Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
Journal of Gambling Studies
Published in: Journal of Gambling Studies 2/2019

01-06-2019 | Review Paper

A Systematic Review of Land-Based Self-Exclusion Programs: Demographics, Gambling Behavior, Gambling Problems, Mental Symptoms, and Mental Health

Authors: Roxana Kotter, Anja Kräplin, Andre Pittig, Gerhard Bühringer

Published in: Journal of Gambling Studies | Issue 2/2019

Login to get access

Abstract

Systematic and quantitative reviews on the effects of land-based self-exclusion are scarce. Therefore, the current review aimed to provide a comprehensive summary of (1) the demographic characteristics of land-based self-excluders and changes after exclusion, including (2) gambling behavior, (3) gambling problems, (4) mental symptoms, and (5) mental health. A systematic database and literature search was performed following PRISMA guidelines. Nineteen naturalistic studies met the eligibility criteria. The quality of all included records was rated via adaption of the Newcastle–Ottawa Scale. Results from higher-quality records were more heavily weighted. Self-excluders were predominantly men in their early or middle forties. Changes after exclusion revealed wide ranges in the rates of abstinence (13–81%), rates of gambling reduction (29–92%), and rates of exclusion breaches (8–59%). The records consistently demonstrated significant changes in pathological gambling from before exclusion (61–95%) to after exclusion (13–26%). Up to 73% of self-excluders exhibited symptoms of anxiety, depression, and substance use disorders at program enrollment. Several aspects of mental health improved after exclusion, e.g., quality of life. Problem and pathological gambling are most prevalent in young men, but self-exclusion was most prominent in middle-aged men. The magnitude of effects widely differed between studies despite overall benefits of self-exclusion, and many individuals continued gambling after exclusion. This shortcoming could be minimized using improved access controls and the extension of exclusion to other gambling segments. High rates of pathological gambling and other mental disorders in self-excluders highlight the need for improved early detection and treatment accessibility.
Appendix
Available only for authorised users
Literature
American Psychiatric Association [APA]. (1994). Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV). Washington, DC: American Psychiatric Association.
APA. (2013). Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). Arlington: American Psychiatric Association.
Blaszczynski, A., & Nower, L. (2002). A pathways model of problem and pathological gambling. Addiction, 97(5), 487–499.CrossRefPubMed
Dowling, N. A., Cowlishaw, S., Jackson, A. C., Merkouris, S. S., Francis, K. L., & Christensen, D. R. (2015a). Prevalence of psychiatric co-morbidity in treatment-seeking problem gamblers: A systematic review and meta-analysis. Australian and New Zealand Journal of Psychiatry, 49(6), 519–539.CrossRefPubMed
Dowling, N. A., Cowlishaw, S., Jackson, A. C., Merkouris, S. S., Francis, K. L., & Christensen, D. R. (2015b). The prevalence of comorbid personality disorders in treatment-seeking problem gamblers: A systematic review and meta-analysis. Journal of Personality Disorders, 29(6), 735–754.CrossRefPubMed
Ewing, J. A. (1984). Detecting alcoholism—the Cage Questionnaire. Journal of the American Medical Association, 252(14), 1905–1907.CrossRefPubMed
Ferris, J., & Wynne, H. (2001). The Canadian Problem Gambling Index: Final report. Ottawa: Canadian Centre on Substance Abuse.
Gainsbury, S. M. (2014). Review of self-exclusion from gambling venues as an intervention for problem gambling. Journal of Gambling Studies, 30(2), 229–251.CrossRefPubMed
Goldberg, D., & Williams, P. (1988). A users guide to the General Health Questionnaire. Slough: NFER-Nelson.
