Reaching Out to Big Losers: How Different Types of Gamblers are Affected by a Brief Motivational Contact Initiated by the Gambling Provider.

Telephone and letter-based motivational interventions with high expenditure gamblers have significant short and long term positive effects on gambling and use of responsible gambling tools. This report examines how different subtypes of gamblers, based upon patterns of play, are differentially affected. A randomized controlled trial design with three conditions (n = 1003 in each): feedback intervention by letter, telephone or a no-contact control condition. Subtypes of gamblers were derived by latent class analyses (LCA) based upon gambling behavior pre intervention. The participants were customers of Norsk Tipping gambling platforms. 1003 statistical triplets from the top 0.5% of customers based upon annual expenditure, matched on sex, age, and net losses. Primary outcome measure was gambling theoretical loss (TL), derived from the Norsk Tipping customer database. The LCA identified six subtypes: High Casino, High Sport, High Lottery, High Video lottery terminal (VLT), Lottery/Mix and Bingo/Casino. There were almost no differences in change in TL between the six subtypes of gamblers receiving the letter or telefone interventions respectively. However, the choice of contact by letter or telephone did have different effects for the different gambling subtypes. Sending a letter seems like a cost effective alternative to telephone contact for the High Lottery type, but telephone contact performs better for High Casino, High Sport and High VLT customers. Responsible gambling interventions can be improved by subtyping of gamblers.

GamTest: Psychometric Evaluation and the Role of Emotions in an Online Self-Test for Gambling Behavior.

Recent increases in the number of online gambling sites have made gambling more available, which may contribute to an increase in gambling problems. At the same time, online gambling provides opportunities to introduce measures intended to prevent problem gambling. GamTest is an online test of gambling behavior that provides information that can be used to give players individualized feedback and recommendations for action. The aim of this study is to explore the dimensionality of GamTest and validate it against the Problem Gambling Severity Index (PGSI) and the gambler's own perceived problems. A recent psychometric approach, exploratory structural equation modeling (ESEM) is used. Well-defined constructs are identified in a two-step procedure fitting a traditional exploratory factor analysis model as well as a so-called bifactor model. Using data collected at four Nordic gambling sites in the autumn of 2009 (n = 10,402), the GamTest ESEM analyses indicate high correspondence with the players' own understanding of their problems and with the PGSI, a validated measure of problem gambling. We conclude that GamTest captures five dimensions of problematic gambling (i.e., overconsumption of money and time, and monetary, social and emotional negative consequences) with high reliability, and that the bifactor approach, composed of a general factor and specific residual factors, reproduces all these factors except one, the negative consequences emotional factor, which contributes to the dominant part of the general factor. The results underscore the importance of tailoring feedback and support to online gamblers with a particular focus on how to handle emotions in relation to their gambling behavior.

Reaching out to big losers: Exploring intervention effects using individualized follow-up.

OBJECTIVE: Previous research suggests that a brief duty-of-care telephone call to high expenditure customers was associated with lower gambling over the subsequent year. The current aim was to assess effects on individual trajectories rather than overall group effects reported previously. The objective was to identify different patterns of individual change over the follow-up year and explore differential responses of subgroups of individuals. METHOD: A matched pair design contrasting the outcome for telephone intervention with a no-intervention control condition. Five hundred and ninety-six statistical pairs randomly drawn from the top 0.5% of customers based upon annual expenditure at Norsk Tipping, Norway. Primary outcome measure was gambling theoretical loss (TL), derived from the Norsk Tipping gambling data warehouse. Player trajectories across time were identified using growth mixture modeling to assess differential intervention effects on homogenous subgroups of individuals. RESULTS: Relatively low, medium, and high TL subgroups were identified. The telephone intervention was associated with greater reductions than the control condition for all three subgroups but showed the strongest effect for the subgroup with the highest TL. The intervention was most effective for casino and sport gamblers, male, young, and middle-aged. CONCLUSIONS: A brief duty of care telephone contact with high expenditure customers showed sustained effects over 12 months, in particular for individuals showing the highest level of TL. Examining trajectories using advanced statistical models identified customer characteristics most strongly associated with reduced TL. These findings can guide prevention strategies with evidence-based knowledge about differential effects. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Game Addiction Scale for Adolescents-Psychometric Analyses of Gaming Behavior, Gender Differences and ADHD.

