Revising the Pathways Model of Problem Gambling: Two Decades of Lessons Learned

The Pathways Model is a highly cited etiological model of problem gambling. Over the past two decades, a number of studies have found support for the model’s utility in classifying gambling subtypes. In addition, empirical research conducted by the original authors has suggested key revisions in the original model to maintain its stability over time. This presentation will provide an overview of the original model, related findings in the past 20 years, and introduce the revised model. A convenience sample of 1,168 treatment-seeking problem gamblers in the U.S., Canada, and Australia completed the Problem Gambling Severity Index and the Gambling Pathways Questionnaire. Empirically validated risk factors were analyzed using latent class analyses, identifying a three-class solution as the best-fitting model. Those in the largest class (Pathway 1) reported the lowest levels of all etiological risk factors. Participants in class 2 (Pathway 2) reported the highest rates of anxiety and depression, both before and after gambling became a problem, as well as childhood maltreatment, and a high level of gambling for stress-coping. Those in class 3 (Pathway 3) reported high levels of impulsivity; risk-taking, including sexual risk-taking; antisocial traits; and coping to provide meaning in life and to alleviate stress. Implications: The revised model provides an evidence-based, parsimonious summary of key risk factors that may variously predispose individuals to develop gambling problems. Those factors provide a “road-map” to guide clinicians in individualizing treatment to address the most important predictors of relapse

Problem gambling severity and LGBTQ+ status: Evaluating influence of age and comorbid mental health and substance use problems

Abstract: This presentation will explore the relationship between LGBTQ+ identification and risk for problem gambling. Research has long identified in sexual minority groups higher rates of most mental health indicators, including anxiety, depression, suicidality, and substance misuse. However, little attention has focused on their risk of developing gambling problems. This study used an epidemiological sample of adults (N = 3,414), 6% of whom identified as LGBTQ+ (n = 216). Bivariate comparisons found those who identified as LGBTQ+ had significantly higher problems with gambling, alcohol, drugs, anxiety, depression, and a wide range of behaviors (e.g., binge eating, pornography use). Furthermore, a logistic regression found a significant interaction effect between LGBTQ+ status and age, such that the odds of having gambling disorder (PGSI ≥ 8) increased with age for individuals who identified as LGBTQ+ when controlling for demographic, mental health, and other addiction variables. Among those who gambled in the LGBTQ+ population, anxiety and/or problems with drugs were most associated with high-risk gambling. Implications: These results underscore the need to screen for gambling problems across all health, mental health, and community sectors where individuals in the LGBTQ+ community, particularly older adults, could be identified and triaged to treatment. Presenter Bios: Jackie Stanmyre, MSW, ABD, is the Assistant Director of the Center for Gambling Studies at Rutgers University. Her research focuses on gambling and sports wagering among athletes and coaches, mindfulness profiles among people who gamble, screening and interventions for problem gambling, and play-by-play analysis for online gambling and sports wagering. Lia Nower, JD, PhD is Professor and Director of the Center for Gambling Studies at Rutgers University. Her research focuses on etiology, treatment, policy initiatives around harm reduction and responsible gambling, and big data analyses of online gambling and sports wagering. She serves as a Senior Editor for Addiction and Assistant Editor of International Gambling Studies. Dr. Nower is also the 2022 recipient of the Lifetime Research Award from the National Council on Problem Gambling in Washington D.C. Michelle L. Malkin, JD, PhD, is an Assistant Professor of Criminal Justice at East Carolina University. Her research interests include problem gambling, diversion courts, and LGBTQ+ experiences in the carceral system. In 2018, she received a research fellowship from the Center for Gaming Studies at University of Nevada, Las Vegas. Her dissertation on Problem Gambling, General Strain Theory and Gender received the 2022 Dr. Durand Jacobs Dissertation Award from the National Council on Problem Gambling

Evaluation of the DSM-5 Internet Gaming Disorder Measures: A COSMIN Systematic Review and Meta-Analysis

