Relationships Between Exposure to Different Gambling Advertising Types, Advertising Impact and Problem Gambling.

People with gambling problems report more exposure and impact from gambling advertising, although less is known regarding the role of specific advertising types. Data on gamblers (n = 5830, 48.5% women, mean age = 44.27) was collected from a general population cross-sectional survey in Norway (32.7% response rate). We examined if problem gambling was associated with perceived advertising impact (on gambling involvement, awareness, and knowledge) or exposure (via internet, TV, retail outlet, newspaper, and direct advertising). We also investigated if advertising exposure was associated with advertising impact. ANOVAs revealed that problem gambling was associated with increased perceived advertising impact on gambling involvement (ω2 = 0.09, p < .001) and awareness of gambling (ω2 = 0.04, p < .001). Reported exposure to direct advertising increased linearly with problem gambling level (ω2 = 0.04, p < .001), whereas we found small/no differences in exposure to other types of advertising. Multiple regressions revealed that among advertising types, internet advertising was the strongest predictor of perceived advertising impact on gambling involvement (ß = 0.1, p < .001). TV advertising was the strongest predictor of advertising impact on knowledge of gambling forms and operators (ß = 0.28, p < .001) and awareness of gambling (ß = .05, p < .05). Future studies should elucidate how different subtypes of internet advertising impact gambling involvement. Clinicians should assess clients' experiences with direct advertising and devise interventions for coping. Researchers should be aware that internet and direct advertising allow for more tailored content compared to other advertising types.

Short rest between shifts (quick returns) and night work is associated with work-related accidents.

PURPOSE: The aim of this study was to examine whether less than 11 h between shifts (i.e., quick returns, QRs) and night shifts is associated with self-reported work-related accidents, near accidents or dozing off at work in a sample of nurses. METHODS: The study was based on cross-sectional data from 1784 nurses (response rate = 60%; mean age = 40.1 years, SD = 8.4; 91% female). Negative binomial regression analyses were conducted to investigate the association between the shift exposures, and eight different self-reported work-related items on accidents, near accidents and dozing off at work, controlling for demographics and work factors. RESULTS: The number of QRs during a year was positively associated with seven of the eight items on work-related accidents, near-accidents and dozing off at work, and number of night shifts was positively associated with five items. Some of the key findings were that QRs were associated with nurses causing harm to themselves (incidence rate ratio [IRR] = 1.009; 95% CI = 1.005-1.013), causing harm to patients/others (IRR = 1.006; 95% CI = 1.002-1.010) and causing harm to equipment (IRR = 1.004; 95% CI = 1.001-1.007); while night shifts were associated with nurses involuntarily dozing off at work (IRR = 1.015; 95% CI = 1.013-1.018), dozing off while driving to/from work (IRR = 1.009; 95% CI = 1.006-1.011), and harming patients/others (IRR = 1.005; 95% CI = 1.001-1.009). CONCLUSION: QRs and night shifts were both associated with the self-reported work-related accidents, near-accidents and dozing off at work. Studies that can establish the causal relationship between QRs and accidents are called for.

Long working hours are inversely related to sick leave in the following 3 months: a 4-year registry study.

PURPOSE: The aim of this study was to investigate the effects of long working hours (≥ 12 h shifts) on sick leave using objective records of shift work exposure and of sick leave. METHODS: A total of 1538 nurses (mean age 42.5, SD 12.0; response rate 42%) participated. Payroll and archival sick leave data over a 4-year period were retrieved from employers' records and aggregated over every third calendar month. A multilevel negative binomial model was used to investigate the effects of exposure to long working hours, on subsequent sick leave rates the following 3 months. Covariates included prior sick leave, number of shifts worked, night and evening shifts, personality, and demographic characteristics. RESULTS: Exposure to long working hours was associated with fewer sick leave days in the subsequent 3 months [adjusted model, incidence rate ratio (IRR) = 0.946, 95% CI 0.919-0.973, p < 0.001]. The interaction long working hours by a number of work days showed that sick leave days the subsequent 3 months was higher by long shifts when number of shifts was high compared to when number of shifts was low [adjusted model, IRR 1.002, 95% CI 1.000-1.004, p < 0.05]. DISCUSSION: Long working hours was associated with fewer sick leave days. The restorative effects of extra days off with long working hours are discussed as possible explanations to this relationship.

