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Aim : To develop and measure the psychometric properties of the Gambling and Gambling Problem Perception Questionnaire (GGPPQ); a scale to evaluate professionals' attitudes towards people with problem gambling in the Japanese context. Data collection : We held 12 workshops in Japan targeted at mental health professionals who consult people with gambling problems. Participants completed the survey before the workshop. Some were also asked to complete the survey after the workshop to measure workshop influence. Setting : Public and private healthcare facilities in all 47 prefectures of Japan. Participants : Medical doctors, nurses, social workers, clinical psychologists, and other professionals working in the aforementioned facilities (n = 653, response rate = 98.5%). Measurements : licence; knowledge about gambling and gambling problems (questionnaire); self-rating of knowledge and general confidence for helping problem gamblers; years of practice; frequency of working with clients; experience in attending workshops; overall satisfaction with the workshop. Results : A five-factor structure extracted by exploratory factor analysis showed a good fit by confirmatory factor analysis (CFI =.973, TLI =.967, RMSEA =.060, AIC = 28913.6, BIC = 29110.8). The GGPPQ showed good internal consistency and good concurrent validity with participants' self-rating of their knowledge, general confidence, frequency of working with clients who have gambling problems, and experience in attending workshops. The workshop had a positive influence on participants' attitudes. Japan's unique gambling industry and lack of training opportunities on problem gambling were assumed to have influenced the psychometric properties of the measurement tool. Conclusion : The GGPPQ is a valid tool to measure the attitudes of healthcare professionals towards people with gambling problems, as well as workshop effectiveness in Japan. [ABSTRACT FROM AUTHOR]

The increase of gambling opportunities in Japan has led to an urgent need to "realize a healthy lifestyle while gambling." Data on regular pachinko/pachislot players with scores below the cutoff value for a disorder in the Pachinko/Pachislot Playing Disorder Scale, who are assumed to have no disorder, are crucial for archiving this goal. This study's objective was to clarify these players' characteristics. We conducted a National Survey using the Pachinko/Pachislot Playing Disorder Scale and divided the respondents (N=582) who had played pachinko/pachislot in the last 12 months into four groups based on their scale score and participation level. Then, we examined each group's demographics and characteristics of play. Chi-square tests indicated that the groups differed in age and the preference for high- and low-stake machines. Residual analysis indicated that the frequent player with no disorder group consisted of many participants in their 60s and a few in their 20s; who also tended to use low-stake machines. Health management for a lifestyle with gambling is discussed based on these findings. [ABSTRACT FROM AUTHOR]

Background: The clinical characteristics and prognosis of gambling disorder (GD) seeking treatment at Japanese addiction medical institutions are unknown. Therefore, we conducted a multicenter 1-year follow-up study of GD outpatients. In the current study, we focused on gambling-related cognition (GRC) and aimed to clarify the relationship between the distortions of GRC and treatment prognosis. Methods: A total of 202 patients who were diagnosed with GD by DSM-5 (male = 96. 5%; mean age = 36.3 ± 8.7) were enrolled from February to September 2021. The facility's medical staff conducted baseline interviews and distributed questionnaires. During the follow-up period, self-administered questionnaires were e-mailed or mailed to the registered address at 1, 3, 6, 9, and 12 months after enrollment. The 12-month follow-up rate was 72.7%. The gambling-related cognition scale (GRCS) was used to measure cognitive distortions. The GRCS consists of five subscales: Illusion of Control (IC), Predictive Control (PC), Interpretative Bias (IB), Gambling Expectancy (GE), and Perceived Inability to Stop Gambling (IS). The evaluation of the treatment prognosis included gambling behavior and social functioning. Results: Mean scores for all GRCS except IC decreased when compared at baseline and at the 6-month follow-up. IC=6.70→7.15, PC=18.8→13.9, IB=15.99→11.0, GE=13.42→9.94, IS=19.9→14.8. Moreover, at the 6-month follow-up, higher mean GRCS scores were associated with more frequent gambling behavior. The oneyear prognosis will be explained on the day of the presentation. Conclusions: Delayed GRC recovery in GD may be associated with a negative prognosis. [ABSTRACT FROM AUTHOR]

