Financial gambling inducements such as ‘free’ bets and welcome bonuses involve complex wagering requirements that many consumers miscomprehend. UK regulations cap these wagering requirements at x10 (i.e., users must wager x10 the bonus before withdrawal) but don’t require worked examples to aid comprehension. This study assessed UK bettors’ comprehension of inducement wagering requirements, whether comprehension varied by gambling severity, whether perceived attractiveness differed when worked examples were displayed, and bettors’ broader perceptions of inducements. A between-subjects, mixed-methods online experiment randomised UK bettors (n = 585) to view a welcome bonus inducement either with or without (control) a worked example detailing its wagering requirement. Participants completed measures of comprehension, perceived attractiveness, gambling severity, and qualitative questioning. Participants in the control condition significantly underestimated the inducement’s wagering requirements (p<.001, r=.94), with a median estimate of £500 versus the correct value of £750. Underestimation did not differ by gambling severity. The inducement was rated significantly less attractive (p<.001, η²=.18) when the worked example was displayed (M = 2.39, SD = 1.46) compared to the control (M = 3.75, SD = 1.48). However, this effect was moderated by gambling severity (B=-0.112, p=.005), with the reduction in perceived attractiveness associated with the worked example becoming smaller as gambling severity scores increased. Qualitative analysis identified three overarching perceptions of inducements: as manipulative, economically worthless, and requiring better regulation. UK bettors significantly underestimate inducements’ wagering requirements, while worked examples significantly reduce their mistaken attractiveness. These findings demonstrate how informed choice can be enhanced via worked examples.

Frontline occupations, including military, healthcare, and first responders, often include frequent exposure to traumatic events, increasing the risk of substance use disorders (SUDs). Research has shown that those in high-intensity occupations are at higher risk of developing SUDs compared to the general population. Women face unique experiences related to substance use, including greater functional impairment and barriers to treatment access. Yet, understanding of the effectiveness of digital health technologies in addressing substance use among women in frontline occupations is limited. This systematic review evaluates the effectiveness of digital health interventions in reducing substance use among women in frontline roles. Four databases (PsycINFO, Ovid MEDLINE, Embase, PsycArticles) were searched for English language full-text articles (2007-2024) that (1) evaluated a digital intervention designed to reduce substance use, (2) reported changes in substance use outcomes such as frequency, intensity or duration, using validated tools (3) included current or former frontline public service workers, and (4) included women as the primary target population or as a subgroup within the sample. 13 papers met inclusion criteria, focusing on eight distinct web and mobile-based interventions for alcohol, tobacco and illicit substances. Most studies (n = 11) reported substantial post-intervention reductions in alcohol and tobacco use, although results for PTSD symptoms, illicit drug use, and quality of life were mixed. This review highlights the potential of digital health interventions for reducing substance use but underscores significant gaps in research. The scarcity of studies focused on women, small and heterogeneous samples, and focus on veterans limits the generalisability to women in frontline roles. These gaps present a pressing challenge in understanding gender-specific digital intervention efficacy. Future research should prioritise larger, representative samples of women across diverse frontline occupations to drive the development of digital technologies tailored to the unique challenges faced by women in these roles.

Intolerance of Uncertainty (IU) is a disposition typified by negative reactions to uncertainty and may influence how university students engage with career development opportunities. IU can be 'Prospective' or 'Inhibitory'. Prospective IU is characterised by a 'desire for predictability', whilst Inhibitory IU is characterised by inaction due to 'uncertainty paralysis'. In this study, we surveyed 568 students to examine whether Inhibitory and Prospective IU (as measured by the IUS-12) were associated with students' attendance at careers' events and their awareness of, and confidence and experience with, commonly used graduate employer selection tests. Results revealed that higher inhibitory IU scores were associated with lower awareness, confidence and experience with employer selection tests but not attendance levels. Prospective IU scores were positively associated with confidence and experience levels. These novel findings demonstrate that IU is a factor impacting on students' employability. Recognising the role of inhibitory IU and cultivating a tolerance to uncertainty may help to improve students' employability.

