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A review of online gambling literature, (Book, ) [meroe.info] Online gambling literature review Internet and Gaming Addiction: A Systematic Literature Review of Neuroimaging Studies

In the past decade, research has accumulated suggesting that excessive Internet use can lead to the development of a behavioral addiction. Internet addiction has been considered as a serious threat to mental health and the excessive use of the Internet has been linked to a variety of negative psychosocial consequences. The aim of this review is to identify all empirical studies to date that used neuroimaging techniques to shed light upon the emerging mental health problem of Internet and gaming addiction from a neuroscientific perspective.

Neuroimaging studies offer an advantage over traditional survey and behavioral research because with this method, it is possible to distinguish particular brain areas that are involved in the development and maintenance of addiction.

A systematic literature search was conducted, identifying 18 studies. These studies provide compelling evidence for the similarities between different types of addictions, notably substance-related online gambling literature review and Internet and gaming addiction, on a variety of levels.

On the molecular level, Internet addiction is characterized by an overall reward deficiency that entails decreased dopaminergic activity. On the level of neural circuitry, Internet and gaming addiction led to neuroadaptation and structural changes that online gambling literature review as a consequence of prolonged increased activity in brain areas associated with addiction.

On a behavioral level, Internet and gaming addicts appear to be constricted with regards to their cognitive functioning in various domains. The paper shows that understanding the neuronal correlates online gambling literature review with the development of Internet and gaming addiction will promote future research and will pave the way for the development of addiction treatment approaches.

In the past decade, research has accumulated suggesting that click here Internet use can lead to the development of a behavioral addiction e.

Clinical evidence suggests that Internet addicts experience a number of biopsychosocial symptoms and consequences [ 5 ]. These include symptoms traditionally associated with substance-related addictions, namely salience, mood modification, tolerance, withdrawal symptoms, conflict, and relapse [ 6 ].

Internet addiction comprises a heterogeneous spectrum of Internet activities with a potential illness value, such as gaming, shopping, gambling, or social networking. Gaming represents a part of the postulated construct of Internet addiction, and gaming addiction appears to be the most widely studied specific form of Online gambling literature review addiction to date [ 7 ].

The excessive use of the Internet has been linked to a variety of negative psychosocial consequences. These include mental disorders such as somatization, obsessive-compulsive and other anxiety disorders, depression [ 9 ], and dissociation [ 10 ], as well as personality traits and pathology, such as introversion and psychoticism [ 11 ].

Internet addiction has been considered as serious threat to mental health in Asian countries with extensive broadband usage, particularly South Korea and China [ 14 ]. In accordance with Cartesian dualism, the French philosopher Descartes advocated the view that the mind is an online gambling literature review that is separate from the body online gambling literature review 15 ].

However, the cognitive neurosciences have proved him wrong and reconcile the physical entity of the body with the rather online gambling literature review entity of the mind [ 16 ].

Modern neuroimaging techniques link cognitive processes i. Altered activity in brain areas associated with reward, motivation, memory, online gambling literature review cognitive control has been associated with addiction [ 17 ]. Research has addressed the neural correlates of drug addiction development via classical and operant conditioning [ 1819 ]. It has been found that during the initial stages of the check this out and controlled usage of a substance, the decision to use the drug is made by specific brain regions, namely the prefrontal cortex PFC and ventral striatum VS.

As habituation to use and compulsion develops, brain activity changes in that the dorsal regions of the striatum DS become increasingly activated via dopaminergic innervation i. On a molecular level, the long-term depression LTD; i. Drug addicts become sensitized to the drug because in the course of prolonged intake, the synaptic strength in the ventral tegmental area increases, and so does the LTD of glutamate in the nucleus accumbens, which will result in craving [ 24 ].

At the same time, the brain i. Craving for drug use involves a complex interaction between a variety of brain regions. Activity in the nucleus accumbens following recurrent drug intake leads to learning associations between drug cues and the reinforcing effects of the drug [ 26 ]. In addition, the orbitofrontal cortex, important for the motivation to engage in behaviors, the amygdala AMG and the hippocampus Hippas main brain regions associated with memory functions, play a role see more intoxication and craving for a substance [ 17 ].

Due to habituation to rewarding behaviors and intake of drugs, a characteristic addiction symptom develops i. Increasing amounts of the substance or increasing engagement in the respective behaviors are needed in order to produce the desired effect. As a result, the reward system becomes deficient.

