Problem Gambling and Sexual Minority Individuals: Evaluating Influence of Age and Comorbid Mental Health and Substance Use Problems.

Little is known about the prevalence of problem gambling among sexual minority individuals. The present study utilized an epidemiological sample, including individuals identifying as lesbian, gay, bisexual, asexual, and pansexual, to explore gambling behavior and problems and associated mental health and comorbid conditions that may contribute to elevated risk. Bivariate comparisons found that sexual minority individuals had higher rates of problem gambling, alcohol and substance use problems, anxiety, depression, and a wide range of problem behaviors (e.g., binge eating, prostitution, excessive video gaming) than heterosexuals. In a logistic regression, age moderated the relationship between sexual minority status and problem gambling, such that the risk for high-risk problem gambling increased with age for sexual minority individuals while it decreased for heterosexuals. Additionally, a logistic regression of sexual minority individuals who gamble found anxiety (OR = 3.80, 95% CI = 1.03, 13.97) and drug problems (OR = 8.57, 95% CI = 1.79, 41.05) predicted high-risk problem gambling. Findings suggest that prevention and screening protocols are needed in systems accessed by sexual minority individuals, particularly those middle age and older, as well as in settings where anxiety and substance use disorders are treated.

Facets of mindfulness among video game players: A latent profile analysis.

OBJECTIVE: This study explores the presence of different profiles of video game players across five mindfulness facets (i.e., describing, observing, nonreacting, nonjudging, and acting with awareness) and nonattachment (i.e., the ability to relate to experiences without clinging onto them). METHOD: Adults who play video games (N = 629) were recruited from Amazon's Mechanical Turk. Participants completed an online survey, assessing their dispositional mindfulness and nonattachment, problem video gaming, emotion-based impulsivity, psychological inflexibility, and mental health. RESULTS: The latent profile analysis identified four profiles, representing those who were highly mindful (n = 131; 20.8%), moderately mindful (n = 289; 46.0%), reactive and attached (n = 132; 21.0%), and judgmental and unaware (n = 77; 12.2%). Subsequent comparisons revealed that the judgmental and unaware profile reported the highest level of problem gaming, followed by the reactive and attached profile. The judgmental and unaware profile evidenced stronger general gaming motivations and higher emotion-based impulsivity; in contrast, the reactive and attached profile demonstrated greater psychological inflexibility and escapism motivation relative to the other profiles. Both the judgmental and unaware and the reactive and attached profiles had elevated levels of anxiety and depression. CONCLUSION: These findings provide a more nuanced assessment of the protective role of mindfulness. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

The intergenerational transmission of gambling and other addictive behaviors: Implications of the mediating effects of cross-addiction frequency and problems.

INTRODUCTION: This study examined the degree to which perceptions of familial and household participation in gambling and other addictive behaviors in youth was associated with frequency and problem severity of gambling, alcohol and/or drug use in participants as adults. METHOD: The study measured perceived frequency of gambling, alcohol use, drug use and other potentially addictive behaviors in family/household members and the frequency and problem severity of gambling, alcohol, and drugs in an epidemiological sample of adults 18 and older (N = 3,499; m = 48.26 %, f = 51.74 %). RESULTS: About 23.45 % of participants reported their father gambled when they were a child or adolescent, followed by mother (13.56 %), grandfather (9.73 %), or grandmother (7.83 %). A pathway model demonstrated cross-addiction inter- and intra-generational influences. Gambling by a father, mother or brother; substance use by a sister; and/or engagement in other behaviors by a brother, sister, grandmother or other household member was related to higher frequency of participant gambling (ps < 0.05), and, in turn, to higher levels of gambling, alcohol, and drug use problem severity (ps < 0.05). DISCUSSION: Findings demonstrate the complex contributions of specific family and household members in the transmission of addictive behaviors. Frequency of gambling, alcohol use, and drug use mediated the relationship of perceived family behavior with and across addictions. In addition, perceptions regarding use of alcohol and/or other drugs, or engagement in other behaviors by family or household members was related not only to participants' alcohol and drug use but also to problem gambling frequency and severity.

Clarifying gambling subtypes: the revised pathways model of problem gambling.

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

Gambling and military Service: Characteristics, comorbidity, and problem severity in an epidemiological sample.

