Gambling-related harms and the use of the responsible gambling tools: Gambling Harms 2016 surveys

In January 2017, three Finnish gambling operators were merged into a single company. The Gambling Harms-surveys aim are to study gambling, gambling-related harm and exposure to gambling marketing before and after the merger. These results are based on the situation before the merger. Finnish gambling operators provide responsible gambling tools for gamblers to assist gamblers to keep the gambling limit in control. This study evaluates the awareness and use of the currently available tools. The randomly sampled population-based first wave data was collected between January-March 2017 (n=7 186, response rate 36%). In addition, we collected the data (n=119) from help-seeking gamblers who sought help from Helsinki Gambling Clinic. In the population survey, financial or emotional harms were most prevalent. In the clinical survey, help-seeking gamblers experienced a noteworthy amount of harm. 92% of the respondents were aware of at least one of these tools. The most familiar tools were closing an online gambling account (82%) and imposing a spending limit (82%). 86% of the respondents had used at least one responsible gambling tool. Over half had used identification at registration phase (59%), set a spending limit (53%) and 52% used self-assessment tool. Implications of these findings are discussed

Rahapelaamishäiriö Suomessa : epidemiologia ja hoito

Disordered gambling is a multifaceted phenomenon, and consequently many factors have a role in its development and maintenance. Adverse consequences of disordered gambling can be mental, social and legal. Only a few epidemiological studies of disordered gambling have previously been conducted in Finland, and none of these studies have been published internationally. Gambling research in Finland has increased during the past years, especially the investigation of treatment options for disordered gambling. In this thesis, disordered gambling is approached from two angles: the epidemiological angle provides an overall picture of the current situation in Finland, and the treatment angle studies the phenomenon from an individual standpoint. In the epidemiological studies of this thesis, the prevalence, socio-demographic characteristics, comorbid substance use, perceived health and well-being and the type of gambling and its relations to the severity levels of gambling were measured. The data were derived from two samples, The Health Behaviour and Health among the Finnish Adult Population, Spring 2010, postal survey (N = 2826) and The Finnish Gambling 2011 (N = 3451), telephone interview. These studies used South Oaks Gambling Screen (SOGS) and Problem Gambling Severity Index as a measure of gambling severity. In the epidemiological studies the prevalence of disordered gambling was found to be about 3% (Finnish Gambling 2011). Disordered gambling was more common among males and the younger age group. Disordered gambling was generally associated with socio-economic disadvantages like being divorced, unemployed or having a low level of education. Comorbid alcohol use and nicotine dependency as well as low self-perceived mental health status were associated with disordered gambling. Lotto (Finnish lottery) was the most popular type of game gambled, but slot machine and internet gambling were found to be associated with disordered gambling. The two treatment studies of this thesis describe the socio-demographic characteristics (N = 471), the severity of disordered gambling, gambling urge, gambling-related erroneous thoughts and the level of control of gambling among the treatment-seeking gamblers. In the treatment studies, comorbid alcohol use and depression were also studied. Moreover, changes in the severity of gambling, gambling urge, gambling-related erroneous thoughts and control of gambling, as well as alcohol use and the level of depression at baseline, post-treatment and 6- and 12-month follow- up were studied. The data were derived from the Peli Poikki program which is an internet-based 8-week cognitive behavioural therapy for gamblers. This study used NORC DSM-IV Screen for Gambling Problems as a measure of gambling severity. Results revealed that 78.8% of the treatment-seeking participants were disordered gamblers. 