Instead, he requires stronger reinforcers, i. In addition, the lack of dopamine in the mesocorticolimbic pathways during abstinence explains characteristic withdrawal symptoms. These will be countered with renewed drug intake [ 17 ]. Relapse and the development of a vicious behavioral cycle are the result [ 28 ].

Research indicates that brain activity alterations commonly associated with substance-related addictions occur following the compulsive engagement in behaviors, such as deposito istanza gratuito patrocinio gambling [ 30 ].

In line with this, it is conjectured that similar mechanisms and changes are online gambling literature review in Internet and gaming addiction. The aim of online gambling literature review review is therefore to identify all peer-reviewed empirical studies to date that used neuroimaging techniques to shed light upon the emerging mental health problem of Internet and gaming addiction from a neuroscientific perspective. Neuroimaging broadly includes a number of distinct techniques.

These are briefly explained in turn before examining the studies that have utilized these techniques for studies on Internet and gaming addiction. With an EEG, neural activity online gambling literature review the cerebral cortex can be measured. A number of electrodes are fixed to specific areas i. These electrodes measure voltage fluctuations i. With event-related potentials ERPsthe relationships between the brain online gambling literature review behavior can be measured via an electrophysiological neuronal response to a stimulus [ online gambling literature review ].

PET is a neuroimaging method that allows for the http://meroe.info/online-casinos-that-accept-american-express.php of brain function on a molecular level.

In PET studies, metabolic activity in the brain is measured via photons from positron emissions i. The subjected is injected with online gambling literature review radioactive 2-deoxyglucose 2-DG solution that is taken up by active neurons in the brain.

The amounts of 2-DG in neurons and positron emissions are used to quantify metabolic activity in the brain. Thus, neuronal activity can be mapped during the performance of a particular task.

It can measure activity distribution in detail. Limitations to PET include relatively low spatial resolution, time needed to obtain a scan, as well as potential radiation risk [ 33 ]. The stronger the metabolic activity in specific brain regions, the stronger the online gambling literature review of gamma rays. The emitted radiation is measured in accordance with brain layers, and metabolic activity is imaged using computerized techniques.

With fMRI, changes in the levels of blood oxygen in the brain are measured that are indicative of neuronal activity. Specifically, the ratio of oxyhemoglobin i. The assessment of this metabolic activity in the brain allows for finer and more detailed imaging of the brain relative to structural MRI. In online gambling literature review to this, the advantages of fMRI include speed of brain imaging, spatial resolution, and absence of potential health risk relative to PET scans [ 35 ].

VBM is used to compare the volume source brain areas and the density of gray and white matter [ 37 ]. DTI is a method used for picturing white matter. It assesses the diffusion of water molecules in the brain which helps to identify interconnected brain structures by using fractional anisotropy FA.

This measure is an indicator of fiber density, axonal diameter, and myelination in click matter [ 38 ].

A comprehensive literature search was conducted using the database Web of Knowledge. The following search terms and their derivatives were entered with regards to Internet use: Online gambling literature review, additional studies were identified from supplementary sources, such as Google Scholarand these were added in order to generate a more inclusive literature review.

Studies online gambling literature review selected in accordance with the following inclusion criteria. Studies had to i assess Internet or online gaming addiction or direct effects of gaming on top casino functioning, ii use neuroimaging techniques, iii be published in a peer-reviewed journal, and iv be available as full text in English online gambling literature review. No time online gambling literature review was specified for the literature search because neuroimaging techniques are relatively new, so that the studies this web page expected to be recent i.

A total of 18 studies were identified that fulfilled the inclusion criteria. It should also be noted that two of these were actually the same study with one published as a letter online gambling literature review 53 ] and one published as a full paper [ 54 ].

One study [ 57 ] met all the criteria but was excluded because the diagnosis details of Internet addiction were insufficient to make valid conclusions. Furthermore, two studies did not directly assess Internet and gaming addiction [ 4350 ], but assessed the direct effects of gaming on neurological activity using an experimental paradigm, and were therefore retained in the review.

Detailed information on the included studies are presented in Table 1. All participants underwent fMRI 3. FMRI was carried out during 40 blocks of online gambling literature review a s ball game with the goal being to gain space or a similar control condition сделав deposit 5 get casino спросил did not include a specific game goal as based on its online gambling literature review makeup.

Results indicated that there was an activation of neural circuitries that are involved in reward and addiction in the experimental condition i.

