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Comorbidities in people who struggle with gambling-related behavioral issues is no novel concept. The generally accepted premise is that more often than not, people who have such symptoms also report symptoms associated with anxiety, depression and other problems.
While dialogue is ongoing regarding whether there is a causal relationship between these struggles, a new paper presents a different approach. In the paper, researchers measure the attitudes of people undergoing treatment for gambling disorder and how that treatment affects those attitudes toward their lives from a broad perspective.
In short, such treatment seemed to positively and strongly correlate with improved attitudes. However, the classic “the chicken or the egg” quandary remains.
Connections between treatment and life perspectives addressed
In the 54th edition of the Journal of Gambling Issues, Svetlana Dzakhotovna Gurieva and Anna Yurievna Zinina published their paper, “Transformation of relationships between time perspective and life-sense orientations in people with gambling disorder in a rehabilitation setting.” The abstract makes their findings clear.
The authors say the study group consisted of 42 respondents “who completed a gambling rehabilitation program” at an unnamed treatment center over six months. The authors used two devices to collect data about the participants.
To understand the findings, it’s necessary to have a grasp of the terminology and those assessment methods.
What are life-sense orientation and time perspective?
The paper defines time perspective as “the process by which the long flow of existence is unified into temporal categories that help to order, structure, and give meaning to our lives.” The observance of time in days, hours, etc., then, could be described as a time perspective if that observance is used to define when we perform certain tasks, visit specific places, etc.
Life-sense orientation, as the authors define it, reflects “personality orientation, existence of life goals, meaningful choices and assessments, and satisfaction with self-realization.” In simpler language, life-sense orientation is the belief that life has a purpose and the willful drive to act accordingly.
To assess possible correlations between these phenomena and treatment for gambling disorder, the authors used the Zimbardo Time Perspective Inventory and the Life-Purpose Orientations test. These are essentially questionnaires that attempt to measure where a participant lands on a spectrum for these qualities.
Using those assessments, the authors were able to show changes in scoring that correlated to the rehabilitation period.
Data show significant improvements in assessment results
In the paper’s discussion of the data, the authors point out that “prior to the rehabilitation program … data analysis revealed significant negative correlations between the indicators” such as “general meaningfulness of life” and “having goals and plans for the future.” The data look quite different in the same assessments in the study group after the treatment period.
The paper shows that “after completion of the rehabilitation program … the dynamics of the formation of positive correlations between” factors like “satisfaction with the process of life” and “the degree of acceptance of one’s own past” were present. Thus, “the patterns revealed imply that participants advanced to the level of meaning-finding as a result of the rehabilitation program.”
That’s a great sign for the rehabilitation program in the study and others like it. Unrelated data seem to confirm the authors’ findings.
A more recent white paper from Kindbridge Behavioral Health also shows comorbidities — defined as separate health issues presenting simultaneously — in treatment participants upon initiation and notable improvements in symptoms associated with those issues after rehabilitation. However, there is one huge limitation that the Gurieva-Zinina paper addresses.
Recency bias is a serious concern
While these data suggest that the treatment was effective at improving participants’ outlook on life, recency bias is a massive drawback. The study assessments were conducted right after completing the rehabilitation program while the control assessments were conducted upon entering treatment.
Thus, it’s likely that participants were in a low emotional state when they took the control assessments and similarly on a high of sorts when completing the study assessments, fresh with the encouragement and sense of accomplishment that completing the rehabilitation program awarded. More longitudinal data is necessary to establish a longer-term efficacy of this treatment in these regards.
Furthermore, the rehabilitation program was in-patient, meaning the participants were removed from potential triggering situations for the duration of the treatment period. More research is necessary to assess whether these improvements in attitudes are present when participants are again faced with the demands of their normal lives.
More considerations for evaluation
It’s also worth considering how representative the study participants are of the broader population of people who seek treatment for gambling-related behavioral issues. Lynn Zakeri, a licensed clinical social worker who received Illinois Social Worker of the Year honors in 2022, disclosed that participants often do not present with such issues upon initiation.
“I would not say they walk in with this [poor attitudes about life-sense orientation and time perspective] unless gambling is a secondary issue for seeking me out, like when alcoholism or depression is the primary motivator,” Zakeri stated. “Sometimes a flippant comment, while nothing is flippant when said to a therapist, may be something like ‘who knows if I will even be around to really suffer from losing the money’ can be revealing.
“I think anger is more frequently seen as a presenter, anger that someone is pushing them to get help.”
As a final caveat, the paper does not examine participants’ level of engagement with the treatment to present firm evidence for causation of improved attitudes. Therefore, it’s still unclear exactly what led to these superior outcomes.
With all these limitations acknowledged, there are still valuable insights to glean from this paper.
How stakeholders should use this information
There are applications for this analysis and data for many stakeholders in the online casino industry. Gamblers themselves, practitioners in healthcare, regulators of gaming and legislators can all glean some new perspective.
For healthcare providers, the data emphasize the need to be aware of the potential risks of gambling for people who present with the attitudes this paper highlights. More conversations about gambling activity are necessary to not only prevent behavioral issues along those lines but also ascertain the potential causation of deterioration of life satisfaction derived from gambling-related issues.
For regulators and legislators, this paper is yet another demonstration of just how important it is to strictly enforce safer gambling standards and ensure that resources for people who need this type of treatment are well-funded. It is beyond irresponsible to regulate gambling or expand the same without providing adequate funding and infrastructure to access such rehabilitation programs.
Finally, for online casino players and those who love them, this paper is another example of potential warning signs of when gambling could cause significant harm. These data suggest that people who struggle with general life satisfaction and poor attitudes toward life’s purpose should take extra care in their gambling, if they choose to do so at all.
Gurieva and Zinina have built a stellar foundation on which, hopefully, more research will be done along these lines. The more these concepts are studied, the better prevention and treatment programs for people who struggle with gambling disorders will become.