High-quality systematic reviews and meta-analyses are essential for translating evidence into practice. We conducted an umbrella review to evaluate the methodological quality of systematic reviews and meta-analyses published in the field of behaviour analysis up to and including 2023. Quality was assessed using the Assessing the Methodological Quality of Systematic Reviews (AMSTAR-2) and the R(Revised)-AMSTAR instruments. Temporal trends were analysed using multilevel Bayesian regression. The protocol was preregistered on the Open Science Framework (doi.org/10.17605/OSF.IO/U38Z4). We identified 64 reviews (16 of which included a meta-analysis), all of which were rated as 'critically low' quality using the AMSTAR-2 criteria. Methodological shortcomings included absent protocol registration, inadequate risk of bias assessment, and failure to assess publication bias. Mean R-AMSTAR adherence was 43.8% (range 11-66%). Adherence increased by 1.08% per year across the study period (population-level average marginal effect from the mixed-effects logistic model (95% CI [0.59, 1.58]), indicating robust methodological improvement over time. Currently, many systematic reviews and meta-analyses in behaviour analysis do not yet meet contemporary standards of methodological rigour. Enhancing the quality, transparency and consistency of evidence syntheses is vital if systematic reviews are to meaningfully inform practice.

Objective: Gambling-related harm is a major public health concern, yet the mechanisms through which gambling-related cues influence behaviour remain poorly understood. Across two experiments, we examined whether gambling-related cues influence behaviour through Pavlovian-to-Instrumental Transfer (PIT), and whether the strength of PIT effects is associated with risk of gambling harm. Method: Participants completed a single-response Go/No-go PIT task, with gambling harm indexed using the Problem Gambling Severity Index (PGSI). Experiment 1 (N = 129) examined PIT using gambling-related conditioned stimuli (CSs), whereas Experiment 2 (N = 129) additionally incorporated visually matched neutral CSs. Results: Robust appetitive and aversive PIT effects were observed across both experiments (ps &lt; .05; Cohen's ds: .56–1.69), demonstrating that conditioned cues systematically modulated instrumental responding. PIT effects showed little association with gambling severity (PGSI group), suggesting cue-driven behavioural transfer may operate independently of risk status. Neutral cues elicited a more graded PIT function in the approach condition than gambling-related cues, suggesting gambling-specific cues may engage a more categorical, rather than incentive-graded, approach response. Conclusions: These findings provide the first experimental demonstration of PIT in a gambling context and establish PIT as a valuable framework for understanding how conditioned gambling cues influence behaviour.

Online gambling operators collect vast amounts of consumer data to track behaviour and personalise inducements. Under the General Data Protection Regulation (GDPR), access to these data requires user consent, obtained via pop-up consent banners. However, such banners tend to exhibit “dark patterns” or designs which nudge users towards accepting data sharing. To date, little is known about the extent of such dark patterns in online gambling. Here, we investigated the format of consent banners used on UK gambling websites and assessed how they may influence behaviour. Study 1 reports an audit of all UK-licensed gambling sites (n = 624). We found that 86% of banners exhibited at least one dark pattern, while GDPR infringements were also identified: 24% of sites offered no option to reject tracking and over two-thirds (67%) processed personally identifiable data prior to obtaining consent. Only 1 in 7 or 14% of sites were GDPR compliant. In Study 2, an online randomised experiment was conducted, whereby participants (n = 615) were assigned to different consent banners within a simulated gambling platform. The most common banner identified in Study 1 significantly increased acceptance of tracking and produced significantly lower alignment between user choices and preferences. No association between banner decisions and self-reported gambling harm severity was detected. Overall, our findings reveal widespread dark patterns and non-compliance of GDPR requirements on UK online gambling sites, influencing users towards unintended data sharing. These findings highlight the need for stronger regulatory enforcement and stricter consent banner design standards to protect consumers.