Online gambling literature review, the presence online gambling literature review an actual game goal a characteristic of most conventional online games that are rule-based rather than pure role-playing gamesmodified brain activity via behavior.

Here, a clear cause and effect relationship is evident, which adds strength to the findings. The results furthermore indicated that playing the game activated the right insula rI; signals autonomic arousalright dorso-lateral PFC maximize reward or change behaviorbilateral premotor cortices blPMC; preparation for reward and the precuneus, lNAc, and the rOFC areas involved in visual processing, visuo-spatial attention, motor function, and sensori-motor transformation compared to the resting state [ 43 ].

The insula has been implicated online gambling literature review conscious craving for addictive substances by implicating decision-making processes involving risk and reward.

Insula dysfunction may explain neurological activities indicative of relapse [ 60 ]. Due to its experimental nature, this study was able to provide insight into idiosyncratic brain activation as a consequence of gaming in a healthy i. The authors presented gaming-related and paired mosaic pictures during fMRI scanning 3T MRscannerand contrasts in BOLD signals in both conditions were analyzed using a cue reactivity paradigm [ 25 ].

The results indicated cue induced craving that is common among those with substance dependence. This activation correlated with gaming urge and a recalling of gaming experience. It was argued that there is a similar biological basis of different addictions online gambling literature review online gaming addiction. The quasi-experimental nature of this study that artificially induced craving in an experimental and controlled setting allowed the authors to make conclusions as based on group differences, and thus linking online gaming addiction status to the activation of brain areas associated with symptoms of more traditional online gambling literature review. All participants completed online gambling literature review Beck Depression Inventory [ 78 ], the Internet Addiction Scale [ 67 ], and a 7-point visual analogue scale VAS to assess craving for Internet video game play.

These were further divided into two groups: They also reported that increased craving for Internet video games correlated with increased activity in the anterior cingulate for all participants.

This quasi-experimental study is insightful for it not only offered evidence for a dissimilar brain activity in online gaming addicts compared to a general reviews casinos control group, but it also elucidated brain activation that occurs as a online gambling literature review of playing read more both groups. This indicates that i craving for online games alters brain activity irrespective of addiction status and might therefore be seen as a prodromal symptom of addiction, and that ii addicted players can be distinguished from non-addicted online gamers by a different form of brain activation.

The sample comprised 19 college students with Internet addiction and 19 controls. Regional homogeneity indicates temporal homogeneity of brain oxygen levels in brain regions of interest. It was reported that Internet addicts suffered from functional brain changes leading to abnormalities in regional homogeneity relative to the control group, particularly concerning the reward pathways traditionally associated with substance addictions.

Among Internet addicts, brain regions in ReHo in resting state were increased cerebellum, brainstem, rCG, bilateral parahippocampus blPHippright frontal lobe, left superior frontal gyrus lSFGright inferior temporal gyrus rITGleft superior temporal gyrus lSTG and middle temporal gyrus mTGrelative to the control group.

The temporal regions are involved in auditory processing, comprehension and verbal memory, whereas the occipital regions take care of visual processing.

Online gambling literature review

Due to the high level of accessibility, immersive interface and ease at which money can be spent, concerns have been online gambling literature review that Internet gambling may increase rates of online gambling literature review gambling. The current paper aimed online gambling literature review provide an overview of the research to date as well as highlight new and interesting findings relevant to Internet gambling addiction.

A comprehensive review of the existing literature was conducted to provide an overview of significant trends and developments in research that relates to disordered Internet gambling. This paper presents research to inform a greater understanding of adult participation in Internet gambling, features of this interface that may impact problem severity, the relationship online gambling literature review Internet gambling and related problems, as well as considering the role of the wider spectrum of online gambling literature review behaviour and relevant individual factors that moderate this relationship.

Internet gambling a term largely interchangeable with interactive remote and online gambling refers to the range of wagering and gaming activities offered through Internet-enabled devices, including computers, mobile and smart phones, tablets and digital television. This mode of gambling, facilitated by technological advances, increased Internet availability and ownership of Internet-enabled devices, is not a separate type of gambling activity. Rather it is a mode of access that is distinct from gambling in person at terrestrial or land-based retail outlets and placing wagers over the telephone.

As such, it is a largely automated activity that could be conducted in private, at any time and location, using high-speed Internet connections enabling rapid placement of bets and notification of outcomes. The ability for large wagers, continuous gambling, rapid feedback and instant, easy access to a vast number of betting options has resulted in concerns that Internet gambling could contribute online gambling literature review continue reading gambling [ 12 ].

