. Ludens is a gambling addiction prevention program that has four goals: inform participants about gambling and gambling addiction; sensitize participants to the risk of gambling for health, especially addiction; promote a change in attitudes toward gambling; and alert participants to risky behaviors that can lead to addiction. The prevention program was implemented during 2017 to 2019. Fourteen psychologists presented it to 2372 adolescents (48.8% females, 51.2% males) aged 14–19 years, none of whom were university students, recruited from 42 Spanish high schools in 132 groups taking different courses. The main dependent variables analyzed were the monthly frequencies of gambling, at-risk gambling, and gambling addiction (as measured by the National Opinion Research Center DSM-IV Screen for Gambling Problems, adapted to diagnose gambling disorder according to DSM-5, in which pathological gambling is considered an addictive disorder). Given that all of the gamblers were adolescents (most were minors), fulfilment of 1–3 the DSM-5 diagnostic criteria was considered to indicate a risk of problem gambling. After the administration of Ludens, statistically significant reductions were observed in the three variables of interest: monthly frequency of gambling, percentage of adolescents with risky gambling, and percentage of adolescents with gambling disorder. The results were analyzed according to sex and age (minors vs. adolescents between 18 and 19 years old). The results obtained after applying the prevention program indicate that Ludens is effective as a universal prevention program for gambling addiction.

Problem gambling provides a strong motivation for perpetrating economic abuse. This study explores the interaction between problem gambling and economic abuse, and how this economic abuse is reinfo...

Purpose of review Despite a significant body of literature related to the treatment of gambling disorder, there are still an insufficient number of evaluation studies regarding their effectiveness or firm conclusions on specific treatment elements that contribute to it. The aim of this article was to provide a review of scientific results regarding the treatment of gambling disorder, to present the most commonly applied modalities of treatment and to explore the elements of the most successful therapeutic interventions. Recent findings A substantial body of literature has shown that the most successful therapeutic protocols are psychological interventions, especially based on cognitive-behavioral therapy/methods and/or motivational interviewing. Other interventions with promising results include different self-help interventions and mindfulness. Interventions such as couples therapy and support groups, may have positive effects in terms of increasing therapeutic adherence and retention, while pharmacotherapy is especially useful in patients with comorbidities. Summary Gambling disorder is a complex mental health problem caused by a wide spectrum of different biological, psychological, and social risk factors. Treatment options for gambling disorder need to be wide, flexible, accessible, and economically justified, providing early inclusion, retention, and sustainability of long-term effects of the treatment, that is, abstinence and higher quality of psychosocial functioning.

Participants in randomized control trials (RCTs) should be representative of those most likely to experience the disorder of focus, yet reviews of psychology research studies consistently find certain demographic groups are overrepresented at the price of others being unincluded. The present review aimed to characterize the demographic representation of US-based RCTs for gambling disorder and compare findings to the population of individuals most likely to experience the disorder. Thirteen US-based RCTs comprising a total of 2,343 participants were reviewed. We found that although gambling disorder is most prevalent among low SES racial minorities, RCTs are mostly conducted among populations who are white, employed, and have some level of college education. Demographic variables that are related to the likelihood of experiencing gambling disorder are not consistently reported, and there are many groups of individuals who experience gambling disorder that have been virtually left out of all treatment study samples to date. We conclude with recommendations for future gambling focused treatment studies, which are geared towards increasing the convergence between characteristics of participants in RCTs and those who experience gambling disorder in the United States.