Active military members and veterans both show elevated risk of Gambling Disorder. However, research comparing these groups to civilians in epidemiological samples is sparse. There is also some research suggesting that there is a stronger association between military service and poor mental outcomes for women. The current study applies bivariate analyses and generalized linear modelling predicting Problem Gambling Severity Index scores to a representative, complex survey sample of 2176 New Jersey adult residents. The results show that problem gambling scores for past and current military service members were more than double that of the civilian participants after controlling for relevant demographic and behavioral characteristics. Additionally, the relationship between problem gambling scores and military service was significantly stronger for women than men. Bivariate analyses indicated that active military service members scored higher on the Problem Gambling Severity Index, indicated greater weekly participation in online gambling, lottery, electronic gambling machine, and sports betting, and nearly 20 times the rate of suicidal ideation compared with civilians. Additional regression analysis show that among military service members problem gambling scores were associated with suicidal ideation, tobacco use, and substance use problems. The results are discussed in the context of a period of expansion of online gambling opportunities. Constrained options for leisure coupled with the high propensity for risk taking among military service members and the relative ease of concealing online gambling on base may expose military service members to disproportionately higher risk of Gambling Disorder.

The relationship of loot box purchases to problem video gaming and problem gambling.

Loot boxes are virtual items in many video games that let players "gamble" on an item of chance. Loot boxes bring an element of gambling into video games, which might prime video game users to engage in online gambling activities. However, few studies have focused on this emerging issue. The present study investigated the relationships between loot box purchases and both problem video gaming and problem gambling severity. Cross-sectional, self-report data were collected from 618 adult video gamers (M = 27 years of age, SD = 8.9, 63.7% male) via an online survey. Nearly half of the sample (44.2%) spent money on loot box purchases in the past year. Loot box purchasers played video games and gambled online more frequently, reported more extended gaming and online gambling sessions, and endorsed higher levels of problem video gaming and problem gambling severity as well as greater mental distress relative to those who did not buy loot boxes. Results from a series of path analyses revealed that loot box purchasing was directly related to problem video gaming and problem gambling severity as well as indirectly through increased video gaming/online gambling engagement, which in turn is related to elevated psychological distress. The present findings provide insight into the role of loot box purchasing in the transition from recreational engagement in video gaming and online gambling to problem video gaming and/or problem gambling.

Preliminary findings on cryptocurrency trading among regular gamblers: A new risk for problem gambling?

Cryptocurrencies are emerging digital currencies that allow anonymity in accessing various risk-taking activities through the Internet (e.g., drugs, gambling). However, given conceptual links to high-risk stocks, the present study sought to assess the association between trading cryptocurrencies and problem gambling. Data was collected through a cross-sectional online survey. Advertisement for the survey was posted on Amazon's Mechanical Turk. Participants were adults who had gambled at least monthly in the past year (N = 876; 58.33% male; M = 33.74 years, SD = 9.73). Participants completed the Problem Gambling Severity Index, Patient Health Questionnaire (2-item version), and Generalized Anxiety Disorder scale (2-item version). Trading cryptocurrencies is strongly associated with problem gambling severity (r = 0.53, p < .001). Results from a linear regression with backwards elimination revealed that sports betting, daily fantasy sports, high-risk stock trading, and problem gambling severity contribute to trading cryptocurrencies more frequently in the past year, whereas gambling in on-land casinos contributed to less cryptocurrency trading. Finally, trading cryptocurrencies overlapped strongly with trading high-risk stocks. Moreover, gamblers who engaged in both forms of trading reported greater problem gambling and depression and anxiety symptoms relative to those trading either cryptocurrencies or high-risk stocks, but not both. The present results suggest that trading cryptocurrencies may be appealing to gamblers that are exhibiting greater problem gambling severity. Future research should begin to include cryptocurrency trading in screening, assessment, and treatment protocols, particularly with regular gamblers.

Daily Fantasy Sports Players: Gambling, Addiction, and Mental Health Problems.

