CoChat
Sign Up
Cited by 442Gambling Behavior and TreatmentsSubstance Abuse Treatment and OutcomesCrime Patterns and Interventions

Early risk and protective factors for problem gambling: a systematic review and meta-analysis of longitudinal studies

Open access
Dowling, N.A., Merkouris, S.S., Greenwood, C.J., Oldenhof, E., Toumbourou, J.W., Youssef, G.J.·2017·Clinical Psychology Review
DOI 10.1016/j.cpr.2016.10.008
Open this paper in CoChat — free accountOpen PDF

Abstract

This systematic review aimed to identify early risk and protective factors (in childhood, adolescence or young adulthood) longitudinally associated with the subsequent development of gambling problems. A systematic search of peer-reviewed and grey literature from 1990 to 2015 identified 15 studies published in 23 articles. Meta-analyses quantified the effect size of 13 individual risk factors (alcohol use frequency, antisocial behaviours, depression, male gender, cannabis use, illicit drug use, impulsivity, number of gambling activities, problem gambling severity, sensation seeking, tobacco use, violence, undercontrolled temperament), one relationship risk factor (peer antisocial behaviours), one community risk factor (poor academic performance), one individual protective factor (socio-economic status) and two relationship protective factors (parent supervision, social problems). Effect sizes were on average small to medium and sensitivity analyses revealed that the results were generally robust to the quality of methodological approaches of the included articles. These findings highlight the need for global prevention efforts that reduce risk factors and screen young people with high-risk profiles. There is insufficient investigation of protective factors to adequately guide prevention initiatives. Future longitudinal research is required to identify additional risk and protective factors associated with problem gambling, particularly within the relationship, community, and societal levels of the socio-ecological model.

AI snapshot

Written from the paper’s full text.

TL;DR

This first systematic review and meta-analysis of longitudinal studies identified 15 studies in 23 articles on early risk and protective factors for problem gambling. The strongest risk factors were problem gambling severity, male gender, and poor academic performance, while protective factors included parent supervision, socio-economic status, and social problems.

Key findings

  • Across 15 studies in 23 articles, 33 thematic factors were quantitatively synthesized; 15 risk factors and 3 protective factors were significantly associated with subsequent problem gambling. Problem gambling severity had the strongest effect (r = 0.40, 95% CI 0.26–0.54), followed by male gender (r = 0.24, 95% CI 0.16–0.33) and poor academic performance (r = 0.24, 95% CI 0.09–0.39).
  • Other significant risk factors included impulsivity (r = 0.21, 95% CI 0.11–0.30), number of gambling activities (r = 0.19, 95% CI 0.14–0.24), alcohol use frequency (r = 0.19, 95% CI 0.15–0.22), cannabis use (r = 0.15, 95% CI 0.12–0.19), depressive symptoms (r = 0.15, 95% CI 0.03–0.27), illicit drug use (r = 0.14, 95% CI 0.11–0.17), tobacco use (r = 0.14, 95% CI 0.10–0.18), peer antisocial behaviours (r = 0.12, 95% CI 0.07–0.16), violence (r = 0.12, 95% CI 0.06–0.17), antisocial behaviours (r = 0.07, 95% CI 0.01–0.14), sensation seeking (r = 0.02, 95% CI 0.01–0.04), and undercontrolled temperament (r = 0.22, 95% CI 0.13–0.31).
  • Significant protective factors were parent supervision (r = −0.10, 95% CI −0.18 to −0.03), socio-economic status (r = −0.07, 95% CI −0.11 to −0.03), and social problems (r = −0.16, 95% CI −0.32 to −0.01). Non-significant factors included activation control, age, aggression, anxiety symptoms, attention problems, big early loss, big early win, dispositional attention, early gambling onset, negative affect, psychological distress, religious attendance, safety-related risk taking, sexual risk taking, and suicidal ideation.
  • Risk of bias assessment showed 87.5% used a standardised problem gambling measure, 87.5% used a current measure, 58.3% had follow-up periods longer than five years, 83.3% had no gambling industry sponsorship, 66.7% reported non-adjusted effect sizes, only 25.0% provided r as an effect size, 75.0% conducted first assessment at 12–25 years, and 75.0% used representative samples.

