Open research questions in Gambling Behavior and Treatments

What the literature leaves open

• This finding sug- gests that students at this university could be experiencing a high rate of gambling problems, which warrants further attention given previous evidence in the UK showing that problem- atic gambling in university students is more prevalent than in young adults not at university (0.

  Gambling Problems in a Sample of UK University Students: Associations with Mental Health, Other Addictive Behaviours, and Transdiagnostic Factors · 2026 · DOI

• Future research could examine whether gambling-related resources are accessible to people with disabilities and, where possible, develop materials and services that reflect their lived experiences. Blindness, visual impair- ment, deafness, hearing loss 1 3Journal of Gambling Studies Third, gambling prevention, assessment, treatment, and support systems should be examined for disability inclusivity.

  Gambling and Disability: An Overlooked Context for Gambling Harm · 2026 · DOI

• To the authors’ knowledge, this is the first qualitative study to explore gambling amongst elite female athletes, addressing a substantial gap in the literature. Although this research provides a meaningful contribution, the generalisability of these results is subject to certain limitations. Firstly, the current study is limited by the short duration of the interviews which meant that certain areas could not be explored in as much depth as initially planned. Despite interviewees being assured of anonymity and confidentiality to encourage open and honest responses, they were reluctant to talk about their own gambling behaviours in more depth. The stigma attached to gambling could mean that levels of gambling cited are underreported by interviewees (Penfold et al., 2024). The brevity of some of the interviews emphasizes the need for further research to explore this in greater depth through methods that encourage female athletes to talk more openly on sensitive aspects of gambling in sports. Additionally, most interviewees were recruited through direct contact with players associations and sports clubs, and this may have also impacted the findings. Efforts were made to ensure that the interviewer’s positionality within the sports associations did not affect the way players answered the questions. When recruiting the participants, they were encouraged to contact the researcher directly if they wanted to participate so the sports associations and clubs had no knowledge of who took part in interviews. However, it cannot be stated whether their shift is reflective of the sensitive nature of the topic, the interviewer’s perceived positionality with regard to the sports associations, or participant preference for privacy. Lastly, the sample consisted only of female athletes; interviewing coaches and managers involved in women’s sports would have strengthened the findings by giving a more holistic overview of the existing gambling cultures within the clubs (Vinberg et al., 2021).

  Understanding Gambling Culture and the Normalisation of Sports Betting in Elite Female Sports Clubs · 2026 · DOI

• To the best of the researchers’ knowledge, this is the first study at both national and international levels to evaluate digital search trends related to gambling addiction. This strengthens the originality and innovative nature of the study and allows the findings to make a significant contribution to the literature. This research has certain limitations. First, it can be said that the findings are temporally limited. The study data are based solely on internet searches conducted in Türkiye between 2004 and 2025. It should be noted that similar analyses conducted in different countries or during different time periods could yield different results. Therefore, it is recommended that the research be repeated with geographically and temporally broader The Journal of Gambling Issues, 2026 9 The Journal of Gambling Issues, 2026 www.cdspress.ca samples. The second limitation is that the data only include users of the Google search engine. Examining similar queries on other search engines could provide more comprehensive and diversified insights into user behaviors. Third, no information was available regarding the identities or demographic characteristics of the individuals conducting the searches. Therefore, it is not possible to determine with certainty whether the queries were made by individuals diagnosed with addiction, their family members, or people simply curious about the topic. This makes it difficult to conduct assessments targeting specific groups. The fourth limitation is the lack of knowledge regarding users’ motivations for searching. Therefore, within the scope of the third and fourth limitations, it is recommended to conduct studies with different research designs (e.g., descriptive, qualitative, prospective) to examine the information needs and search motivations of individuals diagnosed with gambling addiction, their close social networks, or the general population. The final limitation is that this study only examined searches containing the term “gambling addiction.” Therefore, it is suggested that similar studies be conducted to include search terms potentially related to gambling addiction, such as “online gambling addiction.”