Objective This study explored the lived experiences of UK Armed Forces veterans affected by gambling-related harm. It examined how military culture, institutional practices and life transitions shaped gambling behaviours, barriers to help-seeking and the long-term impact on well-being. While quantitative research has documented elevated gambling-related harm among veterans, little qualitative work has examined how veterans themselves understand, experience and navigate gambling harm across military and post-military contexts.Design Reflexive thematic analysis of one-to-one semistructured interviews, covering topics such as the nature of participants' gambling activities, the impact on their lives, pathways to gambling behaviours and help-seeking.Participants Participants were UK veterans (n=14), aged 31-60, including one female, from three service branches, all of whom self-identified as having experienced gambling-related harm.Results Four interrelated themes were generated: (1) Gambling as normalised in both civilian and military contexts, reinforced by institutional routines and downtime activities; (2) Gambling as an emotional coping mechanism, shaped by institutional norms of stoicism and emotional control; (3) Stigma, silence and structural barriers to help-seeking, including fears of professional repercussions and (4) Escalation postdischarge, driven by isolation, unstructured time, digital gambling access and difficulties adjusting to civilian life. Participants reported concealment, debt and relational breakdowns, with some disclosing suicidal ideation linked to gambling harm.Conclusions Gambling harm among UK veterans is shaped by a complex interplay of cultural, emotional and institutional factors. While gambling opportunities are embedded in military life, systems of support remain inconsistent and often punitive. Gambling remains under-recognised as a serious mental health issue within military and veteran care pathways. Findings highlight the need for stigma-free, culturally informed interventions across the military life cycle, including routine screening, gambling harm education and trauma-informed care.

OBJECTIVES:To investigate the efficacy of electronic screening, brief intervention, and referral to treatment (e-SBIRT) at improving gambling outcomes and increasing help-seeking. METHODS:We conducted a two-arm, randomised online pilot trial (n = 83) comparing an e-SBIRT intervention with an active control over 12 weeks. The brief intervention was informed by motivational interviewing and incorporated personalised normative feedback, information provision, and relapse-prevention components. Eligible participants were aged 18 or older, resided in the UK and had scores indicating at least moderate severity gambling. RESULTS:Participants (54 [65.1%] male; mean [SD] age = 40.58 [12.75] years, mean [SD] PGSI = 7.16 [5.58]) in the e-SBIRT and control conditions showed improvements in gambling harms (p = 0.033) and perceived ability to control gambling (p = 0.029). No significant effects of condition assignment or condition x time interactions were observed. However, exploratory analyses of individual model coefficients suggested greater improvement in perceived ability to control gambling among participants receiving e-SBIRT at 12 weeks (p = 0.043). Exploratory analyses also suggested higher rates of help-seeking at 12-week follow-up among participants receiving e-SBIRT. CONCLUSION:Overall, e-SBIRT did not demonstrate clear advantages over assessment and information provision alone. Further research should prioritise refining intervention components and evaluating SBIRT approaches in settings that better reflect its opportunistic delivery model.

Background and aims:Dark patterns are online platform design features that influence consumer behaviour to the advantage of the interface designer. In online gambling, such designs may exacerbate gambling-related harms, particularly among vulnerable consumers. This study aims to provide the first scoping review of dark patterns in online gambling. Methods:Following established scoping review frameworks, we systematically searched databases and grey literature using terms related to dark patterns and online gambling. The review protocol was preregistered. Results:Included articles (n = 16) addressed a variety of gambling-related dark patterns: hidden gambling management tools, inducements with complex conditions, minimum balances required to withdraw funds, unnecessary frictions involved in closing an account, high defaults in stake, deposit, reality check and deposit limit settings, and urgency-based gambling prompts. To address inconsistent terminology across studies, we synthesised existing literature by mapping identified dark patterns to a transdisciplinary framework, providing greater conceptual clarity and direction for future research. Discussions and conclusions:The potential for harm from dark patterns is evident, yet evidence on behavioural impacts is limited, hindered by restricted access to proprietary gambling operator data. Research in this area is sparse and fragmented, often using inconsistent terminology. Future studies should empirically investigate the influence of dark patterns on consumer behaviour, especially among vulnerable populations, and evaluate safer design alternatives. We recommend mandating gambling operators to collaborate with researchers to assess platform safety, and shifting the burden of proof onto operators to demonstrate that their platforms prioritise consumer safety and foster responsible gambling environments.

