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      A Multivariate Evaluation of 25 Proximal and Distal Risk-Factors for Gambling-Related Harm

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          Abstract

          Individual differences in the risk of developing gambling-related harm play an important role in theoretical models and practical interventions. The present study attempted comprehensive measurement and evaluation of 25 known risk factors for gambling-related harm in order to determine which factors provided large and unique explanatory power. We surveyed 1650 regular gamblers from an online panel, screening in 1174 (466 male) who passed all checks of attention and response consistency. We evaluated each risk factor based on bivariate correlations with harms, then made separate multivariate evaluations of proximal (e.g., gambling motivations) and distal (e.g., religiosity) risk factors. Almost all bivariate correlations were significant, but most distal factors were not significant in multivariate models. Trait impulsivity was the most important risk factor by a large margin. Excessive consumption, less use of safe gambling practices, and more fallacies were key proximal risks of harm. Many well-known correlates of gambling harm (e.g., youth, lower educational attainment) do not show a direct role in the development of gambling harm when controlling for other factors. The results support theoretical models that emphasise early conditioning and biological vulnerability (manifested through impulsivity). Since maladaptive cognitive and behavioural schemas appear to be more important than motivations (e.g., escape, excitement, ego), interventions may benefit by targeting these proximal drivers of harm.

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          Most cited references34

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          The dominance analysis approach for comparing predictors in multiple regression.

          A general method is presented for comparing the relative importance of predictors in multiple regression. Dominance analysis (D. V. Budescu, 1993), a procedure that is based on an examination of the R2 values for all possible subset models, is refined and extended by introducing several quantitative measures of dominance that differ in the strictness of the dominance definition. These are shown to be intuitive, meaningful, and informative measures that can address a variety of research questions pertaining to predictor importance. The bootstrap is used to assess the stability of dominance results across repeated sampling, and it is shown that these methods provide the researcher with more insights into the pattern of importance in a set of predictors than were previously available.
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            Dopaminergic network differences in human impulsivity.

            Dopamine (DA) has long been implicated in impulsivity, but the precise mechanisms linking human variability in DA signaling to differences in impulsive traits remain largely unknown. By using a dual-scan positron emission tomography approach in healthy human volunteers with amphetamine and the D2/D3 ligand [18F]fallypride, we found that higher levels of trait impulsivity were predicted by diminished midbrain D2/D3 autoreceptor binding and greater amphetamine-induced DA release in the striatum, which was in turn associated with stimulant craving. Path analysis confirmed that the impact of decreased midbrain D2/D3 autoreceptor availability on trait impulsivity is mediated in part through its effect on stimulated striatal DA release.
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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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                Author and article information

                Journal
                J Clin Med
                J Clin Med
                jcm
                Journal of Clinical Medicine
                MDPI
                2077-0383
                13 April 2019
                April 2019
                : 8
                : 4
                : 509
                Affiliations
                [1 ]Experimental Gambling Research Laboratory, School of Health, Medical and Applied Sciences, CQUniversity, University Drive Bundaberg, Branyan, QLD 4670, Australia; n.hing@ 123456cqu.edu.au (N.H.); m.rockloff@ 123456cqu.edu.au (M.R.); a.m.russell@ 123456cqu.edu.au (A.M.T.R.); n.greer@ 123456cqu.edu.au (N.G.)
                [2 ]Department of Political Science, University of Alberta, Edmonton, AB T6G 2R3, Canada; f.nicoll@ 123456ualberta.ca
                [3 ]Faculty of Extension, University of Alberta, Edmonton, AB T6G 2R3, Canada; garrysm@ 123456ualberta.ca
                Author notes
                [* ]Correspondence: m.browne@ 123456cqu.edu.au ; Tel.: +61-7-5150-7002
                Author information
                https://orcid.org/0000-0002-2668-6229
                https://orcid.org/0000-0002-2150-9784
                https://orcid.org/0000-0002-3685-7220
                Article
                jcm-08-00509
                10.3390/jcm8040509
                6518151
                31013926
                50d68e8a-c46e-4a77-a979-9416ee282ba2
                © 2019 by the authors.

                Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( http://creativecommons.org/licenses/by/4.0/).

                History
                : 27 March 2019
                : 12 April 2019
                Categories
                Article

                risk factors,gambling-related harm,gambling problems,impulsivity,early experiences,safe gambling practices,fallacies

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