Objective: The aims of this systematic review and meta-analysis were to examine the overall prevalence of dropout from psychological treatments for problem gambling and gambling disorder and to examine how study, client, and treatment variables influenced dropout rates. Method: A systematic search was conducted to identify studies of cognitive and/or behavioral therapies and motivational interventions for problem gambling and gambling disorder. Meta-analysis was used to calculate an overall weighted dropout rate. Random effect meta-regressions were used to examine covariates of dropout rates. Mixed-effect subgroup analyses were used to examine moderators of dropout rates. Results: The systematic search identified 24 studies (31 dropout rates) comprising 2,791 participants. Using a random-effects model, the overall weighted dropout rate was 39.1%, 95% CI [33.0%, 45.6%]. Increases in the percentage of married participants were significantly associated with lower dropout rates. Dropout rates were significantly higher when dropout was defined as attending all sessions of a treatment protocol compared to when defined as attending a prespecified number of sessions different from the total in the protocol and when defined as study therapists judging participants to be dropouts. Insufficient reporting of some gambling-related variables and other psychological symptom variables prevented a thorough examination of covariates and moderators. Conclusions: A large proportion of individuals drop out of treatment for problem gambling and gambling disorder. Future research should examine the reasons for dropout across marital statuses and should adopt dropout definitions that consider session-by-session symptom change. (PsycInfo Database Record (c) 2021 APA, all rights reserved) This review suggests that a significant proportion of individuals drop out of psychological treatments for problem gambling and gambling disorder. This review also recommends that the field adopt symptom-based dropout definitions to determine the adequate dosage of psychological treatment for problem gambling and gambling disorder. (PsycInfo Database Record (c) 2021 APA, all rights reserved)

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京都大学 / 新制・論文博士 / 博士(医学) / 乙第13571号 / 論医博第2297号 / 新制||医||1069(附属図書館) / (主査)教授 川上 浩司, 教授 渡邉 大, 教授 村井 俊哉 / 学位規則第4条第2項該当 / Doctor of Medical Science / Kyoto University / DFAM

Under recent years the gambling industry has been moving towards providing their customer the possibility to gamble online instead of visiting a physical location. Aggressive marketing, fast growth and a multitude of actors within the market have resulted in a spike of customers who have developed a gambling problem. Decision makers are trying to fight back by regulating markets in order to make the companies take responsibility and work towards preventing these problems. One method of working proactively in this regards is to identify vulnerable customers before they develop a destructive habit. In this work a novel method of predicting customers that have a higher risk in regards to gambling-related problems is explored. More concretely, a recurrent neural network with long short-term memory cells is created to process raw behaviour data that are aggregated on a daily basis to classify them as high-risk or not. Supervised training is used in order to learn from historical data, where the usage of permanent self-exclusions due to gambling related problems defines problem gamblers. The work consists of: obtain a local optimal configuration of the network which enhances the performance for identifying problem gam- blers who favour the casino section over sports section, and analyze the model to provide insights in the field. This project was carried out together with LeoVegas Mobile Gaming Group. The group offers both online casino games and sports booking in a number of countries in Europe. This collaboration made both data and expertise within the industry accessible to perform this work. The company currently have a model in production to perform these predictions, but want to explore other approaches. The model that has been developed showed a significant increase in performance compared to the one that is currently used at the company. Specifically, the precision and recall which are two metrics important for a two class classification model, increased by 37% and 21% respectively. Using raw time series data, instead of aggregated data increased the responsiveness regarding customers change in behaviour over time. The model also scaled better with more history compared to the current model, which could be a result of the nature of a recurrent network compared to the current model used.

Problem gambling currently affects between 5-7% of youth ages 12-18 (Hardooon & Derevensky, 2002); however, rates of problem gambling among youth who are involved with the Juvenile Justice System are more than twice that of school sample rates (Lieberman & Cuadrado, 2002). Furthermore, disordered gambling often co-occurs with substance use and criminal activity (Huang & Boyer, 2007), issues that are compounded in the Juvenile Justice population. The current study assessed gambling behaviors and risk factors of 145 youth involved in juvenile, juvenile drug, and family courts. Results indicated that nearly 13% of these youth are currently problem gamblers, and that males and African-Americans had higher problem gambling rates than female and Caucasian youth. Furthermore, gambling-related crime, substance use, scope of gambling activities, and time in detention facilities were all predictive of problem gambling severity, while suicidal ideation, urban environment, and lottery sales per capita were not. Finally, having a parent with a gambling problem also emerged as a risk factor;however, the risk was greater for males than for females. These results present a distinct need for youth to be screened for gambling problems upon entering and exiting the Juvenile Justice System, and for prevention and intervention services to be offered within juvenile and family court settings. Furthermore, communities need to take an active role in preventing youth gambling problems through increasing public awareness and insuring that appropriate and accurate messages reflecting gambling opportunities and outcomes are presented.

