Annual Research Review: Emergence of problem gambling from childhood to emerging adulthood: a systematic review

Abstract

Background:The risk for problematic gambling and associated high-risk behaviors is elevated during adolescence and emerging adulthood. Activities with gambling-like features and novel forms of gambling may place youth at an increased risk for problem gambling. Aim and method: The aim of this review is to provide an overview of the association between both activities with gambling-like features and novel gambling activities and problem gambling among youth while examining the role of psychopathology and cognitive processes. Six databases (PsychINFO, MEDLINE, PubMed, Social Work Abstracts, Technology Collection, and Scopus) were searched in November 2021 for peer-reviewed articles investigating the association between the aforementioned variables among youth up to the age of 25 years. Risk of bias was assessed using the Observational Study Quality Evaluation. Findings: Forty-five articles were included in the review. Positive associations were observed between engagement in activities with gambling-like features (e.g., video games, social casino games, loot boxes) and problem gambling. Increased involvement with novel forms of gambling (e.g., online sports betting, fantasy sports, and esports betting) were also associated with a greater risk for problematic gambling. Males reported higher rates of engagement in these activities and a greater risk of problem gambling than females. Impulsivity, risk taking, cognitive distortions, and specific emotional vulnerabilities were associated with an increased risk of problem gambling. Conclusions: Despite the need for additional longitudinal research controlling for relevant confounders, these findings underline how engagement in activities with gambling-like features are relevant in the developmental trajectory toward problem gambling.

Alternative hypotheses regarding the association between early engagement in gambling and gambling‐like activities and later problem gambling – a commentary on Richard and King (2023)

“…We agree with Richard and King's (2023) suggestion that additional longitudinal and genetically informative studies addressing early engagement in gambling and gambling‐like activities are needed. Additional twin studies and GWAS addressing problem gambling in adolescents and emerging adults are also needed.…”

“…Evidence from both cross-sectional and longitudinal studies suggests that engagement with either of these activities is associated with greater risk for problem gambling in adolescents and young adults. Richard and King (2023) discuss two hypotheses explaining this association. The first is the 'gateway hypothesis' (Delfabbro & King, 2020).…”

“…That is, youth engaging in activities with gambling‐like features are put at greater risk for later problem gambling through exposures to behaviorally reinforcing mechanisms. Richard and King (2023) conclude that there is some initial evidence for the gateway hypothesis; frequency of video game playing, early onset of video game playing, and problem video gaming are associated with problem gambling in both cross‐sectional and longitudinal studies. In particular, specific features such as loot boxes (i.e., virtual items of random value and desirability that can be purchased with real money) may provide repeated exposures to reinforcing mechanisms in gaming contexts.…”

“…This hypothesis is based on findings that early initiation of alcohol use is associated with an increased likelihood of alcohol dependence due to common familial and heritable factors rather than via direct influence of early alcohol use on later alcohol‐related problems. Richard and King (2023) review several pieces of evidence congruent with the common‐inherited‐vulnerability hypothesis, including associations between problem gambling and hyperactivity, emotional problems, stress, anxiety, and depressive symptoms. Further, externalizing problems appear to be the primary psychopathology vulnerability for later problem gambling, and risk factors for externalizing problems (e.g., risk taking, impulsivity) have been shown to explain the association between gambling‐like activities/novel gambling activities and later problem gambling.…”

Editorial: Unsettling ‘settled’ science – the importance of questioning received wisdom about the causes of mental health and neuro‐developmental conditions

“…Today, 95% of teens have access to a smartphone (Pew Research Center, 2018) and the majority of teens engage in at least some online gambling (Riley, Oster, Rahamathulla, & Lawn, 2021) with researchers asking whether the “gamblification” of online and gaming environments commonly accessed by children and adolescents is a gateway to more problematic gambling (Delfabbro & King, 2020). As reviewed by Richard and King (2023), youth who engaged in activities with gambling‐like features were at elevated risk for problem gambling and males were particularly vulnerable, given their high rates of engagement with these activities. To the extent that future research can show that online games with gambling‐like features are, in fact, a gateway to more problematic gambling, then policy‐level interventions may be required to prohibit access to such games to minors.…”