Teacher-rated school leadership and adolescent gambling: a study of schools in Stockholm, Sweden

Background So-called “effective schools” are characterised by features such as a strong and purposeful school leadership and a favourable school ethos. A prior study showed that a school's degree of teacher-rated ethos was inversely associated with student gambling and risk gambling. Building on these findings, the current study aims to examine the associations that teachers' ratings of the school leadership share with gambling and risk gambling among students in the second grade of upper secondary school in Stockholm (ages 17-18 years). Methods Data were drawn from two separate surveys performed in 2016: the Stockholm School Survey (SSS) and the Stockholm Teacher Survey (STS), with information collected amongst 5,191 students and 1,061 teachers in 46 upper secondary schools. Gambling and risk gambling was measured by student self-reports in the STS. School leadership was assessed by teachers' responses to ten items in the STS, which were added to an index and aggregated to the school level. School-level information from administrative registers was also linked to the data. The statistical method was two-level binary logistic regression analysis. Results Teachers' average ratings of the school leadership were inversely associated with both gambling (OR 0.96, 95% CI 0.93-0.998, p = 0.039) and risk gambling (OR 0.94, 95% CI 0.89-0.99, p = 0.031) among upper secondary students, whilst adjusting for sociodemographic characteristics at the student and the school level. Conclusions The findings lend further support to the assumption that characteristics of effective schools at different levels of the school organisation may reduce students' inclination to engage in health risk behaviours. Key messages Teachers’ ratings of the school leadership were inversely associated with student gambling and risk gambling, whilst adjusting for student- and school-level sociodemographic characteristics. The findings indicate that a strong school leadership, being one key feature of effective schools, may reduce students’ inclination to engage in health risk behaviours.

Teacher-Rated School Leadership and Adolescent Gambling: A Study of Upper Secondary Schools in Stockholm, Sweden

So-called “effective schools” are characterised by properties such as a strong and purposeful school leadership and a favourable school ethos. In a previous study we showed that a school’s degree of teacher-rated ethos was inversely associated with student gambling and risk gambling. Building on these findings, the current study aims to examine the associations that teachers’ ratings of the school leadership share with gambling and risk gambling among students in the second grade of upper secondary school in Stockholm (age 17–18 years). Data were drawn from the Stockholm School Survey and the Stockholm Teacher Survey with information from 5191 students and 1061 teachers in 46 upper secondary schools. School-level information from administrative registers was also linked to the data. The statistical method was two-level binary logistic regression analysis. Teachers’ average ratings of the school leadership were inversely associated with both gambling (OR 0.96, 95% CI 0.93–0.998, p = 0.039) and risk gambling (OR 0.94, 95% CI 0.89–0.99, p = 0.031) among upper secondary students, whilst adjusting for sociodemographic characteristics at the student and the school level. The findings lend further support to the hypothesis that characteristics of effective schools may reduce students’ inclination to engage in gambling and risk gambling behaviours.

Ludens: A Gambling Addiction Prevention Program Based on the Principles of Ethical Gambling

Gambling is legal in most countries. However, despite having some economic benefits, certain characteristics of gambling can have health consequences, rendering it a public health issue. The effects can be summarized according to the following three “laws” of ethical gambling: “Gambling Dynamics Law”: companies’ economic gains come directly from players’ losses; “Expected Loss Law”: the more one gambles, the greater the probability of losing; and “Addiction Law”: the more one gambles, the greater the need to play again, leading to further losses. Ludens is a gambling addiction prevention program that has four goals: inform participants about gambling and gambling addiction; sensitize participants to the risk of gambling for health, especially addiction; promote a change in attitudes toward gambling; and alert participants to risky behaviors that can lead to addiction. The prevention program was implemented during 2017 to 2019. Fourteen psychologists presented it to 2372 adolescents (48.8% females, 51.2% males) aged 14–19 years, none of whom were university students, recruited from 42 Spanish high schools in 132 groups taking different courses. The main dependent variables analyzed were the monthly frequencies of gambling, at-risk gambling, and gambling addiction (as measured by the National Opinion Research Center DSM-IV Screen for Gambling Problems, adapted to diagnose gambling disorder according to DSM-5, in which pathological gambling is considered an addictive disorder). Given that all of the gamblers were adolescents (most were minors), fulfilment of 1–3 the DSM-5 diagnostic criteria was considered to indicate a risk of problem gambling. After the administration of Ludens, statistically significant reductions were observed in the three variables of interest: monthly frequency of gambling, percentage of adolescents with risky gambling, and percentage of adolescents with gambling disorder. The results were analyzed according to sex and age (minors vs. adolescents between 18 and 19 years old). The results obtained after applying the prevention program indicate that Ludens is effective as a universal prevention program for gambling addiction.