Due to the increasing number of gambling disorders in recent years, various treatment methods have emerged by mental health professionals. Although various approaches address this problem, there are not many studies on the effectiveness of these approaches. The aim of this study is to investigate the effectiveness of cognitive behavioral therapy applied to gambling disorder in the literature. In this study using the PRISMA method, gambling disorder and cognitive behavioral therapy approaches were scanned in electronic databases and 10 studies were included in the systematic review. All studies used cognitive behavioral therapy (CBT) methods. There was no statistically significant difference between the CBT techniques used in the same study. All CBT approaches were found to be effective in the treatment of gambling, and were also effective in non-gambling secondary psychopathological problems. While the studies had a mean follow-up of 6 months, gambling shift behavior was generally observed in the first month of the therapy process. Even though all studies applied different methods, various solutions were provided to gambling disorder and secondary problems. The systematic reviews of studies on gambling disorder will provide more use of therapy methods especially in gambling disorder. In multidimensional examination and treatment of gambling disorder, not only psychopharmacological therapies but also eclectic approaches should be shaped with the addition of these approaches., Kumar oynama bozukluğunun son yıllarda giderek artması nedeniyle bu konuda ruh sağlığı çalışanları tarafından çeşitli tedavi yöntemleri ortaya çıkmaya başlamıştır. Her ne kadar çeşitli yaklaşımlar bu sorunu ele alıyor olsa da bu yaklaşımların etkinliğine dair çok fazla çalışma bulunmamaktadır. Bu çalışmanın amacı alanyazında kumar oynama bozukluğuna uygulanan bilişsel davranışçı terapi çalışmalarını derleyerek etkililiğini araştırmaktır. PRISMA yönteminin kullanıldığı bu çalışmada kumar oynama bozukluğu ve bilişsel davranışçı terapi yaklaşımları elektronik veri tabanlarında taranmış ve tam metnine ulaşılan 29 çalışmadan 10 çalışma sistematik derlemeye dahil edilmiştir. Derlenen tüm çalışmalar bilişsel davranışçı terapi (BDT) yöntemini kullanmıştır. Araştırmalarda farklı BDT yöntemleri aynı çalışmada kullananlar bu teknikler arasında istatistiksel olarak anlamlı bir farklılık olmadığnı tespit etmiştir. Tüm BDT yaklaşımlarının kumar tedavisinde etkin olduğu, bu yaklaşımların ayrıca kumar harici ikincil psikopatolojik sorunlarda da etkili olduğu görülmüştür. Çalışmaların ortalama 6 aylık bir takip sürecine sahip olduğu görülürken, kumara kayma davranışının genellikle terapi sürecinin ilk bir ayında yaşandığı çalışmalarda gözlemlenmiştir. Araştırmaya dahil edilen tüm çalışmalar farklı BDT teknikleri uygulasa da, bu çalışmalarda kumar oynama bozukluğu ve ikincil sorunlara çeşitli çözümler sunulmuştur. Kumar oynama bozukluğu ile ilgili yapılan çalışmaların bilimsel olarak derlenmesi, terapi yöntemlerinin özellikle kumar oynama bozukluğunda daha fazla kullanılmasını sağlayacaktır. Kumar oynama bozukluğunun çok boyutlu incelenmesi ve tedavisinde sadece psikofarmakolojik tedavilerin değil, bu yaklaşımların da eklenmesiyle eklektik bir bakış açısıyla tedavilerin şekillenmesi gerekmektedir.

Despite the emergence of literature on gender differences in gambling problems, few empirical studies have explored how gender norms inform the gender dynamics involved in the development of gambling disorder. This study addresses this research gap by applying general strain theory to gambling disorder across genders. The objectives of this study are twofold. First, we examine the role of gender norms in the social strain-gambling disorder relationship across genders. Second, we explore the extent to which males and females who conform to traditional gender norms are likely to express strain-induced negative emotions that result in gambling disorder. These relationships are examined with data from a cross-sectional survey of 1,620 Chinese married couples in Hong Kong. Our results indicate that gender norms function differently between genders. Specifically, gender norms exacerbate the effect of social strain on gambling disorder in males but mitigate the effect of social strain on gambling disorder in females. In addition, gender norms amplify the effect of strain-induced negative emotions on gambling disorder in males only.

Problem gambling might be associated with risk for self-harm, broadly construed (i.e., suicidal thoughts and behaviors and non-suicidal self-injury; see Nock, 2009 for a typology of intentional self-injury). Such associations would have urgent implications for self-harm screening, assessment, and intervention among people who experience problem gambling. However, it is unclear what kind of information is available in the literature about the potential association between problem gambling and self-harm. Further, gambling, more broadly, is associated with hazardous drinking and other risky behaviors. Given that risk behaviors tend to cluster, it is also important to consider gambling’s relationship with other dangerous behaviors including self-harm. Therefore, we will conduct a scoping review to systematically map the existing research in this area. We will search several electronic databases and chart included studies on a number of characteristics, including level of evidence (Ackley et al., 2008). We will construe “gambling” broadly, to encompass the full spectrum of gambling behavior (i.e., from gambling participation to clinically diagnosable Gambling Disorder). This scoping review will identify any potential gaps in knowledge and determine whether a formal meta-analysis identifying the strength of association between gambling and self-harm is feasible and of value.

