Examining problem gambling, substance use disorders and cluster B personality traits among incarcerated individuals.

Prison populations face heightened rates of addictive behaviors and significant stressors, including health challenges and social disparities. Although problem gambling is prevalent in criminal justice settings, its distinctiveness compared to other addictions among incarcerated individuals remains uncertain. This study examines risk factors associated with problem gambling in Finnish prisoners and explores differences compared to other forms of addiction. Covariates from a questionnaire (N = 527) included gender, age, education, offender status, involvement in theft or property crime, Trauma Screening Questionnaire (TSQ), Depression Scale (DEPS), and lifetime abuse experiences. Of the 527 participants, 330 were interviewed using the Structured Clinical Interview (SCID-II) to assess personality disorders. Multiple logistic regression models were utilized, with separate models for problem gambling (PG), lifetime substance use disorder, and lifetime alcohol disorder. Crime type was not significantly associated with alcohol or substance use problems, but PG was associated with property crime or theft convictions. Borderline personality traits were linked to probable PG, while antisocial traits were linked to drug use, and both traits predicted alcohol misuse. Age and gender were significant only in relation to alcohol use problems, with older age and male gender indicating higher risk. The association between problem gambling and criminal behavior underscores the vulnerability of incarcerated individuals across various domains. Detailed assessments, considering the nature of criminal activity and personality disorders, especially borderline traits and comorbid conditions, are crucial for tailoring rehabilitation and treatment strategies to prevent recidivism. These findings provide valuable insights for clinicians managing addiction and mental health issues within correctional settings.

Engagement in New Gambling Practices and its Association with Gambling Disorder, Impulsivity, and Cognitive Distortions: Findings from a Nationally Representative Sample of Spanish Gamblers.

Most epidemiological surveys focus on adult gambling behaviors related to traditional gambling forms, while studies on novel forms often focus on loot boxes and cryptocurrency trading individually. This study examines the co-ocurrence of emergent gambling and gambling-like practices, analyzing the demographic and psychological characteristics of involved gamblers. A cross-sectional study surveyed 1429 Spanish individuals aged 18-65, using a web-based questionnaire. The survey assessed participation in 19 gambling (e.g., lotteries, sports betting) and gambling-like activities (e.g., trading of cryptocurrencies and other assets, buying loot-boxes), along with sociodemographic and substance use. Problem gambling (PGSI), Impulsivity (UPPS-P), and cognitive distortions (Labrador's cognitive distortions scale) were also assessed. Participants who gambled over the past year (n = 921) were classified into four groups: traditional gambling (TG) only (64.5%, n = 594), TG with trading activities (27.5%, n = 253), TG with gambling withing video games or streaming platforms (2.5%, n = 23), and TG with both trading and video gambling (5.5%, n = 51). Most gamblers engaged exclusively in traditional formats, but 35.5% also participated in novel gambling forms. Those involved in both trading and video gambling were generally younger, male, with higher levels of impulsivity and gambling-related cognitive distortions compared to TG-only gamblers (p < 0.001). This group also exhibited higher rates of problem gambling and substance use (p < 0.001). This study emphasize the importance of including emerging gambling activities, which are particularly prevalent among high-risk gamblers, in epidemiological surveys. Identifying new gambling patterns and associated risk factors could help optimize public policies and develop more effective regulatory and prevention strategies.

Mediating Effect of Perceived Personal Luck in the Relationship Between Narcissism and Problem Gambling in Strategic Gamblers: An Exploratory Study.

Gambling is becoming increasingly frequent among the French population, which has led to an increased number of individuals exhibiting problematic gambling patterns. Studies have found links between narcissism and cognitive distortions in relation to problem gambling, specifically among strategic gamblers, but none has tested perceived personal luck as one type of cognitive distortion in this regard. This study's purpose was to explore the relationship between narcissism, perceived personal luck and problem gambling among strategic gamblers, and to test for the mediating role of perceived personal luck in the relationship between narcissism and problem gambling. A total of 88 regular strategic gamblers were included (mean age = 37.8), with 49 non-problematic gamblers and 39 problematic gamblers. Participants completed the Problematic Gambling Severity Index, the Narcissistic Personality Inventory, and the Personal Luck Usage Scale. Results showed a significant relationship between narcissism and problem gambling, but no significant link between perceived personal luck and problem gambling and no significant mediation effect of perceived personal luck. These results may indicate a strong perception of personal skills compared to a weak perception of personal luck among problem gamblers of strategic games. This study emphasizes the importance of addressing types of gambling and types of cognitive distortions when investigating problem gambling.

