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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.

Young adult men who gamble frequently face an elevated risk of developing gambling-related problems. So far, little is known about how changing levels of perceived social support interact with the course of gambling behaviour and gambling-related problems in this population. Using data from a prospective single-arm cohort study (Munich Leisure Time Study), we applied hierarchical linear models to investigate the longitudinal association of changes in perceived emotional and social support (hereafter PESS; operationalized as ENRICHD Social Support Instrument score) with gambling intensity, gambling frequency, and fulfilled criteria for gambling disorder. Pooling data from three time points (baseline, 12-month and 24-month follow-ups) to assess two 1-year intervals, these models disentangle the associations of (a) “level of PESS” (cross-sectional, between participants) and (b) “changes in individual PESS” (longitudinally, within-participants). Among the 169 study participants, higher levels of PESS were associated with fewer gambling-related problems (− 0.12 criteria met; p = 0.014). Furthermore, increasing individual PESS was associated with lower gambling frequency (− 0.25 gambling days; p = 0.060) and intensity (− 0.11 gambling hours; p = 0.006), and fewer gambling-related problems (− 0.19 problems; p < 0.001). The results suggest a mitigating influence of PESS on gambling behaviour and gambling-related problems. Increasing individual PESS appears more decisive for this pathway than high initial levels of PESS. Treatment and prevention strategies that activate and reinforce beneficial social resources in people with gambling-related problems are recommended and promising.

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 grea, Depto. de Personalidad, Evaluación y Psicología Clínica, Fac. de Psicología, TRUE, pub

Gambling is a legitimate leisure activity in many countries that many people use. However, some of them suffer significant harm because of gambling. This may involve economic, social, physical or mental harm. These harms are not only suffered by the individual gambler, but affect the family, the community and society. The aim of this text is to propose a conceptual framework for understanding the determinants of gambling and its related harms and thus, contribute to the development of prevention policies to reduce its impact on health. The framework proposed in this manuscript places present evidence in the model of health inequalities, analyzing the effect of the socioeconomic and political context, the axes of inequalities, individual and social factors, and the health system in generating the health inequalities of gambling suffered by the most vulnerable groups. The evidence gathered in this framework suggests that health determinants lead to health inequality in relation to gambling and its associated harms., El juego de apuestas es una actividad de ocio legítima en muchos países, la cual muchas personas utilizan. Sin embargo, algunas de ellas experimentan daños significativos como resultado de estos juegos de apuestas. Estos daños, que pueden ser de carácter económico, social o de salud física y mental, no solo los sufre el individuo que juega, sino que afectan a la familia, a la comunidad y a toda la sociedad. El objetivo de este texto es proponer un marco conceptual para comprender los determinantes del juego de apuestas y sus daños asociados, que ayude a desarrollar políticas de prevención para reducir su impacto en la salud. El marco planteado en este manuscrito sitúa la evidencia actual en el modelo de desigualdades en salud y analiza la importancia del contexto socioeconómico y político, de los ejes de desigualdad, de los factores individuales y sociales, y del sistema sanitario en la desigualdad en salud asociada al juego de apuestas que sufren los grupos más vulnerables. La evidencia que se recoge en este marco sugiere que los determinantes de salud conllevan a una desigualdad en salud en relación con los juegos de apuestas y sus daños asociados.

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.

Background and aims: Individuals with gambling disorder (GD) often suffer from psychiatric comorbidities. Previous studies demonstrated greater severity of GD among gamblers with psychiatric comorbidities. However, evidence on the association between psychiatric comorbidity and course of GD severity during and after outpatient treatment is sparse. This study analyses data from a longitudinal one-armed cohort study on outpatient addiction care clients over three years. Methods: We investigated the course of GD severity using data from 123 clients in 28 outpatient addiction care facilities in Bavaria using generalized estimation equations (GEE). We applied time* interaction analyses to examine different development profiles in participants with and without (1) affective disorders, or (2) anxiety disorders, and (3) to account for the co-occurrence of both. Results: All participants benefitted from outpatient gambling treatment. Improvement in GD severity was poorer in participants with anxiety disorders compared to participants without anxiety disorders. The co-occurrence of affective and anxiety disorders was linked to a less favourable course of GD than the presence of affective disorders alone. However, the combined occurrence of both disorders was more favourable than the presence of anxiety disorders alone. Discussion and conclusions: Our study suggests that clients with GD, with and without psychiatric comorbidities, benefit from outpatient gambling care. Psychiatric comorbidity, especially comorbid anxiety disorders, seems to be negatively associated with the course of GD within outpatient gambling care. Addressing psychiatric comorbidity within the treatment of GD and offering individualised help are required to meet the needs of this clientele.

