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Background and aims: This is the first nation‐wide register study based on a total population sample measuring the gender‐specific incidences of chronic diseases and conditions among adults diagnosed with gambling disorder (GD). Design, setting and participants: The study used aggregated data for 2011–22 retrieved from the Register of Primary Health Care visits, Care Register for Health Care and Care Register for Social Welfare, including specialized outpatient and inpatient health care, inpatient social care and institutional care and housing services with 24‐hour or part‐time assistance, set in mainland Finland. Participants comprised people aged 18–90+ years with GD diagnosis [corresponding to pathological gambling, International Classification of Diseases 10th revision (ICD‐10) code F63.0, n = 3605; men n = 2574, women n = 1031] and the general population (n = 4 374 192). Measurements: Incidences of somatic diseases and psychiatric disorders were calculated for the people with diagnosed GD and for the general population, separately for women and men. Findings After standardizing for age, the incidence of each diagnostic group was systematically higher for people with GD compared with the general population, except for cancer. The highest standardized incidence ratio (SIR) values were for psychiatric disorders [SIR = 234.2; 95% confidence interval (CI) = 226.1–242.4], memory disorders (SIR = 172.1; 95% CI = 119.1–234.8), nervous system diseases (SIR = 162.8; 95% CI = 152.8–173.1), chronic respiratory diseases (SIR = 150.6; 95% CI = 137.6–164.2), diabetes (SIR = 141.4; 95% CI = 127.9–155.5) and digestive diseases (SIR = 134.5; 95% CI = 127.1–142.2). Conclusions: In Finland, the incidence of chronic diseases and conditions among people with gambling disorder is higher compared with the general population, apart from cancer. [ABSTRACT FROM AUTHOR]

Introduction: Gender differences in problem gambling have attracted much attention in recent gambling literature. However, relatively little is known about how gender norms relate to social strain and self-control in predicting gambling disorder within a spousal context. This study aimed to increase knowledge about gambling disorder in Chinese married couples by assessing the threeway interaction effects between social strain, self-control, and gender norms. Methods: A total of 1,620 Chinese married couples were recruited from a representative sample of households in Hong Kong. Results: The results of the generalized ordered logit model revealed the selfcontrol mitigation effect of composite strain on the propensity for gambling disorder is strong in men who accept traditional gender norms. In contrast, in women who accept traditional gender roles, self-control attenuates the effect of recent stressful life events on the propensity for gambling disorder, but selfcontrol exacerbates the effect of negative relationships with offspring on the propensity for gambling disorder. Discussion: Although reinforcing self-control is a protective factor that can alleviate social strain and disordered gambling for both men and women, the prominent contribution of gender norms to the self-control exacerbation effect deserves close attention for social workers who provide services to these gambling families. [ABSTRACT FROM AUTHOR]

Co-occurrence between gambling disorder (GD) and other mental disorders is common, but its association with problematic pornography use (PPU) remains unexplored. This study aimed to investigate relationships between sociodemographic variables, personality measures, psychopathology, emotional regulation, and impulsivity and the co-occurrence of GD and PPU using structural equation modeling (SEM). The sample consisted of 359 adults seeking treatment for GD. The short version of the Problematic Pornography Consumption Scale (PPCS-6) identified patients with GD + PPU. Psychopathology, impulsivity, emotional regulation, and personality were also assessed. Higher impulsivity levels statistically predicted co-occurrence between GD and PPU. Impulsivity mediated the relationship between younger age, maladaptive personality features, and emotional dysregulation and co-occurrence. Psychopathological distress did not directly associate with GD + PPU co-occurrence. Impulsivity relates importantly to the co-occurrence of GD and PPU. Younger age, maladaptive personality, and emotional dysregulation contribute to increased impulsivity levels and co-occurrence. The findings highlight the importance of addressing impulsivity in understanding and treating co-occurring GD and PPU. • The sample consisted of 359 adults seeking treatment for GD. • Impulsivity relates importantly to the co-occurrence of GD and PPU. • Psychopathological distress did not directly associate with GD + PPU co-occurrence. [ABSTRACT FROM AUTHOR]

Problem gambling (PG) represents a significant public health concern with widespread effects in various cultures and regions globally, with younger individuals and males at a particularly higher risk. This disparity is attributed to a mix of cultural, developmental, and biological influences. To date, there has not been a comprehensive examination to determine whether this risk pattern holds consistently across different jurisdictions. We performed a systematic review and meta-analysis using the PRISMA framework, identifying 21 eligible studies from 18 countries, encompassing 156,249 participants (47.6% male and 52.4% female). The studies varied considerably by region (Asia: 19%, Europe: 52%, Oceania: 19%, North America: 10%), the diagnostic criteria for PG, and participation rates in gambling (ranging from 12% to 92%). Data on PG prevalence was categorised by gender and three age groups (young: 18–35, middle: 30–55, and older: 45–65). Using a random-effects meta-analysis, we found a global PG prevalence of 1.9%. Europe reported a significantly lower prevalence (1.3%) compared to North America (5.3%). Men were found to be 3.4 times more likely than women to engage in problem gambling, although the gap narrows in North America. The young demographic showed a 1.51 times higher likelihood of reporting PG compared to the middle-aged group, whereas older adults were 0.80 times less likely to report PG. Notably, age-related effects varied significantly across regions. Our findings confirm that age and gender significantly influence PG risk across cultures, with significant heterogeneity observed across jurisdictions. [ABSTRACT FROM AUTHOR]

Background: This study examined the association between Adverse Childhood Experiences (ACEs) and Gambling Severity (gambling severity), considering the mediating roles of internalizing, externalizing, and attention among youth online gamblers. Methods: 762 youth (agemean±SD= 15.03 ± 2.40; agerange = 10–18 years; 75.3% boys) completed the Persian Gambling Disorder Screening Questionnaire (GDSQ-P), Pediatric Symptom Checklist - Youth Report (Y-PSC), and Behavioral Risk Factor Surveillance System Questionnaire (ACE's section, modified by authors). The analysis was done using the SMART PLS software. Results: The reliability and discriminant validity of the provided model were assessed using Partial Least Squares-Structural Equation Modeling (PLS-SEM). According to the results of the PLS-SEM analysis, the present model demonstrated suitable levels of reliability and validity. Adverse Childhood Experiences (ACEs) significantly affected attention, internalizing, externalizing problems, and gambling severity. Additionally, the level of gambling was directly correlated with ACEs. Moreover, the indirect influence of the independent variable on the dependent variable via the mediators was found to be statistically significant (P <.001).These findings suggest that externalizing behaviors, attention problems, and internalizing symptoms mediate the effect of ACEs on gambling severity. Lastly, fitness indices indicated that our proposed model fit the data well (SRMR = 0.06, d_ULS = 1.15, Chi-square = 1291.461, and NFI = 0.71). Conclusion: Our study found that ACEs significantly influence gambling severity among youth online gamblers, with internalizing, externalizing, and attention problems mediating this relationship. Practical implications include integrating ACE screening and targeted interventions for associated mental health issues into youth gambling prevention programs to mitigate the risk of problematic gambling behavior. [ABSTRACT FROM AUTHOR]