Why You Gamble Matters: A Systematic Review and Meta-analysis of the Association Between Gambling Motivation and Problem Gambling.

The propensity for individuals to experience problem gambling (PG) varies depending on their motivation to gamble. The present meta-analysis assessed the effect sizes associated with various gambling motives identified in representative population samples. Studies were sourced through PsycINFO, PudMed, and databases maintained by the Alberta Gambling Research Institute and the Greo Evidence Insights. Quantitative studies and technical studies were included if they reported on gambling motivation as a correlate of PG; were published in English, French, or Spanish; used valid and reliable measures PG as an outcome variable; and targeted the general adult population. A random effects meta-analysis was conducted to estimate pooled odds ratios. A total of 26 studies were included from 17 jurisdictions, with most studies conducted in Canadian provinces (k = 17) or specific states of the United States (k = 7). Number of participants varied, depending on the gambling motivation analyzed, and ranged from 2,835 to 51,685. Fourteen unique motives were identified with odds ratios ranging from 0.53 (95% CI, 0.45, 0.63) for gambling for charity to 6.20 (95% CI, 3.83, 10.05) for the motive "to be alone", with high study heterogeneity being observed for many gambling motives, given variability in important study characteristics. The results generally indicate that coping motives were associated with large effect sizes, enhancement motives with medium effect sizes, and all other motives with small or nil effects. Coping motives are on par with other strong risk factors such as participation in online gambling or electronic gaming machines, and are therefore important elements to consider when screening for PG or designing public health messages.

Gambling in Older Adulthood: Longitudinal Associations Between Stressful Life Events, Individual, and Social Factors.

Older adults are receiving increased attention in gambling research, in part because gambling and related problems appear to be increasing in this population. To date, little or no research has examined the complexities of gambling and later-life circumstances, including life events, and individual and social factors. This study utilized longitudinal data (5 waves) from older adults (60 + ; N = 670) in the Quinte Longitudinal Study (Williams et al., in: The Quinte longitudinal study of gambling and problem gambling 2006-2011, Bay of Quinte region, Ontario, 2014). Longitudinal multilevel models examined between- and within-person effects of stressful life events on gambling frequency and Problem Gambling Severity Index (PGSI) scores, and the possible moderating role of individual (age, gender, mental health, physical health) and social variables (marital status, social support) on this relationship. Results of the final model showed significant effects (p < .01) for linear time (PGSI scores declined across waves; ß = - .06); gender (women's mean PGSI greater than men's; γ = .26); social support (less support associated with greater PGSI; γ = .05); and an interaction between age and stressful life events (effect of stressful events on PGSI is lesser with greater age; γ = - .02). Simple slopes (at mean age of 66 at wave 1, and ± 1SD) showed that at 61 (γ = .35) and 66 years (γ = .23), mean PGSI scores were greater with each additional stressful life event; there was no significant effect for stressful events at age 71. These findings suggest women, those with less social support, and greater stressful life events may be at greater risk of problem gambling, while greater age weakens the effect of stressful events and problem gambling.

Within-session chasing of losses and wins in an online eCasino.

Chasing refers to the escalation of betting behaviour. It is conventionally seen when losing but can also be seen after wins. Diagnostic and screening items for gambling problems describe chasing as returning 'another day' to gamble. However, gamblers may also chase within sessions, and this is particularly relevant in online gambling. This study focused on two expressions of within-session chasing: (1) increasing the bet amount, or (2) a reduced probability of quitting the session, as a function of prior losses or wins. These expressions were examined across five online gambling products: slot machines, probability games, blackjack, video poker, and roulette. Our results showed that gamblers bet more and played longer sessions after immediate losses, but they bet less and played shorter sessions when losing cumulatively. The reversed pattern in the cumulative model may be due to financial constraints. For wins, gamblers bet more after both immediate and cumulative wins, but they also played shorter sessions. Chasing patterns were qualitatively similar by game type-with limited evidence for our hypothesis that chasing would be greatest for slot machines as an established high-risk category. Overall, chasing is multi-faceted, varying across the behavioural expressions, by the immediate or cumulative timeframe of prior outcomes, and by game type.