Studies point to a relationship between fantasy sports/daily fantasy sports (DFS) play and gambling behavior. However, little is known about the nature of those relationships, particularly regarding the development of gambling problems. This study investigates the nature, frequency, and preferences of gambling behavior as well as problem gambling severity and comorbid conditions among DFS players. Data were collected from an epidemiologic survey of 3634 New Jersey residents on gambling and leisure activities. Participants were contacted by phone (land-line and cell) and online to obtain a representative, cross-sectional sample of non-institutionalized adults, aged 18 years or older. Excluding non-gamblers, the remaining 2146 participants, included in these analyses, indicated they had either played DFS (n = 299) or had gambled but not played DFS (1847) in the past year. Univariate comparisons and multiple logistic regression analyses were performed to identify the most significant characteristics and predictors of DFS players. Overall, a higher number of gambling activities, high frequency gambling, male gender, and reports of suicidal thoughts in the past year were most predictive of DFS players. Being Hispanic (vs. Caucasian) and/or single (vs. married or living with a partner) also doubled the odds of DFS play. Findings suggest that DFS players are characterized by high gambling frequency and problem severity and comorbid problems, notably suicidal ideation. Future research should examine the motivations and possible etiological sub-types of DFS players and the nature and course of DFS play, particularly in relation to gambling behavior and the development of gambling and other problems.

Problem gambling among ethnic minorities: results from an epidemiological study.

A few studies have examined gambling behavior and problem gambling among minorities and reported higher rates of both participation and gambling problems among particular minority groups in comparison to Whites who gamble. The present study utilized a representative, epidemiological sample of adults in New Jersey to explore gambling behavior, gambling problem severity, substance use, problem behavior, and mental health issues among minorities. Univariate analyses were conducted, comparing Whites (n = 1341) to respondents who identified as Hispanic (n = 394), Black (n = 261), or Asian/other (n = 177). Overall, the highest proportion of Hispanics were high-risk problem gamblers. Hispanic participants were also significantly more likely than other groups to use and abuse substances and to report mental health problems in the past month, behavioral addictions, and/or suicidal ideation in the past year. Primary predictors of White high risk problem gamblers were being young and male with friends or family who gambled, fair to poor health status, substance use, gambling once a week or more both online and in land-based venues, and engaging in a number of gambling activities. In contrast, gender was not a predictor of minority high risk problem gamblers, who were characterized primarily by having friends or family who gambled, gambling online only, having a behavioral addiction and playing instant scratch-offs and gaming machines. Implications for research and practice are discussed.

Development and validation of the Gambling Pathways Questionnaire (GPQ).

The Pathways Model (Blaszczynski & Nower, 2002) is a theoretical framework that proposes three pathways for identifying etiological subtypes of problem gamblers. The model has been used to assist clinicians in developing individualized treatments that target not only the gambling behavior but also associated risk factors that may undermine recovery and precipitate relapse. The current study sought to develop and validate a new screening instrument, based on the Pathways Model for treatment-seeking gamblers. Participants were gamblers age 18 and over who scored 1+ symptoms on the Problem Gambling Severity Index of the Canadian Problem Gambling Index and presented to one of 22 participating treatment centers in Canada, the United States, and Australia (N = 1,176). Data were collected on 127 items, consisting of 62 core items that reflected variables in the Pathways Model and 65 experimental items derived from recent scholarly literature in gambling etiology. Exploratory and confirmatory factor analyses identified the following six factors: Antisocial Impulsive Risk-Taking, Stress-Coping, Mood Pre-Problem-Gambling Onset, Mood Post-Problem-Gambling Onset, Child Maltreatment, and Meaning Motivation. The Gambling Pathways Questionnaire showed excellent internal consistency (α = .937), with good to high reliability found for each of the six factors, ranging from .851 to .945. Cluster analysis results demonstrated that the three-factor model produced good model fit to the data: Cluster 1 (Behaviorally Conditioned Subtype), Cluster 2 (Emotionally Vulnerable Subtype) and Cluster 3 (Antisocial, Impulsive Risk-Taking Subtype). The present study is the first to present an empirical measure for assigning problem gamblers to etiological subtypes for use as a screening tool in treatment settings. (PsycINFO Database Record

Gambling goals predict chasing behavior during slot machine play.