The main purpose of this study was to evaluate the feasibility of an online psychological intervention for individuals with gambling-related problems, supported by ecological momentary assessments and interventions (EMAs and EMIs), along with weekly phone-calls, before conducting a randomized controlled trial. Participants were required to complete 3 of the 8 modules of the program based on cognitive-behavioral therapy (CBT) and extensions and innovations of CBT. The study measured the outcomes of feasibility (i.e., reach, appropriateness, technology literacy and technology usability, fidelity, and adherence). In terms of reach, 19.8% (n = 11) of the initial population met the inclusion criteria and completed the three modules (mean age = 41; 90.9% men). The perceived appropriateness and the technology usability after the first use were both excellent, fidelity and adherence to the online treatment (73.3%) were adequate. Adherence to the EMAs and the weekly phone calls were more modest (54.51% and 66.67%, respectively). The results of the present study show that an online treatment for gambling problems enhanced by EMA and EMI might be feasible but challenges were noted in terms of reach and adherence to these assessments and calls. These challenges are important to consider for future trials and the scalability of treatments for individuals with gambling disorders. [ABSTRACT FROM AUTHOR]

Desire thinking, within the metacognitive model of addictive behaviors, is conceptualized as a transdiagnostic process linked to the escalation and maintenance of craving for various addictive disorders; however, its application to the understanding of gambling and the Chinese community remains at an early stage. The present study aimed to introduce desire thinking into gambling research in the Chinese context by: (1) testing the applicability of its two-factor conceptualization and assessment tool, the Desire Thinking Questionnaire (DTQ), and (2) exploring its association with dysregulated and regulated engagements in gambling (i.e., Gambling Disorder [GD] and responsible gambling [RG], respectively). We conducted a telephone survey in Macao, China, and obtained a probability sample of 837 Chinese adult past-year gamblers (48.5% men; age: M = 41.11, SD = 14.31) with a two-stage cluster random sampling method. Our data indicated the psychometric adequacy of the two-factor DTQ (i.e., verbal perseveration and imaginal prefiguration) for measuring Chinese gamblers' desire thinking about gambling. After controlling for craving and demographics, desire thinking contributed to an additional 12.1% and 18.9% variance explained in GD tendency and RG behaviors, respectively. This study provides the first empirical evidence of the utility of desire thinking and the DTQ in facilitating gambling research on Chinese gamblers. Our findings also suggest the value of incorporating desire thinking in detecting and treating GD and in promoting RG. [ABSTRACT FROM AUTHOR]

The Gambling Craving Scale (GACS) is a multifaceted measure of gambling craving. Initial validation work by Young and Wohl (2009) in university student samples showed that the GACS had a three-factor structure capturing dimensions of Desire, Anticipation, and Relief. Despite its potential clinical utility as a measure of craving, the GACS has yet to be validated in people seeking treatment for gambling problems. Accordingly, we examined the psychometric properties in a sample of people (N = 209; Mage = 37.66; 62.2% female) participating in a randomized controlled trial testing a novel online treatment for problem gambling. We predicted the GACS would have a three-factor structure. In addition, we also examined measurement invariance across sex and problem gambling risk status. Finally, we assessed concurrent validity of the factors with other measures of problem gambling severity and involvement. Exploratory structural equation modeling findings supported a three-factor structure that was invariant across the groups tested. Each of the Desire, Anticipation, and Relief subscales were significant positive predictors of problem gambling severity and symptoms, and some form of gambling behaviour. Findings show the GACS is a promising scale to assess multidimensional craving experiences among people in treatment for gambling problems. [ABSTRACT FROM AUTHOR]

Analyzing why being a victim of violence has led women to have problems with gambling is a field yet to be explored. Thus, the objectives of the present study were (I) analyze the relationship between gambling motives, received psychological violence, and early maladaptive schemas in women; (II) study differences in the study variables in women with and without gambling disorder (GD); (III) analyze the predictive role of violence and schemas in gambling motives; and (IV) analyze the mediating role of schemas in the relationship between violence and gambling motives. The sample comprised 61 women with GD (M = 48.43, SD = 12.78) and 342 women without GD (M = 26.91, SD = 11.47). The results of the present study revealed positive correlations between gambling motives, psychological violence received and early maladaptive schemas. In addition, women with GD scored higher on the study variables. It was also found that early maladaptive schemas based on subjugation and defectiveness may be a vulnerability factor for engaging in gambling to cope with the negative emotions produced by gender violence. From a clinical perspective, knowing the risk factors related to gambling motives in women is crucial to developing effective prevention and intervention programs. [ABSTRACT FROM AUTHOR]

The Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST) screening tool has not previously been used to evaluate risk for gambling disorder (GD). We aimed to assess the level at which each specific substance involvement score (SSIS), measured by ASSIST, most optimally predicted GD among U.S. college students. Data were analyzed for 141,769 students from the National College Health Assessment (fall 2019-spring 2021) utilizing multivariable logistic regression models. Sensitivities and specificities were utilized to find optimal cutoffs that best identified those with GD, overall and by biological sex and age group. Lower threshold of substance risk related to prescription opioids, cocaine, and hallucinogens (all with SSIS cutoffs of 4) predicts gambling disorder compared to sedatives (SSIS cutoff of 19). Younger students had lower thresholds of substance risk predicting GD than older students for heroin, but for all other substance classifications students 25 years and older had lower thresholds of SSIS predicting GD than students 18–24 years old. This study aids in the understanding that substance use behavior may put students at risk for other addictive behaviors such as GD. This study is the first to utilize the ASSIST tool to predict GD among U.S. college students, extending its application beyond substance use disorders. The identification of optimal cutoffs for each SSIS provides a novel approach to concurrently screen for GD and substance use disorders. This unique contribution could enhance early detection and intervention strategies for GD in the college student population. [ABSTRACT FROM AUTHOR]

The co-occurrence between gambling disorder (GD) and problematic pornography use (PPU) has not yet been explored. Therefore, the present study compared (a) sociodemographic variables, (b) GD-related factors, (c) substance use, (d) psychopathology, (e) personality features, (f) impulsivity, and (g) emotion regulation between individuals with GD (GD group) and those with co-occurring GD and PPU (GD+PPU group). The sample consisted of 359 treatment-seeking individuals with GD: n = 332 individuals had GD only (GD group) and n = 37 individuals had GD and co-occurring PPU (GD+PPU group). GD severity, impulsivity, psychopathology, personality, emotion regulation, and other sociodemographic and clinical variables were assessed. No between-group differences in sociodemographic measures were observed. The GD+PPU group demonstrated greater GD severity and a higher likelihood of substance use compared to those without PPU. Furthermore, the presence of PPU was associated with worse psychopathology, higher impulsivity (except for lack of premeditation and positive urgency), more difficulties in emotion regulation (except for non-acceptance of emotions and limited access to emotions), and a personality profile characterized by lower levels of self-directedness and cooperativeness. The co-occurrence of GD and PPU seems associated with a more dysfunctional clinical profile. [ABSTRACT FROM AUTHOR]