Short rest between shift intervals increases the risk of sick leave: a prospective registry study.

OBJECTIVES: The purpose of this study was to use objective registry data to prospectively investigate the effects of quick returns (QR, <11 hours of rest between shifts) and night shifts on sick leave. METHODS: A total of 1538 nurses (response rate =41.5%) answered questionnaires on demographics and personality and provided consent to link this information to registry data on shift work and sick leave from employers' records. A multilevel negative binomial model was used to investigate the predictive effect of exposure to night shifts and QR every month for 1 year, on sick leave the following month. RESULTS: Exposure to QR the previous month increased the risk for sick leave days (incidence rate ratio (IRR)=1.066, 95% CI 1.022 to 1.108, p<0.01) and sick leave spells (IRR=1.059, 95% CI 1.025 to 1.097, p<0.001) the following month, whereas night shifts did not. 83% per cent of the nurses experienced QR within a year, and on average they were exposed to 3.0 QR per month (SD=1.6). Personality characteristics associated with shift work tolerance (low on morningness, low on languidity and high on flexibility) were not associated with sick leave, and did not moderate the relationship between QR and sick leave. CONCLUSIONS: We found a positive linear relationship between QR and sick leave. Avoiding QR may help reduce workers' sick leave. The restricted recovery opportunity associated with QR may give little room for beneficial effects of individual characteristics usually associated with shift work tolerance.

Suicidality among individuals with gambling problems: A meta-analytic literature review.

Gambling problems have consistently been linked to suicidality, including suicidal ideation, attempts, and suicide. However, the magnitude of the relationship has varied significantly across studies and the potential causal link between gambling problems and suicidality is currently unclear. A meta-analytic literature review was conducted to (a) synthesize pooled prevalence rates of suicidality among individuals with gambling problems; (b) determine if individuals with gambling problems had an increased likelihood of reporting suicidality compared to individuals without gambling problems; and (c) review evidence on causality and directionality. A search in Web of Science, APA PsycInfo, APA PsycNet, Medline, CINAHL, ProQuest, Embase, and Google Scholar electronic databases identified 107 unique studies (N = 4,691,899) that were included for review. Studies were included if they were available in any European language and provided sufficient data for the calculation of prevalence rates or effect sizes. Two researchers extracted the data independently using a predefined coding schema that included the Newcastle-Ottawa Quality Assessment Scale. Random-effects meta-analyses yielded pooled prevalence rates of 31.6% (95% CI [29.1%, 34.3%]) for lifetime suicidal ideation and 13.2% (95% CI [11.3%, 15.5%]) for lifetime suicide attempts. Individuals with gambling problems had significantly increased odds of reporting lifetime suicidal ideation (OR = 2.17, 95% CI [1.90, 2.48]) and lifetime suicide attempts (OR = 2.81, 95% CI [2.23, 3.54]) compared to individuals without gambling problems. Two studies reported that individuals with pathological gambling had an increased risk of dying by suicide. Metaregression analyses suggested that the risk of study bias was positively related to the prevalence rates of suicidal ideation. Sex proportions were found to moderate the odds of suicidal ideation, but the direction of the effect was inconsistent. For suicide attempts, psychiatric comorbidity and sample size were positively and inversely, respectively, associated with prevalence rates. The synthesis indicates that suicidality is common among individuals with gambling problems and hence should be addressed by help agencies. Inferences on causality and directionality are hampered by a lack of longitudinal studies. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Personality traits as predictors of recovery among patients with substance use disorder.

