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A Meta-Analytic Investigation of Problem Gambling and Self-Harm: A Causal Inference Perspective
Objective: Problem gambling may be an underappreciated treatment target for reducing self-harm. Multivariate studies examining the relationship between problem gambling and self-harm have returned inconsistent results, perhaps due to insufficient power or differences in study quality. Method: We con...
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| Published in: | Psychology of addictive behaviors 2023-11, Vol.37 (7), p.946-960 |
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| container_end_page | 960 |
| container_issue | 7 |
| container_start_page | 946 |
| container_title | Psychology of addictive behaviors |
| container_volume | 37 |
| creator | Edson, Timothy C. Slabczynski, John M. Lee, Taylor G. McAuliffe, William H. B. Gray, Heather M. |
| description | Objective: Problem gambling may be an underappreciated treatment target for reducing self-harm. Multivariate studies examining the relationship between problem gambling and self-harm have returned inconsistent results, perhaps due to insufficient power or differences in study quality. Method: We conducted a series of meta-analyses examining the effect of problem gambling on self-harm outcomes of varying severity. We assessed the sensitivity of results to study characteristics, publication bias, and influential cases. To highlight threats to causal inference, we evaluated each study for residual confounding bias. Results: In total, two types of meta-analyses were adequately powered: those assessing (a) the effect of problem gambling (binary) on suicide ideation and (b) problem gambling (binary) on suicide attempt (k = 14 unique studies between the two meta-analyses). For both meta-analyses, we found a positive, statistically significant average effect of problem gambling on the respective self-harm outcome. We did not detect any influential studies among these two meta-analyses, nor residual confounding. However, these findings are limited by the overall quality of included literature. PET-PEESE analysis detected substantial potential publication bias in the main results, with both meta-analytic effects being reduced to statistical nonsignificance. All included studies also used a cross-sectional design for their analysis of interest, thus simultaneity bias cannot be ruled out. Conclusion: While these findings suggest there is an appreciable relationship between problem gambling and at least two forms of self-harm (suicide ideation and attempts), well-designed longitudinal research is needed to make more firm conclusions.
Public Health Significance Statement
Our study suggests there is an appreciable (i.e., nonzero) relationship between problem gambling and at least two forms of self-harm (suicide ideation and attempts). These findings have important implications for treatment providers, gambling operators, and other stakeholders, especially as gambling becomes more liberalized. Given the paucity of longitudinal studies we examined, the results also emphasize the need for more quality research examining the relationship between problem gambling and self-harm. |
| doi_str_mv | 10.1037/adb0000858 |
| format | article |
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Public Health Significance Statement
Our study suggests there is an appreciable (i.e., nonzero) relationship between problem gambling and at least two forms of self-harm (suicide ideation and attempts). These findings have important implications for treatment providers, gambling operators, and other stakeholders, especially as gambling becomes more liberalized. Given the paucity of longitudinal studies we examined, the results also emphasize the need for more quality research examining the relationship between problem gambling and self-harm.</description><identifier>ISSN: 0893-164X</identifier><identifier>EISSN: 1939-1501</identifier><identifier>DOI: 10.1037/adb0000858</identifier><identifier>PMID: 35878077</identifier><language>eng</language><publisher>United States: American Psychological Association</publisher><subject>Analysis ; Attempted Suicide ; Averages ; Bias ; Business Organizations ; Cross-Sectional Studies ; Gambling ; Gambling - epidemiology ; Gambling Disorder ; Human ; Humans ; Inference ; Meta-analysis ; Nonsuicidal Self-Injury ; Pathological gambling ; Self destructive behavior ; Self injury ; Self-Injurious Behavior - epidemiology ; Suicidal Ideation ; Suicide ; Suicide, Attempted ; Suicides & suicide attempts</subject><ispartof>Psychology of addictive behaviors, 2023-11, Vol.37 (7), p.946-960</ispartof><rights>2022 American Psychological Association</rights><rights>2022, American Psychological Association</rights><rights>Copyright American Psychological Association Nov 2023</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-a379t-21c740830500f4feaf80508d2dd85d2d0e9f336138236ea592f5820fb7ccfe593</citedby><orcidid>0000-0001-8886-5989 ; 0000-0001-9293-9688 ; 0000-0003-1652-7600 ; 0000-0003-2702-0098 ; 0000-0002-7680-1686</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>315,786,790,27957,27958,31034</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/35878077$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Witkiewitz, Katie</contributor><creatorcontrib>Edson, Timothy C.</creatorcontrib><creatorcontrib>Slabczynski, John M.</creatorcontrib><creatorcontrib>Lee, Taylor G.</creatorcontrib><creatorcontrib>McAuliffe, William H. B.</creatorcontrib><creatorcontrib>Gray, Heather M.</creatorcontrib><title>A Meta-Analytic Investigation of Problem Gambling and Self-Harm: A Causal Inference Perspective</title><title>Psychology of addictive behaviors</title><addtitle>Psychol Addict Behav</addtitle><description>Objective: Problem gambling may be an underappreciated treatment target for reducing self-harm. Multivariate studies examining the relationship between problem gambling and self-harm have returned inconsistent results, perhaps due to insufficient power or differences in study quality. Method: We conducted a series of meta-analyses examining the effect of problem gambling on self-harm outcomes of varying severity. We assessed the sensitivity of results to study characteristics, publication bias, and influential cases. To highlight threats to causal inference, we evaluated each study for residual confounding bias. Results: In total, two types of meta-analyses were adequately powered: those assessing (a) the effect of problem gambling (binary) on suicide ideation and (b) problem gambling (binary) on suicide attempt (k = 14 unique studies between the two meta-analyses). For both meta-analyses, we found a positive, statistically significant average effect of problem gambling on the respective self-harm outcome. We did not detect any influential studies among these two meta-analyses, nor residual confounding. However, these findings are limited by the overall quality of included literature. PET-PEESE analysis detected substantial potential publication bias in the main results, with both meta-analytic effects being reduced to statistical nonsignificance. All included studies also used a cross-sectional design for their analysis of interest, thus simultaneity bias cannot be ruled out. Conclusion: While these findings suggest there is an appreciable relationship between problem gambling and at least two forms of self-harm (suicide ideation and attempts), well-designed longitudinal research is needed to make more firm conclusions.
