Behavior Change Techniques and Delivery Modes in Interventions Targeting Adolescent Gambling: A Systematic Review.

BACKGROUND: Adolescent gambling can lead to significant harms, yet participation rates continue to rise. Interventions targeting gambling reduction have been implemented in this population. However, it is not clear which behavior change techniques (BCTs) and modes of delivery (MOD) are most effective at reducing gambling. OBJECTIVE: The objective of the study was to identify 'promising' BCTs and MODs by systematically reviewing interventions targeting adolescent gambling behavior. 'Promising' was defined as those present in at least 25% of all interventions and in at least two effective interventions. METHODS: Three databases were searched (PsycINFO, Medline, and Scopus) from database inception to May 2021. Interventions were eligible if they were randomized controlled trials; targeting adolescents (aged 10-25 years); and assessing gambling behavior post-intervention. BCTs were identified using the Behavior Change Technique Taxonomy v1. RESULTS: From the initial 3,315 studies, the removal of duplicates and ineligible articles resulted in sixteen studies included in the review. Eleven of these reported successfully reducing gambling behavior. Eighteen BCTs and six MODs were used across the interventions. The BCTs identified as promising were '4.2. Information about antecedents', '4.4. Behavioral experiments', '5.3. Information about social and environmental consequences', and '5.6. Information about emotional consequences'. Promising MODs were 'face-to-face', 'computer', and 'playable electronic storage'. CONCLUSIONS: The study reviewed the content of interventions targeting adolescent gambling behavior. Four BCTs were identified as promising and should therefore be adopted in future interventions. To facilitate the delivery of these techniques, the study also identified three promising MODs. Interventions developed using these BCTs and MODs may successfully reduce adolescent gambling behavior.

Study framing influences crowdsourced rates of problem gambling and alcohol use disorder.

OBJECTIVE: Crowdsourcing is an increasingly popular source of participants in studies of problem gambling. Studies with crowdsourced samples have reported prevalence rates of problem gambling between 10 and 50 times higher than traditional sources of estimates. These elevated rates may be due to study framing motivating self-selection. In this preregistered study, we examined whether study framing influences self-reported problem gambling severity and harmful alcohol use in a sample of participants recruited from a popular crowdsourcing website. METHOD: Two recruitment notices for an online questionnaire were placed on Amazon Mechanical Turk (MTurk). Notices were framed as "Gambling and Health" or "Alcohol and Health." Only participants who passed data checks were retained for confirmatory analyses (N = 564; 44% of recruited participants). Participants in the gambling framing (N = 261) and in the alcohol framing (N = 303) were compared on the Problem Gambling Severity Index (PGSI) and Alcohol Use Disorders Identification Test (AUDIT). RESULTS: Problem gambling rates and severity scores were significantly greater for participants in the gambling framing compared to those in the alcohol framing. Self-reported scores of harmful alcohol use were significantly greater for participants in the alcohol framing compared to those in the gambling framing, but there was no significant difference in prevalence rates for harmful alcohol use. CONCLUSIONS: Study framing is an important consideration for gambling and alcohol research. We found that study framing may substantially increase the observed rates of problem gambling severity in crowdsourced samples, potentially via encouragement of self-selection. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Development and psychometric evaluation of the Recovery Index for Gambling Disorder (RIGD).

Objective: Recovery from Gambling Disorder lacks established operational criteria and a dedicated outcome measure. Cross-study comparisons and treatment efficacy determinants are difficult without a valid and widely used tool to assess recovery. The current article describes the development and psychometric evaluation of the Recovery Index for Gambling Disorder (RIGD). Method: Item development was based on an integration of academic, clinical, and consumer perspectives of recovery. Expert feedback and cognitive interview techniques were employed to review and refine the initial item pool. An empirical evaluation of the RIGD was conducted using 204 adult participants (63.7% male) with experience of seeking formal help for gambling problems. Results: Partial-least squares structural equation modeling resulted in a 32-item solution across 6 recovery dimensions: gambling reduction, urge coping, recovery wisdom, life functioning, interpersonal relationships, and mental health. The RIGD structural model explained 71.9% of variance in an external self-report global measure of recovery. Convergent validity was evidenced by significant correlations between all RIGD dimensions and other related measures, with the exception of recovery wisdom. Criterion-related validity was demonstrated as RIGD composite scores accurately classified nonproblem from problem gamblers, with a conservative cut-off score of 45. Test-retest reliability was established over a 2-week interval. Conclusions: The RIGD is an empirically supported instrument designed to broadly measure recovery from Gambling Disorder. Valid and uniform measurement of recovery is important given its central role in advancing effective treatments and shaping gambling help service policy internationally. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

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.

Measuring treatment outcomes in gambling disorders: a systematic review.

BACKGROUND AND AIMS: Considerable variation of outcome variables used to measure recovery in the gambling treatment literature has precluded effective cross-study evaluations and hindered the development of best-practice treatment methodologies. The aim of this systematic review was to describe current diffuse concepts of recovery in the gambling field by mapping the range of outcomes and measurement strategies used to evaluate treatments, and to identify more commonly accepted indices of recovery. METHODS: A systematic search of six academic databases for studies evaluating treatments (psychological and pharmacological) for gambling disorders with a minimum 6-month follow-up. Data from eligible studies were tabulated and analysis conducted using a narrative approach. Guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) were adhered to. RESULTS: Thirty-four studies were reviewed systematically (RCTs = 17, comparative designs = 17). Sixty-three different outcome measures were identified: 25 (39.7%) assessed gambling-specific constructs, 36 (57.1%) assessed non-gambling specific constructs, and two instruments were used across both categories (3.2%). Self-report instruments ranged from psychometrically validated to ad-hoc author-designed questionnaires. Units of measurement were inconsistent, particularly in the assessment of gambling behaviour. All studies assessed indices of gambling behaviour and/or symptoms of gambling disorder. Almost all studies (n = 30; 88.2%) included secondary measures relating to psychiatric comorbidities, psychological processes linked to treatment approach, or global functioning and wellbeing. CONCLUSIONS: In research on gambling disorders, the incorporation of broader outcome domains that extend beyond disorder-specific symptoms and behaviours suggests a multi-dimensional conceptualization of recovery. Development of a single comprehensive scale to measure all aspects of gambling recovery could help to facilitate uniform reporting practices across the field.