Aims: To investigate the potential association between gambling disorder and symptoms of sleep problems (including insomnia and excessive daytime sleepiness). It was hypothesised that, compared to controls, individuals with gambling disorder would have significantly greater disturbance of sleep, as indicated by increased scores in: (1) sleep items on the Hamilton Anxiety Rating Scale (HAM-A) and Hamilton Rating Scale for Depression (HAM-D); (2) total score on the HAM-A and HAM-D; and (3) the Epworth Sleepiness Scale (ESS). Methods: Secondary analysis of previously published data from 152 young adults, aged 18–29 years. Individuals were stratified into three groups: controls, those at risk of gambling disorder, and those with gambling disorder. One-way ANOVAs with post-hoc tests were conducted to determine whether groups differed significantly in sleep item scores and total scores of the HAM-A and HAM-D, and the ESS. Results: HAM-D scale insomnia item scores were significantly higher in the disorder group, when compared to controls, this being particularly marked for middle and late insomnia. The HAM-A item score indicated significantly worse sleep quality in the disorder group, compared to at risk and control groups. Total HAM-A and HAM-D scores were significantly higher in the disorder group, but ESS scores did not differ significantly. Conclusion: Measures of disruptions in sleep were significantly higher in gambling disorder than controls. Anxiety and depressive symptom severity was also significantly higher in the gambling disorder group. Further research could have implications for identification and treatment of sleep disorders and psychiatric comorbidities in gambling disorder. [ABSTRACT FROM AUTHOR]

Gambling disorder is a severe condition that significantly compromises the lives of those affected. In light of this clinical relevance, the literature on the antecedents of this form of addiction is constant and continually evolving. Consistently with this framework, the present research aimed at investigating the role of some risk factors in gambling disorder, with a specific focus on alexithymia, dissociation, and locus of control. The research involved a sample of 290 participants (183 males and 107 females; Mage = 34.43, SD = 14.65) who practice gambling at least occasionally. They completed an online survey including the South Oaks Gambling Screen, Twenty-Items Toronto Alexithymia Scale, Dissociative Experience Scale‐II, and Locus of Control of Behavior. ANOVA and a moderated-mediation model were implemented to analyse the collected data. Results showed that 19.0% of the participants were At Risk and Problem Gamblers, while 27.6% fell into the category of Problematic Gamblers. Problematic Gamblers showed significantly higher levels of alexithymia, dissociation, and external locus of control. Moreover, a significant association between alexithymia and the severity of problematic gambling behaviour was found and was significantly mediated by absorption (a dissociation feature). Furthermore, the external locus of control significantly moderated this indirect effect. The role of gender as a covariate was also investigated. Such findings may offer further insights into the field of clinical research on gambling disorder and may provide useful information for effective clinical practice. [ABSTRACT FROM AUTHOR]

The role of dopamine in the pathophysiology of gambling disorder (GD) remains incompletely understood, with disparate research findings concerning presynaptic and postsynaptic structures and dopaminergic synthesis. The aim of this study was to investigate potential correlations between striatal dopamine transporter (DAT) lateralization and asymmetry index, as assessed by 123I-FP-CIT SPECT, and temperamental traits, as measured by Cloninger's Temperament and Character Inventory (TCI), in GD subjects. Significant associations were found between DAT binding asymmetries in the caudate and putamen and the temperamental dimensions of harm avoidance and novelty seeking. Specifically, high novelty seeking scores correlated with increased DAT binding in the left caudate relative to the right, whereas higher harm avoidance scores corresponded to increased DAT binding in the right putamen relative to the left. These observations potentially imply that the asymmetry in DAT expression in the basal ganglia could be an outcome of hemispheric asymmetry in emotional processing and behavioural guidance. In summary, our study provides evidence supporting the relationship between DAT asymmetries, temperamental dimensions and GD. Future investigations could be directed towards examining postsynaptic receptors to gain a more comprehensive understanding of dopamine's influence within the basal ganglia circuit in disordered gambling. If confirmed in larger cohorts, these findings could have substantial implications for the tailoring of individualized neuromodulation therapies in the treatment of behavioural addictions. [ABSTRACT FROM AUTHOR]

Abstract The easy access to Internet through increased availability and ownership of Internet-enabled facilities such as smart/android phones and communication data by adolescents have increased their vulnerability to problem gambling (PG). There is therefore need to understand the relationship between PG and some psychological and situational factors that have the capacity to influence its development and severity. The present study is a test of a moderated mediation model in which the effect of quality of life (QoL) on PG was mediated by escape, and this mediation effect was further moderated by gambling craving (GAC). Participants (N = 197: 83% male, M age = 24.05 years, SD age = 7.23 years) online gamblers took part in the survey and responded to the Problem Gambling Severity Index (PGSI), GQoL scale, Gambling Outcome Expectancies Scale-Escape (GOES-E), and the GAC scale. PROCESS macro analysis result reveals a significant moderated mediation effect of the escape-PG path by GAC. The findings provide support for escape as a potential pathway through which the QoL-PG association may thrive, and this support was further influenced by GAC. This is a significant contribution to the QoL-PG literature. However, we emphasize the need for further investigation of GAC as a criterion for PG.

Abstract Background Dysfunctional decision-making and intense craving represent pivotal aspects across all addictive behaviors, notably evident in gambling addiction where these factors significantly shape chasing behavior—continuing gambling to recoup losses—indicative of problematic gambling. This study explores the correlation between chasing behavior, craving, affective decision-making, decision-making styles, and gambling severity among habitual Italian gamblers. Methods One hundred and sixty-six participants from diverse gambling venues completed assessments including the South Oaks Gambling Screen (SOGS), the Iowa Gambling Task (IGT), the General Decision-Making Style (GDMS), the Gambling Craving Scale (GACS), and a computerized task to measure chasing behavior. Participants were randomly assigned to Control and Loss chasing conditions. Results Regression analyses revealed craving as a predictor of chasing behavior. Interestingly, individuals with a dependent decision-making style exhibited lower tendencies to chase. While IGT performance correlates with chasing frequency, it is not associated with the decision to continue or cease gambling. Intriguingly, gambling severity (SOGS total score) did not feature in the final models of both regression analyses. Discussion These findings emphasize the significant role of craving in driving chasing behavior. Additionally, this study introduces, for the first time, the idea that a dependent decision-making style could potentially serve as a safeguard against chasing proneness. Conclusions The study suggests a fundamental dichotomy between chasers and nonchasers among gamblers, irrespective of gambling severity. This distinction could be instrumental in tailoring more effective intervention strategies for gambling disorder treatment.