The identification of Australian low-risk gambling limits: A comparison of gambling-related harm measures

Background and aimsProblem gambling severity and gambling-related harm are closely coupled, but conceptually distinct, constructs. The primary aim was to compare low-risk gambling limits when gambling-related harm was defined using the negative consequence items of the Problem Gambling Severity Index (PGSI-Harm) and the Short Gambling Harms Scale items (SGHS-Harm). A secondary aim was compare low-risk limits derived using a definition of harm in which at least two harms across different domains (e.g. financial and relationship) were endorsed with a definition of harm in which at least two harms from any domain were endorsed.MethodsData were collected from dual-frame computer-assisted telephone interviews of 5,000 respondents in the fourth Social and Economic Impact Study (SEIS) of Gambling in Tasmania. Receiver operating characteristic (ROC) curve analyse were conducted to identify low-risk gambling limits.ResultsPGSI-Harm and SGHS-Harm definitions produced similar overall limits: 30–37 times per year; AUD$510–$544 per year; expenditure comprising no more than 10.2–10.3% of gross personal income; 400–454 minutes per year; and 2 types of gambling activities per year. Acceptable limits (AUC ≥0.70) were identified for horse/dog racing, keno, and sports/other betting using the PGSI definition; and electronic gaming machines, keno, and bingo using the SGHS definition. The requirement that gamblers endorse two or more harms across different domains had a relatively negligible effect.Discussion and conclusionsAlthough replications using alternative measures of harm are required, previous PGSI-based limits appear to be robust thresholds that have considerable potential utility in the prevention of gambling-related harm.

Changes of Gambling Patterns during COVID-19 in Sweden, and Potential for Preventive Policy Changes. A Second Look Nine Months into the Pandemic

Gambling has been suggested as one of the potential mental health consequences of the COVID-19 pandemic. In earlier self-report studies, increased gambling has been reported by a limited proportion of respondents characterized with a high degree of problem gambling. The present study, carried out with the same methodology and in the same geographical setting, around seven months later in the pandemic, aimed to repeat and to extend the understanding of potential gambling changes in the population during COVID-19. An anonymous sample of web panel members was assessed, altogether 2029 individuals (52% women, 10% moderate-risk or problem gamblers). Results indicated that 6% reported increased gambling, and 4% reported decreased gambling during the pandemic. Having increased gambling was associated with more severe gambling problems (OR 2.78, 95% confidence interval 2.27–3.40), increased alcohol consumption (OR 2.92, 1.71–4.98), and psychological distress (OR 3.38, 1.83–6.23). In the group reporting increased gambling during COVID-19, moderate-risk/problem gambling was very common (62%). Recent governmental policy interventions in the area were known to a minority (30%) of respondents, but awareness of the regulations was markedly more common in individuals with at least moderate-risk gambling (56%) and in self-excluders (78%). Reporting of any perceived influence from policy changes was low (3%), and divided between those reporting an increasing and decreasing effect, respectively. Increased gambling may be a consequence of COVID-19-related changes in everyday lives of individuals with problematic gambling patterns. Thus, a vulnerable group demonstrates higher rates of gambling migration and psychosocial problems, and may require particular attention in screening and treatment contexts, and further scientific evaluations.

