Background Electronic gaming machines (EGMs) are disproportionately associated with gambling-related harm, yet qualitative research exploring these harms from the perspectives of active EGM users remains limited. Understanding how harm is experienced and sustained is critical for informing population-level public health responses. Methods A qualitative study was conducted using semi-structured, in-depth interviews with twelve regular EGM users in New Zealand. Participants were recruited through purposive sampling and were required to have engaged in EGM gambling at least weekly in the past 60 days. Interviews were audio-recorded, transcribed verbatim, and analysed using the framework method to enable systematic comparison across cases. Analysis was guided by a social determinants of health lens. Results Six interrelated themes were identified: social and environmental influences, behavioural and psychological reinforcement, emotional and mental health impacts, financial harm and broader life consequences, barriers to help-seeking, and perspectives on harm minimisation. Participants described how the accessibility of EGMs, immersive venue environments, and reinforcing structural machine features interacted with emotional vulnerability and social context to sustain prolonged gambling. Harms extended beyond financial loss to include relationship disruption, psychological distress, and reduced wellbeing. Help-seeking was often constrained by stigma, limited awareness of services, and a reliance on self-regulation strategies that frequently deteriorated over time. Conclusions Findings highlight the limitations of individual-focused harm minimisation approaches and demonstrate the need for population-level strategies addressing the structural and commercial determinants of gambling harm. Strengthening regulation, reducing accessibility, and improving public awareness may more effectively mitigate EGM-related harm and associated inequities.

Electronic gaming machines (EGMs) are one of the most addictive and harmful forms of gambling. Gaming machine characteristics, easy accessibility of EGMs and normalisation of gambling behaviour have exacerbated these effects. We conducted a pilot study investigating the perspectives of gambling expert stakeholders on gambling harm and effective harm-minimisation policies regarding EGMs. In-depth individual interviews were undertaken with 14 health professionals working in the addiction sector, academics in the field of gambling and individuals from a range of government and non-government organisations who have an impact on gambling policy making in New Zealand. Five major themes were identified: the need to shift focus from problematic people to the problematic product, the need for a holistic approach to gambling intervention, focus on creating an empowered population, and improving protective factors and refining public health initiatives to gambling harm. The results suggest the need to challenge current narratives of EGM-related gambling harm and have wide-ranging implications for EGM harm minimisation and health promotion policies.

This study aimed to investigate the self-reported measures of concurrent disorders (stress, social anxiety, anxiety, depression and alcohol use) among electronic gaming machine (EGM) gamblers with varying levels of gambling severity and to examine its relationship to decision-making. This cross-sectional study in New Zealand involved an online survey that utilised validated questionnaires to assess self-reported measures of concurrent disorders and the Iowa gambling task (IGT) to analyse decision-making. The study comprised of active EGM gamblers (n = 153) who were divided into two groups: non-problem gambling (NPG, n = 71) and problem gambling (PG, n = 82) based on the cut-off point of the South Oaks Gambling Screen (SOGS). Multiple logistic regression models were performed to analyse co-occurring disorders separately and simultaneously, and a log‐linear model was developed to define the associations between significant variables. The first model showed a strong correlation between gambling severity and measures for depression (p < 0.01), anxiety (p < 0.05), stress (p < 0.05) and alcohol use (p < 0.01), however only depression (p < 0.05) and alcohol use (p < 0.01) remained significant in the second model. Further, no association between social anxiety scores and problem gambling was found in this sample of EGM gamblers in both models. On the IGT, EGM gamblers in the PG group performed significantly worse. Further, the presence of poor decision-making was more pronounced with higher depression scores (p < 0.01) across both NPG and PG groups and higher alcohol use scores (p < 0.05) scores in the PG group. The presence of high levels of co-occurring disorders and its link to poor decision-making are important considerations in the treatment paradigm of EGM problem gamblers.

