The Mediating Role of Psychological Distress in Excessive Gambling among Young People: A Four-Country Study

Background and aims: Loneliness and a low sense of mastery are associated with excessive gambling, but the underlying processes of these relationships remain unstudied. Because psychological distress can increase vulnerability to excessive gambling, we investigated its mediating role in these relationships among young people. To meet the need for cross-country research, we also observed how these relationships occur in four countries with different cultures. Design, setting, and participants: Demographically balanced cross-sectional survey data were collected from 15–25-year-olds in Finland (n = 1200; 50% male), the United States (n = 1212; 49.8% male), South Korea (n = 1192; 49.6% male), and Spain (n = 1212; 51.2% male). Measurements: Excessive gambling was measured with the South Oaks Gambling Screen, psychological distress was assessed with the 12-item General Health Questionnaire, loneliness was measured with the three-item Loneliness Scale, and low sense of mastery was assessed with the Pearlin Mastery Scale. Associations were examined first using zero-inflated negative binomial regression analyses with excessive gambling as the outcome. In addition, path analyses were performed to study how loneliness and low sense of mastery relate to excessive gambling, with psychological distress as the mediating variable. Findings: Loneliness and low sense of mastery were associated indirectly with excessive gambling via psychological distress in all country samples. Low sense of mastery was also directly associated with excessive gambling. There was a direct association between loneliness and excessive gambling only in samples from South Korea and Spain. Conclusions: Psychological distress is an important factor in understanding how loneliness and sense of mastery relate to gambling.

The Mediating Role of Psychological Distress in Excessive Gambling Among Young People: A Four-Country Study

Background and aims Loneliness and a low sense of mastery have been associated with excessive gambling, but the underlying processes of these relationships remain unstudied. Because psychological distress can increase vulnerability to excessive gambling, we investigated its mediating role in these relationships among young people. To meet the need for cross-country research, we also observed how these relationships occur in four countries with different cultures. Design, setting and participants Demographically balanced cross-sectional survey data were collected for 15–25-year-olds in Finland (n=1200; 50% male), the United States (n=1212; 49.8% male), South Korea (n=1192; 49.6% male) and Spain (n=1212; 51.2% male). Measurements Excessive gambling was measured with the South Oaks Gambling Screen, psychological distress was assessed with the 12-Item General Health Questionnaire, loneliness was measured with the Three-Item Loneliness Scale and low sense of mastery was assessed with the Pearlin Mastery Scale. Associations were examined first using zero-inflated negative binomial regression analyses with excessive gambling as the outcome. In addition, path analyses were performed to study how loneliness and low sense of mastery relate to excessive gambling, with psychological distress as the mediating variable. Findings Loneliness and low sense of mastery were associated indirectly with excessive gambling via psychological distress in all country samples. Low sense of mastery was also directly associated with excessive gambling. There was a direct association between loneliness and excessive gambling only in samples from South Korea and Spain. Conclusions Psychological distress is an important factor in understanding how loneliness and sense of mastery relate to gambling.

Psychotherapeutic and Pharmacological Treatment for Problematic Digital Technology Use

This chapter focuses on the psychological treatment of problem Internet and digital technology use (PRIU), such as excessive gaming, and also briefly overviews pharmacological approaches. Forms of Internet and digital technology use that provide alternative vehicles for more specific problem or addictive behavior, such as excessive gambling or shopping, and which often seem to present with differing features, are not covered here [editors’ comment: but rather addressed in other chapters of this book]. Although treatment research is still in an early stage of development, an accumulating body of literature involving a diverse range of presentations and populations and a variety of treatment strategies has often yielded positive and robust effect sizes. Hence, a relatively compelling justification can be provided for therapeutic intervention, especially when using treatments of demonstrated effectiveness with similar clients, when PRIU seems to be associated with significant malfunction or worsening of co-occurring conditions, and when trends suggest that problems are not remitting or are worsening. Beyond these broad conclusions, research on PRIU in general and treatment studies, although often considerably less complete than preferable, provide varying levels of guidance for tailoring or designing intervention in lines with client presentation. Hence, the chapter also covers various specific topics and possible guides for therapeutic planning and implementation.