As a result of the empirical comparisons demonstrating the fundamental parallels between gambling problems and substance use, the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders DSM-5 includes a new category of Non-Substance Behavioural Addiction within the substance addictions category [ 3 ].

Mounting evidence of distress and dysfunction related to excessive and problematic Internet use and specifically Internet gaming led the DSM-5 Taskforce to officially call for further research on this behaviour [ 5 ]. Given the similarities in the experience and excessive use of Internet gambling and gaming and the potential for harm based on excessive Internet use, pathological use of Internet gambling also warrants specific consideration [ 4 ].

The current paper aimed to provide an overview online gambling literature review the research to date as well as highlight new and interesting findings relevant to adult Internet gambling addiction. Internet gambling is growing rapidly in terms of popularity, market share and products offered.

Internationally, an increasing number of jurisdictions are legalizing and regulating Internet gambling [ 10 ]. This follows recognition of the difficulties of enforcing prohibition and the benefits of regulation, including requiring harm minimization measures to enhance consumer protection, and generating taxation revenue [ 1 ].

Internet gambling use is likely to continue this web page grow as online platforms become increasingly used to engage in entertainment and recreational activities, including through phones and other wireless devices. Research suggests that the most commonly reported motivators and advantages of Internet gambling are the convenience and accessibility of this mode [ 15 — 17 ].

Other commonly stated advantages of Internet gambling include greater value for money, including payout rates and bonuses, the speed and ease of online gambling, greater number of betting products and options and the physical comfort of being able to gamble from home. Internet gambling represents a fundamental shift in how consumers engage in gambling, and concerns have been expressed by various stakeholders about these changes.

Other concerns include that the high accessibility to Internet gambling may increase gambling, particularly among technology-savvy youth, and lead to online gambling literature review increase in the incidence and prevalence of disordered gambling [ 121 ]. Evidence suggests that there is a relationship, albeit complex, between online met geld availability of gambling opportunities and increased levels of related problems [ 25 — 30 ].

Consequently, it has been asserted that the easy access to gambling provided by Internet modes may lead to the development or exacerbation of gambling problems [ 1go here2431 ]. Internet gambling also has some unique features that may pose additional risks for harm, particularly for vulnerable populations.

The use of digital forms of money e. The immersive nature of Internet gambling is also clear through reports that online gamblers, particularly those experiencing problems, are more likely to report disruption to their sleep and eating patterns than land-based gamblers [ 1836 online gambling literature review, 37 ].

Data collected by gambling treatment services suggest online gambling literature review Internet gambling currently online gambling literature review a small, but growing, contribution to gambling problems among those seeking formal help [ 374041 ]. Surveys have found that online problem gamblers are significantly less likely to have sought formal help as compared to land-based problem gamblers [ 204243 ]. This suggests that problems related to Internet gambling may be underrepresented in treatment-seeking samples and are likely to increase over time as more people participate in this mode and problem severity increases.

Money casino games example, in an Australian nationally representative prevalence survey, the overall problem gambling rate among Australian non-Internet gamblers was 0. Click the following article comparison, the rate among Internet gamblers was three times higher at 2.

Similarly, a total of However, there is little evidence available that would enable the causation of Internet-related gambling problems to be determined, and most longitudinal studies contain too few Internet gamblers to provide meaningful analyses.

Despite some indications of a positive correlation, the relationship between Internet gambling participation and problems has not been confirmed. Some studies have found similar rates of gambling problems among Internet and land-based gamblers [ 1541 ].

For example, even though Internet gamblers were more likely to be classified as being at risk or experiencing gambling problems in a nationally representative survey, when other variables were controlled for, Internet gambling participation was not predictive of problem gambling severity [ 13 ].

This finding was in contrast to earlier analyses online gambling literature review 31 ] online gambling literature review demonstrates the importance of controlling for confounding factors. Further evidence to question the extent to which Internet gambling increases rates of problem gambling can be taken from prevalence studies. Despite rates of Internet gambling increasing in several jurisdictions, little evidence has been found to suggest that the prevalence of problem gambling has increased [ 135354 ].

Evidence is emerging that Internet gambling is not only predictive of gambling problems but also that when online gambling literature review variables are controlled for, individuals who gamble online may have lower rates of gambling problems. The relationship between Internet and problem gambling is likely mediated by the use of land-based gambling.

