Ecological Momentary Assessment of the Relationship between Positive Outcome Expectancies and Gambling Behaviour

Abstract

Relapse prevention models suggest that positive outcome expectancies can constitute situational determinants of relapse episodes that interact with other factors to determine the likelihood of relapse. The primary aims were to examine reciprocal relationships between situational positive gambling outcome expectancies and gambling behaviour and moderators of these relationships. An online survey and a 28 day Ecological Momentary Assessment (EMA) were administered to 109 past-month gamblers (84% with gambling problems). EMA measures included outcome expectancies (enjoyment/arousal, self-enhancement, money), self-efficacy, craving, negative emotional state, interpersonal conflict, social pressure, positive emotional state, financial pressures, and gambling behaviour (episodes, expenditure). Pre-EMA measures included problem gambling severity, motives, psychological distress, coping strategies, and outcome expectancies. No reciprocal relationships between EMA outcome expectancies and gambling behaviour (episodes, expenditure) were identified. Moderations predicting gambling episodes revealed: (1) cravings and problem gambling exacerbated effects of enjoyment/arousal expectancies; (2) positive emotional state and positive reframing coping exacerbated effects of self-enhancement expectancies; and (3) instrumental social support buffered effects of money expectancies. Positive outcome expectancies therefore constitute situational determinants of gambling behaviour, but only when they interact with other factors. All pre-EMA expectancies predicted problem gambling severity (OR = 1.61–3.25). Real-time interventions addressing gambling outcome expectancies tailored to vulnerable gamblers are required.

A Gambling Just-In-Time Adaptive Intervention (GamblingLess: In-The-Moment): Protocol for a Microrandomized Trial

“…These findings, which support the relapse prevention model, suggest that cravings, self-efficacy, and positive outcome expectancies constitute phasic precipitants of gambling behavior, although this may only occur for positive outcome expectancies when they interact with tonic precipitants, such as problem gambling severity [ 90 ]. The presence of these discrete but fluctuating precipitants, in combination with the complex and dynamic nature of gambling episodes or lapses, calls for the development of tailored interventions delivered in real time, such as just-in-time adaptive interventions (JITAIs).…”

“…Each EMA, which will take approximately 1 minute to complete, will comprise 10 items measuring momentary internal states and ecological contexts (including the tailoring variables), most of which are recorded on varying 5-point response scales presented in a multiple-choice format. To ensure an accurate record of gambling events, participants will also be administered an event record ( Multimedia Appendix 1 ) in each EMA, in which they will record gambling episodes (primary proximal outcome) and associated expenditure using single items that have been used in previous EMA and ecological momentary intervention gambling research [ 90 , 92 , 115 , 116 ].…”

“…Ecological momentary assessment (EMA), an event-level longitudinal methodology, overcomes the limitations of cross-sectional research by repeatedly measuring symptoms, emotions, behavior, and thoughts in real time and in natural environments [80]. Although there is now substantial EMA evidence that momentary cognitive processes (cravings, self-efficacy, and positive outcome expectancies) predict the occurrence of tobacco, alcohol, and substance use [83][84][85][86][87][88][89], few EMA studies have explored the associations between these processes and gambling behavior [90][91][92]. In the available studies, momentary cravings and self-efficacy, but not positive outcome expectancies, have predicted the likelihood of a subsequent gambling episode [90][91][92].…”

“…Although there is now substantial EMA evidence that momentary cognitive processes (cravings, self-efficacy, and positive outcome expectancies) predict the occurrence of tobacco, alcohol, and substance use [83][84][85][86][87][88][89], few EMA studies have explored the associations between these processes and gambling behavior [90][91][92]. In the available studies, momentary cravings and self-efficacy, but not positive outcome expectancies, have predicted the likelihood of a subsequent gambling episode [90][91][92]. Moreover, all of these momentary cognitive processes constitute situational determinants of gambling behavior when they interact with other factors implicated in the relapse prevention model, such as high-risk positive reinforcement situations, self-efficacy, coping motives, cravings, positive emotional states, and coping styles [90][91][92].…”

“…In the available studies, momentary cravings and self-efficacy, but not positive outcome expectancies, have predicted the likelihood of a subsequent gambling episode [90][91][92]. Moreover, all of these momentary cognitive processes constitute situational determinants of gambling behavior when they interact with other factors implicated in the relapse prevention model, such as high-risk positive reinforcement situations, self-efficacy, coping motives, cravings, positive emotional states, and coping styles [90][91][92].…”