For Better and For Worse: Frequent Gamblers Use Dual Counterfactuals to Justify Continued Gambling.

How might frequent gamblers convince themselves to keep playing despite persistent losses or after a win that should be savored? The purpose of this research is to examine the unexplored question of how frequent gamblers' use counterfactual thinking to motivate their desire to continue gambling. Using a sample of n = 69 high and n = 69 low frequency gamblers in a field setting, we found that infrequent gamblers tended to consider how the perceived outcome of losing "could have been better" (i.e., upward counterfactual thinking), and how a winning outcome "could have been worse" (i.e., downward counterfactual thinking). This pattern of counterfactual thinking is considered typical in many settings and may, in a gambling context, support a potentially more responsible approach by helping infrequent gamblers to learn from past mistakes to avoid significant future losses and to savor wins to protect returns gained. Alternatively, we found that frequent gamblers were more likely to generate 'dual counterfactuals' which include both upward and downward counterfactuals in response to losses and wins. We argue that this dual pattern of counterfactual thinking may allow frequent gamblers to more easily justify their desire to continue gambling. Findings suggest that challenging gamblers counterfactual thinking patterns could assist clinicians in moderating the potential for high-risk behaviors.

Motor cortex dysfunction in problem gamblers.

Impairments in response inhibition have been implicated in gambling psychopathology. This behavioral impairment may suggest that the neural mechanisms involved in response inhibition, such as GABAA -mediated neurotransmission in the primary motor cortex (M1), are also impaired. The present study obtained paired-pulse transcranial magnetic stimulation markers of GABAA and glutamate receptor activity from the left M1 of three groups-problem gamblers (n = 17, 12 males), at-risk gamblers (n = 29, 19 males), and controls (n = 23, six males)-with each group matched for alcohol use, substance use, and attention-deficit hyperactivity disorder (ADHD) symptomology. Response inhibition was measured using the stop signal task. Results showed that problem gamblers had weaker M1 GABAA receptor activity relative to controls and elevated M1 glutamate receptor activity relative to at-risk gamblers and controls. Although there were no differences in response inhibition between the groups, poorer response inhibition was correlated with weaker M1 GABAA receptor activity. These findings are the first to show that problem gambling is associated with alterations in M1 GABAA and glutamate-mediated neurotransmission.

Staff Perceptions of Responsible Gambling Training Programs: Qualitative Findings.

Staff training in responsible gambling forms an integral component of industry measures designed to respond to and minimize gambling-related harms. Research suggests that venue staff members have the capacity to identify behavioral indicators of problem gambling among patrons, but often are reluctant or fail to respond to patrons unless directly approached for assistance. Understanding the barriers preventing staff from proactively intervening with identified patrons is necessary if a positive shift toward greater levels of assistance for at-risk individuals is to be achieved. A series of focus groups were conducted with management and floor staff (N = 20) from a large New South Wales registered club venue to better understand their experiences and attitudes towards existing responsible gambling training programs. Qualitative phenomenological data were analyzed using inductive thematic analyses and resulted in the identification of three primary domains: ability to identify harmful gambling behaviors; perceived challenges and barriers to intervention; and potential improvements to current programs. Responses were consistent with the literature in demonstrating staff abilities to identify behavioral indicators, but importantly revealed a lack of certainty and understanding in relation to their specific roles, potential legal consequences and implications for employment by taking the initiative to proactively intervene. Recommended improvements to strengthen the effectiveness of programs included the implementation of well-defined protocols setting out role expectations and procedures for floor staff to follow, and importantly, a fundamental shift in middle and senior management culture to one that actively supports and positively acknowledges staff-customer interactions designed to assist problem gamblers.

Use of Consumer Protection Tools on Internet Gambling Sites: Customer Perceptions, Motivators, and Barriers to Use.