A study examining actual Internet gambling account activity combined with a online gambling literature review measure of gambling problems confirmed that gambling involvement, as indicated by number of games played and days bets placed on in past year, is predictive of gambling problems amongst the sample of Internet gamblers analysed [ 58 ].

These results are consistent with a wide body of research which suggests that gambling disorder is related to high levels of involvement in terms of expenditure, time, frequency and variety of gambling forms used [ 13365259 — 63 ]. Therefore, research suggests that highly involved gamblers are more likely to engage with Internet modes, including those with existing gambling problems, than less involved gamblers. However, a study comparing behavioural data from online gambling sites with self-report of gambling problems found that not all highly involved gamblers were http://meroe.info/mobile-slots-deposit-bonus.php risk for gambling-related problems, and likewise, not all those with low involvement screened negatively for gambling-related problems [ 64 ].

This is an important finding as it demonstrates unsurprisingly that a single gambling index such as a frequency of gambling, or expenditure is not adequate to predict gambling problems.

Studies have found that one third to one half of Internet gamblers experiencing gambling problems attribute these to land-based forms of gambling, and over half report that they had existing problems before they ever gambled online [ 1320 ].

This is consistent with one study reporting that problem Internet gamblers prefer land-based over Internet gambling [ 24 ]. Few studies have investigated the types of gambling that are most likely to be associated with problems related to Internet gambling. In an Australian national survey, almost half of all gamblers stated that land-based electronic gaming machines were the primary cause of their problems, including among Internet gamblers [ 13 ]. Internet gamblers are most likely to associate their problems with casino games, sports and race wagering and poker [ 1320 ].

In particular, sports betting appeared to be associated with moderate risk and problem gambling, a finding not replicated among land-based only gamblers [ 13 online blackjack addiction, 20 ].

However, this finding may be specific to the Click here context as sports wagering is one of the few legal forms of online gambling. Conversely, for some Internet problem gamblers, this mode of gambling appears to be the proximal cause of online gambling literature review, with problem gamblers reporting that their problems started after they first gambled online and around half specifically attributing problems to this mode [ 1320 ].

However, most studies examining the relationship between Internet gambling and problems едва online casino download for mac можно cross-sectional, which do not allow for causality to be determined and self-report is subject to bias and reliant on accuracy of reporting.

Longitudinal research will be an important addition to this field to address these issues. As Internet gambling increases in popularity and use, it is likely that the next generation of gamblers will use Internet modes earlier in their gambling career, which may increase the proportion of individuals who experience problems that are attributed to this online gambling literature review. However, there is online gambling literature review growing online gambling literature review visit web page Internet gamblers are a heterogeneous group, and research needs to consider how Internet gambling behaviour may be integrated more broadly with offline gambling [ 4865 ].

Analysis of demographic variables suggests that Internet problem gamblers overall do not represent a distinctly different cohort than gamblers who experience problems related to land-based gambling. Risk factors for Internet problem gambling identified include being male, younger adults, and being from a culturally diverse background [ 1320416667 ]. The consistent relationship found between problematic Internet gambling and younger age suggests that this population is particularly vulnerable to harms related to http://meroe.info/safest-online-gambling.php form, and use of Online gambling literature review gambling энергии" top rated casinos _Синий online gambling literature review males is an area that warrants further attention in terms of research as online gambling literature review as harm minimisation.

Risk factors identified do not appear to be universal; for example, Gainsbury, Russell, Wood, Hing and Online gambling literature review [ einzahlung online willkommensbonus ohne casino ] found problem Internet gamblers more likely to be young, less educated and have greater debts than non-problem Internet gamblers.

A subsequent study found only age differed between Internet and non-Internet problem gamblers when controlling for Internet gambling online gambling literature review, and there were no significant differences based on education or income [ 20 ]. Other studies have also found that Internet gamblers are more likely to have higher educational online gambling literature review and socio-economic profiles [e.

However, these are associations that do not control for the interaction between variables so it is difficult to draw firm conclusions about problem blackjack 1998 online subtitrat in romana compared to non-problem Internet gamblers. It is likely that the profile of those at risk for developing Internet gambling problems will change as this mode of gambling becomes more accepted online gambling literature review widely used and further research is conducted.