Background: Internet gaming disorder (IGD) was recently added in the Diagnostic and Statistical Manual of Mental Disorder as a "condition for further studies." There is no consensus regarding which rating scales should be used but many scholars suggest the GASA (Game Addiction Scale for Adolescents) and a ranking of the criteria, "the core approach" to avoid over-diagnosing of disordered gaming. Male gender and ADHD are commonly listed as risk factors for disordered gaming but little is known about sex differences in gaming and gender specific health correlates. Purpose: The present study aims to evaluate the core approach and the specific indicators of gaming behavior in GASA from a multifactorial perspective and explore the gender differences in a clinical setting, focusing on ADHD. Patients and Methods: Children and adolescents aged 8-18 years (n = 144) from Child and adolescent psychiatry (CAP) in Skane were assessed with the GASA. Psychometric analyses including confirmatory factor analyses (CFA) and structural equation modeling (SEM) were used to identify well-defined constructs and gender differences. Refined factor scores for single constructs were the outcome of alignment, a procedure for assessing measurement equivalence across gender. New model-based gaming behavior variables were used for descriptive statistics and ANOVA testing of gender differences. Results: The results confirm that the core approach two-factor model is valid for the CAP sample, as well as a theory based psycho-social model for gaming behavior with over consumption and negative social and emotional consequences. Our findings suggest that negative consequences of over consumption take a social direction for boys and an emotional direction for girls. Also, ADHD was significantly associated with over consumption of video games and the negative consequences thereof for girls. Conclusion: Guided by psychometric analyses, the GASA could be strengthened by advancing the questionnaire design and by adding complementary items in order to illuminate the complexity of gaming behavior. Our findings suggest that additional research on potential gender related discrepancies of disordered gaming is needed.

A quick and simple screening method for pathological and problem gamblers in addiction programs and practices.

Despite high rates of comorbidity among pathological gambling, substance use disorders, and other psychiatric conditions, health professionals rarely screen their clients for gambling problems. We report on the performance of the NODS-CLiP, an existing brief, three-item screen for problem and pathological gambling, and an alternative four-item screen that demonstrates improved sensitivity, good positive and negative predictive power, and invariance across key demographic groups . Given the high rates of comorbidity, routine and accurate identification of gambling-related problems among individuals seeking help for substance abuse and related disorders is important. The original and the alternative brief screens are likely to be useful in a range of clinical settings.

Reaching out to big losers leads to sustained reductions in gambling over 1 year: a randomized controlled trial of brief motivational contact.

BACKGROUND AND AIMS: A previous randomized controlled trial demonstrated that telephone- and letter-based motivational interventions with high-expenditure gamblers had significant short-term positive effects on gambling and use of responsible gambling tools. This post-trial follow-up examined outcomes in gambling expenditure over 12 months. DESIGN: Observational study following a three-arm randomized controlled trial. SETTING: Customers of Norsk Tipping (NT) gambling platforms, Norway. PARTICIPANTS: A total of 1003 statistical triplets from the top 0.5% of customers based upon annual expenditure, matched on sex, age and net losses. Mean age was 53.4 years; 19% were women, mean yearly loss for 2016 was 88 197 NoK. Interventions and comparator Feedback intervention by telephone, letter or a no-contact control condition. MEASUREMENTS: Primary outcome measure was gambling theoretical loss, derived from the NT customer database. Secondary outcomes were responsible gambling customer actions and whether or not the participant was retained as an NT customer. FINDINGS: Per-protocol analyses of triplets who received the telephone call or letter as randomly assigned (n = 596) showed a positive and sustained effect over 12 months: the telephone group showed a 30% reduction in theoretical loss (d = 0.44) and the letter group 13% (d = 0.18), both outperforming the control group with a 7% reduction (d = 0.11). The telephone condition was superior to both the letter and control conditions in per-protocol (P < 0.001) and to control condition in intention-to-treat analyses (ITT) (P < 0.001). Individuals in the telephone condition took more responsible gambling actions. The letter condition had better outcomes than the control in the ITT-only analysis (P < 0.001). More than 93% were still customers a year after the intervention. CONCLUSIONS: Personal contact with high-expenditure gambling customers in Norway that provided individualized feedback on expenditures was associated with reduced theoretical losses and greater use of responsible gambling tools over a 12-month period, compared with no contact. Telephone intervention with customers had a larger impact than a mailed letter.