This paper describes an undergraduate course in addictions within the health science sector linking theory with practice at a university in New Zealand. The essence of this addiction course includes both a strong theoretical basis and public health focus. The theoretical and practical content is described with examples of the students’ pedagogical journey in the course. Three conceptual elements lay at the foundation of this course and are easily explained by employing the symbolic ROBIN-MARIE SHEPHERD Robin-Marie Shepherd, PhD., has been teaching and conducting research at the University of Auckland since 2004. She has moved on to private practice pursuing a clinical career in Mental Health and Addictive Follow the Yellow Brick Road: Linking Theory and Practice in Addiction Studies Teaching • College Quarterly http://collegequarterly.ca/...-vol20-num01-winter/follow-the-yellow-brick-road-linking-theory-and-practice-in-addiction-studies-teaching.html[2/17/2017 6:51:02 PM] allegory found in The Wizard of Oz(Baum, 1900): that of the heart (the Tin Woodman), the brain (the Scarecrow) and courage (the Cowardly Lion).

Gambling is illegal in Hawai'i, but it is accessible through technology (eg, the internet), inexpensive trips to Las Vegas, and illegal gaming such as lottery sales, internet gambling, and sports betting. Where there are opportunities to gamble, there is a probability that problem gambling exists. The social costs of gambling are estimated to be as high as $26,300,000 for Hawai'i. Because no peer-reviewed research on this topic exists, this paper has gathered together anecdotal accounts and media reports of illegal gambling in Hawai'i, the existence of Gamblers Anonymous meetings operating on some of the islands, and an account of workshops on problem gambling that were provided by the author on three Hawaiian Islands. Through these lenses of gambling in Hawai'i, it is suggested that there are residents in Hawai'i who do experience problem gambling, yet it is unknown to what extent. Nonetheless, this paper argues that research and perhaps a public health initiative are warranted.

This paper examines reflective portfolios of graduate students studying co-existing problems (CEP) within an alcohol and drug studies programme in New Zealand. The methodology employs Todd’s principles of treating co-existing disorders (culture, management, engagement, assessment, integrated care, well-being and management). The metaphor, a GPS, is employed in the title to describe how Todd’s principles are used as a GPS to help navigate the murky waters of working with this specialised client population. The principles, allocated as themes within the portfolios, highlight how these principles are reflected upon within their workplace. Culture and engagement principles were the most endorsed themes within the portfolios. The reflective portfolios also allowed us to reflect upon the ongoing process of curriculum development for this specialised client population.

This study aims to explore recovery for those who ring psychic hotlines excessively. Participants were self-selected and were predominantly female, educated, employed and single. The cohort is retrieved from the Psychic Junkie website, which is the only online support place for these people recovering from ringing psychics excessively. Recovery was defined as attempts to stop or to cut down ringing psychics. Recovery included abstinence or harm reduction strategies to control the amount of spending on psychics. A popular attempt to remain abstinence from psychic hotline ringing was within a spiritual context, which included strategies such as prayer, meditation, and attending 12 step groups. Other strategies included blocking psychic hotlines on their phone, cutting up credit cards, counselling, and medication. Harm reduction strategies included setting a budget to decrease the time spent talking to psychics. These attempts resonated with similar recovery strategies for other excessive behaviours.

This study aimed to qualitatively explore the relationship between young people and mobile phones, with a specific focus on problematic use. Five focus groups were undertaken, comprising 45 participants aged 13 to 18. Focus groups were audio recorded and transcribed verbatim. The data were thematically analysed using a general inductive approach. The analysis revealed five main themes, relating to the practicality of using a mobile phone, socialisation via mobile phones, harm caused by use of mobile phone technology, and the development of attachment and addiction to a mobile phone. The findings suggested that young people recognise problematic behaviour in relation to mobile phone use, and note that such behaviour is linked to physical, social and psychological consequences. This study provides a platform for further inquiry into the subject of problematic mobile phone use.

