Clinical Correlates of Sports Betting: A Systematic Review.

Sports betting is becoming increasingly widespread, and a growing number of individuals, both adolescents and adults, participate in this type of gambling. The main aim of this systematic review was to assess correlates of sports betting (sociodemographic features, gambling-related variables, co-occurring psychopathologies, and personality tendencies) through a systematic review conducted following the PRISMA guidelines. Relevant studies were identified via searches of NCBI/PubMed and APA PsycInfo databases. Individuals from the general population and/or with a clinical diagnosis of gambling disorder (GD) were included, irrespective of gender and age. In addition, the studies needed to have administered at least one clinical interview/psychometric instrument to assess the presence of problematic gambling/GD, contain at least one group of participants with sports betting, and directly analyze the association between sports betting and any of the following features: sociodemographics, gambling-related variables, co-occurring psychopathologies, and/or personality tendencies. Fifty-four articles were included. Multiple sociodemographic variables have been studied in relation to sports betting. In general, males with high impulsivity have greater tendencies for sports betting. The co-occurrence of certain pathologies, especially substance use or other addictive disorders, was also suggested. Most studies were cross-sectional, assessed participants using self-administered instruments, recruited samples using non-probability online panels, included small samples, had unbalanced samples, and included samples from only one country. Impulsive males may be particularly prone to sports gambling and related problems. Future research should examine prevention strategies that may help prevent the development of sport-betting-related GD and other addictive behaviors in vulnerable individuals.

From one year to the next: Video gaming life-style predicts subsequent psychosocial risk in adolescent boys and girls.

AIM: The ubiquitous societal presence of screens and gaming software is ever growing in popularity. However, can this recreational life-style pose risks for children's psychosocial adjustment? We thus examine associations between gaming life-style and later psychosocial development. METHODS: The study sample originates from the 2120 boys and girls from the Quebec Longitudinal Study of Child Development birth cohort. At age 12, 625 boys and 702 girls from the original sample self-reported the number of hours engaged in video gaming per week and 1 year later, they self-reported psychosocial outcomes. RESULTS: Among boys, higher weekly video gaming frequency at age 12 forecasted increases in subsequent reactive aggression, emotional distress and ADHD symptoms at age 13. For girls, higher weekly video gaming frequency at age 12 predicted increases in subsequent reactive aggression and ADHD symptoms at age 13. No association between video game use and emotional distress was found for girls. CONCLUSION: In both boys and girls, a more intense video gaming life-style predicted subsequent risks for reactive aggression and ADHD symptoms, compared with their same sex counterparts reporting less intensity. For boys only, video gaming was associated with subsequent reactive emotional distress, likely due to the gender differences in violent content. Our data were collected at a time when there were less versatile screen-based technologies; therefore, our findings can be interpreted as very conservative compared to current estimates. Paediatric professionals and allied disciplines must take preventive measures to ensure that parents are aware of the risks associated with excessive use by their sons and daughters.

What Contributes to Public Stigma Towards Problem Gambling?: A Comparative Analysis of University Students in Australia, Canada, Croatia and Israel.

Stigma refers to the attribution of negative sentiments towards a particular entity, object or individual. Stigma can be public, perceived, or self-referential and can have negative consequences for individuals, including losses of self-esteem, self-efficacy, social isolation and a reluctance to seek help. Problem gambling is known to be a stigmatized activity, but less is known about what factors are associated with this perception and how it might vary in different countries. The current study examines the relationship between perceived stigma towards problem gamblers and gambling attitudes. perceptions of gambling regulations, gambling involvement, perceived accessibility to gambling, and exposure to people with gambling problems. The sample comprised 1787 university students aged 18-30 years from four countries: Australia, Canada, Croatia and Israel. The results indicated that greater perceived stigma was associated with more negative gambling attitudes, less engagement with gambling, and lower perceived social accessibility (the perception that others approve of the activity). Respondents from Croatia, the country with a newer gambling market, reported the most stigma towards problem gamblers as compared with Australia and Canada where gambling is longer established. The findings appear consistent with exposure-adaptation theory, in which tolerance towards people with problem gambling can develop over time in line with greater social acceptance or familiarity with the activity and its consequences. It is suggested that community campaigns and educational programs draw a distinction between attitudes towards gambling in general and those who are negatively affected by the activity.