224 participants completed the treatment and after 8 weeks of treatment a significant decline was seen in gambling-related problems and gambling urge, and an improvement in control of gambling. The mood of participants improved and alcohol use decreased during the treatment period, and participants reported improvements in their social situations after the treatment. In conclusion, the prevalence of disordered gambling has been more or less unchanged during the past years in Finland. A specific socio-demographic group of individuals seems to be at higher risk of having and developing disordered gambling, especially with the abundant gambling opportunities in Finland. The results of the Peli Poikki program encourages implementing more evidence-based treatment options for disordered gambling in Finland.Rahapelaamishäiriö on monisyinen ilmiö, jonka syntyyn ja jatkumoon liittyy useita osatekijöitä. Rahapelaamishäiriön seuraukset voivat olla terveydellisiä, sosiaalisia, taloudellisia tai oikeudellisia. Ennen vuotta 2013 vain muutama kansainvälinen julkaisu rahapelaamishäiriön epidemiologiasta Suomessa oli saatavilla. Viime vuosina rahapelaamishäiriön tutkiminen Suomessa on lisääntynyt ja samalla tuntemus rahapelaamishäiriön epidemiologiasta ja hoidosta kasvanut. Tämä väitöskirja käsittelee tuoreimpaan tutkimustietoon pohjautuen rahapelaamishäiriötä kahdesta näkökulmasta: väestötutkimus antaa kokonaiskuvan suomalaisten rahapelaamishäiriöstä ja hoitotutkimus valottaa ilmiota yksilön näkökulmasta. Tässä väitöskirjassa on tutkittu väestötutkimusaineistoihin pohjautuen rahapelaamishäiriön esiintyvyyttä suomalaisessa väestössä sekä sosiodemograafisten taustatekijöiden, koetun terveyden ja hyvinvoinnin, rahapelaamisen tyypin ja liitännäisongelmien (kuten alkoholin riskikulutus ja tupakointi) yhteyttä rahapelikäyttäytymiseen ja rahapelaamishäiriön vaikeusasteeseen. Väitöskirjaan sisällytetyt väestötutkimuksen alaan kuuluvat osajulkaisut ovat I) postikyselytutkimus Suomalaisen aikuisväestön terveyskäyttäytyminen ja terveys, kevät 2010 , (N = 2826) sekä II) puhelinkyselynä toteutettu Suomalaisten rahapelaaminen 2011 , (N = 3451). Rahapelaamishäiriön vakavuutta mitattiin väestötutkimuksissa kahdella eri mittarilla: South Oaks Gambling Screen (SOGS) ja Problem Gambling Severity Index (PGSI). Suomalaisten rahapelaaminen 2011 tutkimuksen mukaan rahapelaamishäiriön esiintyvyys väestötasolla oli noin 3 %. Rahapelaamishäiriö oli yleisempää miehillä ja nuoremmissa ikäluokissa kuin naisilla tai vanhemmissa ikäluokissa. Tutkimustulosten mukaan rahapelaamishäiriön esiintyvyys oli yhteydessä sosiaalisiin taustatekijöihin kuten avioeroon, työttömyyteen ja alempaan koulutustasoon. Samanaikainen alkoholin käyttö, tupakointi sekä mielenterveysongelmat olivat yhteydessä rahapelaamishäiriön vaikeusasteeseen. Lotto oli pelatuin rahapeli väestöotoksessa, rahapeliautomaattien ja internetin välityksellä pelatut rahapelit olivat kuitenkin voimakkaimmin yhteydessä rahapelaamishäiriön vaikeusasteeseen. Tässä väitöskirjassa on tutkittu hoitotutkimukseen pohjautuen hoitoon hakeutuneiden rahapelaamishäiriöstä karsivien rahapelaajien (N = 471) sosiodemograafisia taustatekijöitä, rahapelaamisen vaikeusastetta, rahapelihimoa, rahapelaamiseen liittyvien virheellisten uskomusten ja pelaamisen kontrollin astetta sekä liitännäisongelmia (masennus ja alkoholin riskikulutus) sekä muutoksia näissä muuttujissa ennen hoitoa ja hoidon jälkeen sekä 6 ja 12 kuukauden jälkiseurannoilla. Aineistona tutkimuksessa käytettiin Peli poikki hoito-ohjelman (kognitiiviseen käyttäytymisterapiaan pohjautuva virtuaaliterapia) aikana kerättyjä tietoja. Väitöskirjaan on sisällytetyt hoitotutkimuksen alaan kuuluvat osajulkaisut ovat III ja IV. Hoitotutkimuksissa rahapelaamishäiriön vakavuutta mitattiin NORC DSM-IV Screen for Gambling Problems- mittarilla. 78.8% osallistujista täytti rahapelaamishäiriön kriteerit. 244 osallistujaa kävi loppuun 8-viikkoa kestäneen hoito-ohjelman. Hoito-ohjelman läpikäyneiden osallistujien rahapelaamisen vaikeusaste ja rahapelihimo laskivat, kun taas rahapelaamisen kontrolli kasvoi. Lisaksi osallistujien mieliala koheni ja alkoholin kulutus ja negatiiviset rahapelaamisen aiheuttamat seurannaisvaikutukset vähenivät. Väitöskirjan osatöiden perusteella voidaan sanoa, että suomalaisten rahapelaaminen on pysynyt jokseenkin samalla tasolla 2000-luvulla. Tietyt sosiaaliset taustatekijät ovat selkeästi yhteydessä rahapelaamishäiriön vaikeusasteeseen ja kehittymiseen. Peli poikki hoito-ohjelman tulosten perusteella tutkittuun tietoon perustuvan hoito-ohjelman vaikuttavuus on lupaavaa, joten tutkittuun tietoon perustuvia hoito-ohjelmia ja malleja tulisi käyttää rahapelaamishäiriön hoidossa Suomessa laajemminkin. Avainsanat: esiintyvyys, internet-pohjainen hoito, kognitiivinen käyttäytymisterapia, pelityyppi, rahapelaamishäiriö, sosiaaliset taustatekijät, väestötutkimu

