Exploring the associations between gambling cravings, self-efficacy, and gambling episodes: An Ecological Momentary Assessment study

Aims: To explore reciprocal relationships between real-time gambling cravings and self-efficacy with gambling behaviour, and the moderating role of gambling, mental health, and addiction-related variables. Design: Secondary analysis of a 4-week Ecological Momentary Assessment (EMA) study conducted in Tasmania, Australia. Setting: Data were collected via telephone interviews (pre-EMA) and smartphones (EMA). Participants: Ninety-seven regular gamblers (mean age: 45.90 years, 57.73% male) reported 5,113 observations. Measurements: EMA measures included gambling cravings (occurrence, frequency, intensity), self-efficacy (craving-related, gambling-related), and gambling behaviour (episodes, expenditure, duration). Pre-EMA measures included gambling (severity; harms; motives; high-risk situations), mental health (depressive symptoms; anxiety symptoms) and addiction-related (alcohol use; smoking; substance use) moderator variables. Findings: Mixed-effects binary logistic regression analyses revealed that gambling cravings predicted gambling episodes (OR = 2.23, 95% CI:1.61, 3.08), gambling self-efficacy and gambling duration were reciprocally related (OR = 4.65, 95% CI:1.08, 20.04; OR = 0.21, 95% CI:0.05, 0.93), and craving self-efficacy predicted gambling expenditure (OR = 0.30, 95% CI:0.10, 0.86). Moderation analyses revealed that: (1) craving self-efficacy exacerbated craving frequency with gambling expenditure; (2) coping motives exacerbated gambling self-efficacy with gambling expenditure; (3) high-risk positive reinforcement situations exacerbated craving intensity and gambling self-efficacy with gambling episodes, and gambling episode with craving occurrence; and (4) substance use exacerbated gambling self-efficacy with duration, and buffered gambling expenditure with craving intensity. Conclusions: These findings have implications for the development of real-time gambling interventions that aim to reduce gambling cravings and increase self-efficacy, which could be targeted to vulnerable individuals, including people who frequently gambled for coping purposes or positive reinforcement, and people with comorbid substance use.

Automated summary

This study investigated the reciprocal relationships between real-time gambling cravings, self-efficacy, and gambling behavior, and the moderating role of gambling, mental health, and addiction-related variables. The findings suggest that gambling cravings predict gambling episodes, gambling self-efficacy is related to gambling duration, and craving self-efficacy predicts gambling expenditure. Moderation analyses revealed various interactions among the variables, indicating the importance of real-time gambling interventions for vulnerable individuals.