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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.

Background: Studies published on gender-related differences in the gambling behavior of adolescents have focused mainly on psychological and social factors. The aim of this study was to develop separate risk factor models for male and female adolescents, considering the environmental, psychological, behavioral and socio-economic factors related to their gambling., Methods: A survey was conducted through a questionnaire developed on a dedicated web site in 2014 on a representative sample of the Italian 15-19-years-old population, including 34,922 students attending 438 secondary schools. The SOGS-RA questionnaire was used to measure gambling behavior. To verify the risk factors associated with gambling a logistic regression stratified by gender was performed., Results: In our representative sample of Italian adolescents nationwide, the prevalence of each level of gambling was higher in males than in females. The logistic regression stratified by gender found that for both genders, gambling was positively associated with internet surfing, playing sports, getting into a fight, having unprotected sex, pulling stunts, drinking alcohol at least once in the previous month, having not a satisfactory relationship with teachers, receiving pocket money from parents, spending each week much money and having someone in the family (father, sister/brother, other relatives) who gambles. On the other hand, having poor or average school marks, going to ED in the previous year, smoking at least once in the previous month, having dissatisfied with relationships with father and having a lower family income than their friends was only associated with gambling in boys. Having an accident or injury in the previous year and having a mother who gambled was associated only in girls with higher odd of at risk or problem gambling behavior. A low psychological distress is protective only in girls for risk of gambling., Conclusions: Understanding the gender-related differences, and how they emerge in younger people at the start of their gambling careers, can suggest how best to educate individuals, families and the community on the topic of gambling. Programs to prevent substance use and abuse should be multifaceted, and include efforts to prevent gambling with a gender perspective approach., (© 2022. The Author(s).)

The desire to escape from pressures/anxiety represents an important motivation for problematic engagement with short-term rewarding behaviors that could contribute to the development of recognized and candidate behavioral addictions, including problematic shopping, a prevalent condition among youth in the U.S.A. characterized by excessive shopping cognitions/behaviors that lead to distress/impairment. However, to date, the specific correlates of shopping to relieve anxiety or tension have yet to be evaluated. We aimed at addressing this gap by analyzing data (N = 2556) from a high-school survey from Connecticut in an exploratory fashion. Adolescents who acknowledged experiencing a growing tension or anxiety that could only be relieved by shopping were classified as having negative-reinforcement shopping and compared to the remaining students. Data were analyzed in chi-square and logistic regression models to examine negative-reinforcement shopping in relation to socio-demographics, health correlates, gambling-related perceptions/attitudes, and problem-gambling severity/gambling behaviors. Negative-reinforcement shopping was more frequent in female and Hispanic students, was linked to more permissive gambling attitudes and at-risk/problematic gambling, and was associated with the use of alcohol, tobacco, marijuana, and other drugs, dysphoria/depression, and weapon-carrying and physical fighting. Taken together, these findings highlight adverse measures of health and functioning linked to negative-reinforcement shopping that may be particularly relevant to girls and Hispanic youth. Additional efforts to prevent negative outcomes are warranted.

In the field of adolescent gambling prevention, there is a lack of intervention studies reporting and assessing training courses for the intervention providers. The present work fills this gap by realizing a dissemination study inside the PRIZE program aimed at modifying a set of cognitive protective factors and affective risk factors. The purpose of this work was twofold: To develop and evaluate a training course with the intervention providers (Study 1), and to assess the short- and long-term effects of the intervention itself (Study 2). The training course was delivered to 44 health professionals (32 females, Mage = 39.34 years). Results showed a significant increase of correct knowledge about gambling and a significant reduction of their susceptibility to probabilistic reasoning biases. Participants also actually learnt the main competencies to conduct the educational activities, they were satisfied for the training course received, and they felt high levels of self-efficacy. The intervention was implemented with 1894 high school students (61% males; Mage = 15.68 years). In the short term, we found a significant increase of adolescents' correct gambling knowledge, random events knowledge, and probabilistic reasoning ability, and a significant decrease of superstitious thinking, monetary positive outcome expectation, and gambling-related erroneous thoughts and fallacious behavioral choices. In the long-term, a significant decrease of gambling frequency, gambling versatility, and gambling problem severity was obtained. Overall, this work highlights the importance to train prevention program providers in order to optimize the effectiveness of large-scale gambling intervention programs towards adolescents., Competing Interests: The authors have declared that no competing interests exist