A study examining irrational and erroneous thinking found that greater levels of erroneous cognitions significantly predicted problem gambling severity when controlling for other variables among Internet gamblers [ 46 ]. As psychological comorbidities and irrational thinking are related to problems amongst land-based gamblers, these results suggest that the clinical characteristics of Internet problem gamblers are similar to offline gamblers. There is also evidence that Internet problem gamblers have higher rates of drug and alcohol use than non-problem gamblers.

Analysis of surveys completed by online gamblers indicated that compared to non-problem gamblers, problem gamblers were more likely to smoke cigarettes, here a disability click the following article drink alcohol while gambling online [ 67 ].

This is consistent with higher rates of mood and substance use disorders and self-harm among highly involved Internet gamblers [ 70 ]. An Australian telephone survey found that illicit drug use was a significant predictor of having greater levels of gambling problems [ 13 ]. These results may indicate that Internet gamblers who are at risk for gambling problems may engage in a range of risk-taking behaviours, for example, due to high levels of impulsivity [ 72 ].

Nonetheless, the relationships between Internet gambling, gambling problems and other mental health issues are still unclear [ 73 ]. For online gambling literature review, multiple studies in Sweden did not support the assumption that Internet gambling would attract people with low social support, psychological problems, physical problems or health problems such as risky alcohol consumption [ 41 ]. Similarly, offline gamblers were more likely to bonus bingo senza deposito italiani health and psychological impacts of problem gambling than Internet gamblers in an Australian study comparing at-risk online gambling literature review problem gamblers [ 20 ].

Furthermore, in a nationally representative Australian telephone survey, Internet gamblers were less likely to drink alcohol and smoke when they were gambling online than when gambling in land-based venues, indicating they were unlikely to be using Internet modes to avoid restrictions on smoking or online gambling literature review [ 13 ]. Overall, existing studies fail to define specific personal or behavioural risk factors to differentiate between Internet and non-Internet problem online gambling literature review. There is some evidence that these do represent at least partially different cohorts; however, the heterogeneity in each group makes specific risk factors difficult to identify.

No studies have established the causation between associations found and the direction of any link between online gambling literature review online gambling. The individual factors related to Internet gambling problems are under-researched and would benefit from longitudinal studies to clarify the mechanism of action of any relationships between variables. Intense gambling involvement has been verified as a predictor of gambling problems for online and offline gamblers.

Other gambling-related behaviours have also been identified as being potential markers of risky Internet gambling. It is possible that unregulated sites attract individuals who are at greater risk for experiencing problems, and use of multiple online accounts and multiple activities is a proxy indicator of gambling involvement, a known predictor of harm. Analyses of player accounts, including players who exhibit what appears to be risky behaviour, as well as those who have closed accounts due to stated gambling problems, have enabled markers of problem gambling, including early predictors, to be identified.

Potential predictors of risky Internet gambling or the emergence of problems include engaging in multiple online gambling activities, high variability in betting, multiple bets per day, many active betting days per month, many bets per betting day, high overall stakes and net loss, increasing bet size and losses, chasing losses and intervals of increasing wagering size, followed by rapid drops [ 585976 — 80 ].

One notable finding from studies of the bwin. This type of betting allows frequent and repeated bets to be placed during a single sporting event, with rapidly determined outcomes, which may be particularly attractive to people who are highly impulsive and at list of all risk for disordered gambling [ 81 ].

However, this relationship has not been investigated in independent samples. Analysis of customer communication with online operators please click for source risk markers that predicted customers closing their accounts due to online gambling literature review gambling problems. These included expressed doubts about results of games, requests for account reopening, queries about financial transactions and account administration, the frequency of contacts per month urgency and use of a threatening tonality [ 82 ].

These results were based on a relatively small sample with a limited control group. Single, unmistakable indicators for problems are uncommon, and therefore detection of risk indicators usually relies on algorithms to detect interaction between these. Further research is still required to untangle whether game-specific characteristics play a causal role in the emergence of gambling problems.

Research is also needed on a variety of different player accounts, as the vast majority of research has been done with a single dataset from one European gambling site, which may not be generalizable to other online gamblers. Identifying, detecting and acting on early risk indicators may reduce gambling-related harms sustained by Internet gamblers. However, few online operators have shared their data to be used for research purposes or implemented policies and strategies to detect potentially risky players and implement appropriate resources.

Such preventative action is generally not required by Internet gambling regulators, meaning that further action is reliant on operator-initiated action. Taken together, the evidence reviewed here suggests that Internet gambling does not cause gambling problems in, and of, itself.

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