The influence of age on gambling problems worldwide: A systematic review and meta-analysis of risk among younger, middle-aged, and older adults.

Background and Aims: 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. Methods: 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). Results: 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. Conclusions: Our findings confirm that age and gender significantly influence PG risk across cultures, with significant heterogeneity observed across jurisdictions.

Spatio-temporal EEG dynamics during decision-making in online poker players with problem gambling.

Background and aims: Gambling activity evolves along a continuum from recreational to Gambling Disorder (GD) and a particular challenge is to identify whether there are some neurophysiological particularities already present in gamblers at an early stage. Our main goal was to determine whether, in the gamblers' population, neural responses generated during uncertain decisions were different depending on problematic gambling risk defined by the Canadian Problem Gambling Index (CPGI). We tested the following hypothesis, that the Problem Gambling group would show a different brain activity related to outcomes processing than people with low risk. Methods: For this purpose, we established a relatively homogeneous population of Online Poker Players divided into two groups according to the CPGI (Low Risk and Problem Gambling). By means of high-density EEG, we compared the spatio-temporal dynamics generated during the completion of the Iowa Gambling Task. Results: One specific topographic map was observed between 150-175 ms after a negative outcome for both groups, whereas it was displayed in the win condition only for the Problem Gambling group. We found that the Global Field Power of this map was negatively correlated with participants' adherence to a strategy. Source localization identified Anterior Cingulate Cortex and Temporal regions as generators of this map. Discussion and conclusions: Reward hypersensitivity EEG responses identified in the early outcome process could constitute a potential biomarker of problematic gambling.

Unemployment as a risk factor for gambling disorder: A longitudinal study based on national registry data.

Background and aims: Unemployment rates are elevated among individuals with disordered gambling, yet the directionality of the relationship remains unclear. The present study investigated paid and unpaid unemployment as risk factors for future gambling disorder (GD). Methods: The study employed a case-control design, including all adult Norwegians receiving a GD diagnosis within specialist health services from January 2008 to December 2018 (n = 5,131). These individuals were compared with age- and sex-matched controls from the general population (n = 30,164), as well as controls with somatic and psychiatric diagnoses (n = 30,476). Results: Logistic regressions showed that those in the highest quartile of unpaid unemployment days had more than double the odds (odds ratio [OR] 2.23 (95% CI [1.96, 2.52]) of developing GD compared to those with no unpaid unemployment days. Similarly, higher levels of paid unemployment were also found to increase the odds for GD, with those in the highest quartile having an OR of 1.86 (95% CI [1.50, 2.28]) compared to those with no paid unemployment days. Moreover, an interaction analysis indicated that the association between paid unemployment days and GD was significantly stronger among men compared to women. Conclusions: The present study suggests that both paid and unpaid unemployment constitute risk factors for GD. Programs aiming at obtaining and sustaining work have been found to improve health and future studies should examine if the risk for GD can be similarly mitigated.

Gender and trait rumination moderates the link between trait impulsivity and gambling problems severity in young adults.