Researchers from Japan, Korea, Thailand, and Taiwan present and discuss a variety of behavioral addiction-related studies in this symposium. In particular, it is anticipated that we will be able to present the most recent findings from behavioral addiction research following COVID-19 and explore the course of future behavioral addiction research. The detailed topics are as follows. 1. Changes in Addiction Medicine with COVID-19 in Japan; Addiction Behavior and Government Measures 2. Development of risk assessment tool of paraphilic sexual behavior: The Japanese Static-99 3. Internet gaming disorder and methamphetamine use during the era of COVID-19 pandemic 4. Facing internet gaming disorder: Impact on mental health and intervention 5. Altered core networks of brain connectivity in internet gaming disorder and excessive smartphone use. [ABSTRACT FROM AUTHOR]

Background: To understand the clinical situation of GD who visited medical institutions and to clarify the effectiveness of treatment programs in Japan. Methods: Subjects were recruited with the cooperation of 20 medical institutions treating GD in Japan. Baseline data were acquired at their respective medical institutions, and an online follow-up survey using ICT was conducted. Results: 202 subjects were enrolled (men = 96.5%). The average age was 36.2 ± 8.7 years for men and 39.1 ± 9.8 years for women. The average age at which gambling began for the participants was 19.1 ± 3.3 years for men and 20.1 ± 3.1 years for women. Pachinko was the most common form of gambling, with an experience rate of 64.1% for men and 85.7% for women. The median total amount of debt each participant carried was ¥5 million for men and ¥5.75 million for women. All the subjects met the diagnostic criteria for GD on the DSM-5--36.4% of men and 42.9% of women had severe symptoms (a score of 8 points or more). A total of 144 (71.2%) subjects responded to the survey 6 months after the first visit. 78 patients (54.6%) remained on treatment. 81 cases (56.3%) were not gambling 6 months after the examination. Conclusions: A follow-up study using ICT investigated the prognosis of GD treatment. In the symposium, a follow-up survey after 12 months will be added to discuss the factors that influence prognosis. [ABSTRACT FROM AUTHOR]

Pachinko is a type of mechanical gambling game that originated in Japan and resembles an upright pinball machine. Pachinko parlors are located in many parts of Japan and are open to anyone of legal age (18 years old). Due to the availability of pachinko, gambling in Japan is unique. The Integrated Resort Bill, which was passed in Japan in 2018, attempted to institutionalize casinos; however, they remain illegal to date since no corporations have government permission to operate. Although gambling is harmless for most individuals, in some cases it can be addictive and problematic, with severe negative consequences. Therefore, the expansion of legalized gambling is an important public health concern. Researchers worldwide have investigated the epidemiology of gambling to reveal the incidence of gambling disorders and the effectiveness of policies implemented to prevent harmful gambling. However, in Asia, studies within this field are relatively scarce. This symposium aims to present data on the current situation of gambling, prevalence of gambling disorder and gambling disorder treatments and their outcomes in Japan. [ABSTRACT FROM AUTHOR]

Background: Gambling disorder (GD) is a common behavioral addiction which affects the well-being of patients and those around them in multiple ways (e.g., large debts and interpersonal problems). Although imminent casino opening and the high prevalence of GD in Japan, countermeasures to tackle GD are behind schedule. This delay might stem from diverse factors. These factors are exemplified by stigma, large treatment gaps, low treatment persistence and lack of effective pharmacotherapy. To tackle this situation, incorporating different perspectives, such as neuroimaging findings, might help to establish better intervention and prevention. Methods: Summarizing our functional and structural magnetic resonance imaging studies of GD, clinical implication will be proposed. Results: Some of our studies of showed associations between neural activity or connectivity strength and the duration of illness or abstinence of GD. Other studies showed heterogeneity in GD. Discussion: These findings underscore the importance of early diagnosis and intervention as well as the need for the importance of subtype-based interventions, providing insight regarding how to refine interventions for GD. [ABSTRACT FROM AUTHOR]