Measuring Gambling Outcome Expectancies in Adolescents: Testing the Psychometric Properties of a Modified Version of the Gambling Expectancy Questionnaire.

The Gambling Expectancy Questionnaire (GEQ; Gillespie et al. 2007a) is a 23-item scale assessing three positive outcome expectancies (Enjoyment/Arousal, Money, Self-Enhancement) and two negative outcome expectancies (Over-Involvement, Emotional Impact) related to gambling. It is the most used instrument to assess gambling outcome expectancies in adolescents and it has good psychometric properties. To allow a greater and more useful application of the scale, the present study aimed to modify the GEQ to make it usable with all adolescents, regardless of their gambling behaviour and to verify its psychometric properties. To that aim, the items were modified and the response scale was reduced from a seven-point to a five-point Likert scale. To verify the adequacy of the modified scale, two studies were conducted among Italian adolescents. In the first study (n = 501, 75% males, Mage = 16.74, SD = .88), after having removed four items and relocating another through explorative factor analysis, the original five-factor structure of the scale was confirmed by applying a confirmatory factor analysis. Reliability and validity evidence were also provided. The second study (n = 1894, 61% males, Mage = 15.68, SD = .71) attested its invariance across gambling behaviour status and gender. The modified version of the GEQ (GEQ - MOD) can be profitably used for research and preventive purposes with youth.

Variations in Gambling Disorder Symptomatology Across Sexual Identity Among College Student-Athletes.

Gambling disorder has serious negative consequences for individual health and wellbeing, while being more prevalent among college student-athletes compared to the general college population. While previous research reports that sexual minority (i.e., gay, lesbian and bisexual) populations have higher rates of addictive behaviors such as alcohol and drug abuse, no previous research has explored risk for gambling disorder symptomatology by sexual identity status. The aim of the current study is to identify differences in the severity of gambling disorder symptomatology between sexual minority and heterosexual student-athletes. A stratified random sample of 19,299 National Collegiate Athletic Association college student-athletes participated in an anonymous survey assessing gambling disorder symptomatology. Student-athletes completed measures assessing their past 12-month problem gambling as measured by the DSM-5 diagnostic criteria for gambling disorder and provided information on their sexual identity. Gay and bisexual men had disordered gambling scores 3.42 times higher than heterosexual men (p < .01), when adjusting for race/ethnicity, and years in college. Gay/lesbian and bisexual women reported disordered gambling scores 2.57 higher than heterosexual women (p < .01) when adjusting for race/ethnicity and years in college. This is the first study to compare the prevalence of gambling disorder symptomatology across sexual identity status. The higher number of gambling disorder symptoms observed among sexual minorities in the current study underlines the need for more research on this topic, and supports the exploration of intervention efforts designed to better address problem gambling among sexual minority communities.

Which Diagnostic Criteria are Most Useful in Discriminating Between Social Gamblers and Individuals with Gambling Problems? An Examination of DSM-IV and DSM-5 Criteria.

The current study sought to identify which diagnostic criteria for gambling disorder have the greatest ability to differentiate between social and problem gamblers. This study was conducted on a sample of male and female college student athletes across the U.S. (n = 8674). Classification and regression tree analysis represents an appropriate technique when addressing the question of an item's diagnostic value, as it sequentially selects variables to isolate sets of observations with similar outcomes. The current results suggest that the item related to preoccupation ("Have there been periods in the past year where you spent a lot of time thinking about gambling?") was the DSM-5 item best able to differentiate between male and female social and problem gamblers in this sample. When considering only the nine criteria retained in the DSM-5, three criteria were identified as key for distinguishing between social and disordered gamblers among men, and one criterion was identified for distinguishing between groups of women. In addition, these results do not support the notion that the illegal acts criterion has a particularly low base rate and found that it can be an important indicator of disordered gambling in a college-aged sample.

Theory of Planned Behavior in School-Based Adolescent Problem Gambling Prevention: A Conceptual Framework.