The following study was an exploratory journey to examine reflective practice amongst students taking the undergraduate paper 'Communities and Addiction'. This paper has been an elective paper within the Health Sciences for third year students at the University of Auckland for three years. The students were instructed to reflect on two assignments after they had written each one. The first assignment focused on addiction models and the second assignment focused on social marketing as a public health approach to potentially addictive behaviour (e.g. substance abuse, gambling, and eating disorders). The findings from the first assignment suggested that students developed (or enhanced) empathy towards sufferers of addiction. The findings from both of the assignments revealed that many of the students were developing reflective skills, though often this was at quite a basic level. These findings suggested that more guidance and feedback is needed to aid students in the reflective journey.

This is the first study to investigate the interrelationship of social anxiety with the variables anxiety, depression, locus of control, ego strength and ways of coping in a sample of university students. There were high scores of social anxiety which were related to high scores on measures of anxiety and depression, low ego strength, external locus of control and emotion coping rather than problem focused coping. While the results are relational rather than being predictive of causality they raise a number of issues with regard to theory, prevention, intervention and promoting mental health within a university setting. Research suggests that there has been an increase in the use of mental health services amongst university students. Of relevance to the present study the findings of a survey in the UK reported that adjusting to university life was a concern to 35% of the students surveyed while 20% were very concerned about coping with anxieties such as phobias or panic attacks and 35% expressed concern regarding depression or mood changes. In another study, Webb and colleagues (1996) reported that 54% (N= 3057) of their large sample of university students reached the sub-threshold for anxiety and 13% of the same sample were deemed somewhat depressed. These findings suggest that many students find university life a challenging time to cope.

This study examines the relationship between Brown's core criteria for addiction and ringing psychic hotlines. Both quantitative and qualitative data were endorsed to explore Brown's theoretical framework. Fifty-six participants were recruited from the international ‘psychic junkie’ support group website. Most of the participants were female, Caucasian, single, university educated, spiritual and employed. A semi-structure questionnaire along with a psychic hotline questionnaire adapted from Brown's core criteria of addiction was administered. Significant affirmative responses on Brown's addiction criteria included cognitive salience, euphoria, tolerance and relief. The callers were less likely to endorse behavioural salience, relapse or inter-personal conflict as a result of psychic hotline use. Participants spent excessive amounts of money ringing psychic hotlines and many went into debt. The qualitative data as well as Brown's core criteria of addiction supports the supposition that a segment of the population may be addicted to ringing psychic hotlines.‘The most authentic thing about a cold reading is that false information is becoming part of another person's real life and memories’ (Reed ).

This exploratory study examined reflective practice among a class of students studying a ‘communities and addictions’ course as part of the undergraduate health science degree. Most reflective practice publications are focused on medical or teachers’ training rather than undergraduates in general. This is surprising given that reflective practice is an impetus to deeper learning. The students were required to write a 500 word reflective piece after writing essays on the disease model and a public health approach to problem gambling, substance use, tobacco use, or eating disorders. This innovative study demonstrated that reflective practice can help the students learn on a deeper level both academically and personally. In particular, reflective practice should become compulsory for graduates entering the health sectors as they will cross paths with those suffering from addictions. Themes emerging from the reflective writing were discussed.

This paper describes four individuals who report concerns with social phobia and the use of alcohol and the misuse of prescription drugs as a means of coping with their difficulties. These case studies illustrate vulnerabilities that place people at- risk for self medicating. Although the four participants exhibited different patterns and frequencies of drug and alcohol use, they seemed to use the substances to regulate affect or self care capacities. Although three of the four cases did not meet the criteria for "addiction'' to a substance, they did demonstrate dysfunctions with self regulation. Each individual case is presented to illustrate its uniqueness in relation to social phobia, related symptomatology, and self medication. The findings and their implications for counselling are discussed.