  Digital Footprints of Gambling Addiction: A 21-Year Infodemiological Analysis Using Google Trends · 2026 · DOI

• This study had some limitations worth noting. First, as we used administrative databases, data were recorded only if services were used and codifications adequately reported. GD was probably underreported, as it was mostly identified in the addiction treatment database, with ICD-9 mostly used by physicians where the last digit of the 312.31 GD code was missing, and thus could not be used. Second, we didn’t have information on gambling frequency, financial losses, or disruptions to employment or family life. Third, due to differences in how personality disorders are classified in ICD-10 versus ICD-9, sub-diagnoses could not be studied separately. Fourth, no data were available on the patients’ use of services like Gamblers Anonymous, online help, crisis or suicide prevention centers, and private psychologists. Fifth, though imputation and sensitive analyses were produced, there were significant data missing for the education level variable. Finally, findings may have limited generalizability, particularly to The Journal of Gambling Issues, 2026 18 The Journal of Gambling Issues, 2026 www.cdspress.ca individuals without GD, those who are not seeking help, and in countries that have no comparable gaming activities or no public health insurance for vulnerable populations.

  Profiles Of Patients Treated For Gambling Disorder Based On Gambling Activities And Related Features · 2026 · DOI

• Few studies have assessed the uptake and use of smartphone-delivered interventions for gambling by gender, but some research has shown greater acceptability of online treatment modalities among women relative to men (Rodda & Lubman, 2014; Wood & Griffiths, 2007).

  SPRinG—a Smartphone-Delivered Intervention to Support Self-Management of Gambling Harm Reduction and Recovery: A Pilot Feasibility Study · 2026 · DOI

• Several strengths and limitations of the study should be noted. As previously mentioned, the SPRinG study is one of the first feasibility studies of a digital health intervention for gambling widely available on the Apple App Store and Google Play. Relative to existing research, the study includes one of the largest samples to provide an initial descriptive window and realworld evidence on the uptake and use of a smartphone-delivered intervention for gambling. An integrated research database captured realtime user data, producing a unique longitudinal event-driven dataset with high ecological validity relative to more conventional cross-sectional designs. A further strength of the study is the analytical focus on gender and its intersection with other key status characteristics, such as PGSI status, gambling symptom severity, housing status, and income. The communitybased approach to intervention design—including both community service providers and persons with lived experience—is another important strength of the study. Limited use of the urge and gambling journals did not allow for meaningful assessment of patterns and correlates of either journal compliance or changes in urges (e.g., frequency, severity) or gambling (e.g., frequency, losses) over time. Similarly, limited use of the G-SAS did not allow for meaningful assessment of patterns and correlates of G-SAS compliance (i.e., rate of weekly completion) or changes in symptom severity over time as participants engaged with the intervention. Despite these limitations, the study provides unique insight into the real-world adoption of the SPRinG app, with a focus on gender. Future qualitative research has the potential to illuminate the interpretive (i.e., how people make sense of and give meaning to) and interactional (i.e., how people engage digital health interventions in everyday situations) contingencies of app engagement, which could inform improvements to future app design and delivery that aim to enhance engagement and the potential impact of the app in reducing gamblingrelated harms (Rodda et al., 2025). For example, we did not assess participant motivation to change in this study, but readiness for change may be an important contributor to engagement and effectiveness of selfmanagement interventions. For example, the transtheoretical model distinguishes among five stages of readiness for behaviour change: precontemplation, contemplation, preparation, action, and maintenance (Prochaska, 1979; Prochaska et al., 2013; Prochaska & DiClemente, 1982).

  SPRinG—a Smartphone-Delivered Intervention to Support Self-Management of Gambling Harm Reduction and Recovery: A Pilot Feasibility Study · 2026 · DOI

• BackgroundThe proliferation of gambling advertising has intensified concerns regarding its influence on vulnerable populations, yet the neural mechanisms underlying cue-reactivity to these stimuli remain underexplored in ecologically valid settings.

  The emotional impact of gambling-related advertising: an experimental functional Near-Infrared Spectroscopy study protocol · 2026 · DOI