AIMS: Trait impulsivity and trait rumination appear to uniquely contribute to problem gambling. However, only a limited number of studies have investigated their relationship with each other, and no study has tested whether their interplay could explain problem gambling. In this study, we aimed to examine these associations, especially focusing on the putative moderator role of gender. METHODS: The present study utilized data from the first wave of the Budapest Longitudinal Study, representatively surveying young adults. The final, weighted sample consisted of N = 1202 (649 men; mean age = 28.04 years; SD = 4.31) participants who reported gambling in the past year. Gambling severity was assessed by the Problem Gambling Severity Index (PGSI), trait impulsivity was measured by Barratt Impulsiveness Scale short form (BIS-R-10), while rumination was assessed by the short version of Ruminative Response Scale (RRS). RESULTS: Multiple linear regression analysis showed significant positive association between impulsivity and problematic gambling, and we found that both trait rumination and gender moderated this association, even after controlling for depressed mood, age, level of education, and subjective relative wealth. For men, when the level of trait rumination was high, higher levels of trait impulsivity were associated with an increase in gambling problems. However, these associations were not found among women. CONCLUSIONS: Our results suggested that the interplay of trait rumination and trait impulsivity might contribute to problem gambling, potentially by the impulsive desire to alleviate negative mood states. Our results also revealed that these associations could be stronger among men than in women.

Gambling Harm-Minimisation Tools and Their Impact on Gambling Behaviour: A Review of the Empirical Evidence.

The harms accompanying disordered gambling are well documented. Additionally, there is growing attention to the harms that arise from people who gamble heavily but do not meet the criteria for a gambling disorder. Accordingly, there has been an increasing interest in the effectiveness of consumer protection tools for consumers of gambling products. Subsequently, there is a need to properly evaluate the evidence for their effectiveness. This review aimed to conduct a narrative synthesis of empirical studies to identify gaps, weaknesses, and strengths in the existing evidence for the effectiveness of harm minimisation tools available to people who gamble. This review includes studies published between January 2015 to July 2022 and comprises 55 peer-reviewed studies for final synthesis. Findings reveal that while more research is needed to examine the effectiveness of active and passive consumer protection tools, uptake of tools is low in part because users view them as tools for individuals already experiencing gambling harm as opposed to protective tools for all users. Research is needed to determine effective ways of communicating the value of consumer protection tools for gambling.

Applying General Strain Theory to the Relationship Between Strain from Another Person's Gambling Behavior and Gambling Disorder.

Prior research has identified a host of factors that increase the likelihood that an individual will develop problem gambling, clinically diagnosed as Gambling Disorder (GD), most of which would be identified by criminologists as "strains" under the framework of General Strain Theory (GST). This study utilizes propositions from GST to determine whether strain from another person's gambling may be related to why people develop GD and whether gender is a moderating factor in this relationship. Secondary data is analyzed to assess levels of strain individuals experience from another person's gambling behavior, its relationship to the individual's risk of Gambling Disorder, and the role gender plays in this relationship. Findings demonstrate a relationship between the strain from the perceived problem gambling of someone with a close relationship and having a gambling disorder. Experiencing strain from a spouse/partner who is perceived as a problem gambler has the strongest correlation with an individual also having Gambling Disorder. Considering gender as a moderating factor, this effect was stronger on men than women, calling into question the strong belief that it is primarily women who gamble to escape problems.

Does cognitive-behavioral treatment affect putative mechanisms of change among individuals with problem gambling? A systematic review and exploratory meta-analysis.

OBJECTIVE: The current study was a systematic review and meta-analysis of cognitive behavioral treatment (CBT) for problem gambling and gambling disorder and whether it produced different outcomes than minimal or no treatment controls on three putative change mechanisms: 1) gambling cognitions, 2) coping, and 3) self-efficacy. METHOD: Studies were identified from five bibliographic databases (i.e., Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Embase, PsycINFO, and PubMed). Included studies were randomized controlled trials of CBT that included posttreatment data on putative mechanisms. Between-group Hedges's g effect sizes were calculated to examine outcomes of CBT relative to minimal or no treatment control on gambling cognitions, coping, and self-efficacy at posttreatment. Risk of bias was determined using the Cochrane Risk of Bias tool. RESULTS: Fifteen studies, representing 1,536 participants, were eligible for analysis. Participants in CBT had more favorable gambling cognitions (g = -0.41), coping behaviors (g = 0.27), and self-efficacy (g = 1.12) at posttreatment than minimal or no treatment control. CONCLUSIONS: Results of the current study provided preliminary support for the effectiveness of CBT on three putative mechanisms of change among individuals experiencing problem gambling and gambling disorder. Although the results were promising, there was significant heterogeneity in the magnitude of effect sizes for all three outcomes, and outcomes were not consistently assessed with psychometrically established assessment tools.

