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      Prevalence of gambling-related harm provides evidence for the prevention paradox

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          The prevention paradox (PP) describes a situation in which a greater number of cases of a disease-state come from low-risk members of a population, because they are more prevalent than high-risk members. Past research has provided only tangential and disputed evidence to support the application of the PP to gambling-related harm.


          To assess whether the PP applies to gambling, the prevalence of a large set (72) of diverse harmful consequences from gambling was examined across four risk categories for problem gambling, including no-risk, low-risk, moderate-risk, and problem-gambling.


          Respondents who had gambled on non-lottery forms in the past 6 months completed an online survey ( N = 1,524, 49.4% male). The data were weighted to the known prevalence of gambling problems in the Victorian community.


          The prevalence of gambling harms, including severe harms, was generally higher in the combined categories of lower risk categories compared to the high-risk problem-gambling category. There were some notable exceptions, however, for some severe and rare harms. Nevertheless, the majority of harms in the 72-item list, including serious harms such as needing temporary accommodation, emergency welfare assistance, experiencing separation or end of a relationship, loss of a job, needing to sell personal items, and experiencing domestic violence from gambling, were more commonly associated with lower risk gamblers.


          Many significant harms are concentrated outside the ranks of gamblers with a severe mental health condition, which supports a public-health approach to ameliorating gambling-related harm.

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          Most cited references 23

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          Validity of the Problem Gambling Severity Index interpretive categories.

          The Problem Gambling Severity Index (PGSI) is a widely used nine item scale for measuring the severity of gambling problems in the general population. Of the four gambler types defined by the PGSI, non-problem, low-risk, moderate-risk and problem gamblers, only the latter category underwent any validity testing during the scale's development, despite the fact that over 95% of gamblers fall into one of the remaining three categories. Using Canadian population data on over 25,000 gamblers, we conducted a comprehensive validity and reliability analysis of the four PGSI gambler types. The temporal stability of PGSI subtype over a 14-month interval was modest but adequate (intraclass correlation coefficient = 0.63). There was strong evidence for the validity of the non-problem and problem gambler categories however the low-risk and moderate-risk categories showed poor discriminant validity using the existing scoring rules. The validity of these categories was improved with a simple modification to the scoring system.
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            Understanding gambling related harm: a proposed definition, conceptual framework, and taxonomy of harms

            Background Harm from gambling is known to impact individuals, families, and communities; and these harms are not restricted to people with a gambling disorder. Currently, there is no robust and inclusive internationally agreed upon definition of gambling harm. In addition, the current landscape of gambling policy and research uses inadequate proxy measures of harm, such as problem gambling symptomology, that contribute to a limited understanding of gambling harms. These issues impede efforts to address gambling from a public health perspective. Methods Data regarding harms from gambling was gathered using four separate methodologies, a literature review, focus groups and interviews with professionals involved in the support and treatment of gambling problems, interviews with people who gamble and their affected others, and an analysis of public forum posts for people experiencing problems with gambling and their affected others. The experience of harm related to gambling was examined to generate a conceptual framework. The catalogue of harms experienced were organised as a taxonomy. Results The current paper proposes a definition and conceptual framework of gambling related harm that captures the full breadth of harms that gambling can contribute to; as well as a taxonomy of harms to facilitate the development of more appropriate measures of harm. Conclusions Our aim is to create a dialogue that will lead to a more coherent interpretation of gambling harm across treatment providers, policy makers and researchers.
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              Risky Business: A Few Provocations on the Regulation of Electronic Gaming Machines


                Author and article information

                Journal of Behavioral Addictions
                J Behav Addict
                Akadémiai Kiadó (Budapest )
                15 May 2018
                June 2018
                : 7
                : 2
                : 410-422
                [ 1 ]School of Health, Medical and Applied Sciences, Central Queensland University , Branyan, QLD, Australia
                Author notes
                [* ]Corresponding author: Matthew Browne; School of Health, Medical and Applied Sciences, Central Queensland University, Bundaberg Campus, B8 G.47 University Drive, Branyan 4670, QLD, Australia; Phone: +61 7 4150 7002; E-mail: m.browne@
                © 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: 10, Tables: 1, Equations: 0, References: 21, Pages: 13
                Funding sources: Data collection for this study was funded by the Victorian Responsible Gambling Foundation (VRGF). MB has received funding from the NZ Ministry of Health, VRGF, the Queensland Department of Health, the Tasmanian Department of Treasury and Finance, the Alberta Gambling Research Institute, the First Nations Foundation and Gambling Research Australia. MJR has additionally received funding from the Department of Social Services (Federal), the Queensland Treasury, and the Victorian Department of Justice.
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