Methods

  • Systematic review and meta-analysis compliant with PRISMA and MOOSE guidelines; searched Medline, PsycInfo, EMBASE, CINAHL, grey literature, and reference lists from 1990 onward, limited to English. Inclusion required a quantitative prospective design, one or more predictors of subsequent problem gambling, mean age ≤25 years when the predictor was measured, and any measure of problem gambling, pathological gambling, or gambling disorder as outcome.
  • The search identified 2425 records after duplicates were removed, 187 full texts were retrieved, and 15 studies published in 23 articles were included. Data were extracted by two investigators, with independent double extraction and discrepancies resolved by a fourth investigator as arbiter.
  • Findings were synthesized using Stouffer’s p and random-effects meta-analysis using correlation coefficient r, with I² for heterogeneity, Egger’s test for publication bias, and sensitivity analyses for methodological quality. Planned gender subgroup analyses were not conducted because only a small number of articles included gender-specific associations.

Limitations

  • The paper states a relatively limited evidence base: few eligible articles and factors, most factors classified at the individual level of the socio-ecological model, few relationship/community/societal factors, and more emphasis on risk than protective factors. It also notes significant variability for approximately one-third of thematic factors, small samples, high attrition, low threshold definitions of problem gambling, many studies assuming no gambling at baseline and measuring problems at only one later point, mostly North American samples, non-standardised predictor measurement, self-report limitations, time-invariant predictors, and inability to distinguish factors for gambling involvement from those for problem gambling.
  • The paper states that gender subgroup analyses were not conducted, no societal factors were explored in enough articles for quantitative synthesis, and significant publication bias was found for male gender and poor academic performance.
  • Evident from the text: 55 of 88 thematic factors were investigated in only one sample and were therefore ineligible for quantitative synthesis; sensitivity analyses often had large imprecision due to small numbers of articles; and findings for parent supervision and socio-economic status were mixed across included articles.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.1016/j.cpr.2016.10.008

Cites

106 of 106 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

0 of 76 cited sources checked · 0 supported · 0 flagged

  • Findingnone given

    Results were generally robust to the quality of methodological approaches.

    “Results were generally robust to the quality of methodological approaches”
    Quote in the paperNot a substantial claim
  • Findingown data

    Poor school performance is one of the strongest risk factors for problem gambling.

    “Strongest risk factors were gambling severity, male gender, poor school performance”
    Quote in the paperSubstantial claim
  • Findingown data

    High socio-economic status is a protective factor for problem gambling.

    “Protective factors included parental supervision and high socio-economic status”
    Quote in the paperSubstantial claim
  • Findingown data

    Male gender is one of the strongest risk factors for problem gambling.

    “Strongest risk factors were gambling severity, male gender, poor school performance”
    Quote in the paperSubstantial claim
  • Findingown data

    Parental supervision is a protective factor for problem gambling.

    “Protective factors included parental supervision and high socio-economic status”
    Quote in the paperSubstantial claim
  • Classified as probably not a substantial claim. 28
  • May combine two claims. 19
  • The quote only partly states this claim. 2

  • Probably not a substantial claim: may not pass S4 (based).

    Findingnone given

    There are no comprehensive narrative or systematic reviews identifying the risk and protective factors that are longitudinally associated with the development of gambling problems to guide the development of such efforts.

    “To date, however, there are no comprehensive narrative or systematic reviews identifying the risk and protective factors that are longitudinally associated with the development of gambling problems to guide the development of such efforts.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    After duplicate records were removed, the search identified 2425 articles.

    “After duplicate records were removed, the search identified 2425 articles.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    15 studies published in 23 articles were included in this review.

    “Overall, 15 studies published in 23 articles were included in this review.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingreasoning

    33 factors were included in the quantitative synthesis of findings.

    “The remaining 33 factors (29 individual, two relationship, two community) were included in the quantitative synthesis of findings.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Male gender was among the strongest thematic risk factors, with a significant medium mean effect size.

    “The only socio-demographic thematic risk factor was male gender, which was among the strongest thematic risk factors, with a significant medium mean effect size.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    Problem gambling severity was the strongest of all thematic risk factors identified in the review, with a significant medium to large effect size.

    “Problem gambling severity was the strongest of all thematic risk factors identified in the review, with a significant medium to large effect size.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    The included articles explored the associations between 88 thematic factors and problem gambling.

    “In this review, the included articles explored the associations between 88 thematic factors and problem gambling.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    37.5% of included articles had their first assessment during the age of 12-17 years and their follow-up assessment after the age of 18 years.

    “Finally, 37.5% of the articles had their first assessment during the age of 12-17 years and their follow-up assessment after the age of 18 years.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    83.3% of included articles did not have any sponsorship from the gambling industry.