Reaching out to big losers: A randomized controlled trial of brief motivational contact providing gambling expenditure feedback.

Gambling disorder is a public health issue in many countries, and expectations that the gambling industry protects individuals from harm are increasing. The primary objective of this study was to investigate the effects of providing personalized feedback on gambling intensity among high consumers of venue-based and online gambling in Norway. A randomized controlled trial design was used to evaluate how behavioral feedback by telephone or letters sent via surface mail affects subsequent gambling expenditure and use of responsible gambling tools and whether a follow-up contact increases the effect. Gambling expenditure, the primary outcome, was measured using theoretical loss, which is the actual cost to the player, adjusted for the house advantage. From the top .5% of customers based upon annual expenditure, a sample of 1,003 statistical triplets, matched on sex, age, and net losses, were randomly assigned to the feedback intervention by telephone, letter, or a no-contact control condition. Participants assigned to the phone call or letter were also randomly assigned to receive or not receive a subsequent follow-up contact. The results showed that over 12 weeks, theoretical loss decreased 29% for the phone and 15% for the letter conditions, compared with 3% for the control group. A positive effect of the follow-up contact was limited to participants who at the initial call indicated an interest in receiving a follow-up call. Contacting high consumers about their gambling expenditure appears to be an effective method for gambling companies to meet their duty to care for customers. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Acceptance and commitment therapy for clients institutionalized for severe substance-use disorder: a pilot study.

BACKGROUND: Individuals with substance-use disorder (SUD) often have co-occurring mental health disorders and decreased executive function, both of which are barriers to sustained rehabilitation. Clients with severe SUD can be institutionalized in The Swedish National Board of Institutional Care but are difficult to engage and dropout rates remain high. Recent studies suggest that acceptance and commitment therapy (ACT) is an effective treatment for mental health and SUD. OBJECTIVES: The overall aims of the present pilot study were to explore a manual-based ACT intervention for clients institutionalized for severe SUD and to describe the effects on mental health, psychological flexibility, and executive function. This pilot study is the first to use a manual-based ACT intervention within an inpatient context. METHODS: Eighteen participants received a seven-session ACT intervention tailored for SUD. Statistical analyses were performed for the complete data (n=18) and on an individual level of follow-up data for each participant. In order to follow and describe changes, the strategy was to assess the change in 13 clinical scales from pre-intervention to post-intervention. RESULTS: Results suggested that there was no change in mental health and a trend implying positive changes for psychological flexibility and for 9 of 10 executive functions (e.g., inhibitory control, task monitoring, and emotional control). CONCLUSION: The pilot study suggests clinical gains in psychological flexibility and executive functions both at the Institution regulated by the Care of Alcoholics and Drugabuser Act (also known as LVM home) and at the individual level. Since the sample size does not provide adequate statistical power to generalize and to draw firm conclusions concerning intervention effects, findings are descriptive and preliminary in nature. Further development and implementation of ACT on a larger scale study, including the maintenance phase and a follow-up, is needed.