A Systematic Review of Land-Based Self-Exclusion Programs: Demographics, Gambling Behavior, Gambling Problems, Mental Symptoms, and Mental Health

Research output: Contribution to journalReview articleContributedpeer-review

Contributors

Abstract

Systematic and quantitative reviews on the effects of land-based self-exclusion are scarce. Therefore, the current review aimed to provide a comprehensive summary of (1) the demographic characteristics of land-based self-excluders and changes after exclusion, including (2) gambling behavior, (3) gambling problems, (4) mental symptoms, and (5) mental health. A systematic database and literature search was performed following PRISMA guidelines. Nineteen naturalistic studies met the eligibility criteria. The quality of all included records was rated via adaption of the Newcastle-Ottawa Scale. Results from higher-quality records were more heavily weighted. Self-excluders were predominantly men in their early or middle forties. Changes after exclusion revealed wide ranges in the rates of abstinence (13-81%), rates of gambling reduction (29-92%), and rates of exclusion breaches (8-59%). The records consistently demonstrated significant changes in pathological gambling from before exclusion (61-95%) to after exclusion (13-26%). Up to 73% of self-excluders exhibited symptoms of anxiety, depression, and substance use disorders at program enrollment. Several aspects of mental health improved after exclusion, e.g., quality of life. Problem and pathological gambling are most prevalent in young men, but self-exclusion was most prominent in middle-aged men. The magnitude of effects widely differed between studies despite overall benefits of self-exclusion, and many individuals continued gambling after exclusion. This shortcoming could be minimized using improved access controls and the extension of exclusion to other gambling segments. High rates of pathological gambling and other mental disorders in self-excluders highlight the need for improved early detection and treatment accessibility.

Details

Original languageEnglish
Pages (from-to)367-394
Number of pages28
JournalJournal of Gambling Studies
Volume35
Issue number2
Publication statusPublished - Jun 2019
Peer-reviewedYes

External IDs

researchoutputwizard legacy.publication#81185
PubMed 29721719
Scopus 85066863784
ORCID /0000-0002-1612-3932/work/142251074

Keywords

Sustainable Development Goals

Keywords

  • Adult, Attitude to Health, Behavior Control, Behavior, Addictive/psychology, Female, Gambling/psychology, Humans, Male, Mental Health, Middle Aged, Prevalence, Quality of Life, Residence Characteristics, Self Efficacy, Sex Factors, Young Adult