Systematic Assessment of Gambling Type Involvement: Reliability and Validity of the Gambling Disorder Identification Test (GDIT).

Gambling type involvement, both in terms of participation (engagement in specific gambling types) and diversity (how many gambling types an individual engages in), is a key feature to address in gambling self-report measures, but such systematic measurement procedures are scarce. The aim of this study was to test the psychometric performance of the gambling type assessment in the recently developed Gambling Disorder Identification Test (GDIT), in terms of test-retest reliability, convergent validity, and patterns of gambling diversity, among help-seeking and general population gambling samples (total n = 603). Overall, online gambling was more commonly reported as problematic than land-based gambling. Retest reliability varied for specific gambling types (ICC range 0.32-0.64, rtet range 0.66-0.85). In terms of gambling participation, online gambling showed stronger correlations with GDIT total score (i.e., symptom severity) than land-based gambling, where Slots showed the strongest correlation (r = 0.52), followed by Casino table games (r = 0.25), Sports and Horse betting (r = 0.16 and r = 0.14, respectively), and Poker (r = 0.14). Lotteries showed no correlation with GDIT total score (r=-0,01). For Slots gambling, all gambling diversity levels (including Slots as a single gambling type) were on average associated with the highest diagnostic severity level (GDIT total score > 30; severe gambling disorder). Finally, explorative configural frequency analysis identified typical and antitypical gambling diversity patterns. The result from the current study corroborates findings that engagement in specific gambling types matter, and that such features should be included in gambling measurement. We conclude that the GDIT is a reliable and valid measure for systematic assessment of gambling type involvement. The GDIT can be used to assess gambling participation and diversity, as part of a broad measurement setup for problem gambling and gambling disorder.

Expectations of How Acute Cannabis Use Affects Gambling Experiences and Behaviors.

Emerging research shows that many individuals commonly consume cannabis while gambling. However, individuals' expectations for how cannabis consumption will impact their gambling behavior remain unknown. Participants who gambled weekly (N = 472) were recruited from Amazon Mechanical Turk and completed assessments of gambling behaviors, cannabis consumption, and expectations about the influence of cannabis on gambling. Almost all participants (94%) screened positive for problem gambling. Over half of participants (55%) reported lifetime cannabis consumption, and almost all those participants (99%) reported gambling under the influence of cannabis (GUIC) in the past month. Most participants agreed with positive expectations of gambling; they expected that they would feel calmer when under the influence of cannabis (61.4%), that gambling would be more enjoyable (61.0%), and that their gambling skills would increase when GUIC (60.6%). At the same time, most participants also agreed with negative expectations of GUIC. They expected cannabis use would make them more careless (56.4%), more anxious (54.8%), and less able to concentrate (53.7%) while gambling. Negative cannabis expectancies were significantly associated with the severity of cannabis consumption. Both positive and negative cannabis expectancies were significantly associated with gambling problems and time spent gambling under the influence of cannabis. These findings indicate that expectations may influence the decision to consume cannabis and gamble simultaneously. This study contributes to the need for addressing cannabis expectations during treatment of gambling problems.

Excite, or Take Flight? Exploring the Relationship between Difficulties with Emotion Regulation, Outcome Expectancies, and Problem Gambling.

Emotional dysregulation is a transdiagnostic process associated with a range of addictive behaviours including problem gambling, with emerging research indicating that emotionally oriented reasons for gambling (i.e., excitement, escape) are associated with problem gambling. However, the relationships between difficulties with emotion regulation, reasons for gambling, and problem gambling, are unclear. The current study tested whether the association between difficulties with emotion regulation and problem gambling could be explained by escape and excitement gambling outcome expectancies. A total of 187 regular gamblers recruited via social media (50.3% male, 48.7% female) completed measures of difficulties with emotion regulation, gambling outcome expectancies, and problem gambling severity (Mage = 41.07, SD = 15.8). Analyses revealed that escape outcome expectancies partially mediated the relationship between difficulties with emotion regulation and problem gambling severity. However, the mediating effect of excitement on this relationship was not significant. The findings suggest that individuals with greater emotional regulation difficulties may engage in problem gambling to help manage aversive emotional states. The study's findings illustrate the importance of considering emotional dysregulation and outcome expectancies in problem gambling treatment planning and public health strategies.