INTRODUCTION: Substance use disorder (SUD) is often considered a chronic illness in which prolonged recovery, in terms of abstinence, is uncommon. Personality has been found to predict recovery, but not much is known about its long-term predictive ability as the majority of previous studies have had short follow-up periods (≥ one year). The current longitudinal cohort study therefore investigated whether personality traits predict short- (STR) as well as long-term recovery (LTR) in SUD patients. METHODS: Treatment-seeking patients with SUD (n = 123) completed the NEO Personality Inventory - Revised. STR and LTR categories were defined as scoring <8 on the Alcohol Use Disorders Identification Test - C and <2 on the Drug Use Disorder Identification Test - C at the one-year and 6-8-year follow-up, respectively. Whether personality traits predicted outcome was investigated by two-tailed independent samples t-tests, α < 0.05. Additional analysis was conducted with latent growth curve model. RESULTS: Neuroticism (inversely, p = .004, d = 0.55) and Extraversion (p = .04, d = 0.38) predicted STR (n = 114). Although not significant the effect size for Conscientiousness was above the cut-off for a practical significant effect (d = 0.31). No traits predicted LTR category. Still, the effect sizes for LTR regarding Neuroticism (d = 0.36), Extraversion (d = 0.21) and Conscientiousness (d = 0.27) indicated that these traits have relevance for LTR. The latent growth curve model indicated that these traits predicted the short-term use of drugs and long-term use of alcohol in this cohort dominated by patients suffering from severe poly-SUD. CONCLUSION: Personality traits predict recovery. The effect sizes indicate that more studies with larger samples on personality traits and LTR are required to understand their possible influences on the recovery process.

Emophilia: psychometric properties of the emotional promiscuity scale and its association with personality traits, unfaithfulness, and romantic relationships in a Scandinavian sample.

Emophilia is a suggested stable phenomenon referring to how often and easily an individual falls in love (Jones, 2011). The current study investigated the psychometric properties of the Emotional Promiscuity Scale (EPS, i.e., a measure of emophilia) and its association with personality traits, romantic relationships, and unfaithfulness in a Scandinavian sample. The sample consisted of 2,607 participants, who were recruited through Norwegian and Swedish newspapers. Descriptive analyses of the EPS and a confirmatory factor analysis (CFA) to verify the previously obtained two-factor structure were conducted. Correlations between emophilia and the Big Five and Dark Triad traits were calculated to investigate the discriminative validity of the EPS. Lastly, negative binomial regression analyses were run in which emophilia comprised the independent variable and the number of romantic relationships and number of times being unfaithful constituted the dependent variables. The EPS had satisfactory internal reliability and the responses to the items were normally distributed. The CFA indicated a two-factor structure, although the two factors correlated highly, justifying collapsing them into one dimension. Emophilia showed satisfactory discriminant validity (r < 00.40) against the personality traits included. Lastly, emophilia was positively associated with the number of romantic relationships and times being unfaithful. Future research should aim to improve our understanding of the psychological and behavioral aspects of emophilia.

Telescoping and gender differences in high-risk gambling: Loss limit behavior in a population of electronic gaming machine players.

OBJECTIVE: Telescoping refers to the accelerated progression from starting a potentially addictive behavior to reaching a disordered level. For disordered gambling, telescoping has been reported for women compared to men. Most previous studies on telescoping have used clinical samples and retrospective reports, but this study examined a nonclinical population of gamblers using electronically tracked gambling behavior. METHOD: The sample consisted of Norsk Tipping's Multix electronic gaming machine (EGM) customers during the period of March 2013-December 2018 (n = 184,113, 27.0% women, age range from 18 to 103 years, M = 41, SD = 16). We hypothesized that women would be older than men when first playing Multix and that the time between first playing Multix to reaching first loss limit (money one is allowed to lose) would be shorter for women compared to men. RESULTS: Welch two-sample t tests revealed that women were older than men at Multix gambling onset (Women: M = 46, SD = 17; Men: M = 40, SD = 15; p < .001). Kaplan-Meier revealed a median survival time of 46 months, 95% CI [45, 47], for women and 55 months, 95% CI [54, 56], for men before the first loss limit. Cox regression showed higher risk for meeting the loss limit for women compared to men, HR = 1.22, 95% CI [1.20, 1.25], p < .001, when controlling for age. CONCLUSION: Prevention efforts should consider that adult women playing EGMs appear to be at risk for developing high-risk gambling faster than men. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Association between problem gambling and personality traits: a longitudinal study among the general Norwegian population.

