Dataset Information

Problem and non-problem gamblers: a cross-sectional clustering study by gambling characteristics.

ABSTRACT: OBJECTIVES:Gambling characteristics are factors that could influence problem gambling development. The aim of this study was to identify a typology of gamblers to frame risky behaviour based on gambling characteristics (age of initiation/of problem gambling, type of gambling: pure chance/chance with pseudoskills/chance with elements of skill, gambling online/offline, amount wagered monthly) and to investigate clinical factors associated with these different profiles in a large representative sample of gamblers. DESIGN AND SETTING:The study is a cross-sectional analysis to the baseline data of the french JEU cohort study (study protocol : Challet-Bouju et al, 2014). Recruitment (April 2009 to September 2011) involved clinicians and researchers from seven institutions that offer care for or conduct research on problem gamblers (PG). Participants were recruited in gambling places, and in care centres. Only participants who reported gambling in the previous year between 18 and 65 years old were included.Participants gave their written informed consent, it was approved by the French Research Ethics Committee. PARTICIPANTS:The participants were 628 gamblers : 256 non-problem gamblers (NPG), 169 problem gamblers without treatment (PGWT) and 203 problem gamblers seeking treatment (PGST). RESULTS:Six clustering models were tested, the one with three clusters displayed a lower classification error rate (7.92%) and was better suited to clinical interpretation : 'Early Onset and Short Course' (47.5%), 'Early Onset and Long Course' (35%) and 'Late Onset and Short Course' (17.5%). Gambling characteristics differed significantly between the three clusters. CONCLUSIONS:We defined clusters through the analysis of gambling variables, easy to identify, by psychiatrists or by physicians in primary care. Simple screening concerning these gambling characteristics could be constructed to prevent and to help PG identification. It is important to consider gambling characteristics : policy measures targeting gambling characteristics may reduce the risk of PG or minimise harm from gambling. TRIAL REGISTRATION NUMBER:NCT01207674 (ClinicalTrials.gov); Results.

SUBMITTER: Guillou Landreat M

PROVIDER: S-EPMC7044887 | biostudies-literature | 2020 Feb

REPOSITORIES: biostudies-literature

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Problem and non-problem gamblers: a cross-sectional clustering study by gambling characteristics.

Guillou Landreat Morgane M Chereau Boudet Isabelle I Perrot Bastien B Romo Lucia L Codina Irene I Magalon David D Fatseas Melina M Luquiens Amandine A Brousse Georges G Challet-Bouju Gaëlle G Grall-Bronnec Marie M

BMJ open 20200218 2

<h4>Objectives</h4>Gambling characteristics are factors that could influence problem gambling development. The aim of this study was to identify a typology of gamblers to frame risky behaviour based on gambling characteristics (age of initiation/of problem gambling, type of gambling: pure chance/chance with pseudoskills/chance with elements of skill, gambling online/offline, amount wagered monthly) and to investigate clinical factors associated with these different profiles in a large representa ...[more]

PMID: 32075821

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Project description:BACKGROUND:Problem gambling is a growing public health issue that is characterized by low rates of face-to-face help seeking. Helplines and real-time chat services could reduce shortfalls in treatment. OBJECTIVE:This study aimed to (1) describe the characteristics of gamblers contacting a government-funded help service, (2) study the evolution of their characteristics over time, (3) evaluate the differences between subgroups (ie, gender, media used for gambling, and media used to contact the service), and (4) explore factors influencing referral to care. METHODS:From January 2011 to December 2015, a government-funded gambling helpline and real-time chat website in France received 9474 contacts from gamblers. Counselors filled in a form for each contact, collecting demographics, gambling characteristics, and referrals. Time-series analyses were performed. Univariate logistic models were used to assess differences across subgroups. A multivariate analysis was conducted to determine the variables related to an actual referral. RESULTS:Gamblers were predominantly men (7017/9474, 74.07%); the average age was 41 years (SD 14). Compared with the men, the women were older (mean 50.7 years, SD 14.0 vs mean 37.9 years, SD 13.0, respectively; P<.001), were more often solely offline gamblers (1922/2457, 78.23% vs 4386/7017, 62.51%, respectively; P<.001), and had different gambling patterns. Compared with helpline contacts, real-time chat contacts were more often men (124/150, 82.7% vs 3643/4881, 74.64%, respectively; P=.04), younger (mean 32.8 years, SD 12.9 vs mean 41.3 years, SD 14.3, respectively; P<.001), more often poker gamblers (41/150, 27.3% vs 592/4881, 12.13%, respectively; P<.001), and more often web-based gamblers (83/150, 55.3% vs 1462/4881, 29.95%, respectively; P<.001). Referral was positively associated with betting (adjusted odds ratio [aOR] 1.46, 95% CI 1.27-1.67; P<.001), casino gambling (aOR 1.38, 95% CI 1.21-1.57; P<.001), scratch cards (aOR 1.83, 95% CI 1.58-2.12; P<.001), poker gambling (aOR 1.35, 95% CI 1.14-1.61; P<.001), lottery (aOR 1.27, 95% CI 1.03-1.56; P=.03), weekly gambling (aOR 1.73, 95% CI 1.40-2.15; P<.001), request for referral (aOR 17.76, 95% CI 14.92-21.13; P<.001), and a history of suicide attempts (aOR 2.13, 95% CI 1.51-3.02; P<.001), and it was negatively associated with web-based gambling (aOR 0.86, 95% CI 0.75-0.98; P=.030) and refusal to be referred (aOR 0.35, 95% CI 0.26-0.49; P<.001). CONCLUSIONS:The governmental helpline and chat contacts included a broad range of sociodemographic profiles. Compared with the helpline, real-time chat exchanges reached a younger population of web-based gamblers, which was the target population. The development of the gambling helpline and help online website is a considerable challenge for the future.