AIMS: The purpose of this study was to test the effect of gambling goals (i.e., gambling achievement-orientation) on chasing behavior (i.e., decision to chase, chasing spins) over and above known antecedents (e.g., problem gambling severity, winning money motivations, approach/avoidance motivation). METHODS: Young adult gamblers (N=121) were provided $20 and invited to use those funds on a slot machine situated in an immersive virtual reality casino. Unbeknownst to participants, outcomes were manipulated such that a nominal amount of money was either won or lost (depending on experimental condition) after 30 spins. Before the 31st spin, participants were asked if they wished to continue play. If they agreed, all successive spin outcomes were a loss. This permitted an assessment of what factors influence a player's: (1) decision to chase and (2) the number of chasing spins played in the face of loss. RESULTS: Almost all participants (n=95, 78.5%) screened positive for problem gambling symptoms. The majority of gamblers decided to chase (n=67, 55.4%). In bivariate analyses, higher gambling goal and problem gambling severity scores (but not approach/avoidance nor 'loss/win' condition) were positively related to both forms of chasing. Gamblers 'motivated to win money' were more likely to decide to chase. In multivariate analyses, higher gambling goals best accounted for both forms of chasing independent of known antecedents. CONCLUSIONS: This study provides the first evidence that gambling goals can influence chasing. Implications for shaping responsible gambling approaches to be more consistent with motivations for play are discussed.

Risk Factors for Gambling Problems: An Analysis by Gender.

Differences in problem gambling rates between males and females suggest that associated risk factors vary by gender. Previous combined analyses of male and female gambling may have obscured these distinctions. This study aimed to develop separate risk factor models for gambling problems for males and for females, and identify gender-based similarities and differences. It analysed data from the largest prevalence study in Victoria Australia (N = 15,000). Analyses determined factors differentiating non-problem from at-risk gamblers separately for women and men, then compared genders using interaction terms. Separate multivariate analyses determined significant results when controlling for all others. Variables included demographics, gambling behaviour, gambling motivations, money management, and mental and physical health. Significant predictors of at-risk status amongst female gamblers included: 18-24 years old, not speaking English at home, living in a group household, unemployed or not in the workforce, gambling on private betting, electronic gaming machines (EGMs), scratch tickets or bingo, and gambling for reasons other than social reasons, to win money or for general entertainment. For males, risk factors included: 18-24 years old, not speaking English at home, low education, living in a group household, unemployed or not in the workforce, gambling on EGMs, table games, races, sports or lotteries, and gambling for reasons other than social reasons, to win money or for general entertainment. High risk groups requiring appropriate interventions comprise young adults, especially males; middle-aged female EGM gamblers; non-English speaking populations; frequent EGM, table games, race and sports gamblers; and gamblers motivated by escape.

Problem gambling and homelessness: results from an epidemiologic study.

The purpose of this study was to investigate the prevalence of gambling disorder and comorbid psychiatric disorders in a homeless population and identify features related to potential subtypes. At baseline, participants were administered a structured interview including socio-demographic sections of the National Comorbidity Study (NCS) interview; seven diagnostic sections of the Diagnostic Interview Schedule (DIS); the alcohol and drug abuse sections of the Composite International Diagnostic Interview-Substance Abuse Module (CIDI-SAM); and the Homeless Supplement to the DIS. At nine months post-baseline assessment, participants were administered additional NCS family history questions and the South Oaks Gambling Screen (SOGS). Participants were an epidemiologic sample of 275 predominately African-American homeless individuals, grouped as lifetime non-gamblers (n = 60), recreational gamblers (n = 152), and problem gamblers (n = 63), recruited on the street and through homeless shelters. Results indicate that lifetime rates of sub-clinical problem (46.2%) and disordered (12.0%) gambling were significantly higher than in the general population. Problem gamblers were more likely than non-problem gamblers to meet diagnostic criteria for antisocial personality disorder, post-traumatic stress disorder, bipolar disorder, and any psychiatric disorder, and more likely than non-gamblers to use illicit drugs or meet criteria for abuse/dependence for nicotine, alcohol, or any substance. This study provides evidence that problem gambling is a significant public health issue among the African-American homeless population. Homeless services should include assessment for problem gambling along with psychiatric disorders and referrals to resources and treatment programs. Future studies should explore the relationship of the onset and course of problem gambling and other psychiatric disorders with homelessness as well as racial differences in gambling patterns and problem severity over time.

Problem gambling in adolescents: an examination of the pathways model.