Objective: The present study investigates the longitudinal relationship between problematic gambling (PG) and the five factor model's personality traits using autoregressive cross-lagged models. Methods: The data used in the current study was collected by a national survey in 2013 (n = 10,081) and a follow-up study (n = 5,848) in 2015. PG was measured using Canadian Problem Gambling Index (CPGI) while personality was assessed using Mini-International Personality Item Pool (MINI-IPIP). Participants who completed the CPGI and all the personality items during both waves (n = 2,702) were analysed. Results: The results show that neuroticism had positive cross-lagged associations with CPGI. In contrast, conscientiousness and agreeableness in 2013 were found to have inverse cross-lagged effect on CPGI in 2015. Finally, openness and extraversion did not have any cross-lagged associations with CPGI. Conclusion: PG poses serious negative implications for the involved individuals as well as their associated close social circle. Hence, it is important to understand predictors of PG for prevention purposes. Personality traits are one of the influential frameworks for examining uncontrolled psychopathological behaviors like PG. The study findings offer significant theoretical as well as practical implications.

Ethnicity as a risk factor for gambling disorder: a large-scale study linking data from the Norwegian patient registry with the Norwegian social insurance database.

BACKGROUND: The study investigated ethnicity as a risk factor for gambling disorder (GD), controlling for demographics, citizenship, and years of residency in Norway. METHODS: The sample comprised 65,771 individuals from a national patient registry (n = 35,607, age range 18-88 years) and a national social insurance database in Norway (n = 30,164, age rage 18-98 years). The data covered the period from 2008 to 2018. RESULTS: The results showed that when controlling for age and sex, ethnic minorities were overall less likely than those born in Norway to be diagnosed with GD (odds ratio [OR] ranging from 0.293 to 0.698). After controlling for citizenship and years of residency in Norway, the results were reversed and indicated that ethnic minorities were overall more likely to be diagnosed with GD (OR ranging from 1.179 to 3.208). CONCLUSION: The results suggest that citizenship and years of residency are important variables to account for when assessing the relationship between ethnicity and being diagnosed with GD. Our results may be explained by people from ethnic minority groups being more likely to experience gambling problems but less likely to seek contact with healthcare services for gambling problems.

An empirical study on attitudes toward gambling when sportswashing is involved.

Sportswashing is defined as individuals, groups, companies, or countries/regimes' involvement in sports to improve their own reputation and/or to distract from or normalize wrongdoing. This cross-sectional survey is the first empirical study on sportswashing in relation to gambling. The sample consisted of United Kingdom residents who reported past 12-month gambling (N = 786, 50% women, mean age = 45.6, SD = 15.2). We investigated how many were familiar with sportswashing and their attitudes toward gambling when sportswashing is involved. Exploratory and confirmatory factor analysis (CFA) were conducted on the attitudes scale that was developed for the current study. Multiple regressions were used to examine if individual differences in terms of age, gender, personality, moral foundations, political trust and efficacy, and/or gambling risk were associated with such attitudes. Finally, we examined the percentage of people who avoid gambling on teams/events when sportswashing is involved, including group differences in avoidance and motivations for avoidance according to gambling risk. The results showed that only 32% had heard about sportswashing prior to the survey. CFA indicated that attitudes toward sportswashing and gambling as conceptualized in the scale used in the current study can broadly be categorized into two dimensions: How individuals relate to sportswashing when gambling ("self-factor") and how individuals think gambling companies and regulators should regulate sportswashing and gambling [an "external-factor," p < 0.001, CFI = 0.0.996, RMSEA = 0.090, 90% CI (0.077, 0.104)]. Multiple regressions indicated that measures of individual differences explained a significant amount of variance in self-oriented (F (17, 765) = 7.19, p < 0.001, adjusted R2 = 0.12) and external-oriented (F (17, 765) = 8.40, p < 0.001. adjusted R2 = 0.14) attitude toward gambling and sportswashing. Avoidance of betting when sportswashing is involved was reported by 43%. The proportion was lower among those with moderate gambling risk/problem gambling (35%) compared to those with no/low gambling risk (45%). It is concluded that further scale development could help elucidate individual differences in attitudes toward sportswashing and gambling. Sportswashing remains an important social issue, and the present study indicates that this has high relevance for the gambling field.