Public Health Significance Statement
Our study suggests there is an appreciable (i.e., nonzero) relationship between problem gambling and at least two forms of self-harm (suicide ideation and attempts). These findings have important implications for treatment providers, gambling operators, and other stakeholders, especially as gambling becomes more liberalized. Given the paucity of longitudinal studies we examined, the results also emphasize the need for more quality research examining the relationship between problem gambling and self-harm.</description><subject>Analysis</subject><subject>Attempted Suicide</subject><subject>Averages</subject><subject>Bias</subject><subject>Business Organizations</subject><subject>Cross-Sectional Studies</subject><subject>Gambling</subject><subject>Gambling - epidemiology</subject><subject>Gambling Disorder</subject><subject>Human</subject><subject>Humans</subject><subject>Inference</subject><subject>Meta-analysis</subject><subject>Nonsuicidal Self-Injury</subject><subject>Pathological gambling</subject><subject>Self destructive behavior</subject><subject>Self injury</subject><subject>Self-Injurious Behavior - epidemiology</subject><subject>Suicidal Ideation</subject><subject>Suicide</subject><subject>Suicide, Attempted</subject><subject>Suicides & suicide attempts</subject><issn>0893-164X</issn><issn>1939-1501</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>7QJ</sourceid><recordid>eNp90U1rFTEUBuAgir1WN_4ACbgRZWoymXx1d7loW2ixoIK7cCZzUqZkPkxmCvffm3KrQhfNIsniyQsnLyFvOTvhTOjP0LWsLCPNM7LhVtiKS8afkw0zVlRcNb-OyKucb4sRzKiX5EhIow3TekPcll7hAtV2hLhfek8vxjvMS38DSz-NdAr0Ok1txIGewdDGfryhMHb0O8ZQnUMaTumW7mDNEMvLgAlHj_QaU57RL_0dviYvAsSMbx7OY_Lz65cfu_Pq8tvZxW57WYHQdqlq7nXDjGCSsdAEhGDK1XR11xlZdoY2CKG4MLVQCNLWQZqahVZ7H1BacUw-HHLnNP1eywRu6LPHGGHEac2uVraxSrNaFfr-Eb2d1lTmL8pY2XDeaP2kUuWPrdS2LurjQfk05ZwwuDn1A6S948zdl-P-l1Pwu4fItR2w-0f_tlHApwOAGdyc9x5SqSRi9msqP7vch7mSqZ1tlPgDMyiWng</recordid><startdate>20231101</startdate><enddate>20231101</enddate><creator>Edson, Timothy C.</creator><creator>Slabczynski, John M.</creator><creator>Lee, Taylor G.</creator><creator>McAuliffe, William H. B.</creator><creator>Gray, Heather M.</creator><general>American Psychological Association</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7RZ</scope><scope>PSYQQ</scope><scope>7QJ</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-8886-5989</orcidid><orcidid>https://orcid.org/0000-0001-9293-9688</orcidid><orcidid>https://orcid.org/0000-0003-1652-7600</orcidid><orcidid>https://orcid.org/0000-0003-2702-0098</orcidid><orcidid>https://orcid.org/0000-0002-7680-1686</orcidid></search><sort><creationdate>20231101</creationdate><title>A Meta-Analytic Investigation of Problem Gambling and Self-Harm: A Causal Inference Perspective</title><author>Edson, Timothy C. ; Slabczynski, John M. ; Lee, Taylor G. ; McAuliffe, William H. B. ; Gray, Heather M.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-a379t-21c740830500f4feaf80508d2dd85d2d0e9f336138236ea592f5820fb7ccfe593</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Analysis</topic><topic>Attempted Suicide</topic><topic>Averages</topic><topic>Bias</topic><topic>Business Organizations</topic><topic>Cross-Sectional Studies</topic><topic>Gambling</topic><topic>Gambling - epidemiology</topic><topic>Gambling Disorder</topic><topic>Human</topic><topic>Humans</topic><topic>Inference</topic><topic>Meta-analysis</topic><topic>Nonsuicidal Self-Injury</topic><topic>Pathological gambling</topic><topic>Self destructive behavior</topic><topic>Self injury</topic><topic>Self-Injurious Behavior - epidemiology</topic><topic>Suicidal Ideation</topic><topic>Suicide</topic><topic>Suicide, Attempted</topic><topic>Suicides & suicide attempts</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Edson, Timothy C.</creatorcontrib><creatorcontrib>Slabczynski, John M.</creatorcontrib><creatorcontrib>Lee, Taylor G.</creatorcontrib><creatorcontrib>McAuliffe, William H. B.</creatorcontrib><creatorcontrib>Gray, Heather M.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>PsycArticles</collection><collection>ProQuest One Psychology</collection><collection>Applied Social Sciences Index & Abstracts (ASSIA)</collection><collection>MEDLINE - Academic</collection><jtitle>Psychology of addictive behaviors</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Edson, Timothy C.