Abstract Background Problem gambling often goes undetected by family physicians but may be associated with stress-related medical problems as well as mental disorders and substance abuse. Family physicians are often first in line to identify these problems and to provide a proper referral. The aim of this study was to compare a group of primary care patients who identified concerns with their gambling behavior with the total population of screened patients in relation to co-morbidity of other lifestyle risk factors or mental health issues. Methods This is a cross sectional study comparing patients identified as worrying about their gambling behavior with the total screened patient population for co morbidity. The setting was 51 urban and rural New Zealand practices. Participants were consecutive adult patients per practice (N = 2,536) who completed a brief multi-item tool screening primary care patients for lifestyle risk factors and mental health problems (smoking, alcohol and drug misuse, problem gambling, depression, anxiety, abuse, anger). Data analysis used descriptive statistics and non-parametric binomial tests with adjusting for clustering by practitioner using STATA survey analysis. Results Approximately 3/100 (3%) answered yes to the gambling question. Those worried about gambling more likely to be male OR 1.85 (95% CI 1.1 to 3.1). Increasing age reduced likelihood of gambling concerns – logistic regression for complex survey data OR = 0.99 (CI 95% 0.97 to 0.99) p = 0.04 for each year older. Patients concerned about gambling were significantly more likely (all p < 0.0001) to have concerns about their smoking, use of recreational drugs, and alcohol. Similarly there were more likely to indicate problems with depression, anxiety and anger control. No significant relationship with gambling worries was found for abuse, physical inactivity or weight concerns. Patients expressing concerns about gambling were significantly more likely to want help with smoking, other drug use, depression and anxiety. Conclusion Our questionnaire identifies patients who express a need for help with gambling and other lifestyle and mental health issues. Screening for gambling in primary care has the potential to identify individuals with multiple co-occurring disorders.

Hypornanic personality traits have been shown to predict manic episodes, substance abuse, and engagement with pleasurable but potentially harmful leisure activities. Because hypomania-proneness might be linked with an inherent hyper-responsiveness of the Behavioral Activation System (BAS), it is thought that hypomania-prone individuals are more likely to pursue any potentially pleasurable activities or substances with greater enthusiasm and vigor. These tendencies should also place hypomania-prone individuals at risk for general addictive problems, not just addiction to drugs or alcohol.100 adults from the general community completed self-report measures of hypomania-proneness, addictive tendencies, and mood. Participants completed the hypomanic personality scale (Eckblad & Chapman, 1986), a 96-item questionnaire measuring addictive tendencies across twelve domains, and the positive and negative affect scales (Watson, Clark, & Tellegen, 1988).Even after controlling for positive and negative mood, age, and gender, hypomania-proneness correlated with general addictive tendencies, with a self-report scale of addictive personality features and with several addictive tendencies in specific domains.Hypomania-prone individuals may experience themselves as more likely to have an 'addictive personality' and to be intensely engaged in the pursuit of many pleasurable activities, from listening to music or consuming chocolate and caffeine to excessive devotion to work, exercise, and other activities. This intense pleasure-pursuit can potentially result in high achievement, mastery and resource acquisition, but the same addiction-like pleasure-pursuit can also result in the more harmful consequences associated with mania and related clinical syndromes. (c) 2006 Elsevier Ltd. All rights reserved.

A reasons for Internet Use Questionnaire was developed to examine the relationship between internet use, social anxiety, general anxiety, and depression. Research suggests that socially anxious individuals may find it easier to interact online where anonymity can be maintained rather than engage in face to face interaction where being observed by others might induce a fear of negative evaluation. In line with the self-regulation model, it was hypothesised that social anxiety, low ego strength, anxiety and depression, would be related to use of the internet to cope with social fears. The results were partially in line with the hypothesis. Implications of these findings are discussed.

The South Oaks Gambling Screen (SOGS) was administered to veterans in both an outpatient methadone and problem drinking clinic. The instrument was given to 93 veterans who represented the poor and homeless. It was anticipated that the SOGS would provide important diagnostic information to the clinicians counseling the substance abusing population since many compulsive gamblers have a history of substance abuse. A number of clinical obstacles were encountered in administrating the SOGS in this environment. Both Client and staff noncompliance during the screening were major concerns in this respect. The clinical obstacles encountered in this study were examined and suggestions to prevent these problems are discussed.