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      Who uses self-exclusion to regulate problem gambling? A systematic literature review

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          Background and aims

          Self-exclusion programs offer an intervention for individuals with problem gambling behavior. However, these programs are insufficiently used. This review describes sociodemographic features and gambling behavior of self-excluders as well as goals and motives for initiating self-exclusion from terrestrial and online gambling. In addition, use of further professional help and barriers to self-exclusion are examined.


          Based on systematic literature search and quality assessment, n = 16 original studies (13 quantitative, 2 qualitative, and 1 mixed method) published between 1997 and 2017 in English or German language were analyzed. Results are presented for online and terrestrial gambling separately.


          Online self-excluders were on average 10 years younger than terrestrial self-excluders. Self-exclusion was mainly motivated by financial problems, followed by feelings of losing control and problems with significant others. Financial problems and significant others were less important for online than for terrestrial gamblers. Main barriers for self-exclusion were complicated enrollment processes, lack of complete exclusion from all venues, little support from venue staff, and lack of adequate information on self-exclusion programs. Both self-excluders from terrestrial and online gambling had negative attitudes toward the need of professional addiction care.


          To exploit the full potential of self-exclusion as a measure of gambler protection, its acceptance and its utilization need to be increased by target-group-specific information addressing financial issues and the role of significant others, simplifying the administrative processes, facilitating self-exclusion at an early stage of the gambling career, offering self-determined exclusion durations, and promoting additional use of professional addiction care.

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          Most cited references 39

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          Risk factors for problematic gambling: a critical literature review.

          This article is a critical review of risk factors for pathological gambling categorized by demographics, physiological and biological factors, cognitive distortions, comorbidity and concurrent symptoms, and personality symptoms and characteristics. There is also a varia section (availability, parents playing, sensory characteristics, schedules of reinforcement, age of onset, and playing duration). The review found very few well established risk factors for pathological gambling (i.e. more than two studies to support the conclusions). Well established risk factors included demographic variables (age, gender), cognitive distortions (erroneous perceptions, illusion of control), sensory characteristics, schedules of reinforcement, comorbid disorders (OCD, drug abuse), and delinquency/illegal acts. An understanding of risk factors for pathological gambling should enhance prevention and treatment approaches.
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            Internet gambling: issues, concerns, and recommendations.

            The influence of technology in the field of gambling innovation continues to grow at a rapid pace. After a brief overview of gambling technologies and deregulation issues, this review examines the impact of technology on gambling by highlighting salient factors in the rise of Internet gambling (i.e., accessibility, affordability, anonymity, convenience, escape immersion/dissociation, disinhibition, event frequency, asociability, interactivity, and simulation). The paper also examines other factors in relation to Internet gambling including the relationship between Internet addiction and Internet gambling addiction. The paper ends by overviewing some of the social issues surrounding Internet gambling (i.e., protection of the vulnerable, Internet gambling in the workplace, electronic cash, and unscrupulous operators). Recommendations for Internet gambling operators are also provided.
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              Sociodemographic correlates of internet gambling: findings from the 2007 british gambling prevalence survey.

              This study provides the first analysis ever made of a representative national sample of Internet gamblers. Using participant data from the 2007 British Gambling Prevalence Survey (n = 9,003 adults aged 16 years and over), all participants who had gambled online, bet online, and/or used a betting exchange in the last 12 months (n = 476) were compared with all other gamblers who had not gambled via the Internet. Overall, results showed a number of significant sociodemographic differences between Internet gamblers and non-Internet gamblers. When compared to non-Internet gamblers, Internet gamblers were more likely to be male, relatively young adults, single, well educated, and in professional/managerial employment. Further analysis of DSM-IV scores showed that the problem gambling prevalence rate was significantly higher among Internet gamblers than among non-Internet gamblers. Results suggest that the medium of the Internet may be more likely to contribute to problem gambling than gambling in offline environments.

                Author and article information

                Journal of Behavioral Addictions
                J Behav Addict
                Akadémiai Kiadó (Budapest )
                31 October 2018
                December 2018
                : 7
                : 4
                : 903-916
                [ 1 ] IFT Institut für Therapieforschung , Munich, Germany
                [ 2 ]Faculty of Health, H:G University for Health and Sport , Ismaning, Germany
                [ 3 ]Department of Public Health Sciences, Stockholm University , Stockholm, Sweden
                [ 4 ]Institute of Psychology, ELTE Eötvös Loránd University , Budapest, Hungary
                Author notes
                [* ]Corresponding author: Ludwig Kraus; IFT Institut für Therapieforschung, Leopoldstr. 175, Munich 80804, Germany; Phone: +49 89 360804 30; Fax: +49 89 360804 19; E-mail: kraus@
                © 2018 The Author(s)

                This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License, which permits unrestricted use, distribution, and reproduction in any medium for non-commercial purposes, provided the original author and source are credited, a link to the CC License is provided, and changes – if any – are indicated.

                Page count
                Figures: 1, Tables: 1, Equations: 0, References: 47, Pages: 14
                Funding sources: FM, BG, PS, BB, and LK were supported by the Bavarian State Ministry of Finance, Regional Development and Regional Identity via the Bavarian State Ministry of Public Health and Care Services in the context of the Bavarian Coordination Centre for Gambling Issues (LSG Bayern). Funding for JCÖ and LK was provided within the frame of the Swedish program grant “Responding to and Reducing Gambling Problems – Studies in Help-seeking, Measurement, Comorbidity and Policy Impacts” financed by the Swedish Research Council for Health, Working Life and Welfare (Forte), grant number 2016-07091.
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