Background Gambling disorder (GD) has become a wide concern in Indonesia, as many negative consequences arise from this psychiatric condition. Prompt treatment with an appropriate method of delivery is required to achieve optimal outcomes in GD patients. This protocol paper outlines a study to determine the effectiveness, acceptability, and feasibility of internet-based cognitive behavioral therapy (iCBT) in treating GD in Indonesia. Methods This non-randomized pilot and feasibility study will recruit 20 people with GD. All participants will receive the iCBT intervention through self-learning videos and guided weekly group sessions. The effectiveness of the intervention will be assessed at baseline (week 0), post- treatment completion (week 10), and 6 weeks post-treatment (week 16). The outcomes measured will be the change in gambling symptoms, gambling urges, cognitive distortions, readiness to change, emotional problems, and quality of life of the participants. Discussion The feasibility of iCBT for GD patients in Indonesia will be assessed by this study. The study’s results will give an indication of the acceptability of the intervention and the feasibility of a subsequent conclusive trial. The delivery of iCBT may help to address the issue of treatment access in an extensive geographical region and provide immediate implications as a treatment resource for GD in practice.

Background: Dysfunctional decision-making and intense craving represent pivotal aspects across all addictive behaviors, notably evident in gambling addiction where these factors significantly shape chasing behavior—continuing gambling to recoup losses—indicative of problematic gambling. This study explores the correlation between chasing behavior, craving, affective decision-making, decision-making styles, and gambling severity among habitual Italian gamblers. Methods: One hundred and sixty-six participants from diverse gambling venues completed assessments including the South Oaks Gambling Screen (SOGS), the Iowa Gambling Task (IGT), the General Decision-Making Style (GDMS), the Gambling Craving Scale (GACS), and a computerized task to measure chasing behavior. Participants were randomly assigned to Control and Loss chasing conditions. Results: Regression analyses revealed craving as a predictor of chasing behavior. Interestingly, individuals with a dependent decision-making style exhibited lower tendencies to chase. While IGT performance correlates with chasing frequency, it is not associated with the decision to continue or cease gambling. Intriguingly, gambling severity (SOGS total score) did not feature in the final models of both regression analyses. Discussion: These findings emphasize the significant role of craving in driving chasing behavior. Additionally, this study introduces, for the first time, the idea that a dependent decision-making style could potentially serve as a safeguard against chasing proneness. Conclusions: The study suggests a fundamental dichotomy between chasers and nonchasers among gamblers, irrespective of gambling severity. This distinction could be instrumental in tailoring more effective intervention strategies for gambling disorder treatment. [ABSTRACT FROM AUTHOR]

Objective: Although gender-specific evidence on Gambling Disorder (GD) is still limited, some studies reported specific differences, mainly in psychopathological profiles, gambling behavior patterns, and pathogenesis. In order to further examine the role of gender in GD, we conducted a multicenter investigation in a sample of Italian outpatients. Method: One hundred-four outpatients with a diagnosis of GD based on DSM-5 criteria were consecutively recruited at two clinics based in Milan. Socio-demographic and clinical variables were collected for the whole sample and analyzed for the effect of gender. The severity of illness was assessed using the Canadian Problem Gambling Index and the Gambling Attitudes and Beliefs (GABS). Results: Among females, a significantly higher mean age (52.23 ± 10.95 vs. 40.96 ± 15.76; p=0.005) and older age at illness onset emerged (43.5 ± 11.92 vs. 29.22 ± 14.26; p<0.001). Females showed a significantly higher rate of psychiatric comorbidities, lifetime suicide ideation, stressful events at GD onset, and positive family history for GD compared to males. A predictive effect of male gender was found for the GABS questionnaires by performing a linear regression model, with males showing a higher risk to reach higher scores compared to females (B= 11.833; t=2.177; p=0.034). Conclusions: Our study seems to confirm the hypotheses that gender in GD may influence psychopathological profiles, course, and comorbidity. GD in female gender is frequently a comorbid condition with other specific clinical characteristics compared to males. Identifying specific clinical factors by gender may prompt more focus on the public health of women in relation to gambling, while still recognizing that males are at-risk of earlier gambling problems. These findings should be considered in therapeutic perspectives. [ABSTRACT FROM AUTHOR]

Being the only city with legalized casinos in China, Macao has a long-term need for risk factor identification and assessment for gambling disorder. Responding to such a need, this study aimed to validate a translated Chinese version of the Metacognitions about Gambling Questionnaire (MGQ) among Chinese gamblers and apply such a tool to enhance the understanding of gambling disorder tendency and responsible gambling behavior from a metacognitive perspective. We obtained a probability sample of 604 lifetime adult gamblers in Macao, China, through a telephone survey, of which the data of 480 past-year gamblers (Mage = 41.81, SD = 14.73; 45.6% women) was used for data analyses. As its original version, the translated Chinese version of MGQ displayed the two-factor structure (i.e., positive and negative metacognitions regarding gambling) with satisfactory model fit (χ2 (32) = 67.69, CFI =.94, RMSEA =.07, SRMR =.05). Both these two factors had satisfactory reliability (α =.74 and.73) and validity (positive correlation with gambling disorder tendency and negative correlation with responsible gambling behavior). In addition, these metacognitions significantly accounted for the variances of gambling disorder tendency (i.e., positively correlated) and responsible gambling behavior (i.e., negatively correlated) after ruling out demographic and other confounding risk effects. In comparison, negative metacognitions cast a more salient impact than positive metacognitions on gambling disorder tendency and responsible gambling behavior. MGQ can provide a reliable and valid assessment of Chinese gamblers' metacognitions about gambling; it also displays a promising potential in delineating the underlying mechanism of gambling disorder tendency and responsible gambling behavior. [ABSTRACT FROM AUTHOR]

Few studies have analyzed the clinical profile of treatment-seeking patients with the comorbid presence of schizophrenia (SCZ) and gambling disorder (GD), which warrants new research to assess the network structure of this complex mental condition. The aim of this study was to explore the organization of the symptoms and other clinical correlates of SCZ with GD. Network analysis was applied to a sample of N = 179 SCZ patients (age range: 19–70 years, mean=39.5, SD=9.9) who met clinical criteria for gambling disorder-related problems. Variables included in the network were the core GD symptoms according to the DSM-5, psychotic and paranoid ideation levels, global psychological distress, GD severity measures (debts and illegal behavior related with gambling), substances (tobacco, alcohol, and illegal drugs), and personality profile. The nodes with the highest authority in the network (variables of highest relevance) were personality traits and psychological distress. Four empirical modules/clusters were identified, and linkage analysis identified the nodes with the highest closeness (bridge nodes) to be novelty seeking and reward dependence (these traits facilitate the transition between the modules). Identification of the variables with the highest centrality/linkage can be particularly useful for developing precise management plans to prevent and treat SCZ with GD. [ABSTRACT FROM AUTHOR]