Internet gambling has been widely legalised in recognition of its capacity to, and the importance of, providing consumer protection tools to prevent and minimise gambling-related harms. Most licensed Internet gambling sites are required to provide consumer protection tools, including activity statements, deposit limits, and time-outs (temporary self-exclusion). However, few Internet gambling customers engage with the tools. An online survey of 564 customers of Australian Internet gambling sites aimed to understand the extent to which consumer protection tools are used, characteristics of those using these tools, and the perceptions and attitudes towards tool use, including barriers to use. Most participants were aware of the tools and had accessed activity statements; few had used deposit limits (24.5%) or time-outs (8.1%) but use of these restrictive tools was higher among those at-risk of gambling problems. Satisfaction with tools was generally high among users and tools were mostly used as intended; however, only moderate changes in behaviour were reported. Participants predominately did not use the restrictive tools as they did not see these as relevant for them, and they were perceived to be intended for people with gambling problems. The findings are important to drive necessary improvements to consumer protection efforts including efforts to encourage perception that tools are relevant for all customers. Changes to current practice, including terminology and promotion of tools, are needed by Internet gambling operators and policy makers to improve the utilisation and effectiveness of consumer protection tools to enable sustainable gambling among the broader cohort of Internet gamblers.

Correction to: Gambling Research and Funding Biases.

Unfortunately, the original publication contains errors. The authors would like to correct the errors.

Isolating the impact of specific gambling activities and modes on problem gambling and psychological distress in internet gamblers.

BACKGROUND: Gambling disorder is related to high overall gambling engagement; however specific activities and modalities are thought to have stronger relationships with gambling problems. This study aimed to isolate the relationship between specific gambling activities and modalities (Internet and venue/land-based) to gambling disorder and general psychological distress. Past-month Internet gamblers were the focus of this investigation because this modality may be associated with gambling disorders in a unique way that needs to be separated from overall gambling intensity. METHODS: Australians who had gambled online in the prior 30 days (N = 998, 57% male) were recruited through a market research company to complete an online survey measuring self-reported gambling participation, problem gambling severity, and psychological distress. RESULTS: When controlling for overall gambling frequency, problem gambling was significantly positively associated with the frequency of online and venue-based gambling using electronic gaming machines (EGMs) and venue-based sports betting. Psychological distress was uniquely associated with higher frequency of venue gambling using EGMs, sports betting, and casino card/table games. CONCLUSIONS: This study advances our understanding of how specific gambling activities are associated with disordered gambling and psychological distress in users of Internet gambling services. Our results suggest that among Internet gamblers, online and land-based EGMs are strongly associated with gambling disorder severity. High overall gambling engagement is an important predictor of gambling-related harms, nonetheless, venue-based EGMs, sports betting and casinos warrant specific attention to address gambling-related harms and psychological distress among gamblers.

Responsible Gambling Research and Industry Funding Biases.

This brief report examines whether there are differences in aspects of different characteristics, including design/methodologies of responsible gambling (RG), between studies funded by industry as compared to other sources. To investigate this, the authors used those studies included in a recent meta-analysis focusing on the empirical basis of RG initiatives (Ladouceur et al. in Addict Res Theory 25:225-235, 2017). We examined eight associations between funding sources, and different design/methodological characteristics of these studies; type of strategy, inclusion of comparison groups, measurement scales and repeated measures, publication source, number of inclusion criteria met, secondary sources of funding, publication year. The results revealed no statistically significant difference between the funding source, and the index study characteristics. These results do not support claims that funding exerts influence on the design or methodologies of RG studies. However, the absence of statistically significant findings should not be used to assert the absence of a funding effect because there are many reasons for failing to find differences, or interpretation of findings. Unexpectedly, a third of the papers included in this study failed to disclose their funding sources. This finding highlights the need for more open and transparent disclosures.

Gambling Research and Funding Biases.

A recent systematic review of the responsible gambling research suggests that there are no significant differences between gambling industry and non-industry funded research with regard to research design and outcomes. This study empirically synthesizes the outcomes of a larger sample of the scientific gambling literature to determine the generalizability of these original results. Our goal was to determine the extent to which funding sources might differentially influence characteristics of research design and outcomes. We conducted a comprehensive review of 18 research databases and examined studies published between January 2008 and August 2018. For four gambling-related journals, we reviewed all of the available studies. For 14 addiction-related journals, we examined only studies that examined gambling-related outcomes. To be included in this study, publications had to be quantitative and include a clear gambling-related hypothesis. After retrieving 1731 gambling studies, we applied the inclusion criteria and retained 720 studies for our final analytic sample. We used hypothesis confirmation and funding source information to determine the presence or absence of funding bias. Gambling industry funded studies were no more likely than studies not funded by the gambling industry to report either confirmed, partially confirmed, or rejected hypotheses. Nonetheless, studies funded by the gambling industry were more likely than other types of funding sources to include a conflict of interest statement. Studies with disclosed funding sources were more likely than those with undisclosed funding sources to include a conflict of interest statement. These findings highlight the importance of transparency and disclosure during research dissemination.