    “Many had follow-up periods longer than five years (58.3%) and did not have any sponsorship from the gambling industry (83.3%).”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    58.3% of included articles had follow-up periods longer than five years.

    “Many had follow-up periods longer than five years (58.3%) and did not have any sponsorship from the gambling industry (83.3%).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Impulsivity and undercontrolled temperament were among the strongest thematic risk factors identified in the review, displaying small to medium mean effect sizes.

    “Impulsivity and undercontrolled temperament were among the strongest thematic risk factors identified in the present review, displaying small to medium mean effect sizes.”
    Quote in the paperSubstantial claim

  • May combine two claims. The quote only partly states this claim.

    Findingown data

    Antisocial behaviours, violence, peer antisocial behaviours, and poor academic performance generally displayed relatively small effect sizes.

    “Although these risk factors generally displayed relatively small effect sizes, poor academic performance in young people displayed the strongest association with subsequent problem gambling, with a medium effect size.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Each of the three early thematic protective factors (parent supervision, socio-economic status, and social problems) had small but significant mean effects.

    “There were small, but significant, mean effects for each of these protective factors.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    The findings of the included articles were mixed for both parent supervision and socio-economic status.

    “The findings of the included articles, however, were mixed for both parent supervision and socio-economic status.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Risk factors with medium to strong effects in longitudinally predicting gambling problems included problem gambling severity, male gender, and poor academic performance.

    “The findings of this systematic review and meta-analysis suggest that risk factors with medium to strong effects in longitudinally predicting gambling problems included: problem gambling severity, male gender, and poor academic performance.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingnone given

    Involvement in a greater number of gambling activities had consistent small to medium longitudinal effects and problem gambling severity had strong effects in predicting later problems with gambling.

    “Involvement in a greater number of gambling activities had consistent small to medium longitudinal effects and problem gambling severity had strong effects in predicting later problems with gambling.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    The review identified one relationship thematic risk factor (peer antisocial behaviours), one community thematic risk factor (poor academic performance), one individual thematic protective factor (socio-economic status), and two relationship thematic protective factors (parent supervision, social problems) that were significantly associated with subsequent problem gambling.

    “one relationship thematic risk factor (peer antisocial behaviours), one community thematic risk factor (poor academic performance), one individual thematic protective factor (socio-economic status), and two relationship thematic protective factors (parent supervision, social problems) that were significantly associated with subsequent problem gambling.”
    Quote in the paperSubstantial claim

  • Classified as probably not a substantial claim. May combine two claims.

    Premisecitation

    Young adulthood refers to individuals up to 25 years of age, as evidence indicates that individuals at this age are in a sensitive developmental period in which there is continued bio-psycho-social maturation into adult-like roles and responsibilities, and that influences during this period have strong impacts on later lifestyle and behaviour patterns.

    “For the purpose of this review, young adulthood refers to individuals up to 25 years of age, as evidence indicates that individuals at this age are in a sensitive developmental period in which there is continued bio-psycho-social maturation into adult-like roles and responsibilities, and that influences during this period have strong impacts on later lifestyle and behaviour patterns (Arnett, Žukau”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Arnett, Žukauskiene, & Sugimura, 2014 source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductcitation

    The methodology employed in this review was compliant with PRISMA and MOOSE.

    “The methodology employed in this review was compliant with the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) (Moher, Liberati, Tetzlaff, & Altman, 2009) and the guidelines for the Meta-analysis Of Observational Studies in Epidemiology (MOOSE) (Stroup et al., 2000).”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites Moher, Liberati, Tetzlaff, & Altman, 2009 source

      Not checked in the free run.

    • cites Stroup et al., 2000 source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Many children, adolescents and young adults exposed to risk factors never develop gambling problems, suggesting that there are factors that play a protective role.

    “Despite well-established associations between many of these factors and gambling problems, many children, adolescents and young adults exposed to these risk factors never develop gambling problems, suggesting that there are factors that play a protective role (Lussier et al., 2014).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Lussier et al., 2014 source

      Not checked in the free run.

  • May combine two claims.

    Interpretationreasoning

    These factors may be consequences of problem gambling or co-exist because they share common causes.

    “These findings suggest that these factors may be, in fact, consequences of problem gambling or co-exist because they share common causes.”
    Quote in the paperSubstantial claim

  • Classified as probably not a substantial claim. May combine two claims.

