Explore the vast range of titles available.

Purpose of Review Gambling disorder is among the most stigmatized mental health problems. More research is needed to understand the mechanisms that underlie this stigma and the effects of stigma-reduction interventions. This paper reviews extant literature on the stigma of gambling disorder and highlights evidence from this research and the broader mental illness stigma literature to help advance research on the prevention and reduction of gambling-related stigma. Recent Finding The public stigma of gambling disorder includes stereotypes of affected individuals as “greedy” and “irresponsible,” beliefs that affected individuals are to blame for their problems, and desire to avoid social contact with affected individuals. Stigmatizing attitudes held by the public are often internalized by individuals with gambling disorder, which leads to problem concealment, reduced treatment-seeking, and decreased self-esteem. Women with gambling disorder, as well as those with more severe gambling problems and who perceive greater stigma by the public, are most vulnerable to self-stigma. There is evidence that certain beliefs may underlie the stigmatization of gambling disorder, including beliefs about its causes. Contact- and education-based interventions show efficacy for the reduction of mental illness-related stigma more broadly; additional research is needed to determine the efficacy of various stigma reduction strategies for gambling disorder specifically. Summary Gambling disorder is highly stigmatized relative to other mental health problems, in part because it is viewed as more likely to be caused by controllable factors. Interventions that emphasize the biopsychosocial etiology of gambling disorder may help to prevent and reduce the blame and stigmatization of affected individuals. Structural stigma within domains such as legislation, healthcare, and the gambling industry, interventions to reduce self-stigma, stigma among mental health professionals, and the influence of culture on stigma and its reduction are critical issues for future research.

Purpose of Review The gambling industry in Africa has seen substantial growth and evolution over recent years with a growing body of literature describing these shifts. Here, we provide a narrative synthesis of the extant literature on the origins, trends and consequences of the expansion and intensification of the commercial gambling industry in sub-Saharan Africa with a reference for future research on gambling as a growing public health concern. Recent Findings The historical shift and permeation of gambling in sub-Saharan Africa is diverse with evidence of certain countries following a neo-colonial logic. Advances in technology have made gambling more accessible and created new markets in Africa. A key motive driving gambling on the continent is a lack of stable employment. While the intensification and growth of Africa’s gambling industry has brought economic benefits to some African investors and individuals, this has been accompanied by a range of gambling harms. Legislation and policies designed to better regulate the gambling industry and redress these harms are needed. In this context, a small number of services and campaigns designed to mitigate gambling harms demonstrate promise, but more research is needed in this area. Summary The gambling industry in sub-Saharan Africa has undergone a dramatic transformation. While it is true that the growth of the African gambling industry has provided an additional revenue stream to governments, it is also necessary to acknowledge the concurrent rise in gambling addiction and the health-related and social harms that it elicits. As such, designing effective regulatory measures and policy interventions that can reduce the public health burden of gambling harms is vital. However, these interventions need to take in to account the significance of cultural differences that exist among countries on the continent.

Gambling disorder recently was reclassified under the category “substance-related and addictive disorders.” With regard to the diagnostic criteria, it overlaps a great deal with substance use disorder, i.e., loss of control, craving/withdrawal, and neglect of other areas of life. However, the gambling disorder symptom “chasing one’s losses” is the only criterion absent from substance use disorder. Therefore, special forms of reward (i.e., gain/loss) processing, such as the processing of loss avoidance and loss aversion, have just recently attracted attention among gambling disorder researchers. Because gambling disorder might be considered an addiction in its “pure” form, i.e., without the influence of a drug of abuse, investigating brain volume changes in people with this behavioral addiction is an important task for neuroimaging researchers in exploring the neural signatures of addiction. Because the brain is a complex network, investigation of alterations in functional connectivity has gained interest among gambling disorder researchers in order to get a more complete picture of functional brain changes in people with gambling disorder. However, only a few studies on brain structure and functional connectivity in gambling disorder have been performed so far. This review focuses on brain imaging studies of reward and loss processing, with an emphasis on loss avoidance and aversion as well as brain volume and functional connectivity in gambling disorder.

Purpose of Review Legislation and technology have led to unprecedented changes in the frequency and content of gambling marketing in many countries. We build upon previous reviews by exploring research on gambling marketing from between 2014 and 2018. Recent Findings Most literature reviewed was from the UK or Australia, with three key findings identified. First, gambling marketing is highly targeted and ubiquitous around sport, with the most popular strategies being increasing brand awareness, advertising complex financial incentives for participation and advertising complex betting odds. Second, perceptions of gambling advertising, particularly among vulnerable groups (e.g. children, problem gamblers) appear to be influenced by this targeted content. Third, emerging research suggests that awareness of gambling marketing is associated with more frequent and riskier gambling behaviour. Summary The reviewed literature suggests that gambling marketing is targeted and influences how gambling is perceived, and that it may affect gambling-related behaviours.

Purpose of Review Loot boxes are gambling-like monetisation mechanics in video games that are purchased for opportunities to obtain randomised in-game rewards. Gambling regulation is increasingly being informed by insights from public health. Despite conceptual similarities between loot boxes and gambling, there is much less international consensus on loot box regulation. Various approaches to regulating loot boxes are reviewed via a public health framework that highlights various trade-offs between individual liberties and harm prevention. Recent Findings Many countries have considered regulation, but as yet only a few countries have taken tangible actions. Existing regulatory approaches vary greatly. More restrictively, Belgium has effectively ‘banned’ paid loot boxes and prohibits their sale to both children and adults. In contrast, more liberally, China only requires disclosure of the probabilities of obtaining potential rewards to provide transparency and perhaps help players to make more informed purchasing decisions. Most other countries (e.g., the UK) have adopted a ‘wait-and-watch’ approach by neither regulating loot box sales nor providing any dedicated consumer protection response. Industry self-regulation has also been adopted, although this appears to elicit lower rates of compliance than comparable national legal regulation. Summary Many potential public health approaches to loot box regulation, such as expenditure limits or harm-reducing modifications to loot box design (e.g., fairer reward structures), deserve further attention. The compliance and clinical benefits of existing interventions (including varying degrees of regulation, as adopted by different countries, and industry self-regulation) should be further assessed. The current international variation in loot box regulation presents opportunities to compare the merits of different approaches over time.