• Key strengths of this study include the use of a large population-based cohort and repeated assessments enabling joint modeling of adolescent GP and SU trajectories. The integration of variable-centered and person-centered approaches provided a nuanced characterization of adolescents’ developmental patterns relative to their peers. Moreover, examining early adult outcomes within multivariate models that included a comprehensive set of preadoles- cent risk factors strengthens confidence in the observed associations. Several limitations should also be acknowledged. First, GP and SU have been assessed via self-report, which can be subject to recall or social desirability bias, although it remains the most feasible method in large population studies, with acceptable validity for both GP (Edgren et al., 2016) and SU (Harrison et al., 2007). Second, despite the use of inverse prob- ability weighting, attrition from infancy to early adulthood was substantial. As is typical in long-term cohort studies, retained participants were somewhat less at risk than those lost to follow-up. As a result, findings may underestimate associations for higher-risk individuals, potentially yielding conservative estimates of developmental continuity. Third, growth mixture modeling approaches have been criticized for limited replica- bility across samples (Petersen et al., 2019). To mitigate this concern, analyses followed established recommendations for trajectory modeling (Wickrama et al., 2022), including extensive model testing, transparent reporting of preliminary analytic steps, and consider- ation of alternative models using multiple indices and criteria when enumerating classes (Carbonneau et al., 2023). Fourth, smaller class sizes and low base rates for certain out- comes reduced statistical power in some comparisons, resulting in wider confidence inter- vals (Tables 2 and 3) and reduced precision of effect size estimates. Replication in larger samples will therefore be important to refine the magnitude of these associations. Fifth, although sex was included as a covariate, limited power precluded a detailed examination of sex-specific developmental pathways. Sixth, only maternal measures were available regard- ing parental addictive behaviors. Seventh, measurement constraints, including composite indices, can mask substance- or activity-specific patterns that may differ in their develop- mental trajectories and outcomes. Eighth, a potential confounding factor could be the fact that gambling, alcohol and can- nabis (since 2018) consumption become legal at age 18 in Quebec, which affects their availability and accessibility. This could influence GP and SU in early adulthood, beyond simple developmental continuity. The fact that this change in legal status is the same for participants in the reference group and those in the different gamblers-users classes makes it difficult to assess its potential impact. Of note, according to Canada’s National Cannabis Surveys (Statistics Canada, 2023), there was no change in cannabis consumption among 1 3Journal of Gambling Studies Canadians aged 15 years and older living in Quebec between the first quarter of 2018 (pre- legalization) and the first quarters of 2019 or 2020. The possible confounding effect of this change in legal access should nevertheless be considered when interpreting the findings. Finally, the adolescent and early adulthood assessment periods preceded major shifts in substance use trends and in the legal and social context of both behaviors in Canada. These shifts included legalization of adult cannabis use, expansion of online and sports gambling, and increased vaping (Health Canada, 2024; INSPQ, 2022; Johnston et al., 2022; Tremblay et al., 2023). Although findings from earlier cohorts remain informative, caution is warranted when generalizing to contemporary youth. Caution in generalizing findings is further warranted by the predominantly French-speaking Canadian sample, and the fact that this work is grounded primarily in Western-based studies and frameworks. Both cul- tural and contextual factors—including norms surrounding GP and SU, availability, and regulation—may shape the expression and co-occurrence of these behaviors. Further cross- cultural investigations in more diverse populations and social contexts are therefore needed.

  Developmental Trajectories of Gambling and Substance use Throughout Adolescence – A Population-Based Longitudinal Study of Preadolescent Risk Factors and Related Outcomes in Early Adulthood · 2026 · DOI

• This study had some limitations. First, using a secondary dataset constrained recruitment and sample composition. Although the non-partner participants included children, parents, siblings, friends and colleagues, their small numbers limit the ability to examine potentially 1 3Journal of Gambling Studies meaningful differences in how different non-partner AO groups experience and respond to gambling harm. For instance, parents and adult children of those who gamble may differ in their support needs and strategies used, which are distinctions that warrant dedicated exam- ination through future qualitative work using purposive sampling. Additionally, because these interviews were collected for a broader phenomenological study, the sampling strat- egy and topic guide were not tailored specifically to the present aims, which may have constrained saturation on some relational and support-related issues. Finally, interviews were conducted during COVID-19 restrictions in Australia, which may have shaped both gambling behaviour and AO coping strategies in ways that differ from non-pandemic condi- tions. However, interviewees often drew on experiences that extended beyond the immedi- ate pandemic context, suggesting that many of the themes identified are likely to remain relevant outside this period.

  A Balancing Act: How Affected Others Support Themselves and Those Who Gamble · 2026 · DOI

• The study recommends KMTC Mombasa Campus to establish a specialized counselling centre to provide students affected by gambling with easy access to support. Peer education and awareness campaigns should be intensified to raise awareness among students about the potential dangers of gambling and the available intervention options. Financial literacy programs, including webinars, are crucial to help students develop practical skills in managing scarce resources and to make gambling less attractive as an income strategy. Staff capacity-building initiatives should be prioritized to strengthen institutional response and enable teachers and administrators to identify and assist at-risk students. In addition, enhancing alternative recreation opportunities would provide healthier outlets for leisure, while environmental interventions such as regulating gambling opportunities around the campus would reduce exposure. Referral networks linking students to specialized services and close monitoring mechanisms would further reinforce the effectiveness of interventions. Gender-sensitive approaches remain essential to ensure inclusivity and effectiveness. Some measures, such as peer education and awareness campaigns, are already being implemented at KMTC Mombasa Campus, but the findings highlight the need to scale them up and integrate them more systematically into campus life.