    Premisecitation

    The use of quality scoring methods in meta-analyses of observational studies is generally not recommended because scores constructed in an ad hoc fashion may lack demonstrated validity, and results may not be associated with quality.

    “The use of quality scoring methods in meta-analyses of observational studies is generally not recommended (Higgins, Thompson, Deeks, & Altman, 2003;Stroup et al., 2000) because scores constructed in an ad hoc fashion may lack demonstrated validity, and results may not be associated with quality (Juni, Witschi, Bloch, & Egger, 1999).”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites Higgins, Thompson, Deeks, & Altman, 2003 source

      Not checked in the free run.

    • cites Stroup et al., 2000 source

      Not checked in the free run.

    • cites Juni, Witschi, Bloch, & Egger, 1999

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductnone given

    Data were extracted from the included articles by two investigators, and double data extraction was conducted for all included articles by an independent reviewer to ensure accuracy.

    “Data were extracted from the included articles by two investigators.Double data extraction was then conducted for all included articles by an independent reviewer to ensure the data extraction was accurate.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Study design and conductcitation

    A components approach was adopted to assess risk of bias in this review, whereby the research in each article was rated on individual criteria that reflect the methodological risk of bias.

    “A components approach was therefore adopted to assess risk of bias in this review, whereby the research in each article was rated on individual criteria that reflect the methodological risk of bias (Higgins et al., 2003).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Higgins et al., 2003 source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductreasoning

    The planned subgroup analyses to examine gender differences in thematic risk and protective factors were not conducted.

    “The planned subgroup analyses to examine gender differences in thematic risk and protective factors were therefore not conducted.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductcitation

    Sensitivity analyses were conducted to examine whether findings were robust to the quality of the methodological approaches of the included articles.

    “Sensitivity analyses were conducted to examine whether findings were robust to the quality of the methodological approaches of the included articles (Stroup et al., 2000).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Stroup et al., 2000 source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductcitation

    The presence of publication bias was assessed by visual inspection of the funnel plot and by using Egger's test.

    “The presence of publication bias, when there were 3 or more independent estimates available, was assessed by visual inspection of the funnel plot of the meta-analyses and by using Egger's test (p b 0.05) (Egger, Smith, & Phillips, 1997).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Egger, Smith, & Phillips, 1997 source

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Interpretationreasoning

    Screening accompanied with early intervention may provide an effective strategy for preventing gambling problems.

    “This information suggests that screening accompanied with early intervention may provide an effective strategy for preventing gambling problems.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    Gender subgroup analyses were precluded from the review due to the small number of articles including gender-specific associations.

    “Gender subgroup analyses were precluded from the present review due to the small number of articles including genderspecific associations.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    A significant proportion of individuals simultaneously drink and gamble.

    “and that a significant proportion of individuals simultaneously drink and gamble (Baron & Dickerson, 1999;Giacopassi, Stitt, & Vandiver, 1998).”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites Baron & Dickerson, 1999

      Not checked in the free run.

    • cites Giacopassi, Stitt, & Vandiver, 1998

      Not checked in the free run.

  • May combine two claims.

    Interpretationreasoning

    Internalising symptoms and problem gambling may co-exist because internalising symptoms are consequences of problem gambling behaviour or because the two problems share common causes.

    “They indicate that internalising symptoms and problem gambling may co-exist because internalising symptoms are, in fact, consequences of problem gambling behaviour or that the two problems co-exist because they share common causes.”
    Quote in the paperSubstantial claim

  • The quote only partly states this claim.

    Study design and conductown data

    Approximately three-quarters of the included articles reported non-adjusted effect sizes in the analyses.

    “Approximately three-quarters of the included articles employed community-representative samples and reported non-adjusted effect sizes in the analyses.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationreasoning

    This design precludes drawing conclusions regarding changes in problem gambling status across time and precludes examination of prospective cross-lagged links among problem gambling and other factors.

    “Not only does this preclude the drawing of conclusions regarding changes in problem gambling status across time, it precludes the examination of prospective cross-lagged links among problem gambling and other factors.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S2 (checkable).

    Interpretationcitation

    Screening gambling behaviour in young people is important in order to target brief intervention strategies to address high-risk profiles for gambling problems.

    “These findings suggest the importance of screening gambling behaviour in young people in order to target brief intervention strategies to address high-risk profiles for gambling problems (Winters et al., 2002).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Winters et al., 2002 source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S2 (checkable).