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Psychological interventions can improve outcomes and reduce symptom severity for individuals with gambling disorder. This chapter provides an overview of current evidence from moderate- to large-scale randomized controlled trials of psychotherapy interventions for the treatment of gambling problems. Interventions include full-length professionally delivered therapies (behavior therapy, cognitive therapy, and cognitive-behavioral therapy), as well as self-directed workbooks and computer-facilitated programs. Motivational interventions, including motivational interviewing, motivational enhancement therapy, and personalized feedback, are also reviewed. This chapter highlights gambling-related treatment outcomes and comparisons between conditions for randomized trials, with an emphasis on treatment dropout. Attrition rates are generally high across all multi-session intervention modalities and formats. Overall, findings suggest that no specific treatment consistently outperforms other active treatments, but cognitive-behavioral therapy does have the most empirical support for the treatment of gambling disorder. In addition, brief motivational interventions are sufficient for some gamblers to change their behavior, particularly those experiencing only a few adverse symptoms from their gambling involvement. Future research efforts will benefit from further refining existing treatments to improve retention, which in turn may enhance effectiveness.

Additional tax on gambling winnings was announced by the Minister of Finance, Mr. Pravin Gordhan in the 2010 National Budget Speech. This additional tax was proposed to discourage excessive gambling in South Africa. In 2011, it was proposed that all winnings above R25 000 will be subject to a final 15 per cent withholding tax. Gambling plays a significant role in the South African economy and contributes to job creation, infrastructure investment and overall economic growth. The Government faced negative comments from the gambling industry where the administrative challenges of implementing a withholding tax were emphasised. Challenges such as the difficulty in implementing, controlling and administering the proposed tax were mentioned. The objective of the proposal was questioned because excessive gambling declined in South Africa during the last few years. This led to the Government changing their proposed method in 2012 from a withholding tax at 15 per cent to a national gambling tax, based on gross gambling revenue, on a uniform provincial gambling tax base, which constitutes an additional 1% national levy. This raised two main problem statements. The first is which role of government, regulator versus stakeholder, is taking precedence through the implementation of the proposals to levy additional taxes on gambling in South Africa? And the second, is this role (identified above) the correct role that government should play that best supports government‟s objective of curbing excessive gambling in South Africa and does it justify the need for an additional tax to be levied on South African gambling? The two proposed methods were scrutinised to identify the ultimate role of the government. The fact that only the winnings will be subject to a withholding tax system did not contribute to a regulator role to decrease excessive gambling and thereby minimising negative externalities. Not all gamblers will be directly affected by this type of tax. The provincial tax base taxes all gambling activities, as all gamblers participating in gambling will be subject to the additional levy. The problem here is that the gambler will not be directly taxed and will then not be directly influenced to have any effect on their gambling behaviour. The government also recognised that they want to decrease the negative externalities that are associated with excessive gambling. It would seem that the main objective should rather be to address the negative externalities rather than the excessive gambling. It is debatable whether an additional tax levied in any form other than a sin tax would achieve this goal and give the role of regulator precedence. The role as stakeholder took precedence when the government decided to move to a provincial tax base. Research indicated that the main motivational factor behind the election was purely driven on how government would be successful in implementing an additional tax in the most administratively efficient and cost effective manner, while still benefiting from it through the collection of additional state revenue. / MCom (South African and International Taxation), North-West University, Potchefstroom Campus, 2014

Additional tax on gambling winnings was announced by the Minister of Finance, Mr. Pravin Gordhan in the 2010 National Budget Speech. This additional tax was proposed to discourage excessive gambling in South Africa. In 2011, it was proposed that all winnings above R25 000 will be subject to a final 15 per cent withholding tax. Gambling plays a significant role in the South African economy and contributes to job creation, infrastructure investment and overall economic growth. The Government faced negative comments from the gambling industry where the administrative challenges of implementing a withholding tax were emphasised. Challenges such as the difficulty in implementing, controlling and administering the proposed tax were mentioned. The objective of the proposal was questioned because excessive gambling declined in South Africa during the last few years. This led to the Government changing their proposed method in 2012 from a withholding tax at 15 per cent to a national gambling tax, based on gross gambling revenue, on a uniform provincial gambling tax base, which constitutes an additional 1% national levy. This raised two main problem statements. The first is which role of government, regulator versus stakeholder, is taking precedence through the implementation of the proposals to levy additional taxes on gambling in South Africa? And the second, is this role (identified above) the correct role that government should play that best supports government‟s objective of curbing excessive gambling in South Africa and does it justify the need for an additional tax to be levied on South African gambling? The two proposed methods were scrutinised to identify the ultimate role of the government. The fact that only the winnings will be subject to a withholding tax system did not contribute to a regulator role to decrease excessive gambling and thereby minimising negative externalities. Not all gamblers will be directly affected by this type of tax. The provincial tax base taxes all gambling activities, as all gamblers participating in gambling will be subject to the additional levy. The problem here is that the gambler will not be directly taxed and will then not be directly influenced to have any effect on their gambling behaviour. The government also recognised that they want to decrease the negative externalities that are associated with excessive gambling. It would seem that the main objective should rather be to address the negative externalities rather than the excessive gambling. It is debatable whether an additional tax levied in any form other than a sin tax would achieve this goal and give the role of regulator precedence. The role as stakeholder took precedence when the government decided to move to a provincial tax base. Research indicated that the main motivational factor behind the election was purely driven on how government would be successful in implementing an additional tax in the most administratively efficient and cost effective manner, while still benefiting from it through the collection of additional state revenue. / MCom (South African and International Taxation), North-West University, Potchefstroom Campus, 2014