Institute of Health Research of Aragon (IIS Aragón), Miguel Servet University Hospital, 50009 Zaragoza, Spain Chronicity, Primary Care, and Health Promotion Research Network (RICAPPS), 50015 Zaragoza, Spain Department of Psychology and Sociology, University of Zaragoza, 50009 Zaragoza, Spain Healthcare Research Institute of Navarre (IdiSNA), 31008 Pamplona, Spain Department of Psychiatry, Hospital Miguel Servet, University of Zaragoza, 50009 Zaragoza, Spain Primary Care Teaching Unit for Zaragoza Healthcare District 1, 50018 Zaragoza, Spain Department of Health Psychology, Miguel Hernández University, 03202 Elche, Spain Department of Public Health and Maternal and Child Health, Faculty of Medicine, Complutense University of Madrid, 28040 Madrid, Spain CIBER Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain Barcelona Public Health Agency (ASPB), 08023 Barcelona, Spain Public Health Agency of Catalonia (ASPCAT), 08005 Barcelona, Spain, Gambling disorder in youth is an emerging public health problem, with adolescents and young adults constituting a vulnerable age group for the development of gambling-related problems. Although research has been conducted on the risk factors for gambling disorder, very few rigorous studies can be found on the efficacy of preventive interventions in young people. The aim of this study was to provide best practice recommendations for the prevention of disordered gambling in adolescents and young adults. We reviewed and synthesized the results of existing RCTs and quasi-experimental studies covering nonpharmacological prevention programs for gambling disorder in young adults and adolescents. We applied the PRISMA 2020 statement and guidelines to identify 1483 studies, of which 32 were included in the systematic review. All studies targeted the educational setting, i.e., high school and university students. Most studies followed a universal prevention strategy, that particularly targeted adolescents, and an indicated prevention strategy for university students. The reviewed gambling prevention programs generally showed good results in terms of reducing the frequency and severity of gambling, and also regarding cognitive variables, such as misconceptions, fallacies, knowledge, and attitudes towards gambling. Finally, we highlight the need to develop more comprehensive prevention programs that incorporate rigorous methodological and assessment procedures before they are widely implemented and disseminated., Instituto de Investigación Sanitaria Aragón: Hospital Universitario Miguel Servet, Red de Investigación en Cronicidad, Atención Primaria y Prevención y Promoción de la Salud, Departmento de Psicología y Sociología (Universidad de Zaragoza), Instituto de Investigación Sanitaria de Navarra, Hospital Miguel Servet: Departamento de Psiquiatría, Unidad de Atención Primaria del Sector Sanitario de Zaragoza, Distrito 1, Universidad Miguel Hernández: Departamento de Psicología de la Salud, Universidad Complutense de Madrid: Departamento de Salud Pública y Materno-Infantil, Centro de Investigación Biomédica en Red Epidemiología y Salud Pública, Agencia de Salud Pública de Barcelona, Agencia de Salud Pública de Catalunya, Depto. de Salud Pública y Materno - Infantil, Fac. de Medicina, TRUE, pub

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.

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 Iow

Objective: This study examined characteristics of individuals with alcohol use disorder (AUD) or gambling disorder (GD) who were seeking couple therapy based on screening data from a randomized controlled trial on Congruence Couple Therapy at 2 out-patient addiction service sites in Alberta. Method: Screening data of couple therapy seekers (N= 171) were analyzed. Results: Seekers cited various motivations for seeking couple therapy including addiction-related relationship breaches and issues, the desire to recover from addiction together, concerns for the well-being of their children, and the lack of available couple therapy in addiction services until this trial. Significantly more females than males were first to indicate interest, and 77% of the sample had attended other treatment and mutual help programs in the past 12 months. The majority of the treatment seekers met DSM-5 diagnostic criteria for AUD and/or GD scoring in the moderate-severe range with nearly half of the seekers reporting a mental health diagnosis at least once in their lifetime. In addition, 30% of treatment-seekers reported past-year suicidal thoughts, citing their own addiction and their partners’ addiction as reasons and 57% of those individuals reported having a method/plan to carry out their suicide. Suicidal attempts in the past year was 8% based on the entire sample. Finally, 19% of treatment seekers reported experiencing intimate partner violence within the past 12 months. Conclusion: Addiction and couple relationship problems are closely connected. Despite the serious multiple concurrent concerns of seekers identified in this study, there is a general lack of couple therapy availability in addiction services. This study highlights the importance for addiction and mental health professionals to note the complex interaction of couple distress and addiction, understand couple therapy as a treatment modality, and make timely referrals for this vulnerable group.

(1) Background: Inhibitory and rewarding processes that mediate attentional biases to addiction-related cues may slightly differ between patients suffering from alcohol use (AUD) or gambling (GD) disorder. (2) Methods: 23 AUD inpatients, 19 GD patients, and 22 healthy controls performed four separate Go/NoGo tasks, in, respectively, an alcohol, gambling, food, and neutral long-lasting cueing context during the recording of event-related potentials (ERPs). (3) Results: AUD patients showed a poorer inhibitory performance than controls (slower response latencies, lower N2d, and delayed P3d components). In addition, AUD patients showed a preserved inhibitory performance in the alcohol-related context (but a more disrupted one in the food-related context), while GD patients showed a specific inhibitory deficit in the game-related context, both indexed by N2d amplitude modulations. (4) Conclusions: Despite sharing common addiction-related mechanisms, AUD and GD patients showed different patterns of response to (non-)rewarding cues that should be taken into account in the therapeutic context., SCOPUS: ar.j, info:eu-repo/semantics/published

Gambling disorder (GD) is a behavioral addiction that severely impacts individuals’ functioning, leading to high socioeconomic costs. Non-invasive brain stimulation (NiBS) has received attention for treating psychiatric and neurological conditions in recent decades, but there is no recommendation for its use for GD. Therefore, this study aimed to systematically review and analyze the available literature to determine the effectiveness of NiBS in treating GD. Following the PRISMA guidelines, we screened four electronic databases up to July 2022 and selected relevant English-written original articles. We included ten papers in the systematic review and seven in the meta-analysis. As only two studies employed a sham-controlled design, the pre–post standardized mean change (SMCC) was computed as effect size only for real stimulation. The results showed a significant effect of NiBS in reducing craving scores (SMCC = −0.69; 95% CI = [−1.2, −0.2], p = 0.010). Moreover, considering the GD’s frequent comorbidity with mood disorders, we ran an exploratory analysis of the effects of NiBS on depressive symptoms, which showed significant decreases in post-treatment scores (SMCC = −0.71; 95% CI = [−1.1, −0.3], p < 0.001). These results provide initial evidence for developing NiBS as a feasible therapy for GD symptoms but further comprehensive research is needed to validate these findings. The limitations of the available literature are critically discussed.

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.