Gambling Habits and Attitudes among Athlete and Non-Athlete High School Students in Skåne Region, Sweden.

Previous literature has reported increased rates of gambling problems in athletes compared to non-athletes. More liberal gambling-related attitudes have been suggested as a reason, although this rarely has been researched. The present study aimed to examine gambling experience, gambling problems, and gambling-related attitudes and parental gambling experience in high school students, comparing student-athletes to students at conventional schools. This is a cross-sectional web survey study in high school students (N = 473, 53% at sports high schools, 57% male) at eleven schools in the Skåne region, Sweden, who answered a web survey addressed gambling experiences, parental gambling and gambling-related attitudes, and included validated screening instruments for gambling problems and psychological distress. A history of any gambling was common and increased with age. Problem gambling was detected in 10% (13% of males and 5% of females, p < .001), and was associated with paternal and maternal gambling but not with psychological distress. Sports high school students were not more likely (9%) than other students (10%) to endorse gambling problems and history of each gambling type. However, paternal (but not maternal) gambling was more commonly reported in athletes, who also had more positive attitudes to gambling's effects on society and gambling availability. In contrast to other studies, this study did not demonstrate higher prevalence of gambling or gambling problems among young athletes than among other students, but liberal attitudes towards gambling, and experience of parental gambling on the father's side, were more common among athletes than among non-athletes. Gambling attitudes in adolescents may need to be targeted in future preventive efforts in young athletes and others.

Can Positive Play Deficits Explain the Associations Between Posttraumatic Stress Symptoms, Gambling Motives, and Problem Gambling? Results of a National U.S. Sample.

Past research has demonstrated a consistent connection between symptoms of posttraumatic stress disorder (PTSD) and problematic gambling in both general and clinical United States (U.S.) populations. Little is known, however, about the mediating role that responsible gambling practices related to positive play might have in the relationships between symptoms of PTSD, problem gambling (PG) severity, and different motives for gambling. Therefore, using mediation analysis, this study investigated these associations within a census-matched national sample of U.S. adults (N = 2,806). Results indicated PTSD symptoms and PG often co-occur in this population (r = .43, p < .01), and coping motives for gambling were the key mechanism connecting PTSD symptoms to PG severity rather than deficits in positive play practices or other gambling motives. Moreover, it was found that the average gambler who had sought treatment for gambling in the past not only had more severe PTSD symptoms and PG but also had the strongest gambling motives, the largest deficits in positive play, and was more likely to be younger than 50 years old. In this sample, approximately 1 in 10 people who gambled in the past year were classified as problem gamblers, 1 in 5 met criteria for a provisional PTSD diagnosis, and 1 in 33 sought out gambling treatment previously. These findings provide further evidence for the relationship between symptoms of posttraumatic stress and problematic gambling behaviors in the U.S. population and offer critical insights into the explanatory roles of coping motives and positive play practices in this connection.

The Role of Self-Esteem and Self-Efficacy in Responsible Gambling.

Responsible gambling (RG) refers to a set of protective strategies aiming at containing the negative consequences associated with gambling. To improve the effectiveness of RG, it is essential to understand factors influencing gamblers' adherence to RG. Past literatures on addictive behaviors have demonstrated that one's self-efficacy and self-esteem are associated with the adherence to protective behaviors of the specific addictive behaviors. The present study aims to test whether gamblers' self-esteem and RG self-efficacy can be applied to explain their adherence to protective gambling behaviors. Two hundred and thirty-six past-year gamblers were randomly selected to take part in a phone survey. Path analysis showed that both gamblers' RG self-efficacy and self-esteem were positively associated with gamblers' RG behaviors, while RG behaviors were negatively linked to the problem gambling tendency. The findings provided insight into potential promotion and intervention strategies based on self-esteem and self-efficacy and those strategies may be adopted in the primary prevention of gambling disorder.