BACKGROUND:Gambling-related harm is a global public health concern. Suicide mortality is increased among people who experience gambling harm, and people who die by suicide often have contact with mental health treatment services in the months preceding their death. AIMS:To assess via a case-control study how gambling diagnosis predicts suicidal death and mental healthcare utilisation using linked routinely collected healthcare data. METHOD:We linked the Welsh Longitudinal General Practice Dataset, Annual District Death Extract, Patient Episode Database for Wales, and Outpatient Appointments Dataset Wales using the Secure Anonymised Information Linkage (SAIL) Databank. A sample of individuals with gambling diagnosis who died by suicide and an age- and sex-matched comparator group of all-cause decedents between 1993 and 2023 were extracted. Predictors of suicidal death, including mental health diagnosis and treatment contacts, were analysed using binary logistic regression models and chi-squared tests. RESULTS:A matched cohort of 92 individuals diagnosed with a gambling diagnosis (mean age 61.5 years, s.d. 13.1; 71% male) who died by suicide and 2990 comparators were identified. Gambling diagnosis status was a significant predictor of suicide (odds ratio 30.94; 95% CI 3.57-268.28; P = 0.002). Individuals with gambling disorder had significantly more mental health treatment contacts (P < 0.001), particularly in-patient contacts (P < 0.001). No difference in out-patient contacts was found. CONCLUSIONS:Historical diagnosis of gambling harm is a significant predictor of suicidal death and mental health treatment utilisation. Improved screening and coding practices would facilitate greater data linkage research on gambling-related suicide and suicide prevention.

Gambling-related harm among armed forces (AF) personnel is a growing concern, yet public perceptions remain underexplored. Anticipated public stigma (the fear of how others perceive you) of gambling among the AF is a potential barrier to help-seeking. Understanding how the public perceives gambling in the AF is essential for shaping stigma-reduction strategies. A randomised, online 2 × 2 between-subjects experiment was conducted. A representative sample of the United Kingdom public (N = 396) was recruited through Prolific and randomly assigned to view a vignette featuring either an AF member or non-AF civilian who was described as engaging in either harmful or non-harmful gambling. Following exposure to their assigned vignette, participants completed measures assessing stigma and empathy towards the depicted individual. Participants perceived individuals from the AF as significantly more dangerous (p = .002) compared to non-AF civilians. When the vignette depicted gambling-related harm, as opposed to recreational gambling, participants reported significantly higher stigma across seven of the ten stigma measures (all p < .001). This study highlights how public stigma towards gambling harm is strong and can be shaped by military status, with AF personnel facing increased perceptions of dangerousness. Findings underscore the need for public stigma-reduction strategies that address both gambling-related and military-specific misconceptions.

Experiences of gambling-related harm are significant concerns among military veterans, particularly those with posttraumatic stress disorder (PTSD) and complex PTSD (CPTSD). CPTSD, as outlined in the ICD-11, includes disturbances in self-organisation (DSO), encompassing affective dysregulation, negative self-concept, and interpersonal difficulties. While anxiety and distress tolerance (DT) have been implicated in PTSD-related maladaptive behaviours, their roles in the relationship between CPTSD and gambling risk severity remain unclear. This study examines whether anxiety and DT mediate the association between CPTSD symptom clusters (PTSD and DSO) and gambling severity in UK Armed Forces veterans. A cross-sectional study was conducted with UK ex-service personnel (n = 346) who completed the International Trauma Questionnaire for CPTSD, the Generalised Anxiety Disorder scale, the Distress Tolerance Scale, and the Problem Gambling Severity Index. Mediation analyses were conducted using bootstrapped regression models. Anxiety was found to be a significant indirect pathway between CPTSD symptoms and gambling risk severity, with a stronger indirect effect observed for DSO symptoms than PTSD-specific symptoms. In contrast, DT did not show a significant indirect pathway, indicating that deficits in DT may not be central to gambling behaviours in veterans with CPTSD. These findings highlight the critical role of anxiety in gambling-related harm among veterans with symptoms of CPTSD, suggesting that interventions targeting anxiety regulation may be beneficial than those targeting distress tolerance in reducing gambling risk severity. Future research should explore additional potential pathways, such as impulsivity and trauma-related dissociation to further clarify associations between CPTSD and gambling severity.