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

Objective: This study examined characteristics of individuals with alcohol use disorder (AUD) or gambling disorder (GD) who were seeking couple therapy based on screening data from a randomized controlled trial on Congruence Couple Therapy at 2 out-patient addiction service sites in Alberta. Method: Screening data of couple therapy seekers (N= 171) were analyzed. Results: Seekers cited various motivations for seeking couple therapy including addiction-related relationship breaches and issues, the desire to recover from addiction together, concerns for the well-being of their children, and the lack of available couple therapy in addiction services until this trial. Significantly more females than males were first to indicate interest, and 77% of the sample had attended other treatment and mutual help programs in the past 12 months. The majority of the treatment seekers met DSM-5 diagnostic criteria for AUD and/or GD scoring in the moderate-severe range with nearly half of the seekers reporting a mental health diagnosis at least once in their lifetime. In addition, 30% of treatment-seekers reported past-year suicidal thoughts, citing their own addiction and their partners’ addiction as reasons and 57% of those individuals reported having a method/plan to carry out their suicide. Suicidal attempts in the past year was 8% based on the entire sample. Finally, 19% of treatment seekers reported experiencing intimate partner violence within the past 12 months. Conclusion: Addiction and couple relationship problems are closely connected. Despite the serious multiple concurrent concerns of seekers identified in this study, there is a general lack of couple therapy availability in addiction services. This study highlights the importance for addiction and mental health professionals to note the complex interaction of couple distress and addiction, understand couple therapy as a treatment modality, and make timely referrals for this vulnerable group.

[Aim] Recently, a machine-learning (ML) technique has been used to create generalizable classifiers for psychiatric disorders based on information of functional connections (FCs) between brain regions at resting state. These classifiers predict diagnostic labels by a weighted linear sum (WLS) of the correlation values of a small number of selected FCs. We aimed to develop a generalizable classifier for gambling disorder (GD) from the information of FCs using the ML technique and examine relationships between WLS and clinical data. [Methods] As a training dataset for ML, data from 71 GD patients and 90 healthy controls (HCs) were obtained from two magnetic resonance imaging sites. We used an ML algorithm consisting of a cascade of an L1-regularized sparse canonical correlation analysis and a sparse logistic regression to create the classifier. The generalizability of the classifier was verified using an external dataset. This external dataset consisted of six GD patients and 14 HCs, and was collected at a different site from the sites of the training dataset. Correlations between WLS and South Oaks Gambling Screen (SOGS) and duration of illness were examined. [Results] The classifier distinguished between the GD patients and HCs with high accuracy in leave-one-out cross-validation (area under curve (AUC = 0.89)). This performance was confirmed in the external dataset (AUC = 0.81). There was no correlation between WLS, and SOGS and duration of illness in the GD patients. [Conclusion] We developed a generalizable classifier for GD based on information of functional connections between brain regions at resting state.

Altres ajuts: Delegación del Gobierno para el Plan Nacional sobre Drogas: 2017I067 i 2019I47, Impulsive choice, measured by delay discounting (DD) tasks, has been shown in patients with gambling disorders (GD). However, the impact of DD and treatment outcome has been scarcely explored in GD patients. The aims of this study were: (1) to examine the baseline association between DD and clinical variables in GD patients depending on their age and gambling preferences (strategic vs. non-strategic); and (2) to estimate the predictive role of DD on poorer outcomes of cognitive-behavioral therapy (CBT) when considering also the effect of other clinical variables. 133 treatment-seeking male GD patients were evaluated at baseline with a DD task and measures of GD severity, personality traits and psychopathology. Treatment outcome was measured in terms of dropout from CBT and relapses. Results showed baseline associations between DD and GD severity (correlation coefficient R = 0.408 among strategic gamblers and R = 0.279 among mixed gamblers) and between DD and positive/negative urgency (R = 0.330 for the youngest patients, R = 0.244 for middle age, and around R = 0.35 for gamblers who reported preferences for strategic games). Other personality traits such as high harm avoidance and low cooperativeness were also related to DD at baseline (R = 0.606 among strategic gamblers). Regarding treatment outcome, a steeper discount rate predicted a higher risk of relapses in strategic gamblers (odds ratio OR = 3.01) and middle-age ones (OR = 1.59), and a higher risk of dropout in younger gamblers (OR = 1.89), non-strategic gamblers (OR = 1.70) and mixed gamblers (R = 4.74). GD severity mediated the associations between age, DD, personality traits and poor CBT outcome. In conclusion, impulsive choice affects treatment response in individuals with GD and may interfere with it to a significant extent. Considering DD in GD, patients seeking treatment could help control its impact on treatment adherence and relapses.

BACKGROUND Motives to gamble are important in the functional analysis of problematic gambling. This study examines the possibility of classifying young male gamblers based on their motives to gamble and compares the identified groups to validate the obtained classification. METHOD Based on a screening survey among 2,681 young men from Bavaria, n=170 frequent or problem gamblers (Mage = 22.3 years, SD = 2.5) were recruited to participate in a survey with a 2-year follow-up. Latent class analyses (LCA) were conducted based on baseline answers to 10 items measuring five domains of gambling motives: enhancement, coping, self-gratification, and social and financial motives. The identified classes were compared regarding baseline gambling attitudes and impulsiveness as well as gambling behavior and gambling disorder (GD) criteria at baseline and follow-up. RESULTS Analyses revealed a four-class solution based on reported motives: ‘primarily fun-motivated gamblers’ (n=100, 58.8%), who gambled mostly for fun; ‘asset and self-gratification seekers’ (n=19, 11.2%) with a high risk of GD at baseline; ‘thrill seekers’ (n=42, 24.7%) with high impulsiveness; and ‘polymotivated coping gamblers’ (n=9, 5.3%) with a higher risk of GD than the ‘primarily fun-motivated gamblers’ in cross-sectional and longitudinal analyses. CONCLUSIONS The identified group differences support the validity of the classification. ‘Thrill seekers’ and ‘polymotivated coping gamblers’ correspond to the impulsive and emotionally vulnerable pathways described by Blaszczynski and Nower (2002) respectively. The two other groups appear to be subtypes of the behaviorally conditioned type. Motivation-based classification offers a promising approach to identifying individuals with an elevated risk of GD.

