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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]

The author comments on an article by D. Zendle and P. Newall which provides evidence for understanding the link between gambling spending and harm using novel methods. He discusses why Zendle and Newall's article provides an important contribution to the gambling literature, concern on the net-spend values computed by the authors, and basis of the authors' conclusion that affordability checks will not impact no-/low-risk gamblers.

Background and Aims: The pathways model is a highly cited etiological model of problem gambling. In the past two decades, a number of studies have found support for the model's utility in classifying gambling subtypes. The aims of this paper were to refine empirically the model subtypes and to revise and update the model based on those findings. Design and Measurement: Observational study using data collected from treatment‐seeking problem gamblers using the Problem Gambling Severity Index (PGSI) and the Gambling Pathways Questionnaire (GPQ). Setting: Treatment clinics in Canada, Australia and the United States. Participants: A convenience sample of 1168 treatment‐seeking problem gamblers, aged 18 years or older. Findings Empirically validated risk factors were analyzed using latent class analyses, identifying a three‐class solution as the best‐fitting model. Those in the largest class (class 1: 44.3%, n = 517) reported the lowest levels of all etiological risk factors. Participants in class 2 (39.5%, n = 461) reported the highest rates of anxiety and depression, both before and after gambling became a problem, as well as childhood maltreatment, and a high level of gambling for stress‐coping. Those in class 3 (16.3%, n = 190) reported high levels of impulsivity; risk‐taking, including sexual risk‐taking; antisocial traits; and coping to provide meaning in life and to alleviate stress. Conclusions: The revised pathways model of problem gambling includes three classes of gamblers similar to the three subtypes in the original pathways model, but class 3 in the revised pathways model is distinct from class 2, showing higher levels of risk‐taking and antisocial traits and gambling motivated by a desire for meaning/purpose and/or to alleviate stress. Class 2 in the revised pathways model demonstrates high levels of childhood maltreatment as well as gambling for stress‐coping. [ABSTRACT FROM AUTHOR]

Aims: To estimate whether the use of wagering inducements has a significant impact on the gambling behaviors of on‐line gamblers and describe this temporal relation under naturalistic conditions. Design This longitudinal observational study is part of the second stage of the Screening for Excessive Gambling Behaviors on the Internet (EDEIN) research program. Setting: Gambling tracking data from the French national on‐line gambling authority (poker, horse race betting and sports betting) and from the French national lottery operator (lotteries and scratch games). Participants: A total of 9306 gamblers who played poker, horse race or sports betting and 5682 gamblers who played lotteries and scratch games completed an on‐line survey. The gender ratio was largely male (between 87.1% and 92.9% for poker, horse race betting and sports betting, and equal to 65.1% for lotteries). Median age ranged from 35 (sports betting) to 53 (horse race betting and lotteries). Measurements The survey used the Problem Gambling Severity Index (PGSI) to determine the status of the gamblers (at‐risk or not). Gambling tracking data included weekly gambling intensity (wagers, deposits), gambling frequency (number of gambling days), proxies of at‐risk gambling behaviors (chasing and breadth of involvement) and use of wagering inducements. Findings The use of wagering inducements was associated with an increase of gambling intensity [β between −0.06 (−0.08; –0.05) and 0.57 (0.54; 0.60)], gambling frequency [β between 0.12 (0.10; 0.18) and 0.29 (0.28; 0.31)] and at‐risk gambling behaviors [odds ratio between 1.32 (1.16; 1.50) and 4.82 (4.61; 5.05)] at the same week of their use. This effect was stronger for at‐risk gambling behaviors and at‐risk gamblers. Conclusions: Wagering inducements may represent a risk factor for developing or exacerbating gambling problems. [ABSTRACT FROM AUTHOR]

A review of the article "The illusion of control," written by EJ Langer and printed in a 1975 issue of the "Journal of Personality and Social Psychology" is presented.