The overarching aim of this project is to develop and evaluate a website enabling people to self-exclude remotely from multiple land-based gaming machine venues. The current phase (Phase 3) involves N = 20 self-exclusion end users trialling a non-live pilot version of the website in an ecologically valid environment to assess user experiences and satisfaction.

Materialism refers to linking the acquisition of possessions in one’s life to happiness and success (Richins & Dawson, 1992). Materialism may lead people to pursue extrinsic life domains, which would be reflected by an overvaluation of these domains in the self-concept (Dittmar, 2008). For instance, research has shown that materialism is associated with financial success overvaluation among people who gamble (Tabri et al., 2017). Similarly, experimental research in which women were exposed to materialistic advertisements (relative to neutral advertisements) reported greater appearance overvaluation (Study 3 in Ashikali & Dittmar, 2011). Critically, however, although Ashikali and Dittmar’s (2011) provided evidence for a causal link between materialism and overvaluation, there are at least two limitations that lower confidence in their findings. First, appearance overvaluation was not assessed prior to being exposed to the advertisements and so it is unclear whether appearance overvaluation increases among people exposed to materialistic advertisements relative to people exposed to neutral advertisements. Second, the effect size in Ashikali and Dittmar’s study was small (R2 = .03) and results from a post-hoc power analysis indicated that the effect was 20% powered, which is below the conventional 80% power. Nevertheless, Ashikali and Dittmar’s results, to our knowledge, are the first to examine materialism as an antecedent of overvaluation using an experimental research design. Accordingly, the purpose of the current research is to replicate and extend the findings of Ashikali and Dittmar’s results using a repeated-measures pre-post experimental design. We will also recruit men and women and measure both appearance and financial success overvaluation before and after exposure to materialistic or neutral advertisements. The hypothesis is that people will report an increase in overvaluation (financial success and appearance overvaluation) from before to after viewing materialistic advertisements compared to people who are exposed to neutral advertisements.

The RIGAB study aims to characterize online sports bettors with and without gambling disorder concerning individual risk factors and subsequently use this characterization to predict the development, progression and onset of gambling disorder (GD). The RIGAB study is a longitudinal study and consists of three parts: an initial online survey, an in-person study with a randomly selected subsample and a shorter follow-up online survey after one year with the entire sample. This registration pertains to the initial online survey. The other parts of the study will be preregistered separately.

Summarizes all 190 studies in terms of all data items

We will use actual player data from an international internet gambling operator to develop and validate low risk online gambling thresholds.

This registration is an analysis plan for psychometric analysis concerning the Gambling Disorder Identification Test (G-DIT), a newly developed self-report measure.

Several studies have explored the association between gambling disorder (GD) and gambling-related crimes. However, it is still unclear how the commission of these offenses influences treatment outcomes. In this longitudinal study we sought: (1) to explore sociodemographic and clinical differences (e.g., psychiatric comorbidities) between individuals with GD who had committed gambling-related illegal acts (differentiating into those who had had legal consequences (n = 31) and those who had not (n = 55)), and patients with GD who had not committed crimes (n = 85); and (2) to compare the treatment outcome of these three groups, considering dropouts and relapses. Several sociodemographic and clinical variables were assessed, including the presence of substance use, and comorbid mental disorders. Patients received 16 sessions of cognitive-behavioral therapy. Patients who reported an absence of gambling-related illegal behavior were older, and showed the lowest GD severity, the most functional psychopathological state, the lowest impulsivity levels, and a more adaptive personality profile. Patients who had committed offenses with legal consequences presented the highest risk of dropout and relapses, higher number of psychological symptoms, higher likelihood of any other mental disorders, and greater prevalence of tobacco and illegal drugs use. Our findings uphold that patients who have committed gambling-related offenses show a more complex clinical profile that may interfere with their adherence to treatment.