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.

Impulsivity and Gambling Type Among Treatment-Seeking Disordered Gamblers: An Explorative Study.

Several studies have found that certain traits of impulsivity are associated with gambling disorder, and influence its severity. Furthermore, it has been suggested that some forms of gambling, particularly electronic gambling machines, are particularly widespread among pathological gamblers. In the present, exploratory study, we aim to clarify the role played by impulsivity in influencing the choice of specific gambling activities, by examining the relation between individual dimensions of impulsivity, and the choice of specific gambling activities in a clinical population. 100 consecutively admitted pathological gamblers at the National Problem Gambling Clinic in London (UK) in 2014 were administered the UPPS-P and BIS-11 impulsivity questionnaires, the Problem Gambling Severity Index, and underwent a structured interview concerning their gambling activities in the month and year prior to assessment. The correlation between individual gambling activities and impulsivity dimensions was analyzed both at a bivariate level, and using logistic regression. We found a significant correlation between Negative Urgency, Motor impulsivity and low-stakes machine gambling on multivariate analysis. Negative urgency (i.e. the tendency to act impulsively in response to negative affect), and Motor impulsivity (a tendency to rash action and restlessness) might be mediating factors in the choice of electronic gambling machines, particularly among patients whose gambling is escape-oriented. Structural and situational characteristics of gambling machines, particularly the widespread availability of low-stakes-rather than high-stakes-gaming machines, might concur to the choice of this form of gambling among individuals who present higher negative urgency and restlessness.

Systematic Review of Empirically Evaluated School-Based Gambling Education Programs.

Adolescent problem gambling prevalence rates are reportedly five times higher than in the adult population. Several school-based gambling education programs have been developed in an attempt to reduce problem gambling among adolescents; however few have been empirically evaluated. The aim of this review was to report the outcome of studies empirically evaluating gambling education programs across international jurisdictions. A systematic review following guidelines outlined in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Statement searching five academic databases: PubMed, Scopus, Medline, PsycINFO, and ERIC, was conducted. A total of 20 papers and 19 studies were included after screening and exclusion criteria were applied. All studies reported intervention effects on cognitive outcomes such as knowledge, perceptions, and beliefs. Only nine of the studies attempted to measure intervention effects on behavioural outcomes, and only five of those reported significant changes in gambling behaviour. Of these five, methodological inadequacies were commonly found including brief follow-up periods, lack of control comparison in post hoc analyses, and inconsistencies and misclassifications in the measurement of gambling behaviour, including problem gambling. Based on this review, recommendations are offered for the future development and evaluation of school-based gambling education programs relating to both methodological and content design and delivery considerations.

Pathological Gambling and Motor Impulsivity: A Systematic Review with Meta-Analysis.

Motor impulsivity, which is an impairment in withholding and cancelling inappropriate responses, may account for the inability for pathological gamblers (PGs) to inhibit their urges to gamble. The aim of this systematic review was to perform a quantitative and qualitative synthesis of existing studies in order to assess whether PGs without comorbid substance use disorder have elevated motor impulsivity, relative to healthy controls. An exhaustive literature search led to the identification of 20 studies which met inclusion criteria. A meta-analysis was then conducted on the following measures: stop signal reaction time from the stop signal task; commission errors, omission errors, and Go reaction time from the Go/No-Go task; and the motor impulsiveness subscale of the Barratt Impulsiveness Scale (BIS-Motor). The results revealed a moderate to large mean effect size of stop signal reaction time, small to moderate mean effect sizes for commission errors, omission errors and Go reaction time, and a large mean effect size for the BIS-Motor. Significant heterogeneity in effect sizes was observed on most behavioural measures, but not for the BIS-Motor or omission errors on the Go/No-Go task. Overall, these results suggest that motor impulsivity may be one of the features of PG psychopathology, accounting for their poor inhibitory control over gambling behaviours. Moreover, other deficits in sustained attention, or more generally in executive/cognitive control, may be present in PGs. We discuss the implications, limitations of existing research, and suggested avenues for future studies, particularly the need to acknowledge heterogeneity amongst PGs and amongst different behavioural measures.