Problem gaming and suicidality: A systematic literature review.

Background: No studies have so far synthesised the current evidence concerning a possible relationship between problem gaming and suicidality. We therefore conducted a systematic review of the literature. Our objective was to investigate the relationship between problem gaming and suicidality. The review was funded by the Norwegian Competence Center for Gambling and Gaming Research. Methods: The review was pre-registered in PROSPERO International prospective register of systematic reviews (CRD42021279774). Searches were conducted in Web of Science, PsycINFO, EMBASE, PubMed and Google Scholar, September 2021. Studies that reported data on the relationship between problem gaming and suicidality, published between 2000 and 2021, and written in any European language were included. Studies investigating internet addiction/problematic internet use and not problem gaming, specifically, and studies investigating mental health in general or mental health outcomes other than suicidality, were excluded. Data from the included studies were extracted independently by two coders who also evaluated for risk of bias using the Newcastle-Ottawa Quality Assessment Scale. The results from each included study were presented in a table. Results: A total of 12 cross-sectional studies, with in total 88,732 participants, were included in the review. In total 10 studies investigated the association between problem gaming and suicidal ideation. One of these also investigated the association between problem gaming and suicide attempts. Two studies combined suicidal ideation and suicide attempts into one variable and investigated the association between that variable and problem gaming. In total 11 of the 12 included studies found positive, crude associations between problem gaming and suicidal ideation/attempts. Five studies adjusted for possible confounding variables. Three of these still found significant associations between problem gaming and suicidal ideation, one found a positive but not statistically significant association, and the fifth found an inverse, non-significant association. Discussion: The current findings indicate that there is an association between problem gaming and suicidal ideation, and likely between problem gaming and suicide attempts. The most important limitation of the included studies is the lack of longitudinal designs. Future studies should aim to investigate the causality and mechanisms in the relationships using more stringent designs.

Personality and substance use disorder: Characteristics as measured by NEO-personality inventory-revised.

The present study investigates the personality characteristics of a cohort of patients with Substance Use Disorders. The included participants (n = 123) were recruited from specialized treatment for addictions in Norway. The personality scores in the current sample were compared to the Norwegian norm sample with t-tests. Age and gender differences in personality scores were assessed by bivariate correlation analyses and t-tests, respectively. The sample had higher scores on Neuroticism and lower scores on Conscientiousness, Agreeableness, Extraversion, and Openness compared to the norm sample (p < 0.01). The effect sizes of the differences between the current sample and the Norwegian norm sample were large for Neuroticism and Conscientiousness. Older participants scored higher on Agreeableness and its facets A1: Trust and A2: Straightforwardness and lower on the facet E5: Excitement-Seeking (p < 0.01). No significant (p < 0.01) gender differences in NEO-PI-R scores were found. In conclusion, the current results support previous findings regarding personality traits associated with SUD. The clinical relevance of the findings is discussed.

One size does not fit all. Should gambling loss limits be based on income?