Given its serious implications for psychological and socio-emotional health, the prevention of problem gambling among adolescents is increasingly acknowledged as an area requiring attention. The theory of planned behavior (TPB) is a well-established model of behavior change that has been studied in the development and evaluation of primary preventive interventions aimed at modifying cognitions and behavior. However, the utility of the TPB has yet to be explored as a framework for the development of adolescent problem gambling prevention initiatives. This paper first examines the existing empirical literature addressing the effectiveness of school-based primary prevention programs for adolescent gambling. Given the limitations of existing programs, we then present a conceptual framework for the integration of the TPB in the development of effective problem gambling preventive interventions. The paper describes the TPB, demonstrates how the framework has been applied to gambling behavior, and reviews the strengths and limitations of the model for the design of primary prevention initiatives targeting adolescent risk and addictive behaviors, including adolescent gambling.

Teacher awareness and attitudes regarding adolescent risky behaviours: is adolescent gambling perceived to be a problem?

Despite legislative prohibitions, there is empirical evidence that youth gamble on both regulated and unregulated activities. The current survey was designed to assess teachers' awareness and attitudes regarding adolescent gambling and other high-risk behaviours. Three-hundred and ninety teachers from Ontario and Quebec, with experience teaching students aged 12-18, completed an online survey. Results suggest that teachers are aware of the fact that youth gamble. Furthermore, they recognized the addictive nature of gambling and their subsequent consequences. Despite overestimating the proportion of youth experiencing gambling problems, gambling was viewed as being the least serious of issues affecting youth, with drug use and school violence topping the list. Almost half of respondents indicated that gambling in school can constitute a good learning activity. In regards to prevention, all other risky behaviours and academic problems were perceived as issues needing greater attention than gambling. These results, which are largely consistent with findings from a previous study examining parental perceptions of adolescent risky behaviours, suggest a need for greater awareness and teacher education.

Youth aggressive/disruptive behavior trajectories and subsequent gambling among urban male youth.

This study examines the association between aggressive/disruptive behavior development in two distinct developmental periods-childhood (i.e., Grades 1-3) and early adolescence (i.e., Grades 6-10)-and subsequent gambling behavior in late adolescence up to age 20. The sample consists of 310 urban males of predominately minority and low socioeconomic status followed from first grade to late adolescence. Separate general growth mixture models were estimated to explore the heterogeneity in aggressive/disruptive behavior development in the aforementioned two periods. Three distinct behavior trajectories were identified for each period: a chronic high, a moderate increasing, and a low increasing class for childhood, and a chronic high, a moderate increasing, followed by decreasing and a low stable class for early adolescence. There was no association between childhood behavior trajectories and gambling involvement. Males with a moderate behavior trajectory in adolescence where two times more likely to gamble compared to those in the low stable class (OR = 1.89, 95% CI = 1.11, 3.24). Those with chronic high trajectories during either childhood or early adolescence (OR = 2.60, 95% CI = 1.06, 6.38; OR = 3.19, 95% CI = 1.18, 8.64, respectively) were more likely to be at-risk/problem gamblers than those in the low class. Aggressive/disruptive behavior development in childhood and early adolescence is associated with gambling and gambling problems in late adolescence among urban male youth. Preventing childhood and youth aggressive/disruptive behavior may be effective to prevent youth problem gambling.

Problem gambling in adolescents: an examination of the pathways model.

This research tests the applicability of the Integrated Pathways Model for gambling to adolescent problem gamblers, utilizing a cross-sectional design and self-report questionnaires. Although the overall sample consisted of 1,133 adolescents (Quebec: n = 994, 87.7 %; Ontario: n = 139, 12.3 %: Male = 558, 49.5 %; Female = 569, 50.5 %), only problem gamblers were retained in testing the model (N = 109). Personality and clinical features were assessed using the Millon Adolescent Clinical Inventory, attention deficit hyperactivity (ADHD) using the Conners-Wells' Adolescent Self-Report Scale, and the DSM-IV-MR-J and Gambling Activities Questionnaire to determine gambling severity and reasons for gambling. Latent class analysis concluded 5 classes, yet still provided preliminary support for three distinct subgroups similar to those proposed by the Pathways Model, adding a depression only subtype, and a subtype of problem gamblers experiencing both internalizing and externalizing disorders. ADHD symptoms were found to be common to 4 of the 5 classes.

Understanding adolescent esports bettors: Are they a homogeneous group?