Online 8-week cognitive therapy for problem gamblers: the moderating effects of depression symptoms and perceived financial control

Background and aims: Online interventions for problem gambling are increasingly popular, but not everyone benefits from them. We describe 12 years of real-world data from an online intervention for gambling problems and aim to find out the extent to which depression, alcohol use, and sense of financial control influence the effectiveness of the program. Methods: We analyzed treatment effectiveness and moderators in the Finnish "Peli Poikki" program (2007-2018)-an 8-week cognitive behavioral therapy and follow-up program for problem gambling. Participants were Finnish-speaking adults over 18 years of age (N = 2011, 66.9% males). We measured the self-reported level of problem gambling, depression, alcohol use, and sense of financial control across four treatment phases (baseline, post-treatment, 6-month follow-up, and 12-month follow-up), as well as the presence of gambling debt, psychological and physiological health, years suffered from gambling problems, and demographic variables. Results: Participation grew across years with retention rates of 55%, 30%, and 19% for post-treatment and the two follow-ups, respectively. The average problem gambling scores declined significantly following treatment and remained low throughout the follow-ups. However, this decline (the beneficial treatment effect) was reversed after the follow-ups for those with high depression scores and those who felt they had no control over their finances. Discussion and Conclusions: The Peli Poikki program is a well-functioning online intervention but less effective in the long term for participants with persisting symptoms of depression or without a sense of financial control. More attention is needed to screen and direct people with comorbidities to the appropriate services.Peer reviewe

At-risk and problem gambling among Finnish youth : The examination of risky alcohol consumption, tobacco smoking, mental health and loneliness as gender-specific correlates

AIMS - The aims were to compare past-year at-risk and problem gambling (ARPG) and other at-risk behaviours (computer gaming, risky alcohol consumption, tobacco smoking) by age and gender, and to explore how ARPG is associated with risky alcohol consumption, tobacco smoking, poor mental health and loneliness in males and females. DESIGN - Data from respondents aged 15-28 (n = 822) were derived from a cross-sectional random sample of population-based data (n = 4484). The data were collected in 2011-2012 by telephone interviews. The Problem Gambling Severity Index (PGSI, score >= 2) was used to evaluate ARPG. Prevalence rates for risk behaviours were compared for within gender-specific age groups. Regression models were gender-specific. RESULTS - The proportion of at-risk and problem gamblers was higher among males than females in all age groups except among 18-21-year-olds, while frequent computer gaming was higher among males in all age groups. The odds ratio (95% CI) of being a male ARPGer was 2.57 (1.40-4.74) for risky alcohol consumption; 1.95 (1.07-3.56) for tobacco smoking; 2.63 (0.96-7.26) for poor mental health; and 4.41 (1.20-16.23) for feeling lonely. Likewise, the odds ratio (95% CI) of being a female ARPGer was 1.19 (0.45-3.12) for risky alcohol consumption; 4.01 (1.43-11.24) for tobacco smoking; 0.99 (0.18-5.39) for poor mental health; and 6.46 (1.42-29.34) for feeling lonely. All 95% CIs of ARPG correlates overlapped among males and females. CONCLUSIONS - Overall, past-year at-risk and problem gambling and computer gaming seem to be more common among males than females; however, for risky alcohol consumption similar gender differences were evident only for the older half of the sample. No clear gender differences were seen in correlates associated with ARPG.Peer reviewe

Rahapeliriippuvuuden varhainen tunnistaminen on tärkeää - uusia suuntaviivoja diagnostiikkaan, tukeen ja hoitoon

Vertaisarvioitu.• Rahapeliriippuvuudella on yhtäläisyyksiä päihderiippuvuuksien kanssa. • ICD-11-tautiluokituksessa se on luokiteltu samaan luokkaan aine- riippuvuuksien kanssa. • Haittojen vähentämisessä auttavat varhainen tunnistaminen ja puheeksiotto. • Tukea ja hoitoa on saatavilla pääasiassa verkossa.Peer reviewe