Background: Previous research has suggested empirically based gambling loss limits, with the goal of preventing gambling related harm in the population. However, there is a lack of studies relating gambling loss limits to individual factors such as income. The current study examines whether gambling loss limits should be income-specific. Materials and methods: The dataset was derived from three representative cross-sectional surveys of the Norwegian population and consisted of 14,630 gamblers. Four income groups, based on a quartile approximation, were formed. Gambling related harm was measured with the Problem Gambling Severity Index (PGSI), and precision-recall (PR) analyses were used to identify loss limits for the different income groups at two levels of gambling severity: moderate-risk gambling and problem gambling. Results: For both levels of gambling severity, we found the lowest income group to have the lowest gambling loss limits, and the highest income group to have the highest loss limits, which compared to the loss limits for the total sample, were lower and higher, respectively. Calculating the cut-offs for moderate-risk gamblers, we found a consistently ascending pattern from the lowest to the highest income group. Calculating the cut-offs for problem gamblers, we found a similar pattern except for the two middle income groups. Conclusion: The results suggest that income moderates empirically derived gambling loss limits. Although replication is required, income-based gambling loss limits may have higher applied value for preventing gambling related harm, compared to general loss limits aimed at the entire population.

Problematic Gaming and Sleep: A Systematic Review and Meta-Analysis.

Problematic gaming has been linked to poor sleep outcomes; however, these associations have not yet been synthesized quantitatively. This review employed a meta-analysis to investigate the relationship between problematic gaming and sleep-related outcomes. A search of Medline, Embase, Web of Science, PsycINFO, and Google Scholar identified a total of 763 studies, including 34 studies (n = 51,901 participants) eligible for inclusion. Papers were included if available in any European language, addressed problematic gaming, contained original data, and provided sufficient data for calculation of effect sizes. Two researchers independently extracted data using pre-defined fields including quality assessment. Sleep-related outcomes were meta-analyzed for sleep parameters that were reported by 5 or more papers. Significant overall effects were found for sleep duration (g = -0.238, 95% CI = -0.364, -0.112), poor sleep quality (OR = 2.02, 95% CI = 1.47, 2.78), daytime sleepiness (OR = 1.57, 95% CI = 1.00, 2.46) and sleep problems (OR = 2.60, 95% CI = 1.94, 3.47). Between-study heterogeneity was detected for all meta-analyses. Subgroup analyses showed a higher inverse effect size for adolescent samples compared to adult or non-specific age samples in terms of sleep duration. For daytime sleepiness, a larger effect size was found for studies based on single-item sleep measures compared to multi-item sleep measures. For sleep problems, the subgroup analysis showed the opposite with a higher effect size for studies based on single-item sleep measures than multi-item sleep measures. Across all sleep parameters, problematic gamers consistently reported a more adverse sleep status than non-problematic gamers. Systematic Review Registration: https://www.crd.york.ac.uk/PROSPERO/; record ID: CRD42020158955.

Smoking and snus use among Norwegian students: Demographic, personality and substance use characteristics.

Background and aim: Smoking rates are decreasing in Norway while the use of snus has increased. We aimed to investigate the co-occurrence of, and the socio-demographics, personality and substance use characteristics associated with, student smoking and snus use. Methods: Survey data were collected among students in higher education in Bergen, Norway in 2015 (N = 11,236, response rate 39.4%). Multinomial regression analyses comparing snus users and smokers to non-users and non-smokers, respectively, on demographic, personality and substance use variables were conducted. Regression analyses comparing current dual users to current smokers and current snus users and comparing daily smokers to daily snus users, on demographic, personality and substance use variables were also conducted. Results: In total 67.9% of ever snus users identified themselves as non-smokers (past and current). Several demographic, personality and substance use characteristics associated with smoking and snus use were identified (all = p < .05), some of which were common for both (e.g., use of cannabis) and some which were exclusively associated with either smoking (e.g., neuroticism) or snus use (e.g., extroversion). Conclusion: The current study contributes with several novel findings regarding traits associated with smoking and snus use. Though limited by a cross-sectional design, the current findings may suggest that the group of students using snus consists of a combination of previous smokers, students who would have smoked if snus was not available and a new segment who may not have used nicotine if snus was not available.