Aims: To evaluate and compare the effects of three cognitive boosting intervention approaches (computerised cognitive training, cognitive remediation and pharmacological cognitive enhancers) on measures of impulsive action and impulsive choice. Design Systematic review and meta‐analysis of publications that reported original controlled trials of cognitive boosting interventions. Setting: Studies conducted anywhere in the world. No language restrictions were applied. Participants: Treatment‐seeking adults with substance use disorder or gambling disorder. Measurements Our primary outcome was a reduction in impulsive action or choice on a validated cognitive measure post‐intervention. We assessed risk of bias using the Cochrane Collaboration tool and determined pooled estimates from published reports. We performed random‐effects analyses for impulsive action and impulsive choice outcomes and planned moderator analyses. Findings Of 2204 unique studies identified, 60 were included in the full‐text review. Twenty‐three articles were considered eligible for inclusion in the qualitative synthesis and 16 articles were included in our meta‐analysis. Articles eligible for pooled analyses included five working memory training (computerised cognitive training) studies with 236 participants, three goal management training (cognitive remediation) studies with 99 participants, four modafinil (cognitive enhancer) studies with 160 participants and four galantamine (cognitive enhancer) studies with 131 participants. Study duration ranged from 5 days to 13 weeks, with immediate follow‐up assessments. There were no studies identified that specifically targeted gambling disorder. We only found evidence for a benefit on impulsive choice of goal management training, although only in two studies involving 66 participants (standardised mean difference (SMD) = 0.86; 95% CI = 0.49–1.23; P = 0.02; I2 = 0%, P = 0.95). Conclusion: Cognitive remediation, and specifically goal management training, may be an effective treatment for addressing impulsive choice in addiction. Preliminary evidence does not support the use of computerised cognitive training or pharmacological enhancers to boost impulse control in addiction. [ABSTRACT FROM AUTHOR]

Background and Aims: Few meta‐analyses have been conducted to pool the most constant risk factors for problem gambling. The present meta‐analysis summarizes effect sizes of the most frequently assessed problem gambling risk factors, ranks them according to effect size strength and identifies any differences in effects across genders. Method: A random‐effects meta‐analysis was conducted on jurisdiction‐wide gambling prevalence surveys on the general adult population published until March 2019. One hundred and four studies were eligible for meta‐analysis. The number of participants varied depending on the risk factor analyzed, and ranged from 5327 to 273 946 (52% female). Weighted mean odds ratios were calculated for 57 risk factors (socio‐demographic, psychosocial, gambling activity and substance use correlates), allowing them to be ranked from largest to smallest with regard to their association with problem gambling. Results: The highest odds ratio (OR) was for internet gambling [OR = 7.59, 95% confidence interval (CI) = 5.24, 10.99, P < 0.000] and the lowest was for employment status (OR = 1.03, 95% CI = 0.87, 1.22, P = 0.718). The largest effect sizes were generally in the gambling activity category and the smallest were in the socio‐demographic category. No differences were found across genders for age‐associated risk. Conclusions: A meta‐analysis of 104 studies of gambling prevalence indicated that the most frequently assessed problem gambling risk factors with the highest effect sizes are associated with continuous‐play format gambling products. [ABSTRACT FROM AUTHOR]

Background and aims: There is evidence that cognitive behavioral therapy (CBT) is effective for treating problem gambling (PG). Some research points to the possible benefits of involving concerned significant others (CSOs) in treatment. This study compared the efficacy of behavioral couples therapy (BCT) and CBT for both the gambler and the CSO. Design Two parallel‐group randomized controlled study comparing two different internet‐based treatments for PG. Follow‐up measures were conducted at treatment finish, and at 3‐, 6‐ and 12‐month post‐treatment. Setting: Stockholm, Sweden. Participants: A total of 136 problem gamblers and 136 CSOs were included in the study: 68 gamblers and 68 CSOs for each treatment condition. The gamblers were on average 35.6 years old and 18.4% were female. CSOs were on average 45.3 years old and 75.7% were women. Interventions: A treatment based on BCT was compared with a CBT intervention. Both treatments were internet‐based, with 10 therapist‐guided self‐help modules accompanied by weekly telephone and e‐mail support from a therapist. CSOs were given treatment in the BCT condition, but not in the CBT condition. Measurements The primary outcome measures were time‐line follow‐back for gambling (TLFB‐G) and the NORC Diagnostic Screen for Gambling Problems (NODS) for problem gamblers, corresponding to DSM‐IV criteria for pathological gambling. Secondary outcomes measures were the Patient Health Questionnaire‐9 (PHQ‐9), the Generalized Anxiety Disorder seven‐item scale (GAD‐7), the Relation Assessment Scale Generic (RAS‐G), the Alcohol Use Disorders Identification Test (AUDIT), the Inventory of Consequences of Gambling for the Gambler and CSO (ICS) and adherence to treatment for both the problem gambler and the CSO. Findings The outcomes of both gambler groups improved, and differences between the groups were not statistically significant: TLFB‐G: multiplicative effect = 1.13, 95% confidence interval (CI) = 0.30;4.31); NODS: multiplicative effect = 0.80, 95%, 95% CI = 0.24;2.36. BCT gamblers began treatment to a higher proportion than CBT gamblers: P = 0.002. Conclusions: Differences in the efficacy of internet‐based behavioral couples therapy and cognitive behavioral therapy for treatment of problem gambling were not significant, but more gamblers commenced treatment in the behavioral couples therapy group. [ABSTRACT FROM AUTHOR]