Grant, J. E., & Kim, S. W. (2005). Quality of life in kleptomania and pathological gambling. Comprehensive Psychiatry, 46, 34–37.CrossRefPubMed
Hall, G. W., Carriero, N. J., Takushi, R. Y., Montoya, I. D., Preston, K. L., & Gorelick, D. A. (2000). Pathological gambling among cocaine-dependent outpatients. American Journal of Psychiatry, 157(7), 1127–1133.CrossRefPubMed
+ Hayer, T., & Meyer, G. (2011). Self-exclusion as a harm minimization strategy: Evidence for the casino sector from selected European countries. Journal of Gambling Studies, 27(4), 685–700.CrossRefPubMed
+ Hing, N., & Nuske, E. (2012). The self-exclusion experience for problem gamblers in South Australia. Australian Social Work, 65(4), 457–473.CrossRef
+ Hing, N., Russell, A., Tolchard, B., & Nuske, E. (2015). Are there distinctive outcomes from self-exclusion? An exploratory study comparing gamblers who have self-excluded, received counselling, or both. International Journal of Mental Health and Addiction, 13(4), 481–496.CrossRef
+ Hing, N., Tolchard, B., Nuske, E., Holdsworth, L., & Tiyce, M. (2014). A process evaluation of a self-exclusion program: A qualitative investigation from the perspective of excluders and non-excluders. International Journal of Mental Health and Addiction, 12(4), 509–523.CrossRef
Kessler, R. C., Hwang, I., LaBrie, R., Petukhova, M., Sampson, N. A., Winters, K. C., et al. (2008). DSM-IV pathological gambling in the National Comorbidity Survey Replication. Psychological Medicine, 38(9), 1351–1360.CrossRefPubMedPubMedCentral
+ LaBrie, R. A., Nelson, S. E., LaPlante, D. A., Peller, A. J., Caro, G., & Shaffer, H. J. (2007). Missouri casino self-excluders: Distributions across time and space. Journal of Gambling Studies, 23(2), 231–243.CrossRefPubMed
+ Ladouceur, R., Jacques, C., Giroux, I., Ferland, F., & Leblond, J. (2000). Analysis of a casino’s self-exclusion program. Journal of Gambling Studies, 16(4), 453–460.CrossRefPubMed
Ladouceur, R., Shaffer, P., Blaszczynski, A., & Shaffer, H. J. (2017). Responsible gambling: A synthesis of the empirical evidence. Addiction Research & Theory, 25(3), 225–235.CrossRef
+ Ladouceur, R., Sylvain, C., & Gosselin, P. (2007). Self-exclusion program: A longitudinal evaluation study. Journal of Gambling Studies, 23(1), 85–94.CrossRefPubMed
Lesieur, H. R., & Blume, S. B. (1987). The South Oaks Gambling Screen (SOGS): A new instrument for the identification of pathological gamblers. American Journal of Psychiatry, 144, 1184–1188.CrossRefPubMed
+ Lhommeau, N., Alexandre, J. M., Mete, D., Fatseas, M., & Auriacombe, M. (2015). Characteristics of gamblers choosing self-exclusion from casinos: A prospective study in a French overseas territory. Drug and Alcohol Dependence, 156, e127.CrossRef
Lo, C. K. L., Mertz, D., & Loeb, M. (2014). Newcastle–Ottawa Scale: Comparing reviewers’ to authors’ assessments. BMC Medical Research Methodology, 14(1), 1–5.CrossRef
Lorains, F. K., Cowlishaw, S., & Thomas, S. A. (2011). Prevalence of comorbid disorders in problem and pathological gambling: Systematic review and meta-analysis of population surveys. Addiction, 106(3), 490–498.CrossRefPubMed
Merkouris, S. S., Thomas, S. A., Browning, C. J., & Dowling, N. A. (2016). Predictors of outcomes of psychological treatments for disordered gambling: A systematic review. Clinical Psychology Review, 48, 7–31.CrossRefPubMed
Moher, D., Liberati, A., Tetzlaff, J., Altman, D. G., & Grp, P. (2009). Preferred reporting items for systematic reviews and meta-analyses: The PRISMA statement. Physical Therapy, 89(9), 873–880. (Reprinted from Annals of Internal Medicine).PubMed
+ Nelson, S. E., Kleschinsky, J. H., LaBrie, R. A., Kaplan, S., & Shaffer, H. J. (2010). One decade of self-exclusion: Missouri casino self-excluders four to ten years after enrollment. Journal of Gambling Studies, 26(1), 129–144.CrossRefPubMed