Electronic Gambling Machines Outside Casinos: An Environmental Study of Risk Factors in Gambling Venues

Electronic gambling machine (EGM) licenses are meant to be a complementary revenue source for liquor establishments. Considering this, retailers with more than one license to operate EGMs may benefit from promoting their gambling offer, which may in turn facilitate excessive gambling behaviours. This study compares establishments that possess a single license to operate EGMs with those that are multi-licensed regarding four environmental risk factors: advertisements, automated teller machines, isolated gambling area, and EGM operating hours. A field observation was carried out by seven pairs of observers in 166 establishments in Capitale-Nationale de Quebec (QC), Canada. In each establishment, observers had to complete an observational grid on an iPod touch to gather environmental data related to the identified variables. Results from the stepwise logistic regression show that being a multi-licensed establishment increases the chance of having longer operating hours and displaying non-regulated advertisements that promote gambling. Multi-licensed establishments tend to offer a more attractive gambling environment, which may increase the risk of excessive gambling. Reinforcement of regulations for responsible gambling is discussed.RésuméPour les établissements ayant un permis d’alcool, posséder une licence d’exploitation d’appareils de jeux électroniques (AJE) se traduit par un revenu complémentaire. De ce fait, les détaillants ayant plus d’une licence d’exploitation d’AJE peuvent tirer parti de la promotion de leur offre de jeu, ce qui, en retour, peut encourager des comportements de jeu excessifs. Cette étude compare les établissements qui détiennent une seule licence d’exploitation d’AJE avec ceux qui en détiennent plusieurs en tenant compte de quatre facteurs de risque environnementaux : la publicité, les guichets automatiques, la zone de jeu isolée et les heures d’exploitation des AJE. Une observation sur le terrain a été effectuée par sept paires d’observateurs dans 166 établissements de Capitale-Nationale de Québec (QC), Canada. Dans chaque établissement, ils ont recueilli des données environnementales liées aux variables identifiées qu’ils ont compilées dans une grille d’observation sur un iPod touch. Les résultats du modèle logistique utilisant la régression séquentielle montrent que le fait, pour un établissement, d’avoir plusieurs licences augmente la possibilité de prolonger les heures d’exploitation et d’afficher des publicités non réglementées qui font la promotion du jeu. Les établissements ayant plusieurs licences ont tendance à offrir un environnement de jeu plus attrayant, ce qui peut accroître le risque de jeu excessif. Un resserrement des règles pour une réglementation responsable du jeu est à l’étude.

The total volume of gambling and the prevalence of gambling problems

The total consumption model (TCM) implies that only a small fraction of gamblers account for a very large fraction of all gambling activities and of all gambling expenditures. This does not necessarily mean that every gambler with high gambling expenses has problems, but the probability increases with increasing intensity. Ironically, heavy gamblers are influenced by the activities of those who participate only moderately: the more people take up gambling, the more likely vulnerable individuals will be recruited as well. The importance of total volume of gambling in society is reinforced by the fact that the accumulated harm caused by low-risk gamblers in fact exceeds the harm caused by excessive gambling. Although adaptation theory suggests that harmful consequences recede once the novelty of innovation subsides, every increase in consumption increases the risk of harm.

Widening the net: A syndemic approach to responsible gambling

Background: Attempts to address gambling-related harms have evolved rubrics to foster responsible gambling and informed choice. Those efforts have largely focused on apportioning the relative responsibility placed on government, industry, and individuals for reducing excessive gambling that leads to adverse consequences. Empirical evaluations of responsible gambling measures, together with proposed frameworks that set out guidelines for accountability, have met with mixed results and criticism from divergent groups of stakeholders. Aim: While harm reduction remains a worthy goal, this position paper argues against maintaining a stringent focus on the government-industry-individual triumvirate in favor of adopting a syndemic approach to gambling-related harms. Approach: A syndemic perspective suggests that gambling disorder intersects, coexists, precedes or follows other comorbid conditions and interacts with social and environmental factors that promote and enhance the negative consequences of gambling problems. This paper discussions potential syndemic stakeholders and challenges in the implementation of this approach. Conclusions: Initiatives to reduce gambling-related harm should adopt a broader perspective, involving stakeholders from diverse syndemic problem areas in developing a network to identify and address gambling problems in early stages of development across multiple settings.