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

It is estimated that 2 % of the Swedish population have problems with gambling and / or an addiction. The purpose of this study is to provide insight into life as a gambler to explain the emergence of a gambling addiction but also what negative consequences it can have in everyday life, and to investigate the extent to which treatment can function as a crime prevention measure. The chosen method is a case study where semi-structured interviews were conducted with three informants about their experience of treatment of gambling addiction. The results were analyzed through an inductive thematic analysis where the collected empirical data was allowed to lead to a conclusion. Sampson and Laub's age-graded theory of informal social control was the theoretical framework used to interpret the results. The results showed that three factors form a basis for the emergence of a gambling addiction. Three more factors need to coincide for an individual to find acceptance and thus have a purposeful life. Treatment of gambling addiction can serve as a turning point in a player's life and the conclusion of this study is that it can act as a crime prevention measure., 2022-09-02

A nonblinded randomized trial was conducted at two Canadian provincial outpatient addiction clinics that tested the effectiveness of a systemic congruence couple therapy (CCT) versus individual-based treatment-as-usual (TAU) on nine clinical outcomes: (1) primary outcomes—alcohol use and gambling, psychiatric symptoms, and couple adjustment; (2) secondary outcomes—emotion regulation, substance use, depression, post-traumatic stress symptoms, and life stress. Data of primary clients and partners (N = 46) were analyzed longitudinally across baseline, posttreatment (5 months), and follow-up (8 months). Alcohol use disorder (95%) and gambling disorder (5%) were in the severe range at baseline, and co-addiction was 27%. Psychiatric comorbidity was 100%, and 18% of couples were jointly addicted. Between-group comparison favored CCT in primary outcomes with medium-to-large effect sizes (Cohen's h = 0.74–1.44). Secondary outcomes were also significantly stronger for CCT (Cohen's h = 0.27–1.53). Within-group, for all primary outcomes, a significant proportion of symptomatic CCT clients and partners improved, converging with ANOVA results of large effect sizes (0.14–0.29). All secondary outcomes improved significantly in CCT with large effect sizes (0.14–0.50). TAU showed significant within-group improvement in alcohol use, other substance use, and life stress with large effect sizes (0.16–0.40). Primary clients and partners made largely equivalent improvement within CCT and within TAU. Results were triangulated with clients' satisfaction ratings and counselors' reports. Overall, significant within-group effects were detected for CCT both clinically and statistically and between-group difference favored CCT. Future trials are required to validate these promising findings.

Study of change mechanisms is important to advance theory development and to reveal the active components that make a critical difference in treatment. Improved outcomes in a randomized controlled trial that favored Congruence Couple Therapy (CCT) vs individual-based Treatment-as-Usual (TAU) were correlated within each group. Partial correlations were used to test for mediation effects. The aggregate correlation coefficient of improved variables in addiction and mental health, couple adjustment, emotion regulation (ER) and life stress was moderate for CCT and weak for TAU. CCT showed greater number of mediating effects among improved variables than TAU. The prominence of the process mechanism of improved ER with its mediating effects for addiction and psychiatric symptoms evidenced in both groups is noteworthy, but ER improvement was significantly associated with improved couple adjustment only in CCT. Reduction in life stress in CCT was associated with a broader range of improvements in CCT compared to TAU. Correlation patterns were substantiated by CCT participants’ endorsement of treatment targets emphasizing relationship, communication, emotion, problem solving, addiction and intergenerational issues of trauma. TAU participants reported significantly lower endorsements for these treatment targets. The correlation of ER and couple adjustment suggested as a key process mechanism should be further elucidated in future studies to differentiate relationship-based vs individual-based models and their respective outcomes for primary clients and partners. These findings are considered preliminary, requiring larger samples and advanced modelling among variables to provide a more profound mechanism analysis.

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

Experiencing acute stress is common in behavioral addictions such as gambling disorder. Additionally, like most substance-induced addictions, aberrant decision-making wherein a reactive habit-induced response (conceptualized as a Model-free [MF] in reinforcement learning) suppresses a flexible goal-directed response (conceptualized as a Model-based [MB]) is also common in gambling disorder. In the current study we investigated the influence of acute stress on the balance between habitual response and the goal-directed system., SCOPUS: ar.j, info:eu-repo/semantics/published

Gambling disorder, gambling-related cognitive biases, compulsive buying, and materialistic values lead to impaired functioning in important areas of life. The aims of the present longitudinal study are (1) to evaluate the change produced after one year in those mentioned variables and (2) to examine the gender role in these changes and to analyze the mediational mechanisms among the variables of the study. The sample was composed of 182 adolescents (103 females and 79 males) from secondary education Spanish institutions who completed self-administered questionnaires. Structural equation modeling has been used to explore associations between the different variables. Our results show significant decreases in compulsive buying, materialism, and cognitive biases related to gambling after one year. Gambling disorder severity was directly related to cognitive distortions of gambling and being a man. Compulsive buying was associated with older age and the female gender. Materialism was associated with compulsive buying and the male gender. In conclusion, gambling disorder, gambling-related cognitive biases, compulsive buying, and materialistic values change over time in different ways, according to gender. The understanding of gambling disorder and compulsive buying in adolescents could potentially lead to early prevention and treatment programs for the specific needs of gender and age., Instituto de Salud Carlos III (ISCIII)/ FEDER/Delegación del Gobierno para el Plan Nacional sobre Drogas, Ministerio de Economía y Competitividad, Ministerio de Educación, Cultura y Deporte, Depto. de Psicología Experimental, Procesos Cognitivos y Logopedia, Fac. de Psicología, TRUE, pub

Purpose of review: The lockdown response to the COVID-19 pandemic has significantly impacted commercial gambling in many jurisdictions around the world. The goal of this review is to systematically identify and describe the survey data and findings to date examining the effect on individual gambling and gambling disorder. Recent findings: Of the 17 publications meeting inclusion criteria, the majority reported cross-sectional assessments (n = 11, 65%) and remainder were longitudinal in that they had earlier gambling data for participants (n = 6, 35%). Not surprisingly given the closure of land-based gambling, an overall reduction in gambling frequency and expenditure was reported in all studies. The estimate of the proportion of participants in both the general population and the population that gambles who increased overall gambling or online gambling was variable. The most consistent correlates of increased gambling during the lockdown were increased problem gambling severity, younger age groups, and being male. Summary: These results suggest that the impacts of the COVID-19 pandemic on gambling and problematic gambling are diverse – possibly causing a reduction in current or future problems in some, but also promoting increased problematic gambling in others. The longer-term implications of both the reduction in overall gambling, and the increase in some vulnerable groups are unclear, and requires assessment in subsequent follow-up studies. However, in the short term, individuals with existing gambling problems should be recognized as a vulnerable group.