Opportunity Costs or Not? Validating the Short Gambling Harm Screen against a Set of “Unimpeachable” Negative Impacts

Assessing the harmful consequences of gambling is an area of active investigation. One measure intended to capture gambling-related harm is the 10-item short gambling harm screen (SGHS). Although good psychometric properties have been reported, it has been suggested that the screen’s less severe probes may not represent genuinely harmful consequences, but rather may reflect rational opportunity costs. Consequently, it has been argued that the screen may lead to overestimation of the extent of gambling-related harm in the population. The current study sought to examine the psychometric performance of three less severe suspect items in the SGHS. Associations between each of these items and a specially constructed scale of relatively severe “unimpeachable” gambling harms were calculated from archival data from 5551 Australian and New Zealand gamblers. All three suspect items, both individually and upon aggregation, predicted greater endorsement of “unimpeachable” harms, and indicated the presence of gambling problems. Moreover, the SGHS as a whole is highly correlated with “unimpeachable” gambling harms. Including suspect items in the SGHS was found to improve predictions of low- and moderate-risk gambling status, but slightly decreased predictions of severe gambling problems. The results are inconsistent with the notion that SGHS harm probes capture either inconsequential consequences or opportunity costs. They confirm prior findings that harm symptomatology is unidimensional, and that the report of multiple more prevalent, but less severe, harms serves as an effective indicator of the spectrum of experienced harm.

Predicting future harm from gambling over a five-year period in a general population sample: a survival analysis

Background There is little longitudinal evidence on the cumulative risk of harm from gambling associated with excess spending and frequency of play. The present study sought to assess the risk of gambling problems over a five-year period in adults who exceed previously derived low-risk gambling limits compared to those who remain within the limits after controlling for other modifiable risk factors. Methods Participants were adults (N = 4212) drawn from two independent Canadian longitudinal cohort studies who reported gambling in the past year and were free of problem gambling at time 1. Multivariate Cox regression was employed to assess the impact over time of gambling above low-risk gambling thresholds (frequency ≥ 8 times per month; expenditure ≥75CAD per month; percent of household income spent on gambling ≥1.7%) on developing moderate harm and problem gambling. Covariates included presence of a DSM5 addiction or mental health disorder at time 1, irrational gambling beliefs, number of stressful life events in past 12 months, number of game types played each year, and playing electronic gaming machines or casino games. Results In both samples, exceeding the low-risk gambling limits at time 1 significantly increased the risk of moderate harm (defined as ≥2 consequences on the Problem Gambling Severity Index [PGSI]) within 5 years after controlling for other modifiable risk factors. Other significant predictors of harm were presence of a mental disorder at time 1, cognitive distortions about gambling, stressful life events, and playing electronic gaming machines or casino games. In one sample, the five-year cumulative survival rate for moderate harm among individuals who stayed below all the low-risk limits was 95% compared to 83% among gamblers who exceeded all limits. Each additional low-risk limit exceeded increased the cumulative probability of harm by 30%. Similar results were found in models when the outcome was problem gambling. Conclusions Level of gambling involvement represents a highly modifiable risk factor for later harm. Staying below empirically derived safe gambling thresholds reduces the risk of harm over time.

The Development of Empirically Derived Australian Low-Risk Gambling Limits

This study derived a set of Australian low-risk gambling limits and explored the relative and absolute risk associated with exceeding these limits. Secondary analysis of population-representative Tasmanian and Australian Capital Territory (ACT) cross-sectional (11,597 respondents) and longitudinal studies (2027 respondents) was conducted. Balancing sensitivity and specificity, the limits were: gambling frequency of 20–30 times per year; gambling expenditure of AUD $380–$615 per year (USD $240–$388 per year); gambling expenditure comprising 0.83–1.68% of gross personal income; and two types of gambling activities per year. All limits, except number of activities, predicted subsequent harm, with limits related to gambling expenditure consistently the best-performing. Exceeding the limits generally conferred a higher degree of relative and absolute risk, with gamblers exceeding the limits being 3–20 times more likely to experience harm than those who do not, and having a 5–17% risk of experiencing harm. Only 7–12% of gamblers exceeding the limits actually experienced harm. Gambling consumption lower than the limits also conferred a considerable amount of harm. Using a relative risk method, this study derived similar limits from disparate Australian states and territories. These limits can serve as working guidelines for the consideration of researchers, clinicians, and policy makers, but need to be subject to further rigorous empirical investigation.