    Interpretationcitation

    The similarity in risk factors between problem behaviours highlights the need for global prevention efforts that target multiple problem behaviours, not just problem gambling.

    “Regardless of their mechanisms, the similarity in risk factors between these problem behaviours highlight the need for global prevention efforts that target multiple problem behaviours, not just problem gambling (Scholes-Balog et al., 2014;Shenassa et al., 2012;Vitaro et al., 2001;Winters et al., 1995;Winters et al., 2002).”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites Scholes-Balog et al., 2014 source

      Not checked in the free run.

    • cites Shenassa et al., 2012 source

      Not checked in the free run.

    • cites Vitaro et al., 2001 source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S2 (checkable).

    Interpretationreasoning

    Prevention and intervention initiatives should encourage protective factors related to parent supervision and socio-economic status.

    “The findings of this review also suggest that prevention and intervention initiatives should encourage protective factors related to parent supervision and socio-economic status.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    The syndrome model of addiction views addiction as a syndrome with multiple potential presentations.

    “The findings are also consistent with the syndrome model of addiction, which views addiction as a syndrome with multiple potential presentations (Shaffer et al., 2004).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Shaffer et al., 2004 source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Interpretationreasoning

    It is possible that the relationship these time-invariant variables have to problem gambling can also be explored using cross-sectional studies.

    “and it is therefore possible that the relationship these variables have to problem gambling can also be explored using cross-sectional studies.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisecitation

    There is evidence that interventions addressing the underlying determinants of low socio-economic status (for example, enhancing education pathways) improve healthy child development while also reducing the adolescent antisocial behaviours associated with problem gambling.

    “While interventions for modifying socio-economic status are less obvious than those for increasing parental supervision, there is evidence that interventions addressing the underlying determinants of low socio-economic status (for example, enhancing education pathways) improve healthy child development while also reducing the adolescent antisocial behaviours associated with problem gambling (Toumb”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Toumbourou et al., 2007 source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    The funding source had no role in the design of the review, data collection, statistical analysis, interpretation of the data, or in the manuscript preparation.

    “The funding source had no role in the design of the review, data collection, statistical analysis, interpretation of the data, or in the manuscript preparation.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S2 (checkable). May combine two claims.

    Interpretationreasoning

    These findings highlight the need for global prevention efforts that target multiple problem behaviours, not just problem gambling, as well as the importance of screening young people with these high-risk profiles for gambling problems.

    “These findings highlight the need for global prevention efforts that target multiple problem behaviours, not just problem gambling, as well as the importance of screening young people with these high-risk profiles for gambling problems.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim. May combine two claims.

    Interpretationown data

    The findings of this review suggest that initiatives should aim to counteract risk factors related to gambling behaviours, alcohol and drug use, other antisocial and risk taking behaviours, impulsivity and other undercontrolled dispositional characteristics, and depression symptoms, particularly for young males.

    “The findings of this review suggest that initiatives should aim to counteract risk factors related to gambling behaviours, alcohol and drug use, other antisocial and risk taking behaviours, impulsivity and other undercontrolled dispositional characteristics, and depression symptoms, particularly for young males.”
    Quote in the paperSubstantial claim

  • Classified as probably not a substantial claim.

    Interpretationreasoning

    The results indicate that prevention and intervention initiatives should reinforce protective factors related to parent supervision, socio-economic status and social problems.

    “Moreover, the results indicate that prevention and intervention initiatives should reinforce protective factors related to parent supervision, socio-economic status and social problems.”
    Quote in the paperSubstantial claim
43 of 43

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • Depression and social anxiety are psychopathological correlates of gambling disorder.

    “Psychopathological correlates, in particular depression and social anxiety, have been reported repeatedly for gambling (Dowling et al., 2017)”

    From The Interaction of Person-Affect-Cognition-Execution (I-PACE) model for addictive behaviors: Update, generalization to addictive behaviors beyond internet-use disorders, and specification of the process character of addictive behaviors (2019) · cites this paper as Dowling et al., 2017

    Section 4.1 reports a significant but small longitudinal association between early depression and later problem gambling, although many included studies found no significant relationship. It reports non-significant longitudinal associations for anxiety symptoms and does not identify social anxiety specifically, so the cited review does not support both named correlates as repeatedly reported findings. (LLM, conf=0.86)

    Experimental — accuracy not yet measured

  • Increased risk for gambling addiction among AIAN might be due to other inequities faced by AIAN that are also risk factors for problematic gambling.