Gambling disorder is a problem that is affecting increasingly more people. It is associated with difficulties in emotion regulation, gambling motives, blame, and shame. This study aims to study the relationship between gambling severity, blame, and shame, independently and together with emotion regulation and gambling motives; to analyse the mediating role of emotion regulation in the relationship between gambling severity and shame; and to compare mean differences in the study variables according to the sample group. For this purpose, a clinical and non-clinical sample of 158 individuals (119 males and 39 females) ranging in age from 12 to 30 years (M = 19.70, SD = 5.35) was divided into three groups. The questionnaires were administered online and on paper. The results showed that blame and shame are related to the severity of gambling. In the case of shame, this relationship was found to be partially mediated by the emotion regulation strategy of self-blame. Gambling severity, blame and shame were also found to be related to various gambling motives and different emotion regulation strategies. All this information can be of great use in the prevention and treatment of gambling problems. [ABSTRACT FROM AUTHOR]

Impulsivity-characterized executive function impairments have been hypothesized to represent mechanisms underlying the symptomology associated with gambling disorder (GD). Despite this, a clear profile of executive function within GD has yet to be established. Furthermore, it remains unclear whether executive function deficits represent a vulnerability marker for the disorder. This study assessed executive function performance within a GD sample compared to a sample of familial relatives and community controls. Using a family study methodology, a broad assessment of executive function was administered to analyze performance differences and their potential characterization by impulsivity between a sample of individuals meeting criteria for GD, their first-degree familial relatives, and a community control sample. Performance differences emerged regarding the capacity to delay gratification and inhibit automatic task-irrelevant responses between the GD and control samples. Results support the presence of impulsive choice and impulsive cognitive bias as components of the GD executive functioning profile. Similar difficulties inhibiting automatic attentional shifting were observed within the first-degree relative sample. Executive functioning within GD appears to be characterized by an impulsive pattern of behaviours/decisions but impacts processes differently. Evidence suggests that individuals diagnosed with GD demonstrate a statistically different capacity to delay gratification (e.g. a propensity towards smaller, more immediate rewards as opposed to larger delayed rewards) and inhibit cognitive biases (e.g. difficulty shifting attention away from task-irrelevant stimuli). This latter difference may represent a vulnerability marker of GD as preliminary evidence was provided for similar difficulties in a first-degree relative sample. Further research must replicate these findings and assess the impact of task modality, symptom severity, and comorbidity on the observation of executive functioning impairment. [ABSTRACT FROM AUTHOR]

The number of individuals with gambling disorders (GD) associated with online sports betting (OSB) is on the rise, despite the absence of effective treatment. Recently, the effectiveness of noninvasive brain stimulation (NIBS) techniques, such as transcranial direct current stimulation (tDCS) targeting the dorsolateral prefrontal cortex (DLPFC), has been demonstrated in treating various addictive disorders. Consequently, tDCS may be a promising treatment option. In the present case report, we evaluate the efficacy of a new intensified tDCS protocol (ten sessions, 2 mA for 20 min, two sessions daily, with 20 min intervals between daily sessions, one week in total) applied to the DLPFC (anode over the left and cathode over the right) in a patient with GD and OSB. Research variables were measured before, during, and after the intervention. The results indicate that the tDCS intervention improved gambling symptoms, impulsivity, depression, and anxiety states. The highest percentage of changes from before to after the intervention is associated with symptoms of gambling and depression. Our findings indicate that an intensified tDCS stimulation protocol of the left anodal/right cathodal DLPFC may effectively improve gambling behavior. Additional research on large patient populations is required to improve the generalizability of the current protocol. [ABSTRACT FROM AUTHOR]

Laboratory studies reveal that participants' expectations influence the relation between acute alcohol consumption and gambling behaviors. However, specific expectations have not been explored. To fill this gap, people who gamble frequently were asked about their expectations for how alcohol influences their gambling behaviors. Individuals who gamble frequently (n = 472) were recruited via MTurk and completed a survey that included current gambling behaviors and alcohol expectancies while gambling. As many as 55% agreed to some extent that they were more focused, had skills increase, felt calmer, and won more when gambling under the influence of alcohol. Additionally, positive alcohol expectancies significantly predicted percentage of time spent simultaneously consuming alcohol and gambling. Several specific expectations were related to percentage of time gambling while drinking. Individuals who gamble weekly hold both positive and negative expectations about how alcohol consumption impacts gambling. Responsible gambling practices might target these expectations in efforts to educate consumers. Providing resources regarding the effects of acute alcohol use on gambling might curb both alcohol and gambling-related harms. [ABSTRACT FROM AUTHOR]

Making sense of the social world is an intricate process heavily influenced by cultural elements. Gambling is a prevalent leisure-time activity characterized by risk-taking conduct. While some individuals who engage in it do so without experiencing any harm, others will develop gambling problems. Judaism tends to perceive gambling negatively since it contradicts fundamental Jewish principles. The current study focuses on the Jewish Ultra-Orthodox community in Israel which is characterized as a cultural enclave with minimal interaction with the secular world. Hence, it provides a unique and novel socio-cultural context to inquire how individuals with gambling disorder (GD) from this community make sense of gambling. Following constructivist grounded theory guidelines, 22 Ultra-Orthodox men with GD were interviewed using a purposeful sampling design. Sixteen Rabbis were also interviewed, illuminating the socio-cultural context of Halachic regulations and norms regarding gambling in this community. An abductive analysis of the data, interwoven with Bourdieu's concept of habitus, yielded an overarching theme that we dub as "sense for gambling," encompassing matrices of Ultra-Orthodox external (e.g., a conservative cultural structure with numerous prohibitions and life marked by poverty) and internal (e.g., feelings of loneliness, dissatisfaction, and deviance) dispositions imprinted onto the body, creating diverse embodied reactions (emotional and sensory) to gambling, and leading to developing GD. We recommend placing the body, as the locus of internalized dispositions, at the core of examination when researching pathways to GD. We propose that this intricate interplay between external and internal dispositions shapes the decision-making regarding gambling, thus mitigating individual responsibility for GD. [ABSTRACT FROM AUTHOR]

The influence of technological changes on the gambling landscape, coupled with the persistent challenges of prevalence and relapse rates, especially among already disadvantaged population sectors, highlights the need for expanding treatment provision and a comprehensive approach to addressing gambling problems. The aim of this study was to identify the relationship between time perspective and life-sense orientations in people with gambling disorder in a rehabilitation setting. The study involved 42 respondents (70% male and 30% female; mean age: 24.6; SD = 2.4) who completed a gambling rehabilitation program at the "XXX" rehabilitation center for 6 months (due to the confidentiality of the information, the name was removed). The Zimbardo Time Perspective Inventory and Leontiev's Life-Purpose Orientations test were administered immediately prior to and following the rehabilitation program. The research results revealed the dynamics in the development of positive correlations between time perspective and life-sense orientations in people with gambling disorder, which may be indicative of time perspective harmonization and an increasing interest in building a meaningful life beyond gambling. The study's findings expand and deepen existing psychological understandings of time perspective and life-sense orientations in people with gambling disorder. [ABSTRACT FROM AUTHOR]

