Recent increases in the number of online gambling sites have made gambling more available, which may contribute to an increase in gambling problems. At the same time, online gambling provides opportunities to introduce measures intended to prevent problem gambling. GamTest is an online test of gambling behavior that provides information that can be used to give players individualized feedback and recommendations for action. The aim of this study is to explore the dimensionality of GamTest and validate it against the Problem Gambling Severity Index (PGSI) and the gambler's own perceived problems. A recent psychometric approach, exploratory structural equation modeling (ESEM) is used. Well-defined constructs are identified in a two-step procedure fitting a traditional exploratory factor analysis model as well as a so-called bifactor model. Using data collected at four Nordic gambling sites in the autumn of 2009 (n = 10,402), the GamTest ESEM analyses indicate high correspondence with the players' own understanding of their problems and with the PGSI, a validated measure of problem gambling. We conclude that GamTest captures five dimensions of problematic gambling (i.e., overconsumption of money and time, and monetary, social and emotional negative consequences) with high reliability, and that the bifactor approach, composed of a general factor and specific residual factors, reproduces all these factors except one, the negative consequences emotional factor, which contributes to the dominant part of the general factor. The results underscore the importance of tailoring feedback and support to online gamblers with a particular focus on how to handle emotions in relation to their gambling behavior.

Traditionally, gambling and problem gambling research relies on cross-sectional and retrospective designs. This has compromised identification of temporal relationships and causal inference. To overcome these problems a new questionnaire, the Jonsson-Abbott Scale (JAS), was developed and used in a large, prospective, general population study, The Swedish Longitudinal Gambling Study (Swelogs). The JAS has 11 items and seeks to identify early indicators, examine relationships between indicators and assess their capacity to predict future problem progression. The aims of the study were to examine psychometric properties of the JAS (internal consistency and dimensionality) and predictive validity with respect to increased gambling risk and problem gambling onset. The results are based on repeated interviews with 3818 participants. The response rate from the initial baseline wave was 74%. The original sample consisted of a random, stratified selection from the Swedish population register aged between 16 and 84. The results indicate an acceptable fit of a three-factor solution in a confirmatory factor analysis with ‘Over consumption,’ ‘Gambling fallacies,’ and ‘Reinforcers’ as factors. Reinforcers, Over consumption and Gambling fallacies were significant predictors of gambling risk potential and Gambling fallacies and Over consumption were significant predictors of problem gambling onset (incident cases) at 12 month follow up. When controlled for risk potential measured at baseline, the predictor Over consumption was not significant for gambling risk potential at follow up. For incident cases, Gambling fallacies and Over consumption remained significant when controlled for risk potential. Implications of the results for the development of problem gambling, early detection, prevention, and future research are discussed.

Gambling disorder is a public health issue in many countries, and expectations that the gambling industry protects individuals from harm are increasing. The primary objective of this study was to investigate the effects of providing personalized feedback on gambling intensity among high consumers of venue-based and online gambling in Norway. A randomized controlled trial design was used to evaluate how behavioral feedback by telephone or letters sent via surface mail affects subsequent gambling expenditure and use of responsible gambling tools and whether a follow-up contact increases the effect. Gambling expenditure, the primary outcome, was measured using theoretical loss, which is the actual cost to the player, adjusted for the house advantage. From the top .5% of customers based upon annual expenditure, a sample of 1,003 statistical triplets, matched on sex, age, and net losses, were randomly assigned to the feedback intervention by telephone, letter, or a no-contact control condition. Participants assigned to the phone call or letter were also randomly assigned to receive or not receive a subsequent follow-up contact. The results showed that over 12 weeks, theoretical loss decreased 29% for the phone and 15% for the letter conditions, compared with 3% for the control group. A positive effect of the follow-up contact was limited to participants who at the initial call indicated an interest in receiving a follow-up call. Contacting high consumers about their gambling expenditure appears to be an effective method for gambling companies to meet their duty to care for customers.

Background and aims: We previously demonstrated that phone and letter-based motivational interventions with high expenditure gamblers had significant short term positive effects on gambling and use of responsible gambling tools. This report examines outcomes over twelve months.

Design: A randomized controlled trial design with three conditions: feedback intervention by telephone, letter, or a no-contact control condition.

Setting: Customers of Norsk Tipping gambling platforms.

Participants: 1,003 statistical triplets from the top .5% of customers based upon annual expenditure, matched on sex, age, and net losses.

Measurements: Primary outcome measure was gambling theoretical loss, derived from the Norsk Tipping customer database. Secondary outcomes were responsible gambling customer actions and whether the participant was retained as a NT customer.

Findings: The results showed a positive and sustained effect of the phone and letter interventions over 12 months - the telephone group showed a 30% reduction in theoretic loss (d =0.44) and the letter group 13% (d =0.18), both outperforming the control group with a 7% reduction (d =0.11). The phone condition was superior to both the letter and control conditions in per protocol (p<0.001) and intention to treat analyses (ITT) (p< 0.018 and 0.001). Individuals in the phone condition took more responsible gambling actions. The letter condition had better outcomes than the control in the ITT only (p<0.001). Over 99% in the intervention groups were still customers during the follow-up year.

Conclusions: A targeted telephone intervention with high expenditure customers effectively reduced theoretical losses over a 12 month period. Gambling companies can utilize this type of intervention as a response to their duty to care for customers.