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

Altres ajuts: The research was funded by the Delegación del Gobierno para el Plan Nacional sobre Drogas (2017I067 and 2019I47), Instituto de Salud Carlos III (ISCIII; PI17/01167) and co-funded by FEDER funds/European Regional Development Fund (ERDF), a way to build Europe. CIBERObn and CIBERSAM are both initiatives of ISCIII. The funders had no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript. HL-G is supported by a Generalitat de Catalunya Grant (2017 BP 00035). LM was supported by a postdoctoral Grant of the Mexican Institution Consejo Nacional de Ciencia y Tecnología-CONACYT (Science and Technology National Counsel)., Serious games have shown positive results in increasing motivation, adherence to treatment and strengthening the therapeutic alliance in multiple psychiatric disorders. In particular, patients with impulse control disorders and other disorders in which the patient suffers from inhibitory control deficits (e.g., behavioral addictions) have been shown to benefit from serious games. Aim : The aim of this study was to describe the characteristics and to evaluate the usability of a new serious videogame, e-Estesia. This serious videogame was designed to improve emotion regulation in patients with gambling disorder (GD). Preliminary results from a pilot sample are also reported. Method : A pilot sample of 26 patients undergoing treatment for GD was recruited (ranging from 22 to 74 years, mean = 41.2 and SD = 12.9; 80.8% men). Participants used e-Estesia on a tablet, which was connected to a thoracic band that sent heart rate (HR) and heart rate variability (HRV) data to the videogame platform in order to provide biofeedback. The System Usability Scale was completed by patients to determine the usability of e-Estesia. Results and Discussion : e-Estesia performed comparatively well for all the explored groups (i.e., sex, age, and online vs. offline gambling: mean usability score = 83.8, SD = 13.1). Around 84.6% of the patients endorsed that it was easy to use. Female patients with GD presented higher HRV during the use of the serious videogame compared to men.

Background: Gambling landscape has changed in recent years with the emergence of online gambling (OG). Greater accessibility and availability of this betting modality can increase the risk of developing a gambling disorder (GD). Online sports betting (OSB) is currently the most common type of OG, but little is known about the clinical characteristics of OSB compared to slot-machine (SM) gamblers, the most common offline gambling disorder. Methods: This was a prospective study conducted between October 2005 and September 2019, and included outpatients diagnosed with GD seen in a Pathological Gambling and Behavioral Addictions referral unit. Only patients with OSB and SM disorders were included. The main objective was to assess the clinical profile of OSB compared to SM gamblers, and to define clinical predictors for developing OSB gambling disorder. Logistic regression was performed to determine the effects of variables on the likelihood of this disorder. Results: Among 1,186 patients attended in our Unit during the study period, 873 patients were included; 32 (3.7%) were OSB gamblers and 841 (96.3%) were SM gamblers. Overall, mean age was 45 ± 13 years and 94.3% were men. Compared to SM patients, OSB patients were younger (34.9 ± 9.5 vs. 45.3 ±13), more frequently single (43.8 vs. 20.6%) and had a university education level (43.8 vs. 4.5%); they were also more frequently non-smokers (18.7 vs. 66.7%) and had fewer psychiatric comorbidities (12.5 vs. 29.4%) than SM gamblers. GD duration before treatment initiation was shorter in OSB patients than in SM gamblers, most of them (81.3 vs. 42.4%) with ≤ 5 years of GD duration. OSB gamblers showed significant differences in weekly gambling expenditure, spending higher amounts than SM patients. Younger age (OR: 0.919; 95% CI: 0.874-0.966), university education level (OR: 10.658; 95% CI: 3.330-34.119), weekly expenditure >100€ (OR: 5.811; 95% CI:1.544-21.869), and being a non-smoker (OR:13.248; 95% CI:4.332-40.517) were assoc

Altres ajuts: The research was funded by the Delegación del Gobierno para el Plan Nacional sobre Drogas (2017I067 and 2019I47).Co-funded by FEDER funds/European Regional Development Fund (ERDF), a way to build Europe. CIBEROBN and CIBERSAM are both initiatives of ISCIII. IB was partially supported by a Post-Residency Grant from Research Committee of the University Hospital of Bellvitge (HUB; Barcelona, Spain) 2020-2021., Background and Aims: COVID-19 pandemic and confinement have represented a challenge for patients with gambling disorder (GD). Regarding treatment outcome, dropout may have been influenced by these adverse circumstances. The aims of this study were: (a) to analyze treatment dropout rates in patients with GD throughout two periods: during and after the lockdown and (b) to assess clinical features that could represent vulnerability factors for treatment dropout. Methods: The sample consisted of n =86 adults, mostly men (n =79, 91.9%) and with a mean age of 45years old (SD =16.85). Patients were diagnosed with GD according to DSM-5 criteria and were undergoing therapy at a Behavioral Addiction Unit when confinement started. Clinical data were collected through a semi-structured interview and protocolized psychometric assessment. A brief telephone survey related to COVID-19 concerns was also administered at the beginning of the lockdown. Dropout data were evaluated at two moments throughout a nine-month observational period (T1: during the lockdown, and T2: after the lockdown). Results: The risk of dropout during the complete observational period was R =32/86=0.372 (37.2%), the Incidence Density Rate (IDR) ratio T2/T1 being equal to 0.052/0.033=1.60 (p =0.252). Shorter treatment duration (p =0.007), lower anxiety (p =0.025), depressive symptoms (p =0.045) and lower use of adaptive coping strategies (p =0.046) characterized patients who abandoned treatment during the lockdown. Briefer duration of treatment (p =0.001) and higher employment concerns (p =0.044) were highlighted in the individuals who dropped out after the lockdown. Treatment duration was a predictor of dropout in both periods (p =0.005 and p <0.001, respectively). Conclusion: The present results suggest an impact of the COVID-19 pandemic on treatment dropout among patients with GD during and after the lockdown, being treatment duration a predictor of dropout. Assessing vulnerability features in GD may help c