An increase in legal avenues of gambling in the United States has led to growing concern over gambling-related harms and criminal consequences associated with Gambling Disorder. Data for the current study is drawn from a survey of Gambler's Anonymous members. Prevalence of social, economic, and criminal/legal gambling-related harms is considered. Additional analysis includes whether gambling-related harms differ based on gender. Findings include substantial similarities between men and women concerning the types and prevalence of social, economic, and criminal/legal harms. Results offer increased knowledge to better understand the progression of Gambling Disorder which may help explain and potentially prevent gambling-motivated crime. [ABSTRACT FROM AUTHOR]

FreeLudo is an innovative project targeting the primary prevention of DSM-5 Gambling Disorder (GD), addressing children aged between 6 and 8 years attending Primary School. An innovative platform has been developed, which enables hybrid online and offline interaction and provides children with questionnaires aimed at better understanding the potential risk factors for the development of GD. Online interaction consists in providing questionnaires through a simple platform video game; after the video game, the platform also proposes social interaction among children by assigning them social challenges and activities. While providing an interactive user awareness on the risk of Gambling Disorders, the platform allows data collection on potential risk behavior. The paper summarizes the preliminary results of the platform’s first testing phase, conducted on a heterogeneous sample of children aged 6 to 8 years, attending a primary school in the province of Taranto (Apulia, Italy). [ABSTRACT FROM AUTHOR]

While the concept of recovery is receiving increasing attention in the context of gambling disorder (GD), no consensus has yet been reached regarding its definition. This scoping review aims to map the literature on GD recovery, identify gaps, and provide insights for a more holistic and patient-centred perspective. A systematic search of three databases was conducted (PubMed, PsycINFO, and ScienceDirect). Based on the method by which the results of these studies were produced, the studies included were sorted into four categories (quantitative, instrument validation, qualitative, and mixed studies) and subsequently examined using conceptual analysis. One hundred thirteen articles were included in this research after the screening process. In the quantitative and instrument validation studies, recovery was defined or operationalized in terms of abstinence, the absence of a GD diagnosis, or mild GD severity, or by reference to treatment outcomes or controlled gambling. A meta-synthesis of the results of the qualitative studies revealed four core features of recovery (insight, empowerment and commitment, wellbeing enhancement, and reconsideration of the issue of relapse). Discrepancies in definitions, outcomes, and variables used were evident across studies. Additionally, the quantitative and standardized approaches employed in most studies exhibited severe limitations with regard to defining recovery from the subjective and multidimensional perspectives of people recovering from GD. This lack of definitional clarity emphasizes the necessity for further qualitative research. This research should encompass multiple stakeholder perspectives to develop a working definition promoting recovery from a holistic, patient-centred, and tailored approach. [ABSTRACT FROM AUTHOR]

Whilst opportunities to participate in gambling have increased, access to support for problem gamblers is lacking behind. This lack of balance calls for improved and accessible intervention methods. The present double-blind randomized controlled trial (RCT) explored the effectiveness of two interventions targeting automatic cognitive processes, known as Attentional Bias Modification (AtBM) and Approach Bias Modification (ApBM). It was hypothesized these interventions would reduce gambling behavior and reduce or reverse targeted biases. Participants (N = 331) were community-recruited Flemish (35%) and Dutch (65%) adult problem gamblers motivated to reduce or stop their gambling who received either six sessions of active training (AtBM or ApBM) or of the corresponding sham-training (sham-AtBM or sham-ApBM). Due to high attrition rates (90.1% up to the intervention phase) the study was terminated before completion, since it would greatly limit the validity of any results. A post hoc qualitative study was performed on a subset of participants to gain insight into contributing factors for the high attrition rate. Issues negatively impacting participants' motivation to complete the program were identified, as well as elements of the program that received approval. The results from this study provide a first insight into the potential of the use of online cognitive bias modification (CBM) interventions in problem gambling (PG). Suggestions and directions for future studies are discussed. [ABSTRACT FROM AUTHOR]

A large body of previous research has provided support for the role of attentional bias as a maintaining factor in addiction. This systematic review aimed to investigate the extent and nature of attentional bias as a phenomenon which exists within problem gamblers. Studies were identified through searches of three databases (MedLine, PSYCHINFO, and Web of Science) and examination of the reference lists of the final studies meeting criteria for inclusion. The scope of the review included empirical studies making experimental comparisons of problem gamblers and non-problem gamblers across a range of attentional paradigms. A comparison of effect sizes was conducted across studies comparing problem to non-problem gamblers within and between attention paradigms. Twenty-two studies were reviewed systematically across ten experimental paradigms. Attentional bias was demonstrated in 16 of the 22 studies, with attentional bias effects varying across paradigms. Quality assessment revealed two main limitations across studies: lack of a priori power analysis, and failure to control for gambling frequency as a possible confounding variable. Findings support the role of attentional bias as a potential maintaining factor in problem gambling behaviour, in line with evidence for substance addiction. Recommendations for future studies are outlined alongside a discussion of clinical implications. [ABSTRACT FROM AUTHOR]

Objective: Remission from problem gambling (PG) continues to be a priority of clinicians and researchers. Data from cross-sectional studies indicate that some correlates are more predictive of PG, and existing longitudinal studies have exclusively examined risk factors that predict emergence of PG. This study's objective is to fill in the remaining pieces of the puzzle by identifying factors that might facilitate remission from PG. Method: A stratified sample of 10,199 Canadian adult gamblers were recruited from an online panel. Respondents who screened positively for PG at baseline and completed a follow-up assessment 1 year later (n = 468) were assessed on a series of modifiable gambling, psychosocial, mental health, and substance use variables. A forward stepwise logistic regression was conducted to identify the strongest predictors of remission from PG at follow-up. A Least Absolute Shrinkage and Selection Operator regression was also conducted to confirm the most relevant predictors. Results: Out of 75 candidate variables, 10 were retained by the regression model. Two were related to cessation of specific gambling activities, two were related to gambling motivations, two were psychosocial in nature, two were related to substance use while gambling, and one was related to remission from a mental health disorder. The final and strongest predictor was PG severity at baseline. Conclusions: Although PG remission predictors were mostly gambling-related, psychosocial aspects may also be targeted by stakeholders aiming to reduce PG. Ceasing to use tobacco while gambling and diversifying leisure activities may be promising targets. Other mental health and substance use predictors may still possibly be relevant, but only for a subset of people with PG. Public Health Significance Statement: Gambling-related, psychosocial, and mental health variables predict remission from problem gambling 1 year later. Initial problem gambling severity is the strongest predictor of remission. Cessation of electronic gaming machine gambling and decreasing the frequency of tobacco use while gambling is associated with a higher likelihood of remission. Different predictors of remission may be identified when separating people who gamble into subgroups based on their biopsychosocial profiles. [ABSTRACT FROM AUTHOR]