</au><au>Slabczynski, John M.</au><au>Lee, Taylor G.</au><au>McAuliffe, William H. B.</au><au>Gray, Heather M.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>A Meta-Analytic Investigation of Problem Gambling and Self-Harm: A Causal Inference Perspective</atitle><jtitle>Psychology of addictive behaviors</jtitle><addtitle>Psychol Addict Behav</addtitle><date>2023-11-01</date><risdate>2023</risdate><volume>37</volume><issue>7</issue><spage>946</spage><epage>960</epage><pages>946-960</pages><issn>0893-164X</issn><eissn>1939-1501</eissn><notes>ObjectType-Article-2</notes><notes>SourceType-Scholarly Journals-1</notes><notes>ObjectType-Feature-1</notes><notes>content type line 23</notes><abstract>Objective: Problem gambling may be an underappreciated treatment target for reducing self-harm. Multivariate studies examining the relationship between problem gambling and self-harm have returned inconsistent results, perhaps due to insufficient power or differences in study quality. Method: We conducted a series of meta-analyses examining the effect of problem gambling on self-harm outcomes of varying severity. We assessed the sensitivity of results to study characteristics, publication bias, and influential cases. To highlight threats to causal inference, we evaluated each study for residual confounding bias. Results: In total, two types of meta-analyses were adequately powered: those assessing (a) the effect of problem gambling (binary) on suicide ideation and (b) problem gambling (binary) on suicide attempt (k = 14 unique studies between the two meta-analyses). For both meta-analyses, we found a positive, statistically significant average effect of problem gambling on the respective self-harm outcome. We did not detect any influential studies among these two meta-analyses, nor residual confounding. However, these findings are limited by the overall quality of included literature. PET-PEESE analysis detected substantial potential publication bias in the main results, with both meta-analytic effects being reduced to statistical nonsignificance. All included studies also used a cross-sectional design for their analysis of interest, thus simultaneity bias cannot be ruled out. Conclusion: While these findings suggest there is an appreciable relationship between problem gambling and at least two forms of self-harm (suicide ideation and attempts), well-designed longitudinal research is needed to make more firm conclusions.
Public Health Significance Statement
Our study suggests there is an appreciable (i.e., nonzero) relationship between problem gambling and at least two forms of self-harm (suicide ideation and attempts). These findings have important implications for treatment providers, gambling operators, and other stakeholders, especially as gambling becomes more liberalized. Given the paucity of longitudinal studies we examined, the results also emphasize the need for more quality research examining the relationship between problem gambling and self-harm.</abstract><cop>United States</cop><pub>American Psychological Association</pub><pmid>35878077</pmid><doi>10.1037/adb0000858</doi><tpages>15</tpages><orcidid>https://orcid.org/0000-0001-8886-5989</orcidid><orcidid>https://orcid.org/0000-0001-9293-9688</orcidid><orcidid>https://orcid.org/0000-0003-1652-7600</orcidid><orcidid>https://orcid.org/0000-0003-2702-0098</orcidid><orcidid>https://orcid.org/0000-0002-7680-1686</orcidid><oa>free_for_read</oa></addata></record> |
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| ispartof | Psychology of addictive behaviors, 2023-11, Vol.37 (7), p.946-960 |
| issn | 0893-164X 1939-1501 |
| language | eng |
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| source | Applied Social Sciences Index & Abstracts (ASSIA); APA PsycArticles |
| subjects | Analysis Attempted Suicide Averages Bias Business Organizations Cross-Sectional Studies Gambling Gambling - epidemiology Gambling Disorder Human Humans Inference Meta-analysis Nonsuicidal Self-Injury Pathological gambling Self destructive behavior Self injury Self-Injurious Behavior - epidemiology Suicidal Ideation Suicide Suicide, Attempted Suicides & suicide attempts |
| title | A Meta-Analytic Investigation of Problem Gambling and Self-Harm: A Causal Inference Perspective |
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