Gambling is a rapidly growing phenomenon among adolescents associated with negative psychosocial effects. To prevent this public health problem, it is necessary to identify the factors that cause and maintain adolescent gambling. Based on the theory of planned behavior (TPB), structural equation models were used in a sample of 1174 adolescents (aged 12-20 years) to study the effect of attitudes, subjective norms and self-efficacy on gambling intention in adolescent gamblers (n = 432) and non-gamblers (n = 742). Measurement invariance was assessed and then structural model was tested separately in gamblers and non-gamblers. The influence of past gambling experience on the TPB model was also studied through multigroup analysis. All models showed adequate fit to the data. The relationships between attitudes and self-efficacy with gambling intention were significantly stronger in gamblers subsample. These results confirmed that gambling experience increases the predictive ability of the TPB model in gamblers. TPB independent variables explained 16.2% of variance of gambling intention in non-gamblers and 32.4% in gamblers. Subsequently, the TPB model for gamblers explained 19% of variance of gambling frequency. In this last model, gambling intention partially mediates the influence of self-efficacy on gambling behavior. The subjective norm was the variable with the greatest effect on gambling intention in non-gamblers, while self-efficacy to control gambling was the exogenous variable with greatest effect on gambling frequency. The findings suggest the possibility of specific gambling prevention in adolescent gamblers and non-gamblers.

Background and Aims: Gambling education programs typically focus on promoting gambling as a high-risk activity with harmful effects; however, these programs demonstrate limited effects on the prevention of gambling problems. This paper proposes a clear theoretical framework to inform the content and delivery of gambling education initiatives and draws on psychological and pedagogical research to address some of the practical issues associated with its implementation., Methods: Literature was reviewed across fields of psychology, public health, and pedagogy to provide key recommendations to improve the outcomes of gambling education., Results: Four key recommendations were made for the development of future gambling education programs centering on theoretical approach, specialized content, and delivery., Discussion and Conclusions: Recommended advancements are as follows: (a) evidence suggests shifting away from messages about gambling harms and instead applying a cognitive-developmental framework of problem gambling that may improve youth engagement by increasing personal relevance. (b) The cognitive model of problem gambling suggests that misconceptions about the profitability of gambling games (e.g., the gambler's fallacy) play an important role in the development of problems and should be a key target for education. However, exposing such misconceptions requires the challenge of teaching the mathematical principles that underpin them. (c) The pedagogical field provides valuable insights into teaching complex concepts. Research that applies the conceptual change model to science education suggests misconceptions also facilitate learning new complex information, such as gambling-related mathematical concepts (i.e., randomness and statistics). (d) In addition, improvements in computer-assisted teaching methods provide opportunities to use simulations and visualizations to help teach abstract concepts and correct such misconceptions.

Given its serious implications for psychological and socio-emotional health, the prevention of problem gambling among adolescents is increasingly acknowledged as an area requiring attention. The theory of planned behavior (TPB) is a well-established model of behavior change that has been studied in the development and evaluation of primary preventive interventions aimed at modifying cognitions and behavior. However, the utility of the TPB has yet to be explored as a framework for the development of adolescent problem gambling prevention initiatives. This paper first examines the existing empirical literature addressing the effectiveness of school-based primary prevention programs for adolescent gambling. Given the limitations of existing programs, we then present a conceptual framework for the integration of the TPB in the development of effective problem gambling preventive interventions. The paper describes the TPB, demonstrates how the framework has been applied to gambling behavior, and reviews the strengths and limitations of the model for the design of primary prevention initiatives targeting adolescent risk and addictive behaviors, including adolescent gambling.

Aims: The aim of the study was to explore the reasons for alcohol misuse and other risk-taking behaviours in adolescence., Methods: Narrative review., Results: Vulnerable adolescents make suboptimal addictive-related choices in the period of initiation of alcohol use and gambling, which is also a period of cognitive and brain development, and in health behaviours. Hyperactive response to rewards as well as possibly hypoactive responses to punishments combined with weaknesses in the abilities to regulate strong impulses results in greater risk of alcohol and gambling misuse., Conclusion: Abnormal patterns of alcohol consumption (e.g. binge drinking) could dramatically reinforce this disequilibrium by enhancing salience for alcohol and associated information and compromising self-regulatory processes. There are some preventive and therapeutic cognitive training strategies that can strengthen willpower in adolescents.