The purpose of this article is to analyze the legislation of Ukraine on the protection of gambling players from the formation of gambling addiction, to identify ways and means of protection, to evaluate their effectiveness and to formulate proposals for improving (strengthening) the protection of the rights of gambling players. The research used general scientific and special scientific methods of scientific knowledge. In particular, the dialectical method of learning the phenomena of the surrounding reality, comparative-legal, systemic-structural, methods of logic (analysis, synthesis, induction, deduction, analogy). Many prevention measures have already been implemented in Ukraine. In addition, the player is protected by the right to receive free psychosocial assistance in the event of problems with gambling and free medical assistance in the event of a diagnosis of gambling addiction. The state also provides free socio-psychological rehabilitation of players during and after treatment for gaming addiction. The disadvantage is the bringing of the player to administrative responsibility for participating in illegal gambling and the impossibility of recognizing him as a victim in criminal proceedings to compensate for the damage caused by the crime (engagement in the gambling business). [ABSTRACT FROM AUTHOR]

Background Gambling disorder (GD) has become a wide concern in Indonesia, as many negative consequences arise from this psychiatric condition. Prompt treatment with an appropriate method of delivery is required to achieve optimal outcomes in GD patients. This protocol paper outlines a study to determine the effectiveness, acceptability, and feasibility of internet-based cognitive behavioral therapy (iCBT) in treating GD in Indonesia. Methods This non-randomized pilot and feasibility study will recruit 20 people with GD. All participants will receive the iCBT intervention through self-learning videos and guided weekly group sessions. The effectiveness of the intervention will be assessed at baseline (week 0), post- treatment completion (week 10), and 6 weeks post-treatment (week 16). The outcomes measured will be the change in gambling symptoms, gambling urges, cognitive distortions, readiness to change, emotional problems, and quality of life of the participants. Discussion The feasibility of iCBT for GD patients in Indonesia will be assessed by this study. The study’s results will give an indication of the acceptability of the intervention and the feasibility of a subsequent conclusive trial. The delivery of iCBT may help to address the issue of treatment access in an extensive geographical region and provide immediate implications as a treatment resource for GD in practice.

Gambling always carries risks for the player's mental health, as it can provoke the development of gaming addiction. A direct connection between the socio-psychological portrait of the player, his gaming behavior, and the risks of game addiction can be traced. The purpose of the work is to form a socio-psychological portrait of a "pathological" gambler. The work was performed based on the State Institution "Institute of Forensic Psychiatry of the Ministry of Health of Ukraine". Methods used: CAWI (Computer Assisted Web Interviewing) questionnaires in online gambling establishments; CAPI (Computer Assisted Per­sonal Interviews - server event tracking method) in land-based casinos (more than 9,000 people were inter­viewed); statis­tical (for selection and analysis of materials). A questionnaire specially developed by the authors with a point evaluation of the results (from 71 to 90 points) allows us to conclude that the interviewee is a pathological gamb­ler. For the first time in Ukraine, the survey was conducted exclusively among gamblers at gambling establishments. The obtained results made it possible to form a statistically reliable р

Background Gambling disorder (GD) has become a wide concern in Indonesia, as many negative consequences arise from this psychiatric condition. Prompt treatment with an appropriate method of delivery is required to achieve optimal outcomes in GD patients. This protocol paper outlines a study to determine the effectiveness, acceptability, and feasibility of internet-based cognitive behavioral therapy (iCBT) in treating GD in Indonesia. Methods This non-randomized pilot and feasibility study will recruit 20 people with GD. All participants will receive the iCBT intervention through self-learning videos and guided weekly group sessions. The effectiveness of the intervention will be assessed at baseline (week 0), post- treatment completion (week 10), and 6 weeks post-treatment (week 16). The outcomes measured will be the change in gambling symptoms, gambling urges, cognitive distortions, readiness to change, emotional problems, and quality of life of the participants. Discussion The feasibility of iCBT for GD patients in Indonesia will be assessed by this study. The study's results will give an indication of the acceptability of the intervention and the feasibility of a subsequent conclusive trial. The delivery of iCBT may help to address the issue of treatment access in an extensive geographical region and provide immediate implications as a treatment resource for GD in practice.

Gambling disorder can be treated with cognitive behavioral therapy (CBT), but treatment is under-dimensioned in many settings. For example, in Sweden, a setting with mixed responsibility for addiction treatment between health care and social services, treatment for gambling disorder has only recently been introduced in the responsibilities of public institutions. After the introduction of gambling in treatment legislation in 2018, few studies have assessed the real-world feasibility of such treatment. In addition, treatment in social services specifically has not been documented or evaluated, and therefore, in a pioneer gambling treatment facility in such a setting, this study aimed to investigate treatment outcome in patients with gambling disorder six months after completed CBT treatment within a social service setting. Twenty patients receiving CBT treatment during 2018–2020 were followed with respect to gambling habits at end of treatment and at follow-up six months after treatment. The National Opinion Research Center DSM Screen for Gambling Problems (NODS) was used as screening tool. Rates of gambling abstinence, as well as subjective experience of the treatment, are reported. Ninety percent of the patients were abstinent from gambling at six-month follow-up, and 95 percent of the patients no longer fulfilled criteria of a gambling disorder. In conclusion, these pilot results suggest that CBT treatment is a feasible method for treatment of gambling disorder also in a social service setting. However, due to the limited sample size of this pilot study, and the limited background information of clients who could not be reached, future studies with larger sample sizes are needed.

AbstractBackgroundMethodResultsConclusionsThe Problem Gambling Severity Index (PGSI) is a widely used assessment of disordered gambling. However, it has been claimed that instead of measuring a single factor of problem gambling severity, the PGSI measures two correlated factors of behavioral dependence and harms/consequences. The existing literature using exploratory and confirmatory factor analysis has notable limitations that mean these accounts cannot be discriminated.Secondary data from 13 nationally representative surveys of gamblers in the UK (n = 42,422) between 2007 and 2023 were used to examine five different approaches to specifying one- and two-factor models of the PGSI.Overall, the findings supported a single construct account. Fit indices provided slight support for a two-factor model. However, the composition and loadings of these factors did not replicate in the disaggregated datasets and demonstrated poor model-based reliability. The best-fitting model was a bifactor ESEM model with a general gambling severity factor and a group-specific factor subsuming additional covariance between the first three or four items.This study provides support for a unitary gambling severity construct and the use of total PGSI scores. The second factor observed elsewhere appears to consist of residual covariances between the first 3-4 PGSI items or a methods factor that can be explained by item framing (e.g. items that ask about gambling behavior). [ABSTRACT FROM AUTHOR]