    “The increased risk for gambling addiction among AIAN might be due to other inequities faced by AIAN that are also risk factors for problematic gambling.”

    From Substance and Behavioral Addictions among American Indian and Alaska Native Populations (2022) · cites this paper as [88]

    The Conclusions identify socioeconomic status, depression symptoms, and alcohol and drug use as factors relevant to problem gambling in young people. The review does not establish that AIAN people face these particular inequities or that they explain increased gambling risk among AIAN; that population-specific explanation is an extrapolation. (LLM, conf=0.85)

    Experimental — accuracy not yet measured

  • Low education, unemployment, few socioeconomic opportunities, untreated historical trauma, higher rates of substance use, and having a casino nearby that serves as the main employer and source of revenue for the community are inequities/risk factors for problematic gambling among AIAN.

    “These inequities and risk factors include low education, unemployment, few socioeconomic opportunities, untreated historical trauma, higher rates of substance use, and having a casino nearby that serves as the main employer and source of revenue for the community [88,89,90,91].”

    From Substance and Behavioral Addictions among American Indian and Alaska Native Populations (2022) · cites this paper as [88]

    Section 1.1 identifies lower socioeconomic status, poor academic performance, substance use, and gambling availability as risk factors among young people; section 4.3 identifies education as a potential protective factor. The paper does not establish these factors specifically for AIAN people, nor does it support the claims about unemployment, untreated historical trauma, or a nearby casino serving as a community’s main employer and revenue source. Page numbers were unavailable in our copy. (LLM, conf=0.88)

    Experimental — accuracy not yet measured

  • High impulsivity is associated with gambling disorder.

    “Temperamental features, such as high impulsivity, have also been associated with gambling (Dowling et al., 2017)”

    From The Interaction of Person-Affect-Cognition-Execution (I-PACE) model for addictive behaviors: Update, generalization to addictive behaviors beyond internet-use disorders, and specification of the process character of addictive behaviors (2019) · cites this paper as Dowling et al., 2017

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

  • Risk-of-bias percentages do not fit the stated article count

    Minor

    The risk-of-bias results describe percentages of articles, including 87.5% and 83.3%, but neither percentage can represent a whole number of the 23 included articles. These percentages instead fit a denominator of 24.

  • Two-thirds is described as approximately three-quarters

    Minor

    The risk-of-bias assessment says 66.7% of articles reported non-adjusted effect sizes, whereas the discussion describes that proportion as approximately three-quarters.

2 of 2

Cites

Flagged first, then by citations

Cited by

Sorted by citations

Related

Authors
Dowling, N. A., Merkouris, S. S., Greenwood, C. J., Oldenhof, E., Toumbourou, J. W., & Youssef, G. J.
Affiliations
  • Australian National University (AU)
  • Deakin University (AU)
Corresponding author
Dowling, N.A.
ORCID
Venue
Clinical Psychology Review
Publisher
Elsevier BV
Published
2017-02
Volume
51
Pages
109-124
ISSN
0272-7358 (ISSN-L)
DOI
10.1016/j.cpr.2016.10.008
OpenAlex
W2547708582
Cited by
439
References
103
Citations by year
2026: 46 · 2025: 52 · 2024: 41 · 2023: 53 · 2022: 49 · 2021: 59 · 2020: 54 · 2019: 40 · 2018: 30 · 2017: 13 · 2016: 1
FWCI
4.15
Type
journal article
Language
en
Open access
Licence
Locations
  • Clinical Psychology Review (publishedVersion, cc-by-nc-nd)
  • PubMed (publishedVersion)
  • Figshare (submittedVersion, cc-by)
  • ANU Open Research (Australian National University) (submittedVersion, cc-by-nc-nd)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Gambling Behavior and Treatments
  • Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
  • Social Sciences › Sociology and Political Science › Crime Patterns and Interventions
Keywords
problem gambling, risk factors, protective factors, childhood, adolescence, early adulthood, antisocial behavior, impulsivity, sensation seeking, alcohol consumption, cannabis use, illicit drug use, depression, tobacco use, socioeconomic status, parental supervision, academic performance, gambling prevention, socio-ecological model
MeSH terms
Alcohol Drinking, Depression, Female, Gambling, Humans, Impulsive Behavior, Male, Risk Factors, Sex Factors, Protective Factors

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Claims read by deepseek-v4.1-flash under definition version 3 (extract-v3) on 2026-10-10.

Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-10-10.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review