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- Author or Editor: Nicki A Dowling x
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Background and aims
To date, no systematic approach to identifying the content and characteristics of psychological interventions used to reduce gambling or problem gambling has been developed. This study aimed to develop a reliable classification system capable of identifying intervention characteristics that could, potentially, account for greater or lesser effectiveness.
Methods
Intervention descriptions were content analyzed to identify common and differentiating characteristics. A coder manual was developed and applied by three independent coders to identify the presence or absence of defined characteristics in 46 psychological and self-help gambling interventions.
Results
The final classification taxonomy, entitled Gambling Intervention System of CharacTerization (GIST), included 35 categories of intervention characteristics. These were assigned to four groups: (a) types of change techniques (18 categories; e.g., cognitive restructuring and relapse prevention), (b) participant and study characteristics (6 categories; e.g., recruitment strategy and remuneration policy), and (c) characteristics of the delivery and conduct of interventions (11 categories; e.g., modality of delivery and therapist involvement), and (d) evaluation characteristics (e.g., type of control group). Interrater reliability of identification of defined characteristics was high (κ = 0.80–1.00).
Discussion
This research provides a tool that allows systematic identification of intervention characteristics, thereby enabling consideration, not only of whether interventions are effective or not, but also of which domain-relevant characteristics account for greater or lesser effectiveness. The taxonomy also facilitates standardized description of intervention content in a field in which many diverse interventions have been evaluated.
Conclusion
Application of this coding tool has the potential to accelerate the development of more efficient and effective therapist-delivered and self-directed interventions to reduce gambling problems.
Background and aims
Few studies have investigated the association between problem gambling (PG) and violence extending into the family beyond intimate partners. This study aimed to explore the association between PG and family violence (FV) in a population-representative sample. It was hypothesized that: (a) PG would be positively associated with FV, even after adjusting for sociodemographic variables and comorbidities and (b) these relationships would be significantly exacerbated by substance use and psychological distress. A secondary aim was to explore whether gender moderated these relationships.
Methods
Computer-assisted telephone interviews were conducted with a population-representative sample of 4,153 Australian adults.
Results
Moderate-risk (MR)/problem gamblers had a 2.73-fold increase in the odds of experiencing FV victimization (21.3%; 95% CI: 13.1–29.4) relative to non-problem gamblers (9.4%; 95% CI: 8.5–10.4). They also had a 2.56-fold increase in the odds of experiencing FV perpetration (19.7%; 95% CI: 11.8–27.7) relative to non-problem gamblers (9.0%; 95% CI: 8.0–10.0). Low-risk gamblers also had over a twofold increase in the odds of experiencing FV victimization (20.0%; 95% CI: 14.0–26.0) and perpetration (19.3%; 95% CI: 13.5–25.1). These relationships remained robust for low-risk gamblers, but were attenuated for MR/problem gamblers, after adjustment for substance use and psychological distress. MR/problem gamblers had a greater probability of FV victimization, if they reported hazardous alcohol use; and low-risk gamblers had a greater probability of FV perpetration if they were female.
Discussion and conclusion
These findings provide further support for routine screening, highlight the need for prevention and intervention programs, and suggest that reducing alcohol use may be important in these efforts.
Abstract
Background and aims
Problem gambling severity and gambling-related harm are closely coupled, but conceptually distinct, constructs. The primary aim was to compare low-risk gambling limits when gambling-related harm was defined using the negative consequence items of the Problem Gambling Severity Index (PGSI-Harm) and the Short Gambling Harms Scale items (SGHS-Harm). A secondary aim was compare low-risk limits derived using a definition of harm in which at least two harms across different domains (e.g. financial and relationship) were endorsed with a definition of harm in which at least two harms from any domain were endorsed.
Methods
Data were collected from dual-frame computer-assisted telephone interviews of 5,000 respondents in the fourth Social and Economic Impact Study (SEIS) of Gambling in Tasmania. Receiver operating characteristic (ROC) curve analyse were conducted to identify low-risk gambling limits.
Results
PGSI-Harm and SGHS-Harm definitions produced similar overall limits: 30–37 times per year; AUD$510–$544 per year; expenditure comprising no more than 10.2–10.3% of gross personal income; 400–454 minutes per year; and 2 types of gambling activities per year. Acceptable limits (AUC ≥0.70) were identified for horse/dog racing, keno, and sports/other betting using the PGSI definition; and electronic gaming machines, keno, and bingo using the SGHS definition. The requirement that gamblers endorse two or more harms across different domains had a relatively negligible effect.