Due to the rising concern of problem video gaming, the DSM-5 has suggested including Internet Gaming Disorder (IGD) as a possible new behavioral addiction and proposed nine criteria to assess IGD. In response, a number of measurement instruments have been developed based on the DSM-5 IGD criteria. This presentation will discuss results from a systematic review that evaluated psychometric properties of these measures. Systematic search identified 22 measures. Meta-analysis revealed that 3.1% of the general population and 6.4% of video gamers had IGD. The estimated prevalence rates largely varied across different measures. Although many measures demonstrated satisfactory structural and construct validities, these measures accounted for an average \u3c 50% of the variance of the items. This suggests that measures do not fully operationalize the DSM-5 criteria and other symptoms should be considered. Measurement invariance and test-retest reliability were established for \u3c 50% of these measures. Diagnostic performance were only examined for two measures using data from clinical structured interviews. While much more work is needed to accurately conceptualize and measure IGD, the present review indicates that the Internet Gaming Disorder Scale – Short Form is the most optimal DSM-5 measure of IGD currently available. Implications: This work is conducted in response to the call for rigorous research on Internet gaming disorder (IGD). Findings have important implications for implementing uniform, psychometrically sound measures that accurately conceptualize, assess, and identify IGD in both research and clinical settings

The Nuance of Mindfulness among Gamblers and Video Game Players: Empirical Findings from Latent Profile Analysis and Links to Intervention for Problem Gambling and Problem Video Gaming

Abstract: This presentation reviews two studies that investigate different profiles of gamblers and video gamers across five facets of mindfulness and nonattachment using latent profile analyses. Study 1 identified four profiles among 843 adults who gamble (59.9% male, Mage=39 years): High, Moderate and Low Mindfulness, as well as a Judgmentally Unaware profile, characterized by low levels of nonjudging and acting with awareness. Gamblers with the Judgmentally Unware profile demonstrated more frequent gambling, stronger gambling motivations and gambling-related cognitions, more severe problem gambling, and poorer mental health compared to other profiles. Study 2 identified a different four-profile model among 629 adults who play video games (62.8% male, Mage=38 years): High and Moderate Mindfulness, Judgmentally Unware profile, and Reactive and Attached profile, characterized by high non-reacting and low nonattachment. Video gamers with the Judgmentally Unware profile evidenced the most severe problem gaming, followed by the Reactive and Attached profile. The Judgmentally Unware profile reported stronger gaming motivations and higher emotion-based impulsivity; in contrast, the Reactive and Attached profile demonstrated greater psychological inflexibility and escapism motivation relative to the other profiles. Implications of mindfulness profiles as risk and protective factors will be discussed in light of reducing harm for both gambling and video gaming. Implications: Findings suggest a variety of ways in which gamblers and video gamers might be mindful. Given the overlap between gambling and gaming and the Judgmentally Unaware profile, mindfulness-based harm reduction intervention could be particularly useful for addressing problem gambling/video gaming and decreasing future harms from these activities

Internet Gaming in New Jersey: Calendar Year 2014 Report to the Division of Gaming Enforcement

Permission to include this report in the Institute research repository granted by Lia Nower, Director, Center for Gambling Studies, Rutgers University on August 26, 2016.This report, prepared pursuant to N.J.S.A. 5:12-95.18, is the first in a series of four annual reports that will examine the impact of Internet gaming on problem gambling and gambling addiction. The current report covers the first year of Internet gaming in New Jersey. Subsequent reports will be issued in the first quarter of each calendar year, as specified in a Memorandum of Agreement between the Division, Rutgers Center for Gambling Studies, and the Department of Human Services. Future reports will examine the relationship of play patterns, use of responsible gaming features, and the prevalence of Internet gaming in New Jersey to problem gambling.NoDivision of Gaming Enforcement, New Jerse

Crypto-currency Trading Among Regular Gamblers: A New Risk for Problem Gambling?

Abstract Crypto-currency or “crypto” is digital money that can be used to fund risk-taking activities anonymously via the Internet (e.g., drugs, gambling). There is growing concern in the field of gambling studies that trading cryptos will appeal to high-risk gamblers. The present study assessed the prevalence of crypto trading among regular gamblers and its relationship to problem gambling severity. Adults (18+) who gambled at least monthly in the past year were recruited through Amazon’s Mechanical Turk (N = 876; 58.33% male) and completed the Problem Gambling Severity Index, Patient Health Questionnaire, and Generalized Anxiety Disorder scale via an online survey. More than half of the sample indicated they had traded cryptos in the past year. Crypto trading was strongly associated with higher levels of high-risk stock trading (r = .67), greater problem gambling severity (r = .53), and modestly associated with both anxiety (r = .20) and depressive symptoms (r = .20). Results from a linear regression revealed that sports betting, daily fantasy sports, high-risk stock trading, and problem gambling severity were positive predictors of crypto trading frequency, whereas gambling in land-based casinos was a negative predictor. Implications for problem gambling education, screening, and treatment will be discussed. Implications Statement The present findings represent an initial assessment of the prevalence of cryptocurrency trading among regular gamblers, and its relation to problem gambling. Future research should begin to include cryptocurrency trading in screening, assessment, and treatment protocols, particularly with regular gamblers