The whole sample consisted of 88 treatment-seeking patients diagnosed with GD according to DSM-5 criteria [61], who were, for the first time, attended to at the Behavioral Addictions Program of the Hospital de la Santa Creu i Sant Pau in Barcelona (Spain). The period of the recruitment was between September 2018 and September 2019. The current study was linked to the duration of a project funded by ONCE's Fourth International Grant for Research on Responsible Gambling, Organización Nacional de Ciegos Españoles-ONCE., Several risk factors have been related to the onset and maintenance of gambling disorder (GD). The aim of this study was to explore the differences in emotion dysregulation, impulsivity, cognitive distortions, and attentional bias between online and land-based gamblers. The sample consisted of 88 treatment-seeking patients from the Behavioral Addictions Unit at the Hospital de la Santa Creu i Sant Pau, Barcelona (Spain). Patients were divided into two groups by considering their main type of gambling, i.e., online (n = 26) and land-based gambling (n = 62). Online gamblers were younger, more often employed, with a higher educational level than land-based gamblers. Regarding the rest of the variables, statistically significant differences were only found in Positive Urgency, one of the UPPS-P subscales, in which the land-based gambling group scored higher than the online gambling group. In this exploratory study, individuals with online and land-based GD phenotypes did not differ either in difficulties in emotion regulation or in attentional and cognitive biases. However, land-based GD patients showed a higher tendency to succumb to strong impulses under the influence of positive emotions. These preliminary findings warrant the need to continue investigating GD phenotypes in larger patient samples.

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.

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.

Research has highlighted the pivotal role of craving in the onset and perpetuation of gambling disorder. This has led to a growing interest about craving in research and in clinical practice, even though it is not included as a diagnostic criterion in international nosography manuals. Craving was systematically studied by reusing existing models and assessment instruments related to substance-use disorders and by applying a confirmatory approach, which might have resulted in neglecting the unique features of gambling craving. In this PhD thesis, we instead adopted an exploratory approach to improve the conceptualization, assessment, and treatment of gambling craving. In a first study, a mixed-method approach was used to explore the phenomenology of gambling craving. The results were put into perspective with the elaborated intrusion theory (EIT) of desire, an increasingly popular cognitive theory of desire and craving that has been applied to substance and food craving in the recent years. This first study supports the relevance of the EIT to account for gambling craving. The next two studies investigated the properties of two instruments that aim to assess gambling craving. On the one hand, the gambling craving scale is a widely used tool that is used to evaluate gambling craving in research. Yet, we found that this scale rather measures urge, a motivational component of craving that corresponds to positive and negative expectations. On the other hand, and by capitalizing on the results from our first study, we adapted and validated in the context of gambling the Craving Experience Questionnaire, which is theorized in the EIT. Our gambling version of the questionnaire presented the same factorial structure as the original one. In a fourth study composed of two experiments, we tested the effect of interference-based methods, also grounded in the EIT, on laboratory induced gambling craving. We found that these interventions successfully diminished laboratory-induced, Le trouble lié au jeu d’argent est reconnu comme un trouble addictif dans les dernières éditions des principaux manuels diagnostiques. Bien qu’il ne soit pas inclus comme un critère diagnostique, de nombreuses études considèrent le craving comme un facteur favorisant ce trouble. Dans cette thèse, nous avons investigué la phénoménologie du craving au jeu d’argent avec une méthode mixte dans une optique exploratoire. Les résultats ont été mis en perspective avec une théorie cognitive du craving : la théorie de l’intrusion élaborée, démontrant la pertinence de cette dernière pour rendre compte du craving au jeu. Les propriétés psychométriques de deux échelles ont ensuite été investiguées afin de mesure adéquatement ce phénomène. Finalement, nous avons testé la méthode d’interférence, une intervention visant à réduire le craving au jeu d’argent. Cette thèse offre des perspectives d’interventions adaptées pour les personnes souffrant d’un trouble lié au jeu d’argent et encourage à poursuivre la recherche en population clinique., (PSYE - Sciences psychologiques et de l'éducation) -- UCL, 2021

Gambling disorder (GD) is a form of behavioral addiction. In recent years, it has been suggested that the application of transcranial Direct Current Stimulation (tDCS) to the dorsolateral prefrontal cortex (DLPFC), which plays a key role in top-down inhibitory control and impulsivity, may represent a new therapeutic approach for treating addictions. Here we investigated the effectiveness of a novel low dose tDCS protocol (i.e. six sessions of right anodal/left cathodal tDCS for 20 min, with a current intensity of 1 mA) applied to DLPFC in a patient with GD. To evaluate the effect of the proposed intervention, cognitive, psychological and behavioural evaluations were performed at different time points, pre and post intervention. The results showed improvement of impulsivity, decision making, and cognitive functioning after tDCS intervention. Findings of the present study suggest that low doses of right anodal/left cathodal tDCS to DLPFC may effectively improve gambling behaviour. They also suggest to carefully evaluate the effects of this tDCS polarity on the patient's emotional state. The current protocol warrants further investigation in large groups of patients, as it may provide relevant insights into the design of effective, low dose treatments of gambling disorder.