Abstract: Background and Aims: Considerable variation of outcome variables used to measure recovery in the gambling treatment literature has precluded effective cross‐study evaluations and hindered the development of best‐practice treatment methodologies. The aim of this systematic review was to describe current diffuse concepts of recovery in the gambling field by mapping the range of outcomes and measurement strategies used to evaluate treatments, and to identify more commonly accepted indices of recovery. Methods: A systematic search of six academic databases for studies evaluating treatments (psychological and pharmacological) for gambling disorders with a minimum 6‐month follow‐up. Data from eligible studies were tabulated and analysis conducted using a narrative approach. Guidelines of the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) were adhered to. Results: Thirty‐four studies were reviewed systematically (RCTs = 17, comparative designs = 17). Sixty‐three different outcome measures were identified: 25 (39.7%) assessed gambling‐specific constructs, 36 (57.1%) assessed non‐gambling specific constructs, and two instruments were used across both categories (3.2%). Self‐report instruments ranged from psychometrically validated to ad‐hoc author‐designed questionnaires. Units of measurement were inconsistent, particularly in the assessment of gambling behaviour. All studies assessed indices of gambling behaviour and/or symptoms of gambling disorder. Almost all studies (n = 30; 88.2%) included secondary measures relating to psychiatric comorbidities, psychological processes linked to treatment approach, or global functioning and wellbeing. Conclusions: In research on gambling disorders, the incorporation of broader outcome domains that extend beyond disorder‐specific symptoms and behaviours suggests a multi‐dimensional conceptualization of recovery. Development of a single comprehensive scale to measure all aspects of gambling recovery could help to facilitate uniform reporting practices across the field. [ABSTRACT FROM AUTHOR]

The authors respond to commentaries on their study published within the issue which aimed to refine the pathways model subtypes of problem gambling and to revise and update the model based on the findings of studies which found support for the model's utility in classifying gambling subtypes. Topics covered include a range of risk factors considered and tested by the revised pathways model, and the relevant factors found in the model, such as attention deficit hyperactivity disorder (ADHD).

The authors comment on a study published within the issue which aimed to refine the pathways model subtypes of problem gambling and to revise and update the model based on the findings of studies which found support for the model's utility in classifying gambling subtypes. Topics covered include the strong assertion of the study that the model is aimed to classify relevant gambling patterns, and the need for research designs and approaches that can characterize key factors in the model.

The authors comment on a study published within the issue which aimed to refine the pathways model subtypes of problem gambling and to revise and update the model based on the findings of studies which found support for the model's utility in classifying gambling subtypes. Topics covered include the important diagnostic and treatment implications of the model for disordered gambling and the relevance of the connection with attention deficit hyperactivity disorder (ADHD) to gambling disorder.

Following the recent changes to the diagnostic category for addictive disorders in DSM-5, it is urgent to clarify what constitutes behavioural addiction to have a clear direction for future research and classification. However, in the years following the release of DSM-5, an expanding body of research has increasingly classified engagement in a wide range of common behaviours and leisure activities as possible behavioural addiction. If this expansion does not end, both the relevance and the credibility of the field of addictive disorders might be questioned, which may prompt a dismissive appraisal of the new DSM-5 subcategory for behavioural addiction. We propose an operational definition of behavioural addiction together with a number of exclusion criteria, to avoid pathologizing common behaviours and provide a common ground for further research. The definition and its exclusion criteria are clarified and justified by illustrating how these address a number of theoretical and methodological shortcomings that result from existing conceptualizations. We invite other researchers to extend our definition under an Open Science Foundation framework. [ABSTRACT FROM AUTHOR]

