Does gender moderate the subjective measurement and structural paths in behavioural and cognitive aspects of gambling disorder in treatment-seeking adults?
BACKGROUND
Gender differences have been observed in the pathogenesis of gambling disorder and gambling related urge and cognitions are predictive of relapse to problem gambling. A better understanding of these mechanisms concurrently may help in the development of more directed therapies.


METHODS
We evaluated gender effects on behavioural and cognitive paths to gambling disorder from self-report data. Participants (N=454) were treatment-seeking problem gamblers on first presentation to a gambling therapy service between January 2012 and December 2014. We firstly investigated if aspects of gambling related urge, cognitions (interpretive bias and gambling expectancies) and gambling severity were more central to men than women. Subsequently, a full structural equation model tested if gender moderated behavioural and cognitive paths to gambling severity.


RESULTS
Men (n=280, mean age=37.4years, SD=11.4) were significantly younger than women (n=174, mean age=48.7years, SD=12.9) (p<0.001). There was no gender difference in conceptualising latent constructs of problem gambling severity, gambling related urge, interpretive bias and gambling expectancies. The paths for urge to gambling severity and interpretive bias to gambling severity were stronger for men than women and statistically significant (p<0.001 and p=0.004, respectively) whilst insignificant for women (p=0.164 and p=0.149, respectively). Structural paths for gambling expectancies to gambling severity were insignificant for both men and women.


CONCLUSIONS
This study detected an important signal in terms of theoretical mechanisms to explaining gambling disorder and gender differences. It has implications for treatment development including relapse prevention.
Flinders University, Department of Psychiatry, Flinders Human Behaviour and Health Research Unit, GPO Box 2100, Adelaide, SA 2001, Australia. Electronic address: david.smith@flinders.edu.au.
David
D
Smith
Flinders University, Department of Psychiatry, Flinders Human Behaviour and Health Research Unit, GPO Box 2100, Adelaide, SA 2001, Australia. Electronic address: malcolm.battersby@flinders.edu.au.
Malcolm
M
Battersby
Flinders University, Department of Psychiatry, Flinders Human Behaviour and Health Research Unit, GPO Box 2100, Adelaide, SA 2001, Australia. Electronic address: peter.harvey@flinders.edu.au.
Peter
P
Harvey
D000328:Adult; D016739:Behavior, Addictive / Q000523:psychology*; D003071:Cognition / Q000502:physiology*; D005260:Female; D005715:Gambling / Q000523:psychology* / Q000534:rehabilitation; D006801:Humans; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000523:psychology*; D012189:Retrospective Studies; D057566:Self Report; D012737:Sex Factors
Gambling cognitions; Gambling disorder; Gambling urge; Gender; Moderation; Structural equation modelling