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- Author or Editor: Tony Leino x
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Abstract
Background and aims
Unemployment rates are elevated among individuals with disordered gambling, yet the directionality of the relationship remains unclear. The present study investigated paid and unpaid unemployment as risk factors for future gambling disorder (GD).
Methods
The study employed a case-control design, including all adult Norwegians receiving a GD diagnosis within specialist health services from January 2008 to December 2018 (n = 5,131). These individuals were compared with age- and sex-matched controls from the general population (n = 30,164), as well as controls with somatic and psychiatric diagnoses (n = 30,476).
Results
Logistic regressions showed that those in the highest quartile of unpaid unemployment days had more than double the odds (odds ratio [OR] 2.23 (95% CI [1.96, 2.52]) of developing GD compared to those with no unpaid unemployment days. Similarly, higher levels of paid unemployment were also found to increase the odds for GD, with those in the highest quartile having an OR of 1.86 (95% CI [1.50, 2.28]) compared to those with no paid unemployment days. Moreover, an interaction analysis indicated that the association between paid unemployment days and GD was significantly stronger among men compared to women.
Conclusions
The present study suggests that both paid and unpaid unemployment constitute risk factors for GD. Programs aiming at obtaining and sustaining work have been found to improve health and future studies should examine if the risk for GD can be similarly mitigated.
Background and aims
Although alcohol intake and gambling often co-occur in related venues, there is conflicting evidence regarding the effects of alcohol expectancy and intake on gambling behavior. We therefore conducted an experimental investigation of the effects of alcohol expectancy and intake on slot machine gambling behavior.
Methods
Participants were 184 (females = 94) individuals [age range: 18–40 (mean = 21.9) years] randomized to four independent conditions differing in information/expectancy about beverage (told they received either alcohol or placebo) and beverage intake [actually ingesting low (target blood alcohol concentration [BAC] < 0.40 mg/L) vs. moderate (target BAC > 0.40 mg/L; ≈0.80 mg/L) amounts of alcohol]. All participants completed self-report questionnaires assessing demographic variables, subjective intoxication, alcohol effects (stimulant and sedative), and gambling factors (behavior and problems, evaluation, and beliefs). Participants also gambled on a simulated slot machine.
Results
A significant main effect of beverage intake on subjective intoxication and alcohol effects was detected as expected. No significant main or interaction effects were detected for number of gambling sessions, bet size and variation, remaining credits at termination, reaction time, and game evaluation.
Conclusion
Alcohol expectancy and intake do not affect gambling persistence, dissipation of funds, reaction time, or gambling enjoyment.
Abstract
Background and aims
The effect of internet-based psychological treatment for gambling problems has not been previously investigated by meta-analysis. The present study is therefore a quantitative synthesis of studies on the effects of internet-based treatment for gambling problems. Given that effects may vary according to the presence of therapist support and control conditions, it was presumed that subgroup analyses would elucidate such effects.
Methods
A systematic search with no time constraints was conducted in PsycINFO, MEDLINE, Web of Science, and the Cochrane Library. Two authors independently extracted data using a predefined form, including study quality assessment based on the Cochrane risk of bias tool. Effect sizes were calculated using random-effects models. Heterogeneity was indexed by Cochran’s Q and the I 2 statistics. Publication bias was investigated using trim and fill.
Results
Thirteen studies were included in the analysis. Random effects models at post-treatment showed significant effects for general gambling symptoms (g = 0.73; 95% CI = 0.43–1.03), gambling frequency (g = 0.29; 95% CI = 0.14–0.45), and amount of money lost gambling (g = 0.19; 95% CI = 0.11–0.27). The corresponding findings at follow-up were g = 1.20 (95% CI = 0.79–1.61), g = 0.36 (95% CI = 0.12–0.60), and g = 0.20 (95% CI = 0.12–0.29) respectively. Subgroup analyses showed that for general gambling symptoms, studies with therapist support yield larger effects than studies without, both post-treatment and at follow-up. Additionally, on general gambling symptoms and gambling frequency, there were lower effect sizes for studies with a control group compared to studies without a control group at follow-up. Studies with higher baseline severity of gambling problems were associated with larger effect sizes at both posttreatment and follow-up than studies with more lenient inclusion criteria concerning gambling problems.
Discussion and conclusions
Internet-based treatment has the potential to reach a large proportion of persons with gambling problems. Results of the meta-analysis suggest that such treatments hold promise as an effective approach. Future studies are encouraged to examine moderators of treatment outcomes, validate treatment effects cross-culturally, and investigate the effects of novel developments such as ecological momentary interventions.