With the rapid rise of competitive video gaming (esports), increased attention has been placed on understanding the profiles of youth who wager on esports. With adolescents being at increased risk of gambling problems and endorsing high rates of past year engagement in video games, there is a need for research investigating psychological and social correlates of adolescent esports bettors and to identify whether youth who engage in esports betting are a homogenous group. Survey responses were collected from 5,997 high-school students (48.4 % male, Mage = 14.7 years [SD = 1.6], age range 12-17) from Wood County, Ohio, United States. A latent class analysis was conducted to identify subgroups of esports bettors based on self-reported measures of gambling frequency, risk for problem gambling, gaming frequency, disordered gaming, preference for virtual life and risky loot box use. Results indicated that 5.5 % of the sample reported esports betting over the past year. Four classes of esports bettors were identified which were indicative of a group of low-risk esports bettors, a group of esports bettors at risk of gaming problems, a group of esports bettors at risk of gambling problems, and a group of esports bettors at high risk of both gambling and gaming problems. Although no significant differences based on sex and age were noted between the classes, differences were noted in experienced childhood adversity, mental health symptoms and problem behavior severity. Results are discussed in line with previous findings relevant to adolescent and adult esports betting.

Gambling and adverse life events among urban adolescents.

This study explored the cross sectional association between adverse life events and gambling in a sample of 515 urban adolescents (average age 17, 55% male, 88% African American). Approximately half of the sample had gambled in the past year (51%); 78% of the gamblers gambled monthly and 39% had a gambling-related problem. On the other hand, 88% of the sample had experienced at least one life event in the past year, and those experiencing events tended to live in more disadvantaged neighborhoods. The mere acknowledgement of experiencing a stressful life event in the past year (yes/no) was not associated with an increase in odds of being a gambler, with gambling more frequently, or with having a gambling problem. However, when the context of the event was considered, an association was found between directly experiencing threatening and deviant/violent types of events and frequent gambling (OR > 2). Additionally, the probability of being a gambler increased as the number of events experienced increased (aOR = 1.07, 95% CI = 1.01, 1.13, P = 0.013), but problems among gamblers were not associated with the number of events experienced (aOR = 1.01, 95% CI = 0.92, 1.11, P = 0.876). During adolescence, life events appear to be connected more with the frequency of gambling rather than with problems related to gambling.

Sports-betting-related gambling disorder: Clinical features and correlates of cognitive behavioral therapy outcomes.

BACKGROUND AND AIMS: The number of patients with gambling disorder (GD) whose gambling preference is sports betting is increasing. However, their clinical profile and their responses to psychological treatments -compared to patients with other forms of gambling- have not been thoroughly studied. Therefore, the aims of this study were: (1) to compare the clinical characteristics of GD patients whose primary gambling activity was sports betting (SB+; n = 113) with GD patients with other primary gambling activities (SB-; n = 1,135); (2) to compare treatment outcomes (dropout and relapses) between SB + and SB- patients; and (3) to explore relationships between specific variables (GD severity, psychological distress and personality features) and treatment outcome in SB + and SB- GD patients, through correlation models and path-analysis. METHODS: The cognitive behavioral treatment consisted of 16 weekly sessions. Personality features, psychopathology, and sociodemographic and clinical factors were assessed. RESULTS: The SB + group included higher proportions of younger patients who were single and had higher educational levels, older ages of GD onset, and greater GD severities. Regarding treatment outcomes, the dropout rate was lower in the SB + group, and no between-group differences were found regarding relapse. Dropout within the SB + group was related to being unemployed, and relapse was related to being unmarried and experiencing more psychological distress. DISCUSSION AND CONCLUSION: The differences between SB + and SB- GD patients suggest that GD patients with sports-betting problems may benefit from tailored therapeutic approaches.

Sexual risk-taking behaviors, gambling, and heavy drinking among U.S. College athletes.