Trends in gambling participation and gambling severity among Finnish men and women: cross-sectional population surveys in 2007, 2010 and 2015

Objective The aim of this study is to evaluate trends in past-year gambling participation and gambling severity among Finnish men and women from 2007 to 2015.Design Cross-sectional population surveys from years 2007, 2011 and 2015.Setting Data were drawn from the population register and collected using computer-assisted telephone interviews.Participants Representative random samples of Finns aged 15-74 were drawn in the study in 2007 (n=5008), 2011 (n=4484) and 2015 (n=4515) with response rates of 58%, 40% and 62%, respectively.Outcome measures The outcome measures were gambling versatility, type of games, gambling intensity and gambling severity. Significance (p) between time points was determined using (2) tests. All temporal comparisons between 2007-2011, 2011-2015 and 2007-2015 were performed separately for all respondents aged 15-74 and for women and men.Results Gambling participation overall showed a rising trend (6.6 percentage points, 95%CI 4.9 to 8.3) from 2007 to 2015. In 2007-2011 women's gambling participation increased more (7.8 percentage points, 95%CI 5.5 to 10.4) than men's (5.4 percentage points, 95%CI 3.2 to 7.6). The most popular game types since 2007 have been lottery games, scratch cards and electronic gaming machines (EGMs). EGM gambling, on the other hand, has decreased since 2007. Online gambling has increased significantly from 2007 to 2015 in both genders. Men's at-risk gambling decreased from 2007 to 2011, while women's at-risk gambling and problem gambling increased from 2011 to 2015.Conclusions Women's increasing gambling participation is causing gender differences in gambling behaviour to narrow. The article concludes with a discussion of the need for gender-specific interventions aimed at preventing gambling-related harm and ultimately at protecting the most vulnerable groups

Money used in gaming is associated with problem gambling: Results of the ESPAD 2019 Finland

Background and aimsThe convergence of gaming and gambling may pose a risk for adolescents. Thus, it is important to find out how these behaviours are associated with other addictive behaviours in order to develop efficient preventive measures for youth. The aim of this study was to examine 1) whether problematic gaming and money used for gaming activities are risk factors for gambling, and 2) what kind of impact adolescents’ substance use along with other factors related to friends and parents have on this association.MethodsThe European School Survey Project on Alcohol and Other Drugs data, 2019 of Finnish adolescents aged 15 to 16 (N = 4595). Cross-tabulations with Rao-Scott’s chisquare tests were applied to study the associations of the background factors with gambling in the past 12 months. A multinomial logistic regression model was fitted for the outcome variable (gambling in the past 12 months) adjusted for all independent and background variables.ResultsProblematic gaming alone was not associated with gambling participation, whereas using money for digital games increased the risk of gambling. Boys gamble more than girls. The use of alcohol and drugs increased the risk of gambling. Parental monitoring reduced the risk of gambling, whereas hanging around weekly with friends increased the risk.Discussion and conclusionsUsing money on gaming sites may put some adolescents at risk of developing problems with either gaming or gambling. The link between using money in digital games and gambling participation calls for preventive measures, intervention and regulatory acts.</p

Online Betting Intensity is Linked with Extraversion and Conscientiousness

Introduction Extraversion and Conscientiousness are well-studied personality traits associated with reward processing and goal prioritization, respectively, and bear on individual differences in financial risk-taking. Using unique large datasets, we investigated the link between these traits and male online gamblers' actual betting participation and intensity. Method We combined datasets containing online horse betting data (during 2015-2016) from the Finnish monopoly betting company, administrative registry data from Statistics Finland, and personality trait measures from the Finnish Defence Forces corresponding to Extraversion and Conscientiousness as defined in the five-factor model. We modelled associations between these traits and betting participation (n = 471,968) and intensity (n = 11,217) among male horse bettors (age = 36-53). Results Controlling for demographics and IQ, individuals scoring high on Conscientiousness (or Extraversion) were less (or more) likely to bet and less (or more) intensive bettors-even when personality was measured 16-34 years before betting occurred. One SD personality score increase represented an annual decrease (Conscientiousness) or increase (Extraversion) of euro570-754 in spending. Conclusions Extraversion and Conscientiousness are implicated in real-life financial behavior with tangible consequences for individuals. These effects are stronger than for many known demographic variables used in gambling studies and persist up to 34 years after personality has been measured.Peer reviewe