General practitioners knowledge about use of topical corticosteroids in paediatric atopic dermatitis in Australia.

BACKGROUND: Topical corticosteroids are the standard of care in paediatric atopic dermatitis (pAD). However, messages that overstress possible side effects can have a negative impact on perceptions of safety and contribute to treatment non-adherence. The aim of this study was to assess general practitioners' (GPs') perception of the safety of topical corticosteroids in pAD treatment. METHODS: Australian GPs participating in continuing professional development programs were assessed before an education session on pAD. Responses were recorded via an electronic survey. RESULTS: A total of 257 GPs were surveyed. More than one-third (40.7%) of the GPs instructed parents to apply topical corticosteroids for two weeks or less. Nearly half (47.7%) instructed parents to apply topical corticosteroids sparingly or with the smallest amount possible. Furthermore, nearly one-third (30.2%) reported skin atrophy as the most common side effect of topical corticosteroids. DISCUSSION: Advice to patients given by Australian GPs may carry unintentional risk messages contributing to treatment non­adherence. Evidence-based information on the safety of topical corticosteroids is needed to empower GPs to improve treatment outcomes in pAD.

Attitudes of Australian dermatologists to the use and safety of topical corticosteroids in paediatric atopic dermatitis.

BACKGROUND: Atopic dermatitis is a common paediatric dermatological condition. Topical corticosteroids (TCS) are central to treatment, but non-adherence leads to poor outcomes and treatment failure. Parents commonly cite TCS phobia as an obstacle to treatment adherence. Dermatologists play a key role as clinician educators around the use, safety and efficacy of TCS. OBJECTIVES: To assess dermatologists' attitudes towards and experiences of the use and safety of TCS in managing paediatric atopic dermatitis (pAD). METHODS: All 455 practicing Australasian College of Dermatologists fellows in Australia were surveyed either when attending the May 2014 annual scientific meeting or via two subsequent emails. The survey assessed their attitudes towards the use and safety of TCS in treating pAD. RESULTS: Of 198 completed surveys, nearly all responders prescribed potent or super-potent TCS to treat pAD. The most common TCS side-effect cited by over two-thirds of respondents was peri-orificial dermatitis. Most stated that pharmacists were the most common source of misinformation leading to TCS phobia. Of the respondents, 75% strongly agreed that TCS do not cause skin atrophy when used appropriately and under clinical supervision. Furthermore, 77% agreed or strongly agreed that the words 'use sparingly' should be removed from pharmacist labels on TCS prescriptions. CONCLUSIONS: Dermatologists manage pAD with potent or super-potent TCS. Pharmacists are cited as the main contributor of misinformation leading to TCS phobia, supporting the removal of the words 'use sparingly' from prescription TCS. Most dermatologists believe TCS do not cause skin atrophy when used appropriately in pAD.

Pharmacists' knowledge about use of topical corticosteroids in atopic dermatitis: Pre and post continuing professional development education.

BACKGROUND/OBJECTIVES: Topical corticosteroids (TCS) are the standard of care in paediatric atopic dermatitis (pAD). Parents commonly cite TCS phobia as a major impediment to treatment adherence. Misinformation on TCS side-effects can impact on perceptions of TCS safety. We aimed to assess pharmacists' beliefs and information on the safety of TCS in pAD treatment and determine whether their beliefs could be modified. METHODS: Australian pharmacists attending a continuing professional development conference were assessed before and after an evidence-based lecture on the use of TCS in pAD. Responses were recorded in real time on electronic keypads. RESULTS: The mean response rate was 86% of the 292 surveyed. Of responders, 64% recognised that treatment non-adherence was a major reason for treatment failure in pAD. The post-education session assessment demonstrated a major attitude shift compared to the pre-education assessment. After education, pharmacists would instruct parents/patients to apply TCS until the eczema is clear (27 vs 92% pre and post-education, P < 0.0001). The proportion that would instruct patients to use TCS sparingly dropped from 54 to 8% (P < 0.0001). The belief that cutaneous atrophy was the commonest side-effect dropped from 46 to 7% (P < 0.0001). The belief that side-effects from TCS would occur, even if used appropriately, dropped from 56 to 11% post-education (P < 0.0001). CONCLUSIONS: The significant knowledge gaps about the use and safety of TCS in pAD in Australian pharmacists and their advice to patients potentially contributes to poor treatment concordance. These attitudes appear modifiable through targeted, evidence-based education delivered by a dermatologist.