Changes Over Time and Predictors of Online Gambling in Three Norwegian Population Studies 2013-2019.

Objectives: To investigate changes over time and identify predictors of online gambling among gamblers by using three Norwegian representative samples covering a 6-year (2013-2019) period. We also aimed to identify different characteristics (including video game participation and video gaming problems) of online compared to offline gamblers. Methods: Data from gamblers (N = 15,096) participating in three cross-sectional surveys (2013, 2015, and 2019) based on random sampling from the Norwegian Population Registry were analyzed. Participants were asked how frequently they engaged in online gambling on different platforms (e.g., mobile phone). Data on sociodemographics, games gambled, gambling problems, gaming, and problem gaming were collected and analyzed by logistic regression analyses. Results: Overall, an increase in online gambling from 2013 to 2015 was found (a larger percentage of gamblers reported having gambled online at least once during the last year), and an increase in online gambling from 2015 to 2019 was found (more gamblers reported having gambled online at least once last year and at least once per week). The increase was largest for gambling on mobile phone. Consistent predictors of online gambling (at least once last year and at least once per week) were male gender, high income, being unemployed, being on disability pension, having work assessment allowance, being a homemaker or retiree, number of games gambled, and gambling problems. Conclusions: Online gambling, especially on mobile phones, has increased significantly during the last 6 years in Norway. Hence, gambling availability seems to have grown, which may pose a risk for development of gambling problems. Compared to offline gamblers, online gamblers were more likely to be men, young, not working or studying, gambling on several games, and having gambling problems. Responsible gambling efforts aiming at preventing or minimizing harm related to online gambling should thus target these groups.

The Relationship Between Gambling Problems and the Five-Factor Model of Personality: A Systematic Review and Meta-Analysis.

Objectives: The aim of the present meta-analysis was to synthesize results from the association between problem gambling (PG) and dimensions of the five factor model of personality and to identify potential moderators (gambling diagnosis: yes/no, comorbidity: yes/no and trait assessment: four or fewer items vs. five items or more) of these associations in meta-regressions. Methods: Searches were conducted in six databases; Medline, Web of Science, PsychInfo, Google Scholar, OpenGrey, and Cochrane Library (conducted on February, 22, 2021). Included studies: (1) reported a relationship between PG and at least one of the personality traits in the five-factor model, (2) contained information of zero-order correlations or sufficient data for such calculations, and (3) were original articles published in any European language. Case-studies, qualitative studies, and reviews were excluded. All articles were independently screened by two authors. Final agreement was reached through discussion or by consulting a third author. Risk of bias of the included studies was assessed by the Newcastle-Ottawa Scale. Data were synthesized using a random effects model. Results: In total 28 studies, comprising 20,587 participants, were included. The correlations between PG and the traits were as follows: Neuroticism: 0.273 (95% CI = 0.182, 0.358), conscientiousness -0.296 (95% CI = -0.400, -0.185), agreeableness -0.163 (95% CI = -0.223, -0.101), openness -0.219 (95% CI = -0.308, -0.127), and extroversion -0.083 (95% CI = -0.120, -0.046). For all meta-analyses the between study heterogeneity was significant. Presence of gambling diagnosis was the only moderator that significantly explained between-study variance showing a more negative correlation to extroversion when participants had a gambling diagnosis compared to when this was not the case. Discussion: The results indicated some publication bias. Correcting for this by a trim-and-fill procedure showed however that the findings were consistent. Clinicians and researchers should be aware of the associations between personality traits and PG. Previous studies have for example showed neuroticism to be related to treatment relapse, low scores on conscientiousness to predict treatment drop-out and agreeableness to reduce risk of treatment drop-out. Systematic Review Registration: PROSPERO (CRD42021237225).

Internet-based treatment of gambling problems: A systematic review and meta-analysis of randomized controlled trials.

