Aims

To explore reciprocal relationships between real-time gambling cravings and self-efficacy with gambling behaviour, and the moderating role of gambling, mental health, and addiction-related variables.

Design

Secondary analysis of a 4-week Ecological Momentary Assessment (EMA) study conducted in Tasmania, Australia.

Setting

Data were collected via telephone interviews (pre-EMA) and smartphones (EMA).

Participants

Ninety-seven regular gamblers (mean age: 45.90 years, 57.73% male) reported 5,113 observations.

Measurements

EMA measures included gambling cravings (occurrence, frequency, intensity), self-efficacy (craving-related, gambling-related), and gambling behaviour (episodes, expenditure, duration). Pre-EMA measures included gambling (severity; harms; motives; high-risk situations), mental health (depressive symptoms; anxiety symptoms) and addiction-related (alcohol use; smoking; substance use) moderator variables.

Findings

Mixed-effects binary logistic regression analyses revealed that gambling cravings predicted gambling episodes (OR = 2.23, 95% CI:1.61, 3.08), gambling self-efficacy and gambling duration were reciprocally related (OR = 4.65, 95% CI:1.08, 20.04; OR = 0.21, 95% CI:0.05, 0.93), and craving self-efficacy predicted gambling expenditure (OR = 0.30, 95% CI:0.10, 0.86). Moderation analyses revealed that: (1) craving self-efficacy exacerbated craving frequency with gambling expenditure; (2) coping motives exacerbated gambling self-efficacy with gambling expenditure; (3) high-risk positive reinforcement situations exacerbated craving intensity and gambling self-efficacy with gambling episodes, and gambling episode with craving occurrence; and (4) substance use exacerbated gambling self-efficacy with duration, and buffered gambling expenditure with craving intensity.

Conclusions

These findings have implications for the development of real-time gambling interventions that aim to reduce gambling cravings and increase self-efficacy, which could be targeted to vulnerable individuals, including people who frequently gambled for coping purposes or positive reinforcement, and people with comorbid substance use.

中文翻译：

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探索赌博渴望，自我效能感和赌博事件之间的关联：一项生态矩评估研究。

目的

探索实时赌博的渴望与赌博行为的自我效能之间的相互关系，以及赌博，心理健康和成瘾相关变量的调节作用。

设计

在澳大利亚塔斯马尼亚进行的为期4周的生态矩评估（EMA）研究的二级分析。

设置

通过电话采访（pre-EMA）和智能手机（EMA）收集数据。

参加者

有97名定期赌徒（平均年龄：45.90岁，男性占57.73％）报告了5113次观察。

测量

EMA措施包括赌博渴望（发生，频率，强度），自我效能感（与渴望相关，与赌博有关）和赌博行为（事件，支出，持续时间）。EMA之前的措施包括赌博（严重性，伤害，动机，高危情况），心理健康（抑郁症状，焦虑症状）和与成瘾有关的（饮酒，吸烟，吸毒）主持人变量。

发现

混合效应二元logistic回归分析显示，赌博渴望预测了赌博事件（OR = 2.23，95％CI：1.61，3.08），赌博自我效能和赌博持续时间相互相关（OR = 4.65，95％CI：1.08，20.04 ； OR = 0.21，95％CI：0.05，0.93），并渴望自我效能感预测的赌博支出（OR = 0.30，95％CI：0.10，0.86）。适度分析显示：（1）渴望自我效能感会增加对赌博支出的渴望频率；（2）应对动机加剧了赌博的自我效能和赌博支出；（3）高风险的正强化情况加剧了人们对游戏的渴望强度和赌博自我效能感，以及赌博事件的发生；（4）滥用药物会延长赌博的自我效能感，

结论

这些发现对实时赌博干预措施的发展具有意义，该干预措施旨在减少对赌博的渴望并提高自我效能，这些措施可能针对弱势人群，包括经常为应对目的或积极强化而赌博的人以及患有共病的人使用。