Veterans are prone to experiencing both mental health challenges and harm from gambling, yet little is known about the psychosocial factors that may increase risk. This study examined predictors of gambling harm severity in a sample of UK Armed Forces veterans with a focus on coping styles and reintegration into civilian employment. A cross-sectional survey was conducted among 414 former personnel using validated measures of gambling behavior, coping, and mental health symptoms including alcohol use. Of the 226 (54.6%) who had gambled in the past year, 3.1% had scores suggestive of problem gambling. Results showed that 46% of participants exhibited symptoms suggestive of posttraumatic stress disorder (PTSD), while 8.4% reported severe anxiety, 10.2% severe depression, and 11.1% high-risk alcohol use. Gambling harm severity was positively predicted by difficulties adapting to civilian employment and maladaptive coping strategies such as self-blame and substance use, while use of informational support was found to be protective. Given higher rates of primary care engagement among veterans, routine screening for gambling-related harm in such settings may improve early detection and intervention. The findings underscore the need for integrated mental health services that consider both psychological and social determinants of gambling harm severity in veterans during the military-to-civilian transition.

BackgroundGambling livestreams, where content creators broadcast themselves engaging with various gambling products, represent an emergent form of both digital entertainment and gambling promotion. Research has recently begun to highlight the motivations for viewership and its associations with gambling behavior/severity. However, qualitative inquiry into engagement experiences and ascribed value is needed to extend existing findings and provide deeper insights into the underlying processes that drive viewership.MethodSemi-structured interviews were conducted with 15 young adults from the UK who regularly viewed gambling livestreams. The interviews addressed experiences of gambling livestreams, motivations for viewership, structural feature engagement, and perceived impacts. Qualitative data were audio recorded, transcribed, and thematically analyzed via an interpretivist epistemology.ResultsThree main themes were identified: 'Social experiences and vicarious excitement' highlighted how viewers were drawn to gambling streamers' personalities via parasocial relationships. Thrills were derived from streams that broadcasted high stakes gambling scenarios. 'Interactivity and building loyalty' revealed how gamified structural characteristics transformed passive viewing into active community-based participation during livestreams. 'The urge and harm paradox' demonstrated participants using livestreams to reduce gambling urges while simultaneously experiencing heightened urges to gamble. Increased gambling participation was reported as a result of gambling livestream viewership and streamers' deceptive marketing tactics were recognized.ConclusionsGambling livestreams are highly valued among those who regularly view them. They represent a complex digital phenomenon that simultaneously entertains and potentially harms audiences. These findings emphasize the need for broader regulatory frameworks and protective measures to address the emerging risks posed by digital gambling landscapes.

Introduction Harmful gambling negatively impacts individuals, families and communities. Growing international evidence indicates that the Armed Forces (AF) community may be at a comparatively higher risk of experiencing harm from gambling than the general population. The current study sought to identify general predictors of harmful gambling and gambling engagement among UK AF serving personnel (AFSP).Methods We conducted a cross-sectional, exploratory survey to identify associations between demographic factors, mental health, gambling engagement and gambling type in a sample (N=608) of AFSP.Results Most of the sample reported past-year gambling, with 23% having experienced harm. Male gender, younger age and lower educational attainment all predicted harmful gambling, as did mental health variables of prior generalised anxiety and post-traumatic stress symptomatology. Strategy-based gambling and online sports betting were also predictive of experiencing harm from gambling.Conclusions The risk of harm from gambling is associated with demographic, mental health and gambling engagement variables among AFSP. Better understanding of these predictors is important for the development of individualised treatment approaches for harmful gambling.