Background and Aims Gambling disorder is characterized by poor regulation of negative emotions and impulsive behaviours. This study aimed to (1) compare gambling disorder patients (GDPs) and healthy controls (HCs) in self-report and brain activation measures of emotion regulation; and (2) establish its relationship with negative emotion-driven impulsivity. Design Two cross-sectional case-control studies including GDPs and HCs. Setting and Participants GDPs and HCs were recruited from specialized gambling clinics in Andalusia (Spain), where they were following out-patient treatment, and from the community, respectively. Study 1 included 41 GDPs and 45 HCs [All males; Mage = 35.22, 33.22; standard deviation (SD) = 11.16, 8.18; respectively]. Study 2 included 17 GDPs and 21 HCs (16/20 males; Mage = 32.94, 31.00; SD = 7.77, 4.60; respectively). Measurements In study 1, we compared both groups on suppression and re-appraisal emotion regulation strategies [Emotion Regulation Questionnaire (ERQ)]. In study 2, we compared GDPs with HCs on brain activation associated with down-regulation of negative emotions in a cognitive re-appraisal task, measured with functional magnetic resonance imaging (fMRI). In both studies, we correlated the measures of emotion regulation with mood-related impulsivity indicated by negative urgency (UPPS-P impulsive behaviour scale). Findings GDPs relative to HCs showed higher levels of emotional suppression [ F = 4.525; P = 0.036; means difference MHCs-MGDPs = −2.433, 95% confidence interval (CI) = −4.706, −0.159] and higher activation of the premotor cortex and middle frontal gyrus during negative emotion regulation in the fMRI task [ P ≤ 0.005, cluster size (CS) > 50 voxels]. Negative urgency correlated positively with emotional suppression ( r = 0.399, 95% CI = 0.104, 0.629, one-tailed P = 0.005) and middle frontal gyrus activation during negative emotion regulation ( P ≤ 0.005, CS > 50) in GDPs. Conclusions Gambling disorder is associated with greater use of emotional suppression and stronger pre-motor cortex and middle frontal gyrus activation for regulating negative emotions, compared with healthy controls. Emotional suppression use and middle frontal gyrus activation during negative emotion regulation are linked with negative emotion-driven impulsivity in this disorder. [ABSTRACT FROM AUTHOR]

A commentary on an article by Heirene & Gainsbury is presented, which explores the prevention of gambling.

Aims To derive empirical subtypes of problem gamblers based on etiological and clinical characteristics described in the Pathways Model, using data from a nationally representative survey of US adults. Design & measurement Data were collected from structured diagnostic face-to-face interviews using the Alcohol Use Disorder and Associated Disabilities Interview Schedule DSM- IV version IV ( AUDADIS- IV). Setting The study utilized data from US National Epidemiologic Survey on Alcohol and Related Conditions ( NESARC). Participants All disordered gambling participants ( n = 581) from a nationally representative cross-sectional sample of civilian non-institutionalized adults aged 18 years or older. Findings Latent class analyses indicated that the best-fitting model was a three-class solution. Those in the largest class (class 1: 50.76%, n = 295) reported the lowest overall levels of psychopathology including gambling problem severity and mood disorders. In contrast, respondents in class 2 (20.06%, n = 117) had a high probability of endorsing past-year substance use disorders, moderate probabilities of having parents with alcohol/drug problems and of having a personality disorder, and the highest probability for past-year mood disorders. Respondents in class 3 (29.18%, n = 169) had the highest probabilities of personality and prior-to-past year mood disorders, substance use disorders, separation/divorce, drinking-related physical fights and parents with alcohol/drug problems and/or a history of antisocial personality disorder ( ASPD). Conclusions Three subtypes of disordered gamblers can be identified, roughly corresponding to the subtypes of the Pathways Model, ranging from a subgroup with low levels of gambling severity and psychopathology to one with high levels of gambling problem severity and comorbid psychiatric disorders. [ABSTRACT FROM AUTHOR]

The article presents an overview of the periodical's series on National Gambling Experiences, a commentary on the development and effect of gambling in various countries. It notes how authors detailed the periods of restriction, prohibition, and legalization of gambling. Particular attention is given to the trend of expansion in the late 1980s as well as subsequent studies on the harms, addiction, and treatment.

In many countries, it is currently possible to gamble on every sport event while being exposed to a high number of sports betting advertisements. Research is needed to examine how the increased popularity of sports betting is currently reframing the way that sports are being experienced by (young) sports fans. [ABSTRACT FROM AUTHOR]

Highly realistic slot machine simulations are a powerful way to test the impact of gambling structural features.‘ Nudging’ may provide a framework to mitigate the effects of Losses Disguised as Wins and, more broadly, to translate research findings into gambling policy. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented in response to the article "McCarthyism, Conflict of Interest and Addiction's New Transparency Declaration Procedures" by T.E. Babor and P.G. Miller in volume 109 of the periodical.

The article presents a psychological autopsy study which examines the relationship between suicide and gambling in Hong Kong, China. The study revealed that a gambling disorder is completed suicides' third most contributory psychiatric disorder in Hong Kong, after depressive and psychotic disorders. It showed that 20% of 3,686 clients who seek treatment from problem gambling services had suicidal thoughts.