BACKGROUND AND AIMS: The effect of internet-based psychological treatment for gambling problems has not been previously investigated by meta-analysis. The present study is therefore a quantitative synthesis of studies on the effects of internet-based treatment for gambling problems. Given that effects may vary according to the presence of therapist support and control conditions, it was presumed that subgroup analyses would elucidate such effects. METHODS: A systematic search with no time constraints was conducted in PsycINFO, MEDLINE, Web of Science, and the Cochrane Library. Two authors independently extracted data using a predefined form, including study quality assessment based on the Cochrane risk of bias tool. Effect sizes were calculated using random-effects models. Heterogeneity was indexed by Cochran's Q and the I 2 statistics. Publication bias was investigated using trim and fill. RESULTS: Thirteen studies were included in the analysis. Random effects models at post-treatment showed significant effects for general gambling symptoms (g = 0.73; 95% CI = 0.43-1.03), gambling frequency (g = 0.29; 95% CI = 0.14-0.45), and amount of money lost gambling (g = 0.19; 95% CI = 0.11-0.27). The corresponding findings at follow-up were g = 1.20 (95% CI = 0.79-1.61), g = 0.36 (95% CI = 0.12-0.60), and g = 0.20 (95% CI = 0.12-0.29) respectively. Subgroup analyses showed that for general gambling symptoms, studies with therapist support yield larger effects than studies without, both post-treatment and at follow-up. Additionally, on general gambling symptoms and gambling frequency, there were lower effect sizes for studies with a control group compared to studies without a control group at follow-up. Studies with higher baseline severity of gambling problems were associated with larger effect sizes at both posttreatment and follow-up than studies with more lenient inclusion criteria concerning gambling problems. DISCUSSION AND CONCLUSIONS: Internet-based treatment has the potential to reach a large proportion of persons with gambling problems. Results of the meta-analysis suggest that such treatments hold promise as an effective approach. Future studies are encouraged to examine moderators of treatment outcomes, validate treatment effects cross-culturally, and investigate the effects of novel developments such as ecological momentary interventions.

Direct Marketing Experiences Among Individuals With Current and Lifetime Gambling Disorder.

Gambling providers use varied and complex marketing techniques, including marketing that targets the individual directly. Previous research indicates that individuals with gambling disorder are disproportionately influenced by gambling marketing, however, very few studies have examined gamblers' experiences with direct marketing. The current exploratory interview study examined experiences with direct gambling marketing among 12 individuals with either current (n = 5) or lifetime (n = 7) gambling disorder. A broad research question was employed encompassing experiences with different types of direct marketing and corresponding attitudes, influences, and interactions. The interview data were analyzed with thematic analysis using an inductive approach, and the participants reported extensive and varied experiences with direct marketing. Two overarching themes, with two and four subthemes, respectively, were identified. The overarching themes showed that marketing experiences were intimately connected with participants' gambling behaviors and their relationships to their own problems. Overall, direct marketing was experienced as an interactive form of marketing with individually tailored promotions such as free gambling credits, bonuses, and special gifts. Some promotions were experienced as personal, while others were experienced as mass produced. Direct marketing was in some cases experienced as predatory and was reported to hamper the participants' ability to cope with their gambling disorder. Participants' attitudes toward direct marketing varied as a function of the participants' engagement in gambling. During periods of active gambling, direct marketing was experienced as beneficial and positive as the participants took advantage of the offers or actively manipulated how the offers were made. In contrast, when attempting to reduce/abstain from gambling, the participants experienced direct marketing as aggressive, and they reported making considerable efforts to try to limit it. Direct marketing was experienced as a trigger for gambling urges and was reported to induce a conflict between gambling and abstinence. Directly marketed promotions are discussed in relation to ecological factors of access and availability that form a basis for the development of gambling disorder, and variations in experiences are related to stages of change in gambling disorder. Implications for treatment are discussed where the current findings suggest that coping with marketing should be addressed in treatment.