Project description:IntroductionDevelopment of fully internet-based programs could provide a new avenue to improve access to healthcare for problem gamblers. In this project, we aim to assess the efficacy of a web-based cognitive intervention targeting inhibitory control among problem gamblers, using a randomised controlled design. As impaired inhibitory control is involved in self-regulation difficulties in behavioural addictions, it represents a particularly relevant cognitive process to target for an online psychological intervention.Methods and analysisThis will be a single-blinded, randomised, comparative therapeutic web-based, controlled trial. Up to 200 non-treatment seeking adult problem gamblers with a Problem Gambling Severity Index-recent (PGSI-recent) score ≥5 will be included. The intervention will be a computerised cognitive training program targeting inhibitory skills. The comparator, an active control, will be a computerised neutral sensorial program. Both programs will be carried out under similar conditions: biweekly online training for 6 weeks and optional telephone support will be offered to patients for debriefing. The main objective of the study is to assess the clinical efficacy of the online cognitive training program at 6 weeks, measured with the PGSI-recent. The secondary objectives are to assess the efficacy on the gambling behaviour assessed by the account-based gambling data, on the self-reported gambling practice, and on the inhibition performance at the neuropsychological level at 6, 14 and 52 weeks. We will also assess the acceptability of this program and the preferred level of guidance. Data analysis will be in intention-to-treat.Ethics and disseminationThis randomized controlled trial will be executed in compliance with the Helsinki Declaration, and was approved by the local ethics boards (Comité de Protection des Personnes) in October 2017. The findings will be published in peer-reviewed journals.Trial registration numberNCT03673800.

Project description:Disinhibition over drug use, enhanced salience of drug use and decreased salience of natural reinforcers are thought to play an important role substance dependence. Whether this is also true for pathological gambling is unclear. To understand the effects of affective stimuli on response inhibition in problem gamblers (PRGs), we designed an affective Go/Nogo to examine the interaction between response inhibition and salience attribution in 16 PRGs and 15 healthy controls (HCs).Four affective blocks were presented with Go trials containing neutral, gamble, positive or negative affective pictures. The No-Go trials in these blocks contained neutral pictures. Outcomes of interest included percentage of impulsive errors and mean reaction times in the different blocks. Brain activity related to No-Go trials was assessed to measure response inhibition in the various affective conditions and brain activity related to Go trials was assessed to measure salience attribution.PRGs made fewer errors during gamble and positive trials than HCs, but were slower during all trials types. Compared to HCs, PRGs activated the dorsolateral prefrontal cortex, anterior cingulate and ventral striatum to a greater extent while viewing gamble pictures. The dorsal lateral and inferior frontal cortex were more activated in PRGs than in HCs while viewing positive and negative pictures. During neutral inhibition, PRGs were slower but similar in accuracy to HCs, and showed more dorsolateral prefrontal and anterior cingulate cortex activity. In contrast, during gamble and positive pictures PRGs performed better than HCs, and showed lower activation of the dorsolateral and anterior cingulate cortex.This study shows that gambling-related stimuli are more salient for PRGs than for HCs. PRGs seem to rely on compensatory brain activity to achieve similar performance during neutral response inhibition. A gambling-related or positive context appears to facilitate response inhibition as indicated by lower brain activity and fewer behavioural errors in PRGs.

Dataset Information

Problem and non-problem gamblers: a cross-sectional clustering study by gambling characteristics.

Publications

Problem and non-problem gamblers: a cross-sectional clustering study by gambling characteristics.

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