  Gambling, the Zero- Sum Game among KMTC Students: A Descriptive Cross-Sectional Case Study of KMTC Mombasa Campus · 2026 · DOI

• This study has several limitations. First, most participants were from urban families, so the findings may not capture the experiences of children in rural or different cultural settings. Second, the predominance of boys in the sample may limit the transferability of findings to girls, who might experience distinct peer relationships or parental expectations around play. Third, the overrepresentation of smoking households (90.5%) reflects China’s high smoking prevalence (approximately 50% of men smoke). Moreover, the snowball sampling bias, where participants tend to refer peers with similar characteristics, may also limit the transferability of our findings to non-smoking families. Finally, as a qualitative study, the findings are exploratory and hypothesis-generating rather than generalizable.

  Exploring Gambling-like Behaviors in Children’s Cigarette Card Games and Parental Pro-game Perceptions in China: A Qualitative Study · 2026 · DOI

• Furthermore, considering the widespread adoption of virtual currencies in both economic and psy- chological experiments, future research should explore the relevance of the effect in different tasks, such as investments. Future research should investigate this issue to improve understanding of how and when distortions arise. Moreover, future research should focus on crypto-currency transac- tions, and see whether distortions take place in real world settings, and for transaction which do not involve risk. Future research should examine more in detail the interplay of non-intuitive exchange rates and money illusion bias and how it could affect consumers’ WTP. Future research could explore the causes of these effects, assisting the development of policy interventions aimed at improving consumer protection in digital marketplaces. An open question is whether the money illusion bias linearly increase with the distance between real and nominal values. For example, an open question is how the WTP is affected by an exchange rate which is non-intuitive and affected by money illu- sion, for example 133:1.

  Virtual currencies in online gaming increase the willingness to pay for loot boxes: an experimental analysis · 2026 · DOI

• Desire thinking about gambling (DTG) is found as a risk factor for GD in general gamblers, but little is known about its role in esports gamblers and its bidirectional relationship with GD.

  Bidirectional relationships between desire thinking and gambling disorder tendency: Insights from a longitudinal study of Esports gamblers · 2025 · DOI

• Background and aims: While the concept of recovery is receiving increasing attention in the context of gambling disorder (GD), no consensus has yet been reached regarding its definition.

  Definitions and assessments of recovery from gambling disorder: A scoping review · 2024 · DOI

• Although gambling participation appears to have declined, the recent increase in 2019 that coincides with increased sports gambling advertisements, media coverage and availability warrants further study.

  Gambling participation among Connecticut adolescents from 2007 to 2019: Potential risk and protective factors · 2023 · DOI

• However, while reports of associations are common, few studies have attempted to evaluate and compare the relative risk of all available forms, and none have estimated the relative contribution of each form to the total burden of gambling problems (GP) in a population.

  Unambiguous evidence that over half of gambling problems in Australia are caused by electronic gambling machines: Results from a large-scale composite population study · 2023 · DOI

• To contribute to this understudied area, we qualitatively analyzed interviews with 19 elite online professional poker players, by examining factors from the disordered gambling and decision-making literatures.

  Elite professional online poker players: factors underlying success in a gambling game usually associated with financial loss and harm · 2023 · DOI

• Responsible gambling policies implemented by the conservative government of Spain (2011–2018) and by gambling companies were insufficient to prevent such disorders from becoming an epidemic among Spanish adolescents.

  “That’s No Country for ‘Young’ Men”: A Critical Perspective on Responsible Online Gambling Policies for Gambling Disorder Prevention in Spanish Minors · 2022 · DOI

• DISCUSSION AND CONCLUSIONS: Although the exact pathways linking HRV and IA to impaired decision-making in GD remain to be identified, a broader exploration relying upon an embodiment-informed framework may contribute to shed further light on the clinical phenomenology of the disorder.

  Heart rate variability and interoceptive accuracy predict impaired decision-making in Gambling Disorder · 2021 · DOI

• DISCUSSION AND CONCLUSIONS: This study suggests that loot boxes may be attractive to people who are already predisposed to engage in other gambling, and females who use loot boxes may have unique vulnerabilities to gambling problems that could be explored in future research.