Background: Internationally, the prevalence of gambling disorder has been reported to be higher among homeless people than the general population; however, little is known about the correlates with gambling disorder in this population. The present study aimed to investigate the prevalence of gambling disorder and its correlates among homeless men using shelters in Osaka City. Methods: A cross-sectional survey was conducted from 30 December 2018 to 4 January 2019, using the 2017 Japanese National Survey of Gambling (JNSG) questionnaire, supplemented with questions about homeless experiences, drinking, and smoking. Using the South Oaks Gambling Screen, the presence of gambling disorder was determined by a score≥5 out of 20. Multivariate logistic regression was conducted to explore factors associated with lifetime gambling disorder. Results: Lifetime and past-year prevalence of gambling disorder among 103 participants was 43.7% (95% confidence interval [CI]: 34.5-53.3) and 3.9% (95% CI: 1.5-9.6), respectively, which are higher than the 6.7% and 1.5% found among men in the 2017 JNSG. Factors associated with lifetime GD included "more than 20 years since the first incidence of homelessness" (adjusted odds ratio [AOR]: 4.97, 95% CI: 1.50-16.45) and "more than five incidences of homelessness" (AOR: 4.51, 95% CI: 1.06-19.26). Conclusions: When homeless individuals with gambling disorder try to rebuild and stabilize their lives, gambling disorder may make the process difficult and pose a risk of recurring homelessness. Comprehensive support services for homeless individuals with gambling disorder are required. [ABSTRACT FROM AUTHOR]

In tandem with the legalization of casinos in Japan, the Japanese government established the Basic Act on Measures against Gambling Addiction in 2018, which marked the true start of the treatment response for gambling disorder (GBD) in Japan. The extent of the treatment gap for GBD is a serious issue in this country. The main treatment modality is a CBT-based program, and a standardized program developed by our center has been widely used in the clinical context. The results of a recent multi-treatment center study on the effectiveness of GBD indicated favorable treatment outcomes. Consultation services provided by mental health and welfare centers, which have been established in each prefecture and in large cities in Japan are gradually expanding. Similarly, while the number of facilities providing recovery support is limited these are gradually increasing. Back in 1989, Gamblers Anonymous was launched in Japan and is now available throughout the country. Unlike GBD, a basic act has not been developed or even considered for gaming disorder (GMD). While the number of facilities providing specialized treatment has constantly increased since 2011, this has failed to keep pace with the growing demand. Moreover, these facilities are unevenly distributed and concentrated in urban areas, limiting access for many people. Various treatment programs have been developed, including CBT-based day-treatment, inpatient, and camp programs. At our center, capacity building for treatment experts has been undertaken since 2014, with support from the government. To tackle increasing CMD-related problems, concerted efforts are required by a range of sectors. [ABSTRACT FROM AUTHOR]

In Japan, gambling has been illegal except for certain types of gambling. Some types of gambling were recently legalized with the Integrated Resort (IR) Promotion Law for setting up casino resorts. However, this law does not legalize all acts of illegal gambling. Therefore, we examined the possibility of adopting psychological approaches to treat problems related to illegal gambling. Results suggested the significance of using functional analysis to examine the problem of illegal gambling as gambling disorders. Furthermore, personal traits associated with illegal gambling need to be ascertained. Then, to solve illegal gambling problems, these findings should be integrated with efforts to improve and rehabilitate individuals in the Japanese judicial and criminal justice systems, such as avoiding risk-situations and setting adaptive goals. Accumulating knowledge of psychological approaches remains a task for the future. [ABSTRACT FROM AUTHOR]

While many people across the world enjoy gambling as a form of leisure, approximately 1-5% of the population struggles with gambling disorder. This rate is known to be even higher in Japan. Although a clinical diagnosis for gambling has long existed, not many clinicians are familiar with its etiology or treatment methods. Casino operation was recently legalized in Japan; while an economic boost is expected, an increase in gambling-related problems is also of concern. Because of the growing interest on the impact of gambling and gambling disorder in Japan, this paper aims to provide a comprehensive review of literature on gambling-related issues. Specifically, the following topics are discussed: 1) the prevalence and diagnostic classification, 2) etiological factors, and 3) interventions. Due to similarities between Japanese and American treatment environments, findings from the studies conducted in the U.S. are the primary focus of this paper. Recommendations to Japanese researchers, treatment providers, and other stakeholders are also provided. [ABSTRACT FROM AUTHOR]

In Japan, legalized casinos have been developed through the enactment of the Integrated Resort Promotion Bill. In this review, previous findings on cognitive behavioral therapy (CBT) for gambling disorder are discussed as an established treatment available in Japan. Results of the review suggested that there are three CBT agendas for case formulation and intervention in gambling disorders. It would be important for future studies to (i) set intervention goals by focusing on improving adaptation, (ii) develop subtypes of gambling disorder based on descriptions of the function of gambling behaviors, and (iii) develop intervention techniques to modify the influence of risk situations. It is expected that findings of health psychology, which emphasizes the importance of adaptive behaviors would contribute to future CBT research and practice for gambling disorders. [ABSTRACT FROM AUTHOR]