Characteristics of Sports Betters in an Epidemiological Study

ABSTRACT The potential impact of the recent legalization of sports wagering in the U.S. on rates of problem gambling is unknown, particularly in light of interactive media. The current study examines the self-reported behavior of 332 sports betters in a representative sample of 2,213 participants (\u3e18 years) in a statewide study on gambling. Results of univariate analyses and multiple regression modeling indicated: More than 97% of sports betters also bet on other forms of gambling, including daily fantasy sports (58%). Compared to other gamblers, those who bet on sports were more likely to be younger, male, undereducated (less than high school) and to report a physical limitation or disability. In addition, sports betters were more likely to smoke, binge drink, use illegal drugs, report a mental health problem in the past year and to seriously have contemplated suicide. Unlike a majority of other gamblers, sports betters gambled both online and in land-based venues; preferred activities were lottery, poker, live casino tables games, daily fantasy sports, and horse track betting. Finally, sports betters in the study were significantly more likely to score as moderate or high risk problem gamblers on the PGSI than other gamblers in the study. IMPLICATIONS: States are legalizing sports wagering without investigating the potential impacts on underage youth or young adults, who may subvert regulatory age limitations on interactive platforms. Our findings suggest these effects should be a serious concern. Suggestions for harm reduction, prevention, and education strategies targeting this group will be discussed

Loot box: A nexus of Internet gambling and video gaming

A loot box is a virtual item for purchase in many video games that features betting money on elements of chance. This study aims to investigate the characteristics of video game users who purchase loot boxes and the links of loot box purchase to Internet gambling engagement and problem video gaming and gambling. Cross-sectional, self-report data on video game and Internet gambling engagement, and loot box purchase were collected from 577 adult video game users (Mean age = 28.82 years, 62.64% male) via an online survey. Standardized measures were used to assess participants’ severity of problem gambling, problem video gaming, and mental distress symptoms. Almost half of the sample (46.63%) reported having ever purchased loot boxes in video games. Compared to those who never purchased a loot box, participants who bought loot boxes reported significantly higher levels of video game and Internet gambling engagement, more binge gaming and gambling episodes, greater problem video gaming and gambling severity, and more mental distress symptoms. Regression analyses revealed that purchasing loot boxes emerged as a significant predictor of greater severity of both problem gambling and problem video gaming, respectively. Implications: Loot box brings an element of gambling into many popular video games and could prime video game users to engage in Internet gambling. This study increases our understanding regarding the role of loot box in problem gambling and video gaming behaviors. Implications for regulation, prevention and treatment will be discussed

Cross-Cultural Validation of the Gambling Pathways Questionnaire (GPQ): A Collaborative Approach to Measurement

ABSTRACT: The Gambling Pathways Questionnaire (GPQ; Nower & Blaszczynski, 2017) is a 48-item screening instrument, designed to identify etiological risk factors that may go unidentified in treatment but may adversely impact recovery. Researchers in multiple jurisdictions worldwide have undertaken to validate and use the GPQ with culturally diverse groups in partnership with the original authors. This presentation will: 1) provide an overview of the development and validation of the GPQ and initial considerations in designing measures for worldwide administration; and 2) detail the validation of the Italian version of the GPQ, which was administered to 490 treatment-seeking problem gamblers who attended treatment units in Italy (84% males; mean age = 43.77 years, SD=13.25; range = from 18 to 76). Results from the study confirmed the original six-factor structure and three pathways, as well as the reliability of the total scale and subscales. Collaborative solutions to cultural challenges will be discussed. IMPLICATIONS: Screening tools for gambling are rarely developed with worldwide generalizability in mind. Replicating the collaborative approach of this cross-cultural collaboration with other instruments should increase the overall validity and application of gambling screening tools and aid in standardizing measurement in studies across jurisdictions

Internet Gaming in New Jersey: Calendar Year 2015 Report to the Division of Gaming Enforcement

Permission to include this report in the Institute research repository granted by Lia Nower, Director, Center for Gambling Studies, Rutgers University on August 26, 2016.This report, prepared pursuant to N.J.S.A. 5:12‐95.18, is the second in a series of four annual reports, examining the overall impact of Internet gaming and problematic patterns of play and the relationship to the state‐wide prevalence of problem gambling. Analyses in this report are focused on player demographics, play patterns and use of responsible gambling features from the first full year of operation, 2014; subsequent reports will feature play data from 2015 and 2016.NoDivision of Gaming Enforcement, New Jerse