Ample evidence indicates that early maladaptive schemas play an important role in the perceived impact of COVID-19 on individuals. Likewise, people with gambling disorder (GD), as well as women, show more maladaptive schemas than people without an addictive condition and men. However, no research to date has investigated the interrelationship between maladaptive schemas and the perceived impact of COVID-19, and even fewer studies have disaggregated the results by sex and clinical condition. This study aimed to examine the relationship between maladaptive schemas and the perceived impact of COVID-19 (i.e., emotional, physical, occupational, social, care, and quality of life). Second, we assessed the moderating role of sex and clinical group (i.e., gambling vs. non-gambling) on this relationship. A case-control study was performed with 160 participants, specifically 80 people with GD and 80 non-gamblers. The findings showed that individuals with greater maladaptive schemas showed higher COVID-19 impact. Moreover, gamblers presented higher maladaptive schemas and lower COVID-19 impact. Finally, the outcomes indicated that the male sex moderates the failure and imperfection schemas and the perceived impact on occupational and physical health, while the female sex moderates the attachment schemas and the global impact. These findings underscore the necessity of incorporating variables such as sex and GD when tailoring strategies for prevention, evaluation, and intervention for individuals. Additionally, the significance of adopting a gender-inclusive perspective was emphasized. [ABSTRACT FROM AUTHOR]

Background: This longitudinal register study aimed to investigate the association between gambling disorder (GD) and work disability and to map work disability in subgroups of individuals with GD, three years before and three years after diagnosis. Methods: We included individuals aged 19–62 with GD between 2005 and 2018 (n = 2830; 71.1% men, mean age: 35.1) and a matched comparison cohort (n = 28 300). Work disability was operationalized as the aggregated net days of sickness absence and disability pension. Generalized estimating equation models were used to calculate adjusted odds ratios (AORs) and 95% confidence intervals (CIs) for the risk of long-term work disability (>90 days of work disability/year). Secondly, we conducted Group-based Trajectory Models on days of work disability. Results: Individuals with GD showed a four-year increased risk of long-term work disability compared to the matched cohort, peaking at the time of diagnosis (AOR = 1.89; CI 1.67–2.13). Four trajectory groups of work disability days were identified: constant low (60.3%, 5.6–11.2 days), low and increasing (11.4%, 11.8–152.5 days), medium–high and decreasing (11.1%, 65.1–110 days), and constant high (17.1%, 264–331 days). Individuals who were females, older, with prior psychiatric diagnosis, and had been dispensed a psychotropic medication, particularly antidepressants, were more likely to be assigned to groups other than the constant low. Conclusion: Individuals with GD have an increased risk of work disability which may add financial and social pressure and is an additional incentive for earlier detection and prevention of GD. [ABSTRACT FROM AUTHOR]

Background: In 1990, the United States' Institute of Medicine promoted the principles of outcomes monitoring in the alcohol and other drugs treatment field to improve the evidence synthesis and quality of research. While various national outcome measures have been developed and employed, no global consensus on standard measurement has been agreed for addiction. It is thus timely to build an international consensus. Convened by the International Consortium for Health Outcomes Measurement (ICHOM), an international, multi-disciplinary working group reviewed the existing literature and reached consensus for a globally applicable minimum set of outcome measures for people who seek treatment for addiction. Methods: To this end, 26 addiction experts from 11 countries and 5 continents, including people with lived experience (n = 5; 19%), convened over 16 months (December 2018–March 2020) to develop recommendations for a minimum set of outcome measures. A structured, consensus-building, modified Delphi process was employed. Evidence-based proposals for the minimum set of measures were generated and discussed across eight videoconferences and in a subsequent structured online consultation. The resulting set was reviewed by 123 professionals and 34 people with lived experience internationally. Results: The final consensus-based recommendation includes alcohol, substance, and tobacco use disorders, as well as gambling and gaming disorders in people aged 12 years and older. Recommended outcome domains are frequency and quantity of addictive disorders, symptom burden, health-related quality of life, global functioning, psychosocial functioning, and overall physical and mental health and wellbeing. Standard case-mix (moderator) variables and measurement time points are also recommended. Conclusions: Use of consistent and meaningful outcome measurement facilitates carer–patient relations, shared decision-making, service improvement, benchmarking, and evidence synthesis for the evaluation of addiction treatment services and the dissemination of best practices. The consensus set of recommended outcomes is freely available for adoption in healthcare settings globally. [ABSTRACT FROM AUTHOR]

Introduction: New knowledge was projected into the ICD-11 classification in clinical manifestation of mental disorder associated with gambling. The independent diagnostic category of gambling disorder according to ICD-11 should not be assessed, contrary to pathological gambling in ICD-10, if the onset of impaired control over gambling behaviour is corresponding to use of the methamphetamines. The aim of the study: To detect the prevalence of gambling/pathological gambling according to ICD-10 classification among methamphetamine users with dependence in treatment, and with selected micro case-illustrations indicate the necessity to revise the diagnosis by the implementation of new ICD-11criteria. Patients and methods: It was retrospective, descriptive, clinical study of the medical records of 178 patients treated for methamphetamine dependence with the addition of three selected micro case-illustrations, which provided the opportunity to present different diagnostic assessment according to ICD-11 and its patognomic significance. results: Gambling behaviour was detected in 30% of the patients treated for dependence on methamphetamines, in the same time 18% had the the diagnosis of pathological gambling according to ICD-10. The new diagnostic approach according to ICD-11 was documented with use of qualitative method by three micro case-illustrations. Discussion and conclusion: The findings of the study have shown the high prevalence of the impaired control over gambling behaviour among the patients in treatment due to dependence on methamphetamines, which in large part of them, had the neurobiological base due to the direct effects of dopamine on the CNS, so as it is sometimes in the treatment of Parkinson disease by dopamine agonists. According to ICD-11 it is not an independent diagnostic category, but it is only behavioural sign induced by psychoactive substance. Finally, the authors are discussing the consequences of the change in diagnostic assessment and the number of inevitable changes in the clinical practice after the adoption of ICD-11. [ABSTRACT FROM AUTHOR]

Participation in various types of gambling is associated with age and gender. Younger men tend to be drawn toward online gambling whereas women and older individuals tend to engage more in land-based gambling such as electronic gaming machines (EGMs). The present study examined how annual trends in theoretical loss, a robust measure of risk propensity/gambling intensity, varied according to age groups and gender among an EGM-population in Norway (N = 195,318, 26.5% women, age range 18 to 103 years [M = 40.13, SD = 16.29]). Quantile regression on the 25th percentile, median, and 90th percentile theoretical loss showed that higher theoretical loss at these quantiles were associated with older age. At the 90th percentile: Individuals aged 60–69 years had highest theoretical loss at 15,343 NOK (1,784 USD). Compared to men, women had higher 90th percentile theoretical loss (1,658 NOK≈193 USD). Interaction analyses showed that the positive association between age and theoretical loss was stronger for men compared to women. Gambling expenditure is positively associated with disordered gambling and the findings suggests that older individuals and women represent more vulnerable groups among the EGM population. [ABSTRACT FROM AUTHOR]