This research tests the applicability of the Integrated Pathways Model for gambling to adolescent problem gamblers, utilizing a cross-sectional design and self-report questionnaires. Although the overall sample consisted of 1,133 adolescents (Quebec: n = 994, 87.7 %; Ontario: n = 139, 12.3 %: Male = 558, 49.5 %; Female = 569, 50.5 %), only problem gamblers were retained in testing the model (N = 109). Personality and clinical features were assessed using the Millon Adolescent Clinical Inventory, attention deficit hyperactivity (ADHD) using the Conners-Wells' Adolescent Self-Report Scale, and the DSM-IV-MR-J and Gambling Activities Questionnaire to determine gambling severity and reasons for gambling. Latent class analysis concluded 5 classes, yet still provided preliminary support for three distinct subgroups similar to those proposed by the Pathways Model, adding a depression only subtype, and a subtype of problem gamblers experiencing both internalizing and externalizing disorders. ADHD symptoms were found to be common to 4 of the 5 classes.

Subtypes of disordered gamblers: results from the National Epidemiologic Survey on Alcohol and Related Conditions.

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

Responsible gambling: general principles and minimal requirements.

Many international jurisdictions have introduced responsible gambling programs. These programs intend to minimize negative consequences of excessive gambling, but vary considerably in their aims, focus, and content. Many responsible gambling programs lack a conceptual framework and, in the absence of empirical data, their components are based only on general considerations and impressions. This paper outlines the consensus viewpoint of an international group of researchers suggesting fundamental responsible gambling principles, roles of key stakeholders, and minimal requirements that stakeholders can use to frame and inform responsible gambling programs across jurisdictions. Such a framework does not purport to offer value statements regarding the legal status of gambling or its expansion. Rather, it proposes gambling-related initiatives aimed at government, industry, and individuals to promote responsible gambling and consumer protection. This paper argues that there is a set of basic principles and minimal requirements that should form the basis for every responsible gambling program.

Gambling motivations, money-limiting strategies, and precommitment preferences of problem versus non-problem gamblers.

Studies attempting to identify the specific 'addictive' features of electronic gaming machines (EGMs) have yielded largely inconclusive results, suggesting that it is the interaction between a gambler's cognitions and the machine, rather than the machine itself, which fuels excessive play. Research has reported that machine players with gambling problems adopt a number of erroneous cognitive perceptions regarding the probability of winning and the nature of randomness. What is unknown, however, is whether motivations for gambling and attitudes toward pre-session monetary limit-setting vary across levels of gambling severity, and whether proposed precommitment strategies would be useful in minimizing excessive gambling expenditures. The current study explored these concepts in a sample of 127 adults, ages 18 to 81, attending one of four gambling venues in Queensland, Australia. The study found that problem gamblers were more likely than other gamblers to play machines to earn income or escape their problems rather than for fun and enjoyment. Similarly, they were less likely to endorse any type of monetary limit-setting prior to play. They were also reticent to adopt the use of a 'smart card' or other strategy to limit access to money during a session, though they indicated they lost track of money while gambling and were rarely aware of whether they were winning or losing during play. Implications for precommitment policies and further research are discussed.

Do warning signs on electronic gaming machines influence irrational cognitions?

Electronic gaming machines are popular among problem gamblers; in response, governments have introduced "responsible gaming" legislation incorporating the mandatory display of warning signs on or near electronic gaming machines. These signs are designed to correct irrational and erroneous beliefs through the provision of accurate information on probabilities of winning and the concept of randomness. There is minimal empirical data evaluating the effectiveness of such signs. In this study, 93 undergraduate students were randomly allocated to standard and informative messages displayed on an electronic gaming machine during play in a laboratory setting. Results revealed that a majority of participants incorrectly estimated gambling odds and reported irrational gambling-related cognitions prior to play. In addition, there were no significant between-group differences, and few participants recalled the content of messages or modified their gambling-related cognitions. Signs placed on electronic gaming machines may not modify irrational beliefs or alter gambling behaviour.

Consequences of winning: the role of gambling outcomes in the development of irrational beliefs.

BACKGROUND: The development and maintenance of gambling and problem gambling with its corresponding irrational beliefs may be fundamentally linked to patterns of wins and losses during electronic gaming machine (EGM) play. METHOD: The current study investigated the extent to which irrational thoughts and erroneous perceptions of chance differed based on individual wins or losses. Undergraduate students (n = 45) completed questionnaires assessing irrational beliefs and perceptions of chance prior to and following EGM play with credits rather than money. RESULTS: It was found that players who lost reported a significantly greater decrease in irrational thoughts and erroneous perceptions of chance and significantly fewer superstitious beliefs than winning players following play. CONCLUSIONS: Future studies are needed to further investigate the relationship of winning to cognitive distortions to guide education and interventions.