Purpose of Review Propelled by the rise of online and social media, gambling marketing has developed extremely fast, moving far beyond traditional techniques. Policy makers need to ensure that children and young people are protected in this space but it is hard for empirical research to keep pace with industry developments. This article aims to provide some direction to policymakers and the scientific community, by reviewing what literature there is on social media gambling marketing and its effects on children. Recent Findings Research suggests that exposure to social media gambling advertising is high in volume and reach; that gambling ads are more appealing to young people than to adults; and that advertising portrays gambling as a harmless and fun activity with few warnings of potential health dangers. Most gambling brands’ followers on social media are under 25 years old and current regulations are not entirely fit for purpose. Summary Social media gambling ads are booming with high rates of exposure to children and young persons. Paid-for ads target specific young people (with tempting but complex financial incentives), whilst organic ads thrive by being shared across youth user networks. The effects on children and young people are worrisome. Gambling accounts are using content marketing, in particular, to create humorous and seemingly harmless posts to target young people who have not fully developed advertising recognition skills. As regulators struggle to keep up, there are concerns that young people are particularly influenced by these ads, and may be lured into gambling.

Purpose of Review The internet and virtual environments have enabled the formation of online communities around a variety of interests. Online communities focused on gambling are increasingly popular and attract users to interact and share ideas and experiences with likeminded others. This study reviews evidence from the latest research examining the role of online communities in gambling behaviors and gambling problems. Recent Findings A systematic literature search resulted in 17 studies. Research shows that online communities are used for diverse reasons like discussing gambling experiences and problems, sharing tips, and celebrating winnings with others. These reasons of online community use can have both adaptive and maladaptive implications. Online gambling communities often grow through social means by inviting friends or social media contacts to join. Active users of online gambling communities are more likely at-risk or problem gamblers. Summary Online communities have an increasingly central role in learning about gambling, continuing, and spreading of gambling behaviors. Participation in communities that support harmful gambling habits involves risks for problem gambling.

Purpose of Review Gambling operators’ capacity to track gamblers in the online environment may enable identification of those users experiencing gambling harm. This review provides an update on research testing behavioral variables against indicators of disordered gambling. We consider the utility of machine learning algorithms in risk prediction, and challenges to be overcome. Recent Findings Disordered online gambling is associated with a range of behavioral variables, as well as other predictors including demographic and payment-related information. Machine learning is ideally suited to the task of combining these predictors in risk identification, although current research has yielded mixed success. Recent work enhancing the temporal resolution of behavioral analysis to characterize bet-by-bet changes may identify novel predictors of loss chasing. Summary Data science has considerable potential to identify high-risk online gambling, informed by principles of behavioral analysis. Identification may enable targeting of interventions to users who are most at risk.

Purpose of Review Legacy gambling harm refers to adverse consequences that extend past the period where people are actively gambling at harmful levels. These harms can affect the gambler, people close to them and the wider community. This article reviews current research that investigates legacy harms; the types of legacy harm, how long they last and whether evidence suggests these harms are real or instead imagined injuries or reflections on past regrets. Recent Findings Legacy harms to individuals can be broadly categorised as including financial, relationship, emotional/psychological, health, culture, work/study and criminal/deviance harms. In addition, legacy harms affect entire communities by drawing funds and social capital away from vulnerable communities, leaving them socially, culturally and materially impoverished. Most legacy harms that accrue to gamblers have a half-life of 4 years, although financial harms last somewhat longer at 5 years. Greater distance in time from a past gambling issue is reliably and positively related to health and well-being indicators, including the Health Utility Index and the Australian Unity Wellbeing Index, which suggests that legacy gambling harms are real and have a lasting impact on well-being, rather than just imagined hardship from prior gambling difficulties. Summary These findings suggest programme and policy development to support gamblers in reducing and managing their legacy harms, rather than focusing only on relapse prevention.

Purpose of Review Social media enables a range of possibilities in the way gamblers and gambling operators interact and content communicate with gambling. The purpose of this systematic review was to synthesise the extant literature to identify the ways in which social media has been investigated in the context of gambling. Recent Findings A systematic review of the literature identified 41 papers that collected primary data pertinent to gambling and social media from multiple disciplines. These papers broadly fell into three themes: communication, community and calculation (of sentiment). Papers on communication focused on the content of gambling advertising on social media and the impact on people exposed to it. Studies of gambling communities studied the activity and structures of discussion groups on social media concerning recreational or problematic gambling. Papers on calculation collated social media data to assess sentiment and compared it against betting odds. Summary There is an emerging multidisciplinary literature that has looked at the use of social media in relation to gambling. There is preliminary evidence that the content and the reach of gambling advertising on social media is a source of concern, particularly for younger people. The themes discussed on gambling support forums appear to be common across communities, focusing on negative emotions, recovery, addictive products and financial support. Using social media to assess sentiment appears to be particularly effective at identifying potential upsets in sporting matches. Future suggestions for research are explored.