Background: The study examined in adolescents how alcohol-drinking frequency relates to gambling-related attitudes and behaviors and perceptions of both problem-gambling prevention strategies and adult (including parental) behaviors/attitudes., Methods: A survey assessing alcohol, gambling, and health and functioning measures in 1609 high school students. Students were stratified into low-frequency/nondrinking and high-frequency-drinking groups, and into low-risk and at-risk/problematic gambling groups., Results: High-frequency drinking was associated with at-risk/problematic gambling (χ(2)(1,N = 1842) = 49.22, P < .0001). High-frequency-drinking versus low-frequency/nondrinking adolescents exhibited more permissive attitudes towards gambling (e.g., less likely to report multiple problem-gambling prevention efforts to be important). At-risk problematic gamblers exhibited more severe drinking patterns and greater likelihood of acknowledging parental approval of drinking (χ(2)(1, N = 1842) = 31.58, P < .0001). Problem-gambling severity was more strongly related to gambling with adults among high-frequency-drinking adolescents (odds ratio [OR] = 3.17, 95% confidence interval [95% CI] = [1.97, 5.09]) versus low-frequency/nondrinking (OR = 1.86, 95% CI = [0.61, 2.68]) adolescents (interaction OR = 1.78, 95% CI = [1.05, 3.02])., Conclusions: Interrelationships between problematic drinking and gambling in youth may relate to more permissive attitudes across these domains. Stronger links between at-risk/problem gambling and gambling with adults in the high-frequency-drinking group raises the possibility that interventions targeting adults may help mitigate youth gambling and drinking.

Purpose: To evaluate short-term effects of a school-based media education program for sixth- and seventh-grade adolescents on gambling knowledge, attitudes, and behavior., Methods: A two-wave cluster randomized control trial with two arms (intervention vs. control group) was conducted in the German Federal State of Schleswig-Holstein. The intervention group received a four-unit media education program, which contained one unit on gambling. The program was implemented by trained teachers during class time. The control group attended regular classes without any specific intervention. Survey data from 2,109 students with a mean age (SD) of 12.0 (.85) years was collected before and shortly after the intervention., Results: Thirty percent of the sample reported lifetime gambling; 6.7% were classified as current gamblers. Results of multilevel mixed-effects regression analyses revealed significant program effects in terms of an increased gambling knowledge (d = .18), decreased problematic gambling attitudes (d = .15), as well as a decrease of current gambling (d = .02) in the intervention group compared to the control group. The program had no significant influence on lifetime gambling., Conclusions: A 90-minute lesson about gambling can improve gambling knowledge and change attitudes toward gambling and gambling behavior among adolescents. Studies with a longer follow-up period are needed to test the long-term effects of such an intervention., (Copyright © 2013 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.)

This study investigated the nature of gambling-related knowledge and beliefs in a survey study of 2,669 students aged 13-17 years in South Australia. Students were classified as pathological gamblers, at risk, or not at risk based upon the DSM-IV-J, and their responses to questions relating to objective odds, probabilities, and common misperceptions were compared. The study confirmed previous studies which have shown that pathological gamblers are more susceptible to erroneous beliefs concerning randomness and chance, but do not differ in terms of their knowledge of objective odds. These findings were discussed in terms of Ladouceur's notion of "cognitive switching" and the distinction drawn between "hot" and "cold" cognitions in clinical outcome studies. The implications for school-based education programs are examined with attention given to the potential value of role-playing and simulations in encouraging student reflection and self-awareness.

This paper examined the nature of irrational gambling-related cognitions in a sample of 926 adolescents (mean age = 14.5 years) sampled from Australian schools. Students were differentiated according to gambling status and administered a series of items that assessed their understanding of objective odds, the nature of randomness, the role of skill in gambling, and the perceived profitability of gambling. The results confirmed previous findings that problem gamblers tend to be more irrational in their perceptions, as indicated by stronger beliefs in the role of skilful play in chance activities, and that gambling is a potentially profitable activity. However, counter intuitively, problem gamblers did not appear to have any poorer understanding of objective probabilities. These results are discussed in terms of Sevigny and Ladouceur's (2004) concept of cognitive switching as well as psychological research concerning the role of emotional and motivational factors in the development of an illusion of control. The implications of these findings for gambling education programs are discussed.