Introduktion: Spelberoende är idag ett folkhälsoproblem som både drabbar den spelberoende själv och dennes anhöriga. Riskfaktorer kopplade till spelberoende är många, men det saknas samstämmighet. Dessutom är skyddsfaktorerna få. Trots att det finns en åldersgräns för pengaspel är många unga drabbade där samsjuklighet är vanligt. Kostnaden för att behandla spelberoende beräknas vara låg även om det idag finns liten evidens kring effektiva behandlingsmetoden. Få personer söker dessutom vård för spelberoende. Syfte: Syftet med denna litteraturstudie var att beskriva vilka riskfaktorer och hälsokonsekvenser som är kopplade till spelberoende, samt att beskriva utsatta grupper i befolkningen. Metod: En strukturerad litteraturstudie utfördes med 13 inkluderade artiklar. Analysen genomfördes med hjälp av tematisk analys. Resultat: Resultaten visar att genetiska, biologiska, sociala, kognitiva, geografiska faktorer tillsammans personliga beteenden samt livsstils- och miljöfaktorer är avgörande för risken att utveckla spelberoende, vilket också kan leda till samsjuklighet och hälsokonsekvenser. Främsta samsjukligheten är substansberoende tillsammans med psykisk ohälsa och ökad risk för självmord. Utsatta grupper i befolkningen är unga män med familjeproblematik och migrationsbakgrund. Slutsats: Spelberoende är ett komplex beroende med många negativa hälsokonsekvenser. Ur ett folkhälsoperspektiv är det viktigt att förstå hur faktorer samverkar för att tidigt kunna förebygga spelproblem., Introduction: Gambling is a growing public health issue that affects both the person with gambling disorder and relatives. There are many risk factors associated with gambling disorder, but there is a lack of agreement. In addition, there are few protective factors. Although there is an age limit for gambling, many adolescents are affected where comorbidity is common. The cost of treating gambling disorder is estimated to be low, although today there is little evidence of effective methods. Few people also seek care for gambling disorder. Aim: The aim of this literature study was to describe the risk factors and the health consequences that are linked to gambling disorder, and to describe vulnerable groups in the population. Method: A structured literature study was conducted with 13 included articles. The analysis was implemented using thematic analysis. Results: The results show that genetic, biological, social, cognitive, geographical factors together personal behaviors as well as lifestyle and environmental factors are crucial for the risk of developing gambling disorder, which can also lead to comorbidity and health consequences. The main comorbidity is substance addiction together with poor mental health and increased risk of suicide. Vulnerable groups in the population are young men with family issues and migration backgrounds. Conclusion: Gambling disorder is a complex addiction with many negative health consequences. In a public health perspective, it is important to understand how factors interact in order to prevent gambling problems at an early stage.

The diffusion and growth of the web and the social media applications that it has provided have seen people increasingly turn to social media to express their feelings, frustrations, and ambitions and to generally share life events. Like other internet users, those with a gambling disorder are also known to use specialized online forums to read the experiences articulated by others and to open up, share, and express themselves online. In this study, we examined how those with a gambling disorder talk about their emotions and express sentiment through their online comments. Sentiment Analysis in IBM Watson was used to capture expressed emotions (anger, disgust, fear, happiness, sadness, and surprise) and sentiments. These data were then used as input to a latent class cluster modelling procedure aimed at categorizing those with a gambling disorder into distinct groups. The findings show how qualitative online data can be transformed into quantitative insights in order to identify different categories of people with a gambling disorder. The technique offers a non-intrusive method of data collection that can provide useful insights into the emotions felt and expressed by those with a gambling disorder., QC 20210629

BackgroundPatients in methadone maintenance treatment (MMT) with problem gambling (PG) experience worse psychosocial outcomes than their non-PG counterparts. Interventions targeting PG in MMT may enhance psychosocial functioning beyond gambling reduction and abstinence. The present study was a secondary data analysis that examined the trajectories of non-gambling outcomes of three brief PG interventions (i.e., brief psychoeducation, brief advice, motivational enhancement therapy plus cognitive-behavioral therapy [MET + CBT]) among MMT patients.MethodsParticipants (N = 109) were engaged in substance use disorder treatment, met criteria for PG, and had a current or lifetime history of MMT. Latent growth curve models examined outcome trajectories of psychiatric, medical, legal, employment, and social problems, as well as psychological distress and quality of life. Follow-up analyses examined clinically significant change.ResultsMET + CBT patients reported lower medical problems at baseline and over time than the brief interventions. There was no evidence of differences between interventions on the other outcomes. Psychiatric problems and psychological distress decreased over time for the entire sample, regardless of the PG intervention. About 24% and 13% of the sample demonstrated clinically significant improvements in psychological distress from baseline to 5 months, and 5 months to 12 months, respectively. Nearly 21% of the sample showed clinically significant improvements in psychiatric problems from 5 months to 12 months. Among all patients, men and those with more severe opioid dependence symptoms demonstrated the greatest psychological improvements.ConclusionsMany patients in MMT with PG experience improvements in psychological problems, including long-term improvement, regardless of the PG intervention offered.

The Pathways Model of problem gambling suggests three developmental pathways, subtypes, to a gambling disorder and the importance of individualized treatment with different treatment interventions for different subtypes. The study aimed to investigate to what extent the therapist made considerations related to the Pathways Model and take psychiatric comorbidity into account when planning the treatment. The hypothesis was that therapists assumed to plan treatment in the same way based on directives from above and to small extent take the patient's subtype or psychiatric comorbidity into account. A cross-sectional study with a self-report questionnaire survey as a data collection method was conducted among three therapist networks. Quantitative data were analysed with SPSS. The result was based on 47 answers. A minority of the therapists (38%) used Gambling Pathways Questionnaire (GPQ) to a higher extent, to define subtype and thereby psychiatric comorbidity. Furthermore, 17 % lacked knowledge of GPQ. Most of the therapists (96%), in accordance with the National Board of Health and Welfare, offered a treatment based on cognitive behavioural therapy (CBT). Amongst the therapists, 81% relied on a manual-based method which they stated was difficult to individualize.Directions from above tend to dictate the treatment plans rather than personalfactors such as subtype and psychiatric comorbidity.