Discussion and conclusions
Although replications using alternative measures of harm are required, previous PGSI-based limits appear to be robust thresholds that have considerable potential utility in the prevention of gambling-related harm.
Background and aims
Relatively little is known about co-occurring gambling problems and their overlap with other addictive behaviors among individuals attending mental health services. We aimed to determine rates of gambling and substance use problems in patients accessing mental health services in Victoria, Australia.
Methods
A total of 837 adult patients were surveyed about their gambling and administered standardized screening tools for problem gambling and harmful tobacco, alcohol, and drug use. Prevalence of gambling problems was estimated and regression models used to determine predictors of problem gambling.
Results
The gambling participation rate was 41.6% [95% CI = 38.2–44.9]. The Problem Gambling Severity Index identified 19.7% [CI = 17.0–22.4] as “non-problem gamblers,” 7.2% [CI = 5.4–8.9] as “low-risk” gamblers, 8.4% [CI = 6.5–10.2] as “moderate-risk” gamblers, and 6.3% [CI = 4.7–8.0] as “problem gamblers.” One-fifth (21.9%) of the sample and 52.6% of all gamblers were identified as either low-risk, moderate-risk, or problem gamblers (PGs). Patients classified as problem and moderate-risk gamblers had significantly elevated rates of nicotine and illicit drug dependence (p < .001) according to short screening tools. Current diagnosis of drug use (OR = 4.31 [CI = 1.98–9.37]), borderline personality (OR = 2.59 [CI = 1.13–5.94]), bipolar affective (OR = 2.01 [CI = 1.07–3.80]), and psychotic (OR = 1.83 [CI = 1.03–3.25]) disorders were significant predictors of problem gambling.
Discussion and conclusions
Patients were less likely to gamble, but eight times as likely to be classified as PG, relative to Victoria’s adult general population. Elevated rates of harmful substance use among moderate-risk and PG suggest overlapping vulnerability to addictive behaviors. These findings suggest mental health services should embed routine screening into clinical practice, and train clinicians in the management of problem gambling.
Abstract
Background and aims
It is well understood that engagement with some forms of gambling, like EGMs, is riskier than other forms. However, while reports of associations are common, few studies have attempted to evaluate and compare the relative risk of all available forms, and none have estimated the relative contribution of each form to the total burden of gambling problems (GP) in a population.
Methods
Using an aggregated dataset of national and state-based prevalence studies in Australia (N = 71,103), we estimated prevalence and unique effects of frequency of engagement on each form on GP. Two alternative numerical methods were then applied to infer the relative contribution of each form to the total amount of GP.
Results
EGMs are responsible for 51%–57% of gambling problems in Australia, and 90% of gambling problems are attributable to EGMs, casino, race, and sports betting. Casino table games and EGMs are equally risky at the individual level, but the former contribute far less to problems due to low participation. Bingo and lottery play show no statistically detectable risk for GP.
Discussion and conclusion
The results illustrate which forms present the greatest population burden and illuminate the reasons why. EGMs have an outsized impact. EGM uniquely combines high risk conditional on play, with a high participation rate and a high frequency of play among participants. This is in contrast to risky but less commonly played casino games, and prevalent but non-risky forms like lotteries. We conclude that EGM regulation should be a primary focus of policy action in Australia. More innovative policy ideas relating to EGMs should be tested due to the disproportionate impact of this product type.
Abstract
Background and aims
Gambling-related harm to concerned significant others (CSOs) is an important public health issue since it reduces CSOs' health and wellbeing in numerous life domains. This study aimed to 1) estimate the first national prevalence of CSOs harmed by gambling in Australia; 2) identify the characteristics of CSOs most at risk of harm from another person's gambling; 3) compare the types and number of harms experienced by CSOs based on their relationship to the person who gambles; and 4) compare the number of harms experienced by CSOs by self-identified gender.
Methods
Based on a national CATI survey weighted to population norms, 11,560 respondents reported whether they had been personally and negatively affected by another person's gambling in the past 12 months; and if so, answered detailed questions about the harms experienced from the person's gambling who had harmed them the most.
Results
Past-year prevalence of gambling-related harm to adult Australian CSOs was (6.0%; 95% CI 5.6%–6.5%). CSOs most commonly reported emotional harms, followed by relationship, financial, health and vocational harms, respectively. Former partners reported the most harm, followed by current partners, other family members and non-family members, respectively. Female CSOs were more likely to report more harm and being harmed by a partner or other family member, and male CSOs from a non-family member.
Discussion and conclusions
The findings provide new insights into the wider societal burden of gambling and inform measures aimed at reducing harm to CSOs from gambling and supporting them to seek help.