The purpose of this study was to empirically examine the prevalence patterns of sexual risk-taking behaviors (i.e., unprotected sex and having multiple sex partners) in relation to levels of gambling problems and heavy episodic drinking (HED) status among U.S. college athletes. Data from a representative national sample of 20,739 U.S. college athletes were derived from the first National Collegiate Athletic Association national survey of problem gambling and health-risk behaviors. Among college athletes who were sexually active during the past year, males reported significantly higher prevalence of unprotected sex (10.2%) and multiple sex partners (14.6%) than females (7.9% and 9.3%, respectively). Using the DSM-IV Gambling Screen classification, as the level of gambling severity increased, the prevalence of sexual risk-taking behaviors also increased among female athletes, but decreased among male athletes. As regards the effect of heavy drinking, while both male and female HED athletes reported elevated sexual risk-taking, the effect of HED was twice as large in females as in males. It is important to note that the definitions of sexual risk behaviors in this study took into account committed sexual relationship status; hence, the results of this study need to be interpreted with the refined sexual risk measures in mind. Further investigations are warranted to help us better understand and explicate the interrelationships of sexual risk-taking behaviors, gambling, and heavy drinking among these college athletes. Findings from this exploratory study suggest new directions for future research and practice and also highlight the importance of a more inclusive multi-component approach to address these co-occurring youth risk behaviors.

Does early emotional distress predict later child involvement in gambling?

OBJECTIVE: Younger people are engaging in gambling, with some showing excessive involvement. Although a consequence of gambling could be anxiety and depression, emotional distress could be a precursor to gambling involvement. This could reflect developmental proneness toward problem behaviour. We assessed whether early emotional distress directly influences later gambling or if it operates through an indirect pathway. METHODS: Using a prospective longitudinal design, an intentional subsample of children from the 1999 kindergarten cohort of the Montreal Longitudinal Preschool Study (Quebec) from intact families were retraced in 2005 for follow-up in Grade 6. Consenting parents and children were separately interviewed. Key child variables and sources included kindergarten teacher ratings of emotional distress and impulsivity and self-reported parent and child gambling. RESULTS: Higher levels of teacher-rated emotional distress in kindergarten significantly predicted a higher propensity toward later gambling behaviour. Impulsivity, a factor often comorbidly present with emotional distress, completely explained this predictive relation above and beyond potential child- and family-related confounds, including parental gambling. CONCLUSIONS: Children with higher levels of emotional distress at kindergarten were more inclined toward child gambling behaviour in Grade 6. The influence of early emotional distress completely vanished when behaviours reflecting impulsivity were considered when predicting later child gambling behaviour. The relation between emotional distress and child gambling involvement in children was thus explained by its comorbidity with early impulsivity. This study does not rule out the possibility that emotional distress could become a correlate or consequence of excessive involvement in gambling activities at a later developmental period.

Risk and protective factors associated with youth problem gambling.

Risk factors for youth gambling problems are best understood within an ecological model recognizing the interwoven relationship that exists between the individual and their environment. Empirical studies covering individual, relationship, community, and societal factors associated with adolescent gambling problems are reviewed. The cumulative body of research suggests that males who are exposed to gambling at an earlier age are at greater risk of developing gambling problems. Individuals who report poor family cohesion, have family members or friends who also gamble, and those exposed to and engaged in a wider variety of gambling options are at greater risk. Adolescents with impulsive, high sensation-seeking personalities and exhibit emotion-focused coping styles are more likely to experience gambling problems. Anxiety, depression, ADHD, poor academic performance, substance use, and delinquency are also strong predictors. Many of these risk factors appear to predict a general behavior syndrome encompassed by overall mental health problems, substance abuse, delinquency, and problem gambling. Increased exposure to gambling opportunities and marketing of gambling is recognized as a potential risk factor at a community level while gambling-permissive cultures may instill positive attitudes and beliefs toward gambling. A call is made for more research that can identify the causal risk factors that lead to gambling problems among youth which will ultimately improve our prevention efforts.

Two Lifestyle Risks Intertwined: Parental Smoking Predicts Child Gambling Behavior at Age 12 Years.