Kockanje se može definisati kao zajednički naziv za skup različitih igara, ponašanja i aktivnosti, koje uključuju ulaganje novca ili neke druge vrednosti, uz rizik i nadu u očekivanje pozitivnog ishoda. Razvojem društva, kockanje je poprimalo različite oblike i značenja u zavisnosti od društveno-kulturoloških normi i uverenja date epohe. Danas govorimo o kockanju kao opšteprihvaćenoj aktivnosti, prisutnoj u različitim društvenim kontekstima. Iako većina pojedinaca učestvuje u kockanju kao zabavnoj društvenoj aktivnosti, mala grupa ljudi postaje ozbiljno uključena u kockarske aktivnosti, što aktuelno dovodi do prepoznavanja kockanja kao bihevioralne zavisnosti, poznate pod nazivom „poremećaj kockanja“. Ogroman doprinos u popularizaciji i liberalizaciji kockanja imaju različiti faktori javne politike, ekonomski faktori, faktori zajednice, socijalne norme, zakonska regulativa, kao i medijski prikazi kockanja. Cilj rada je sumiranje naučnih saznanja o ključnim socijalno-kulturološkim aspektima kockanja. Na osnovu pregleda relevantne i recentne literature, u radu će biti prikazan razvoj kockanja kroz istoriju, društveno-kulturološki faktori kockanja i društvene implikacije kockanja., Gambling can be defined as a common name for a set of different games, behaviors and activities, which involve investing money or some other value, with risk and hope in anticipation of a positive outcome. With the development of society, gambling took on different forms and meanings depending on the socio- cultural norms and beliefs of a given era. Today we are talking about gambling as a generally accepted activity, present in different social contexts. Although most individuals participate in gambling as a fun social activity, a small group of people become seriously involved in gambling activities, which currently leads to the recognition of gambling as a behavioral addiction, known as “gambling disorder”. Various public policy factors, economic factors, community factors, social norms, legislation, as well as media coverage of gambling have made a huge contribution to the popularization and liberalization of gambling. The aim of this paper is to summarize scientific knowledge about key socio- cultural aspects of gambling. Based on a review of relevant and recent literature, the paper will present the development of gambling throughout history, socio- cultural factors of gambling and the social implications of gambling.

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This study examines if overweight/obesity are related to higher impulsivity, food addiction and depressive symptoms, and if these variables could be modified after 1 year of a multimodal intervention (diet, physical activity, psychosocial support). 342 adults (55-75 years) with overweight/obesity and metabolic syndrome (MetS) from the PREDIMED-Plus Cognition study were randomized to the intervention or to the control group (lifestyle recommendations). Cognitive and psychopathological assessments were performed at baseline and after 1-year follow-up. At baseline, higher impulsivity was linked to higher food addiction and depressive symptoms, but not to body mass index (BMI). Food addiction not only predicted higher BMI and depressive symptoms, but also achieved a mediational role between impulsivity and BMI/depressive symptoms. After 1 year, patients in both groups reported significant decreases in BMI, food addiction and impulsivity. BMI reduction and impulsivity improvements were higher in the intervention group. Higher BMI decrease was achieved in individuals with lower impulsivity. Higher scores in food addiction were also related to greater post-treatment impulsivity. To conclude, overweight/obesity are related to higher impulsivity, food addiction and depressive symptoms in mid/old age individuals with MetS. Our results also highlight the modifiable nature of the studied variables and the interest of promoting multimodal interventions within this population.

COVID-19 and lockdown strategies may affect mental health and addictive behavior differently in the population, and elite athletes are among the professions clearly affected by the pandemic. This study in top elite athletes aimed to study current perceived psychological influence from COVID-19 and symptoms of depression, anxiety and changes in alcohol drinking, gambling behavior and problem gambling in the midst of the COVID-19 lockdown. This web survey included athletes in top leagues of soccer, ice hockey and handball in Sweden (N = 327, 62% men). A total of 66% and 51% were worried about the future of their sport or about their own future in sports, respectively. Feeling worse psychologically during the pandemic was common (72% of women, 40% of men, p < 0.001); depression criteria were endorsed by 19% of women and three percent of men (p < 0.001); anxiety criteria by 20% of women and five percent of men (p < 0.001). Reporting increased gambling during the pandemic was associated with gambling problem severity. Moderate-risk or problem gambling was seen in 10% of men and none of the women (p < 0.001). Depression and anxiety were associated with feeling worse during the COVID-19 pandemic and with concern over one's own sports future. In conclusion, COVID-19-related distress is common in elite athletes and associated with mental health symptoms. Gambling increase during the pandemic was rare, but related to gambling problems, which were common in male athletes. The calls for increased focus on COVID-19-related concerns in athletes and on problem gambling in male athletes.

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, Funding information: Svenska Spel's Independent Research Council. Grant Number: 2013‐0015

Background: Problem gambling and gambling disorder are major public health concerns worldwide, and awareness of associated negative consequences is rising. In parallel, treatment demand has increased, and Internet interventions offer a promising alternative for providing evidence-based treatment at scale to a low cost. Method: We developed a novel Internet-delivered cognitive behavioral treatment for gambling, based on qualitative interviews with treatment-seeking gamblers, behavioral research on gambling behavior, and the pathway model for problem gambling. This research protocol describes a non-randomized pilot and feasibility trial conducted in routine addiction care with adult treatment-seeking patients (max N = 25) with problem gambling. The primary aim is to ensure acceptability and safety, measured by satisfaction, credibility, working alliance, and possible negative effects. Secondary aims are feasibility of study procedures in terms of recruitment and measurement procedures as well as potential effectiveness measured weekly by gambling symptoms as primary outcome and gambling behavior, quality of life, symptoms of depression and anxiety, alcohol, and drug use as secondary outcomes. Potential mediators measured weekly are loss of control, verbal rules, and well-being. Discussion: This study is innovative in several respects, regarding both treatment development and implementation. The results of the study will guide a future randomized controlled trial, as well as the development of the intervention and intervention implementation within ordinary addiction care. Trial registration: Clinical trials.gov, NCT ID: NCT03946098. Registered 10 May 2019