  Young people who purchase loot boxes are more likely to have gambling problems: An online survey of adolescents and young adults living in NSW Australia · 2021 · DOI

• For example, studies were often not based on precise hypotheses, only two studies had a longitudinal design, overall quality ratings varied widely, operationalizations of gambling availability were sometimes not objectively measured, follow-up periods were insufficient, and shifting behaviour was not assessed.

  The Relationship Between Physical Availability of Gambling and Gambling Behaviour or Gambling Disorder: A Systematic Review · 2021 · DOI

• Further investigation of the changes in gambling participation, and a closer look at optimizing GD service delivery among vulnerable population sectors during the COVID-19 crisis is warranted.

  Gambling behaviours and treatment uptake among vulnerable populations during COVID-19 crisis · 2021 · DOI

• CONCLUSIONS: Despite empirical evidences supporting the theoretical assertions toward the relationship between GD and dissociation, few studies have reached an articulated understanding of this topic, mostly failing to identify specific dissociative features involved in GD.

  Gambling disorder and dissociative features: A systematic review and meta-analysis. · 2021 · DOI

• Regression results were mixed: Three of the four subscales (enhancement, social, and coping) were significant predictors of problem gambling and gambling variety, only the enhancement and coping subscales were significant predictors of gambling frequency, and none of the subscales significantly predicted average monthly expenditure on gambling.

  Validating the GMQ-F in a Canadian Sample of University Students · 2020 · DOI

Most-cited papers in Gambling Behavior and Treatments

• DSM-IV pathological gambling in the National Comorbidity Survey Replication · Psychological Medicine · 2008 · 739 citations
• Scholars’ open debate paper on the World Health Organization ICD-11 Gaming Disorder proposal · Journal of Behavioral Addictions · 2016 · 429 citations
• Early risk and protective factors for problem gambling: A systematic review and meta-analysis of longitudinal studies · Clinical Psychology Review · 2016 · 365 citations
• A Comparison of Young, Middle-Aged, and Older Adult Treatment-Seeking Pathological Gamblers · The Gerontologist · 2002 · 302 citations
• Common Genetic Vulnerability for Pathological Gambling and Alcohol Dependence in Men · Archives of General Psychiatry · 2000 · 277 citations
• Cognitive-behavioral therapy for pathological gamblers. · Journal of Consulting and Clinical Psychology · 2006 · 251 citations
• Measuring cognitive distortions in pathological gambling: Review and meta-analyses. · Psychology of Addictive Behaviors · 2013 · 192 citations
• The natural history of problem gambling from age 18 to 29. · Journal of Abnormal Psychology · 2003 · 179 citations
• A prospective study of youth gambling behaviors. · Psychology of Addictive Behaviors · 2002 · 174 citations
• Reliability and validity of data obtained from alcohol, cannabis, and gambling populations on Amazon’s Mechanical Turk. · Psychology of Addictive Behaviors · 2016 · 173 citations

Most recent work

• Dark patterns in online gambling: A scoping review and classification of deceptive design practices · Journal of Behavioral Addictions · 2026
• Lower-Risk Participation in Gambling – Opportunities and Challenges · SUCHT - Zeitschrift für Wissenschaft und Praxis / Journal of Addiction Research and Practice · 2026
• Gambling Advertising During the UEFA Euro Football Championship: A Frequency and Content Analysis in TV Coverage and Social Media · SUCHT - Zeitschrift für Wissenschaft und Praxis / Journal of Addiction Research and Practice · 2026
• Do Casinos Boost Local Payroll Income and Employment? A Case Study of Arkansas · Economic Development Quarterly · 2026
• ‘Betting with mates’: Gambling apps, masculinities and the financialisation of everyday life · Journal of Consumer Culture · 2026
• Global Review of Assessments of Online Gambling Policies Affecting Youths: Bans, Legalisation, Advertising Restrictions, and ‘Responsible Gambling’ · Current Addiction Reports · 2026
• Self-Exclusion from Gambling: Systems and Regulations in Europe · SUCHT - Zeitschrift für Wissenschaft und Praxis / Journal of Addiction Research and Practice · 2026
• Gambling adverts on social media reach 2.3 times more men than women: Using the Meta Ad library to assess gambling advertising in Ireland · Journal of Behavioral Addictions · 2026
• All sides of politics backed ambitious gambling reforms. The government’s response is half-hearted at best · 2026
• Virtual currencies in online gaming increase the willingness to pay for loot boxes: an experimental analysis · Experimental Economics · 2026

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