A Case of Mistaken Identity? A Comparison of Professional and Amateur Problem Gamblers.

Professional gamblers are more likely than amateur gamblers to meet criteria for problem gambling but minimal research has examined their gambling behavior and its consequences. This study compared gambling behavior, problem gambling symptoms, related harms, recognition, and help-seeking among problem semi/professional gamblers (PPGs/PSPGs) and problem amateur gamblers (PAGs). Surveys completed by 57 self-identified professional gamblers, 311 semi-professional gamblers and 4226 amateur gamblers were analysed. PPGs/PSPGs were significantly more likely than PAGs to be male, younger, never married, speak a language other than English at home, and have higher psychological distress, compared to PAGs. PPGs/PSPGs were more likely to gamble more frequently on many skills-based forms, but most also participated in several chance-based forms. PPGs'/PSPGs' most common problematic gambling form was electronic gaming machines and they were more likely to have problems with sports betting than PAGs. Most PPGs/PSPGs reported coming out behind on all gambling forms over the previous year. PPGs/PSPGs were more likely than PAGs to report chasing losses and numerous detrimental financial gambling consequences. This group's self-identification as PPGs/PSPGs is clearly inaccurate and perhaps a means to avoid stigma, elevate status and support problem denial. PPGs/PSPGs may represent an extreme example of gamblers with erroneous cognitions and beliefs who lack the required discipline and skill to be successful professional gamblers. The findings identify a group of problem gamblers who may benefit from interventions to dispel their mistaken self-identity, and emphasize the need for more rigorous confirmation of professional gambler status in future research.

Greater involvement and diversity of Internet gambling as a risk factor for problem gambling.

BACKGROUND: Concerns that Internet gambling has elevated the prevalence of problem gambling have not been substantiated; however, evidence suggests a subgroup of Internet gamblers do experience higher rates of gambling harms. Greater overall involvement in gambling appears to be predictive of harms. The purpose of this study was to examine differences between Internet gamblers with a single or multiple online gambling accounts, including their gambling behaviours, factors influencing their online gambling and risk of experiencing gambling problems. METHODS: Internet gamblers (3178) responding to an online survey that assessed their gambling behaviour, and use of single or multiple online gambling accounts. RESULTS: Results revealed that multiple account holders were more involved gamblers, gambling on more activities and more frequently, and had higher rates of gambling problems than single account holders. Multiple account holders selected gambling sites based on price, betting options, payout rates and game experience, whereas single account holders prioritized legality and consumer protection features. CONCLUSION: Results suggest two different types of Internet gamblers: one motivated to move between sites to optimize preferred experiences with a tendency to gamble in a more volatile manner; and a smaller, but more stable group less influenced by promotions and experiences, and seeking a reputable and safe gambling experience. As the majority of Internet gamblers use multiple accounts, more universal responsible gambling strategies are needed to assist gamblers to track and control their expenditure to reduce risks of harm.

Characteristics and help-seeking behaviors of Internet gamblers based on most problematic mode of gambling.