BACKGROUND: Parental smoking can create a toxic environment for child development. A parental smoking lifestyle can predispose children to executive deficits, influencing precocious risk activities. Using a prospective birth cohort design, we examine the association between 2 lifestyle factors by estimating the relative contribution of long-term parental household smoking in predicting subsequent precocious child gambling behavior. METHOD: Parents reported on the amount of household smoke exposure from ages 1.5 to 7.5 years for children from the Quebec Longitudinal Study of Child Development. The main outcome measure was children's self-report of gambling behavior (at age 12 years). RESULTS: Sixty percent of parents reported that their children were never exposed to secondhand smoke in the home, while 27% and 13% reported transient and continuous levels of secondhand smoke, respectively. Overall, 16% of children reported gambling participation. When compared with never-exposed children, children exposed to secondhand smoke had 18% more chances of having participated in gambling at age 12 years (odds ratio = 1.18; 95% CI = 1.080-1.293). These results are adjusted for competing explanations and possible individual and family confounders. CONCLUSIONS: Higher levels of early childhood household smoke exposure are associated with greater odds of reporting gambling participation at age 12 years, which is more than several years before it is normative youthful behavior. By connecting the neurotoxic influence of one lifestyle factor on another, we show a nontrivial link between 2 public health issues (smoke exposure and precocious gambling) associated with considerable individual and societal costs that are amenable to community information campaigns.

Emotion regulation interacts with gambling motives to predict problem gambling among emerging adults.

BACKGROUND: It is presently estimated that as much as 10% of emerging adults are at risk for a gambling disorder. The consequences stemming from problematic gambling engagement include increased substance use, mental health disorders, suicidality, financial strain and legal issues. The present study explores whether deficits in specific dimensions of emotion regulation coupled with the motivation to escape negative emotions (i.e., coping motives) increases the likelihood of problem gambling severity, while controlling for variables such as gambling frequency, age, and sex. METHODS: A sample of 919 emerging adult gamblers (Mage = 21.16 years-old, SD = 2.90, 48.1% female) completed an online survey including an assessment of problematic engagement in gambling over the past year, gambling motivations, and difficulties in emotion regulation. In total, 15.2% and 8.1% of this sample were at moderate or high risk for gambling disorder. RESULTS: A series of six moderation analyses revealed that the total models accounted for approximately 37-38% of the variance in problem gambling and that coping motives interacted with less difficulties engaging in goal-directed behavior, increased lack of emotional clarity, and increased lack of emotional awareness to create a toxic mixture for problem gambling. CONCLUSIONS: These findings reveal the importance of considering both psychological factors such as emotion regulation and motivational factors in understanding who is at greatest risk for gambling problems.

Exploring Differences Among Video Gamers With and Without Depression: Contrasting Emotion Regulation and Mindfulness.

Video games are a leisure activity with mass appeal for individuals of all ages. However, for some individuals, playing video games may become problematic and addictive, resulting in negative consequences affecting their physical, social, and psychological well-being. Internet gaming disorder (IGD) has estimated prevalence rates of around 3 percent and has been strongly associated with several psychopathologies, including depression. Given that emotion regulation (ER) and mindfulness are fluid constructs that can be enhanced, the potential for intervention and prevention is considerable. Thus, this study sought to, as a first step in determining clinical relevance, explore the differences in ER, mindfulness, and impulsivity among emerging adult gamers who met criteria for IGD, depression, or both IGD and depression (Dep + IGD). A sample of 1,536 gamers (45 percent male, Mage = 20.45 years old) completed an online survey, including an assessment for IGD, depression, difficulties with ER, impulsivity, and mindfulness. Relative to individuals below IGD and depression cutoffs (control), the clinical groups (IGD, depression, and Dep + IGD) reported greater ER difficulties, higher impulsivity, and lower mindfulness. Finally, relative to the IGD + depression group, the other two clinical groups had fewer difficulties with cognitive impulsivity, whereas the depression group reported more difficulties with strategy use. These results suggest that gamers should be considered a heterogeneous group and that comorbid disorders are important considerations when developing targeted treatments for individuals with IGD.

Behavioral Addictions: Excessive Gambling, Gaming, Internet, and Smartphone Use Among Children and Adolescents.

The introduction of behavioral addictions is a relatively new concept in psychiatry. It was not until 2010 that the term behavioral addictions was added to the official classification of psychiatric diagnoses in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Gambling, typically thought to be an adult behavior, has become commonplace among adolescents. Although technological advances have made accessing information and communication easier, excessive use of the Internet and smartphones can result in multiple mental and physical health issues. Gambling disorders, gaming disorders, Internet use disorder, and excessive smartphone use often begin during childhood and adolescence.