+ Nower, L., & Blaszczynski, A. (2006). Characteristics and gender differences among self-excluded casino problem gamblers: Missouri data. Journal of Gambling Studies, 22(1), 81–99.CrossRefPubMed
+ Nower, L., & Blaszczynski, A. (2008). Characteristics of problem gamblers 56 years of age or older: A statewide study of casino self-excluders. Psychology and Aging, 23(3), 577–584.CrossRefPubMed
Petry, N. M., Stinson, F. S., & Grant, B. F. (2005). Comorbidity of DSM-IV pathological gambling and other psychiatric disorders: Results from the National Epidemiologic Survey on Alcohol and Related Conditions. Journal of Clinical Psychiatry, 66(5), 564–574.CrossRefPubMed
Prochaska, J. O., Velicer, W., Rossi, J., Goldstein, M., Marcus, B., Rakowski, W., et al. (1994). Stages of change and decision balance for 12 problem behaviors. Health Psychology, 13, 39–46.CrossRefPubMed
+ Responsible Gambling Council. (2008). From enforcement to assistance: Evolving best practices in self-exclusion. Discussion paper by the Responsible Gambling Council. https://​www.​gaming.​ny.​gov/​gaming/​20140409forum/​Kelly (Responsible Gambling Ontario)/Supplemental Material/Responsible Gambling Ontario, From Enforcement to Assistance, Evolving Best Practices in self-exclusion (2008).pdf. Accessed 7 Nov 2017.
Sassen, M., Kraus, L., & Bühringer, G. (2011). Differences in pathological gambling prevalence estimates: Facts or artefacts? International Journal of Methods in Psychiatric Research, 20(4), e83–e99.CrossRefPubMed
Shamseer, L., Moher, D., Clarke, M., Ghersi, D., Liberati, A., Petticrew, M., et al. (2015). Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015: Elaboration and explanation. British Medical Journal, 349, g7647.CrossRef
Sheehan, D. V., Lecrubier, Y., Sheehan, K. H., Amorim, P., Janavs, J., Weiller, E., et al. (1998). The Mini-International Neuropsychiatric Interview (MINI): The development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. Journal of Clinical Psychiatry, 59, 22–33.PubMed
Stinchfield, R., Govoni, R., & Frisch, G. R. (2005). DSM-IV diagnostic criteria for pathological gambling: Reliability, validity, and classification accuracy. American Journal on Addictions, 14(1), 73–82.CrossRefPubMed
+ Townshend, P. (2007). Self-exclusion in a public health environment: An effective treatment option in New Zealand. International Journal of Mental Health and Addiction, 5, 390–395.CrossRef
+ Tremblay, N., Boutin, C., & Ladouceur, R. (2008). Improved self-exclusion program: Preliminary results. Journal of Gambling Studies, 24(4), 505–518.CrossRefPubMed
Woodruff, C., & Gregory, S. (2005). Profile of internet gamblers: Betting on the future. UNLV Gaming Research & Review Journal, 9(1), 1–14.
Metadata
Title
A Systematic Review of Land-Based Self-Exclusion Programs: Demographics, Gambling Behavior, Gambling Problems, Mental Symptoms, and Mental Health
Authors
Roxana Kotter
Anja Kräplin
Andre Pittig
Gerhard Bühringer
Publication date
01-06-2019
Publisher
Springer US
Published in
Journal of Gambling Studies / Issue 2/2019
Electronic ISSN: 1573-3602
DOI
https://doi.org/10.1007/s10899-018-9777-8

Other articles of this Issue 2/2019

Journal of Gambling Studies 2/2019 Go to the issue

Original Paper

Online Self-Directed Interventions for Gambling Disorder: Randomized Controlled Trial

Original Paper

Gambling Disorder in Male Violent Offenders in the Prison System: Psychiatric and Substance-Related Comorbidity

Original Paper

Effectiveness of At-Risk Gamblers’ Temporary Self-Exclusion from Internet Gambling Sites

Original Paper

Self-Reported Negative Influence of Gambling Advertising in a Swedish Population-Based Sample

Original Paper

Decision-Making Styles, Negative Affectivity, and Cognitive Distortions in Adolescent Gambling

Review Paper

The Psychology of Esports: A Systematic Literature Review