BACKGROUND: Previous studies of problem Internet gamblers have failed to distinguish whether their problem gambling relates to Internet or land-based gambling modes. Therefore, characteristics and help-seeking behaviors of people whose gambling problems relate specifically to Internet gambling are unknown, but could inform the optimal alignment of treatment and support services with the needs and preferences of problem gamblers. OBJECTIVE: This study aimed to compare (1) characteristics of problem Internet gamblers and problem land-based gamblers and (2) uptake of different types and modes of help between problem Internet gamblers and problem land-based gamblers. Hypothesis 1 was that problem Internet gamblers are less likely to seek help. Hypothesis 2 was that problem Internet gamblers are more likely to use online modes of help. METHODS: A sample of 620 respondents meeting criteria for problem gambling was drawn from an online survey of 4594 Australian gamblers. Respondents were recruited through advertisements on gambling and gambling help websites, Facebook, and Google. Measures consisted of gambling participation; proportion of gambling on the Internet; most problematic mode of gambling; help seeking from 11 different sources of formal help, informal help, and self-help for gambling problems; psychological distress (Kessler 6); problem gambling severity (Problem Gambling Severity Index, PGSI); and demographics. RESULTS: Problem Internet gamblers were significantly more likely than problem land-based gamblers to be male (χ(2) 1=28.3, P<.001, φ=0.21), younger (t616.33=4.62, P<.001, d=0.37), have lower psychological distress (χ(2) 1=5.4, P=.02, φ=0.09), and experience problems with sports and race wagering (χ(2) 4=228.5, P<.001, φ=0.61). Uptake of help was significantly lower among problem Internet compared to problem land-based gamblers (χ(2) 1=6.9, P<.001, φ=0.11), including from face-to-face services, gambling helplines, online groups, self-exclusion from land-based venues, family or friends, and self-help strategies. Both problem Internet and problem land-based gamblers had similarly low use of online help. However, problem land-based gamblers (37.6%, 126/335) were significantly more likely to have sought land-based formal help compared to problem Internet gamblers (23.5%, 67/285; χ(2) 1=14.3, P<.001, φ=0.15). CONCLUSIONS: The findings suggest that more targeted and innovative efforts may be needed to increase use of gambling help by problem Internet gamblers. Alternatively, their lower PGSI and K6 scores suggest Internet problem gamblers may have less need for gambling-related help. This is the first known study to classify problem Internet gamblers as those whose problem gambling specifically relates to Internet gambling. Further research is needed to better understand why help-seeking rates are lower among Internet problem gamblers.

Dopaminergic Medication in Parkinson's Disease and Problem Gambling.

Studies on Parkinson's disease patients on dopaminergic medication report elevated rates of problem gambling. Results suggest changes in gambling behaviour are associated with the commencement and termination of dopaminergic medication implying a direct causal relationship. However, previous reports have not controlled for possible factors independent of dopamine medication contributing to the onset of problem gambling. This study aimed to explore the temporal relationships between problem gambling and dopamine medication taking into account premorbid gambling risk factors in a sample of Parkinson's disease patients. Twenty patients with Parkinson's disease meeting criteria for moderate risk or problem gambling were compared to twenty patients with Parkinson's disease who did not meet such criteria. The cross-sectional research design compared between group qualitative and quantitative differences. Participants completed an in-depth interview and timeline follow back, and battery of psychometric measures assessing impulsivity, gambling status, affective states, and obsessionality. Results revealed a complex and varied temporal relationship between dopaminergic medication onset and gambling. A small number of participants manifested excessive gambling following dopaminergic medication, with some ceasing on reduction in dosage or change in agonist class. Many demonstrated a range of individual and situational characteristic similar to problem gamblers in the general population, and in older adults with gambling problems. The obtained results provide a better understanding of the role of dopaminergic medication in problem gambling. Such findings have theoretical relevance to the reward deficiency model of gambling and have implications for the treatment of pathological gambling in PD and the general community.

What's in a Name? Assessing the Accuracy of Self-identifying as a Professional or Semi-Professional Gambler.

Growing interest in pursuing a professional gambling career has been accompanied by a rise in individuals self-identifying as professional gamblers. Whether this trend reflects an actual increase in individuals sustaining livelihoods from gambling or inaccurate appropriation of a now glamorized identity is unclear. Adopting a self-image of professional gambler in the absence of ability to earn a sustainable income from the activity may increase risk of problem gambling and deter help-seeking. However, extent of problem gambling in this cohort is uncertain. This study aimed to: (1) determine any differences that might validate the self-reported identity of professional and semi-professional gamblers by investigating characteristics and behaviors that distinguish them from amateur gamblers; and (2) identify characteristics and behaviors that distinguish between self-identified semi-professional/professional gamblers with and without gambling problems. In an online survey of 4,594 Australian gamblers, 1.2% identified as professional gamblers, 6.8% as semi-professional gamblers, and 92.0% as amateur gamblers. Self-identified professional and semi-professional gamblers were distinguished from amateur gamblers by preference for skill-based gambling, higher reported likelihood of winning, and greater use of online gambling and multiple online operators. Two-fifths of professional and three-fifths of semi-professional gamblers scored as moderate risk or problem gamblers, but negative consequences were more likely personal, interpersonal and work/study related, rather than financial. Although results support the general accuracy of self-reported semi/professional gambling status, measures are needed to help semi/professional gamblers distinguish whether their gambling is a problem or profession.